Assessment Management Case Study Example | Topics and Well Written Essays - 1000 words

Assessment Management - Case Study Example Initially when application deployment used to take place in most companies, the process was a long, tedious and expensive one. Not only would it consume a lot of resource, it could also take years and end up producing unsatisfactory results. Instead, today more and more companies are opting for software as a service option. There are various other benefits of using the SAAS model. It ensures accuracy of data and information recorded and conveyed around. Because, the responsibility of the application is outside the company it alleviates the management of the need for more corporate applications. (Laudon K) While the companies benefit from low cost of implementation of this model, there are some disadvantages that vendors might face. First of all the investment of the vendor can be heavy. He has to build an entire network infrastructure through which the application has to be hosted and delivered. He will also have to ensure that the application is available at all times, it is secure and ensure privacy of customer related information and lastly, ensuring that users have access to latest releases of the software. These aforementioned issues and their solutions are not only time consuming but also costly. Q2: What are some of the challenges facing Salesforce as it continues its growth? How well will it be able to meet those challenges? Sales force faces many challenges. The biggest challenge for the company comes in the form of its competitors. It has to counter the influence of its competitors who are on prying Sales force’s success and trying to replicate it. Some of the bigwigs in the industry who have tried their hands at it include Microsoft, SAP and Oracle. Each of the aforementioned companies has taken out their own subscription based models of the CRM. Then there are smaller companies like Net Suite who have also tried their hands in this market. Industry analysts have already predicted that Microsoft could deride the sales of Salesforce but provide them stiff competition through their available on-demand CRM product. This is because Microsoft has an already established customer base and it would be offering the product at half the price of Salesforce.com. The second challenge that confronts Salesforce is expansion into new areas. It needs to explore and develop business products for other areas as well. The third challenge that Sales force faces is availability. The success of Salesforce depends on its ability to satiate its customers by ensuring that the software is available at all times i.e. 24*7. It will be quite a challenge ensuring that the software is available at all times. Salesforce is keen on countering the challenges it is faced with. It has partnered with Google Apps and is using its services of Gmail, Google docs; Google Talk and Google Calendar to assist its customers accomplish more tasks through the internet. The partnership is also going to act as a buffer to counter Microsoft and both companies are hopeful that it will further galvanize the growth of this on demand software. Another big step to counter challenges is the introduction of Force.com application through which its customers can download above 800 software applications. Qs 3: What kind of businesses could benefit from switching to Salesforce and why? Small and Medium line business can draw a lot of benefits and advantages from switching to Salesforce. This is because these businesses have a huge dearth of resources, capital and

Theory And Practice Of Supervision

Theory And Practice Of Supervision Supervision theories and practices began emerging as soon as counsellors started to train other counsellors (Bernard Goodyear, 2009). Several different theoretical models have developed to clarify and support counselling supervision. The focus of early models of supervision had generally been based on counselling theories (such as Cognitive Behavioural Therapy, Adlerian or client-centred), but these orientation-specific models have begun to be challenged as supervision has many characteristics that are different to counselling. Competency as a counsellor does not automatically translate into competency as a supervisor, and when supervisee/supervisor orientations differ, conflicts may arise (Falender Safranske, 2004). More recent models of supervision have integrated theories from psychology and other disciplines, for one-to-one, peer and group supervision. As supervision has become more focused, different types of models emerged, such as developmental models, integrated models, and agency models. As a result, these models have to some extent replaced the original counselling theory models of supervision, and supervisors may utilise several different models to qualify and simplify the complexities of supervision (Powell, 1993). This paper will briefly look at a definition of supervision, and an outline of two different models agency and developmental. What is Supervision? Supervision is the process where by a counsellor can speak to someone who is trained to identify any psychological or behavioural changes in the counsellor that could be due to an inability to cope with issues of one or more clients. A supervisor is also responsible for challenging practices and procedures, developing improved or different techniques, and informing clients of alternative theories and/or new practices, as well as industry changes. The supportive and educative process of supervision is aimed toward assisting supervisees in the application of counselling theory and techniques