Review Research Paper Example | Topics and Well Written Essays - 500 words

Review - Research Paper Example dality of IMRI with CT and ultrasound to identify that IMRI presents no limitations when it comes to neurological imaging, the report does not lag behind in discussing the primarily important applications of IMRI. It is claimed by the report that with advancements made in IMRI systems over time, not only the scan time is reduced resulting in minimum patient exposure but the image quality in terms of contrast and resolutions has also dramatically enhanced. Starting with the GE Double Donut system which was the first ever IMRI system introduced, a question can definitely be raised about the advantages mentioned in the report about this system like if superior access to the patient and no patient movement required during the imaging procedure happen to be the reasons enough for the level of popularity this system amassed? Not enough credible facts related to imaging time and contrast quality are mentioned in the advantages of any of the systems talked about in the report, which leaves the readers doubtful to some extent about the advantages associated with IMRI systems available currently in terms of time and quality. Though there is much detail contained in the report about the core technicalities associated with IMRI systems like low field and high field systems, one would definitely like to get more information about the pulse sequences running in these systems. Also, some questions concerning the benefits of IMRI related to breast e xaminations and how it can be preferred over mammography for breast cancer detection remain unanswered. One of the most effective improvements which can be made to this report would be going into less detail about the IMRI magnets and hardcore physics of the low field and high field IMRI systems, while relying more on introducing the benefits in terms of image quality, exposure time, and how capable a certain IMRI system is of imaging a totally disabled person who cannot cooperate with the physician in any way possible. Another

Global Crimes Analysis Research Paper Example | Topics and Well Written Essays - 1000 words

Global Crimes Analysis - Research Paper Example As a result, there is comparison and contrast of the various international criminal justice systems especially on addressing the major global crimes and criminal issues. Addressing some major global crimes Gangs provide significant contribution to crime activities such as firearms transactions and violence, drug sales and use, home invasions, car theft, homicide, graffiti, and other related major crimes in the world (Muraskin & Roberts, 2009). To address these issues, Muraskin and Roberts exemplified four generic programs such as prevention, intervention, suppression, and comprehensive strategies. In the US and even the world, punishments integrated with the justice systems are the usual way on how society addressed global crimes (Muraskin & Roberts, 2009). Furthermore, according to Muraskin and Roberts, in the US justice system so as to address major crimes especially those associated with terroristic acts, policy to address them requires sophistication and resources. This means, th e US has to advance further especially within its justice system when it comes to addressing global crimes. In the case of US’s war on drugs, which has become global, some advocates believe that there is a need for policy improvement and development in the justice system (Waller, 2009). For instance, based on Waller’s book, since the number of incarcerated law offenders is in an upward spiral in the US, taking for instance the figure from 1980 to 2001 which is 1,300 percent, it has become one of the bases for legalization of possession or sale of marijuana, cocaine and opium. According to some experts as pointed out from the book of Waller, this should be a remarkable indication that the US justice system has eventually failed on its war on drugs, which at some point have resulted to social consequences. At this point, Waller presents some significant facts that it is important to understand that the only means US could promote effective implementation of its policy as sociated with its war on drugs is to encourage the entire world to have its stand to fight on illegal possession and use of prohibited drugs. However, it is not only on fight against drugs is active in its participation. In fact, the fight against terrorism is not just a main concern of the US and the essential proof of this is the emancipation of international standards in the detaining of suspects in the said country (Hakimi, 2009). On the other hand, European governments are against transnational organized crime particularly on smuggling of migrants, trafficking in persons, and trafficking of firearms, which eventually lead to anti-political campaign for anti-trafficking interventions (Anderson & Andrijasevic, 2008). Although economic incentives are of primary importance in the organization of organized crime, non-economic nature associated with it such as cultural, social, and political issues are also remarkable prior to understanding and policing it (Arsovska & Kostakos, 2008) . There are many reasons why modern form of human slave in a form of sex trafficking and slave labor continue to persist today and these include debt as tool of manipulation, fraudulent practices which associate middle-men brokering across international boundaries, weak laws and weak enforcement of them, sponsorship laws in Persian Gulf States, lack of understanding of human

