Wednesday, July 31, 2019

Macbeth Paper on Evil Essay

Macbeth is a real tragedy written by William Shakespeare for what’s presented is a morally significant struggle, one that attempts to engage our sympathies and understanding. In this dark and powerful tragedy, Macbeth is a part of several murders, including the murder of King Duncan of Scotland. Macbeth performs these murders after he encounters the weird sisters and hears the prophecy that he will one day become the King of Scotland. But although Macbeth was the one that was directly involved in every murder, there are other influences that have an impact on his pursue for the crown of Scotland and could be responsible for the evil done in the play. When Lady Macbeth first hears about the prophecy of the witches, she immediately plans Duncan’s murder because of her ambition for her husband to become king. The weird sisters, also known as the three witches, initiates the murders because they prompt Macbeth to murder Duncan with their prophecies that Macbeth will one day become the King of Scotland. But ultimately, Macbeth is the villain of this tragedy in view of the fact that he is accountable for the murder of Duncan and also orders his subordinates to murder Banquo and the family of Macduff. Macbeth is most responsible for the evil done in the play owing to the fact that his killing of Duncan provokes the other murders and evil in the play. Although Lady Macbeth is a part of the murders that occur in Macbeth, she is not responsible for the evil done in the play. Lady Macbeth is a very cunning, manipulative character. When she hears about the witches’ prophecy of Macbeth becoming the future king of Scotland, she immediately demands Macbeth to murder Duncan so Macbeth could become king. Lady Macbeth successfully persuades him to kill Duncan by questioning his masculinity. Lady Macbeth puts the idea in Macbeth’s mind that he will be a coward if he does not commit the murder. After persuading him, Macbeth finally commits the murder. Therefore, Lady Macbeth is evil for she pressures Macbeth into killing Duncan. But, she is not responsible for the evil done in the play. Although she is a strong, significant figure in the murder of Duncan, she begins to change through the play as she starts to feel the guilt and remorse for persuading Macbeth to kill Duncan. She ultimately kills herself because she couldn’t manage the guilt and grief for her involvement in the murder and seeing her husband turn into an evil, uncontrollable villain. Therefore, she is not responsible for the evil done in the play because although she persuades Macbeth to kill Duncan, she later feels guilt for what she’s done. The three witches are also not responsible for the evil done in the play. In the beginning, the three witches tells Macbeth his prophesy that he will one day become the king of Scotland. When Lady Macbeth hears about the prophecy, all she thinks about is her husband becoming king. So, Lady Macbeth convinces Macbeth to kill Duncan in order for Macbeth to become king as soon as possible. If the three witches never told Macbeth the prophesy of him becoming king, none of the murders would have happened. Therefore, without the witches, there would be no evil in the play. But, the three witches are not responsible for the evil done in the play because even though they incite Macbeth and Lady Macbeth’s desire for king, it was Macbeth who ultimately decides to murder Duncan, which causes the rest of the evil done in the play. Macbeth is responsible for the evil done in the play. Macbeth is more evil than the other characters because he is the reason why all of the murders in the play occur. He murders Duncan because of his evil desire to become the king of Scotland as soon as possible. â€Å"Stars, hide your fires; Let not light see my black and deep desires.† (I, Scene 4, lines 57-58) This quote shows Macbeth’s great desire to become king and also shows how he is aware that his thoughts are evil. But, he does not do anything to keep himself away from these dark thoughts and he eventually commits the evil murder. The murder is certainly avoidable, but he let Lady Macbeth influence him. â€Å"This night’s great business†¦ sway and masterdom.† (I, Scene 5, Lines 80-82) This quote shows how Lady Macbeth has total control over Macbeth and how Macbeth put the power into Lady Macbeth’s hands. Macbeth could have told Lady Macbeth to stop her plans, but instead he gives all the power to her and eventually agrees with her. Therefore, the murder of Duncan is completely his fault because he lets Lady Macbeth influence him and commit the murder himself. Macbeth is also responsible for the other murders in the play because he hires three murderers to kill Banquo and orders his servants to kill Macduff’s family. Consequently, Macbeth is responsible for the evil done in the play because he involves himself in all of the murders in the play. Macbeth is accountable for the evil done in Macbeth because his murder of Duncan causes a chain reaction and brings about the rest of the evil in the play. Although Lady Macbeth has a notable influence on Macbeth to commit the murder of Duncan, it was ultimately his decision to kill Duncan and order the other murders. The Three Witches incites Macbeth and Lady Macbeth’s desire for the throne of Scotland, but Macbeth’s decision to commit the murders ultimately brought darkness and fear onto Scotland. Macbeth is responsible for Duncan’s death, and that murder causes a chain reaction and incites the other murders. If he did not murder Duncan, there would not have been any evil in this play to start with. Ultimately, Macbeth compels to arise these evils, and it is his greed to blame. Macbeth is already known as a man of integrity for being appointed as the Thane of Cawdor, but his greed and avarice brings about the evil that he carries out. This relates to human nature because even if a man has everything to gratify his needs, his greed can demand for more, leading to trouble just like Macbeth. This demonstrates that if you only care about your own needs and always ask for more, you will be unsuccessful. As Mohandas Karamchand Gandhi once said, â€Å"Earth provides enough to satisfy every man’s needs, but not every man’s greed.† [Word Count: 1057]

