Friday, August 28, 2020
Beowulf, Themes and Symbols Term Paper Example | Topics and Well Written Essays - 1000 words
Beowulf, Themes and Symbols - Term Paper Example insidious through the fight among Grendel and Beowulf, at last the saint had the option to crush him and set up goodness through which, as indicated by the Christian conviction, reclamation is conceivable. The individuals are consistently under the danger fiendish powers. They are covetous to the thrived and tranquil existences of individuals. This is the thing that occurs in the realm of Shield Sheafson. The Heorot worked by the lord is an image of the riches and amicable existence of the individuals have a place with that nation. The start of the story is from the dangers of Grendel who lives in the close by swamplands of Hrothgars realm. The impact of such sinister powers is to be prevailed upon by force and quality. After numerous long stretches of affliction, Beowulf came to think about the predicament of Hrothgar. He sails to Denmark with an organization of men to battle against the beast. This activity is additionally to offer his thanks towards the lord for some help his dad got before. Gallant code of that book requests quality, fortitude, and dedication in warriors. The ruler is relied upon to have political aptitudes, accommodation, liberality and so on. The lord and the saint are attempting to set up their own personality. The basic conviction that respect is picked up however deeds is upheld all through the story. Beowulf is dealt with exceptionally by the lord before his brave activity. That delineates the desire for the lord and his devotees. The lord hangs tight for the challenging snapshots of triumph over the beast. Beowulf prevails there. In any case, impediment is going ahead the way. As a saint Beowulf needs to experience another underhanded animal who is the mother of Grendel. The impedance of insidiousness powers is a consistent procedure in human life. As a saint, in real life as well as in contemplations, he never dithers to do such perilous occasions. The change that happens in the life of Beowulf is to be taken in. At the point when h e restores his own nation, he clarifies his gallant deeds to the lord. Beowulf at that point hands over the vast majority of his fortune to Hygelac, who, thus, rewards him. Later he was enhanced as the lord of spot. The warrior and the lord have incredible distinction. Accordingly Beowulf develops from a valiant warrior. He conveys a various arrangement of qualities for every one of his jobs. These dissimilarities can be watched more when we look at Beowulf and King Hrothgar. At the point when the youthful Beowulf, long for individual credit, the old Hrothgar looks for the insurance of his devotees. These are the desires for the general public. The job of an individual is characterized by the general public. Along these lines Beowulf as a ruler is featured more than Beowulf as a ââ¬Ëheroââ¬â¢ in this sonnet. We should believe that the Beowulf-writer has intertwined diverse good frameworks, agnostic and Christian ethics at the same time and therefore the sonnet is a vehicle of Christian ethics. As per Thomas D Hill the Beowulf-artist is a ââ¬ËGermanic humanistââ¬â¢ an antecedent to the renaissance humanist who might accommodate their Christian mores with the extraordinary agnostic personalities that had preceded them. The savagery speaks to one of the poetââ¬â¢s most quick difficulties to settle his Christian confidence and agnostic history. The confidence in pardoning and benevolence which are qualities of Christianity is responded with retribution and fight in agnostic conviction. Consequently in the two fights ââ¬first with Grendel and the second with Grendelââ¬â¢s mother Beowulf attempts to secure his kin. This topic of Christian righteousness gives enough imagery to pass on the Christian good. When dealing with the subject of viciousness, as per
Saturday, August 22, 2020
Veja Case Study Summary Essay Example
Veja Case Study Summary Essay Example Veja Case Study Summary Essay Veja Case Study Summary Essay Contextual analysis Assignment Newman was careless in his activities out and about when he turned into approaching traffic. Julie Mycology is just searching for pay for her wounds. The way that Newman is anything but a full time representative and possibly works when he sees fit makes him a self employed entity that you pay for his administrations. Since he is a self employed entity, you could contend that self employed entities have risk, and this might assist you with protecting your organization against the claim. Elaine going into business and the utilization of the old, utilized tock is an issue since you can't escape or recreate your agreement right now. Because of the way that you both are traders and withstand to the USC, you are not permitted to change the conditions of your understanding. This was Just an awful choice on your part. George not knowing the game plan between the organization and Elaine isn't an issue. Both of you are not to blame for not educating George since he doesn't hold a situation in the corporate office, in this way has nothing to do with what business choices are made. He will potentially attempt to sue for this game plan contending that he is the larger part adamant along these lines, George can sue under Shareholders Derivative Suit, which implies, that since he is an investor, he has the privilege to sue if the organization Is accomplishing something deceptive. For this situation, George will lose the case in light of the fact that despite the fact that this plan with Elaine wasnt brilliant, it wasnt untrustworthy either. In the event that Elaine offers her offers to George, there is a chance of him removing you from your situation as President. In the Articles of Incorporation, it expresses that there are preemptive buying rights on any stocks being sold by any investor.
Friday, August 21, 2020
TLE cooking session Free Essays
Adhere to the directions of the instructor. 2. Remain with your gathering and abstain from setting off to different gatherings. We will compose a custom exposition test on TLE cooking meeting or then again any comparative subject just for you Request Now 3. Dole out each undertaking to each part. 4. Set up the materials and fixings required. 5. Wash your hands before cooking. 6. Wear cover and for the young ladies, they should tie their hair. 7. Handle the sharp materials with care to maintain a strategic distance from mishaps. 8. Clean your place subsequent to cooking. 9. utilize the materials as per Its capacities. 10. Mood killer spigots and ovens when not utilized. TOCINO Ingredients: 3 lbs boneless pork shoulder rost cup lemon-lime pop (sprite or 7 up) 1/3 cup of soy sauce 2 cups earthy colored sugar 1 h cups pineapple juice h ketchup 1 tablespoon garlic, minced 2 tablespoons of salt 1 teaspoon of dark pepper Procedures: 1 . Cut h Inch cuts of pork shoulder and spot In a one gallon zip-lock plastic sack. 2. In a different bowl, blend the remainder of the fixings and afterward add to the meat. Seal the pack, while attempting to evacuate abundance air. Let the pork fix Inside the cooler for 4-5 days, turning the sack over consistently. . In the wake of restoring, you can either cook the meat or segment them off Into littler sacks and freeze. 4. To cook the Toclno, include a little water, marinade and a couple of cuts of meat to a skillet. Over medium warmth, let the fluid boll off and afterward fry the meat for two or three minutes to carmellze It. Cause sure not to consume the meat. Cured VEGGIES WITH CHILLIES white radish 3 carrots 3 chillies 2 cups vinegar sugar 1. 1 lbs salt 1 OF2 1 . Cut the carrots and radish vertically. (finger size) 2. Cut the chillies corner to corner. 3. Put all the vegetable in a holder. 4. Include some salt and leave it for 5 minutes. 5. Press the vegetables to discharge its blends. 6. Wash it with water. 7. Put sugar and bubble it. 8. Chill it for 5 minutes. MANGO JAM Mango ascorbic corrosive water 1. Set up the materials and the fixings. 2. Cut the Mango. 3. Blend the Mango, sugar, and water. 4. In the wake of blending, bubble it and include 2 tablespoons of ascorbic corrosive. 5. Blend it until it becomes clingy and brilliant earthy colored. 6. Following 20-15 minutes, prepare it and it is to serve. The most effective method to refer to TLE cooking meeting, Papers
Tuesday, May 26, 2020
The Most Disregarded Fact Regarding Best Mba Essay Samples Uncovered
The Most Disregarded Fact Regarding Best Mba Essay Samples Uncovered Lies You've Been Told About Best Mba Essay Samples Your essays can play a crucial function in communicating to the admissions committee why they ought to consider you over thousands of different applicants. Admissions officers would like to know who you are. They want to know what excites you. Admissions committee officers are on the watch for the finest possible candidate profiles. The Little-Known Secrets to Best Mba Essay Samples More to the point, the essays that follow are most likely to supply comfort, that there's no formula or singular means to craft a thriving answer. To successfully answer the question, there are a couple of things you will need to continue in mind. After editing is done, your thoughts, voice, and style stay intact. You should have your reasons, and our principal concern is that you wind up getting a great grade. As a result, if you're searching for an urgent writing assistanc e, then mba-essay. As our group of writers is pretty big, we always have free writers keen to bring a manageable and well-paid purchase. You may always request help from our writers. Brilliant and superior work! Top Choices of Best Mba Essay Samples Whoever developed the. When contemplating the optional essays, it is going to be important to choose topics that will enable you to demonstrate both achievements on the job and your extracurricular or individual activities. Students utilize online MBA essay writing services so as to increase their likelihood of selection. Quality customized essays uk. Details of Best Mba Essay Samples The whole paper needs to be free of errors. Handling plagiarism Typically, plagiarism is no problem. Our essay prompts are extremely personal in nature and we would like to get to understand the applicant as best as possible. Essay writing tips You want to take a while to think about a few fundamental questions. Yes, the essay is a really sig nificant part your application, but it is not the only part. MBA essays can be difficult to write, but they are among the most essential components of the MBA application approach. Your application essay is a distinctive chance to assist you stick out from the crowd. An MBA admissions essay is a significant portion of the MBA admissions process. Using Best Mba Essay Samples There's, naturally, a limit on the variety of pages even our finest writers can produce with a pressing deadline, but generally, we figure out how to satisfy all the clients seeking urgent assistance. Showing the initial result to somebody who knows you well could be a fantastic way to establish the potency of a working draft. So you don't need to pay for something upfront, once you aren't certain in case you'd use the service. As you proceed through the procedure, you will realize a more powerful, logical and impactful version emerging. The Best Mba Essay Samples Cover Up MBA adcoms wish to realize tha t you've got a particular direction in mind and that you've got valid reasons for your choices. Understanding how to best write MBA essays will help to make your entire MBA experience considerably more pleasant. An MBA from LBS is an ideal choice because it will equip me with the abilities and knowledge required to produce a professional small business program, finance new ventures, assess the worth of an organization, and make a self-sustainable enterprise. Find out more about tips to boost your MBA. You probably meant to think long and difficult about it. You should explain specifically why School X is critical to your success. Students lead busy lives and frequently forget about a coming deadline. Essay about police services. Whatever you decide to write, it's essential that you discuss the way that it contributes to your distinctive perspective. Candidates opting to submit an essay may wish to use their words wisely to provide the reader a feeling of who they are and h ow they'd improve the IE community. You let us know how you wish to construct your package and we are going to provide you with a quote. You already understand how bad plagiarizing is, but when all the stresses of life, work, and greater education combine you might be tempted to throw decent sense out the window. The Demise of Best Mba Essay Samples Next, you have to discuss how an MBA can help you attain both your short-term and long-term targets. An MBA is a critical part of my career objectives, and as such plays an important part in achieving my life objectives. Not just any MBA should get the job done for your targets. You may not be as specific about companies or job titles when speaking about your long-term targets, but it doesn't indicate you shouldn't have a strategy. If you intend to switch careers and don't have the track record to demonstrate you're serious about your objectives, it's going to be handy to reveal your commitment through research you've done, extracurricular activities you've been involved with, or relevant accomplishments in your present-day position. Make sure you are able to clearly demonstrate the way your past and present career and individual experiences support your aims, and why you have settled on your individual aspirations. Think about it as a work application where you must demonstrate how your skills will assist a company achieve their objectives. If you are studying thoroughly you're already capable of writing a strong essay, however you will want to verify whatever you say with credible sources. Whether you must generate a paper of special flawlessness, ju st get an essay here and our writers will provide help. Your essays ought to be in a position to join the dots and finish the picture. Your MBA essays are your very best opportunity to sell the individual behind the resume. Do not merely use exactly the same essays for many schools. Take care to prepare your essays.
