The Greek God Poseidon, Lord of the Sea, Neptune

The Greek God Poseidon, Lord of the Sea, Neptune The mighty Earthshaker, Poseidon ruled the waves that the ancient seafaring Greeks depended upon. Fisherman and sea captains swore fealty to him and avoided his wrath; the sea gods persecution of the hero Odysseus was well known, and few wished to wander so far and so long before finding their home port. In addition to his influence over the seas, Poseidon was responsible for earthquakes, striking the ground with his trident, a three-pronged spear, to awesomely devastating effect. Birth of Poseidon Poseidon was the son of the titan Cronos and brother to the Olympian gods Zeus and Hades. Cronos, fearful of a son who would overthrow him as he vanquished his own father Ouranos, swallowed each of his children as they were born. Like his brother Hades, he grew up inside the bowels of Cronos, until the day when Zeus tricked the titan into vomiting up his siblings. Emerging victorious after the ensuing battle, Poseidon, Zeus and Hades drew lots to divide up the world they had gained. Poseidon won dominion over the waters and all its creatures. Alternate Greek myths suggest that Poseidons mother, Rhea, transformed him into a stallion to stymie Cronos appetite. It was in the form of a stallion that Poseidon pursued Demeter, and fathered a foal, the horse Areion. Poseidon and the Horse Oddly for the god of the sea, Poseidon is deeply associated with horses. He created the first horse, introduced riding and chariot racing to mankind, and rides above the waves in a chariot drawn by horses with golden hooves. In addition, some of his many children are horses: the immortal Areion and the winged horse Pegasus, which was the son of Poseidon and the gorgon Medusa. Myths of Poseidon The brother of Zeus and Greek god of the sea figures in many myths. Perhaps the most notable are those related by Homer in the Iliad and Odyssey, where Poseidon emerges as a foe of the Trojans, champion of the Greeks and dire enemy of the hero Odysseus. The Greek gods antipathy toward the wily Odysseus stems is kindled by the mortal wound that the hero deals to Polyphemus the Cyclops, a son of Poseidon. Again and again, the sea god conjures winds that keep Odysseus away from his home in Ithaca. A second notable story involves the contest between Athena and Poseidon for the patronage of Athens. The goddess of wisdom made a more compelling case to the Athenians, giving them the gift of the olive tree while Poseidon created the horse. Finally, Poseidon figures prominently in the story of the Minotaur. Poseidon gave to King Minos of Crete a fantastic bull, intended for sacrifice. The king couldnt part with the beast, and in anger, Poseidon caused the princess Pasiphae to fall in love with the bull, and to birth the legendary half-bull, half-man called the Minotaur. Poseidon Fact File Occupation: God of the Sea Attributes of Poseidon: The symbol for which Poseidon is best known is the trident. Poseidon is often shown alongside his wife Amphitrite in a sea chariot drawn by sea creatures. The Inferiority of Poseidon:Poseidon asserts equality with Zeus in the Iliad, but then defers to Zeus as king. By some accounts Poseidon is older than Zeus and the one sibling Zeus didnt have to rescue from his father (the power leverage Zeus usually used with his siblings). Even with Odysseus, who had ruined his son Polyphemus life, Poseidon behaved in a less fearsome manner than might be expected of an enraged Sturm und Drang kind of god. In the challenge for patronage of the polis of Athens, Poseidon lost to his niece Athena, but then worked cooperatively with her as in the Trojan War where they try to thwart Zeus with Heras help. Poseidon and Zeus:Poseidon may have had an equal claim to the title of King of the Gods, but Zeus is the one who took it. When the Titans made the thunderbolt for Zeus, they made the trident for Poseidon.

Book Designers or Book Design Templates

Book Designers or Book Design Templates Book Designers or Book Design Templates? Last updated: 2017/07/07Freelance journalist Simon Owens wrote a brilliant investigative piece on how the rise of self-publishing has led to a boom of freelance editing services. This is also true in all the other areas of a book’s production, like cover design, layout, and formatting – and is even a growing trend in marketing and publicity.Most independent authors publish with a â€Å"digital first† approach; they tend to invest less in book interior design, layout and typography because most e-readers have standard formatting whereby the reader chooses the font, size and colour. That leaves the cover design. But even with book covers, the thumbnail size of books on Amazon has prompted many authors to think twice before heavily investing in a professional cover design (where quotes can range from $200 to $2000).This tendency to cut corners on design has given birth to another possibility in the past few years: pre-made book layout and cover design templates. It has also given birth to some fantastic websites like Lousy Book Covers and Kindle Cover Disasters, but that’s another story†¦Book design  templates: Opportunities and risksHere’s how Joanna Penn put it in a blog post on DIY book cover design: â€Å"Although I personally believe in paying professionals, I’m also aware that some people want to have a go themselves, or need to because of budget restraints.†That’s the great thing about today’s publishing landscape: there are enough options out there to suit all kinds of authors, including the budget-conscious or DIY-lovers. Joel Friedlander from The Book Designer offers pre-made book design  templates. Graphic design startup Canva has a free online book cover maker. And a number of other websites offer templates and DIY tools for authors to make their own covers based on existing templates.Of course, the risk when using a template is a copyright one. If the site you purchase the templat e (or pre-made cover) from doesn't grant you the rights - or an exclusive perpetual license - as a result of the purchase, then they might be re-selling that pre-made cover to other authors. That's how so many authors end up with covers that look almost identical to another one out there.So, to the question: is it worth investing in a book designer with all the free tools, templates, imagery and DIY advice out there? To answer, I decided to start a little Facebook survey on two indie author groups.A Facebook surveyMost of the members of these groups are professional indie authors who take their writing careers just as seriously as a traditionally published author would. They are educated enough to know about all â€Å"options† out there.In a sample of 116 respondents:70% indicated they worked with a professional designer or design company27% indicated they did their own covers3% indicated they purchased pre-made cover design templatesNote 1: Over 50% of the DIY-enthusiasts in this survey are actually either professional designers (as well as indie authors) or well-versed enough in editorial design to produce covers of a same quality standard as traditional publishing.Note 2: Several authors (around 20) indicated in the comments that they worked with a professional designer for some of their â€Å"main† books and did the covers themselves for short stories.ConclusionsIf over 80% of authors in this sample place a high enough value on book design to consult and hire a professional, it seems reasonable to say that debuting authors should do the same. In an extremely competitive market, first-time authors who want to realistically compete with seasoned professionals would do well to note the value a professional designer can add.DIY tools offer great value to those who already possess design skills, but cannot replace or teach those skills to the uninitiated. Book design templates can be a starting point for a cover, but are rarely â€Å"just right † for the book, which means they will need to be tweaked†¦ and then we’re back to requiring design skills.The results of this mini-survey should come to readers as a relief. For a while, the rise of templates and cheap designs seemed to be leading the book industry towards more visual standardization. Indie authors continuously contribute to publishing’s diversity by blending genres, inventing new ones, and revealing new niche markets. It’s important that this pioneering diversity is equally represented in a new range of book designs.More awesome posts on book design:6 Tips for Briefing your Book DesignerBook Design in Self-Publishing: Breaking New GroundThe Perfect Book CoverWe are big believers in the value of talented professional designers.  So whether you're looking for cover design, typesetting or illustration, visit our designer's  marketplace!