Tuesday, July 30, 2019

The Use of Intraosseous Vascular Access

The Use of Intraosseous Vascular Access Table of Contents Title Page†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 1 Table of Contents†¦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 Executive Summary†¦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‚¬ ¦. 3 Body of Paper†¦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‚¬ ¦.. 4 Plan†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 6 Do†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 7 Check†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 7 Act†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦8 Research to Support Change†¦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‚¬ ¦8 Change 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‚¬ ¦ 6 Conclusion†¦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‚¬ ¦Ã¢â‚¬ ¦.. 18 References†¦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‚¬ ¦Ã¢â‚¬ ¦.. 20 Timeline†¦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‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚ ¬ ¦. 22 Executive Summary First introduced by Drinker and colleges in 1922, intraosseous (IO) vascular access was a method used during World War II for accessing the non-collapsible venous plexuses within the bone marrow cavity to provide access to a patient’s systemic circulation. This method later fell out of use after the development of intravenous catheters.Then during the 1980s IO vascular access was again introduced as a rapid way of gaining vascular access for swift fluid infusion particularly during resuscitation attempts of pediatric patients. (Tay & Hafeez, 2011) Plan-Being by implementing a policy for the use of IO vascular access within the Emergency Department of Hays Medical Center (HMC) for critically ill patients. This would expedite critically ill and severely injured patients in receiving the intravenous fluids and medications.Currently there is no policy in place for the placement of IO devices as opposed to peripheral intravenous catheters, or central veno us catheters. However, if there was a policy in place the staff would know when it was appropriate to insert an IO device, as opposed to having to make a difficult decision based on personal judgment. Do- Create a group of physicians and nurses to write a policy outlining when it is appropriate for the placement of an IO device compared to traditional techniques for gaining venous access. Once the policy has been written implement its use within HMC’s ED.Check- Keep a careful record of when an IO device is placed, in accordance to the new policy. Monitor the outcomes of these patients. Evaluate the effectiveness of the new policy and determine if any changes need to be made. Act- Based on the information obtained during the check phase of this project, management will determine whether the policy will be continued, improved, or discontinued. The Use of Intraosseous Vascular Access in Critically Ill Patients The origin of the intraosseous cavity as an access sight to the circu latory system was originally discovered during World War II.Medical personnel during this time used an IO route to resuscitate patients suffering from hemorrhagic shock. It was first documented in medical journals by Drinker and colleges in 1922. It was later rediscovered by American pediatrician James Orlowski. During his time working in India, Orlowski observed medical personnel during a cholera epidemic using IO access to save patients in whom IV cannulation was impossible and who might have died without access. He later wrote about his experiences in a paper entitled, My Kingdom for an Intravenous Line. Wayne, 2006) Since Dr. Orlowski brought the use of IO access in pediatrics back into the medical spotlight, the implications for its use within the adult population were soon being addressed. In 2005, the American Heart Association stated in its Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care that â€Å"IO cannulation was appropriate to provide acc ess to the non-collapsible venous plexus found in the bone marrow space, thus enabling drug delivery similar to that achieved by central venous access. (American Heart Association) Intravenous access can mean the difference between life and death when dealing with critically ill patients. IV access means that patients can receive fluids, blood products, and life-saving medications. During situations when time is precious, and access is critical is not when nurses should be making their fifth attempt at a peripheral intravenous catherization (PIV). It also shouldn’t be when chest compressions are stopped, so that the doctor can try for a central venous line (CVL).The average time necessary for PIV catherization is reported to add up to 2. 5-13 minutes and sometimes even up to 30 minutes in patients with difficult to access peripheral veins. (Leidel, Chlodwig & Bogner, 2009) This is one of many reasons why it is imperative to have a policy in place so that the staff knows that IO access should be a go to option rather than a last resort. There are very few contraindications when it comes to the placement of an IO device. However, to untrained medical personnel the thought of having to place an IO device is very daunting.I didn’t realize until this semester that it is within the scope of practice for a RN to place an IO device, but it is absolutely is! â€Å"It is the position of the Infusion Nurses Society that a qualified RN, who is proficient in infusion therapy and who has been appropriately trained for the procedure, may insert, maintain, and remove intraosseous access devices. † (â€Å"The role of,† 2009) There is also the fact that of having to explain the procedure to the patient and the patient’s family. The fear of needles is a real one.The thought of an intramuscular injection can send certain patients into a full blown panic attack. So the thought of actually having their bone pierced with a needle is a frightening o ne. Thankfully most patients who are critically ill enough to necessitate the placement of an IO device are unconscious. In cases where patients are not unconscious, an IO device can be placed with minimal discomfort if proper anesthetic techniques are used. These techniques should be taught along with placement so that nursing staff is aware of how to place an IO with minimal discomfort to the patient.It needs to be noted that â€Å"the pain associated with insertion of the EZ-IO needle is similar to that associated with insertion of a large peripheral intravenous needle and may be alleviate with infusion of lidocaine solution. † (Luck, Haines & Mull, 2010) Unlike PIVs and CVLs, IO access can be obtained from multiple sites with less chance of being unsuccessful. The locations include: proximal tibia, distal to the tibial tuberosity, distal end of the radial bone in the upper imb, proximal metaphysis of the humerus, distal tibia, proximal to the medial malleolus, distal femu r, above the femur plateau, the sternum, and also the calcaneus (Tay & Hafeez, 2011). However, IO access is typically obtained via the proximal tibia or proximal metaphysis of the humerus. There are currently three different ways to gain IO access. The first and oldest way is a manual insertion of the IO device. In this way the device is placed using the force applied by the clinician, and is done in a rotating motion. The second technique is the use of an impact device.In this case, a spring-loaded IO device is to insert the needle into the bone using direct force. The last technique is a powered drill. The small, handheld device drills the IO needle into the bone with a high-speed rotating motion. Plan To implement a policy within the Emergency Department at Hays Medical Center that clearly outlines when the placement of an intraosseous access device should be used as opposed to more traditional techniques for gaining venous access. A committee would be assembled to look at the re search on IO placement.This committee would consist of three physicians and three nurses, and will be given three months to write a policy for the department. This committee will determine in which situations an IO should be placed. The American Heart Association guidelines for intraosseous vascular access should play a major role in this decision. Once criteria has been chosen a checklist will be created that can be hung on the walls of the trauma rooms and handed out to staff. This checklist will aide in helping the staff to be able to more quickly determine in which situations placement of an IO is within the department’s policy.The appointed committee would also be in charge of deciding on which type of IO device the department should use. They will research the availability of the device chosen and what the cost will be to stock the department which the device. Do Once the research is gathered, the assigned research committee will reassemble to compose the policy that wi ll become implemented within the Emergency Department. After the policy has been written, a mandatory unit meeting will be called to introduce the new policy and answer any questions that the staff might have.During this meeting, a demonstration will be given on the correct technique for IO placement, depending on which type of device is chosen during the planning phase. After the demonstration the staff will then be asked to practice placing IO devices using practice bones. One member of the department will then be voted upon to keep track of which patients coming through the department have IO devices placed. They will keep track of for the next six months. The data collected will include any outcomes that the patient experiences, good or bad, in regards to their IO placement.Check The member of the department will look at the data collected from the outcomes of patients who had IO devices placed within the ED in the last six months. This data will then be taken back to the origin ally assigned committee. The committee will be responsible for analyzing the data. They will look at the outcomes and determine if changes need to be made to the original policy. They will also look at the outcomes to determine if there need to be changes made in the placement technique used by the department.For example, is the rate of successful placement higher or lower when done via the humerus verses the tibia? Or is there a problem with post procedural infection? Should the technique be changed from aseptic to sterile? Etc†¦ They will also ask staff within the department to fill out a survey indicating their comfort level in placing IO devices. Act Depending upon the findings of the committee they can either be decided to leave the policy in place, as is. The committee could find that the policy needs to be altered and then reviewed in another six months’ time to see if the changes were effective.Or they could find that within the ED at Hays Medical Center IO devic es for venous access should not be used although the review of literature will prove why this outcome is highly unlikely. Research to Support Change An article published in the Journal of Emergency Medicine, collaborated by three different physicians who work in Emergency Departments in Philadelphia talks about the technical side of intraosseous access. The article states that â€Å"intraosseous vascular access is indicated in the critically ill patient of any age when rapid and timely access via the intravascular route cannot be established or has failed. The article goes on to list conditions in which this might occur, including: cardiopulmonary arrest, shock, sepsis, major traumatic injuries, extensive burns or edema, and status epilepticus. (Luck, Haines & Mull, 2010) Indications may also include obese patients on who multiple PIV attempts have failed. Because studies have shown that IO infusions have the same onset of action, as that of intravenous infusions the authors recomm end that the dose used for IV fluids and medications should remain unchanged when using the IO route.They go one to state that other studies have shown that the results of several different blood test values drawn from bone marrow aspirates are comparable to those taken from venous samples. These include blood gas analysis, blood group typing, and electrolyte, drug, and hemoglobin levels. (Luck, Haines & Mull, 2010) The authors also talk about the relatively few contraindications for IO insertion. These include a fracture to the bone that the IO device is to be placed, an extremity with a vascular injury, placement to an area with an overlying skin infection or burn.IO insertion is also contraindication in patients with certain conditions that make their bones fragile such as osteogenesis imperfect and osteoporosis. The last contraindication is a new IO insertion where another IO needle may have recently been placed. This is because the opening left by the last needle can cause flui ds to extravasate. In their research of other studies, the authors found that success rates for IO insertion vary between 75%-100%, and successful infusion achieved within 30-120 seconds in the majority of cases. Luck, Haines & Mull, 2010) The most common complication was found to be extravasation of blood, fluids, and drugs into the soft tissues surrounding the site, but this occurred less than 1% of the time. With a 0. 6% chance of incidence, the most serious adverse complication was osteomyelitis. However, this was attributed to prolonged infusion. For this reason, it is recommended that the IO need be replaced by either a PIV or a CVL once the patient has stabilized and no longer than 24 hours after IO placement. (Luck, Haines & Mull, 2010)This article concluded that the use of IO access devices is a safe, reliable, and timely way of attaining vascular access. Although vital for critically ill and injured patients, it is also a technique that can be applied in non-emergent cases where multiple attempts at peripheral and central IV access has been unsuccessful. (Luck, Haines & Mull, 2010) In a study conducted by physicians at the University of Medicine Berlin’s Department of Emergency Medicine, they looked at ten consecutive adult patients who each received an IO device and also a CVC placement during a resuscitation situation.The results showed that the success rate on first attempt was 90% for IO access versus 69% for CVC placement. They also found that the mean time required for the IO access procedure was significantly shorter, 1-3 minutes, compared to the mean CVC placement time of 4-17 minutes. While conducting this study, one IO cannulation failed â€Å"due to operator mishandling by not selecting the correct insertion site at the proximal humerus. (Leidel, Chlodwig & Bogner, 2009) The physicians of this study also noted that four CVC cannulations failed on the first attempt at insertion and had to be reattempted. The study then went on to st ate that the failed placement of one IO cannulation was the only complication regarding the IO devices placed. There was â€Å"no malposition, dislodgment, bleeding, compartment syndrome, arterial puncture, haeatothorax, pneumothorax, venous thrombosis, and vascular access related infection observed. † (Leidel, Chlodwig & Bogner, 2009)In conclusion the researchers go on to state â€Å"IO vascular access is a safe, reliable, rapid option in the acute setting of adult patients under resuscitation with inaccessible peripheral veins in the emergency department†¦ Therefore, a change in practice from CVC to immediate IO access for the initial emergency resuscitation should be strongly considered as a reasonable bridging technique to increase patient’s safety in the emergency department. † (Leidel, Chlodwig & Bogner, 2009) Another study found was performed by physicians and researchers in the Department of Emergency Medicine of Singapore General hospital.It is a l arge urban hospital that handles nearly 120,000 patients annually. 