Nursing and midwifery council Essay Example for Free

Nursing and midwifery council Essay Malnutrition can be defined as a serious condition that occurs when a person does not include the right amount of nutrients in their diet such as water, protein, fats, carbohydrates, vitamins and minerals in their diet (NICE, 2012). This can lead to serious adverse circumstances where one can become malnourished. Kirch (2008) also stresses that malnutrition can also arise as a result of disease. The rational for the chosen topic ‘malnutrition in elderly patients, was based on being one of the largest contributors to elderly mortality in health care. In support Sinclain (2011) states that up to 15% of elderly in the community, 62% of hospitalised patients and 85% of nursing home residents suffer from malnutrition which is a strong independent predictor of mortality in elderly. Evidence based practice in nursing is finding solid research and applying them in nursing practices, in order to promote quality of care given to patient’s. Furthermore Baker (2013) states that it is a process which involves the use of evaluation, research process, problem solving, assessment of care, decision making and requires the patients involvement. Evidence based practice is important in clinical settings having the potential to improve the of care patient, implemented to improve recovery. The nursing and midwifery council (NMC 2008) recommended that all nurses must have the ability to critique and use evidence based practice. Developing a framework for critiquing health research (Caldwell et al, 2005) will be used as an appraisal method to critique the 3 empirical research articles. This was chosen by the writer because the authors made it clear, straightforward, easy and precise to use in critiquing academic research papers, both qualitative and quantitative using tables, numbers, keywords subheadings, guidelines and relevant websites. It was also discussed that this assists the ‘novice’ nursing student and health-related research with learning about the two approaches to research by giving consideration to aspects of the research process that are common to both methodologies approach and different stages of crit iquing them. Boud et al (1985) articulate reflection as a act in which an individual examines their experiences, beliefs, values behaviour and knowledge that leads to a new understanding and appreciation of a situation which prompted the reflective process. Yun, (2008) emphasise reflection is an active and intentional process that uses thinking in order to learn from experience. We reflect in order to learn from current or future experiences  aiding us in improving academic skills in theory and in practical, the ethics of reflection contain information such as asking questions or reflecting on what actually happened, looking at the skills that were used to deal with the situation, examine the negative and positives looking into what feelings arose from the experiences, what could have be done and what can be done better in the future. As nurses we need to reflect on our own practice to enhance the care given to patients. Rolfe et al model (2001) Cycle has been chosen to support writer reflection and this was chosen because it is a simple model which raises the following questions what, so what and now what in order to reflect effectively and improve the quality of care given to patients stimulating both personal and professional growth. In nursing practice we need to plan and leave time in order to reflect on the care delivered to patients. Following this we need to reveal the service given has confidentiality, privacy and dignity and this is being maintained, check if the patient treated is being fairly and with respect, if the nurses communicate with the patients in ways they understand. All these collective questions need to be in place when caring for patients in order to support reflection and deliver a good standard of care. Elder, Evans and Nizette (2012) states reflection allows nurses to examine both thei r practice and the accompanying cognitions and effective meanings in relation to values, biases and knowledge and in relation to the context in which the situation occurred.

A Rose for Emily - Poem Interpretation Essay Example for Free

A Rose for Emily Poem Interpretation Essay The novel of William Faulkner ‘A Rose for Emily’ recounts a part of the past in the life of Miss Emily Grierson and the society in a town of Jefferson after the Civil War. We can watch the intriguing story of a young woman when she is changing from nice and likable young lady to a hermit-like individual, a burden and nuisance for the people and authority of the town. She lived in a gorgeous but rundown house without any major ‘troubles’, like paying taxes for example, which was settled (established?) in 1894 with the Mayor, when she couldn’t afford it. When the change in the office came the tax collectors started asking her to pay the debt to no avail. There was a ‘silent war’ going on for years between Emily and the town people until she fully retreated to her house after the death of her father. There is a short time of romance when Emily met a man and the fear of being abandoned made her crazy to a point where she tried to ‘keep’ him for herself ‘with the little help’ of arsenic. This was the last time he was seen alive. People suspected something bad happened but with no evidence there was nothing they could do about it. Only after her death they entered one of the rooms on the second floor and discovered what took place 40 years earlier. Her lover was ‘asleep’ in a bed, still in nightclothes. Next to him, on the pillow, Emily’s strand of hair. The author tries to go deeper into dark, psychological side of American Goth, going away from its basic ideas like haunted houses, castles, deaths, ailments (diseases), madness, curse, etc. The end of the novel is startling, giving a reader quite a criminal case sample, where the guilty got away with the crime. The question â€Å"Is it possible to commit a crime with no consequences?† lingers in the air. According to the author apparently yes. In his times. It is doubtful that an incident like that could happen in present times, however we still have shocking stories in the news that occur every day and still cannot believe how human mind can lead a person to do heinous crimes.