Correlation of Birth order and Motor development Research Paper

Correlation of Birth order and Motor development - Research Paper Example Development of movements are often invisible and aren’t recognizable at an early age. These physical impairments create numerous challenges for children affecting their psychological and physical development. Thus, Development Coordination Disorder (DCD) enables slow motor development, in children. It affects both intellectual and physical progress of a child. Children born with extreme low weight are more inclined to motor, cognitive and behavioral impairments and they increase with age. Therefore, recent record shows that preterm children are persistently diagnosed with deficient motor skills. Children have to go through a neuro-motor exam, which establishes their standard of DCD for treatment (Dewey et al., 2011).  Ã‚   Lehman has described birth order as customary environment and parental influence on children. The difference in behavior and physical growth is directly affected by the presence of siblings. However, these affects can differ due to optimistic and pessimist ic environment around the child. It also includes school’s environment, and its impact on child’s psychological and motor development. However, evaluation of relationship between birth order and academic achievements has shown pessimistic results. Investment of quality time by parents with higher order sibling has been observed less, which has resulted in negative and measured development of children (Lehmann et al, 2012).Child’s position in the family and sibling’s gender are important factors that affect development. However, psychological.

Do curfews keep teens out of trouble Essay Example | Topics and Well Written Essays - 4000 words

Do curfews keep teens out of trouble - Essay Example ect various age groups in our society, we fear the most for the young people in our society who, due to reckless abandon caused by their youthful enthusiasm for life, tend to place themselves in precarious situations. These dangerous situations are usually connected to their love of the fun time offered by a night life. As parents who fear for the safety of their children, a curfew placed upon their childs night time activities offers a semblance of protection for both parties. The idea being that if a child is home by a certain hour of the night, he or she will be able to avoid the pitfalls that often befall the adventurous teens at night. An analysis of the history and reasons behind the implementation of parental and citywide curfews reveal the details as to why these sectors find curfews an effective deterrent when it comes to keeping their children out of trouble: the night holds some unseen circumstances that children and teenagers may not be capable of dealing with at their current age. Therefore there needs to be some sort of system in place that can help protect them from the things that go bump in the night on public streets. Since teenagers these days can be really hot headed and emotional, it is important to make sure that they are in a safe place once night time sets in because as the night deepens, tempers may end up flaring in certain situations. It is saddening to note that curfews were not needed during the past eras in the United States. The night streets were safe places for them to hang out with their friends after dinner or on a Friday night so they can relax after a hectic school week. Teenagers were not always held in the grips of curfew mania as they are today. Newspaper articles from decades gone by have shown that there was a time in our country when it was safe for teenagers to go out and party at night. Schools did not need to have metal detectors at the gates, school dances were the highlight of the school year, and teenagers would go