9% of these patients are priority 1 patients, or patients that need resuscitation. The inclusion criteria for this study were â€Å"patients who presented to the ED with age greater than 16 years or >40kg body weight requiring intravenous fluids or medication and in whom an intravenous line could not be established in two attempts or 90 seconds. They also had to be seriously ill or injured and meet at least one or more of the following: altered mental status, respiratory compromise, haemodynamic instability, or cardiac arrest. (Ngo, Oh, Chen, Yong & Yong, 2009) The study ran from March 1, 2006 through July 30, 2007. During this time 24 patients were met the qualifications for this study. Of all the IO cannulations, only three attempts failed on the first attempt. No failures were recorded on the second attempt. The researchers also did a comparison between junior operators and senior operators and found that there w ere no disparity regarding success rates between the groups, they both had a 100% success rate. The average insertion time for both groups was approximately five seconds. Ngo, Oh, Chen, Yong & Yong, 2009) There were only two complications regarding the insertion of an IO device with this study. The first was when an operator’s glove was caught on the need during insertion. However, this could have been prevented if the operator was holding the drill properly. The other complication noted was that of extravasation of fluid at an insertion site. This is the most common type of complication, and is seen when the need is misplaced or there is an excessive amount of movement during or after the insertion. Ngo, Oh, Chen, Yong & Yong, 2009) The results of this study concluded that â€Å"the EZ-Io is a feasible, useful and fast alternative mode of venous access especially in the resuscitation of patients with no venous access or when conventional intravenous access fails. Flow rates may be improved by the use of pressure bags. Complications encountered such as extravasation of fluid and gloves being caught in the drill device can be easily prevented. † (Ngo, Oh, Chen, Yong & Yong, 2009)The third research article was a prospective, observational study conducted by researchers in the Department of Emergency Medicine at Singapore General Hospital in Singapore. The study was conducted on a convenience sample of 25 medical students, physicians and nursing staff. They were recruited to secure intraosseous access using the EZ-IO powered drill device. Unlike the previous two studies they only need to secure access on a plastic bone model rather than a live patient. (Ong, Ngo & Wijaya, 2009)The study participants were allowed multiple attempts in placement with the aim of ensuring success in placement. Their placement times were measured by an independent observer with a stopwatch, from the time the participant placed the need set into the driver and attempted to insert the needle with the ES-IO into the plastic bone. The participants then recorded their perception on the difficulty of insertion using a visual analog scale with 0 representing very easy and 10 representing very difficult placement. (Ong, Ngo & Wijaya, 2009) The results showed 96% success rate for placement.Twenty-three of the 25 participants only required one attempt at place the IO device, and only one participant was unsuccessful at securing placement of the device. This failure was attributed to â€Å"unfamiliarity with the equipment and procedure, and hesitating beyond the allocated time given for insertion. † (Ong, Ngo & Wijaya, 2009) The results of this study also showed that the mean placement time was 13. 9 seconds. The researchers also found that 87% of their participants reported that using the EZ-IO was easier compared to intravenous cannula. Ong, Ngo & Wijaya, 2009) The researchers of this study concluded that â€Å"the I/O access device (EZ-IO) evaluated in this study appears to be easy to use with high success rates of insertion with inexperienced participants. There is potential for use in the Emergency Department. (Ong, Ngo & Wijaya, 2009) The next piece of research was a randomized trial conducted by Dr. Reades from Methodist Hospital System, in Dallas, TX, Dr. Studnek from Carolinas Medical Center and the Center for Prehospital Medicine, Charlotte, NC, S.Vandeventer from Mecklenburg EMS Agency, Charlotte, NC, and Dr. Garrett from Baylor Healthcare Systems, Department of Emergency Medicine, Baylor University Medical Center, and Dallas, TX. The purpose of this study was to determine whether the tibial or humeral placement site was more effective for intraosseous placement during out-of-hospital cardiac arrest. â€Å"All patients eligible for inclusion in this study had their first attempt at vascular access randomized to one of 3 locations: proximal tibial intraosseous, proximal humeral intraosseous or peripheral intravenous. ( Reades, Studnek, Vandeventer & Garrett, 2011) Randomized note cards were distributed to the paramedic staff at the beginning of their shifts, and told them which access site was to be initially used if they came had a patient who met the inclusion criteria. There were two outcomes that were being monitored in this study. The first was a first-attempt success at the assigned method of vascular access. This qualified in one of two ways, either as an initial success or an overall success.The second measured outcome was the â€Å"total number of attempts required for successful vascular access, time to successful vascular access, time to first ACLS medication, and total volume of fluid infused during resuscitation. † (Reades, Studnek, Vandeventer & Garrett, 2011) Overall there were 182 patients randomized to one of the 3 vascular access methods. Fifty-one patients had humeral IO placements, 67 had PIV placements, and 64 had tibial IO placements. The results showed that first-atte mpt success was greatest in patients randomized to tibial IO access at 91%, compared to both humeral IO access at 51% and PIV access at 43%.The result of the secondary outcome was also significantly shorter in patients with tibial IO access. These patients had their devices in place and ready to use in an average of 4. 6 minutes. Those assigned to the humeral IO access site averaged a 7. 0 minute placement time, which was also the same time for a PIV access site. (Reades, Studnek, Vandeventer & Garrett, 2011) This study demonstrated that there is a significant different in the frequency of first-attempt success when placing tibial IO access devices as opposed to humeral IO access devices or even PIV catheters.The researchers go on to state that the â€Å"results from this study may help stakeholders such as EMS medical directors choose the most appropriate site for first-attempt vascular access†¦Ã¢â‚¬  (Reades, Studnek, Vandeventer & Garrett, 2011) The last article was a cons ortium on intraosseous vascular access in healthcare practice, published in a journal entitled critical care nurse. It too outlined the history of IO access, dating back to World War II. It discussed the clinical considerations for the use of IO access, and the clinical situations in which IO access should be considered.It went on to talk about the types of IO devices and how they’re used. It mentioned the contraindications for IO use, and also the possible complications. All of the aforementioned material was consistent with research already discussed. This article lends credibility in support of change because it discusses the education and training needed to implement IO device use in the clinical setting. It states that â€Å"to insert and maintain an intraosseous device in a patient, the clinician must demonstrate adequate knowledge and psychomotor skill competency in the procedure. (Phillips, Brown, Campbell, Miller, Proehl & Young-berg, 2010) The article then went on to discuss the economic considerations that must be looked at when considering implementing an IO insertion policy. It states that â€Å"the cost of intraosseous devices and needles should be compared with the cost of central catheter kits, ultrasound evaluation, and human resources required for their insertion. † (Phillips, Brown, Campbell, Miller, Proehl & Young-berg, 2010) The authors also note that â€Å"the economic factors must be weighed along with potential complications of therapeutic strategies should be considered. (Phillips, Brown, Campbell, Miller, Proehl & Young-berg, 2010) This article also brings to light the issue of risk management and patient safety. In this day and age where liability concerns continue to drive clinical decisions, it is important to note that delays in treatments are often cited as the cause of injury leading to malpractice claims. If there is an evidenced based option to safely and quickly provide fluid and drug resuscitation, when vascu lar access is not readily attainable, then it needs to be closely looked at.After reviewing the data the Consortium on Intraosseous Vascular Access in Healthcare Practice reached eight consensuses: 1. Intraosseous vascular access should be considered as an alternative to peripheral or central intravenous access in a variety of health care settings, including intensive care units, high acuity/progressive care units, general medical units, preprocedure surgical settings where lack of vascular access can delay surgery, and chronic care and long-term care settings, when an increase in patient morbidity or mortality is possible. . Intraosseous vascular access should be considered as part of an algorithm for patients treated by rapid response teams in whom vascular access is difficult or delayed. 3. A new algorithm that includes the intraosseous route should be developed for assessing the appropriate route of vascular access. 4. For patients not requiring placement of central catheters ei ther for long-term vascular access or hemodynamic monitoring, intraosseous access should be considered as the first alternative to failed peripheral intravenous access. 5.Techniques of intraosseous catheter placement and infusion administration should be a standard part of the medical school and nursing school curriculum. 6. In evaluating the economic implications of adopting intraosseous technology, the following should be considered: the expense of diagnostic tools to guide and confirm placement, the cost of human resources, the known and unknown risks to patient safety, and the cost of complications related to delayed treatment. 7. Organizational policies, procedures, and protocols that establish the responsibility of insertion, maintenance, and removal of intra-osseous access devices should be developed. . Further research should be conducted on, but not limited to, the safety and efficacy of use of intraosseous access in all practice settings, its economic impact on patient car e, and to support the use of intraosseous access in all health care settings. Change Theory The change theory focused upon in this paper is Gordon Lippitt’s Theory of Planned changed. According Lippitt, â€Å"Planned change or ‘neomobilistic’ change is defined as a conscious, planned effort which moves a system, an organization, or an individual in a new direction.This theory is applies because it can be applied at an individual, group, and institutional level. The basis for Lippitt’s theory of change is center around an agent for change. This agent should be a person skilled in the changed wanted to apply. It is this person who is in charge of planning for the change, initiates the change, and is credited for the accomplishment of change. Lippitt’s theory is centered around 7 phases of change. His phases are not set in stone, and there is no time frame on how long each phase should last. There should be a fluid movement back and forth between thes e seven phases.The first step is identification and diagnosis of the problem. In this case, the problem is HMC not having a firm policy in place recommending when the use of IO access devices should be implemented. The second step is the change agent assessing the client systems motivation and capacity for change. In this case, myself being the change agent, I would talk with the administrators of the ED department and determine if they agreed with my assessment for a policy to be implemented. The third step would be the initiator assesses his or her ability in helping the situation.In this case this flows back to the first step, because I saw the need for change and felt that I was equipped with the skills needed to bring about such a change. The fourth step is the change agent then chooses an appropriate role in the phase. In this case, I would choose to be part of the policy committee who is responsible for researching. The fifth step states that the change agent may be actively involved in the implementation of change, serve as an expert in fathering and providing data, or function as a liaison within the organization. I feel like in this case, I would function as a liaison within the policy making committee.The sixth step consists of maintenance of change. This involved the â€Å"Do† portion of the plan for change. This is where the decisions made by the policy are provided to the department, and the employees become responsible for implementing and maintaining the new policy. The final step is termination of the helping relationship. This step is accomplished when all parts of the PDCA plan have been completed. (Ziegler, 2005) Conclusion In a day and age where medical technology is advancing, the research about IO access devices proves that newer technologies are not always the best for a positive outcome.IO access applications have great potential in patients who are critically ill, injured, or are incapable of having PIV or CVL access. The fact that IO access is fast, reliable, and safe proves that competent placement of IO devices is a medical technique that all Emergency Departments should have in their repertoire. References (2009). The role of the registered nurse in the insertion of intraosseous access devices. Journal of infusion nursing,  32(4), 187-188. American Heart Association. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2005;112(24):57-66. Leidel, B. Chlodwig, K. , & Bogner, V. (2009). Is the intraosseous access route fast and efficacious compared to conventional central venous catherization in adult patients under resuscitation in the emergency department? a prospective observational pilot study. Patient safety in surgery,  3(24), doi: 10. 1186/1754-9493-3-24 Luck, R. , Haines, C. , & Mull, C. (2010). Intraosseous access. The journal of emergency medicine,  39(4), 468-475. Ngo, A. , Oh, J. , Chen, Y. , Yong, D. , & Yong, D. (2009). Intraosseous vascular access in adults using the ez-io in an emergency department. International journal of emergency medicine,2(3), 155-160. oi: 10. 1007/s12245-009-0116-9 Ong, M. , Ngo, A. , & Wijaya, R. (2009). An observational, prospective study to determine the ease of vascular access in adults using a novel intraosseous access device. Annals of the academy of medicine, singapore,  38(2), 121-124. Phillips, L. , Brown, L. , Campbell, T. , Miller, J. , Proehl, J. , & Young-berg, B. (2010). Recommendations for the use of intraosseous vascular access for emergent and no emergent situations in various health care settings: A consensus paper. Critical Care Nurse,  30(6), e1-e7. Reades, R. , Studnek, J. , Vandeventer, S. , & Garrett, J. (2011).Intraosseous versus intravenous vascular access during out-of-hospital cardiac arrest: A randomized controlled trial. Annals of Emergency Medicine,  58(6), 509-516. Tay, E. T. , & Hafeez, W. (2011). Intraosseous access. In R. Kulk arni (Ed. ),  Medscape reference: Drugs, disease & procedures. Retrieved from http://emedicine. medscape. com/article/80431-overview Wayne, M. (2006). Adult intraosseous access: an idea whose time has come. Israeli journal of emergency medicine,  6(2), 41-45. Ziegler, S. (2005). Theory-directed nursing practice. (2 ed. , p. 204). New York, NY: Springer Publishing Company, Inc. Timeline for Change 1/20-11/27Researched the benefits of having a policy about intraosseous access within the ED at HMC 11/28Spoke with the Director of Nursing for the ED and the Director of Emergency Medicine about my research findings 12/1A committee of three physicians and three nurses is assembled to draft a preliminary policy regarding intraosseous access 12/1-3/1The committee is given three months to compose their policy 3/2-3/10The policy is given to the Director of Nursing and Director of Emergency Medicine, who present it to the board of directors for approval 3/15A mandatory staff meeting is held outlining the new policy and answering any questions or concerns the staff has 3/16-9/16The new policy is put into effect and data is collected 9/16-10/16The original committee will analyze the data, and changes are made as needed. 10/20The final committee approved policy is present to the Director of Nursing and Director of Emergency Medicine 11/1The Director of Nursing and Director of Emergency Medicine, take the final recommendations for the policy to the hospital board of directors for approval

