Critical Appraisal The WritePass Journal

Critical Appraisal Introduction Critical Appraisal ). This was a cohort study that used the data from a sample of 91,843 Danish mothers. It was found that 55% of the cohort abstained completely during pregnancy, whilst the rest of the cohort reported consuming alcoholic drinks during this time. The authors reported that there was a substantially increased risk of either spontaneous abortion or stillbirth in women who consumed even moderately low amounts of alcohol (2-3.5 drinks per week) before their 16th week of pregnancy. However, alcohol consumption after 16 weeks appeared not to have an effect. The introduction of this paper is extremely short, although it does manage to summarise why the study was conducted and the aim of the research is clear. The authors highlight that previous research into the effects of moderate alcohol consumption on foetal death have produced conflicting results and that there appear to be geographical trends in the outcome of such studies. Although a lack of conclusive evidence is a solid basis on which to conduct a new study, the authors do not explicitly detail why the current study will be any different and how it will seek to overcome the limitations of previous research. The Critical Appraisal Skills Progamme (CASP, www.casp-uk.net) recommends approaching critical appraisals using three steps. The first step is to assess whether the study is valid by evaluating the methodological quality. The methodology of the current study is clearly laid out and replicable. Despite this, one criticism of the methodology is the use of self-reported alcohol consumption data. Self-reported data is vulnerable to social desirability bias by which participants may withhold or fabricate certain behaviours in order to fit in to what others expectations of them. Social desirability has been found to confound reports of other health related behaviours, such as diet (Klesges et al., 2004) and physical activity (Adams et al., 2005). Using the levels of evidence hierarchy (Foster, 2011), cohort studies lay below systematic reviews and randomised control studies in their ability to avoid bias. Therefore, the study’s design helps reduce the risk of other biases that could confound the results. The statistical analysis used was the hazard ratio. This analysis calculates the ratio of the hazard rate corresponding to the two conditions of an explanatory variable (Spruance et al., 2004). In the current study, it was found that women who drank even just low levels of alcohol during pregnancy had higher hazard rates of early foetal death than those women who abstained. This is a suitable statistical analysis that answers the research question at hand. The second step in the CASP recommendations for appraising evidence is to examine the results. It is important to consider how clinically important the results are and how much uncertainty surround them. Potentially, the current study has excellent clinical utility. Firstly, the sample size was large and as a result, the findings are likely to be very representative of the population as a whole. There is some cultural bias to be aware of as the sample was collected exclusively from a Danish sample. Therefore, the results may not be generalisble to women in other countries. For example, in the UK, alcohol consumption has been found to be much higher, especially among females in their teen years (Mukherjee et al., 2005). The last step suggested by CASP is to assess whether the results are useful. The current results may certainly be useful in the area of health policy development. The knowledge that even low alcohol consumption within the first trimester of pregnancy can increase the risk of foetal death strengthens current Government guidelines that recommend that women abstain completely from alcohol during pregnancy. In the United Kingdom, the Chief Medical Officer currently advises that women should avoid alcohol altogether but that if they must drink, to consume no more than 1-2 units once or twice a week. However, the current paper suggests that just two drinks per week could increase a woman’s risk of losing the baby. Nevertheless, the conclusions drawn by the study are based on the assumption that alcohol consumption contributed to the increased risk of foetal death and should be interpreted with caution. The study did not collect data on various other variables that may have contribut ed to the increased risk, such