Global Warming Essay Example for Free

Global Warming Essay Global warming is the increase of Earth’s surface temperature due to the effect of greenhouse gases. The main causes of global warming is the greenhouse effect, fossil fuels in cars, and global emission. Global warming is having an effect on our environment such as rising seas, changes in rainfall patterns, and etc. What we can do to stop this is, lower down emissions, cut greenhouse gases and so on. This paper will focus on what global warming is doing to our environment. The greenhouse effect is one of the things causing global warming. The greenhouse effect is the warming that happens when gases in the earths atmosphere gets trapped with heat. An example of a greenhouse effect is, sunlight passing through transparent windows. The reason it happens is because gases absorb ultra violet heat that is radiated into space. When it is radiated carbon dioxide absorbs this heat and the more carbon dioxide there is in the atmosphere, the air gets warm. If the air gets extremely hot the world will be destroyed because animals and plants will die. Another thing that is causing global warming is fossil fuels in cars. Coals and gas are burned to make electricity, cooking, and warming or cooling our homes. Even though we are using these for our own benefits it is harming our environment and later it will have an effect on us. Fossil fuels are made from remains from other plants, and animals that was buried in the Earth for millions and millions of years. Did you know that a long time ago, that heat and pressure has made these remains into fossil fuels that everyone calls coal and gas? Well today, these fossil fuels are burned so that they can release energy that was stored inside of them. When they are burned the carbon inside of them are released in the air and creates carbon dioxide which is also bad for our environment. Burning petrol’s that are in cars, pollute the air we breathe and is harming both us and the environment but yet we still use it. Global emissions are also one of the things that is causing global warming. Global emission is, worldwide air pollution. Global emissions jumped 3 percent in 2011 which make a huge difference.. There are emissions from factories, greenhouse gases, or global greenhouse emissions. The things that cause global emissions are, carbon dioxide, methane, nitrogen oxides, and hydro fluorocarbons. .This can create smog, and acid rain. Emissions seems to be one of the greatest causes of global warming. This is happening because Earth is surrounded by a layer of gases. Global emissions includes heat creating-gases so when this is released, it rises and becomes trapped by the atmosphere. These trapped gases seem to be responsible for increasing temperatures on Earth. The effect that is having on our environment is rising of seas, changes in rainfall patterns, melting glaciers, spread of disease, warming seas, glaciers shrinking, droughts, and severe rainstorms. Rising sea levels are due to the melting of the polar ice caps, as well as an increase in occurrence and severity of storms and other severe weather events. The cycle of global warming is changing the climate that all living things have come rely upon. Global warming is making the Earth more humid which causes abnormal temperature and because of it, the weather is changing. The temperature of the Earth has raised 0.4 and 0.8 degrees Celsius in 100 years because of global warming. Glaciers are shrinking because the Earth is warming up. When the seas were warming up, the population of planktons decreased. When the Earth spins, the hat spins with it and the Earth is collecting moisture over the seas. Due to these droughts, farmers are having a difficult time planting, growing, and making a li ving. This paper covered on what global warming is doing to our environment. As it had said in the paper, global warming changed Earths climate, causing the weather to change. The temperature of the Earth has raised 0.4 to 0.8 degrees Celsius in the past 100 years. The things that are often affecting the earth is the effect on greenhouse gases, fossil fuels in cars, and global emissions. Global emissions jumped 3 percent in 2011. Since global warming is harming our environment, we can all work together to find a way to help our environment.