Monday, July 29, 2019

Organizational Change Project Essay Example | Topics and Well Written Essays - 250 words

Organizational Change Project - Essay Example The organization has also undergone transitions from its family based orientation to its current form that is professionally managed. Simmons has also identified a decision-making culture in which decisions are based on the organization’s history. Its culture also involves creativity and innovation, utility optimization and customer satisfaction as core principles. Even though it once deviated from its core objective of manufacturing mattresses, the organization realigned to its original objective. Two years ago, Simmons recruited Eites, a dynamic manager who has proposed a cultural change program to the organization’s environment that has become unfavorable. Effects of recession and the September 11 terror attack besides bankruptcy of three major customers have for example hit the organization. One of the organization’s suppliers also delivered spoilt raw materials, leading to defective product (Edmondson, 2007). Facts in the case identify diversified challenges and problems that require change. Its historic decision making culture that induces rigidity and resistance to change is an example. The organization also faces adverse economic conditions from recession and effects of the terror attack. Resistance to proposed changes and receipt of bad materials are other issues that identify the need for change (Edmondson,

Sunday, July 28, 2019

Information system of the Defense Logistics Agency (DLA) Essay

Information system of the Defense Logistics Agency (DLA) - Essay Example In line with the agency's transformation goals, the BSM caters to improve on supply chain management across 4 areas: the customer relationship management, for customer related information, the supplier relationship management, for vendor purchase request/invoice information, the Defense Finance and Accounting Service, for payment information and the Defense Automatic Addressing System, for contracts, solicitation and inventory information. The MJM3 information systems will address particularly these four areas of management in the DLA agency instead of the entirety of the agency itself. The MJM3 information system introduces the following software package. The TopShelf2.0 handles information on business inventory, handheld scanning technology and wireless network transfers. The TopRFID is used to count inventory, write and tag information or plan a store layout to specific item-level detail. The InStore software deals with order placement, shipment tracking and inventory monitoring. EnRoute software help input and access information on route accounting, package tracking and ordering, plus additional ERMA software helpful in times of item breakdowns. This is used for order repairs, replacements or software reconfigurations. Other important feature of the services available with MJM3 systems is the one website center that interlinks all departments of the agencies for easy information transfers in any transactions involved. It also introduces a security system that ensures that no unwanted infiltration on the system will occur. Added to this is the future improvements package which ensures the customer that changes or upgrades in the system in line with R&D outputs will be recommended and applied. Then, upon approval or purchase, MJM3 technicians commence planning on set-up, testing and installation. These, together with top hardware items to complement the need, gives the agency less paper work, faster delivery times, greater access to information with lesser flaws to inter-department coordination and cooperation, This paperless, push-of-a-button technology will be a great investment for the DLA's modernization program. Organizational Structure of DLA The Corporate Board sets the agency direction and actively oversees execution of the DLA mission. The board supports the Director through decisions, deliberations and advice. The Corporate Board is the agency's senior leadership management team consisting of 19 divisions with its corresponding Directors, Commanders, Comptroller, General Counsel and Executives. This Division is structured to simultaneously play 2 important tasks namely, Business Process improvement initiatives and Transformation Commitments. The Transformation Executive Board (TEB), composed of senior civilians, has the oversight to insure that successful

Saturday, July 27, 2019

Past Experiences and Present Situation Personal Statement

Past Experiences and Present Situation - Personal Statement Example In almost all the cases the rivals belong to one and the same group and community. Somehow, the individuals having experience of living and interacting with different people and cultural environment are in a position to adjust in every atmosphere; the same is applied to me. Since the nature of my father’s job demanded to settle down at different places, I also had to move along with him in various cities of my country. Hence, I sought education from three different cities, during which I came across the people having divergent family and cultural backgrounds. Somehow, my active participation in the curricular activities and unflinching co-operation with the fellow-students during classroom discussions, library consulting, group-participation, giving vent to ideas during examination preparations and others made me a popular student of all the educational institutions I attended during the course of time. Additionally, my keen interest in extra-curricular activities including debates and speeches, sports and games and long-tours and trips also proved me as a flexible and amiable person in the eyes of others. I had been the football player for the last many years at school and college levels and played at different positions in the playground. The sports made me learn patience, endurance, tolerance and respect for others even after winning or losing the game. During the sports, I experienced fluctuation of moods and several other pleasant and unpleasant situations; however, my patience and efficiency always supported me.

Friday, July 26, 2019

Operating System Essay Example | Topics and Well Written Essays - 1750 words

Operating System - Essay Example (e.g. for a system call). This mechanism is used to prevent programming mistakes with system resources. It also shares common system resources in an appropriate manner under OS control. It prevents accessibility to protected memory segments. It also identifies instructions that can cause error conditions and inconsistent system state. Memory location of interrupt handler that signifies interrupts and also will save them in a queue if multiple interrupts are in processing, is called interrupt vector. The interrupt vector is a matrix of pointers to specific interrupt-handling routines. A hardware part that is called the device controller along with any device makes up the computer system. The device controllers basically acts as an interface between the device and the OS of that computer. Device controllers is also responsible of transferring data from other devices that controls it and the local buffers. To store and execute necessary commands in device controller, registers and buffers are integrated in the device controller. To provide interface between a device controller and OS, there is a device driver in OS that presents a steady interface into the device. First the device driver is introduced in to the OS to which the device is to be connected and then User and the system can exchange data with help of device through the device itself. In multiprocessor, two copies of the same data may reside in the local cache of each CPU. If one of the CPU changes the data, the Caches of the other cache coherency includes. Storing the data in multiple caches signifies one of the best ways of storing data. In this kind of shared memory, there is different cache memory for each of the processors. It is possible that many copies of one direction operand would exist on multiple caches that would exist on different processors. If one copy is changed, all the copies that are present on the other

Sociology (Social Movements) Essay Example | Topics and Well Written Essays - 750 words

Sociology (Social Movements) - Essay Example As a strategy for the clarification of the aforementioned, the differences between past and present social movements shall be elucidated with particular focus upon identity movements within the context of the information age. An example which exposes the difference between past and present social movements is the feminist movement. As Melucci explains, the feminist movement was traditionally focused upon equality, as in the attainment of legal and social recognition of gender equality. While the present feminist movement shares much in common with its predecessor, the fact is that they are distinct in one key aspect. Notably, earlier feminist movements demanded equality while the present one calls for equality with a recognition of differentiation. The current feminist movement is new in the sense that it no longer aspires towards equality and same-ness but equality within the parameters of individuation and individuality. The message of the movement is not that the genders are equal but that women are equal to men and reserve both their collective right to maintain their distinctness as females and their individual right to forge their unique identity, define themselves and shape their bodies. Proceeding from the above, it is evident that Melucci partly defines current social movements as new, even if they have their roots in the past, because of the very nature and content of their public message. While the group message, in the present as in the past, is there, it is bound with an individual message which effectively states that, apart from the group identity, there is an individual identity which shall not be subsumed by group affiliation, ideology or culture. Individuation and the right to maintain unique individuality are, therefore, the key distinctions. The determination to maintain individuality, concomitant with the individuation process, invariably leads to conflict. Culture and ideology impose not just behavioral rules upon people but effectively shape their worldview, culminating in the forging of a common, a shared, identity. Within the context of this process, individuality is largely suppressed and the real self is rarely allowed expression. Insofar as contemporary social movements are distinguished by their fortification of the right to individuality and are supportive of the individuation process, conflicts are bound to arise. These conflicts are, as Melucci explains, carried out in the public sphere by a multitude of individuals acting as public, and individual, actors. The conflict here is between the established order, with its determination to impose particularistic definitions of individuality upon people and the determination of individuals to articulate the parameters of their on individuality and to give expression to their real but, previously, silenced, selves. From this perspective, one may even assert that the newness of contemporary social movements also emanates from the newness of the conflicts which they have generated. To a large degree, the identified area of newness has been largely instigated by the very nature of the contemporary information age. Given the proliferation of information channels and the ever-expanding capacities for individual communication on the

