Thinking Critically Simulation Review Essay Example for Free

Thinking Critically Simulation Review Essay Through the thinking critically simulation, I was able to exercise my own problem solving techniques. In the simulation, real-life business scenarios were given as examples to be resolved. It was divided into three parts: (1) Framing the problem, (2) Making the decisions, and (3) Evaluation the decision. Each phase has its own sublevels which specifically advise the decision makers on what tasks to do in order to effectively address the problem. In the first phase, I was given several possible problems and I was asked to rank them based on urgency and criticality. The detailed background information about the company helped me in analyzing the situation. However, in the end I resorted to my own techniques in coming up with the best way to rank the problems. It was easier for me to select the problem that when solve can immediately help increase the sales of the electronics store. It was just a manner of choosing the problem that would caused a major impact on the store if it is not straight away confronted. Based on the results, my efforts received a B+ grade which meant that I fairly did well in that activity. Â  Meanwhile, for the second phase, I was asked to match the best solutions for the immediate concerns of the company. It was mentioned that formulating solutions includes identifying the problem, planning alternatives and evaluating the alternatives. I followed these steps but unfortunately I was not able to get a good assessment based on the solutions that I have selected for the given problems. Probably, it would have helped if I paid more attention to details and weighed the consequences of each probable solution. I think the practicality and convenience of the solutions should also be considered in order to optimize the resources of the company without the risk of decreasing sales or losing employees. More so, I have realized that in most problems, single or the so-called best solutions are hard to find. It is easier to draft several solutions and try to implement all of them which could help in addressing all the aspects of the identified problems. In the third phase of the simulation, I was asked to evaluate the given solutions through metrics which will measure the efficiency of each resolution. It is very important that before a decision is made; all sides of the situation or the problem should have been carefully analyzed. In the end, the decision maker should always keep in mind that in making decisions, every detail no matter how small should be considered. Also, there are obvious problems and solutions that may seem as the only appropriate options for a particular situation. But a decision maker must be critical with this so as not to waste time and effort on fallacies that poses only as problems and solutions but in reality, these are just the actual scenarios.

Effects of Vitamin C on Chemotherapy Outcome | Claim Review

Effects of Vitamin C on Chemotherapy Outcome | Claim Review Media Claim on ‘Vitamin C’ gives chemotherapy a boost’ The headline ‘Vitamin C’ gives chemotherapy a boost’ suggested by a US scientist was a misleading and inaccurate statement as the study was looking specific at late stage ovarian cancer. From the study, scientists did not find high dosage of vitamin C help with cancer survival nor reducing the risk of cancer (Ma and Chapman et al., 2014). Yet, the study did show that there was a slight chance of reducing minor chemotherapy side effect. Therefore, the study has been oversimplified and misinterprets results and statements which can lead to assumptions from general public misunderstanding this article resulting in toxicity of vitamin C when overdosed. Overdose of vitamin C can lead to other problems and health disease such as indigestion, diarrhea and iron poisoning which only occurs in people who have rare iron overload disorders – hemochromatosis (Zobel, 1976), lack of vitamin C in the diet can also cause scurvy (Naidu,2003). ‘Vitamin C’ gives chemotherapy a boost’ was published in BBC Health website on 9th February 2014, written by Helen Briggs and science editor. Comments were from Dr Jeanne Drisko, lead researcher Qi Chen and Dr Kat Arnet – science communications manager for Cancer Research UK. The claim is based on a study that was carried out by researchers from University of Kansas in the US and world cancer research fund (WCRF) and American Institute for cancer research (AICR). The article itself was published in the peer-reviewed journal, Science Translation Medicine. Cancer is a condition where specific cells in parts of the body grow and reproduce uncontrollably and forming tumours. Cancer cells can invade and destroy surrounding healthy tissue and organs (King and Rotter et al., 1992). Cancer may also spread to more distant parts of the body through the lymphatic system or bloodstream (Mendelsohn, 2008). Many factors have been identified which can increase risk of cancer such as tobacco use, dietary intake, certain infections, environmental radiation, lack of physical exercise, obesity and genetics which potentially can damage genes and causes mutation in cells (Kushi and Byers et