Basic Tools in Nutrition Essay Sample free essay sample

Food groups or nutrient ushers* Food ushers translate quantitative nutritionary demands into simple. practical and non- proficient linguistic communication utilizing available and common nutrients of the state. * Food groups are developed by nutrition experts as a quantitative tool in be aftering alimentary diets for the multitudes. * The three chief nutrient groups are: 1. Body-building nutrients: nutrients that supply good quality proteins. some vitamins and minerals. 2. Energy nutrients: largely of rice and other cereals. starches. sugars and fats contribute the majority of Calories. 3. Regulating nutrients: composed of fruits and veggies that provide vitamins and minerals. peculiarly ascorbic acid and pro vitamin A. DIETARY STADARDS* Dietary criterions are digests of alimentary demands or allowances in specific measures. * Dietary demand is the minimal sum needed for a food to achieve good wellness under specific conditions ( age. weight. physical activity. sex. physiological status. province of wellness position. etc ) . * Dietary allowance is the minimal demand plus a safety factor or â€Å"margin of safety† to account for single fluctuations in organic structure storage of foods. We will write a custom essay sample on Basic Tools in Nutrition Essay Sample or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page province of wellness. alimentary use. twenty-four hours to twenty-four hours fluctuations within an person. etc. Recommended Dietary Allowance:* The RDA. the estimated sum of a food ( or Calories ) per twenty-four hours considered necessary for the care of good wellness by the Food and Nutrition Board of the National Research Council/ National Academy of Sciences. The RDA is updated sporadically to reflect new cognition. It is popularly called the Recommended Daily Allowance Nutrient denseness * Nutrient denseness is a step of the foods a nutrient provides compared to the Calories it provides. Foods low in Calories and high in foods are alimentary dense. while nutrients high in Calories and low in foods are alimentary hapless. * Nutrient-dense nutrients should be eaten frequently. whereas nutrient-poor nutrients should merely be eaten on occasion. A healthful diet includes largely nutrient-dense nutrients. * People who restrict their Calories should obtain as much nutrition as they can from the Calories they consume by taking nutrient-dense nutrients. Those who systematically choose nutrient-poor nutrients will non acquire the foods they need. * Liver has a moderate sum of Calories but is rich in vitamins and minerals and is considered a high food denseness nutrient. * A bicycler has an increased energy demand but no important addition in alimentary demands. Because of this he/she can eat nutrients with a lower food denseness than the mean individual. This means that a bic ycler can be less choosey about the nutrients that are eaten provided he/she realizes his/her specific food and energy demands that must be met. Food exchange list * The word exchange refers to the fact that each point on a peculiar list in the part listed may be interchanged with any other nutrient point on the same list. An exchange can be explained as a permutation. pick. or functioning * Within each nutrient list. one exchange is about equal to another in Calories. saccharide. protein. and fat. Each list is a group of measured or weighed nutrients of about the same nutritionary value. * The exchange lists are intended for be aftering diabetic diets. therefore the nutrients included are simple and merely those allowed in the diabetic diet are listed. Besides. because of the truth and convenience of the exchange system. the exchange lists are used for weight direction every bit good. Examples: * Cereals. grains. pasta. staff of lifes. crackers. bites. starchy veggies. and cooked beans. peas. and lentils are on the starch list. In general. one amylum exchange is ? cup cereal. grain. or starchy veggie ; one ounce of a bread merchandise. such as one piece of staff of life ; one-third cup rice or pasta ; or three-quarterss to one ounce of most snack nutrients. * Fresh. frozen. canned. and dried fruits and fruit juices are on the fruit list. In general. one fruit exchange is: one little to medium fresh fruit. one-half cup of canned or fresh fruit or fruit juice. or one-fourth cup of dried fruit.

