The dissolution of the monasteries Essays - Christianity

The disintegration of the religious communities By Tommaso Faulkner 8RN Here we are today at one of the religious communities ruler Henry has as of late shut down and we are here to find how the protestants and Catholics consider this change so all we know is that lord Henry the eighth needed a separation to his new spouse Catherine of Aragon so he asked the pope in light of the fact that lone the pope can allow him to separate yet the pope said no so Henry said that the pope had no force in England and that starting now and into the foreseeable future all the clerics and priests would need to do what he said and not what the pope said and made himself the leader of the congregation in England then he gave himself a separation and wedded the pregnant Anne Boleyn seeking after a child now while you may imagine that he was protestant he was neither not catholic and not protestant in actuality he passed a law saying that the congregation despite everything needed to have catholic administrations and didn't change within a congregation by any means. Yet anyw ay back to the current right now I am going to meet a protestant how about we see what he makes proper acquaintance what's your name?' My names john.' Can you mention to us what your protestant convictions are?' We accept that the congregation is to rich. Individuals give the congregation loads of cash however the clerics and priests spend everything on garments and royal residences rather than on helping the poor after all that is the reason we offer cash to the congregation with the goal that they can support poor people yet rather they spend it on what they need catholic ministers are degenerate and sluggish they don't carry out their responsibilities appropriately, the administrations are all in Latin they ought to be in English so we can get familiar with the narratives thus that we can be nearer to god and it's difficult to be near god on the off chance that you can't comprehend the administrations or read the good book yourself and, at that point they permit rich individuals to pay a religious administrator or a pope to have their wrongdoings pardoned and no one but god can overlook your transgressions, holy places ought to be basic and plain on the grounds that a straightforward church brings individuals closer to god the raised area ought to be supplanted by a wooden table and there ought not be any decorations which occupy individuals from concentrating on god. Clergymen should wear straightforward robes they are conventional individuals they ought to be allowed to wed Jesus Christ is the leader of the congregation Christ is a higher priority than a human chief like the pope the best approach to salvation is to follow the lessons of Jesus Christ no one but Jesus can excuse sins individuals needn't bother with clerics to assist them with discovering god having confidence in Jesus is the best way to paradise and salvation the manner in which you practice religion is significant on the off chance that you don't revere in the correct manner you will push off forever' thank you john farewell' farewell' so now we have figured out how the protestants get a handle on we should discover about the Catholics hi what are you called?' My name is victor,' hi victor would you be able to mention to us what your Catholics convictions are?' We accept that the raised area is the point of convergence of the congregation it should look fabulous to show god the amount we love him there ought to be candles and trimmings on it the pope and his diocesans can pardon sins individuals can show that they are upset for their wrongdoings on the off chance that they give a blessing to the congregation, chapels ought to be exceptionally designed with artistic creations and hued windows demonstrating divine beings wonder individuals nee ministers to assist them with discovering god the clerics go about as a connection between an individual and god clerics should wear extraordinary garments to mirror their uncommon status as the connection among man and god they ought not get hitched however give their lives absolutely to god the pope is the leader of the congregation god named him he knows best what god needs the congregation to do the best approach to salvation is to follow the lessons of the congregation what you accept about god and the manner in which you practice your

Corporate Social Responsibility At Shipley Do-Nuts

Corporate Social Responsibility Corporate Social Responsibility (CSR) has become a popular expression in the advanced associations. The purposes behind concentrating on it might be generous, plain window dressing to maintain a strategic distance from Governments obstruction or essentially an advertising exercise. The creator has attempted to investigate how well Shipley Do-nuts, a Houston based organization, has figured out how to satisfy its moral and social commitments. The inner and outside impact to its CSR procedure has been concentrated with the assistance of SWOT lattice. In light of the investigation, the creator is of the sentiment that the organization should move its methodology from a humanitarian one to a network based one to accomplish practical turn of events. The creator has recommended utilization of a network sports region for accomplishing the equivalent. Established in 1936 in Texas, Shipley Donuts has become a well known donut chain in the United States with more than 220 stores spread all through the southern states. Since its initiation, Shipley Donuts has been effectively included inside its locale which adds an entirely different measurement to its crucial creation life heavenly (Shipley Do-nuts, 2008). The organizer of the organization, Lawrence Shipley, Sr. established the organization close to the finish of the Great Depression. He had seen the detestations that individuals of his locale had experienced during the Depression. Along these lines giving the network back that made him rich was one of his top needs. In addition, in a nation which is taking on a conflict against youth stoutness, the job of an inexpensive food chain like Shipley Do-nuts expect importance particularly its demeanor towards moral practices and social commitments. The accompanying segments talk about how well Shipley Donuts has contributed towards its C orporate Social Responsibility. Shipley has embraced a generous way to deal with CSR. In this methodology, the associations give money related gifts, help or loan their names to the nearby networks for social causes. As indicated by Wood (1991), this methodology causes them to turn out to be inconceivably regarded in their neighborhood network and ensures their home market in any event, during times of wild rivalry. Shipley has been related with numerous social causes from schools, places of worship to good cause gatherings. For instance, Shipley loaned its name to yearly reasonable devoted to malignancy survivors and veterans during last October (Lowman, 2009). Shipley likewise makes huge commitment towards advancing the US culture and convention. Shipleys establishments have been known to give a piece of their income during Christmas to Angel Tree, a neighborhood association that helps in purchasing presents for poor kids during the Christmas (Tribune Herald, 2009). Likewise, it parts with free doughnuts to its clients on June 5 consistently in the memory of Chicago Salvation armed force which offered ascend to the National Doughnut Day (Tribune Herald, 2009). Being a cheap food chain, Shipley has likewise taken its commitment of making America solid truly. Complete dietary data of its items is shown conspicuously at all its establishments and furthermore at its site. Any client can see the neatness of the kitchen territory and the bread shop procedures being utilized through its auditorium seeing windows. In addition, to show its responsibility towards wellbeing, it supports neighborhood sports groups like Houston Dynamos (proficient soccer club in MLS) and Houston Astros (proficient Major League Baseball crew) (Shipley Do-nuts, 2008). Such has been Shipleys pledge to keep up quality that it has been hesitant to become excessively quick (the chain has included just 220 stores in its 74 years of presence contrasted with a large number of stores opened by McDonalds or Pizza Hut in lesser time) which is reflected in its severe measures for an establishment. SWOT Analysis A SWOT examination is led on the moral works on being utilized by Shipley to assess their CSR procedures Qualities Dynamic inclusion in network: From giving a piece of its income to nearby foundation associations to supporting neighborhood sports clubs, Shipley has been effectively engaged with the network improvement. Additionally, it welcomes nearby associations to look for help through its site. This methodology shows its responsibility towards network assembling and has helped it to cut a specialty for itself in the Texas people group. Moral practices: Shipley not just makes dietary data about its doughnuts open, yet additionally tells its clients the procedures being utilized at the kitchen through an open window framework. This moral practice has discovered wide acknowledgment among the Texas people group who run to its establishments. Adhering to conventional bread shop procedures: Despite the appearance of current robotized pastry kitchen methods, Shipley Do-nuts have adhered to the customary bread shop strategies to hold its delicate and new smell and taste. This expects it to utilize a more prominent number of laborers therefore helping the neighborhood network in getting a new line of work (Shipley Do-nuts, 2008). Shortcomings Working conditions: To hold the expenses of work down, the organization has depended on the utilization of modest illicit foreigners from Mexico before. The foreigners have regularly griped to the utilization of harsh language and racial slurs by the proprietors (Houston Chronicle, 2009). This has hurt its picture in the national awareness. Less commitment to nearby ability advancement: A generous way to deal with CSR doesnt contribute a lot to the aptitude improvement of the neighborhood individuals and subsequently doesnt lead to an economical turn of events. Shipley has regularly been exasperated for not adding to the nearby expertise improvement. Mystery of its doughnut blend: Although it is key to its upper hand, the mystery about its doughnut blend, which makes the doughnuts extraordinary, is likened to concealing significant nourishing factsfrom its clients. This has not gone down well with some purchaser rights activists. Openings Expanding people group based methodology: A people group based way to deal with CSR is increasingly fruitful in associating with the nearby network. This may include joining forces with a nearby school for instruction of the kids. This will help the organization in adding to the nearby ability advancement and in accomplishing manageable turn of events. Solid doughnuts: Shipley can include a couple of sound doughnuts, which are low in calorie, to its item run. This may not really sell a lot, however will validity to its endeavors towards building a solid America. Dangers Rivalry: With an expanding rivalry in the inexpensive food space and the expense of serving a client expanding, the battle for regular assets will increment. This may imply that CSR exercises may need to assume a lower priority in Shipleys strategy. Intercession by Government offices: Due to its past record in utilizing illicit settlers, the Government offices may mediate in the hierarchical approaches, for instance, the Labor Department may complete a review about its representatives pay and fundamental working conditions. This may end up being a danger to the companys picture in the people groups eyes. End The current research about the CSR exercises at Shipley Do-nuts shows that the organization is paying attention to its CSR exercises. The organization has added to different causes from malignant growth, battling wrongdoing and observing Christmas to supporting games exercises. Nonetheless, it was seen that as of now Shipley sees CSR as a strategy for offering back to the network which is independent from its corporate goal of making benefits. It should look towards integratingits CSR methodology into its companys targets with the goal that it tends to be seen as basic for maintainable advancement of the organization. For instance, Dunkin Donuts Center has set up a middle in Providence, Island. It gives best in class preparing offices to the games clubs in the areas. This middle has delivered various stars and is a fascination for youthful games fans in the area. This offers a more grounded expression towards improvement of sports than simply supporting an occasion or a games club. Adding to its rundown of CSR exercises, Shipley can support a games region in Houston which gives playing territory to the small kids in the Texas area. This games territory can have a b-ball court or basically open spaces for playing soccer. Standard Shipley clients and their wards can get free access to the offices. The ordinary clients can be given these goes at the Shipley establishment. This will help the organization in Building client arrange: Building on companys endeavors towards interfacing with its clients through Facebook, the organization can monitor its clients through this games region Lift its deals: Since free passes will be given to the customary clients, it will help in boosting the deals and accomplishing higher client dedication Advancement of sports: It will help being developed of sports in the network which will expand on the companys endeavors towards building a wellbeing America. In this way, this thought can end up being a decent one to follow for Shipley Do-nuts as a major aspect of its moral and social commitments (CSR). The organization can hope to add to the ability improvement of the nearby network through this activity. This will assist the organization with realizing the significance of incorporating its CSR exercises with its corporate technique.