al., 2006). Many researchers have found that there are over 200 different types of cancer cells (Schram and Ng, 2012). However, according to Jemal and Bray et al., 2011, many cancers can be prevented by living healthier life styles, one of the factors is reducing excess smoking which can preclude the risk of getting lungs cancer, plus eating plenty of fresh vegetable and fruits, and reducing the intake of meat and carbohydrates can prevent other health factors such as obesity. Ovarian cancer is where cancer cells are found in ovaries. However, the exact causes of cancer still remain unknown (Hunn and Rodriguez, 2012). Women who have had menopause and have not had any children would have a higher chance of developing ovarian cancer (Vo and Carney, 2007). However, ovarian cancer can affect all ages. There are three types of ovarian cancer – epithelial ovarian cancer; germ cell tumours and stromal tumours (Bandera and Era, 2005). The best and effective treatment for ovarian cancer are the combination of surgery and chemotherapy, all treatments are depending on the stages of cancer (Ehrlich and Teitelbaum et al., 2007). Vitamin C also known as ascorbic acid acts as an antioxidant; an oxidative stress; an enzyme cofactor for the biosynthesis, also most importantly vitamin C acts an electron donor for enzymes (Vobecky and Shapcott et al., 1975). Acting as an antioxidant prevents free radicals during oxidation reaction to form chain reactions in cells which can damage or kill cells. Instead, antioxidant interacts with those chain reactions by removing free radicals and inhibits other oxidation reactions in the cells, protecting against lip peroxidation, reducing nitrates and stimulating the immune system (Bender, 1993). Vitamin C has also shown to inhibit formation of carcinogens and protects DNA from mutagenic attack and most vitamin C is found in critic fruits (Combs, 2012). Furthermore, Ma and Chapman et al., 2014 stated that the study was looking if vitamin C could potentially be a cancer treatment and the study was mainly looking into women who are in their late stage ovarian cancer. BBC’s report on this study was miscellaneous as there were some bias comments towards the study, but BBC did include some accurate quotes from the study such as the sample size only 22 patients were participated which showed that the study was not reliable as the sample size was too small to prove whether vitamin C helped to kill cancer cells or increase survival rate (Park, 2013). Moreover, the title ‘Vitamin C’ gives chemotherapy a boost’ was misleading as the study found no supportive evidences that vitamin C can prevent cancer, only can inhibit some mechanisms and reduce the risk of cancer development (Ma and Chapman et al., 2014). However, the study did show that vitamin C may reduce side effects from treatment for women, yet, the sample s ize was too small which was unable to support the outcome. However, the expert from the study quoted that in order to find out if high-dose vitamin C has an effect on cancer cells, further studies and large clinical trials are needed to ensure safety and effectiveness (Ma and Chapman et al., 2014). Additionally, BBC may have been over analysed the press release from the University itself, as it claimed that ‘Researchers establish benefits of high-dose vitamin C for ovarian cancer patients’. This statement was supported via Park, 1985‘s research which stated that ‘vitamin c is involved in the mechanism of action of the intracellular oxidation state changes which is an identification of genes or protein synthesis.’. This suggested that vitamin C has the ability to regulate specific cellular phenotypes which potentially could improve the efficacy of cancer therapies. Nevertheless, the report stated that the vitamin C treatment worked along with standard chemotherapy drugs which slow down tumour growth in mouse studies, not human. Therefore, the benefits of high-dose vitamin C for cancer cells cannot be taken into account due to the fact that human and mouse have different types of genes and intracellular mechanism (Park, 1985). As a result, there ar e not any beneficial effects on human, but there are beneficial effects on mouse. In addition, within the small group of patients that were tested on, they have found fewer side-effects when vitamin C was given out along with the chemotherapy. According to WCRF and AICR‘s report on diet and ovarian cancers, it showed that vitamin C has no effect on ovarian cancer which do not decrease nor increase the risk of cancer. However, according to Part 2 evidence and judgements and Part three Recommendations chapter twelve- public health goals and personal recommendations from WCRF and AICR, it suggested that the population should consumption an average of non-starchy vegetables and of fruits to be at least 600g (21 oz) daily. This is because there are evidences that diets high in vegetable and fruits could protect against oesophagus cancer not ovarian cancer (Mikirova and Casciari et al., 2012). According to BBC, the researcher’s injected vitamin C into human ovarian cancer cells as well as mice in the laboratory conditions. BBC stated that ‘researchers found ovarian cancer cells were to be