Advanced Practice Nursing Role Essay

Health professionals like nurses have a chance to go for autonomy in the nursing career which is beyond the practice of being a staff nurse. Various pathways for advanced specialization in nursing career have been established for the past few decades. This expansion of responsibilities and vision as a health professional helps nurses to fulfill growth as professional and as a person. Among the advanced practice nursing roles, the author deeply prefer Family Nurse Practitioner specialized in cardiology. This will help her utilize skills in nursing science and as a health care specialist with a twist on promotion of health of the cardiovascular system. Creative APN Role in Health Promotion The author has chosen the field of family nursing practitioner because of the challenges and roles that it holds. The current responsibilities of the family nurse practitioner posts promising personal as well as professional growth on the field of the health care industry. The advance practice nursing role of family nurse practitioner is composed of different skills which pertains to the areas of management skills of community health nursing, patient care, primary care, intervention on the desired population, and it also deals with community assessment and actions regarding the said assessment. It focuses on promotion of health and healthy living, avoidance of degenerative diseases, and the supervision of the illnesses in different ages, both chronic and acute. (UTA 2008) The author has chosen a specialized field in cardiology because in reference to the data given by the Centers for Diseases Control and Prevention for 2005 Death data table C, the leading cause of death in the United States is cardiovascular related. According to the statistics, 652, 091 deaths were related to heart problems (CDC 2008). The stated data poses a major concern that there is a very big problem related to cardiovascular disorders. In relation to this, the author envisions to help in solving this problem via the career chosen by the author. The family practice nursing with a specialization in cardiology will help the author contribute in building the foundations of a society with healthy cardio vascular systems. Among the probable setting that the author hopes to practice the stated advanced practice nursing role is in the Christ Hospital. It was established for more than 115 years and it was well known to be one of the leading hospitals which continue to promote, plan and innovate for the healthy future of the region. It was noted as one of the best medical institution in the United States for the last few decades consistently. The setting includes 555 beds with more than 1200 physicians and holds the most advanced and sophisticated technology for health care. It is a not-for-profit acute care facility which is supervised by the highly trained specialists that has great passion for health care. It focuses on the services for major surgery, orthopedics, cardiovascular care and other related fields (Christ Hospital 2008). The competencies required for this job ranges from clinical expertise to social relationship within the community. It requires expertise in retrieving records for the data regarding the health, medical history, psychosocial and family records. Ability to conduct physical examination, for the health problems related to the acute and episodic phases are required as well as the ability to interpret the laboratory findings. Provide health assessment to the visited areas or patients and to arrange referrals to other health professional. It is also required to have a knowledge on developing and implementing plans for the supervision of problems in the acute and episodic problems of the assessed in and out patients. In the competencies required to assess patients also include ability to enclose screening evaluation for the cardiovascular health and other relevant information regarding it, distinguishes between normal and abnormal change. Evaluate the pressure of the family or psychosocial factors on patient sickness, situations related to developmental delays and learning disabilities in all ages, reproductive health of both women and men, sexual health, pregnancy, and postpartum care, assess some problems like substance abuse like drugs. Performs and accurately documents appropriate comprehensive or symptom-focused physical assessment on patients of all ages. Recognize health and cardiovascular risk factors of patients of all ages and families in all stages of the family life cycle. Demonstrates proficiency in family assessment; show proficiency in functional assessment of family members. Assesses specific family health needs within the context of community assessment especially the ones that is related to the cardiovascular diseases. Identifies and plans interventions to promote health with families at risk of heart disease (NONPF 2002). Diagnosing of health status focused on the health of heart is also needed, the following competencies are required. Recognize signs and symptoms of acute physical heart disease across the life span. Recognize signs and symptoms of chronic cardiovascular disease across the life span. Evaluates and summarizes collected data for patients of all ages. Plans complete differential diagnoses, with relevance to the epidemiology, environmental and community characteristics, this also includes life stage development and the arrangement seen with increasing age, family, and heart risk factors (NONPF 2002). Upon diagnosis of the members with cardiovascular or heart related diseases. The planning caring and management of the treatment of the disease will proceed which requires a lot of competencies indicated below. It is required for the nurse to have abilities to provide health information for protection, health promotion, formulate strategies for the intervention and prevention of the cardiovascular diseases which aims in improving the cardiovascular system of the family, requires a knowledge on how to treat acute and chronic of cardiovascular diseases in all ages to minimize the risk of developing complications and increase quality of living, prescribe proper medication for the pharmacodynamics and pharmacokinetics, adapts care for to meet the needs of the at-risk patients, evaluate the effectiveness of the plan in relation to the plans made for the at-risk group. Assist the members of the family of the cardiovascular disorder patient, provide referrals to the health care professionals that can support the treatment of the heart disease, and apply the study regarding the idea that is family centered and can supply positive change in the health of the family. Family or Population Health Promotion Theories & Models The family nurse practitioner specialized in the cardiology focuses on promoting health in relation to individual level and the family level. The health promotion theory that is suitable for the family nurse practitioner in the individual level is the Health Belief Model which focuses on the person’s perception of the possible risk and the evaluation of the actions that would prevent the problem from occurring again. In this case, the author’s future interaction with individuals who are at-risk to cardiovascular diseases will give her chance to use the said model in promoting the health information. Upon approaching, an at-risk patient, the author will be discussing the perceived susceptibility of the subject to cardiovascular diseases and the initial reaction of the patient will more likely to be curios. The next part is the explanation of the perceived severity and the possible consequences of the CVD in the patient; the next step is to discuss with the patient the possible benefits of positive action. In such case, the patient will soon realize the benefits of the perceived action. And will arrive eventually on the conclusion that the patient should consider on performing the perceived actions that could give benefits. The author also considers another theory of which the community level is involved. The community organization is theory which focuses the involvement of the members of the community in evaluating health problems. Upon interaction within community sites, the author will soon be empowering these families in relation to the participation in campaigns for heart related problems. The participation of the community and the relevance of the selected issue to the problem of the community like the cardiovascular diseases will greatly enhance the active development of the community. The most important activity that the author can do is the critical consciousness that she will be spreading in the community (HPA 2008). Agency and Financing of APN Practice The Christ Hospital will be the institution where the author hopes to apply in the mere future it was the medical establishment that was considered in this paper. It was established for more than 115 years and it was well known to be one of the leading hospitals which continue to promote, plan and innovate for the healthy future of the region. It was noted as one of the best medical institution in the United States for the last few decades consistently. The setting includes 555 beds with more than 1200 physicians and holds the most advanced and sophisticated technology for health care. It is a not-for-profit acute care facility which is supervised by the highly trained specialists that has great passion for health care. It focuses on the services for major surgery, orthopedics, cardiovascular care and other related fields (Christ Hospital 2008). The mission of the Christ Hospital is to lead the region in giving the excellent experience in health care especially the personalized one while forwarding clinical excellence, technology and education. The role that the author will be holding will help the institution in a way of providing personalized health care especially in the cardiology patients. The author’s expertise will also help the institution in advancing clinical excellence especially in the field of cardiology. The role will be financially supported by the hospital or allied services institutions relating to cardiology. In the specific case, the Christ Hospital will be responsible for the financial support of the role. The nurse practitioner in the said institution is included in the employee pay. Some stakeholders that can support the role are the health related institutions, hospitals, clinics, nurse organizations and cardiology specialty centers. The role of family practice nurse practitioner goes beyond the limits of a staff nurse which will promote personal and professional growth. The specialization in cardiology will greatly help in the regression of cardiovascular disease cases in the United States. Thus the APN role stated above will surely benefit not only the author but also the society at large.