Journey of a Thousand Miles free essay sample

The Journey of Nishiyuu, which implies The Journey of the People in Cree, started in Whapmagoostui, Quebec. a little while back and reached a conclusion on Monday. Seven walkers six youngsters and a 49-year-old guide ace left their homes in January resolved to walk right to the countries capital. The gathering at long last showed up in Ottawa on Monday with rankles on their feet and many new walkers close by, as supporters participate from a few networks en route. Police and volunteers evaluated that the gathering was around 400 in number when it arrived at its goal. One of the first seven walkers, 18-year-old David Kawapit, said the excursion has helped him adapt to his downturn and self-destructive considerations. It feels great, and yet Im extremely tragic that its completion, he said on Sunday. It feels great that many individuals are focusing on whats going on, and that a ton of these folks that are strolling with us are helping themselves on this excursion. We will compose a custom exposition test on Excursion of a Thousand Miles or then again any comparable subject explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page A huge number of supporters accumulated on Parliament Hill to invite the gathering on Monday. The Prime Minister was welcome to welcome the walkers simply outside his office on Parliament Hill, yet he decided to go through taxpayers’ cash to travel to Toronto and have his image taken with Panda bears from China. Individuals kept on testing Prime Minister Harper on his absence of pledge to settling First Nations issues. He wouldn’t meet with their pioneers after Chief Spence took a chance with her life in an appetite strike and he won’t meet with their childhood after they strolled 1,600kms in the soul of solidarity. At some point or another Stephen Harper will comprehend that First Nations individuals won't stop with regards to battling for acknowledgment of their privileges. â€Å"This government consistently guarantees it’s helping out First Nations than some other government, yet in all actuality they’ve accomplished more mischief than anything. The committed youngsters like the Nishiyuu Walkers are helping out us than any legislature. † states Grand Council Chief Patrick Wedaseh Madahbee.

The welfare myth essays

The government assistance fantasy articles Publicizing is a type of selling. Since 1872 there have been people who have attempted to convince others to purchase the food they have created, however none obviously like the Chocolate they make at the Hershey Factory. In any case, the large scale manufacturing of merchandise coming about because of the Industrial upset in the nineteenth century made individual to-individual selling less proficient than it recently was for most items. The mass appropriation of merchandise that followed the improvement of rail and interstate frameworks made individual to-individual selling excessively moderate and costly for practically all organizations including Hershey. Simultaneously, notwithstanding, a development in mass correspondence happened first papers and magazines at that point radio and TV that made mass selling conceivable. Promoting, at that point, is only selling or charisma working in the paid space or time of different mass correspondence media. The target of any ad is to persuad e an individual that is to their greatest advantage to make a move the publicist is suggesting. This is the situation with the Hershey chocolate bar. Publicizing as a business grew first and most quickly in the United States, the nation that utilizes it to the best degree. Those that utilization it most are organizations that must make an interest for a few items among numerous individuals living in an enormous region. For example, the Hershey Bar in high impulse for individuals of all age gatherings. Promoting makes the item so accessible. So let me start by disclosing to you a concise history of chocolate. Everybody considers chocolate an enhancing or desert flavor for food. As a food and a seasoning, chocolate is generally well known. Individuals wherever appreciate chocolate confections, cakes and beverages. Chocolate is produced using seeds, or beans, of the tropical cacao tree. The beans develop inside ... <!

CODEX The Fairest of the Handmade Book Arts

CODEX The Fairest of the Handmade Book Arts You know when you dont realize youve got a fetish for something until you see it for the first time? Well, that was me a couple years ago when I attended my first ever CODEX, the bi-annual hand-made book fair, which is taking over Craneway Pavillion this February in Richmond, California. To be honest, till I visited the astoundingly fun fair, housing some of the worlds most beautiful handmade books from printers all over the world, I hadn’t really thought much about the art of the handmade book. Book Earrings, by Suzanne Lydia Wienert, bookearrings.com PP, the abridged, pop up mini book, by Green Chair Press But then I got my hands on these awesome book earrings made, I was told, from actual recycled 16th century monkish paper, and this giggle-tastic swoon-worthy teeny-tiny abridged, illustrated, POP UP  Pride and Prejudice, which, naturally I keep under lock and key. And I became instantly and forever hooked on handmade book art. The fair first is the brain/lovechild of Peter Koch, veteran typographer, printer and publisher, who, with his partner and paper conservator Susan Filter, traveled the world in search of other artisanal bookmakers, with a particular eye towards those from underrepresented countries in Latin America, North Africa, Asia and Australia. In 2005 they founded the CODEX Foundation in Berkeley, CA to preserve and promote the hand-made book as a work of art” and the corresponding Fair and Symposium as a place to promote and bring together book artists and fine press printers from around the world. The first CODEX Book Fair and Symposium took place in 2007: held every two years and open to the public, the Fair is now held over four days, and boasts “180 exhibitors and almost 3,000 visitors,” and, according to the press release, is “THE LARGEST BOOK FAIR OF ITS KIND IN THE WORLD TODAY!” This year’s Fair hosts book artist exhibitors from Argentina, Australia, Canada, Chile, China, Fr ance, Germany, Ireland, Israel, Italy, Japan, Mexico, Russia, South Korea, Taiwan, United Kingdom and the United States. The corresponding Symposium, at $250 per head, hosts speakers and artists and attracts everyone from printers to librarians and collectors, and usually sells right out. CODEX books are breathtaking works of art. Loves Me/Not,Personal stories of the rollercoaster of love gingerburrell.com Loves Me/Not,Personal stories of the rollercoaster of love gingerburrell.com Loves Me/Not,Personal stories of the rollercoaster of love gingerburrell.com As they should be a codex, the ‘modern’ bound, paginated book form that replaced the scroll and became popular with that titular title, the Bible, is made from paper, vellum, papyrus or parchment, handwritten or hand made, one at a time, exquisitely. And you can purchase collectible books and prints, priced anywhere from $20 to $3,500+. Funds from the fair produce a spectacular volume of commissioned essays regarding the state of book arts from a global perspective, high-quality images of books that have graced previous exhibits (the Book Art Object series),  and this year, in honor of the 5th CODEX Symposium, the 10th anniversary of the CODEX Foundation, and the 500th anniversary of the death of Aldus Manutius,  Alchimie du Verbe, “the first ever CODEX Assembly-Exchange, a carefully curated collection of printed works from some of the finest book artists and printers in the world.” Box of Happiness, Alice Austin, amaustin.com Don’t let the ethereal beauty of these bookish arts fool you: CODEX invites you to talk to the authors and representatives from fine presses around the world (they’re very nice!) and even touch the pretty books.  They’re collectibles, and art, but they’re accessible, and, most of all, they’re books. Check them out. ____________________ Follow us on Pinterest for drool-worthy covers, Book Fetish-y lit swag, bookish inspiration, and more!

How to Make Reading

   Enjoy this guest post by Sarah Mackenzie, author and creator of the popular blog, Read-Aloud Revival. When you’re done, check out Sarah’s newest book, The Read-Aloud Family, available from IEW later this spring. By now you may be convinced that reading aloud is one of the best things you can do for your kids. I hope you are! But what do you do if reading aloud is not quite what you’d envisioned? Maybe your kids are a bit less enthusiastic than you thought they’d be, and you’re starting to wonder if it really makes that big of a difference. Does this sound familiar? You finally gather the kids and work up the gumption to start reading aloud, and everything begins to fall apart. The toddler pitches a fit, or maybe the teenager does. The kids are wiggling and noisy, they’re interrupting you, nobody can keep their toes on their own sofa cushion, and you can’t hear yourself read over the din. To make matters worse, as much as you try, you can’t even keep your eyes open through an entire chapter. Let me tell you—I have been there! I believe in the power of reading aloud. I know that it helps develop my kids’ sense of empathy and compassion for others, that it prepares them for academic success better than just about anything else, and that it inspires them toward heroic virtue. Even so, some days it just feels really, really hard. So how do we enjoy this reading aloud business? How do we make that time of day our favorite part of homeschooling? Here are five ways to make reading aloud more delightful and successful in your home.    1. Choose a Book YOU Love (even if it’s not a classic). The first thing you want to do is just make sure you’re reading something you enjoy. We can all agree that reading classics is a lovely thing to do, but if read-aloud times have been a bit strained in your home lately, maybe go a little easier on yourself. When you’re enjoying a read-aloud, your enthusiasm and delight is passed along to your kids. Of course, this means that when you aren’t enjoying a book, your lack of enthusiasm and delight is also passed along to your kids. Delight in the story will carry you a long way, so make sure whatever you’re reading is enjoyable and lights you up. If it’s not? Ditch it and try something else. You can even pick one of your own childhood favorites. You might be surprised at how fun that can be.    2. Keep Your Kids’ Hands Busy. If you’re frustrated that your kids won’t sit still during read-aloud time, I’ve got great news for you: They don’t need to. Your children may actually listen better when they’re doing something with their hands. Dr. Michael Gurian came to the Read-Aloud Revival podcast to tell us exactly this. Need ideas for what your kids can do while you read? Head here for a whole list, no matter your kids’ ages. You just may find that all of your kids, from toddlers to teens, will sit and listen for much longer stretches if they can do something with their hands while you read.    3. Read for Just 10 Minutes If you’re waiting until you have a 30-minute chunk of time to read aloud to your kids, you’re probably not doing it very often. If you were to read aloud for just ten minutes every day, you would read sixty hours over the course of a year. But it’s hard to do something every day, right? Let’s be more realistic—if you read aloud just ten minutes every other day, you’ll read over thirty hours over the course of the next year. Thirty hours is a tremendous amount of reading! You could read the entire Chronicles of Narnia in that amount of time, or over two hundred picture books. You don’t want read-aloud time to go too long anyway, so that the next day when you pull out the book, it’s still an activity everyone wants to participate in. No more putting this off. Everyone can find ten minutes, and I’m willing to bet it’ll be the best investment of time you can make with this day.    4. Read aloud earlier in the day. Look, we’re homeschooling parents— we’re tired! If you save reading aloud until the end of the day, there’s a good chance that you’ll be too tired, or something else will come up. If you get to your read-aloud time before you hit other subjects in your school day, you’ll know that even if the rest of the day falls apart (and it just might!), you’ve gotten to the most important thing. You’ve helped your children get correct and sophisticated language patterns in through their ears. You’ve nurtured their moral imaginations. You’ve prioritized spending a little time being fully present with them. And that, my friends, is time well spent— even if it’s only ten minutes.    5. Use audio books. Look, audiobooks aren’t cheating. The magic of a read-aloud experience is achieved when we share stories together. It’s that shared experience itself that make the biggest impact, regardless of whose voice is doing the actual reading. A bonus, of course, is that you’ll fit in a whole lot more reading if you start using audiobooks in your home. Turn them on while everyone eats breakfast, in the car on your way to co-op, or during a quiet time activity in the middle of the day. And don’t tell yourself you’re cheating. Audiobooks count. Reading aloud with our kids is a power punch. It’s simple, it’s easy, it doesn’t take a lot of time, and it makes an incredible difference in the lives of our kids. If we can take a few small steps to make it more pleasant, we’ll treasure the time we spend sharing books with our kids more than just about anything else. And who knows? We might just find that these are the memories our kids treasure most, as well. We hope you enjoyed gleaning some wisdom from Sarah about how to consistently enjoy read-alouds within your family. Sarah was a recent guest on our podcast. Check out the episode for even more insight on the benefits and joys of reading aloud.    Sarah Mackenzie is the author of both The Read-Aloud Family: Make Meaningful Connections with Your Kids and Teaching from Rest: A Homeschooler’s Guide to Unshakable Peace. On the immensely popular Read-Aloud Revival podcast, she helps families all over the world make meaningful and lasting connections with their kids through books. She lives with her husband, Andrew, and their six kids in the Northwest. Sarah loves to homeschool and make sure her kids are well-stocked with the best books she can find. Connect with Sarah at readaloudrevival.com.