Friday, May 15, 2020
Argumentative Essay on Banning Cigarettes Do You Support It
One of the most debated topics on the globe is smoking and the movements for banning it. Youââ¬â¢re a lucky student once youââ¬â¢re assigned with the task to complete an argumentative essay on banning cigarettes! The thing is that this topic can be approached in many different ways and itââ¬â¢s up to you to decide which one youââ¬â¢d like to choose. Letââ¬â¢s imagine like youââ¬â¢re one of those cigarettes anti-fans eager to ban this harmful habit once and for all. What kind of arguments one can suggest to prove that smoking should be banned in bars, restaurants and all other public places? No more second-hand smoking! It is a well-known fact that second-hand smoking is one of the cancer causes. Second-hand smokers receive the same amount of harmful nicotine and other chemicals as the real smokers. Once smoking is banned, the amount of people who suffer from second-hand smoking will be reduced. Make sure to support your viewpoint with the statement that second-hand smoking reduction will also minimize the risk of cancer. Cigarettes banning will help smokers to quit Each smoking ban leads to a decrease in the number of cigarettes. With every banning law more and more smokers make a decision to quit altogether. In accordance with the information provided by the Mayo Clinic Nicotine Dependence Center representatives, the number the brain receptors that are longing for nicotine increase from the inhalation of tobacco. Once the number of receptors begins to decrease the need to have ââ¬Å"just one more cigaretteâ⬠decreases too, which, in turn, results in no smoking. All the bans also give smokers one more reason to quit smoking for it is really inconvenient to spend hours searching for a place where smoking is allowed. No more heart attacks! In accordance with the Journal of the American Heart Association, the cities where smoking in public places is banned have less heart attacks in comparison with the areas where smoking is allowed everywhere. Make sure to give enough space for statistics within your essay. It is recommended to mention that almost 225à 000 cases of heart attacks (per year) can be prevented by means of smoking bans. Provide real-life examples of the fact that smoking bans tend to lower the risk of heart attacks not only among smokers, but also among the people who do not have this habit. Samples Download this sample Paper title: Argumentative Essay: ââ¬Å"Learning To Save Energyâ⬠Academic level: College (3-4) Discipline: Sociology Paper Format: APA Sources: 0 Pages: 4 Download this sample Paper title: Argumentative Essay: ââ¬Å"The Problem of Consuming Resourcesâ⬠Academic level: College (3-4) Discipline: Environment Paper Format: MLA Sources: 0 Pages: 2 Download this sample Paper title: Argumentative Essay: ââ¬Å"Graduating University and Further Recruitmentâ⬠Academic level: College (3-4) Discipline: Education Paper Format: APA Sources: 2 Pages: 4
Wednesday, May 6, 2020
The Doctrine Of Freedom Of Contract - 1504 Words
The particular focus of this essay is on how terms are implied. This is central because the courts intervene and impose implied terms when they believe that in addition to the terms the parties have expressly agreed on, other terms must be implied into the contract. Gillies argued that the courts have become more interventionist in protecting the rights of contracting parties thereby encroaching upon the notion of freedom of contract. The doctrine of freedom of contract is a prevailing philosophy which upholds the idea that parties to a contract should be at liberty to agree on their own terms without the interference of the courts or legislature. Implied terms can be viewed as a technique of construction or interpretation of contracts. It has been argued that the courts are interfering too much in their approach to determine and interpret the terms of a contract. The aim of this essay is to explore this argument further and in doing so consider whether freedom of contract is lost due to courts imposing implied terms. The essay will outline how the common law implies terms. The final part of the essay will examine whether Parliament, by means of a statute, or terms implied by custom restrict freedom in a contract. An overall conclusion on the issue will be reached. On the one hand it is evident that terms implied at common law can be ââ¬Ëimplied in lawââ¬â¢ or ââ¬Ëimplied in factââ¬â¢. Terms implied as a matter of fact are said to give effect to unexpressed intentions of theShow MoreRelatedThe Business Law Short Essay1215 Words à |à 5 PagesUnfair Contract Terms) Act 2015 ()will affect from 12 November 2016. it has changed some sections to the Australian consumer law. Last version of this law only applicable to the individual consumer, Act 2015 extend the scope to the small business that employs fewer than 20 persons. This thesis will discuss the following questions; ï µWhat is an unfair term under the new law and when will it apply? ï µWhat is the legal effect if a court decides a contract term is unfair? ï µExplain the doctrine of freedomRead MoreEssay about The Criticism of Social Contract Theories1232 Words à |à 5 Pagesï » ¿Tatum Schneidmiller Justice Theory Assignment #1 Ward Churchills criticism of social contract theory clearly applies to classic social contract theories that we discussed.à However, Rawls adds the veil of ignorance concept to his more modern social contract theory.à A) Explain the basics of Rawls and Churchills arguments and how they each criticize classic social contract theories.à B) Discuss whether or not Churchills argument applies to Rawls modification and explain how and why it doesRead MoreThe Rules Of Law Must Be Prepared1632 Words à |à 7 Pagesbind itself by contract. A sufficient reason to enforce a promise is based on a free will of exchange between the parties. The orthodoxy on the doctrine of consideration is described as incoherent, uncertain in scope and inconsistent with the intention of the parties. Lord Goff observed in White v Jones that[ [1995] 2 AC 207, at 262 - 3.]: Our law of contract is widely seen as deficient in the sense that it is perceived to be hampered by the presence of an unnecessary doctrine of considerationRead MoreAt Will Employment Law1374 Words à |à 6 Pagesto cancel the contract at any time without consequence. ââ¬Å"Employment at-will means that employers are able to terminate ones employment at any time, for any cause - with or without noticeâ⬠, Rogers, S. 2012. By the late 1800ââ¬â¢s the doctrine ââ¬Å"At Will Employmentâ⬠was established in the United States. The principle was valued at first by the employers because it allowed the employers to have exclusive freedom as to how they could operate their companies. The principle of this doctrine also gave theRead MoreAffirmative Action On Equal Rights1655 Words à |à 7 PagesUniversal Human Rights declaration states that all human beings have a natural right to equal freedoms thereby providing the basis for proactive measures to guarantee the enjoyment of equal rights in employment. Discourse on the controversial employment edicts of affirmative action and exceptions to the at-will employment doctrine signify the ambiguity in the implementation of the declaration on equal freedoms. White-male employees feel that the preferential treatment of women and racial minorities atRead MoreThe Racial Contract And Sexual Contract Affect Poverty1495 Words à |à 6 Pagesthey are inferior, u nequal to men. How do the racial contract and sexual contract affect poverty? Using Howard Zinn or other class readings, provide specific examples of what Mill calls: An expropriation contract An exploitation or slavery contract a domination or colonial contract Some ways that the racial contract affect poverty is the ?color-coded distribution of wealth?.1 Most of the worlds wealth is controlled by whites.1 The sexual contract can correlate with poverty in which some societies areRead MoreThe Law Of Obligation Is A Private Law1672 Words à |à 7 PagesIntroduction Throughout history, the law of obligation has held such prodigious value in the face of private law. Being the heart of both Contract and Tort law, it is a pervasive phenomenon of our social life. Both Tort and Contract law protect the rights, and ââ¬Ëthat protection cannot be legitimately compromised to achieve the aim of just distributingââ¬â¢ . This proposition may be true in the late 19th century, in the present time, however, the law of obligation has been ââ¬Ëbuilt on the law of its predecessorsRead MoreMonetary Compensation For A Loss, Detriment, Or Injury? Essay1488 Words à |à 6 Pagesdefined as ââ¬ËMonetary compensation for a loss, detriment, or injury to a person or a person s rights or property, awarded by a court judgment or by a contract stipulation regarding breach of contractââ¬â¢ (1). Also referred to as liquidated and ascertained