to client concerns (Bernard Goodyear, 2009). The supervisor is responsible for monitoring the mental health of their supervisee, in turn protecting the public from unhealthy counsellors. Counsellors can face issues such as transference and burn out without any recognition of the symptoms. A supervisor should notice the symptoms before the counsellor (Australian Counsellors Association, 2009). Supervision is a formal arrangement for counsellors to discuss their work regularly with someone who is experienced in counselling and supervision. The task is to work together to ensure and develop the efficiency of the counsellor/client relationship, maintain adequate standards of counselling and a method of consultancy to widen the horizons of an experienced practitioner (ACA, 2009). The supervisors primary role is to ensure that their clients are receiving appropriate therapeutic counselling. By ensuring the counsellor continually develops their professional practice in all areas, the supervisor ensures a counsellor remains psychologically healthy. The supervisor is also responsible for detecting any symptoms of burn out, transference or hidden agendas in the supervisee. The Australian Counsellors Association (2009) recommends that supervisors cover the following as a matter of course: Evaluation Supervisees counselling; Developing process of self-review; Quality assurance; Best practice; Service outcomes of service delivery; Identifying risk for supervisee and clients; Referrals; Follow up on client progress; Helping the counsellor assess strengths and weaknesses. Education Establishing clear goals for further sessions; Providing resources; Modelling; Explaining the rationale behind a suggested intervention and visa versa; Professional development; Interpreting significant events in the therapy session; Convergent and divergent thinking; Use of self; Topping up; Facilitating peer connection; Duty of care; Legal responsibilities. Administration Procedures; Paperwork; Links; Accounting; Case planning; Record keeping; Insurance. Support Advocate; Challenge; Confront; Empower; Affirm; Availability; Empowering; Use of self. A range of different models have evolved to provide a framework for these topics within which supervisors of can organize their approaches to supervision, and act as an aid to understanding reality (Powell, 1993). Agency Model of Supervision Kadushin Kadushin describes a supervisor as someone to whom authority is delegated to direct, coordinate, enhance, and evaluate on-the-job performance of the supervisees for whose work he/she is held accountable. In implementing this responsibility, the supervisor performs administrative, educational, and supportive functions in interaction with the supervisee in the context of a positive relationship (Powell, 1993). In educational supervision the primary issue for Kadushin is the counsellor knowing how to perform their job well and to be accountable for work performed, and developing skills through learning and feedback. The object is to increase understanding and improve skill levels by encouraging reflection on, and exploration of the work (Tsui, 2005). In supportive supervision the primary issue is counsellor morale and job satisfaction, as well as dealing with stress. The stresses and pressures of the coaching role can affect work performance and take its toll psychologically and physically. In extreme and prolonged situations these may ultimately lead to burnout. The supervisors role is to help the counsellor manage that stress more effectively and provide re-assurance and emotional support (Tsui, 2005). The administrative function is the promotion and maintenance of good standards of work and adherence to organisational policies and good practice. This includes reviews and assessments. The interpretation here is that the supervisor inducts the counsellor into the norms, values and best practices. It is the community of practice dimension ensuring that standards are maintained (Tsui, 2005. Not every supervision session will involve all three areas or functions, and at different times there may be more of a focus on one area rather than another. The supervisor cannot avoid the pressure that arises from their responsibility to the workplace, other staff, and to clients. No simple model of supervision is to be expected to be practical in every situation. Supervisors are expected to adapt approaches to the developmental level of supervisees, and both must adapt to the varying demands of any professional situation (Powell, 1993). For this model, the focus of supervision is as a prompt for behavioural change and skill acquisition. The emphasis is on persuading staff to learn how to use oneself in counselling to promote behavioural change in the client (Powell, 1993). The supervisors attention should be on the activities of the supervisee rather than on study of the supervisee themselves. With a focus on the activity, rather than the worker, it allows the supervisee to listen to constructive criticism rather than feeling compelled to defend themselves from a personal attack (Tsui, 2005). This model has several strengths in that it is very flexible, and open to exploration and experimentation. It is also more challenging for both the supervisor and supervisee. This style of supervision can be tailored to meet different needs and variables. This model may prove unsatisfactory when the supervisor has insufficient experience to be able to provide proper direction and support, and where supervisor skills do not allow for appropriate evaluation of the supervisee (Powell, 1993). Developmental Models of Supervision Erskine