as illegal drug use during pregnancy has been associated with foetal death (Wolfe et al., 2005). Furthermore, consumption of large quantities of caffeine (Wisborg et al., 2003) has been found to be associated with a higher risk of early foetal death. The current study collected information on coffee consumption and it was found that 32.6% of women consumed between one and seven cups of coffee during their pregnancy. Therefore, coffee consumption and not just alcohol may have had an impact on the results. In the discussion, the authors acknowledge the large number of confounding variables that may have impacted upon the study. The discussion of the study does discuss the potential usefulness of the results. However, the authors state in the introduction that discrepancy amongst previous research was a driving force behind the study but fail to discuss why or how the current study may have alleviated this issue. In conclusion, this is a reasonably strong piece of research that could contribute considerably to health policy. However, it is flawed in some key areas and so the results should be interpreted with caution. For example, if the study is to be replicated, future researchers may consider additional outcome measures that could identify participants at risk of social desirability bias. Nevertheless, the finding that even very low consumption of alcohol before the 16th week of pregnancy may contribute to early foetal death suggests that this should be further investigated as health policy may subsequently consider recommending women abstain completely from alcohol until after their 16th week. References Adams, S.A., Matthews, C.E., Ebbeling, C.B., Moore, C.G., Cunningham, J.E., Fulton, J. and Herbert, J.R. (2005) The effect of social desirability and social approval on self reports of physical activity. American Journal of Epidemiology, 161(4), pp. 389-398. Andersen, A.N., Andersen, P.K., Olsen, J., Gronbaek, M. and Strandberg-Larsen, K. (2012) Moderate alcohol intake during pregnancy and risk of fetal death. International Journal of Epidemiology, 41, pp. 405-413. Foster, N. (2011) Making sense of the evidential hierarchy. In: Carmen, A. (Ed), Assessing Evidence to Improve Population Health and Wellbeing. Exeter: Learning Matters Ltd. Klesges, L.M., Baranowski, T., Beech, B., Cullen, K., Murray, D.M., Rochon, J. and Pratt, C. (2004) Social desirability bias in self-reported dietary, physical activity and weight concerns measures in 8-to-10-year-old African-American girls: results from the Girls health Enrichment Multisite Studies (GEMS). Preventative Medicine, 38, pp. 78-87. Mukherjee, R.A.S., Hollins, S., Abou-Saleh, M.T. and Turk, J. (2005) Low level alcohol consumption and the fetus. British Medical Journal, 330(7488), pp. 375-376. Spruance, L.S., Reid, J.E., Grace, M. and Samore, M. (2004) Hazard ratio in clinical trials. Antimicrobial Agents and Chemotherapy, 48(8), pp. 2787-2792. Wisborg, K., Kesmodel, U., Bech, B.H., Hedegaard, M. and Henriksen, T.B. (2003) Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: prospective study. British Medical Journal, 326, pp. 420. Wolfe, E.L., Davis, T., Guydish, J. and Delucchi, K.L. (2005) Mortality risk associated with perinatal drug and alcohol use in California. Journal of Perinatlogy, 25, pp. 93-100.

Carbon Monoxide Detectors and How They Work

Carbon Monoxide Detectors and How They Work According to the Journal of the American Medical Association, carbon monoxide poisoning is the leading cause of accidental poisoning deaths in America. Carbon monoxide detectors are available, but you need to understand how they work and what their limitations are in order to decide whether or not you need a detector and, if you purchase a detector, how to use it to get the best protection. What is Carbon Monoxide? Carbon monoxide is an odorless, tasteless, invisible gas. Each carbon monoxide molecule is composed of a single carbon atom bonded to a single oxygen atom. Carbon monoxide results from the incomplete combustion of fossil fuels, such as wood, kerosene, gasoline, charcoal, propane, natural gas, and oil. Where is Carbon Monoxide Found? Carbon monoxide is present in low levels in the air. In the home, it is formed from incomplete combustion from any flame-fueled (i.e., not electric) device, including ranges, ovens, clothes dryers, furnaces, fireplaces, grills, space heaters, vehicles, and water heaters. Furnaces and water heaters may be sources of carbon