Thursday, December 26, 2019

The Conflict Between Syrian And Foreign Policy - 2325 Words

Given the high level of foreign interest in Syria, it is a fact that the conflict cannot be resolved without the involvement of both opposing Syrian parties and their foreign backers. This refugee disaster has only become more complicated with the involvement of these foreign nations. As well, the ordeal has exponentially worsened with the rise of jihadist organizations like ISIS. These groups seek to eliminate all other opposition forces as well as the Syrian state itself, in an effort to claim all of the leftover territory. Scarcity in weapons and funds in Syria are also leading to additional struggle. From the beginning of the Syrian war, regional and international powers have intervened in the conflict through direct support. Many argue that if Syria had been a major ally of Western countries, or even of Russia, this war would have been stopped years ago. As it is now, Syria is caught in-between two major power blocs, and the government under Assad has gradually become an issue t hat these two nations believe should be dealt with. But how? From the perspective of rational choice theorists, their model assumes that states and their leaders make choices that they believe will lead to the best possible outcomes for them in terms of their individual goals. The interests of these parties include enhancing the state in various manners; such as a stronger government, more economic power, proliferation of a military, and so on. Decision makers under the rational actor model seekShow MoreRelatedEssay about American Foreign Policy in Syria1237 Words   |  5 Pagesin the Syrian conflict, and whether this intervention should be military or strategic. The U.S. has recently avoided interfering militarily in Syria or providing the rebels with direct support, but admitted the presence of the Syrian opposition. However, the U.S. has been criticized for its non-intervention policy, especially with the rise in the level of violence and the spread of conflict to other areas of the country, and even to its borders with Lebanon, Jordan and Turkey. The Syrian Crisis beganRead MoreAnti Assad Regime : Saudi Arabia1378 Words   |  6 Pagesaction by funding and arming Syrian rebels, including Islamists. Qatar, another oil-rich country, is supporting its own group of insurgents, and these include jihadists. Thanks to these nations, there is now foreign fighters operating in Syria. While America was interrogating its policy of backing up rebels, the Saudis were seeking US and UN endorsement for â€Å"heavier weapons†. These rebel groups have brought anarchy and intensified the sectarian dimensions of the conflict. With brutal violence beingRead MoreThe International Community Witnessed Dramatic Changes During The Tunisian Revolution1655 Words   |  7 Pagesfragile region. The Syrian conflict started as another Arab uprising to topple the authoritarian leader. However, it has since evolved into a proxy war involving Russia, the US, and other state and non-state actors. In September 2015, Russia intervened in Syria after a request from the Syrian government for military assistance to combat rebel and terrorist groups. After the death of Hafez al-Assad, the new president, Bashar al-Assad, promised freedom and democracy. Syrians quickly learned theseRead MoreUS and the Cold War Era1364 Words   |  6 PagesWhile the U.S. maintained a relatively confusing agenda regarding foreign policies during the Cold War era, its attitudes are clearer in the present as globalization has strengthened connections between all international actors and made it more difficult for some to focus on maintaining hostile outlooks. The U.S. has had a long history with Syria and Israel, as the superpower has struggled to keep the two countries from abusing each-other and has, at times, provided the latter with significant financialRead MoreAn Analysis of the Current Conflict in Syria1253 Words   |  5 Pagesï » ¿An analysis of the current conflict in Syria Introduction The modern Syria obtained its self-rule from France, it colony, in 1946. However, the country has experienced political instability periods compelled through the clashing interests of religious and ethnic groups. Between 1958 and 1961 Syria united with Nassers Egypt, but independence was restored through an army coup that took place before a renaissance led by the Baath party that controlled of Syria in 1963 (Diamond Plattner, 2012)Read MoreA Brief Note On The And Foreign Involvement908 Words   |  4 PagesISIS and Foreign Involvement In Syria civil war has been raging since March 2011. The conflict an attempt to overthrow the second Assad regime, led by Bashar al Assad, and multiple rebel groups, including the Free Syrian Army (FSA), the Islamic Front, the Islamic State in Iraq and Syria(ISIS), and Jabhat al-Nusra (the Syrian branch of al-Qaeda). Like his father, who held power before him, Bashar al Assad has been a corrupt tyrant who rigged elections and eliminated personal freedoms. TwoRead MorePolitical Disagreements Between Russia And The U.s. Essay1092 Words   |  5 PagesWith hundreds of thousands of Syrian refugees leaving Syria everyday due to warlike conditions under the current Syrian regime, many have asked what the US government’s involvement can and should be. The current regime in Syria acts with international support from powerful