Coaching - 1508 Words

Diane Stevenson Regent University LDRC 502 Leadership Coaching: Convergence Spiritual Life Coaching When we look at the role of coaching and how it speaks to a person’s spiritual life we first must understand the definition of coaching. Whitmore (2001) quoted Gallwey’s definition of coaching as â€Å"Coaching is unlocking a person’s potential to maximize their own performance. It is helping them to learn rather than teaching them† (p. 8). There are several definitions of coaching that attempts to pinpoint or identify the various types of coaching. Harkavy (2007) shared what the purpose of a coach is, â€Å"Your purpose as a coaching leader is to add the most value to the people you lead and to help them improve† (p. 4). This definition of†¦show more content†¦Those with the right attitude will embrace their role as a positive reinforce and they will strive to help others see themselves as God sees them. The coach will build up, strengthen and encourage the client with the love of Christ as they provide professional coaching. Crane amp; Pa trick (2005), suggested â€Å"Coaching requires the very best from all aspects of our humanity. It is not a path for the weak-hearted or for people who are afraid to grow. It is a path for the courageous and for people who are committed to making a difference in the lives of those they touch through coaching† (p. 217). The spiritual aspect of coaching as it relates to this previous quote is that we must be willing to be like the eagle as shared in Isaiah 40:3, â€Å"But those who wait on the Lord Shall renew their strength; They shall mount up with wings like eagles, They shall run and not be weary, They shall walk and not faint.† The effective coach must be willing to stay in for the long haul, when things are not moving as quickly as you would like. O’Neill shared that there may be times when what you are coaching and what the direction of the company may lose its clarity or maybe the coachee has lost focus. O’Neill (2000), stated, â€Å"May leaders try to suppress ambiguity, rather than acknowledge it, even to themselves† (p.26). The best way to handle a situation like this is to deal with it headShow MoreRelatedCoaching1157 Words   |  5 Pagesthe role of Human Resourcing Unit Number 3DCS Developing Coaching Skills for the Workplace Nichola Mackay 0510453 CIPD Foundation Certificate 15 January 2014 1000 Words Summary The below should help you understand the nature and purpose of coaching, know how to use a coaching style to improve performance in the workplace and be able to identify ways in which coaching can be implemented in an organisation. 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It can also help individuals to deal with the challenges and issues of skills and competencies, before the issues become client’s major problem. The coaching sessions generallyRead MoreCoaching and Tony998 Words   |  4 PagesAnalysis Our role-play transcript addressed questions one, three, and four, Chapter 10, Leadership Case Problem B. Question one states â€Å"What advice can you offer Sally Gorman to do a better job of coaching Tony Costello† (DuBrin, 334). Tony was upset that Sally was helping Roy and not him. Sally told Tony that Roy had been with the company longer and when Tony asked for advice, Sally told him to â€Å"turn up the heat.† Tony demonstrates characteristics of the equity theory. 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Counseling And Parent Support Workers At Together Lives...

1. History of Agency: Since 2007, the dedicated counselors and parent support workers at Together Lives Change (TLC) have been supporting families by helping to provide support planning and family asset management. Their goal is to help families find better ways to manage family life. They assist with preventing or eliminating the need for out of home placement of children by enhancing parental functioning. The agency’s mission is to strengthen and improve lives with a strong emphasis on prevention and intervention while meeting the unique and concrete needs of an individual or family by reinforcing positive behavioral changes. They strive for excellence through accountability and exceptional work ethic. TLC believe that honesty and dedication is the foundation for success of under privileged families. They are passionate about rebuilding the family structure by strengthening, assisting and resolving all community based needs. 2. Board of Directors: Mrs. Tiffany Hassell-Gregory is the founder and Director of TLC. 3. Sources of Funding: Each program within TLC funds itself. The only program funded by Medicaid is Therapeutic Day Treatment (TDT). All the programs within TLC are funded through the Family Assessment and Planning Team (FAPT) or the Community Assessment Team (CAT) which is Child Service Act (CSA). The Virginia Comprehensive Services Act provides for the pooling of eight specific funding streams to support services for high-risk youth. These funds are returned to

Refugee Crisis - Free Essay Example

Sample details Pages: 4 Words: 1170 Downloads: 9 Date added: 2019/07/01 Category Society Essay Level High school Tags: Refugee Essay Did you like this example? According to the recent UNHCR report, there are over 68.5 million forcefully displaced individuals in the world, with 24.5 million of them being refugees who have fled their homes to seek protection against violence or persecution. In September 2016, this problem was exasperated after 4.8 million Syrians fled their homeland amidst a gruesome civil war (Ngo, 2018). Although there are efforts by many countries to alleviate this problem, the Syrian refugee crisis continues to exasperate an already existing global refugee problem. Don’t waste time! Our writers will create an original "Refugee Crisis" essay for you Create order This paper explores what moral values and obligations incentivizing state actors to resettle refugees within their borders by looking at the Syrian Refugee Crisis and comparing Germanys response to the United States response. This paper begins with an overview of how refugee resettlement rationales fit within the context of human rights based approaches. Then, it examines which human rights based approaches compelled Germany and hindered the United States to take action. It concludes by taking into account what prompts state actors to take actions to resettle refugees at all, and how these approaches can be used to encourage state actors to do more in the future. There are three main arguments under the human rights evaluation that provoke action from the states: the Good Samaritan duty, the political responsibility, and the duty to protect. The duty of a Good Samaritan rule instructs that states should take steps to assist non-citizens only when there is dire need and the expenses for the assistance is low (Momin). Thus, if a states own wellbeing could be compromised in helping non-citizens, such as through national security concerns or through economic burdens, then it is reasonable for states to evade helping non-citizens (Lyon, 2009). The political responsibility argument highlights the responsibility that states must take for remedying the injustices that have occurred on behalf of their political actions (Carens,1992). Countries involved with global politics have a greater responsibility to fix structural injustices by joining with others and organization collective action against injustice. People that are pro-refugees will bring up the examples of the American administration making an arms deal with Saudi Arabia that leads to the bombings and brutal war in Yemen. In addition large corporate companies like the Car lyle Group and Wesco are supporting the war efforts by letting the Saudi government purchase large numbers of shares and influencing decisions made in America that influence innocent lives in vulnerable countries. There are many current examples of American military actions that are indirectly or directly causing war or displacement due to gang violence, unemployment, and severe corruption. There have been numerous lawsuits in Central America regarding the massacres in Guatemala that caused people to flee their homes. The American government supporting these military efforts against indigenous people has put their lives at risk and forced them to flee their homes to seek protection elsewhere. Many times, Chevron, and other major American oil companies have caused severe oil spills in the Amazon. These actions, although beneficial for the United States, have caused many to die due to disease or starvation. These heinous crimes against the individuals, gives them the right to ask the United States for safe refuge. The counterargument that many propose, argues that there is no legal obligation or provision in international law that requires a country to take in refugees (Friedman, 2018). Since there is no legal document binding the United States in taking in refugees, it is not their legal responsibility to provide fleeing people with the resources to settle down in a safer environment. In the refugee context, many state and corporate policies have had a hand in causing turmoil, leading many to flee from their homes and seek protection. Thus, those states are responsible for helping bystanders who are subject to the meddling (Cromwell, 2016). The third argument focuses on the duty to protect. It highlights that states have to protect human lives when their own states fail to provide protection to their own citizens.This argument is often used to help gain the support of NGOs and Endowments. The duty to protect is more of an ideal scenario, as in reality, much of this practice is declining in state policy. Often the enforcement of this particular duty is through media article and photographs as well as the UNHCR reports, but unfortunately, they serve as a subtle nudge to influence governmental policy, not as a hard enforcement. Both Germany and the United States are international leaders that receive numerous refugee asylum applications and have the resources to resettle refugees. Both states, based on economic and national security arguments, are not compelled to accept refugees. On the other hand moral arguments of responsibility seemed to motivate both countries to take more action than they previously may have under ot her legal obligations. In the case of Germany it was a combination of its political responsibility from their past actions in the Holocaust and its duty to protect that moved it to resettle refugees in August 2015. Despite the law or economic and national security concerns they faced during the initial resettlement, Germany still persevered in resettling refugees and creating programs to help the new population assimilate. For the United States, although the gesture was not as generous as Germany, the Obama administration did vow to allocate spaces for at least 10,000 Syrians, almost ten times as many Syrians admitted from the year before. This moral sense quickly decimated in the United States with the entrance of the Trump administration in 2017 into the White House (Sean, 2017). A ban was placed on the arrival of refugees as it posed a major security threat to the United States. In addition, The United States used the Good Samaritan principle to argue that their humanitarian effo rts could be implemented more domestically. The United States still continues to lag behind Germany in terms of the number of refugees resettled within its borders. It can be argued that this discrepancy between the numbers for Germany and the United States is due to the stronger moral responsibility Germany felt to resettle refugees. Unlike the United States, Germany recognized that it had a tainted past and the consequences of the worst genocide in human history continues to reverberate in the Middle East. Furthermore, Merkel, being a champion of humanitarian work, was confronted by the emotional appeals of individual refugees far more than Obama. This could be because the European countries would be facing a greater influx due to geographical proximity, or because of the economic power of the country and its progressive public policies. Although there is no conclusive measures to encourage state actors to settle more refugees, NGOs and the international community accountable for their actions and should push for policy favo ring refugee communities. In addition, there needs to be a continuous movement to present moral, political, and economic arguments that benefit the United States to legislatures. This will not only expose them to the complexity of the refugee crisis, but present a more humane perspective of the refugee experiences and encourage them to gain a more holistic knowledge about the benefits of refugee resettlement for the international community.