Shakespeares Female Characters Essays

Shakespeares Female Characters Essays Shakespeares Female Characters Paper Shakespeares Female Characters Paper Essay Topic: The Taming Of the Shrew Come, you spirits, That tend on mortal thoughts, unsexes me here, And fill me from the crown to the toe top-full Of direst cruelty! demanded one of them furiously (Shakespeare 853). If I be waspish, best beware my sting, sneered the other (Shakespeare 333). Although they emerged nearly five centuries ago, the women who said these lines are undeniably two of Shakespearean most famous female characters. Lady Macbeth and Katherine are still known today as conspicuous figures in Shakespearean plays. The first stands out as a strong, manipulative, cunning woman; so ambitious to achieve her goal that she even becomes fear-provoking (Corning). The latter is prominent for her temper and feral exhibitions of rage. She is repulsed by mens attitudes toward her and repeatedly spits degrading Insults at them in fury. She Is revolted at the Idea of having to comply with her fathers wish of her wedding one of her wooers. Considering the time period Shakespeare lived in, one can conclude that the female characters in his plays behaved ways that was came as a shock to such a patriarchal society (Shakespearean unruly Women). Shakespeare portrayed them in roles that, for his era, were reserved strictly for men. Women of this era were not the strong, powerful, intelligent females we see in Macbeth, nor were they the Like the Ironic Katherine, who we meet In Taming of the Shrew, who even dares to strike Petroleum upon being angered by his Insolence. Females were not at all thus; they were creatures raised to believe themselves inferiors to men (Elizabethan Women). However, despite all this criticism, Shakespeare portrayed his female characters in a way that they transcended the pre-established constraints of his time. This portrayal of women is due to the Elizabethan periods influence. By having an unmarried woman as a monarch, he was inclined towards writing plays that pleased her. In order to understand Shakespearean representation of women, it Is necessary to take Into account the era he lived In. One must consider the roles and expectations for women in his society. As mentioned above, Shakespeare lived in the Elizabethan period. Queen Elizabeth Tudor I assumed the throne as an unmarried woman and remained unmarried throughout her entire life (Thomas). Her reign brought innovative ideas about women to England. Even though they could not attend universities, some upper class females were able to receive a basic education. Some were even taught to speak different languages, play Instruments, and dance (Elizabethan Women). However, the Elizabethan era is rather paradoxical. The irony of it lies in the fact that despite having a single woman as a monarch, the situation for women in society, particularly for single women, did not improve significantly. Women were expected to be the stereotypical stay-at-home mothers that they had always been. The unmarried women of the Elizabethan society minded Limited to certain roles. At a certain point, women had two alternatives; marriage or Tie at a nunnery. However, rater monasteries were terminate, ten only option left for them was marriage; household service (The Role of Unmarried Women ). When Shakespeare was hired by an acting company called Lord Chamberlains Men, he first came into close contact with the queen (Finely). Queen Elizabeth was a frequent spectator of the companys plays. Shakespeare was faced with a slight dilemma. He had to write plays to please both an unmarried monarch, and a patriarchal society (Richardson). As a result, Shakespearean female characters turned out as something untraditional, yet by some degree, still the typical females of his era (Racking 67). Shakespearean female characters did depend on the male characters on some level (Corning). They depended on either on their fathers when they were young or on their husbands later on in life. An example of this can be observed in Othello, in the first act when Desman says that she owes her life, her up-bringing, and education to her father. Later on in the same act, Othello believes he will be away from her for some time. He requests that the duke provides her with accommodations and a monetary allowance in his absence (Shakespeare 827). Obviously, this implies that Desman would not be able to fend for herself while Othello is away. This accurately reflects the situation for women in the Elizabethan society. Desman depended first on her father, and then on Othello for money, food, and shelter. Even by going to early productions, the gender stereotypes for women could be observed. In early productions, the roles of the female characters were played by young men or boys whose voices hadnt changed. Having a female actress was regarded as something highly inappropriate and unnecessary. It was not a role for women (Duisenberg 7). Consequently, until the year 1660 there were no female actresses on stage (Thomas). Yet even though they did not appear on stage, Shakespearean female characters held surprisingly dominant roles (Milliard). To support this proposal, two of Shakespearean most prominent female characters will be analyzed. Different aspects of their behavior will be evaluated. The more powerful aspects as well as their weaker aspects will serve as evidence to support the proposal that Shakespearean female characters held dominant roles yet while on some level, till being characteristic of the Elizabethan era. Lady Macbeth is one of Shakespearean most prominent creations. Put simply, Lady Macbeth is full of evil. She is a ferocious, brutal, cold-blooded character from the moment she is introduced in the play. She pressures her husband into committing regicide as though it