Sunday, February 9, 2020

Peresonal development and life long learning Essay

Peresonal development and life long learning - Essay Example Minimization of infection due to catheters, improvement of flow rate and the prevention of thrombo-embolism are some of the factors which have determined research activities in this area (Lok, 2006). As the intensity of catheterization has doubled since their initial use the risk of occurrence of complications arising due to such procedures has also increased which can put tremendous stress on the patients’ health as well as finances. Catheterization has a significant effect on the clinical outcome in such patients due to the high incidence of morbidity and mortality (Tal & Ni, 2008). A variety of anticoagulants have been used in the CVCs to prevent thrombo-embolism and anticoagulant management in haemodialysis in itself is a vital area of therapeutic intervention per se in dialysis patients (Lo et al, 2005). Dialysis patients are prone to venous thromboembolism as well as atrial fibrillation and warfarin and low-molecular weight heparins are frequently used in such cases (Lo et al, 2005). Patients with end stage renal disease (ESRD) are more prone to a hypercoagulable state due to the development of a biochemical milieu in which there is elevation of particular prothrombin fragments and thrombin-antithrombin complexes (Lo et al, 2005). This necessitates effective control measures in such patients for the control of embolus formation all along the course of haemodialysis. Sodium citrate and heparin in various forms are the preferred agents for prevention of embolus formation in patients undergoing haemodialysis due to renal impairment. Continuous renal replacemen t therapy (CRRT) is frequently used as a preventive measure in high risk kidney patients (Bagshaw et al, 2005). When CVCs are used in patients undergoing haemodialysis, thrombosis at the catheter surface itself poses a big problem which affects dialysis quality as well as catheter survival (Grudzinski et al, 2006). A study by these authors has attempted to weigh the pros

Saturday, February 8, 2020

Smoking cessation Essay Example | Topics and Well Written Essays - 750 words

Smoking cessation - Essay Example According to Pignone and Salazar (2009), smoking cessation can increase life expectancy of up to 3 years in women smokers and 2 years in men. In other researches, the life expectancy of a non-smoker is 13-14 years higher than a smoker (Chandler and Rennard, 2010). Studies have confirmed that smoking cessation has inflicts immediate health benefits to the individual. Several interventions are successful in smoking cessation which includes counseling, pharmacotherapy or a combination of both. In this respect, the most important factor is client’s self chosen health goal to quit smoking and both pharmacotherapy and counseling prove to be useful for such patients, however, in patients with unwilling behavior to quit pharmacotherapy is ineffective. Medical counseling approach should emphasize on health and economic benefits of cessation, motivational interviews, patient education on disease risk factors, community/family support and relapse prevention. Pharmacological therapies con sist of nicotine replacement therapy which includes nicotine patch, gums, lozenges, nasal sprays, inhalers etc. (Pignone and Salazar, 2009). All of these have shown to be equally effective in smoking cessation. In addition, anti-depressant therapy with drugs such as Bupropion, varenicline and Clonidine have been proven as effective smoking cessation agents. Several studies have suggested that a combination of these pharmacological therapies is quite effective i.e. nicotine gum with nicotine patch etc. (Chandler and Rennard, 2010).