Underlying developmental models of supervision is the notion that as people and counsellors we are continuously growing and maturing; like all people we develop over time, and this development and is a process with stages or phases that are predictable. In general, developmental models of supervision define progressive stages of supervisee development from novice to expert, each stage consisting of discrete characteristics and skills (Bradley Ladany, 2000). For example, supervisees at the beginning or novice stage would be expected to have limited skills and lack confidence as counsellors, while middle stage supervisees might have more skill and confidence and have conflicting feelings about perceived independence/dependence on the supervisor. A supervisee in a later developmental stage is expected to employ good problem-solving skills and be reflective about the counselling and supervisory process (Haynes, Corey, Moulton, 2003). Erskine (1982) identifies three stages in the development of the skills of a therapist, each of which represents specific characteristics and responds to specific training needs. In the beginning stage of training, therapists have operational needs as they are developing professional skills, a sound theoretical reference system, and intervention techniques. They also have emotional needs: to feel comfortable in their professional role, to be reassured of their ability to do the work, and to feel adequate to act in this new undertaking. This is the stage at which trainees most need positive motivations centred on their skills so that they can know their strengths and on which they can build their skills. Erskine (1982) suggests temporarily ignoring what the trainee does not do well so as to reduce any feelings of inadequacy and to support self esteem, provided this does not cause harm to the trainee or clients. During the intermediate stage of training, Erskine proposes that trainees need to reinforce their personal identity as therapists, learn to define the direction of treatment, and draw up a treatment plan. At the personal level, their goal is to integrate their sense of self and to work on their emotions in order to understand and solve any personal difficulties that might create obstacles to their contact with clients. According to Erskine, in this second phase, trainees personal therapy is of highest importance (Bradley Ladany, 2000). During the advanced stage of training, trainees need to learn various approaches and to integrate theoretical frameworks, to recognise alternative interventions, and to choose among them so as to encourage flexibility. Trainees must also practise self-supervision and learn to differentiate between observations of behaviour, and theorising about observations (Stoltenberg Delworth, 1987). One of the potential drawbacks of developmental models is that not only do people learn in different ways but they also develop at diverse speeds, in varied areas. The development model does not show how the supervisee develops and moves from one stage to the next, and how this progress is connected to the supervision process (Bradley Ladany, 2000). For this model, it is necessary to modify the relationship to meet the supervisees needs based on their current developmental level. Supervisors employing a development approach to supervision need to be able to accurately identify the supervisees current stage of development and provide feedback and support appropriate to that developmental stage, while at the same time assisting the supervisees advancement to the next stage (Stoltenberg Delworth, 1987) Commonalities Regardless of the model used or theoretical background, any model or theory of supervision should cover some common fundamental principles. Supervisors are responsible for the professional developmental of those under supervision. These responsibilities involve issues such as informed consent, confidentiality, and dual relationships (ACA, 2009). Ethical and legal concerns are central to supervision. The balance between a supervisory relationship and a therapeutic one only becomes a problem when the supervisor discovers that personal problems hold back the supervisee. The supervisory relationship becomes a dual relationship if the supervisor tries to become the students therapist. A dual relationship is considered unethical (Powell, 1993). Dual relationships can occur in different ways. A supervisory relationship can develop into a close, emotional relationship between supervisor and supervisee. The supervisory relationship will in this situation be less effective and supervision should not continue. In consensual relationships the emotional relationship can continue; however, the professional relationship has to end. The supervisory relationship needs to be governed by the same ethical principle as is the therapeutic process (Powell, 1993). Different ways of evaluating the supervisory process are important both for the supervisor and the supervisee. Establishing a contract for the supervisory relationship makes evaluation easier. The contract should include the students developmental needs, the supervisors competencies, and supervisory goals and methods (Stoltenberg Delworth, 1987). Throughout the supervision process, the supervisor is responsible for evaluating the quality of the supervisory relationship (Powell, 1993). This responsibility especially comes to bear when a conflict arises or an impasse develops. Investigating problems and challenges often begins with asking questions about various aspects of the supervisory relationship. When asking these questions, it is important to consider not only how the