Ingls bsico - Present Simple o Present Continuous

Ingls bsico - 'Present Simple' o 'Present Continuous' Present Simple Use el present simple para hablar sobre actividades o rutinas que toman lugar de forma regular. Ejemplos: I often go jogging on Saturdays.He usually has coffee for breakfast. Present Continuous Use el present continuous para hablar sobre lo que est sucediendo en un momento presente del tiempo, en torno a un momento presente o para un programado evento futuro. Ejemplos: Were working on the Smith account this month.Shes watching TV at the moment. Los verbos de estado Los verbos de estado son verbos que expresan un estado. Los verbos de accià ³n son verbos que expresa algo que una persona hace. Ejemplos: I hope to see you soon. (stative verb) He is cooking dinner at the moment. (action verb) Los verbos de estado no pueden ser usados en las formas continuas. A continuacià ³n hay una lista de comunes verbos de estado: believeunderstandthink (opinion)wanthopesmelltastefeelsoundlookseemappear Pruebe su conocimiento con esta breve prueba.  Learn more Espanol here.

Differentiation in Special Education Classrooms

Differentiation in Special Education Classrooms Differentiation is the way a teacher prepares instruction to meet the needs of all the children in an inclusive classroom, from the most challenged to the most gifted. Differentiating instruction is not only going to help your special education students fully participate, it will also enrich and improve the experience of the general education students. Everybody wins. A well designed differentiated lesson will include some of the following: A strong visual component, collaborative activities, peer coaching, a multi-sensory approach to presenting information and differentiated assessment based on strengths. A Strong Visual Component Arent digital cameras and online image searches wonderful resources? Children with reading problems have a great deal less difficulty dealing with pictures than symbols. You might even have teams of children work together to gather pictures for instruction, or you might ask Mom to email you  some favorite vacation pictures. Autistic students can benefit from the use of cards to learn sight vocabulary, attributes, safety signs and to evaluate new vocabulary. Collaborative Activities Collaboration will be the mark of a successful leader and employee in the future, so this is a skill all students will need. We also know that children learn best from peers. One of the strongest reasons for inclusion is the fact that working across ability groups pulls up the lower functioning group. You need to take time to teach collaboration, using a fishbowl approach. Have a group of students model the process of collaboration, and then evaluate their performance as a group. As you are teaching a lesson using collaborative teams, spend time evaluating them as a group: Did everyone get a chance to talk? Did everyone participate? If you observe that groups are not functioning well, you may need to move in, stop, and do some coaching. Peer Coaching Its a good idea to create several partners for every child in the class. One method involves 4 pairings in each class a clock face to illustrate: a 12 oclock partner, with a student most like each student in ability (assigned by the teacher,) a 6 oclock partner, who is the opposite level of ability, and 3 and 9 oclock partners of their choosing. Spend time early in the year training your students to work in partnerships. You might try trust walks with your partners, having each child take turns walking their blindfolded partner around the classroom with only spoken directions. Be sure to debrief with your class, and talk about the importance of listening to each other and understanding each others strengths and weaknesses. Be sure you model the kind of positive interpersonal interactions you want to see from kids. Peer coaches can help each other with flashcards, with written assignments, and with collaborative activities. A Multi-Sensory Approach We are way too dependent on print as a way to introduce new information. Some of the children with IEPs may have strengths in unexpected areas: they may be great illustrators, creative builders, and very capable at gathering information visually on the internet. The more sensory avenues you engage as you are introducing new material, the more likely all your students will retain it. Do some tasting with a social studies lesson: How about coconut for a unit on the Pacific, or trying some salsa when you are learning about Mexico? How about movement? You can use a molecule game to teach children what happened when you heat elements. When you turned up the heat (orally, and raising my hand to raise the temperature) they would rush around the room as far apart as possible. When you drop the temperature (and my hand) the students would gather together and move just a little bit, slowly. You can bet every one of those kids remembered what happened when you heat a liquid or gas! Assessment that Builds on Strengths ​ There are lots of ways to assess mastery other than a multiple choice test. Rubrics are one great way to create clear ways for students to show they have mastered the materials. A portfolio may be another way. Rather than asking a student to write, you may ask a student to sort or group pictures according to criteria you have learned, name pictures, or have the students answer questions that help them display knowledge of new materials.