Two Examples of Environmental Impact Assessments Essay Example for Free

Two Examples of Environmental Impact Assessments Essay The cities of Baku, Azerbaijan and Kingston, Ontario Canada are worlds apart, both geographically and culturally. They share at least one characteristic: the need for water. Like every other city on earth, they have built systems to accommodate their needs for water, electricity, and all the other necessities of modern life. Each city also has environmental problems that go hand in hand with urban habitation. The two Environmental Impact Assessments are examples of the challenges engineers and city planners face everyday to minimize the adverse effects on the ecosystem. Both cities, like all modern cities, are locked in a perpetual struggle to find a balance between the needs of the environment and the needs of the city. Wastewater Treatment In Baku, Azerbaijan Azerbaijan is a small country in central Asia on the Caspian Sea. Russia lies to the north. Georgia is to the northwest, Armenia is to the west, and Iran is on its southern border. The capitol of Azerbaijan is Baku and is also its largest city. Located on the Absheron peninsula, it is home to nearly 2 million people. The Caspian Sea is the largest enclosed body of water on the planet and Baku is its largest port . Azerbaijan is rich in petroleum products and oil drilling has polluted Baku and the Caspian Sea. The Hovsan Wastewater Treatment Plant is another source of pollution to Baku and the Caspian Sea. The treatment plant handles almost half of the capitols wastewater. The wastewater is only partially treated and then dumped into the Caspian Sea via pipeline. The result has made most of the beaches around Baku unusable. The area surrounding the treatment plant inland is also unpleasant because of the odor. In the past, recreation along the sea shore was the most popular recreation for the public and tourists. Today, many are surprised to hear this fact because the bay is so polluted from sewage(Gischler, 2000, p. 41). There is a project proposed to alleviate the shoreline pollution. The plan is to extend the length of the pipeline farther out into the Caspian so the currents will disperse and diffuse the effluent material into the sea and away from the beaches. The current system is so inadequate because of years of neglect that it can only hope to just catch up to its current needs in a few years time. The construction of the longer pipeline will cause some negative effects, but they pale in comparison to the present state of the littoral around Baku. Table 1 outlines the environmental impact projected from the construction of the pipeline. The construction of the outfall is still in the planning stages, but it is expected to start in 2011. Water Treatment In Kingston, Ontario The expansion of the Point Pleasant Treatment Plant in Kingston, Ontario is the focus of this half of the paper. Kingston shares with Baku the distinction of being on the shore of one of the largest inland bodies of water, Lake Ontario. Kingston is located in the province of Ontario in Eastern Canada. To the west is Manitoba, east is Quebec, north is Hudson Bay, and Lake Ontario is to the south.. The Point Pleasant Treatment Plant is a direct filtration facility that supplies the 118,000 people of Kingston with drinking water. The water is drawn from Lake Ontario and goes through a series of filters and chemical treatments before being piped into the main water supply. The Point Pleasant project proposes to double the water pumped in and treated from 40 MLD (mega litres per day) to 80 MLD. The increase is needed for the projected increase in population and expected changes in regulatory standards for drinking water purity. The EIA for the plants upgrade identifies the surrounding vegetation and trees as being vulnerable to harm from construction activities during the plants renovation. The Butternut tree is specified in the report as a major concern because it is already an endangered species. Other issues are the pollution of the ground water and soil erosion. Table 2 outlines the environmental impact from the upgrade of the facility. Kingstons treatment plants upgrade is one that shows the existing system is sound because it is for projected future use and not just getting the current system up to par. The many years of investments and planning regarding the water infrastructure have paid off so they do not have to â€Å"catch up† just to make the system function nominally. A strong infrastructure can mean less damage to the environment. Conclusion Environmental impact from city living is inevitable, but it can be minimized. It requires a firm commitment to good planning and major investments in clean technologies. Comparing the upgrade of the water treatment plant in Kingston and the plant in Baku illustrate the differences in the conditions of each citys water systems. Laws protecting the environment vary from country to country and it is evident that Azerbaijan had few such laws. Canada has much more stringent environmental protection laws than Azerbaijan. Although Kingston has a much smaller population, the larger cities of Canada have done fairly well protecting the environment. Unfortunately, a countrys wealth dictates the priority that can be given to environmental protection. Lower standards for the construction and maintainence of urban infrastructure increases the chances of environmental degradation. References Azerbaijan. (2010). In Encyclopedia Britannica. Retrieved May 23, 2010, from Encyclopedia Britannica Online Library Edition: http://www. library. eb. com/eb/article-44298 Baku. (2010). In Encyclopedia Britannica. Retrieved May 23, 2010, from Encyclopedia Britannica Online Library Edition: http://www. library. eb. com/eb/article-9011883 Gischler, Maarten A (2000, summer) â€Å"Beautifying the Bay† Azerbaijan International, 8(2), 40-42 Kingston. (2010). In Encyclopedia Britannica. Retrieved May 23, 2010, from Encyclopedia Britannica Online Library Edition: http://www. library. eb. com/eb/article-9045553 Townsend, Mike. (2002, July). BETWEEN TWO SEAS: Progress on the BTC Pipeline Project. Azerbaijan International, 10(3), 90. http://ezproxy. spl. org:2048/loginurl=http://proquest. umi. com/pqdweb

Chemical Reactions Essay -- science

Chemical Reactions Chemical reactions are the heart of chemistry. People have always known that they exist. The Ancient Greeks were the firsts to speculate on the composition of matter. They thought that it was possible that individual particles made up matter. Later, in the Seventeenth Century, a German chemist named Georg Ernst Stahl was the first to postulate on chemical reaction, specifically, combustion. He said that a substance called phlogiston escaped into the air from all substances during combustion. He explained that a burning candle would go out if a candle snuffer was put over it because the air inside the snuffer became saturated with phlogiston. According to his ideas, wood is made up of phlogiston and ash, because only ash is left after combustion. His ideas soon came upon some contradiction. When metal is burned, its ash has a greater mass than the original substance. Stahl tried to cover himself by saying that phlogiston will take away from a substance’s mass or that it had a negative mass, which contradicted his original theories. In the Eighteenth Century Antoine-Laurent Lavoisier, in France, discovered an important detail in the understanding of the chemical reaction combustion, oxigine (oxygen). He said that combustion was a chemical reaction involving oxygen and another combustible substance, such as wood. John Dalton, in the early Nineteenth Century, discovered the atom. It gave way to the idea that a chemical reaction was actually the rearrangement of groups of atoms called molecules. Dalton also said that the appearance and disappearance of properties meant that the atomic composition dictated the appearance of different properties. He also came up with idea that a molecule of one substance is exactly the same as any other molecule of the same substance. People like Joseph-Lois Gay-Lussac added to Dalton’s concepts with the postulate that the volumes of gasses that react with each other are related (14 grams of nitrogen reacted with exactly three grams of hydrogen, eight grams of oxygen reacted to exactly one gram of hydrogen, etc.) Amedeo Avogadro also added to the understanding of chemical reactions. He said that all gasses at the same pressure, volume and temperature contain the same number of particles. This idea took a long time to be accepted. His ideas lead to the subscripts used in the formulas f... ...st, stimulating a reaction between two reactants, just stimulating a reaction one molecule at a time. The molecules are stimulated in a pattern giving the wanted results. This discovery opens doors for nanoengineering and material sciences. It gives a good view of what happens, one molecule at a time. Chemical reactions are a large part of chemistry. This paper is an overveiw of that extensive subject. It gives a good idea about the history of chemical reactions as well as the future. Hopefully, there will be no end to the expansion of chemistry and our knowledge. Since Scientists are still experimenting, chemical reactions will always be a part of chemistry. Bibliography "Chemical Reactions," Encyclopedia Brittanica MACROPEDIA, 1995, Vol. 15 "Dances With molecules," Science News, Vol. 147, May 27, 1995 Eastman, Richard H., General Chemistry: Experimental and Theory, Holt, Rhinehart, and Winston Inc., 1970 "One Molecule at a Time", Discover, January 1996 Pauling, Linus and Peter, Chemistry, W. H. Freeman and Co., 1975 "Reactions, Chemical," Encyclopedia Americana, 1982, Vol. 23 "Reactions, Chemical," Academic American Encyclopedia, 1991, Vol. 16