Thursday, July 25, 2019

Kaizen and T.Q.M Essay Example | Topics and Well Written Essays - 2250 words

Kaizen and T.Q.M - Essay Example Brief History and contribution of Dr Deming: After the Second World War, Dr. Deming who was the expert on statistical procedures and quality management started spreading his expertise in Japan and this gave rise as the foundation brick gave risk to a complete profession in the name of Total Quality Management. Japanese started implementing these principles in the industrial arena and found out its fruits in form of increased yield and customer satisfaction. Deming was assisted in his efforts by Juran and Ishikawa. T.Q.M is acronym for â€Å"Total Quality Management†, as the name implies it takes into account all the factors of organization that can have an impact on the life of organization, its working and its output. T.Q.M is a concept and at the same time a philosophy and hence has a very vast scope. Since, its rules and working mechanism are so flexible which enables this philosophy to be implemented in both the service industry and the manufacturing industry. It is based on the principles of Continuous Quality Improvement (C.Q.I) initiatives which makes improvement and quality maintenance as part of the organizational activities (Roy, 2007). This philosophy is termed as the bench mark towards achieving excellence in the corporate environment since it provides sufficient guidance for all the necessary aspects. T.Q.M can be split into three major parts, totality, quality, and management. Its scope covers all three important areas of an organization and management field. The term totality refers to the coverage scope for all the essential aspects of organization. The totality factor demands participation, commitment from every personnel who is part of the organization. Ranging from top management individuals to supervisors and shop floor workers, each is expected to provide input and contribute in any way possible. Apart from individuals, the totality factor is fully applicable to the teams and departments and divisions within the organizations. The totality factor addresses the human resource management department, marketing, finance, and all other important departments of the network that have can any positive or negative impact on the organization. The totality factor takes into account all the processes that are involved during the manufacturing stages as well the service delivery stage s (kawatra, 2000). Role of Inspectors: Prior to the implementation of T.Q.M, the inspectors were integral part of organizational framework. Their role was to monitor the performance of various departments and individuals associated. This consumed a lot of resources and department had to bear the burden of a special extra department in the name of inspection department. With the advent of Total Quality Management, the inspectors are no more needed, since the system is devised in such a manner which holds each department and individual responsible for their own role and performance. The large amount of resources and time that used to be consumed and wasted by inspection processes is controlled through the implementation of T.Q.M system. The second part of the acronym is â€Å"Q† which stands for quality. Quality is a subjective definition and can be defined in number of ways. However it can have a pretty simple definition which makes work easy both for the organization and the customers. Quality service or product can be defined as that particular service or product which is in accordance with the demand of customer and fulfils the conformance level. In past a small â€Å"q† was used in the field of marketing and organizations. This did not cover all the aspects of organizational structure. With small â€Å"q† in practice, the onus of productivity and responsibility was largely emphasized on

Wednesday, July 24, 2019

John Brown- Terrorist or Freedom Fighter Essay Example | Topics and Well Written Essays - 1500 words

John Brown- Terrorist or Freedom Fighter - Essay Example Using one of the most famous accounts of such a confrontation in America, the author illustrates the impact of humanitarians’ calls for abolition linking John Brown’s Raid as a possible origin of the American Civil War. However, the noble intentions of the raid are usually taken out of context to associate its consequences with acts of terrorism. In spite of the dangerous approach adopted by John Brown and his associates in the Harpers Ferry episode, abolition campaign was like a time bomb that would have anyway exploded due to neglect and contempt of human rights issues. Flanked by this thesis statement, this essay will attempt to analyze the life of John Brown and the events at Harpers Ferry raid to pick a position on legality of his actions as reiterated in the accompanying conclusion. Inequality and slavery in the polarized American society concerned John Brown to the extent that he found an alternative to peaceful abolition campaign that had not delivered results. Besides his desire to have a successful campaign for a slave free country, he was angered by some abolition positions that did not advocate for equality to the marginalized slave community (Earle, 13). Terrible aggression had been observed against slaves who were also subjected to inhumane conditions, a matter that inspired John Brown to apply similar tactics on the perpetrators of the violence on slaves. Alternatively, there was an apparent division into two southern and northern factions along hard-line positions on the issue of slavery. John Brown was a northerner, the faction that largely advocated for peaceful resolution of the American humanitarian concerns. Despite the fact that religious input into the campaign quelled application of any hostility tactic, the emergence of certain abolition acti vists who were desperate for the continued suppression of slaves and minorities was on the rise. The hostile abolitionists had realized that however dangerous it appeared, hostility

Tuesday, July 23, 2019

Introduction To E-Business Essay Example | Topics and Well Written Essays - 500 words

Introduction To E-Business - Essay Example All cross-organizational elements of the Inbound Supply Chain, including different aspects like Enquiry/RFQ details, Online and Offline Quotation logging, Order Placement, Delivery compliance monitoring, Order amendments, Material Receipt and Payment tracking are covered and also relevant transactions can be made through this e-procurement site. In addition to these new features and benefits, value-added services such as Negotiation Chat Room with Bid revision tracking (Reverse Auction), Transactional correspondence (mails initiated on a transaction hitting appropriate mailboxes) and e-Mail notifications and acknowledgements, are also offered (Tata Steel, 2004). While the site incorporates all the basic functionalities that may be required, the company is still putting in continuous effort towards providing value-added services and features. Taobao.com, China's leading consumer e-commerce website is a division of the Alibaba Group (Alibaba Group, 2007). Taobao is a shopping marketplace for consumers in China. Founded by parent Alibaba Group, it facilitates transactions between individual consumers and a wide range of sellers such as retailers, wholesalers, and other individuals.

Monday, July 22, 2019

Teenage Texting and driving Essay Example for Free

Teenage Texting and driving Essay With the advent of the smartphone, life has become much easier for all of us. We can now make a phone call, text, access social media sites and other pertinent applications all from one device. While the advances in the cellphone industry are amazing, they have come with dire consequences. Texting while driving has now become the leading cause of death of teenagers in the United States, overtaking drunk driving. Nearly every teenager looks forward to driving, it represents independence and freedom. While this new found freedom is great for the teenage driver, it represents fear and sleepless nights for parents. Today, not only does a parent have to worry about how their teenage son/daughter is driving but what they are doing while they are driving. In the past, the biggest fear of a parent was whether their child was drinking and driving, which is the cause of over 2,700 deaths and 282,000 treated for injuries, per year (Ricks 2013). As a result, drinking and driving has been the leading cause of deaths among teenagers for the past 30 years. However, per the CDC, since 1991, drinking and driving among teenage drivers has dropped over 54%, while 50% of teens between the ages of 15-18 admit to texting while driving (Ricks 2013). This shift in teenage driving habits has created a whole new concern among law enforcement and parents. Experts say texting while driving can be as distracting as drinking and driving, and laws banning texting while driving have very little if any effect on stopping the practice. â€Å"Composing a typical text message is roughly akin to closing ones eyes for nearly five seconds, during which time a car going 55 mph covers more than the length of a football field† (Savitz 2012). Due to the technological advances of the smartphone, and the fact that 50% of all teenagers admit to texting while driving, deaths of teenagers from texting while driving has skyrocketed. The latest data shows that over 3,000 teenage drivers died and over 300,000 were injured last year, as a result of teenage texting while driving. â€Å"The Insurance Institute for Highway Safety estimates that it is to blame for 11 teen deaths each day† (Savitz 2012). These deaths and injuries now make teenage texting while driving the leading cause of death among teenagers in the United States. With laws making no difference on whether drivers text, the number of deaths attributed to teenage texting while driving will only rise in the coming years. We can now manage our whole life from a cellphone, due to the technological advances in the cellphone industry. While this convenience saves everyone countless hours a day, over 3,000 teenagers die and over 300,000 are injured every year from this convenience. Texting while driving among teenagers is at epidemic levels and is now the number one cause of teenage deaths in the United States. Laws are not enough, only knowledge, training and a teen driver saying â€Å"No† to texting while driving will stop this epidemic. I for one have said â€Å"No†. References Ricks D. Study: Texting while driving now leading cause of death for teen drivers. Newsday, (Melville, NY) [serial online]. May 8, 2013:Available from: Newspaper Source, Ipswich, MA. Accessed September 1, 2013 Savitz E. Naughty, Naughty: Nearly Third Of Teens Text While Driving. Forbes. Com [serial online]. June 7, 2012;:36. Available from: Business Source Complete, Ipswich, MA. Accessed September 15, 2013