Case Study Of Meningococcal disease Essay

Case Study Of Meningococcal disease Essay As a paramedic attending a patient it is important that all presenting conditions, signs and symptoms are adequately assessed using the tools available to paramedics. Along with the assessment a thorough history must be obtained to identify the main presenting problem so appropriate management and treatment can be implemented. Through the limited information provided it has been determined that the patient is presenting with signs and symptoms of meningococcal disease. Patient presentation of meningococcal disease will generally present with typical triad of symptoms such as fever, intense headache and altered conscious state. However one of the clearest and most important signs of meningococcal is the petechial or purpuric rash on the trunk and limbs. Other signs and symptoms of meningococcal are joint pain, photophobia, general malaise and lethargy, hypotension and/or tachycardia (Victorian Department of Health, 2009). Meningococcal disease has two main clinical presentations which are meningitis which is an inflammation or infection of the meninges and affects the cerebrospinal fluid within the subarachnoid space. The second presentation is septicaemia which is a systemic infection present in the blood caused by an infection which started in another part of the body (Harris, Nagy Vardaxis, 2006). Meningococcal disease can occur at any age with babies and young children under the age of five at most risk, it should be noted that susceptibility decreases with age however there can be a secondary peak of infection which occurs in adolescents and young adults aged between 15 24 years of age (Victorian Department of Health, 2009). As our patient is presenting with the classic signs and symptoms of meningococcal disease and is within the relevant age group for increased susceptibility it is important that as paramedics we treat the patient in accordance with the clinical practice guidelines keeping the pay off principle in mind. Meningococcal disease can result in death from cardiovascular failure or increased intracranial pressure. Treatment of meningococcal in accordance with Ambulance Victoria Clinical Practice Guidelines is to confirm meningococcal septicaemia by confirming a purpuric rash, headache, fever, joint pain, altered conscious state, hypotension and/or tachycardia. Ceftriaxone is to be given either intramuscularly or intravenously and is considered as a chemoprophylaxis for meningococcal as it has excellent activity against Neisseria species. Neisseria meningitides is the bacteria which causes meningococcal infection (Ambulance Victoria, 2009). Differential Diagnoses Encephalitis is a viral infection of the brain which may occur after an infection such as chickenpox, measles or influenza. Clinically there is little difference between encephalitis and meningococcal disease as they both present with a headache, fever and altered conscious state, however a patient with encephalitis will have seizures and paralysis and no purpuric rash. Further investigations at hospital such as a CT scan, lumbar puncture and spinal fluid analysis is required to definitively diagnose a patient with suspected encephalitis. (Cameron, Jelinek, Kelly, Murray, Brown, 2009) Subarachnoid haemorrhage a patient presenting with a subarachnoid haemorrhage will be complaining of a severe headache and may present with an altered conscious state with lucid intervals, neck stiffness and abnormal pupils. Syncope and seizures are common along with hypertension and bradycardia. As our patient is not presenting with seizures, abnormal pupils, hypertension or bradycardia then as paramedics we may be able rule out a subarachnoid haemorrhage however it is strongly recommended that further investigations at hospital occur to definitively rule out a subarachnoid haemorrhage (Caterino Kahan, 2003). Heat Stroke is when the bodys core temperature is above 40Â °C. A patient will present with an altered conscious state, high body core temperature, tachycardia and anhidrosis. A rash may be present due to the blockage of sweat glands. Based on the information provided our patient is exhibiting a fever and further investigation such as obtaining a detailed history of activities (prolonged heat exposure) and taking a tympanic temperature would need to undertaken to rule out possible heat stroke (Caterino Kahan, 2003). CVA/Stroke there are two classifications of stroke. The most common stroke is the ischemic stroke which occurs when cerebral blood flow is interrupted and the second most common is hemorrhagic stroke. The patient will present with a headache, decreased conscious state, progressive deficits such as parethesias, visual disturbances and numbness. Information provided indicates that our patient does not have progressive deficits however as paramedics we would rule out stroke by referring to using the FAST stroke assessment on the patient (Kahan Ashar, 2009). Anaphylaxis is a severe overwhelming systemic allergic reaction which presents with urticaria, angiodema, nausea and vomiting, respiratory distress, poor perfusion and altered conscious state leading to loss of consciousness. A thorough history from the patient would indicate any past history of allergies or anaphylactic reactions. As our patient has no past history and limited clinical presentations of anaphylaxis, then treatment of the patient should be in accordance with the main presenting problem (Caterino Kahan, 2003). Migraine/headache a patient suffering from a migraine will present with dull and deep pain which is exacerbated during movement of the head. The patients conscious state is not affected and the patient will often have a past history of the illness (Cameron et al., 2009). Assessment Tools Kernigs sign and Brudzinskis sign are to be used in conjunction with each other in determining meningism. However it should be noted that these signs are only present in 50% of suspected adult cases. Kernigs sign is performed with the patient lying supine with legs raised and the knee is to be extended. Failure to extend the knees is considered to be a positive sign of meningism due to the spasming of the hamstrings. Brudzinskis sign is when the head is flexed causing the thighs and knees to also flex. These signs are thought to be caused by irritable motor root nerves which pass through the inflamed meninges causing tension in the roots (Cameron et al., 2009). The Meningitis Research Foundation and the Joint Royal Colleges Ambulance Liaison Committee in the United Kingdom have developed an identification and management protocol of meningococcal septicaemia for ambulance personnel. The protocol starts with the assessment of airway, breathing, circulation and conscious state and then includes exposure and observation which is a simplistic secondary survey that primarily looks for a rash. The protocol states that the rash will be purpuric and will not fade or blanche if a glass is pressed firmly against rash, the rash will remain visible through the glass. Other signs and symptoms are given such as raised respiratory effort, tachycardia, poor capillary refill, vomiting/nausea, painful joint and limbs as often not all signs and symptoms will be present. Management of the patient with suspected meningococcal septicaemia in accordance to the protocol is as follows: High flow oxygen (assisted ventilations as required) Load patient and transport to nearest hospital. Give benzylpenicillin in transit (Infant 300mg, small child 600mg, large child adult 1200mg) Treat for shock during transport with a bolus of crystalloid (children 20ml/kg and adult 250ml bolus). Re-assess vital signs before repeating dose. It should be noted that no more than 3 boluses of crystalloid for children and a maximum of 2 litres for adults. Alert hospital of patient and give relevant history. Benzylpenicillin commonly known as penicillin G is used as it is an antibiotic considered to be the gold standard of penicillin to be used for the treatment of group B streptococci, non- ÃŽÂ ² lactamase producing staphylococci (Meningitis Research Foundation, 2008). Conclusion As paramedics this assignment highlights the importance of obtaining a thorough past history, current history and chief complaint, vital sign statistics and any other relevant information such as temperature, medications and secondary surveys to ensure that an accurate assessment of the patient can occur. A thorough assessment allows the paramedic to implement the right management and treatment for the patient until they reach definitive care and treatment at a hospital.

