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How To Write An A Paper

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Difference Between Research Paper Writing And Thesis Writing, Best Online Writing Service In Canada

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Writing A Research Paper

Writing A Research Paper Be particularly careful with acronyms and initials and formulae. Explain as soon as, then use the total label every 5 or 6 instances the acronym or method is subsequently deployed. Always re-label or re-clarify when you stop utilizing an acronym or formulation for 200 words or a page, however now are going to restart. If you must use specialist vocabulary (‘jargon’) â€" and in academic work, generally you must â€" maintain it to a minimal, and explain all terms prone to be unfamiliar when you first use them. Next clarify early on in your body textual content the core of your discovering or argument from the journal model. Lastly, embrace a couple of (fourâ€"5) traces of ‘bio’ about your self. Ideally this could give your organizational place, hyperlink to your Twitter, Facebook or email accounts, and perhaps briefly point out latest books or other key works. For the LSE blogs and many good high quality retailers, we additionally need a small photograph of every creator. Writing a blogpost is a good digital networking opportunity, and these elements all help maximize readers’ capacity to find out extra about you and your work. Search through the documents inside Microsoft Word and gather writing and language ideas whereas writing. Get sentence, paragraph and document degree outcomes. Each essay have to be accompanied by a $70 submission fee. We can bill your existing account for the new submission. Do not replace your account with the brand new information until you could have heard from us. You could submit a historical past research paper to The Concord Review should you accomplished the paper earlier than finishing secondary school and you have not but enrolled in a college or university. The paper must be in English and may not have been previously revealed besides in a publication of a secondary faculty that you just attended. It's finals week and I even have to finish my essay instantly. Dashlane helps each regionally-saved passwords and a cloud-primarily based version. It's free to use on one pc, compared to $24.ninety nine for 1Password. But Dashlane is pricy for people who wish to hold their passwords synchronized across multiple gadgets. And if a bit further on you spot any errors, just resend the texts with corrections marked on and it’s good as new, either instantly or within a day. They believe that point devoted to a blogpost is time away from your major research â€" it’s not. Bring all your team’s ideas and visuals together. Collect inspiration from apps like Pinterest and YouTube, exchange ideas in actual time, and get feedback. Just drag and drop your personal recordsdata out of your pc, shared network drive or cloud. Unfortunately another multi-writer or group blogs will nonetheless drastically prune or omit these elements, but a minimum of you’ll have tried. Write shorter paragraphs than in a journal â€" say one hundred fifty words. But don’t write bitty textual content the place every sentence is its own paragraph â€" that type may work for press releases, however strange readers will quickly find it disorganizing. Proper paragraphs are models of thought â€" they give your text a delicate sub-construction that makes it much more understandable, when accomplished properly. Next do away with the long literature evaluation at the beginning â€" in the weblog context, nobody cares about educational credentializing or level-scoring. Also minimize out most of any closing dialogue of how your results agree with or diverge from different individuals’s work. A line or two somewhere close to the beginning, after which 2 lines of closing ideas or pointers at the end of the submit, normally suffices. And yet we know an enormous fraction of analysis continues to be being churned out solely in obscure shops read by very few people. It takes the ‘memes’ key to your research into a limited viral unfold. It additionally gets read by lecturers exterior your instant sub-area and self-discipline, probably pulling new audiences to your work. You get your 1,000 words completed in Word or equivalent. Include a desk or a chart or two, being scrupulous to current them properly. You get an e-mail by return saying ‘Great let’s do it’, and a couple of days later your text is online at the weblog. Finally, of course a blogpost might nicely not be cited itself (though now reputable multi-author blogs increasingly are) â€" but when not, this is because it’s job is totally different. Academically a blogpost boosts citations for the core article itself. It advertises your journal article in ways that may get it much more extensively learn than simply pushing the article out into the ether to sink or swim by itself. A post reaches other researchers in your discipline . And as a result of it’s accessibly written, it travels well, goes abroad, will get re-tweeted and re-liked. Instead, move straight to what worked in your analysis or experiment or archive search, etc. and tell readers clearly what you found or concluded. In a blogpost one of the best bits arrive early on, not just on the finish. Cut out any textual content from your article covering intermediate stages, or earlier models, or avenues taken that did not result in results. It’s made out there only as onerous-boiled, jargon-prone and inaccessible textual content. It’s illustrated with mounds of ‘lifeless on arrival’ information that no one will ever look at again. Little marvel that folklore has it that 90% of journal articles go uncited, even by the original writer.

Writing A Research Paper

Writing A Research Paper Be particularly careful with acronyms and initials and formulae. Explain as soon as, then use the total label every 5 or 6 instances the acronym or method is subsequently deployed. Always re-label or re-clarify when you stop utilizing an acronym or formulation for 200 words or a page, however now are going to restart. If you must use specialist vocabulary (‘jargon’) â€" and in academic work, generally you must â€" maintain it to a minimal, and explain all terms prone to be unfamiliar when you first use them. Next clarify early on in your body textual content the core of your discovering or argument from the journal model. Lastly, embrace a couple of (fourâ€"5) traces of ‘bio’ about your self. Ideally this could give your organizational place, hyperlink to your Twitter, Facebook or email accounts, and perhaps briefly point out latest books or other key works. For the LSE blogs and many good high quality retailers, we additionally need a small photograph of every creator. Writing a blogpost is a good digital networking opportunity, and these elements all help maximize readers’ capacity to find out extra about you and your work. Search through the documents inside Microsoft Word and gather writing and language ideas whereas writing. Get sentence, paragraph and document degree outcomes. Each essay have to be accompanied by a $70 submission fee. We can bill your existing account for the new submission. Do not replace your account with the brand new information until you could have heard from us. You could submit a historical past research paper to The Concord Review should you accomplished the paper earlier than finishing secondary school and you have not but enrolled in a college or university. The paper must be in English and may not have been previously revealed besides in a publication of a secondary faculty that you just attended. It's finals week and I even have to finish my essay instantly. Dashlane helps each regionally-saved passwords and a cloud-primarily based version. It's free to use on one pc, compared to $24.ninety nine for 1Password. But Dashlane is pricy for people who wish to hold their passwords synchronized across multiple gadgets. And if a bit further on you spot any errors, just resend the texts with corrections marked on and it’s good as new, either instantly or within a day. They believe that point devoted to a blogpost is time away from your major research â€" it’s not. Bring all your team’s ideas and visuals together. Collect inspiration from apps like Pinterest and YouTube, exchange ideas in actual time, and get feedback. Just drag and drop your personal recordsdata out of your pc, shared network drive or cloud. Unfortunately another multi-writer or group blogs will nonetheless drastically prune or omit these elements, but a minimum of you’ll have tried. Write shorter paragraphs than in a journal â€" say one hundred fifty words. But don’t write bitty textual content the place every sentence is its own paragraph â€" that type may work for press releases, however strange readers will quickly find it disorganizing. Proper paragraphs are models of thought â€" they give your text a delicate sub-construction that makes it much more understandable, when accomplished properly. Next do away with the long literature evaluation at the beginning â€" in the weblog context, nobody cares about educational credentializing or level-scoring. Also minimize out most of any closing dialogue of how your results agree with or diverge from different individuals’s work. A line or two somewhere close to the beginning, after which 2 lines of closing ideas or pointers at the end of the submit, normally suffices. And yet we know an enormous fraction of analysis continues to be being churned out solely in obscure shops read by very few people. It takes the ‘memes’ key to your research into a limited viral unfold. It additionally gets read by lecturers exterior your instant sub-area and self-discipline, probably pulling new audiences to your work. You get your 1,000 words completed in Word or equivalent. Include a desk or a chart or two, being scrupulous to current them properly. You get an e-mail by return saying ‘Great let’s do it’, and a couple of days later your text is online at the weblog. Finally, of course a blogpost might nicely not be cited itself (though now reputable multi-author blogs increasingly are) â€" but when not, this is because it’s job is totally different. Academically a blogpost boosts citations for the core article itself. It advertises your journal article in ways that may get it much more extensively learn than simply pushing the article out into the ether to sink or swim by itself. A post reaches other researchers in your discipline . And as a result of it’s accessibly written, it travels well, goes abroad, will get re-tweeted and re-liked. Instead, move straight to what worked in your analysis or experiment or archive search, etc. and tell readers clearly what you found or concluded. In a blogpost one of the best bits arrive early on, not just on the finish. Cut out any textual content from your article covering intermediate stages, or earlier models, or avenues taken that did not result in results. It’s made out there only as onerous-boiled, jargon-prone and inaccessible textual content. It’s illustrated with mounds of ‘lifeless on arrival’ information that no one will ever look at again. Little marvel that folklore has it that 90% of journal articles go uncited, even by the original writer.

