Gender Differences in Religious Belief Essay Example for Free

Gender Differences in Religious Belief EssayCritically examine the race amidst gender, religious participation and religious organisation Studies of religious belief verify consistently that the distaff gender shows greater participation to pietism than that of males. This greater commitment to religion described by sociologists such(prenominal)(prenominal) as Bensen applies throughout the course of the womans life, and as noted by Glock and Stark, their greater take to religion is consistent regard slight of the religious organization, whether it be New Religious movements, New Age spirituality, or traditional faiths. Beit-hallahmy and Argyle state that whether it is a motion of undercover churchgoing or private prayer and regardless of religious belief women appear more religious than men.Religions universally have been found to be deeply oppressive to women, born from ancient teachings indicating their inferiority to men. Writers wish de Beauvoir and Sadwai see relig ion and religious ideology as playing a part in maintaining male subordination that is found in many aspects of contemporary social life. In religious scriptures women take the lesser position De Beauvoir highlights how scriptures in most religions raise that man is master by divine right and Aldridge explains how in the Quran women ar legally inferior to men.Why, then, do women pursue a faith which encourages their oppression, more so than the gender with the power to dominate it? Biological factors begin with Miller and Hoffmans explanation that women take fewer risks than men and as a result strain to conform to a groups religious identity rather than undertake the challenge of authority and autonomy. Men more often reject the religious beliefs of the mainstream and engage in risk-taking behaviors. According to Stark this risk taking inclination in a man to not think ahead means that men are less religious because they are willing to take a gamble on there not being an afte rlife. However sociologists like Freese and Montgomery debate this competition works on an assumption that everyone makes the same risk assessment when in fact men are just more prepared to take that risk.Roth produced a study which showed there to be a smaller gap between genders in the percentage who believe in an afterlife but a elephantine gap in those who give attendance and prayer to religion, suggesting women just infix actively more than men. Armstrong states that biological differences between men and women gave way to male domination patriarchal montheism has replaced polysthetic beliefs which promoted the role of the female person in society, for which evidence was found by archeologists in the form of old statues of goddesses. He argues that natural male aggression was the calamus use to manipulate religion into a patriarchal institution.The socializations built upon this biology, are of men to be strong and domineering, and of women to be passive, obedient, and nurt uring, which according to Mol, are the qualities associated with religiosity. Miller and Hoffman progress that gender socialisation makes women more cooperative and caring, and this posterior leads to many explanations for their greater participation in religion. One is their role of guardians in family life. Bruce states that womens child tutelage and rearing experiences for instance develop their traits as nurturers as opposed to confrontational and goal seeking.Luckmann further explains that women have a greater responsibility for rearing children and participate to a lesser degree in the labor force, leaving them with more time for church-related activities and a greater need for a source of personal identity and commitment. Women are more likely to take on the task of the moral development of their child along with the rest of their duties in socializing a child. there is an expectation for women to be defenders of tradition and Halman and Draulans note that these roles giv e women a greater focus on the family. Luckmann also highlights how womens role as a woman of the house gives them lesser participation in the labor force, leaving them with more time for church-related activities and a greater need for a source of personal identity and commitment.They are more likely to experience status frustration, born from the constraints of housework and child wish or the unsatisfying lower middle class jobs which are mainly make by women. Religious participation can reinstate identity and give women focus, because where men gain individuality through work, women revive their low sense of deserving through religion. Religious faith and practice can enhance psychological public assistance by being a source of comfort to women in propagation of distress and by enhancing their social interaction with others in places of worship. More responsive and sensitive personality traits in a woman mean they are more likely to contemplate emotional wellbeing and not on ly seek solace in religion bit find meaning and purpose in life. Personality was be attested as a key factor by Thompson, who found that men who possess those qualities more commonly found in women, such as sensitivity , were similarly more likely to be religious.Reasons other than oppression that lead a higher percentage of women to respond to their surroundings and pursue happiness through religion are the increased levels of poverty they experience. Official figures show women are 14% more likely than men to lie in households with incomes that are 60% below the national average. More frequently diagnosed mental illness and depression in women can explain their higher constituent to religion, as cults, sects as a social network and comfort for women outside the isolation of the home or of their minds. Womens tend to be more point-blank about sharing personal problems and are more relational than men which is encouraged in the close knit community of a sect.The intimacy of the private sphere can also replicate womens sphere of the home whilst theodicies explaining their feelings and offering solutions justify their role as a woman. New Religious Movements such as cults are also generally more popular with women because of cult focus on self-discovery and extent, which correlates with the female inclination towards self-criticism and self-improvement, due to their suffering higher levels of marginalization and lack of self-confidence. Some evidence contradicts the male role as non-spiritual however, as Davie found there is an equal spiritual confidence in the existence of ghosts between genders. A key to understanding modern womens higher participation in religion is the shifts in demographic trends.Brierlys study found that in 1979 the proportion of male church goers were 45% but in 1989 it had dropped to 42%. The ratio of live females to live males rises steadily and correspondingly a disproportionate piece of elderly women seek refuge in the church i n response to loneliness or consoling philosophy nearing the end of their lives. Davie explains how women are more actively responsive to religion because males and females have differing visions of God males associate him with power and status whereas women associate with his traits of love, comfort and forgiveness which explains their greater involvement in community religions.They are more concerned with people orientation than control. Female differences in nature also explains the particular appeal of New Age ideas revolved around well-being and stress relief. Concepts such as herbalism, yoga and meditation, homeopathy, aromatherapy and massage, horoscopes, astrology, fortune-telling are strongly associated with females, according to Glendinning and Bruce. This recent marketization of religion often promotes earthly concepts which are more linked to femininity and female empowerment than the tradition of male domination.Mother Gaia, the theory of Mother Earth as a living entity , is more appealable to women for instance. Womens heightened spirituality can be attributed to their greater role in biological life processes. Walter and Davie see women as more emotionally exposed to the ups and downs of life because of childbirth, and their nurturing role as teachers, care assistants, social workers, and so on, and also the expectation that they be unpaid carers for vulnerable family members.This heightens their sensitivity and attunes the spiritual dimension of human existence, because as Davie argues, these factors give women a impending association with birth and death which are generally central concepts of religion. As females live longer than men some studies have shown that many widowed women whitethorn turn to religion for the comfort of reassuring philosophies and social networks. It is possible that some women take refuge from some of the theoretical oppressions bore by religion. Swatos talks of the fulfilment that can be had from being a second class citizenship. Feminist writers like Walby and be Beauvoir suggest that the doctrine of many of the worlds religions have an ideology of the family which emphasises womens traditional roles as wives and mothers in the family. Some women, however, are happy to take on this role.Barrett and Pryce, for instance, highlight how Rastafarianism assumes the womans position as a housewife and mother as a protection from sexual and racial abuse in the outside world. On one hand this gives eventual(prenominal) power to men by denying female participation to society in the name of protection, but some more introverted Rastafarian women may please this safety within the sphere of the home. A similar contradiction of female subjugation is the veil whilst Aldridge notes the hijab in Islamic cultures as a symbol of patriarchy, degrading women to a state of invisibility and keeping them devoid of identity, some women find anonymity to be protective from the judgement and sexual degradation of men. A developing number of Western Muslims have taken to wearing the veil to in fact reinstate a female identity separate from their face writers like Ahmed and Watson argue that the veiling of ones face can be a way to resist the patriarchy and sexual objectification of Western culture which views women as visual objects. Faiths as a majority oppose the admission of women to leadership in religious organisations.A pun of the stained glass ceiling is used as a pun by sociologists to explain how women are maintained at the bottom of the career ladder to authority within the church, and barred exclusively from the priesthood in Roman Catholicism and Orthodox Judaism, which is seemingly discriminatory, but perhaps female role models within religious doctrines presented as meek and nurturing figures have had such an influence on the identity of a religious women that they feel more comfortable in a non-domineering role. Examples can be taken from any religion proving the sub-ordinance of women taught by most faith systems.The socialisation of women to be obedient and take on the follower role means they are further likely to be a willing follower of religion. Overall social, psychological, and biological factors interlink to form explanations for greater female participation in religion and religious organisation. The gravity of female relation to religion as an explanation, compensator, duty, and social outlet mean that their commitment is likely to persist regardless of the injustices and subjugations it bears upon the gender.

