How to write a research paper for kids
Tuesday, August 25, 2020
Current Issues in Business Ethics and CSR Essay
Current Issues in Business Ethics and CSR - Essay Example See the remarks nearby the content for insight concerning course material that truly would have been helpful help for focuses you make. You additionally discard 10% of the imprints accessible by not composing a self-reflection on your group bunch introduction. Of the 60 or so understudies on the module you are just about the only one not to present a self-reflection-why? This criticism is being offered for reasons for guidance and direction and to help your learning and advancement in this module. References to gauges or stamps are altogether temporary and subject to affirmation following University systems. Just University Assessment Boards can give affirmed, complete marksâ⬠ââ¬Å"The issue with sweatshops is that there are insufficient of themâ⬠(Jeffrey Sachs ââ¬Å"The End of Povertyâ⬠). Considering the Rana Plaza Bangladesh sweatshop fire that executed 1,100 individuals (2013) is it wrong to cherish sweatshops? Business morals includes the idea of social obligation towards the partners. The partners incorporate the financial specialists, clients, workforce, and government. They are those individuals who are associated with the corporate procedures and furthermore are affected from the corporate choices and any progressions that occur in the corporate. Corporate partners are additionally those individuals who can influence the corporate choices and working too (Werther and Chandler et al, 2010). Partners, particularly the workforce should be given equivalent chances and their privileges must not be abused. The workforce drives the corporate capacities, particularly the individuals that work in the lower classes as in sweatshops. These gatherings of individuals follow requests and work for the creation of products for the organization working for extended periods of time in a day. The partners of an organization should be fulfilled and their requests need to met consistently (Werther and Chan dler et al, 2010). This is on the grounds that as referenced before they are very
Saturday, August 22, 2020
Alexander the Greatââ¬â¢s Legacy Free Essays
Alexander the Great was perhaps the best broad the world has ever observed. His assurance helped him spread the Greek culture (additionally called Hellenism) all through his realm. In a short thirteen years, Alexander vanquished the Persians and controlled probably the greatest realm ever. We will compose a custom exposition test on Alexander the Greatââ¬â¢s Legacy or then again any comparable theme just for you Request Now Lead by his dads partiality against the Persians and famous personality has lead numerous history specialists to ponder, was Alexander extremely extraordinary? Alexanderââ¬â¢s first fight was with the Persians at Granicus River in 334 B. C. E. By the accompanying spring, Alexander controlled the whole western portion of Asia minor. The Persian lord, Darius the third, attempted to stop Alexander however fizzled at Issus in 333 B. C. E. After his triumph Alexander at that point turned south and by the winter of 332 B. C. E, Alexander controlled Syria, Palestine, and Egypt. In 331 B. C. E Alexander indeed battled the Persians at Gaugamella in the Northwest of Babylon. After his triumph Alexander entered the Persian legislative centers of Susa and Persepolis and ravaged the entirety of the gold and fortunes of the city. Not happy with his triumph over Persia, Alexander kept on pursueing the Persian ruler Darius the third just to find that he had been slaughtered by one of his own men. This lead Alexander to go east to India. Depleted and exhausted of one more fight, Alexanders men mutinied against him and constrained him to withdraw from India. Alexander had made one the greatest realms the world has seen, yet unfit to leave a beneficiary, it fell similarly as fast as it rose after his demise at 32 years old. Some theorized that fever or over the top liquor utilization lead to his demise, others accept that he was harmed. Climate he had plans for a world realm are obscure, however in his dads last wishes he answered to advise Alexander to â⬠grow your domain for the one I left you isn't sufficient. â⬠Was Alexander extremely extraordinary? Alexander was a self announced decedent of the Gods, guaranteeing that he was identified with Hercules. He was known to kill dear Friends and guides in the event that they restricted his desires and had a brutal temper. Before the finish of his rule, Alexander has butchered thousand whose solitary wrongdoing was being in his manner. His personality persuades that his armed forces prevailing inspired by a paranoid fear of Alexander as opposed to his administration. Be that as it may, Alexanderââ¬â¢s heritage was significant. He crushed the Persian realm and spread Hellenism all through the terrains. Without Alexander, the Greek culture would have fell and passed on nearby the realm. References: 1. ââ¬Å"Alexander the Greatâ⬠. Joseph Cortelli. Historyofmacedonia. organization Web. 13 July, 2013 2. William J. Duiker, Jackson J. Spielvogel. Cengage Learning: World Civilizations 1. 2009 Manson, Ohio. Step by step instructions to refer to Alexander the Greatââ¬â¢s Legacy, Papers
Wednesday, July 29, 2020
Behold, a day job!