Sigumand Freud And Nietzsche Personalities And The Mind...

Sigumand Freud and Nietzsche: Personalities and The Mind There were two great minds in this century. One such mind was that of Sigmund Freud (1856-1939). In the year 1923 he created a new view of the mind. That view encompassed the idea we have split personalities and that each one have their own realm, their own tastes, their own principles upon which they are guided. He called these different personalities the id, ego, and super ego. Each of them are alive and well inside each of our unconscious minds, separate but yet inside the mind inhabiting one equal plane. Then there was Nietzsche (1844-1900) who formulated his own theories about the sub-conscious. His ideas were based on the fact that inside each and every one of us is a raging†¦show more content†¦It could then be said that the id represents the primitive, unconscious basis of the psyche dominated by primary urges. The psyche of a newly-born child, for instance, is made up of primarily the id. But then contact with that child and the outside world modifies the id. This modification then creates the next part of the psyche, the ego, which begins to differentiate itself from the id and the rest of the psyche (Dilman, 163). nbsp;nbsp;nbsp;nbsp;nbsp;The ego should be seen primarily as Freud puts it is, quot;...first and foremost a bodily ego; it is not merely a surface entity, but is itself the projection of a surface,quot; (Freud, The Ego and the Id, 20). An analogy that could help with this definition could be one that states the following. If we were to identify it with the, quot;cortical homunculus,quot; (Freud, TEI, 20) of the anatomists, quot;which stands on its head in the cortex, sticks up its heels, faces backwards and, as we know, has its speech area on the left side,quot; (Freud, TEI, 20). Ego, the Latin word for quot;I,quot; is a persons conception of himself or herself. The term has taken on various shades of meaning in psychology and philosophy. In psychoanalysis, the ego is a set of personality functions for dealing with reality, which maintains a certain unity throughout an individuals life. Freud, with whom the concept is closely associated, redefined it several times. In 1923, Freud used the term to refer to the conscious,

Environmental Issue (Moral Studies) Free Essays

FACULTY OF INFORMATION SCIENCE AND TECHNOLOGY MPW2153 MORAL STUDIES DRAFT REPORT TITLE: ENVIRONMENTAL AND POLLUTION Group member: 1. Tai Fei Li 2. Tan Ling Qiao Date of submission:21/3/2013 Lecturer: Madam Rohaidah Binti Mashudi INTRODUCTION: Nowadays, a variety of environmental problems affect our entire world. We will write a custom essay sample on Environmental Issue (Moral Studies) or any similar topic only for you Order Now It becomes a popular issues among societies. Therefore, we want to do some research about this issue and find out a few solutions for this matter. OBJECTIVES: * To determine the types of environmental pollutions. To exploring the factors of environmental pollutions. * To recommend the effective methods to cope with environmental pollutions problems. DISCUSSION: Types of environmental pollution 1. Air pollution 2. Water pollution 3. Soil pollution 4. Sound pollution 5. Radioactive pollution 6. Thermal pollution Causes of environmental pollution 1. Usage of fossil fuels 2. Agriculture sector 3. Trading activities 4. Residential sector Ways to reduce environmental pollution 1. Reduce , Re-use and Recycle 2. Put less load on your furnace and air conditioner. . the authorities should conduct continuous inspections, move out polluting industries or encourage them to modernize with latest technology. 4. Join national groups to put pressure on governments and corporations to cut down on the ir energy consumption. 5. Build efficient railway system to reduces vehicle used or encourage car pooling. MORAL PERSPECTIVES: We decide to use ethics theories which include social morality, personality virtue for this report. CONCLUSION: Pollution is a global crisis. Stop environmental pollution is everybody’s duty. It is important to encourage your family and friends to help take care of the world in which we live. REFERENCE: * Website http://environmental. laws. com/types-of-pollution http://www. pollutionpollution. com/2012/05/types-of-pollution. html http://www. pages. drexel. edu/~cy34/ * TextBook Environmental Pollution Studies(1999). Environmental Pollution Studies. Publisher by LIVERPOOL UNIVERSITY PRESS VIDEOS: I believe in a world free of pollution and war. It may seem to be a far off dream of impossibility but I do think one day we can reach that goal. We must join together on a united front and never back down. It’s not only about us in the right here right now, but about our children, our children’s children, and so on. I dream of a world of good and peace, a world where we fear not the air we breathe or the water we drink. We need not worry about the streets we travel down, or countries we’d like to visit. This world was a gift to us and I believe we need to take better care of this precious gem. http://www. youtube. com/watch? v=V5MN5VU_pYE http://www. youtube. com/watch? v=X6ociuRh3zo How to cite Environmental Issue (Moral Studies), Papers

Futuristic Definitude Essay Example For Students

Futuristic Definitude Essay Walter Millers A Canticle for Leibowitz has been hailed as a representation of the long future of mankind as a recapitulation of its own long past. Milan Kundera claims that kitsch is the passing off of thoughtless concepts as art, and that the non-thought of received ideas can be very misleading. In my opinion, these two ideologies, while taught together, conflict harshly in practice and cloud the issue of whether or not we can ever become modern. For centuries mankind has attempted, through the use of the novel, to predict the future of civilization, while exposing inner human values. Since Revelations, religious factions have made efforts to persuade the general population that a specific deity will lead His people to a paradise, or a Hell of sorts, as He sees appropriate. When reading any work of this nature, as the Canticle clearly is, we must take the motive(s) of the author into consideration, before we can come to a final conclusion. The feeling I sensed after the final page, is that Millers goals in producing this work are numerous as well as vague. My first impression was that the Canticle is an attempt at finishing, if not just prolonging the Bible. The titles for these three new books could be The Book of Francis, The Book of Dom Pedro, and The Book of Zerchi. The religious biases that are prevalent in almost every personal interaction within the book make it hard to decipher what is Human and what is God as far as decisions and opinions. The idea of autonomous individuals, as taught in Cultural Analysis, stands in direct opposition to the lack of independence demonstrated by members of the Monastery. Where the Church and the Brothers of AOL represent that which is modern and advanced after the Simplification, there is an obvious lack of autonomy displayed when a lifetime of actions have been devoted to God. Albeit, the decision to devote oneself to God is an autonomous one, that independence is forfeited sho rtly. This idea is intrinsic of the servant status attained upon entering the Order. The whole process of writing in the future also has vagueness in and of itself. The simple fact that no one knows what is going to happen makes accuracy an impossibility here. Thus, another motive of the author becomes apparent. Like Nostradamus and the recent rise in tele-psychics, one way of immortalizing ones own name, is by predicting the future with a reasonable amount of believability. Since we have no way of predicting accurately what society and culture will make of itself, we must rely on those who read what we write to make our predictions come true. By creating a positive depiction, we can raise the likelihood that the reader will try to make it come true. If and when it does come true, the author gains credibility, status and immortality. If that is not a motive to create a fictional future, I dont know what is. The concept of fact in a prophecy is a contradiction, until it comes true. Therefore, no prediction made today can have truth, because its truth is, of yet, undeterminable. This means that at present, all predictions are poor information, and those presented in novels, television, or any art should be considered kitsch. This is what Kundera claims is an enemy of culture, because it can specifically be used to promote ones position without substantial cause. Another aspect of modernity as found within the Cultural Analysis I Syllabus is faith in progress as a result of continuous increases in our knowledge of the world and in our ability to map and control it. Throughout the Canticle, Miller depicts a society that is incapable of a progression beyond a certain era. That being the Nuclear Age, an age that our own culture has not surpassed and Millers culture had just entered, the extrapolation Miller makes, based on only a few years of nuclear technology, quickly proves to be unfounded . Those who do not come to this realization are victims to Kunderas second enemy of culture the non-thought of received ideas. .u93795d8d767add02bb0800565a422efd , .u93795d8d767add02bb0800565a422efd .postImageUrl , .u93795d8d767add02bb0800565a422efd .centered-text-area { min-height: 80px; position: relative; } .u93795d8d767add02bb0800565a422efd , .u93795d8d767add02bb0800565a422efd:hover , .u93795d8d767add02bb0800565a422efd:visited , .u93795d8d767add02bb0800565a422efd:active { border:0!important; } .u93795d8d767add02bb0800565a422efd .clearfix:after { content: ""; display: table; clear: both; } .u93795d8d767add02bb0800565a422efd { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u93795d8d767add02bb0800565a422efd:active , .u93795d8d767add02bb0800565a422efd:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u93795d8d767add02bb0800565a422efd .centered-text-area { width: 100%; position: relative ; } .u93795d8d767add02bb0800565a422efd .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u93795d8d767add02bb0800565a422efd .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u93795d8d767add02bb0800565a422efd .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u93795d8d767add02bb0800565a422efd:hover .ctaButton { background-color: #34495E!important; } .u93795d8d767add02bb0800565a422efd .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u93795d8d767add02bb0800565a422efd .u93795d8d767add02bb0800565a422efd-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u93795d8d767add02bb0800565a422efd:after { content: ""; display: block; clear: both; } READ: Diesel Engine Parts EssayThis is also a very dangerous aspect of the Canticle, in that Miller has made it rather easy to believe the future will unravel as he has written, though there is little reason to believe that it will. It is very misleading and does not allow the less insightful to make a distinction. The only sure-fire way to escape this trap is to realize that fiction is, by definition, false. The futuristic novel attempts to claim that there is something that can be determined about the future by looking at the past. This is not possible because every day is a new one. Too many variables are present for any sort of definiteness in prediction. Generalities are very helpful to most for short-term guesses, but not in the case of the future of mankind. For me, there now arises a major conflict as to what I will accept after this analysis. While Millers novel appeals to my sense of humor, as a fantastic, imaginative, sadistic dream of one suicidal Walter M Miller, Jr., it holds little more than entertainment value, and I will never read it again. Kunderas ideas however do move me to ponder what motives are present when I see an obvious example of kitsch in society. If I am going to be autonomous, I must make decisions like this. I have only my own opinions and experiences to base my life on, and the way I see things will always be the way I see things. To accept a novel that is so hard to believe would be to contradict myself and give up some of my own autonomy. If I have the choice to be modern, then this is my opinion.

