Sunday, November 17, 2019
Effective Classroom Management Plan Essay Example for Free
Effective Classroom Management Plan Essay Teaching is considered as one of the most exciting and challenging professions (Walden University 2009). It is through teaching that everyone is able to learn the things that they needed for their jobs. Everyone can not be a professional without the people who have the ability to teach. During teaching process, teachers usually experience the pressure when dealing with students who have different cultures, behaviors and attitudes. Therefore, an appropriate teaching plan is necessary to address these differences and to prevent the pressure which can hinder the teacherââ¬â¢s performance. Through a right plan and use of resources, teachers are able to make most out of everything and prepare the students towards their future (Bosch 2006). Classroom is considered as the most important place for both teachers and students. It is the place where students and teachers freely exchange ideas and learn from each other. à I believe that an appropriate and effective classroom planning is critical in teaching because it aids in imparting knowledge by making the teachers prepared, confident and comfortable with their profession (Bosch 2006). For me, an effective classroom management planning is not only about establishing rules, rewards and consequences but it is also about the establishment of a mutual relationship between the teacher and the students. If a healthy atmosphere is present, then the teacher will not experience difficulty in teaching and students will learn more. In addition, the learning process is student centered (Walden University 2009). This means that learning is imparted through the application of the things learned through classroom activities and tasks. Rules, consequences and rewards are there to guide the students on proper behavior and etiquette but they are not limited to what is written. It is through the real happenings that rules are applied and exercised by the students. In the end teachers are there to guide the students not only in learning but also in correct behavioral decision making.
Thursday, November 14, 2019
Effective Teaching Practices in the Writing Classroom Essay -- English
"While I had thought initially to matriculate into the English Department, it seems to be more heavily weighted toward theory than application, whereas the pedagogical training that I consider necessary for teaching is available through ETAP." So I had thought and so I wrote in my application for admission to the doctoral program. At the same time, realizing that I still would need a solid grounding in my subject area to teach composition and rhetoric, my goal for pursing a Ph.D., I co-matriculated the next semester into the English Department's M.A. program on the writing sequence. Returning to school from a corporate background meant that, while I had trained individuals and small groups in the workplace, I had had no classroom experience with teaching writing. As well, the sun has risen so many times on my memories of learning to write myself that those memories are fairly well bleached out by now. Yet, after almost two years worth of education and English courses, I have learned little about effective teaching practices in the writing classroom. Iââ¬â¢ve read about issues of culture and diversity (Apple, 1996; Banks, 1997; Bruner, 1996; Freire, 1998; hooks, 1994) and Iââ¬â¢ve been exposed to the history of composition and different approaches to teaching writing (Berlin, 1987; Durst, 1999; Elbow, 1973; Haswell, 1991; Herrington & Curtis, 2000; Lindemann, 1995; Miller, 1993, for example). The better part of class time has been spent discussing racism and feminism and sexism and classism and Marxism and structuralism and expressionism and post-colonialism until the appearance of "ism" makes my eyes glaze over. The teaching of anything concrete or structured, such as the specific formats put forth by current-traditional rhetoric or gr... ...000). Persons in Process: Four Stories of Writing and Personal Development in College. Urbana, IL: National Council of Teachers of English. hooks, b. (1994). Teaching to Transgress: Education as the Practice of Freedom. New York: Routledge. Lindemann, E. (1995). A Rhetoric for Writing Teachers (Third ed.). New York: Oxford University Press. Miller, S. (1993). Textual Carnivals: The Politics of Composition. Carbondale and Edwardsville, IL: Southern Illinois University Press. Richlin, L. (Ed.). (1993). Preparing Faculty for the New Conceptions of Scholarship (Vol. 54). San Francisco: Jossey-Bass. Sosnoski, J. J. (1991). Postmodern Teachers in Their Postmodern Classrooms: Socrates Begone! In P. Harkin & J. Schilb (Eds.), Contending with Words: Composition and Rhetoric in a Postmodern Age (pp. 198-219). New York: The Modern Language Association of America. Effective Teaching Practices in the Writing Classroom Essay -- English "While I had thought