Behold, a day job! This summer at nerd camp, I heard about a band called The Pipettes. I spent more time than necessary looking into the origins of their name and hoping its selection somehow involved science, since I pipette things all the time. As it turns out, the name is simply part of this 50s-British-girl-group kitschy image theyre trying to pull off, which has nothing to do with science at all. I was crushed. (The feeling lasted about two seconds. Give me some credit, people Im not that big of a nerd, although I do occasionally go OMG SCIENCE! about things.) I just shared that with you for two reasons, the first being that I already go to MIT; denying my nerdiness is futile, so I might as well be unabashedly proud of it. The second one involves what I do all this pipetting for: lets talk about my UROP! (You want some wine with that cheesy intro?) Remember this Paint-classy picture of how far I walk every day? It still applies. (The fun part comes when Im standing at the west parallel of EC, since I can see both my window at work and my window at home.) Last September, I started a UROP in the OConnor Lab. The labs a part of the chemistry department; our research, however, is centered around the natural compounds produced by the periwinkle plant C. roseus, so a major part of what we do involves techniques in molecular biology as well as biochemistry and organic chemistry. I came across the labs website last year when I was looking for a summer job, and the work they were doing sounded really interesting. Since Sarah OConnor was one of my 5.12 professors at the time, I stayed after class one day and told her what I thought. I also asked for a job. The exchange went exactly as awkwardly as it sounds. Um, I dont actually have a question about lecture today, but I was looking at the webpage for your lab and what you guys do sounds really cool. Can I have a UROP? It couldnt have been that bad, though rather than immediately turn me down (which is what I thought would happen its hard to find a UROP if you start looking too late in the year), she asked me if I was okay with starting in the fall instead. I spent my summer at CTD instead and started working with a grad student at the start of the fall term. Since last semester was my first experience with anything in a lab outside of the experiments in AP Bio, I spent most of the term learning basic lab techniques and playing around with bacteria. More than once a week, you could hear me swearing loudly at petri dishes Id inoculated with mutant strains of E.coli Express my f***ing protein! EXPRESS! Dont make me have to do this again Thisll start happening again in the spring. (Im sure everyone in the lab misses it.) My project this IAP, though, involves running kinetic reactions for twelve different analogs of one compound, secologanin, to find out whether any of these new substrates react more effectively with the enzyme strictosidine synthase (STS) than regular ol secologanin. (I referenced Wikipedia! Twice! If this were a paper for a class, Id be in hot water right now.) If youve ever taken samples while running kinetics before, you know that it essentially works like this: A three-sample example of what Ive spent the last two weeks doing at my UROP 0:00:00 Start first reaction. 0:00:30 Start second reaction. 0:01:00 Start third reaction. One hour and fifty-six minutes of downtime, during which I prepare LC-MS vials for the rest of the day, look for summer research programs my GPA is too low for me to be accepted into, and take care of the million emails Ive received from people about Wild Party or prefrosh who want to know how to get into MIT 1:57:21 Suddenly remember Im supposed to take samples of the reactions at the two-hour mark. Wonder whether Ive missed it. Panic, run to my bench, spin down samples, wait. 2:00:00 Take sample from first reaction. 2:00:30 Take sample from second reaction. 2:01:00 Take sample from third reaction. Repeat at 3, 4, and 5 hours. This is my last week working full-time, though Ill be taking a three-unit neuroanatomy class (braaaaaiiinnns, yay!) for four hours every morning next week, and then spring semester will start. (Already?! Didnt IAP start around two seconds ago?) Next week is also prod week known as hell week to anyone who has ever been involved in theater for Wild Party, so Ill be swamped with producery things until we close on the 9th. If youre in the area, come see us! Itll be wild. Some might even call it a wild, wild, party. Its almost 2:00:00, so thats all youll get from me today. Im about to show off my pipetting skills like nothing else.