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This commentary was issued lately by money managers, analysis companies, and market e-newsletter writers and has been edited by Barron’s. The extra we ask the large, shifty questions about energy and privilege and reality, the extra our basis must be rock solid. Multiple studies show that digital display use may be causing a variety of troubling downstream effects on reading comprehension in older high school and faculty students. In Stavanger, Norway, psychologist Anne Mangen and her colleagues studied how high school college students comprehend the identical materials in numerous mediums. We know from analysis that the studying circuit isn't given to human beings via a genetic blueprint like imaginative and prescient or language; it needs an environment to develop. These vary from writer expertise and skills to topics or research materials. We’ll do our very best to answer them all for you here. All it takes to get started is for you to let your author know the topic or the subject of your research paper; they will do the remaining. You can contribute as much or as little as you wish and talk along with your author each step of the way. If you need to get a prime grade, use our essay assist online without any hesitations. All you should do is contact us, and we'll answer you at any time of the day or night. 2 step â€" Pay for work We do not disclose any monetary transactions to outsiders. Editors should insist on reality checking budgets for their authors, and authors must hold insisting for them such that we are able to all pay fact checkers fairly. There are also ethical and energy imbalances for the fact checkers themselves embedded into the present state of nonfiction e-book fact checking affairs. In broad strokes, hourly rates are more favorable to fact checkers, whereas lump sums are more favorable to writers. 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Research Paper Sections

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Using Motivational Interviewing Techniques for OCD

Using Motivational Interviewing Techniques for OCD OCD Treatment Print Using Motivational Interviewing Techniques for OCD By Owen Kelly, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on April 30, 2019 Blend Images-Ned Frisk/Brand X Pictures/Getty Images More in OCD Treatment Causes Symptoms and Diagnosis Types Living With OCD Related Conditions The effectiveness of  psychological treatments  for obsessive-compulsive  disorder (OCD), such as exposure and response prevention therapy, is well-established. But given that exposure-based therapies require the patient to directly confront those things they fear most, many people refuse  treatment, drop out shortly after its started, or dont keep up with homework assignments. Because of this, its estimated that only 50% of people with  OCD  are able to benefit from exposure-based treatments despite their effectiveness. But research has been ongoing to find ways to make exposure-based therapies more attractive for more people, and motivational interviewing techniques show considerable promise in this respect.   History and Purpose of Motivational Interviewing Techniques Originally, motivational interviewing techniques were developed to help increase peoples motivation to change and reduce negative feelings towards treatment in individuals struggling with substance use disorders. Recently, motivational interviewing has been explored as a way of addressing these same issues in anxiety disorders, such as OCD.   Motivational interviewing assumes that you want positive changes to take place in your life, but at the same time recognizes that fear can sometimes get in the way of such change. The objective of motivational interviewing is to increase your motivation to change so that you can realize your goals, such as finding a romantic partner or steady employment. Exploring What Drives You One of the biggest components of motivational interviewing is thoroughly exploring what keeps you in the same OCD patterns and thoughts, despite the harm and suffering you may be experiencing. Why do you keep doing what youre doing? For example, although someone with OCD may currently be spending over two hours a day washing their hands, the desire to avoid the anxiety that comes with feeling contaminated may outweigh  the distress and disruption to their life caused by this behavior. In another instance, someone experiencing extremely distressing intrusive and violent sexual obsessions about molesting children may be willing to suffer through them to avoid having to disclose these potentially embarrassing and shameful thoughts to a therapist, family member or spouse.   Identifying Your Barriers Motivational interviewing techniques can be used to help you become ready for more targeted exposure-based treatment. Barriers that could get in the way of your starting or completing therapy are identified and discussed in depth. Your therapist will usually use open-ended questions that are designed to help you arrive at your own conclusions. Remember, it is not uncommon to be unaware of or even to want to avoid thinking about the reasons you do not want to change. This is normal, particularly if your reasons for avoiding change are potentially distressing. Once the barriers to change are identified, your therapist will work with you to identify both the advantages and disadvantages associated with participating in an exposure-based therapy. Following this, you and your therapist may have extensive discussions about your goals and whether the disadvantages of participating in therapy outweigh the goals you want to achieve or not. Do Motivational Interviewing Techniques Improve Outcomes? Overall, clinical research suggests that motivational interviewing techniques help more people benefit from exposure-based treatments for OCD. As well, there is some evidence that motivational interviewing may help patients gain more insight into the severity of their symptoms and how much OCD truly disrupts their lives. If you are interested in behavioral therapy but also have strong reservations about such treatment, it may be helpful to try to find a therapist who specializes in motivational interviewing to help you along this treatment path.