countries, more specifically, Russia. This complicates matters in terms of US involvement due to how an aspect of Russia’s â€Å"power† can be defined internationally. For the purposes of this paper, Russia’s power or internationalRead MoreThe Refugee Crisis And The Arab Spring1371 Words   |  6 Pagesnow the Syrian crisis. The Arab Spring was a series of anti-government protests, uprisings, and armed rebellions that spread across the Middle East in early 2011. The Arab spring protest against al-Assad’s Syrian government in the spring of 2011 evolved into an armed conflict between oppositions and government forces in certain cities and then evolved into a civil war. The Syrian civil war caused the large-scale diaspora of Syrian citizens, leading to the Syrian refugee crisis. The Syrian refugeeRead MoreThe Causes Of The Overwhelming Civil War In Syria1183 Words   |  5 Pagesseemingly one of the major conflicts in recent times. It got the attention of most countries in the world. The crisis wakes the interest among researchers and induces them to take a close look at the effect of the crisis on the economic growth in Lebanon. Theoretical literature reviews. 1) Tourism: For Faysal Itani (2016) Lebanon tourism pays the price of the Syria’s war. It threatens the economic growth of the country. †¢ Several foreign countries (US, UK, Canada)Read MoreSyrian Refugees Essay1021 Words   |  5 PagesCurrent Event Syrian Refugee Crisis The Syrian refugee crisis has become the worst humanitarian crisis in the world today. Currently, more than 12 million people are affected by the ongoing conflict happening in Syria. For the sake of comparison, the amount of people affected by both hurricane Katrina and the Haiti Earthquake, only totals to 5.2 million people (World Vision staff, 2015). These tragedies both hail in comparison to what his happening in Syria today. Ethical Issue The current

Wednesday, December 18, 2019

Technology Education And Its Impact On Teaching And Learning

Jane Healy presented a strong argument encouraging others to pay attention to technology in schools and its impact on teaching and learning. She stated that her ideas about technology have changed over the years to now becoming a â€Å"cautious critic.† She argues passionately that technology will not solve our educational systems issues, cautions against the capitalistic consumerism of purchasing products, the pros and cons of computer use, and whether or not technology provides better support in the classroom rather than a strong teacher. Healy takes a strong position that the increase in technology has not necessarily changed the delivery of instruction. She demonstrated a curiosity regarding if technology was simply substituting past practices rather than providing a redefinition of task and purpose. This leads itself to inquiring whether technology has enhanced the constructivist movement. Rather than the teachers dictating the learning, students are now driving the learning. Healy still insisted that the teacher’s role is still an important part of the educational process. She made it clear that technology is not meant to take over the teacher’s role, and that students will benefit equally, if not greater, by simply having a strong, intellectual teacher in the classroom. Regardless of learning task, it is the responsibility of the educator to define the learning rather than a software program. Education has become a big business regarding product consumption.Show MoreRelatedThe Concept Of E Learning Inclusion Into An Education Essay1555 Words   |  7 PagesThe Concept of e-learning inclusion into an education begins with the teacher and the manner in which they teach. A simple explanation of the view is that the teacher is the final authority and source of knowledge.The problem for many teachers is transition of teaching in manner than accommodate the use of technology. Mining how they have previously been teaching with the use of technology which gives birth to e-learning. In e-learning, Technology is simply a mean that teachers may use in differentRead MoreTeaching And Learning Of The 21st Century1098 Words   |  5 Pages Teaching and learning in the 21st century Introduction Things are changing in this modern society at an epidemic rate. The world is starting to become much more interconnected and technology is constantly changing the world. We now live in an increasingly different, globalized, and complicated media saturated culture. So this Technological overthrow will have a greater change in education. Our students are facing many difficulties like increased population, climate changeRead MoreImpact of Technology on Education1146 Words   |  5 Pages------------------------------------------------- Positive Impact of Technology on Education Technology plays a very important role in the field of education, especially in this 21st century. In fact, computer technology has become easier for teachers to transfer knowledge and for students to obtain it. The use of technology has made the process of teaching and learning more convenient. Talking in a positive sense, the impact of technology on education has been extraordinary. Using Internet and computersRead MoreTechnology Has Changed Our Society Essay1425 Words   |  6 PagesRATIONALE The predominance of technology has significantly influenced our society. Technology is being used all over the place, anywhere and is instant. When we say technology, it can mean a lot of things. But according to the New Zealand Ministry of Education, â€Å"technology is the use of practical and intellectual resources to develop products and systems (technological outcomes) that expand human possibilities by addressing needs and realising opportunities.