counsellor may be contributing to a problem but also how the supervisor may be contributing. The supervisor has a responsibility to ensure that confidentiality is maintained, and any information obtained in a clinical or consulting relationship is discussed only for professional purposes and only with persons clearly concerned with the case (ACA, 2009). Conclusion Supervision is not a senior counsellor watching over the shoulder of a new or junior counsellor. Nor is it a conversation between two practitioners, or a dialogue of personal matters with a counsellor. It is a distinct intervention, to enhance professional functioning and monitor the quality of counselling services being provided (Bernard Goodyear, 2009). Clinical supervision is a complex activity; it can be education or support, assists with confidence or doubts, it can process through different levels or stages. The competent clinical supervisor must embrace not only the domain of psychological science, but also the domains of client service and trainee development. The competent supervisor must not only comprehend how these various knowledge bases are connected, but also apply them to the individual case (Bradley Ladany, 2000). The purpose is to help identify obstacles that prevent the supervisee from learning, growing and ultimately helping their client. No matter what theoretical framework is used, supervision can be used as a means to develop professionally. Like any other relationship in life it is not perfect, nor is it an answer to every problem. Like any other relationship, it is necessary to be honest, consistent, and dependable, and work hard to build trust. Supervisors and supervisees have to work together to make it successful. Powell (1993) theorised that the emphasis should not be on why a counsellor feels a certain way, but on being able to put a end to behaviours that inhibit change. Powell advises professionals to develop their own model of supervision in order to understand what one is doing and why. Whatever model of supervision if employed, a supervisor should seek to encourage ongoing professional education, challenge the supervisee to improve their skills and techniques A supervisor should intervene where client welfare is at risk, and ensure that ethical guidelines and professional standards are maintained. A supervisee should endeavour to uphold ethical guidelines and professional standards, be open to change and alternative methods of practice, maintain a commitment to continuing education and consult the supervisor in cases of emergency. Supervision, regardless of any model used, should enable counsellors to acquire new professional and personal insights through their own experiences. REFERENCES Australian Counsellors Association (2009). Professional Supervision. Accessed 2nd February 2010. http://www.theaca.net.au/docs/Supervision_Complete.pdf Bernard, J. M., Goodyear, R. K. (2009). Fundamentals of clinical supervision (4th ed.). Needham Heights, MA: Allyn Bacon. Bradley, L.J., Ladany, N. (2000). Counsellor Supervision: Principles, Process and Practice. Philadelphia, PA: Brunner-Routlege. Erskine, R. G. (1982). Supervision for psychotherapy: Models for professional development. Transactional Analysis Journal, 12, 314-321. Falender, C. A., Shafranske, E. P. (2004). Clinical supervision: A competency-based approach. Washington, DC: American Psychological Association. Haynes, R., Corey, G., Moulton, P. (2003). Clinical supervision in the helping professions: A practical guide. Pacific Grove, CA: Brooks/Cole. Powell, D. (1993). A developmental approach to supervision. In Clinical supervision in alcohol and drug abuse counselling. (p. 58-84). New York, NY: Lexington Books. Stoltenberg, C. D., Delworth, U. (1987). Supervising counsellors and therapists. San Francisco, CA: Jossey-Bass. Tsui, Ming-Sum (2005). Social work supervision: contexts and concepts. Thousand Oaks, CA: Sage Publications.

Terry Fox :: essays research papers

Terry Fox was born in Winnipeg, Manitoba, but raised in Port Coquitlam, British Columbia, a community near Vancouver on Canada's west coast. As an active teenager involved in many sports, in 1977 Terry was only 18 years old when he was diagnosed with bone cancer and forced to have his right leg amputated six inches above the knee. The night before his operation, Terry read an article about an amputee who had competed in the New York Marathon. Indirectly that story, along with Terry's observations of the intense suffering of cancer patients, set the stage for what would ultimately become the most important decision of his young life. In 1980, Terry Fox inspired the nation by attempting to run across Canada with an artificial leg. He called this journey the Marathon of Hope. Its mission was to raise money and awareness for cancer research in Canada. With little to no attention, Terry started his journey in St. John’s, Newfoundland on April 12, 1980. Although it was difficult to get attention in the beginning, hype soon grew, and the money collected along his route began to rise. He ran 43 kilometers a day through Canada's Atlantic Provinces, Quebec and Ontario. September 1, 1980 -- it was a dull day in Northern Ontario when Terry Fox ran his last miles. After 18 miles he started coughing and felt a pain in his chest. Terry knew how to cope with pain. He'd despite it as he always had before, he'd simply keep going until the pain went away. For 3,339 miles, from St. John's, Newfoundland, Canada's eastern most city on the shore of the Atlantic, he'd run through six provinces and now was two-thirds of the way home. He'd run close to a marathon a day, for 144 days.