were something casual. It is she who drugs the kings companions and prepares the weapons for the murder. When her husband vacillates about killing the king, she manipulates him into following through by questioning his manhood. Finally, he gives in and murders the king. After committing the crime, she orders him to go back. When he refuses to do so, it is she who goes in herself and wipes the bloody weapons on the unconscious attendants to frame them. For anyone who has read the play, it is undeniable that Lady Machetes character is particularly eccentric. Yet in certain ways, she is contradictory. Certainly, it is true that Lady Macbeth is a dominant female. Nevertheless at a particular point in the story, her strength begins to degrade. Lady Macbeth constantly acknowledges a connection between masculinity and ambition. This particular play has quite a few references to gender territories. This is exemplified when Lady Macbeth cries for the spirits to unsexes near (snappers B By using ten word unsexes, seen acknowledges ten link TN she believes exists between femininity and weakness and cowardice. She wishes to be unsexes so that her influence would have an effect on her husband. A feminine character could not carry out an act that required such wickedness and strength. She considers her husband too soft or to kind to go through with it (Shakespeare 859). Another reference to the gender stereotypes is the dialogue that occurs right before Macbeth kills King Duncan. Watching her husband hesitate to go through with the plan, Lady Macbeth reacts by suggesting that he is not masculine enough. Apart from challenging his masculinity, she also questions his love for her. She then proceeds to asking him a series of rhetorical questions as an attempt to manipulate his actions. She asks whether he was drunk earlier on when he was entirely supportive of the plan (Shakespeare 863). She calls him a coward for not daring to do that which he said he would. Macbeth replies that he is only doing what is appropriate. Lady Macbeth retorts that he was more of a man when he was willing to kill the king. When you durst do it, then you were a man; And to be more than what you were, you would Be so much more the man (Shakespeare 864). She then makes a savage remark that she would rather dash out her bays brains than to break her word, had she sworn anything the way Macbeth did. Near the end of the scene, Macbeth alludes do his wifes masculinity by making a comment that she should only have male children, for her undaunted mettle (Shakespeare 857) would pass on to them. Yet as aggressive and brutal Lady Macbeth may appear, certain aspects of her character, certain comments indicate that she is not as brutal as she mess. When speaking to her husband about killing King Duncan, she tells him that she is unable to commit murder because he greatly resembles her father (Shakespeare 864). This tiny piece of information, which appears to be unimportant, is evidence that Lady Macbeth is not the ruthless creature she lets on to be. In addition to this, we see how Lady Machetes character begins to transform after the murder of King Duncan. After the regicide, Lady Machetes role is no longer as powerful and influential as it was in the first two acts. Her relationship with her husband slowly begins to degrade. When Macbeth plans on killing Banana, a character who he feels is a threat to his power, he tells her nothing (Shakespeare 870). Another example of the deterioration of their relationship is seen in the banquet scene. Macbeth sees the ghost of Banana and begins yelling at it to leave. Lady Macbeth, irritated by her husbands behavior, yells at him for making a scene in front of their guests (Shakespeare 877). Lady Macbeth slowly begins to break down and submerge into madness. Her sensitivity to the guilt turns into a great burden and eventually drives her insane. By the end of the play it overpowers her. In the last scene we see her, she has been reduced to this creature that sleepwalks, ranting on madly about horrifying images and recollections, apparently hallucinating. She yells about wanting to get rid of the spots of Dunces blood (Shakespeare 879). This is metaphorical to her desire to rid herself of the guilt she feels for her role in King Dunces murder. One can conclude that Lady Macbeth is certainly a classic Shakespearean female character. On one hand, powerful, ruthless, and dominant, yet on the other hand, displaying signs of weakness and sensitivity as her character diminishes. Apart from Lady Macbeth, another well-known Shakespearean contracted Is ten Tetra, villous Katherine. In ten play, seen Is Wally Known as an aggressively, nasty tempered woman; a shrew. She is well known in her town, Pad, for lashing out at anyone who angers her, and discharging her fury by nastily insulting and even striking he or she who dares enrage her. As the plot unfolds, we discover that Katherine is an especially intelligent, independent, and clever woman. She will not succumb to marry any of the dull-witted men who she usually has contact with. Though at first it may seem that Skates behavior is thus by nature, as e see more of her throughout the play, it is safe to assume that her behavior is a result of feeling unhappiness and discomfort at her environment. She despises the male-dominated, patriarchal society she is stuck in. She is also resentful and Jealous because her father, Baptists, always favors Bianca, her younger sister. Katherine hints this in various ways. When Baptists announces that Katherine must get married before her younger sister Bianca may, he is almost implying that Katherine is somewhat of a burden that he would like to get off his hands first. In response to this, Katherine asks if it is his intention is to make a fool out of her amongst Bananas suitors (Shakespeare 