Choosing The Correct Teaching Method - 1290 Words

Teaching Methods Introduction Choosing the correct teaching method is important to help the learner retain and learn information in an effective and efficient way. Tobacco use is a health related topic that needs further education and intervention from a nurse. When selecting two teaching methods that are of interest to me, which would be beneficial to use when educating a small group of five people about this health-related topic are group discussion and demonstration and return demonstration. Group discussion involves the deliverance of medical information or education to a small group of individuals which may include their family so information, opinions can be exchanged with the nurse. This is simple way to deliver information to more than one person at one time if time management is a concern, and the nurse is able to build trust and rapport with the group as a whole. Demonstration and return demonstration works more effectively in a small group and involves education or teaching with the nurse and lea rner(s). This method also allows time for feedback from both parties. The nurse gives the learner a demonstration of a task to perform and the learner has to attempt to carry out the task back showing competence, and the nurse is on standby to give cues as needed. Group discussions Group discussions are beneficial as this teaching method is useful as it allows the learners to share information about their personal experiences and is both economically andShow MoreRelatedHow Tobacco Use Teaching Methods1280 Words   |  6 PagesTobacco Use Teaching Methods Introduction Choosing the correct teaching method is important to help the learner retain and learn information in an effective and efficient way. Tobacco use is a health related topic that needs further education and intervention from a nurse. Group discussion and demonstration, and return demonstration are two teaching methods of interest to me, which I believe will be beneficial to use when educating a small group of five people about this health-related topicRead MoreStatistics Is A Useful Tool In The Medical Field. This1051 Words   |  5 Pagesservicing people to improve their health. Just like looking through mechanical tools you must choose the right tools to conduct, or carry out the duties needed to improve the situation. In which identifying the correct statistics by knowing and understanding that there are several statistics methods. Hence, the first step is to recognize the appropriated statistic used in the study. When assessing statistics, it is important to determine if it is either descriptive, or inferential statistics. A descriptiveRead MoreOne Size Fits All Schooling915 Words   |  4 PagesSchools need the ability and the freedom to experiment with teaching methods and figure out which ones work and which ones do not. However, by only using one standardized method across the board it makes it harder to discover what needs to be taught and how it should be taught. Some people may be thinking, â€Å"why should we take a risk with something as vital as a child s education?† I mean, we should just pick the best approach at teaching and educate everyone that way, should we not? Sadly, it sRead MoreTa Level 3 Ncfe Course1727 Words   |  7 PagesExplain 5 strategies that a teaching assistant might use to support literacy development. The teaching assistant could read to the pupils on a daily basis, this will help pupils learn how fluent reading sounds and this will help them understand how sentences and text can make sense, and will learn when to pause for full stops, question marks etc, and they will also learn how using expression in reading can make a story more exciting and understandable. The teaching assistant can have one to oneRead MoreKey Features of AL and CLT Approach1363 Words   |  5 Pages1. Compare and contrast the key features of AL and CLT approach Audio-lingual approach Communicative teaching language approach Approach Nature of language -structural view -Language: a system of structural phonological, grammatical and lexical patterns to express the functional meanings -functional view -Language: a medium for social interaction and communication Nature of language learning Behaviorism – Habit formation via over-learning Learners’ engagement in authentic and meaningfulRead MoreEssay on Teaching as an Art or a Science721 Words   |  3 PagesTeaching as an Art or a Science Teaching: Is it an Art, or is it a science? I think that teaching requires both art and science. They both play a role on each other, because if a teacher only demonstrates one of these types of teaching, their classroom will most likely be very boring. Teaching as an art demonstrates ways in which the teacher may use creative ways to present the material so it is fun and interesting for his or her students. Some examples are games, â€Å"hands-on† activitiesRead MoreFor Many Years, Teachers Have Worked To Make Their Students1662 Words   |  7 Pagesvocabulary skills (Constantinescu, 2007). The primary method teachers have used when teaching vocabulary is explicit instruction which includes mentioning the definition and expecting students to remember the word meanings (Kennedy, Deshler, Lloyd, 2013). Instead of continuing to use explicit instruction to teach vocabulary, educators should use untraditional methods of teaching such as the use of technology to enhance their methods of teaching vocabulary to better all students. It has been increasinglyRead MoreQuestions On Online Research Skills1613 Words   |  7 Pages Online Research Skills Student’s Name Institutional Affiliation Online Research Skills Introduction Technology has revolutionized the realm of education through increasing the number of sources and methods of research (Cottrell, 2013). The accessibility of online-based research platforms has created an avenue for students to have ultimate desire to learn and eventually become qualified scholars. Research and more especially educational research open the heart and minds of studentsRead MoreDifferent Approaches Of Teaching Second Language1119 Words   |  5 Pages Throughout history, different approaches of teaching second language have been developed. These approaches have been adopted by some and criticized by others. Nobody has ever agreed on a certain approach to be the best or the worst. Language teaching methods mainly refer to the approaches that the teacher adopts and the materials used by the teacher to facilitate the process of learning. The methods of language teaching have been prioritized according to the main skills in anyRead MoreHow Technology Has Revolutionized The Realm Of Education1535 Words   |  7 PagesIntroduction Technology has revolutionized the realm of education through increasing the number of sources and methods of research (Cottrell, 2013). The accessibility of online-based research platforms has created an avenue for students to have ultimate desire to learn and eventually become qualified scholars. Research and more especially educational research open the heart and minds of students to greater inventions; hence, creating a better and accomplished society. Accessibility of information

India Has a Federal Form of Government - 11085 Words

India has a federal form of government, and hence a federal finance system. The essence of federal form of government is that the Centre and the State Governments should be independent of each other in their respective, constitutionally demarcated spheres of Action. Once the fundamentals of the government are spelt out, it becomes equally important that each of the government should be provided with sources of raising adequate revenues to discharge the functions entrusted to it. For the successful operation of the federal form of government financial independence and adequacy for the backbone. Sales taxes are most important revenue for the state sin India. While the taxes vary in their design, they are generally levied in the first point†¦show more content†¦List III is a concurrent List, which includes administration of justice, economic and social planning, trade and commerce, etc. According to Article 246, Seventh Schedule, Parliament has exclusive powers to make laws regarding matters enumerated in List I, not withstanding the provisions of the other clauses of this Article. On the other hand, the Legislature of any state has exclusive power to make laws for the state regarding any of the matters enumerated in List II, subject to other clauses[5]. With regard to List III, both the Parliament and a State Legislature can make laws but the law listed in I or III, vests with the Union. Thus, the Union has supremacy over a wide range of the legislative field. These lists include the powers of taxation also. The union List includes among others, taxes on income othe r than agricultural income, excise duties, customs and corporation tax. The State list includes land revenue, excise on Alcoholic liquors, tax on agricultural incomes, estate duty, taxes on sale or purchase of goods, taxes on vehicles, on professions, on luxuries, on entertainment, on stamp duties, etc. the concurrent list does not include any important taxes. Accordingly there are both mandatory and enabling provisions in the Constitution for facilitating a wide-ranging transfer of resources, arranged in a systematic manner, through 1) Levy of duties by the Center butShow MoreRelatedDifferences Between Unitary And Federal System1524 Words   |  7 Pagesprovincial levels. The major distinctions that can be made are between unitary and federal systems. Only the central government has the constitutional sovereignty and power in unitary system. The central government shares that constitutional sovereignty and power in subdivisions called, states, provinces, regions while applying the federal system. 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A federalist government is very unique and contrasts with other government types such as a unitary and confederate government. Overall the balance between aRead MoreOthe Native Population And Original Form Of Government1652 Words   |  7 Pageso The native population and original form of gov ernment in Pakistan. The population of Pakistan is 195,685,058 as of March 27th, 2017, based on the latest United Nations estimates. This is equivalent to 2.62% of the total world population, ranking at number 6 in the list of countries and colonies by population. In 1955, just a few years after Pakistan became an independent country in 1947, the population was at 40,427,072. This is a rise of approximately 150,000,000 in 62 years. o The colonial era