Building The Skill To Administer Intramuscular Injections

Building The Skill To Administer Intramuscular Injections The aim of this essay is to reflect on how I have become competent in a particular clinical skill. The clinical skill I have selected is administering intramuscular (IM) injections. I will provide a rationale for choosing this skill and use appropriate literature to demonstrate my knowledge underpinning this skill. Although there are five sites for administration of IM injections, for the purpose of this essay I will discuss only two of the sites. Firstly, the dorsogluteal (DG) site as this is the site I used when giving IM injections in line with the local trust policies and procedures. Secondly I will discuss the ventrogluteal (VG) site, as recent literature has shown this site to be the safest to use when administering IM injections. I will then reflect on my learning and how I have become competent in this area. There is a need for nurses to be skilled in the administration of intramuscular injections in the learning disability field. The National Institute for Health and Clinical Excellence (NICE) (2006) suggests that when de-escalation and intensive nursing techniques have failed to calm the patient and they are at risk of harming themselves or others, then rapid tranquillisation should be used as a last resort. Although oral tranquilisation will be offered first, due to the high state of aggression, agitation or excitement the patient may be unable to give their consent. Therefore the 1983 Mental Health Act and the guidance on Consent to Treatment (DH 2002) must be followed. Consequently, rapid tranquilisation will be achieved by the administration of medication through IM injection to control severe mental and behavioural episodes and to calm the patient quickly. Greenway (2006) suggests that IM injections are generally likely to happen in association with the administering of antipsychotic medication in the form of depot injections and/or rapid tranquilisation, for managing mental illness and/or challenging behaviour for people with a learning disability. Greenway also implies that there will only be a small number of learning disability nurses that will actually use the skill of administering IM injections after they have qualified, due to a decline in depot administration. However, the Nursing and Midwifery Council (NMC) (2004) identifies that the role of the learning disability nurse is forever changing and the administration of injections will depend on the client group and the practice areas in which they work. They recognise that it is a key challenge for learning disability nurses to update their knowledge and maintain competence in a skill that they may use infrequently. Irrespective of this, the clinical procedure should be develope d and maintained in line with evidence based practice, regardless of how often it is used. The administration of IM injections is a vital component of medication management and is a common nursing intervention in clinical areas. Less pain to the patient and unnecessary complications can be avoided by the nurse being skilled in the injection technique used (Hunter 2008). The National Patient Safety Agency (NPSA) (2007) notes that the injecting of medication is complicated and patients can be put at risk. Incompetency, lack of training and varying knowledge levels of nurses were factors highlighted in errors made around injecting medicines. Adhering to the aseptic technique during preparation and administration of the injection, and inspecting the injection site for any signs of skin deterioration are vitally important to prevent infection and complications (Dougherty 2008). Alexander et al (2009) describe the correct way to give an intramuscular injection in the DG site using the Z tracking technique. Using the thumb or the side of the non-dominant hand stretch the skin taught over the site of injection maintaining the tautness during the procedure. With a darting motion, insert the needle at 90 degrees to the skin, 2-3mm of the needle should be exposed at the surface and the graduation marks on the syringe barrel must be visible throughout. Use the remaining fingers of the non-dominant hand to steady the syringe barrel, whilst using the dominant hand to pull back on the plunger to aspirate. If blood appears all equipment should be discarded and the procedure should be started again. It is safe to carry on if no blood appears. The plunger should be depressed at a rate of 1ml per 10 seconds to give the muscle fibres time to expand and accommodate the drug. After a further 10 seconds remove the needle and then release the traction on the skin. The injection site may be wiped with dry gauze if need be. A plaster can be applied if the patient requires and if they have no known allergy to latex, iodine or elastoplasts. Controversy lies around the site area chosen for administering the IM injection. Although the DG site is the traditional choice by nurses for the administration of IM injection there are risks associated with this site of injection. The DG site is situated in the upper outer quadrant of the buttock and is often landmarked by visually quartering the buttock horizontally and vertically, then repeating this action in the top right hand square. Evidence shows that the use of this site for IM injection can run the risk of injury to the sciatic nerve and the superior gluteal artery (Small 2004). Additionally it can cause skin and tissue trauma, muscle fibrosis and contracture, nerve palsy and paralysis as well as infection (Zimmerman 2010). The belief by nurses that the VG site is hard to landmark suggests reluctance on their part to change a practice they are competent in. Although once nurses have become familiar with location of the VG site and the surrounding anatomy, they will become confident in using this site (Greenway 2006). Hunter (2008) suggests to locate the VG site the nurse should place the palm of her right hand on the patients left hip (the greater trochanter), then make a v by extending the index finger to the anterior iliac spine. The injection is given in the middle of the v in the gluteus medius muscle. Administering IM injections using anatomical features leads to a more specific and correct way of carrying out the procedure. In contrast to the DG site, the VG site has no major complications associated with the administration of IM injections. Zimmerman (2010) also