My Educational Goals and Philosophy Statement Essays

My Eclectic Educational Philosophy Thinking back on the years of high school, I remember having wonderful experiences both inside the classroom and out. I had influential teachers and the drive to succeed in order to obtain a higher education. I realize that not all students have that drive to continue their education, but as an aspiring educator I wish to seek and find that drive in each of my students. The famous philosopher and educator, John Dewey, once said, The aim of education is to enable individuals to continue their education -- or that the object and reward of learning is continued capacity for growth. As a facilitating instructor, I plan to pursue this aim of education with an eclectic blend of elements†¦show more content†¦With English/Language Arts as my content specialization, I will teach my students how to express their ideas and/or feelings properly and how to do it well. Part of this expression will come through venues such as writings and artwork just to name a few. By accomplishing self-expression, my students will grow to respect themselves and others. As mentioned before, the progressive philosophy utilizes practical activities and by using this idea, I can mediate physical interaction to teach communication. Group work, class discussions about inside and outside issues, oral presentations such as speeches, mock interviews if the grade level allows, and hands-on activities will help in grasping the concept. One other vast component of communication comes from the social reconstructivism philosophy. As the students build their relationship with their community, they will possess the capability to be effective future-citizens. Along with this capability, they will be able to apply the fundamentals elements of society to help them make wise, just choices in their everyday lives. An example of one of these fundamentals would be community service and knowing how to voice their opinion as a community member when appropriate like voting or starting an organization. The definition of social reconstructivism education is to change the world and make society better through education. I am a firm believer that changing the world and making it aShow MoreRelated My Educational Goals and Philosophy Statement Essay867 Words   |  4 PagesMy Educational Goals and Philosophy Statement I believe that each child is a unique individual who needs a secure, caring, and stimulating atmosphere in which to grow and mature emotionally, intellectually, physically, socially, and academically. It is my desire as a future educator to help students meet their fullest potential by providing an environment that is safe, supports risk-taking, and invites a sharing of ideas. There are two elements that I believe are essential to establishingRead MoreEssay on My Educational Goals and Philosophy Statement1439 Words   |  6 PagesMy Educational Goals and Philosophy Statement The most important function of education at any level is to develop the personality of the individual and the significance of his life to himself and to others -Grayson Kirk. The teaching philosophy of progressivism focuses on developing the whole child. This philosophy not only teaches the core subject material, but it also allows the teacher to help develop the person the child is going to be. John Dewey, founderRead More My Educational Goals and Philosophy Statement Essay721 Words   |  3 PagesMy Education Philosophy I’ve always believed very strongly in hard work, perseverance, strong moral character. These traits to me are what exemplifies a superior teacher that has the privilege to touch many lives and change the world we live in. Hardwork is something that isn’t artificial, or can’t be bought. It’s a very special characteristic that sets people apart in the respect that it shows who want’s to be successful and make a difference and who doesn’t. InRead More My Educational Goals and Philosophy Statement Essay881 Words   |  4 PagesMy Education Philosophy Developing a personal education philosophy is a process that may never end, but I believe that I am in the midst of creating one based on my own experiences and the lessons I am receiving in college. After examining the various education philosophies outlined in the â€Å"Teachers, Schools Society† textbook by Myra Pollack Sadker and David Miller Sadker, I have decided that my present philosophy is an eclectic combination of Essentialism andRead MoreMy Personal Philosophy Of Education1476 Words   |  6 PagesPersonal Philosophy of Education Submitted by: Wessam Elamawy . Personal Philosophy of Education Introduction: From the very beginning of my life I recognized the importance of higher education. I am 34 years old. I am Egyptian. I was born in a highly educated family . My father earned a Ph.D. in chemistry. My uncle earned a Ph.D. in Engineering . My aunt is a doctor. My grandparents were highly educated and they were great leaders in the educational field. This shaped my personalityRead MoreEssay about Personal Educational Philosophy1069 Words   |  5 PagesAbstract This paper is my personal educational philosophy statement. It represents my ideas and values about teaching and learning; it reveals my personal teaching beliefs and their relation to the five major established educational philosophies; it shows my role and responsibilities in educational process. I place great significance on personal style of instruction and its influence on curriculum implementation. The paper also highlights my career aspiration and orientation. Read MoreMy Philosophy Of Professional Practice1416 Words   |  6 PagesMy Philosophy of â€Å"Professional Practice† statement My philosophy of professional practice statement is to give the maximum in work not only for the students but also for those that surround me. My philosophy is very simple to respect all people to respect me.Strive to help students think critically, facilitate learning with customized modifications, and help students use problem-solving strategies. My personal core of belief is always practiced active listening to assist the students better. ItRead MoreEssay on Mission and Vision Statement897 Words   |  4 Pages Mission and Vision Statement Mission Statement: As an educator I will provide for students the opportunity to make a positive difference in their lives to help them accomplish unexpected goals. I will enhance learning to support my students in achieving their highest potential by integrating technology into the curriculum. I will integrate conceptual technology learning techniques that will implement concrete knowledge of technology that will emphasize mastery of understanding. Through committedRead More My Philosophy Statement Essay1177 Words   |  5 PagesMy Philosophy Statement In this philosophy statement you will not be reading the statement of a great philosophical mind, but of an education student who loves to work with kids and who tries to have the students best interest in mind. comparing and contrasting my views with the views of many of the philosophical giants throughout history I will discuss five topics: 1.) the nature of students, 2.) the nature of knowledge, 3.) the purpose of public education, 4.) the method of education,Read MoreEducational Philosophies650 Words   |  3 PagesEducational Philosophies Elizabeth Howell Liberty University What is the philosophy of education? It is a set of ideas and beliefs that guides teachers’ actions and provides a framework for thinking about educational issues. (Kauchak and Eggen, 197) Teachers use philosophy everyday in their classrooms. From the time the first student enters their room until the last student walks out, philosophy is affecting the way the teacher runs his/her classroom and how they interact with their students

The Illusion of Racial Identity Essays - 3986 Words

In common sense thought, race is simply a fact: humans are not all alike, there are whites, blacks and yellows, maybe reds and browns too, and these different kinds are races, and thats just a feature of the way the world is. However, recent work on the concept of race shows that race and race-talk can be understood by analogy to what Foucault suggests about psychiatry and mental illness coming into being together: (1) it is now beginning to appear than race and racism came into existence together as well. It is racism that has made talk of race something that we can take seriously. A statement attributing intelligence or laziness to a person on the basis of her/ his skin color, can only be judged true if there are resources in†¦show more content†¦The distinction Heidegger proposed in Being and Time (4) between several senses of being became the starting point of existential phenomenology, and the subsequent work of Sartre and deBeauvoir, on which I will draw in a moment, d erives important ideas from it. Specifically, I want to distinguish between three meanings of being with respect to the meaning of race, deriving from the discourse of existential phenomenology. With this distinction, I believe it is possible to gain some insight into the problem of race and the question of truth. Vorhandenheit and Existenz are Heideggers words for a distinction between two senses of being; Vorhandenheit has come to be known in English as presence-at-hand, but substantiality is another way to sum up its meaning. This refers to the kind of being that we attribute to, for instance, natural phenomena. When we ask what is it? with regard to some natural phenomenon, we are expecting, and will be satisfied with, an account of what the thing is composed of; this answer speaks of the object not primarily in terms of its usefulness, its value, its relation to other things, but primarily in terms of itself independently. In contrast, to name the kind of being that humans have, Heidegger uses the word existence, and by it he means especially to call attention to the fact of care:Show MoreRelatedCritical Analysis: Ralph Ellisons Invisible Man Essay1651 Words   |  7 PagesInvisible Man, struggle in an attempt to uncover his identity buried beneath African American oppression and an aggr egation of deception. Ellison shows us how lies and deceit may serve as a grave but invaluable obstacle to one’s journey to find their identity. Through the use of imagery, symbols, and motifs of blindness along with invisibility, Ellison portrays the undeniable obstacle that deception plays in one’s ability to establish their identity along with the necessity of it. Within the openingRead MoreEssay on Exploring Race and Challenging Privilege1610 Words   |  7 PagesExploring Race and Challenging Privilege I thought I understood racism well enough. Since early childhood I’ve learned from parents and teachers that racism is a sense of racial superiority, a way of making judgments about people based on their skin color before you get to know them, and a cause of hate crimes and foul language. I think I’m not racist, and as a white woman I’m not likely to be the victim of racism, so I usually think racism has nothing to do with my life. But I’m uncomfortableRead MoreMulticulturalism Is America s Unresolved Race Problem911 Words   |  4 Pagesmulticulturalism of the 80s and 90s) as something quite similar to a â€Å"racial project† a la Omi and Winant. Seen as an integral step in guiding racial formation, Michael Omi and Howard Winant defines a racial project as following (Omi and Winant 1994,56): â€Å"A racial project is simultaneously an interpretation, representation, or explanation of racial dynamics, and an effort to reorganize and redistribute resources along particular racial lines. Racial projects connect what race means in a particular discursiveRead MoreMulticulturalism Of The United States As An ( Ethno ) Racial Project939 Words   |  4 PagesKim 2004: 996). Thus, it might be more appropriate to speak of multiculturalism in the United States as an (ethno)racial project. While the direct origin of multicultural rhetoric was America’s race problem, it cannot be fully said that multicultural theory directly answered questions of American’s race problem. In fact, as much as official multiculturalism attempted to make sense of the increasing â€Å"diverse† makeup of its nation, it also hid many of the issues that it was attempting to resolveRead MoreGender Inequality And Racial Inequality Essay924 Words   |  4 PagesFor centuries and even today, gender inequality and racial prejudice continue to exist. Throughout time these concepts have overlapped and intertwined, each other creating complex interactions and a negative influence upon society. In the 1980s, Kimberle Williams Crenshaw through her article, named Mapping the Margins: Intersectionality, Identity Politics, and Violence Against Women of Color, introduced the term â€Å"Intersectionality.† Intersectionality, is the theory of how different types of discrimination sRead MoreWhat Is The Negro s Racial Identity?940 Words   |  4 PagesNegro’s Racial Identity? Racial identity growth has speedily increased and reshaped during the Harlem Renaissance as some blacks writers were coming to terms with the fact that there some differences among the black community. Two writers created their own personal translation concerning the Negro in the course of these years. In Alain Locke’s essay, The New Negro, he presents the variation of the â€Å"new† and â€Å"old† Negro. On the other hand Langston Hughes essay, The Negro Artist and the Racial MountainRead MoreI Agree With Aarvik s Comment1642 Words   |  7 Pagesabout those who stand around and watch rather than taking the initiative to aid another person? 2. Everyone has a different story to tell. The relationship between our experiences and our identities is that everything we have willingly (and unwillingly) experienced has shaped us into who we are. Our identities are the results of choices made in the past. Some examples in works we have read in the past are Jean Valjean, Javert, and almost all of the characters in Les Miserables. Spending the majorityRead MoreWoman Is The Nigger Of The Wolrd: The Bluest Eye by Toni Morrison934 Words   |  4 PagesAfrican-Americans feel inferior to white people, as a result of white people trying to distance themselves as far as possible from African-Americans. White people want to have clear boundaries between me and not-me, the Other, in order to retain their identity (Kolehmainen). In The Bluest Eye, African-Americans function as the Other for white people, thereby representing everything that they do not want to be. However, without the Other, there is no self. So people that consider thems elves to be betterRead MoreHenry Ossawa Tanner : An African American Artist857 Words   |  4 Pages Final Research Paper Henry Ossawa Tanner is an African-American artist. His works often subvert racial stereotypes and display his experiences as an African-American. The Annunciation (1898) depicts a traditional biblical scene in a modern manner; the painting portrays the well-known scene of Gabriel appearing before Mary to deliver news that she is to be the mother of Christ, however instead of merely accepting this fate she seems to be reluctant. Tanner takes a common biblical subject matter andRead MoreGender Inequality And Racial Prejudice1130 Words   |  5 PagesGender inequality and racial prejudice are alive and well in the United States and around the world despite the strides that have been made here over the past fifty years. Over time fixed notions about gender differences have been interwoven into the fabric of society, each leading to complex interactions among people. Traditionally, most of these rigid views have supported the dominance of men and the subservience of women in most social structures. In her article entitled: Mapping the Margins:

Chicory Root Extract Atopic Dermatitis Health And Social Care Essay Free Essays

Atopic dermatitis is a genetically transmitted, chronic inflammatory tegument disease that is characterized by chronic redness of epidermis1. The disease normally presents during early childhood but may get down or prevail in big life 2. 10 % to 20 % of kids and 1 % to 3 % of grownups are affected by this status. We will write a custom essay sample on Chicory Root Extract Atopic Dermatitis Health And Social Care Essay or any similar topic only for you Order Now Adult atopic dermatitis is normally a continuance of the childhood status although in 2 % of the entire instances may get down after 20 old ages of age 3. It is the earliest presentation of atopic characteristics in patients who suffer from allergic coryza and/or asthma in ulterior life 4. The atopic dermatitis may undergo remittal at pubescence and so gets exacerbated in big life particularly in response to environmental exposure to thorns 3. The characteristic characteristics of disease are pruritus, scrape, and chronic and/or get worsing eczematous lesions 5. Presently, there is no unequivocal remedy for this status and direction is aimed at relieving the symptoms of the status hence it presents a clinical challenge 6. The direction includes good tegument attention ( such as usage of moisturizers and creams ) , trigger turning away while pharmacological interventions such as usage of anti-inflammatory drugs ( topical corticoids and unwritten antihistamines ) besides contribute to the curative armamentarium 3. The new calcineurin inhibitors are among the new intervention options which limit the badness and frequence of flare-ups 6. Due to an increased hazard of infection, anti-bacterial, anti-fungal and anti-viral drugs are besides portion of the intervention regimen 6. Different intervention options available are shown in the figure 1: hypertext transfer protocol: //onlinelibrary.wiley.com/store/10.1111/j.1398-9995.2006.01153.x/asset/image_n/ALL_1153_f5.gif? v=1 A ; t=ghv2sj68 A ; s=0e428ba76d59dc1a7fd694a0dcbd25f4c38e76d4 Beginning: Akdis et Al, 2006 The furnace lining or terrible instances present a challenge in their direction and necessitate alternate therapies like the application of wet dressings in combination with topical corticoids, short-run intervention with systemic corticoids, phototherapy with ultraviolet visible radiation 8, immunomodulatory or immunosuppressive agents ( cyclosporins, pimecrolimus and tacrolimus ) 9, Imuran, interferon- IA? , 3. However, bulk of these therapies have been found to be associated with side-effects like nephritic toxicity, hepato-toxicity 3, skin combustion and thinning etc.9 This has resulted in involvement in the alternate traditional therapies. Cichorium is a medicinally of import works that belongs to the household Asteraceae 10. The tuberous root of this works is made up of a figure of medicinally of import compounds such as inulin, acrimonious sesquiterpene lactones, coumarins ( esculin ) , flavonoids and vitamins 10. Hence, the root infusion of the works has been used as an antihepatotoxic, antiulcerogenic, antiinflammatory, appetiser, digestive, gastric, liver tonic, cholagogue, cardiotonic, depurative, diuretic, emmenagogue, antipyretic, alexeteric and besides as tonic 11. Furthermore, it is besides helpful in headache, heapatomegaly, degenerative arthritis 12, anorexia, indigestion, flatulency, gripes, urarthritis, firing esthesis, icterus, splenomegaly, hyperdipsia, Hansen’s disease, , amenorrhea, chronic and biliary febrilities, ophthalmitis, sore throat and emesis, arthralgia, lumbago, asthma and general infirmity 13. Chicory root has been shown to hold anti-inflammatory action by suppression of COX-2 activity 14. Furthermore, the chicory root infusion has been shown to possess antibacterial 10 and clamber protecting belongingss 15. The safety profile chicory root infusion is good 16 and is better tolerated 17. A combination of these belongingss makes it a suited agent to be tested against atopic dermatitis. Although its usage in the intervention of skin allergic conditions has been mentioned in the literature, no surveies could be identified proving the efficaciousness of chicory infusion against atopic dermatitis in grownups or kids. Despite the deficiency of identifiable research into the usage of chicory root infusion in pull offing grownup atopic dermatitis, the grounds available pertaining to its widespread usage and anti-inflammatory and anti-bacterial usage suggests that chicory root infusion could be a good direction option by bettering the disease symptoms and associated conditions. In drumhead, a randomised control test on an equal sample size, focused entirely on the consequence of chicory root infusion on the symptoms of atopic dermatitis should be carried out utilizing blinded research workers. Research Question Does the chicory root infusion better the symptoms in patients enduring from grownup atopic dermatitis? Proposed Probe The probe aims to find whether the root infusion of chicory works decreases the badness and symptoms of grownup atopic dermatitis. A randomized vehicle-control dual blind test will be performed on 100 patients enduring from atopic dermatitis at the Liverpool infirmary. Inclusion and Exclusion Criteria Participants between 20 to 50 old ages of age enduring from or diagnosed with non-exudative atopic dermatitis utilizing the Hanifin and Rajka criteria 18 will be indiscriminately assigned to instance and control groups. Exclusion standards for participants enduring from exudative dermatitis, patients who received UVB phototherapy or photo-chemotherapy in the last 1 month, and patients who received systemic therapies such as steroid or other immunosuppressive drugs in the last 3 months were excluded. Study and vehicle Group Preparations The ethyl ethanoate chicory infusion will be dispensed in an ointment signifier with a standard base pick which contains a mixture of glyceryl mono/distearate and polythene ethanediol stearate, isoparaffin and cyclopentadimethylsiloxane 19. This base will function as vehicle and cream merely with no other actions. The control group will have the base pick merely along with ethyl ethanoate to minimise the consequence of any confounders. Intervention Following blessing from the local moralss commission, informed consent will be taken from all the patients while making the baseline hiting for atopic dermatitis. Subjects will so be indiscriminately allocated into either the intervention group or control group after baseline appraisal and marking. The survey group ( n=50 ) will have ethyl acetate chicory root infusion in ointment signifier whilst the vehicle group ( n=50 ) will have a placebo in ointment signifier with indistinguishable visual aspect and wadding. Treatment will dwell of using a thin bed of unction on the affected country twice daily for a period of eight back-to-back hebdomads. All other signifiers of interventions will be prohibited during the survey period. The marking will be done at 4 hebdomad intervals. Both the clinicians and the patients will be blind to the intervention that they are giving or having as the survey and vehicle unction will be dispensed in indistinguishable wadding. Result Four major parametric quantities of the disease, viz. , extent, strength, waterlessness, and itchiness, will be flatly recorded harmonizing to the eczema country and badness index ( EASI ) 20. The symptoms will besides be estimated by hiting patient reported symptoms utilizing a structured questionnaire with nonsubjective standards. A usage of hiting systems and nonsubjective standards will assist to standardise and compare the results in both groups. The result tonss of the two groups at baseline and at 4 hebdomads interval will be compared utilizing a two-tailed Studentaa‚Â ¬a„?s t-test with the significance degree set at 5 % . All the analysis will be done utilizing SPSS. Restriction Restrictions of the survey include the fact that the participants may endure from flair ups due to surcease of all other types of interventions. However, if at any point it is felt by the wellness attention squad that the intercession is arousing any unwanted effects and patient demands systematic therapy, the test will be terminated early or that patient will be dropped out. This may increase the bead out rates and compromise the cogency of the survey. Ethical Issues Participants will be informed that non-participation or backdown at any phase wonaa‚Â ¬a„?t compromise their medical attention. Informed consent will be taken from the patient and his doctor before get downing the intervention and will be discontinue at any clip if the patient or his physician want to make so. How to cite Chicory Root Extract Atopic Dermatitis Health And Social Care Essay, Essay examples