monoxide, but if they are vented properly the carbon monoxide will escape to the outside. Open flames, such as from ovens and ranges, are the most common source of carbon monoxide. Vehicles are the most common cause of carbon monoxide poisoning. How Do Carbon Monoxide Detectors Work? Carbon monoxide detectors trigger an alarm based on an accumulation of carbon monoxide over time. Detectors may be based on a chemical reaction causing a color change, an electrochemical reaction that produces current to trigger an alarm or a semiconductor sensor that changes its electrical resistance in the presence of CO. Most carbon monoxide detectors require a continuous power supply, so if the power cuts off then the alarm becomes ineffective. Models are available that offer back-up battery power. Carbon monoxide can harm you if you are exposed to high levels of carbon monoxide in a short period of time, or to lower levels of carbon monoxide over a long period of time, so there are different types of detectors depending on how the level of carbon monoxide is measured. Why is Carbon Monoxide Dangerous? When carbon monoxide is inhaled, it passes from the lungs into the hemoglobin molecules of red blood cells. Carbon monoxide binds to hemoglobin at the same site as and preferentially to oxygen, forming carboxyhemoglobin. Carboxyhemoglobin interferes with the oxygen transport and gas exchange abilities of red blood cells. The result is that the body becomes oxygen-starved, which can result in tissue damage and death. Low levels of carbon monoxide poisoning cause symptoms similar to those of the flu or a cold, including shortness of breath on mild exertion, mild headaches, and nausea. Higher levels of poisoning lead to dizziness, mental confusion, severe headaches, nausea, and fainting on mild exertion. Ultimately, carbon monoxide poisoning can result in unconsciousness, permanent brain damage, and death. Carbon monoxide detectors are set to sound an alarm before the exposure to carbon monoxide would present a hazard to a healthy adult. Babies, children, pregnant women, people with cir culatory or respiratory ailments, and the elderly are more sensitive to carbon monoxide than healthy adults. Where Should I Place a Carbon Monoxide Detector? Because carbon monoxide is slightly lighter than air and also because it may be found with warm, rising air, detectors should be placed on a wall about 5 feet above the floor. The detector may be placed on the ceiling. Do not place the detector right next to or over a fireplace or flame-producing appliance. Keep the detector out of the way of pets and children. Each floor needs a separate detector. If you are getting a single carbon monoxide detector, place it near the sleeping area and make certain the alarm is loud enough to wake you up. What Do I Do if the Alarm Sounds? Dont ignore the alarm! It is intended to go off before you are experiencing symptoms. Silence the alarm, get all members of the household to fresh air, and ask whether anyone is experiencing any of the symptoms of carbon monoxide poisoning. If anyone is experiencing symptoms of carbon monoxide poisoning, call 911. If no one has symptoms, ventilate the building, identify and remedy the source of the carbon monoxide before returning inside, and have appliances or chimneys checked by a professional as soon as possible. Additional Carbon Monoxide Concerns and Information Dont automatically assume that you need or dont need a carbon monoxide detector. Also, dont assume that you are safe from carbon monoxide poisoning just because you have a detector installed. Carbon monoxide detectors are intended to protect healthy adults, so take the ages and health of family members into account when assessing the effectiveness of a detector. Also, be aware that the average life span of many carbon monoxide detectors is about 2 years. The test feature on many detectors checks the functioning of the alarm and not the status of the detector. There are detectors that last longer, indicate when they need to be replaced, and have power supply backups you need to check to see whether a particular model has the features you require. When deciding whether or not to purchase a carbon monoxide detector, you need to consider not only the number and type of carbon monoxide sources but also the construction of the building. A newer building may have more airtight construction and may be better insulated, which make it easier for carbon monoxide to accumulate.