strongly advocates the use of the VG site. Although there appears to be a lack of current evidence for choosing the VG site rather than the DG site for rapid tranquilisation during restraint of a patient. Because of the nature of the situation during this procedure, safety for all involved has to be considered. Local policies should be utilised for specific guidance on positioning the patient safely and for use of specific holds needed to allow the VG site to be landmarked and the injection administered. The VG site can be used if the patient is prone, semi-prone or supine (Greenway 2006).However, following a literature review of damage to the sciatic nerve from IM injections, Small (2004) recommends that the VG site should be chosen over the DG site for IM injection. Zimmerman (2010) concurs with this, strongly advocating the use of the VG sit e for IM injections of more than 1ml in patients over the age of seven months. More evidence for choosing the VG site is a study carried out by Nisbet (2006) showing that the subcutaneous fat level of the DG site is significantly higher than that of the VG site. It also showed that penetration of the target muscle at the DG site was only 57 percent meaning the remainder of the injection would deposit into the subcutaneous fat leading to a deficit in the uptake of the drug. Emerson (2005) reports an increased risk of obesity in people with a learning disability. In one study 90 percent of adult females and 44 percent of adult males had fat deposits in the DG site area that were one inch deeper than the shorter IM needles would reach (Zaybak et al, 2007). The VG site has a shorter distance to the targeted muscle and is a safe alternative choice for the administration of an IM injection, Greenway (2006), Small (2004) and Zimmerman (2010) suggest it is time for professionals to rethink the site of IM injections in people with a learning disability. I will now discuss how I have become competent in carrying out this clinical skill and to do this I will use a reflective model. Reflection is a way in which nurses can bridge the theory-practice gap. The process of reflective practice allows the nurse to explore, through experience, reflection and action, areas for developing their practice and skills. It is an important part of gaining knowledge and understanding. The use of a recognised framework allows for a more structured approach when reflecting upon practice (Johns, 1995). I have decided to use Gibbs (1998) Reflective Cycle, as it provides a straight forward and structural framework and encourages a clear description of the situation, analysis of feelings, evaluation of the experience, analysis to make sense of the experience, conclusion where other options are considered and reflection upon experience to examine what the nurse would do should the situation arise again. In describing what happened in learning this skill the theory of experiential learning can also be used as a framework. The theory of experiential learning was developed by Steinaker and Bell (1979). The Experiential Taxonomy highlights 4 levels of learning that the nurse will go through in learning a new skill i.e. exposure and participation, identification, internalisation and dissemination. During exposure there is a consciousness of the event and the nurse will have observed a competent practitioner carry out the task. In this case I had an awareness of needing to be able to administer IM injections competently due to the client group involved. In my first week of placement I observed a qualified nurse administering PRN and depot IM injections several times while the nurse talked me through the procedure step by step. As she was demonstrating the procedure and talking me through it my thoughts and feeling at the time were that I would not be able to remember all the steps needed to administer the IM injection safely and I was also feeling anxious about potentially causing pain and/or injury to the patient. Participation involves the nurse becoming part of the experience. After observing the practice I participated in the drawing up of the injection and then administering it. Identification involves the nurse becoming competent in the skill. On reflection as soon as I started on placement I realised that I would have to gain as much experience as I could administering IM injections, not just the actual procedure of giving the injection but also the knowledge to underpin this skill. Internalisation occurs when the new skill becomes part of everyday routine. Several weeks into my placement I felt that I had eventually become competent in administering IM injections, my anxieties began to lessen and I started to feel more confident that I was becoming proficient in carrying out the procedure. I found that the more times I carried out the procedure the better I felt about it. Dissemination involves the nurse being able to influence others and showing others how to carry out the skill. Although this was only my second placement I feel totally competent in carrying out the task. I also feel that I have a good understanding of the underpinning knowledge involved. Therefore I feel I would be able to teach others how to do this. On reflection I do not think I would have learned this skill any other way, I have realised that initial anxieties about carrying out a new task are usual. But I will have to remember this will pass as I practice more and become more experienced. I have also realised through reflection the importance of having underpinning knowledge in relation to clinical skills and understanding why we do things rather than just simply learning how to do them. In conclusion, this assignment has explored one clinical skill in which I have gained competence. A rationale was provided in that IM injections are an important part of everyday life for the client group involved. IM injections are considered to be a routine procedure, it is a valuable and necessary skill for nurses. To provide safe practice and ensure accurate and therapeutic drug administration, the nurse should use clinical judgement when choosing the injection site, understand the relevant anatomy and physiology, as well as the principles for administering an IM injection. By using a reflective model and theory in relation to experiential learning I have discussed my own personal and professional development in terms of my knowledge and skill acquisition in this area of clinical practice.