The Return: Midnight Chapter 32

â€Å"Damon doesn't mean to be such a – a bastard,†Bonnie said explosively. â€Å"He's just – so often he feels like it's the three of us against him – and – and – â€Å" â€Å"Well, who started that? Even back riding the thurgs,†Stefan said. â€Å"I know, but there's something else,†Bonnie said humbly. â€Å"Since it's only snow and rock and ice – he's – I don't know. He's al tight. Something's wrong.† â€Å"He's hungry,†Elena said, stricken by a sudden realization. Since the thurgs there had been nothing for the two vampires to hunt. They couldn't exist, like foxes, on insects and mice. Of course Lady Ulma had provided plenty of Black Magic for them, the only thing that even resembled a substitute for blood. But their supply was dwindling, and of course, they had to think of the trip back, as well . Suddenly Elena knew what would do her good. â€Å"Stefan,†she murmured, pul ing him into a nook in the craggy stone of the cave entrance. She pushed off her hood and unrol ed her scarf enough to expose one side of her neck. â€Å"Don't make me say ‘please'too many times,†she whispered to him. â€Å"I can't wait that long.† Stefan looked into her eyes, saw that she was serious – and determined – and kissed one of her mittened hands. â€Å"It's been long enough now, I think – no, I'm sure, or I would never even attempt this,†he whispered. Elena tipped her head back. Stefan stood between her and the wind and she was almost warm. She felt the little initial pain and then Stefan was drinking and their minds slid together like two raindrops on a glass window. He took very little blood. Just enough to make the difference in his eyes between Stillgreen pools and sparkling, effervescent streams. But then his gaze went Stillagain. â€Å"Damon†¦Ã¢â‚¬ he said, and paused awkwardly. What could Elena say? I just severed al ties with him? They were supposed to help one another along these trials; to show their wit and courage. If she refused, would she fail again? â€Å"Send him quick then,†she said. â€Å"Before I change my mind.† Five minutes later Elena was again tucked into the little nook, while Damon turned her head back and forth with dispassionate precision, then suddenly darted forward and sank his fangs into a prominent vein. Elena felt her eyes go wide. A bite that hurt this much – Well, she hadn't experienced it since the days when she had been stupid and unprepared and had fought with al her strength to get free. As for Damon's mind – there was a steel wal . Since she had to do this, she had been hoping to see the little boy who lived in Damon's inmost soul, the one who was the unwil ing Watch-Keeper over al of his secrets, but she couldn't even thaw the steel a little. After a minute or two, Stefan pul ed Damon off of her – not gently. Damon came away sul enly, wiping his mouth. â€Å"Are you okay?†Bonnie asked in a worried whisper, as Elena rummaged through Lady Ulma's medicine box for a piece of gauze to staunch the unhealed wounds in her neck. â€Å"I've been better,†Elena said briefly, as she wrapped up her scarf again. Bonnie sighed. â€Å"Meredith is the one who real y belongs here,†she said. â€Å"Yes, but Meredith real y belongs in Fel ‘s Church, too. I only hope they can hold on long enough for us to come back.† â€Å"I only hope that we can come back with something that wil help them,†Bonnie whispered. Meredith and Matt spent the time from 2:00 A.M. to dawn pouring infinitesimal drops from Misao's star bal onto the streets of the town, and asking the Power to – somehow – help them in the fight against Shinichi. This brisk movement from place to place had also netted a surprising bonus: kids. Not crazy kids. Normal ones, terrified of their brothers and sisters or of their parents, not daring to go home because of the awful things they had seen there. Meredith and Matt had crammed them into Matt's mother's second-hand SUV and brought them to Matt's house. In the end, they had more than thirty kids, from ages five to sixteen, al too frightened to play, or talk, or even to ask for anything. But they'd eaten everything Mrs. Flowers could find that wasn't spoiled in Matt's refrigerator and pantry, and from the pantries of the deserted houses on either side of the Honeycutts'. Matt, watching a ten-year-old girl cramming plain white bread into her mouth with wolfish hunger, tears running down her grimy face as she chewed and swal owed, said quietly to Meredith, â€Å"Think we've got any ringers in here?† â€Å"I'd bet my life on it,†she replied just as quietly. â€Å"But what are we going to do? Cole doesn't know anything helpful. We'l just have to pray that the un-possessed kids wil be able to help us when Shinichi's ringers attack.† â€Å"I think the best option when confronted by possessed kids who may have weapons is to run.