Nature and Importance of the Study Essay

Trisales Business Systems Corporation, built for almost 30 years already, is a company engaged in the business of retailing office equipment. Such equipment range from Photocopying machine, Fax machines, down to smaller ones such as calculators and electronic typewriters. Their main suppliers include big names in the appliance industry including Sharp Philippines, Copier Online, Epyon Corporation, Panasonic and Sanyo. TBSC is a small to medium in size. All in all, the company consist of no more than 50 employees, including the staff and the people in the managerial levels. They cater to a number of clients around the Cebu province. TBSC is located in Ramos St., Cebu City. The main aim of sales and stock inventory system is to hold the inventory records accurately and a healthier sales transactions with their costumers and suppliers. Manual recording is really giving them hard time in going thru further for their business. And because they include big names in the appliance industry with a number of clients around the Cebu province, they need to provide an accurate records of their transactions including their inventory as much as well. They also want to have a more secure business flow, and for a well-organized inventory and transaction records. To necessary avoid chaos when it comes to storing information. They believe that having a healthy system for their company is another way of showing their professionalism in the business industry. Statement of the Problem Below specified are the current problems faced by the Trisales Business System Corporation: i) Time consuming transactions and inventory process Without a system, recording transactions and conducting inventory is one of the most difficult and time-consuming job for their company. Their employees are spending most of his/her time jotting down all transactions for the day. By the end of the month, or whenever the company conducts the inventory of stocks, they have to dig through a whole pile of files to determine the number of sales from the previous workdays, to match it with the results of the inventory. ii) Inaccurate inventory of stocks and sales TBSC nowadays is still using the manual recording of informations and data for their business. This causes their records in transactions and stocks to be misguided, filed inappropriately and cluttered. As result, there is difficulty in retrieving data, making analysis and making adjustments to the records. iii) Unsecured records of data and informations The manual system of recording data in TBSC, to be direct to the point, unsecured. Anytime, it may get lost, edited or faded which is more prone to miscalculations and causing incorrect changes to the records. iv) Stocks outs and excesses of stocks in inventory Shortages in the stock inventory can result in product delays to customers which will reduce their expectations to the company. A poor forecasting in the inventory is also leading them in excesses of stocks that results in additional costs to the organization in storage costs and funds tied up in unused stocks. If the company do not use inventory quickly after purchasing, the business will begin to lose money on the materials just because of their slow and unorganized scheme. Objective of the System The main objective of this study is to obtain answers to the questions stated above. We want to know the problems encountered by TBSC employees with regards to their information storing and accessing. Furthermore, we want to demonstrate how the system focuses on those information can be a determinant to improve customer service in Trisales Business Systems Corporation. A proposed solution to the problem: i) To achieve a hassle-free, time bounded transactions and inventory process for the employees in-charge. That would lessen their time in spending on the process of doing transactions and inventory records. Equals more time for doing other productive tasks and to help create a healthier and more productive environment for TBSC. ii) To determine and to minimize the errors in recording transaction and informations. Since TBSC is a growing company, the system will not only stores data, but also does analysis on day to day company transactions. iii) To secured the company important files and records by having a log-in and password boxes as a gatekeeper. Also to prevent from editing forms and important data such as dates and amounts. iv) To control excesses of stock and to prevent stock outs. The system will function to update and arrange the stocks inventory in the appropriate order to give the precise count of their products to prevent excessing and stock outs in further. Significance of the study To the TBSC and Company The planned system significance is to minimize errors and confusion of the employees in recording. Importantly to organize and to give accurate records of the inventory and transactions, for the company to built-up in the industry. Mostly to give stand and to serve the customer’s wants on further. To the fellow researcher The significance of this system is to give a vivid inner view on how the nature of technology will help our career along the way. To embolden researchers who has the same field as mine. There’s no easy way of having this study but it would be the best ever pleasure when that almost everyone in a company is using your programmed system. To the proponents The significance of this study is to support everyone in the field of technology, and to stretch a bit of my knowledge in this field. This will serves as the proponents guide as they embrace the same field as mine. Importantly to give a healthier deal in the business industry. Scope and Limitations Scope of the project The proposed system generally on the sales and stock inventory of the Trisales Business System Corporation. The system purpose is for the regular transactions and operation of their sales and inventory. The proposed system could minimize the problems stumble upon the company records of important data. These are the scope for the proposed system: i) Can build account Employees could have their accounts, especially the person who’s in charge with the sales transactions and stocks inventory. ii) Accumulating Products Through the system, adding new products for the business is more appropriate. The person in charge would just simply input the asked information to the system example: product id, product description, date delivered, pieces ect. The inputted information for the new product will be stored in the database, and could also easily access by the system. iii) Can manage sales transactions The proposed system can manage sales. For example the client requested for a new office supply/product from TBSC. The system will simply ask the user to input some important data from the client and the system will automatically store it. The stored data and information can be used for further transactions with the client. Limitations Below are the possible limits of the proposed program for Trisales Business System and Corporation: Registration in the system is done only by the administrator or the person in charge. Does not support network and internet topology, or online transactions. Storing of informations is limited, only important and the specified information in the system are allowed Multi-tasking could possibly done, but only for the given system for example; Entering data for the new arrived supplies while having the purchasing transaction. Could go through compatibility issues while installing the system. Because of the programmed used in creating the system. Review of Related Literature Chapter II This chapter will be discussing the findings of related research to this study. It will provide a discussion on the significance of this study to the existing literature. Moreover, this chapter will discuss several issues regarding sales and stock inventory system development and based on the existing literatures. The following discussion chronicles the subject of inventory systems. Theoretical Background The theoretical background is the structure that can hold or support a theory of a research study. The knowledge organization by way of theoretical background has two disciplinary root Related Literature This chapter represents the review on related literature regarding topic about the Sales and Stock Inventory System. Review of Related Literature In exploration, we find new techniques, new knowledge, even develop new substances, gadgets, equipment, processes or procedures, imagination and skill is employed by the researcher. The commodities, new devices, services, in technology are needs of man for a better fuller life which is the concern of the research. These useful arts are the products of the technological environment and the end-user is society in general. The fast growing trend and innovation in technologies today prompts researchers to conduct studies about the efficiency of system program. This Chapter presents a brief review of literature and studies, both local and foreign that is related to these studies.