Anabel Family problems Essay Example for Free

Anabel Family jobs EssayOne year later. After implementing the ethnography students achievement plan, the students have developed well. Although not all in all were able to meet all the goals I set to them at the beginning of the teach year, each champion of them was able to excel this year. Since all of them have difficulties in reading, writing, spelling, and Mathematics, teaching was basically the same. However, for each ones special needs, the approaches were different.Some of them were found to be real good in peer to peer tutoring while separates were good in one on one tutoring. Aside from academic struggles, problems on manner, anger and frustration watchfulness and lack of confidence were common among them. Dukes and co-authors (2007) argues that problem behavior is causes risk in the impressive teaching and learning strategies and excessively with the safety and convenience of both the students and the teachers. Thus, while honing their academic skills, I als o had to be concerned about each other behavior problem.Different strategies like joining what they would not want to do and what they want to do in one activity was found effective to hike up the child to do what he needed to do. Letting them feel that they were good in some skills encouraged them to learn take down to a greater extent than. Although a lot of strategies regarding behavior problems exist, not all are found to be effective. Some teachers would prefer to do punishments with problem students but this would not frequently change the students behavior. Some researchers would purpose the functional behavior assessment (FBA) technique (Dukes et al, 2007).Functional behavior assessment (FBA) is the process of identifying the events that reliably predict and maintain problem behaviors before an intervention is laid (Scott, Nelson, Zabala, 2003). Such process requires a school-wide or perhaps district-wide training so that FBA entrust be properly implemented. Moreover , the parents were also counseled so that childrens learning could continue at home. A careful guidance of both parents and teachers was still found to be the most effective among all processes of handling a child with special needs.It may also be noted that teaching self management requires follow up procedures especially from the teacher. Some may expect that effective self management would require independence from the teachers and parents, children with disabilities need continuous follow up and monitoring (Sears, 2006). On a more personal note, the students were not just the only learners in the sessions. I also gathered more learning and insights for this school year. Although the students were not aware, the teacher was able to observe them personally.The students have taught me to have more patience, more kindness, and even the technical aspects of teaching special children. Indeed, special education must be put into a higher respect, love, and passion for teaching. More th an a profession, teaching was more of motherhood to these children who have special needs that are needed to be given in a special way. Three among my five students were able to go through the goals of the course while the other two need more time. Anabel, ascertain and Henry fulfilled most of the goals I set for them at the beginning of the school year while Jessica was not able to improve a lot.Lastly, Juan dropped out due to financial problems and problems about his health. The highest among the five is Mark who was able to achieve all the goals. His determination and parents support was present throughout the school year. If this would continue, he bed excel to class even more in the next grade level. His parents were very thankful because he was able to make them proud whereas Mark was sure inspired by them. They would continue to support them and promised that they would always cooperate with the teacher for Marks continuous learning.Second was Anabel who almost achieved al l the goals too. This lovely young girl had shown her potential and allowed the teacher to help her develop these. Her behavior was never been a problem towards the end of the school year. She was very willing to learn and wanted to learn even more. Also, her lack of self confidence improved. She was more interactive and participates more in and out of class. The least was Henry. This was duly because of his problem attitude. He refused to participate and failed to show willingness to learn.He was not able to improve a lot because he did not want to practice and follow my instructions to him. He was not able to behave well in class. Thus, I plan to handle with this problem behavior first before really forcing him to study, which is never convenient for him and for me. Jessica is still young. Like Henry, her behavior had hindered her development. Thus, she must undergo behavior management procedures. Also, her parents are also advised not to let her do what she wants to do just to ma ke everything be fine.She needs to be treated in a way that she will learn how to follow authorities and when to do what she does not like to do. This lovely girl has the potential. She only needs to become more responsible so that she can focus more on her tasks. Her great sociable characteristics should be honed so that she will continue to learn more things to more people. Lastly, for Juan, he needs more constant medication with his doctor. I still talk to his parents so that Juan could continue to go to school because he sure has potential. Case Study I Anabel Family problems lots hindered Anabel to come to class.Since her family is not financially stable, some of her needs like school supplies and others stuffs needed to school were not duly given to her. Moreover, she was greatly affected by the fights of her parents and refused to come to class at times. Sometimes, while her mother was out to work, she was left to attend to her younger brother. Family problem is perhaps the greatest dilemma for the young psyche of Anabel. It hinders her self development and only adds up to her hang ups. Thus, I advised her parents to undergo marriage counseling not only for their children but also for their family sprightliness as a whole.

Swot Analysis Is Use For Strategic Planning Marketing Essay

Swot Analysis Is Use For Strategic Planning Marketing endeavorIntroductionIn a parentage world the strategical planning is necessary for running musical ar head for the hillsment successfully and go their objective as well. The strategic planning is done in numerous way, all atomic number 18 beneficial for the business. For this such an depth psychology is need to done in organisation such as, prep be compendium, PEST analysis, and so forth Such an analysis is done within the organisation and some of the analysis is done in outside of the organisation. As in machinate analysis the intensitys and weakness is the analysis which made inside in organisation and opportunities and threats are the analysis of outside the organisation. In this report major part is shown on fancy up analysis. The company is taken as example is habitual electric. This report shows the pulverization analysis performance on world-wide electric car. The advantages and limitation of General Electri c during rig out analysis is also shown in this report. trick out AnalysisIn the business and organisation for all sorts of situations the SWOT analysis is the useful tool as an unusually for caring and administrative. SWOT is a short form for Strengths, Weaknesses, Opportunities, and Threats. A good framework is provided by the headings of SWOT analysis for re-evaluate direction, side of meat and strategy of a business or industry plan, or any other idea. It is so simple to complete a SWOT analysis, and for the workshop sitting it is an excellent flying field. This SWOT analysis is also works well in brainstorming convention. SWOT analysis is use for strategic planning, marketing, competitor evaluation, business planning, harvesting phylogeny and research and business reports. The SWOT analysis is also use as games of team building exercises.A SWOT analysis measures a business unit, a mesmerism or idea. A SWOT analysis is a subjective assessment of data which are organized by the SWOT format into a pellucid order that helps understanding, presentation, discussion and decision-making. The four dimensions are useful extension of a basic two heading list of pros and cons.SWOT analysis after part be used for all sorts of decision-making, and the SWOT template enables proactive thinking, rather than relying on habitual or instinctive reactions.The SWOT analysis template is normally presented as a grid, comprising four sections, one for each of the SWOT headings Strengths, Weaknesses, Opportunities, and Threats. The free SWOT template below includes sample questions, whose answers are inserted into the relevant section of the SWOT grid. The questions are examples, or discussion points, and obviously foundation be altered depending on the subject of the SWOT analysis. Note that many of the SWOT questions are also public lecture points for other headings use them as you find most helpful, and make up your own to suit the issue being analysed. It is impor tant to identify clearly the subject of a SWOT analysis, because a SWOT analysis is a perspective of one thing, be it a company, a product, a proposition, and idea, a method, or option, etc.SWOT issues into actions under the six categoriesAlbert Humphrey advocated that the six categoriesProduct (what are we selling?)Process (how are we selling it?)Customer (to whom are we selling it?)Distribution (how does it relegate them?)Finance (what are the prices, costs and investments?)Administration (and how do we manage all this?)Provide a framework by which SWOT issues can be create into actions and managed using teams.This can be something of a leap, and so the stage warrants further explanation. Translating the SWOT issues into actions, are best sorted into (or if necessary broken down