Frontal Lobe Syndrome :: Brain Medical Neurology Essays

Frontal Lobe Syndrome Although volumetrically the frontal lobes are the largest portion of the brain their function remains somewhat elusive (Jacobs, 2005). Even neuropsychologists have a difficult time creating test that accurately test frontal lobe functioning. We do know however, that the frontal lobes are involved in the storage of memories, concentration, abstract thought, judgment, and self control. The frontal lobe lies directly behind our forehead (NINDS, 2005) It contains the primary motor cortex and the prefrontal cortex, which extend from the central sulcus to the anterior of the brain. The posterior part of the frontal lobe is the precentral gyrus which is specialized in the control of fine movements. The very most anterior portion of the frontal lobe is the prefrontal cortex. The neurons in this area have up to sixteen times as many dendritic spines as neurons in the occipital lobe or primary visual cortex. As a result, the prefrontal cortex is able to integrate a great deal of information (Kalat, 2004). For most people the left frontal lobe controls language and the right non-verbal abilities (UNL, 2005).On the left frontal lobe is an area called Broca’s area which allows thoughts to be transformed into words. In addition, there are many connections from the frontal lobe to other parts of the brain that control vision, respiration, blood pressure and gastrointestinal activity (NBTF, 2005). Damage to the frontal lobe results a range of behaviors referred to collectively as ‘frontal lobe syndrome.’ There are numerous ways of damaging the frontal cortex including lesions, tumors, and strokes. Lesions damage the frontal cortex when a blow to the head or a sudden change of motion causes the boney structure underneath the frontal lobes to tear the axons (as is the case with prefrontal lobotomy or leucotomy). A stroke can result in ventral and medial frontal lobe damage. Tumors can damage the frontal lobe by being located on one of the lobes, or by causing pressure on the frontal lobe, as is the case with meningioma, subdural hematoma or similarly meningitis (UNL, 2005). Frontal lobe syndrome results in the impairment of language, motor functions, social behavior, abstract reasoning, and cognition. Furthermore, there is often a change in personality (UNL, 2005). Although language remains fluent and in proper syntax, the overall amount of talking decreases. Patients have difficulty maintaining conversations and some even become mute. Motor functions are often uncoordinated and patients often have difficulty constructing three