PROJECT MANAGEMENT - TASK 2 Summary Essay Example | Topics and Well Written Essays - 4000 words

PROJECT MANAGEMENT - TASK 2 Summary - Essay Example The roles of the team manager and those of the team tend to be different in each project, especially so in creative projects like this one. The current level of engagement with projects has fuelled concerns that Project Management (PM) is becoming an increasingly complex discipline. Lack of clarity is probably among the major causes why projects fail. This vagueness ultimately results in missed deadlines, confusion among team members and costs going way over the top. It was my job as team manager to confront and eliminate them. The problems were partly due to an improper understanding of what projects were. A project is a series of tasks executed as part of a temporary undertaking to help create a service or product, which is unique in nature. The endeavour is temporary owing to the fact that the team members will disperse and then be involved in other projects. The time bound nature of the project made it very critical that we had no cost overruns and I had to have an ongoing perspective on the planning and implementation. Any spillage of resources would have diluted the objective. This time around, I felt that the event we were involved with was vital in its outcome. The funds raised were to be directed for the construction of orphanages. Moreover, the project was our responsibility till the end. The connections to be made on the way were several in numbers making it necessary for us to be in control of the project from the beginning. Eventually these techniques, which I considered appropriate to the outcome, were accepted by a senior management team. The idea was to smoothly control the three elements of tasks, resources, and time. (Turner, 2000) The following sections are a critical look at the tools used: Value Tree or Work Breakdown Structure (WBS) In discussions with team members, I noticed that WBS as a monitoring tool was not taken seriously enough by those entrusted with project execution. However, I can confidently claim now that WBS aligned with Value Tree has contributed tremendously to our recent fundraiser music show staged for a charity. However, initially there were difficulties in perception and the following is a note on the progress to final adoption of this analytical process culminating in our huge success. (Stainton, 1999) The Problem Value Management was perceived by my team to be peripheral to the core activity. The technique is actually employed in the early stages of a project so that preparations lead to the proper

Managing financial resources and decisions Essay

Managing financial resources and decisions - Essay Example Broadly, the types of sources of finance are divided into two categories namely: 1. Internal sources of finance 2. External sources of finance Different types of business have different sources of funds. The most common types of business are: sole trader, partnership, public limited company, and private limited company. Sole Trader: This form of business consists of one individual owner who is legally not disconnected from the business. But the company and personal accounts are separated. The internal sources of funds for this type of business only include the sale of the goods and stocks. This source of finance is short term as the money from sales of goods is first used for covering the operating expenses of the company (Arnold, 2008). On the other hand, the external sources of finance available to sole trader consist of different loans from banks or venture capitalists. This also includes secured loans, leases, and grants from government. The sale of the goods and stocks is only b eneficial in the short term, however the loans from banks can be beneficial for the sole trader for long term financing. The venture capitalists demand for high interest rates (Gitman, 2003). ... Private Limited Company: In this form of the business, the shares of the business are sold on private basis only by the consent of the board of directors. This type of business is normally popular for the family businesses. The organisation has control over the distribution of the shares and can decide who can own the shares of the company. Private limited company has more long term internal sources of funds. The company can sale the shares and also assets in order to raise finance. Along with this the directors of the company can also decide to issue new shares. The external sources of funds available for the private limited company includes: debentures, loans from banks, grants from government, and also funds from venture capitalists (Khan, 1993). The internal sources of funds like sale of shares can result in diluting the ownership of the organisation. The grants from government can be beneficial for long term financing (Gitman, 2003). P2: IMPLICATIONS OF THE DIFFERENT SOURCES OF FINANCE: Different sources of finance have different implications associated with them. For instance, the option of issuing new shares for the private limited company can result in diluting the ownership of the organisation. Also, different external sources of finance have different implications and influence on the business. All external sources of finance results in increasing the short term and long term liabilities of the company. The internal sources of funds can be beneficial for the private limited companies in the long run but the sole traders and partnership forms cannot use internal sources for the long term objectives and aims (Atkinson, Kaplan, Matsumura, & Young, 2007). P3: EVALUATION OF THE APPROPRIATE SOURCES OF