Human rights institutions

Human rights institutions Introduction AIDS and HIV affect the lives of every human being, from those who are HIV-positive, those who know someone who is infected and those non-infected people. This is because, once AIDS and HIV hit, it will in directly or directly influences aspects of our life. As a matter of fact, AIDS is the only health concern in the world that has its own United Nations agency, also known as UNAIDS. However, apart from the work of the United Nations and its several organs does, there are several other international organisations that operate in the worldwide fight against AIDS and HIV. Examples of these international organisations are the Global Fund to Fight AIDS, Tuberculosis and Malaria and the African Union (AU). The United Nations The United Nations does not only contribute to the fight against AIDS and HIV by supply financial, technical and human resources to UNAIDS organisation only, but also coordinate a collaboration of projects and schemes through the majority of the UN agencies. These organisations all have their own particular international responses to reverse the spread of AIDS and HIV virus. Such illustrations are these international organisations: Food and Agriculture Organisation (FAO) Food expenditure in Sub-Saharan African has dropped by forty per cent in rural villages because of the AIDS and HIV virus. As stated by Marcela Villarreal who is a FAO and AIDS specialist Food is the first medicine for HIV/AIDS and often the only medicine as tragic as it is to be orphaned, it is very different being orphaned at 15 years of age than being orphaned at 7. If parents could live a few more years, they could take their children to the fields and teach them by doing.[1] In brief, parents cannot pass on the agricultural trade to their children, if their children are already orphaned by the age they could learn and understand. For this reason, FAO is working on the issue that everyone should have access to food. Food and agricultural are two vital issues for AIDS and HIV prevention, because malnutrition will increase body infections and spread AIDS-related illnesses in communities where extreme poverty reigns. International Atomic Energy Agency (IAEA) Based in Vienna, IAEA is operating to provide the technological expertise and the know-how to underdeveloped countries in regards to health and food nourishment. In 2005 the IAEA and its Director Dr. Mohammed El Baradei won the Nobel Peace Prize for the prevention of nuclear energy being used for military intentions instead for peaceful measures and goals. Therefore, IAEA decided to distribute the Nobel Peace Prize with the whole world by establishing the IAEA Nobel Prize Cancer and Nutrition Fund. This fund sponsor knowledgeable experts and research related to aid infant malnutrition and health in developing countries. Over the years the IAEA has supported numerous activities in infant nutrition where stable isotope techniques have been applied. These include projects to measure human milk intake in breast-fed infants, lean body mass (muscle mass) in lactating mothers, and bioavailability of iron in infants and young children.[2] International Labour Organisation (ILO) As stated by Juan Somavia, Director of ILO HIV/AIDS is a major threat to the world of work: it is affecting the most productive segment of the labour force and reducing earnings, and it is imposing huge costs on enterprises in all sectors through declining productivity, increasing labour costs and loss of skills and experience.[3] Concisely, employment plays a crucial role in AIDS and HIV prevention, because there are several matters that indirectly affect the livelihoods of human beings who are HIV-positive, such as: sexual discrimination, child labour and universal fundamental human rights. Thus, if there are more people who are not infected by AIDS or HIV, they can find a decent job sustain themselves and their family and thus in the end they are economically contributing the society and increasing the economic wealth. Joint United Nations Programme on HIV/AIDS (UNAIDS) Based in Geneva, UNAIDS is an innovative joint venture of the United Nations family, bringing together the efforts and resources of ten UN system organizations in the AIDS response to help the world prevent new HIV infections, care for people living with HIV, and mitigate the impact of the epidemic.[4] As a result since 2000, AIDS become an international health concern when the UN Security Council approved Resolution 1308, following this event; a series of achievements became apparent about the importance to reverse the spread of AIDS and HIV for instance the 2000 Millennium Development Goals, the 2001 Declaration of Commitment on HIV/AIDS and the 2006 Political Declaration on HIV/AIDS.[5] UNAIDS is also working in partnership with UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, ILO, UNESCO, WHO, World Bank, NGOs, MNCs and governments to put to an end AIDS by the year 2015. Office for the United Nations High Commissioner for Human Rights (OHCHR) In 2001, the UN General Assembly ratified the Declaration of Commitment on HIV/AIDS, as part of the programme to fight AIDS and HIV by promoting universal human rights on a domestic, regional and international level. Annex 1 of the Declaration of Commitment on HIV/ AIDS states that [T]he full realization of human rights and fundamental freedoms for all is an essential element in a global response to the HIV/AIDS pandemic, including in the areas of prevention, care, support and treatment, and [] it reduces vulnerability to HIV/AIDS and prevents stigma and related discrimination against people living with or at risk of HIV/AIDS.[6] These universal human rights consist of health, gender equality, basic education and decent employment, which all play a significant role to fight AIDS and HIV epidemic. Therefore, if these human rights are not respected, human beings are vulnerable to be infected by this pandemic disease. United Nation Development Fund for Women (UNIFEM) UNIFEMs procedure is targeted to help women and young girls combating AIDS and HIV from sexual relations, have access to reproductive health, by promoting maternal health and preventing mother to child transmissions. This is because gender inequality and violations of womens rights make women and girls particularly susceptible, leaving them with less control than men over their bodies and their lives. Women and girls often have less information about HIV and fewer resources to take preventive measures. They face barriers to the negotiation of safer sex, including economic dependency and unequal power relations.[7] Thus, UNIFEM forefront approach is reducing aggression and discrimination against women, improving women decision-making power and decreasing the household burden women carry on their own, especially when it comes to taking care of HIV-positive relatives while continuing to manage their household and working full-time. United Nations Childrens Emergency Fund (UNCEF) AIDS and HIV has radically altered the perspective of Sub-Saharan African children on how they view the world, especially if they are orphaned at a young age with nowhere to go and no one to feel belong to. As a result, UNICEF launched its response to prevent the transmission of AIDS and HIV particularly among children is by encouraging thefour Ps guide, which are preventing mother-to-child transmission, providing paediatric care, preventing infection among adolescents and protecting children affected by AIDS.[8] The 2005 campaign Unite for Children, Unite Against AIDS was aimed to do away with the situation that few children reach beyond their fifth birthday, because of child mortality, inadequate medical care and lack of primary education. UNICEF isnt just seeking to eliminate AIDS among children, but according to Mr. Jimmy Kolker UNICEF Chief of HIV/AIDS and Associate Director of Programmes, UNICEFs goal is to eliminate the need for that treatment by seeing an AIDS-free generation .[9] United Nations Development Programme (UNDP) UNDP is undertaking the responsibility to prevent the spread of HIV/AIDS and reduce its impact. As a trusted development partner, and co-sponsor of UNAIDS, it helps countries put HIV/AIDS at the centre of national development and poverty reduction strategies; build national capacity to mobilize all levels of government and civil society for a coordinated and effective response to the epidemic; and protect the rights of people living with AIDS, women, and vulnerable populations.[10] UNDP is currently concentrating on AIDS in relation to development planning and mainstreaming; governance of AIDS responses; international law, human rights, gender equality such as sexual minorities, public health and development partnerships, basic education and maternal and child morality.[11] United Nations Educational Scientific and Cultural Organisation (UNESCO) UNESCO is working to stop the spread of AIDS and HIV around the world, by eradicating the social and cultural barriers and put forward on its international agenda the issue of universal education. This is because by increasing [the] role of education sectors is also a recognition that a good education is one of the most effective ways of helping young people to avoid HIV/AIDS.[12] Education is the basic foundation of every human being. Without education, human beings are more prone to be vulnerable to AIDS and HIV and that particular individual cannot develop the knowledge of trade so that anyone can economically stable. On the other hand, through its programme The Cultural Approach to HIV and AIDS Prevention and Care UNESCO is continuing to eliminate cultural ignorance of the local citizens to help them combat the stigma and discrimination that surrounds AIDS and HIV. United Nations Environmental Programme (UNEP) As stated by Achim Steiner, Executive Director of the UNEP, UNEP as the principal UN body in the field of the environment, recognizes that human well-being is the focus of environment and sustainable development issues. Tackling poverty, promoting gender equality and combating HIV/AIDS are all linked to environmental sustainability; just as environmental sustainability is an essential component of achieving all the UN Millennium Development Goals.[13] In fact, developing countries were the least countries emitting greenhouse gas emissions, but they were the most affected by climate change due to desertification, lack of rain and drought. The environment erected a barrier towards AIDS and HIV prevention since there was the lack of food storage among African citizens. Thus, this is why, UNEP is contributing its share to compensate African countries which are the most badly affected by the issue of climate change. United Nations High Commissioner for Refugees (UNHCR) Refugees around the world are more prone to be infected by AIDS and HIV because of ethnic conflict, dislocation, food insecurity and extreme poverty.[14] Food insecurity is the major cause for the fleeing of thousands of refugees to neighbouring countries for shelter and a chance to have a better life. However, refugees who leave their homeland, because of racial clashes often take whatever they have in hand to escape. Once they are in another region they are in deeper poverty because they do not have sufficient money to start a new life and thus they end up living in slum areas and relying on begging in order to get something to eat. Therefore, UNHCR is operating on the notion of food insecurity is the result for the spread of AIDS and HIV since human beings especially women against their wish turn to sex work as a means to economically sustain themselves. United Nations Human Settlements Programmes (UN-Habitat) UN-Habitat is working together with local and international policy-makers to improve this lies of people living both in urban and rural areas. These measure which include improved water and sanitation facilities, enhance the lives slum dwellers, eliminate extreme poverty and encourage sustainable development. Dr. Anna Kajumulo Tibaijuka Executive Director of UN-Habitat, stated that in order to prevent the continuation of the spread of AIDS and HIV, one needs to first focus on the goal to have secure shelter, because without a secure home, and a caring family and community, it was difficult, if not impossible, to provide health care and effective counselling to those afflicted.[15] In other words, UN-Habitat has the responsibility to prevent AIDS and HIV, by first tackling the issue of safe housing particularly in Sub-Saharan Africa where there are a lot of homeless people due to extreme poverty. United Nations Office of Drugs and Crime (UNODC) UNODC is in charge on the issue to prevent AIDS and HIV epidemic among injecting drug users and in prison settings around the world especially in the Sub-Saharan region. Therefore, the UNODC is mainstreaming HIV and AIDS into its activities at the national, regional and global levels, and is helping States and civil society organizations to develop and implement comprehensive HIV and AIDS prevention and care programmes for injecting drug users.[16] Also, with the slogan Think AIDS, before you start, before you shoot, before you share, the UNODC is aiming to increase awareness and knowledge on the dangers of illegal substances and their relation to AIDS and HIV viruses especially among adolescents. This is because, it is estimated that there are around 16 million drug users globally and there is the possibility that one in five are HIV-positive.[17] United Nations Population Fund (UNPFA) UNPFAs responsibility is to promote prevention of AIDS and HIV among all genders and all generations, because UNPFA considers AIDS and HIV as an international humanitarian crisis that affects every human being around the globe. These are mainly done by distributing contraceptives and knowledge of birth control among women, refugees and young people, advertising universal access to health especially anti-retroviral drugs, gender equality, respect for human rights and eliminate abject poverty. UNPFA view the role of women as a key factor towards the progress of AIDS and HIV prevention. In fact, as stated by Ms. Thoraya Ahmed Obaid, Executive Director of UNFPA Women who have been affected by the epidemic are the real experts in the response to HIV Their experience allows them to give concrete, practical, down-to-earth advice. But their participation must continue beyond an advisory role. Women should also have more say in budgetary decisions.[18] World Food Programme (WFP) Like FAO and UNHCR, WFP is tackling the issue of food security as a root for AIDS and HIV prevention. Famine in Sub-Saharan African countries has forces local citizens to turn into piracy, crime and prostitution to feed themselves and their family. This is why WFP is working to distribute food as food is the forefront means against the battle of AIDS and HIV disease. According to James T. Morris, Executive Director of WFP, he believes that Existing therapies require sound nutrition. Adequate food is essential for prolonging the lives of parents and enabling them to have a few more precious weeks, months or maybe even years to work and spend time with their families. Perhaps we cannot give them hope for a cure, but we can give them time.