initially to matriculate into the English Department, it seems to be more heavily weighted toward theory than application, whereas the pedagogical training that I consider necessary for teaching is available through ETAP." So I had thought and so I wrote in my application for admission to the doctoral program. At the same time, realizing that I still would need a solid grounding in my subject area to teach composition and rhetoric, my goal for pursing a Ph.D., I co-matriculated the next semester into the English Department's M.A. program on the writing sequence. Returning to school from a corporate background meant that, while I had trained individuals and small groups in the workplace, I had had no classroom experience with teaching writing. As well, the sun has risen so many times on my memories of learning to write myself that those memories are fairly well bleached out by now. Yet, after almost two years worth of education and English courses, I have learned little about effective teaching practices in the writing classroom. Iââ¬â¢ve read about issues of culture and diversity (Apple, 1996; Banks, 1997; Bruner, 1996; Freire, 1998; hooks, 1994) and Iââ¬â¢ve been exposed to the history of composition and different approaches to teaching writing (Berlin, 1987; Durst, 1999; Elbow, 1973; Haswell, 1991; Herrington & Curtis, 2000; Lindemann, 1995; Miller, 1993, for example). The better part of class time has been spent discussing racism and feminism and sexism and classism and Marxism and structuralism and expressionism and post-colonialism until the appearance of "ism" makes my eyes glaze over. The teaching of anything concrete or structured, such as the specific formats put forth by current-traditional rhetoric or gr... ...000). Persons in Process: Four Stories of Writing and Personal Development in College. Urbana, IL: National Council of Teachers of English. hooks, b. (1994). Teaching to Transgress: Education as the Practice of Freedom. New York: Routledge. Lindemann, E. (1995). A Rhetoric for Writing Teachers (Third ed.). New York: Oxford University Press. Miller, S. (1993). Textual Carnivals: The Politics of Composition. Carbondale and Edwardsville, IL: Southern Illinois University Press. Richlin, L. (Ed.). (1993). Preparing Faculty for the New Conceptions of Scholarship (Vol. 54). San Francisco: Jossey-Bass. Sosnoski, J. J. (1991). Postmodern Teachers in Their Postmodern Classrooms: Socrates Begone! In P. Harkin & J. Schilb (Eds.), Contending with Words: Composition and Rhetoric in a Postmodern Age (pp. 198-219). New York: The Modern Language Association of America.
Tuesday, November 12, 2019
The Effects of Colonization in Africa
While Africans were deprived of basic human rights in some regions and lost many of their cultural aspects, these characteristics were overridden by industrialization, more job opportunities, and improved political structure during the European colonization of Africa from late 19th to mid-20th century. In document 5, it states ââ¬Å"when the whites came to our country, we had the land and they had the Bible; now we have the Bible and they have the land,â⬠an African proverb regarding the Europeans. Through missionaries, Africans gained the trade network and interracial relations, and Europeans expanded their territories as a result.The cheap labor force and raw materials were sent back to the mainland to be finished. The surplus goods from Europe were then sold in higher prices to Africans who could afford it (doc. 2). However, the natives were not always guaranteed equality (doc. 8), thus creating tension. Furthermore, there was friction among different tribes within a colony, due to the fact they were in the same location (doc. 11). Yet, it had a positive impact on economics as well. In some parts of Africa, one woman stated that the people were fortunate to be treated well compared to other parts.They were rewarded goods for their work, and the word ââ¬Å"slaveryâ⬠was abolished (doc. 6). The railroad was constructed for transporting the materials. Also, different tribes developed irrigation systems, and learned the use of the domestic animals, manure, and mechanical work (doc. 3). Additionally, people were taught different skills such as mining and blacksmithing. Some argued that this is forced, but it is rationalized that the natives are savages, therefore it was for their own good (doc. 1). In addition to economics, Europe brought political stability.From the Europeansââ¬â¢ perspective, the new government implemented by Europeans guaranteed the protection of people and their possessions (doc. 9). The tug-of-war (doc. 4) between the nations shows how it affected a colonyââ¬â¢s political system. Thanks to the railroad, the government can oversee their colonies efficiently (doc. 7) while using militarism when needed (doc. 10), protecting their own colonies. Documents that would be helpful are from the ruling class for better understanding of its influence on the social hierarchy.