sensitive to vitamin C treatment, but normal cells were unharmed (De Laurenzi and Melino et al., 1995). High dosage of vitamin C could prevent cancer was originally suggested by chemist and double Nobel Prize winner Linus Pauling in 1970s in which the clinical trial was abandoned due to failed to replicate the expected results to the theory behind vitamin C and cancer (Cameron and Pauling, 1979). The method used in the study was by injecting vitamin C straight into the bloodstream as it is safer, can be effective, low-cost (Head, 1998). The rate at which human body excrete vitamin C through oral ingestion is a lot faster than by injection through bloodstream (Cameron and Pauling, 1979). Furthermore, patients were not completely blind tested as most of them knew what they were given vitamin C and placebo, therefore, many physiological effects have been taken into account toward the analysis of results. In conclusion, due to lack of supportive evidences, vitamin C has no significant back story in supporting the evidence of beneficial effect on ovarian cancer even though from the study some beneficial effects did show on mice. Furthermore, the clinical trial was tested unfairly as participants knew about the comparison test with placebo, which might have had effected the results, in which the results are not accurate and reliable as the sample size was consisting of 22 participants. Nevertheless, the study did find moderate result from patients who have taken parts in the vitamin C trials; as a result, vitamin C might reduce the side effects of chemotherapy. References Bandera and Era, C. A. 2005. Advances in the understanding of risk factors for ovarian cancer. The Journal of reproductive medicine, 50 (6), pp. 399406. Bender, D. A. 1993. An introduction to nutrition and metabolism. London: UCL Press. Cameron, E. and Pauling, L. 1979. Cancer and vitamin C. Combs, G. F. 2012. The vitamins. Amsterdam: Elsevier/Academic Press. De Laurenzi, V., Melino, G., Savini, I., Annicchiarico-Petruzzelli, M., Finazzi-Agro, A. and Avigliano, L. 1995. Cell death by oxidative stress and ascorbic acid regeneration in human neuroectodermal cell lines. European Journal of Cancer, 31 (4), pp. 463466. Ehrlich, P. F., Teitelbaum, D. H., Hirschl, R. B. and Rescorla, F. 2007. Excision of large cystic ovarian tumors: combining minimal invasive surgery techniques and cancer surgery—the best of both worlds. Journal of pediatric surgery, 42 (5), pp. 890893. Head, K. 1998. Ascorbic acid in the prevention and treatment of cancer. Alternative medicine review: a journal of clinical therapeutic, 3 (3), pp. 174186. Hunn, J. and Rodriguez, G. C. 2012. Ovarian cancer: etiology, risk factors, and epidemiology. Clinical obstetrics and gynecology, 55 (1), pp. 323. Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E. and Forman, D. 2011. Global cancer statistics. CA: a cancer journal for clinicians, 61 (2), pp. 6990. King, R. A., Rotter, J. I. and Motulsky, A. G. 1992. The Genetic basis of common diseases. New York: Oxford University Press. Kushi, L. H., Byers, T., Doyle, C., B, Era, E. V., Mccullough, M., Gansler, T., Andrews, K. S. and Thun, M. J. 2006. American Cancer Society Guidelines on Nutrition and Physical Activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA: a cancer journal for clinicians, 56 (5), pp. 254281. Ma, Y., Chapman, J., Levine, M., Polireddy, K., Drisko, J. and Chen, Q. 2014. High-Dose Parenteral Ascorbate Enhanced Chemosensitivity of Ovarian Cancer and Reduced Toxicity of Chemotherapy. Science translational medicine, 6 (222), pp. 2221822218. Mendelsohn, J. 2008. The molecular basis of cancer. Philadelphia, PA: Saunders/Elsevier. Mikirova, N., Casciari, J., Rogers, A., Taylor, P. and Others. 2012. Effect of high-dose intravenous vitamin C on inflammation in cancer patients. J Transl Med, 10 p. 189. Naidu, K. A. 2003. Vitamin C in human health and disease is still a mystery? An overview. Nutrition Journal, 2 (1), p. 7. Park, C. H. 1985. Biological nature of the effect of ascorbic acids on the growth of human leukemic cells. Cancer research, 45 (8), pp. 39693973. Park, S. 2013. The effects of high concentrations of vitamin C on cancer cells. Nutrients, 5 (9), pp. 34963505. Schram, F. R. and Ng, P. K. 2012. What is Cancer?. Journal of Crustacean Biology, 32 (4), pp. 665672. Vo, C. and Carney, M. E. 2007. Ovarian cancer hormonal and environmental risk effect. Obstetrics and gynecology clinics of North America, 34 (4), pp. 687700. Vobecky, J., Vobecky, J., Shapcott, D., Cloutier, D., Lafond, R. and Blanchard, R. 1975. Vitamins C and E in spontaneous abortion. International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin-und Ernahrungsforschung. Journal international de vitaminologie et de nutrition, 46 (3), pp. 291296. WCRF- AICR Diet and Cancer Report. 2014. [online] Available at: http://www.dietandcancerreport.org/cancer_resource_center/downloads/chapters/chapter_12.pdf [Accessed: 10 Mar 2014]. Zobel, M. 1976. Toxicological Evaluation of Some Food Additives Including Anticaking Agents, Antimicrobials, Antioxidants, Emulsifiers and Thickening Agents. Who Food Additives Series, No. 5. 520 Seiten. Geneva 1974. Preis: Sw. fr. 23,—. Food/Nahrung, 20 (6), pp. 681682.