324). In addition to this, Katherine also shows displays her anger and Jealousy towards Bianca when she binds her hands and violently interrogates her to find out for which one of her suitors she is affectionate (Shakespeare 327). The issue of who was going to marry Katherine is resolved when Patriotic, a friend of one of Bananas suitors, comes to Pad in search of a wife (Shakespeare 330). At first, he is only attracted by Katherine dowry and quickly goes o meet her. Upon meeting him, Kate seemingly despises Patriotic. Their first meeting consists of an argument in which he calls her a wasp. Infuriated by his audacity, she strikes him. Patriotic simply replies that if she strikes him again, he will strike her back (Shakespeare 333). Following this meeting, Patriotic reports to Baptists that he was successful at wooing Katherine. Shocked by this, she responds by quickly contradicting him. Ignoring her, Patriotic announces that they have agreed to marry the following Sunday. Oddly, Katherine does not object (Shakespeare 336). It seems that Katherine, who was used to out-witting the unintelligent men who normally surround her, is intrigued by Buttercups clever responses. Patriotic then engages in a series of unusual methods to tame her. He arrives inebriated and late to the wedding. Then after marrying her, he tells her that he will now do with her what he wishes. He orders her to go to Verona before the feast. Then, upon getting to his home, he does not allow her to eat or sleep for days, saying that he would not have her eat his poor food or sleep in his inadequately made bed. However his treatment of her is not without reason. His intention is to make her see how preposterous her behavior was; to give her a taste of her own medicine. By the end of the play, Buttercups success at taming her is so effective, that she obeys him in practically everything he tells her to do. At the end of the play, she and Patriotic go back to Pad. The last impression she leaves on the reader is when she gives a speech about the devotion and loyalty a woman owes to her husband. Katherine is the typical of Shakespearean characters. Looking at her role in society superficially, it would seem as though she is the classic female of his era. She depends on the male characters for survival. Similar to Desman and her dependence first on her father, then on Othello for a home and survival in society, the way Katherine depends teen on near Tanner Ana Petroleum Is comparable. Yet Katherine Allays an array of unusual characteristics for a female of the Elizabethan period. It was not common to see a female abusing men as Katherine did. Not only her treatment of men, but a woman behaving the general way Katherine did, degrading anyone who she felt deserved it, with her cruel insults, and her nasty temper was absolutely shocking. In the eyes of a patriarchal society, the image of Katherine was not unlike the image left by Lady Macbeth. Although the two characters differ greatly, they are similar in various ways. At the beginning of the play, they are both fierce, dominant women. Yet at a certain point in the play, their dominance begins to diminish. For Lady Macbeth, this occurs after Macbeth kills Duncan and needs her no more. He kills and carries out other deeds by himself, without even informing her. Her guilt about murdering Duncan weakens her so much, that she commits suicide. In Taming of the Shrew, Katherine weakness is displayed when she demonstrates that she can be tamed. Patriotic is able to shape her behavior in the way he wishes. As mentioned above, her final speech evidences her transformation from a shrew to a compliant, obedient wife. Many factors may have influenced Shakespearean portrayal of his female characters. However the main influence was his frequent contact with Queen Elizabeth I and the pressure to please an unmarried female monarch and a patriarchal society simultaneously. However, despite them having a common weakness, Shakespearean most conspicuous female characters have one major aspect n common: they were women portrayed in a way that transcended the limiting roles which their society had assigned them.

Product Differentiation and Cost Reduction as Booster of Companys Sale Dissertation

Product Differentiation and Cost Reduction as Booster of Companys Sale - Dissertation Example A primary source is a data obtained by the first-hand interview, observation, filling with questionnaires among other many sources. Secondary source, on the other hand, is the data that is originally collected and published by another researcher for other purposes. Voice recording, video and images determine the qualitative of the collected data while figures, statistics and measurement determine the quantitative of a collected data. Observation, carried out on a traffic jam, which can involve manual counting of the cars, is a source of data. Information from insurance companies is important since in the company's information about the car insurance is available. Interviews will be conducted on the different location from which important information, which may be, was not obtained in other sources will be available. For qualitative data, images of the cars can take. Conduct industries dealing with the cars spare part is also since if the number of cars increases in the location the demand of the spare part due to wear and tear increases.Distribution of questionnaires to the literate people provide information on the increase of the cars or decrease, and this can assist in getting relevant data on whether the step being taken by the company is productive. As research encompasses Mercedes Benz Company and focuses on its product over the others, therefore the data collected mostly should be from the mortars having t he product or any website with relevant information about the product.