The Soldier :: essays research papers

Travis was a quite a bit older than the other soldiers who enlisted for service during World War 11. He was in his early thirties, but most of the soldiers were in their late teens or early twenties. Travis had been working since he was a boy, so he felt that he knew something about how the world worked. He enlisted because he not only felt it was his duty to do so, but he also was looking for adventure. He was a tall, friendly man, with a booming voice and a good sense of humor. Soon, the younger soldiers were coming to him for advice or just to talk about how homesick they were. When his platoon needed a leader, Travis was chosen.It wasn’t long before Travis’s unit was shipped overseas. They eventually wound up on an island in the Pacific, far different from any place that the soldiers had ever seen. Snakes, monkeys, and bugs were everywhere, and the heat was almost unbearable. Many of the men quickly became sick, but their biggest problem was the enemy fire that con stantly surround them. Travis had been looking for adventure, but he had to admit that this was not the kind of adventure he had hoped for. Still, he found himself doing things he never thought he would or could do : bandaging wounds, planning attack strategies, thinking up camouflage ideas, and even writing letters home for the wounded soldiers. He knew that the men in his platoon trusted him and relied on him, and he was determined not to let them down.Travis served nearly four years in the army, all during World War 11. When he finally returned home, he was welcomed with great excitement and joy by his family and friends. Travis was glad to be home, of course, but he knew he was not the same person who set out adventure years before. The Soldier :: essays research papers Travis was a quite a bit older than the other soldiers who enlisted for service during World War 11. He was in his early thirties, but most of the soldiers were in their late teens or early twenties. Travis had been working since he was a boy, so he felt that he knew something about how the world worked. He enlisted because he not only felt it was his duty to do so, but he also was looking for adventure. He was a tall, friendly man, with a booming voice and a good sense of humor. Soon, the younger soldiers were coming to him for advice or just to talk about how homesick they were. When his platoon needed a leader, Travis was chosen.It wasn’t long before Travis’s unit was shipped overseas. They eventually wound up on an island in the Pacific, far different from any place that the soldiers had ever seen. Snakes, monkeys, and bugs were everywhere, and the heat was almost unbearable. Many of the men quickly became sick, but their biggest problem was the enemy fire that con stantly surround them. Travis had been looking for adventure, but he had to admit that this was not the kind of adventure he had hoped for. Still, he found himself doing things he never thought he would or could do : bandaging wounds, planning attack strategies, thinking up camouflage ideas, and even writing letters home for the wounded soldiers. He knew that the men in his platoon trusted him and relied on him, and he was determined not to let them down.Travis served nearly four years in the army, all during World War 11. When he finally returned home, he was welcomed with great excitement and joy by his family and friends. Travis was glad to be home, of course, but he knew he was not the same person who set out adventure years before.