Sexuality in Legislation

Title of pending legislation: â€Å"Denouncing the practices of female genital mutilation, domestic violence, â€Å"honor† killings, acid burnings, dowry deaths, and other gender-based persecutions, expressing the sense of Congress that participation, protection, recognition, and equality of women is crucial to achieving a just, moral and peaceful society, and for other purposes â€Å" (Lee, 2011).Advertising We will write a custom essay sample on Sexuality in Legislation specifically for you for only $16.05 $11/page Learn More Introduction The issue of sexuality and its abuse has been in the public debate for quite some time. Sexuality has always been violated and abused since ancient times for self-satisfaction, monetary gains, and political reasons. Currently, there are many crusades on empowering women against human rights violations of their sexuality globally, which are mostly committed during war times and for self-interest, political rea sons, monetary gains, customs, religious beliefs, and negative ethnicity. Subjectively, this legislation is intended to protect women against human rights violation at domestic, community, and international levels while ensuring that they are empowered to enjoy equal rights with men in terms of individual rights and representation in the governments and with proper enforcement of laws by governments to safe guard the fundamental human rights of the women worldwide. The legislation is also aimed at promoting earning level and increasing literacy levels amongst women worldwide with an aim of empowering them reach equality with men. Purpose of the Legislation The legislation is aimed at the Senate and the House of Representatives to formulate more legislation to tackle the problem of human rights violations against women globally. First, it is aimed at ensuring the congress refusal on cruel acts of female circumcision, domestic violence, acid burning, dowry deaths and other gender base d persecutions and crimes while asserting that women are not commodities to be sold, misused, trafficked and they should be given right to education, property ownership and be accorded complete participation in economic, community and political aspects (Lee, 2011). Secondly, the legislation is aimed at ensuring that these cruel practices stop and the social and organizational systems, which promote them, are abolished. In this case, all governments are urged to create laws banning these practices, with the offenders being persecuted and punished accordingly, while measure to empower women and girl child should be put in place (Lee, 2011).Advertising Looking for essay on criminal law? Let's see if we can help you! Get your first paper with 15% OFF Learn More Thirdly, the legislation is aimed at compelling the President to collaborate with other donor countries and regional authorities to promote rights, health and ensure the empowerment of women in all areas of their li ves by influencing foreign aid to developing countries and campaigning against these cruel practices against women, as well as the impunity (Lee, 2011). In addition, the legislation aims at ensuring participation, security, appreciation, stability, and equality in human rights of women and girl child in the society, thus bringing justice and peace to all. Lastly, no matter what religion, location, or nationality, women human rights should not be abused and they should always be respected, supported, and enforced to safeguard against their violation. Level of Success Given the following reasons, the legislation is likely to pass. First, the country has some of the best laws relating to sexuality and gender-based issues, while the congress members are well enlightened on gender issues and the U.S government is always in forefront in promoting democracy with observance of basic human rights. Secondly, the1998 United Nations International Criminal Tribunal for Rwanda set a precedent in international law by establishing and prosecuting rape and sexual violence in times of violent conflict as war crimes and crimes against humanity, thereby, setting the pace for government to formulate, amend and accept international laws on sexuality (Lee, 2011). In addition, there are many international organizations such as FIDA, Amnesty International, locally based NGOs, and human rights advocacy groups operating globally to champion the fight against violation of women human rights and promoting women empowerment programmes. The major challenge to this legislation globally can be the traditions and customs of communities that practice these acts as part of their way of life, while the fundamentalist religious beliefs discriminating against women are so stuck to people who practice these beliefs. Regarding sex and sexuality of the legislation’s audience, the legislation is a bit quiet because the U.S already has many laws as a country relating to sexuality and gender based issues and this legislation is intended for international relations and application.Advertising We will write a custom essay sample on Sexuality in Legislation specifically for you for only $16.05 $11/page Learn More Assumptions of the Legislation First, the legislation assumes that, with the American society being much enlightened on matters relating to sexuality and gender issues, the legislation stands to get enough support in the congress. Moreover, the legislation assumes that after passing, the international community of donors will accept it and be able to influence developing countries to adopt it. In addition, it also assumes that there is much global awareness on matters relating to sexuality violations. Advocacy Groups working for and against the Legislation The bill has been referred to the Subcommittee on Africa, Global Health, and Human Rights; thus, the bill is yet to be published. It will receive much support from Amnesty International based on the argument that it will promote human rights for women and their empowerment globally. However, the bill has received some criticism from some members of the house, some arguing that no person shall be required by the United States or by any State to participate in prayer regarding the issue of saying prayers in school in times of crisis, conflict, or terror. References Lee, J. (2011). Bill Summary Status: 112th Congress (2011 – 2012). H.J.RES.12. Library of the Congress Press. Retrieved from https://www.congress.gov/ This essay on Sexuality in Legislation was written and submitted by user Asia Lott to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Brief Psychotic Disorder essays

Brief Psychotic Disorder essays Another type of psychotic disorder is a brief psychotic disorder. This type of psychotic disorder lasts for at least one day, but not longer than one month. It has a very rapid onset. The strange part of this disease is that there is little or no forewarning that the disorder is coming. Though eventually it will seem as if the disease never existed. The person will return to their prior state of functioning. There are several different symptoms used to diagnose brief psychotic disorder. One or more of these symptoms must be present. The first of these symptoms is delusion. The second symptom is hallucinations. The third is disorganized speech. The patient may slur their words or sound incoherent when talking. The fourth and final symptom is disorganized behavior. This disturbance is very similar to and easily confused with other disorders. Some of the other disorders, which doctors must differentiate between are psychotic disorder due to a medical condition or substance induced psychotic disorder. Mood episodes, schizophreniform disorder, and personality disorder also carry many of the same symptoms. The causes for this brief, yet scary disorder are widely unknown to the medical world. The patients who develop this disorder may actually be biologically or psychologically vulnerable to developing these psychotic symptoms. Stress factors like family conflicts, divorces, accidents, and loss of loved ones can also cause the onset of symptoms. There are also some studies, which point to a genetic predisposition to developing brief psychotic disorder. There are several different types of treatment. Some of the typical antipsychotics, which are used in treating this disorder, are chlorpromazine, thiothixene, and haloperidol. There are also atypical antipsychotics, which include, risperidone and olanzapine. There are some adverse reactions to these drugs. One such reaction is neuroleptic malignant syndrome. This can happen at any ti...