† Technology is currently more complex andRead More21st Century Classrooms Essay1377 Words   |  6 PagesIn education today there is the view to link educational strategies, programs, initiatives, or technology to student achievement. There are many groups and organizations that are advocating for increased technology literacy. Generally in all aspects of our society, technology has revolutionized and in many ways simplified while enhancing our way of life. It is no surprise that the public expects that technology should have a similar effect on education. 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Higher education institutes are now spending million to implement computer technology projects like institute manage ment, campus management, student management etc. computer technologies could save higher education institutes millions of dollars. Computer technology is the design and construction of computers to better help people at work, school, homeRead MoreE Learning, Or Electronic Learning1294 Words   |  6 PagesLIS Education through E-Learning M.Thamaraiselvi M.Manthiramoorthi Librarian information Assistant Anna Centenary Library Chennai – 25 Mthamaraiselvi.acl@gmail.com mmanthira@gmail.com Introduction E-learning, or electronic learning, has been defined a number of different ways in the literature. The American Society for Trainers and Development (ASTD) defines e-learning as â€Å"instructional content or learning experiences delivered or enabled by electronic technology. â€Å"Electronic technologyRead MoreThe Impact Of Technology On Education And Revealed Reactions1666 Words   |  7 Pagesdetect the impact of technology on education and revealed reactions for both students and teachers of using technology in classroom. These researches has given us three results: 1) Some research has shown a dramatic difference between the schools in the past and now. 2) What Is Successful Technology Integration? 3) However, some of researches indicate to several difficulties and disadvantages that associated with using technology. What Is Successful Technology Integration? The education in theRead More The Case for Technology Essay1710 Words   |  7 Pages Technology permeates our society. In work settings, employees are expected to use computers for such tasks as communication, information management, problem-solving, and information seeking. Because technology is such an integral part of modern life, it behooves educators to prepare learners to use it effectively. Technology also has a role in the instructional process for it can serve as a means of supporting and enhancing instruction. Based on an analysis of the literature, Hopey (1998) noted

Tuesday, December 10, 2019

Evidence Based Practice in Health Service Management

Question: Case Study: Evidence based practice in health service management. Answer: In this study patient fall in the hospital is identified as the evidence. Based on the evidences available, it was decided to implement patient fall prevention strategy in a 100 bed hospital. There are lots of literatures available for, the evidence of fall, reasons of fall, its consequences and strategies to prevent the fall in hospitals. On an average the rate of fall in hospitals is between 3 10 per 1000 patients. Out of total fall patients, injury was reported in 30 50 % patients and 1- 2% patients experience hip fractures. This fall percentage of the patient is during different activities and at different positions. At the time of ambulation 19 %, when coming out of the bed 11 %, while sitting and standing 9 %, and while using toilet 4 % fall of the patients occur. Fall percentage also varies from place to place. In patient room 80 %, patient bathroom 11% and 10 % fall occur in the treatment room (Hitcho et al, 2004; Krauss et al, 2007). More falls in patient happen between 65 -85 yrs. of age and it increases with age. Fall percentage is more in the woman than the male. Falls is a very common community health problem worldwide, specifically in the elder patients. There are numerous reasons for the fall of the patient. These reasons for the fall are due to physical, physiological and psychological condition of the patient. Reasons responsible for the fall of the patient may be external or internal. Internal reasons include disturbance in balance and gait, different types of medications with improper consultation, visual impairment with loss of visual motor coordination, memory problems and cardiovascular problems mainly hypotension. External reasons include inadequate light, improper stairs, floors with slippery nature, unsuitable clothing and shoes and deficient in walking sticks, grab bars and hanging straps. Fall at one time may lead to consequences for a long time in terms of injury or fear of fall lead to less movement which results in functional loss and more risk of fall (Kannus et al, 2005; Evans et al, 2001). Moreover, there is evidence and the results of the studies available for less occurrence of fall, prevention of injury due to the fall, improvement in the patient condition due to implementation of fall prevention