Case Study: Osteoarthritis with a Total Knee Arthroplasty Essay

DN is a 68 year old Caucasian male who lives in Pomona, Missouri. On September 14, 2009, DN underwent a scheduled left total knee arthroplasty at Baxter County Regional Medical Center. A consultation appointment about a total knee arthroplasty was scheduled when DN had increasing pain in his knees while doing chores and working on his dairy farm. The increasing pain DN was having been due to a history of osteoarthritis and the wear-and-tear on his joints throughout his life, no specific injury was noted. Depending on the outcome of the left knee, DN was consulted on having his right knee done in the future due to his active lifestyle as a dairy farmer. DN is presently in very good health despite his pain from osteoarthritis. Osteoarthritis is caused from wear and tear on the joints. The bones between a joint is cushioned by cartilage which after many years of use decreases. When the bones no longer have the cushion, pain and stiffness develops when the bones rub together (Total Knee Replacement, 2009). His health history includes overcoming prostate cancer approximately six years ago. After a prostatectomy to remove his cancer, DN continues to experience erectile dysfunction even after seeing many specialists and trying many treatment options. In 1999, DN had his appendix removed at Ozark Medical Center. DN has a herniorrhaphy and cataract surgery prior to this hospitalization. DN has no known allergies to drugs, food, or environmental allergens. The patient lives at home with his wife on a dairy farm. He handles about 170 head of dairy cattle that are milked twice a day. He retired from Howell-Oregon County Electrical approximately five years ago to help manage his farm on a full time basis. DN and his wife raised three children and have several grandchildren who come and visit frequently. DN does not have any significant history of nicotine, alcohol, or drug use. His diet has consisted of fresh fruits and vegetables from the garden throughout his life. These factors have all played a part in helping DN stay healthy without any underlying chronic disease processe s. Physical Assessment My physical assessment was performed on September 16, 2009. DN’s vital signs consisted of an apical pulse of 98, a respiration rate of 20, a temperature of 99.1 degrees Fahrenheit, an oxygen saturation of 96%, a lying blood pressure of 117/78, a sitting blood pressure of 116/75, and a standing blood pressure of 116/74. Patient was alert and oriented to person, place, time, and situation. Patient was able to spell WORLD forward and backwards. PERLA and noted cardinal field of gaze were intact. Eyes were clear with conjunctiva pink and no discharge noted. Patient’s head and face was symmetrical with no apparent skin breakdown. Patient had dentures intact in mouth with healthy, pink gums with no lesions present inside the mouth. Thorax was symmetrical with no signs of pulsations or lesions. Breath sounds clear in all lobes. Unlabored breaths. Heart sounds S1, S2 were heard upon auscultation in all four cardiac areas with normal rhythm. Abdomen is soft, symmetrical with hyp oactive bowel sounds present in all four quadrants. Last bowel movement was on Sunday, September 13. Patient was passing flatus. No masses, distention, or lesions noted on the abdomen. No tenderness was noted in the abdomen. No edema was noted in the upper or lower extremities. Upper and lower extremities had no sign of lesions or discoloration. Saline locked on left forearm was intact with no redness or swelling. Surgical incision on lower left extremity had scant amounts of serosanguineous drainage, wound edges were well-approximated, slight erythemateous around incision, no odor present, and dressing was dry and intact. Pulses were strong and equal bilaterally- including carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibialis. Skin was warm and pink with no signs of cyanosis, rash, or skin breakdown. Gait was symmetrical and coordinated when using a walker, without the supportive device there is some unsteadiness due to the left total knee arthroplasty. There was no hearing deficit noted with normal conversation. Patient only had complaints of pain at surgical site after ambula tion, physical therapy or the CPM. Patient was taught he could ask for the pain medicine prior to these events to hopefully avoid intense pain. Current Medications Throughout DN’s hospital stay he was prescribed medicine to alleviate the pain caused from the total knee arthroplasty, help prevent any infection that had potential to be a problem, and prevent any complications. DN’s urrent medications while in the hospital were as follows: 1.) Docusate-Senna (Trade Name: Peri-Colace) 1 tablet by mouth, twice a day; used for softening and passage of stool for the relief of constipation caused by post operative anesthesia and decreased activity (Deglin & Vallerand, 2007). 2.) Enoxaparin (Trade Name: Lovenox) 40 mg by subcutaneous injection, once every morning; used for the prevention of thrombosis formation (Deglin & Vallerand, 2007). 3.) Psyllium (Trade Name: Metamucil) 1 tablespoon by mouth, twice a day; used for relief and prevention of constipation (Deglin & Vallerand, 2007). 4.) Acetaminophen-Oxycodone (Trade Name: Percocet 5/325) 1-2 tablets by mouth, every four hours; used for decreasing pain as well as decreasing a temperature (Deglin & Vallerand, 2007). 5.) Magnesium Hydroxide (Trade Name: Milk of Magnesia) 30 mL by mouth as needed; used for replacement in a deficient state or evacuation of the colon (Deglin & Vallerand, 2007). 6.) Morphine (Trade Name: Astramorph) 8 mg by intravenous piggyback, every three hours as needed; used for a decrease in the severity of pain (Deglin & Vallerand, 2007). 7.) Promethazine (Trade Name: Phenergan) 12.5 mg by intravenous piggyback, every four hours as needed; used for diminishing nausea and vomiting, as well as provide some sedation (Deglin & Vallerand, 2007). Diagnostic Tests DN had diagnostic tests prior to being admitted to the hospital for his total knee arthroplasty to determine the best treatment option for his osteoarthritis. After his surgery, more diagnostic tests were done to monitor for complications of the procedure. The results were compared to normal and were as follows for the patient: 1.) White Blood Cells (Normal Value: 5,000-10,000/mm3) Patient’s white blood cell count was 12,800/mm3, which is a high value. This value indicates the stress on the body and inflammation around the knee involved after the operation. The value is also a possible indicator of infection, which would require continued monitoring (Pagana & Pagana, 2006). 2.) Red Blood Cell Count (Normal Value: 4.7-6.1Ãâ€"106/ µl) Patient’s red blood cell count was 3.74Ãâ€"106/ µl, which is a low value. This value indicates the blood lost during surgery, which is a common finding after an invasive surgery. A decreased level may indicate a hemorrhage, overhydration, or a dietary deficiency, which may need to be corrected (Pagana & Pagana, 2006). 3.) Hemoglobin (Normal Value: 14-18 g/dL) Patient’s hemoglobin was 11.8 g/dL, which is a low value. This value is a common finding after surgery due to the blood loss, but the value may also indicate anemia or nutritional deficiency (Pagana & Pagana, 2006). 4.) Hematocrit (Normal Value: 42-52%) Patient’s hematocrit was 34.4%, which is a low value. This is a normal finding after surgery, but may indicate anemia, malnutrition, or a dietary deficiency that may need to be corrected (Pagana & Pagana, 2006). 5.) Mean Corpuscular Hemoglobin (Normal Value: 27-31 pg) Patient’s mean corpuscular hemoglobin was 31.8 pg, which is just slightly elevated. This value could possibly indicate a macrocytic anemia, but is not elevated enough to be a significant concern (Pagana & Pagana, 2006). Basic Conditioning Factors and Power Components Dorthea Orem identifies ten basic conditioning factors that identify the patient and help assess the need for care in her Self-Care Deficit Theory of Nursing. The basic conditioning factors identified by Orem consist of age, gender, Erikson’s developmental state, health state, sociocultural orientation, health care system factors, family system factors, patterns of living, environmental factors, and availability of resources (Caton, 2008). DN is a 68 year old Caucasian male who lives in Pomona, Missouri where he and his wife own a house. DN grew up in Dora, Missouri where he graduated high school, then relocated to Pomona at the age of nineteen. DN has three grown children and several grandchildren. DN’s family remains very close and visit often to where DN lives. DN quit his job at Howell-Oregon Electric in 1980 to become a full time farmer. DN and his wife own approximately 300 acres to operate a dairy and beef cattle farm with 170 head of cattle. They milk the cows twice a day keeping them very active throughout the day. DN considers himself to be in the middle-class economically, but with the unpredictable cattle market economic status can change throughout the year. DN has Medicare as primary insurance with supplements. Before his admission to the hospital, DN’s health state was good. DN’s health care system factors consist of a medical diagnosis of osteoarthritis. The treatment of choice for DN was a left total knee replacement. After discharge, home health will help organize physical therapy closer to home. DN does not have any underlying diseases, such as hypertension or diabetes, which can cause complications or alter the ability of DN to have a speedy recovery. He has a primary physician in Willow Springs for yearly check-ups and minor problems. DN’s patterns of living include hunting and fishing, going to church, and taking care of the farm. DN does not smoke or drink alcohol. According to Erikson, he is in a developmental stage of ego integrity versus despair (Berman et al., 2007). DN belongs in this psychosocial developmental stage because he is at a stage where he is content with his life and satisfied with everything that has happened in his life thus far. He is able to reflect on his past without regret. DN feels as if he has lived a life full of happiness. Orem identifies ten power components that are important in evaluating how much nursing care is needed by the patient. The ten power components consist of attention span and vigilance, control of physical energy, control of body movements, ability to reason, motivation for action, decision making skills, knowledge, repertoire of skills, ability to order self-care actions, and ability to integrate self-care actions into patterns of living (Caton, 2008). DN’s attention span ad vigilance is a strength because throughout the physical assessment and health history, he remained very attentive and honest when answering the questions. His control of physical energy is a potential weakness due to the fatigue DN could experience after his knee replacement. After surgery, becoming fatigued is easier due to the pain and inability to get a good night’s rest in the hospital. DN seemed to know his limits with what kind of physical energy he had to use throughout his stay. The patient’s control of body movements is a strength. Even though DN is recovering from a total knee replacement, he maintains good control over his movements. He also has a steady gait when walking with a supportive device. The patient’s ability to reason is a strength. When he needed help, he knew to ask his wife, a nurse, or an aide for help. He understood that Home Health would be a benefit once he was discharged from the hospital. Motivation for action is definitely a strength. DN was very motivated to get back on his feet as soon as he could. He knew physical therapy was what would help the most so he was always ready to go when physical therapy came to take him to the Joint Club. After returning after a trip to physical therapy, the patient stated, â€Å"The physical therapist said I did better than all of the other patients with knee replacements.