More than one topic look at the instructions Essay

More than one topic look at the instructions - Essay Example Treatments for such a syndrome are limited; however, it has been proven that avoiding or abstaining from alcohol and caffeine entirely can have a profound effect on the level to which an individual will experience the syndrome (CDC 2012). Furthermore, in severe cases, drugs such as dopamine can be applied to seek to help to regulate the neurological responses within the human body. Lastly, a healthy diet combined with exercise and proper stretching prior to bed has been proven to ameliorate many of the symptoms (RLS Factsheet 2012). According to the Sleep Foundation of the United States, Restless Legs Syndrome affects approximately 10% of all adults within the nation (CDC 2012). As such, one can of course infer that this is exhibited in varying degrees of severity; however, nevertheless the fact of the matter is that RLS has been proven to only worsen with age (WHO 2011). In this way, the propagation and progression of the syndrome with age means that it becomes less and less of an annoyance and more and more of a life-altering syndrome that must necessitate treatment. Accordingly, due to the high level of occurrence within the general population, health care providers must be increasingly conscious of such a malady as well as being ever open-minded with regards to the varying ways in which RLS can afflict their patients and the varying models by which it can be ameliorated. CDC - Key Sleep Disorders - Sleep and Sleep Disorders. (2012, April 7). Centers for Disease Control and Prevention. Retrieved  November  22, 2012, from http://www.cdc.gov/sleep/about_sleep/key_disorders.htm Restless Legs Syndrome Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS). (2012, February 15). National Institute of Neurological Disorders and Stroke (NINDS). Retrieved  November  22, 2012, from

Spiritual Diversity Assignment Example | Topics and Well Written Essays - 1250 words

Spiritual Diversity - Assignment Example Panentheism or animism characterizes the spirituality of Native American with an emphasis on personal spirituality and connectivity with daily activities that occur in spiritual and natural â€Å"worlds† (Rainbow of Spirituality, 2013). Native American Spirituality makes the people to have a belief in sacred and that everything that is done originates from the heart of an individual. As such, the spiritual perspective of this religion is that the Supernatural Being has the sovereign power of bringing illness to the community members. For individuals to receive this healing, spiritual components such as belief, meditation and prayer have to be integrated. This acts as the means of these people to communicate with their creator in order to receive this healing. Native American belief bases on the provision of services from the heart of an individual. As such, the faith of the people is vested on the quality and reliability of services, which are offered by care providers of othe r spiritual beliefs. However, differences in cultural practices make it complex for these people to focus on the healing from the health care providers of other spiritual beliefs. This is because of ethnic barrier and differences in communication pattern with source of healing power (Rainbow of Spirituality, 2013). This makes the Native Americans not to have a strong belief in healing from health care providers of other spiritual beliefs.... Further, the philosophy of Christian and Native American is connected in terms of reliability of health care providers from other spiritual beliefs to contribute towards healing of an individual. This includes provision of quality health care and protection, which is aimed at ensuring that the patient gets well. Treatment of patients in both cases is the same such that there is no bias in terms of how health care services are provided to the patients. This implies that both Christian philosophy and Native American Spirituality accept to have health care services provision from people of other spiritual beliefs provided that their services are based on best practices and interests for the patients under consideration. Buddhism is one religion that has a strong emphasis on â€Å"mindfulness†. This implies that health care providers have to note that patients may seek for quietness and peace in order to meditate. This is an issue of concern for Buddhism religion (Ehman, 2007). Mo desty is another virtue that Buddhism religion emphasizes on. As such, cultural concerns of treatment by opposite sex may impact the process of patient caring and delivery of medication. The perspective of this religion with respect to healing of a patient is that prayers that are characterized of meditation by the patient contribute significantly towards the healing process. These prayers should be done in a silent and secure place where there are no people to interfere with the patient during the meditation process. The critical components of healing for this religion are praying. This involves loud chants that are done in a repeated manner within a quiet environment, which is

Nature And Benefits Of Collaboration