† Meredith nodded absently, but Matt noticed she took the stave everywhere with her now. â€Å"I've devised a little test for them. I'm going to smack every one with a Post-It, and see what happens. Kids who've done things they regret may get hysterical, kids who're already just terrified may get some comfort, and the ringers wil either attack or run.† â€Å"This I have to see.† Meredith's test lured out only two ringers in the whole mob, a thirteen-year-old boy and a fifteen-year-old girl. Each of them screamed and darted through the house, shrieking wildly. Matt couldn't stop them. When it was al over and the older kids were comforting the younger ones, Matt and Meredith finished boarding up the windows and pasting amulets between the boards. They spent the evening scouting for food, questioning the kids about Shinichi and the Last Midnight, and helping Mrs. Flowers treat injuries. They tried to keep one person on guard at alltimes, but since they had been up and moving since 1:30 A.M., they were al very tired. At a quarter to eleven Meredith came to Matt, who was cleaning the scratches of a yel ow-haired eight-year-old. â€Å"Okay,†she said quietly, â€Å"I'm going to take my car and get the new amulets Mrs. Saitou said she'd have done by now. Do you mind if I take Saber?† Matt shook his head. â€Å"No, I'l do it. I know the Saitous better, anyway.† Meredith gave what, in a less refined person, might have been cal ed a snort. â€Å"I know them well enough to say, excuse me, Inari-Obaasan; excuse me, Orime-san; we're the troublemakers who keep asking for huge amounts of anti-evil amulets, but you don't mind that, do you?† Matt smiled faintly, let the eight-year-old go, and said, â€Å"Well, they might mind it less if you got their names straight. ‘Obaasan'means ‘grandma,'right?† â€Å"Yes, of course.† â€Å"And ‘san'is just a thingy you put at the end of a name to be polite.† Meredith nodded, adding, â€Å"And ‘a thingy at the end'is cal ed an ‘honorific suffix.'† â€Å"Yeah, yeah, but for al your big words you've got their names wrong. It's Orime-grandma and Orime-Isobel's-mother. So Orime-Obaasan and Orime-san, too.† Meredith sighed. â€Å"Look, Matt, Bonnie and I met them first. Grandma introduced herself as Inari. Now I know she's a little wacky, but she would certainly know her own name, right?† â€Å"And she introduced herself to me and said not just that she was named Orime, but that her daughter was named after her. Talk your way out of that one.† â€Å"Matt, shal I get my notebook? It's in the boardinghouse den – â€Å" Matt gave a short sharp laugh – almost a sob. He looked to make sure Mrs. Flowers wasn't around and then hissed, â€Å"It's somewhere down at the center of the earth, maybe. There is no den anymore.† For a moment Meredith looked simply shocked, but then she frowned. Matt glared darkly. It didn't help to think that they were the two most unlikely of their group to quarrel. Here they were, and Matt could practical y see the sparks flying. â€Å"All right,†Meredith said final y, â€Å"I'l just go over there and ask for Orime-Obaasan, and then tel them it was al your fault when they laugh.† Matt shook his head. â€Å"Nobody's going to laugh, because you're going to get it right that way.† â€Å"Look, Matt,†Meredith said, â€Å"I've been reading so much on the Internet that I even know the name Inari. I've come across it somewhere. And I'm sure I would have made†¦made the connection†¦Ã¢â‚¬ Her voice trailed off. When Matt turned his eyes down from the ceiling, he started. Meredith's face was white and she was breathing quickly. â€Å"Inari†¦Ã¢â‚¬ she whispered. â€Å"I do know that name, but†¦Ã¢â‚¬ Suddenly she grabbed Matt's wrist so hard that it hurt. â€Å"Matt, is your computer absolutely dead?† â€Å"It went when the electricity went. By now even the generator is gone.† â€Å"But you have a mobile that connects to the Internet, right?† The urgency in her voice made Matt, in turn, take her seriously. â€Å"Sure,†he said. â€Å"But the battery's been kaput for at least a day. Without electricity I can't recharge it. And my mom took hers. She can't live without it. Stefan and Elena must've left their stuff at the boardinghouse – â€Å"He shook his head at Meredith's hopeful expression and whispered, â€Å"Or, should I say, where the boardinghouse used to be.† â€Å"But we have to find a mobile or computer that works! We have to! I need it to work for just a minute!†Meredith said frantical y, breaking away from him and beginning to pace as if trying to beat some world record. Matt was staring at her in bewilderment. â€Å"But why?† â€Å"Because we have to. I need it, even just for a minute!† Matt could only gaze at her, perplexed. Final y he said, â€Å"I guess we can ask the kids.† â€Å"The kids! One of them has got to have a live mobile! Come on, Matt, we have to talk to them right now.†She stopped and said, rather huskily, â€Å"I pray that you're right and I'm wrong.† â€Å"Huh?†Matt had no idea what was going on. â€Å"I said I pray that I'm wrong! You pray, too, Matt – please!†