† The patient’s decision making skills were strength because he took all options into consideration prior to getting his knee replacement. He knew it would be the best option with the active lifestyle that he has. Knowledge was a potential deficit for the patient because he had never had a knee replacement surgery before. The patient was informed of all the procedures, hospital stay, and expected outcomes during consultation appointments, but all the information at once can be overwhelming for the patient. Even after the surgery, the patient still questioned the health care team members throughout the hospital stay to refresh his memory. Repertoire of skills is a strength because the patient has a high school education, as well as the same occupation throughout his life. He is able to retain information and repeat skills if needed. DN’s ability to order self-care actions is a strength because he is able to decide what actions are most important and follow through with them. He decided to have his knee surgery to benefit his lifestyle and made it a priority to get it done as soon as he could. The ability to integrate self-care actions into his patterns of living is a strength for DN. He integrates a healthy diet and active lifestyle to prevent complications of his osteoarthritis. After trying minor treatment options to control pain and discomfort from the osteoarthritis, DN opted for surgical treatment and he realizes the physical therapy he will have to integrate into his lifestyle for full recovery. Universal Self-Care Requisites Orem’s General Theory of Nursing involves self-care, self-care deficit, and nursing systems. Orem’s definition of self-care is what people plan and do on their own behalf to maintain life, health, and wellness. The nursing systems that Orem identifies are wholly compensatory, partly compensatory, and supportive-educative. The universal self-care requisites that patient may be deficient, potentially deficient, or a strength in consists of air, water, food, elimination, activity and rest, solitude and social interaction, prevention of hazards to human life, and normalcy (Berman et al., 2007). Air: Potential Deficit Air is a potential deficit for this patient. Upon assessment, his respiratory rate was within normal range at 20 breaths per minute. Normal respirations for the age group of the client range from fifteen to twenty per minute (Berman et al., 2007). The patient has a stable respiration rate between this level, but with decrease red blood cells, hemoglobin, and hematocrit the patient’s oxygen level may increase to compensate for the lack of cells that can carry the oxygen, especially during physical therapy. DN’s lung sounds when auscultated were clear in all lobes, bilaterally. A critical side effect of morphine, one of the medications DN was taking while in the hospital, is respiratory depression, which can happen in a matter of minutes causing a deficit (Deglin & Vallerand, 2007). Water: Strength Water is a strength for DN. No edema was noted upon assessment. Good skin turgor was indicative that there was adequate hydration for the patient. DN’s average intake was 2000 mL of fluids, usually water and ice tea. This was within normal range with the requirements being set at a minimum of 1500 mL of fluids daily (Berman et al., 2007). Food: Strength Food is a strength for the patient. The patient was on a regular diet and had no trouble eating. On some occasions, his wife brought meals to the patient. DN consumes a healthy diet, full of fruits and vegetables from his own garden when home. Protein consumed in his diet usually consists of very lean beef from home grown cattle. DN consumed enough calories to aid in recovery of his surgery. Elimination: Deficit Elimination is a problem for the patient. He has not had a bowel movement since the day before he had the surgery. DN had an epidural anesthesia until the first day post-op and is taking narcotic analgesics for pain control, which both contributed to the impaired elimination. The side effects from the medication cause the intestines to decrease peristalsis. Monitoring bowel functions, as well as administer the stool softeners and laxatives that are ordered, are two important nursing interventions (Lemone & Burke, 2008). Activity and Rest: Deficit The patient had a deficit in both activity and rest. The patient stated he was not getting adequate rest in the hospital due to the different environment and the pain he was experiencing from his surgery. In the hospital, the patient was also put on activity restrictions due to his total knee arthroplasty. He was able to go to physical therapy three times a day, but normal activities were limited for DN. At home DN does not have activity or rest deficit, he participates in an active lifestyle with lots of walking and daily physical labor. He also gets approximately 7 or 8 hours of sleep a night which is adequate for a man his age (Berman et al., 2007). Solitude and Social Interaction: Potential Deficit The patient did not have a deficit with social interaction. His wife was in the room majority of the time and he also had many people drop in and see him throughout his hospital stay. DN also interacted with people on the health care team, whether it was the nurses or physical therapists, he was always having a conversation with someone. Due the many visitors and activities DN had during the day, solitude was a potential deficit. The physical therapists and nurses that came in the room consistently make it difficult for the patient to get any time to rest and relax by himself. Adequate rest is easier to obtain when there are no interruptions in the rest period and some solitude is allowed. Hazard Prevention: Deficit Hazard prevention is a deficit for DN. The total knee arthroplasty causes the patient to be at an increased risk for infection due to all the invasive procedures done. Prophylactic antibiotics were being considered to help prevent any infection that may develop. The patient is also at risk for falls. The intravenous line and pole make it difficult for the patient to ambulate on his own while dealing with his surgery. The medications DN were taking could cause confusion, dizziness, and sedation which could lead to a fall. The patient is also at risk for a deep vein thrombus due to the surgery, which could be a fatal complication if not prevented. Compression stockings and devices were used to decrease the chance of venous stasis. Promotion of Normality: Deficit Promotion of normality is a deficit for the patient. He has only been hospitalized two other times in his life and feels uncomfortable. Since DN is not used to being in the hospital, he is hesitant to ask for pain medication until the pain is already present. Teaching DN to ask for the pain medicine prior to activities and when he recognizes the pain coming back. DN’s normal routine at home will be changed to accommodate for the knee surgery he underwent. He will have to adjust to the limitations on his activities until he is fully recovered. For example, he will have to depend on his wife and other family members to help milk the cows and take care of the farm until he has full range of movement so he does not damage his newly replaced knee. Developmental Self-Care Requisites Developmental self-care requisites are associated with conditions that result in maturation (Berman et al., 2007). DN has lived a long, productive life and many life changing events have occurred throughout his life. He graduated high school and worked multiple jobs which gave him the experience he needed to now be a self-employed farmer. He and his wife raised a family with three children, and now have several grandchildren. All of these different aspects in DN life have helped DN mature, which puts him in a developmental stage of ego integrity versus despair. According to Erikson, people in this stage should have acceptance of their life and self-worth (Berman et al., 2007). DN seems very satisfied with everything that has happened in his life. He is able to reminisce about the things that have happened in his life with a smile. He does not have any regrets about his life. At this point in DN’s life, he is always thinking of others and enjoying the small things in life. Even though DN is in this developmental stage, he has not fully completed this stage. DN is in a position where he still works and provides for his family. He is not ready to leave his family at this point in his life. Health Deviation Self-Care Requisites According to Orem, there are six health deviation self-care requisites. The health care deviation self-care requisites consist of seeking and securing medical help when needed, responsibly attending to the effects and results of pathologic conditions, effectively carrying out prescribed interventions, responsibly attending to the regulation of effects resulting from prescribed interventions, accepting the fact that sometimes self or others need medical help when faced with certain life challenges, and learning to live productively with the effects of pathologic conditions and treatments while promoting continued personal development (Caton, 2007). The patient is strong in seeking and securing medical help when needed. As soon as the patient realized his pain was increasing in his knee, he scheduled an appointment with his family doctor who referred him to Dr. Know the orthopedic surgeon. The patient is also responsible in attending to the effects and results of pathologic conditions. The patient is aware of the physical therapy regime he needs to complete for full recovery, as well as the preventive measures he needs to take to protect his right knee. The third health deviation self-care requisite is to effectively carry out prescribed interventions, which is a strength for the patient. DN realizes he will continue with physical therapy after discharge on the hospital and will be on a few prescription medications. Other interventions, such as wearing TED hoses, limiting activities, and allowing home health to help with his care, will all be followed by the patient. The fourth health deviation self-care requisite is to responsibly attend to the regulation of effects resulting from prescribed interventions is a potential deficit. Even though the patient stated he will do the interventions asked of him, the task of depending on others for help may be difficult. As a farmer, it is difficult to let someone else do the chores the patient is usually doing on a daily basis. The fifth health deviation self-care requisite is accepting the fact that sometimes self or others need medical help when faced with certain life challenges. This health deviation self-care requisite is a strength for the patient. When DN realized his knee was not functioning at the level he needed it too, he sought help from professionals after trying alternative treatments. When DN had his prostate removed due to prostate cancer, he also pursued help from many specialists to deal with the many complications a prostatectomy can cause. The sixth health deviation self-care requisite is learning to live productively with the effects of pathologic conditions and treatments while promoting continued personal development. This is a strength for the DN because he looks forward to having better function in his knee to live a more productive life. The chores he does on the farm were becoming difficult with the increasing pain in his knee prior to the surgery. The patient now talks enthusiastically about getting back out on the farm to do the things he loves to do. Nursing Diagnosis I. Nursing Diagnosis #1: Acute Pain related to tissue trauma caused by surgery and intense physical therapy regime as evidenced by patient verbalizing his pain an 8 on a 1-10 scale. a. Expected Outcome: Patient verbalizes relief of pain as less than a 3 on a 1-10 scale at least thirty minutes after administration of pain medication. i. Intervention #1: Assess the patient’s description of pain and effectiveness of pain-relieving interventions. 1. Rationale: Assessing pain description leads to the best interventions to control the pain, as well as assess for any complications with a different pain description. Every patient has a right to effective pain relief (Gulanick & Vallerand, 2007). ii. Intervention #2: Instruct the patient to request pain medication before the pain becomes severe. 