Individual Analysis Free Essays

Individual Case Analysis Contents 1. 0Analysis Using Motivation Theories1 1. 1Equity Theory1 1. We will write a custom essay sample on Individual Analysis or any similar topic only for you Order Now 2Expectancy Theory1 1. 3 Three-need Theory†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 2 2. 0Criticisms of the Management Functions3 3. 0Main Problems Defined4 4. 0References5 5. 0Appendices6 5. 1Appendix 1: SWOT Analysis6 5. 2 Appendix 2: Equity Theory Table†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 7 1. 0Analysis Using Motivation Theories 1. 1Equity Theory According to Robbins, Bergman, Stagg and Coulter (2003) equity theory was developed by J. Stacey Adam. Campebell, Dunnette and Miller (1969) states the purpose of this theory is aim at employees’ assimilation from a job situation. Kaplan, Reckers and Reynolds (1986) notes these are outcomes, in relation to the efforts they put in, inputs, and then compare with others. In the case, Lisa compares her input-outcome ratio with Leanne, which seems imbalance and unfair. Lisa feels jealous as Steve decided to go again her suggestion to hand over half of her workload to the youngest team member, Leanne. She also sees that Leanne became more dominant. Lisa was treated unfairly by two other members putting the blames at her who forced Steve to reprimand her. The distraught Lisa’s thinking was to give other members of the team who has more experience to take over some of her work rather than Leanne. In the end Lisa lodged a compensation claim for her nervous breakdown cased by Leanne. Also stated by Robbins, Bergman, Stagg and Coulter (2003), employees’ motivation is influenced by rewards. Base on the above-mentioned, Steve should use the equity method in treatments of staff. Therefore, whenever an employee assess their own equity and perceive inequity, he or she will act to correct the situation rather than lack of motivation. Please refer to 5. 2 Appendix 2 for table showing equity theory. 2. Expectancy Theory According to Montana and Charnov (2000), expectancy theory shows that rewards could motivate employees to increase their efforts. Taylor (1964) notes this encourages better performance leading to a positive outcome. Steve applied the expectancy theory under his management. By doing this, he made an announcement that he will increase employees’ salary base on performance rating. Due to massive increase in training loads, Lisa was overworked and with projects behind schedule. Then Green (1992) states on of the believing is that employees believe if they perform well, they will get the reward. Leanne is an ambitious person that is why she offers help as she believes in good performance could get better outcome and reward. On the other hand, according to Montana and Charnov (2000), an employee can decide on which outcome they prefer. Due to immense pressure from overload and conflict with Leanne, Lisa has made a decision to take stress leave. This reduces the efforts Lisa requires to put into her work. 3. Three-need Theory McClelland (as quoted by anonymous, 2008) states an employee’s motivation and effectiveness are influenced by the following: Need for Achievement – McClelland (quoted by Pattanyak, 2006) notes motivation that influences employees to direct his or her behaviour towards attaining goals. According to the achievement explained, Lisa is not motivated to challenge of orking at a problem and do not accept any personal responsibilities for failure, rather leaving the actions and chance for Leanne to achieve the outcome. Need for Affiliation – Courtney (2002) notes McClelland had suggested that people are motivated by different things. Also, base on the statement stated by Tosi, Mero and Rizzo (2000), McClelland’s theory on affiliation has a need for friendly relationships an d have good interactions with others. These people can co-operate well in a team. Referring to the explanation of affiliation, Lisa’s jealousy and conflict with Leanne had caused friction and resignation in the team. It shows there is a lack of communication skills and co-operate for Lisa in the team. Lisa’s personal attitude problem towards Leanne also caused her relationship problems with colleague and manager. Need for Power – McClelland (quoted by Pattanyak, 2006) notes that people at a high position would want the power to control other people for their own goals. According to Ved (2005) there are: Social – controls the company’s movement, and Personal – influence others to further the desire. Leanne entered InsureCo. as a new team member under Lisa’s leadership in a team. Soon after, Leanne quickly made good relationship with the manager and quick to promote her skills, which lead her over stepped the power of Lisa. Therefore, Lisa felt she was unable to control Leanne to achieve her outcome. Lisa has also lost control of her team when couple of the team members resigned. With the lost control of power, Lisa lost the battle to be promoted. Therefore, she is not motivated. 2. 0Criticisms of the Management Functions The management of InsureCo. has several negative practices, they are: – The way Steve manages the company’s environment The way Steve supervise employees, and – How staff co-operate with each other as a team. According to Bell and Smith (2006), the use of communication and verbal skills for managers is vital in their management work. By listening to employees, companies could improve employees’ job satisfaction. According to Deci and Ryab (1985), the greatest motivation act is managers could do for his or her empl oyee is listening. In this case, Steve does not communicate effectively to his staff about his expectations and resolving problem issues within the working environment. He does not think of the concern that if he recognise the new employee, Leanne, Lisa would complain about the recognition. To prevent the complaining obstacle, Steve should listen to Lisa when she complained about Leanne in regards to her I. T. skills. Steve should act on the complaint and assess Leanne’s ability in the I. T. field. If it does prove that she has the skills, there would not be jealousy in Lisa. Schuler and Jackson (1999) mentioned that fair treatment of employee which will make them more committed in an organisation. It means, Steve should treat Lisa and Leanne equally. It is not where he should reprimand Lisa in front of her colleagues and in a way without her giving reasons. This is an embarrassment for Lisa. This also shows there is a lack of fair treatment within the management system of the company. According to Cook (1999), employees will produce more effort in their work when they are appreciated, valued and understood by the employer. Steve should set up a guide of basic principles to coach employees when there is a problem. Base on the value of Lisa to the company, Steve should not reprimand her straight away without any options for explanation and when he did reprimanded her he should explain his decision. Steve could improve the relationship between Lisa and Leanne by informing them how others feel, how much effect can cause, and suggest them how to improve themselves. Steve’s management at InsureCo. he is committed to the company’s goals, according to Salaman (2001), it sometimes refers to as mission statement. In the case, increase salary was any approach that Steve regarded as important. The aim is to fend off growing competition. The increase of salary could not always motivate his staff. The reasons are mentioned in the previous citations. 3. 0Main Problems Defined |Primary Problems |Secondary Problems | |Poor leadership – New leadership of the firm, lack of managerial |Poor motivational skills | |experience. |Staff lacks motivation | |Poor planning – No technical training system been put in. No specific job description written for employees | |No formal policies written for rewards and punishment |Increase in workloads | | |Lack of co-operation | | |Manager has poor communication skills | | |Ineffective communication of expectations | | |Employees’ value not appreciated | | |Overload work causes delays | | |Multitask been given to employees | | |Management has no understanding of employees’ needs | | |Poor relationship between staff and manager | | |Pressure in the training department | | |Lack of fair treatment for staff | 5 . Appendices 5. 1Appendix 1: SWOT Analysis [pic] 2. Appendix 2: Equity Theory Table by Robbins, Bergman, Stagg and Coulter (2003) Perceived ratio comparisonEmployee’s assessment Outcomes AOutcomes B Inputs A Inputs B (Inequity-under rewarded) Outcomes A=Outcomes B Inputs A Inputs B (Equity) Outcomes AOutcomes B Inputs A Inputs B (Inequity-over rewarded) ———————– Threats ? Exposed weaknesses in the company ? Strong global competitors ? Complaints from staff ? Compensation claim from staff Opportunities ? Government proposed new Financial Services Reform Bill – Make sure entire staff had been trained Weaknesses ? Poor leadership ? Poor planning ? No formal policies for rewards punishments are written ? Poor motivational skill ? Staff lacks motivation ? No specific job description written for employees ? Increase of workload ? Lack of co-operation ? Poor communication skills ? Staff’s value not appreciated ? Overload work causes delays ? Multitask given ? Management has no understanding of employees’ needs ? Poor decision making ? Pressure in the training department ? Lack of fair treatment for employees ? Strengths ? Large finance and insurance company ? Market presence ? Large customer base ? Long profitable history ? Promotions for employees ? How to cite Individual Analysis, Papers

Patriots or Traitors free essay sample

However, as history shows, the Founding Fathers were clearly patriots. Through their love of this country while trying to resolve issues without violence, their patriotism clearly defines this nation. In the aftermath of the French and Indian War, Britain was not only victorious, but also deep in debt. Taking advantage of the colonies, Britain attempted to raise revenues by taxing the colonists heavily. Taxation acts such as the Stamp Act, Townsend Acts, and Intolerable Acts enraged the Illinois.However, rather than acting in full violent revolt, the Sons of Liberty as well as other colonists tried to solve this problem through nonviolent means, such as boycotting British goods. In May 1 773, the English Parliament passed the Tea Act which was unfavorable to the colonists. Instead of declaring war, the Bostonians boarded the ships carrying the tea and dumped them into the bay, instigating what is now known as the Boston Tea party. We will write a custom essay sample on Patriots or Traitors or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Throughout the beginnings of this nation, the Founding Fathers showed their attrition without bearing arms against the crown.Today, a citizen of the Lignite States has several duties. Obligations such as voting not only allow the people to voice their opinions, but also show that they care for the nation as well. The Founding Fathers are testaments to this, as they were heavily involved in the foundations of this nation. Thomas Jefferson suggested creating committees of correspondence to communicate with the other colonies about British activities. George Washington, Samuel Adams, and others led the protesting of the Townsend Acts.Clearly, the involvement of the Founding Fathers in this time of British oppression invokes a sense of patriotism. Furthermore, the Founding Fathers never chose to go to war with Britain. On the contrary, they repeatedly tried to reconcile with King George Ill. On July 1 775, the Continental Congress sent the Olive Branch Petition to the king which urged him to resolve their grievances peacefully. However, the king rejected the petition. On July 4, 1776, Congress issued the Declaration of Independence, to which it was received by a deaf ear. Through the attempts at reconciliation, the Founding Fathers were shown not to be traitors. Instead, it can be argued that Britain turned its back on the colonists when it declared war on the colonies. The online Merriam-Webster Dictionary defines traitor as one who commits treason. The Founding Fathers never committed this act. They resorted to nonviolent means for combating the taxes placed on them, they were heavily involved in the nations roots, and they attempted to reconcile with the king on several occasions.Although one may argue that they committed treason when signing the Declaration of Independence, this is not the case. They had already previously tried to resolve conflicts with the king, but to no avail. Instead, the signing of the Declaration of Independence signifies their most patriotic act. If captured, the Founding Fathers would be deemed for an act they had not committed (treason) and would be hanged. Thus, the Founding Fathers literally put their lives on the line for this nation and are and have always been patriots.

Was Hitler Really To Blame For WW2 Essay Essay Example

Was Hitler Really To Blame For WW2? Essay Essay Some people say that Hitler was to fault for the 2nd universe war. but what did Hitler really do to do it? We know that Hitler hated the Treaty of Versailles. But was Hitler’s feelings against the pact the ground why the World War started. Germany received the dainty when they signed the cease-fire to state they were guilty to fault for the first universe war. This so lead to the pact. The pact limited Germany’s ground forces size. This was to seek to and dis-encourage Germany to get down another war. because they’d have the smallest ground forces because the other states have no limitations on their ground forces Numberss. Germany was besides in a batch of debt because they were made to pay for the harm they’d caused. This so lead to occupation deficit in Germany. because employers couldn’t fund to pay people to work for them. We will write a custom essay sample on Was Hitler Really To Blame For WW2? Essay specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Was Hitler Really To Blame For WW2? Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Was Hitler Really To Blame For WW2? Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Even though states fought against Germany and at first believed that the pact was the right. just penalty for what they’d done. But after the pact had been made and was in advancement states felt sympathetic towards Germany. because the pact was excessively rough on them. Then Germany tried to forestall the pact from being carried on. Hitler was really powerful during this. and a batch of Germans supported Hitler because they believed he was powerful plenty to halt the pact. It was clear that Germany wanted the pact to be destroyed. it was doing them pain in mundane life. forestalling them from being satisfied or happy. Therefore anybody who was brave adequate to state that they could or seek to halt the pact would derive instant support from all of Germany. This made it really easy for Hitler to take over Germany. because people would vote for him instead than the other two work forces that were in charge. The other two work forces in charge of Germany was really weak and frequently got ruled over a batch. Hitler did this really much. On a few occasions. when the leaders of Germany had meetings Hitler’s Nazi party had the most seats. They frequently stood up and walked out of meetings if they didn’t agree with the determinations what were being made. When the Nazi party walked out. this made the 2 work forces who were meant to be more powerful than Hitler. were being controlled by Hitler’s Nazi party. Because Hitler was a really aggressive. commanding and persuasive individual he got his ain manner on a batch occasions. For illustration Hitler merely got made 3rd most powerful adult male in the state because they thought that if Germany did this they would be able to command him. We all know that they were incorrect. it would take a batch to command Hitler. The League of Nations was a group set up by America. The purpose of this was to seek and unify the states. so there would be universe peace. Wilson was the adult male who created this thought and made it come to populate. Unfortunately Wilson was ill in infirmary while the League was being set up. Other states took control of the group and made it so Germany were non allowed to fall in the group. This made the thought pointless. and defeated the aim of the whole thought. Just to recap why Wilson created the League. for universe peace so Germany would non get down war once more. Germany would desire to get down a war once more the League now. because they’ve been left out and hold no say in what goes on. Wilson disagreed with the determination the other states made about censoring Germany from the League. Sing that Germany were able to be in the Second World War. they must hold had a large adequate ground forces. This is impossible if the pact was still in topographic point. but we know that Germany destroyed this. The states against Germany like Britain. were still experiencing sorry for Germany. This gave the Germans a opportunity to re-build their ground forces. and go strong. Then Germany were ready to get down war against Britain and France. In my sentiment I believe Hitler was to fault for the Second World War. Although I think that The Treaty of Versailles was unjust and excessively rough on Germany. Hitler and Germany shouldn’t have reacted the manner they did. There were a batch other options that Germany could hold took to work out the job. France and Britain should hold truly stopped Hitler and stood up to Hitler. But I don’t fault them for non seeking to halt Hitler because so that would hold caused another universe war anyhow. Who knows that might hold been a bad move. and caused more problem than the war that Hitler created.