Movie Adaptation essay Example | Topics and Well Written Essays - 750 words

Movie Adaptation - Essay Example Several scenes in this movie depict self-reflection. For instance; Griffin Mill a movie executive is stalked and threatened by a screenwriter whom he rejected. Mill sets out to find his stalker and kill him. He later gets a note informing him that he killed the wrong man. Mill offers his stalker to make his movie for silence. The greediness of Hollywood movie makers is brought out here. Mill then betrays Cahain, the mysterious writer, by getting into a romantic affair with Cahain’s girlfriend, June. June later tips Mill on the whereabouts of Cahain giving Mill the chance to murder him. Mill and June fall in love and live together depicting the immorality in Hollywood. 2) Double Indemnity (1994) Double Indemnity by Billy Wilder is considered a noir movie. In most noir movies, the male lead characters are considered weaklings. The motivations behind the deeds of the male lead character are inspired by the sexual appeal of a female character. The femme fatale character is clearly brought out in Double Indemnity. In this case, a treacherous woman makes a man commit a crime that will benefit her by using her sexual charms (Blair 58). There are promises of sex and money to the man if the deal is successful. Double Indemnity like every noir movie is in black and white. Elements of noir movie are incorporated in the movie Double Indemnity. To begin with the movie is in black and white. The movie is about Walter Neff, an insurance agent who gets into an affair with Phyllis the wife of Dietrichson, his client. Phyllis, the femme fatale, and Neff conspire and come up with an insurance scam that will make Mr. Dietrichson loss fifty thousand dollars. Neff is controlled by the urge to go to bed with Phyllis thereby succumbing to her request. Neff and Phyllis plan to escape if the scam goes through and Mr. Dietrichson murdered. Later Neff confesses on being part of the scam when Phyllis accuses him of being the mastermind. Sex has been used as a symbol of self destruct ion on the part of Neff. 3) The Silence of the Lambs Clarice Starling, a trainee in the FBI, is tasked to interview Dr. Hannibal Lecter. Hannibal â€Å"the cannibal† upon being interviewed admits of his knowledge on where to find Buffalo Bill, a man who skins women and then wears their skin. In this movie, telling who the protagonist is and who the antagonist is can be a problem. Starling and Lecter play an important role. Starling seeks the help of Dr. Lecter who is locked up in a mental hospital. He likes her and offers her the details she needs on tracking down Buffalo Bill. Clarice Starling’s vulnerability gives the movie a turn when Dr. Lecter realizes that they have a lot in common; her parents died when she was still young while he was abused as a child. He likes her and is ready to help her at all costs. 4) Maltese Falcon (1941) In the novel Maltese Falcon, Miss Wonderly walks into Spade’s and Archer’s office premise after Effie informs Spade. Mis s Wonderly finds Spade all alone in the office. She tries to inform about her visit but takes moments before speaking. After a while of narrating her problem to him, Archer walks in, and Spade introduces him to her as his partner. In the movie, Miss Wonderly presents her case to Archer and Spade who are together in the office. There are several alterations noted. In the

KIEU Eaasy-Theme 2 Essay Example | Topics and Well Written Essays - 1000 words

KIEU Eaasy-Theme 2 - Essay Example Although it may be assumed that the spirit behind Kieu’s decision to engage in immoral activities is ethical, the actions the she takes are immoral and against the standards set by the society. Kieu’s liberal personality is revealed when she decides to engage in prostitution in order to cater for the needs for her family. Kieu was well educated and had a bright future ahead, but problems befall her family. As a result, she takes the path of prostitution and becomes a victim of circumstances. According to her society, prostitution is immoral and an abuse of womanhood, but Kieu takes a bold step to engage in it in order to assist her brother and father. The spirit behind her decision to join prostitution in order to assist her family may be taken as a moral action, but in the real sense and based on her society’s norms, it is immoral (Du 151). Kieu falls in love with Kim. Both are teenagers but they follow their desires to develop a passionate relationship. The soc iety prohibits teenage relationship because they are likely to fall into temptation and engage in sexual intercourse. The society is against the relationship, but Kieu’s liberal personality enables her to fall in love with Kim, thus breaking the social norms set by her community. Although Kieu may be considered to be moral when she decided to preserve herself until marriage when her boyfriend Kim tried to make sexual advances to her, the whole relationship is immoral because it contravenes the basic moral codes that prohibit sexual relationships between teenagers (Du 118). Judging whether Kieu’s actions are moral or immoral depends on the society that one is coming from. Every society defines morality in its own context. Looking at Kieu’s character, it is somehow admirable because she loves her family more than herself and decides to practice prostitution in order to save them. If Kieu were a selfish individual, she would have agreed to get married to Kim and le ave her family to suffer. Therefore, in another context, her decisions are admirable and she can be considered to be a bright person. She chooses to assist her family, even though it meant going against social norms and beliefs. Nevertheless, her actions cannot be taken to be those of a hero because the path of prostitution is not a correct one and is not acceptable in any society. Prostitution is immoral and is taken to be lack of respect to oneself and the society at large. Kieu could have made other choices rather than prostitution. Many bright girls around the globe face similar circumstances in life, and prostitution to a morally upright person is immoral. Even though Kieu proved to be morally upright when Kim made sexual advances to her, she later proved to be a weak human being who uses family as a reason to practice prostitution. It is clear that her decision to practice prostitution could not be deterred by social norms and so she had to follow her liberal attitudes to do w hat fulfilled her desire and what she felt was good for her and her family (McLeod and Nguyen 69). Morals are ethics that determine whether the behavior of an individual is good or bad. Every society has its own way of expressing moral behavior and ethics. One may be faced by a situation where the moral behavior can be abandoned in order to save another from bigger problems. For instance, Kieu is forced to join the brothel and start practicing prostitution in a bid to save her father and