Saturday, November 9, 2019
Nursing Pressure Sore
What are pressure sores? Pressure sores are areas of injured skin and tissue. They are usually caused by sitting or lying in one position for too long. This puts pressure on certain areas of the body. The pressure can reduce the blood supply to the skin and the tissues under the skin. When a change in position doesn't occur often enough and the blood supply gets too low, a sore may form. Pressure sores are also called bedsores, pressure ulcers and decubitus ulcers. What are the symptoms of a pressure sore? There are 4 stages of pressure sores. Symptoms at each stage include the following: Stage 1.The affected skin looks red and may feel warm to the touch. The area may also burn, hurt or itch. In people who have dark skin, the pressure sore may have a blue or purple tint. Stage 2. The affected skin is more damaged in a stage 2 pressure sore, which can result in an open sore that looks like an abrasion or a blister. The skin around the wound may discolored. The area is very painful. St age 3. These types of pressure sores usually have a crater-like appearance due to increased damage to the tissue below the skin's surface. This makes the wound deeper. Stage 4.This is most serious type of pressure sore. The skin and tissue is severely damaged, causing a large wound. Infection can occur at this stage. Muscles, bones, tendons and joints can be affected by stage 4 pressure sores. Who gets pressure sores? Anyone who sits or lies in one position for a long time might get pressure sores. You are more likely to get pressure sores if you are paralyzed, use a wheelchair or spend most of your time in bed. However, even people who are able to walk can develop pressure sores when they must stay in bed because of an illness or an injury.Some chronic diseases, such as diabetes and hardening of the arteries, make it hard for pressure sores to heal because of poor blood circulation. Peripheral vascular disease,MI, Stroke,Multiple trauma,Musculoskeletal disorders/fractures/contractu res,Gibleed , Spinal cord injury (e. g. , decreased sensory perception, muscle spasms),Neurological disorders (e. g. , Guillain-Barre', multiple sclerosis),Unstable and/or chronic medical conditions (e. g. , diabetes, renal disease, cancer, chronic obstructive pulmonary disease, congestive heart failure),History of previous ressure ulcer,Preterm neonates, Dementia, Recent surgical patient. Where on the body can you get pressure sores? Pressure sores usually develop over bony parts of the body that don't have much fat to pad them. Pressure sores are most common on the heels and on the hips. Other areas at risk for pressure sores include the base of the spine (tail bone), the shoulder blades, the backs and sides of the knees, and the back of the head. How are pressure sores treated? There are several things you can do to help pressure sores heal: * Relieving the pressure that caused the sore * Treating the sore itself Improving nutrition and other conditions to help the sore heal What can be done to reduce pressure on the sore? Don't lie on pressure sores. Use foam pads or pillows to take pressure off the sore. Special mattresses, mattress covers, foam wedges or seat cushions can help support you in bed or in a chair to reduce or relieve pressure. Try to avoid resting directly on your hip bone when you're lying on your side. Use pillows under one side so that your weight rests on the fleshy part of your buttock instead of on your hip bone. Also, use pillows to keep your knees and ankles apart.When lying on your back, place a pillow under your lower calves to lift your ankles slightly off the bed. When lying in bed, change your position at least every 2 hours. When sitting in a chair or wheelchair, sit upright and straight. An upright, straight position will allow you to move more easily and help prevent new sores. You should change positions every 15 minutes when sitting in a chair or wheelchair. If you cannot move by yourself, have your caregiver help you shift your position. How should the pressure sore be kept clean? In order to heal, pressure sores must be kept clean and free of dead tissue.Stage 1 sores can be cleaned with mild soap and water. You can clean stage 3 sores by rinsing the area with a salt and water solution. The saltwater removes extra fluid and loose material. Your doctor or nurse can show you how to clean your pressure sore. Pressure sores should be kept covered with a bandage or dressing. Sometimes gauze is used. The gauze is kept moist and must be changed at least once a day. Newer kinds of dressings include a see-through film and a hydrocolloid dressing. A hydrocolloid dressing is a bandage made of a gel that molds to the pressure sore and helps promote healing and skin growth.These dressings can stay on for several days at a time. Dead tissue (which may look like a scab) in the sore can interfere with healing and lead to infection. There are many ways to remove dead tissue from the pressure sore. Rinsing the sore e very time you change the bandage is helpful. Special dressings that help your body dissolve the dead tissue can also be used. They are left in place for several days. Another way to remove dead tissue is to put wet gauze bandages on the sore and allow them to dry. The dead tissue sticks to the gauze and is removed when the gauze is pulled off.For more severe pressure sores, dead tissue must be removed surgically. Removing dead tissue and cleaning the sore can hurt. Your doctor can suggest a pain reliever for you to take 30 to 60 minutes before your dressing is changed to help reduce pain. Why is good nutrition important for healing sores? Good nutrition is important because it helps your body heal the sore. If you don't get enough calories, protein and other nutrients (especially vitamin C and zinc, which can help heal wounds like pressure sores), your body won't be able to heal, no matter how well you care for the pressure sore.Your doctor, nurse or a dietitian