What are the benefits of adopting from a shelter Professor Ramos Blog

What are the benefits of adopting from a shelter Adoption

Human Rights Research Paper Example | Topics and Well Written Essays - 500 words

Human Rights - Research Paper Example orts and medical personals who attended to these patients, the symptoms were largely internal including breathlessness, foaming from the nose and mouth, dizziness, running nose, irritation and constriction of the eye pupils, blurredness, nausea, vomiting, general body weakness and loss of consciousness. These symptoms were consistent with exposure to neurotoxic substances The US assessment confirmed the death of more than 1400 people including many children (The White house, 2013; Syria chemical attack, 2013). Experts believe that this attack by the Syrian government aimed to eradicated opposition forces in the Damascus regions. In its previous attacks using most of its conventional weaponry the regime has been unable to clear the region of the opposition elements and hence has resorted to chemical warfare. The Syrian government has loads of chemicals in stock including sarin, mustard, VX, and munitions to deliver these agents to the target locations. The Syrian military is believed to possess thousands of tons of chemicals and its precursors including huge quantities of sarin along with the required knowledge and expertise on the use of chemical warfare (The White house, 2013; Syria chemical attack, 2013). The final call for carrying out a chemical attack rests with the Syrian President, Bashar al-Azad, who had initiated a similar chemical attack, but on a smaller scale last year in the Damascus region. Further reports have also confirmed that personal from the Syrian Scientific Studies and Research Center (SSRC) were involved in the preparation of the chemical weapons before the attack. The chemicals used for the attack were mixed in a nearby region and the regimen employed surface to surface rockets and artilleries to carry out the attack. Within three hours following the attacks, many hospitals in the Damascus region received thousands of people displaying symptoms of neurotoxin exposure. The role of the regimen in the attack was further confirmed through

Roy Adaptation Model applied to Leadership and Management and Nursing Research Paper

Roy Adaptation Model applied to Leadership and Management and Nursing Education - Research Paper Example Theories have always been of prime importance in the field of nursing. They are the set of actions or activities, whose foundation is on the policies, guidelines, procedures, plan, or method that an individual follows. These specialized theories and doctrine have come under several classifications and groupings that professionals carry out and perform in various parts of the earth. There had been many theories associated to nursing and health care that has the primary focus on looking after the ill, unwell, ailing, with poor health conditions, injured and old-aged people (Meleis, 2007). NURSING THEORY Philosophical perception has molded the Nursing theory, which is the understanding of a phenomenon or an event that assists the nursing convention or process through the conglomeration of knowledge, thus, assimilating many researches and experiments when identifying the nursing convention. ... One of the most well-known and popular personalities that the world has recognized, for the uncountable services that she had provided to numerous people, known as Florence Nightingale has emerged and originated the concept of contemporary nursing theory in the middle of 1800s. Prior to the existence of the nursing theory, the nurses acted liked puppets in the hands of doctors, as the foremost and principal job of any nurse was to follow only the doctor’s prescription and guidance for taking care of the patient. Florence Nightingale placed the cornerstone with her approach that not only gave a broad and a new form and path to the nursing occupation, but also made it noticeable and apparent in the field of medical science. She developed a sense of consciousness amongst the nurses with her incredible work that this profession does not merely mean to take care of the patients upon doctor’s prescription, as it is not at all an acceptable approach for patient care. Rather, t hey should comprehensively assess the patients need and make them satisfy, comfortable and healthy with their behaviors and actions through the execution of appropriate patient care (Marriner-Tomey & Alligood, 2006). The nursing theories come under development so that the nurses have a standardized set of actions as it administers a structure and a guideline for them. The theories are in continuous support to the practices of the nursing models that have emerged as several divisions of nursing have came into existence, thus, the patients’ needs became utmost important and provision of the proper care for the patients is the basis for each nursing model (Alligood & Marriner-Tomey, 2006). The types of nursing theories include â€Å"grand nursing

Statement of purpose 4 Essay Example | Topics and Well Written Essays - 1000 words

Statement of purpose 4 - Essay Example The fees are the least of my concerns for now because I know that in the end, all my sacrifices will pay off whatever I will spend as I enter your university to get the education I so much desire to enhance my communication and teaching skills. I am Hashem Adnan Ahmed Hussein Abdullah Jasem, a Kuwaiti who is proficient in Arabic and the English languages. I am currently employed at the Ministry of Education in Kuwait as an intermediate school English teacher specifically for boys, starting during the last quarter of last year. Being new in the profession, I found out I still have so much to learn and one of which is about teaching the English language to speakers of other languages. When I was a student myself, it all seemed so easy for me to teach the English language but that, I now realize, was because I had the inclination to easily learn foreign languages. Learning however, is an entirely different thing because in the learning process, I concentrated more on how I could assimil ate all the information given me at the speed I desired. Teaching on the other hand involves learning and imparting what one has learned, to various students who have different levels of speed in absorbing the information given. ... experience, I searched for schools that could accommodate me and at the same time cater to my needs and I found your good school to meet the help I am seeking for to improve me in my chosen profession. I believe I could work well with my professors if given the chance because I know I have the determination and passion of a young student who so much desires to be educated by efficient instructors who know how to bring out the potentials of their students. I am completely confident that your institution has all the resources not only materially but especially in the employment of quality educators. I have gone over the program of the school for the course I like to enroll in and I pretty much like it especially practical teaching, research methods in language learning and teaching and the theories of foreign language learning. I believe these programs would help me a lot in the improvement of my skills when it comes to communication and teaching the language I am most interested in, E nglish. As an applicant to your well-known school, I am looking forward to be a part of your achievements with my humble contributions. Being young and voracious to learning, I know the university can take advantage of my possible contributions, though they might not be world-changing. I have been a good student, though not excellent enough to claim awards but my involvement to sports could give me some good credits. I have been an enthusiastic football player since I was eleven and have been privileged to be a part of the team sent to the Arabian games tournament for schools in Algeria in 2006. In addition to that, I also took part in the football team of our college which won the Kuwait University Championship Games for three consecutive years during my stay in college. Currently, I am