Jane Austen’s use of Gothic Traditions in Northanger Abbey Essay

The term ‘Gothic’ was first really used by Italian writers who ‘accredited’ what they thought was the ugliness of the art and architecture of the twelfth to fifteenth centuries. They often related this art and architecture to the northern tribes of German Barbarians known as the ‘Goths’; these were the first to corrupt the style of the grand architecture back. They would make towers that were too tall, walls that were too thick and arches that were too steeply pointed – thus destroying the architecture of the generation. By adding such grotesque and mysterious objects such as gargoyles, the Italian writers seemed as though they were just adding insult to injury. They were horrified. But just as ‘Gothic’ was at its peak around the mid-fourteenth century, it seemed to decline slowly and make its way into a history book, never to be seen again. But by the late eighteenth century, the Gothic revival was back in business, and more popular than ever before! The Gothic revival was first started by a man named Horace Walpole (1717-1797), as a reaction against the Classicism of the previous era. Horace was a writer who transformed his simple home into the most Gothic building of its age. It had pillars, vaults, arches, and a great tower. This signalled the beginning of a new cultural era. Walpole’s Gothic house was inspired by a dream, which he could only describe as † I had thought myself in an ancient castle†¦Ã¢â‚¬  Inspired by his vision, Walpole sat down and produced ‘The Castle of Otranto’, the world’s first Gothic novel and named one of the most influential novels in the history of English literature. In response to this, there were of course many other Gothic novels to be published, among these, was the very popular ‘The Mysteries of Udolpho’ by Ann Radcliffe. Gothic novels between 1790 and 1830 fell within the category of romantic literature, and you could say it was a rebellion against the formality and rigidity of how other kinds of literature were written at that time. Ever since ‘The Castle of Otranto’, many Gothic novels have followed the similar pattern: the terrifying old castle on the hill or the misty graveyard. The setting is always greatly influential in Gothic novels. It not only evokes the atmosphere of horror and trepidation, but it also portrays the dramatic deterioration of what used to be a beautiful piece of architecture. At one time the abbey, castle or mansion was something treasured and appreciated, but now it is just a mere shadow of its former self. As for traditional Gothic characters, there is always a hero, usually a female, who has no idea of how to deal with the situations put towards her, and you are always able to see a pattern in their characterisation. There is almost always an isolated protagonist, and their part in the story is mainly summarised nearing the dramatic end of the story. Then, there is the villain, who is the epitome of evil. This character could be anyone you could think of; mad scientist, inn keeper, or baron of the manor house. The Gothic novel could be seen as a description of a fallen world and we experience this world through all aspects of the novel: plot, setting, characters and theme. In order for a novel to be Gothic, it must be accurate to Gothic traditions, impeccable language, possibly of old chapters in history. But with great novels come great sceptics; Jane Austen was not altogether pleased with this new genre of writing. She did not regard Gothic novels as ‘proper literature’. She criticised the readers of the novels (mainly young teenage girls). Jane Austen went about her earlier criticisms of Gothic novels to little avail; people still enjoyed reading them and by 1798, Gothic novels were at their peak in fashion although it was never taken seriously as literature. Jane Austen knew she had to do something drastic to proclaim her annoyance of this new genre; so she wrote a parody, Northanger Abbey. Yet the characteristics shown in Chapter 1 do not suggest that Catherine Morland was a Gothic Heroine at all! Catherine Morland is the heroine of the book. She is described as having â€Å"a thin awkward figure, a sallow skin without colour, dark lank hair, and strong features–† and that â€Å"and not less unpropitious for heroism seemed her mind†. Her behaviour was equally inept: â€Å"She was fond of all boy’s plays, and greatly preferred cricket not merely to dolls, but to the more heroic enjoyments of infancy, nursing a dormouse, feeding a canary-bird, or watering a rosebush†. Jane Austen employs great irony to describe her, satirising â€Å"her abilities† as â€Å"quite as extraordinary†. Austen ends with the comment â€Å"She never could learn or understand anything before she was taught; and sometimes not even then, for she was often inattentive, and occasionally stupid†. By Chapter 5, Catherine is taken to Bath by some wealthy godparents for her first experience of high society, attending various balls and parties. Catherine meets Isabella Thorpe, an attractive, flirtatious young lady, who introduces her to Gothic novels, such as the ‘Castle of Otranto’ and Catherine is ‘enchanted’ by them. But most of the Gothic moments happen during Catherine’s visit to the Abbey itself. For example, in Chapter 21, during the day, Catherine notices a large chest, standing at one side of the fireplace in her bedroom: ‘The sight of it made her start; and, forgetting everything else, she stood gazing on it in motionless wonder, while these thoughts crossed her’. In classic gothic style, Catherine questions herself: ‘An immense heavy chest! What could it hold? Why should it be placed here?’ This is an example of Austen’s Gothic parodying of the gothic characters and literary style it is, aimed to mock the traditional Gothic heroines who followed this curiosity, usually a feature in all Gothic novels. But it also mocks the way the novels are written. Panting punctuation, excessive exclamation marks and ridiculous hyperbolic adjectives. We see an example of her gothic language when she speaks to herself (concerning the chest): â€Å"I will look into it; cost me what it may, I will look into it, and directly too—-by daylight†. We cannot deny that Catherine is somewhat ‘over-doing it’ with the ridiculous questions â€Å"What could it hold? Why should it be placed here?†. The Chest is described with ridiculous accuracy: â€Å"The lock was silver, though tarnished from age; at each end were the imperfect remains of handles also of silver, broken perhaps prematurely by some strange violence; and, on the centre of the lid, was a mysterious cipher, in the same metal†. This over-descriptive language creates a tense gothic-style passage yet in a way, is ‘too gothic’. By doing this, Austen succeeds in making a ‘spoof’ as it were, of gothic novels written previous to this novel. Catherine decides to investigate, by opening the chest: â€Å"and seized, with trembling hands, the grasp of the lock† and â€Å"she raised the lid a few inches; but at that moment a sudden knocking at the door†¦Ã¢â‚¬ . This is when the maid enters; this build-up of tension, and sudden interruption is very anticlimactic, and we see this not only once in Northanger Abbey. When Catherine dismisses the maid, she goes at the chest once more, only to find that it contains white linen! Once again, an anticlimax, which leaves Catherine very surprised (and embarrassed, when Miss Tilney enters shortly afterwards). Later on in this Chapter, Catherine comes to discover a Japan Cabinet: â€Å"She took her candle and look closely at the cabinet. It was not absolutely ebony and gold; but it was Japan†. Catherine (like any other Gothic heroine) is intrigued by this new discovery, and decides to open it, hoping the contents would be more exciting than them of the chest. Thr sequence of events happen by night, giving the cabinet an almost mysterious awe about it, which would only add to the tone of the passage. Austen uses words like â€Å"mysteriously†, â€Å"the wind roared† and â€Å"the rain beat down in torrents against the windows† to give the scene an even more gothic-like tone. Catherine finds that however hard she turns the key on the cabinet, however she manages to open it â€Å"the door suddenly yielded to her hand: her heart leaped with exultation at such a victory† revealing a series of lesser bolts and doors within the cabinet. Catherine’s curiosity would not stop there. She decided to delve further into the cabinet of mystery! A lot of the text on the page is devoted to the examination of this cabinet. â€Å"With less alarm and greater eagerness she seized a second, a third, a fourth–each was equally empty†: this was describing the many smaller drawers within the Japan Cabinet, all with seemingly obvious, predictable outcomes – they contained nothing. The tension has become somewhat lost however in one of the other drawers Catherine finds a parchment: â€Å"her eyes directly fell on a roll of paper pushed back into the further part of the cavity†. There is an air of tension, as Catherine reaches out to unveil what the manuscript beholds. But suddenly (dramatic tension), â€Å"The dimness of the light her candle emitted made her turn to it with alarm; but there was no danger of its sudden extinction† – the candle was flickering yet she did not think it would go out. However the flame did go out: â€Å"Alas! it was snuffed and extinguished in one†. Catherine was now submerged into complete darkness (very much gothic; darkness and candles becoming suddenly snuffed out). Austen uses words like â€Å"horror† and â€Å"trembled† to create an atmosphere of terror and uncertainty. As Catherine stood â€Å"motionless with horror† she thought she could hear â€Å"receding footsteps†. This usage of noises in a perfectly still, quiet and dark atmosphere is used to scare not just Catherine but the reader also. â€Å"A cold sweat stood on her forehead, the manuscript fell from her hand† and she hastily jumped back into bed. This is very anticlimactic, and very unlike a gothic heroine to come running back to a place of safety. One would expect a gothic heroine to relight the candle and look at the parchment nevertheless. However, that is not the case in this instance. A sense of tension is still apparent in the text when Catherine can still hear the slow ‘ticking’ of the clocks in a silent atmosphere – this is bound to be unnerving for Catherine. The weather is still apparent, keeping the tone a tense and restless one: â€Å"The storm still raged, and various were the noises, more terrific than the wind, which struck at intervals on her startled ear†. Austen also uses â€Å"Hollow murmurs seemed to creep along the gallery† to keep the tension on tenterhooks. However, the sheer fact that Catherine falls asleep destroys the atmosphere and tension completely, as we turn to a completely new chapter. Jane Austen’s uses of Gothic traditions are very apparent in this text: she describes the room and the Cabinet so vividly. She adds the traditional gothic tone, the pathetic fallacy, the weather, at night, the rain, and the storm, † The night was stormy; the wind had been rising at intervals the whole afternoon: and by the time the party broke up, it blew and rained violently† all Gothic traditions yet Catherine running back to her bed scared left on a gothic cliff hanger of suspense, however when Catherine ran back to her bed it was totally anticlimactic. In the morning (and the opening of Chapter twenty-two), the scene is completely different. Sun is pouring through the windows and birds are singing. Catherine discovers the precious lists are only laundry bills, â€Å"‘To poultice chestnut mare,’ a farrier’s bill!†: this is very anticlimactic. But this is why Northanger Abbey is a parody, continually acting against what Gothic novels are based around and may contain. Later in chapter twenty-two, Catherine is talking to Eleanor about the death of her mother, and her father’s relationship with her mother. Many of these questions were very rude and personal. As the conversation led on, Catherine drew new conclusions about Mrs Tilney’s death: that General Tilney had murdered his wife and was hiding her away secretly somewhere in the Abbey. This is another example of Catherine’s strange and vivid imagination. â€Å"Was she a very charming woman? Was she handsome? Was there any picture of her in the abbey? And why had she been so partial to that grove? Was it from dejection of spirits?†. These were some of the questions Catherine was asking herself. This is very insensitive, whilst talking on such a delicate matter as a family member. This is unlike a gothic heroine to ask so many questions. The two come onto the subject of a portrait of Mrs Tilney, and how General Tilney most not have valued her, â€Å"A portrait, very like, of a departed wife, not valued by her husband† and that because of this microcosm, â€Å"He must have been dreadfully cruel to her†. Catherine relates these misunderstanding to those of characters she had read in other gothic novels previous to her visit to the abbey: â€Å"She had often read of such characters; characters, which Mr. Allen had been used to call unnatural and overdrawn† . Right now Catherine is mixing fact with fiction, and lets her imagination run wild with vivid ideas of how General Tilney is an evil baron of some sort. Catherine often hears the slightest microcosm, yet turns it into a macrocosm, and lets these new ideas go to her head, and we see this is exactly the case in Chapter 24. Jane Austen’s use of questions and thoughts in Catherine’s head gives us an insight into how the mind of a gothic heroine works, however Catherine has been too taken in by other novels that she actually dreams of becoming a gothic heroine and wants to have a passion for danger (thus the investigations at nightfall in chapter 21 and yearning for answers to the ‘mystery’ which never was). Yet her profile (in Chapter 1) tells us otherwise; it mentions she is nothing at all like a gothic heroine! This new wild passion for mystery and conspiracy led Catherine to enter Mrs Tilney’s room in chapter twenty-four, just when General Tilney was out on a walk: â€Å"The general’s early walk, ill-timed as it was in every other view, was favourable here; and when she knew him to be out of the house, she directly proposed to Miss Tilney the accomplishment of her promise. Eleanor was ready to oblige her; and Catherine reminding her as they went of another promise, their first visit in consequence was to the portrait in her bed-chamber† When she ventures in â€Å"On tiptoe she entered† she notices that the room is entirely normal: â€Å"She could not be mistaken as to the room; but how grossly mistaken in everything else!–in Miss Tilney’s meaning, in her own calculation!†, Catherine expected to enter a room full of mysterious torture instruments and dungeon-like atmosphere. Instead, there was normal furniture, paintings and various other decorations: â€Å"She saw a large, well-proportioned apartment, an handsome dimity bed, arranged as unoccupied with an housemaid’s care, a bright Bath stove, mahogany wardrobes, and neatly painted chairs, on which the warm beams of a western sun gaily poured through two sash windows† – yet again we see the over descriptive language which is ever present in the novel. This is an anticlimax and not Gothic because Catherine was expecting something very different. Northanger Abbey is the epitome of Gothic Spoof. Jane Austen succeeds in mocking what Gothic novels are all about, the content and the way the characters act, as well as the young teenage girls who read them. The description of places and objects is amusingly hyperbolic, and excellent as a parody of a gothic novel. It has to be, because the trend of Gothic novels is to have deep descriptions, and Austen is able to utilize the gothic traditions and add to them somewhat ridiculously! Austen makes good use of the characters i.e. Catherine, and you are able to see what they do and what they think. Austen is good at writing in a gothic style – she builds up tension and pulls us in, only to let there be an anticlimax and let us down. She makes good use of Ann Radcliffe’s Mysteries of Uldopho and the way she entwined some of the ideas from that book to this novel.

Effect of positive feedback on achievement Essay

Effect of positive feedback on achievement - Essay Example The study focuses upon the impact of positive feedback on achievement. This might be best supported by the idea of formative assessment techniques, which help in shaping a student’s learning ability and educational gains acquired by the child during the process of classroom education. Interaction between a teacher and a student is the key to improvement in the effective gains from education accruing to the student. Formative educational techniques entail the diagnostic application of evaluation means where the teacher needs to assess a student based on observations, discussions in the classrooms, homework done by the student, tests and analysis of the work of a student. Taras (2008) notes that much needs to be done in order to understand the recent improvements or changes brought about in the area of assessment in education. Black & William (1998) in their work â€Å"Inside the Black Box† observe that the evaluation system is formative when the feedbacks or information collected by the teachers are utilized in reshaping the teaching and learning process such that the actual requirements are met. These might incorporate some alternative teaching practices, adjustments in the instruction or providing more occasions for practice to the students. The aim of this paper is to explore the impact of positive feedback on the achievement of an individual with a focus on the areas of improvement essential for the implementation of formative assessment procedures. In the context of education, assessment plays a very important role. This is especially true in case of children and adolescents. Certain teachers believe that earning involves the transfer of knowledge from the teachers to the learners and understanding can develop later. Others are committed to form a teaching base, which involves interactions. In such an environment formative

Leadership Approach Essay Example | Topics and Well Written Essays - 750 words

Leadership Approach - Essay Example Different approaches tackle different ways of scrutinizing leaders in different organizations. However, they have a common feature which is the determination of effective leadership. The leadership study approaches have been in existence since the early 90’s. The approaches have evolved to more efficient and appropriate approaches. The leadership study approaches include the trait approach, behavior approach, power influence approach, situational approach and the integrative approach. All the approaches have three key variables; characteristics of the leader, characteristics of the followers and the characteristics of the situation. This paper will focus on behavior approach of studying leadership (Yuki, 2010). It will give an insight in the characteristics of this leadership study approach. Additionally, the paper will include an insight on its strengths and weaknesses and an example of its application in studying leadership. Behavioral approach of studying leadership was est ablished in the early 1950’s after the trait approach failed to provide researchers with the required results to evaluate leaders (Yuki, 2010). The behavior approach pays close attention to managers and leaders in organizations. It evaluates some personal attributes and skills at a closer perspective. The approach is divided into two categories of scrutiny. The first category focuses on the research on the manager’s job description, how they spend their time, their daily pattern of activities, their responsibilities and the functions of their managerial jobs. In this category some researches also focus on how managers deal with constraints and demands and how they resolve conflicts in their line of duty. In this category data collection is mainly done through observation, job description questionnaires, diaries and anecdotes from retrieved from interviews (Griffin, 2011). The mangers effectiveness in this subcategory is their ability to solve role conflicts cope with d emands, deal with constraints and recognize opportunities. The other subcategory in behavior study approach entails the identifying of effective and appropriate leadership behavior. In this subcategory research methodology is mainly done by a survey of the research field and using an appropriate questionnaire. The questionnaire is an inclusion of behavior description questions. Since the establishment of this approach researchers have been able to identify the correlation between a manager’s behavior and effective leadership (Yuki, 2010). This leadership approach has several weaknesses and strengths when it comes to application and results. According to Yuki (2010) the strengths of this approach revolve around the personal knowledge of a leader. This approach enables researchers to know a manager more when not and when in their job description. The personal attributes of a manager are very important in analyzing their effectiveness. By its method of data collection a managerà ¢â‚¬â„¢s skills and effectiveness is able to be scrutinized in a personal basis. The evaluation of a manager’s ability to solve conflicts is also a unique feature in this leadership study approach (Griffin, 2011). Additionally, this approach provides a perspective on the correlation between the personal attributes of a manager and their effectiveness in their job description. This approach mostly questionnaires as a tool of data collection. This