Discuss how Ralph changes in the course of the novel

Lord of the Flies Short Essay Discuss how Ralph changes in the course of the novel and why these changes occur. Ralph is an English schoolboy who is stranded on an isolated island without adults together with the other boys after a plane crash. He tries to establish a civilized society with rules and order by blowing the conch to assemble the boys. His charismatic nature allows him to be elected the leader. Rally's changes throughout the story can also be reflected by his changing perception on Piggy. â€Å"At the beginning: bullies PiggyAs the story progresses: has become more dependent on logical thinking and Is more determined to rebuild the community with the help of Piggy and his rational mind â€Å"Rally's perception towards Piggy has changed from an inferior boy with physical illnesses to an intelligent true friend by the end of the story He has changed from a bully to a mature boy and a responsible leader who understands the need to establish a civilized society with democr acy He relies on Piggy's reminders and his intelligence to call assemblies and make himself clear->He treasures Piggy and ales his opinions Piggy's Intelligence has a great Influence on Ralph (how adults perceive the world)† Examples: â€Å"Exercised verbal violence on Piggy (sucks to your ass- mar/auntie) Insisted on calling him the name he hates-â€Å"Apply', laughed at his name â€Å"Ralph wept for the end of Innocence, the darkness of man's heart, and the fall through the air of the true, wise friend called Piggy. † â€Å"Seeing how savage the boys like Jack and Roger can be while having Piggy as his companion,By Caring As the story progresses: has become more dependent on logical thinking and is more establish a civilized society with democracy He relies on Piggy's reminders and his values his opinions Piggy's intelligence has a great influence on Ralph (how adults mar/auntie) Insisted on calling him the name he hates-â€Å"PiggY', laughed at his name Ralph wep t for the end of innocence, the darkness of man's heart, and the fall need to maintain rational thinking all the time (like Piggy) in order not to degenerate and is therefore, not lured by the temptation of food More determined to maintain Jack Piggy as â€Å"role model† as he thinks in a logical manner and has enough knowledge to comprehend how adults' may think† â€Å"†Piggy could think. He could go step by step inside that fat head of his, only Piggy was no chief. But Piggy, for all his while maintaining a rational mind thanks to the constant reminders from Piggy