Niccol? Machiavelli - The Qual :: essays research papers

Machiavelli’s views on human nature are unjust; nevertheless, his philosophy, or rather instructions, is reasonable in capturing the selfishness of men. As written in The Qualities of the Prince by Machiavelli, “Men are ungrateful, fickle, simulators and deceivers, avoiders of danger, greedy for gain; and while you work for their good they are completely yours, offering you their blood, their property, their lives, and their sons… when danger is far away; but when it comes nearer to you they turn away.'; Machiavelli’s generalization demonstrates his low opinion on the nature of men because he views them as selfish and lacking in both loyalty and honesty. Machiavelli’s general opinion that men are selfish contains an underlying truth to the human nature. Inside every human being, there is a sense of selfishness that lay dormant until given cause to awake. It is a truth that many will not be willing to admit or acknowledge. Many will even say that there are people who are or were selfless in their actions. Yes, there are, but when the situation comes, normally no one can take away their selfishness to still act like “saints'; when they cannot even save themselves. Selfishness is an ugly trait among people; however, disloyalty is probably the most offensive trait found in human nature. Machiavelli’s says, “when it comes nearer to you they turn away';, which clearly establishes where a person’ true loyalty stands. Loyalty is more consistent to oneself rather than to others. Past events in history supports Machiavelli’s opinion with Julius Ceasar and Brutus as an example. Brutus’s loyalty to his most trusted friend, Caesar, went astray when a problem arose among his Roman peers, and the betrayal was committed against Caesar which resulted in death. A lesson worth learning from this example is that a person’s loyalty can never be trusted unless it is proves to stand strong through any situations. As Machiavelli wrote, “a prince must be cautious in believing and in acting…';. His instructions for the prince stand true for almost everyone nowadays. Unlike disloyalty, dishonesty, according to Machiavelli, is an important factor in the relationship of all human beings. Machiavelli wrote, “princes who have accomplished great deeds are those who have cared little for keeping their promises and who have known how to manipulate the minds of men by shrewdness; and in the end they have surpassed those who laid their foundations upon honesty.

Mordernism

Modernism During the 20th century a communications revolution that introduced motion pictures, radio, and television brought the world into view†and eventually into the living room. The new forms of communication competed with books as sources of amusement and enlightenment. New forms of communication and new modes of transportation made American society increasingly mobile and familiar with many more regions of the country. Literary voices from even the remotest corners could reach a national audience.At the same time, American writers†particularly writers of fiction†began to influence world literature. The 20th century saw the emergence of modernism. Modernism responded to the world's complexity by asserting that the individual had the potential to achieve a broader perspective than that offered by any one society or its history. Although realism, naturalism, and regionalism were still viable modes of expression, they reflected the increasingly complex reality of 20th- century society. Immigration and industrialization led to increasing urbanization, nd, in turn, to class stratification.Theme: Some writers examined the sometimes complex psychology of America's elite, other writers turned to the psychological and physical reality of the laboring classes, whose ranks continued to swell with high rates of immigration in the late 19th and early 20th centuries. Several American authors who are sometimes known as social realists looked at working conditions, often for the purpose of social reform. A period of disillusion and cynicism that followed World War I (1914-1918) found expression in he writings of a group of Americans living in Paris who became known as the Lost Generation.They shared a bitterness about the war, a sense of rootlessness, and dissatisfaction with American society. They portrayed the emotional exhaustion of this generation and their seemingly vain search for meaning and value in life. Some other writers focus on the overwhelm ing forces of nature and on issues of class. Gender issues remain major topics in 21st century American literature, and more gay and lesbian authors are publishing their work and bringing their community and oncerns into focus. Characteristics 1.Diversity The reading audience of the United States changed as social and economic realities changed. Immigrant populations added great variety to 20th-century American fiction. American literature at the is exceptionally diverse, with rapidly growing multicultural influences. New voices continue to emerge within the Native American, African American, Asian American, and Hispanic American communities. After the 1960s it became increasingly difficult even to define a mainstream. Jewish-American iterature: among the first to record their experiences.African American literature: focuses on slavery and its legacies while also offering hope, particularly in the strength of bonds among women. Native American literature: reassesses the experience o f their cultures. Hispanic American literature. Asian American authors brought strong voices to American literature after the 1960s. those who bridge two cultures. Modernity and Americanization are typically the realm of youth, while traditional culture and history remain the dying province of their elders.While creating unique worlds for various distinct communities, America's diverse literary voices continue to reflect the unique characteristics of its land, people, and culture. 2. Regionalism The vastness of the United States and the great diversity of its people have always been reflected in its literature. This was especially true in the 20th century, which witnessed the blossoming of strong regional traditions in the West and the South. The South was also rich in women writers during the 20th century. 3. Bilingualism.Many American authors incorporate a lot of their mother tongue language into their writing. This reflects both the alienation and the strong cultural identity tha t comes from being a nonnative English speaker in the United States. 4. style Writing is noted for innovations in narrative style, such as simplification and fragmentation of plot and the use of unconventional syntax and punctuation. Representatives: Henry James Theodore Dreiser Sinclair Lewis Ernest Hemingway and F. Scott Fitzgerald, William Faulkner,