Healthcare Demonstrating Critical Thinking â€Myassignmenthelp.Com

Question: Discuss About The Healthcare Demonstrating Critical Thinking? Answer: Introduction Inter-professional healthcare team is considered as the collaborative practices which occur when the providers of healthcare work with people of same profession within an organization or outside people with same profession and with families as well as patients. The essay will focus on registered nurse as a member of the healthcare team. It will be defined the different role of nurse such as styles of leadership, collaborative team work, effective and ineffective teamwork and professionalism. Inter professional team helps patients and clients and it is the member which develop the common plan for clients outcomes and work to attain them. It is the team which is helpful and advantageous for not only healthcare but also for client, advisor and educator. Along with that the standards of registered nurse will be discussed in this essay. Role of registered nurse as the member of inter-professional healthcare team The practice of registered nurse is person-centered and evidence based along with formative, curative, supportive, preventive and palliative. The work of RN is to make the professional relationship with clients, groups and communities. These people may be influenced from the disease of mental or illness or any health challenges. There are certain standard which has to be followed by RN. Practice is not constrained to the stipulation of direct care of clinical (Farrell, Payne Heye, 2015). The practice of nursing can be enhanced to any paid or non-paid form where the nurse utilizes the skills and knowledge of nursing. It is the practice of nurse which may include the various forms such as working in management, research, regulations, advisory, education, and policy development and in other roles which is considered as safe. These standards for practices consist seven standards such as thinks significantly practices of nurses, captivate in the relationship of professional, handle the ca pability of standard practice, make a plan for practice of nursing, offer the safe and appropriate quality nursing practices and analyze the results to inform the practices of nursing. As a member of inter-professional team, the role of registered nurse is very effective.Registered Nurse can improve the services to provide the efficient care by enhancing the co-ordination of services. RegisteredNurse can use efficient time for clients and patients. As per nursing standard codes, standard 1 describes thinks critically and analyses nursing practice. With this practice, she will provide the benefits to providers as well in the form of professional satisfaction (Nursing and midwifery board of Australia, 2016), the role of nurse is to provide the innovation environment and permits providers to focus on particular areas of expertise (Griffiths, Ball, Murrells, Jones Rafferty, 2016). As a member ofteam, nurse provides the various paradigms of healthcare to study. She has to maximize the resource and facilities. She will be able to reduce the burden on acute care facilities as an outcome of enhanced prevention and patient education interventions.Along with that there are so many roles of registered nurse as the member of inter-professional healthcare team. These roles can be distinguished as professionalism, leadership, effective and ineffective teamwork, and inter-professional collaboration with other healthcare team member. Registered nurse has various standards that has to be followed in healthcare system. Each standard of nurse has a specific criterion which demonstrates the standard. Figure 1: Standards of registered nurse Source: (Mellor Greenhill, 2014). Role of Registered Nurse Professionalism In the role of professionalism, she practices in a safe and competent manner. The practices of nurse are accordance with the standards of profession. RN respects the dignity and culture. She encourages the patient for getting treatment and care (Dellefield, Castle, McGilton, Spilsbury, (2015). It involves effective action to make sure the safety and quality of their care which cannot be compromised due to prejudicial harms attitudes such as culture race, gender, color and spirituality. Engages in therapeutic and professional relationship is the standard 2 of RN that helps to establish the effective communication. RN provides advice regarding patient care with its benefits and loss of alternative care. It would be very helpful for the clients to make choice. RN shows the enthusiasm of their services which they want to provide. It is the responsibility of the nurse to maintain and create the trust of an individual, groups and communities on the professional of nurse. It has been obser ved that the unlawful and unethical actions of any team member of inter-professional team will influence adversely on the reputation of the profession. Along with that RN fulfill roles outside the professional role such as family members, community and friends. RN knows that double bonding always demeanor the relationship of professional with the prior purpose of advantage for the care receiver. It is the important duty of the RN to take care of all those aspects which is considered important in the point of view of safety (Kangasniemi, PakkanenKorhonen, 2015). RN in the inter-professional team does not accept any gifts. It has been described in the standard 5 of RN is to develop a plan for nursing practice. Being as a professional, RN should develop a plan by using assessment data. The role of RN is to co-ordinate with other team members effectively for planned actions. RN uses plans and negotiates how plan will be executed and by what time it would be accomplished. RN evaluates an d analyzes the growth of the goals as per their expectations. RNs,as regulated health professional, are liable for making sure that they are working or getting services at safe place, and have the ability to perform well. it has been mentioned in standard o3 of RN is to maintain the capability of practices. It involves the on-going self-analyses and answering in the case of concern about other capabilities of health professional for practices. RNs are responsible for the development of professional and giving relevant information to enable people to decide and take action in terms to their health. RNs should be complied with guidelines, regulations and policies to the term of practices while making decisions in the context of health concern and use framework of ethical. RNs should contribute in the improvements of quality and factual research. Leadership Leadership is the important element for registered nurse because in inter-professional team, RN needs to manage all aspects which come under safety zone. Inter-professional healthcare team has numerous people to attain the same objectives so the leadership of each member will be different. Registered nurse need to be accepted a single form of a leadership style for attaining a desired objectives. Inter-professional care is the important element in the healthcare industry services. Registered nurse need to be having various skills of leadership to provide the better services of inter-professional care. Leadership style of registered nurse can be transformational leadership (Hunt, Ramjan, McDonald, Koch, Baird Salamonson, 2015). It is the one of the important type of leadership which defines inspiration and motivation in numerous forms so that followers can get influenced towards accomplishing the task. By following this style, registered nurse can inspire other staff members and staff to accomplish the work beyond the expectations of the organization. Inspirationalmotivation by registered nurse includes the vision and mission of the organization and motivates others to complete the task. Intellectual stimulation will be helpful to replace the old assumptions in a new way. A personalized consideration occurs when registered nurse would concern about the skills of his or her followers. It would definitely impact on the patients as well in the context of getting effective services from the staff of the organization (Ishani, Christopher, Palmer, Otterness, Clothier, Nugent Borah, 2016). Transformational leadership will be helpful to provide the satisfaction services t he patient because it motivates other members and bring new ideas in the organization. Registered nurse need to be active and effective while performing the task because transformational leadership is only succeeded when leaders performefficiently because in this style followers follow them and do as they did. It has been mentioned in standard 4 of RN is that conduct assessment that are holistic and culturally efficient. The role of registered nurse to give better example to motivate and observe every activity while providing the services to patients by other members of inter-professional team. Communication skills, integrity and confidence of registered nurse should be perfect to convey the message to others regarding motivation and patient care. Patients care is important for the hospital and being a transformational leader will be helpful to the organization for getting effective outcomes (Bahr, Siclovan, Opper, Beiler, Bobay Weiss, 2017). RN brings new initiative in the organization so that possible changes can occur as per demand of time changing. Effective team work Inter-professional team comprises with number of professionals and families and communities. It is important for the each member to perform perfectly to enhance the performance of team. Better individual performance facilitates to grow team work. It is the team which comes in existence to make sure that professions of team complete the care task appropriately (Bloomfield, Gordon, Williams Aggar, 2015). Team of healthcare providers does not mean to put them together that they know automatically about the work (Bernoth, Dietsch, Burmeister Schwartz, 2014). There are so many factors which may influence the effective teamwork such as economic and historical political factors. The role of registered nurse need to put effort to define the complex interactions between psychological traits of team, outcomes of team, design of team, process of team and importance of team to gain the advantages by providing the efficient services. Task design involves the team effectiveness such as project man agement and delivery of care. Effective team work can be move ahead progressively if communications between team members done efficiently. Task design is capable to show the results directly or indirectly (Lartey, Cummings Profetto?McGrath, 2014). Integrated team effectiveness model plays a crucial role in the inter-professional team of health care. It is the model which is capable to differentiate between objectives and subjective results. Objective outcomes determine the measurable improvements in the results of patients care suchas functional status and satisfaction, efficiency and cost of organization, behaviour of staff such as absenteeism and stipulate patterns. On the other hand subjective result refers attitudinal effectiveness of team such as role and perception of team memberstowards the team effectiveness. The role of registered nurse in the effective teamwork should be co-operated (Smolowitz, Speakman, Wojnar, Whelan, Ulrich, Hayes Wood, 2015). He or she should focus on team effectiveness by contributing his or her work as a team. RNs role is in effective teamwork to establish relationship in a way that distinguishes the boundaries between professional and personal relationship. He or she communicates appropriately because it maintains the reputation of health care in the eye of an individual. Along with that, provides support team members to optimize health related concerns. RN needs to utilize supervision, delegation, consultation, referrals and co-ordination in the relationship of professionals to obtain improved outcomes of results. To increase the team effectiveness, RN should participate in the team meeting and perform as per decided structure. Considers and answers within a time frame to the health and wellbeing of self. Effective teamwork will enhance if an individual actively mingles with the professions. The aim of inter-professional team will be accomplished if each member of team focus on one goal and bring innovative ideas to accompli sh the task within the time frame (Smolowitz, Speakman, Wojnar, Whelan, Ulrich, Hayes Wood, 2015). Inter-professional collaboration The emergence of inter-professional collaboration is considered as the patient centered care. Interprofessional collaboration is the communal involvement of numerous professional providers of healthcare working with caregivers, patients, other professional and family for the purpose to communicate effectively s that unique and better patients care can be delivered. It has been mentioned in the standard 6 of the registered nurse to provide safe, appropriate and effective nursing practices. In the role of as leader, RN should be empowered as the partners of collaborative in the conception of results of values for the patient and community in which they serve. There can be so many barriers which may influence the collaboration of inter-professional team (Melnyk, Gallagher?Ford, Long, Fineout?Overholt, 2014). To reduce that impact, Interprofessional team should build the environment of Interprofessional collaboration and way to reduce disparities of healthcare. There is an example of Int erprofessional collaboration is illustrated by through a joint meeting of Virginia BON and the board of medicine in the year of 1970. It is the meeting which was conducted to enhance the clinical skills and surgical first assistant of RNs. The role of RN in Interprofessional collaboration is to provide the deep knowledge about the requirement of healthcare system because RN has the good bonding with physicians, nurse, colleagues, researcher, accretingrepresentatives and administrators who have huge influence on the result of patients as well as communities (Hellman, Jensen, Orchard Bergstrm, 2016). In addition to communicate with other members of inter-professional team, RN contributes its services in to the development and implementation so that possible improvement could be done in the health process such as tele-nursing and E-health records. The scope of RN is important in the inter-professional team because the role of them is being a good listener, interact with patients as wel l as other team member, earning trust of others and empowering others. Strong Interprofessional collaborative team make sure its members to hold care of patient and concern about the policies and protocols which is based on team and patient centered. RN is able to interact with diverse populations such as physicians, patients, and administrator and family members. As per standard 7 that are evaluate outcomes to inform nursing practice defines the monitor of progress towards the expected goals. This ability makes them excellent co-coordinator. Various efforts of collaborative give opportunity to RN to lead an improvement process by showing clinical leadership skills. There can so many barriers come in Interprofessional collaboration team such as lack of employer accountability and insufficient research investment. To reduce these impacts, RN should build a shared commitment on the basis of evidence programs which should be cost effective by the development of collaborative (Brock, Ab u-Rish, Chiu, Hammer, Wilson, VorvickZierler, 2013). Conclusion It has been concluded that Interprofessional team comprises with various professionals, family members, groups and communities. It is made to attain the one goal which is decided by team for the growth of health care. It is the essay which has been described the role of Registered nurse in various aspects. RN has the practice of person-centered. The work of RN is to identify the history and culture to health. RN is liable to the Midwifery Board of Australia which has settled up about the registered nurse standards for practice. The role of RN as a professionalism, leadership, in effective team and Interprofessional collaboration is an important. RN plays a lead role to interact with other team members as well as patients and their family. There are a various standards of RN which has to be followed while performing in the context of healthcare. The role of RN is responsible for independent practice within active systems as well as other health care professionals. References Bahr, S. J., Siclovan, D. M., Opper, K., Beiler, J., Bobay, K. L., Weiss, M. E. (2017).Interprofessional Health Team Communication About Hospital Discharge: An Implementation Science Evaluation Study.Journal of nursing care quality,32(4), 285-292. Bernoth, M., Dietsch, E., Burmeister, O. K., Schwartz, M. (2014). Information management in aged care: cases of confidentiality and elder abuse.Journal of Business Ethics,122(3), 453-460. Bloomfield, J. G., Gordon, C. J., Williams, A. M., Aggar, C. (2015). Nursing students intentions to enter primary health care as a career option: Findings from a national survey.Collegian,22(2), 161-167. Boet, S., Bould, M. D., Layat Burn, C., Reeves, S. (2014). Twelve tips for a successful interprofessional team-based high-fidelity simulation education session.Medical teacher,36(10), 853-857. Brock, D., Abu-Rish, E., Chiu, C. R., Hammer, D., Wilson, S., Vorvick, L, Zierler, B. (2013).Interprofessional education in team communication: working together to improve patient safety.BMJ QualSaf,22(5), 414-423. Dellefield, M. E., Castle, N. G., McGilton, K. S., Spilsbury, K. (2015). The relationship between registered nurses and nursing home quality: An integrative review (2008-2014). Nursing Economics, 33(2), 95. Farrell, K., Payne, C., Heye, M. (2015).Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process.Journal of Professional Nursing,31(1), 5-10. Grant, J., Lines, L., Darbyshire, P., Parry, Y. (2017). How do nurse practitioners work in primary health care settings? A scoping review.International Journal of Nursing Studies,75, 51-57. Griffiths, P., Ball, J., Murrells, T., Jones, S., Rafferty, A. M. (2016). Registered nurse, healthcare support worker, medical staffing levels and mortality in English hospital trusts: a cross-sectional study.BMJ open,6(2), e008751. Hellman, T., Jensen, I., Orchard, C., Bergstrm, G. (2016).Preliminary testing of the Swedish version of the Assessment of Interprofessional Team Collaboration Scale (AITCS-S).Journal of interprofessional care,30(4), 499-504. Hunt, L., Ramjan, L., McDonald, G., Koch, J., Baird, D., Salamonson, Y. (2015). Nursing students' perspectives of the health and healthcare issues of Australian Indigenous people.Nurse education today,35(3), 461-467. Ishani, A., Christopher, J., Palmer, D., Otterness, S., Clothier, B., Nugent, S, Borah, T. (2016).Telehealth by an interprofessional team in patients with CKD: a randomized controlled trial.American Journal of Kidney Diseases,68(1), 41-49. Kangasniemi, M., Pakkanen, P., Korhonen, A. (2015). Professional ethics in nursing: an integrative review.Journal of advanced nursing,71(8), 1744-1757. Lartey, S., Cummings, G., Profetto?McGrath, J. (2014). Interventions that promote retention of experienced registered nurses in health care settings: a systematic review.Journal of nursing management,22(8), 1027-1041. Mellor, P., Greenhill, J. (2014). A patient safety focused registered nurse transition to practice program.Contemporary nurse,47(1-2), 51-60. Melnyk, B. M., Gallagher?Ford, L., Long, L. E., Fineout?Overholt, E. (2014). The establishment of evidence?based practice competencies for practicing registered nurses and advanced practice nurses in real?world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs.Worldviews on Evidence?Based Nursing,11(1), 5-15. Nursing and midwifery board of Australia, (2016). Registered nurse standards for practice. Retrieved on 13th September 2017 from: www.nursingmidwiferyboard.gov.au. Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., Wood, L. (2015). Role of the registered nurse in primary health care: Meeting health care needs in the 21st century.Nursing Outlook,63(2), 130-136.