strategy in the hospitals. Also use of fall evidence to implement in practice already gave an idea of effective management of fall of patients. For implementation of patient fall strategy all the parameters are well established in different studies. These parameters include screening of patients for risk of fall, intervention for fall and injury prevention. These parameters are applied in this case to implement patient fall prevention strategy in the 100 bed hospital. Stakeholders involved: Stakeholders involved in this process includes patient, family members, clinicians, nurses, ward boy, pharmacist and other healthcare staff. Other than those mentioned directly involved stakeholders in falls prevention, other stakeholders are top management of the hospital, external consultant to implement the strategy, administrative officer and financial officer of the hospital (Tzeng Yin, 2008). Critical analysis: In general, patient fall is the neglected subject in the hospitals. This topic is neglected because most of the hospitals didnt report fall cases anywhere due to safeguard reason. When a patient is admitted to the hospital, most of the attention is used to give to the primary condition of the patient. Both family members and healthcare staff concerned about the primary condition of the patient. However, this fall and its subsequent consequences can be very serious and harmful to the patient. This fall can be prevented by the minimal efforts from the family members and healthcare staff. Consequences from this fall are alarming and disturbing the work of every stakeholder of the patient care. This patient fall leads to extra stress on everybody. Moreover, problem of this issue can be taken care very comfortably by taking extra care. Implementation of fall prevention strategy is also a value addition to the hospital, because this implementation fall strategy upgrades the value of hospit al both in terms of economic and social terms. Recently, lots of studies have supported the importance of this fall condition in the elderly patients. There is lots of literature available containing causes, effects, consequences and prevention strategies for the fall of the patient (Oliver, Healey, Haines, 2010). Reasons for change: Fall of the elderly patient in the hospital is more serious and dangerous than original or primary health condition of the patient. So it is very much required to change strategy to reduce, these fall events in the hospital. These fall events complicate the treatment strategy for the primary health condition. There is a double burden on the patient, family members and health care staff. This fall leads to the increase in the sufferings for the patient and there is both physical and mental downfall of the patient. There may be possibility of patients not responding to the treatment of the primary condition due to fear of falling again, pain due to injury and loss of confidence. By keeping in mind overall wellbeing of the patient and family members, it is very much required to change the strategy of the hospital to prevent the fall of the patient. Moreover, there is the possibility of serious nature of injury to the patient and it remains for a long time, which can disturb day to day a ctivities of the patient. For this long term injury or disability, patient and family requires more amount of money. It also includes more stay in the hospital that increase burden on the patient mentally and it costs more. Also it has been proved that, if a patient falls 2 or 3 times, there is possibility of falling again and again. Falls prevention programmes have been successfully implemented in few hospitals. Looking at all the above issues, it is very much required to change the strategy in the hospital to prevent the fall of the patient (Inouye, Brown, Tinetti, 2009). Driving forces assistive and resistive: There are both the types of assistive and resistive forces for the implementation of the strategy change for elder patient fall in the hospitals. Assistive forces made the stakeholders to implement this policy change in the hospitals. Condition of the patient and family members, those affected more due to this fall, make hospital management to implement fall prevention strategy. As described earlier, injury may be an acute or long term, make patient and family members to request hospital management to implement this strategy in the hospitals. Due to implementation of this fall strategy, there is double burden on family members for the treatment of primary condition and cost due to injury after the fall of the patient. Earlier fall of the patients in the hospitals was not recorded. Now a day, these cases are published in the literature along with the seriousness about this particular issue. This makes hospitals to implement these strategies in the hospitals. Also, preventive strategie s to prevent these fall conditions in the elderly patients are available in the literature and positive outcome and success of the strategies make hospitals to implement these strategies in the hospitals. Along with these assistive strategies, there are also resistive strategies which prevent implementation of the fall prevention strategies in the hospitals. In hospitals there are different departments operating at the same time. It is difficult to maintain coordination with all the departments due to large number of patients inflow. Also lack of