Similarities And Differences Between Sport And Physical Education Essay

Similarities And Differences Between Sport And Physical Education Essay Introduction Throughout this essay I will identify the definition for both sport and physical education, implementing my own interpretation. I will also explain the differences and similarities between them. My research will be based largely on the affect physical activity has on school children. I aim to concentrate my research on the method of teaching PE and sports, introducing both linear and non-linear pedagogy. Finally, I will conclude with my own understanding of my findings and where I feel research should be continued in order to ensure both PE and sports is an active part of every childs life, especially after leaving school. Sport v PE Classifying the definition of sport is not as simple as it seems. Research states, an athletic activity requiring skill or physical prowess and often of a competitive nature, as racing, baseball, tennis, golf, bowling, wrestling, boxing, hunting, fishing, etc. (http://dictionary.reference.com/browse/sport). This is true, however, there is a lot more to it that just skill and competition. Although rules are a major part of sport, making it sound more serious, it can also be fun and entertaining. Physical skill is a key advantage in playing sport, however lets not forget that most sports also require mental skill for strategic planning. The most important aspect of sport is having fun with the added bonus of maintaining a good fitness level. The term sport comes from the old French desport which means leisure. http://en.wikipedia.org/wiki/Sport. Physical Education is Training in the development of and care for the human body; stresses athletics; includes hygiene. http://www.wordwebonline.com/en/PHYSICALEDUCATION. It is a taught course taken during primary and secondary education that encourages psychomotor learning in a play or movement exploration setting. http://en.wikipedia.org/wiki/Physical_education. In the UK, Physical Education classes are compulsory in school until approximately age 16. As well as learning basic sporting skills, the curriculum also pays attention to health and fitness. My first recollection of PE at School was playing pirates in the school gym which involved running around on sporting apparatus being chased. PE is not always being taught the obvious sporting game such as football, hockey, etc. Its aim is to enhance an individuals progress through a variety of activities, which will boost their confidence level; hence my pirate game vastly improved my agility skills. As the student progresses, leaders hip skills are incorporated into the programme as well as being encouraged to be player independent in their decision-making. The most obvious similarity between sport and PE is that they both involve physical activity. Physical health benefits are gained by taking part in regular physical activity, whether that is during school hours (PE lessons), an extra-curriculum activity, or playing for a local club. Research shows that children who participate frequently in physical activity will reduce their chances of acquiring certain ailments such as diabetes and obesity, therefore improving their quality of life. However, other benefits such as affective and social are also gained. Research suggests that affective development is now evident with children. One of the main signs of this is a childs self-esteem that grows stronger when partaking in physical activity. Research show that stress, anxiety and depression, can also be significantly reduced with regular exercise. Probably the most important aspect of both sport and PE is social benefit. Whether you are playing football with a few friends or in a controlle d PE lesson, it is evident that this is a major part of a childs social learning skills. Anti-social behaviour is frowned upon and, to fit in, children tend to conform to the norm. Also, for an introvert child, communication though activity can help dramatically improve their interaction with other children outside of sports and PE and this has a knock-on affect with their affective skills also (Bailey, 2006). However, there may be implications. For example, we are assuming that pupils are enjoying the physical activity and are good at it. What if a child suffers with ability and/or may be teased by other school children for their lack of coordination? This may cause the child to become introvert and depression and anxiety could occur. Although PE has a positive effect for most, this concern needs to be considered carefully when planning PE lessons at school. However, sport is more about being competitive and winning medals and trophies. Although PE can be competitive, teachers introduce fair play; ensuring teams are equally balanced, whether that is by age, sex, and/or ability. However, in sports, the best players are selected for the clubs first team and those with less skill will be placed in a lower performing side. Sport is voluntary and the number of participants can vary from club to club, but the size of group/team can be adapted to suit the requirements of a match. However, PE is compulsory in schools and classes can be vast, this can cause problems for the teacher when applying rules and instructions, especially given that a proportion of children do not want to partake and may be unruly. Within sports there are leagues and competitions, involving officials and a fixture secretary and each club concentrates on one particular sport. However, the chosen activity for a particular PE lesson is usually decided by the teacher and can vary from lesson to lesson. This decision can also depend on the environmental conditions and equipment available to that school. For example, it is difficult for a school in the centre of London to partake in an outdoor adventure activity, as there are no local amenities to support this and some inner city schools dont have the funds to purchase expensive equipment. Linear and non-linear pedagogy The basic skills of PE are learned during a childs school years. This is normally taught using linear pedagogy, a more traditional method. Once the basics are learnt, a pupil may wish to expand on this skill and join a particular sport they excel in. This is where further, more advanced coaching, takes place and in my experience, a more non-linear pedagogy approach is implemented. Linear pedagogy is teacher centred, instructional, technique-based and practiced method. This style is more advantageous in schools than clubs, where, due to enormous class sizes, it is easier for the teacher to maintain control of the class. However, there are problems with this approach. For example, in my school-day experience, in order for skills to be learned, the teacher would use drills to demonstrate a technique and it was a luxury to play a game. This was a disappointment to my peers and me. Tactics were rarely mentioned therefore my decision-making was poor. Non-linear pedagogy leans more towards the Teaching Games for Understanding (TGfU) way of teaching where it is player centred, involving engaging an individual in being encouraged to think for themselves in both tactical and technical aspects (Thorpe and Bunker 1989). Its major advantage it that it is designed to guide players to become independent in their decision-making. For example, a typical training session may involve a short modified game to identify the teams failings. Drill sessions would then take place to strengthen these weaknesses. After the drills, another game would be played to implement the new skill, using their own thoughts. The coach encourages player independence by applying strategies to match an individual players game, therefore improving their decision-making throughout a game (Light, 2006). The main problem with linear pedagogy is that it can be strict and disciplined, almost military style, therefore enjoyment, which should be a major factor, is low on the list of achievements and participating in both PE and sport should definitely achieve this. Lessons become predictable and children tend to pay less attention due to boredom, therefore not much learning will take place. Also, too much structure wont allow those with less ability to achieve the aimed outcome and, instead, may become stressed at their inability to master the skill. This could also damage their confidence. By not allowing children to think for themselves, it reduces their scope of learning and their tactical skills will be limited. Non-linear pedagogy is not without its faults. At school level, it may lack adequate theoretical teaching from a motors learning perspective. Receiving little instruction from the teacher can result in the child not being able to make the correct decision. It is very difficult to measure whether or not the children are learning anything and it can look a lot like chaos (Mack, et al, 2000). Conclusion Taking into consideration the research and my own interpretation, it is encouraging to see that both PE and sports has a positive affect on majority of children. However, my findings highlight the need for schools to reconsider their method of teaching PE. Other less traditional styles should be implemented to enhance the enjoyment of the lesson, which may encourage children to continue their interest in extra-curriculum sporting activities and perhaps join sporting clubs upon leaving school. This will then increase the number of potential elite athletes. Further research needs to be undertaken to investigate the effects of social behaviour in children. For example, how does participating in PE and sports help reduce crime rate? What can the government do to ensure people from deprived areas are given more opportunities to partake in sport? Overall, any type of physical activity should be a part of everyones lifestyle. Although playing sport is more of an individual choice, it is vital that PE remains a compulsory part of the curriculum at schools as this is the grass roots encouragement they require to continue in their enjoyment and progress to playing sport after leaving school. Reference list: http://dictionary.reference.com/browse/sport http://dictionary.reference.com/browse/Physical+education Ones I have not used yet: http://www.tgfu.org/taskforce/index.htm http://www.citejournal.org/vol1/iss1/currentissues/english/article1.htm http://www.suite101.com/content/teaching-breathing-exercises-for-singing-a146136 http://www.questia.com/googleScholar.qst?docId=5002249790 http://www.bmj.com/content/327/7415/592.full

Ibsens A Dolls House being Dated Essay -- A Dolls House Henrik Ibse

Ibsen's A Doll's House being Dated To answer the above, one needs to be aware of when the drama was first written (1879) and how audiences were shocked at Ibsen's radical perception of the social roles of husband and wife in middle class society at that time. The role of middle class women at that time was simple, they bore children and kept house in a very clear manner, albeit with the aid of a housekeeper or maid. They were subservient to men and were considered accoutrements and playthings. This comes across very strongly in the manner that Torvald Helmer addresses Nora. The main thrust of the play has a lot to do with gender relations in modern society. It offers us, in the actions of Nora, a strengthening of the view of women struggling to overcome a society governed wholly by men resistant to change. Although this has changed dramatically since, there are still many corners of society nowadays that still cling to this belief and ethic. What was radical the case of this play was that Ibsen chose to bring this into the open. My first impression of Nora was that she was a shallow figure, that she was a selfish, self indulgent manipulative person with not a care in the world. We see as the play progresses that this is not the case and her personality changes to reveal someone very different. The will to 'do right' by her husband becomes evident as the play unfolds. We learn that life then was very much the same as today, in that middle class life was, in the main, affluent and agreeable, but only for those that could operate within it successfully. For those who couldn't life was brutal and unforgiving. We see that the Helmers are looking forward to life being even more comfortable once Torv... ...n truly happy, she had only experienced fun. That she had finally lost her love for him because of his reaction to Krogstadt's letter outlining the dishonesty in obtaining the loan. 'No man can be expected to sacrifice his honour, even for the person he loves' he exclaims. 'Millions of women have' she retorts. She leaves, the play closes. What I gather from the play, the only clue to the age is that of some of the dialogue. I don't think the theme is dated at all. Consider, the need for social standing, still as potent today as then. Consider the political manoeuvrings, surrounding position in the workplace, very much still in place today. Consider the power of seduction and finally, the strength of character a woman needs to stand up for what she feels is right even to her own detriment. Very powerful, very thought provoking and very, very enjoyable.

Case Analysis †Giant Consumer Products Essay

1)Using data in Exhibits 1 & 4 develop solution templates in Exhibit 3 for Sanchez. From the table above, it is clear that the impact of a promotion cannot be considered in isolation. On the whole, the promotion has resulted in a loss instead of a profit for the Dinardo range of products. Considered in isolation a promotion on Dinardo 32 may look attractive but overall it’s a loss-making proposition. 2)Do you advise Sanchez to run a national sales promotion? If so, which one of the items the funds be allocated: Dinardo 32, dinardo 16 or natural meals? Sanchez can run a sales promotion for Natural meals. This is the only profitable option as can be seen from Solution template Part-3 in the table above. 3)Prepare Sanchez for additional strategic/ tactical questions that he anticipates from Flatt given at the end of case. a)The promotion of Natural Meals would be a win for FFD, the retailer as well as the consumer. FFD gains due to a positive increase in marketing margin due to the promotion. For the retailer, the benefit will be on account of the increased spending by FFD for promotional activities. The margins on Natural Meals are higher for retailers and an increase in volumes would directly have a positive impact on retailers’ revenues. The consumer benefits due to the reduced prices from the promotion. b)FFD should go with the pay for performance approach for promotion of Natural Meals. The price on the box of the product should not be reduced and instead a discount must be offered at the time of billing. The retailer should then be reimbursed for the discounts offered to customers. This would help retain the premium positioning of FFD’s products and avoid customers from looking at the products to be available at a deal during subsequent purchases.

Believing God

My parents thought me Christian values and Christian ethics and they sent me to a Catholic school during my childhood that's why I grew up believing that there is really a God. There are always obstacles in life that makes one another question if there is a God out there. I had personal experiences that there is God's presence. One question, why do we pray? To whom do we pray? I think this is the best way to see the presence of God. We pray because we believe in God. The Muslims, Buddhist, Christians, etc. may have different Gods but they believe that there is a God. God's presence for me is when I pray.Every night, before I go to bed, I always pray for the safety and health of my family and friends. When I wake up and knew everybody is okay, I also pray to thank Him for answering my prayer. Every morning, I already feel His presence inside me. Also, when I'm feeling sad and depressed, I always ask His guidance and help to resolve my problems. Blessed, He answered my prayers and most of my problems were resolved. I think we all have different types of relationship with God. Another example about the presence of God is about what my grandmother(who lived with us for 16yrs) told me when she was sick and diagnosed with stage 4 ancer.She told me that every night, every time she sleeps, she always dream of his husband, dead relatives, or sometimes an unknown man calling her. One time, she told me that she dreamed that she was in the sky and an unknown man is calling her to go with her. She told that He was God. Maybe she didn't go with Him many times because she knew that we are not yet ready to let her go with her Creator. For how many days have passed and we told her that we are ready to accept whatever happens, she Joined with her Creator. With her story, I really felt the presence of God and my faith in Him grew stronger. Another influence is from my parents.We celebrate a lot of Christian events. For example, the Holy Week. Our family do Visita Inglesia during Holy Weeks and we do the Stations of the Cross to know more about the story of God's son, Jesus. I think this influence also helped me to really believe in There are also times that I feel the absence of God. Every time I fail to achieve something, I always blame God. For example, recently I took the BSA Qualifying Exam. not pass the exam. I was so depressed during those times and thought to myself where is God during those times. After how many days, I still pray to him to help me ith my decisions in life and He answered my prayers.My parents and friends comforted me, help me decide and told me that it is not the only course in college that will make me a successful person. They said that I should work hard and pray hard to resolve my problems. These are the only things(failure) that I feel the absence of God but with these failures, good things happen right away. We can always see the presence of God everywhere. For example, we can see a lot of Holy objects everywhere – ros ary, pictures, etc. We can also see a lot of people going to Church to pray and ask petitions to Him. Also, why do people avoid to commit sin?Maybe because they believe in Heaven and Hell. They also know that they lose the presence of God when they commit a sin. As long as we try very, very hard not to commit sin, deliberate mortal sin, God is on our side and we are in His Presence. God continues to love us, no matter what, but He hates the sin. God is everything. For what I understand, God created all the things here on Earth. As a conclusion, to feel His presence, we should always pray for Him, have faith, avoid sins, follow the ten commandments, and we should love all the things He had created.