3 Tips to Improve Writing in English

3 Tips to Improve Writing in English The most important rule to writing effectively is to not repeat yourself. Each of these three rules focuses on avoiding repetition in English. Rule 1: Dont Repeat the Same Word One of the most important rules in writing English is to avoid repetition. In other words, dont use the same words over and over again. Use synonyms, phrases with a similar meaning, and so on to spice up your writing stile. Sometimes, this is not possible. For example, if you are writing a report about a specific disease or perhaps a chemical compound, you will not be able to vary your vocabulary. However, when using descriptive vocabulary, its important to vary your choice of words.   We went on holiday to a ski resort. The resort was very beautiful with lots of things to do. The mountains were also beautiful, and, to be honest, there were also many beautiful people. In this example, the adjective beautiful is used three times. This is considered poor writing style. Here is the same example using synonyms.   We went on a holiday to a ski resort. The resort was very beautiful with lots of things to do. The mountains were majestic, and, to be honest, there were also many glamourous people.   Rule 2: Dont Repeat the Same Sentence Style In a similar way, using the same sentence structure by repeating the same structure over and over again is also considered bad style. Its important to know a variety of ways to make the same statement. This is often referred to as using equivalencies. Here are some examples  of similar types of sentences using different equivalencies to vary the style. The students studied hard as the test was sure to be difficult.They reviewed the grammar in great detail due to the many exceptions.Sentence structure was reviewed, for it was sure to be on the test.As they had covered all the materials, the students were assured success. In the four sentences above, Ive used four different variations on because. Sentences one and four use subordinating conjunctions. Note that the dependent clause can begin the sentence if followed by a comma. The second sentence uses a preposition (due to) followed by a noun phrase, and the third sentence uses the coordinating conjunction for.   Heres a quick review of these forms: Coordinating Conjunctions - also known as FANBOYS. Combine two simple sentences with a coordinating conjunction preceded by a comma. Coordinating conjunctions can NOT begin a sentence.   Examples The weather was very cold, but we took a walk.She needed some extra money for her vacation, so she found a part-time job.The toy was broken, for the boy had thrown it against the wall. Subordinating Conjunctions - Subordinating conjunctions introduce dependent clauses. They can be used to begin a sentence followed by a comma, or they can introduce the dependent clause in the second position without using a comma. Examples Though we need to review the grammar, we decided to take the day off for some fun.Mr. Smith hired a lawyer as he needed to defend himself in court.Well take car of the problem when John returns. Conjunctive Adverbs - Conjunctive adverbs begin a sentence linking it directly to the sentence before. Place a comma directly after the conjunctive adverb. Examples The car was in need of repair. As a result, Peter took the car into the repair shop.Its very important to study grammar. However, knowing grammar doesnt necessarily mean you can speak the language well.Lets hurry up and finish this report. Otherwise, we wont be able to work on the presentation. Prepositions - Prepositions are used with nouns or noun phrases NOT full clauses. However, prepositions such as due to or despite can provide a similar meaning to a dependent clause.   Examples Just like our neighbors, we decided to put a new roof on our home.The school decided to fire the teacher despite the students protest.As a result of poor attendance, well have to repeat chapter seven. Rule 3: Vary Sequencing and Linking Language Finally, when writing longer passages youll be using linking words and sequencing to connect your ideas. As in word choice and sentence style, its important to vary the linking language you use. For example, there are many ways to say next. If you are providing instructions, try to vary the words you use to take someone through each step in the process.   Instead of writing: First, open the box. Next, take out the equipment. Next, insert the batteries. Next, turn the device on and begin work. You could write: First, open the box. Next, take out the equipment. After that, insert the batteries. Finally, turn the device on and begin work. This is a just a short example to give you an idea. Try to vary the sequences, or linking language you use in each paragraph. If you use first, secondly, thirdly, finally in one paragraph, switch it up and use to begin with, next, after that in another paragraph. Follow the links in this article to study each of these variation types in more depth and you will quickly improve your writing style through variety.

Other than the September 11, 2001 attacks, and later than 2000, Term Paper

Other than the September 11, 2001 attacks, and later than 2000, identify and describe one event that has influenced (changed, modified, added, subtracted) homel - Term Paper Example Hurricane Katrina turned out to be the worst thing that could happen to our homeland and the pieces were left for Department of Homeland Security to pick up. Katrina was a category 4 hurricane and FEMA, part of the Department for Homeland Security, reacted to it according to a prepared plan. But nothing could have prepared Americans for the destruction brought on by the hurricane. No one had anticipated the ruin and damage (Borja 2008). Before the development of one Department of Homeland Security, these activities were carried out by more than 40 federal agencies. Although there had always been talk of bringing all of them under one banner; the need for one entity was truly felt after the 9/11 attacks. A March 2001 bill proposed that FEMA, Border Patrol, Customs along with several other offices be merged into one agency that will be responsible for all security related services for homeland. The Office of Homeland Security was announced 11 days after the 9/11 attacks. Its main purpose was to safeguard the country against any threats of terrorism is the future (Borja 2008). This report will discuss how the hurricane forever changed homeland security and led to the introduction of a whole new set of previously ignored challenges. Hurricane Katrina was unprecedented due to its sheer force and size. It was a huge challenge and the most destructive event in American history. It challenged our disaster response capabilities to the extreme and brought out the deficiencies in our nation’s preparedness and response facilities (Townsend 2006). According to a presidential address in 2002, the Department of Homeland Security had four goals that became the responsibility of four of its divisions accordingly. The Border Security Division is responsible for guarding the borders and preventing terrorists from entering the country. The Emergency preparedness and Response Centre has to work in tandem

Enhancing Employability in Marketing Essay Example | Topics and Well Written Essays - 2000 words