coordination between employees of different departments, prevent implementation of this elderly patient fall prevention strategy. Lack of adequate number of employees and funding is the resistive driving force for implementation of this strategy. Willingness of the top management is most important driving force for the implementation of this fall prevention strategy (Aberg, Lundin-Olsson, Rosendahl, 2009). Strategies used: Some of the innovative methods applied to change the policy of the hospital about the fall of the patient. Few of the strategies to prevent patient fall are discussed in this section. At the time of admission to the hospital, patients were screened for fall risk and these susceptible patients for fall risk were selected for the fall prevention strategy. One of the strategies is keeping the colored band on the hand of the fall risk patient, so that anybody can identify the patient as susceptible for the fall and assist the patient for routine work. Education to the family members of the patient to prevent the fall of the patient is very good and effective strategy to prevent fall of the patient. Because family members of the patient can accompany them all the time and fall can be prevented in an efficient way. Moreover, family members can convince the patient to avoid few acts which are prone to the fall. Hence, family members of the patient trained in the fall prevention strategy. An other effective strategy to prevent the fall of the patient is by mentioning fall risk factor in all the reports when shift of the hospital changes. By doing this, healthcare staff attending in the next shift can understand the condition of the patient in a better way and plan their work. To implement a quality strategy of the prevention of the fall of the patient, it is very much required to maintain a proper checklist and documentation. This checklist and documentation will help to prepare standardized procedure to implement fall prevention in the future. Also this documentation also helps to evaluate the regular efficiency of the strategy and amend accordingly to seek for the improvement. Most of the elderly patients are on the antipsychotic medication and these medicines are the major cause of fall of the elderly patients. Consumption of these medications was stopped for the patients with fall sick. Administration of the vitamin D, is one the strategy to prevent fracture in the patient with fall. This antipsychotic drugs withdrawal is one of the fall prevention strategies applied. Implementation of fall prevention strategy in terms of psychological trainings to the patient is the most important strategy for fall prevention. These psychological training include building confidence in the patient, avoiding patient from fear of fall and giving patients feeling of wellbeing. This wellbeing is very important for elderly patient because of memory loss and depression in older age. Patients with risk of fall are trained for exercise to increase physical strength which results in the resistance to fall. All the above description suggests that multifactorial strategy has been applied for fall prevention of the elderly patient. This multifactorial strategy includes both physical, psychological and medicine related strategy, also it include patient and healthcare team (Schwendimann et al, 2006; Vassallo et al, 2004). The type and quality of evidence applied: In general terminology evidence is used as experience to understand that particular matter. In health care evidence has broad meaning and includes proof, reasoning, observation and verification. In healthcare, importance of evidence is based on the historical data of the evidence available in the literature. In healthcare there are different types of evidence are present. These evidences are research based evidence, clinical experience based evidence, patients based evidence and local context and environment based evidence. This evidence of elderly fall patient is the overlap of the clinical experience and patient based evidence. In clinical based experience, both clinicians or practitioners and nurses learn from their practical knowledge and implement their experience to make that particular condition as evidence. Patient based evidence is based on the experience of the patient and their family members. These patient and family members experiences are very useful in implementing the best healthcare practices because the final aim of the healthcare professional ids to give relief and satisfaction to the patient and family members. Learning from the patient and family members experience helps health professionals to act in that direction and this whole procedure is more effective. Hence this evidence of patient fall, which is based on the clinical and patient experience, is valid evidence for evidence based healthcare management (Rycroft-Malone et al, 2004; Barker, 2000; McCaughan et al, 2001). Decision making process involved: Decision making for the implementation of the fall prevention strategy mainly based on the findings from the literature and opinion and discussion of all the stakeholders in this process (Dykes et al, 2010). Decision making process of the fall prevention strategy incorporated all the stakeholders of the healthcare like clinicians or practitioners, experts in hospital management, nurses, ward boy, and pharmacist. Patient and family members also included in the decision