Free Essays on Elvis

Elvis’s Influences Elvis has meant many things to many people all over the world. He was gone from Rock’n’Roll to Hollywood Heartthrob, back to Las Vegas megastar. But if you look carefully Elvis was nothing than a mere boy raised in the south that was taught to love his mama and Jesus. These are the basic things that made him a great rock and roll legend. Elvis changed the face of rock and roll forever with his dance moves, sexuality, style of clothes, long hair, and different style of music that was no accepted by all Americans. Also his used of black music and black style made a lasting impression in history (Pratt 377). Elvis introduced many different styles to the music world during the 1950s. The black population influenced many of these. Elvis did t sound fully white, were fore many radio stations we cautious of playing his music due to the â€Å"black-white rigidities of a segregated society† (Pratt 376). He used different types of black music to make his own. He was â€Å"the only artist to have the same record at number one on the pop, country, and rhythm and blues charts† (Schmidt 339). Many black Southerners resented this and all the success that he gained by it because he was using music that had originated by black but was unable to be sold on the market due to the â€Å"segregated commercial world† (Pratt 377). Although some black musicians resent him, some pay tribute to him like B. B. King and James Brown. They believe that through his use of black music it opened up many opportunities for them (Rosenbaum 388). Fusing black music with white country music to make a new kind of music was the thought be his â€Å"best known aspect of his career and his greatest accomplishment† according to Pratt (337). From his gyrating hips to his shaking body, Elvis’s must stunning quality was his sexuality. He was banned form performing and was shunned by mothers and fathers but he was adored by all his young fans that... Free Essays on Elvis Free Essays on Elvis Elvis’s Influences Elvis has meant many things to many people all over the world. He was gone from Rock’n’Roll to Hollywood Heartthrob, back to Las Vegas megastar. But if you look carefully Elvis was nothing than a mere boy raised in the south that was taught to love his mama and Jesus. These are the basic things that made him a great rock and roll legend. Elvis changed the face of rock and roll forever with his dance moves, sexuality, style of clothes, long hair, and different style of music that was no accepted by all Americans. Also his used of black music and black style made a lasting impression in history (Pratt 377). Elvis introduced many different styles to the music world during the 1950s. The black population influenced many of these. Elvis did t sound fully white, were fore many radio stations we cautious of playing his music due to the â€Å"black-white rigidities of a segregated society† (Pratt 376). He used different types of black music to make his own. He was â€Å"the only artist to have the same record at number one on the pop, country, and rhythm and blues charts† (Schmidt 339). Many black Southerners resented this and all the success that he gained by it because he was using music that had originated by black but was unable to be sold on the market due to the â€Å"segregated commercial world† (Pratt 377). Although some black musicians resent him, some pay tribute to him like B. B. King and James Brown. They believe that through his use of black music it opened up many opportunities for them (Rosenbaum 388). Fusing black music with white country music to make a new kind of music was the thought be his â€Å"best known aspect of his career and his greatest accomplishment† according to Pratt (337). From his gyrating hips to his shaking body, Elvis’s must stunning quality was his sexuality. He was banned form performing and was shunned by mothers and fathers but he was adored by all his young fans that...

Financial Plan for Small Business Research Paper

Financial Plan for Small Business - Research Paper Example The financial plan in this case is based on NASDAQ listed 1st Century Bancshares, Inc (Ticker: FCTY). The total market capitalization of the company is $66.44 million as on May 9, 2014 (Yahoo Finance, 2014). The balance sheet is the most important financial statement of any business irrespective of its size or market capitalization. It presents the financial position of the business on a given date. It is divided into three sections namely, assets, liabilities and owners’ equity. Assets and liabilities are further classified on basis of period of maturity. Assets include, cash, accounts receivables, inventory, land & buildings, goodwill, etc. Liabilities include account payables, debt capital, creditors, etc. The positive difference between total assets and total liabilities is the shareholders’ equity (Ramachandran and Kakani, 2009, pp.3-9). The historical balance sheet of business reveals that during the period 2011 to 2013, the company had very strong cash and its equivalents. However, the net cash and cash equivalents declined by 5.7 percent annually to $0.155 million in 2013. The total current assets of the company comprised of net receivables, cash and cash equivalents only. The total assets of the business increased by 15.2 percent historically from 2011 to 2013. In comparison, the current liabilities and total liabilities of the business increased by 15.8 percent historically from 2011 to 2013. The company does not intend to issue debt instruments as it has sufficient cash resources available for attaining its financial objectives. Historically, the shareholders’ equity increased by approximately 10.9 percent at compounded annual growth rate. The historical information about the financial position of the business will assist in determining the probable course of action of the business through projected fin ancial forecasts. The pro-forma balance sheet of the business is presented below: By observing the historical information about the

Autonomy of Financial Institutions Research Paper

Autonomy of Financial Institutions - Research Paper Example While politicians and regulators propose a regulated trade system that would mitigate risks of default of one party, maintaining transparency, and providing consistent prices, the bankers pull in the complete opposite direction. The banks want the market to remain as it is whereby over the counter derivatives (OTC) remain unregulated and with unpublished prices to the public. Banks warn that any ban on the unregulated OTC will upset the current markets and lead to possible lawsuits. However, the European Commission maintains that its proposal for a regulation is meant to protect consumers, and spur competition. Thus, on this issue, bankers and politicians hardly see eye to eye. The U.S, as an answer too to the Great Depression, also passed the Dodd-Frank Wall Street Reform and Consumer Protection Act, geared towards more regulations for the financial institutions. However, it lacks the cutting-edge proposal of banning the over the counter derivatives. It should be remembered that these proposals are law in no shortage of critics. While some people, especially bankers, say that it encroached too deeply into the financial institutions’ regulations; others argue that it is hard enough to curtail the possibility of another financial meltdown.  If the banks continue in the direction where there are no published prices for the OTC, no specified quantity and quality on the deliverable, then there is an obvious lack of transparency. This grey region only benefits the  banks. It cushions them from taking the responsibility of the financial losses.  Bankers argue that the small companies which have not attained the exchange listing requirements will be l ocked out of the securities trade if the government bans the OTC. Markets in Financial Instruments Directive (MiFID) proposal is clear cut- it wants to ban the over the counter derivatives.

Wal-Mart Article Example | Topics and Well Written Essays - 250 words

Wal-Mart - Article Example It also has an incredible team of executives who form its leadership. This has equipped Wal-Mart with management of high caliber. Finally, the Company spends its resources carefully with the aim of maximizing their margins while reducing costs. The company focuses on strategies such as everyday low prices that helped it stay ahead of its competitors. More so, the company’s retailer opened new small stores, which helped it overcome its competitors such as Amazon.com and dollar stores. It faced tough competition from these companies but it managed to make profits. The company has been replacing its discount stores with supercentres. In this supercentres, Wal-Mart added grocery products and other new services to its existing traditional merchandise offerings. The company tried to expand internationally by offering the everyday low prices strategy. More so, it opened more formats and ventured into e-commerce opportunities. The company should reshuffle its top management in United States to head the U.S stores. In addition, the company needs to replace urban stores with Wal-Mart express stores, which will resemble convenience stores. The company had to rely on e-commerce by expanding its online business such as moving into digital books, appliances, music, and groceries. This made it compete with Amazon.com since it took advantage of its physical presence by providing daily pickup for digital or online

Software Requirement Specification Essay Example for Free

Software Requirement Specification Essay In existing system, professor takes the attendance manually and records the details of absentees or presenters. Using this records professor stores the student’s attendance in each day in the attendance list and calculates the attendance percentage manually. In this system professor must consider each student separately and keep this list safely. It takes lot of time. Professor must spend more time to record the each student’s attendance in the attendance list. The project aims in implementing software that helps professor to take the attendance using mobile phone. For this mobile must support java application. This project is based on J2ME technology. Professor enters the attendance to the mobile using keypad. It is a manual process. After saving the absentees or presenters in to the mobile, teacher can edit the attendance list in the mobile. And this attendance details can send to a computer using GPRS. After sending the files to a computer, attendance list must be updated automatically. Modules 1.User Module: The main purpose of the user module is to provide security. This module is specially designed for staffs, which use mobile phone to take attendance. Each staff enter username and password before enter in to attendance list. If username and password cannot match, he/she can’t enter in to attendance page. 2. Attendance Entry Module: The purpose of Attendance Entry Module is to mark the attendance using cell phone. In this module Lecturer takes the attendance using the cell phone. Lecturers select the branch, semester and year. After this session he enters in to attendance page. Here staff makes a mark on the absentees. 3. GPRS connectivity Module: The main function of GPRS connectivity module is sends attendance list to the server database by connecting cell phone with the server through GPRS. In this module attendance list in the cell phone is sends to the database. 4. Updating the Database Module: The first function of this module is to update the attendance list from the cell phone. When the attendance list from the cell phone receives, server automatically updates its database. The server updating the database whether any change from cell phone occurred. 5. Display Module: The Displaying attendance list Module deals with the WEB application of CBAS. In this module Students can view their attendance through WEB. Student must select the branch and year then they get the attendance list of the class. 6. SMS Module: The main advantage of SMS module is that the Students can know their attendance by sending SMS from anywhere. Students send a SMS to the server with their register number. If it is in correct format, the server will replays the attendance of corresponding student through SMS. Otherwise sends an error message.