Evidence-based Interventions for a Patient Suffering from Dementia

Introduction Evidence-based practice has been promoted in all healthcare levels in the NHS (Department of Health, 2012). This is done to ensure that interventions are supported by current evidence in healthcare and have been found to be effective for most patients (Pearson et al., 2009). The use of evidence-based practice is rooted in the belief that patients should only receive quality care (Pearson et al., 2009). The same approach is used when caring for patients with mental health conditions. In the policy, No Health without Mental Health (Department of Health, 2012), the NHS has emphasised that patients suffering from mental health conditions should receive quality and evidence-based care. This brief aims to critically discuss the case of an 80-year old woman who is suffering from dementia and the different forms of interventions that could be applied to the case. Consistent with the Nursing and Midwifery Council’s (NMC, 2008) code of conduct, a pseudonym will be used to hide the identity of the patient. This brief discusses the purpose of evidence-based practice in managing patients with a progressive condition such as dementia. An investigation on the different forms of evidence-based interventions and their potential impact for promoting inclusion would also be presented. A discussion on interventions as means to develop a shared understanding of the patient’s needs would also be done. Legal, ethical and socio-political factors that influence the intervention process would also be explored. Finally, the last part discusses my role as a nurse in the intervention process. Using Evidence-based Interventions for Patients with Dementia The Nursing and Midwifery Council’s (NMC, 2008) Code of Conduct has stressed the importance of delivering quality evidence-based care that is patient-centred. Fitzpatrick (2007a) emphasised that the past model of evidence-based intervention relies only on current evidence from literature to support clinical decisions. Current studies that are of high quality are often used to inform current practices. Fitzpatrick (2007b; 2007c) exmphasised that nurses and other healthcare professionals should have the skills to critically assess the quality of a study and determine whether the findings are applicable to one’s current and future practice. Evaluating the strength of the evidence presented in a research study would require understanding of the search process and whether themes or findings from the study are credible or trustworthy (Polit and Beck, 2010). In recent years, this definition has included best practices, personal experiences of healthcare professional on providi ng care, experiences of colleagues, opinions of experts and current guidelines on a health condition (Fitzpatrick, 2007a; 2007b, 2007c; Greenhalgh, 2010). This new definition embraces other sources of evidence that could be used to help healthcare practitioners and patients make decisions regarding their care. Greenhalgh (2010) specifically points out that while there is reliance on good evidence from published studies, including the experiences of nurses, expert opinion and best practices to aid decision-making would ensure that patients receive quality care. Communicating evidence from published literature is also essential in helping patients decide on the best form of intervention. Morrisey and Calighan (2011) emphasises that effective communication is needed to convey findings of a study in a manner that is understandable to the patient. Successful use of evidence depends first on the quality of relationship between the healthcare providers and the patients (Croker et al., 2013. Kizer (2002) argued that for better care, the relationship between the healthcare professionals and the patients should be strengthened first. Kizer (2002) observe that, â€Å"this intimate relationship is the medium by which information, feelings, fears, concerns, and hopes are exchanged between caregiver and patient† (p. 117). In the UK, The National Institute for Health and Clinical Excellence (NICE, 2006) and the National Collaborating Centre for Mental Health (2007) have provided evidence-based guidelines on how to care for patients with dementia. These guidelines along with current literature, my own and my colleagues’ experiences, expert opinion and the experiences of my patient and her carers will form evidence on the best form of interventions for the patient. My patient’s name is Laura (not her real name). She is 80 years old with dementia, a condition that is progressive and characterized by deterioration of mental state, aggressive behaviour and agitation (Department of Health, 2009). A psychiatric consultant oversees the management of her condition. She has been receiving medications for her dementia but her GP and psychiatrist are discussing alternative drugs to reduce her anxiety level and regulate her sleeping patterns. She is diagnosed with type 2 diabetes and is mobilised with a frame following a broken hip. While she is still lucid and can communicate clearly, it is a challenge to care for her during nighttime when she becomes more anxious and shows signs of confusion. Patients with dementia suffer from progressive cognitive impairments (Department of Health, 2009) that could have an impact on how they receive information from their healthcare professionals and carers and in their adherence to medications. In the case of my patient, she is now showing signs of advanced dementia (NICE, 2006). This could be a challenge since her ability to refuse treatment or engage in healthcare decisions is severely reduced (Department for Constitutional Affairs, 2007). In the UK, the Mental Health Act 2007 (UK Legislation, 2007) and the Mental Capacity Act (Department for Constitutional Affairs, 2007) serve as guides on how to care for patients with mental health conditions such as dementia. These acts serve to protect the rights of the patient by locating a representative of the patient who could decide on her behalf. Hence, any interventions introduced for the patient should be agreed by the patient’s immediate family members or appointed guardian (Depart ment for Constitutional Affair, 2007). Since dementia is a progressive condition that could eventually lead to palliative care, the nurses have to ensure that the patient receives appropriate support during the trajectory of the condition. In my patient’s case, she needs immediate interventions for anxiety and sleep disturbance. She is also currently taking medications for her type 2 diabetes. The NICE (2006) guideline has stated the use of psychological intervention for patients with dementia. These include cognitive behavioural therapy, which will include the patient’s carers, animal-assisted therapy, reminiscence therapy, multisensory stimulation and exercise. Evidence-based Interventions and Potential Impact for Promoting Inclusion A number of studies (Casartelli et al., 2013; Monaghan et al., 2012; Ewen et al., 2012) have shown that exercise could improve the mobility of patients following hip surgery. Most of these studies use the randomised controlled trial study design, which ranks high in the hierarchy of evidence (Greenhalgh, 2010). This type of design reduces selection bias of the participants and increases the credibility of the findings of the study (Polit and Beck, 2010). The NICE (2013) guideline for fall also supports exercise intervention for improving patient’s mobility. My patient Laura is using a frame to aid her walking following a fall and an exercise intervention would improve her mobility. Considering that Laura is also suffering from anxiety, I counseled with the carer that we might consider an exercise intervention to both manage anxiety and improve mobility of the patient. This was well-received by the carer who expressed that they could help the patient with a structured walking e xercise. Meanwhile, cognitive behavioural therapy (Kurz et al., 2012; Hopper et al., 2013) has also been shown to be effective in reducing anxiety amongst patients and in regulating sleep behaviour. This form of intervention was also introduced to Laura and her carer. A programme was created where she would receive CBT on a weekly basis. It should be noted that the psychiatrist and the GP in the healthcare team are considering on alternative pharmacologic therapy to regulate sleeping behaviour and anxiety of the patient. While this might have a positive effect on the patient, it should be noted that medications for anxiety have side effects. For instance, the acetylcholinesterase inhibitors such as rivastigmine, galantamine and donepezil are known to have side effects on the cognition of patients (Porsteinsson et al., 2013; Moncrieff and