Enhancing Employability in Marketing - Essay Example The world has achieved tremendous grounds in the technological advancement and therefore much of the marketing is done through technology based communication (Clark 2004, p. 203). As such, a little creativity is needed which will determine whether graduates secure jobs and afterwards they can keep them by being able to perform. Bolstering a marketing degree with other professional qualifications related to finance is also important so that potential employers can be attracted to your technical capabilities in marketing (Gibbs, Steel & Kuiper 2011, p. 379). Current Employability/Graduate Trends in Marketing According to recent studies and research in the job market, marketing careers are on the increase whereas other careers are decreasing. This is a good indication that the marketing industry is growing and opening new areas for graduates to work and explore. Despite the fact that many industries have recently undergone serious cutbacks during the previous economic hard times, market ing is still an important aspect of firms. Marketing forms the basis of attracting and selling a firm to new clients while still maintaining the already existing clientele. It follows then that in the face of a shrinking economy and earnings, firms have to invest in marketing in order to keep afloat in the corporate world. Thanks to technology, the marketing can be simple or complicated depending on the amount of capital available (Bennett 2002, p. 464). Gone are the days when business directories were the major modes of advertising a business. With the advent of the internet, marketing campaigns have become relatively easy because all that a firm needs is to open a website and upload all its required information there. In the past, business firms needed to spend a lot of capital in sending mail to their customers. When potential customers go online to search for goods and services, there is are huge potential that is created for sales both now and in the future. These adverts are c reated by marketing career people because they know what the client wants and they understand their goods and services. As such, being able to understand the market trends and having IT skills is very important in the marketing filed (Achrol & Kotler 1999, p. 152). Recent changes in the way business reposition themselves for competitive advantage has led changing trends on what is required of marketers. Marketing people must also change with time and adapt to the new market demands by first becoming technology savvy. This entails being able to develop and implement all the different ways in which business can market themselves through technology. The jobs in marketing can be very vague (generalized) or specialised depending on a business’s size. In large business firms, there are many activities and campaigns that need coordination and therefore they usually need specialized marketers. On the other hand, small business outfits need a marketer who is able to handle all forms o f challenging marketing problems with no specialized training. However, some firms usually need a marketer who can popularize their goods and services to the general public without much use of resources or technology (Brousseau, Driver, Eneroth & Larson 1996, p. 59). Career Paths of a Marketing Degree Marketing as course encompasses a wide array of activities that are related to conceptions about the delivery of goods and services. In this regards, there are many options in which career paths may be oriented