2. Rationale: Relief will take longer if the patient waits until the pain is too severe (Gulanick & Vallerand, 2007). The best pain control is proactive, not reactive. iii. Intervention #3: Administer narcotic analgesics as ordered by the doctor. 3. Rationale: With all of the tissue damage done during surgery, the nurse should assume the patient is in pain and needs analgesics (Gulanick & Vallerand, 2007). a. Implementation/Evaluation: Nurse assessed the patient’s description of pain to adequately treat the pain symptoms. Nurse taught the patient the request the pain medication at the onset of pain to reduce the amount of time it takes to start working. The goal was met because the patient verbalized his pain less than a 3 on a 1-10 scale within 30 minutes of administration of pain medication. b. Expected Outcome: Patient appears comfortable as evidenced by absence of facial grimacing and use of stress management techniques between doses of pain medication and throughout hospital stay. iv. Intervention #1: Nurse will teach patient to use guided imagery and progressive relaxation. 4. Rationale : Use of guided imagery and progressive relaxation will distract patient from the pain he is experiencing (Gulanick & Vallerand, 2007). v. Intervention #2: Nurse will teach patient to change position frequently. 5. Rationale: Changing positions (within limits) will relieve pressure and pain on bony prominences, reduce muscle spasm, and undue tension (Gulanick & Vallerand, 2007). vi. Intervention #3: Nurse will apply ice packs as ordered. 6. Rationale: Applying ice packs may decrease edema and enhance comfort (Gulanick & Vallerand, 2007). b. Implementation/Evaluation: Nurse taught the patient different comfort measure to relieve pain in between doses of pain medication. Using repositioning and relaxation measures helped the patient stay comfortable between doses of pain medication. The goal was met. II. Nursing Diagnosis #2: Impaired physical mobility related to pain after surgical procedure as evidenced by limited ability to ambulate. c. Expected Outcome: Patient will maintain optimal mobility within limitations throughout hospital stay. vii. Intervention #1: Assess postoperative range of motion in affected and unaffected joints. 7. Rationale: Assessment of range of motion will give a baseline to see if the patient is improving. Range of motion exercises are important to strengthen affected joint (within limitations) and unaffected joints need to maintain current mobility in periods of decreased activity because joints with arthritis lose function more rapidly (Gulanick & Vallerand, 2007). viii. Intervention #2: Nurse will assist patient to ambulate with less assistance as tolerated. 8. Rationale: This will allow for patient to become more independent before discharge (Gulanick & Vallerand, 2007). ix. Intervention #3: Nurse will encourage the patient to move from the bed to the chair as tolerated, as well as ambulate in the room three times a day. 9. Progress will be monitored toward normal activities patient will do once discharged from the hospital (Gulanick & Vallerand, 2007). c. Implementation/Evaluation: Nurse assessed postoperative range of motion to have a baseline of function. Improvement was noted th roughout shift that the patient was able to move more independently. d. Expected Outcome: Patient participates in rehabilitation program throughout hospital stay. x. Intervention #1: Assess the patient’s fear or anxiety in ambulating and going to physical therapy. 10. Rationale: If the patient’s fear and anxiety is too great, the patient may not get the full benefit of physical therapy and is at a greater risk for falls or other injuries (Gulanick & Vallerand, 2007). xi. Intervention #2: Nurse will encourage use of supportive walking devices, such as a walker. 11. Rationale: Use of a walker will help the patient feel more independent and encouraged to go to physical therapy as ordered. More weight bearing will progress throughout the use of walker (Gulanick & Vallerand, 2007). xii. Intervention #3: Nurse will reinforce instructions for rehabilitative activities as ordered. 12. Rationale: Reinforcing instructions will help the patient achieve mobility throughout the hospital stay and adhere to the physical therapy program (Gulanick & Vallerand, 2007). d. Implementation/Evaluation: The patient was enthusiastic about physical therapy and gaining full mobility of affected leg. He participated in the rehabilitation program and was able to go home on schedule, so the goal was met. III. Nursing Diagnosis #3: Self-care deficit related to impaired mobility as evidenced by inability to perform activities of daily living, such as dressing, bathing, and ambulate independently. e. Expected Outcome #1: Patient will safely perform all self-care activities of daily living independently before discharge. xiii. Intervention #1: Nurse will assess the patient’s ability to perform activities of daily living. 13. Rationale: This will provide a baseline to know where the priority deficits in the patient’s performance of ADLs and help nurse assist with the patient’s needs (Gulanick & Vallerand, 2007). xiv. Intervention #2: Assist the patient in accepting help from others. 14. Rationale: The patient may need to realize after a total knee replacement, some assistance may be needed and dependence on people or supportive devices may be necessary temporarily (Gulanick & Vallerand, 2007). xv. Intervention #3: Nurse will implement measures to facilitate independen ce, but be available to help patient when needed. 15. Rationale: Giving the patient independence will help encourage patient to attempt ADLs on his own, but with assistance when needed will prevent falls or other injuries (Gulanick & Vallerand, 2007). e. Implementation/Evaluation: Nurse assessed the patient’s ability to perform activities of daily living and realized where the patient needed assistance. Patient was encouraged to do ADLs on his own, but to recognize and ask for help if he needed it. Patient was able to ambulate on his own the bathroom, perform most activities independently, but required some help from his wife by discharge. This goal was met because the patient realized when he needed help and performed all ADLs safely by discharge. f. Expected Outcome #2: Resources are identified that are useful in optimizing the autonomy and independence of the patient by discharge from the hospital. xvi. Intervention #1: Nurse will assess what assistance will be needed when the patient is discharged. 16. Rationale: This will be helpful to the patient and other caregivers to recognize deficits until they are overcome (Gulanick & Vallerand, 2007). xvii. Intervention #2: Nurse will encourage patient to use assistive devices until no longer needed, and reassure patient that use of them can prevent falls and injuries. 17. Rationale: This allows patient to know total independence is not expected just because the patient is being discharged (Gulanick & Vallerand, 2007). xviii. Intervention #3: Nurse will help the patient set short term goals to becoming more independent. 18. Rationale: Setting short term goals will decrease the frustration the patient may have in not being able to do activities he could do before surgery (Gulanick & Vallerand, 2007). f. Implementation/Evaluation: Nurse assessed what assistance may be needed to help with activities of daily living. Patient used assistive devices and help from others when he recognized he could not do them independently. Short term goals were set and patient was able to be discharged with a walker and home health services. This expected outcome was met. IV. Nursing Diagnosis #4: Risk for ineffective tissue perfusion related to surgical procedure and impaired physical mobility. g. Expected Outcome: Patient maintains adequate tissue perfusion and remains free from deep vein thrombosis, as evidenced by warm extremities, good capillary refill, bilaterally equal pulses, negative Homan’s sign, and stable vital signs. xix. Intervention #1: Assess neurovascular status of affected limb preoperatively and postoperatively, as well as assess for signs and symptoms of deep vein thrombosis. 19. Rationale: Preoperatively a baseline should be established and assessing for changes postoperatively will be indication of a problem. Signs and symptoms could be an early indication of a blood clot which leads to early intervention (Gulanick & Vallerand, 2007). xx. Intervention #2: Nurse will assist patient in using thromboembolic disease support hoses and sequential compression devices as prescribed. 20. Antiembolic devices, such as TED hose and SC Ds, increase venous blood flow to the heart and decrease venous stasis, which could prevent a blood clot (Gulanick & Vallerand, 2007). xxi. Intervention #3: Nurse will administer thrombolytic and anticoagulant agents as ordered. 21. Rationale: Prophylactic anticoagulants will reduce the risk of deep vein thrombosis and thrombolytic drugs may decrease the complications if a blood clot does develop (Gulanick & Vallerand, 2007). g. Implementation/Evaluation: Patient was assessed preoperatively and postoperatively for neurovascular status. Patient was monitored closely for any signs of ineffective tissue perfusion. Nurse encouraged use of antiembolic devices and patient adhered to regimen. The goal was met because ineffective tissue perfusion was not a problem and not deep vein thrombosis developed. V. Nursing Diagnosis #5: Deficient knowledge related to a new procedure and unfamiliar with the discharge plan as evidenced by patient questioning health care team members about the process. h. Expected Outcome: Patient verbalizes understanding of procedure and discharge instructions. xxii. Intervention #1: Assess the patient’s current understanding of process in hospital and discharge instructions. 22. This will allow the nurse the individualize the teaching plan for the patient and teach only what the patient does not understand (Gulanick & Vallerand, 2007). xxiii. Intervention #2: Nurse will review total knee arthroplasty precautions according to what the patient does not already know, for example, using the walker, maintain proper body weight, and when to notify the physician. 23. Rationale: Reviewing the information will reinforce adherence to the rehabilitation program (Gulanick & Vallerand, 2007). xxiv. Intervention #3: Nurse will explain the discharge follow up instructions, and reinforce the need to continue with home health for physical therapy. 24. Rationale: Home health and physical therapy will increase the patient’s strength to have a full recovery. When the patient understands the process, he will be more motivated to continue with the program (Gulanick & Vallerand, 2007). h. Implementation/Evaluation: This goal was met. The patient had a full understanding of the limitations of a knee arthroplasty, in the hospital and after discharge. He understood the follow-up appointments and how home health would assist in his recovery. VI. Nursing Diagnosis #6: Constipation related to inactivity and medication use as evidenced by patient having frequent but nonproductive desire to defecate. VII. Nursing Diagnosis #7: Risk for infection related to invasive procedure. VIII. Nursing Diagnosis #8: Risk for falls related to unsteady gait and pain in left leg. References Berman, A., Snyder, S., Kozier, B., & Erb, G. (2007). Fundamentals of nursing: Concepts, process, and practice (8th ed.). Upper Saddle Road, NJ: Pearson. Caton, B. (2007). Orem’s self care requistes. Handout for NUR100 Fundamentals of Nursing. Missouri State University-West Plains, Fall 2007. Deglin, J.H., & Vallerand, A.H. (2007). Davis’s drug guide for nurses (10th ed.). Philadelphia: F.A. Davis. Gulanick, M., & Myers, J.L. (2007). Nursing care plans: Nursing diagnosis and intervention. St. Louis: MO: Elsevier. LeMone, P., & Burke, K.M. (2004). Medical-surgical nursing: Critical thinking in client care (3rd Ed.). Upper Saddle Road, NJ: Pearson. Pagana, K.D., & Pagana, T.J. (2006). Mosby’s manual of diagnostic and laboratory tests (3rd ed.). St. Louis, MO: Mosby. Total Knee Replacement (2009). American Academy of Orthopaedic Surgeons. Retrieved October 19, 2009, from http://orthoinfo.aaos.org/topic.cfm?topic=A00389.