into) the six categories, because in the context of the way that business and organisations work, this makes them more quantifiable and measurable, responsible teams more accountable, and therefore the a ctivities more manageable. The other pivotal part in the exhibit is of course achieving the commitment from the team(s) involved, which is partly explained in the item summarising Humphreys TAM model and process.As far as identifying actions from SWOT issues is concerned, it all very much depends on your reasons and aims for using SWOT, and also your authority/ability to manage others, whom by implication of SWOTs breadth and depth, is likely to be involved in the agreement and delivery of actions.Depending on pretext and situation, a SWOT analysis can produce issues which very readily translate into (one of the six) category actions, or a SWOT analysis can produce issues which everywherelay a number of categories or a mixture. Whatever, SWOT essentially tells you what is good and bad about a business or a particular proposition. If its a business, and the aim is to remedy it, then work on translatingStrength ( primary(prenominal)tains, build and leverage),Opportunities (Priorit ise and optimise),Weakness (remedy or exit),Threats (counter)Into actions (each within one of the six categories) that can be agreed and owned by a team or number of teams.If the SWOT analysis is being used to assess a proposition, then it could be that the analysis shows that the proposition is too weak (especially if compared with other SWOTs for alternative propositions) to warrant further investment, in which case further action planning, other than exit, is non required.This is my understanding of Albert Humphreys theory relating to developing SWOT issues into organisational change actions and accountabilities. (Im pleased to say that Albert kindly confirmed that this is indeed correct.)There are other ways of applying SWOT of course, depending on your circumstances and aims, for instance if concentrating on a department rather than a whole business, then it could make sense to revise the six categories to excogitate the functional parts of the department, or whatever will en able the issues to be translatable into manageable, accountable and owned aims.Simple framework of SWOT analysis is a generating strategic alternative from a situation analysis. This analysis is either applicable to the business unit level or corporate level and in marketing plans it appears frequently. The Council of General Electric Growth used this analysis form because it concentrate on the issue that potentially go through the most collision, when there is a express mail time amount is available for addressing a complex strategic situation the SWOT analysis is useful.The diagram of SWOT analysis and how it fits into situation of strategic analysis is shown below.Situation Analysis /Internal Analysis/ StrengthsWeaknessesThe large amount of information can produced by the internal and away situation analysis, among them may not be high gearly relevant. To reduce the information to a convenient amount of key issue the analysis of SWOT can serve as an interpretative filter. Th e SWOT analysis classifies the internal aspects of the company as strengths or weaknesses and the external situational factors as opportunities or threats. Strengths can serve as a foundation for building a competitive advantage, and weaknesses may hinder it. By understanding these four aspects of its situation, a firm can wear out leverage its strengths, correct its weaknesses, capitalize on flourishing opportunities, and deter potentially devastating threats.General Electric (GE) is a manufacturing company functioning in a range of section. For use in wind turbines, aircraft, peeing systems, natural gas and oil compressors and more, its infrastructure section produces jet engines and related parts. To end users it is various financial services is offered by the Commercial Finance segment. financial services to the retailers and consumers are provided by the GE Money section. Equipment which use in medical field is manufactured by the Healthcare section and the television net profit services is provided by its NBC Universal section. The Industrial section offers lamps, commercial lighting systems, home appliances, motor and control systems and many others.Internal AnalysisFor internal analysis we can say that it is a complete assessment of the internal environments prospective weaknesses and strengths. Across the organisation it should be appraising such factors in areas such asCompany imageOrganisational structureKey staffBrand awarenessAccess to natural resourcesCompany culture working(a) capacityExclusive contractsOperational efficiencyFinancial resourcesPosition on the experience curvePatents and trade secretsMarket shareAs a list of weakness and strengths it is review the privileged factors by the SWOT analysis.External AnalysisTo make better profits it is the ability to set up service or a new product which this is known as an opportunity. When changes happen in the external environment then opportunities can occur. These numerous changes can be a pparent as threats to the market position of running goods and may require a change in creation provision or the expansion of new goods in order for the firm to tab competitive. The external environment changes may be associated toCompetitorsCustomersSuppliersMarket trendsPartnersAs a list of threats and opportunities the external factors of environmental is analysed and summarized by SWOT analysis.StrengthsThe positive essentials of an organisation or business are their strengths, it is in under their control and they do something well. The strengths are valued to the business or a group, and it can give the edge over the competitors in some areas. The main strengths of GE is outline below. The major plus point of General Electric is having alliances with other strong and popular businesses. It helps GE to stop in new customers and make company further successful. The key to their success for General Electric is to being as a market leader, is as it improve status, market share a nd earnings. General Electric provide and offered original and good products and services, to obtain them General Electrical make most people return to them. The main key of General Electric is their most experienced employees which help GE to drive them forward with capability and knowledge. The other strength of General Electric is its high class machinery, well known staff, good infrastructure offices and equipment. It ensures the job is done to the greatest standard. Regarding profit and sales the General Electric major strength is its spacious customer base. The reputation of General Electric is powerfully popular, which way people believe in it and it is viewed with the respect. General Electric being strong as financial, this helps them to betray and solve any problems which arise. General Electrics essential strength is its strong brand as it is appreciated and accepted. General Electric has the market share with high percentage, which means GE is to the lead of numerous competitors. To ensure that the customers be returns, General Electric have high whole step services and/or products as a cardinal strength. International operations of GE shortenify customers base wider, a stronger brand and a greater large piece of the international market. General Electrics innovation and development are high with observe to their services and/or products. It is the strength of its overall performance. General Electric has a high and strong market position. This is the major strength in this type of industrial area as they are in front of numerous rivals. GE is in front of numerous competitors as their online front end is strong. GEs Research and development department is strong. Number of business acquired by GE. GEs profits and revenues are high. Its culture and organisational structure is strong.WeaknessesUnder their control as organisation or business, their weaknesses are the things which need to be performed better or to be improved. Weaknesses makes th e company in behind with the competitors or may be it stop company to meet their objectives. In this section it is shown the weakness which present in General Electric The performance of General Electric is not mark able in Asiatic market. General Electrical is did not keep and not meet with demand because they have a stock problem. Due to the financial recession the stock prices is low.OpportunitiesOpportunities are the external changes which trends or needs that could improve the company or organisations tactical place, or which could be of a gain to them. The opportunities of the General Electric are shown below. As in the form of training, allowances, grants etc. as governmental support General Electric could benefit from it. An opportunity of technological changes gives the General Electric to strengthen their prospective achievement. It is used to acquire new resources, enter in new market and new customers as the merger and takeover opportunities could be discover for Gener al Electric Towards the corporate social responsibility GE should have to focus more. To maintain their position in the market research and development is done. To improve cash flows they have opportunity to merge and joint venture in Asian market. They have the opportunity of look at natural resources to meet their high demands. It is positive sign for the General Electric as growth in aviation industry.ThreatsThe factor which place areas of the organisation or company risky or may check into damage is called as threats. These factors are outside of the companys control. The main threats of the General Electric are outline below. It require spent the money on regulations or taken the measure which could put pressure on General Electric as financial or other. It is to be a threat or risk for General Electric as entering of the new competitors in the market and extra competition. Price cuts could reduce the profits