Instant Messenger Changed My Life (For the Better!) :: Internet Essays

Instant Messenger Changed My Life (For the Better!) Since I was in Seventh or Eighth grade I have used AOL Instant Messenger as a way to communicate with my friends and family. I would sit â€Å"online† for hours upon hours talking to my friends. You weren’t cool unless you had AIM (AOL Instant Messenger) at your home. Every since the day I started using it I have become â€Å"addicted† to it. For a couple of months when it first came out it was kind of taking over my life. It would be the first thing I did when I got home from school, take a break for dinner then go straight back to chatting online until my mom forced me to go to bed. I never thought of it as a learning experience until I got a little older. When thinking back on how I learned to do things on the computer and/or some things in everyday life they all connect to AIM in a strange way. AIM had forced me to write and talk like I would type. I would use abbreviations and even spell words shorter on paper so they would be faster to write down just like on AIM when you use shorter spellings to type faster. For example the word because, first became shortened to cause then it became â€Å"cuz† since it was only three letters instead of the original seven. I think it was just around the age of sixteen when I could finally drive, that I stopped being so obsessed with AIM. Although when I left home for college, I quickly became once again obsessed. I found that instead of doing my homework I’d try to talk to my friends that didn’t have away messages up. If they did have a message up I’d check it like five times just in case it changed. Even when I have class or go to work I don’t sign off, I just put an away message up explaining to my friends and family where I am and how to get a hold of me. Now my sister who is thirteen is â€Å"a ddicted† to AIM and following in the same footsteps as myself. She would rather spend her entire summer vacation inside on the computer rather than swimming, rollerblading or riding her bike with friends.

hackers Essay -- essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Computer hackers in today’s world are becoming more intelligent. They are realizing that people are constantly developing more hack proof systems. This presents the hackers with a bigger challenge and a bigger thrill. The government is realizing this and is working on making harsher laws to, hopefully, scare away potential hackers. With the increase in hacking and the hackers intelligence, governmental regulation of cyberspace hasn’t abolished the fact that it’s nearly impossible to bring a hacker to justice.   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Hackers do not have consequences because of the laws that the government has passed. Most hackers are good enough to cover their backs, and their trails, and phone calls. If a hacker is caught, he or she can face a long jail sentence. Unfortunately, they do not spend a long jail sentence. It is extremely hard to determined how to penalize a hacker. First we need to determined if this crime has effected anyone, and whether or not this crime has caused damages and loss of money to the victim. What it comes down to is the age of the hacker, I feel that their age should not be taken into consideration. Because hacking is extremely difficult to accomplish, so the hacker has knowledge of what he or she is doing. Hacking is extremely complicated crime to commit, it takes years to learn to how to hack correctly. When one hacks for pleasure or for profit they should both have the same con...