making process. For decision making clinician or practitioner critically appraised the evidence. This critical appraisal helps in understanding all the positive and negative aspects of the evidence. This critical appraisal and study of the evidence based healthcare enhances the confidence of the clinician and helpful in decision making. Scientific studies with large number patients are helpful in decision making for the clinicians. So studies with large number of patients were selected for the evidence and decision maki ng. Along with the evidence for the decision making, other factors also involved in the decision making. These factors are associated with resources. All the resources like equipments, availability of rooms, medicine and manpower to handle the additional activities due to implementation of the fall prevention strategy. In terms of manpower, competency of the manpower to handle the change and willingness to accept change was considered for decision making. Patient and family members also considered in decision making, as they have to stay in the hospital for a longer time in the hospital and bear more cost for treatment. Solutions offered: Other than the medical treatment other solutions offered to prevent this fall strategy. More attention was given to the patient safety. Hospital structure was changed to the patient centered. This hospital structure change is very much required because elderly patients are more comfortable with their known environment and due to age they are not ready to accept the change. To make elderly patients more comfortable with the hospital conditions, it is required to change the structure of the hospital. Patient fall risk assessment tool was implemented in the hospital and proper checklist maintained for the analysis of the patient. Training has been provided to the healthcare professionals to prevent the fall of the patient and regular assessment of the trained people has been done to understand their competency. This type of training is very much important because these trained people are very much effective in preventing these falls of the elderly patient. This risk assessment tool help s to separate patients of fall risk from the other patients. Patients with fall risk can be given special attention to prevent the fall. Height of the bed has been reduced for the patient at risk of fall because this is one of the prominent reasons for the fall of the patient during their day to day activities. Different types of accessories have been provided to the patients and trained them along with their family members for utilizing these accessories. These accessories help in giving support to the patient and also it protects the patient from serious injury, though patient fall (Shubert et al, 2014). Evidence based outcome: Implementation of the evidence based fall prevention strategy results in the number of positive outcomes for the patient. Implementation of the suitable exercise for the patients with the risk of fall, results in the less incidence of the fall. Psychological diseases are more common in the elderly patients, because these patients are on the chronic dosing of the antipsychotic drugs. Withdrawal of these antipsychotic drugs, results in the lesser incidence of fall in the elderly patients. Instead of practicing fall prevention programme on all the elderly patients, it was implemented to the targeted patients i.e. fall risk patients. Result of this targeted patient intervention results in a more efficient outcome as it reduces unnecessary burden on the healthcare team and cost to the hospital management. Working in the multidisciplinary team results in the more effective prevention strategy for the fall of the elderly patient. Multidisciplinary team has a more accurate diagnosis and trea tment of the said condition. Administration of vitamin D in the patient with risk of fall, results in less number of fractures and less severity fractures in the hospital. There are different strategies for the prevention of fall, like physical, counseling or training, psychological and medicine based. It has been observed that the combined effect of these strategies gives better results, i.e. multifactorial strategies are more effective as compared to the individual strategies. Implementation of this strategy results in the decreased fall rate in the hospital, recurrent fall and admissions to the hospital due to the fall (Healey et al, 2014). Impact on each stakeholder: There are different stakeholders involve like patient, family members, clinician or practitioner, nurses, wardboy, and pharmacist. Implementation of this strategy is very beneficial to the patients. This helps patients to be more positive about the fall. Patients neednt be worried much about their fall because most of the matters related to the fall are taken care by the other stakeholders from the family and healthcare profession. Family members also feel relaxed after the implementation of this strategy. Because family members neednt required to take the patient to the other hospital or other department after the fall of the patient. Also in terms of cost of the treatment also, there is a noteworthy reduction in the cost of treatment as all the segments of the treatment are happening at the same place. For the healthcare professional, there is so many tasks are there to perform after the implementation of the strategy. Also, there