Patient Diagnosis: Lack of Energy Presentation

Patient Diagnosis: Lack of Energy Presentation Summary This dissertation is based on two patients who presented to medical services with a presenting complaint of a lack of energy?. My first patient, Mrs W, 61 years, has Diabetes Mellitus, type 2 and my second patient, Mr H, 59 years, has severe anaemia from unknown lower Gastrointestinal blood loss. I shall begin by focusing on the clinical aspects and basic medical sciences of their diseases and then go on to discuss psychosocial aspects, management, investigations and the role of professionals involved in their health care. I will then look at research and evidence based trials to explore the scope of their conditions and look at any current research that is being carried out. Throughout my dissertation I aim to reflect and convey what I have learnt and how I felt about my experiences. From writing this report I have developed as an individual and have gained personal advancements that I didnt expect to achieve. I have been able to widen my understanding of diseases and patients experience of their disease. Furthermore, I have gained an appreciation for research and evidence based medicine and developed a respect for other health care professionals. I have learnt the vital importance of taking on a holistic approach when dealing with a patient, rather than just looking at the basic science behind a disease. All in all, writing this dissertation has enabled me to truly understand how a disease can affect a patient and I now appreciate that it is not always about curing a patient, but about treating, advising and working towards a better quality of life for the patient and their family. 1. Introduction In my dissertation I aim to explain, explore and reflect on my experience of the People and Disease course. In particular I will focus on my experience of meeting with two individual patients with the same presenting complaint a lack of energy?. Both patients seem to be concerned with the prognosis of their disease but from very different points of view. My first patient wants to overcome her diabetes and not let it worsen; whereas, my second patient does not wish to know the cause of his anaemia, but is worried about the associated symptoms of his condition and how they will progress. Before contacting my first patient, Mrs. W, I felt apprehensive and quite anxious about the idea of having my own patient. I was worried about what she would think of me, how we would be able to build a rapport and what sort of questions I would ask her. In all honesty, I had naturally stereotyped her as a typical old lady?, but on meeting her, my initial thoughts were soon corrected. From this I have learnt that when given details about a patient you shouldnt necessarily stereotype and categorise them into a certain group in society. When asking her the initial questions that I had prepared I felt that it made the conversation very informal, so to adapt to the situation I just literally let her speak and tell me whatever she wanted to. This was very helpful to me as she had a lot of things she wanted to tell me and talk about. However, I do realise from communication skills seminars that not all patients will be as open as this in the future and therefore I do need to have the ability to speak to patients that are perhaps a bit more reluctant and unwilling to share their problems and thoughts. For example, you can use a lot of open questions to allow the patient to answer what they feel is comfortable for them and just gradually develop the conversation from what they say, rather than chit chatting?, which is what I found with my first patient. After asking Mrs.W about her recently diagnosed diabetes she seemed very unsure how to explain to me what she thought was wrong with her, she seemed to resent the fact she has a disease and questioned what she had done to deserve becoming ill. She said that even though the Doctor had explained everything to her, she was unsure of what to expect in the future and seemed quite worried about the aspect of not being able to care for herself. From telling me all of this, I felt quite overwhelmed and unsure of how to reassure her. Even though I wanted to help, I found myself in a situation where I physically couldnt, which was very frustrating. On my second and third visits I asked a bit more about her family situation, her social activities and her thoughts, ideas and feelings (psychological factors). From taking on this broader approach, I began to realise the true picture of Mrs Ws life and how it contributed to the worries of her illness. She told me about her husband leaving her and h er daughter and son becoming quite distant, she explained that she often felt lonely and at times it made her feel quite depressed. This seemed to be more of a concern to her than her actual illness, but it demonstrated why she is concerned about her diabetes worsening because she has very little family support and would have to cope by herself. From the meetings with Mrs W, I have learnt the vital importance of taking on a holistic approach when speaking to a patient. I have learnt that its not just a biological illness that contributes to the wellbeing of a patient; you have to take into consideration the home/family environment and the social and psychological factors. Not only have I had the opportunity to see an illness in the context of real life but I have greatly improved my confidence and patient communication skills by being able to gather information, take family history and cope in a one-to-one based home environment. However, my experience from meeting my first patient contrasted completely with my second patient experience. Initially I had some difficulties finding my second patient, as the consultant I had contacted only ran morning clinics; so I took the initiative to go into the hospital and find a suitable patient myself. Even though I felt quite nervous, I went onto the haematology ward and simply explained to one of the nurses about my course and what had happened so far with trying to find a patient. She was extremely helpful and understanding, which put me at ease and she more or less found me a patient right there and then (which I hadnt expected). However, even though I hadnt really prepared anything I already felt that I had developed some good skills and awareness of communicating appropriately with patients, both from my first patient and communication skills seminars, to be able to build up a good report with my second patient. Mr. H (my second patient) was very different to my first patient in the sense that he wasnt as open when talking about his illness. He is suffering from severe anaemia and has to have blood transfusions every week (so like my first patient, had the presenting symptom of no energy). However, he didnt seem to recall any dates of his illness and didnt want to explain what had caused the anaemia. However, after reading his medical records and meeting with his consultant, I came to realise that Mr. H had had a bad experience with a doctor and had adamantly refused further investigation, so his severe/worsening anaemia remains an unknown cause. Also, in comparison to my first patient, he had a much more considerable loss of energy, so even though he gave consent for me to talk to him, I felt at times he needed a break so I ensured that I did not stay too long and trouble him during my visits. Nevertheless, I found that meeting a patient in a hospital environment is completely different to meeting them in a home environment. In a hospital environment you need to be very aware of everything around you, how you are acting towards other staff and patients and there is a real need to realise certain cues from the patient (as they are in a more severe situation than a patient in a home environment). Overall, the People and Disease course has been a really enjoyable learning curve. Ive been able to put my communication skills to practice and see how to adapt to different situations, which has boosted my confidence enormously. Even though there is much more to learn, I really look forward to doing so and I hope that I will develop the skills needed to become a good doctor in todays society. 2. Clinical Features In this section I aim to discuss clinical features of my patients diseases and differential diagnoses. My first patient was diagnosed with Type 2 Diabetes Mellitus and my second patient suffers from severe anaemia; both of these conditions have similar clinical features and the same presenting complaint of a lack of energy and fatigue. Both of my patients recorded symptoms of lethargy, dizziness, fainting and shortness of breath; exploring these similar symptoms demonstrates the importance and accuracy needed for a diagnosis, as these symptoms could be indicative of a variety of other diseases. It is also vital to have a correct diagnosis, as a misdiagnosis would lead to unnecessary grievance, treatments or investigations which would cause a patient a lot of stress. Fatigue is the common presenting complaint in both of my patients and is clinically difficult to define; it is related to tiredness, exhaustion and a general lack of energy. Fatigue is a very common health complaint and around 20% of people in the United Kingdom claim to have fatigue intense enough to interfere with them having a normal life. Physical causes are estimated at 20-60%, and emotional causes are the other 40-80% (1).The fact that fatigue alone can disrupt ones life so severely indicates the important role of a doctor to be able to make a correct diagnosis for the cause of it. However, my individual patients described their fatigue in very different ways. Mrs W described her lack of energy in relation to feeling lethargic and very tired all the time, whereas Mr Hs fatigue was very much to do with a sudden onset of shortness of breath and chest pain. The symptoms that patients with anaemia normally present with are highlighted in the image below: (2) Mr. H has anaemia with haemoglobin levels often as low as 3.2gm/dL; with the normal range being 13 18 gm/dL for a male and 12 16 gm/dL for a female (2); indicating that his anaemia is very severe and therefore explains why he would experience fainting, chest pain and angina as shown in the image above. And in comparison to Mrs. W, highlights the difference in their experience of their clinical presentation of a lack of energy. Type 2 diabetes was previously referred to as adult onset diabetes and is related to insulin resistance and a relative, rather than an absolute, deficiency of insulin secretion (3). Due to the fact that this type of diabetes is concerned with gradual insulin resistance/deficiency means that individuals do not always (or initially) require insulin to achieve satisfactory diabetic control. The common symptoms associated with Type 2 Diabetes are (4): Polyuria: the need to urinate more often due to the body trying to excrete the extra glucose that is in the blood and in turn creating an osmotic gradient resulting in more urine production. Polydipsia: feeling thirsty more often than usual, due to the loss of fluids (increased urine production). Weight loss: this is due to the fact that glucose is not being taken up by cells due to insulin deficiency/resistance, so the body starts to burn up fat instead, which results in weight loss due to fat storage depletion. The majority of diabetic patients experience lack of energy because the cells in the body are not getting the glucose that they need, resulting in lethargy and tiredness. As type 2 diabetes progresses, patients may also experience blurred vision, yeast infections and prolonged time for wound healing. Mrs W was diagnosed with type 2 diabetes in February 2007; initially only experiencing a lack of energy. Over the months that I met with her she also started to experience polyuria and polydipsia. She was concerned as to how much her diabetes would progress and worsen because it had not been made very clear by her Doctor. This demonstrates the important need for a Doctor to be aware of patients concerns and level of understanding of their disease process. However, when speaking to Mr H about his clinical presentation and symptoms he had a very nonchalant attitude towards the cause of his disease. I later discovered that his anaemia was in fact due to unknown lower Gastro-intestinal (GI) blood loss and on questioning Mr H about this; he explained that he refused investigation to find the cause of the blood loss due to dissatisfaction with the way he was treated. He explained that during a scheduled procedure for a colonoscopy, the doctor carrying out the investigation was extremely rough and caused him a lot of distress and discomfort. And even though Mr H asked for the procedure to be stopped, the doctor proceeded against the patients wishes; this aggravated Mr H and led to violent behaviour towards the doctor and the dispute was later taken to court. I was very shocked to hear of his experience and also felt deeply concerned that he refused future investigations as his symptoms and anemia are very severe and have lead to angina and disabling conditions; with him being unable to walk and get out of bed unassisted due to such severe lack of energy. This emphasizes the crucial need for a good doctor-patient relationship, as shown in this case, without it, a doctor may be unable to make a proper diagnosis and prescribe ideal treatment.   