Terms of my knowledge Essay Example for Free

Terms of my knowledge Essay In answering to handout 6, I would like to begin with stating that cognitive is private, yet I believe it is psychologys job investigate the phenomenon. To that extent I will use all my acquired knowledge from this class to discuss my interpretations and doubts with handout 6. For the most part I agree that we have set boundaries on what is me or you, although I am having trouble understanding the concept in terms of my knowledge. But I am aware that in order for me to identify me as a self then the other people must have selfs too, yet I do not know if this is was the handout is trying to explain. I believe this is like the idea that if there is good, there must be evil, for one cannot exist without the other. For example, Watson believed the mind was associated with the idea of a soul, which did not fit into science. He wanted scientific results and reactions all of which the mind had no power over and could not do. For Watson the mind could not think because thinking was not observable, therefore he did not accept the mind in this theory. In addition, Watson despised the notion of mind because it gave meaning to self , which also had no place in science. In this sense, Watson wanted to use matter and energy that were useful to him and produced visible results. He had no use for spirits and ideas because those were nothing, and consisted of conjugated notions that people had identities. For this matter he did not like the self set boundaries because they too were not visible. Like in Dr. Wapners story is cognitive because it is based on one individual personal experience. His feelings and emotions for scientific proposes in the story were not observable which means that Watson, would have rejected the story from any psychology class. The story is an example of desire, which can only be felt by the self/ mind and is identifiable by human cognition. The story was written in with a certain identity and acknowledgment of self that became evident in Dr. Wapners need to diet and skip desserts. In addition to the emotions of anticipation, shock, nerves, and anxiety transpired throughout the story are all synonymous to the mind. The cravings observed by the fact that the Eskimo Pie had been secretly hidden for emergencies gave the notion that the self needed comfort in knowing it had support. Whereas behaviorist would have dismissed the cravings in the story because they are unattainable, like the mind and have no scientific base. In addition to Dr. Wapner feeling pressure of not having dessert was building up inside him. The ice cream was needed to function and Dr. Wapners awareness of his need for ice cream was cognitive privacy. I will use Dr. Wapner story because I can really distort it apart and it works well in my paper. But Dr. Wapners need for dessert was private from all the members of his family, and although there was an advantage to his cognitive privacy this can back fire. It is important to note that have is ability because it first, allows us to have selfs. Second it gives people the opportunity to be individuals, or like the handout stated; have more than meets the eye. If people had no boundaries then we as humans would be all part of one gigantic identity, and that as we all know cannot be true. Psychologists in fact dig into those deep thoughts that are not visible to help people with various problems. I have a hard time believing that things and objects have identities separate for what humans are. In fact, I agree that our ( human) identity is more complex than that of a pencil, who is to say what degree of identity an object can have without being it. Form my perspective a pencil is a writing tool that I use, but the pencil might say it is a tool that uses me. I can very simply identify myself as having an identity and be able to distinguish a pencil from a pen, but who is to say that is was not the pencil who distinguishes it self. I am trying to agree that just because we as people have selfs and identities that does not make other objects lesser than us. I believe that in psychology, although it is the study of the mind, we are very self centered and concentrate too much on the small things. As people we are so ego centric that we many time fail to see beyond was our perception and eyes show us, but that topic is for a different paper. Moving on to our self identity and how we define it, I will use my one year old son as an example since he is on the verge of defining his persona. Although it is true that he still has not fully developed a sense of time or space, and that many times he will act on his impulse without regard to the world around him. He is slowly learning how not to do certain things which may have a bad result. For example, I have been teaching him to eat fruit and he has caught on well and likes most fruits accept for oranges. He is very good at eating very thing I give him but he has now learned to differentiate the orange when he looks at it. And every time he see it, hell make a funny face like if I had given him lemon. Now I realized this is something small, but he is developing self identity and he is now telling me what he likes and does not like. I think it is important for psychology to be aware a notion of the self and identity. I do not know if I am right on the spot which is what Dr. Wapner wanted me to understand. I would really like to know if I am on the right track, because it is important for me understand this so that I can incorporate it into my life. I am a strong believer of self identity and believe it is the essence of psychology, and I believe it because I see in my of son. In the last few papers I have written, I really bashed on Watson but I will admit he did try to make psychology real and honest. In all I have learned in this class self-identification as been the most valuable to me in my life. I am also aware that this is Dr. Wapners last quarter teaching and I would like to say that in the few classes I have been in it has been a pleasure.

Analysis Of Clockwork Orange Essay -- essays research papers

Analysis of Clockwork Orange   Ã‚  Ã‚  Ã‚  Ã‚  The film, â€Å"A Clockwork Orange,† is, to me, an almost exact replica of today’s society. Basically, one kid, who seems to have come from a financially sound home and community, goes through about three stages--1. He violates the laws society has set forth to maintain order. 2. He is caught and punished for his crimes against society. 3. He feels remorse for his violence and sexually deviance (although, at the end of the film, he’s back to his old, delinquent self).   Ã‚  Ã‚  Ã‚  Ã‚  The main character, Alex, is shown as a typical juvenile offender. He is shown in such a comparable manner not because all juvenile offenders are out robbing, rapping, and murdering people (although an argument could be made that today’s offenders are as bad, if not worse), but because he can do such things and feel no remorse until he is caught. His parents provide for him, but only in a financial light. What good is it if his parents don’t get involved in his extracurricular activities. He goes out all night doing wrong, and his parents think he’s out working, c’mon!! In today’s society, many parents are at the source of why a child may start to commit crimes. They are not involved, or in some cases just don’t care enough about their children to teach them the rights and wrongs of society.   Ã‚  Ã‚  Ã‚  Ã‚  Alex seemed to find the love he didn’t get from his parents in his friends. Alex and his friends did a lot of damage to others, but of course they did it as a group. They beat up an old man who asked for change, they fought another group of people, they broke into a house and beat up the old man who lived there, then beat up his wife, killing her, but only after they raped her.   Ã‚  Ã‚  Ã‚  Ã‚  As a group they were to be feared, but when two of them tried to stand up to Alex, who was the leader, things seemed amusing to me. Of the two who tried to stand up to Alex, there was one obvious leader, while the other was a follower, again. Alex started beating them up, and while this was happening, the fourth of the group got scared and ran. He didn’t have a mind of his own to take sides either way, he just did what he was told. This shows me that the people who were following Alex were in obvious need of a role model, or even just a hug. Taking terms from chapter six, Alex was not a d... ...rend in our society.   Ã‚  Ã‚  Ã‚  Ã‚  When a 10 year old boy (Robert â€Å"yummi† Sandifer, from Atlanta) in a gang is executed by his gang â€Å"friends† because he was bringing heat from the cops on the gang because that boy shot a 12 year old girl, it’s a sad commentary on society. When there is a lack of social stability in a community, it reflects onto the children who seem to have nothing else to do, or no other way of getting the attention they need.   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"A Clockwork Orange† is a perfect example of a society where it doesn’t matter if your black or white, yellow or purple. If you are human, you could fall into the trap. To me, the trap is where the rich stay rich, the poor stay poor, and the people in the middle work hard to keep from being poor while striving to be rich. I think I had heard that the movie was made in the 70s as a description of the 90s. If this is true, then the creating minds of the film are telepathic, or extremely intelligent. To predict how our society would be in twenty years is either sad because they were right, or great because we should just ask them how our deviant subculture will be acting in the NEXT twenty years.