for General Electric as the price wars amidst competitors. As fluct uation of currency it may impact on the revenues as General electric is operating in many countries. As the other business the same threats of GE is recession. The biggest threat of the General Electric is the regulation of government because in all over the world GE is the fourth major manufacturer of pollution.Analysis and Benefits of SWOT AnalysisIt is well-known that General Electric has several strengths that effort to its gain by striking efficiency. Its worldwide appreciation, competitiveness and strengths put General Electrical at a constructive situation as compared to other businesses in the similar sector. To manage the expensive business the use of company units for organisation presents an successful way. The option of irresistible senior management through work is not only reduces but it also promotes production rooted in liability accepted from the company part managers. It extremely contributes to effectiveness while there are many activities undertaken by company . This is improved with the acquisitions and mergers that have spread the companys manufactured goods range and in sequence foremost to development on returns gain.However the opportunities and strengths have not arrived without constraints. Different weakness and threats intimidate the concert of the business by presenting constraints on the organisations management. High levels of rivalry, threat of information loss and financial crises are a threat to the companys endurance. Weaknesses within the business counting the deprived efficiency of the power division and suppleness threat could collision unhelpfully on the business.The corporation could use the opportunities and strengths to moderate them, in order to decrease the collision of threats and weaknesses. Multiple Perspectives NeededThe quality of the analysis is affected by the method which is used to obtain the inputs to the SWOT matrix. During a speedy discussion with the CEO if the information is obtain hurriedly, althoug h CEO may have a broad view of the corporation and business, the information would signify a single point of view. The excellence of the examination will be better significantly if interview are held with a range of stakeholders such as suppliers, employees, strategic partners, customers, etc.SWOT Analysis LimitationsWhile valuable for sinking a huge amount of situational factors into an additional convenient summary, the SWOT structure has a inclination to generalize the condition by classifying the firms environmental factors into categories in which they may not always fit. The classification of some factors as strengths or weaknesses, or as opportunities or threats is somewhat random. For example, a particular company culture can be either strength or a weakness. A technological change can be a either a threat or an opportunity. mayhap what are more significant than the external classification of these factors are the firms consciousness of them and its growth of a strategic pla n to use them to its benefit.ConclusionAs the SWOT analysis issues is sorting into the six planning category these cans get a scheme which present a sensible way of assimilating the internal and external information about the business unit, delineating short and long term priorities, and allowing an easy way to build the management team these cans achieve the objectives of profit growth.This comes within acquire of captures the collective agreement and pledge of those who will ultimately have to do the work of meeting or exceeding the objectives finally set. It permits the team leader to throttle and develop co-ordinated, goal-directed actions, which underpin the overall agreed objectives between levels of the business hierarchy.GE recognizes that part of being successful and well-respected is being socially responsible as wellHas huge potential to remain successful without any major threats from competitorsStaying PowerWill only continue to expand

Challenges to Project Management in Construction

Challenges to disgorge care in ConstructionBy Aivaras SymanasIntroductionThis exertion subprograms Dreadnought frame as a vehicle for discussion for challenges and of project c are in construction as well as examining risk management strategy, particularly focusing upon the issues that hook from .Challenges to Construction Project ManagementThe complexity of lymph glands demands, in concert with the increasing complexity of the construction manufacturing, particularly as a get out of technological developments, has over the years resulted in specialisation within the industry. Variety of professions have developed as separate skills (e.g. Architecture, Quantity Surveying, ME Engineering etc.) and yet on a small project all of those skills are involved. The key to the management of construction projects is therefore the way in which the contributors are organised so that their skills are used in the right manner and at the right beat for the maximum benefit to the client. There is little point in the construction industry developing its skills if they are not then implemented effectively.(Walker, 2002)Scenario issuesIn addition to the professions already mentioned, every construction project involves many of the following additional stakeholders five-fold regulatory bodies, local residents, statutory undertakers, end users etc. Internal and external stakeholders would be involved in different stages of the project. Early and comprehensive stakeholder identification and analysis, together with regular monitoring and updating, is necessary in order to deal successfully with all stakeholders and defuse many possible project obstacles. (Guerin, 2012)Successful Construction Project ManagementA project may be considered as successful if the building is delivered at the right time, at the appropriate price and quality standards, and delivers the client with a high level of satisfaction. (Naoum Langford, 1989). Effective project management seeks to make su re that these objectives are achieved, but nonetheless, completing large construction projects on time and on budget depends on a high degree of synchronization among many stakeholders which requires the entire team to take a crap in collaboration. The need for collaboration arise and are depended on level of uncertainty, interdependence and complexity of the project.Issues with construction industry and its link with collaboration was recognized in the Latham Report (Constructing the Team) in 1994, and again strengthen by the Egan Report in 1998 (Rethinking Construction)(Gardiner, 2014) .It is fair to say, that collaboration is even more needed in todays industry with its complex chain of supply and introduction of specialist subcontractors and supplier design. Effective collaboration is one of the tools to ensure that stakeholders bottom accomplish the complex sequence of interconnected tasks on time.Tools to achieve collaborationhttp//www.constructionbusinessowner.com/topics/ strategy/construction-company-management/key-successful-construction-project-management social function makingIron TriangleAs mentioned earlier, time personify and quality, in like manner known as iron triangle, is often associated with project success, finding a blameless balance between them, or identifying the priorities of key elements could play a big role of project management.Lawrence Miles developed methodology called value engineering which is used to make problems and identify and eliminate unwanted costs, while improving function and quality. In construction this involves considering the availability of materials , construction methods , transportation issues, site limitations or restrictions, planning and organisation, costs, wage and so on. https//www.designingbuildings.co.uk/wiki/Value_engineering_in_building_design_and_constructionKnowledgeDreadnought project involves major refurbishment works, as well as replacement of existing services. According to (Koehn To wer, 1982) refurbishment work demands even greater supervision than impudent build work, given the increase in labour, together with a corresponding increase in fragmented specialized work and the difficulties associated with unforeseen challenges such as as trump outos findings in demolition stage. The high level of uncertainty in refurbishment projects tends to lead to project over-run. The ability of project motorbus to cope with unexpected change and/or conflicts are necessary as well as knowledge associated with the analysis of project risks. (Smyth Pryke, 2008)Provision of a danger Management StrategyRisk Management is a particular form of decision making within project management, these decisions are made against a influence set of objectives, rules or priorities based upon knowledge, data and information relevant to the issue. (J.Smith, et al., 2009). Nevertheless, it is not possible to have all relevant information on time, or conditions of inwardness certainty and in some cases decisions are ill-founded, not based on a logical assessment of project specific criteria and lead to difficulties later. (J.Smith, et al., 2009). Dreadnought project was intended to be open by 2016, but due.kas nutiko ? the main contractor was liquidated.In construction projects each of the three primary targets of iron triangle entrust be likely to be subject to risk and uncertainty. It follows that a realistic estimate is one which makes appropriate allowances for all those risk and uncertainties which can be anticipate from experience and foresight. Project managers should undertake or propose actions which eliminate the risks they authorise, or reduce the effects of risk or uncertainty and make provision for them if they occur when this is possible and cost effective. (J.Smith, et al., 2009).Most commonly, the Client has an overall risk management strategy and policy included in the strategic documents and quality management systems. main issues concerning proje ct owner risk strategy are risk ownership (which party owns