No need for topic Essay Example | Topics and Well Written Essays - 2500 words

No need for topic - Essay Example The Foreign Corrupt Practices Act of 1977, FCPA was enacted to reduce corruption in foreign markets. Therefore, the act was enacted to correct market failures. Corruption involves using money or other resources to influence the decisions of an individual in preferring one entity to the detriment of others. Companies that did not participate in corruption in foreign markets lost to those that did in awarding of government contracts and in venturing into new markets. This was a major problem that characterized market failure. Moreover market failure occurs in cases where there are weak laws to discipline and monitor institutions. Institutions will fail to protect their investors due to managerial misconducts. Consequently, both investors and customers lose huge amounts of investments.3 Examples of these include Enron, Global Crossing and WorldCom corporations that failed due to bad managerial decisions. Government failure on the other hand arises in cases where a government has created major inefficiencies by failing to intervene at the initiate stages of a problem when it could have been more appropriate to solve it more efficiently.4 Such intervention is of many benefits to the investors and consumers. Pareto optimization may be used to measure the extent of government failure in the same way it is used to measure the extent of market failure. Public choice theory explains government failure in a market. The theory stipulates that an individual will be more inclined to be motivated by self-interest, though some may base their actions on the concern for others.5 Government’s failure to prevent such selfish behavior among individuals at the expense of others is the main factor leading to government failure. Therefore, a government is responsible for putting in place checks and balances to ensure organization discipline in insuring investors against losses.6 i. Considering the two cases, market failure explains the policy behind Foreign Corrupt Practices Ac t of 1977, FCPA. Market failure involves unfair balance of resources that may lead to monopoly, lack of information, lower public good, among others. Most foreign corruption acts involved a company bribing foreign officials in foreign markets to have unrestrained access to resources, to block competitors from accessing resources or from enjoying government contracts, and blocking some companies from accessing the market. This resulted in creation of monopolies, and use of resources that did not accord to the public’s good. Therefore, the policy was as result of market failure. b. A negative externality that may result from market failure is damage to environment quality. When companies are allowed to harness resources in a country, most companies do not have regard to environmental degradation, and the effects it will have to the public. Companies will be more concerned on tapping resources for their production and not taking care of the environmental concern from people invo lved. When such companies have a monopoly over such resources, the general public may not benefit; the companies over exploit resources for profitability. An example is in the mining sector. Some companies are awarded rights to harvest certain minerals mostly in developing countries to contribute to the overall GDP of a country in exports. However, such companies leave large gaping holes of dilapidated land. Some do not take

Subjective Health Assessment

Subjective Health Assessment Despite the importance of an individual’s perspective of their health and wellbeing, individuals are extremely influenced by the extent to which their treatment outcomes meet their expectations (O’hagan et al., 2014). This is why it is important for nurses to incorporate the individual’s perspective into the interventions; to accomplish this nurses need to use effective communication, such as verbal and non-verbal techniques, to receive the appropriate subjective health information (O’hagan et al., 2014). Nurses further must implement the individual’s perspective into the development of nursing interventions; this will help influence a positive recovery (O’hagan et al., 2014). This essay will define communication in the context of nursing; it will discuss the process followed regarding the selection of an individual and the arrangements made, also which interview techniques were utilised. The essay will further discuss the health strengths of an individual, as well as any health concerns which may benefit from health promotional education. Lastly, there will be a summary about what I learnt from this assignment. It is crucial to understand the importance of communication in the context of nursing, in order to implement it in a