Cohen, 2009). As a nurse and part of the team, I suggested to the team to consider the effects of pharmacologic interventions on the patient. Further, the NICE (2006) guideline also states that only specialists, that include GPs specialising in elderly care or psychiatrists, should initiate pharmacologic interventions. This guideline also emphasises that the Mini Mental State Examination (MMSE) score of the patient should be between 10 to 20 points. In Laura’s case, she is pro gressing from moderately severe dementia to its severe form. Introducing pharmacologic interventions might only worsen the cognitive state of Laura. Meanwhile, there is strong evidence from a systematic review (Filan and Llewellyn-Jones, 2006) on the effectiveness of animal-assisted therapy in reducing psychological and behavioural symptoms of dementia. A systematic review also ranks as high as randomised controlled trials in the hierarchy of evidence (Greenhalgh, 2010). Findings of Filan and Llewellyn-Jones (2006) also reveal that it can promote social behaviour amongst patients. This form of therapy was initially considered in Laura’s case due to its possible effects on the sleep behaviour of the patient. However, current evidence is still unclear on whether the effects could be sustained for prolonged periods. In application to my patient’s case, the use of animal-assisted therapy might be difficult to carry out since the patient has to depend on a carer for her daily needs. However, our team decided on using music therapy for the patient. Similar to animal-assisted therapy, there is also strong evidence on the e ffectiveness of music therapy in managing anxiety, depression and aggression amongst patients with dementia (Sakamoto et al., 2013; Wall and Duffy, 2010). Importantly, cognitive behavioural and music therapies and exercise interventions all promote inclusion of the patient in the care process (Repper and Perkins, 2003). In cognitive behavioural therapy, the patient and her carer receive support on how to manage anxiety and sleeping behaviour. Since carers are highly involved during CBT, there is a higher chance that the intervention would be successful (Hopper et al., 2013). It has been shown that carers of patients with chronic conditions such as dementia are also at risk of developing depression and anxiety (Department of Health, 2009). Smith et al. (2007) explain that this might be due to the realisation that the patient would not recover from the illness. Further, these carers have to prepare themselves for the patient’s end-of-life care. All these realisations could influence the carer’s own mental health (Smith et al., 2007). Hence, it is important that interventions are not only holistic for the patient, but should also include the carers in the process. Hence, implementing CBT would promote inclusion in practice (Wright and Stickley, 2013). The patient in my care is also suffering from type 2 diabetes. Pharmacologic interventions would include metformin and insulin therapy (NICE, 2008). Non-pharmacologic interventions include exercise, behavioural modification and diet. This presents a complex problem for Laura since it has been shown that elderly patients are also at greatest risk of malnutrition due to the aging process (Department of Health, 2009). Patients with dementia could experience feeding behavioural problems. When patients are admitted in hospitals, the new environment and lack of social interaction with peers could act as triggers in behavioural problems (Department of Health, 2009). Since patients might lack the cognitive ability to express themselves, this might present as aggressive behaviour (NICE, 2006). Hence, ensuring that Laura receives appropriate nutrition during her hospital stay could be influenced by changes in her behaviour. It is important that patients with type 2 diabetes do not only receive pharmacologic interventions but should also have sufficient diet. This is seen as a challenge in Laura’s case since she could experience feeding problems due to loss in cognitive abilities. For instance, she might be reminded on how to chew food or why she needs to eat (Department of Health, 2009). In patients with severe forms, the main aim of feeding is now focused on comfort feeding rather than allowing patients to eat the proper amount of food (Department of Health, 2009). Hence, managing Laura’s type 2 diabetes through proper feeding would be an added challenge to her care. Legal, Ethical and Socio-Political Factors that Influence the Intervention Process Decisions on the care and interventions received by the patient are influenced by several factors. First, the Mental Health Act 2007 (UK Legislation, 2007) states that patients with mental health condition could seek voluntary admission to hospitals and leave whenever they want. This Act also states that patients could only be forced to receive treatment in hospital settings if they are detained under this Act. Laura and her carer could refuse treatment or interventions at any point of her care and my team and I would respect her decision. Observance of this provision under the Mental Health Act would also be consistent with patient-centred care where patients are empowered to act for own benefit and to choose appropriate interventions. Apart from the legal aspects that influence the delivery of interventions, ethical issues should also be observed. In the ethics principle of beneficence, nurses and ot her healthcare practitioners should ensure that the interventions would be beneficial to the patient (Beauchamp and Childress, 2001). In Laura’s case, all the interventions cited previously have been shown to be beneficial to the patient. Only the pharmacologic interventions are associated with adverse and side effects for the patient (Popp and Arlt, 2011). Hence, as a nurse, I lobbied for inclusion of non-pharmacologic interventions instead of reliance on anticholinergic drugs to control the patient’s behaviour. In addition to beneficence, Beauchamp and Childress (2001) also add the ethics principles of autonomy, non-maleficence and justice. In Laura’s case, her autonomy would be respected. Allowing patients to participate in the decision-making process is crucial. However, patients with dementia suffer from cognitive impairments that could influence their decision-making ability (Wright et al., 2009). In accordance with the Mental Capacity Act 2005 (Department for Constitutional Affairs, 2007), the carers of Laura could be appointed to act on her behalf. In non-maleficence, the main aim of the interventions is to promote the health of the patient. There are no known side effects of the psychosocial and exercise interventions. Justice will be observed if Laura receives tailored-interventions that would address her needs. It is important that regardless of the patient’s background, religion, race, gender, ethnicity, she should receive healthcare interventions fit for her needs. This ethics principle is observed since a healthcare team has been addressing Laura’s healthcare needs. While all interventions are patient-centred, socio-political issues that could influence the interventions include the recent changes in the NHS structure where local health boards are primarily responsible for allocating funds to healthcare services (Department for Constitutional Affairs, 2007). Hence, if dementia care is not a priority in the local health board, health programmes for dementia might not receive sufficient funding. This could pose considerable problems for the elderly who are dependent on the NHS for their care. Laura has been receiving sufficient support for her mental health condition. This demonstrates that dementia care remains a priority in my area of care. A survey of the support system in my community reveals that support groups for carers are available. This is essential since supporting carers is also a priority in the NHS (National Collaborating Centre for Mental Health, 2007). Role of the Nurse in the Intervention Process On reflection of the case, I have a role to coordinate care with other team members and to ensure that the patient receives patient-centered care. As a nurse, I have to adhere to the NMC’s (2008) code of conduct and observe patient safety. Recognising that dementia is a progressive condition, I should also focus on interventions that not only addresses the current behavioural problems of the patient but also on preparing the carer and Laura’s family members on palliative care. The NICE (2006) guideline has stated that nurses have an important role in preparing patients of dementia and their family members on end-of-life care. This could be a highly stressful stage in the patient’s disease trajectory or could be one of acceptance and peace for the family. As a