the risk risk exposure and transfer) and risk financing (how to include and use budget risk allowance or contingency). Project planning methods should be utilized to communicate to all parties in a project, to identify sequences of activities and to draw maintenance to potential problem areas. The successful realization of a project exit depend greatly on careful planning and continuous monitoring and updating. Sequences of activities will be defined and linked on a timescale to ensure that priorities are identified and that efficient use is made of expensive and/or scarce resources. The purpose of planning are therefore to persuade people to perform tasks before they delay the operations of other groups pf people, and in such a sequence that the best use is made of available resources and to provide a framework for decision making in the event of change. Project management information systems (PMISs) should forecast the solution of a project in price related to achievement of its objectives. Integrated cost models link time with money. They provide project managers with forecasts to completion in terms of cost, time resource usage and cash flow. Decision about future actions can be made with the best available forecasts in these terms. Cost models also help to overcome an implementation gap between monitoring systems and the managers action. Risk management software (RMS) is the term used to denote a specialist software, which can be used to apply on of the many risk assessment methodologies (e.g. Origami, Procore)It is well known fact that managing risk has two major objectives to avoid the downside risks and to effort opportunities. And very often, the latter has been neglected, as the former has much more to do with securing your project objectives, which for many organizations is priority. But on the hand, the major leaps in project cost and time reduction are results of innovative thinking with focus on exploring opportunities by challenging the risks. The trend today is to establish ambitious goals, to seek for new technological solutions and concepts and to look for effective ways of organizing and managing projects (J.Smith, et al., 2009)To achieve these aims it is suggested that a systematic approach is followed to identify the risk sources, to quantify their effects, to develop management responses to risk and finally to provide for residual risk in the projects estimates. These four stages comprise the core of the process of risk management. Risk Management can be one of the just about creative task of project management. (J.Smith, et al., 2009)ContingencyConclusionConclude recommend there are specific parts to the question, however, there may be a variety of options, it is useful to appraise these before you conclude the conclusion should re-iterate, this may be subjective, if a balanced view is stated, this cannot be wrong, however there essential be a conclusionWord count (excluding References) 2000Guerin, D. M., 2012. Project Management in the Construction Industry, Massachusetts Brandeis University.J.Smith, N., Merna, T. Jobling, P., 2009. Managing Risk in Construction Projects. 2nd ed. Oxford Blackwell Publishing.Koehn, E. Tower, S., 1982. authoritative aspects of construction rehabilitation.. ASCE, 108(C02), pp. 330-340.Naoum, S. Langford, D., 1989. An investigation into the performance of management contracts and traditional method of building procurement. s.l.Brunel University School of Engineering and Design PhD Theses.Smyth, H. Pryke, S., 2008. Collaborative Relationships in Construction. Oxford Blackwell Publishing Ltd.Walker, A., 2002. Project Management In Construction. 4th ed. Oxford Blackwell Science Ltd.

Reflection Has Become An Important Concept In Nursing Nursing Essay

Reflection Has Become An Important Concept In defy Nursing EssayIntroductionIn recent years, reflection has undoubtedly become an fundamental concept in cargon for, stimulating debate and influencing nursing practice and genteelness a fermenting the world. Much has been written astir(predicate) the theory of reflection, the majority of which has been applied to the educational setting (Price 2004). However, the process of reflecting has been described as a transferable expertness which may be incorporated into clinical practice, enabling practiti championrs to better understand themselves and others, and solve problems (Mantzoukas Jasper 2004). so, the capability to reflect consciously upon iodines professional practice is generally considered of the essence(predicate) for the development of education and, hence, for clinical expertise (Mamede Schmidt 2004).Reid (1993) defines reflection as a process of reviewing an experience of practice in order to describe, analyse, e valuate and so protest learning most practice (Reid 1993, p. 305). The nursing profession bes to advocate the need for nurses to be educated and practice in ways that develop their censorious thinking, indecorum and sensitivity to others (Reed Ground 1997). Bulman (2004) contends that reflective practice may provide a means of achieving this. Within an intensifier negociate setting, some evidence exists to suggest a strong relationship in the midst of lived experience and learning, with most critical c ar practitioners learning from previous experience (Hendricks et al 1996). more than recently, reflection has been closely associated with the concepts of critical thinking and deconstruction. It is argued that a combination of these principles create a retrospective and prospective dimension, giving the practitioner the ability to deconstruct events, to reason the origins of situations, and to consider what has gone before and what may happen yet (Rolfe 2005).In order to be effective in practice there is a requirement to be purposeful and finale directed. It is suggested therefore that reflection cannot just be concerned with grounds, but must too focus on locating practice within its social structures, and on changing practice (Bolton 2001). This suggests that a structured approach to reflection is of benefit to the practitioner. Indeed the use of a model or framework of reflection is advocated as a tool which can aid and facilitate the practitioner in reflection, promoting a process of continuous development (Bulman 2004).Reflection is seen as a driving process and not a static one (Duke 2004), and thus the use of a framework which adopts a cyclic approach to reflective practice seems appropriate. one and only(a) such framework is Gibbs (1988) brooding Cycle, which is adapted form a framework of experiential learning, and uses a series of questions to guide, and provide structure for the practitioner when reflecting on an experience. Gibbs (1 988) highlights 6 important areas of consideration when reflecting on a specific situation, encouraging the practitioner to consider what happened, why it happened and what could be done differently in the future. The 6 components of the Reflective Cycle are outlined belowDescription What happened?Feelings What were you thinking and feeling?Evaluation What was good and bad about the situation?Analysis What sense can you make of the situation?Conclusion What else could you possess done?Action Plan If the situation arose again, what would you do?It is clear that the idea of reflective practice has come to have a considerable impact on the nursing profession. This paper w macabre focus on 2 clinical scenarios happenring within an intensive help setting. The issues brocaded will be discussed within the context of Gibbs (1988) Reflective Cycle. The aim in doing so is to highlight the benefits of a structured reflective process, and to identify ways in which clinical practice may be improved in the future.Scenario 1DescriptionThe first scenario concerns the care of an elderly, critically ill forbearing, who was cosmos treated in a surgical intensive care unit. At the time of this scenario the tolerant had been in intensive care for almost 3 weeks, having been admitted with respiratory misery requiring intubation, and displaying clinical symptoms consistent with sepsis. The patient had many other underlying medical exam problems, was morbidly obese, and despite antibiotic therapy was requiring high levels of inotropic and ventilatory support. Despite the patients symptoms, no definite seeded player of sepsis had been identified.The above patient was being cared for by the creator on a 12 hour day shift and at the morning ward round it was noted that the patients condition had deteriorated significantly over the previous 2 days, with increased inotrope dependence and worsening renal function. With few handling options left to try, the consultant anaes thetist decided that the patient should have a CT read to identify or rule out an abdominal problem as a come of the sepsis. The patient was reviewed by a consultant surgeon who snarl that in view of the patients co-morbidity, surgery of any kind would not be appropriate, despite effectiveness positive findings on CT.Kat onceing that a CT scan had been carried out 1 week previously with no significant findings, the root raised concerns about the benefit of such a procedure, and suggested that at the very least the patients family should be informed or consulted about the planned investigation. The patients son had been spoken to the previous day and informed that the prognosis was very poor. Withdrawal of treatment had been mentioned as a possibility in the event of no improvement in the patients condition. The son nonetheless was not informed about the scan which went ahead the same day.Transferring the patient to the radiology department for scan proved difficult. The patien t was sedated for transfer resulting in a need for increased inotropes due to further hypotension caused by the sedation. The patients large size also created a problem in finding an appropriate transfer trolley to take the patients weight. Again the author voiced concerns, stating that perhaps transfer was inadvisable in view of the patients unstable cardiovascular status. The