damages, liquidated damages are damages whose amount the parties agreed upon during the formation of a contract which the injured party can claim as compensation upon a specific breach, unlike unliquidated damages which are not specified in detail in theRead MoreAssignment 2 ââ¬â Employment-At-Will Doctrine. Forsha Anderson.1586 Words à |à 7 PagesEmployment-At-Will Doctrine Forsha Anderson LEG500 ââ¬â Law, Ethics and Corporate Governance Professor Lori Baggot April 28, 2017 Introduction The employment At-Will doctrine is in place to allow employment relationships to be restricted. It allows employers and employees to terminate a relationship at any time without cause. The doctrine will allow employees to quit without any fear of being held liable for any inconvenience or disruption to the business at the time of quitting. This doctrine also allowsRead MoreThe Extent and Location of Collective and Individual Bargaining in Britain and USA1435 Words à |à 6 Pagesrepresentatives negotiate a contract with the management regarding wages, hours, benefits, and other terms and conditions of employment, such as protection from termination of employment without just cause. Once the contract is agreed to by the workers committee and management, it is then put to a vote of all workers at the workplace. Primary means of addressing American workersââ¬â¢ needs is through individual bargaining. In contrast to the UK, two facets of the system of individual contract rights in the United
Tuesday, May 5, 2020
Abcd free essay sample
In Parsons Journey the children are the only hope for Afghanistan s future. Do you agree? Children are the only hope for the future of Afghanistan because Varian and the others used to live differently than the other people in Afghanistan. One day Varian found a baby inside a bombed house and she took the baby girl along with her so that she doesnt get bored. Varian found ASPI in a cave who couldnt walk because he lost his leg in the war, ASPI scared Varian by saying that he Is holding a gun towards her and if she comes any further he will be shooting her.Still Varian as not angry or was not offended. Later on when they were friends she took care of ASPI she never use to make fun of ASPI as he Is not having a leg. Varian was a kind of girl who use to take care of everybody throughout the Journey through the villages. We will write a custom essay sample on Abcd or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page When Varian was going through villages, one day she saw a baby crying In a house where his mother was lying beside she said the boy you are Like my brothers height. This shows that Varian was a caring natured girl even If she Is having to many hurdles in her own life. ASPI was rude. E used to shout at Varian by saying bring some food by throwing the pot towards dont like people throwing things to me. .. If you want food go get it by yourself Varian said.. . Again he shouted back saying L cant walk cant you see that? How stupid you are, even though ASPI was rude she never used to be upset about that and still took him with him as he was all alone. Moreover when use to say her plans to ASPI about how she will be escaping from Afghanistan. He said that he was coming with her, Just to annoy her, but that was not the only reason for coming with her. This character shows that she was all et that she will take ASPI and Hosannas along with him to live a better life. Her imagination keeps them going. They found a girl named Leila, she takes them to her house and she also teaches them how to get food from the mines. They decided to stay for a while Varian use to educate ASPI what she knows. When they were out of food and were all hungry she was the one to go to the village and ask for job in change of food. Her dream was to live forever happily in green valley where there will be no bombs or no mine and they will live happily ever after.
Tuesday, April 14, 2020
Application of Evidenced
Introduction Sackett et al (1996) defined Evidenced-based practice (EBP) based on medicine as, ââ¬Å"the conscientious, explicit, and judicious use of current best evidence based in making decisions about the care of individual patience, furthermore EBP involves integrating individual clinical expertise with the best available external clinical evidence from systematic researchâ⬠(cited in Social Work Resources, 2010).Advertising We will write a custom essay sample on Application of Evidenced-Based Practice in Autism specifically for you for only $16.05 $11/page Learn More Individual clinical expertise constitutes those adeptness and judgmental aspects a professional clinician builds over time as a result of field experience and practice. While on the other hand, external clinical evidence constitutes precise research built from the sciences of medicine but reflecting patient-focus clinical research that largely involves, ââ¬Å"correct and meticul ous diagnostic tests, the power of prognostic markers and the efficacy and safety of therapeutic rehabilitative and preventive regimensâ⬠(Social Work Resources, 2010, p.1; Curtin, 2008). Autism is a disorder that affects a childââ¬â¢s social and communication skills. In many instances, these children have a problem in interpreting the usual messages and signals, experience difficulty in social relationships, have problems in development of play and imagination, always appear resistance to change in routine, and lastly, these children normally demonstrate to possess unique skills and talents in art, music and even science (Autism Reality, 2007). Demonstrating numerous social problems and with no particular specific medicine available to treat the disorder, this paper tries to answer a question that arises as to how well can Autism children be clinically and ââ¬Ësociallyââ¬â¢ treated based on a communication intervention program in an effort to integrated them properly in the society. Treating disability based on Evidence-based practice Debate has persisted for a long time about how mental health problems have manifested themselves in those individuals with different degrees of disability. Broad consensus is that individuals who manifest mild learning disability can be diagnosed by adopting criteria usually used for the general population. These criteria include, International Classification of Disease-10, adopted by World Health Organization in 1993 and the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) adopted by the American Psychiatrist Association in 1994 (Raghavan and Patel, 2005). These treatments have been a challenge to victims who demonstrate severe to profound learning disabilities.Advertising Looking for essay on psychology? Let's see if we can help you! Get your first paper with 15% OFF Learn More Individuals with such disabilities have problems that are more individualized in form manifested as behavioral disorder, and for them to have better forms of treatment, there is need for assessment that is qualitative in nature, case study approach using person-centered planning models and behavioral approaches such as functional analysis. When there is no adequate recognition of the mental health problems specifically to those with learning disabilities, the victims experience major effect on their general well being, personal independence, productivity, and quality of life. At the same time, the family of the victim gets affected together with other caregivers. When learning disabilities combine with mental ill health, victims may always experience stigmatization and prejudices that sometimes lead to social exclusion. Treatment for the victims has generally involved differential diagnosis of challenging behavior and mental health disorder which in turn has resulted in numerous and serious consequences with regard to understanding the therapeutic needs of these people with disabilities. Du al diagnosis has become complex and sometimes confusing in nature whereby, various practitioners have not understood the form and types of needs of people with learning disabilities and sometimes who experience mental health disorders (Raghavan and Patel, 2005). Evidence shows that people with dual diagnosis have intricate needs, which in most cases are poorly identified, and in most cases, these people receive fruitless therapeutic services. Providing therapeutic care in addressing mental health problems and learning disabilities requires in-depth understanding of the biopsychosocial dimensions of learning disability (Raghavan and Patel, 2005). This has led to search and identification of a systematic process of identifying needs and providing appropriate interventions to meet the needs. Further, providing care for these people needs to be undertaken with professional integrity, respecting the individuality, rights, and choices of the people.Advertising We will write a custom essay sample on Application of Evidenced-Based Practice in Autism specifically