Learning Outcomes Assessment for Student Nurse

Learning Outcomes Assessment for Student Nurse Learning Outcome 1 – Pre-assessment The ultimate goal of the pre-assessment is to assure that those patients identified as suitable for day surgery are properly identified while those considered unsuitable for a selected procedure are identified early enough in the process to allow for other treatment options (National Health Services, n.d.a, p. 13). Although ultimately it is a joint decision between the surgeon and anaesthetist who make the final determination (National Health Services, n.d.b), the nurse plays a vital role in the process and should be involved in the selection criteria (Royal College of Nursing 2004, p. 1). Pre-assessments of patients scheduled for day surgery are usually performed by an outreach nurse from a day surgery centre, by telephone screening, or by questionnaire (National Health Services, n.d.a, p. 9) or via appointments with day surgery staff or in specialized pre-admission clinics (Joanna Briggs Institute 2004, p.2). Many institutions are combining pre-assessment interviews with the opportunity to work with the patient in a preoperative education status in order to decrease patient anxiety, assess the needs of the patient and/or family members and to personalise information (Joanna Briggs Institute 2004, p.2). The National Health Services (n.d.a, p. 11) states this is an effective opportunity to also discuss the surgical procedure in greater detail with the patient, note special requirements for admission, surgery and/or discharge and allow the patient to choose their own date for surgery, finalizing and/or setting the appointment. According to the Royal College of Nurses (2004, p. 3), nurses performing the pre-assessments must have the option of being able to contact the anaesthesiologist of surgeon if a problem is identified that could potentially increase the risk during anaesthetic or surgical intervention.† This is critical; otherwise, there is no apparent reason for the assessment if the nurse cannot raise her concerns. The National Health Services (n.d.a, p. 9) day surgery guidelines state pre-assessments performed as soon as possible following the surgical consultation can allow for treatment of underlying physical issues that might preclude them from the day surgery procedure, such as high blood pressure and/or arrange for home care. If this is not possible, the National Health Services (n.d.a., p. 13) recommends that patients should then complete a â€Å"health-screening questionnaire before leaving the outpatient department.† According to the National Health Services (n.d.a., p. 11), incorporating the pre-assessment step in the day surgery process has been shown to reduce surgical cancellations and increase communication across the multidisciplinary team. Based on research, it is important to note that the day surgery pre-assessment is a valuable tool that can help the patient, the perioperative and surgical nursing teams as well as surgeons and anaesthesiologists. The pre-assessment is a way of initiating a comprehensive set of documentation for the entire team. Learning Outcome 2 – Effective communication According to the Joanna Briggs Institute (2004, p. 4), caseload can determine the staffing mix required. The staffing mix for a day surgery centre, however, can vary from a group of individuals who work together on a regular basis such as the case in a specialized clinic setting to a group of individuals who rely on departmental shift staffing for perioperative nurses and surgical residents in a busy teaching hospital. No matter what the group mix is, however, the need for communication is critical to patient care in all settings, especially surgical, where according to Cowen et al. (2005) communication is especially challenging for workers in environments that are high stress and time sensitive. Vazirani et al. (2003, p. 72) states that improving the level of collaboration, not just communication, can enhance job satisfaction among medical professionals while increasing the quality of care and patient satisfaction. While traditional communication techniques such as â€Å"active listening, positive voice tone, [and] reiteration to confirm understanding† are desirable goals, in the surgical setting other barriers often compound communication problems, including status and posturing between doctors versus the communication found between doctors and nurses or nurses and nurse practitioners. Vazirani et al. (2003, p. 72) discuss the care nurse practitioners took â€Å"not to violate the autonomy of residents or interns [and] did not admit patients on their own or write orders without the consent of a resident or an intern.† Essential to a multidisciplinary team is the need for collaboration, where decision-making is a shared event for doctors and nurses and that open communication between the two professionals exists (Vazirani et al. 2003, p. 73). It is important to note that research demonstrates physicians view collaboration differently than nurses, such that physicians believe collaboration implies â€Å"cooperation with follow-through† pertaining to following orders rather than sharing in the decision making process (Vazirani et al. 2003, p. 75). Vazirani et al. (2003, p. 76) also cited nurses as not being provided timely or accurate information regarding patient information when physicians autonomously make a change in their normal protocol, stating nurses need the information most as they are the ones at the patient’s bedside. Communication is a commonly sited problem and is one that, despite all the best suggestions and recommendations, from outlining roles and responsibilities, collaborating as a team or mutual team members each afforded appropriate professional respect (Vazirani et al. 2003) to developing Integrated Care Pathways (ICPs) as outlined by Fisher and McMillan (2004) is difficult to remedy. Ultimately, human emotions and professional pride create unnecessary friction that discourages open communication for fear of reprisal. Cowen et al. (2005) emphasize the need for an accurate flow of information between various disciplines as the most critical aspect in order to assure patient safety. Learning Outcome 3 – Patient selection criteria Patient selection criteria primarily focus on three primary factors: surgical, medical and social (National Health Services, n.d.a, p.11; National Health Services, n.d.b.). Surgical criteria assess whether the procedure will leave the patient dependent on others and/or if it has a statistically significant postoperative morbidity level. The National Health Service (n.d.b.) states that the surgical procedure should take less than 1 hour, involve minimal blood loss, be unlikely to produce severe post surgical pain or nausea and be unlikely to result in a loss of physical independence. When assessing social appropriateness, according to the Association of Anaesthetists of Great Britain and Ireland (cited by Joanna Briggs Institute 2004, p. 2), the pre-screening interview is an opportunity to assess the patient’s willingness to have surgery, the certainty of adult care in the home following surgery, telephone access and taking into consideration the patient’s home situation. For example, are there several young children and toddlers or infants at home requiring constant care; is the only adult available to help the patient an elderly or frail individual, or has the patient stated they feel they are being pressured into having the surgery. These are all reasons that should be presented to the surgeon, anaesthesiologist and the rest of the multidisciplinary team as reasons the patient should be precluded from day surgery. Additionally, patients with a social history of significant levels of alcohol consumption and/or who smoke are indications of potentia l preclusion or the need for additional counselling prior to surgery (National Health Service n.d.b.). The Royal of College of Nurses (2004) also states that the patient must have the availability of an escort home following surgery and that the travel time home must be within one and a half hours; and if small children are present in the home that a caregiver is available specifically to tend to the children. Medically, it is important to assess cardiac fitness, assurance of height/weight appropriateness and if they are â€Å"physiologically under 70 years of age[1].† Exclusions are usually automatic if there is uncontrolled hypertension, recent history of cardiac failure, pregnancy, angina, asthma, diabetes or epilepsy. Additional issues that require notification of the appropriate medical personnel include prior difficulties with anaesthesia or current medications that would either preclude day surgery or require either a modification and/or temporary cessation of the pharmaceutical agent, particularly warfarin. The American Society of Anaesthesiologists’ (ASA) (cited by The Royal College of Nursing 2004) uses three classifications to assess physical status: Class 1: patient is mentally and physically fit and the surgical procedure is localized without systemic disruption, for example, removal of a uterine fibroid in an otherwise healthy female or the repair of an inguinal hernia in a healthy individual. Class 2: patient suffers from mild to moderate systemic pathology that is either caused by the pathology to be treated by the day surgery or by other pathology, for example anaemia or mild diabetes or slightly limiting organic heart disease. Class 3: patient suffers from a severe mental or physical disorder from whatever cause, such as angina pectoris, moderate to severe levels of pulmonary insufficiency, vascular complications from severe diabetes or significantly limiting heart disease. Criteria used for patient evaluation and assurance of fitness for day surgery as outlined above are focused primarily on the suitability for general anaesthesia without complication. It is essential however, to couple both the individual patient status as provided by the pre-assessment with the type of surgical intervention proposed. The medical professional cannot use the same set of pre-assessment criteria for all patients for all procedures; they must simply be a guide. For example, physiological trauma, anaesthetic requirements and post-operative pain are different for those having arthroscopy as opposed to a laparoscopic cholecystectomy or partial thyroidectomy. All three are considered day surgical procedures by the Royal College of Nurses (2004, p. 2). Patient selection criteria are important for nurses to understand from many aspects. The nurse has to understand the physician’s reason for suggesting day surgery for their patient, she needs to understand the surgeon’s belief in appropriateness and she has to understand the potential risks that are often overlooked by physicians and surgeons that now become her responsibility to ascertain. Although it is often a delicate position for the nurse to be in, it is essential that she bring to the surgeon or anaesthesiologist’s attention any patient not appropriate for day surgery. This is an issue of legal liability for all professions on the multidisciplinary team and for the clinic or hospital as well as one of ethical concerns for the patient’s overall care and wellbeing. Learning Outcome 4 – Pain management According to Lipp and Yap (2005, p. 64) prior to 2003, the responsibility for post-surgical pain was the sole responsibility of the anaesthesiologist and no routine or regular pain assessments were conducted. In 2003, pain management assessments and the nursing role in pain management in the day surgery setting became the standard. The Royal College of Anaesthetists (as cited by Lipp Yap 2005, p. 64) tell us that following a day surgical procedure, less than five percent of all patients should experience severe pain while up to 85 percent will have mild or no pain following surgery. Beauregard et al. (1998, p. 309) believes that it is not unusual for pain to persist during the entire week following surgery, but that the best predictor of significant post-surgical pain following hospital discharge was inadequate pain control during the first few hours of following surgery. Research has acknowledged that the longer an individual is experiencing pain that is not attended to or interrup ted in some way, the more sensitive to painful stimuli the patient becomes (Mukherji Rudra 2006, p. 355). Ultimately, the goal of effective post-surgical pain management is to be â€Å"safe and effective, produce minimal side effects such as nausea. It was stated that the criteria for patient selection should be individualized based on patient status and type of surgery. Similarly, Mukherji and Rudra (2006, p. 355) state that patients should be identified as potentially at risk based on â€Å"age, physical status, presence of pre-existing pain, site and extent of surgery.† Additionally, researchers believe that the amount of postoperative pain a patient experiences is also a factor of the surgeon and surgical techniques used ( Mukherji Rudra 2006, p. 356; Chung et al. cited by Beauregard et al. 1998, p. 305). Mukherji and Rudra (2006, p. 355) discuss several pain assessment tools: the visual analogue scale (VAS) where pain is rated along a continuum from â€Å"no pain at all to the worst pain imaginable† and the Oucher’s scale for children. Many patients themselves downplay post-surgical pain for reasons ranging from believing that pain is part of the natural recovery process and what they are experiencing is normal (Beauregard et al. 1998, p. 209). Post-operative pain management can take different forms, including pre-emptive analgesia and prophylactic analgesia (Mukherji Rudra 2006, p. 356). There are also pharmacologic and non-pharmacologic pain management interventions. Pharmacological interventions can be opioid or non-opioids. Opioids are centrally acting and systemic in nature whereas non-opioids are also centrally acting but have a peripheral mode of action, and include codeine, metamizol, paracetamol and non-steroidal anti-inflammatory (NSAIDS) (Mukherji Rudra 2006, p. 356). Another problem cited by the Joanna Briggs Institute (2004) is that of inadequate pain management techniques and/or follow-through by the patient place additional burdens on family caretakers and the community at large. For example, Girgis and Sanders (2004, p. 66) tell us that parents generally underestimate and under treat pain; this can be extrapolated to caregivers in the adult community as well. Home caregivers failing to recognize and/or intervene in pain management is often problematic and it is the responsibility of the nurse to assure that proper discharge information is adequately communicated to the patient and/or caregiver/escort, including proper pain management techniques and interventions. To assure there is no confusion, these should be clearly documented and reviewed with the patient and caregiver verbally. References Beauregard, L., Pomp, A. Choiniere, M., 1998. Severity and impact of pain after day surgery. Canadian Journal of Anesthesia, 45 (4), pp. 304-311. Fisher, A. McMillan, R., 2004. Integrated care pathways for day surgery patients. British Association of Day Surgery [Online]. Available from: http://www.bads.co.uk/pdf%20files/IntegratedCarePathways.pdf [cited March 17, 2007]. Girgis, M. Sanders, D. 2004. Are we giving our children the right dose? The Journal of One-Day Surgery, 14 (3), pp. 65-68. Joanna Briggs Institute, 2004. Management of the day surgery patient [Online]. Joanna Briggs Institute Best Practices. Available from: http://www.adsna.info/attachments/BPISSup.2004.pdf [cited March 17, 2007]. Lipp, A. Yap, H, 2005. Is our pain relief protocol effective? The Journal of One-Day Surgery, 15 (3), pp. 64-66. Mukherji, S. Rudra, A., 2006. Postoperative pain relief for ambulatory surgery. Indian Journal of Anaesthesia, 50 (5), pp. 355-362. National Health Services, n.d.a. Day surgery pre-assessment: A brief guide [Online]. Available from www.wise.nhs.uk/surgery/NationalGoodPractice/downloads/14/14d4.doc [cited March 17, 2007]. National Health Services, n.d.b. Day surgery: A good practice guide [Online]. Available from: http://www.wise.nhs.uk/sites/crosscutting/access/Access%20Document%20Library/1/Day%20Surgery/Day%20Surgery%20Guide.pdf [cited March 17, 2007] Royal College of Nursing, 2004. Day surgery information: Selection criteria and suitable procedures [Online]. Available from: http://rcn.org.uk/publications/pdf/daysurgery_selection.pdf [cited March 17, 2007]. Society of Critical Care Medicine, 2005. Tools for effective communication [Online]. Society of Critical Care Medicine. Available from: http://www.sccm.org/SCCM/Publications/Critical+Communications/Archive/February+2005/communicationsfeb05.htm [cited March 17, 2007]. Vazirani, S., Hays, R. D., Shapiro, M. F. Cowan, M., 2005. Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses. American Journal of Critical Care, 14 (1), pp. 71 – 77. 1 Footnotes [1] According to the National Health Service (n.d.b), the phrase refers to a patient who is â€Å"independent, active and compos mentis.†