College Bio Essay Samples

College Bio Essay SamplesCollege bio essay samples can be the first step in creating a great essay. These essays are used for various reasons and require different styles and methods of writing. The goal is to help you create a great essay that is unique.Creating your bios online is fast, easy, and free. All you need is a computer and a good internet connection. Simply find a website that offers samples, either free or paid, and follow the instructions.The greatest benefit of making your bios online is time. Since you are saving time, you can spend more time developing your essay. The more time you spend developing your essay, the better it will be. It's a win-win situation.To begin, consider creating a personal statement about yourself. This section should be short and to the point, but the most important part of your essay will be the concluding paragraph that addresses the topic at hand.You should then use a paragraph introduction to start off the actual body of your essay. Make s ure you have one bullet point in this paragraph and it should be in the last paragraph. You want to have one and you should always include your contact information.After your introduction, use a three-line paragraph to go into the previous paragraph. If you feel the current topic of the paragraph is irrelevant, write something brief in the space provided. However, keep in mind that the main idea of the paragraph should be to outline what you're going to say.By using a college essay sample, you will know exactly what style you should use. Researching and finding the best writing styles will ensure that your body of work is professional and informative. It also helps to avoid self-indulgent language, since college is meant to teach young adults new skills and expand their minds.Once you've completed a college biography sample, it's time to turn it in. Since you already have a list of topics covered, you will be able to narrow down what you need to write about and target specific stude nts. If you're lucky, you may be contacted by the college you selected to do an interview for you!

Maggie Obituary Essays (227 words) - Maggie Greene, Maggie

Maggie Obituary Margaret Johnson, only daughter of Mary Murphy: found dead in the East River at age 23 Margaret Johnson, also called Maggie, was a successful seamstress and the only daughter of Mary Murphy died on November 19 in the East River where she was spotted floating atop the freezing cold water. The cause of death seems to be suicide due to a longing case of depression but there are still tests being done on the body. Because of the poverty Maggie was born into she did not have the chance to learn how to swim which leads to the thought of her getting hypothermia once she either jumped or got pushed in the river. Maggie was said to be a very intelligent young lady who was always very popular around the men. She was also said to be very dependent and that was clearly seen when she ran away from home and went straight to a guy friend of hers whose name will not be released. As soon as they realized their differences she quickly ran back home to her mother who then rejected her, claiming that she was the "devil." Earlier in her short, prosperous life Maggie had to deal with the death of both her baby brother and her father, the one close family member that protected her in tough times that she often encountered. Margaret Johnson is survived by a brother Jimmie Johnson and her mother Mary Murphy.