Advanced practice nurse role within palliative care Essay

The purpose of this assignment is to compare and contrast the current literature related to advanced nursing practice. And to relate this literature to my practice and the role of the palliative care nurse across clinical settings. In my current role as a pain nurse specialist, I am involved in the care and management of patients with intrathecal (IT) catheters mainly for patients with intractable cancer pain. Patients who have been tried and failed on escalating doses of various opiates, and continue to have unsatisfactory pain management with intolerable side effects are often referred to our service for consideration for an intrathecal catheter. Intrathecal catheters have been used for many years now in effort to target the specific pain pathways within the spinal cord, as the medication is delivered directly into the Central nervous system, only small doses are required, and therefore patients experience less side effects, with improved pain control (Myers, J. Chan, V., Jarvis, V., Walker-Dilks, C., 2010). The majority of these patients are approaching the end stages of their disease process, therefore we work quite closely with the hospital Palliative care service when the patient in an inpatient. However post discharge we visit the patients weekly in their own homes, this often involves working at an advanced nursing level, working autonomously, assessing the patient and titrating medication via their IT pump, with some direction from the doctor at Auckland hospital. However this role also involves providing the patient and their family with an element of palliative care also, they often require additional emotional support at this stage. In 2002 the World health organization (WHO) defined palliative care as † An approach that improves the quality of life of patients and their families facing he problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.† Advanced nursing practice refers to nurses working at an expanded level of practice within a specialized area. Advanced practice is generally defined as the integration of practical knowledge, clinical experience, theoretical knowledge and research base, education, and may involve organization leadership (ANA, 1995). The term advanced practice has been given to various roles within nursing, such as Clinical nurse specialists (CNS), nurse practitioners (NP’s) and other specialized roles within nursing, such as the anaesthetic nurse (Davies, Hughes, 1995). The literature related to advanced nursing practice and palliative care was reviewed using online databases, such as Medline, Ovid, Pubmed and the Cumulative index for nursing and allied health literature (CINAHL). Key words used in the search, were ‘advanced practice nursing’, ‘Clinical nurse specialist’, ‘nurse practitioner’, ‘palliative care’ and ‘nurse prescribing†. After reviewing the literature, three articles were selected, and will be summarized below. Article one In 2004 Aigner et al did a comparative study of nursing resident outcomes between care provided by NP/Physicians, compared to Physicians only. The study was based in Texas, USA. The main objective of the study was to determine how the standard of care for nursing homes residents compares when provided by either NP/Physician, or physician only. Eight nursing homes were evaluated, and two hundred and three residents were randomly blinded. Chi-squared tests were used for comparison for the data analysis. Four outcomes were selected to assess the quality of the care provided by the two groups, they were, patients charts were retrospectively reviewed and the following outcome assessed- Number of presentations to the emergency department (ED), the cost of the visit, and the diagnosis. Number of hospital admissions in general, and the cost of being admitted to hospital. The number of acute visits and diagnoses for that visit. The completion of progress notes, patient histories and assessments. Also the average number of medications used by each subject and the number of telephone calls and / or beeps relayed to the nurse practitioner, was collated. Comparisons were also made between the two groups regarding, diagnosis made during acute visits compared to during hospital admissions, and the comparison between the cost of recurrent admissions versus hospitalization (Aigner, M., Drew, S., Phipps, J., 2004). The results overall did not show a significant difference of care provided by either the NP/physician group compared to the physician only group. No decrease was found in the amount of ED presentations and the costs were approximately the same. There was however a significant difference in the amount of acute visits made by the NP/Physician group , which was likely related to an increase presence of the NP in the nursing homes (P If a similar study was to be conducted again, it would interesting to explore patient satisfaction between the two groups, and the satisfaction of the other staff working within each clinical area. And also to look more into cost effectiveness. Article 2 Macmillian nursing was first introduced to the UK in 1975, and today there are over 2000 Macmillan nurses. The role of the Macmillan nurse is a specialist palliative care nursing role that involves expert clinical skills, consultation, education, teaching and leadership (Corner et al, 2002). In 2007 Ryan -Woolley, McHugh, G. and Lucker, K. conducted a study in Manchester, looking at Macmillan nurses view on nurse prescribing in cancer and palliative care medicine. It looked at the perceived motivators of why specialist nurses felt nurse prescribing would benefit them and their patient groups, and also explored the potential barriers to training for the implementation of this extended role. A national postal survey was sent out to 2225 Macmillan nurses throughout the UK, 70% response rate was achieved (1575), 11% of Macmillan nurses who responded were already trained as extended formulary independent nurse prescribers. Half of the nurses (88 of 168) were able to prescribe from the extended drug formulary. The mean age was 43.9 years (SD 7.3), with a range 26-63 years. The majority of the nurses that responded were either working as palliative care clinical nurse specialists (CNS) (772, 49.0%) or tumour site specific CNS (413, 26.2%). Others were either working as different types of CNS in the community (83, 5.3%), oncology (61, 3.9%) and chemotherapy (19, 1.2%) or as a lead cancer nurse (45, 2.9%) (Ryan-Woolley et al, 2007). Extended formulary independent nurse prescribing (EFINP) was initiated in the UK in 2002, to allow patients to get improved access to medicines and also  make the best use of nurses clinical skills and experience. This differs from independent nurse prescribing, as independent nurse prescribers may need to assess and diagnose and treat patients (Ryan-Wooley et al, 2007). 