for you for only $16.05 $11/page Learn More More so, there is a need for thorough assessment of the problems and needs of the people, and this calls for the use of structured assessment processes using standardized screening tools, interview schedules, rating scales and checklists. Treating Autism using evidence-based practice Autism victims demonstrate greater disability with regard to communication skills. They tend to have problem in communication skills, which in general affect their associative social world (Glicken, 2009; Gordon, 2010, p.1). Practitioners adopting and utilizing the broad definition of the EBP have integrated it into communication assessment and intervention for the Autism victims. In general, EBP process takes place based on the following steps: asks a well-built question; search for research evidence; appraise the evidence; apply the evidence; and evaluate the effectiveness of the application (Matson, 2009; Neville and Horbatt, 2008). At the same time, to effectively carry out this evidence-based practice process, the practitioner requires to: assess and incorporate stakeholder perspectives into the communication assessments and interventions; identify and select the most relevant, adequate and effective empirically validated procedures and adapt the procedures to suit the unique elements of individual children; and gain and apply the requisite clinical expertise to effectively apply and evaluate assessment and treatment procedures (Matson 2009; Olszyk 2005). Evidence-based practice puts much emphasis on incorporating stakeholdersââ¬â¢ perspectives in the implementation of assessment and intervention. Stakeholders in this context include direct stakeholders, who are recipient of the intervention; indirect stakeholders, who may involve family members of the child; immediate stakeholders, comprising peers and teachers; and extended s takeholders, the various people the child may interact with (Matson, 2009).Advertising Looking for essay on psychology? Let's see if we can help you! Get your first paper with 15% OFF Learn More Incorporating stakeholders plays a significant role in communication intervention since these are the people who constitute the childââ¬â¢s frequent communicative partners. At the same time, inclusion of stakeholders will result into a collaborative interaction between the stakeholders and practitioners in implementing the intervention. When the participation and commitment of stakeholders is effective, then there is likelihood of experiencing successful treatment outcomes and maintaining treatment gains. Moreover, evidence-based practice advocate for incorporation of stakeholders from the beginning when the intervention process is initiated. Selection of appropriate target behaviors and negotiation of stakeholdersââ¬â¢ involvement during the initial stages of designing communication intervention programs for Autism children is important. Critical decisions to make during this stage include the methods and modes of communication that the child will be taught to use and the ini tial communicative skills to target for acquisition (Matson, 2009). In addition, stakeholders need to be taught the full range of speech and non-speech communication modes that include speech, gestures, manual sign, picture communication, and a range of communicative functions that largely involve verbal behavior (Matson, 2009). Evidence-based practice further requires practitioners to utilize procedures that have precise establishment or that are empirically supported. To do this, the practitioner will need to evaluate the nature of the encountered problem; the time constraints; and the level of expertise. In a communication intervention program of Autism children, EBP postulate that there should be flexible use of well-established techniques. In selecting the best empirical procedures for the communication intervention program, practitioners are required to select procedures that: suit the childââ¬â¢s unique attributes and characteristics; practitioners should also collect and use learner-generated performance data to determine if the intervention is fruitful; then the practitioner is further required to understand the fundamental principles that underlie the empirically validated procedures(Matson, 2009). The third aspect of evidence-based practice is that practitioners should utilize relevant educational and clinical expertise in generating and foster an assessment or intervention. The overall requirement of this element is that practitioners should demonstrate exemplary skills in implementing empirically supported procedures and working within a high degree of treatment fidelity (Matson, 2009). At the same time, practitioners are required to constantly update themselves with the new and emerging evidence that characterize the evidence-based practice. Conclusion Autism largely is connected to communication abilities of a child, a situation that later results into the child experiencing disability problems in effectively encoding and decoding communicati ve messages. These communicative disabilities further affect the quality of the childââ¬â¢s life. To effectively address this issue, evidence-based practice has come out as the intervention method that appears holistically to address the needs of the Autism children. Evidence-based practice is seen to integrate the numerous available researches with relevant educational and clinical expertise (Boswell, Gatson, Baker and Vaughn, 2008) without forgetting the key stakeholders in generating effective assessment and intervention decisions that are efficient in treating Autism children. Reference List Autism Reality. 2007. AutismPro-ââ¬Å"Somewhatâ⬠Evidence Based Internet Autism Intervention or Not Evidence Based At All? Web. Available from: http://autisminnb.blogspot.com/2007/11/autismpro-somewhat-evidence-based.html . Boswell, C., Gatson, Z., Baker, D. and Vaughn, G., 2008. Application of Evidence-Based Practice through a Float Project. Nursing Forum, Vol. 43, No. 3. Web. Avai lable from: http://proquest.umi.com/pqdweb?index=64did=1549949831SrchMode=1sid=7Fmt=3VInst=PRODVType=PQDRQT=309VName=PQDTS=1288348111clientId=29440 . Curtin, L. J., 2008. The Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines. The Journal of Continuing Education in Nursing, Vol. 39, No. 9. Web. Available from: http://proquest.umi.com/pqdweb?index=57did=1550210641SrchMode=1sid=7Fmt=3VInst=PRODVType=PQDRQT=309VName=PQDTS=1288347364clientId=29440 . Glicken, M. D., 2009. Evidence-Based Practice with Emotionally Troubled Children and Adolescents. CA, Academic Press. Web. Available from:http://books.google.com/books?id=PpF1yVncGDACpg=PA233lpg=PA233dq=evidenced-based+practice+in+treating+autismsource=blots=j92JXWtuFUsig=ptccFylkpK2nsv6L1u-Sp2gJAEYhl=enei=06HKTO6fENTNjAeFza3TDwsa=Xoi=book_resultct=resultresnum=7ved=0CDIQ6AEwBg#v=onepageqf=false . Gordon, M., 2010. New program helps autistic students transition into ââ¬Ëreal worldââ¬â¢ after high school. McClatchy-Tribu ne Business News, Washington. Web. Available from: http://proquest.umi.com/pqdweb?index=1did=2160184831SrchMode=1sid Fmt=3VInst=PRODVType=PQDRQT=309VName=PQDTS=12883487 0clientId=29440 . Matson, J. L., 2009. Applied Behavior Analysis for Children with Autism Spectrum Disorders. NY, Springer. Web. Available from: http://books.google.com/books?id=gUlW1gA3yyACpg=PA122dq=Evidence+Based+Practice+%28EBP%29+and+Autismhl=enei=BnPKTO_cFYKQjAe7z8HRDwsa=Xoi=book_resultct=resultresnum=1ved=0CCkQ6AEwAA#v=onepageq=Evidence%20Based%20Practice%20%28EBP%29%20and%20Autismf=false . Neville, K. and Horbatt, S., 2008. Evidence-Based Practice: Creating a Spirit of Inquiry to Solve Clinical Nursing Problems. Orthopaedic Nursing, Vol. 27, No. 6. Web. Available from: http://proquest.umi.com/pqdweb?index=50did=2140407801SrchMode=1sid=7Fmt=3VInst=PRODVType=PQDRQT=309VName=PQDTS=1288347363clientId=29440 . Olszyk, R. K., 205. Change in symptomatology and functioning of preschoolers with autism in the context of the DIR model. Pace University. Web. Available from: http://proquest.umi.com/pqdweb?index=1did=885699711SrchMode=1sid=11Fmt=2VInst=PRODVType=PQDRQT=309VName=PQDTS=1288349666clientId=29440 . Raghavan, R. and, Patel, P., 2005. Learning disabilities and mental health: a nursing perspective. Wiley-Blackwell. Web. Available from: http://books.google.com/books?id=5LGzTQPdvAECpg=PA2dq=general+issues+of+evidence+based+practice+in+disabilityhl=enei=EXzKTKfkF4ztOempgIwBsa=Xoi=book_resultct=resultresnum=1ved=0CCcQ6AEwADgK#v=onepageq=general%20issues%20of%20evidence%20based%20practice%20in%20disabilityf=false . Social Work Resources. (2010). Evidenced Based Practice. Web. Available from: http://sophia.smith.edu/~jdrisko/evidence_based_practice.htm . This essay on Application of Evidenced-Based Practice in Autism was written and submitted by user Shatterstar to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.