nurse-client relationship. Communication is central to human interaction, as it allows individuals to establish, maintain and improve contact with each other (Juvà ©-Udina et al., 2014). The word communication originates centuries ago from the Greek word â€Å"communis† meaning to make common (O’hagan et al., 2014). Tay, Hegney and Ang (2011) define communication as ‘a two-way process –sending the right message that is also being correctly received and understood by the other person’. Communication in the context of nursing is where the nurse and patient perceive the other in the situation and, through communication of verbal and non-verbal messages, sets goals, and agrees on interventions to help achieve these goals (Tay et al., 2011). The initial goal for this assignment is to find a healthy individual between the ages of thirty and sixty five who is not a friend, family member or anyone I knew well. This was achieved by ringing my aunty and asking if she knew anyone in the area that would be happy to help with my assignment. My aunty gave me the phone number and the email of a colleague; from here I sent an email explaining the â€Å"subjective health assessment† project to her. Jenny (pseudonym) promptly replied saying she would be happy to assist, when she agreed I emailed her a consent form. I also ensured her that to be in accordance with The Nursing Council Code of Conduct (2012) as a student nurse I must respect her rights to confidentiality and therefore any personal or identifiable information will be altered to protect her privacy and dignity. From here we arranged to have the interview take place at her house as it would not only be private but it would help ensure that she feels comfortable, we worked out a time that suited us both and decided at 10am on Wednesday 30th of July. The quality and reliability of information is influenced by the way in which information is collected, which is related to the use of nonverbal and verbal communication (Jarvis, 2012). Nonverbal communication of appearance, demeanour, facial expression, silence, and listening are highly influential. I incorporated all these aspects into my interview. Firstly I wore my nursing uniform which made my appearance look professional, and kept a neutral friendly expression throughout the interview. I also made sure my attitude was non-judgemental and that we were seated at eye level; this helped to maintain eye contact which showed that I was alert and listening to her. Sitting at eye level also helped make us both feel equal as no one had an authoritative role over the other. However, verbal communication is just as important as nonverbal communication. I ensured that all the questions I asked were open ended this allowed Jenny to expand in areas which provided me with relevant and detailed information. Also, by using the communication technique refection I was able to respond in a way that allowed Jenny to realise that I was listening and understanding what she was communicating. June has the belief that, for her age she is healthy and she is content with her current level of health. She lives a healthy lifestyle and has few health issues. Junes health and wellbeing is supported by having had completed all of the immunisation programs recommended for her through her childhood. These immunisations are very important during an individual’s childhood as it protects children from negative impacts of illness (Grant, Luxford, Darbyshire, 2005). However, even though June completed these immunisation programs she still contracted chicken pox at seven years of age. This is an extremely contagious disease which is spread by the same methods as the common cold such as coughing, sneezing and skin to skin contact (Grant, Luxford, Darbyshire, 2005). There are many things that influence an individual’s overall health, and the likelihood of developing diseases (Jarvis, 2012). Diseases can occur due to a combination of genetic, lifestyle and environmental factors (Jarvis, 2012). In the context of Jennys health she is unaware of any hereditary diseases in her family history. This is a great strength to have as Jenny does not have any increased risks of getting genetic disorders or passing them onto her children. Another strength Jenny has is that she works on a farm; this means she is often outdoors in the natural environment. Tardona, Bozeman and Pierson (2014) research indicates that exposure and experiences in natural environment can improve wellbeing by increasing self-esteem, spiritual well-being, cognitive functions and relieving stress. This shows that Jenny is free of health illnesses and her job contributes to her overall wellbeing Peterson (2000) discusses how this is a proven benefit not only to the individual but the family as well. Regular exercise and sleep patterns are more beneficial strengths displayed by Jenny which contributes positively to her overall wellbeing. Ekblom-Bak, Ekblom, Vikstrà ¶m, De Faire, and Hellà ©nius (2014) discusses how at least 150 minutes per week of moderate to vigorous exercise is important for maintaining a healthy lifestyle. Jenny well and truly does more than 150 minutes per week as she motivates herself to go for a power walk every day for around an