21% or nurses who completed his survey had completed the EFINP course., some had completed other relevant courses that enabled them to be independent prescribers, and 2% were in the process of completing the EFINP course (Ryan-Wooley et al, 2007). In the surveys the overall agreement was that nurse prescribing improved patients care by enabling them to receive their medication in a timely fashion. One quarter of the prescribers felt there were issues around training, and that the medical mentoring was not adequate. Some felt that the training provided was not specific enough for cancer and palliative care nursing. Out of 88 of the nurses who were already prescribing, 44 were community based, 28 were hospital based, and the other 15 were based in both the hospital and community. The majority of the nurses had been prescribing regularly throughout the past month. The qualifications of Macmillan nurses were mixed with around half having a first degree (57%) but only a minority (244 of 1504, 16.2%) having a Masters degree. Some of the barriers for nurse prescribing that were identified in the survey were; Having a supportive organization and team Having medical support Clinical supervision/mentorship Multi-disciplinary team (MDT) support Appropriate guidelines Financial incentive Supported practice and training once practicing Access to GP computer systems (Ryan-Wooley et al, 2007). Article 3 In 2012 Steiner, K., Carey, N, Courtney, M., did a study on the profile and practice of nurses who prescribe pain medication throughout the United Kingdom (UK). They looked at the nurse backgrounds, experience, work setting and prescribing practice. 214 nurses throughout the UK that were on the Association for nurse prescribing (ANP) website were sent a questionnaire. All participants were qualified as nurse independent /supplementary prescribers (NIP/NSP). The questionnaire included fixed choice and open-ended questions. The questionnaire had four sections; Section 1 covered demographic information (age, job title, area of practice, geographical area, type of services provided, how many nurse prescribers the service had, and what future provisions they had in place for nurse prescribers within that clinical area. Section 2 looked at prescribing qualifications, levels of experience and the area they practiced in. Section 3 focused on nurse prescribing within pain management, including the type of medications prescribed and the number of pain medications that would be prescribed during a typical week. Section 4 asked the nurses about the level of training they had received to become a nurse prescriber, and if they were satisfied with the training program that they had undergone, and if they had any unfulfilled training needs. It also asked them what there preferred training method was. Out of the 214 nurses that responded, 35% were in primary health care and nurse practitioners, 11.7% were pain or palliative care nurses and 10% in emergency care. The nurses worked across a variety of settings, both  primary, secondary and tertiary care. 43.1% prescribed pain medications up to 5 times per week, and 42.6% prescribed between 6-20 times per week, and remainder prescribed upto 50 times per week. The main category nurses prescribed medication for was patients in acute pain post surgery (40.6%), 12% prescribed for patients with cancer or advanced illness (palliative care), 12.1% prescribed for chronic pain. A further 33.6% prescribed for patients with a overlap of different pains. The main types of medication prescribed were as follows- Paracetamol and Non steroidal anti inflammatories (95.3%) Opioids (34.6%) Other medications to treat side effects, such as antiemetic’s, were also prescribed by the nurses. The nurses who worked within a pain service or palliative care service were significantly more likely to prescribe opiates than the other participates (p  The lack of training at an appropriate level (n=9) The lack of support for role development (n=1). The preferred learning methods of the nurses surveyed were: Elearning (74.3%) Journals (69.6%) Formal study days (62.6%) Prescribing forum (57.5%) Work-based learning 45.3%) (Stenner et al, 2012). Despite the relatively low sample size, this study clearly identifies that nurses working in a wide variety of settings throughout the UK are prescribing pain medications. It also identifies that nurses in pain specialist or palliative care roles are more likely to have post graduate education in pain management, and also more likely to prescribe strong opioids. Training and development issues were highlighted. DISCUSSION By 2051, it has been predicted that there will be over 1.14 million people aged 65 years and over in New Zealand (NZ statistics, 2000), by 2051 there is likely to be about half as many older people than children (NZ Stats, 2000). In the last decade, the number of people being diagnosed with cancer has increased by 24% (Ministry of health 2001). Therefore there will need to be sufficient palliative care services to meet the needs of an increasing number of people with cancer. Introducing more NP’s into specialist palliative care services would possible be a good way of managing the increased workload predicted. More NP’s in the community and residential care facilities may also take the strain off tertiary centre’s, by  preventing hospital admissions. To assist with the predicted increase having NP or CNS that can prescribe will help ease the burden. The Acute pain service nurse specialists at Auckland city hospital are currently in the process of applying for expanded practice roles, to allow nurses with the correct post graduated training (according to NZ nursing council framework) to prescribe a limited number of medications, working alongside a designated prescriber. In 2013 the NZ nursing council put together a consultation document for expanded/extended nurse prescribing, it stated â€Å"that the reason for this consultation is to improve patient care by enabling registered nurses to make prescribing decisions so patients receive more accessible, timely and convenient healthcare. The role of the Nursing Council is to ensure public safety in reaching that goal. The reasons for extending nurse prescribing are to: †¢ improve patient care without compromising patient safety; †¢ make it easier for patients to obtain the medicines they need; †¢ increase patient choice in accessing medicines; and †¢ make better use of the skills of health professionals† (NZ Nursing council, 2013). In order for nurses to obtain expanded practice roles, professional development and recognition