[19] In other words, Sub-Saharan African people, apart from decent supply of medicines and drugs they are in need more of good quality of food. World Health Organisation (WHO) WHO is at the front position in regards to the wellbeing and health of citizens of those who are HIV-positive, are affected by AIDS and HIV or are in danger to be infected by this pandemic disease. Moreover, WHO strategic plan to prevent the spread of HIV and AIDS are by facilitate inhabitants to know their HIV status, enlarge the health divisions towards the continuation of AIDS and HIV prevention, increase the development of HIV treatment, support and care, improve and enlarge health procedure, Invest in premeditated knowledge and awareness for better education in regards to AIDS and HIV response.[20] These five important guidelines will help to give a better life to patients suffering from AIDS or HIV. Policies of the African Union African Union is a pan-African and inter-governmental organisation that aims to have a mutual partnership to increase affluence and peaceful relations between all African nation states. This union, which consists of thirty-five member states, is currently chaired by Colonel Muammar Gaddafi of the Great Socialist Peoples Libyan Arab Jamahiriya. The African Unions purposes in international relations is to point towards to promote unity and solidarity among African States; to coordinate and intensify cooperation for development; to safeguard the sovereignty and territorial integrity of Member States and to promote international cooperation within the framework of the United Nations.[21] Above all, the African Union has various projects to put Africa on the international agenda, among these projects there are specific measures taken to eliminate the burden of malaria, tuberculosis and AIDS and HIV in Africa. These international health concerns are tackled, on an international level, with a collaboration of other international organisations such as the United Nations and the Millennium Development Goals. In order to deal with the problem of AIDS and HIV in Africa, the AU on May 2006 organised a Special Summit themed as the Universal Access to HIV/AIDS, Tuberculosis and Malaria Services by 2010 in Abuja, Nigeria. This summit included delegations from civil society organizations, the UN and its agencies together with members of the African Union and its thirty-five AU member states. This summit started with a follow-up of the results that came out from the 2000 Declarations and Frameworks for Action on the Abuja Summit on Roll Back Malaria and the 2001 Abuja Summit on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases.[22] However, this special summit set out new goals that were: first is to re-evaluate the accomplishments made since the 2000 and the 2001 Abuja summits to make sure the AU reach the objectives, in the context of the Millennium Development Goals. Second is to recognise the disparities, limitations and confrontations of the aims of the Abuja Summits and Millenni um Development Goals. Third is to ascertain new plan of action that will allow the African Union to keep a record of additional and more pragmatic route with regards to attain the mention targets. Fourth is to get hold of the improved responsibility of the African Leaders for addressing the diseases of AIDS/HIV, malaria and tuberculosis and encouraging health and wellbeing in Africa. Fifth is to intensify the African Peer Review Mechanism (APRM) within the framework of the New Partnership for Africas development (NEPAD) and for assessing the development towards establishing social development. And, sixth was to plan Africas Common Position to global forums such as the 2006 UNGASS on AIDS and the 2006 World Health Assembly.[23] Recently, between the 4th and the 8th of May 2009 in Addis Ababa, Ethiopia was launched the 4th Session of the AU Conference of Ministers of Health. The subject of this conference was Universal Access to Quality Health Services: Improve Maternal Neonatal and Child Health. The AU Conference of Ministers of Health provided an important forum for Member States, development partners and other stakeholders to, among others: review progress in health sector development, particularly universal access to services and the health-related MDGs in Africa; devise/adopt strategies for accelerated action towards more effective implementation of commitments for promotion of maternal and child health, survival and well-being in Africa; share experiences and learn from each other as concerns ongoing programmes and activities on health and development in Africa.[24] In other words, this conference shows that African states especially Sub-Saharan countries are well aware about problems in their individu al health sector, and the lack of medicine and drugs to combat HIV and other AIDS-related diseases. Therefore, this is why they are working in an alliance to achieve mutual goals. This conference also publicly introduced the AUs Campaign on Accelerated Reduction of Maternal Mortality in Africa. As well as, the African Union is also giving special attention by concentrating on the issue of AIDS and HIV among the armed forces. Furthermore, on July 2009 in Sirte, Libya during the ordinary session of the African Union launched a programme named Investing in Agriculture for Economic Growth and Food Security.'[25] Overall, all of these key procedures are taken to deal with the issue of health and wellbeing especially AIDS and HIV from an African perspective, particularly focused to help fellow Sub-Saharan African states. African policy-makers and leaders are taking considerate interest to fight AIDS and HIV from every viewpoint, because they know at firsthand about the social, cultural and economical difficulties this virus brings among their nation. Thus, this is why they are undertaking the notions of health both maternal and infant wellbeing, the local economy, national security and agricultural and food security as a serious matter. Global Fund to Fight AIDS, Tuberculosis and Malaria The Global Fund to Fight AIDS, Tuberculosis and Malaria was founded in 2002, by a mutual partnership between national governments, the civil society, bilateral and multilateral international organizations, the private sector and affected societies stand in for innovative paradigm to global health funding.[26] The Global Fund is an exclusive international public and private partnership dedicated to attracting and disbursing additional resources to prevent and treat HIV/AIDS, tuberculosis and malaria. On June 10th 2009, the Global Fund participated in the 2009 HIV/AIDS Implementers Meeting in Windhoek, Namibia, together with the U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR), UNAIDS, UNICEF, WHO, World Bank and The Global Network of People living with HIV (GNP+). This meeting themed Optimizing the Response: Partnerships for Sustainability, attracted more than 1,500 representatives of governmental and non-governmental institutions related to AIDS and HIV. The scope of this conference was to implement a strategic plan and new policies for prevention that will help to stop the spread of AIDS and HIV around the world. In fact, recognizing the importance of a sustainable global AIDS response, the focus of this years meeting will be on optimizing the impact of prevention, treatment and care programs; enhancing program quality; promoting coordination among partners; and encouraging innovative responses to the pandemic.[27] Carla Bruni-Sarkozy who is Frances First Lady is currently the ambassador for the Global Fund to Fight AIDS, Tuberculosis and Malaria. Ms. Bruni-Sarkosy is advocating the issue of mother-to-child transmission, by giving a voice on an international level for the many women and children suffering from or affected by AIDS and HIV. On September 2009, Ms. Bruni-Sarkozy delivered a speech at the UN General Assembly, to call on all world leaders to guarantee the increase of the amount of anti-retroviral drugs to HIV-positive expecting mothers. During her speech, which also attended by UN General Secretary Ban Ki-Moon, Carla Bruni-Sarkozy stated that In large parts of the world, the face of AIDS is a womans face, and often the face of a mother, a mother afraid for herself and for her child. Isnt this a major failure of our efforts to promote development, when women under treatment can better care for themselves and their families, and form the solid foundation of an entire community, an enti re economy?[28] Concisely, Bruni-Sarkozys vision is that, if African countries, with the help of Western nation states remove the barriers and start to educate women about maternal and reproductive health. This investment will build on fertile grounds, the basis of loving and supporting families which will be beneficial to the whole society and will results in better economic system that will be valuable to the whole nation. As part of World AIDS Day campaign, on 1st of December 2009, the Global Fund to Fight AIDS, Tuberculosis and Malaria together with The U.S. Presidents Emergency Plan for AIDS Relief introduced another project that will mutually be providing anti-retroviral drugs to more than three million patients, around the world who live in states that have low or middle wages. PEPFAR and the Global Fund enjoy a complementary and supportive relationship in the fight against HIV and AIDS worldwide. In order to exploit synergies, PEPFAR and Global Fund-financed programs coordinate at the country level to ensure that resources are used efficiently and effectively. Collaboration and coordination are crucial to the efficient use of money and for making further progress in providing AIDS treatment and care to the millions still in need.[29] In other words, both PEPFAR and the Global Fund aim to eliminate AIDS and HIV around the world by promoting preventive health care as well as anti-retroviral drugs t o patients suffering from AIDS or HIV in developed and underdeveloped countries. This is mainly done, by making the most of their available medicine to reach the vast number of people as possible, and thus change for the better the lives of the citizens. The Global Funds mission is to bring international health concerns like AIDS, tuberculosis and malaria on the international agenda so that the general public around the world can educate oneself about prevention and symptoms of such diseases. It also inform the civil society about how it badly effective underdeveloped countries such as Sub-Saharan states because of the lack of education that is available to the public. This is why, the Global Fund had launched a series of schemes and project to donate medicine and drugs in order to cure patients affected by AIDS and HIV or other related illness while educating those people who are not infected on how to prevent being contaminated by this virus. Conclusion AIDS and HIV consumes health, resources and productivity within the national and international; community. Therefore, this is why we are in need of a global response to fight AIDS and HIV illness from every aspect, because every aspect of ones life that is from education to health to housing to the national economy, affects the lives of the inhabitants especially those who are in danger to be infect by HIV or have an AIDS-related infection. Affluence plays a major role in the policy of a nation state, because the wealthier the country is, the more people can have a better standard of living and distant from any deathly disease. This is why the UN, AU and the Global Fund are bringing about the downfall of AIDS and HIV by implementing policies from every outlook. http://www.fao.org/english/newsroom/news/2002/11580-en.html [assessed December 2009] Kinley D. III (ed.) (2006) IAEA Nobel Peace Prize Cancer and Nutrition Fund. Austria: International Atomic Energy Agency. Page: 7. Citing Juan Somavia, Director-General of the International Labour Organisation (2001) An ILO Code of Practice on HIV/AIDS and the World of Work. Geneva: International Labour Office. Page: iii. http://www.unaids.org/en/AboutUNAIDS/default.asp [assessed December 2009] http://www.unaids.org/en/AboutUNAIDS/Goals/default.asp [assessed December 2009] Citing the Declaration of Commitment on HIV/AIDS from OHCHR and UNAIDS (2007) Handbook on HIV and Human Rights for National Human Rights Institutions. Geneva: Office of the United Nations High Commissioner for Human Rights and the Joint United Nations Programme on HIV/AIDS. Page: 3. http://www.unifem.org/gender_issues/hiv_aids/ [assessed December 2009] http://www.unicef.org/aids/index.php [assessed December 2009] Citing Mr. Jimmy Kolker UNICEF Chief of HIV/AIDS and Associate Director of Programmes from http://www.unicef.org/aids/index_51958.html [assessed December 2009] http://www.undp.org/hiv/ [assessed December 2009] http://www.undp.org/hiv/docs/UNDP%20response%20to%20AIDS_08.pdf?asset_id=1671970 [assessed December 2009] http://www.ibe.unesco.org/AIDS/doc/WorldBank_Sourcebook.pdf [assessed December 2009] http://www.unep.org/Documents.Multilingual/Default.asp?DocumentID=496ArticleID=5445l=en [assessed December 2009] http://www.unhcr.org/cgi-bin/texis/vtx/search?page=searchdocid=42f31d492query=aids and hiv [assessed December 2009] http://www.unhabitat.org/content.asp?cid=3011catid=5typeid=6subMenuId=0 [assessed December 2009] http://www.unodc.org/unodc/en/hiv-aids/ [assessed December 2009] http://www.unodc.org/docs/thinkaids/Factsheets_2009/factsheet_EN.pdf [assessed December 2009] Citing Ms. Thoraya Ahmed Obaid, Executive Director of UNFPA from http://www.unfpa.org/public/cache/offonce/News/pid/1141 [assessed December 2009] Citing James T. Morris, Executive Director of WFP from http://www.wfp.org/sites/default/files/First%20Line%20of%20Defense%20English.pdf [assessed December 2009] http://www.who.int/hiv/aboutdept/en/index.html [assessed December 2009] http://www.africa-union.org/root/au/AboutAu/au_in_a_nutshell_en.htm [assessed December 2009] http://www.africa-union.org/root/au/conferences/past/2006/may/summit/summit.htm [assessed December 2009] http://www.africa-union.org/root/au/conferences/past/2006/may/summit/summit.htm [assessed December 2009] http://www.africa-union.org/root/UA/newsletter/publication%2040%20may%202009.pdf [assessed December 2009] http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2009/20090702_African_Union.asp [assessed December 2009] http://www.theglobalfund.org/en/partnership/?lang=en [assessed December 2009] http://www.theglobalfund.org/en/pressreleases/?pr=pr_090611 [assessed December 2009] Citing Ms. Carla Bruni-Sarkozy, First Lady of France from http://www.theglobalfund.org/en/pressreleases/?pr=pr_090922 [assessed December 2009] http://www.theglobalfund.org/en/pressreleases/?pr=pr_091201a [assessed December 2009]