Differential Diagnosis:- Diabetes:- The process of looking at a differential diagnosis involves weighing the probability of one disease against the possibility of other diseases accounting for a patients illness. For example, Mrs W presented with a lack of energy for her diabetes mellitus, but this complaint could have been diagnosed as any other kind of condition such as, hypothyroidism or Cushings disease as they can also present with fatigue. Differential diagnosis to Diabetes Type II:- Why is the condition considered to be a differential diagnosis How to make the correct diagnosis:- Hypothyroidism Also results in a lack of energy and fatigue. Often diagnosed via a blood test, examining the levels of T3,T4 and TSH in the blood. Cushings Disease Polyuria (and associated polydipsia); insulin resistance (especially common in ectopic ACTH production) (5)which can lead to hyperglycaemia (high blood sugar levels), which can in fact lead to diabetes mellitus. Dexamethasone suppression test or/and a 24hour urinary measurement of cortisol(6). Hyperglycaemia High circulating blood glucose levels this is a symptom of diabetes, but could also be due to physiological stress, critical illness or certain drugs. Blood test which indicates a glucose level of 10+ mmol/L (180mg/dl) also a test for diabetes, therefore, need drug/medical history. Anaemia:- The differential diagnosis of anaemia would be any condition relating to the presenting complaint of a lack of energy?, or any other condition relating to the symptoms of anaemia, as discussed in the clinical features section. In particular relation to Mr Hs lower gastrointestinal bleeding the differential diagnoses are as follows: Differential diagnosis for lower GI bleeding:- Why is the condition considered to be a differential diagnosis? How to make the correct diagnosis:- Haemorrhoids Swelling/inflammation of veins in the rectum commonly due to straining in constipation. These can often rupture and bleed. Physical examination of external haemorrhoids, digital rectal examination for internal haemorrhoids. Colorectal Cancer Cancerous growths in the colon (thought to be adenomatous polyps) can rupture, thus causing a bleed. Digital rectal examination, Fecal occult blood test (testing for blood in the stool), endoscopy (7). Ulcerative Colitis A form of Inflammatory Bowel Disease, includes ulcers and open sores which lead to constant diarrhoea mixed with blood. Endoscopy; involving both colonoscopy and sigmoidoscopy. From exploring the differential diagnosis of my patients conditions it has made me more aware of the vital importance of making the correct diagnosis; as there are a number of conditions that certain symptoms could be caused by. Furthermore, considering Mr Hs anaemia it does highlight the fact that his condition could be a number of quite serious conditions, which shocks me even more as he has chosen not to find out the cause of his worsening anaemia due to his troubled experience with a doctor. 3. Pathophysiology It is quite complex to discuss the aetiology of both my patients conditions as the exact cause of type 2 diabetes is not fully understood, although clear risk factors have been identified. Furthermore, Mr H refused investigation into his GI bleeding, which results in the cause of his anaemia remaining ambiguous. Diabetes Mellitus Type 2:- Diabetes Mellitus is a group of metabolic disorders characterised by chronic hyperglycaemia (high blood glucose concentration), due to insulin deficiency, insulin resistance, or both. There are two main types of diabetes; type 1 and type 2. They can clearly be distinguished by their epidemiology and probable causation, but not always so easily separated clinically. Type 1 diabetes is due to autoimmune destruction of insulin-producing beta cells of the pancreas therefore, causing an increase in fasting blood glucose. However, diabetes type 2 is a disorder that is characterised by high blood glucose due to insulin resistance and relative insulin deficiency (8). Since diabetes is a disease that affects your bodys ability to utilize glucose, it is important to understand what glucose is and how your body would normally control it. Glucose is a monosaccharide (simple) sugar that comes from the food we eat, cells take in glucose from the blood and break it down for energy; brain cells and red blood cells rely solely on glucose for fuel. The Pancreas:- The pancreas (where Insulin is synthesised) has both endocrine and exocrine functions. The exocrine function involves the secretion of digestive enzymes that are secreted from acinar cells and released into the small intestine via a system of ducts. Additionally, the endocrine part of the pancreas consists of millions of clusters of cells called Islets of Langerhans that produce hormones. Within the islets there are four main cell types; cells secrete glucagon, cells secrete insulin, cells secrete somatostatin, and PP cells secrete pancreatic polypeptide (9). Glucagon and Insulin are hormones secreted from the pancreas that work concomitantly to control the level of glucose in our blood. Glucagon is released when blood glucose levels fall, therefore resulting in stored glycogen being converted to glucose and thus increasing blood glucose levels, preventing a hypoglycaemic state. Insulin is a hormone that causes cells to take up glucose from the blood and store it as glycogen, thus a deficiency or resistance of this hormone will result in a high concentration of glucose in the blood. Insulin Release:- Beta cells release insulin via the following process; The glucose uptake takes place through a specific transporter protein called GLUT-2. The pancreatic ?-cell membrane contains several K+ channels, and two of them are directly involved, the K+-ATP channel and the maxi-K+ channel. The hyperglycaemia (high blood sugar level) accelerates the glucose uptake and metabolism and thus increases the ATP/ADP ratio. Increased ATP closes the K+-ATP channels, so the cell depolarises. During deploarisation from the normal resting membrane potential of -70 mV, a threshold is reached at 50 mV, resulting in the opening of Ca2+   channels. The Ca2+ influx triggers exocytosis of insulin and C-peptide containing granules following vesicular fusion with the cell membrane. ne. This process is demonstrated in the diagram below (10): However, in an insulin resistant individual normal levels of insulin that are released (via the process described above), do not have the same effect on muscle, adipose and liver cells, therefore resulting in glucose levels staying higher than normal. Increased levels of glucose in the bloodstream over a sustained length of time result in damage to blood vessels. Poorly controlled glucose levels can lead to complications such as nephropathy, retinopathy, neuropathy and cardiovascular diseases. Even though these complications may take a while to develop, it is important to realise that type 2 diabetes is often diagnosed at a relatively late stage. From looking at the pathophysiology of diabetes, Mrs Ws main symptom of lack of energy/tiredness can be explained. Due to her slow progression of insulin resistance means that more glucose remains in the blood and is not utilised by certain cells, such as muscle cells. Therefore, due to the fact that her cells are not able to use the glucose, she experiences weakness and tiredness. This lack of energy will progressively become worse and she may develop other complications if her diabetes is not controlled appropriately. Anaemia:- Anaemia occurs when there is a decrease in the level of haemoglobin in the blood and occurs when the production rate of red blood cells does not match the loss rate. It is a common condition in which all forms can be defined on the basis of physiological mechanisms. There are three broad categories: decreased/defective red blood cell production; increased destruction of red blood cells; and a mixture where both mechanisms operate simultaneously (11). Haemoglobin:- Haemoglobin is a substance contained within red blood cells and is responsible for their colour. It is composed of haem (an iron-containing porphyrin) linked to a protein, globin (12). Adult haemglobin consists of two and two globin chains. The iron containing porphyrin in the haem group is bound to each globin chain and a ferrous atom that can reversibly bind one oxygen molecule (as shown below (13). The biconcave shape of red blood cells enables a large surface area for the uptake and release of both oxygen and carbon dioxide. Haemoglobin becomes saturated with oxygen in the pulmonary capillaries where the partial pressure of oxygen is high and haemoglobin has a low affinity for oxygen (therefore, binds easily). Oxygen is then released in the tissues where the partial pressure of oxygen is low and haemoglobin has a low affinity for oxygen (therefore, oxygen offloads easily). The haemoglobin molecule itself exists in two conformations, relaxed (R) and tense (T). The tense state is characterized by the globin units being tightly held together by electrostatic bonds; when oxygen binds to the haemoglobin these bonds are weakened and broken, resulting in the relaxed conformation. The binding of one oxygen molecule leads to an increased affinity for the remaining binding sites, this is known as co-operativity, and is the reason for the sigmoid shape of the oxygen dissociation curve (below (14)). The binding of oxygen to haemoglobin can also be influenced by secondary effectors (as seen in the above image) i.e. hydrogen ions, carbon dioxide, and 2-3 diphosphoglycerate. The binding of 2, 3 DPG stabilizes the tense state and therefore, reduces haemoglobins affinity for oxygen (15). In conditions with lowered haemoglobin/oxygen levels, such as anaemia or hypoxia the concentration of 2, 3 DPG increases to raise oxygen availability for tissues. Haemoglobin Synthesis:- Haemoglobin is synthesised in a series of complex steps, it takes place in the mitochondria of the developing red blood cells. The major rate limiting step is the conversion of glycine and succinic acid to ?-aminolaevulinic acid (ALA), this occurs via ALA synthetase. Two molecules of ?-ALA condense to form a pyrrole ring, called porphobilinogen. The pyrrole rings are then grouped together   in fours, to form protoporphyrins. Iron is then inserted into the rings to form haem and then finally, haem is attached to the globin chains to form haemoglobin. Production and removal of red blood cells:- Red blood cells are formed and develop in the red bone marrow of large bones; the process by which they are produced is called erythropoiesis. The organ responsible for turning on the faucet of red blood cell production is the kidney. The kidneys can detect low levels of oxygen in the blood. When this happens, the kidneys respond by releasing a hormone called erythropoietin, which then travels to the red bone marrow to stimulate the marrow to begin red blood cell production. Within the bone marrow there are many stem cells from which red blood cells can be formed. As these cells mature, they extrude their nucleus and fill with haemoglobin, forming reticulocytes which can circulate around the body. After 3/4 months, approx 120 days, red blood cells begin to weaken and their cell membranes become very fragile. The red pulp of the spleen allows mechanical filtration and removal of red blood cells, and any leftover components i.e. iron from the haemoglobin are recycled to form new red bl ood cells (16). There are several different types of anaemia such as B12 deficiency, iron deficiency, diseases of the bone marrow and in relation to Mr H, chronic loss of blood. His severe loss of blood has subsequently led to his anaemia as there is a mismatch in production of red blood cells and loss of blood. Due to his deficiency in circulating reticulocytes, oxygen, via haemoglobin is insufficiently supplied to his body, resulting in severe lack of energy. Complications of his condition have led to shortness of breath and angina.   Angina Pectoris:- Angina pectoris literally means a choking sensation in the chest?. It is an episodic pain that is usually felt in the centre of the chest, often radiating to the neck and left arm. Angina occurs because myocardial oxygen requirement is greater than what it is supplied with. This results in a buildup of metabolites, causing pain (17). Classic angina occurs after exertion, excitation or emotion and is caused by insufficient oxygen supply to meet its demand; however, the pain normally subsides with rest. Due to Mr Hs chronic blood loss, there is insufficient blood supply to the heart and subsequent stress is placed on the organ which has led to his angina. 