Nature And Benefits Of Collaboration The exact translation of word collaboration from Latin is together in labour. In dictionary, collaboration is defined as work with another or others on a project. However, Henneman et al (1995) stated that defining collaboration in practice is complex, vague, variable and difficult phenomenon where the term can be used inappropriately. According to Baggs and Schmitt (1988), collaboration in nursing and medicine are nurses and physicians working together cooperatively, solving problems by sharing responsibility and making decisions to carry out patient care and treatment. However, this definition was limited due to its meaning because this does not involve the significant contribution of other health care professionals. Professional Partnership In an environment constantly demanding adaptability, cost-effectiveness, and quality betterment, inter-professional collaboration assures re-examination because maximizing nurse-physician collaboration improves patient care and creates gratifying work roles. From personal experience as a sister in Cardiac Surgery Intensive Care Unit, patients require Level 3 care. Patients are mechanically ventilated and sedated on their admission. Most of the patients get extubated and transfer to ward within 48-72 hours but some stay back due to post- operative complications. Patient needs multidisciplinary team (MDT) approach and care during their recovery including Surgeon, anesthetist, Physicians, respiratory technicians, nurses, physiotherapist, dietician, occupational therapist (OT), Pharmacist, and speech and language therapist. As there are complications involved in a patients treatment and care, collaboration among MDT in the clinical practice area is very essential. Multidisciplinary team actually formed in 1950s and 1960s in order to meet the changes that occurring in the medicine there for able to meet patients social, psychological, rehabilitation and environmental needs (Brown 1982). Atwal and Caldwell (2002) conducted a large research study to evaluate how to improve Inter-professional collaboration through multidisciplinary integrated pathway (ICP). But this study found ICP did not improve MDT collaboration, however, this helped to improve the documentation. Another study conducted by Atwal and Caldwell (2006) found that there have been various argument regarding MDT existing in the surrounding however nurses described MDT as a complete myth or idealistic. According to Baggs and Schmitt (1988) collaboration here includes sharing of planning, decision making, problem solving, setting objectives taking responsibility, working co-operatively, communicating and more over coordinating each other. Nature and Benefits of Collaboration Collaboration has several dimensions. It can happen in both face-to-face appointments and via computerized communications such as voice mail and e-mail. It mainly encompasses swapping of outlooks and concepts that contemplates the viewpoints of all the collaborators. The term collaboration should not be misunderstood. Successful professional collaborative correlations require mutual respect and esteem. They also need trust and persistence. It parallely agrees with patient care quality. Collaboration between physicians and nurses is fruitful when role for patient well-being is divided and allocated. Professionalism is fortified when all members take admiration for successful collaboration which in-turn leads to high-quality patient care. Alas, the contribution of nursing towards the boundary limit is often not naive to spot out. Doctors have usually been sighted as the essential income generators for hospitals. Nevertheless, nurses are also significant makers of earnings. The variance in income and gender lead to consequences between the power balance of nurses and medical doctors. (Fagin,1992). The remainder of this assignment focuses on categories of collaborative strategies, namely self-development, team-development, and communication-development strategies, which can intensify nurse-physician collaboration and associated positive patient and nurse outcomes.(refer) Self-Development Strategies A quota of discrete attributes sways the extent of co-operation between professionals in hospitals. Improving emotional maturity, apprehension of the outlooks of others, and evading sympathy fatigue are self-development behaviors that can increase interdisciplinary collaboration. Team-Development Strategies The one of the recent established organizational concepts is the Team development. Collaboration is vital for team growth and success; and advancing positive execution. Team development includes the following tasks: group formation, respectful arrangememts, dispute control, curtail of negative behaviours, and workplace outline to accelerate collaboration.(refer) Communication-Development Strategies A number of nurses and doctors have been tutored how to contact patients in complicated conditions where bad news has to be conveyed or difficult decisions must be formulated. (Quill and Townsend,1991). The strategies include to communicate effectively in emergencies and via electronically. Physicians and nurses fortified their communication skills in these circumstances. Therapeutic Communities Therapeutic community in UK is portrayed as bijou groups where decisions and options are framed involving the patient based on the views of shared duties, authority and evading reliance on professionals. Formidable leadership is needed to have a secured therapeutic community. In UK, this prototype is instigated within prison service. In USA, therapeutic community is used to depict user-runner cliques with a ranking framework and remuneration. Key issues of collaborative partnership The main issues underlying collaborative partnership between physicians and nurses when the attributes of partnership gives out negative impacts such as problems arising between trust in partners, respect for partners, joint working, teamwork and not trying to eliminate boundaries. The studies show that there are certain negative and supervisoral physician behaviour patterns and the nurses find it difficult to cope up with when they are in a partnership. Research have indicated that if nurse-physician co-operation is successful, it do intensify quality of care, ameliorate correspondence