Thursday, January 30, 2020

The Link between Crime and Mental Disorder Essay Example for Free

The Link between Crime and Mental Disorder Essay In an effort to understand, and therefore reduce or eliminate crime, studies are conducted that examine the many factors that influence or affect it. One of the influences [or possible influences] that affect crime [particularly violent crime]is mental disorder. Several studies have been carried out that investigate this link, which have uncovered much important information. These studies [as with most studies] however, are not without bias. Things such as definition of mental disorder or abnormality are often questionable, as are sample distributions. There are also individual factors, such as type of mental disorder and previous criminal records of subjects, which can influence the results. After taking these factors into account, the research results when examined, suggest, contrary to popular belief, that individuals with mental disorders are generally no more likely to commit crime than individuals without mental disorder. It is a common assumption, that whenever a brutal, violent or senseless crime is committed, it is by someone who is mentally ill or sick. Blaming violent and senseless crime on mental disorders may be comforting but it is not necessarily accurate. A stereotype has developed of the insane mass murderer largely due to the media, however, research evidence suggests that this stereotype is far from accurate. Much research on the link between crime [specifically to this discussion, violent crime] and mental disorder has been conducted, however there are different factors that need to be taken into account when examining this link. Definition of mental disorder is a major one, along with possible uneven sample distributions. Also, there have been changes in mental health and criminal justice policies that have increasingly made hospitalisation restricted to those who are more socially disruptive or dangerous. With these considerations in mind, research evidence can be then be examined. As previously stated, there are many problems with the mental disorder definition. The major symptom of mental disorder is abnormal behaviour, however, there is no strict criteria that sufficiently defines abnormality. Behaviour could be labelled abnormal if it deviates from the statistical  norm, however, as the American Psychiatric association [1987] notes there are no sharp boundaries between normality and abnormality. It can be concluded from this then, that there are no sharp boundaries between mental order and mental disorder. Behaviour could also be labelled abnormal if it deviates from the cultural norm. This is problematic because what society deems as normal is subjective and constantly changing. For example, homosexuality was regarded as being a mental disorder until 1973. These are only two of the ways in which mental disorder is possibly identified but others, such as behaviour that is subjectively distressing, deviates from optimal social or psychological functioning or fails to meet some ideal of health [Blackburn, 1993, p.247] are all subjective and are by no means exact. As such, these classifications have numerous exceptions. Another element of research on the mental disorder and crime link that is often questioned, is the sample distribution. Some believe that many of the studies conducted in this area have an uneven sample distribution that introduces bias in the results. As with many studies conducted in the criminology field, there is the question: should only those convicted of crime [and in this case, those officially diagnosed with a mental disorder] be studied or, should only those who indulge in criminal activity but have not yet been detected by the criminal justice system [or those with undiagnosed mental disorders] be studied, or both? Furthermore, if it is decided that both should be studied, how can people who commit crime, but have not been convicted, or people with mental disorders who have not been diagnosed, be included? These are difficult questions that are up to the individual[s] who are conducting the study to answer, and, different answers, can and usually will, dramatically affect the results. This, however, is not the only way in which a sample distribution could become uneven. A study conducted by Teplin [1984, 1985] cited by Bartol [1999, p.143] examined the tendency of police officers to arrest individuals with a mental disorder. Graduate students of psychology looked at 1382 encounters, and evaluated the mental health of the citizens according to a symptom checklist. The police qualified 506 citizens as suspects and arrested 148.  The students classified 30 of the 506 suspects and 14 of the 148 suspects that were arrested as having a mental disorder. Therefore it was found that 20% more individuals were arrested with mental disorder symptoms than those without. This is believed to be due to the fact that many people with a mental disorder have symptoms such as verbal abuse, belligerence, and general disrespect. This makes it fairly understandable that their arrest record is significantly higher than the general population, but it must be understood that it does not indicate a greater proneness to criminal activity. While considering uneven sample distributions, one must also consider the relatively recent changes in mental health and criminal justice policies. Long term inpatient care or hospitalisation of the mentally disordered is a practice that has largely disappeared [Bartol, 1999, p.141]. Therefore, the mentally disordered have become a more visible presence in the community, and so, if a problem occurs, it is usually up to the law enforcement officials to handle it. According to Teplin, as a result jails and prisons may have become the long-term repository for mentally ill individuals who, in a previous era, would have been institutionalised within a psychiatric facility [cited in Bartol, 1999, p.141]. Also, it has been suggested that studies which examine the criminal activity of recently released patients may be biased, as there has been an increased number of patients with previous arrest histories being admitted to mental hospitals from 15% to 40% over a thirty year period. This is due to an increasing tendency of courts to refer habitual offenders for psychiatric diagnosis. Therefore any post treatment criminal activity may not be related to the mental disorder at all, but more related to their having a previous criminal record. Once these, as well definition issues have been considered, the actual relationship between mental disorder and crime [specifically violent crime], and the research evidence can be examined. There have been several studies conducted on criminal behaviour in psychiatric patients, with the earlier findings indicating that mentally disordered individuals are no more likely to commit violent crimes than  those in the general population. However, more recent research has shown that male psychiatric patients who have a history of at least one violent incident, have a high probability of being violent within a year after being released from hospital. Rabkin [1979], cited by Bartol [p.142], conducted a review of the criminal behaviour of discharged mental patients, and found that the arrest