programs (PDRPs) are being introduced, so nurses have a framework to work to (Kai Tiaki, 2009). As discussed in both articles 2 and 3 there are likely to be some implications to the introduction of this new role, such as financial/time restraints, lack of medical support, standardization of training and on going education needed to remain up to date on current practice (Ryan-Wooley at el, 2007, Stenner at el, 2012). However with the continued shortage of doctors and the continued increase for healthcare, especially within the older population, expanding the role of the nurse is a necessary initiative, which is likely to improve patient outcomes (World health organization, 2006). Introducing expanded nurse roles and designated prescribing into palliative care services within New Zealand, especially in primary and residential home settings, may be a good way of managing the predicted increased need for more palliative care services in the future, secondary to the rise in the older population and the number of people being diagnosed with cancer. As mentioned in the above articles it will provide patients with a more effective service that they can access easily, decrease the burden on doctors, provide a more cost effective service, and likely a more holistic approach to patients (Aigner, M et al, 2004). Also more nurses may be inclined to train for the role as the expectation and education required is less than what is required to be an NP. In relation to my role as a pain nurse specialist and caring for palliative patients with intrathecal catheters, I believe the implementation of expanded practice nursing with designated prescribing and or a Nurse Practitioner role would without a doubt improve patient outcomes. Pain is the most concerning aspect for patients (and their family) facing the end stages of their life, and currently cancer pain is under-treated in nearly 50% of patients (Joshi, M., Chambers, W., 2010). At diagnosis 20-50% of cancer patients present with pain and 70 % of patients with advanced disease will require large doses of strong opiates for pain management (Joshi, M., Chambers, W., 2010). These patients will often end up being admitted into hospital for pain management, and management of associated side effects, and the quality of there life is often very impaired due to the side effects of opiates (drowsiness, nausea, pruritis etc ). According to recent figures from Auckland hospital, the cost of an inpatient bed is over $4000 a day. When patients have intrathecal catheters inserted for their pain management, they require significantly less opiate, and therefore side effects are less. With good pain control and minimal side effects these patients can often  return to there homes and have a better quality of life, and not require recurrent hospital admissions for poor pain control, which therefore saves thousands of dollars to the health service. However due to the possible dangerous complications related to Intrathecal analgesia (infection, catheter migration, overdose) (Sjoberg, L., et al, 1991), specialized nursing management is required in the community (Myers et al, 2009). If there were more specialized Nurse practitioners or CNS with delegated prescribing rights, in the primary care setting, patients could be discharged from hospital sooner and medications titrated and symptoms treated within the patients home, without requiring a Doctor to make changes to prescriptions and therefore providing the patient with more effective and timely treatment. Aside from pain and symptom management, having the advanced knowledge and skills to provide the necessary psychosocial, emotional and spiritual support to both patients and their family is also very important in this patient group (O’Connor, M., Lee, S., Aranda, S., 2012). Often time listening and counseling these patients can be more important than the medications (Meier, D,.Beresford, L., 2006) CONCLUSION According to WHO, 56 million people die throughout the world each year, 60% of these people would benefit from palliative care. With the amount of older people in New Zealand predicted to increase so rapidly in the next 50 years, the need for more advanced practice nurses within this specialty is obvious. A comprehensive framework is required to allow nurses to have a sound professional development plan and providing good clinical support and continued opportunities for learning is necessary. Primary health care settings have been highlighted as an area were NP and CNS are in shortage and likely investment in training nurses with the necessary advanced skills to manage palliative patients in the community will be a cost effective investment in future years by keeping patients out of tertiary care, and likely improve patient and family satisfaction by providing a more holistic  approach to the end stages of life. REFERENCES Aigner, M., Drew, S., Phipps, J.,. (2004). A comparative study of nursing home resident outcomes between care provided by nurse practitioners/physicians versus physicians only. _JAMDA_, 16-23. ANA. (1995 ). _Advanced nursing practice_. Davies, B. H., A.,. (1995). Clarification of advanced nursing practice:characteristics and competence. _Clinical nurse specialist, 9_(3), 156-160. Joshi, M., Chambers, W., (2010) Pain relief in palliative care:a focus on interventional pain management, _Expert review of neurotherapeutics, 10,5,_ 747. Meier, D., Beresford, L., (2006) Advanced practice roles in Palliative care:a Pivotal role and perspective, _Journal of palliative care medicine, 9 (3),_ 624-627 Ministry of Health. (2001).The NZ _Palliative care strategy_. Myers, J., Chan, V., Jarvis, V., Walker-Dilks, C.,. (2010). Intraspinal techniques for pain management in cancer patients:a systematic review. _Support cancer care, 18_, 137-149. Nursing council of New Zealand. (2013). Nurse prescribing consultation document. O’Connor, M., Lee, S., Aranda, S. (2012) _Palliative care nursing-A guide to practice.,_ Ausmed publications, North Melbourne , Austrailia. World health organisation. (2002). _Palliative care plan_. Ryan-Wooley, M., G., Lucker, K. (2007). Prescribing by specialist nurses in cancer and palliative care:results of a national survey. _Palliative medicine, 21_, 273-277. Sjoberg, M., Appelgren, L., Einarsson, S., Hultman, E., Linder, L., Nitescu, P., Curelaru, I., (1991) _Long -term intrathcal morpine and bupivicaine in â€Å"refractory† cancer pain. I. Results from the first series of 52 patients, Acta Anaesthesiology Scand, 35_, 30-43 Statistics, N. Z. (2000). _Population ageing in NZ_. Stenner, K., . Carey, N., Courternay, M.,. (2012b). Prescribing for pain-how do nurses contribute? A national questionnaire survey. _Journal of clinical nursing, 21_, 3334-3345.