can give you advice about a healthy diet. Be sure to tell your doctor if you have lost or gained weight recently. What if the sore gets infected? Pressure sores that become infected heal more slowly and can spread a dangerous infection to the rest of your body. If you notice any of the signs of infection listed below, call your doctor right away. Signs of an infected pressure sore include the following: * Thick yellow or green pus * A bad smell from the sore * Redness or warmth around the sore * Swelling around the sore * Tenderness around the soreSigns that the infection may have spread include the following: * Fever * Chills * Mental confusion or difficulty concentrating * Rapid heartbeat * Weakness How are infected pressure sores treated? The treatment of an infected pressure sore depends on how bad the infection is. If only the sore itself is infected, an antibiotic ointment can be put on the sore. When bone or deeper tissue is infected, antibiotics are often required. They can be given intravenous ly (through a needle put in a vein) or orally (by mouth). How can I tell if the sore is getting better? As a pressure sore heals, it slowly gets smaller.Less fluid drains from it. New, healthy tissue starts growing at the bottom of the sore. This new tissue is light red or pink and looks lumpy and shiny. It may take 2 to 4 weeks of treatment before you see these signs of healing. How can pressure sores be prevented? The most important step to prevent pressure sores is to avoid prolonged pressure on one part of your body, especially the pressure points mentioned previously. It's also important to keep your skin healthy. Keep your skin clean and dry. Use a mild soap and warm (not hot) water. Apply moisturizers so your skin doesn't get too dry.If you must spend a lot of time in bed or in a wheelchair, check your whole body every day for spots, color changes or other signs of sores. Pay special attention to the pressure points where sores are most likely to occur. If you smoke, you shou ld quit. People who smoke are more likely to develop pressure sores. Exercise can help improve blood flow, strengthen your muscles and improve your overall health. Talk to your doctor if physical activity is hard for you. He or she can suggest exercises that can work for you, or refer you to physical therapist that can help. Pressure Sore PreventionRelieving pressure: Position must be changed on a regular basis, at least every two hours, and in the very frail at least every hour. Good Diet: A good and balanced diet contributes to healing, as well as avoiding severe nutritional and weight loss Skin Care: Keep the skin clean. Moisture should be minimized. Skin care products should be used that moisturize the skin but do not make it wet or soggy. Use continence aids if a person is unable to control their bladder or bowels. Pads, diapers, convenes or catheterizing. Inspect the skin to see if any redness or breaks in the skin are developing.Use products to relieve and treat pressure sore s; airbeds, foam bed, bed and chair protectors, chair products, continence aids can all contribute to avoiding of bed sores. Clean skin with warm water and minimal friction. Apply lotion often. ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- Avoid direct pressure to bony areas such as ankles and hips. Use pillows and padded protectors to support arms, legs and vulnerable areas. Change the position of a bed-bound person every two hours. Handle and move carefully to avoid skin tears and scrapes.Change the position of a chair-bound person hourly. Discourage the bed-bound or chair-bound person from sitting with the head elevated more than 30 degrees, except for short periods of time. Check and change bed linens as often as necessary Use continence management products if necessary to reduce exposure to moisture. Padded supports, such as doughnut cushions may, themselves, become a source of pressure. Do not massage bony areas of the body. Do not massage pressure sores. Do not use remedies such as iodine, peroxide and cornstarch that may further irritate the skin.Pressure sores (bedsores, decubitus ulcers, pressure ulcers) are areas of skin damage resulting from a lack of blood flow due to pressure. â⬠¢ Sores often result from pressure but may also result from pulling on the skin or friction, particularly over bony areas. â⬠¢ The diagnosis is usually based on a physical examination. â⬠¢ Treatment includes cleansing, removal of pressure from the affected area, special dressings, and, sometimes, surgery. Pressure sores can occur in people of any age who are bedbound, chairbound, or unable to reposition themselves. They are more common among older people.They tend to occur over bony projections where pressure on skin can be concentrated, such as over the hip bones, tailbone, heels, ankles, and elbows. They occur where there is pressure on the skin from a bed, wheelchair, cast, splint, or other hard object . Pressure sores lengthen the time spent in hospitals or nursing homes and increase the cost of care. Pressure sores can be life threatening if they are untreated or if underlying health conditions prevent them from healing. Causes Causes that contribute to the development of pressure sores include: â⬠¢ Pressure Traction â⬠¢ Friction â⬠¢ Moisture â⬠¢ Inadequate nutrition Pressure on skin, especially when over bony areas, reduces or cuts off blood flow to the skin. If blood flow is cut off for more than 1 or 2 hours, the skin dies, beginning with its outer layer (epidermis). The dead skin breaks down and forms an open sore (ulcer). Most people do not develop pressure sores because they constantly shift position without thinking, even when they are asleep. However, some people cannot move normally and are therefore at greater risk of developing pressure sores.They include people who are paralyzed, comatose, very weak, sedated, or restrained . Paralyzed and comatose people are at particular risk because they also may be unable to move or feel