Friday, May 22, 2020
Mr. Robert Worstell s Invisible Man - 1937 Words
Jordan Welty Mr. Robert Worstell AP Literature and Composition Wednesday, August 26, 2015 In all stories, novels, and plays, cultural, physical, and geographical surroundings not only affect the plots of literature, but also shape psychological and moral traits in all characters. Pauline Hopkins said in Contending Forces, ââ¬Å"And, after all, our surroundings influence our lives as much as fate, destiny, or any supernatural agency.â⬠This can be seen in Ralph Ellisonââ¬â¢s Invisible Man. In the prologue of the novel, the narrator immediately tells the reader that he is an invisible man, but he is not talking about physically. He states, ââ¬Å"I am invisible, understand, simply because people refuse to see me. That invisibility to which I refer occursâ⬠¦show more contentâ⬠¦I never told you, but our life is a war and I have been a traitor all my born days, a spy in the enemyââ¬â¢s country since I give up my gun back in the Reconstruction. Live with your head in the lionââ¬â¢s mouth. I want you to overcome ââ¬â¢em with yeses, undermine ââ¬â¢em with grins, agree ââ¬â¢em to death and destruction, let ââ¬â¢em swoller you till they vomit or bust wide open. Learn it to the younguns,â⬠(Ellison, page 16). These words had an impact on the narrator all throughout his life and led to him accepting his invisibility at the end of the novel. When the narrator was a junior in college, he had his first experience with betrayal. He was asked to drive a wealthy white trustee of the college named Mr. Norton around the campus. Mr. Norton asked the narrator to drive him to the old slave quarters, where he meets a sharecropper named Jim Trueblood. After listening to Trueblood talk about getting his own daughter pregnant, Mr. Norton began to feel faint and asked the narrator to get him some whiskey. The narrator took him to the Golden Day, a saloon for black people and mentally imbalanced veterans. Once Mr. Norton regained consciousness, the narrator got him back to the college and had to face Dr. Bledsoe, the president of the col lege. Dr. Bledsoe was very angry with the narrator for not showing Mr. Norton an idealized version of black life. Dr. Bledsoe lectured, ââ¬Å"Ordered you? He ordered you. Dammit, white folk are always giving orders, itââ¬â¢s a habit
Saturday, May 9, 2020
Health Related Essay Topics Guide
Health Related Essay Topics Guide Life After Health Related Essay Topics The expense of prescription drugs is too significant. A conventional medical insurance plan in which you opt for the doctors is the very best. Just take a test to see whether you're at risk for absolutely any dangerous disease or virus. Why the brain is so crucial. Knowing your ancestry is essential for health. Unfortunately, huge numbers of people have never been insured. Why you ought to be a blood donor. An increasing number of individuals are experiencing health problems brought on by a modern life style which cannot be treated with modern medicines. Provide certain examples of how you've been affected including services you have used, care you've received, or knowledge and information you use to produce health decisions. Why taking a vacation is beneficial for your wellbeing. The price of running the health care is extremely costly. The expense of employing qualified personnel in the medication field is another issue accessible. The Benefits of Health Related Essay Topics Training to compose essays on various topics is going to be the ideal preparation to the exam. For many students, selecting the most suitable topic is easily the most challenging part of making a literature review. The topics aren't restricted to the above topics only, you can always locate an inspiration from different sources and write about them. There are a few great topics to think about when deciding on a topic for your argumentative essay. There are lots of aspects about a sport that may be argued in an essay. Once you comprehend the kind of essay, it's time to choose a topic. To put it differently, the politician who would like a vote, or the fake news websites that just need a click. Strictly don't utilize Wikipedia you will surely get penalty for it. Such essays shall have a good deal of quotations, based just on facts and laws, and show no more than the true picture of the circumstance. Argumentative essay topics are so important since they are debatableand it's important to at all times be critically considering the world around us. The topics for argumentative essays are often quite self-explanatory they're common understanding. Recent argumentative essay topics that are related to society is going to do. What you aspire to teach your reader will decide on the sort of your essay. Because of our free texts, you have the newest information that's prepared by our experts in writing. The same as the essay type name suggests, it's supposed to inform. When you choose the best topic you shall allow it to be attractive to the reader. Why exercise is very good for you. Wearing pajamas in bed is helpful for your wellness. Fire safety awareness should be raised. Teen suicide awareness should be raised. Our life is about words. Tattoos mean unique things to various men and women. Write about how they are created. Taking a peek at what others have written before will provide you with a very good idea about what depth and complexity is expected for your writing. Remember that you may make funny argumentative essays if you do a few things. To be certain you are on the most suitable way you require help in writing your paperwork. When you want assistance with something such as finding sources of literature review ideas or if you will need help locating a topic, we're here to supply you with the assistance you are searching for.