rate for discharged mental patients was higher than the rate for the general population, particularly for assaultive or violent behaviour. There are two explanations suggested for this. Firstly, a small percentage of the patients studied that had criminal records before being admitted to hospital continued their criminal activities after being released. These patients substantially inflated the arrest rates for the other mental patients. Also there is the factor of arrest bias, as was previously mentioned. Secondly, Rabkin found that most offences committed after discharge were by those diagnosed with alcoholism, substance addiction or personality disorder. Alcoholism and substance abuse appear quite often in this type of research but do not represent serious or typical mental disorders, and the classification of personality disorders are vague and often questioned. It was found that with these three categories excluded, or considered separately, the remainder of the group appeared to be considerably less dangerous than those in general population. Another study conducted a 19 month follow up of discharged mental patients in 1968 and 1975 by Steadman, Cocozza and Melick, cited by Blackburn [1993, p. 266] Of the two samples, 6.9% and 9.4% were arrested about three times higher than the general population rate. It was found that the arrests after release were related to prior arrests, age or alcohol abuse. For patients with no prior arrests, the level was lower than that of the general population. Similarly, a study conducted by Linqvist and Allebeck {1990] cited by Blackburn {1993} which did a fifteen year follow up of released mental patients found that offence rates for the males were only slightly higher than the general population, but on the other hand, females offended at twice the expected rate. In contrast to these studies, one conducted by  Sosowsky, which studied patients with no previous arrest records, found that the arrest rates were five times higher than those of the local county in which it was conducted. It was believed, however, that when other factors such as age, race or socioeconomic status are taken into account in this study, the arrest rate becomes comparable to that of the general population. The results of these studies imply that criminal activity after discharge moreso depends upon previous arrest and other demographic factors than the mental disorder itself. Another way to examine the mental disorder and crime link is to look at mental disorder in prisoners, as opposed to criminal activity in individuals with a mental disorder. Mental disorders in prisoners is sometimes believed to be evidence of a link between crime and abnormal behaviour. Research reveals that the rate of mental disorders in prison significantly varies ranging from five to 16 percent psychotic [Teplin, 1990, cited by Bartol, 1999] In New York prisons, it is estimated that about eight percent of inmates have severe mental disabilities while sixteen percent have significant mental disabilities. A study conducted by Taylor of life sentenced prisoners in London [mostly murderers] found that 9% had symptoms of schizophrenia, 13% were found to be depressed and 33% personality disordered. These statistics are mostly similar to others found in Britain, but are significantly higher than those found elsewhere. This form of research, however is unclear on whether the mental disorder was present before being imprisoned, or if it happened as a result of being imprisoned. It is believed that prison may have detrimental effects on mental states meaning that the mental disorder may have come after the crime was committed. This would not be reflected in the results and so, would therefore introduce a bias. Research evidence indicates that there is no significant link between mental disorder and violence, however, it has been suggested that some disorders increase the risk. A study conducted in 1982 by Hafner and Boker, cited by Blackburn [p.269] surveyed all 533 case of murder, attempted murder and manslaughter in the Federal Republic of Germany between 1955 and 1964, who were found to be not responsible for their actions because of a serious mental disorder  [schizophrenic or affective psychosis, organic brain disorder, mental retardation]. The authors of the survey estimated that the mentally disordered accounted for 2.9% of convictions for serious violence and for 5.6% of murders. Hafner and Boker found that schizophrenia was overrepresented and affective psychosis underrepresented in their sample. Though the risk of serious violence in schizophrenia is very low [about 0.05%], it is much higher than other disorders, such as affective disorders and mental retardation [0.006%]. Depression has also been linked to violence, particularly homicide, mainly among females, Some recent research has indicated that there has been a link between violence and post traumatic stress disorder. Despite the fact that aggression is not among the criteria for diagnosing this disorder, irritability is, and it is also sometimes associated with unpredictable explosions of aggressive behaviour [American Psychiatric Association, 1987, cited in Blackburn, p. 273]. A study of 100 Vietnam veterans with PTSD found that 97% were explosive and irritable, 87% were socially avoidant and 72%were substance abusers. [Solursh, 1989, cited in Blackburn, p.273. This study, however, is unclear on the actual arrest or assault level. With the exception of some forms of personality disorder, no mental disorder seems strongly associated with violent behaviour, unless, as was previously stated, there is already a history of violence in the patient. Though schizophrenia has higher rates of violent occurrence, it is important to note that very few patients with this disorder actually commit acts of violence approximately 5 out of every 10 000 schizophrenics are likely to become violent. Only in very rare case does mental disorder completely absolve anyone of responsibility for their actions. [Bourne and Russo, 1998, p.569] The link between crime and mental disorder is a hard one to measure, because of the many and various other factors that come into play. Sample distributions are always questionable, as are specific definitions. Also, it is reasonable to assume that because neither crime nor mental disorder is extremely rare, it is inevitable that the two will overlap, however correlation is not causation [Bourne and Russo, 1998, p.571] the two may  exist even in the absence of a causal relationship. Research evidence suggests that no form of mental disorder [with the possible exception of some forms of personality disorder] seems strongly associated with violent crime, unless, the individual already has a history of violence some research in this area suggests that these individuals may be dangerous, and are prone to indulging in violent behaviour. However, the stereotype of the psychotic mass murderer that kills indiscriminately is inaccurate. Though, mental disorder may be one of the factors, it is seldom the only factor in play. Having a mental disorder rarely excuses or accounts for any act of crime, violent or otherwise. The numerous studies on the subject have generally found that the link between mental disorder and crime is not as significant as is often assumed.