British Rule In England

â€Å"Trade was Britain’s doorway to India. † (Bogard et. al. 4th par. 3rd sentence) The colonization of Asia is often referred to as the Second British Empire; the British East India Company India was successful in annexing the Indian subcontinent (India, Bangladesh, Pakistan, Myanmar), an extremely lucrative acquisition as it became a large source of revenue (British East India Company 1st par. 1st sentence). India is a country with a rich culture and a civilization far older than that of the British (Bessant 2nd par. 2nd sentence). Its identity has been forged long before the coming of Western Civilization.However, during the period of the annexation of the subcontinent, India was in a period of regional strife. There were wars being fought among the different governors in the territory. The local leaders were fighting each other as well as the foreign invaders. In â€Å"Did Great Britain Unify India? †, the authors think that when Great Britain first came to India, it was suffering a period of division (2nd par. ). The governors of India tended towards disintegration, leading to outrageous defense expenditures which continued with the conflicts against the British (Birodkar).The British made external changes that led India to desire and achieve national unity (Bogard, et. al. 4th par. ). An example of the unifying external changes introduced was the concept of a universal language. The British required knowledge of the English language to qualify for employment in the government. It was also taught in the universities. But the Indians did not completely accept the foreign language of the colonizers. The regional languages still exist today, and only a small portion of population speaks English.However, even if the Indians still speak in different languages and there is still no universal language in India, Hindi has become the official language. Hindi is taught in the elementary and high school level. English is taught in the college le vels, it is the language of the educated in India. (Bogard, et. al. ). The British also introduced western developments. The Empire built railroads, highways and ports across the Indian subcontinent to facilitate trade, built canals for irrigation and created public health measures to prevent diseases.On the flip side, the activities of the British were geared towards acquisition of economic wealth for Britain. (Bogard, et. al). According to Bidokar, â€Å"The policy of ‘Great' Britain was of a systematic annihilation of Indian handicraft industries by exposing them to the ruinous competition from the cheap machine products coming from UK. † (18th par. 1st sentence) A large bulk of the raw materials produced by India is acquired, at very cheap prices, by the Britain; then, later on, finished products are dumped back to India, resulting to very large profits for Britain (Bidokar18th par. 2nd sentence).This exacerbated the poverty of India (Bidokar18th par. 2nd sentence). Bidokar also believed that: Thus after nearly two centuries of living through the twilight of two ages of the dying feudalism and the deformed nascent newborn Capitalism, we inherited an economy which bore the worst features of both feudalism and colonial capitallsm at the dawn of our independence. (20th paragraph) Bogard et,al, on the other hand, claims that poverty in India is a result of improved health care. The public health measures created by the British led to lower infant mortality rates and population explosion.The caste system is a social system by which the members of society are divided into four groups which are ranked. These four groups are priests and teachers, rulers and warriors, merchants and traders and workers and peasants. In the Indian caste system, a person is born within a caste and has little means of improving social standing, except through reincarnation. The occupation and acquaintances of a person is also governed by his caste. The caste system has alr eady been criticized and attacked by various groups before the coming of the British, among these are Buddhists and Muslims.It was convenient for the British to strengthen the caste system when it first came to India (Bogard, et. al). It gave back the privileges of the priests and teachers which the Muslims had previously taken away. However, the changes in society introduced by the British weaken the caste system (Bogard, et. al). People of different caste started mingling in public transportation. British laws also do not allow a higher punishment for a person of lower caste from that of a higher one for the same offense. The advances in transportation allowed people of lower caste from other regions to pretend to belong in a higher caste in a different region.India is the birth place of Hinduism, Buddhism and Sikhism. Religion is a vital part of Indian life; it permeates all other aspects of life and culture. Religion’s impact is felt even on political matters. Moreover, i t constantly clashed with the western culture introduced by the British. As an example, the Sepoy Rebellion arose because the Buddhist soldiers believed that the British did not respect their religion. Christianity made its debut in India before the British through the Portuguese and Spanish missionaries. Later, Anglican and Protestant missionaries also helped spread Christianity in India.At present, it is the second largest religious minority in India; Islam is the first. Christianity also influenced Hinduism. Ram Mohan Roy, a hindu leader, was inspired by the story of Jesus Christ that he fought against the social abuses inherent in Hinduism. It was through his effort that the suttee was declared illegal. (Bogard, et. al) Another devout Hindu influenced by teachings of Christianity is Mahatma Gandhi. Mahatma Gandhi read the works of many west’s great thinker and the gospel of Christ’s He actions is greatly influenced by his readings, but he never lost his faith in Hi nduism or his Indian identity.(Bogard, et. al) The effects goes both ways, Ramakrishna, a Hindu missionary, roamed the United States and England to preach Hinduism. Lamb said: The fact that he had so successfully preached Hinduism in the very lands from which the Christian missionaries came seemed to prove that political subjection need not involve religious subjection. Hindus could be proud at least of the essential truths of their religion. The reaffirmation of Hinduism served as an emotional counterbalance to the damage to Hindu self-respect caused by British political domination.(qtd. Bogard, et. al. ) Religion spilled over Indian literature. The Ramayana and Mahabharata, considered as two of the greatest literature of all time, are familiar epics of the Sanskrit. It is written in verse and orally passed down. In more modern times, Indian literature is represented in the world by the works of Rabindranath Tagore and Allama Iqbal. The more lasting influence of Britain to India is in the field of sports. Cricket, a sport invented by the British, is India’s favorite past time (Bogard, et. al). In fact in the 1993At present, the ties between India and Great Britain are being kept strong by international trade. India and Britain entered into a partnership in 1993. Britain reported a 69% increase in bilateral trade after the partnership was entered into and several joint ventures have been signed between Indian and British companies. Britain is also the largest market for Indian trade services, this amount to 12% of the total IT service exports. Cited Works Bessant, Annie. â€Å"England and India. † Theosophical Publishing Co. 1921. http://www. theosophical. ca/EnglandIndiaAB. htm. Birodkar, Sudheer.â€Å"The Coming of European Colonialism. † http://www. hindubooks. org/sudheer_birodkar/hindu_history/landbritish. html. â€Å"British East India Company. † Wikipedia. http://en. wikipedia. org/wiki/British_Empire. â€Å"British Raj. â⠂¬  Wikipedia. http://en. wikipedia. org/wiki/British_Raj. Bogard, Medina, et. al. â€Å"Did Great Britain Unify India? † May 1, 1997. http://home. snu. edu/~dwilliam/s97/india/. â€Å"Indian Literature. † Wikipedia. http://en. wikipedia. org/wiki/Indian_literature. â€Å"Indo-UK Partnership. † http://www. google. com. ph/search? hl=tl&q=indo-british+partnership+initiative&meta=.

Electric Medical Records Essay Example | Topics and Well Written Essays - 750 words

Electric Medical Records - Essay Example In addition, the paper will highlight network infrastructure and the end user devices and other technology considerations. There are stimulus programs and government initiatives in the United States, the European Commission of eHealth Action Plan, Canada’s Health Inforway, and China’s Guidelines on deepening the reform of the Healthcare System; which accelerate the clinical applications adoption. EMR infrastructure provides portfolio to offer integrated and validated solutions in the healthcare industry. EMR transforms electronic care processes in the industry. With a well developed IT infrastructure, there will be a high level of performance, security, availability, integration, and virtualization of health records. The computer network and technology infrastructure that supports EMR in healthcare infrastructure is EMC EHR Infrastructure Solutions Suite. As a current technology, it can transform and change completely the healthcare infrastructure. It can do this throug h consolidating, managing and virtualization of clinical applications effectively and efficiently. It can also ensure the security of personally identified information and protected health information in the delivery of care. EMC HER Infrastructure Solutions Suite can also protect both past and future healthcare information technology investment. The EMC HER Infrastructure Solutions Suite also ensure improvement of clinical workflow and productivity for collaborative and safer care decisions. This cuts out the present EMR framework that is being used. Although NextGen KBM 5.6 framework is advantageous compared to manual recording systems, it is wise enough for the recent medical data recording and maintenance specifications set by the federal government calls for the deployment of a more complex but smoother EMR technology. It is of much importance that a more centralized and coherent data administration system should be adopted. Development of online collaboration and adoption of u niform terminology are the major areas of challenge, where improvements are highly desired in order to advance the current EMR (NextGen and NEON, 2011). On a daily basis, healthcare organizations process an increasing data amounts. Currently, it’s a challenge to share information and connect affiliated doctors in a health system. In most healthcare organizations, there is no current technology that offers an end to end electronic medical record solution that enhances standards for accessibility, accuracy, and security. There is a manual system of processing patient flows which is tiresome and complicated. In the current situation, workflow processes are analyzed and documented. There are various inefficiencies and bottlenecks even in the billing system. The current processes that require and efficient EMR infrastructure include: Billing, scheduling appointments, referral management, procedures of office visits, patient check-in and check-out, and e-prescribing and laboratorie s (NextGen and NEON, 2011). There are various gaps and issues in the healthcare environment concerning EMR. There is a huge lack of innovation in the health records thwarting the attempts of doctors to advance the process and workflow of healthcare. The vendors of EMR control the data and even resist functionality improvement as well, although they reap financial gains from it. The EMR vendors have always insisted on the uniqueness of healthcare

Comparing Othello to Genji. What kind of heroes were they What made Essay

Comparing Othello to Genji. What kind of heroes were they What made them different than the heroes that we studied before them - Essay Example This leads him to kill Desdemona, his wife, as well as himself towards the end. (Shakespeare, William) On the other hand, the Tale of Genji, written by Murasaki Shikibu is a masterpiece and great contribution to both Japanese as well as world literature. It has been recalled as one of the first novels ever written in the world, in fiction. It presents a very realistic view of life through the actions and characteristics of a young man by the name of Genji. It has been set during the time of aristocracy in Japan as Genji was the son of an Emperor. It is a play centred around the romantic life that he led with the love of his life, and the complications of societal pressure that are sought upon people with time and human bondage. (Murasaki, Shikibu) The two characters of Othello and Genji have quite a number of similarities and differences between them. They can be compared and contrasted against and with each other on the basis of a number of traits that they possess. Both plays have a background of the main protagonist acting out of the passion of love. Othello was madly in love with Desdemona, and Genji, with Lady Fujitsubo and later Murasaki. However, Othello has been constant in his love for his woman; despite him being posted far away from her,he tried to keep the flame alive within himself, in hopes of soon being able to meet with his Lady love. However, Iago changed his mind with time regarding her character and personality and made him believe that she was indeed a woman that engaged in adultery with other men, and that she could not really love someone. Genji, however, understood love as he matured from a boy to a man. He was first in love with the Lady and this love was forbidden. It made him want it even more and soon she bears his son. In the meantime, he falls in love with a number of different women as he pleases, and seduces a number of them, leading them on and making them believe that they have a shot in being his wife. As compared to Othello, t hus, Genji does not come off as a character that would die for the love of his life during this point in his life. He was a young man who was hell bent on enjoying the frivolous pursuits of life; he proves through Murasaki’s writings that the young royals at the time in Japan had no qualms about whether or not their decisions were affecting other people or the rest of the country, they only wanted to do whatever pleased them, and in this case, it involved randomly involving oneself with different women. Towards the end of both the plays however, both characters witness the emotion and feeling of what death is and how it dawns upon a person when it happens to a loved one. Genji realizes that his true love was only for Murasaki, and when she dies, his memories of her begin to haunt him. He then is able to comprehend how fleeting his entire life was and how easily time just passed him by. He understands that he did not give her enough time even though she was his wife, and that he should have told her that he loved her while he still had the chance. Othello too, was forced by his own emotions to undergo the pain and trauma of the death of a loved one. (Penguin Reading Guides) He was overpowered by the force of his own emotions and feelings to kill Desdemona because he was made to believe that she was having an affair with one of the soldiers in his army. The jealousy that erupts within the man threatens to ruin his life and also subsequently ruins the image of