Thursday, March 12, 2020
Medicines management â⬠an introduction to non-medical prescribing 2000 word case study The WritePass Journal
Medicines management ââ¬â an introduction to non-medical prescribing 2000 word case study 1. INTRODUCTION Medicines management ââ¬â an introduction to non-medical prescribing 2000 word case study 1. INTRODUCTION1.1 . MEDICINES MANAGEMENT1.2 . NON-MEDICAL PRESCRIBING1.3 . CASE STUDY2. PATIENT OVERVIEW3. DIAGNOSIS3.1 . DIAGNOSTIC TOOL3.2. TREATMENT RECCOMENDATIONS4. MEDICATIONà 4.1. GALANTAMINE4.2. MIRTAZAPINE4.3. LORAZEPAM5. LEGAL, ETHICAL AND PROFESSIONAL ISSUES5.1. ADHERENCE5.2. MENTAL CAPACITY5.3. ETHICAL CONCERNS6. REFERENCESRelated 1. INTRODUCTION 1.1 . MEDICINES MANAGEMENT Medicines management can be defined as; ââ¬Å"â⬠¦a system of processes and behaviours that determines how medicines are used by the NHS and patients.â⬠(National prescribing centre,2002, P1). According to Dr Michael Dixon chair of the NHS alliance, Medicines management services are the processes for designing, implementing, delivering and monitoring patient-focused care, based on need, and include all aspects of supply and therapeutic use of medicines within healthcare settings. ââ¬Å"Poor medicines management within organisations can lead to low public confidence in health services, unaddressed health needs and unsatisfactory patient outcomes and can lead to unscheduled emergency admissions or failure to maintain independence in the community leading to re-admission to hospital and other acute care settings. It can also lead to organisational issues such as, unmet targets, inappropriate allocation of resources, inefficient services, and risk.â⬠(Calderdale pct, 2004) ââ¬Å"Good medicines management means that patients receive better, safer and more convenient care. It leads to better use of professional time and enables practitioners to focus their skills where they are most appropriate. Effective medicines management also frees up resources which means that NHS money can be used where it is most effective. Good medicines management benefits everyone.â⬠(npc.co.uk/mm/index.htm) 1.2 . NON-MEDICAL PRESCRIBING ââ¬Å"Non-medical prescribing is prescribing by specially trained nurses, optometrists, pharmacists, physiotherapists, podiatrists and radiographers, working within their clinical competence as either independent or supplementary prescribers.â⬠(npc.co.uk/prescribers/resources/NMP_QuickGuide.pdf) The Department of health recognised that non-medical prescribers are a large and growing workforce. They found that by the end of 2009 there were over 14,000 nurse prescribers, 1700 pharmacist and supplementary prescribers and many community nurse prescribers and allied health professional prescribers that had qualified to prescribe within their competence. (DOH, London, 2009). 1.3 . CASE STUDY This piece of work is a case study of a service user from the authors practise placement area at the time of writing. The case study incorporates three key elements within it; The service user Three medications prescribed to them The legal and professional issues surrounding the above The case study will look at these three elements in detail within the report. 2. PATIENT OVERVIEW (In order to uphold confidentiality, during this report the service user in question will be referred to as ââ¬ËMaryââ¬â¢. (NMC, Code, 2008) Mary is a seventy three year old lady who was admitted to the inpatient practise placement area on the 02/04/2011. Mary has a diagnosis of Alzheimers Dementia and was presenting with increased confusion and according to her care givers (Mary was a resident in a nursing home) had been showing signs of depression and aggression over the last few months culminating in a series of aggressive outbursts which ended in a serious attack on a member of her care home staff. The decision had been made that a hospital admission to the organic illness assessment ward (Older peopleââ¬â¢s services) was necessary to manage risk, assess the progression of Maryââ¬â¢s condition and reassess her package of care. Mary was initially resistant to all interventions from the ward team and displayed high levels of agitation and aggression. The consultant and nursing team felt that medication would play an important role in the management of Maryââ¬â¢s initial presentation. However Maryââ¬â¢s resis tance to any therapeutic interventions meant that alternative approaches were felt to be the only option at the start of treatment. John was also given a capacity assessment and found to lack capacity which allowed the ward staff to treat Mary effectively in her best interests. (For Maryââ¬â¢s pen story see appendix 1) 3. DIAGNOSIS Mary has a diagnosis of Alzheimersà Dementia. The Alzheimerââ¬â¢s society explain the term dementia describes a group of symptoms these include a decline in memory, reasoning and communication skills a gradual loss and decline in the skills needed to manage the individuals activities of daily living , confusion and a change in behaviour or personality. These symptoms are caused by the physical impact of disease or injury on the brain. There are a number of different conditions that lead to dementia including Alzheimers disease. (alzheimers.org.uk/site/scripts/documents_info.php?documentID=160) 3.1 . DIAGNOSTIC TOOL ââ¬Å"Making a diagnosis of dementia is often difficult, particularly in the early stages The time it takes to make a diagnosis can vary. If scans and other investigations are required, it could be 4-12 weeks. If the person is in the early stages of dementia, a 6-12 month period of monitoring may be required before a diagnosis can be made.â⬠(alzheimers.org.uk/site/scripts/documents_info.php?documentID=121) ââ¬Å"The Mini Mental State Examination (MMSE) is the most commonly used test when a diagnosis of Dementia is being considered The MMSE is the test that the National Institute for Health and Clinical Excellence (NICE)à recommends for deciding whether a drug treatment for Alzheimers Disease should be prescribed.â⬠(http://guidance.nice.org.uk/DT) However NICE do stress it should not be relied on as the only means of assessment alone as diagnosing dementia involves careful monitoring and assessment. 3.2. TREATMENT RECCOMENDATIONS ââ¬Å"Treatment for Dementia should only be initiated and supervised by a specialist experienced in the management of Dementia.â⬠(BNF, 2009, P280) 4. MEDICATION ââ¬Å"Being prescribed a medicine is arguably the most frequent intervention in the NHSâ⬠(Shepherd, 2002). Maryââ¬â¢s medication was reviewed on admission to the inpatient ward due to her aggressive and volatile presentation. For the purpose of this report three of the medications Mary was prescribed will be discussed in detail. à 4.1. GALANTAMINE ââ¬Å"Acetylcholinerase inhibiting drugs are used in the treatment of Alzheimers disease, specifically for mild to moderate disease.â⬠(BNF, 2009, P280) Galantamine is a medication used to treat moderate Alzheimers dementia disease. Alzheimers occurs as a result of atrophy of the cerebral cortex. The disease causes changes in central neurotransmitter function especially the cholinergic system. It is linked to a lack of sufficient acetycholine levels. Evidence also points to raised levels of glutamate (a neurotransmitter). Galantamine is one of the centrally acting inhibitor of acetylcholinerase. It is a reversible acetylcholinerase inhibitor medication which works by increasing levels of acetylcholinerase in the synaptic cleft of central nervous system neurons. Galantamine is used to ââ¬Ëslowââ¬â¢ neuronal degeneration by impeding further atrophy of the cerebal cortex. Evidence for the drug relates to an individualââ¬â¢s cognitive enhancement, however there is no cure for Alzheimers dementia and so medication is purely palliative. (Aarbakke, J et al, 2006) Interactions of Galantamine from a patient safety perspective include:- Warfarin effects are enhanced. Antipsychotics and barbiturates effect is reduced (Johns dose of Zuclopenthixol increased to counteract this) Muscle relaxants effects are modified. Dosage of Galantamine must be carefully considered and the individualââ¬â¢s renal functioning and Creatinine levels must be checked prior to treatment. Side effects of Galantamine include:- Nausea Sleep disturbance Headache Dizziness Drowsiness and fatigue Depression (Treated with Mirtazapine in Maryââ¬â¢s case) (BNF, 2009, P281) Mary was prescribed Galantamine Hydrobromide (Reminyl XL) a prolonged release medication. The Scottish medical consortium state Reminyl XL is recommended for the treatment of moderate Alzheimers dementia and allows a reduction in dose frequency and is as cost effective as immediate release forms of Galantamine. (scottishmedicines.org.uk/files/reminyl_XL_Summary_Advice__FINAL__for_website.pdf) 4.2. MIRTAZAPINE Mirtazapine is a medication used to treat depression. Theories explain the cause of depression as a neurobiological change resulting in too little Noradrenaline and 5HT in some central nervous synapses. Mirtazapine is an Atypical antidepressant. It is a presynaptic alpha2 adrenoreceptor antagonist and increases central noradrenergic and serotonergic neurotransmission which then increases the release of noradrenaline. Mirtazapine has an antihistamine effect with sedative effects and so is beneficial to Mary due to her agitation and restless presentation. Mirtazapine is also suitable for older adults due to its anticholinergic effect. (Aarbakke, J et al, 2006) Interactions of Mirtazapine from a patient safety perspective include:- Alcohol ââ¬â Sedation increased Warfarin ââ¬â Enhances anticoagulant effect Anxiolytics and hypnotics ââ¬â Sedation increased. Mary is also prescribed Lorazepam at present and this is monitored closely when given for over sedation. Withdrawl from Mirtazapine must be staggered due to side effects of withdrawing. (medicinenet.com/mirtazapine/article.htm) Dosage ââ¬â Mary is on a titrating dose of Mirtazapine and so may be experiencing side effects which she is not used to and may cause her further distress. It was important that Mary be monitored closely and reassured during this time. Side effects of Mirtazapine include:- Increased appetite and weight gain (regular weight assessed and diet chart commenced) Oedema Sedation (Mary is monitored closely for over sedation due to her other medications sedative effects) Dizziness and headache Postural hypotension (Maryââ¬â¢s blood pressure is checked daily) ââ¬Å"Mirtazapine causes few antimuscarinic effects and is therefore recommended over Trycyclic antidepressantsâ⬠(BNF, 2009, P215). 4.3. LORAZEPAM Lorazepam is an Anxiolytic. Benzodiazepine anxiolytics are indicated for use short-term in anxiety states. However they are also used as an adjunctive therapy at the beginning of anti-depressant treatment to ease the initial worsening of symptoms, as in Maryââ¬â¢s case. Interactions of Lorazepam from a patient safety perspective:- Respiratory Depression- (Mary was monitored and physical obs taken post dose) Sleep apnoea syndrome (Mary was on arms length observation levels anyway) Severe hepatic impairment Myasthenia Gravis Side effects of Lorazepam include:- Drowsiness Lightheadedness Confusion Ataxia Headache Hypotension (Maryââ¬â¢s bp was taken on a daily basis) Confusion and Ataxia may be particularly apparent in elderly and should be closely monitored. (BNF, 2009,P189) 5. LEGAL, ETHICAL AND PROFESSIONAL ISSUES Therapeutic interventions which involve the prescribing and administration of medications have legal, professional and ethical implications. In Maryââ¬â¢s case these included the following issues. 5.1. ADHERENCE One of the problems with medication administration as part of planned care was Maryââ¬â¢s resistance to all interventions from the ward staff. ââ¬Å"People with dementia often have problems taking prescribed medication. They may forget to take it without prompting or supervision, and can lack awareness of their health problems. Some believe they do not need medication as they think there is nothing wrong with them.