anaesthetist decided that we should proceed with the scan.The patient remained unstable throughout the transfer, requiring a further increase in inotropes on arrival at scan. Whilst on the CT table, the patient became dangerously hypotensive and bradycardic, and it seemed that cardiac arrest was imminent. Adrenaline boluses were administered, and large fluid boluses of gelofusine were also given. In view of this, the CT scan was abandoned midway, and the patient was quickly transferred endorse to ICU. Further adrenaline boluses were needed during transfer.On arrival back to ICU, the author was met by the p atients son, who was not aware that the patient was being scanned. He was made aware of the patients poor condition. hold up in ICU it was decided that further resuscitation was not appropriate. The son was present when the patient died a few proceedings later.FeelingsOn the day these events took place, the predominant thoughts and feelings of the author were ones of guilt and inadequacy. Having considered the multiple health problems faced by the patient at this time, the author felt that the process of transferring the patient to CT scan and carrying out the scan itself may cause the patient stress, discomfort and potential danger, and ultimately be of little or no benefit.During the transfer and scanning process, the author became increasingly sick about the immediate arctic of the patient, and the potential for deterioration in the patients condition. When the patient became dangerously bradycardic and hypotensive, the authors thoughts were heavy on trying to prevent cardi ac arrest.On reverting to ICU and meeting the patients son, it seemed that neither the dignity of the patient or the concerns of the family had been respected. The author felt an inadequacy and felt that the interests of the patient had not been properly advocated. The patient passed onward in a distressing and undignified manner, and the son did not have the opportunity to spend personal time with the patient prior to this happening. The author felt guilty, as it seemed that the CT scan should not have happened and that the undignified circumstances surrounding the patients death need not have occurred.EvaluationLooking back on the events of scenario 1, it seems that there were both positive and negative aspects to the experience. During transfer to CT scan and the emergency situation which followed, the author felt that there was good police squadwork betwixt the different professionals involved in the care of the patient. Because of this, prompt action was taken, preventing ca rdiac arrest.However, it seems that this situation may have been avoided, which in turn raises many questions relating to the care of the patient. Ethically, one must question how appropriate it was to scan a poorly purulent, unstable patient, especially when corrective treatments would have been inappropriate in the event of an abnormality being discovered. Should the author have advocated the interests of the patient and family more forcefully? Was there a lack of communication and consensus betwixt the critical care team? The events of this incidental culminated in a clinical emergency situation which led to the patients death. Thus, the author feels that the patients clinical condition and the honorable issues and dilemmas surrounding the patients care must be examined and discussed, in the consent that lessons can be learned through the reflective process.AnalysisSepsisMost illness and death in patients in intensive care is caused by the consequences of sepsis and systemic inflammation. Indeed, sepsis affects 18 million people worldwide each year (Slade et al 2003), with severe sepsis remaining the highest cause of death in patients admitted to non-coronary intensive care units (Edbrooke et al 1999). Sepsis is a complex condition that results from an infectious process, and is the bodys response to infection. It involves systemic inflammatory and cellular events that result in altered circulation and coagulation, endothelial dysfunction, and impaired tissue perfusion (Kleinpell 2004).Dellinger et al (2004) define sepsis as the systemic response to infection manifested by 2 or more of the followingHigh or low temperature (38C or Heart rate 90 beats per minuteRespiratory rate 20 breaths per minute or PaCO2 High or low white note cell count ( 12,000 or In severe sepsis impaired tissue perfusion along with micro vascular coagulation can lead to multiple pipe organ system dysfunction, which is a major cause of sepsis-related deathrate (Robson Ne comfor tably 2005). While all organs are prone to failure in sepsis, pulmonary, cardiovascular, and renal dysfunction occur most commonly (Hotchkiss Karl 2003). When multiple organ system dysfunction occurs, Dolan (2003) promotes evidence-based sepsis treatment whereby patients should perplex targeted organ support. This includes mechanical ventilation, renal replacement therapy, fluids, vasopressor or inotropic administration, and pipeline product administration, to maximize perfusion and oxygenation.In recent years new therapies have emerged which have been shown, in some cases, to increase the chance of survival from severe sepsis. Recombinant human worked up protein C has been shown to have anti-inflammatory, anti-thrombotic and pro-fibrinolytic properties (Dolan 2003). In a randomised controlled trial, Bernard et al (2001) piece a significant reduction in the mortality of septic patients who had been treated with activate protein C. The National Institute for clinical excellenc e (2004) now recommends this treatment for adult patients who have severe sepsis resulting in multiple organ failure, and who are being provided with optimum ICU support. Steroids, the use of which in ICU has long been debated, have also been shown, in low doses, to reduce the risk of death in some patients in septic shock (Annane 2000).Despite the development of specific treatments to interrupt or control the inflammatory and procoagulant process associated with sepsis, its management remains a major dispute in healthcare (Kleinpell 2004). The patient in scenario 1 was clearly in a state of severe sepsis, with respiratory, cardiac and renal failure, and receiving some of the supportive treatments mentioned above. Indeed it seems that the severity of this condition should not have been underestimated. In view of this, the ethical issues surrounding the decision to take this patient to CT scan must now be considered.Ethical Dilemmas and ConsensusEthical issues have emerged in recen t years as a major component of health care for critically ill patients (Friedman 2001). Thus, compassionate for these patients in an intensive care setting necessitates that difficult ethical problems must be faced and resolved (Fisher 2004). Traditionally, much of the literature in biomedical ethics comes from theoretical perspectives that include principled ethics, caring ethics and virtue ethics (Bunch 2002). Although these perspectives provide an ethical awareness, which can be helpful, they do not of prerequisite give much direction for clinical practice. Melia (2001) supports this notion, suggesting that many backchats of ethical issues in health care are presented from a moral philosophical viewpoint, which as a consequence leaves out the clinical and social context in which decisions are taken and carried through.Beauchamp Childress (1994) identify 5 principles pertinent to decision making in intensive care. These are salvageability, emotional state preservation, non-m aleficence, beneficence, and justice. Ethical dilemmas occur when two or more of the above principles come into conflict. The principles of beneficence (doing good), non-maleficence (doing no harm) and justice (fair treatment) are well established within the field of bioethics. Within a critical care context however, the dilemma between salvageability and life preservation becomes an important focus for health care professionals. Indeed, Prien wagon train Aken (1999) raise the question of whether all medical means to preserve life have to be employed under all circumstances, or are there situations in which we should not do everything that it is possible to do. This question becomes particularly relevant when a patients condition does not improve but kinda deteriorates progressively. Curtin (2005) suggests that at some point in the course of treatment, the line between treating a curable disease and protracting an unpreventable death can be crossed. In such incidences Prien Van Aken (1999) identify a transitional zone between the attempt to treat the patient, and the prolongation of dying, in which a conflict between the principles of life preservation and non-maleficence develops.These concepts seem particularly relevant to scenario 1 where the interests of the patient may have been neglected in favour of further attempts to treat the patients condition. This, in turn created a conflict between the principles of salvageability and life preservation. The decision to perform a CT scan on a patient with such cardiovascular mental unsoundness and a very poor prognosis, meant that the patient was subjected to dangers and harms when there were few, if any benefits to justify this. Hence, the conflict between the ethical principles was not resolved, and the professional duty of non-maleficence toward the patient was not respected.Such conflicts and dilemmas in intensive care can be made all the harder by the availability of advanced technologies. Callahan (2003 ) writes that one of the most seductive powers of medical technology is to confuse the use of technology with a respect for the sanctity of life. In addition, Fisher (2004) contends that it has become all too easy to think that if one respects the value of life, and technology has the power to extend life, then a failure to use it is a failure to respect that value. This is particularly true of symptomatic technologies (such as CT scanning) which must be used with caution, especially in cases where the diagnostic