Stagnant Performance of Textile Industry of Pakistan Essay

Stagnant Performance of Textile Industry of Pakistan - Essay Example Industry is even experiencing other issues that have taken place internally, the workforce is under trained and the productivity levels are lower, there is a lack of leadership within the industry, the industry has failed to differentiate and add value. Other internal issues that are hurting the industry very badly includes high rate of inflation, low rate of production of power and increased rates of interest at which bank loans and funds are provided. Body There has been an increase in the demand for clothing and textile industry goods throughout the world (FAINI, 1992). Past two decades have experienced tremendous amount of success of the industry of textile. During the period 1990 the total export of textile conducted throughout the world was 212 billion and after 18 years it increased by $401 billion (Ahmed, 2012). Pakistan even witnessed an increase in the amount of textile goods produced and exported during the era of 1990 to 2008. During the period of 1990, Pakistan exported $3.6 billion worth of textile related goods and by 2008, this figure increased to 11 billion (SHARMA, 2006, p.19, LOPEZ ACEVEDO, 2012, p, 1999). Pakistan has experienced growth in the industry but has faced various obstacles and challenges due to which the growth rate has been slow. Pakistan’s share in the export of textile has declined to 1.81% during 2008 from 2.23% as recorded in 2005 (SCHAFFER, 2009, p.344). During this three years period the production of textile has remained volatile due to heavy increase in power prices and low amount of availability of power. Pakistan faces various problems due to which the growth of their textile industry has remained sluggish. The main element of any textile industry is cotton raw material and... This paper gives an insight into Pakistani textile industry and gives recommendations on its further development. The major role in the success of the textile industry of Pakistan has been plated by Cotton which is a very important raw material for the nation. Pakistan is regarded as the fourth most producer of cotton raw material and third most user of this raw material throughout the world. It is expected the industry will continue to grow and become one of the reason of economic growth in the economy of Pakistan. This industry has proven to attract foreign money into Pakistan’s economy and it is responsible for hiring the highest number of employees in Pakistan and there is no other industry that can replace it. Over the previous four decades the textile industry of this nation has displayed its strength in the international arena. Textile industry of Pakistan is not new and has a very huge history. The day when Pakistan gained existence on the world map, it had only two te xtile mills operational within the nation. Later, due to policies adopted by the government, the industry grew at a very fast pace. Today it is the leading sector of Pakistan and is the major contributor for the success of the economy of Pakistan and the manufacturing industry. The paper states that cost of production can be further decreased with the adoption and implementation of machinery that produces higher amount of bales as compared to the quality of bales being produced currently.

Conversation Topics for business occasions Essay

Conversation Topics for business occasions - Essay Example Awareness of these goals provides the subordinates with a direction so that they can equip themselves with the skills required to be eligible for the opportunities lying ahead. The subordinate should particularly try to ask the boss how he/she would be involved in the project. The subordinate should try to consent with the boss over the basic approach and standards. The subordinate should share with the boss what he/she thinks the ideal approach is and then he/she may ask the boss for input. â€Å"Be sure you understand upfront what the guiding principles are for the work — not just the tactical elements. These principles are what you should be discussing with your boss† (Chatman cited in Gallo, 2011). In addition to that, the chances of subordinates’ consideration for those opportunities by the boss are enhanced because the boss has already discussed the plans with them. A very good and informative topic of discussion is technology. Discussing latest technologic al research and products with a boss not only sets a good impression upon the boss, but also forms a very interesting topic of discussion. These days, with the pace of technological development being so fast, there is a lot to discuss. Subordinates can discuss the innovative features of the latest gadgets, draw comparison between the newest and the old models of gadgets, discuss whether a particular gadget is worth investing money in or not, and most importantly, whether a certain gadget can be used to improve the business they are concerned with in some way. Business meetings are very suitable occasions to discuss innovative ideas in. Subordinates can suggest to a boss how the use of a new gadget can help them in the business operations, and how it can be integrated into the organizational culture. This impresses upon the boss that the subordinates are very knowledgeable, hard working, and can contribute to the development of the organization. Politics might be a good topic of disc ussion with a boss in a business meeting provided that the subordinates can consent with the boss’s opinion and show respect for his/her views. Nevertheless, it is a risky topic to discuss with a boss because many people have emotional connections with their political parties and when they discuss politics, they indulge into a heated argument with the critics. If this happens between a boss and a subordinate, it is not good for the relationship. While discussing politics, it is recommendable for the subordinates to first listen to the boss’s stance, if they can agree with that, they should discuss it; if they cannot, they should either remain silent or try to change the topic articulately. Every topic that is discussed in a business meeting between a boss and the subordinates does not necessarily have to relate to business. Sports is another very interesting and engaging topic to discuss with a boss on a business meeting. Meetings are wonderful occasions for discussing sports because the boss and the subordinates are having a one-to-one discussion, and have sufficient time to discuss such things. This is different from the daily interaction that happens in the office which is constrained by limited time and pressure of work. â€Å"During the frenetic work week, they encounter the boss as the source of discipline, assignments, occasional reprimands and, typically, very little personal chit

Financing a Business Magazine Article Coursework

Financing a Business Magazine Article - Coursework Example In the year 2011, the number of small businesses in the UK was found to be around 4.5 million, which indicated that around 99 percent of the businesses were small firms (Nanto, 2010). The financial crisis has made it difficult for many small firms to get funding assistance from the banks. According to the Huffington Post, around 170,000 small businesses had to close down in the USA, in the year 2008-10; out of which around 6.79 million small firms closed in 2010, and around 6.96 firms closed in 2008 (Kavoussi, 2012). The rate of self-employment diminished by 4 percent in 2007 and further by 12 percent in 2009 (Halm-Addo, 2010). A series of survey was done, which revealed that the reducing employment, sales, investment rate during 2009 and even during 2008, were affecting the small business and their performances. About 165 small firms were surveyed in the UK and it was found that around 1 in every 20 firms had doubts of their survival, and around 8 percent were forecasting deep troub le for themselves. The small businesses do not have high cash reserves or large proportion of capital assets which would be acting as collateral. So it becomes difficult for them to secure additional financing during economic crisis. Bankruptcy among the small businesses are common than the large firms because even banks do not take the guarantee of financing them during such situation (Forrest, and Yip, 2011). The current economic crisis has created major liquidity issues in the banks, which in turn has influenced the lending practices. Bank of England has reported that financial crisis has observed the weakest flow of funds to the small businesses in the UK. The demand for secured and unsecured lending has increased in the UK since 2009, but it has been noticed that the changing policies of the banks due to rising risk of bankruptcy and insolvency, has limited the supply of funds. Evidences have been accumulated that the small enterprises in UK have faced difficulties in accessing funds during the period of 2008-09. According to the Forum of Private Business Reports, poor flow of cash and late payments were the major issues that the Economic Downturn Panel has referred to. They have also highlighted that these were mainly due to the slow decision-making, lack of any sales activity, and the increasing cost of lending rates. It was found in June 2009, that in the UK, about 33 percent of the small businesses could not access financial aid from banks, and around 44 percent of the small firms had to face immense difficulty to receive financial assiatnce. All the above statistics reveal that it is indeed difficult to raise money in the present economic climate. This is the reason why other ways of financing need have to be evaluated, so that small businesses do not close down just because of not getting access to bank loans (Stokes, and Wilson, 2010). The alternative sources of funding are discussed below: Merchant Cash Advances: In this type of financing the lend er does not lend money on equated monthly installment (EMI) basis, but they are interested in the sale and purchase of credit card income of the future. So they collect a fixed percentage of the credit card income daily, until the loan is repaid (Department of Business Innovation & Skill, 2012).

Biostatistics. Advantages of a randomized controlled trial over a Essay

Biostatistics. Advantages of a randomized controlled trial over a trial with systematic allocation - Essay Example Random controlled trials are experimental set ups with treatment and control groups, and elements of a study’s sample space have an equal probability of selection and allocation to either the treatment of control group. Systematic sampling however follows a defined approach with unequal probability for each sample space elements. One of the advantages of randomized control trials over systematic allocation is its ability to eliminate bias. Researchers and participants in randomized controlled trials lack influence of sample selection and allocation to either of the experimental groups and this eliminates chances of sampling bias. Eliminated bias in the randomized trials has significant effects on research processes such as enhanced reliability and validity which systematic allocation into biased sample may compromise (Miller, Strang and Miller 2010, p. 38). Randomized controlled trials also offer higher probability of homogeneity of background information on research participants within control and treatment groups as compared to systematic allocation that may have a set of background characteristics in one group and generate another group with different background characteristics. Such variations may result from bias, challenge comparability of observations from a study’s group, and identifies systematic allocations with validity and reliability challenges. Randomized controlled trials also have the advantage of probability sampling basis, which offers validity to data analysis, over the non-probability based systematic sampling (Friedman, Furberg and DeMets 2010, p. 71-72). Lack of a standard approach to systematic allocation also identifies benefit of randomized trials because variation in sampling criteria may be formulated to achieve bias and periodic sampling is an example (Miller, Strang and Miller 2010, p. 38). Variable data type and justification Number of adverse events Number of adverse events is a quantitative variable because it assumes numeric values. It can further be classified as discrete quantitative variable because it can only assume positive whole numbers (Weiers 2010, p. 8). Air blast sensitivity Air blast sensitivity, based on applied scale in the study, is a quantitative variable because of its numeric value on an ordinal scale that further classifies it as a discrete quantitative variable (Weiers 2010, p. 8; Neuhaus et al. 2013, p. 352). Tactile hypersensitivity Tactile hypersensitivity, based on the research, is a qualitative variable because it lacks numeric values. Its values are either yes or no and are further subjective, sub ject to study participants’ judgment (Weiers 2010, p. 8; Neuhaus et al. 2013, p. 352). Age Age is a quantitative variable because it assumes a numeric values and can further be categorized as a continuous quantitative variable because of its scope that can assume unlimited range of non-negative real numbers (Weiers 2010, p. 8). Gender Gender is a qualitative variable because it lacks numerical value (Weiers 2010, p. 8). Question 2 Graphical summary of the mean tactile sensitivity and variability The table bellow summarizes the mean and standard, for variability, for the tactile sensitivity values across the three groups at the end of 28 days. Table 1: Mean and standard deviation after 28 days Treatment Mean Standard deviation test A 21.48 11.86 Test B 20.58 11.32 Control 11.77 5.95 This data can be presented in graphical form as follows. Graph 1: Graph of mean and standard deviation after 28 days Interpretation of the sample mean and standard deviation of each group Mean of t est group A indicates that each of the group subjects is expected to have an average score of 21.48. The group’s standard deviation, 11.48, defines the mean deviation of each of the group’s scores from the group’s mean. Mean for the test group B shows that members reported an average score of 20.58 and the standard deviation