â⬠(Stapleton, L. 2010) Medication adherence can be improved by applying some simple measures:- Ensure patients know what drugs they are taking, why they are taking them, and when.à Also check that they are aware of any possible side effects, and what to do if they experience them. Check that all patients with dementia are able to take their medication safely by organising dosette systems, and ensure carers can help patients where necessary. Give all patients and their familiesââ¬â¢ information about how to contact the clinic nurse by providing verbal information and written leaflets. Ensure patients have a written treatment plan. (Stapleton, L. 2010) According to Cheesman (2006), adherence is an approach to achieving the best use of medication involving the sharing of information between healthcare professionals and patients. The prescriber can promote an effective therapeutic relationship by building a patientââ¬â¢s confidence in their ability to self-manage their condition. 5.2. MENTAL CAPACITY ââ¬Å"The Mental Capacity Act 2005 provides a statutory framework to empower and protect people aged 16 and over who lack, or may lack, capacity to make certain decisions for themselves because of illness, a learning disability, or mental health problems. The act was fully implemented in October 2007 and applies in England and Wales. If someone is unable to make a decision for themselves at the material time because of an impairment of the mind, then that person can be said to lack the mental capacity to make that decision.â⬠(Alzheimers society, 2011). According to the law, a person is defined as being unable to make decisions for themselves if they are not able to undertake at least one of the following: understand information given to them retain that information long enough to be able to make a decision weigh up the information available to make a decision communicate their decision by any possible means, including talking, using sign language, or even through simple muscle movements such as blinking an eye or squeezing a hand. (Rethink, 2010) Mary was found to lack capacity as she was unable to retain or weigh up the information given to him to make a decision. Mary lacked any insight into her recent worsening of symptoms, changes in behaviour and aggression. This is often the case with dementia disease. ââ¬Å"The act encompasses five main principles: 1à A presumption of capacity âËâ Every adult has the right to make their own decisions and must be assumed to have capacity to do so unless it is proved otherwise. 2à The right for individuals to be supported to make their own decisions âËâ All reasonable help and support should be provided to make their own decisions. 3à It should not be assumed that someone lacks capacity simply because their decisions might seem unwise or eccentric. 4à If someone lacks capacity, anything done on their behalf must be done in their best interests. 5à If someone lacks capacity, before making a decision on their behalf, all alternatives must be considered and the option chosen should be the least restrictive of their basic rights and freedoms.â⬠(Warren, L. 2010) ââ¬Å"When considering a persons views and wishes it is important that they are given weight, and are carried out, unless the effects would be detrimental to that person.â⬠(National archives, 2010) The multi-disciplinary team worked to all these principles in Maryââ¬â¢s case by:- 1. Presuming capacity by letting Mary make decisions until the capacity assessment had been done and a formal plan of care put in place. Mary was also supported to continue to make decisions on a daily basis which she was deemed to have capacity to make e.g. what to wear that day. 2. Support was provided in the form of an Independent mental health advocate (IMHA). 3. Mary was found to have capacity to make certain decisions even if they seemed strange to the ward staff. Staff supported her in this. 4. Mary had a best interest assessment and the findings were used to formulate a comprehensive care plan for Mary. 5. The MDT sought input from the deprivation of liberty safeguarding team (DOLS) around the intervention decisions with Mary to ensure they were applying the least restrictive care. 5.3. ETHICAL CONCERNS When working with people with dementia ethical practise should be considered as dementia is a long-term illness with no cure. Treatment is purely palliative and the evidence for the benefit versus drawbacks to treatment is not fully understood. (www.mind.org.uk) Foot Anstey solicitors explain that Advance directives and lasting power of attorneys put in place can ensure that the service user receives the treatment and care they want when they are no longer able to voice their requirements themselves. (www.repod.org.uk) Healthcare professionals must make the service user the centre of care decisions in the service userââ¬â¢s best interests to uphold ethical practise. 6. REFERENCES Aarbakke, J et al, (2006) Illustrated Pharmacology for nurses. Hooder Arnold, London. Alzheimers society (2011). Diagnosis and assessment. [Internet] Available from: alzheimers.org.uk/site/scripts/documents_info.php?documentID=260 [Accessed on 5/4/11] British National Formulary (March 2009) Galantamine, pg 281-282, BMJ and RPS, London. British National Formulary (March 2009) Mirtazapine, pg 215-216, BMJ and RPS, London. British National Formulary (March 2009) Lorazepam, pg 188, 190 BMJ and RPS, London. Calderdale pct, (2004) Improving health, improving lives: commissioning strategy for Calderdale. [Internet] Available from: calderdale.nhs.uk/fileadmin/files/Public_Information/Publications/Strategic_Plan_Appendix_1.pdf [Accessed on 6/4/11] Cheesman S (2006) Promoting concordance: the implications for prescribers.Nurse Prescribing; 4: 5 205-208. Dixon, M (2010) Modernising medicines management. A guide to achieving benefits for patients, professionals and the NHS, Executive summary. National prescribing centre, (2001) [Internet] Available from: npc.nhs.uk/developing_systems/intro/resources/library_good_practice_guide_mmmexecutive_summary_2002.pdf [Accessed on 10/4/11] Fittock, A. (2010) Non-medical prescribing by nurses. National prescribing centre [Internet] Available from: npc.co.uk/prescribers/resources/NMP_QuickGuide.pdfà à à à à à [Accessed on 6/4/11] MedicineNet.com, Mirtazapine index. [Internet] à Available from: medicinenet.com/mirtazapine/article.htm [Accessed on 30/1/11] Modernising Medicines Management. A guide to achieving benefits for patients, professionals and the NHS. National Prescribing Centre, (2001). [Internet] à Available from: npci.org.uk/medicines_management/medicines/medicinesintro/library/5mg_intro_to_mm.php [Accessed on 6/4/11] The National Archives (2010) Mental Capacity Act, 2005. [Internet] Available from: legislation.gov.uk/ukpga/2005/9/part/1 [Accessed on 10/4/11] National prescribing centre (NHS) Medicines management [Internet]. Available from: npc.co.uk/mm/index.htm [Accessed on 9/4/11] Non-medical prescribing programme, (2009) DOH, London. [Internet] Available from: dh.gov.uk//TheNon-MedicalPrescribingProgramme/index.htm [Accessed on 5/4/11] Nursing and Midwifery Council. (2008). The code: Standards of conduct, performance and ethics for nurses and midwives. [Internet].à Available from: nmc-uk.org/Nurses-and-midwives/The-code/The-code-in-full/ à [Accessed on 10/4/11] Rethink National Advice and Information Service. (2010). Mental Capacity Act 2005. [Internet] Available from: rethink.org/living_with_mental_illness/rights_and_laws/laws_you_need_to_know_about/mental_capacity_act.html [Accessed on 12/4/11] Scottish medicines consortium (2004) NHS Scotland, Treatment for Alzheimers dementia [Internet] Available from: scottishmedicines.org.uk/files/reminyl_XL_Summary_Advice__FINAL__for_website.pdf [Accessed on 13/4/11] Shepherd, M. (2002). Medicines. Nursing Times,à VOL: 98, ISSUE: 15, PAGE NO: 43 [Internet] Available from: nursingtimes.net/nursing-practice-clinical-research/medicines/206461.article [Accessed on 12/4/11] Stapleton, L (22 Nov, 2010) Can nurse prescribing improve medication concordance in people with dementia?. Nursing Times, 106:46 [Internet] Available from: nursingtimes.net/nursing-practice/clinical-specialisms/prescribing/can-nurse-prescribing-improve-medication-concordance-in-people-with-dementia/5022174.article [Accessed on 11/4/11] Warren, L (2010) Mental capacity Act, 2005 Factsheet. [Internet] Available from: alzheimers.org.uk/site/scripts/documents_info.php?documentID=354 [Accessed on 5/4/11]
Monday, February 24, 2020
You can choose the topic Essay Example | Topics and Well Written Essays - 1500 words
You can choose the topic - Essay Example These finding are alarming and it is a clear call to revisiting safety and health measures at work places. However, work related risks are different in the various sectors with some holding higher risks than others are. This implies that some of the safety and health measures and conditions may differ and hence all organizations should ensure that safety and health measures provided are in line with the risks related to the specific sectors. Therefore, it is the responsibility of every organization to ensure the safety and health of its entire workforce at all times. For instance taking a scenario of a company manufacturing high tech composite components for the US defense department, there are a number of measures that can be taken to ensure safety and health of its workforce. Such companies as the one in reference require significantly many safety and health measures due to the nature of activities carried out in the organization. For starters, the company should ensure to have a well written safety program addressing all the common accidents in relation to the companyââ¬â¢s activities. Additionally, the safety program should address all necessary steps that should follow in case of an accident. In manufacturing industries, accidents are prone to happen from time to time therefore it is important to identify some of the most common accidents prone to happen. In a bid to ensure accessibility and frequent revision of these particular accidents, the company can produce some printed copies and attach them on various appropriate sites within the company. Furthermore, it is necessary that the company keeps on updating the written safety program as new accidents occur. With such a program, the entire workforce including new recruits can be alerted on these a ccidents thereby becoming more cautious in dealing with equipment or events attributed to these accidents. In line with the Occupational Safety and Health Administration (OSHA) safety and health
Saturday, February 8, 2020
The Traditional Pedagogical Method of Learning Assignment
The Traditional Pedagogical Method of Learning - Assignment Example Teachers have to provide motivation and further encourage the student to continue exploring and questioning the matter. It is important for the students to learn to apply what the teacher has delivered as information. This educational goal can be achieved if they learn how to think abstractly. The teacher has to equip them with the tools to critically evaluate situations and problems and then determine by themselves the solution. This happens when the teacher uses strategies and concepts that build skills required for productive collaboration. Students have to construct their own meaning despite the directions and teaching methods of the teachers (Science for all Americans 1990). Through the principles of learning and teaching, the learning environment also encourages students to develop their independent and interdependent learning abilities. The teachers should establish an atmosphere where the students can learn both individually and with each other. Such tasks can be beneficial especially for young students who still orient themselves in the educational setting. Learning usually occurs when students have the opportunity not only to express their ideas but also to get feedback both from their peers and teachers (Science for all Americans 1990).