nurse, I have to ensure that interventions are appropriate to the stage of dementia that the patient is experiencing. Since nursing is a continuing process, I have to inform the family members that the patie nt will increasingly lose her cognitive abilities and would have difficulty feeding in the last stages of the condition (National Collaborating Centre for Mental Health, 2007). I have to ensure that the patient receives both spiritual and physical support at this stage. Evidence-based care is crucial in ensuring that patients receive the appropriate intervention. In my role as a nurse, I have to ensure that interventions are acceptable to the patient. I should also consider the preferences of the patient, their past experiences and their own perceptions on how to best manage their condition. Since I would be caring for a patient with declining cognitive abilities, I should ensure that her dignity would be maintained (Baillie and Gallagher, 2011). As part of my future learning development, I will attend courses on how to conduct end-of-life care for patients with dementia. Through Laura, I realised that a patient’s dignity should always be observed. It is recommended that in my future and present practice, I will continue to rely on literature on the best form of interventions of my patient. I will also consult with my colleagues, seek expert opinion and the patient’s experiences on how to choose and deliver interventions. Conclusion Evidence-based practice is important in helping patients achieve quality care. In this case, Laura is an 80-year old patient with dementia. She exhibits the moderate form of the condition but is beginning to show signs of advance dementia. As her nurse, I have the duty to observe ethics in healthcare and to seek for interventions that are evidence-based. However, I also realised that other factors also influence the delivery of interventions. These include socio-political, legal and ethical factors. As a nurse, I have to protect the patient’s rights, act as her advocate and ensure her safety during the trajectory of the condition. For future practice, I will continue to practice evidence-based practice. I will also encourage others in the mental health profession to always consider the patient’s preferences when caring for patients with dementia. When patients are unable to decide for their own care, the carer of the patient could act on her behalf. Finally, as a mental health nurse, I should constantly update myself with the best form of interventions for patients with dementia. This will ensure that my patients will receive evidence-based interventions. References Baillie, L. & Gallagher, A. (2011). ‘Respecting dignity in care in diverse care settings: Strategies of UK nurses’. International Journal of Nursing Practice, 17, pp. 336-341. Beauchamp, T. & Childress, J. (2001). Principles of biomedical ethics. 5th ed. Oxford: Oxford University Press. Casartelli, N., Item-Glatthorn, J., Bizzini, ., Leunig, M. & Maffiuletti, N. (2013). ‘Differences in gait characteristics between total hip, knee, and ankle arthroplasty patients: a six-moth postoperative comparison’. BMC Musculoskeletal Disorder, 14:176 doi: 10.1186/1471-2474-14-176. Croker, J., Swancut, D., Roberts, M., Abel, G., Roland, M. & Campbell, J. (2013) ‘Factors affecting patients’ trust and confidence in GPs: evidence from the national GP patient survey’, BMJ Open, 3(5). Pii: e002762. Doi: 10.1136/bmjopen-2013-002762. Department of Health (2012). No Health Without Mental Health. London: Department of Health. Department of Health (2009). Living Well with dementia: A National Dementia Strategy. London: Department of Health. Department for Constitutional Affairs (2007). Mental Capacity Act 2005 Code of Practice. Norwich: The Stationery Office. Ewen, A., Stewart, S., St Clair Gibson, A., Kashyap, S. & Caplan, N. (2012). ‘Post-operative gait analysis in total hip replacement patients- a review of current literature and meta-analysis’. Gait Posture, 36(1), pp. 1-6. Filan, S. & Llewellyn-Jones, R. (2006). ‘An animal-assisted therapy for dementia: a review of the literature’. International Psychogeriatrics, 18(4), pp. 597-611. Fitzpatrick, J. (2007a). ‘Finding the research for evidence-based practice: Part one- The development of EBP’. Nursing Times, 103(17), pp. 32-33. Fitzpatrick, J. (2007b). ‘Finding the research for evidence-based practice: Part two-selecting credible evidence’. Nursing Times, 103(18), pp. 32-33. Fitzpatrick, J. (2007c). ‘How to turn research into evidence-based practice: Part three- Making a case’. Nursing Times, 103(19), pp. 32-33. Greenhalgh, T. (2010). How to read a paper: the basics of evidence-based medicine. West Sussex, UK: John Wiley and Sons. Hopper, T., bourgeois, M., Pimentel, J., Qualls, C., Hickey, E., Frymark, T. & Schooling, T. (2013). ‘An evidence-based systematic review on cognitive interventions for individuals with dementia’. American Journal of Speech and Language Pathology, 22(1), pp. 126-145. Kizer, K. (2002). ‘Patient centred care: essential but probably not sufficient’. Quality and Safety in Health Care, 11, pp. 117-118. Kurz, A., Thone-Otto, A., Cramer, B., Egert, S., Frolich, L., Gertz, H., Kehl, V., Wagenpfeil, S. & Werheid, K. (2012). ‘CORDIAL: Cognitive rehabilitation and cognitive-behavioral treatment for early dementia in Alzheimer disease: a multicenter, randomized, controlled trial’. Alzheimer Disease and Associated Disorders, 26(3), pp. 246-253. Monaghan, B., Grant, T., Hing, W. & Cusack, T. (2012). ‘Functional exercise after total hip replacement (FEATHER): a randomised control trial’, BMC Musculoskeletal Disorder. 13:237 doi: 10.1186/1471-2474-13-237. Moncrieff, J. & Cohen, D. (2009). ‘How do psychiatric drugs work?’. British Medical Journal: 338 [Online]. Available from: http://www.bmj.com/content/338/bmj.b1963#alternate. Morrissey, J. & Callgahan, P. (2011). Communication skills for mental health nurses. Maidenhead: Open University Press. National Collaborating Centre for Mental Health (2007). Dementia: The NICE-SCIE Guideline on supporting people with dementia and their carers in health and social care. London: The British Psychological Society and Gaskell and Social Care Institute for Excellence and NICE. National Institute for Health and Clinical Excellence (NICE) (2013). Falls: assessment and prevention of falls in older people: NICE clinical guideline 161. London: NICE. National Institute for Health and Clinical Excellence (NICE) (2008). Type 2 Diabetes: The Management of type 2 diabetes. London: NICE. National Institute for Health and Clinical Excellence (NICE) (2006). Dementia: Supporting people with dementia and their carers in health and social care. London: NICE. Nursing and Midwifery Council (NMC) (2008). The Code: Standards of conduct, performance and ethics for nurses and midwives. London: NMC. Pearson, A., Field, J., Jordan, Z. (2009). Evidence-Based Clinical Practice in Nursing and health Care. Assimilating Research, Experience and Expertise. Oxford. Blackwell Publishing. Polit, D. & Beck, C. (2010). Essentials of nursing research: appraising evidence for nursing practice. 7th ed. London: Lippincott Williams and Wilkins. Popp, J. & Arlt, S. (2011). ‘Pharmacological treatment of dementia and mild cognitive impairment due to Alzheimer’s disease’. Current Opinion in Psychiatry, 24(6), pp. 556-561. Porsteinsson, A., Drye, L., Pollock, B., Devanand, D., Frangakis, C. Ismail, Z., Marano, C., Meinert, C., Mintzer, J., Munro, C., Pelton, G., Rabins, P., Rosenberg, P., Schneider, L., Shade, D., Weintraub, D., yesavage, J. & Lyketsos, C. (2013). ‘Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial’. JAMA, 311(7), pp. 682-691. Repper, J. & Perkins, R. (2003). Social inclusion and recovery: A model for mental health practice. London: Balliere Tindall. Sakamoto, M., Ando, H. & Tsutou, A. (2013). ‘Comparing the effects of different individualized music interventions for elderly individuals with severe dementia’, International Psychogeriatrics. 25(5), pp. 775-784. Smith, G., Greogry, K. & Higgs, A. (2007). An integrated approach to family work for psychosis. London: Jessica Kingsley Publishers. UK Legislation (2007) Mental Health Act 2007 [Online]. Available from: http://www.legislation.gov.uk/ukpga/2007/12/contents (Accessed: 13th May, 2014). Wall, M. & Duffy, A. (2010). ‘The effects of music therapy for older people with dementia’. British Journal of Nursing, 19(2), pp. 108-113. Wright, N. & Stickley, T. (2013). Concepts of social inclusion, exclusion and mental health: A review of the international literature. London: SAGE. Wright, J., Turkington, D., Kingdon, D. & Basco, M. (2009). Cognitive-behaviour therapy for severe mental illness: An illustrated guide. USA: American Psychiatric Publishing Inc.