Essay: A Visit to the Zoo

A Visit to the Zoo Zoo is a place where all sorts of tame and wild animals are kept. There are birds and beasts which tell us about the flora and fauna of our country as well as foreign countries. It is in this respect a giver of knowledge and information. Delhi zoo is housed in the Purana Kila on the Mathura Road. It has a fine and rare collection of birds and animals from all parts of the world. The zoo is spread over several acres of land. The birds and animals are kept, as far as possible, in their natural surroundings. There is a moat encircling the enclosures of wild animals so that they might not escape.One day I went to the zoo in the company of some of my friends. We bought tickets at the gate, and entered the zoo. First we came upon the enclosure where water fowls were swimming in water. The ducks and drakes were swimming and picking up things thrown to them. We enjoyed their playful antics for some time and moved on. Next we came to the enclosure of the wild animals. There were lions, tigers, and leopards belonging to different countries. The Gir lion of India seemed to be most ferocious. The enclosures smelt of meat, provided to them everyday.In another enclosure were the monkeys. They too, were of several varieties. The ape with a black face seemed to be the most mischievous. He was all the time grinning at the onlookers. The visitors threw parched grams to the monkeys and they seemed to relish it. At a small distance we saw a peacock. It was dancing. I ran to that side. The peacock seemed td be unmindful of the presence of the crowd. Closeby was an enclosure for the deer. It covered a vast area and the deer were roaming about freely- Near to the enclosure we saw a buffalo-like animal.It was the rhino munching some maize plants. It looked dreadful with its sharp horn on the nose. The sight of the rhino at once reminded me of the adventure of Colonel White as given in our text-book of English. On our way back we saw some elephants. They were being u sed for a joy-ride on payment. Lastly, we saw the covered enclosures where birds were flying about. They were of different colours and shapes. Now it was getting dark. The bell rang and we came out. The visit to the zoo added a good deal to our knowledge of birds and beasts.

Nursing Accountability Vte Essays

Nursing Accountability Vte Essays Nursing Accountability Vte Essay Nursing Accountability Vte Essay Running head: NURSING ACCOUNTABILITY Nursing Accountability Sarah Redmond Grand Canyon University Professional Dynamics NRS-430V July 24, 2011 Nursing Accountability Venous thromboembolism (VTE) is a disease that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). More than 2 million Americans suffer from VTE each year, with over half of these individuals developing their VTE in the hospital or in the 30 days post hospitalization. In a large registry trial capturing more than 5,450 patients at 183 sites over a 6-month period, 50 percent (2,726) developed their VTE during hospitalization. Nurses are accountable in helping change the practice of venous thromboembolism prophylaxis. There are many risk factors that can cause VTE including recent hospitalization, surgery, prolonged immobility, recent travel, trauma, and certain conditions including heart disease, respiratory disease, cancer, and clotting disorders. In our study, waist circumference was more predictive of a VTE than body mass index. We also found that heavy smoking predicted a VTE, whereas hypertension did not (Hansson et al. , 1999). There are pharmacological and non pharmacological ways to protect patients in the hospital setting. Using these in conjunction with each other is the overall safest method. Non pharmacological methods of VTE prophylaxis include early ambulation, sequential compression devices (SCD), and compression stockings. Early ambulation promotes venous return and helps minimize length of stay in hospitals. Compression stockings and SCDs help prevent venous stasis. A recent systematic review found that graduated compression stockings, intermittent pneumatic compression devices, and foot pumps reduce the risk of DVT in surgical patients by two thirds when used in monotherapy and by an additional 50% when added to drug prophylaxis (Roderick et al. 2005). Pharmacological methods of VTE prophylaxis include anticoagulants such as low molecular weight heparin, unfractionated heparin, and vitamin k antagonists. These medications are given to prevent clot formation, not to actually dissolve the clots. It’s important to know which patients are at greater risk and which type of prophylaxis should be used. In most hospitals there is a VTE protocol that is followed to determine the risk level of patients and which prophylactic measure to implement. It’s important for medical personnel