Writing to Your Reader

Writing to Your Reader Would you consider giving a speech to a group without first knowing who they were and what they expected from you? The same logic applies to the written word, from resumes and cover letters to romance novels and sales brochures.While oral presentations have the added benefit of facial expressions, hand gestures, listener feedback and even visual aids, written communications must rely solely on their words for the desired response or effect. For that reason, the most important research you must obtain for everything you write is the information about your audience.Whether the subject of your document is of your own choosing or a scholastic assignment, before you put pen to paper, you must first ascertain the purpose of your communication and the identity of your reader(s) by finding answers to as many of the following questions as possible:Is your audience primarily male or female? This is important in your choice of words and phrases, imparting feelings or opinions, drawing conclusio ns, etc., as depending upon your topic and your purpose, you might elicit more positive responses if your document is tailored toward one sex or the other.What native nationality is your audience? As an example, if you are writing in English as your second language to a group that is primarily English-speaking, you should definitely have an English-speaking associate review your document.What is the age group? From childrens books to advertisements for denture adhesive, always determine the probable age of your major audience so that your words are read, not ignored or discounted as either too difficult to understand or too childish.What is the average annual income? Even a guess will help you determine word choices, tone, and possibly subject matter if you know whether you are writing to college students on a limited budget or to business executives who fly First Class and drive a Mercedes.Are you writing to please, persuade, or inform your reader(s)? Your purpose may change depend ing upon your audience, but you should always begin your writing with an idea of what you want to accomplish based on the identity of your reader(s).Under what conditions will your document be read (i.e., at home, in a classroom, in a magazine or newspaper)? The length and content of your writing may depend on where you expect your audience to be when they read your document. A casual setting like the kitchen table lends itself to more casual wording and more detail, while a teacher may have many papers to read and may be looking for immediate positive or negative reasons for a grade.Does your reader want to read your document? You must determine if your audience is looking forward to reading your document (i.e., someone buying your novel), and if it is a requirement or necessity (i.e., a teacher grading your essay or a consumer looking for a low price).What response do you expect (i.e., a good grade, the sale of a product, a phone call)? No matter what you are writing - advertisin g copy, a short story, a personal statement, an essay - always keep in mind the end result you expect, and when you read your final draft, ask yourself, If I were my audience, would I respond as intended?Knowing your reader(s) actually makes writing easier, forcing you to focus rather than just throw words on a page, and ensuring that your final document has a much better chance of succeeding for any purpose. Before you begin to write, take a few minutes to explore your readers mind and environment; youll discover that your written communications will be better organized, more interesting and well-received.

Aspectual evaluation of IS in use Essay Example | Topics and Well Written Essays - 2000 words

Aspectual evaluation of IS in use - Essay Example This flash will be linked to several internet website e.g. YouTube for the users to have a video watch on how basketball is played. This also will save the user some money since it does not need to be bought. Champion basketball flash evaluation There are several users in the family who are subject to use the champion basketball flash and whom must be considered in the family. Unlike me being a professional basket baller, my wife is not a basketball fan; my oldest daughter loves games but plays tennis. However if may appear erroneous since my last born is a basket baller but is not a fan, consequently my second born son does not play basketball but is a good basketball fan. Physical aspect This is the relation to feelings of the user on this champion basketball flash which can be manipulated from one screen to another. A good example is when the user will feel happy and delighted by the presence of star players like tiger woods who is the best Basketball international player. This wi ll also bring excitement to the user especially when the team of stars are playing the game. These moments will make the user happy and make the champion basketball flash to be exciting. ... The main presentation is linked to the major and attractive sites visited in the internet to give the user the best videos and pictorials for the related game. This videos and games raise the user’s level of enjoyment, this games and videos in the internet are always updated and the user will have an access of the current sports only. Eventually some of this graphics are funny picture of the players that they like most and this makes the users happy and excited to use the champion basketball flashy. Consequently, this makes the young users to gain more interest in this game and hence helps the user to understand more about the game. Quantative aspect The user will not be able to see all the presentation in the same day as this is more than what human can take. This is as a result of videos and images which keep on updating and changing on a daily basis. In this context, the users will have to keep on revisiting the presentation to find what is new in the game. The navigation b etween screens on Basketball playing and its relations to different players, fields and different countries is more complex and this will take time to cover. World records keep on being broken and this will make the presentation change on the player’s information part leading to an update of a new record with a new player. This wills make the users to revisit a certain careen when a new record is set. Also my daughter like watching something twice for a deep understanding and this will make her revisit the screens and this will consume time, my sons well likes watching videos and thus videos watching will consume a lot of time in order for one to have a good understanding. Moral aspect In any application developed, on has to consider its ethical implications and values. In this

HSBC Bank Research Paper Example | Topics and Well Written Essays - 2250 words

HSBC Bank - Research Paper Example d.). The HSBC holdings are one of the largest banking and financial services organizations in the world. HSBC holdings were established in Honk Kong in 1990 as a parent company to the HSBC and were incorporated as a public limited company in England and Wales in the same year 1990. The bank has its new headquarters at London after 1993. Formerly, that is until 1992 Honk Kong served as its headquarters. The reason was the takeover conditions for the acquisition of Midland Bank that forced the HSBC to move its headquarters from Honk Kong to London in 1993 (Cavallo, 2001). The bank's international network consists of around 8500 offices in 86 countries and territories with assets worth around US$ 2,527; 210,000 shareholders, 331,458 employees and 128 million customers worldwide. In the UK the number of HSBC was more that is, 1600 branches than that of UAE HSBC Bank that had only 8 branches and around 110 ATM machines. The Forbes magazine in April 2, 2008 recognized HSBC, as the fourth large st bank in the world in terms of assets ($2,348.98 billion); the second largest in terms of sales ($146.50 billion), the largest in terms of market value ($180.81 billion). ... d.). The factor that helped the HSBC to reach this position is its high loan-deposit ratio of 90% that claim to have more deposits than loans. Such a high loan-deposit ratio facilitated the bank to build and retain the trust among its investors and customers and also keeping these users assured with the financial strengths of the banks. Thus the sound financial position of the bank helped the bank to maintain stock at relatively high price even during the times of credit crunch phase, which could not been seen in other banks. The present study focuses on the aspects of financial and banking performance of HSBC bank. The study is carried out to achieve mainly three objectives, which are: To measure how well the HSBC banks are performing in compared to other banks; What are the necessary steps that have been taken by the HSBC banks to improve their overall performance and; Finally to provide sufficient important information to its investors (Hunter, 1990) Literature Review The analysis of financial performance has always been a subject of interest to scholars and academicians. The banking performance in particular invites the attention of bankers as well to evaluate how successfully their operations are being conducted and the interest of various stakeholders are protected. There have been many measures and indexes to evaluate the performance of a bank. These include broadly economic and non-economic measures. For instance, Rovell (1980) remarks banking performance can be best evaluated by interest rate margin over different periods of time. Interest income here is defined as the difference between the interest income and dividend expenses and the