The Criminal Justice System Research Paper Example | Topics and Well Written Essays - 2500 words

The Criminal Justice System - Research Paper Example An in-depth analysis of the criminal cases reported in Britain in the past elaborates that black males have been, more of than not, involved in a vast majority of the offenses committed by the black community. Representation of black women in the crime is far less than that of black men. In addition to that, male juvenile crimes make a large portion of the total crimes committed by the black community in Britain. Particularly, black males aged 13 to 19 are fundamentally responsible for the number of crimes committed by the British black community. In a recent survey conducted by (HCHAC, 2007), the percentage of boys from all ethnic origins who confessed having indulged in crime was 13% against a mere 7% of the girls that made the confession of the crime and this fact is also evident from the fact that male prisoners were found to be 70986 more in number than the female prisoners till February of 2007. This proves that black girls are definitely quite less in number than black boys wh o are suspected of the crime yet their representation in the British criminal justice system is far more than that of non-black girls. Although there is a lot of controversy about the black male teenagers’ involvement in crime in general, yet there is no denying the fact that they do make a considerable portion of the criminals in Britain. â€Å"At the peak teenage, 19, blacks suffer firearms murder rates 17 to 20 times higher than do whites.† (Males, 2008). In order to minimize the widespread susceptibility of black male teenagers towards crime, and minimize the number of real young black male teenagers remaining within the existing form of British criminal justice system, it is imperative that the factors that increase their susceptibility towards crime are identified and evaluated against other ethnicities. The chief causes that defame black male teenagers as a non-considerate and socially irresponsible community include, but are not limited to social exclusion, poverty, and low social status, lack of discipline, lack of sufficient education, social disaffection.

Safety And hazards of pyrotechnics Essay Example | Topics and Well Written Essays - 1000 words

Safety And hazards of pyrotechnics - Essay Example A pyrotechnic technician should be aware of the various measures of creating a convincing explosion while ensuring that they maintain control of the process. Safety refers to the situation of acquiring protection form physical, damage, harm, accidents, errors and other events that are undesirable. It is also the control of various recognized hazards to acquire an acceptable level of risk. Safety is extremely vital in daily life and human should be cautious under all circumstances especially when dealing with pyrotechnics (Agrawal 9). A hazard refers to a situation that poses a certain level of threat to property, health, environment, or life. Majority of the risks are potential or dormant and have a characteristic of theoretical risk of harm. A hazard does not exist if it does not happen. When a hazardous situation comes to pass, people call it an incident. Pyrotechnics is a dormant hazard since they have the potential to be hazardous but do not affect the people or the environment. The key factor that leads to identification of a hazard in pyrotechnics is the energy stored that can cause damage upon release. Pyrotechnics store energy in various forms, which includes chemical, thermal, mechanical, and radioactive forms. Pyrotechnics are tremendously valuable in the entertainment industry and regularly used to mark various critical events. The producers or manufacturers of such pyrotechnics have a responsibility to ensure that the individuals who use them are not liable to adverse effects. They should achieve this through ensuring that they decrease the level of toxic materials in the pyrotechnics. They should ensure that it has minimal side effect to intended users. The employee who uses these pyrotechnics should also be protected since they work with them on a daily basis. Education concerning various measures of minimizing the chances of people being affected is particularly beneficial. Employees and

Death Essay Example for Free

Death Essay Death, to many who believe in reincarnation is passing into another life. The quality of this life could be well dependent on the, â€Å"karma† or the deeds that one has carried out in previous birth. Death thus need not be the end of life but just a new beginning. Reincarnation is generally thought to be an Eastern belief predominantly prevalent in Buddhism. Karma, some believe is an ancient Hindu cliche increasingly picked up by Buddhist scriptures which provide a cause – effect link to our actions. Reincarnation takes these links further and seeks to provide a relation between our actions and its outcomes in this birth to our karma in the previous birth. Karma is generally said to be unseen to the common man but ancient Hindu mythology believes that it is evident to the wise and knowledgeable sage. There are many such believers of this phenomenon in the West as well. Stevenson (1980) has even supported it with extensive scientific reasoning and examples. The instances quoted are of children who are said to have taken to speaking about their earlier life immediately after they had started talking. There are some studies which link birth marks or defects with past lives. These defects are seen as the wounds on a person of previous birth, who is remembered in the embryo, wounds which could possibly have been fatal. (Stevenson, 1997). Rationalists and particularly rational biologists would not believe that the biological deformities which are found at birth such as defective speech, hearing or blindness could have been a cause of an accident in previous life rather than defective growth of the embryo in its formative stage. There has thus been extensive skepticism about reincarnation particularly amongst the rationalist of the West. However there are numerous believers of incarnation who quote a number of examples which are there in the Bible including the teachings of Jesus where John the Baptist is considered as a reincarnate of Elijah the prophet. What then is the reality?