Ict Procurement Trends in the Uk Essay Example for Free

Ict Procurement Trends in the Uk Essay This report presents the findings from a survey of 136 UK enterprises regarding their approach to Information and Communication Technology (ICT) procurement. The survey investigates the way that UK enterprises like to purchase technology, as well as the major IT and business objectives influencing their IT investment strategies. Introduction and Landscape Why was the report written? To highlight the criteria on which UK enterprises select their IT providers as well as the roles which have influence while making IT purchasing decisions. What is the current market landscape and what is changing? UK enterprises are set to increase their IT spending in 2013. Kables survey shows that ICT spending in the UK is being driven by investments in core technology areas such as security, enterprise applications, IT systems management, and content management. What are the key drivers behind recent market changes? With enterprises being continuously exposed to malicious attacks on their business critical information, the demand for security solutions is growing. What makes this report unique and essential to read? Kable Global ICT Intelligence has invested significant resources in order to interview CIOs and IT managers about their IT Procurement. Very few IT analyst houses will have interviewed 130+ ICT decision makers in the UK market in H2 2012. Key Features and Benefits Provides insights into UK enterprises preferred buying approaches. Comprehend the business objectives that UK enterprises are looking to achieve through their IT investment strategy. Appreciate the IT objectives that UK enterprises are looking to achieve through their IT investment strategy. Understand the factors that are influencing UK enterprises decision to select an ICT provider. Understand which organisational roles influence IT purchasing decisions and signing off budgets. Key Market Issues Despite the uncertain economic conditions across Europe and the UK governments large scale austerity measures which have impacted public sector ICT spend, the vast majority of respondents from Kables survey indicate that their IT budgets will remain at the same level or will increase in 2013. With regards to the authority over signing off budgets, UK enterprises surprisingly give an equal rating to CEOs, CFOs, and CIOs. UK enterprises rate Improve supplier relationships with an average rating of X, indicating that enterprises focus is weighted more to their own operations, followed by their customers, amidst the difficult global economic outlook. Investments in cloud computing are expected to grow with the penetration of this technology increasing from the current level of X% to Y% in the next twenty-four months, driven by factors such as lowering cost and complexity, and ease of use. According to Kables survey, X% of enterprises have a somewhat complex ICT infrastructure with several hardware manufacturers, operating systems, databases, applications, and other elements. Key Highlights Although on-premise deployment is favoured, the demand for hosted applications is also gaining traction, as enterprises are continuously focused on reducing costs in the current economic climate. Raising efficiency is a primary business objective influencing IT investment strategy amongst UK enterprises with the highest rating of X on a scale of 1 to 4. The recent survey reveals X% of enterprises have rated the objective of meeting internal service level agreements as a highest priority. With an average rating of X on a scale of 1 to 4, UK enterprises consider Financial stability and Price to be the most important criteria in choosing an IT solutions provider. UK enterprises rate the CIO/IT department as the most influential authority when making IT purchasing decisions, with the highest average rating of X on a scale of 1 to 4.