is lots of learning for the healthcare professional s in all this exercise. Clinicians and practitioners visited the patients frequently and attended the cases. There is double work load on clinicians. Nurses became more systematic and documentation became more standardized for the nurses. Nurses are completely occupied with their patients because their frequency of attending the patient has increased more than double to the patient. Wardboy has to lots of work for patients like adjusting the bed height to the low height, assisting patient for toilets, helping patients in changing cloths and providing patients with accessories for fall prevention. These are the extra tasks, wardboy has to perform. Pharmacist have to be very careful while dispensing medicine. Pharmacist should study all the medicines for the patient for adverse reactions and drug interactions among the provided medicines. Impact of change on the professional practices: There are noteworthy changes in the approach and thinking of so many stakeholders of the hospital. Top management generally thinks in the business oriented direction. However, in this change top management of the hospital accepted the change for the wellbeing of the patients and improving the healthcare qualities of the hospital. There are number of professional qualities has been developed in the existing staff due to implementation of this strategy. These qualities include leadership, ownership, team work, interdisciplinary access, commitment and discipline. There are lots of learning for every stakeholder in this process. Staff of the hospital is ready for the change, staff is working with certain goals and staff is excited about this change. Many standardized protocols have been introduced in the hospital for evaluation of risk factors for the fall of the patient and also procedures have been established for the treatment and prevention of the fall. These protocols and procedures are useful for the long time, also it increases the speed of the services at the hospitals due to set guidelines and there are very less chances of errors in implementing this strategy. Training programmes have been developed for the patient, family members and healthcare staff, to educate them about protocols and procedures. There is the improvement in creative thinking, deep rooted literature search, and strategic communications of the staff of the hospital. This overall exercise resulted in the quality of the services at the hospital. Impact upon health service management: With the implementation of this strategy there is linkage happened between healthcare professionals of the hospital, educationalist, policy makers in the medical field and top management of the hospital. Association of all these stakeholders makes the implementation of this change more valid and robust. All these stakeholders agreed that evidence is one of the important criteria to make necessary decisions to improve the health care services and manage the services more effectively. If we look at above mentioned discussion, mainly four topics plays a major role. These four topics are, critical thought process and interpretation, collecting most useful information, critical appraisal of the selected evidence and application of evidence in decision making. These four areas collectively are very effective in healthcare service management. It leads to the quality up gradation of the hospital and matching with the global health policy. There is overall improvement in the economics and bud geting of the hospital. This change in strategy for fall of the elderly patient gives complete justification to the functions of the healthcare management. These healthcare management functions include working in changed scenario, adopting new skills during change, effective planning, managing human resource and improving personal performance. Recommendations for using evidence to effect further changes: We can use basis of the evidence for further changes in both the terms i.e. screening for fall risk and intervention of the fall i.e. prevention of fall and treatment of injury due to fall. Recommendations for the screening include, compulsory screening of all the patients above a certain age, and standardized protocol for screening which is globally acceptable. Recommendation for intervention include, monitoring of medication for all elderly patients, compulsory administration of vitamin D, isolated and specialized room for the elderly patient in the hospital and establishment of compulsory accident or trauma unit in each hospital. References: Aberg, A.C., Lundin-Olsson, L., Rosendahl, E. (2009). Implementation of evidence-based prevention of falls in rehabilitation units: a staff's interactive approach. Journal of Rehabilitation Medicine, 41(13), 1034-40. Barker, P. (2000). Reflections on caring as a virtue ethic within an evidence-based culture. International Journal of Nursing Studies, 37, 329336. Dykes, P. C., Carroll, D.L., Hurley, Ann., Lipsitz, S., et al. (2010). Fall prevention in acute care hospitals a randomized trial. Journal of the American Medical Association, 304(17), 19121918. Evans, D., Hodgkinson, B., Lambert, L., Wood, J. (2001). Falls risk factors in the hospital setting: a systematic review. International Journal of Nursing Practice, 7(1), 3845. Healey, F., Lowe, D., Darowski, A., Windsor, J. et al. (2014). Falls prevention in hospitals and