The Myth of Education and Empowerment Essay Example | Topics and Well Written Essays - 1250 words - 33

The Myth of Education and Empowerment - Essay Example The books in the libraries are tattered, dated and discolored while many of the books are in a state of disintegration. "The available books contain outdated facts as well as theories that may not be much help to the students. There are no important books with information relating to AIDS or other diseases, past USA history, exploration and such books" (163) as Moore depicts. To make the education system even worse, "president bush government proposed to reduce and cut federal government spending on libraries by a total of $39 million, a reduction of approximately 19 percent (162)". The Americans view and consider education as the gateway to success as well as a crucial ascend to socio-economy ranking. Nevertheless, writer of this essay depicts that there is no equal distribution of education to students in schools across the different socio-economic course. He depicts it as a fraudulent mirage that the country leadership uses to keep the middle class and working class students in go od schools while the others lament in schools without some crucial education materials such as books and qualified teachers. The writer portrays the poor education system, lack of educational materials and different education philosophies in the school systems affect the standard of education and empowerment in the country. In empowering the students through education, the writer says that it is very important to develop and provide the necessary learning materials such as funding libraries and construction of classes.

Presentation on Genocide In Congo Essay Example | Topics and Well Written Essays - 500 words

Presentation on Genocide In Congo - Essay Example But they had a hidden agenda of tapping the natural resources and using the strategic positions. The Observer on June 15, 2003, quoted a former student of Bukavu university, named Feli: â€Å"Women, children, everyone we could get our hands on, we killed them all,† leaving â€Å"not even babies† (www.observer.guardian.co.uk). â€Å"In Central Africa three countries viz. Burundi (1993-96), Rwanda (1994) and Zaire (1996) have been overtaken by catastrophes in 3 years.† (Newbury, 1998). Western Media gave wide coverage to the catastrophe, but none, including the UNO, took any cognizance of the real issues. This propaganda was used to shield Multinational Corporations, and the West in general, who had a vested interest of exploiting the natural resources, especially Coltan and Niobium used for the production of cell phones and other high tech electronic equipment. The role of propaganda is evident in the statement: â€Å"The tragedy of the Congo conflict has been instituted by multinational business corporations, their proxy armies and supra-governmental bodies that support them.†

Smoking in public places Essay Example | Topics and Well Written Essays - 750 words

Smoking in public places - Essay Example According to the Centers for Disease Control and Prevention, the use of tobacco is the single most preventable risk to human health in the developed countries. In addition, it is one of the most vital causes of worldwide premature deaths. In the United States, many states have already banned smoking at the public places and California is one of them. In fact, the state of California has one of the strictest laws against smoking at the public places in the world. California decided to take serious steps to control the smoking in the public places in 2001. Governor Davis signed AB188 prohibiting the smoking or disposal of any "cigarette, cigar, or other tobacco-related product" within a playground or tot lot sandbox area and establishing a $100 fine for any violation. (Not Available) Smoking is prohibited in all the workplaces, including but are not limited to restaurants, bars, casinos, gambling clubs, play pits, play structures, backstops, sports fields, tennis courts, and picnics reserved places. When adults smoke in front of young children, it would not give a good impact on their amateur minds. They start feeling that smoking is a good thing and normalizes it. According to the statistics, the average starting age of an adult smoker is thirteen years old. All city laws rely on public education, signage, and voluntary compliance while providing citation authority to peace officers and, in some cases, park rangers and environmental health officers. (Board of Supervisors) Restricted Places (LA) The restricted places in the Los Angeles County are Alhambra - prohibits smoking within 100 feet of a tot lot playground or baseball field; Baldwin Park - has smoke-free policies for its parks; Compton - has smoke-free policies for its parks; Covina - has smoke-free policies for its parks; Beverly Hills - curb-to-curb, smoke-free parks; La Puente - has smoke-free policies for its parks; Long Beach - Drake park is smoke free; Los Angeles -tobacco-free zones include play areas, baseball diamonds, sport courts and areas, and permitted picnic areas; Pasadena - prohibits smoking in all parks and public golf courses; Santa Monica - curb-to-curb, smoke-free parks; San Fernando - curb-to-curb, smoke-free and tobacco or tobacco-related products parks; and West Hollywood - one pocket park is entirely smoke free. (Not Available) From the above discussion, we can conclude that the passive smoking is as dangerous as actual smoking. The passive smoking is not only the issue of the United States - it is the prevalent issue of the whole world. Every day hundreds of people are dying just because of the smoking related diseases such as lung cancer. It is believed that there is no other way except to ban smoking in the public places to reduce its lethal effects. In the United States, many states have already taken several steps to

The disclosure of sensitive and classified information by persons Research Paper

The disclosure of sensitive and classified information by persons currently or previously employed by or affiliated with the Uni - Research Paper Example However, these sources and not authorized disclosures of the core information. This is also because the press only releases individually and cumulatively. Just like secret intelligent actually works. But however, this is a very major issue. If one is working or has worked with United States federal government, then one should know the importance of keeping your organization secrets to yourself. Being not an ordinary citizen, you are of the key persons of the country to keep in-charge of the national security of the United States. The unauthorized disclosure of classified intelligence has always been extraordinarily been resistant to the authenticity. Though there is a committee named as Foreign Denial and Deception Committee. This organization makes an interagency effort in order to understand how other agencies get to know about and how they try to defeat the US secret intelligence activities, but then even the unauthorized disclosures of classified intelligence still seem to be a s erious problem for the US national security. Where the term classified information means the information, which at the time of violation of the US laws is, for thenational security, specifically designated by a United States Government Agency for limited rights of distribution. George Tenet – the Director of the CIA, said in an interview about unauthorized disclosures, that they have become one of the biggest threats to the survival of the US intelligence. And definitely, what harm the wikileaks did to the US national security, no one would deny it. Though the US law states that whoever intentionally shares any kind of classified intelligence information to an unauthorized person or transmits, furnishes or publishes it in any way which leads to the benefit of any other foreign government or to the insecurity if the United States concerning the preparation or use of any code, design, construction, maintenance or repair of any device or apparatus or communication of any intelli gence activities of the United States with any foreign government shall be either fined or be imprisoned for not more than ten years, or as a punishment may be have to suffer from even both but the steps take to stop the violation of these rules must be improved in order to assure the security of the US intelligence. George England, the Acting Deputy Secretary of Defense while stating the rules and the responsibilities for the national defense of the US in his Reporting and Investigation Guide said that every civilian employee, active or reserved National Military Guard, any member, contractor or an employee of a contractor of the department of defense working with the classified material is instantly supposed to report through any security channel, any suspect disclosing the classified information to anyone. Then further actions will be taken after consulting with the Assistant Secretary of Defense for Public Affairs and other officials after confirming if the information of offici ally released under a proper authority or what. Then further decisions would be made for starting an investigation by some military organization or Federal Bureau of Investigation, which will base on how accurate was the information that was disclosed, how much damage was caused to the national security by the disclosure of that information, how many people gained access to that information, if its investigation will increase the damage caused, the reasonable expectations of the

Antimony Essay Example for Free

Antimony Essay The ancient Egyptians used it as makeup and today we use it in many ways, â€Å"it† is the element antimony. Discovered by the ancients, this element serves many purposes (it is no longer used as eyeliner, like it was for them), but also has many negative effects on people and the environment. Antimony is a metalloid found in group 15. It is a silvery lustrous rock, and its standard state is a solid. It is a poor conductor of heat and electricity. Antimony has many universal applications that are meant to be beneficial to people. One of its usages is in its form of antimony trioxide, is made into a flame retardant frequently used in toys and seat covers. Of its many functions, antimony is commonly used as an alloy to make other metals stronger. It is primarily alloyed with lead to make it harder. Its alloys are frequently used in batteries and cables. It is also used in some food packaging, usually used as a catalyst in manufacturing polyethylen terephthalate. One can come in contact with antimony in many ways. Antimony is found in the environment, but found in very low levels. The majority of antimony comes from the resources humans use. The antimony used in human products increase the amount of antimony in the natural environment. There is some antimony in soil, but high concentrations of it are found in wastes sites. The most common ways antimony can enter the body is simply consuming it or breathing its dusts in. Also contact with soil with high amounts of antimony can increase unwanted exposure. Since antimony is used to produce some types of food packaging, such as plastic water bottles, consumption is much more likely than breathing it in and touching toxic soil. The use of antimony in the medical field is very scarce considering it has negative side effects. To name a few, some utilizations are, compounds of antimony are used as antiprotozoan drugs and veterinary purposes, tending to be used as a skin conditioner, which is quite ironic considering what antimony is known for doing to skin. Antimony is known for having negative health effects. Antimony as well as its compounds are known to be toxic. If one has too much exposure to antimony it can cause major health impairments. A modest exposure to antimony by breathing it in can have an effect on skin and eyes. A skin condition that one can get by contacting antimony is antimony spots. It is a rash of pustules around sweat glands. Its effect on eye health consists of ocular conjunctivitis. Extreme amounts of antimony exposure can lead to more severe effects on the heart and lungs as well as skin and eyes. And although not proven, antimony and some of its products have been linked to cancer. The only way to prevent any of the bad conditions some antimony product provide, one needs to make sure that one gets as little exposure as possible. It is impossible to steer completely clear of antimony, and it is not necessary, a little exposure will not kill a person, but too much of something is never good.