Violence In Leda and the Swan by W.B.Yeats Essay -- essays research pa

Violence In Leda and the swan by W.B.Yeats â€Å"Leda and the Swan† is one of the most well known poems by Yeats, although it’s controversy as to what really happens during the lines of this sonnet. There are many different ways as to how one can approach the interpretation of the poem, is it influenced by Yeats’ own life, in which case he puts all his frustration towards Maud Gonne into words, or is it a poem about power, or about politics? I have deliberately chosen not to take into consideration the political and social background of Ireland at that time. This, because I prefer to restrain my analysis to the poem itself, and how one could interpret its proper meaning. As a consequence, it is interesting and important to remember that one of Yeats’ many interests was Greek mythology, more precisely issues linked to Helen of Troy. In this poem, Yeats shows his vision of how Leda got pregnant by Zeus who was disguised as a swan when he raped her. This act gave birth to two eggs, and one of them was to become Helen of Troy. It is her birth that was the real cause of the Trojan War and Agamemnon’s death. To write this poem Yeats was inspired by a carving, a Hellenistic bas-relief reproduced in Elie Faure's History of Art (1921) , which he owned. His description of what happens in the poem concurs with this carving. This is a strong poem, where the image of a woman can be seen as dirtied, dehumanised, and shameful, the girl was not only raped in a ‘normal way’, but it was an animal that carried out the act. Still, Yeats describes what happened in such a way that one wonders if at some point, Leda’s body actually is led by lust, and puts back her fear, or if she is really trying to fight back, as we will see further on, in... ...me, he does play on provocation, as when the poem was written Gaelic tradition included a strong involvement of the catholic church both in law making, and in morality. There were censorship everywhere, in books, films, and to show how far it went, we can add that even contraception and divorce was made illegal! Yeats was against all this, and it can be felt in his poem, as it touches pornography, and female purity. Bibliography: Cullingford Elizabeth, Gender and history in Yeats’ love poetry, New York: Syracuse Hargrove, Nancy D., â€Å"Aesthetic Distance in Yeast’s ‘Leda and the Swan,’† in Arizona Quarterly, Vol. 39, 1983 Scott C. Holstad, California State University, Long Beach, Yeast’s 'Leda and the Swan': Psycho-Sexual Therapy in Action Univ.Press W.B.Yeats, Selected poems, Penguin Modern Classics www.sparknotes.com

Ghost Stories :: English Literature

Ghost Stories Ghost stories revolve around lots of Spooky tales that work on displacing the reader's fear. Some of the main techniques which make them successful involve: Fear, Drama, Danger and Suspense. However, the main idea is that they create tension too. Such stories which use tension to dramatic affect are "The Red Room" by H.G. Wells and "Farthing House" by Susan Hill; both are written in first person narrative to allow the reader to get scared along with the main character. Both stories also build tension through their Style, Setting, Structure and Language. "The Red Room" is about a ghost hunter who is a legendary ghost, "Farthing House" is about a woman who stays with her aunt at a residential house and feels and sees a woman's supernatural presence in her room - both tales have a dramatic twist at the end! Tension is created through "The Red Room's" setting in many ways - Firstly: "I can assure you, said that it will take a very tangible ghost to frighten me". This dramatic opening to the story sets the ghost hunter as a Brave, Strong character. The word 'tangible' suggests it will take more than a scary image to frighten him, yet tension is caused because the reader now expects that something will be frightening him - soon. H.G. Wells builds on this subtle tension and the supposed 'invincible man' by setting his story to contradict and unease the man's assurances, not only is he in a strange house with a legendary red room (building immediate suspicion by the fact that the room is renowned, "You will show me to this haunted room of yours,") but Wells surrounds him with grotesque characters too. The three custodians set the story by introducing the reader to the Red Room and through their crusty appearance. "If is your own choosing, said the man with the withered arm and glanced at me askance" only four lines into the story and the main character, along with the reader already senses that all is not well, mainly because the man is deformed - "withered" and because he is acting oddly i.e.; "looking askance". This action suggests the custodian knows something we don't, he appears too shifty. Wells continues to build tension through introducing the second man who also adds to the scene: "shambling step", "more bent, more wrinkled, more aged", "his lower lip half averted, hung pale and pink from his decaying yellow teeth", "began to cough". The verb 'shambling' suggests the man may have a limp and the repetition of the word 'more' portrays a disgusting image of the ageing wreck, barely human. The man's manky description backs this up and encourages the

Nurse Role, Management of Obesity