Hypertension Case Study Nursing

Hypertension Case Study Nursing 1) CASE SUMMARY Mr. MS is a 58-year-old Malay male who was previously diagnosed with hypertension, gout and triple vessel ischemic heart disease. He first presented with chest pain in March 2010 where he was diagnosed with ischemic heart disease. He was unable to complete an exercise stress test and an angiogram done in Hospital Sultanah Aminah found him to have triple vessel disease. He was told angioplasty was not possible due to the severity of the blocks and was counseled for CABG but he was not keen. Meanwhile, he has had angina attacks 2 to 3 times per week every week since his initial diagnosis for the last 3 months, usually relieved by sublingual GTN and was currently admitted for the 4th time for chest pain not relieved by GTN. ECG done 2 hours after onset of chest pain showed ST depression of 2mm at leads I, aVL, V3 V6 and left axis deviation with no Q waves. Trop T was positive (2.75 ng/ml) at 4 hours after onset and other cardiac enzymes were also raised significantly. He was diagnosed with NSTEMI and treated with aspirin 300mg, IV morphine 2.5 mg, sublingual GTN 3 tablets and subcutaneous clexane 60mg BD for 3 days as well as continuing his current medication regime of simvastatin, metoprolol, cardiprin, ISDN, amlodipine and GTN. Following admission, he was well in the ward with no recurrence of chest pain and did not develop any new complaints. He was discharged after 3 days of inpatient treatment with instructions to attend his follow-up appointment at the cardio clinic in HSAJB on the 16th of June 2010 to make an appointment for surgery. Following this episode of chest pain, which he says is the worst so far, he is now quite keen for CABG. PATIENTS DETAILS I/C NUMBER: 510831015263 AGE: 58 SEX: Male DATE OF ADMISSION: 3/6/2010 R/N: 1348445 2) CLINICAL HISTORY Chief Complaint Chest pain for 1 day. History of Present Illness Mr. MS is a 58-year-old Malay male who was previously diagnosed with gout, hypertension and ischemic heart disease with triple vessel disease. He was awoken from sleep at about 10pm due to a central chest pain of sudden onset. He described the character of the pain as crushing in nature and radiated to his neck. This episode of chest pain was the most severe since he was first diagnosed with ischemic heart disease. The pain was associated with profuse sweating, body weakness and was not relieved by rest. However, it was relieved by sublingual GTN, of which he has a supply of. His discomfort was made worst by exertion so he lay in bed to recover. Despite this, he had another episode of chest pain 30 minutes later. He took the sublingual GTN again but this time, the pain did not resolve. He was then brought to the emergency department of Hospital Batu Pahat by his son. This is Mr. MSs fourth admission for chest pain since March 2010. Since his diagnosis of ischemic heart disease in March, he has experience angina attacks two to three times per week, especially on exertion such as when straining while passing motion. During these attacks, he uses sublingual GTN to relieve his symptoms and normally feels much better after that. He only comes to the hospital when GTN does not work to relieve his symptoms. Systemic Review Mr. MS does not experience symptoms such as palpitations, dizziness, headache, nausea, vomiting, orthopnoea, paroxysmal nocturnal dyspnoea, epigastric pain, shortness of breath, fever, and had no syncopal episodes. He also does not have loss of appetite or loss of weight. Bowel and urinary habits are normal. His sleep has not been affected until this current episode whereby he was awoken by the chest pain. Past Medical History Mr. MS was diagnosed with hypertension 6 years ago when he had an episode of headache. He has been on medication since and was on regular follow-up with KK Rengit. He was diagnosed with gout 5 years ago when he had a left big toe swelling which resolved after some medication. He is not on long term medication for gout. Mr. MS was admitted for the first time 5 years ago in 2005 when he had bilateral renal calculi. He was subsequently referred to Hospital Sultanah Aminah for further management of this problem and it has since resolved and does not have follow-up anymore. Mr. MS was diagnosed with ischemic heart disease in March 2010 when he presented with chest pain for the first time. Following his recovery, he underwent a stress test in Hospital Batu Pahat but according to him, was unable to complete the procedure due to chest discomfort. He was referred to the cardiology unit in Hospital Sultanah Aminah for further management where an angiogram was performed and he was told to have triple vessel disease. He was also told that angioplasty was not possible due to the severity of the blocks. He was recommended to have Coronary Artery Bypass Grafting (CABG) but as of yet, no appointment has been made as he was still unsure of going through with the procedure. Following this episode of chest pain, Mr. MS has decided that going for the CABG is the only thing that will keep him alive. His current medications include: Tab Simvastatin 20mg OD Tab Metoprolol 75mg BD Tab Cardiprin 100mg OD Tab Isosorbide Dinitrate (ISDN) 5mg TDS Tab Amlodipine 10mg OD Sublingual Glyceryl Trinitrate (GTN) PRN He is compliant to his medication regime. Mr. MS is not known to have diabetes or hyperlipidemia. He also does not have any known food or drug allergies. Family History Mr. MS is the 3rd of 9 siblings. His father had hypertension and passed away a long time ago due to unknown causes. His mother and other siblings are healthy. None of them have hypertension, diabetes, ischemic heart disease or malignancy. Social History He lives in a kampung in Rengit with his wife and 5 children. Mr. MS does not smoke nor consume alcohol. He works in a palm oil plantation. The distance from his house to Hospital Batu Pahat is about half an hour. On further enquiry, Mr. MS says that the cost of the CABG is about RM1000, which he can afford. 3) FINDINGS ON CLINICAL EXAMINATION (Mr. MS was examined by me 9 hours after onset of chest pain) Mr. MS was alert, conscious, and communicative. He was not in obvious pain or respiratory distress. He was lying down comfortably on his bed. There were no tendon xanthomata, xanthelasma, pallor, corneal arcus or pedal edema. His JVP was not raised. His clinical parameters are: Blood Pressure : 158/94 mmHg Heart Rate : 94 beats per minute. Regular rhythm Respiratory Rate : 20 breaths per minute Temperature : 37Â °C SpO2 : 97% under room air On examination of the precordium, the apex beat was located at the 5th intercostal space on the midclavicular line and was normal in character. Parasternal heave was not felt and there were no thrills. First and second heart sounds were heard. There were no murmurs or added heart sounds. On examination of the chest, there was no deformity and chest expansion was equal on both sides. Percussion and tactile vocal fremitus was normal and equal on both sides. On auscultation, vesicular breath sounds were heard throughout all lung fields with good air entry. There was no wheezing or crepitations heard. On examination of the abdomen, it was soft and non-tender. There were no masses felt. Bowel sounds were heard and normal. 4) PROVISIONAL AND DIFFERENTIAL DIAGNOSES WITH REASONING Provisional Diagnosis Acute myocardial infarction with underlying triple vessel ischemic heart disease and hypertension With a history of diagnosed triple vessel ischemic heart disease with multiple episodes of angina attacks since the initial diagnosis, it is highly likely that Mr. MS is presenting with an acute coronary event and this should be a priority until proven otherwise. This is evidenced by the presentation of central, crushing chest pain of sudden onset that radiated to the neck and associated with profuse sweating and body weakness which is classical of a myocardial infarction. Mr. MS will require immediate investigations such as an electrocardiogram and cardiac enzymes to differentiate the acute coronary syndromes so that the appropriate management may be instituted for him e.g. if he has an ST-segment elevation myocardial infarction (STEMI), he will require myocardium-saving thrombolytic therapy to disrupt the ischemic event. As Mr. MS did not present with features such as acute shortness of breath, loss of consciousness and severe palpitations, it seems that he does not have complicati ons of acute myocardial infarction but these developments should be watched out for throughout his admission as complications may arise later. Differential Diagnosis Pulmonary embolism Pulmonary embolism is a possibility that can be considered when a patient presents with an acute chest pain that is accompanied by shortness of breath, hemoptysis, tachypnea, fever and even cyanosis and collapse in severe cases. Furthermore, the chest pain is of a pleuritic nature, of which it is worsened on breathing, and a pleural rub can be heard on auscultation of the chest. However, Mr. MS did not present in such a way. At the same time, Mr. MS did not have risk factors such as a deep vein thrombosis, prolonged immobilization or recent surgery. It is still highly likely that Mr. MS has suffered an acute myocardial infarction, and an ECG would help to differentiate between the two as pulmonary embolism might show the classic S1Q3T3 pattern of right axis deviation or right bundle branch block. Either way, the diagnosis should be made quickly so treatment may be instituted before his condition becomes worse or complications develop. Aortic dissection Aortic dissection presents as an acute onset chest pain that is tearing in nature, and often radiates to the back. It is often confused with myocardial infarction due to its presentation but differences include the lack of profuse sweating, signs of heart pump dysfunction and a normal ECG. Risk factors are usually uncontrolled hypertension, connective tissue disorders or chest trauma. Mr. MS has hypertension, but is under control, and does not have the other risk factors. A diagnosis of myocardial infarction should be the priority as thrombolytic therapy is vital, but if there is any reason to doubt that diagnosis, then further investigations should be performed. 5) IDENTIFY AND PRIORITISE THE PROBLEMS 1. Acute chest pain Mr. MS has acute chest pain with features very suggestive of a classical picture of myocardial infarction as he presents with crushing central chest pain that radiates to the neck and associated with profuse sweating and weakness. Given that he is known to have triple vessel ischemic heart disease and that he has suffered many angina attacks since his initial diagnosis, it is highly likely that he is having an acute myocardial infarction. Without further a due, he needs an electrocardiogram (ECG) and cardiac enzymes tested to distinguish between the different acute coronary syndromes so that the appropriate treatment protocols may be initiated for him as soon as possible to disrupt the ongoing ischemia. As Mr. MS is having severe chest pain that may overstimulate his sympathetic system and cause further ischemia, he will require immediate supportive therapy such as effective pain medication and oxygen therapy. 2. Triple vessel ischemic heart disease awaiting CABG Mr. MS was diagnosed with triple vessel ischemic heart disease when he first presented with chest pain in March 2010 and has since experienced many episodes of angina. Given his diagnosis and disease pattern, he is at a very high risk of developing a severe acute coronary event that may prove fatal if the infarction is too extensive or if complications develop. As percutaneous revascularization with a stent or balloon was not possible for him, he will require a CABG to both relieve his symptoms and reduce his mortality risks in the long term. He was unsure of going ahead with the operation previously, therefore no appointment date was given for surgery. However, now that he has changed his mind, every effort should be made by both the doctors in charge of him here in Hospital Batu Pahat and in the cardiology unit of Hospital Sultanah Aminah to arrange for his surgery as soon as possible, given the circumstances of his condition. 3. Compliance to medication Mr. MS is on several medications for his triple vessel ischemic heart disease and will require revascularization surgery soon in order to decrease his mortality risks. However, waiting for a CABG in the government setting may take some time, even under dire circumstances due to the nature of the system. Therefore, it is extremely crucial that Mr. MS is compliant to his medication regime while awaiting a CABG to prevent another episode of infarction. He should be counseled to fully understand this and the situation of his ischemic heart disease. It is also the responsibility of his doctors to ensure that he is taking the right combination of medications with the aim to prevent another acute cardiac event. Meanwhile, a sufficient supply of sublingual GTN should be provided for Mr. MS in cases of angina attacks at home. He should come to the hospital immediately if GTN fails to relieve his symptoms. 4. Regular screening for comorbid diseases Mr. MS has not been diagnosed with diabetes or hyperlipidemia previously but these diseases are strong risk factors for the long term implications of his ischemic heart disease. Therefore, Mr. MS should be screened regularly e.g. twice yearly during his follow-up appointments. Early detection of diabetes is necessary so that treatment can start as soon as detected in order to prevent his ischemic heart disease from becoming worst than it already is. As for his lipid control, if his lipid profile is found to be outside the normal limits, the dosage of his medication can be increased as necessary. Following his CABG, he will need to maintain a healthy lifestyle of a good, well-balanced, low-salt and low-fat diet and regular exercise within his limits. 6) PLAN OF INVESTIGATION, JUSTIFICATIONS FOR THE SELECTION OF TESTS OR PROCEDURES, AND INTERPRETATION OF RESULTS 1. Electrocardiogram (ECG) To look for any changes that may indicate an ongoing ischemic event, such as ST elevation or depression and T wave inversion in order to support the diagnosis of an acute myocardial infarction so appropriate treatment can be started. Differentiation of ST segment elevation or depression is also crucial in initiating treatment as thrombolytic therapy is only indicated for ST-elevation myocardial infarction. Results: ECG on admission (2 hours after onset) shows sinus rhythm with ST depression at leads I, aVL, V3 V6 with left axis deviation. T wave was present and normal. Interpretation: The ST depression in the leads above indicate an ischemic event at the anterolateral sections of the heart. The lack of ST elevation concludes a diagnosis of either unstable angina or NSTEMI, depending on the levels of cardiac enzymes. There is no sign of old infarction. 2. Cardiac Enzymes To look for elevated levels of cardiac enzymes such as troponin T, creatinine kinase (CK), lactate dehydrogenase (LDH) and aspartate transaminase (AST) that will indicate myocardium ischemia and necrosis. If elevated, a diagnosis of NSTEMI can be made in accordance with the ECG changes. However, cardiac enzymes when done too early after onset may not show any rise in levels 1. This does not mean that necrosis has not taken place and the test should be repeated once more at 6 hours after onset 1. Results: Troponin T (4 hours after onset) 2.75ng/ml ↑ (12 hours after onset) (60 hours after onset) Normal Range (U/L) CK 997 ↑ 263 ↑