Maintainanse of relationship Essay Example for Free

Maintainanse of relationship Essay The social exchange theory assumes relationships provide both rewards (e.g. sex, affection, intimacy) and costs (e.g. time, energy, money). Everyone tries to max reward for min costs. If a relationship is to continue, people expect the partner to reward them as much as they do. Therefore, the greater the rewards and lower the costs, the more attractive the relationship is. How to judge whether the rewards worth more than costs or vice versa depend on the Comparison Level (CL). CL is the overview of what to expect in the exchange from our past experience. If the person has a bad relationship before, he/she will expect little from the current partner; How satisfactory a person feels depends on the rewards (e.g. sex) and costs (e.g. argument) involved if they have another relationship with someone else (CL alt). The equity theory extends this view. It proposed that people strive for fairness between rewards costs. So, a person expects the same proportion of rewards to their costs; otherwise they will feel distress. This theory can account for individual differences as people have diff. view towards rewards and costs and so what is acceptable may not apply to others. For example, Argyle found that many women feel less satisfied when they are over-benefited in a relationship, whereas many males feel little dissatisfaction. Therefore, it becomes very useful in explaining extreme cases where some people in very unhappy relationship do not dissolve, yet those in mediocre marriages do- this is because the investment is high (e.g. children) and the alternatives are low (e.g. no money) and so people tend to stay (Rusbult). However, the claim that people constantly strive for rewards as motivation to maintain relationship has suggested people are selfish and self-centred in relationships. Yet it may be true to the Western individualistic cultures which emphasises on personal interests, but may not apply to non-western collectivistic cultures. This is because they emphasise on group values and so personal selfish concerns become socially undesirable. Therefore these theories are only relevant to Western cultures (Moghadamm et al). Another theory, the socio-biological theories, states that our behaviours are the result of evolution in order to max the chance of passing on the genes. This would mean all relationships are evolved to increase the survival of individuals and opportunities for successful reproduction. Buss suggested that women often seek older, successful men because these men can support them and their children; whereas men prefer younger women because they are likely to be more fertile than older ones. After successfully pass on the genes, we have to protect them so as to max the chance to pass on further. So we are evolved to form close families to protect our children as they shared genes with us. The closer the genes, the more we prepare to sacrifice to protect them. This is the kin-selection which suggests survival of an individuals genes is ensured by helping close relatives to survive. The claim for kin-selection is supported by Fellner Marshalls study who found that 80% of parents are willing to donate their kidneys to their children. This shows that people with the closest generic relationships (i.e. parents children) are willing to sacrifice to protect each other for their survival, thus support kin-selection. Therefore, this theory has made the specific nature of family worldwide- the enormous resources and energy devoted to children- explainable. This means it appears to gain validity. However, such validity is limited because it cannot explain other common relationships such as homosexuals and close friendships. If the claim that relationships are to reproduce successfully is true, it will not apply to homosexuals as they cannot pass on genes. Furthermore, Grajek found that women love their best friend more than their partners. This cannot be explained by this theory as friends outside relatives cannot help pass on genes and so should be as important as their partner. Grajeks contradictory findings have made this theory insufficient to explain most relationships.