Gym Cultures Prominence In Society Cultural Studies Essay

Gym Cultures Prominence In Society Cultural Studies Essay Gym culture holds a prominent place in contemporary society. Studies1 focused on the physical dimensions of self-concept document the significance placed on physical appearance in evaluations of self-worth. The inconsistency between the real and ideal self is an important trigger within gym culture and this relationship is comprehensively and covertly exploited through media narratives and advertising images. Roland Barthes asserts that an imitated object makes something appear which remained invisible, or if one prefers, unintelligible in the natural object. Structural man takes the real, decomposes it, then recomposes it.2 Unravelling the means by which texts and images recomposed the original is at the centre of structuralist analysis. Concepts of semiology developed by Ferdinand de Saussure form the basis for structuralist methodology. Saussure rejected the conventional view of the linguistic sign as a name attached to an object in favour of the notion of the linguistic sign as a two-sided psychological entity.3 The word sign is used to describe the whole created through the combination of the signified (signifie) and the signifier (signifiant). The signifier is the materially perceptible component such as a sound, picture or written mark whilst the signified is the conceptual meaning. The relationship between the two, according to Saussure is arbitrary, founded entirely on social convention. Signs employed in the discourse of gym culture habitually focus on bodies. Figures 1, 2, 3, 4, 5, and 6 all contain images of young, slim, and attractive 1 Maguire, J. and L. Mansfield, No-bodys perfect: women, aerobics, and the body beautiful Sociology of Sport Journal 5, 2 (1998): 109-137. 2 Critical Terms for Literary Study. Chicago: The University of Chicago Press, 1995. 3 The Oxford Dictionary of Literary Terms. Chris Baldick. Oxford University Press, 2008. Oxford Reference Online. Oxford University Press bodies. The relationship between the photographic images, the signifier, and the concept of youth, health and attractiveness, the signified, combine to create the sign. Roland Barthes however noted that this model focuses extensively on denotation to the detriment of connotation. In his initial investigations Barthes distinguishes between two forms of reference: denotation and connotation. Conventionally denotation is referred to as the literal, primary sense or straightforward dictionary meaning, whilst connotation refers to the range of further associations that a word evokes in addition to its denotation. The connotations of a particular word are a formulated sequence of qualities, contexts, and emotional responses commonly associated with that to which it refers. The context in which the word or phrase is used and the individual inclinations of the audience determine which connotations will be initiated. Initially Barthes suggested that analytically connotation can be distinguished from denotation4 in the same way that a photographic image represents the denotation of what is photographed, the connotation is exposed through how it is photographed. Barthes however later concluded that: denotation is not the first meaning, but pretends to be so; under this illusion, it is ultimately no more than the last of the connotations (the one which seems both to establish and close the reading), the superior myth by which the text pretends to return to the nature of language, to language as nature. The two women in Figure 1 and the woman in Figure 3 are all pictured wearing long pants. The same particular item of clothing is denoted in both advertisements, namely pants. However in Figure 1 the 4 Chandler, Daniel:  Semiotics for Beginners  (1994) pants are cargo pants whilst in Figure 3 the model wears jeans. Cargo pants connote youth, hip-hop and dance culture whilst jeans are associated with the everyday down-to-earth, girl-next-door. The style of pants selected reflect a range of connotations, the denoted image is inherently connotative. Barthes perspective exposes denotation as being no more natural than connotation but rather as stemming from a process of naturalization. Denotation is thus proved to be a product of ideology. Images prevalent in gym culture discourse documents this well. Note the similarity between the models selected in Figures 4, 5 and 6. They are all slim, tanned and tall with long blond hair and have been selected to portray a specific image of femininity influenced by historical attitudes and social convention, which conforms to contemporary westernized ideology. Similar images are presented to both male and female consumers. Fitness magazine (Figure 5) features an image of American television host K elly Ripa, with a byline suggesting that the magazine contains the secrets to how she got this buff, whilst the cover of Mens Fitness (Figure 6) has a byline suggesting that the magazine contains the secrets of how to gain hard abs, strong enough for a night with the featured Carmen Electra, glamour model and actress. Connotatively men should be fit and muscular to attract their ideal woman, and women should strive to be that ideal- attractive, slim, tanned and blond. The selection of celebrities this physical represented ideal suggests that fame, success and wealth accompany the ideal. These associations formed by groups of signs create a cultural paradigm. In the same way the Zumba advertisement in figure 1 is designed to immediately invoke connotations of a gym culture paradigm. The images are of one male and two female bodies. Little of their faces, apart from smiles suggesting fun and happiness, can be seen reinforcing a focus on moving bodies and physicality. Naked midriffs whilst emphasize muscled, slim bodies also invokes sexual connotations. Through metonymy the graphic representation of a speaker emphasizes the role of music and its associations with parties, social interaction. Strong colours are used and orange, the adverts predominant colour believed to be invigorating as it increases oxygen supply to the brain is used to reflect joy, enthusiasm, creativity, attraction, success and stimulation. It is also used to attract attention as it is high visibility. The line Ditch the workout, join the party! aligns working out with having a party. The word join is repeated four times reinforcing the idea of belonging, identifying wit h and being part of a particular group. The language choice is deliberately relaxed and informal, to emphasize fun. The paradigm created is one of youth, music, party, fun, sexual attraction, dancing and fitness, with a focus on belonging. Figure 2 is an advertisement for a Sony water resistant walk-man. Sony employ an approach common to brand-name product advertising, one whereby their product is aligned with culturally desirable paradigms, in this case fitness and health, thus advancing a connotative association between their product and other values their audience might hold. A young man is pictured, dressed in a vest he appears to have been running. The aim is to establish paradigmatic relationships between exercise and fitness and Sonys brand. In so doing Sony hope to include their product in a fitness paradigm and through this inclusion their brand comes to connote all that characterizes gym culture. Whilst Paradigmatic relations rely on familiar cultural associations to create meaning, syntagmatic relations create meaning through the sequence in which the signs are displayed. In Figure 1 the line Ditch the workout, join the party! aligns working out with having a party. In figures 3 and 4 both advertisements rely on an alternative semiotic structure in addition to paradigmatic relations to communicate their message. Both advertisements offer promises of transformation, figure one blatantly telling us before and after. A syntagmatic relation can be represented by the connotative narrative, a sequence of associated events: She joined the gym, exercised regularly, ate the right food, lost weight, and was thereby transformed. Because this is such a familiar narrative to us, the advertisement can invoke it and all its associations by just showing us a single image, the mirrored but subtly altered image of the women that represents the start and finish of the narrative. Our understand ing of figure 4 relies on previously learnt and accepted conventions. Barthes identified these previously learnt and recognised conventions as cultural codes which could be utilized in structural analysis of texts. 5 In contrast to the conventional definition of myth as a traditional or customary story Claude Levi-Strauss and Roland Barthes shifted the emphasis of myth as a plot to myth as a way of thinking akin to a kind of ideology. Roland Barthes 1957 Mythologies brought to light how myths are part of everyday modern life. Barthes demonstrates an idea of myth as a further sign, its foundations in language, but to which further implication is added. To make a myth, the sign itself is used as a signifier, and a new meaning is added, which is the signified. This additional meaning is not arbitrarily, even if the reader is not aware of it. Historically determined circumstances are presented as natural. Predominantly media driven modern myths are created to disseminate an impression of society that is 5 Leak, Andrew N. Barthes, Mythologies. London: Grant Cutler, 1994. compliant with current ideologies. The earlier discussion of the models chosen in figures 4, 5 and 6 is an example of how pervasive myth can be. Barthes characterizes myth as ubiguitous6 being or seeming to be everywhere at once. The tall, slim, blond woman is unanimously presented to male and female consumers alike as the ideal women. In addition myth is axiomatic operating as a sort of fusion of fact and value, it is assertive. Axiological language presenting a theory as a fact is frequently found in advertising narratives. Figure 4 contains a good example: inside everybody is a better body. Myths are not just narratives, but narratives mixed with other signs: Figure 3 suggests, through a combination of images, graphic representation and narrative, that joining their gym will make you younger. Gym culture serves as a good example of how myth permeates consumer driven society. According to Barthes uncovering of the Ideological abuse hidden in the display of what goes without saying lies at the centre of structuralist analysis and serves to warn that since the theft of language perpetrated by myth is so subtle that nothing appears to have been taken8 consumers are affected by it without even recognising its existence. 6 Leak, Andrew N. Barthes, Mythologies. London: Grant Cutler, 1994. 7 Ibid., 8 Ibid., p57