to help develop and implement these VTE protocols. These protocols should be mandated in every hospital at time of admission. Doctors need to review VTE risks for patients and order which prophylactic measure to use along with admission orders. In addition to the doctor’s risk assessment for VTE, nurses should assess their patients for risk factors and signs or symptoms. If prophylactic measures are not ordered, nurses can ask the doctor if they feel prophylaxis is warranted or make them aware. Quality improvement teams can be initiated throughout hospitals. Team members can help develop, improve, and review VTE protocols to make sure they are being ordered and are effective in prevention. There are many ways nurses can be accountable in the prevention of venous thromboemobolisms. Nurses can walk high risk patients often and help patients perform leg exercises without a physician’s order if not contraindicated. Proper measurement and correct application of compression stockings are essential to their performance, so helping the patients with this would be beneficial. There should be frequent assessments of patient’s skin integrity, pulses, and comfort when using compression stockings. Patient education is very important in the prevention of VTE. Nurses should make sure patients understand reasons for the different prophylactic measures and make them aware of signs and symptoms to watch for. Proper medication administration of anticoagulation agents is essential, as with any other medication. It’s important to have the patient’s exact weight, because even the slightest wrong dose of some of these anticoagulants can be very detrimental and even kill a patient. To make sure these medications have a purposeful effect, it is important to teach the patients how to take them properly. Nearly two-thirds of 9,675 medical patients at risk for venous thromboembolism received no inpatient pharmacologic prophylaxis, and more than 98% received no outpatient prophylaxis, a retrospective analysis showed (Wendling, 2010). Prophylaxis is the most important way to prevent these deadly venous thromboembolisms from forming. References Agency for Healthcare Research and Quality. (2011). Retrieved from ahrq. gov/qual/vtguide/vtguideapa. htm Hansson, P. O. , Eriksson, H. , Welin, L. , Svardsudd, K. , Wilhelmsen, L. (1999). Smoking and abdominal obesity. Archives of Internal Medicine, 159(16), 1886-1890. Roderick, P. , Ferris, G. , Wilson, K. , Halls, H. , Jackson, D. , Collins, R. et al. (2005). Evidence based guidelines for the prevention of venous thromboembolism. Health Technology Assessment, 9 Wendling, P. (2010). Many at-risk patients lack VTE prophylaxis. American College of Chest Physicians. Retrieved from chestnet. org/accp/article/chest-physician/many-risk-patients-lack-vte-prophylaxis

Sexual revolutions impact on the american character essays

Sexual revolutions impact on the american character essays In the mid-1960s, a major change in morals and attitudes towards sexual expression, known as the Sexual Revolution, affected all of American society. Popularity of rock music, fashion changes, displays of nudity, youth rebellion, and openness to ones sexuality, brought on by the Sexual Revolution, contributed to anchor young Americans awareness of cultural change in the 1960s. The Sexual Revolution created a major change in the music styles of the sixties from the music styles of the fifties. The music styles of the fifties was mainly rhythm-and-blues and pop, but over the decade between 1960 to 1970 music, shifted to psychedelic mysticism. Fashion was more exciting and risqu in the sixties. Womens fashion changed from traditional shirtwaist dress suits in the fifties to pants. The sixties was the first decade fashion designers began to design pants for women. Another difference the Sexual Revolution created between the youth of the fifties and the youth of the sixties was their sex ual attitude. In the 1950s most young people were awaiting getting married, having a nice home, and having children whereas youth of the sixties looked at marriage as being part of the straight society they disliked. Not only did the youth of the sixties marry later, but also the birthrate decreased due to the legalization of contraceptives. The Sexual Revolution contributed to a chaotic decade of youth rebellion and protests against traditional social customs with its influences on music, fashion, media and personal choices through its impact on sexual and individual freedoms. One of these freedoms impacted by the Sexual Revolution was the music world. Music in past decades was considered music that was good for the soul. It had soothing melodies and lyrics focused on true love, crushes, and dancing. The music of the sixties created a completely different tune. It began to take on a hipper beat with lyrics that alluded to drug ...