and organization of care, decrease patient morbidity and mortality, heighten patient contentment, and increase job satisfaction and retention. The issues underlying in a nurse-physician relationship were dissimilar and hierarchical in ranking, with physicians with an attitude as superiors and nurses as lower ranking subordinates. Nurses have to make counsels in a way that made their proposals appear t o be initiated by the physicians. Nonetheless, nurses were taught that they are professionals and their bond between doctors is as a colleague, not submissive. Regrettably, the viewpoints of some physicians have been insensitive to change and some still view conveying out their command as the nurses foremost duty. However, the correlation between doctors and nurses in hospitals has never been a balanced one. The main differences in this partnership is contrasting levels of prestige and ranking, and distinct sides of the gender gap. The substantial differences between the two professions were on gratification with inter-departmental co-ordination, and doctors are more applauded for the work done and they take more credit; and nurses have more positive attitude towards patients than the doctors. For instance, a physician was more probably to prioritize on lab results and what measures to undertake, hardly recognizing the significance of the information contributed by nurses verbally. Because nursing and medicine demons trate two different intellectuals with differing practice perspectives, disputes can be reckoned between them. The professional fraternization of doctors stresses cure related activities and that of nursing stresses care related behaviours. The last and the most important issue is lack of communication because it causes the safety of patients to be at a risky level due to lack of censorious data, misconceiving information, vague orders over the telephone, and fail to spot noticing changes in status. These issues have the possibilities which lead to grave damage or unpredicted death of patients. Effective clinical practice must emphasize not only on technological framework problems, but also on the human factor. By tackling these issues, health care consortiums have a chance to enhance their clinical results. Critical Analysis of the collaborative partnership with the importance of individual professions The critical analysis has been done and studied from the personal experience as a sister in Cardiac Intensive Unit. In the unit after the common hand over, sister-in-charge assign the patient and staff will take individual hand-over from the previous staff. Then ward-rounds are carried out by Anesthetic consultant, Surgical and anesthetist registrar along with nurse-in- charge. Then, decisions are made regarding patient management, discharge and transfer outs. Anesthetist gets irritated with registrar and nurses when adequate information was not given. As a unit team leader, main responsibility is to pass correct information to the doctors also involve the patient while discussing their treatment and care if they are awake. Patient recovery and condition are normally discussed during hand-over and bedside nurse opinion has been taken into account while making decision. Patients are not being involved while discussing about their condition. Atwal and Caldwell (2006) commented about three types of team working in clinical practice. The first model excluding patient from all team meeting, the second model, consultant performing bedside round, discussing patient condition and asking how they are feeling? Third one including patient in the team meeting. In 2008, part of Essence of care I have undertaken a patient satisfaction survey in my unit. The main suggestion patients given through this audit was that, they have not been involved whilst discussing about their treatment and recovery. They also commented Doctors and nurses stand at the end of the bed and talk, cannot listen what they are talking about, we are worried. The things are changed now most of the doctors introduce self to the patient, discuss ab out their treatment, listen to them and explain whats happening with them. As a team leader in critical care, the responsibility as a sister is to delegate tasks effectively, prioritizing aspects of care, ensure team members are comfortable with the allocation, encourage team members and listening to them. It is important to know the patients entire clinical condition prior to the shift so that nurses can delegate the patients effectively to team members. At times, effective delegation is not possible due to staff shortage and skill mix. In such situation, sister-in-charge works along with them, as junior staffs are always hesitant to speak up because of fear, retaliation or lack of confidentiality. Disagreements are common in decision making regarding patient management and treatment by surgical team and anesthetist in the unit. However, final decision has been taken by Consultant anesthetist since they have more power in the unit. Inter-professional working clearly recommends making considerable changes to this kind of practice by the power and status. Conflicts do occur sometimes between physiotherapist and nurses regarding time arrangement for mobilizing long term sick patient. Physiotherapists are coming to mobilize the patient but the staff may not be ready for that time due to their various role and responsibilities. When the staff disagrees with time they suggest them to do their own they may not be able to help later. This is due to the lack of understanding about each others role. Pritchard (1981) notes that, lack of awareness of roles leads to develop stereotypical attitudes within a MDT. One study conducted by Dally and Sim (2001) found that the