Conflict Management in the Workplace: Causes and Effects

Conflict Management in the Workplace: Causes and Effects INTRODUCTION What is conflict? Conflict is a process that involves people disagreeing. It is usually a process in which one party perceives that its interests are being opposed or negatively affected by another party. Conflict could be created due to different opinions of the interested parties, or due to the show of authority that some of the involved parties might have. It can be separated in substantive conflict and emotional conflict. Substantive conflict is a disagreement over ends or goals and the means for their accomplishment. Emotional conflict is usual coming out over feeling of anger, mistrust, fear, etc. In addition, conflict may be classified in three types: Intrapersonal conflict, interpersonal conflict and intergroup conflict. TYPES OF CONFLICT Intrapersonal Conflict Intrapersonal conflict arises within a person. It is a fight you have to give with your ego, in front of several solutions for a decision you have to take. For example, if you are a sales manager and you are in front of a deal that you have to make on time with a customer, you might have to decide, either to close it according to your companys usual policy, or based mostly on your customer needs. In this occasion you are facing an intrapersonal conflict. To be more specific, in case you proceed with the first choice you will be ok with your company, but you may disappoint your customer and this can cause problems either in your personal relationship with him, or in your sales volumes. If you follow the second option, then you might have problems with your company, but you will probably improve your relationship with your customer and as a result the sales volumes as well. But, of course, youre taking a big risk, in case the sales results will not come as you have planned. This exampl e could be a typical, usual, daily intrapersonal conflict of many employees in several organizational environments. Interpersonal Conflict Many companies suffer because of interpersonal conflicts, due to high competition (internal or external), different personalities of those who are decision makers in a company, authority showing, etc. Interpersonal conflict is arriving between colleagues, CEOs, boards of director, etc. and actually can be created in any level of a company. It is a usual reason which tends employees to resign. We have all faced during our working experience colleagues and managers fighting each other. Most of the times these fights or strong disagreements guide to problematic relationships between staff and finally in resign of those that dont want to go a step back. It is important to refer that according to one research, 31.9% of CEOs quitted from their jobs, because they had conflicts with the board of directors. (Whitehouse, K. 2008, January 14). CEOs of competing companies might also have public conflicts. For example, in 1997, Michael Dell was asked what he would do about Apple Computer. What would I do? Id shut it down and give the money back to shareholders. Ten years later, Steve Jobs, the CEO of Apple Inc., indicated he had clearly held a grudge as he shot back at Dell in an e-mail to his employees, stating, Team, it turned out Michael Dell wasnt perfect in predicting the future. Based on todays stock market close, Apple is worth more than Dell. (Haddad, C. 2001, April 18). Intergroup Conflict Intergroup conflict takes place among different groups. Types of groups may include different departments in a company, employees and management, or competing companies in a market. Departments may conflict over budget planning. For example marketing budget or equipment budget usually creates a big conflict between marketing or production management or the general management. Employees and management may disagree on work rules and procedures. Suppliers may conflict with each other on the quality of goods, or in the pricing policy theyre promoting in the market. For example, we will refer below a typical labor issue when a joint venture between two airline companies has taken place: Canadian Air and Air Canada pilots were facing long term personal and legal conflicts when the two airlines seniority lists were combined following the merger Seniority. This fact is a valuable and scarce resource for pilots, because it helps to determine who flies the newest and biggest planes, who receives the best flight routes, and who is paid the most. In response to the loss of seniority, former Canadian Air pilots picketed at shareholder meetings, threatened to call in sick, and had ongoing conflicts with pilots from Air Canada (Stoykewych, R. E. 2003, March 7). POTENTIAL CAUSES OF CONFLICT Organizational Structure Conflict can be created depending on the organizational Structure that a corporation follows. For example, if a company uses a matrix structure as its organizational form, it will have decisional conflict built in, because the structure specifies that each manager report to two bosses (Jaffe, D. 2000). For example, global company ABB Inc. is organized around a matrix structure based on the dimensions of country and industry. This structure can lead to confusion as the company is divided geographically into 1,200 different units and by industry into 50 different units. (Taylor, W. 1991, March-April). Employees Benefits differentiation Resources offered from corporations as extra benefits to their employees such as money, time, and equipment are often a problem. Competition among people or departments for different benefits is a frequent cause for conflict. For example, cars, mobile phones, credit cards, laptops are benefits that are offered not in all the employees, or not with the same value. For example salesmen might have different car according to their position in the company. This small issue can cause big conflicts. Differentiation in salaries of people in the same position level, but with different performance can as well create conflicts. Human beings are always jealous and feel unfair. Task Interdependence Task interdependence could be another cause of conflict. This issue is coming when your success or your achievement in your objectives is also depending on other people performance. For example, when you are a project engineer and you have to complete a building construction in timelines with the correct way and the planned resources, it might be a big success for you, but you have to be supported for example, from the electrician, the plumper, the builder, the supplier of the materials, etc. If you lose control, you will probably have big conflicts with all your above coordinators. Incompatible Goals Sometimes conflict arises when two parties think that their goals are exclusively in their responsibilities. Within an organization, incompatible goals often arise because of the different ways department managers are approaching them. For example, a sales manager who s bonus system depends on sales figures, believes that he has to offer higher credit periods in a big client, in order to earn bigger sales volumes. But the financial manager whose bonus terms, might depend on how fast the clients pay their amounts is disagreeing with this option. Then these two managers may conflict each other, because they focus on their personal interests and not on the companys common goal. Unless this issue is not resolved with the intervention of someone who has the authority to overlap those two, they might continue conflict without coming up to a solution. Personality Differences Personality differences among personnel are something common and usual. Many times youre arguing with your colleagues, because you see things and issues in different way based on your ethics and your growing environment. Matching of the personalities and team spirit is a difficult thing, through a corporation and needs a special care from the Human Resource management department. Communication Problems In many occasions conflict arises out of problematic communication system, such as unread-forgotten emails or dealing with people who dont give feedbacks in your inquiries, or they often forget to reply. Then conflicts are a typical result, usually from the involved parties who try to drop the fault each one in the other. Consequently, many working hours are lost in finding where the mistake in the communication history was. OUTCOMES OF CONFLICT Conflict can be dysfunctional if it affects negatively an organization, leads to low performance, or in the worst case, to workplace violence. To understand how to get to a positive effect of conflict, we first need to understand its causes, consequences, and tools to help manage it. If conflict is too low, then performance is low. If conflict is too high, then performance also tends to be low. (www.flatworlfknowledge). The positive thing is to keep conflicts in the middle of this thin line. Most of us might have the opinion that it is quite strange to try in leave conflicts existing in middle levels, but as we will see in the following paragraphs, we can definitely have positive outcomes. Positive outcomes include the following: Creation of bigger range in quality ideas Identifying and bring in the surface the dark inaccurate cases Clarification of individual views that build learning Improvement of participation and creativeness Motivate your employees in participate in useful discussions and improve their negotiations skills within healthy procedures Examples of negative outcomes Increased stress and anxiety among personnel, which guide in low performance and personal satisfaction Feelings as being defeated and humiliated, which affect negatively individuals morale A mistrust climate, which reduce working relationships, collaboration and teamwork. CONFLICT STAGES Latent Conflict. Latent conflict is visible conflict waiting to happen. Felt Conflict. Felt conflict is experienced as discomfort and tension. Perceived Conflict. Perceived conflict is the awareness that we are in a conflict situation. Manifest Conflict. After conflict is perceived and felt, it may or may not become open, or manifest. Conflict Aftermath. Conflict is likely to breed more conflict and, when it does, that conflict is likely to take on a life of its own. (Gholipour A. 2006). CONFLICT MANAGEMENT STYLES Everyone in his personal life has his own style in facing conflicts. In the following paragraphs you can see the most well known frequent and usual approaches in conflict management. Avoidance Avoidance is a conflict style, where the involved parties or groups are pretending that everything is fine, while inside of them they feel that there is a serious problem. Avoidance can also be an occasion where some of the parties are quitted from the conflict issue, not so much interested in find the solution, since it might considered from their side as a non personal obligation, or because they unlike the other parties opinion. In low levels and not so important issues, this style can be sometimes a good solution, but usually it finally guides in bad working environment and relationships. Accommodation The accommodating style of conflict management is more cooperative than the previous one. In this style, the one party offers or accepts, what the others believe that it is correct. This type of person is usually afraid to argue with their opponents because either they believe that they will destroy their relationships with them, or they feel that they will not come up to a solution. We can say that from one side theyre giving up their proposals. This style is a good way to manage conflicts, but you might lose proposals or ideas, which could be interesting from the person that always go a step back in front of the most dominant persons. Compromise The compromising style is always referred as the middle-level solution. In this style all the involved persons are giving a little of them in order to come up in the best solution. We can say that it is a kind of bargaining. It is a quite effective in overpass conflicts usually without negative outcomes. Competition People often show a competitive style to in order to achieve their goals or to perceive the other parties following their ideas. Competition may create bad relationships with others, if one is always trying to maximize his own outcomes at the expense of others well-being. This approach may be effective if one has strong moral objections to the alternatives or if the alternatives one is opposing, are unethical or harmful. (www.flatworldknowledge.com) Collaboration Collaboration is a conflict management style that is almost similar to effective negotiation or to win-win solutions. In this occasion both of the involved parties may conflict each other, but they always try to find the best solution, which can satisfy all of them and also serves the common goal. For example if an employee is performing well in his job obligation and he is asking to attend an MBA program in order to improve more his management skills, then he may ask from his company to pay the program for him. Then the manager can propose to him: Yes I will pay your MBA program, but you have to stay 2 years more in the company, after you will have finished it. Otherwise you will return back our paid amounts. It sounds like a fair solution for both of the sides. APPROACHES TO CONFLICT RESOLUTION Change the Composition of the Team If the conflict is between colleagues then a good solution could be, separating the personalities that are creating the biggest problems. In circumstances where conflict is attributed to the widely different styles, values, and preferences of a small number of members, replacing some of these members may resolve the problem. If thats not possible because everyones skills are needed on the team and substitutes arent available, consider a physical layout solution. Research has shown that when known antagonists are seated directly across from each other, the amount of conflict increases. However, when they are seated side by side, the conflict tends to decrease. (Howat, G., London, M. 1980) Create a Common Opposing Force Group conflict within a corporation can be reduced by turn their attention on a common enemy such as the competition. For example, two product managers might argue in which of their two products are going to spend more marketing expenses, each trying to get more resources in order to promote more his product to the market. Then instead of fighting each other, it would be better someone to turn them in focusing on a competitive product and get them responsible how to develop their products together, much more than the competition to the market. Consider Majority Rule Group conflict can be dramatically reduced by using the traditional majority rule process. In this case every one of the involved parties is proposing an idea and then all together vote in order to choose the one with the higher votes. Majority rule could be a creative process, but it has to be followed always with creative discussions and not operating as an easy solution for decreasing conflicts, through groups or persons. Sometimes it has negative outcomes, when most of the times the same persons ideas frequently pass. Then the other members of the procedure might feel that something unfair is going on, as for example the cliques creation between persons that voting all the time their personal ideas. Problem Solve Problem solving is a common approach to resolving conflict. In problem-solving mode, the individuals or groups in conflict are asked to focus on the problem, not on each other, and to uncover the root cause of the problem. This approach recognizes the rarity of one side being completely right and the other being completely wrong. (www.flatworldknowledge.com). CONCLUSION Summarizing all the above described in this assignment, we can easily realize that conflict management is a very important issue in workplace. We cannot evaluate how it could be solved, or which is the best way to manage or approach to its resolution. It would be definitely positive for companies to set up conflict policies, so they can control better such problems. But the assured thing is that, even policies would be set up, every manager, every employee has to be careful and try to take advantage of the positive effects that conflict can give. Thus, in order to achieve this, everyone has to do it with his own style, since he has to adapt his behavior depending on the working environment he is occupied. If we think again that conflict guides in violence in workplace, but can guide also to creative solutions, integrative negotiations, passion for participating in problems solving, we have to individually think and drive ourselves at the positive part of conflict results. REFERENCES Wall, J. A., Callister, R. R. (1995). Conflict and its management. Journal of Management, 21, 515-558. Michaels, D., Power, S., Gauthier-Villars, D. (2006, October 10). Airbus CEOs resignation reflects companys deep structural woes. Wall Street Journal, pp. A1-A10. Whitehouse, K. (2008, January 14). Why CEOs need to be honest with their boards. Wall Street Journal, Eastern edition, pp. R1-R3. Haddad, C. (2001, April 18). Why Jobs and Dell are always sparring. Business Week Online. Retrieved May 1, 2008, from http://www.businessweek.com/bwdaily/dnflash/apr2001/nf20010418_461.htm; Markoff, J. (2006, January 16). Michael Dell should eat his words, Apple chief suggests. New York Times. Retrieved January 19, 2007, from http://www.nytimes.com/2006/01/16/technology/16apple.html. Stoykewych, R. E. (2003, March 7). A note on the seniority resolutions arising out of the merger of Air Canada and Canadian Airlines. Paper presented at the American Bar Association Midwinter Meeting, Laguna Beach, CA. Baron, R. A. (1989). Personality and organizational conflict: Type A behavior pattern and self-monitoring. Organizational Behavior and Human Decision Processes, 44, 281-297. Bergman, T. J., Volkema, R. J. (1989). Understanding and managing interpersonal conflict at work: Its issues, interactive processes and consequences. In D. M. Kolb J. M. Kolb (Eds.), Hidden conflict in organizations (pp. 7-19). Newbury Park, CA: Sage. Howat, G., London, M. (1980). Attributions of conflict management strategies in supervisor-subordinate dyads. Journal of Applied Psychology, 65, 172-175. www.flatworldknowledge.com

Shakespeares Alls Well That Ends Well, Macbeth, Much Ado About Nothing, and Hamlet :: Free Macbeth Essays

Finding Ourselves in Shakespeare's All's Well That Ends Well, Macbeth, Much Ado About Nothing, and Hamlet Who are we? Paul Simon said, "I am a rock." John Lennon said, "I am the walrus." Steve Miller said, "I'm a joker, I'm a smoker, I'm a midnight toker." Richard Nixon said, "I am not a crook." Basically, it boils down to this: people naturally don't really know who they are, or really are. These metaphorical song lyrics (excluding Tricky Dick) seem to be searches at an explanation of the self. People have been attempting to secure their identities forever. At first this search seemed synonymous with a search of an origin. Religious doctrines were devised to explain who people are and if not, how they should be. However, one's identity or soul or true self is not a stagnant or secure identity. One's character or self is always apt to evolve with age and experience, or quicker, depending on situations like if one is drunk (Cassio), etc. The ambiguity of people's personage is a theme Shakespeare explores in most of his works. He does so with many means: the use of costumes, magic, dishone sty, and most often with confusion. Characters in Shakespeare are never what they seem. Hamlet says, "I know not 'seems.'" Iago says, "I'm not what I am." Henry V says, "Presume not that I am the thing I was." What Shakespeare seems to be doing is breaking down identities. We develop a discourse of pattern-based predictions about who people are and how they will behave. When people act differently or out of our perception of their character we assume something is wrong. We all fester a natural tendency to seek black and white or at least know where people stand. Trust and honesty, declared and respected virtues, are based on this inherent need. Shakespeare again and again breaks these beliefs down by basing all significant action in his plays on people acting out of their perceived characters. Examples include the love quadrangle in A Midsummer Night's Dream; the rejection of Falstaff in Henry IV, Part 2; Othello's struggle with Desdemona's potential promiscuity; Claudio and Prince John's assumption of Hero's whorishness; the Archbishop, Mowbray, and Hastings' belief in the honor of Lancaster's inferred intentions; etc. So often in Shakespeare's plays, characters put on disguises and wear masks to hide who they truly are for some purpose or another. So much of his story lines depend on instances where people's assumptions are false perceptions of who someone really is.