pain (pain normally motivates people to move or to ask to be moved). Traction also reduces blood flow to the skin. Traction occurs when the skin is stretched by being wedged against something or when it sticks to something, often bed linens. When the skin is stretched, the effect is much like pressure. Friction can lead to or worsen pressure sores. Repeated friction may wear away the top layers of skin.Such skin friction may occur if people are pulled repeatedly across a bed. Moisture can increase skin friction and weaken or damage the protective outer layer of skin if the skin is exposed to it a long time. For example, the skin may be in prolonged contact with perspiration, urine, or feces. Inadequate nutrition increases the risk of developing pressure sores and slows the healing process of sores that do develop. Malnourished people may not have enough body fat to pad the skin and bones or to keep the blood vessels from being squeezed shut.Also, skin repair is impaired in people whose diets are deficient in protein, vitamin C, or zinc. Did You Knowâ⬠¦? â⬠¢ Inadequate nutrition increases the chances of developing pressure sores and slows the healing of sores that do develop. â⬠¢ Repositioning people who cannot move themselves at least every 1 to 2 hours can help prevent pressure sores. Symptoms For most people, pressure sores cause some pain and itching. However, in people whose senses are dulled, even severe sores may be painless. Pressure sores are categorized into four stages according to the severity of damage: â⬠¢ Stage I: Redness and inflammation Stage II: Some shallow skin loss, including abrasions, blisters or both â⬠¢ Stage III: Full-thickness skin loss down to the layer of fat. â⬠¢ Stage IV: Full-thickness skin loss with exposure of underlying muscle, tendon, or bone Pressure sores do not always progress from mild to severe s tages. Sometimes the first noticeable sign is a late-stage sore. If pressure sores become infected, they may have an unpleasant odor. Pus may be visible in or around the sore. The area around the pressure sore may become red or feel warm, and pain may worsen if the infection spreads to the surrounding skin (causing cellulitis).Infection delays healing of shallow sores and can be life threatening in deeper sores. Infection can even penetrate the bone (osteomyelitis), requiring weeks of treatment with antibiotics. In the most severe cases, infection can spread into the bloodstream (sepsis), causing fever or shaking chills. Spotlight on Aging Aging itself does not cause pressure sores. But it causes changes in tissues that make pressure sores more likely to develop. As people age, the outer layers of the skin thin. Many older people have less fat and muscle, which helps absorb pressure.The number of blood vessels decreases and blood vessels rupture more easily. All wounds, including pr essure sores, heal more slowly. Certain conditions make pressure sores more likely to develop: â⬠¢ Being unable to move normally because of a disorder such as stroke â⬠¢ Having to stay in bed for a long time, for example, because of surgery â⬠¢ Being excessively sleepy (such people are less likely to change position or ask someone to reposition them) â⬠¢ Losing sensation because of nerve damage (such people do not feel discomfort or pain, which would prompt them to change ositions) â⬠¢ Becoming less responsive to what is happening in and around them, including their own discomfort or pain, because of a disorder such as dementia Diagnosis Doctors can usually diagnose pressure sores by doing a physical examination. A doctor or nurse usually measures the size and depth of a sore to determine its stage and plan treatment. If the damage is severe, radionuclide bone scanning or gadolinium-enhanced MRI (magnetic resonance imaging) may be done to check whether infection has spread from the sore to boneââ¬âa disorder called osteomyelitis.To diagnose osteomyelitis, doctors may need to take a small sample (biopsy) of bone to see if bacteria grow from it (culture). Prevention Prevention is the best strategy for dealing with pressure sores. In most cases, pressure sores can be prevented by meticulous attention from all caregivers, including nurses, nurses' aides, and family members. Close daily inspection of a bedridden or chairbound person's skin can detect early redness or discoloration. Any sign of redness or discoloration at pressure areas is a signal that the person needs to be repositioned and kept from lying or sitting on the discolored area until it returns to normal.Because shifting position is necessary to keep the blood flowing to the skin, oversedation should be avoided and activity encouraged. People who cannot move themselves should be repositioned every 2 hours if they are in bed and every hour if they are in a chairââ¬âmore often if possible. The skin must be kept clean and dry because moisture increases the risk of developing pressure sores. Dry skin is less likely to stick to fabrics and cause friction or traction. For people confined to bed, sheets should be changed frequently to make sure they are clean and dry.Applying noncaking body powder to skin in areas where two parts of the body press against each other (such as the buttocks and groin) can help keep the skin in these areas dry. Bony projections (such as heels and elbows) can be protected with soft materials, such as foam wedges and heel protectors. Donut-shaped devices and sheepskins should be avoided as they only shift pressure or friction from one vulnerable site to another. Special beds, mattresses, and seat cushions can be used to reduce pressure in people who are wheelchair-bound or bedridden.These products can reduce pressure and offer extra relief. A doctor or nurse can recommend the most appropriate mattress surface or seat cushion. It is important to remember that none of these devices eliminate pressure completely or are a substitute for frequent repositioning. Treatment Treating a pressure sore is much more difficult