hour. Kemmler and Von Stengel (2013) research shows that there is a lower chance of experiencing heart disease, some cancers, stroke and type two diabetes when regular exercise is implemented into everyday life. Exercise further helps to improve sleeping patterns. As Jenny is a farmer she has to wake up at 5am most mornings, this results in Jenny having to manage her time well to make sure she gets enough sleep. Jenny goes to sleep around 9.30 at night usually without waking throughout the night and does not nap throughout the da y this shows Jenny has healthy sleep patterns. According to Gruber (2013) healthy sleep patterns are shown to have a positive impact on an individual’s body as it enables the individual to cope with everyday living tasks. Musculoskeletal disorders are the main representation for absence at work worldwide, Jenny experiences back pain which is increased by stress (Là ¶vgren, Gustavsson, Melin, Rudman, 2014). Lundberg and Melin (2002), look at how the conditions at work, such as time pressure and heavy lifting, can contribute to elevated stress levels and muscular tension. They further explore how the elevated levels of stress can reduce the time for rest and recuperations (Lundberg Melin, 2002). Therefore it is important for Jenny to implement interventions that help improve her back pain, when Jenny is at work she could limit the amount of heavy lifting she does and also be educated on the correct lifting technique to avoid further injuries or strains to her back. Jenny can further implement the use of over the counter medication such as deep heat to help relieve the pain and tension in her muscles. The increasing instability in the economic sector and the increase in unemployment rates are likely to trigger financial worries, which can contribute to fatigue levels (Stewart, Abbey, Meana Boydell, 1998). This is because financial worries present themselves as a psychological threat which is prolonged and chronic in nature. This causes an increase in fatigue levels as our bodies are not designed to cope with prolonged periods of increased stress hormone (cortisol) levels (Stewart et al., 1998). In Jennys context she has a job however she still feels financially unstable which could be related to her increased levels of fatigue. Therefore Jenny needs to implement interventions such as seeing a financial consultant to help her understand her future options and avoid finical crisis. Through completing this assignment I feel I now have a greater understanding of the importance of communication in a nurse-client relationship. I learnt that without using proper communication skills you will be unable to understand the individual’s perspective of their health and what they want in life. What I found is that by being non-judgemental and honest throughout the interview developed the nurse-client relationship more, which is extremely important with the client as they are the primary source of information. I believe this was shown when Jenny felt respected as she opened up more by telling me more about her life instead of answering briefly. I further understand the importance of asking open ended questions and using non-verbal communication skills as if I had not the information I received would have been different. I also learnt the importance of taking your time and just listening to the client, especially in Jennys case as she got very excited talking about he r children and upset when I approached the subject of finical stability. So from this I understood that her major worries and weakness in her life is to do with finical pressure and that her children provide her with a source of happiness. In conclusion, effective communication provides nurses with a way to gather information from a client successfully. This essay looked at how I went about selecting an individual and the arrangements made. While also disusing how non-verbal techniques of eye contact and appearance helped make Jenny feel comfortable and verbal techniques of open ended questions to receive more relevant detailed information. This essay further suggested that Jenny’s strengths included having a healthy childhood, no hereditary diseases in the family history, working on a farm and having regular exercise and sleep patterns. However Jenny’s weakness of back pain and feeling financial unstable can lead to health issues which is why interventions of education of proper lifting techniques, using deep heat and seeing a financial advisor can help Jenny’s overall health. This essay also looked at what I learnt from completing this assignment which was that communication skills majorly affect the quality of the information gathered and the trust between a nurse and a client. Reference List Ekblom-Bak, E., Ekblom, B., Vikstrà ¶m, M., de Faire, U., Hellà ©nius, M. (2014). The importance of  non-exercise physical activity for cardiovascular health and longevity. British Journal Of  Sports Medicine, 48(3), 233-238. Retrieved from  http://eds.a.ebscohost.com.ezproxy.massey.ac.nz/eds/pdfviewer/pdfviewer?sid=605a2018-d38e-4eef-945d-f1ae2481136a%40sessionmgr4005vid=3hid=4211 Grant, J., Luxford, Y., Darbyshire, P. (2005). Culture, communication and child health. Contemporary Nurse, 20(2), 134-142. Gruber, R. (2013). Making room for sleep. Journal of Canadian Psychology/ Psychologie canadienne, 54(1), 62-71. Jarvis, C. (2012). Physical Examination and Health Assessment. Chatswood, NSW: Elsevier Juvà ©-Udina, M., Pà ©rez, E., Padrà ©s, N., Samartino, M., Garcà ­a, M., Creus, M., Calvo, C. (2014).  