Cultural Values Of The Body Shop

Cultural Values Of The Body Shop I just want The Body Shop to be the best, most breathlessly exciting company and one that changes the way business is carried out. That is my vision. Anita Roddick, Human Rights Activist Founder of The Body Shop This was the vision with which Anita Roddick started off The Body Shop in The United Kingdom. Anita had stepped into this industry in 1976 when she used  £4,000 to finance for a small stand-alone shop of natural-ingredient cosmetics and personal care products. Her idea was inspired from a visit to a shop with a similar name in California. Her aim, at that time, was to support herself and her two daughters while her husband had gone horse-riding for two years. The interior design of her store, product packaging, and marketing approach were all born from survival instinct to support the livelihood of her family. She used dark green paint on the walls to hide cracks (and not in symbolism of the environment!). The clear plastic bottles she used then, that received much appreciation were in fact urine sample containers which she has purchased from a local hospital. She saw success promptly. Her cosmetic store flourished, and she was motivated to open another even before the company had their first anniversary. When her husband Gordon Roddick returned in 1977, he joined hands with his wife in her thriving business. Together they realized that they wanted to franchise the operations of their enterprise during the companys second year. By 1984, The Body Shop already boasted of 138 stores, 87 of which were located overseas, i.e. not within the territory of United Kingdom. Over time, franchising soon took over the number of openings of company-owned stores in 1994 franchises comprised 89 percent of Body Shop stores. Over the years of success Anita decided to support and contribute to social and environmental change through her enterprise. Initially she associated The Body Shop with reputable groups, which include Greenpeace, Amnesty International, and Friends of the Earth. Later she launched her own campaigns, specifically on ones that focused primarily on recycling and abolishing animal testing in the cosmetics industry. Body Shops put up posters and made petition sheets for the customers. Half way through the 1990s, the franchises were also asked to support some of these campaigns a year for such causes as AIDS education, voter registration, and opposition to animal testing in the cosmetics industry. The Body Shop, now has 2,400 stores in 61 countries, and is the second largest cosmetic franchise in the world, following O Boticario, a Brazilian company. The Body Shop is headquartered in Little Hampton, West Sussex, England, is now part of the LOrà ©al corporate group. Cultural values of The Body Shop The Body Shop follows the mission statement: To dedicate our business to the pursuit of social and environmental change. Dame Anita believed that businesses have the power to do good, contrasting with the traditional view of profit-driven businesses. In 1999, few days before third ministerial conference of the World Trade Organization (WTO), she campaigned against WTOs profit-obsessed system that overlooked social and ecological aspects of businesses. These standards transcend to personal values and motivating factors for external stakeholders, employees and consumers to do good for the society and at the same time, act as strategic marketing tools to gain popularity and reputation for the organization. Every product in The Body Shop has a story to tell; each communicates ideas on business ethics, human rights and environmental issues. From raw material extraction to product packaging, every process is inseparable from the firms values. The five core values include activating self-es teem, protecting our planet, against animal testing, supporting community trade and defending human rights. Activate Self-Esteem Dame Anita believed that being confident in appearance and feeling good about self are crucial in developing ones self-esteem and confidence. While The Body Shop uses people to portray vigor, energy and attitude that embrace ones style and self-worth, it does not use very thin and young models to avoid giving the impression that size and age defines beauty, unlike many other beauty products out there in the market nowadays. They look for pink and fresh faces that are full and blossomed. Treating women with respect and empowering them boosts confidence and self-esteem. This belief ties in with the value support community trade as the firm outsources its natural ingredients to marginal communities, using trade to empower women and giving them employment, improving the lives of their family in more than one ways. Volunteerism is intertwined with The Body Shops philosophy of looking good, feeling good and doing well. The global volunteering policy was implemented in 2008, offering all employees at least 3 paid volunteering days yearly and maximum to 6 different locations. An Anita Week was also introduced to encourage employees to undertake additional volunteering activities. Individual self-development is highly embraced as the firm provides leadership training and management development programs for its employees worldwide, providing opportunities for learning, self-improvement and skills upgrading. It also rolled out a Learning is Of Value to Everyone (LOVE) program which funds employees for courses, events, training and health treatment, encouraging them to learn new skills, and stay fit and healthy. Protect our planet The Body Shop dedicates enormous amounts of efforts in its efficient environmental system and continues to review their high, yet achievable targets set through the voluntary European Union Eco Management and Audit Regulation, ensuring constant progress in protecting our planet. The firm pays attention to fine details of supply chain processes. Even when sourcing for natural raw materials, the Body Shop obtains supply only from those sustainable plantations and rainforests, ensuring no deforestation or destruction of fragile ecosystems associated. Since the beginning of 2008, all soaps have been sourced from suppliers successfully audited against the Roundtable on sustainable palm oil (RSPO) criteria. With the progress of obtaining its 63% of wood from sources managed by the Forest Stewardship Council (FSC) in 2008, The Body Shop aims to source 100% of its wooden products by the end of 2010. In 2001, the Body Shop partnered with Greenpeace International in a joint campaign, raising awareness on renewable energy to combat global warming. In becoming a Carbon Neutral Retailer the firm actively seeks renewable sources, achieved 30% reduction of store carbon emissions and reduced emissions from transportation of products by using 93% hybrid cars and offsetting all air travel. Even at the end of life of each product, environmental considerations are taken into account. While as little packaging is used for all products, recycled used plastic known as Post Consumer Recyclate (PCR) is used to make bottles of the products that are sold are retailed. Also, the 100% recyclable and 100% biodegradable paper bags used in all stores are strong enough to be re-used several times after being taken from the stores. They even looked into delicate details such as use of water-based ink that contain no harmful solvents. The meticulous nature of this kind is remarkable. The Body Shop carefully selects chemicals, ensuring the quality, safety and efficacy of products to maintain a good environmental record. It resorts to use of synthetic chemicals only when there are no other appropriate natural alternatives available. With regular reviews, following up updates on environmental research on chemicals and constantly refining guidelines for product production, the Body Shop phases out and bans chemicals that are harmful, i.e. polycylic musk that contributes to the fragrance component. Against Animal Testing The Body Shop is known for its effort in advancing Cosmetics Directive successfully in March 2009 to ban animal testing on all cosmetic products in The European Union. It is one of the few firms that adhere to the Human Cosmetics Standards(HCS), an internationally-recognized scheme that allows consumers to identify and purchase cruelty free products. While the Body Shop collaborates with suppliers endorsing non-animal testing ingredients only, it has regular audits both internally and externally to ensure adherence to HCS. The Body Shop invests heavily in developing alternatives for animal lab-based tests. Recently, it bought Loreals non-animal skin irritancy test technology which develops artificially grown human skin for all Body Shops product testing. Even where animal-derived ingredients are used, the Body Shop commits that these ingredients do not cause or derived from the death of animals and they are suitable for vegetarians use. Common animal-derived ingredients include bees wax, honey, wool wax (lanolin) and shellac (resin secreted by lac bug). Community Trade Community trade is another aspect that The Body Shop has been actively practicing. Being the pioneer of the program, the company performs a fair trading relationship with its suppliers which involve income fairness, community development, and predicable supply. In line with the values, the organization has been trading with communities from third world countries with regards to ingredients used, gifts and accessories. Such an approach is utilized so that these communities will be able to benefit from the trade and use the financial resources to develop the area around them and for education of the youth. To begin with, natural ingredients are obtained from marginalized communities from Brazil to Samoa. Ethical concerns are addressed by ensuring workers human rights are in accordance to international standards. Most importantly, child labor and excessive hours are prohibited as suppliers adhere to The Body Shop Code of Conduct. Moreover, to tackle the issue of deforestation, palm oil for Body shops products is sourced reliably to prevent deterioration of this global phenomenon. Over the past years, new trade relationships have been forged with communities such as Kenya Organic Oil Farmers Association and CADO from the mountains of Ecuador. The organization have also traded with Teddy Exports, a manufacturer based in Tamil Nadu with the aim to solve social problems in the region by exporting timber and textile related products to both domestic and international market. In all, over 25, 000 people in more than 20 countries have benefitted from this approach. Defending Human Rights Not all social issues can be resolved due to inadequate awareness and low coverage by the media. Thus, the company decided to focus on areas of social issues that are usually ignored in an attempt to overturn the situation. One example of social issue faced by the world is domestic violence. To put a stop to the rampage of this human right abuse, The Body shop aided by raising awareness of the public, generating funds for the victims and their families as well as work alongside with governmental bodies to prevent at-risk and affected individuals. Increasingly over the years, there has been a rise in markets undertaking the campaign of Stop violence in the home. Since The Body Shop is not expert in working on the issue, funds were raised and contributed to non-governmental organizations that focus on them. Training programs were also administered to employees globally enabling them to become active campaigners rather than passively promoting the issue. In total, more than 375 million of children are affected positively and the markets participating in the campaign raise both funds and awareness to protect the children from further harm. Another social issue faced is the prevalence of HIV and AIDs, where The Body Shop has been partnering with MTV international to increase the awareness amongst young people and raise funds for the fight against the issue. Raising awareness of how the disease is transmitted is one of the best ways to prevent the spread of the epidemic, as prevention is always better than cure. Amounts are also granted to entrepreneurial projects to reach out to youths at risk ad keep them safe from HIV. More markets around the world have also joined in to reach out to millions of young people worldwide. Till date, the Body Shop has made some notable achievements around the world: Organized street march in Seoul, calling for the government to provide better rehabilitation services, more financial assistance and increased protection for victims of domestic violence Sponsorship for the site to tie in with Stop violence in the home campaign in Switzerland and took the message in classrooms. Long term partnership with The National Coalition Against Domestic Violence to help create awareness in US. Programs such as Face-to-Face reconstructive surgeries for victims to rectify fatal injuries caused by domestic violence benefitted from the funds that were raised. Charitable Organization Last but not least, the organization set up a charitable trust known as The Body Shop Foundation that annually donates to more than 3000 projects around the world. To induce social and environmental changes, innovative projects are funded to aid in promoting the common good. Currently, the foundation is working on environmental conservation in Romania, education in Zambia as well as domestic violence initiatives across Europe and child trafficking in Asia. Critiques Authenticity of Claims In reinstating its position as a company that cares for its environment, Body Shop claims to be many things: To use all natural products To be involved with environmental protection Trade not aid Anti-animal testing Natural Products Despite its claims, many of the ingredients used are not being disclosed appropriately and are dubious with regards to origins. This is unlike industry norm wherein companies marketing the same products would in their packaging state the original sources of their ingredients. Any discerning consumer should note that the seemingly superiority attached to the word natural over man-made is not always guaranteed. In actuality, many natural ingredients can conjure allergies and are thus less safe than the well-tested synthetics. Moreover, the marketing counterparts of consumer companies are quick to exploit the loophole due to deficiency in universal meaning accrued to the word, natural. The public at large may gullibly assume a product that reads 100% natural to be free from any synthetics, when in fact; they may just as well be derived from petrochemicals. Although synthetic chemicals were said to be introduced only to prolong shelf-life of its products, it has been shown that they were used for other reasons as well. In fact, the Body Shop has used synthetic colourings and fragrances widely in their line of products. In fact, these cheerfully-coloured perfumes and lotions became part of the companys trademark. In effect, this seems a case of exploitation the word natural. Environmental Protection Given its extensive greening efforts, ranging from sourcing of ingredients to materials for packaging, the Body Shop serves as a Green Model for other companies. Even so, there exist some environmental contradictions and setbacks. Long gone are the days when the Body Shop offered the option of refills for customers as part of its innovative take at reducing packaging and waste. However, it is due to the heightened safety-regulatory issues that this service has been terminated. To overcome this setback, the Body Shop uses recycled materials in manufacturing of the packaging. This allows for significant reduction of resources, bypassing the need for customers to transport them back. Also, standing in contention with the 100% recyclable paper bag, in 1993, the Body Shop switched to printing their pamphlets on ReComm Matte paper from Georgia Pacific, infamous for rainforest logging. Trade not Aid Whilst the Body Shop claims that it ethically sources its products and takes prides in its Trade Not Aid policy, which pays first world prices to third world workers. The impact of this program is queried by many industry observers and critics. For instance, according to renowned journalist, Jon Entine, the company failed to match up to its claims and commitment on emphasizing trade with other third world countries. In fact, in 1993, these products made up less than 1% of Body Shops overall purchases. In particular, the controversy centered its sourcing of Brazilian nuts. Broken promises to former face of this promotion, Kayapo Chief, Pykati-Re, landed in a successfully lawsuit against Body Shop International (BSL) for exploitation of the natives image. In words of Dr Turner, Body Shop gets the aid in the form of native images and in return, natives get almost no tradein return. Currently, the term has been replaced by Fair Trade. Nevertheless, Roddick has facilitated the idea that trade was superior to aid, in the long run; poor people were better off with businesses of their own, rather than with dependency on handouts. Animal Testing What immediately conjures to mind when we think of the Body Shop? The phrase Against Animal Testing is bound to be amongst the first. It is pivotal that we note that this was a fairly recent phenomenon, with BSI revision (in1996) that they will cease to use an animal-tested ingredient for the cosmetic industry after December 31, 1990. Their efforts today are evident in clearance of the regular audits which ensures adherence to Human Cosmetics Standards (HCS). However, an internal memo exposed in 1992 suggests that almost 50% of the companys products are linked with animal testing. According to Hoffman LaRoche, vice president of cosmetics specialties, Dave Djerrasi , purchased animal-tested Vitamin E acetate in 1991 from Hoffman LaRoche for use in sunscreen. Franchising and IPO According to Paul Burns an observer of the company, Body Shop brand is inexorably linked with its culture, which in turn is based firmly in its ethical and environmental beliefs and values. However, with its extensive franchising and expansion to different location across the globe, there appears to be a dilution of its corporate culture. For instance, according to Paul Burns, in Body Shop, employees are given time off to work on local social projects, however, it would be very difficult to enforce this on every single Body Shop outlet across different countries, even if they were to state it in a clause, enforcement itself would be difficult too. In relation to their massive expansion and foray into the equity market, as any finance and behavioral management would postulate, a decrease in ownership stake would meant less incentive for the owners to be involve in the company which also arises from lesser control over their company. For the case of Body Shop, after a failed attempt at re-privatization and voluntarily limiting their involvement in the company, the Roddicks eventually resign from the company in 2000. This is especially detrimental to Body Shops image as Anita is often regarded to be the human face of Body Shop and the soul of its many humanitarian initiatives. Hence, Body Shops authenticity as an activist for the environment is increasingly challenged as Body Shop expands. The Loreal Takeover The companys authenticity as an activist for the environment is further challenged after takeover by Loreal -a large MNC with an opposite business culture as Body Shop: ruthless profit maximization versus profits with a conscience. In an attempt to lessen the connection between Loreal (an MNC) and Body Shop, Loreals CEO reassures that Body Shop will be run as an independent subsidiary from Loreal. Roddick justified the decision to merge with Loreal using the Trojan Horse Theory, which means that to enact any change, The Body Shop has to enter the company. However, it remains questionable as to whether full autonomy is really possible given the strong capitalistic outlook of Loreal and if two distinct corporate culture remained independent from each other even after merger. Conclusion At its heart, Body Shop is a profit-generating company, the very fact that it is a listed company meant that its main obligations stems from its promise to its investors to generate revenue that matches with their expected return on this investment. The question remains as to whether Body Shop is able to fulfill its dual responsibility: one to its investors and the other to the environment; and whether these two responsibilities are inherently contradictory with one another. When Dame Anita Roddick began her campaigning ways, social marketing was a radical stance in the corporate world. Now, every part of the company appeared to be going green. Arguably, many of these socially responsible initiatives have their origins in promotions embraced. This raises an important question: What is Anita Roddicks real legacy? Did The Body Shop walk its talk as Anita and her husband, Gordon used to boast? However, the fact still remained that the Body Shop had a good record of environmental audit and disclosure. The Body Shop was a signatory of the CERES principles, an environmental code of conduct that was created by environmentalists and social investors. Apart from that, the Body Shop was one of the few companies to have an efficient environment management system and environment audit which followed the voluntary European Union Eco Management and Audit Regulat References Funding Universe. (2003). The body shop international plc. Retrieved from http://www.fundinguniverse.com/company-histories/The-Body-Shop-International-plc-Company-History.html Hope, C. (2005). Anita Roddick to give away entire  £51m fortune. Telegraph.co.uk. Retrieved from http://www.telegraph.co.uk/finance/2928175/Anita-Roddick-to-give-away-entire-51m-fortune.html National Post. (2007). The myth of the green queen. Retrieved from http://www.canada.com/nationalpost/news/issuesideas/story.html?id=41bea314-6b01-4697-83c1-593f4a22d0c1 National Public Radio Morning Edition. (1994). Body Shop International takes heat with ethics charges. Retrieved from http://www.jonentine.com/articles/NPR.htm Paul, B. (2010) Case Studies in Entrepreneurship. Entrepreneurship and small business. (3rd Ed.) Retrieved from http://www.palgrave.com/business/burns/students/pdf/06%20Body%20Shop.pdf Roy, S. Ghosh, L. (2008). Business as unusual: A case study on the Body Shop. Journal of Applied case research. Retrieved from http://www.swcrahome.org/Cases/Body_Shop.pdf The Body Shop International PLC. (2008). Chemicals Strategy. Retrieved from http://www.thebodyshop.com/_en/_ww/services/pdfs/AboutUs/BSI_Chemicals_Strategy.pdf The Body Shop International PLC. (2009). Living our values: values report 2009.Retrieved from http://www.thebodyshop.com/_en/_ww/values-campaigns/assets/pdf/Values_report_lowres_v2.pdf The Body shop International PLC. (2010). How we make our customers and employees feel good about themselves? Retrieved from http://www.thebodyshop.com/_en/_ww/services/pdfs/AboutUs/BSI_Chemicals_Strategy.pdf The Body Shop International PLC. (2010). Our history. Retrieved from http://www.thebodyshop.com/_en/_ww/services/aboutus_history.aspx