Wednesday, May 6, 2020
Foundations of physiotherapy practice Free Essays
string(139) " strength may be directly linked with the fact there is a decrease in activity of the lower limbs in patients with COPD \(Thomas, 2006, p\." Introduction The aim of the essay was to explore COPD in both theory and practice in correlation with the three main body systems. The body systems investigated in detail where the respiratory, musculoskeletal, cardiovascular and the neurological systems. Each system was researched for the effects it has on exercise intolerance, quality of life and the limitations that develop for a patient as a result of COPD. We will write a custom essay sample on Foundations of physiotherapy practice or any similar topic only for you Order Now The role of pulmonary rehabilitation is inspected throughout the essay and its significance in the management of patients with COPD is expressed immensely within the context of the essay. There is an evidence based background to the exercise program used for the leaflet; it underpins the importance of using both endurance and strength training in order to improve some of the symptoms of COPD. The use of breathing exercises and techniques is also incorporated as it is a substantial part of the rehabilitation program. The role of the physiotherapist is fully established in the essay. The physiotherapist is recognised for his/her role in each aspect in the management of the condition. Chronic obstructive pulmonary disease (COPD) is a disease defined by airflow limitation that cannot be fully reversed. COPD is a combination of emphysema, and chronic bronchitis. Chronic bronchitis is defined by excessive mucus secretions and a productive cough for a sustained period of time (more than two years). Emphysema is defined by destruction of the alveoli and smallest airways and secondary effects on lung elasticity, and other airways (Gupta and Brooks, 2006, p.180).The airflow obstruction is generally progressive in nature correlated with an abnormal inflammatory response of the lungs to gases. Despite the fact COPD affects the lungs; it also contributes to a substantial systemic reaction (Celli et al., 2004).although evidence shows that no change in lung function (FEV1) occurs, no matter how radical the treatment for the patient may be. Even tough loss of lung function is not regained; affective pulmonary rehabilitation helps slow the rate of decline (Bellamy and Brooker, 2004, p.12). COPD is important common respiratory disorders in primary care. Diagnosis of COPD is often delayed until patients present with severe symptoms. There are a high percentage of individuals that are undiagnosed in the population. Aside from patients being advised to stop smoking, it is important that pulmonary rehabilitation is part of the management of this condition and physiotherapist understand how to prescribe appropriate exercise training for patients with COPD (Gupta and Brooks, 2006, p.180).Patients with COPD are in the largest percentage of individuals referred for pulmonary rehabilitation. There is an increase in the evidence-based support for pulmonary rehabilitation in the management of patients with COPD (Nici et al., 2006). It addresses the numerous needs of the patient. It has many components which are highly effective in caring for the patient. Pulmonary rehabilitation incorporates the following: smoking cessation, education, exercise training, psychology i nterventions, physiotherapy, and nutrition. Exercise training is a vital component of pulmonary rehabilitation and is aimed at improving some of the restricting problems associated with the disease, such as dyspnoea and exercise tolerance despite the irreversible deformities in lung function (Tiep, 1997, p.1652). Management is essential in helping the patient have a better quality of life, as patients with COPD sink into an inactive and dependent state causing them to be at high risk of depression and anxiety. (Maurer et al., 2008). Depression and anxiety are addressed in the psychosocial component of the rehabilitation program (Nici, et al., 2006, p.1399). During the progression of COPD, all body systems in some way become affected (Tiep, 1997, p.1631).patients with COPD tend to stop or reduce their level of physical activity as exertion leads to the patient having unpleasant sensations. A vicious cycle can occur, with reductions in physical activities causing severe deconditioning, and more limitations in each system affected by the condition (Thomas, 2006, p. 62).The changes in each of these systems are coexisting factors that contribute to the exercise intolerance in patients with the disease. The respiratory system is affected greatly by COPD; it contributes to exercise intolerance in a number a ways. Ventilatory limitations occur for many reasons. An increase in both airway resistance and expiratory flow limitations causes a severe increase in the work of breathing. The elastic walls of the alveoli provide a certain amount of driving force behind the active process of exhalation (Rochester, 2003, p.61). Airflow obstruction leads t o impaired lung emptying and a higher end expiratory lung volume due to the loss in elasticity of the alveolar walls. This worsens during exercise leading to dynamic hyperinflation. Hyperinflation restricts the tidal volume response to excretion, flattens the diaphragm and the accessory muscles are then used to aid respiration, and the muscle length-tension relationship of the respiratory muscles is altered forcing the muscles into a shortened position which puts them at a mechanical disadvantage. The degree of hyperinflation a patient is subject to is an important indicator of their exercise tolerance and dyspnea during exercise (Bellamy and Booker, 2004, p 23). Ventilatory limitations to exercise causes interruption in gas exchange that emerges from the increase dead space to tidal volume ratio, ventilation-perfusion mismatch, and the reduction in diffusing capacity caused by the loss