mental health units: an extended evaluation of the FallSafe quality improvement project. Age Ageing, 43(4), 484-91. Hitcho, E.B., Krauss, M.J., Birge, S., Claiborne, D.W., Fischer, I., et al. (2004). Characteristics and circumstances of falls in a hospital setting: a prospective analysis. Journal of General Internal Medicine, 19(7), 732-9. Inouye, S.K., Brown, C.J., Tinetti, M.E. (2009). Medicare nonpayment, hospital falls, and unintended consequences. New England Journal of Medicine, 360, 23. Kannus, P., Sievanen, H., Palvanen, M., Jarvinen, T., Parkkari, J. (2005). Prevention of falls and consequent injuries in elderly people.Lancet, 366(9500), 18851893. Krauss, M.J., Nguyen, S.L., Dunagan, W.C., Birge, S. et al. (2007). Circumstances of patient falls and injuries in 9 hospitals in a midwestern healthcare system. Infection Control Hospital Epidemiology, 28(5), 544-50. McCaughan, D., Thompson C., Cullum N., Sheldon T. Thompson D.R. (2001) Acute care nurses perceptions of barriers to using research information in clinical decision-making. Journal of Advanced Nursing, 39(1), 4660. Oliver, D., Healey, F., Haines, T.P. (2010). Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine, 26(4), 645-92. Rycroft-Malone, J., Seers, K., Titchen, A., Harvey, G., Kitson, A., McCormack, B. (2004). What counts as evidence in evidence-based practice? Journal of Advanced Nursing, 47(1), 81-90. Schwendimann, R., Buhler, H., De Geest, S., Milisen, K. (2006). Falls and consequent injuries in hospitalized patients: effects of an interdisciplinary falls prevention program. BMC Health Services Research, 6, 69. Shubert, T.E., Smith, M.L., Prizer, L.P., Ory, M.G. (2014). Complexities of fall prevention in clinical settings: a commentary. Gerontologist, 54(4), 550-8. Vassallo, M., Vignaraja, R., Sharma, J.C., Hallam, H. et al. (2004). The effect of changing practice on fall prevention in a rehabilitative hospital: the Hospital Injury Prevention Study. Journal of the American Geriatrics Society , 52(3), 335-339. Tzeng, H.M., Yin, C.Y. (2008). Nurses' solutions to prevent inpatient falls in hospital patient rooms. Nursing Economics, 26(3), 179-87.

Monday, December 2, 2019

Plot To Steppenwolf Essays - Steppenwolf, Magic In Harry Potter

Plot To Steppenwolf THE PLOT of steppenwolf - Steppenwolf opens with a preface by a young businessman, who introduces a sheaf of notes left behind by a lodger in his attic rooms several years before. This young man, the landlady's nephew, describes the eccentric lodger, Harry Haller, who called himself a Steppenwolf, meaning in German a wolf of the steppes, or plains. The narrator finds this an odd but apt description of the shy, lonely wanderer who revealed little about himself but left a haunting memory. The preface recounts Harry's arrival and the narrator's several encounters with him- on the stairs, at a concert and an art lecture, and in a tavern. He has decided to publish Harry Haller's records although he can't say whether the experiences it relates were real or fictitious. Haller's records, subtitled For Madmen Only, begin with a walk in the dusk after a boring day. The walk takes Harry into an imaginary world by way of a flickering sign, an appearing and disappearing little door in a church wall, and a peddler with a placard advertising, Magic Theater- Entrance Not For Everybody. The peddler hands Harry a pamphlet and vanishes. in his room again, Harry examines the pamphlet. It is called Treatise on the Steppenwolf and is a second portrait of Harry, a psychological one this time. It analyzes Harry as inwardly half man and half wolf, two selves in constant conflict. It describes Harry's struggle to be himself, which has resulted only in greater loneliness. It explains to Harry the role of the Steppenwolves- the artists and intellectuals- in middle-class society, and the geniuses who break free and become Immortals. It tells Harry that his wolf is an oversimplification, that he has not two but hundreds of selves. Some day he may see himself in one of the Immortals' magic mirrors, or find in one of their magic theaters what he needs to free his soul. Finally the anonymous authors bid Harry good-bye and cheer him on his path toward becoming an Immortal. Harry, again in the first person, compares what the Treatise says of him with a poem he has written about the wolf. He finds them both true and unbearable. He recalls the successive crises in his life, the despair, and the new self-knowledge he has gained each time at the cost of increased loneliness. He will not go through this again. He will end it, commit suicide. But first, the Magic Theater. After nights of search he finds the peddler, who directs him to a seedy tavern. Here he meets the bar girl Hermine, who introduces him to the prostitute Maria and the jazz musician Pablo. With Hermine as guide, Harry learns to dance and to enjoy sex and the night life of the city. He joins the revelers at a masked ball. Pablo, as master of ceremonies, invites Harry into the Magic Theater. Here, in a series of dreamlike adventures, Harry fights a war against automobiles, makes love to all the women he has ever loved, commits an imaginary murder, and prepares to be executed. Instead, he is con demned to go on living. Pablo rebukes him for messing up his magic with reality. Harry acknowledges that he will go on trying to face his inner self, and perhaps learn to do better next time.