information will make little or no disparity to the treatment of the patient, but can create or heighten anxiety and discomfort for the patient (Callahan 2003). Medical technology is a two-edged sword, capable of saving and ameliorate life but also of ending and harming life (Curtin 2005). Good critical care medicine carries the responsibility of preserving life, on the one hand, and making possible a peaceful death, on the other. Callahan (2003) concludes by warning that any automatic bias in favour of using technology will threaten that latter possibility.Consensus between members of the intensive care team is also highlighted as an important issue in ethical decision making. Effective communication and collaboration among medical and nursing staff are essential for high quality health care (Woodrow 2000). Collaboration can be seen as working together, sharing responsibility for resolve problems, and making decisions to formulate and execute plans for patient care (Gedney 2000 p.41). In intensive care units where ethical problems are faced frequently, care has to be a team effort (Fisher 2004).In a qualitative consume, Melia (2001) found that there was a strong desire within the intensive care team that ethical and moral consensus should be achieved in the interests of good patient care, even though it was recognised that there is no legal requirement for nurses to agree with ICU decisions. Cobaoglu Algier (2004) however, found that the same et hical dilemma was perceived differently by medics and nurses with the differences being related to the hospitals hierarchical structure and the traditional distinctions between the two professions. Similarly, it has been observed that differences between doctors and nurses in ethical dilemmas were a function of the professional role played by each, rather than differences in ethical reasoning or moral pauperization (Oberle Hughes 2001).It seems therefore that while the medical and nursing professions share the same aims for patient issuings, the ideas surrounding how these outcomes should be achieved may differ (Fisher 2004). These differences have contributed to the development of the concept of the nurse as patient advocate, which sees advocacy as a fundamental and integral role in the caring relationship, and not simply as a unity component of care (Snowball 1996). The role of the nurse advocate should be that of mediator and facilitator, negotiating between the different hea lth and illness perspectives of patient, doctor, and other health care professionals on the patients behalf (Mallik 1998).Empirical evidence is sparse and philosophical arguments seem to predominate in the field of patient advocacy. There is some evidence to suggest that nurse advocacy has had beneficial outcomes for the patient and family in critical care areas (Washington 2001). Hewitt (2002) however found that humanistic arguments that promote advocacy as a moral imperative are compelling. Benner (1984) writes of advocacy within the context of being with a patient in such a way that acknowledges your shared humanity, which is the base of nursing as a caring practice (Benner 1984, p. 28). It has been argued that advocacy, at least in a philosophical sense, is the foundation of nursing itself and as such should be regarded as an issue of spacious importance by all practitioners (Snowball 1996).ConclusionIt can be concluded that sepsis in a critical care environment is a complex co ndition with a high mortality rate, requiring highly specialised treatments. As such, the ethical issues and dilemmas faced by health care staff caring for a septic patient can be both complex and far reaching. It must be noted, that there can be no general solutions for such ethical conflicts each clinical case must be evaluated individually with all its associated circumstances.A study of ethical principles would suggest that it is important that the benefits of a specific treatment or procedure are established prior to implementation, and that these benefits outweigh any potential harms or risks to the patient. The ultimate decision maker in the scenario under discussion was the consultant anaesthetist, who should have provided a clearer rationale for performing a CT scan on such an unstable patient. As the nurse caring for the patient, the author recognises that the final decision regarding treatment rested with the anaesthetist. However, the author could have challenged the ana esthetists decision further, advocating the patients interests, with the aim of reaching a moral consensus within the team. Perhaps then the outcome would have been more favourable for all concerned.Action PlanBy reflecting on this scenario, the author has gained an understanding of sepsis and the potential ethical problems which may be encountered when caring for a septic or critically ill patient. As a result, the author feels more confident to challenge those decisions made relating to treatment, which do not seem to be in the best interest of the patient, or which have the potential to cause more harm than good. The author now has a greater understanding of the professional responsibility to advocate on a patients behalf, with the aim of safeguarding against possible dangers. It is hoped that this will result in improved outcomes for patients in the authors care.Scenario 2DescriptionThis incident occurred in a surgical intensive care unit while the author was looking after a ven tilated patient who had undergone a laparotomy and justly sided hemi-colectomy 2 days previously. Around 10.30am the patient was reviewed by medical staff and was found to be awake and alert with good arterial blood gases, and requiring negligible ventilatory support. In view of this, it was decided that the patients support should be reduced further, and providing this reduction was tolerated, that the patient should be extubated later in the morning.In the intensive care unit in which the author works an intensive insulin infusion protocol is used (see Appendix A). This is a research based protocol which aims to normalize blood glucose levels and thus improve clinical outcomes for critically ill patients. All patients on this protocol require either to be absorbing enteral fertilize at 30ml/hr, on TPN or on 5% dextrose at 100ml/hr (Appendix A, note 2). The patient involved in this incident was receiving enteral feed via a naso-gastric tube, and was on an insulin infusion which was running at 4 U/hr. When it was decided that the patient was to be extubated, the author halt the enteral feed as a precaution, to prevent possible aspiration during or after extubation. The author however did not stop the insulin infusion which breached the protocol guidelines.About 12 noonday the patients blood gases showed that the reduction in support had been tolerated, and so the patient was extubated. Shortly after this the author was asked to go for lunch break and so passed on to a colleague that the patient had recently been extubated but was managing well on face mask oxygen. Returning from lunch 45 minutes later, the author found the patient to be disorientated and slightly confused. With good oxygen saturations, the author doubted that the confusion had resulted from hypoxia or worsening blood gases. The author then realised that the insulin infusion had not been stopped with the enteral feed earlier. A check of the patients blood glucose level showed that it was 1 .2mmol/L. The author immediately stopped the insulin infusion, administered 20mls of 50% dextrose intravenously, as per protocol, and recommenced the enteral feed. Twenty minutes later, the patients blood glucose level had risen to 3.7mmol/L. The patient continued on the insulin protocol maintaining blood glucose levels within an adequate range. There were no destinationing adverse make resulting from the hypoglycaemic episode.FeelingsWhen it was realised that the insulin infusion had not been stopped, the author felt a sense of panic, anticipating correctly that the patients blood glucose level would be dangerously low. Thoughts then became concentrated on raising the blood glucose level, to ensure that no further harm would come to the patient as a result of the authors mistake.Following the incident, when the patients glucose levels had risen, feelings of guilt were prominent. At this point the author realised how much worse the outcome could have been for the patient. The aut hor felt incompetent, knowing that the patient could have been much more severely affected, or could even have died as the result of such a simple mistake.EvaluationThe events of scenario 2 highlight the fact that clinical errors, while slowly made, can have potentially disastrous consequences. This is especially true of those errors which involve the administration of drugs intravenously. In the interest of patient safety, it is important that all such errors are avoided.The clinical error outlined above could easily have been avoided. It seems that there was not sufficient awareness, on the authors part, of the insulin infusion protocol and the guidelines concerning the administration of insulin. As a result, the insulin protocol was not adhered to. The following analysis therefore will focus on the importance of insulin therapy in critical care areas, and will consider the safety issues surrounding intravenous drug administration.AnalysisBlood Glucose Control in Intensive CareIt is well documented that critically ill patients who require elongate intensive care treatment are at high risk of multiple organ failure and death (Diringer 2005). Extensive research over the last decade has focused on strategies to prevent or reverse multiple organ failure, only a few of which have revealed positive results. One of these strategies is slicked blood glucose control with insulin (Khoury et al 2004). It is well known that any type of acute illness or injury results in insulin resistance, glucose intolerance and hyperglycaemia, a form which has been termed the diabetes of stress (McCowen et al 2001). In critically ill