4. Psychosocial aspects of Illness and Disease The impact of chronic illness and disability is far reaching, extending beyond the patient to all those whom the individual has contact. Illness and disability affects all aspects of life, including social and family relationships, economic status, activities of daily living, and recreational activities. Even though several factors influence the extent of impact, every illness or disability requires some adjustment to everyday life. The extent of the impact can depend on (18): The nature of the condition Individuals pre illness/disability personality The meaning of the illness to the individual Individuals current life circumstances The degree of family/social support With reference to my patients, they each had different outlooks on their illnesses as mentioned previously. However, they do have certain similarities when considering the psychological aspect of their diseases. Both patients were shocked to find out their conditions as neither of them had expected to be diagnosed with a lifelong illness. This is known as biographical disruption, which is a key sociological concept as it identifies severe illness or disease as a major disruptive and unexpected experience. The illness/disease leads to a biographical shift from a perceived normal trajectory to an abnormal one, with the development of a new consciousness of the body, fragility of self and grief for a former life. For instance, Mrs W had future intentions to look after and care for her grandchildren and Mr H wanted to carry on working as a HGV driver; but due to their conditions they cannot achieve these former life plans and now have to adapt to a new ones. Additionally, they both explained to me how they experienced the feeling of facing stigma. Stigma refers to the identification and recognition of a negatively defined condition, attribute, trait or behaviour in a person or group of persons (19) . There are different types of stigma, such as enacted or felt. Mr H explained how he felt shunned from his friends and some relatives which refers to enacted stigma; the real experience of prejudice, discrimination and disadvantage as the consequence of his illness. Whereas, Mrs W spoke about her fear of being discriminated against and what people would think/say, which falls under a felt stigma; a fear of enacted stigma, also encompasses a feeling of shame associated with being diabetic?. I feel that this notion of facing stigma is perhaps underestimated in health care because it is not necessarily something a Doctor would automatically think about and therefore, perhaps wouldnt advise the patient on how to deal with such feelings. However, from talking to my patients about how they feel about having an illness they both stressed how psychologically disruptive it is, and how the feeling of being categorised as an ill individual has often led to depressive moods and anxiety. Therefore, from this experience I have learnt the importance of considering the patients thoughts and feelings rather than just focusing on how to treat their disease. Biological-psychosocial Model (Engel, 1977):- This is a model that incorporates psychological, sociological and biological factors in contribution to well being and health of an individual (20). It suggests that all three of these factors together and individually play an important role in relation to health and emphasises the importance of taking on a holistic approach when caring for a patient. The obvious factor of health is the biological factors of disease, the process of the disease and the individuals genetic make-up. Sociological factors include individuals family and friend support network as well as financial status and social class. Psychological factors include peoples disposition, their emotional status, whether they are stressed, depressed or anxious all contribute to ill health. From learning about this model it is important to note what factors affect a patient and how to deal with them accordingly when it comes to management and treatment of their disease. Both of my patients spoke of their psychological and social aspects and how they thought these factors had affected their illness. Mrs W, for example often felt quite depressed and lonely as she recently divorced her husband, and due to her illness often felt too tired to see her grandchildren. She also explained how she felt useless?, as she would get tired grocery shopping and house cleaning and she would get frustrated with herself, which often made her feel worse. This highlights how illness can be affected by more than just a biological aspect, and as a Doctor it is important to recognize other factors that affect a patients life. In comparison to Mrs W, who quite openly spoke about her psychological and social problems, Mr H was much more reluctant to tell me how he felt about his illness and how it was affecting him. However, over time I felt that he became much more comfortable talking to me and we were able to build a good rapport. He later went on to explain how he felt he had to keep a bravado about himself, being an ex army sergeant and that he was embarrassed that he often felt severely depressed and stressed about his worsening condition, but felt that by standing his ground and refusing investigation he Mechanisms Of Granule Formation: Pharmaceutical Industry Mechanisms Of Granule Formation: Pharmaceutical Industry For the production of solid oral dosage forms most fine pharmaceutical compounds require granulation to improve their flowability and processing properties prior to tabletting.    http://www.pharmamanufacturing.com/articles/2008/096.html http://www.scribd.com/doc/6601180/Tablet-Granulation Tablets are the most common drug dosage form today, and thus granulation, which allows primary powder particles to adhere and form granules, is one of the most important unit operations in drug manufacturing. Understanding granulation grows more complex each year. This article reviews the most current methods and mechanisms of pharmaceutical granulation, including factors that can lead to improved control. Particle-bonding Mechanisms a) Adhesion and cohesion forces in immobile films. If sufficient liquid is present in a powder to form a thin, immobile layer, there will be an increase in contact area between particles. The bond strength between particles will increase, as the Van der Waals forces of attraction are proportional to the particle diameter and inversely proportional to the square of the distance of separation [1]. b) Interfacial forces in mobile liquid films. During wet granulation, liquid is added to the powder mix and distributed as films around and between the particles. There are three states of water distribution between particles. At low moisture levels, the pendular state, particles are held together by surface tension forces of the liquid/air interface and the hydrostatic suction pressure in the liquid bridge. ADVERTISEMENT On Pharma Blog Get the latest analysis and commentary on manufacturing and the drug industry at our editors blog. On Pharma looks at the drug industry with a special focus on manufacturing, which is coming into its own as a strategically important area. When all the air has been displaced from between the particles, the capillary state is reached, and the particles are held by capillary suction at the liquid/air interface. The funicular state represents an intermediate stage between the pendular and capillary states. Moist granule tensile strength increases about three times between the pendular and the capillary state. These wet bridges are, however, a prerequisite for the formation of solid bridges formed by adhesives present in the liquid, or by materials that dissolve in the granulating liquid. Solid bridges can be formed in two ways: Hardening binders. When an adhesive is included in the granulating solvent it forms liquid bridges, and the adhesive will harden or crystallize on drying to form solid bridges to bind the particles. Crystallization of dissolved substances. The solvent used to mass the powder during wet granulation may partially dissolve one of the powdered ingredients. When the granules are dried, crystallization of this material will take place and the dissolved substance then acts as a hardening binder. c) Attractive forces between solid particles. In the absence of liquids and solid bridges formed by binding agents, there are two types of attractive force that can operate between particles in pharmaceutical systems, electrostatic forces and Van der Waals forces. Van der Waals forces are about four orders of magnitude greater than electrostatic and add to the strength of granules produced by dry granulation. Mechanisms of Granule Formation a) Nucleation. Granulation starts with particle-particle contact and adhesion due to liquid bridges. A number of particles will join to form the pendular state. Further agitation densifies the pendular bodies to form the capillary state, and these bodies act as nuclei for further granule growth [2]. b) Transition. Nuclei can grow in two possible ways: either single particles can be added to the nuclei by pendular bridges, or two or more nuclei may combine. The combined nuclei will be reshaped by the agitation of the bed. This stage is characterized by the presence of a large number of small granules with a fairly wide size distribution. c) Ball Growth. If agitation is continued, granule coalescence will continue and produce an unusable, over-massed system, although this is dependent upon the amount of liquid added and the properties of the material being granulated [1]. There are four possible mechanisms of ball growth, which are illustrated in Figure 1 [3]: Coalescence. Two or more granules join to form a larger granule. Breakage. Granules break into fragments which adhere to other granules, forming a layer of material over the surviving granule. Layering. When a second batch of powder mix is added to a bed of granules, the powder will adhere to the granules, forming a layer over the surface and increasing the granule size. Abrasion Transfer. Agitation of the granule bed leads to the attrition of material from granules. This abraded material adheres to other granules. Granulation Methods  [4] Dry Granulation. This requires two pieces of equipment, a machine for compressing the dry powders into compacts or flakes, and a mill for breaking up these intermediate products into granules. The dry method may be used for drugs that do not compress well after wet granulation, or those which are sensitive to moisture. Wet Granulation. In this method, the wet mass is forced through a sieve to produce wet granules which are then dried. A subsequent screening stage breaks agglomerates of granules. Organic solvents are used when water-sensitive drugs are processed, as an alternative to dry granulation, or when a rapid drying time is required. Because direct compressing is not the best technology for many active substances, wet granulation is still a preferred method. Even if the active substance is sensitive to hydrolysis, modern equipment (e.g., a fluidized bed) eliminates all problems in wet granulation [2]. http://www.investopedia.com/terms/l/leptokurtic.asp Dawar Qhoraish (k0920236) Nazmul Islam (k) Introduction Granulation can be used to For the production of solid oral dosage forms most fine pharmaceutical compounds require granulation to improve their flowability and processing properties prior to tabletting.    Method and Materials The experiment was carried out as explained in PY2020A practical booklet, without any amendments. Paracetamol (25g), lactose (265g) and sodium starch glycollate (2.945g) and PVP solution 15% (30ml) was used. 1 Erweka AR402 oscillating granulator with the finer sieve was used to granulate the drug without too much force with variables of turns (rpm) and time (minutes). The machine had an emergency switch off button and safeguard on top which turns off machine when you put your hand in. Sieve shaker used was Retsch A5 200 basic was used to separate the particles into different sizes by vibration with variables of amplitude and speed. The top sieve was fixed by parallel bars with screws and bottom of sieves contained rubber bands to control any overflow and stability. Discussion Modal: Low so most particles are fine. (low) Relate to flow rate. Better flow rate. Small IQR-data close to each other. Positive skewness means more particles with finer particles, so flow rate is better. What Does Leptokurtic Mean? A description of  the kurtosis in a  distribution in which the  statistical value is positive. Leptokurtic distributions have higher peaks around the mean compared to normal distributions, which leads to thick tails on both sides. These peaks result from the data being highly concentrated around the mean, due to lower variations within observations. Limitations: 7.9% MC was lost after 45 minutes in 75oC oven compared to 9.51% in 130oC heater balance. Tray was exposed to air for different amount of periods each time, errors as tray was allowed to cool down. Not dried properly Granulators normally used for large quantities. If lubricant used, particle size would be higher. Improvements: More repeats, heat for longer and at high temperature.