physiotherapist doesn t understand the external pressure that nurses facing and the lack of awareness of their professional autonomy and decision making in rehabilitation. Nurses reported that, they often try to minimize conflicts but not always able to resolve disagreement in their satisfaction level as conflict is the one of the main barrier for collaboration (Allen 1997 and Thomas et al 2003). Lack of understanding on each others role and responsibilities are one of the main barriers in collaborative practice between the nurse and other medical practitioners. In order to have mutual respect and value to other professionals need achieving professional competence in your practice area (Bradford 1989 and Stichler 1995). Inter-professional education helps to develop role awareness, effective communication, mutual trust and respect (Barr et al and Freeth 2001). In critical care, teamwork between MDT is very essential saying that Department Of Health in their NHS plan (2000) introduced the importance of implementing individual professional role in the team. There is remarkable evidence showing that, the team without an undefined role is an unsuccessful team. Every individual should be confident in their own professional role. They should also able to carry out their responsibility, exchange and receive information using their skills, knowledge and effective communication. DAmour and Oandasan (2005) stated that acquiring professional satisfaction is the most individual professional outcome. One of the main concerns in the health care system is that, not meeting the health needs (WHO 2002) of the older, sick and vulnerable people despite increasing the expenditure as nurses drive towards evidence-based practice, cost effective with increasing responsibility. Nurses are able to provide only what demanded of them than providing care (Litchfield 2002). Nurse should be able to make clinical judgment and decision making according to the situation for that critical thinking and education is important. It is essential to have staff development which helps providing up to date information, evidence-based practice research knowledge etc. Since NHS is under the cost cutting they are unable to provide enough funding for their own professionals for the development. Each member of the team contributes their knowledge, skills and experience to improve the patient care, so a therapeutic synergy is possible while working with other health care professions. Summary and Conclusion This report illustrates a fundamental model to document an effective collaborative practice. The core model is based on a framework or structure that consists of seven essential elements.: responsibility and accountability, co-ordination, communication, co-operation, autonomy, mutual trust and respect. The model includes a process for identifying the roles and functions of the nurses and physicians. The partnership between nurses and physicians is being studied using theoretical perspectives: team-working, partnership working, patient-professional collaboration, therapeutic communities and power differentials.

Fifth Business by Robertson Davies :: Fifth business robertson davies Essays

Fifth Business by Robertson Davies   Ã‚  Ã‚  Ã‚  Ã‚  In Robertson Davies' novel Fifth Business, the author uses the events that occurred in Deptford as a Canadian Allusion to reveal character identity. Three characters in the novel from Deptford: Boy Staunton, Dunstan Ramsey and Paul Dempster, leave Deptford to embark on a new identity to rid of their horrid past. The three main characters of the novel, all of whom to some extent try to escape their small town background, change their identity to become people of consequence. All in some way take on a new identity. Imbedded in this transformation is the assumption that one's original self, especially one's small town origins, must be discarded before one can become significant in the world. Firstly, Paul Dempster grows up as an outcast in Deptford, his mother's 'simpleness' leading the tight social world of the town to cast out his whole family and force's Paul to leave the town and create a new image for himself. Paul runs away to the circus in his early teens because of the mental abuse he took from the town because of his mothers incident with the tramp. Dunstable comment's, "Paul was not a village favorite, and the dislike so many people felt for his mother - dislike for the queer and persistently unfortunate - they attached to the unoffending son," (Davies' 40) illustrates how the town treated Paul because of his mother's actions. Paul leaves his past because of the actions displaced by his mother and the guilt he feels because his "birth was what robbed her of her sanity," (Davies' 260) explains why Paul left Deptford. However, while Boy merely tries to ignore his Deptford past, Paul tries to create a completely new one and Paul asks Dunstan to write an autobiography that "in general terms that he was to be a child of the Baltic vastness, reared perhaps by gnomelike Lapps after the death of his explorer parents, who were probably Russians of high birth." (Davies' 231). The scenery of this autobiography seems significantly Canadian, but Paul does not want his book to represent his past life in Deptford. Therefore, Paul Dempster is a troubled child because of his mother's actions in Deptford which in turn force Paul to leave Deptford and to create a new identity for himself. Secondly, Dunstable Ramsey is haunted by the guilt of Mary Dempster over his entire life and he must create a new identity for himself. After a rock has hit Mary in the head (in a snowball thrown by Boy Staunton meant for Ramsay), and her preacher husband is crying over her, young Ramsay's only thought is that