Wednesday, January 29, 2020
I Have a Dream Essay Example for Free
I Have a Dream Essay Martin Luther King Jr. was born in Atlanta, Georgia on January 15th 1929. He was a pastor, activist and the prominent leader in the African American civil rights movement and is often presented as a heroic leader in the history of modern American liberalism. He is most famous for his speech called ââ¬Å"I have a dreamâ⬠. It is about not being segregated or discriminated against and to have equal rights between white and black people. It is now recognized as one of the greatest speeches in history. Martin Luther King used a number of rhetorical devices in his speech. The main rhetorical device used throughout the speech is repetition and parallelism. In each paragraph he repeats different sentences to emphasize what he is saying. He repeats phrases such as ââ¬Ëone hundred years laterââ¬â¢, ââ¬Ëwe can never be satisfiedââ¬â¢, ââ¬ËI have a dreamââ¬â¢ and ââ¬Ënow is the timeââ¬â¢ to make the listener remember the parts he wants to emphasize. It is effective because the people are anticipating it so then they can join in. Also later on in life people will look back at the speeches and remember it for certain phrases because of the repetition. Martin Luther King also uses inclusive pronouns in his speech, for example we, our and addressing the audience as brothers and sisters. ââ¬ËThe sons of former slaves and the sons of former slave owners will be able to sit down together at the table of brotherhood.â⬠He makes the audience feel as though it is there duty as well to overcome the discrimination and try and make all the southern states of America united and equal. He also makes the audience feel like it is their dream too and not just his. Martin Luther used different parts of the English language to enhance the meaning of his speech and bring out the details. The different rhetorical devices, allusions to historic documents, and metaphors seemed to have brought about the emotions that King was trying to arouse in his listeners. This helped him influence his listeners towards wanting equality for all and changing what was happening in the present so they didnt repeat things in the past.
Tuesday, January 21, 2020
A Brief Analysis of The Steel Industry Essays -- Industry
Steel Industry In the early part of this century was a time when industry was booming with growth around the installation of major railroads. With this growth came the transatlantic cable, the telegraph, and a whole lot of steel. Steel would be needed in the construction of these new transportation systems and communications were now possible between businesses and industries. (Wren, 2005) This paper will first discuss the development of the steel industry. Next, it will examine steel, and in the impact it had on the transportation industry. Finally, it will discuss systematic management practices of this time and how they gave birth to the scientific approach that is still in use today. Steel The steel industry was needed for almost everything. Alfred D Chandler Jr. could see the potential market value early on. According to Wren: Chandler traced the history of various firms and delineated four phases in the history of the large U.S. enterprise: 1. The initial expansion and accumulation of resources 2. The rationalization of the use of resources 3. The expansion into new markets and lines to help assure the full use of resources; 4. The development of a new structure that rationalized the renewal of growth. For many companies, the phases started and ended at different times, depending on the state of technology and the firmââ¬â¢s ability to react and capitalize on market opportunities. Chandler further noted two facets of industrial growth: 1. Horizontal growth from 1879 to 1893- which occurred when producers of similar fields combined through mergers, pools, or trusts to gain economies of scale, and 2. Vertical growth from 1898 to 1904- which occurred when firms moved backward or forward in ter... ...vents/pande01.html English Online. (Ed.). (n.d.). The Industrial Revolution. Retrieved April 23, 2012, from English-online.com Web site: http://www.english-online.at/history/industrial-revolution/industrial-revolution-manufacturing.htm History.com. (Ed.). (n.d.). Andrew Carnegie. Retrieved April 23, 2012, from History.com Web site: http://www.history.com/topics/andrew-carnegie Kernsanalysis.com. (Ed.). (n.d.). An Overview of Management. Retrieved April 24, 2012, from Fredrick Taylor Scientific Management Web site: http://www.kernsanalysis.com/sjsu/ise250/history.htm Vectorstudy.com. (Ed.). (2008). Henri Fayol Management Gurus. Retrieved April 25, 2012, from Vector Study.com Web site: http://www.vectorstudy.com/management_gurus/henri_fayol.htm Wren. (2005). The History of Management Thought (5th ed.). Danvers, MA: Wiley & Sons. (Original work published 1976)
Monday, January 13, 2020
A Look Into The Arts Essay
Art is one aspect of the past that has carried on for decades. Art in any form may it be poetry, novels, and playwright, sculpting as well as painting, has been an outlet for generations and continues to be an outlet and a means for expression. This paper will discuss ââ¬Å" The Mona Lisaâ⬠one of Da Vinciââ¬â¢s most famous paintings, as well as another great painting, Antonio Venezianoââ¬â¢s ââ¬Å"Virgin and Childâ⬠(c. 1380). Both paintings focus on the human form and exhibit many variations of styles from lines, shading, color and possible meanings behind the work. The first piece of artwork that will be looked is from the Renaissance Era. Da Vinciââ¬â¢s ââ¬Å"Mona Lisaâ⬠(c. 1519) a painting that is known around the world, which has been known to cause skepticism as to who is this woman. Did she really exist? Or is this merely a self-portrait that Da Vinci was able to show his private devotion for the female form? The second piece of artwork that will be discussed is from The Middle Ages. Antonio Venezianoââ¬â¢s ââ¬Å"Virgin and Childâ⬠(c. 1380) both pieces of art work stem from different eras but share many commonalities as well as shows the transformation of art techniques from Sfumato, to perspective, as well as linear perspective, Humanism, foreshortening and more between each era. In the Early Renaissance Era, artists from Da Vinci, Michelangelo, Raphael Sanzio, Piero della Francesca, Sandro Botticelli and more, developed a passion and ability to create art that could capture a moment may it be a beautiful moment or tragic moment. These artists were also able spark creativity and question in the human mind as to what is or was and why. Much like the middle Ages, art from both eras focused on religious forms, humanism, from the finite details of a lock of hair to the muscle tone. The Renaissance era developed the linear perspective to create; depth and angles in work, though the Middle Ages opened the door for linear perspective to be created. Most depictions from the Middle Ages showed a human form that was stiff and schematic, like a rough draft that was never completed. However art from the Renaissance Era had a profound effect on European art. Lilian H. Zirpolo (SNHU. ââ¬Å"Chapter 8.â⬠2012 FAS 201, Introduction to Humanities I.) Stated ââ¬Å" The outburst of creativity of the era, resulted in the most influential artistic revolution ever to have taken place.â⬠There was so much depth and thought put into Renaissance art that it was the stepping-stone for all who dared to create. Da Vinciââ¬â¢ s the ââ¬Å"Mona Lisaâ⬠(c.1519) holds Miss. Zirpoloââ¬â¢s statement to be true. When viewing the piece, one can see the exquisite line work and Foreshortening, to linear perspective. This art form shows his attention to detail and his passion for his work. The ââ¬Å"Mona Lisaâ⬠(c.1519) is a small piece of artwork that became very popular. To this day the ââ¬Å"Mona Lisaâ⬠(c.1519) still triumphs over Michelangeloââ¬â¢s ââ¬Å"Creation Of Adamâ⬠(c.1511), which became a part of the ââ¬Å"Sistine Chapel.â⬠(C.1512) When one views ââ¬Å"The Mona Lisaâ⬠they can see the dark color scale that is used, perhaps to depict an unhappy time. Da Vinci through out this piece is able to use an aerial perspective within the background of this portrait. Da Vinci was the first artist to successfully depict an aerial perspective. Da Vinci also uses Sfumato in his negative space by blending, blurring and softening the landscape, this technique is used to create a gradual transition between areas of different color, avoiding sharp outlines, to which I believe was done as to not take away the focal point in his positive space of the canvas. Another great aspect to the ââ¬Å"Mona Lisaâ⬠is that is demonstrates the art of science discoveries that came to fruition in the Renaissance period, which is that they were able to acknowledge how the eye perceives light, thusly how light reacts with colors and how the human eye adapts to the change in color and light. So why is that of any significance in art? Well when one takes a painting such as the ââ¬Å"Mona Lisaâ⬠once can see how the color gradation changes to separate the neck and face from her clothing. It creates more of a realistic feel to the art. The Middle Ages on the other hand focused on two-dimensional compositions, their depictions of humans were frail and stiff, and the human art form was inert. (SNHU. ââ¬Å"The Middle Ages.â⬠2012 FAS 201, Introduction to Humanities I.) Like art from the Renaissance, they also focused a lot on Religion, saint hood and humans. In fact it depicted the importance of humans based on the size they were painted or sc ulpted. It focused on women and God, as the two were of major importance at the time. Woman we scared and givers of life and love, their beauty was unfounded and they were cherished. God was the almighty and the one who created a life form that woman were there to carry on the tradition, so to speak. Is it believed through the Bible and studies that Jesus was born into this world as a miracle from a virgin. So Antonio Venezianoââ¬â¢s ââ¬Å"Virgin and Childâ⬠(c. 1380) upholds that belief and leaves room for discussion. In the early times of God and Mary and the birth of Christ it was believed that Immaculate Conception was possible, as pre-martial sex was a sin. So to have depictions of such a scene may make one wonder if it was at all possible at one point in time. This picture depicts a Virgin mother coddling her newborn, both are pictured with a ââ¬Å"haloâ⬠above their heads which signifies the importance of their religion and the acceptance of religion into not only their life but into Gods life. As you can see here as well as in the ââ¬Å"Mona Lisaâ⬠there is a contrast between light and dark as to separate the two bodies and distinguish the Virgin from the Child. In a personal opinion in the color choice of the Virgin as compared to the Child, I would say that light colors are used for the child because he is born pure and free from sin, where as the Virgin is with sin and thusly wears a dark robe. Art from the middle ages depicts religious events, because it was the basis of life at the time. Most art from that time were done by artists who either choose to or had to be anonymous, they we for the most part two dimensional pieces of art work with a single color background, which when looking at Antonio Venezianoââ¬â¢s ââ¬Å"Virgin and Childâ⬠(c. 1380) one can see how this, the background is primarily one color, it has been shaded to show detail in the halo and architect, but holds close to the standard for Middle Aged era art. Though the painting is set fourth to show a natural pose of a mother and child, the line work and attention to detail in the human form lacks. This painting though a well painted, blends the line work of the bodies making the figures seem almost uncomfortable in their poses. The colors used in this painting may foreshadow an unhappier time for the two, as dark colors tend to represent tragic, mournful and displeased events. As one can see the ââ¬Å"Mona Lisaâ⬠from the Renaissance and the ââ¬Å"Virgin and Childâ⬠from the Middle Ages, share many similarities in terms of their impressions of humans. Both eras focus their art on humanism, religious, two and three ââ¬â dimensional works of art, the hatching used to create depth and more dimensions. Both the Renaissance and the Middle Ages have very different ways of executing the precision of the human form. The Renaissance paid very close attention to detail, the line work that is depicted in the human form is natural and lifelike, and where as artists from the Middle Ages who painted humans were stiff and motionless. Though both Eras have great works of art, it was the Renaissance that had more of a well-rounded and idealistic way of executing their work, thusly making it one of the better Eras for art. Resources Page: SNHU. â⬠Chapter Seven The Middle Ages.â⬠2012 FAS 201, Introduction to Humanities I. SNHU. â⬠Module Eight The Renaissance, Reformation and Age of Exploration.â⬠2012 FAS 201, Introduction to Humanities I.