The role of nurses in the management of Obesity The case study provided regarding diet and weight management has led me to explore the role of a nurse specifically during the management of obesity. The investigation aims to determine how a nurse can intervene and control obesity. The research generally looks at the role of the nurse in managing a patient that is clinically classed as obese. Obesity is calculated using BMI measurements (appendix 1). Limitations to this investigation from a personal perspective are that I haven’t yet practised as a nurse so I can’t use reflection on my own practise as a learning tool.Taking this into consideration I have sourced my information with the use of secondary research methods, thus meaning the summary and synthesis of existing research already available to me via published articles, books and other relevant resources. As you will see as you read on the value of knowledge and evidence to professional practise is critical. The mai n reason why you need to base your professional practice on the best available evidence is explained by Aveyard and Sharp (2009, p6), â€Å"†¦Ã¢â‚¬ ¦ t enables us to deliver the best possible patient/client care rather than out of date practice’’. Aveyard and Sharp (2009, p7) goes on to say that â€Å"evidence based practice is practice that is supported by clear reasoning, taking into account the patient or clients preferences using your own judgement†. This description is backed up by Sackett et al (1996, p71-72) who described EBP as, â€Å"the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patient/clients†.Gray (1997,p9) emphasized a focus on patient values describing EBP as , â€Å"an approach to decision making in which the clinician uses the best evidence available in consultation with the patient, to decide upon the option which suits the patient best. The NMC code of Condu ct (2008) foregrounds the importance of evidence based practice in professional development and requires that all nurses should be accomplished in practicing evidence based care.After reading various journal articles and books on EBP I have discovered that it is about integrating individual clinical expertise, for example your own proficiency and expertise, along with the best external evidence and also taking in mind the best interests for the patient. It is of high importance to use current best evidence, according to Greenhalgh and Donald (2000) without current best evidence, â€Å"practise risks becoming rapidly out of date, to the detriment of the patients†. Ultimately EBP is the formalization of the care process that the best clinicians have practiced for generations.The contribution of EBP to clinical practice is the delivery of high quality, cost effective and quality care (Aveyard and Sharp, 2009). Challenges surrounding EBP are a nurses experience, for example new n urses may be a little anxious of their new surroundings and unable to utilize all their newly learnt skills. According to Ferguson and Day (2007), â€Å"access to evidence in nursing practice is often challenging due to time constraints, difficulties in interpreting the disparate research reports on particular issues, or lack of up-to-date print-based resources or Internet connections on nursing units†.The main tool applied during my research process was Library Gateway which can be accessed via Shu space. Library Gateway enables you to access a large number of information resources and search tools. The main resource I used is Library Search, which can find results from books, full text journals and many other sources, and return them in one integrated list. The other Gateway tools include Subject Guides, help pages for referencing, the Video, Images and Audio guide and a list of subject databases.Textbooks provide good background information and offer an excellent starting point for more in-depth research, the information provided is not normally rapidly changing and it must be remembered that it may be out of date. Journal articles contain current information and research. They provide detailed reports of the methodology and results of laboratory research, case series reports, clinical trials, program evaluation, and other kinds of research studies. Journal articles focus on finding solutions to specific health care problems. The Internet is not always the best place to look for professional-level information.While it can be easily searched and you get a lot of what you find in full-text, the quality of the health care information found can be questionable. It is important to look at trusted authorities online, however the internet can be useful for looking into a patient’s perspective, for example a patient may explain their worries and experiences in an online chat forum which is always an interesting insight. The tables that follow details the databases used and the search criteria applied. Each database offers a different value of evidence. It is important to consider the following factors when looking t text documents regardless whether it a book, journal, article or online†¦.. Who wrote it, why it was written and when it was produced (SHU 2012). Once you have found a source that is deemed suitable it is then important to consider if the study was original, was the design of the study sensible, has systematic bias been avoided or minimised, was assessment ‘blind’, were preliminary statistical questions addressed (Greenhalgh, 2010). After summing up these points the methodological quality will have been accurately assessed and providing no flaws or faults are found it can be deemed accurate and reliable information.Table 1. Databases used; Database| Details| SHU Library Search| SHU Library Search searches for academic journal and newspaper articles, books,videos, maps and much more from a single sea rch bar. It searches the SHU library catalogue, full text journals and other linked databases. It is limited to content subscribed to by SHU. | Internurse| Internurse is the online archive of peer reviewed nursing articles published by MA healthcare Ltd. It draws together articles from 13 high quality journals. | Table 2. Search Strategy;Database| Keywords| Rationale| Criteria| No. of results| Search terms used in Library Search and Internurse| Nurs* AND manag* AND obes*| The word nurse/nurses/nursing and manage/managing/management and obese/obesity| 2008 to 2012English languageNo country specified. Type of publication: Peer reviewed journals and books | 32| You can search as far back as 2004 using Inter-nurse. For the chosen subject area I decided to concentrate my research more specifically on more recent research as I found I was bombarded with information when I looked as far back as 2004.This has allowed me to look at more recent publications which I feel is highly important in a profession where health care routines are often being changed and improved. Once I had narrowed down the search I was able to pick journals, articles and books which I felt where