Wednesday, January 22, 2020

The Truman Doctrine :: American America History

The Truman Doctrine "I believe that it must be the policy of the United States to support free people who are resisting attempted subjugation by armed minorities or by outside pressure." (Harry Truman mach 1947). This is part of the speech Harry S. Truman gave to congress on the behalf of small countries falling to the pressures of communism. The Truman Doctrine was a anti-communist foreign policy that would change of the world. Turkey and Greece were under a great threat by the Soviet-supported rebels seeking to topple the government and install communist power. This made the United States and especially Truman very nervous. This is why the Marshall Plan which is one of the direct influence to the Doctrine was thought up. This plan was designed to give aid to any european country damaged during WW2. It tremendously helped ravaged European nations such as Italy and France. By helping these countries the United States was economically forcing away communism. This was the way the United States had it all planned out. We weren't making the Communist very mad cause it was very indirect but later on this wouldn't be the case. The process by which the Truman Doctrine came about was a long and tedious one. After WW2 the US and Soviet Union were at the top of all world powers. Everything was pretty much equal such as military, economics, and nuclear power. The one thing that scared the US the most was the fact that the Soviets were greedy and wanted more and more land. This is where we began to see a huge threat to Greece, Turkey, and Iran. Because of all this on March 12, 1947 President Harry S. Truman gave a speech to congress that would later be call the Truman Doctrine. The Truman Doctrine would ask for a total of 400 million dollars for both Greece and Turkey (Freeland pg. 87). The money for Greece would be split between economic and military aid and for Turkey the aid was entirely for military purposes. The President had turned debate on two modest proposals into a vote of confidence on his administration's foreign policy and a test of American willingness to resist a threat defined to endanger the basic security and values of the American society (Pemberton pg. 92). By Truman doing this it almost put congress at a no win situation. Congress couldn't go against Truman cause this speech was nationally broadcast which would mean the people would be scared. The Truman Doctrine :: American America History The Truman Doctrine "I believe that it must be the policy of the United States to support free people who are resisting attempted subjugation by armed minorities or by outside pressure." (Harry Truman mach 1947). This is part of the speech Harry S. Truman gave to congress on the behalf of small countries falling to the pressures of communism. The Truman Doctrine was a anti-communist foreign policy that would change of the world. Turkey and Greece were under a great threat by the Soviet-supported rebels seeking to topple the government and install communist power. This made the United States and especially Truman very nervous. This is why the Marshall Plan which is one of the direct influence to the Doctrine was thought up. This plan was designed to give aid to any european country damaged during WW2. It tremendously helped ravaged European nations such as Italy and France. By helping these countries the United States was economically forcing away communism. This was the way the United States had it all planned out. We weren't making the Communist very mad cause it was very indirect but later on this wouldn't be the case. The process by which the Truman Doctrine came about was a long and tedious one. After WW2 the US and Soviet Union were at the top of all world powers. Everything was pretty much equal such as military, economics, and nuclear power. The one thing that scared the US the most was the fact that the Soviets were greedy and wanted more and more land. This is where we began to see a huge threat to Greece, Turkey, and Iran. Because of all this on March 12, 1947 President Harry S. Truman gave a speech to congress that would later be call the Truman Doctrine. The Truman Doctrine would ask for a total of 400 million dollars for both Greece and Turkey (Freeland pg. 87). The money for Greece would be split between economic and military aid and for Turkey the aid was entirely for military purposes. The President had turned debate on two modest proposals into a vote of confidence on his administration's foreign policy and a test of American willingness to resist a threat defined to endanger the basic security and values of the American society (Pemberton pg. 92). By Truman doing this it almost put congress at a no win situation. Congress couldn't go against Truman cause this speech was nationally broadcast which would mean the people would be scared.