Differentiated Instruction

Due to the differences in the ability of every student to learn, the need for differentiated instruction, also known as differentiated learning and multi-level instruction, increases that involves a variety of strategies used by teachers in addressing every students learning. Basically, differentiated instruction is a way by which teachers find a variety of ways in teaching in order for students to have multiple options in gathering information, creating new ideas and teaching students in the same class with different abilities.It involves the recognition of the difference in the students background knowledge, preferences in learning, interest and as well as language, readiness and their ability to react responsively. The main premise of the theory is that the teaching approaches should vary and be adapted in relation to the diverse students in the classroom and as well as in relation to every individual students. Thus, the teacher’s main challenge is to come with a variety of ways in order to maximize the growth of every student by individually meeting each student while assisting in the learning process.Differentiated instruction aims to encourage the inclusion of all the students while addressing different learning styles and allowing diversity among the students. It also fosters self-worth together with social relation among the students while meeting the emotional and especially the academic needs of every student and allowing the teachers to reach all of his or her students. Thus, teachers really have to put a lot of effort in order to differentiate instruction for the benefit of their students.Differentiated instruction is important especially in the elementary grade because students at this level greatly vary especially in their knowledge background and ability to comprehend. Thus, teachers at this level have the greatest challenge of maximizing every students potential by attending to their differences in various ways, thus differentiating instr uctions. It can also be said that differentiating instruction also relates to the professionalism of every teachers, their competency and creativeness.It can also determine the eagerness and dedication of the teachers to help their students since differentiated instruction takes a lot of time and preparation. Based on the readiness of students, there are at least four elements in which teachers can differentiate such as content, process, products and the learning environment. The contents are the information that every student must comprehend and differentiating content would mean using different materials and elements in order to support the context.Differentiating process involves activities in order for the students to have an understanding and grasp of the subject matter that most of the time uses flexible grouping. The products involves the termination of the activities and asking the students to rehearse, extend and apply everything the he or she was able to learn in the activ ity thus, making the students active in exploring the knowledge that he or she acquires. Differentiating learning environment on the other hand is basically the way the classroom feels and works.If for example in an elementary school, differentiating content may include putting the text materials in a tape or using both auditory and visual means in presenting a topic. It may also include having buddies or forming a small group and using different reading materials with varying levels of readability. Differentiating process on the other hand may include activities in which learners with the same understanding and ability work together or offering hands-on supports for those students who are in need.Time variation for students to be able to finished a certain task can also help in supporting struggling students to have a full understanding of the topic while encouraging advanced learners to search for the topic in a deeper sense. Differentiating products may include activities in whic h students have to work on their own or in group in order to accomplished a certain task or giving the students the options for them to express the required learning through different activities such as letter writing or maybe, a puppet show.Differentiating learning environment on the other hand may include ensuring that the place or room is free from distractions such as noises and other distractions or providing materials in relation to the topic for better understanding. There are certainly several ways of presenting a topic to students and differentiated instruction is widely needed by students especially in the elementary level. However, differentiated instruction does not only fit elementary students but every student from different levels as well.Through differentiated instruction subject matter can also be more comprehensible for English Language Learners and as well as those students with special needs through the use of different activities. Acknowledging the different nee ds of every student specially those with special needs will also help the teacher to prepare special teaching methods for the students to have an understanding of the subject matter. It will also help to pay more attention to these kinds of students, offering them more of their time.Traditional method of teaching, commonly lecture discussions, practice works and others have its own advantages such as being uniform and consistent, however, due to the differences in the learning ability and adaptability of every student (that is recognized by every teacher) flexibility is also needed, one thing that traditional method lacks. On the other, differentiated instruction take into consideration that every student are different and have different learning abilities, thus, making appropriate actions to fill in the gap of those who are left behind.The use of differentiated instruction involves the clarification of key concepts to ensure that all students are gaining powerful understanding that will serve as their foundation for future learning. Assessment tools are also used before, during and as well as after the given learning activity that does not necessarily mean a written examination. Also, the goal of differentiated instruction is to provide critical and creative activities to ensure understanding on the part of every student. It also takes into account that every learners, although different are essential and thus striving to meet the needs of every students.Differentiated instruction also helps in creating a balance student-selected and teacher-assigned task. These characteristics enable differentiated instruction to be more effective that traditional teaching methods. Differentiated instruction is also flexible to meet the needs of other students to maximize their potential and learning. Thus, it can be said that differentiated instruction indeed is needed in the contemporary time. It was said that differentiated instruction is a compilation of many theories an d practice in the field of learning thus, providing a greater understanding of the needs of every student.It is based on years of studies and researches and as well ass educational theories and concept such as the concept of readiness. Researches from the 1980’s up to the contemporary time also shows that practices such as grouping of students and engaging learners are really effective in the learning of students. We may have been used to the traditional method of teaching, i. e. board lectures and the likes; however this method may not be suitable in the contemporary time. What we need today is not set of rules and activities.The needs of every student’s changes along with time and traditional methods may not just work in every situation. Maximizing learning and understanding is the main purpose of every teacher and if that would mean acquiring new methods then, there is nothing wrong in doing so. Thus, differentiation must be encouraged in every learning institution for the betterment of the present and the generations to come. Changes are part of our everyday life and there are times that we must embrace those changes, such as differentiated instruction, in order to achieve greater heights.