Schools Should Prepare Children For Life In Society :: essays research papers

Schools Should Prepare Children For Life in Society In today's information society people often think that characters from TV-shows or talkshow guests reflect our society. Although that opinion is rather based on the disability of people to use information than on any logical thoughts, there is something every talkshow reminds us of: people are not perfect. So, I say, society can not be perfect either. I believe that society works by that society doesn't work. People are too different to put them all into one melting pot, but you have to, because otherwise society would end in destruction and hate (as seen in the Third Reich). I believe that schools have an obligation to prepare children for life in society. Therefore they don't necessarily have the ability to change society but I think today's situation in Germany is not nearly as bad as the situation in "Dead poet's society", a movie based on a true story. In the movie a teacher tries to let his students be creative and critical towards everything they see and hear while neglecting values like punctuality and obedience. At first he is successful, but as soon as the school board notices his ambitions, he gets suspended for some odd reason. If a teacher in Germany tries to influence students in the way that they are more creative that is generally seen as positive, but what almost makes this impossible is the number of students in a class and the time frame of just 45 minutes, which is short if you are going to hear all the different opinions of all the students. If we accept that there do exist problems in society that need to get fixed, we also have to see that it is not school's job to do this alone.

Essay --

Historically, Myasthenia Gravis was discovered by Thomas Willis in 1672. It was not until late 19th century that Wilhelm Erb and Samuel Goldflam described the muscle disease due the lack of nervous input. Initially, it was called the Erb-Goldflam syndrome until Friedrich Jolly, a German neurologist coined it as Myasthenia Gravis Pseudoparalytica. He created the Jolly test, which tested for muscle weakness by eliciting faradic stimulations for continuous muscular contractions that caused fatigue (Ropper & Samuels 2009). Myasthenia Gravis (MG) is an autoimmune disease that causes antibodies to destroy the signal transduction in neuromuscular transmission. In an autoimmune disease such as myasthenia Gravis, the immune system cannot differentiate between healthy cells and antigens. The host’s antibodies block the acetylcholine nicotinic receptors resulting in inhibition of the excitatory effects of the neurotransmitter acetylcholine. It also degrades the acetylcholine receptors. Normally, the antibodies do not attack normal healthy acetylcholine receptors on the postsynaptic end of the neuromuscular junction. Acetylcholine is released from the vesicles from the presynaptic end into the synaptic cleft where it binds to the acetylcholine nicotinic receptors eliciting an excitatory effect for muscle contraction. Once this action is inhibited, muscle contraction in that cell cannot be elicited. These nicotinic acetylcholine receptors are found on the motor end plate of the muscle cell. Acetylcholine binding allows a cascade of events to release calcium into the muscle cell. This allows the movement of actin and myosin based on the sliding filament theory to power stroke causing the cell to contract (Ropper & Samuels 2009). Myasthenia Gra... ...l lives. In conclusion, immunosuppressive agents and acetylcholinesterase inhibitors help in reducing the symptoms of Myasthenia Gravis. While acetylcholinesterase inhibitors have a short half-life accompanied by various side effects, it is the best solution at this time to alleviate muscle weakness and fatigue. Pyridostigmine is the most commonly used drug with the lowest toxicity amongst these inhibitors because of its limited bioavailability. Immunosuppressive drugs inhibit antibody release reducing the amount of malfunctioning T-cells that attack the nicotinic acetylcholine receptors. While its effects are not immediate with poor absorption, it provides longer periods of symptom relief. The immunological agents are only reduced and not destroyed and thus regenerate to elicit myasthenic symptoms. Further research is necessary to continue the search for a cure.

Clinical Decision Support

A state of irritability, exhaustion, or bewilderment triggered in clinicians who have been exposed to too many alerts which cause the user to ignore some or all the alerts. American National Standards Institute (ANSI) ; coordinates for the development of Health bevel Seven's Arden Syntax Standard. Bar Code Medication Administration (ABACA) ; An inpatient CADS to assist nurses with the five rights of medication administration. ; Provides warnings if any of the five rights are violated. ; It also requires the nurses to enter an override reason if he/she chooses to proceed.Bar Code Medication Administration Health Level Seven (HAL) ; A standards development organization for health information technology (HIT) Look-Alike, Sound-Alike (ALAS) ; Drugs with similar spelling or pronunciation. ; Refers to providing clinicians or patients with clinical knowledge and patient-related information, intelligently filtered or presented to appropriate times, to enhance patient care. ; Integrate patie nt-specific data with an available knowledge base in order to assist the clinician in selecting and delivering the safest and most effective therapies.Clinical Decision Support System A system intended to provide CDC to clinicians, caregivers and health care consumers. ; An Automated CADS includes: 1. A Knowledge base 2. An Event monitor 3. A Communication system Take Note: ; CADS may be a stand alone system ; CADS may be integrated into other technology solutions (ex. Bar code scanning technology and e-Prescribing) General Attributes of CADS 1. Designed for three purposes: Improve the quality of clinical decisions Notify of potential change in patient status ;. Prevent errant action at the point of care a.Error of commission b. Error of omission 2. Patient specificity 3. Context sensitive- relates directly to the work at hand 4. Integrated into workflow- convenient to use. 5. Timely- executes in real time 6. Pushes information to the clinician, care-giver or health care consumer 7. Intelligently filtered clinical information ; Information, advice or warning is relevant and meaningful ; CADS uses patient data to infer that the message is actually needed. ; CADS is customizable to clinical preferences. Types of Clinical Decision Support A. Patient-specific CADS B.Non-patient specific CADS ; This type of CADS consist of three types f alerts 1 . Commercial drug-interaction alerting system 2. Commercial dose and dose-range checking alerts 3. Commercial clinical rules engine Commercial drug-interaction alerting system ; Most common in COPE and Pharmacy Information systems. ; Provides alerts for drug-allergy, drug-drug, drug-pregnancy and other interactions. ; Limitation is that severity levels Of drug interaction is pre-assigned by the vendor based on the anticipated adverse reaction and cannot be customized.Four Possible Results from deterioration alerting system Alert Result Produces alert? Relevant? Clinician deeds to see? True Positive Yes True Negative NO No P ositive False Yes but never gets the chance Commercial dose and dose-range checking alerts ; Currently, this is rudimentary using few patient data, usually only age. Therefore this systems only loosely fit paternalistic category. Commercial clinical rules engine ; These allow local development or customization of clinical content and programming logic. 2. 3. 4.Data mining Informational notice Order sets Knowledge retrieval systems ; Provides population specific relationships and information. ; Encompasses numerous methods used to identify patterns and relationships in data. ; Usually just-in-time, product specific information. ; Examples: 1 . Provides alert for possible ALAS 2. In COPE, it might be order specific information such as the cost off lab test, or formula status of a drug. ; An organized set of patient care orders that are usually population, procedure or disease specific. It may be evidence-based such as clinical guideline. ; The KIRKS ; It could be: 1. Primary KIRKS ex. Google and 2. Secondary KIRKS (Harridan's online) 3. Tertiary KIRKS (ASAP, Thomson Health care and How to maximize the benefits Of CADS? Maximizing the benefits 1. Ensure that the data available for decision-making is as comprehensive as possible. Data should be current and urge Larry updated. 2. Optimize the method by which the decision support information is delivered to the health care provider values of CADS ; Application of CADS in different current medical technologies available: 1.COPE 2. OMAR(Getronics Medication Administration 3. Smart Pumps 4. Automated distribution cabinets CADS in COPE CADS integrated in COPE can: ; Reduce medication errors (any preventable event that may lead to inappropriate medication use or cause harm to he patient while the medication is in the control of a health care professional, patient or consumer) ; Improve compliance with recommended monitoring or adjunctive therapies. ; Improve efficiency by reducing the time spent clarifying incomplete ord ers. Screen for a variety or risks on the point of entry (ex. Duplicate therapy, drug-drug, allergic cross sensitivities) ; can reduced mathematical errors by automating weight-based and similar dosing calculations. ; can identify possible ALAS medications. Computerized Provider Order Entry CADS in Omar ; OMAR (Electronic Medication Administration Record) CADS integrated in Omar can: ; Can provide real time confirmation of the 5 rights of medication administration: 1. Right medication 2. Right dose 3. Right route 4. Right patient 5.Right time ; Can screen for recent changes in laboratory parameters, vital signs, or allergy status which may interact with a scheduled medication and alert the nurse prior to administration. ; Ex: laboratory shows critical level of potassium thereby alerting the nurse before administering dioxin to patient. CADS in Smart Pumps ; Smart pump- a computerized infusion device that can be programmed to include specific set of data. CADS integrated in Smart Pum ps can: ; Provide real time confirmation of the volume, rate and concentration of the solution being administered.Smart Pumps CADS in Automated Dispensing Cabinets ; ADS- secure storage cabinets typically located decennially on patient care units capable of handling most unit-dose and multiple dose medications. ; CADS integrated in ADS can: ; Notify nurses of potential hypersensitivity or ADAIR when certain trigger medications are withdrawn for a patient. ; In pharmacy, can provide alerts when medication is withdrawn too early or too ate based on scheduled administration time. Automated Dispensing Cabinets Unintended consequences in CADS ; A. Alert fatigue ; 8. Delay in care ; C. System performance A.Alert fatigue ; Tendency users to become overwhelmed and begin to ignore CDC messages due to a high quantity of alerts or a perception that the alerts have little perceived value. B. Delay in care ; The risk that interruptions in the workflow caused by clinical decision support alerts o r system limitations may lead to a delay in delivery of patient care. C. System Performance ; The risk that the processor resources seed by the CADS will cause the hospital information system software to perform slowly. Arden syntax standard ; A programming language designed for clinicians to build clinical rules. Streamlined computer language based on Pascal. ; Developed in Columbia University Arden Homestead in 1989. ; This standard provides a method to construct clinical rules, such as alerts, reminders and recommendations, known as Ml. ; Provides a flexible and clinically way to develop Ml. What is Ml? Ml ; Means Medical Logical Modules ; Offers a suggestion or warning (alert, recommendation or reminder) regarding a alnico decision or action, or an informational notice to report a change in a patient's clinical status.