most appropriate by reading the abstract to get a more in depth overview of what would be best for my topic. Obesity can lead to the onset of several complications, which with the intervention of nurses could be prevented, these complications are highlighted in appendix 2.Maggi Banning (2005) states that there is an ever increasing need for the evolvement of a nursing role as an obesity nurse specialist. She claims the nursing profession needs to step up and prepare for obesity management. The National Obesity Forum provides an ‘Obesity Care Pathway Toolkit’. It strengthens the need for the use of EBP by claiming weight management should ‘†¦. be based on best evidence, where ever possible’. It also states the following, â€Å"It is essential that services be developed in c onsultation with the users and people who will be delivering them, working together as a multi-disciplinary group.Training on weight management control, healthy eating and increasing physical activity to health professionals is necessary to ensure consistent, accurate and up to date messages are given to patients at all times. Currently, very few NHS weight management services are monitored or audited, this will be a must in the future and needs to be built in at the planning stage. The feedback will result in improved services to patients. † Changes in eating habits and activity levels are thought to lie at the heart of obesity (Wadden et al, 2002).As a nurse will get to see their patients everyday it is the ideal opportunity for them to advise patients on healthy eating and provide encouragement for increased levels of activity. Drummond (2002) identified that communication between the nurse and patient is important as some patients may be self conscious or body-conscious. F or example certain terms should be avoided such as ‘sport’ or ‘exercise’ which may have negative associations for patients, a higher level of activity and ‘avoiding sedentary pursuits should be emphasised’.Body weight is considered a sensitive issue for most people so it is vital that healthcare professionals handle the subject of weight loss with sensitivity. Crogan (2006) emphasized that it is important that nurses establish an open approach to communication when addressing issues relating to obesity. I feel a multi-component intervention would be the best way for nurses to manage obesity. It should include behaviour change strategies to increase peoples physical activity levels or to decrease inactivity levels, improve eating behaviour and the quality of the persons diet and aim to reduce energy intake.According to (Sheehan and Yin, 2006) nurses constitute a political force in health policy, because they are situated in a wide range of setti ngs. This is backed up by Bennett 2007 who states, ‘Nurses in the primary care setting are uniquely placed to support patients to make the necessary changes’. Nurses need to have an understanding of the patients multiple needs and to collaborate with other members of the health team to discuss personalized holistic care issues.Chrystalleni and Christiana (2010) have recognised that â€Å"the aetiology of obesity is multi-factorial, and dietary factors that relate or are responsible for the development of obesity are complex and still not understood†. As they define development of obesity to not be understood I feel this is a large limitation and therefore requires constant comparison of current techniques used in managing obesity along with any current evidence that has arisen through trustworthy practice research. In conclusion, the role of a nurse in managing an obese patient should involve discussing the weight issues and the severity on the patient’s h ealth.As supported by Green et al (2000) this will enable the nurse to gain insight into the magnitude of the problem and to negotiate realistic goals in terms of weight loss and to support and provide dietary advice which is acceptable for the individual. Nurses should consider each patient holistically and use appropriate language in order to encourage and not offend. As encouraged by the national obesity forum patient selection should be active rather than passive, with opportunistic screening rather than reliance exclusively on self-referral.The nurse should discuss ways in which a negative energy balance is achievable. References AVEYARD, Helen and SHARP, Pam (2009). A beginners guide to evidence based practice in health and social care,. Open University Press, McGraw-Hill. BENNET D (2007). Nurses at the cutting edge of obesity. Practise Nursing. 18,9,454-458. CHRYSTALLENI, Lazarou, CHRISTIANA, Kouta (2010). The role of nurses in the prevention and management of obesity. [onlin e]. 19 (10) 641-647. Journal from British Journal of Nursing last accessed 12th November 2012 at http://www. internurse. om CROGAN E (2006). A bio-behavioural approach to obesity. Practise nursing. 17, 9, 439-442. DRUMMOND S (2002). The management of obesity. Nursing Standard. 16(48), 47-52. GRAY J. A. M (1977). Evidence-based Healthcare. Churchill Livingstone, Newyork, USA. GREENHALGH, T & DONALD,A (2000). Evidence based health care work book: Understanding research for individual and group learning. London, BMJ Books. Last accessed 16th November 2012. GREENHALGH, Trisha (2010). How to read a paper: the basics of evidence based medicine. [online]. London, BMJ Books.Book from Library Gateway last accessed 12thNovember 2012 at: http://library. shu. ac. uk FERGUSON, Linda & RENE, Day (2007)Challenges for new nurses in evidence-based practice. [online]. Journal of Nursing Management. 15(1), 107-113. Last accessed 15th November at: http://onlinelibrary. wiley. com. lcproxy. shu. ac. uk/ doi/10. 1111/j. 1365-2934. 2006. 00638. x/full JOLLEY, Jeremy (2010). Introduction to evidence based practice for nurses. Harlow. Pearson Education. MAGGI, Banning. The management of obesity: the role of the specialist nurse. online]. 14 [3]140. Journal from British Journal of Nursing last accessed 12th November 2012 at http://www. internurse. com Nursing & Midwifery Council (2008). The code: standards of conduct, performance and ethics for nurses and midwives. Nursing & Midwifery Council. London. SACKETT, D. L. , et al. (1996). Evidence based medicine: what it is and what it isn't. British Medical Journal, 312[7023],71-72. Sheffield Hallam University (2012). Evaluation: Why evaluate. [online] Last accessed November 2012 at http://infoskills. shu. ac. k/skills/evaluation. html SHEEHAN NC, YIN L (2006). Childhood obesity: nursing policy implications. J Pediatr Nurs 21(4): 308-10, Last accessed November 2012 at http://www. who. int World Health Organisation (2005). Obesity and Overwei ght: Factsheet. [online] Last accessed 12th November 2012 at http://www. who. int/en Appendix 1. (WHO 1995) BMI (kg/m2) Category of Obesity 18. 5–24. 9 Normal weight 25. 0–29. 9 Grade I obesity 30. 0–39. 9 Grade II obesity ;40. 0 Grade III obesity