than preventing one. The main goals of treatment are to relieve pressure on the sores, keep them clean and free of infection, and provide adequate nutrition. Adequate nutrition is important in helping pressure sores heal and in preventing new sores from forming.A well-balanced, high-protein diet is recommended as well as a daily high-potency vitamin and mineral supplement. Supplemental vitamin C and zinc may help with healing as well. Electrical stimulation, heat therapy, massage therapy, and hyperbaric O2 therapy have not proven helpful. In the earliest stage, pressure sores usually heal by themselves once pressure is removed. When the skin is broken, a doctor or nurse considers the location and condition of the pressure sore when recommending a dressing. Film (see-through) dressings help protect ea rly-stage pressure sores and allow them to heal more quickly.Hydrocolloid (oxygen- and moisture-retaining) patches protect, keep the skin appropriately moist, and provide a healthy environment for deep sores. Other types of dressings may be used for deeper sores, those that ooze a lot of fluids, and those that are infected. If the sore appears infected or oozes, rinsing with saline and dabbing gently with a gauze pad are helpful. A doctor may need to remove (debride) dead tissue with a scalpel or a chemical solution. Removal of dead tissue is usually painless, because pain is not felt in dead tissue. Some pain may be felt because healthy tissue is nearby.Health care practitioners may flood (irrigate) the sore, particularly its deep crevices, with a sterile solution to help clean away hidden debris. Sometimes a bed that circulates air (an air-fluidized bed) is used in hospitals and nursing homes. This special bed helps reduce or redistribute pressure on the body. ââ¬âââ¬ââ⠬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- Deep pressure sores are difficult to treat. Sometimes they require skin and muscle flaps, in which healthy, thicker tissue with a good blood supply is surgically repositioned to cover the damaged area.This type of surgery is not always successful, however, especially for frail older people who are malnourished. Often, when infections develop deep within a sore, antibiotics are given. When bones beneath a sore become infected, the bone infection (osteomyelitis) is extremely difficult to cure and may spread through the bloodstream, requiring many weeks of treatment with an antibiotic (see Bone and Joint Infections: Osteomyelitis). ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- The terms decubitus ulcer and pressure sore often are used interchangeably in the medical community.Decubitus, from the Latin decumbere, means ââ¬Å"to lie down. â⬠Decubitus ulcer, therefore, does not adequately describe ulceration that occurs in other positions, such as prolonged sitting (eg, the commonly encountered ischial tuberosity ulcer). Because the common denominator of all such ulcerations is pressure, pressure sore is the better term to describe this condition. Pressure is exerted on the skin, soft tissue, muscle, and bone by the weight of an individual against a surface beneath.These pressures are often in excess of capillary filling pressure, approximately 32 mm Hg. In patients with normal sensitivity, mobility, and mental faculty, pressure sores do not occur. Feedback, conscious and unconscious, from the areas of compression leads inIndividuals who are unable to avoid long periods of uninterrupted pressure over bony prominencesââ¬âa group of patients that typically includes elderly individuals, persons who are neurologically impaired, and patients who are acutely hospitalizedà ¢â¬âare at increased risk for the development of necrosis and ulceration.These individuals cannot protect themselves from the pressure exerted on their body unless they consciously change position or have assistance in doing so. Even the most conscientious patient with an extensive support group and unlimited financial resources may develop ulceration resulting from a brief lapse in avoidance of the ill effects of pressure. [2, 3] dividuals to change body position. These changes shift the pressure prior to any irreversible tissue damage. The inciting event for a pressure sore is compression of the tissues by an external force, such as a mattress, wheelchair pad, or bed rail.Other traumatic forces that may be present include shear forces and friction. These forces cause microcirculatory occlusion as pressures rise above capillary filling pressure, resulting in ischemia. Ischemia leads to inflammation and tissue anoxia. Tissue anoxia leads to cell death, necrosis, and ulceration. à ¢â¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- Irreversible changes may occur after as little as 2 hours of uninterrupted preSpecialized support surfaces are available for bedding and wheelchairs, which can maintain tissues at pressures below 30 mm Hgssure. urning and repositioning the patient remain the cornerstones of prevention and treatment. The wound and surrounding skin must be kept clean and free A new international guideline with regard to the prevention of pressure ulcers was released in 2009. [11] A collaboration between the National Pressure Ulcer Advisory Panel and the European Pressure Ulcer Advisory Panel, the guideline covers the latest evidence-based recommendations for all patients in all healthcare settings.Clinical practice recommendations in regard to prevention will include: * Current definitions and classification of pressure ulcers; * Risk assessment, including the role of nutrit ion; * Skin inspection and skin care; * Positioning and repositioning patients; * Evidence for use of various support surfaces (air-fluidized beds; alternating air mattresses and cushions; foam-, gel-, or fluid-filled mattresses; overlays for operating tables; turning beds; and other aids for pressure redistribution); * Protective devices used for pressure ulcer prevention; and * Education and training for healthcare providers.