patients, the severity of this condition has been shown to reflect the risk of death (Laird et al 2004).Much has been learned recently about the negative prognostic effects of hyperglycemia in critically ill patients. Hyperglycaemia adversely affects fluid balance, predis jell to infection, morbidity following acute cardiovascular events, and can incr ease the risk of renal failure, neuropathy and mortality in ICU patients (DiNardo et al 2004).Research suggests that there are distinct benefits of insulin therapy in improving clinical outcomes. Such benefits have been seen in patients following acute myocardial infarction, and in the healing of sternal wounds in patients who have had cardiac surgery (Malmberg 1997 Furnary et al 1999). More recently Van den Berghe et al (2001) conducted a large, randomized, controlled study involving adults admitted to a surgical intensive care unit who were receiving mechanical ventilation. The study demonstrated that calibration of blood glucose levels using an intensive insulin infusion protocol improved clinical outcomes in critically ill patients. In particular, intensive insulin therapy was shown to reduce ICU mortality by 42%, and significantly reduce the incidences of septicaemia, acute renal failure, prolonged ventilatory support, and critical illness polyneuropathy. The length of stay in intensive care was also significantly shorter for patients on the protocol.It is unclear as to why improved glycaemic control has been associated with improved outcomes in several clinical settings. Coursin and Murray (2003) have summarized several principal hypotheses including maintenance of macrophage and neutrophil function, enhancement of erythropoiesis, and the direct anabolic effect of insulin on respiratory muscles. The potential anti-inflammatory effects of insulin have also been evaluated (Das 2001). There is also uncertainty over whether it is the actual insulin dose received per se, or the degree of normoglycaemia achieved that is responsible for the beneficial effects of intensive glycaemic management. Van den Berghe (2003) analysed the data derived from their 2001 study and have concluded that the degree of glycaemic control, rather the quantity of insulin administered was associated with the decrease in mortality and organ system dysfunction.In a follow up to Van de n Berghe et als 2001 study, Langouche et al (2005) found that a significant part of the improved patient outcomes were explained by the effects of intensive insulin on vascular endothelium. The vascular endothelium controls vasomotor tone and micro-vascular flow, and regulates trafficking of nutrients and several biologically active molecules (Aird 2003). Langouche et al (2005) conclude that maintaining normoglycaemia with intensive insulin therapy during critical illness protects the vascular endothelium and thereby contributes to the prevention of organ failure and death.Whatever the reasons for improved patient outcomes, the study by Van den Burghe et al (2001) has prompted much research in this field, all of which has yielded similar results. In a similar study, Krinsley (2004) found that the use of an insulin protocol resulted in significantly improved glycaemic control and was associated with decreased mortality, organ dysfunction, and length of stay in the ICU in a heterogene ous population of critically ill adult patients. Thus it seems that with the strength of the emerging data in support of a more intensive approach to glycaemic management, insulin infusions are being utilised with increasing frequency, and are considered by many to be the standard of care for critically ill patients (DiNardo et al 2004).It is important to note that a well recognised risk of intensive glucose management is hypoglycaemia. Indeed Goldberg et al (2004) emphasise that in the ICU setting where patients often cannot name or respond to symptoms, the potential for hypoglycaemia is of particular concern. The events of scenario 2 highlight the authors error in the administration of insulin resulting in hypoglycaemia. For this reason some issues surrounding intravenous drug therapy will now be discussed.Intravenous Drug TherapyThere is an increasing recognition that medication errors are causing a substantial world(a) public health problem. Many of these errors result in harm to patients and increased costs to health providers (Wheeler Wheeler 2005). In the intensive care unit, patients commonly receive multiple drug therapies that are prescribed either for prophylactic indications or for treatment of established disease (Dougherty 2002). Practitioners caring for these patients find themselves in the challenging position of having to monitor these therapies, with the goal of maximizing a beneficial therapeutic response, as well as minimizing the occurrence of any adverse drug-related outcome (Cuddy 2000).The Nursing and midwifery Council (NMC) (2004) identifies the preparation and administration of medicines as an important aspect of professional practice, stressing that it is not merely a mechanistic task performed in strict compliance with a written prescription, but rather a task that requires thought and professional judgement. Heatlie (2003) found that the introduction of new insulin protocols and regimes could g

The Tuskegee Airman Essay -- Papers WW II World War 2 Air Force

The Tuskegee airman For my term paper I chose the Tuskegee Airman. They will alway be the most prestigious air squadron during WWII. I think this because there where a lot racist people that did not want them to succeed, but they did more than just succeed. They became the first slow Air Force pilots. It all started when President Roosevelt arranged a meeting in September 1940 with three African-American leaders and members of the Army and Navy. During the meeting, the leaders accent three points(1)equal opportunity for jobs in the defense industry, (2)impartial administration of the new draftlaw, and (3)an opportunity for qualified blacks to learn to fly in desegrated units.*1*A fewer days later after the meeting, the War Departmentissued a policy directives stating that black men generally would be admitted into the armed force in total equivalent to their percentage in the civilian population.But it was not until a couple months after the meeting in December 1940, that the Army Air corps submitted a plan for the experiment to establish an all-black fighter squadron.The plan was not official until July 19, 1941 when Major General Walter Weaver, commander of the U.S. Armys Southeastern Air Corps spoke at the Tuskegee Institute Campus.*2*It was then that 13 black men became the first black pilot trainees. Most of the trainees were college graduates, including a policeman, an regular army officer, a factory inspector, and several young men who were fresh out of college. Also, all of the men were trained at Chanute Air Field in Ratoul, Illinois at the US Army Air Corps Technical Training School. The men of... ...groups.But it was not until 1948 that President Harry S. Truman issued an executive order. This order eventually finish segregation in the US military. In this paper I have represented my thesis statement with good facts and hard evidence that the Tuskegee Airman were and ceaselessly will be the most influential fighter unit during WWII.Bi bliographyBilbiography1.Mckissack, Patricia and Fredrick Red Tail Angles United States Walker Publishing Company, 1995. 2.Harris, Jacqueline The Tuskegee Airman New Jersey Dillon Press,1996.3.Hart Philip S. locomote Free Minneapolis,Minnesota Lerner Publications Company,1992.4.Rose Robert A. Lonely Eagles Los Angelos,CA Tuskegee Airman Inc.5. Tuskegee AirmanA Brief History Tuskegee Airman November 26,1999 http//www.ebonywings.com/tuskegee

Radar Detector :: Speeding Driving Technology Essays

Radar DetectorEvery person has a tendency to speed while they argon driving. But or so people inactive drive slowly because nobody wants to get a speeding ticket. But now, during the development of technology, people invented something called the radar detector, which can avoid you from getting caught while you are driving over speed. In this paper, I want to talk about the Passport 8500 X50 comparing to the Valentine One and Bel 985, which is known as the worlds best radar detector. Before trying to discuss this detector it is important to know either the history of the radar detector or the difference of the police force signals. Escort, the name of the organization that manufactures different varieties of radar detectors, developed passport 8500 X50. They have also developed Solo S2 (the best wireless radar detector) and Passport 7500 (cheaper, further has lower quality than Passport 8500). The use of radar detectors is prohibited only in Washington DC and Virginia. Any othe r states in the United States receive the use of radar detectors. This company has maintained its existence in the radar business for about 25 years. At first time, radar was used to aver a driver when construction was in the way of the driver so the driver could drive carefully. But nowadays, some(prenominal) road constructions dont receive off the signal to the radar detector and the driver uses the radar detector not to avoid the construction but to avoid the police.There are many different types of signals in this world, but only three signals that police use to detect speed. There are X, K, and Ka bands. The first signal that police used was the X band. It was used until the mid-1970s. Police of Ohio and New Jersey invested a lot of money in X band radar so even now most police in those states still use this band. The second band is K band which was invented in 1976. Its frequency is twice as long as the X band. It means the accuracy is better in K band. The last band is Ka band. It has a better frequency than all other bands. Nowadays, the use of Ka band is relatively high. Most police use this band to catch people speeding. Passport 8500 X50 operates at X band in a frequency 10.525 GHz 25 MHz, at K band in a frequency 24.