Effective Active Listening Skills Essay

Effective active listening is a must in every communication process. Everyday, people engage in communication processes, but some fail to perform effective active listening skills. Neglecting this important aspect of communication can hamper communication. In the video clip, Planning to Promote Socially Appropriate Behavior, we see how effective active listening skills work to attain communication among the participants. Four teachers serve as participants in the video clip. They are kindergarten teachers who express the importance of teaching affective communication skills. Each teacher is given her chance to express herself to the group, while others listen intently. Notably, several factors affect the success of their communication process, among which is effective active listening. The communication takes place in the school. The teachers are seated along one edge of a long table. Although the table is long, they sit closely with each other, which makes it easy for them to hear the one speaking. This way, they did not have to raise their voices or stand to be recognized before they speak. The environment and position of the teachers notably affect the communication process. Since there is the absence of noise, we find the environment conducive to achieving communication. Obviously, the teachers have a common concept in mind of what needs to be discussed. This is very important in every communication situation. Setting a target for the group will help facilitate understanding. For instance, when holding a faculty meeting, the head should identify the agenda in advance. By doing this, concerns which are not relevant to the given topic may be avoided. Particularly in this meeting, the teachers are exchanging ideas on how to teach affective skills to students. One of the teachers expresses that most of the students she encounters do not show respect in communicating with peers. She feels that students should be taught the proper way to approach others, including their teachers. This statement serves as the lead for other participants to discuss ways on how they incorporate affective skills in their classroom. Aside from serving as the lead, this statement also limits the discussion to one single topic. As Lansberger (1996) notes, active listening requires focusing intentionally on who you are listening to in order to understand what the person is saying. This does not mean agreeing with, but rather understanding what is being said. Particularly, we can note that the teachers in the video achieve focus by speaking one by one. This makes the message come across clearly, making the flow of thought more comprehensible and organized, thus allowing for effective active listening. In the same way, this helps the audience summarize more easily the points raised. Also, according to Lansberger, active listening is present when the listener is able to repeat back in her own words what is said. This pertains to the feedback part. Before one is able to report what she listens to, there is the process of internal communication in which the person tries to â€Å"digest† the perceived ideas. For instance, when we are listening to a lecture, we sometimes hear ourselves repeat exactly what our teacher says. This is a sign that we are listening actively. In the video, we see that the teachers are able to follow the ideas of their colleagues. In addition, although they do not repeat what their colleague is saying, at one point, one teacher is able to complement the thought of the speaker. This is a sign of effective active listening, as the listener is able to construct the statement at the same time the speaker is trying to convey it. Another sign that demonstrates effective active listening is the listener’s facial reaction. As one teacher speaks, we can note that others react by nodding, winking, smiling, and sometimes even bending slightly towards the speaker to hear more clearly. Moreover, they take down notes while someone is speaking. Taking down notes can sometimes distract the speaker’s attention, thus some speakers prefer to give handouts to allow the audience to respond well during a lecture. However, in the video clip, we see that by looking at the speaker while writing, the teachers are still able to maintain the rapport with each other. Therefore, the gesture of taking down notes does not affect the communication process in this particular situation. Although the teachers in the video clip demonstrate evidences for effective active listening, there remain some points to be improved. In particular, the participants who have shared their views could elicit the views of one speaker who did not talk. While it is commendable for the others, especially the teacher wearing a black blouse, to share their views, it would also help if they give a chance to the other participant who has not talked. Eliciting one’s opinion or asking for clarifications (i. e. , asking, What do you think? ) can help detect signs of effective active listening. Through this, the speaker can check if the audience is truly listening. When the listener responds coherently to the speaker’s idea, we can note active listening signs. Otherwise, the speaker should find out factors that hinder effective active listening. Such factors may include outside noise, thoughts of the listener, or language barriers.