Thursday, November 7, 2019
censorship in schools essays
censorship in schools essays Imagine for one moment that you are not yourself any longer. Visualize instead that you are a young girl; old enough to know right from wrong yet still young enough to be terrified by the dark shadows in your room. It is a cool autumn night and your parents have opted to attend a party which you are not allowed at. It will be fine, they say. Although you already know what is to come. Your uncle comes over to watch you for the evening, and your parents are so pleased by the fact that they do not have to find a sitter. As soon as he arrives, your mother kisses you on the cheek and scurries out the door to join your father already waiting in the car outside. The nightmare begins. His slimy hands casually slide an ebony cartridge into the VCR as he smiles at you seductively. You can feel his eyes worming their gaze through your clothes every time that he looks at you. You feel dirty and violated every time you think about what he does to you when you are alone. He walks over to the couch and sits down next to you. His hand slithers it way onto your knee and you cringe in revulsion. Dont be afraid, I wont hurt you, he chides. Your mind feels panicky as you feel his touch in more intimate places and you scream involuntarily. His grip tightens as he places his hand over your mouth. Well have to do this the hard way! comes his intense whisper. You flail your arms at him, but it doesnt help. His writhing massive body is on top of yours, and you feel so powerless. Eventually, you sink into a sobbing heap and simply wait for his passions to stop. You wait for the nightmare to end. When he is done, you limp to the laundry room and try fruitlessly to get the blood stains out of your clothes. It is all your fault... Abuse: The violation or defilement of; What you have just experienced is one type of abuse that occurs millions of times every year across America. Estimates of abuse rang...
Tuesday, November 5, 2019
A Short History of the Toothpick
A Short History of the Toothpick Thanks to the humble toothpick, taking care of your oral hygiene after meals has become somewhat of a ritual. With needle-like precision, it makes removing unseemly pieces of food debris, such as that stubborn sliver of shredded chicken, a thoroughly satisfying task. So who should we thank for it? DIY Originsà The toothpick is one of the few inventions being used today that predates the arrival of modern humans. Fossil evidence of ancient skulls, for instance, suggests that early Neanderthals used tools to pick their teeth. Scientists have also found tooth indentations indicative of teeth picking in human remains among Australian Aborigines, prehistoric Native Americans, and the earliest Egyptians. à The practice of teeth picking was not uncommon among early civilizations, too. Mesopotamians used instruments to keep dental crevices clear and artifacts such as toothpicks made out of silver, bronze and various other precious metals that date back to antiquity have also been unearthed. By the Medieval period, carrying a gold or silver toothpick in a fancy case became a way for privileged Europeans to distinguish themselves from commoners. The toothpick wasnââ¬â¢t always quite the lowly, mass-produced and disposable piece of wood that weââ¬â¢ve come to know today. Queen Elizabeth once received six gold toothpicks as a gift and would often showcase them. Thereââ¬â¢s even an anonymous portrait depicting her as an old woman wearing multiple chains around her neck, from which hung a gold toothpick or a case. Meanwhile, those who couldnââ¬â¢t afford such luxuries resorted to more creative ways of fashioning their own toothpicks. The Romans came up with a particularly clever method of pulling bird feathers, chopping off the quill and sharpening the tip. The technique was passed on to future generations in Europe and eventually carried over to the new world. Over in the Americas, native peoples carved toothpicks from deer bone. And just up north, Eskimos used walrus whiskers. Coincidentally, wood was generally considered unsuitable for the purpose of dislodging trapped food bits. Twigs from trees were inadequate because they tended to wear down when wet and had a propensity to splinter, which tended to be problematic. One exception is the mastic gum tree of southern Europe, with the Romans among the first to take advantage of the plantââ¬â¢s pleasant aroma and its teeth whitening properties. A Toothpick for the Masses With the ubiquity of tooth picking tools across the world, it was only a matter of time before an industry was built around them. As small businesses specializing in toothpick manufacturing began to pop up, demand for toothpicks also grew.à American entrepreneur named Charles Forster. The mass production of toothpicks can be traced to the Mondego River Valley in Portugal. It was there, in the small municipality of Coimbra, that the 16th century nuns of the Mos-teiro de Lorvo monastery began making toothpicks as a disposable utensil for picking up sticky confections that tended to leave residue on fingers and teeth. Locals eventually picked up the tradition, using only the finest orangewood and a jackknife to handcraft the toothpicks. The region would over time earn a reputation as the world capital of the toothpick industry where the finest toothpicks were made. Orders soon came in from all over Europe and shipment were sent out as far overseas as the Americas. The Portuguese were especially renowned for a special type of cocktail tooth called ââ¬Å"palitos especialesâ⬠distinct for their carved involutes and curly shafts. In the U.S., some vendors seek to mimic the classy, festive aesthetic with toothpicks topped with colored cellophane. Toothpicks in America The American entrepreneur Charles Forster was particularly