Have vs Having in Certain Expressions

Have vs Having in Certain Expressions Have vs Having in Certain Expressions Have vs Having in Certain Expressions By Maeve Maddox Paul Russell poses an interesting question about the use of have and having. He points out the common ESL error of saying I am having a headache and asks: Why can I say Im having my lunch but not Im having a headache? Some explanations Ive read indicate its all to do with possession. Â  But every time I think I have it figured, I have to wonder why I must say I have a cold when I cant say I have a heart attack. Im sure youll be having a good explanation for me:-) Heres the usual rule given to ESL students concerning the use of have to show possession or to describe medical conditions: Have should always be in the simple present tense for the meaning to own, or to describe medical problems. For example: They have a new car. I have a bad cold. It is incorrect to say I am having a cold or I am having a new car. Im having a heart attack does seem to contradict this rule. I think that the difference between I have a headache and Im having a heart attack may have more to do with duration than with either a medical condition or possession. One can have a heart condition, but a heart attack is a singular event, usually over in a few seconds or minutes. One may say I hope I wont have a heart attack, but in the event that one has oneand is capable of telling someoneam having is the only possibility. A headache is generally of longer duration than a heart attack. It may last an hour, several hours, or days. The same applies to a cold. Both are events of indeterminate duration. You have them for a while. If youre seated at a table having your lunch, youre engaged in an activity with a predictable end. Youll stop having lunch when youve finished eating. Thats my theory, anyway. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Expressions category, check our popular posts, or choose a related post below:"Because Of" and "Due To" 36 Poetry Terms10 Terms for the Common People

Teaching English Listening Skills to ESL Classes

Teaching English Listening Skills to ESL Classes Teaching listening skills is one of the most difficult tasks for any ESL teacher. This is because successful listening skills are acquired over time and with lots of practice. Its frustrating for students because there are no rules as in grammar teaching. Speaking and writing also have very specific exercises that can lead to improved skills. This is not to say that there are not ways of improving listening skills, however, they are difficult to quantify. Student Blocking One of the largest inhibitors for students is often mental block. While listening, a student suddenly decides that he or she doesnt understand what is being said. At this point, many students just tune out or get caught up in an internal dialogue trying to translate a specific word. Some students convince themselves that they are not able to understand spoken English well and create problems for themselves. Signs that Students are Blocking Students constantly look up wordsStudents pause when speakingStudents change their eye contact away from the speaker as if they are thinking about somethingStudents write words down during conversation exercises The key to helping students improve their listening skills is to convince them that not understanding is OK. This is more of an attitude adjustment than anything else, and it is easier for some students to accept than others. Another important point that I try to teach my students (with differing amounts of success) is that they need to listen to English as often as possible, but for short periods of time. Listening Exercise Suggestion Suggest a number of shows in English on the radio, podcasts online, etc.Have students choose one of the shows based on interestAsk students to listen to the show for five minutes three times a weekKeep track of student listening to encourage them to keep up the practiceCheck with students to confirm that their listening skills are improving over time Getting in Shape I like to use this analogy: Imagine you want to get in shape. You decide to begin jogging. The very first day you go out and jog seven miles. If you are lucky, you might even be able to jog the whole seven miles. However, chances are good that you will not soon go out jogging again. Fitness trainers have taught us that we must begin with little steps. Begin jogging short distances and walk some as well, over time you can build up the distance. Using this approach, youll be much more likely to continue jogging and get fit. Students need to apply the same approach to listening skills. Encourage them to get a film, or listen to an English radio station, but not to watch an entire film or listen for two hours. Students should often listen, but they should listen for short periods - five to ten minutes. This should happen four or five times a week. Even if they dont understand anything, five to ten minutes is a minor investment. However, for this strategy to work, students must not expect improved understanding too quickly. The brain is capable of amazing things if given time, students must have the patience to wait for results. If a student continues this exercise over two to three months their listening comprehension skills will greatly improve.

Organisational Communication Essay Example | Topics and Well Written Essays - 1250 words

Organisational Communication - Essay Example Therefore during the time of participation there is a need of information flow from both the sides. However the process of communication can be in the form of interacting, talking and writing as well. The present world of business is more saturated and also the companies have global presence. Such endeavors make communication even more multifaceted. Communicating across borders requires sound communication abilities that would allow people from different areas to cooperate with each other. The communication process can be divided into 5 dimensions. The five dimensions are described below:- International or Unintentional. Verbal or Nonverbal. Internal or external. Communication which involves Humans or Machines. Communication among individuals or groups. In the context of the project, only internal and external communication within the organization will be portrayed. Internal communication refers to the way of communication that takes place within the organization. The communication b etween the employees of an organization is denoted as internal communication. It is also important to achieve organizational objectives (â€Å"Internal communications†). ... The communications are:- The internal communication Employees: - The Company mainly uses E-mail and fax to communicate within the employees. The employees have their customized programs installed on their computers, so as to receive and send E-mails. Fax is also another medium which is being highly used in the company. Management: - In order to communicate with the top management of the organization pagers are mainly used. However customized E-mail programs are also used. Also the company in order to conduct vital meetings the company uses video conferencing. The external communication In this context the communication takes place among the company and its end customers, distributors and suppliers. The company in its external communication strategy uses various techniques, but remains transparent about the offerings. In order to portray the offerings the company used the promotions from the company is mainly TV advertisements and other trade and consumer schemes. Customers: - In orde r to directly communicate with the customers the company sends direct E-mail from the customer information database. Distributors and Suppliers of Coca Cola: - In this respect the company makes use of fax and video conferencing techniques. Now in the case of Pepsi, the internal and external communication also plays an important role towards the success of the company. In respect with its internal communication, the company mainly uses E-mail and also uses verbal communication. In order to communicate with the internal employees the company mainly uses meetings to communicate information within the team members. The external communication method of Pepsi is almost similar to that of Coca cola. Pepsi also uses TV advertisements