Sunday, July 21, 2019

Social Media and Young Adolescents

Social Media and Young Adolescents As technological innovations continue to expand, access to devices that connect one to social media have become more readily available to the public. A study conducted by Radesky et al. (2016) about the use of mobile technology among children found that mobile device usage by young children, even among those from disadvantaged backgrounds, continues to increase rapidly (p.504). The increasing usage of social media networks is strongly affecting the social development of young adolescents. The effects social media is having on young adolescents is can be positive or negative depending on how the child is being exposed to it. For instance, social media positively affects adolescents by enabling them to build stronger social connections with their peers as they are able to easily stay connected to them. In contrast, these connections can also have a negative effect on the social development of young adolescents if they are victims of bullying or other damaging relationships because thei r abuser can easily remain connected to them. In addition, the use of social media among young adolescents will also have an impact on their mental health as they can be exposed to unrealistic ideals of body image which can affect their self-esteem and have long term effect on their social development. It is highly important for the effects of social media usage on the social development of young adolescents to be studied because there can be many long-term effects if this milestone is not met. It is the job of professionals in the early childhood field alongside parents to assure they are educated in the matter and give the children the tools to surpass each developmental stage. One of the many benefits of the advances technology has made is the way in which people can remain connected and easily reached throughout the day. This indicates that young adults are able to remain connected to their friends outside of school hours, which aids their social development. According to Minna Ruckenstein (2013), mobile phones, game consoles, and computers are an essential part of the sociality between children in increasingly diverse ways (p.476). By having access to devices in which social interactions can occur outside of a school setting, children and young adolescents are practicing social skills on a regular basis. In addition, a study conducted by Sarah Wilson (2016) indicated that social media usage was helping children and adolescents stay connected to people in many ways. For instance, not only were they able to maintain relationships with peers but they were also able to remain in contact with long-distance friendships and find long-lost friends and family thr ough social media sources. Furthermore, social media is being used as a topic of communication among children. More specifically, meanings from home (and many other places) are carried to the playground, and in the social context of playing with media texts, children participate in social processes of meaning-making and identification (Willett, 2015, p.411). This indicates that media is being used as a form of socialization among children, therefore, if fostered away from the use of social media, some children could potentially risk the inability to build strong relationships with their peers. It is clear that when it comes to the social development of young adolescents, social media networks are an essential part of communicating and building relationships with one another. In contrast, although the use of social media networks has positive effects on the social development of young adolescents, there are also dangers that arise from using it. For example, if children are being victims of bullying, having access to social media can cause the aggressors to have another source at which to attack. Research on bullying and social media usage among children has found that online bullying, though sometimes anonymous, is typically done by peers whom know the victim personally. (Canty, Stubbe, Steers, Collings, 2016, p.52). This would mean that these victims would not be able to escape the bullying, it would follow them to their homes. In addition, the study found that children and young people recognise a greater likelihood of doing or saying something they would not if it were face-to-face (Canty et al., 2016, p.53). To further explain, children may feel more inclined to act a certain way if they are behind a screen because it is not as intimidating as in pe rson, which can result in a higher risk for online bullying and thus be detrimental to the social development of the victim. Another danger with young adolescents using social media is that their use may be uncensored and parents cannot always control what their children are doing or whom they are interacting with. For instance, children could be exposed to communicating with complete strangers they have never met, which could end up being predators. A study conducted by Elizabeth Daniels and Eileen Zurbriggen (2016), explored the dangers with teen sexuality and social media use. They found that young adolescents are using social media as ways in which they can post provocative images to capture the attention of their peers and attain social acceptance (p.938). The problem with this is that social media is being used as a way to attract attention but in doing that, everyone on the internet is having access to these inappropriate photographs of young adolescents, whom are underage and with a possible lack of understanding of the dangers that may come with it. This may result in a negative form of social dev elopment because they are growing up and engage in provocative content that may be above their developmental age. Apart from the positive and negative effects on the social development of young adolescents when using social media, there are also factors that may affect their mental health in connection to their social development. For instance, social media can become addictive and impede children from face to face interactions or in other cases more serious factors can occur such as self esteem problems and depression. Studies have shown that social media addictions are very real and can cause a lot of problems for youth in and outside of school because there is a lack of attention span and face to face communication with peers (Bà ¡nyai et al., 2017, p. 2). An addiction is a mental health problem that could potentially cause a lot of long term problems if it goes unresolved. These children could end up isolated from their peers and eventually struggle graduating from school or finding a job. Furthermore, the constant use of social media could affect at-risk children in many ways when it comes to self esteem. This is because of the pressures of being socially accepted by peers, as well as the pressure to look a certain way that is perceived by the media. Some of these negative aspects to the mental health of young adolescents include increased risk-taking behaviours, cyberbullying, depression, exclusion of minority groups and negative influences on health and wellbeing, namely reduced self-image and self-esteem (Richards, Caldwell, Go Caldwell, 2015, p.1154). This can affect the social development of children and young adolescents because not only are they dealing with the changes of transitioning from a child to a teenager but they now have to struggle with a mental health problem, which can result in loss of friendships and interest in activities they previously enjoyed. As an early childhood professional, it is highly important to be informed about the issues surrounding social media and young adolescents. With the up rise in technology and social media usage within schools, one needs to understand all aspects of the effect it has on the social development of children and young adolescents because if ignored there can be detrimental effects. As an educator, one needs to make choices on how to deal with the media students are using and in which ways to help them meet their full potential within social development, therefore it is very important to know the positives and negatives of social media usage. It is important to note that steps can be taken by parents, professionals and creators of media sites in order to prevent some of these issues. For instance, some of the social media risks for children can be minimised by adding in safety features (Richards, Caldwell, Go Caldwell, 2015, p.1154). If features are added to make sites safe, children will still be able to use them and interact with peers but in a way which inhibits access to inappropriate content or interactions with people they have never met before. In addition, there is a tool called the Bergen Social Media Addiction Scale, which is used to assess whether a child has an addiction to social media or not. This could be used to test children whom one thinks could be having a problem with a social media addiction and thus develop a treatment to help the child early on (Bà ¡nyai et al., 2017, p. 10). Lastly, it is advised for educators to teach children and youth about social media in school so that they are prepared for the things they may encounter while connected to the online world. Daniels and Zurbriggem (2016) posited that media literacy curricula that address social media specifically are important given the almost whole scale adoption of social media by young people and the electronic footprint using it entails (p.960).Teaching children about social media could highly aid in fostering a safe social development and prevent some of the negative outcomes. In conclusion, social media usage can affect the social development of young adolescents in many ways. There are positive outcomes to using social media such as better connectivity to peers and social acceptance as one is able to interact with peers outside of the school setting. To contrast, there are also negative outcomes such as increased forms of bullying that carry on from the school to the home, and risks of meeting strangers or being exposed to content that is not age appropriate. Lastly, there can be many detrimental factors to social development when it comes to mental health. Addiction to social media has been reported among youth as well as issues such as self esteem, which can result in young adolescents forming negative relationships with peers and having long term problems in and outside of the online world. Early childhood professionals, parents, and community members should realized the importance of this growing issue and aid young adolescents with social media usage. Social media sites should be made safe with restrictions for people under a certain age, tests should be conducted to help children battle social media addictions, and education on social media should be taught in school. These methods could aid in helping children have a safe social development and grow to be healthy adults. Overall, social media should be used among young adolescents with a great deal of supervision and a high level of education about the dangers of social media usage should be given, especially in a time where social media is easily accessed. 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