Basic Nursing Care: Retrospective Evaluation of Communication and Psychosocial  Interventions Documented by Nurses in the Acute Care Setting. Journal Of Nursing  Scholarship, 46(1), 65-72. doi:10.1111/jnu.12062 Kemmler, W., Von Stengel, S. (2013). Exercise Frequency, Health Risk Factors, and Diseases of  the Elderly. Archives Of Physical Medicine Rehabilitation, 94(11), 2046-2053. Retrieved from http://www.sciencedirect.com.ezproxy.massey.ac.nz/science/article/pii/S000399931300422X Là ¶vgren, M., Gustavsson, P., Melin, B., Rudman, A. (2014). Neck/shoulder and back pain in new  graduate nurses: A growth mixture modeling analysis. International Journal Of Nursing  Studies, 51(4), 625-639. doi:10.1016/j.ijnurstu.2013.08.009 Lundberg, U., Melin, B. (2002). Stress in the development of musculoskeletal pain. Pain Research and Clinical Management 12 (1), 165-179. OHagan, S., Manias, E., Elder, C., Pill, J., Woodward-Kron, R., McNamara, T., McColl, G.  (2014). What counts as effective communication in nursing? Evidence from nurse educators  and clinicians feedback on nurse interactions with simulated patients. Journal Of Advanced  Nursing, 70(6), 1344-1355. doi:10.1111/jan.12296 Peterson, G. (2000). Making Healthy Families. Berkeley, Calif: Shadow and Light Publications. Stewart, D., Abbey, S., Meana , M., Boydell, K. (1998). What makes women tired: A community sample. Journal of Womens Health, 7(1), 69-76. Tardona, D. R., Bozeman, B. A., Pierson, K. L. (2014). A Program Encouraging Healthy Behavior,  Nature Exploration, and Recreation through History in an Urban National Park Unit. Journal Of  Park Recreation Administration, 32(2), 73-82. Retrieved from http://eds.b.ebscohost.com.ezproxy.massey.ac.nz/eds/pdfviewer/pdfviewer?vid=11sid=b0ae001b-42b0-4b53-83c8-7d6bbdf8bada%40sessionmgr198hid=107 Tay, L., Hegney, D., Ang, E. (2011). Factors affecting effective communication between registered  nurses and adult cancer patients in an inpatient setting: a systematic review. International  Journal Of Evidence-Based Healthcare, 9(2), 151-164. doi:10.1111/j.1744-1609.2011.00212.x Nursing council of New Zealand. (2012).Code of conduct. Retrieved from http://file:///C:/Users/Jessica/Downloads/Nurses%20Code%20of%20Conduct.pdf

The Controversy Over the Electoral College System Essay -- Politics Po

The Controversy Over the Electoral College System A number of Americans fail to realize that when they vote they are not voting for the president and vice-president directly, but for electors who then cast their ballots in the Electoral College. Until the recent battle between Gov. George W. Bush and Vice-president Al Gore for the presidency, this new generation of American voters has never witnessed a controversial election. Historically, there have been problematic elections allowing voters to question this system. The Electoral College is now a process open to criticism and debate, specifically because many do not understand its origin or purpose today. On November 7, 2000, Election Day, I was excited to become an official voter. Considering myself mature, responsible, and finally of age to vote, I had mailed my registration, received my voter’s card, ready to become a participant in one of the most crucial events of the year. I was a faithful supporter of my candidate, crossing my fingers in hopes of victory. That night I watched CNN, eating my dinner and sipping a Diet Coke when the station announced Al Gore had won Florida, which held twenty-five electoral votes. Two hundred and seventy are needed to win, and presidential candidates Bush and Gore had switched leads all night. Each state held a close percentage ranging from an average 2-6 percent difference in votes between candidates. Florida had been anticipated as a Republican victory, which led to disappointment among Republican voters when its electoral votes were awarded to Al Gore. I continued to watch as each state was announced and electoral votes were awarded to either candidate. About an hour later, Florida became â€Å"too close to call† and CNN among other st... ... situation may cause discouragement in some voters, but in others motivation to become a participant in voting for entrusted electors to select our next president. Between the presidential candidates, whomever wins among this controversy should be respected and relied upon to reunite a divided country. Americans must have faith in a system that despite its flaws works and has set us apart from other nations in our freedoms and rights. Works Cited Best, Judith A. The Choice of the People? Debating the Electoral College. England: Rowman & Littlefield Publishers, Inc., 1996, pgs. 43-44. Glennon, Michael J. When No Majority Rules: The Electoral College and Presidential Succession. Washington D.C.: Congressional Quarterly Press, 1993, p.20. Schmidt, Shelley, and Bardes. American Politics and Government Today. Wadsworth Publishing Company, 1999, pgs. 325-327.