Hotel on the Corner of Bitter and Sweet Essay

One should not stop going for what they want. Through the struggles and obstacles being thrown at two people who are in love but the others may not be able to see it, they will always find a way back to each other. This book demonstrates the hardship two young people who are in love to find a way to each other even though at the time, interracial dating was not very common and looked down upon. During the Japanese internment in WWII, Henry, who is a first-generation Chinese American, went to an only non-white school was forced to work in the kitchen during lunch and clean after school because that was how his â€Å"scholarship† was being paid for. At that school, he met a Japanese-American girl named Keiko and became friends instantly. Even though Henry’s father was not very fond of the â€Å"enemy† Japanese people, that did not stop Henry from being her friend. One night, both Henry and Keiko snuck out to see each other. When they saw each other, Keiko gave him her family pictures because all Japanese had to get rid of any possession that could link them being known as Japanese so they could avoid being taken away. Japantown was filled with families and businesses who were forced to shut down and leave to the safer internment camps. Henry had to go through that pain of watching Keiko’s entire family leave, he was helpless to stop them but at the same time afraid that he would be herded with them for his similar physical appearance. Because it was a tradition for the Chinese to send their children back to China to complete their schooling, that is what Henry’s father did. He sent him back to China. He agrees to go if his father saves the Panama Hotel where Keiko’s family stored a lot of their belongings when they were shipped to the internment camps. While sending letters back and forth letters to Keiko, that is how Henry met the women he ended up marrying, Ethel. She worked at the post office and befriended him. As the war was going on, Keiko’s letters stop coming. The only reason why Keiko’s letter stops coming because his father interfered with the delivery of the mail for Henry’s own good. That is when Henry eventually moves on with his life, finishes school and marrying Ethel, but does not forget about Keiko. After the wife dies of  cancer he tries to find meaning for living. By doing so he goes back and visits the last Japanese habitation, which was the Panama Hotel. He never really forgot about Keiko, that was his first love. Even though Henry’s son, Marty, and Henry were not close, slowly but surely he eventually told him about Keiko. Marty and his fiancà © go out finding Keiko and sends Henry to New York to be reunited with his first love, Keiko. Being in Henry’s father’s shoes, I could see why he stopped the communication between Henry and Keiko. He was really just doing what is best for his children. At that time interracial relationships were not common but I guess nowadays parents cannot really choose who is going to marry their children. You cannot help how you feel and when you feel a certain way you will do whatever it takes to be back with the one you love. I think it was so cute how Keiko and Henry sent letters back and forth, nowadays it is only text messages or snapchats being sent. There was no sentimental feeling like there was before. Now we rely on technology as our form of communication and that is why some relationships fail. It is hard bringing your culture to America especially when you want to live the American lifestyle or culture. I know Henry’s father did not want him speaking Cantonese at home because if he spoke English, he would be more acceptable as an American. He was proud that Henry was going to an American school but of course he was not going to let some of the traditions go so therefore sends him to China. Henry’s father’s morals are very different with Henry as he grows up to being a father. When Henry has a son who is planning on marrying an American girl. At that time, dating outside the race is more acceptable. With me dating outside the Filipino race, my parents are okay with that. To them race does not matter. What matters is how the other person feels about you and vice versa. One that cares for you, takes care of you, and how they treat you should be the bigger concern and not the race. I always thought I would have to date within my race because I know that is what my parents would want, but they told me race should not matter. It is just how the other person can make you feel that matters the most. As long as I am happy, my parents are happy. I wish Henry’s father saw that Henry was happy with Keiko, but since his father was not very fond of the  Japanese, he did everything he can for them not to keep in contact. The story ends on a sweet note. The first thing Henry says when they meet was a Japanese phrase to tell her how beautiful she was, that he learned when he was a boy. Through the search from the city and pain and memories Henry had in the past, finding Keiko was the main purpose in his life. He wanted to be rekindled with his first love again. Hotel on the Corner of Bitter and Sweet did a good job at alternating between telling the story at adolescent Henry’s war years with his later life in 1986. The author manages to tell the story of the Japanese evacuation, of the struggles between generations in immigrant families, and of the friendship that later turned into love between Henry and Keiko. This book also tells an important story, that of the internment of Japanese-Americans during World War II and it was heartbreaking to watch Keiko’s family as they were evacuated, despite the fact that her family was more â€Å"American† than Japanese, and that Keiko was born in the U.S. Keiko’s frustration at seeing those of Japanese heritage taken away and her family’s strength as they are forced to leave behind their entire life is hard. I cannot image being taken to an unknown place with my family because of who we were. I liked how the author incorporated the generation of Chinese-American Henry and his immigrant parents. Henry’s father demands that he speak only English in their home, despite the fact that this leaves Henry unable to communicate with his parents but be more acceptable to the American culture. This book was overall a touching book. It was more than a love story between two people, it was the hardships that was going on during the WWII that kept those two from being with each other and with Henry’s father stopping communication between Keiko and Henry. I had mixed emotions because I was happy they found their way back to each other but at the same time I was upset because I wanted to know what would happen next.