impressed by the high quality of the toothpicks in South America. While working in Brazil, he noticed that the locals often had impeccable teeth and credited it to the use of imported toothpicks from Portugal. Inspired by fellow American Benjamin Franklin Sturtevantââ¬â¢s shoe-making machine, Forster got to work on building something similar that would be capable of mass-producing millions of toothpicks a day. While he was ultimately able to come up with the goods, Americans simply werenââ¬â¢t interested. Part of the problem was that Americans were already accustomed to whittling their own toothpicks and doling out cash for something that can easily make themselves made little sense at the time. What was needed was a sea change in ingrained lifestyle habits and attitudes if there was any hope of generating demand. Forster just so happened to be crazy enough to take on such a seemingly insurmountable challenge. Some of the unusual marketing tactics he employed included hiring students to pose as store customers seeking toothpicks and instructing Harvard students to ask for them whenever they dined at restaurants. Soon enough, many local eateries would make sure toothpicks were available for patrons who somehow developed a habit of reaching for them as theyââ¬â¢re about to leave. Though it was Forster who at the time nearly singlehandedly established a growing market for mass-produced wooden toothpicks, there were a few others jockeying to get into the game. In 1869, Alphons Krizek, of Philadelphia, received a patent for an ââ¬Å"improvement in toothpicks,â⬠which featured a hooked end with spoon-shaped mechanism designed to clean out hollow and sensitive teeth. Other attempted ââ¬Å"improvementsâ⬠include a case for a retractable toothpick and a scented coating meant to freshen oneââ¬â¢s breath.à à Towards the end of the 19th century, there were literally billions of toothpicks made each year. In 1887, the count got as high as five billion toothpicks, with Forster accounting for more than half of them. And by the end of the century, there was one factory in Maine that was already making that many.à à Toothpicks Not Just for Picking Teeth With the commercialized ubiquity of disposable wooden toothpicks, the concept of the toothpick as status symbol, which stubbornly persisted well into 19th century, would slowly begin to fade. Silver and gold toothpicks, once immensely popular amongst societyââ¬â¢s most well-heeled elites, were increasingly turned in as donations at fundraisers. But that doesnââ¬â¢t mean a toothpickââ¬â¢s usefulness was simply relegated to oral hygiene. Most people, for instance, are familiar with the use of toothpicks in social settings where eau doeuvres and other finger foods are served. Yet theyââ¬â¢ve also proved capable of pinning down overstuffed deli sandwiches, cleaning dirt from underneath fingernails, and even picking locks. While the standard toothpick of today remains essentially unchanged from the ones Forster was cranking out over a century ago, entrepreneurs still seek to improve upon its very basic iteration. One early attempt by Forster and others to make them more appealing was the introduction of flavored toothpicks. Popular flavors included cinnamon, wintergreen, and sassafras. For a time, there were even liquor flavors, such as Scotch and Bourbon. Inventors have also tested other coatings such as imbuing sticks with zinc as a disinfectant. Another therapeutic approach involved combining a toothpick and a gum massager. Others have tried tinkering with the shape by making the center square as a way to prevent rolling when dropped while some newer ones claim to offer enhanced cleaning ability with the addition of brush-like bristles to the head. Though such efforts to build a better toothpick may arguably yield some advantages, theres something about the toothpickââ¬â¢s modest simplicity that makes it so users dont have much of a desire to deviate. A disposable, cheap object with a simple design that achieves its desired goal, you really couldnââ¬â¢t ask for more - as a consumer or as a manufacturer.
Sunday, November 3, 2019
Globalisation , the World Economy and MNEs Essay - 2
Globalisation , the World Economy and MNEs - Essay Example The government of the will be left fighting to retain its power. The monopolizing effect and lack of local industries will eventually draw the economy into a foreign driven system where the country will depend on the decisions made by these foreign MNEs (Dicken 123). The other disadvantageous effect of foreign investments is felt on the countryââ¬â¢s Balance of Payment. As the MNE invest on the countryââ¬â¢s economy, they bring in initial capital that will boost the countryââ¬â¢s economy, but the earnings from these investments always go back to their parent country (Hill 240). Taxation is also mostly done on the parent country level, meaning that the country does not gain anything from these investments. Another effect is on the importation sector, the main offices of these MNEs are on the parent country and the foreign subsidiary receives their goods from the main office (Rojec 204). This means that the host country will end up being importers, which debits their current accounts of the balance of payment. National sovereignty of the host country and its autonomy also faces some challenges. The MNEs will be on the forefront on the decisions affecting the economy, basing that their major interest is to maximize profit, they would not have much concerns with the economy of the host country. They would make decisions on what is best for them leading to uneven development in the country (Saggi 54). The effort of the countryââ¬â¢s government to still retain the decision making control on its economy will not help because they have no control over the foreign
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