Tuesday, January 21, 2020

Free Essays: Oedipus Rex and Antigone :: comparison compare contrast essays

Oedipus Rex and Antigone  Ã‚   There is no curse on the house of Oedipus. Because of the many terrible things that happen to the members of Oedipus's family, a reader might be led to believe that there is such a curse. However, if that person examines the stories of Oedipus Rex and Antigone more closely, he or she will find that the reason so many tragedies happened to Oedipus's family is not because of some curse, but rather because of one common thread. Each person in the line of Oedipus tries to defy authority in one way or another. Oedipus and Jocasta both defy the authority of the gods by trying to run away from a prophesy of theirs, which results in Jocasta's death and Oedipus's dethroning and downfall. Antigone defies the authority of the king by violating his edict, which results in her death. In Ismene's case, the authority that is defied is that of the moral law, and for that she has to live out her days with guilt and regret. The authority which Oedipus and Jocasta defy is the same. Both the king and his mother defy the authority of the gods by trying to evade their edict. The edict states that a son would be born to Jocasta who would marry his mother and kill his father, as Oedipus says, â€Å"How mating with my mother I must spawn a progeny...having been my father's murderer.† (OEDIPUS, Oedipus, 44). When Jocasta hears of this, she attempts to kill the baby Oedipus, thus trying to escape the prophesy. Similarly, when Oedipus, as an unmarried adult, hears that he would kill his father, he runs away from his home town, Corinth, never to return. Oedipus and Jocasta both defy the gods' authority, which in this case comes in the form of running away from a menacing prophesy. In the end, however, Jocasta dies and Oedipus is overthrown and ruined. Like her parents, Antigone defies a powerful authority. Unlike her parents though, that authority is not of the gods, but rather of a person who thinks he is a god: Creon, Antigone's uncle, great-uncle, and king. He proclaims that the body of Polyneices, Antigone's brother who fought against Thebes in war, would be left to rot unburied on the field, â€Å"He must be left unwept, unsepulchered, a vulture's prize....† (ANTIGONE, Antigone, 192). Antigone, enraged by the injustice done to her family, defies Creon's direct order and buries her brother.

Tuesday, January 14, 2020

My first day at a new school Essay

The first day if a new school is very difficult because you don’t know any one and u feel all alone. Most kids do good because they are a people person which can help because they talk to people and know were or how to get around from talking to other kids. There are also kids that don’t talk as much to other people they don’t know either because there shy .So this I how I overcame the obstacles on my first day. The most memorable first day I had was when I went to Kenny Guinn middle school. I knew no one in my home room so I sat there for a moment and the teacher began to call roll call then after that passed the kids in the class began to talk and so nothing. the teachers got their attention and explained rules and regulations. shortly after that some kid s started getting kinda loud so the teacher got their attention he sent one of the three to another class and his friend threw a paper airplane instead of the teacher doing something to punish he made a funny remark about the kid. The bell sone rang and we all got up and head off to our next class remember the first class I had was science,at first I was about the tenth student in the classroom I noticed one of my friends walked in the classroom and sat next to me . I told him how frustrated I was and he told me to â€Å"just don’t worry about it and calm down†. so after he convinced me to calm down and I began to relax. The teacher then started her lesson plan, then she explained her classroom rules and regulations shortly after that she told us what we were going to do the rest of the school year. When she had finished, the class began to talk. that was when I realized my friend that was sitting next to me, as I mentioned earlier had the next class with me. dong dong dong the bell has just rang so we headed for our next class, that next class was math. and he began to do the same as the first teacher then that class ended so we my friend and I went to lunch. The most exciting part of the hole day was the lunch period .Were I got lucky enough to meet most of my friends there that day so that was a big relief. I ate some lunch that help because the hole day I was feeling kind of sick so that helped me replenish my self, then we all started talking to one another  after a short amount of time we all got confused so then we laughed at ore selves for being so stupid. then I diced to walk over to this girl I liked after being convinced that nothing terrible can happen and it won’t be the end of the world so I did it and I then had a date to the dance thing they were having, the school was throwing it for the new year. So the day has gone smoothly and not too difficult in anyway or manner. Soon after lunch ended we/all the kids went to class then I went to my next class the same routine was used for the lesion plane for the last four class and once that was over it was a little frustrating to find my buss but then I found it just in time and when I got home I said hi to my dad and then had something to eat. And I learned if I was to ask someone I don’t know can still help me and being shy has its down falls.