Group Roles and Norms Essay

Explicit norms are rules that are clearly stated. Implicit norms are hard for people with difficulty with socially-based learning. Roles within groups are different tasks that different people perform and the specific accomplishments each is expected to attain (Baron, Branscombe & Byrne, 2009, p. 384). An example of an explicit role is a professor for a class. The students in the class play the explicit role in the course. The professor’s role is to guide and nurture their students. An implicit role that students have is that they are just as likely to have a great deal to offer to the class as a group if the professor can create a safe, accepting environment that encourages the free exchange of ideas. Norms are rules established by groups which define acceptable and unacceptable behaviors (Baron, Branscombe & Byrne, 2009, p. 387). Horne (2004) specifically focuses on the sanctions which enforce the rules. An explicit norm for the classroom is that the students come prepared to class, as the roles are clearly stated in the syllabus. An implicit norm is that students have to come to class prepared. Students attempt to enforce the implicit norm by letting the instructor know they are prepared for class. An explicit norm is the length of time for classes. The class can deviate from the implicit norm while adhering to the explicit norm that classes will meet the whole length of class time. Some of the initial consequences to deviating from the implicit norm which students are that they wish the professor will follow their body language to let class out early. This reinforces the explicit norm that they will come to class prepared, violating their implicit norm that they will not participate in class. The professor can uses a form of sanctioning called Jeopardy. Professors can have students clear their desk so that students cannot attempt to enforce the implicit norm that class will dismiss early. Rewards are provided by group assessments. Creating accountability, both to the group and to oneself by creating a grading system that balances group work, daily grades, and tests is the best way to ensure a fairly smooth and regular routine to the classroom. Students unwilling to meet these explicit norms will ideally move on quickly to other courses where the implicit norms are more likely to be met or choose to adjust their behavior. References Baron, R. A., Branscombe, N. R., & Byrne, D. (2009). Social psychology (12th ed.). Boston: Pearson Education, Inc. Horne, C. (2004). Collective benefits, Exchange interests, and norm enforcement. Social Forces, 82(3), 1037-1062.

The Colorful History of Lipstick

The Colorful History of Lipstick Lipstick by definition is a cosmetic used to color lips, usually crayon-shaped and packaged in a tubular container. No individual inventor can be credited as the first to invent lipstick as it is an ancient invention, however, we can trace the history of the use of lipstick and credit individual inventors for creating certain formulas and methods of packaging. The First Lip Coloring The actual term lipstick wasnt first used until 1880, however, people were coloring their lips long before that date. Upper-class Mesopotamians applied crushed semi-precious jewels to their lips. Egyptians made a red dye for their lips from a combination of fucus-algin, iodine, and bromine mannite. Cleopatra was said to have used a mixture of crushed carmine beetles and ants to color her lips red. Many historians give credit to the ancient Arab cosmetologist, Abu al-Qasim al-Zahrawi for inventing the first solid lipsticks, which he described in his writings as perfumed sticks rolled and pressed in special molds. Innovations in Lipstick Packaging Historians note that the first cosmetic lipstick manufactured commercially (rather than homemade products) occurred around 1884. Parisian perfumers had begun to sell lip cosmetics to their customers. By the late 1890s, the Sears Roebuck catalog started to advertise and sell both lip and cheek rouge. Early lip cosmetics were not packaged in their familiar tubes that we see used today. Lip cosmetics were then wrapped in silk paper, placed in paper tubes, used tinted papers, or sold in small pots. Two inventors can be credited with inventing what we know as the tube of lipstick and made lipstick a portable item for women to carry. In 1915, Maurice Levy of the Scovil Manufacturing Company invented the metal tube container for lipstick, which had a small lever at the side of the tube that lowered and raised the lipstick. Levy called his invention the Levy Tube.In 1923, James Bruce Mason Jr. of Nashville, Tennessee patented the first swivel-up tube. Since then the Patent Office has issued countless patents for lipstick dispensers. Innovations in Lipstick Formulas Believe it or not, the formulas for making lipstick used to consist of such things as pigment powders, crushed insects, butter, beeswax, and olive oil. These early formulas would only last for a few hours before going rancid and often had ill effects on ones health. In 1927, French Chemist, Paul Baudercroux invented a formula he called Rouge Baiser, considered to be the first kiss-proof lipstick. Ironically, Rouge Baiser was so good at remaining on ones lips that it was banned from the marketplace after being considered too hard to remove. Years later in 1950, chemist Helen Bishop invented a new version of long-lasting lipstick called No-Smear Lipstick that was very successful commercially. Another element of lipstick formulas effects is the lipsticks finish. Max Factor invented lip gloss in the 1930s. Like much of his other cosmetics, Max Factor first invented lip gloss to be used on movie actors, however, it was soon worn by regular consumers

How to Conjugate the French Verb Craindre (to Fear)

How to Conjugate the French Verb Craindre (to Fear) Craindre  (to fear)  is an  irregular -re verb  thats conjugated like all other  French verbs ending in -aindre,  -eindre, and  -oindre.  This is evident in the conjugation table below that shows the simple conjugations of craindre; compound conjugations that consist of the conjugated auxiliary verb avoir and the past participle craint are not included in the table. Craindre: Conjugated Like all verbs ending in -aindre Irregular -re verbs fall into a few patterns that make memorizing their conjugations a little easier: verbs conjugated like prendre, verbs conjugated like battre, verbs including mettre and all its derivatives, those including rompre and its derivatives, and a fifth group including all verbs that end in -aindre like craindre, -eindre like peindre, and -oindre like joindre. A final group of very irregular verbs, such as dire, à ©crire, faire, have such unusual and unwieldy conjugations that they follow no pattern and need to be memorized in order to use them. The fifth group of verbs ending in -aindre like craindre drops the d in the stem in both singular and plural forms and adds a g in front of the n in plural forms. Other verbs like craindre include:   contraindre   to force, to compel  plaindre  Ã‚  to pity, to feel sorry for Usage and Expressions   Craindre is a transitive verb thats used in numerous idiomatic expressions. It can be translated as to fear, to be frightened of, or to be afraid of. The causative se faire craindre means to intimidate. craindre Dieu  Ã‚  to go in fear of / to fear Godcraindre le pire  (familiar)   to fear the worstNe crains rien.  Ã‚   Have no fear. /  Never fear. / Dont be afraid.Il ny a rien craindre.   Theres no cause for alarm. / Theres nothing to fear.Sa grosse voix le faisait craindre de tous ses à ©là ¨ves.  Ã‚  His booming voice made all his  pupils  afraid of him.Elle sait  se faire craindre de ses subordonnà ©s.   She knows how to intimidate her subordinates.Je ne crains pas les piqà »res.  Ã‚  Im not afraid  of injections.Il y a tout craindre dune intervention militaire.   One can expect the worst from a military intervention.Craignant de la rà ©veiller, il a retirà © ses chaussures. He took off his shoes for fear of waking her up.Je crains de lavoir blessà ©e.   Im afraid Ive hurt her.Je crains fort quil (ne) soit dà ©j trop tard.   Im really afraid its already too late.Je crains que oui / non. Im afraid so / not.Ça craint le froid. Its s ensitive to cold.Ça craint. (very informal) Its a real pain. craindre pour quelquun / quelque chose to fear for somebody or something Simple Conjugations of the Irregular French -re Verb Craindre Present Future Imperfect Present participle je crains craindrai craignais craignant tu crains craindras craignais il craint craindra craignait nous craignons craindrons craignions vous craignez craindrez craigniez ils craignent craindront craignaient Pass compos Auxiliary verb avoir Past participle craint Subjunctive Conditional Pass simple Imperfect subjunctive je craigne craindrais craignis craignisse tu craignes craindrais craignis craignisses il craigne craindrait craignit craignt nous craignions craindrions craignmes craignissions vous craigniez craindriez craigntes craignissiez ils craignent craindraient craignirent craignissent Imperative (tu) crains (nous) craignons (vous) craignez