picturing society :: essays research papers

In the article, Family Photograph Appreciation, Richard Chalfen discusses a teenage view of the relation between family snapshots and home videos. He first explains the value of personal photos using an example of natural or humanly coerced disasters and the mourning of visual traces of the past, or in other words, photographs. Family photographs are a very important aspect of peoples lives and without them we may never remember our past. By looking at snapshots, slides, home movies, etc, we stimulate our memory of important dates and events. He asks many questions about memory and video verses photography which will be discussed with teens he has interviewed.   Ã‚  Ã‚  Ã‚  Ã‚  Chalfen has structured an exploratory project that asked a small sample of thirty teenagers, living in the Cambridge/Boston areas of Massachusetts to evaluate the relative merits of using still photography and/or videography as a preferred medium of family photography. (Richard Chalfen) He conducted the interviews with two teens at a time while having a meal in a small restaurant. He was interested in their opinions on comparing photography and videography, which came out to be very interesting.   Ã‚  Ã‚  Ã‚  Ã‚  The teens explained to him about the effects of video tapes and how they were a way of â€Å"being there† all over again. Some of them felt it was more realistic than flipping through a picture album. Here we will introduce a few more of the theories made by teens during their interviews. Videotapes seem to supply the viewer with more information and makes it easy to remember. You get sound and movement to enhance the overall effect which brings you to see the whole experience. In many interviews the teens did not feel that videos were the best way to go. By looking at photographs it set off a whole lot of memories, not just what happened play by play like a home video. By looking at photographs you can use your imagination and over the years the stories from one picture will grow and change. You don’t have to think when you watch videos but by looking at photographs you search your memory for the details. One girl explained that she can look at photos over and over but watching a video will get boring after a few times. Perhaps we can conclude from this that there is a higher liking of still photographs over videography by most teens. They seem to be willing to put some work into collecting this important information.   Ã‚  Ã‚  Ã‚  Ã‚  To explain the difference, Chalfen discusses some examples, such as the two acting as memory aids in their own significant way.

Biography Of Miles Davis Essay -- Jazz, Biographical, Music

Biography of Miles Davis Born on May 26, 1926, Miles Davis is considered to be one of the most influential jazz musicians in history. Being a trumpeter, keyboardist, composer, and band-leader, Miles is responsible for the popularization of many styles of jazz throughout his long and prolific career. Miles Dewey Davis was born into a well-to-do family in the town of Alton, Illinois. The family owned a large portion of a farm where Miles learned to ride horses as a young boy. In 1927 the family moved to East St. Louis. Miles' mother, Cleota Henry, encouraged him to play the violin while his father bought him a trumpet when he turned thirteen and arranged his first lesson with trumpeter Elwood Buchanan. One of the main reasons Miles' father chose the trumpet is due to the fact Cleota was annoyed by its sound. His teacher stressed a style of play that did not involve vibrato. Miles carried this style throughout his entire career. Buchanan would rap Miles' knuckles with a ruler every time he used vibrato. Miles had numerous offers from bands when in high school but his mother insisted he finish school before he continued with his music career. In 1944, the Billy Eckstine band came to St. Louis. Prominent jazz figures during the time including Dizzy Gillespie and Charlie Parker were part of the band. Due to one of the band members being ill, Miles took on the position of third trumpet for a couple weeks. After the band resumed its normal condition, Miles was left behind to finish his academic studies as requested by his parents. ... ...ived the Grammy Lifetime Achievement Award. Due to constant health issues in his later years, Miles passed at the age of 65 due to stroke, pneumonia and respiratory failure. Though Miles Davis' life ended at a rather early age, he left behind work that no other could attempt to emulate. His music is still enjoyed by those of all ages and will be renowned for the future of jazz music. Works Cited 1. "Miles Davis." Rock and Roll Hall of Fame. 6 Aug. 2007 . 2. "Miles Davis." Wikipedia. 6 Aug. 2007 . 3. "The Biography of Miles Davis." 6 Aug. 2007 .

Education: Its Aims And Objectives Essay

â€Å"Education†, says Aristotle,† is the creation of a sound mind in a sound body†. It encompasses in itself the all round development of an individual. The success of spreading education to the widest possible area lies in the way it is imparted. With the ever changing technology scenario, the methods of imparting education too have been undergoing changes. But education itself is an age old process, rather as old as the human race itself. It was man’s education through Nature, our greatest teacher, that he learned how to make fire by rubbing stones or invented the wheal to make tasks easier. Education in real earnest helps us in restraining the objectionable predisposition in ourselves. The aims of education have been categorized variously by different scholars. While Herbert Spencer believed in the ‘complete-living aim’, Herbart advocated the moral aim. The complete living aim signifies that education should prepare us for life. This view had also been supported by Rousseau and Mahatma Gandhi. They believed in the complete development or perfection of nature. All round development has been considered as the first and foremost aim of education. At the same time education ensures that there is a progressive development of innate abilities. Pestalozzi is of the view â€Å"Education is natural, harmonious and progressive development of man’s innate powers. † Education enables us to control, give the right direction and the final sublimation of instincts. It creates good citizens. It helps to prepare the kids for their future life. Education inculcates certain values and principles and also prepares a human being for social life. It civilizes the man. The moral aim of Herbart states that education should ingrain moral values in children. He is of the view that education should assist us in curbing our inferior whims and supplant them with superior ideas. This moral aim has also been stressed upon by Gandhiji in the sense of formation of character. The preachers of this aim do not undermine the significance of knowledge, vocational training or muscular strength. But simultaneously they have also laid stress on their view that the undisclosed aim of education is to assist development of moral habits. Then there is the social aim which means that education should produce effective individuals in the sense that they realize their responsibilities towards the society. And we all know that man is a social being. The interactive ability is a must as it is through interaction that we come to know of our responsibilities. Edmund Burke asks and he himself answers: â€Å"What is education? A parcel of books? Not at all, but an intercourse with the world, with men and with affairs. † Only bookish knowledge takes a child nowhere. It should be further perfected by practical usage with experience. â€Å"Reading maketh a full man; conference a ready man; and writing an exact man† is a pithy and precise statement in which the essayist Francis Bacon sums up the advantages of studies. Even Wordsworth in his poem ‘The Tables Turned’ advocated against bookish knowledge. Books! ’tis a dull and endless strife: Come, hear the woodland linnet, How sweet his music! on my life, There’s more of wisdom in it. Wordsworth was a die-hard naturalist. He wanted man to consider Nature his teacher. Naturalists believe that instincts of the child should be taken as the basis of education. The child should have freedom. Rabindra Nath Tagore was of the opinion that child should be left free in order to gather experience and to understand his own mistakes and shortcomings. The twentieth century saw the emergence of the concept of Pragmatism. Charles Pierce was the first man to introduce the concept of pragmatism in his philosophy. Later on it was popularized by John Dewey, William James, Kilpatrick and Schiller. They believed that the external world is real and the reality is being constantly created and is always changing. Knowledge and truth is one and the same thing according to them. Whatever the approach towards education, one thing we all agree: Education is for the betterment of the individual and in the long run for the society. Education helps us prepare ourselves for the life ahead. Darwin gave the theory of the ‘survival of the fittest’; we can say in a way that education prepares the individual for the struggle of life for his own survival. Knowledge combined with proper guidance can spell success. A dose of proper guidance should be commenced right from the base itself, that is, in school days. Here comes the role of the teacher in moulding a child’s mind. Educating a child, especially in the beginning years of schooling, is a very tricky job. That is probably because the child’s mind is like the unmoulded clay at that time. Therefore to get the best results and prepare well-informed and erudite adults, proper guidance is a must. For a proper system of education the teacher should encourage a student both in terms of mental encouragement and in lending a helping hand as and when needed. A student needs help for training his mind in such a way that it develops a tendency to gather knowledge from all possible sources. While on the other hand too much help if lent to him will make him dependant and used to spoon feeding. Self-study is the most sought after quality in a student. It helps them at the later stages. But because the ‘child is the father of man’ (Wordsworth) all the qualities have to be inculcated right in childhood. And teacher along with parents plays a very significant role. The aims of education should be kept in mind, although a thorough study of these aims may not be imperative. A teacher should make a child ready to face the society, inculcate moral habits in him and thus, assist him in his all round development. Education should not be considered synonymous with all that we learn. It does not signify the things we mug up before appearing for an examination. Education is what remains behind, when we fail to remember the mugged up portion. After we have left school, we realize that although we have forgotten quite a few things we learnt but still retain a very large part of it. The latter part is education. Education formally begins in school but actually it begins the day we are born and the process goes on for the whole of our life. This is where the aims of education come in. Education is not only the formal part we gain in schools, colleges or universities. It also includes the lessons life teaches us in various forms. For instance, when a child gets his finger pricked by a needle accidentally he learns that a needle is sharp and can hurt a person, so he will learn to avoid hurting himself in the future. This is only one example from thousands of other instances. We can even learn a lesson of a lifetime from a beggar. The birds inspire us to rise high. An ant motivates us for hard work. We learn some things just by doing them on our own, they are never taught in a school. A child’s first teacher is his mother, then his home and then come the formal agencies of education. Nature too is a great teacher. English poetry too gives us quite a few guidelines for leading a better life. It was not for nothing that Wordsworth went on to remark: â€Å"One impulse from the vernal wood May teach you more of a man Of moral evil and of good Than all the sages can. † As long as there is life, we require education; we need ways to modify our views about life, to face it, to live it in a better way. And education teaches us all this. Even when you read a comic strip, it educates you in some way. They improve our language and make us realize that life isn’t so bad after all that it can’t get worse, as states Bill Watterson in ‘Calvin and Hobbes’. The witty humour of ‘Dennis the Menace’ enriches us no end. â€Å"The aim of education,† says Walter Grophices, â€Å"is not the specialist but the man of vision who can humanize our life by integrating emotional demands with our new knowledge. † In another way too, the insects and animals also teach you a lot. The easiest example is that of an ant. It inspires you to work hard. Therefore we can say there are innumerable modes of education, all that one needs is to have a discerning eye. Education enriches a person in terms of accepting a defeat. A student should first of all be taught so that he is encouraged to study. Side by side he should be readied to face a failure. As Charles F. Kettering rightly says,† The chief job of the education is to teach people how to fail intelligently. † This will help the child coping with the other adversities of life. Education, thus, makes a person an improved version of himself and the world a much better place to live in.