Sunday, January 5, 2020
Industrialization in Hard Times by Charles Dickens
The industrial revolution was an era of mechanization. During this era, in 1854, Charles Dickens (1812-1870) wrote Hard Times to comment upon the change within society and its effect on its people. Dickens points out the flaws and limitations of this new society in his eloquent and passionate plea on behalf of the working poor (Charles Dickens Hard Times, 2000). The novel shows presents to readers the authors perspective of life during the nineteenth century and makes comments on the central theme of fact versus fancy. Due to this theme, the novel ends with many characters realising that a person needs more than just fact in their life. The novel examines the utilitarian system through various characters such as Tom, who has been broughtâ⬠¦show more contentâ⬠¦This shows that, even though Tom has been provided with what was believed to be the finest education, ad has learnt every Ology, he is still extremely selfish and uses people to his own will and benefit. Tom has turned o ut to be a very corrupt man and, being a product of the utilitarian system, Dickens uses Tom to declare that this system does not work. Dickens portrays the idea that the utilitarian system has drained all the goodness of human nature through the symbolic description of Sissy and Bitzer within Hard Times. For example, when Sissy and Bitzer are introduced to the reader, it is evident through the symbolism used that Dickens favours Sissy, of the lower class. The girl was so dark eyed and dark haired, that she seemed to receive a deeper and more lustrous colour from the sun when it shone upon her, the boy was so light eyed and light haired that the self-same rays appeared to draw out of him what little colour he ever possessed (p50). This passage is significant because it reveals Dickens opinion of the utilitarian system. It is no coincident that Bitzer, the boy who was educated under the system of fact has been described as colourless while Sissy, the poor and uneducated girl, has been described as lustrous. The colour symbolises the fancy while the paleness represents the fact and through the above passage Dickens states that Bitzer is being filled with so much fact that it is draining all theShow MoreRelatedEssay on Industrialization and Utilitarianism in Dickens Hard Times1505 Words à |à 7 PagesIndustrialization and Utilitarianism in Dickens Hard Times à à Charles Dickens uses his fictitious town in Hard Times to represent the industrialization of England at that time or close to it. Most of this representation, however, isnt accurately described compared the way things really were during industrialization. It is important to remember throughout this paper that not only is Hard Times a work of fiction, it was meant to be a satire, a parody of ideas and ways of thinking atRead MoreEssay on Themes, Symbolism, and Atmosphere in Dickens Hard Times1376 Words à |à 6 Pages When Charles Dickens was writing his commentary on a fast industrializing world, the thought that Hard Times would still be relevant over 150 years later is assumed to be far from the forefront of his mind. And yet at present, 158 years after its first publication, Charles Dickensââ¬â¢ tale of industrialization and its implications still holds a prominent place in todayââ¬â¢s society. The following is one interpretation of Dickensââ¬â¢ story of an industrialized dystopia, and discussed are its ever-relevantRead MoreA Social Morality Of The Victorian Age1355 Words à |à 6 PagesOscar Martin Professor Stephen Mendonca English 2323 2 August 2015 A Social Morality The Victorian age ranged from 1830 to 1901, during this time England reached its highest point as a world imperial power. Industrialization and the reign of Queen Victoria (1837 to 1901) played a major role in Englandââ¬â¢s success. The overwhelming industrialization caused a population boom that changed Englandââ¬â¢s population from two million to six million people. The abundance of people created new social problemsRead MoreThe Effects Of Industrialization On English Towns Essay1730 Words à |à 7 PagesHard Times symbolizes the negative effects of industrialization on English towns (Coketown in the story) including education. Charles Dickens was born in 1812, and was a contemporary of the Industrial Revolution. Industries were growing by leaps and bounds; bringing with it pollution, social imbalance and individual confusion. Dickens was rather poor and had no proper education. At the age of 12 he worked in Warrenââ¬â¢s Blacking Factory attaching labels to bottles. He labored hard to educate himselfRead MoreCharles Dickens Hard Times1494 Words à |à 6 Pages May 1, 2015 Mr. Johnson Literature Dickens Calls for Desperate Measures in Hard Times ââ¬Å"I want to change the world.â⬠How many times is that line heard from small children, aspiring to be someone who achieves their maximum potential? If a child is asked how they might go about doing so they might respond with an answer that involves a superhero or princess who helps people for the greater good. As one grows and adapts to their surrounding society, the art of seeing the big picture includingRead More Improving Society Through Individuals Essay876 Words à |à 4 PagesEngland underwent a period of industrialization and urbanization, referred to as the Industrial Revolution. During this time, life became more difficult for a large majority of the citizens and hardships began to pile one on top of another. In the book Hard Times, by Charles Dickens, the lives and relationships of a range of people from this time are illustrated in order to demonstrate the nature of this society. Dickens uses the fictitious characters in Hard Times as examples of the varying degreesRead More Social Classes of Industrial England in Charles Dickens Hard Times548 Words à |à 3 PagesEngland in Charles Dickens Hard Times In his novel, Hard Times, Charles Dickens used his characters to describe the caste system that had been shaped by industrial England. By looking at three main characters, Stephen Blackpool, Mr. Josiah Bounderby, and Mr. Thomas Gradgrind, one can see the different classes that were industrial England. Stephen Blackpool represented the most abundant and least represented caste in industrial England, the lower class (also called the hands) in Charles DickensRead MoreThe Industrial Revolution through the Eyes of Charles Dickens1149 Words à |à 5 Pageseveryday activities could maximize productivity and efficiency. Charles Dickens explores the dangers of neglecting emotions and imagination in his novel Hard Times. Dickens separates Hard Times into three books: Sowing, Reaping and Garnering in order to reveal the negative consequences of industrialization and forsaking imagination for facts through the events, settings, and characters in the novel. In Book the First: Sowing, Dickens introduces the destructiveness of the wrong kind of education onRead MoreThe Great Expectations Of The Industrial Revolution1528 Words à |à 7 Pagesgovernments who viewed them as having little to no civil rights outside of their parents wishes, and Charles Dickensââ¬â¢ Great Expectations helps bring some of these conditions to light. The times of the Industrial Revolution were the root of child labor issues. Laborers were in greater demand than ever, and not enough men or women could fill their needs; children were cheaper and easier to control. At that time, the government didn t establish a minimum age, wage, or working hours. Children of all agesRead MoreTreatment towards Migrant Workers1241 Words à |à 5 PagesTreatment towards Migrant Workers Within In the novel Hard Times by Charles Dickens and the novel The Grapes of Wrath by John Steinbeck both express a theme of vulgar treatment toward migrant workersââ¬â¢ and even towards anyone who was different and did not fit into their society. Both of novels tell great stories of disasters that have happened during the course of history. Throughout history, humans have been victimized by poverty. Poverty always turns up after a life changing event occurs. Events
Subscribe to:
Posts (Atom)