Nike and Adidas Essay Example | Topics and Well Written Essays - 500 words

Nike and Adidas - Essay Example Umbro, Hurley as well as Cole Haan are owned by Nike whereas Reebok, Tylor and Rockport are owned by Adidas. As introduced above, Nike and Adidas are the most popular companies in the world that produce sportswear. Both of their popularity is so significant in the world that they are perceived as household names. Both companies have also the same targets; their target involves people who love sports. Just like Nike, Adidas has also an international awareness because of its sponsorship to professional athletes as well as athletic teams. Adidas cuts its production cost by using low wage labor. The strategies used by the two sports giants in order to win more customers are very similar. For instance, it is evident that both are working extensively towards reducing their costs of production. It is also evident that they both take part in sponsoring different professionals and sports. Additionally, it is also evident that they produced different designs of sportswear so as to capture the interest of their customers. Nike is widely known in the world of not only their sponsorship, but also because of their expansion of their target market to individuals who participate in basketball as well as running. This is evidenced by the contract it signed with a famous basket ball player, Michael Jordan so that he can be its spokesperson. Additionally, it also signed a seven year contract with tennis player Serena Wiulliams so that he can market it in the world. Unlike in the past in which their market was solely domestic (the U.S.), their market has expanded internationally. In addition to changing shoe designs frequently, Nike has also created new appearance of shoes to capture the attention of the bored customers so as to stay ahead of its competitors. In addition to Nike using oversees factories in producing its products; it also maintains a close relationship with its suppliers so as to minimize costs as much as

Perfusion-weighted imaging (PW) MRI (magnetic resonance imaging) Essay

Perfusion-weighted imaging (PW) MRI (magnetic resonance imaging) - Essay Example Either endogenous or exogenous tracers (that is, either native or non-native) can be utilized to regulate haemodynamic quantities, for instance blood movement, blood capacity, and the average time it consumes for the tracer molecule to go through the tissue, or the average transit time. (Luypaert et al., 2001) 1-Exogenous tracer for example gadolinium 2- Utilizing arterial body fluid as an endogenous tracer. 2- Exogenous tracers Perfusion-weighted imaging (PWI) utilizing exogenous tracers confu on magnetic vulnerability and inflow influences to get haemodynamic stats. An exogenous tracer such as gadolinium (in the compound Gd-DTPA or gadolinium diethyltriamine pentaacetate) can be inoculated into the venous mechanism (Luypaert et al., 2001). There is a temporary signal loss as the gadolinium perfuse through the tissues, which can be trailed by MRI. Gd-DTPA is paramagnetic; consequently a change in susceptibility happens between capillaries comprising gadolinium and the nearby tissues . This consequences in robust field gradients in the vicinity of the vessel barriers, bringing to straight signal phasing out in both gradient echo illustrations and diffusion-mediated in spin echo illustrations. Simulation Figure 1: Graphic summary of perfusion-weighted MRI procedure when utilizing intravascular tracers Figure 1 Simulation Figure 2 reveals perfusion-weighted illustrations as gadolinium goes through the brain. There is a postponement before the bolus of tracer blowouts the tissue. As it initializes to rinse through, the signal reduces. As it goes out, the signal returns to normal. Figure 2 Gd appear like to an exogenous tracer that is inoculated into the blood stream and trailed serially with T2*EPI. A signal loss is persuaded every time that GD goes through the capacity of concentration due to the susceptibility influences from the paramagnetic tracer. As it goes through the vessels, a strong gradient is created at the vessel boundaries, which hints to a decrease o f the signal. This damage of signal is proportionate to the concentration of gadolinum. The signal versus time curve can be utilized to make the concentration time curve, which is deconvoluted to get haemodyamic outcomes such as blood movement, blood capacity, and average transit time. Dynamic imaging takes benefit of passing variations in the resident magnetic arena of the adjacent tissue persuaded by a bolus of paramagnetic tracer going through the tissue capillary system. These variations in the native magnetic field can be dignified as signal variation on Magnetic Resonance imaging. Ultrafast illustration methodologies, for example echo planar and helical MR imaging, permit the correct dimension of quickly changing signal variations that are because of the principal permit of the bolus with satisfactory time-based resolution which less than 2 seconds for exposure of the whole brain (Australian Bureau of Statistics, 1999). Signal time progress stats can then be transformed to com parative tracer tissue absorption time progression info. Tracer application time curvatures can then be examined to regulate numerous tissue hemodynamic factors, for example tissue blood capacity, blood movement, transportation time, and bolus