of alveolar/capillary connections. The increased dead space to tidal volume ratio in turn cause s an increased ventilatory demand, for the same degree of bodily exertion (Rochester, 2003, p. 61). Other factors also further increase ventilatory demand these include, lactic acidosis and hypoxemia which directly or indirectly limit exercise tolerance (Nici et al., 2006, p. 1391). The musculoskeletal system is affected also, there is evidence showing that muscle dysfunction contributes to exercise intolerance in COPD. The reduction in physical activities leads to damage in skeletal muscle function which in turn causes more symptoms at a less intensive level of work. Inactivity produces many structural and biomechanical changes in the skeletal muscle. Muscle strength is decreased in patients with COPD; peripheral muscle strength is to a much greater extent affected than upper limb muscles strength. The reduction in peripheral muscle strength may be directly linked with the fact there is a decrease in activity of the lower limbs in patients with COPD (Thomas, 2006, p. You read "Foundations of physiotherapy practice" in category "Essay examples" 63). There is also a reduction in endurance in both lower and upper limb muscles. Loss of lower limb muscle strength is equivalent to the reduction in muscle mass. With prolonged inactivity type 11a fibres (slow twitch f ibres) convert to type 11b (fast twitch fibres), Reduction in fibre type and decrease in cross-sectional of type 1 and 11a fibres is linked to muscle atrophy. Reduction in oxidative capacity and muscle atrophy is standard in patients with COPD. Deconditioning is an important factor in skeletal muscle dysfunction (Mador and Bozkanat, 2001). Chronic obstructive pulmonary disease has an extensive impact on the cardiovascular system. The increased right ventricular afterload which is caused by the increased pulmonary vascular resistance resulting from the structural abnormalities in pulmonary circulation, and the hypoxic pulmonary vasoconstriction all contribute to the effects of COPD on the cardiovascular system. All of these processes lead to structural changes in the heart which include right ventricular dilatation and hypertrophy, to help conserve right ventricular output (Vonk-Noordegraaf, et al., 2005, p. 1901). The impaired ventricular filling is caused by hyperinflation and or other mechanical impairments. Cardiac output is relatively maintained in patients with COPD compared to normal individuals both at rest and during physical activities. Studies have proven that exercise training has no measurable impact on the changes in the cardiovascular system as the result of COPD. Like the irreversible effects COPD has on lung function, exercise training can slow it down but it can never be reversed back to normal no matter how extensive the treatment (Sietsema, 2001, p. 656-657). The neurological system is affected as a result of COPD. Neuropsychiatric disorders are common in patients with COPD, particularly depression and anxiety. The prevalence of depression is higher than anxiety it is over 20% higher than anxiety. They often go untreated in patients with COPD; the lack of adequate treatment leads to patients having a poor quality of life and is associated with premature death in COPD patients. The overall impact of depression and anxiety on COPD patients, their families, and society is important. Studies show that depression has been found to cause fatigue, dyspnoea, and disability (Maurer, et al., 2008, p. 43). Depression increases with hypoxemia, carbon dioxide levels, and dyspnea. Hypoxia in patients with COPD may be a major factor in the development of depression and anxiety due to lack of sufficient oxygen to the brain. However reduced physical capacity and negative self image may also be a causing factor in the development of the disease (Armstrong, 2010, p. 132). Pulmonary rehabilitation is the main intervention used to try and improve the systematic effects of COPD; its main concern is to control the symptoms and disease by including essential components such as the multidisciplinary team for support and guidance and the exercise training program for improvements in the patientââ¬â¢s physical limitations (Burton, et al., 1997, p. 879). The exercise training program of pulmonary rehabilitation must address the individual patientââ¬â¢s limitation to physical activity; these limitations may include ventilation limitations, gas exchange irregularities, and skeletal or respiratory muscle dysfunction. Exercise training aims to improve motivation for exercise, neuropsychiatric well being, decrease symptoms and improve quality of life. Moreover, the substantial improvement in oxidative capacity and efficiency of skeletal muscles has caused a decrease in alveolar ventilation for same degree of exertion. This can reduce dynamic hyperventilation, thus decreasing exertional dyspnoea (Aliverti and Macklem, 2001, p. 229). Pulmonary rehabilitation normally focuses on lower limb training, as loss of peripheral muscle strength in patients is high as loss of quadriceps muscle is reduced by up to 20-30% with patients in the moderate to severe phase of COPD. This is why exercise training is used to improve muscle strength. The dist ribution of muscle strength in patients with COPD is not equal between the lower and upper limb, there is evidence to prove the better preservation of the upper limb muscle strength (Thomas, 2006, p. 63). However upper limb exercises should be incorporated into the training program. Upper limb training results in an improvement in a patientââ¬â¢s ability to perform daily activities involving the upper body. Upper limb exercises also reduce dyspnoea and ventilatory requirements for arm elevation. Evidence based guidelines recommend the use of upper limb exercise as part of the exercise program as it is safe and requires little equipment (Rochester, 2003, p. 70) There are two types of exercise training used in the rehabilitation program aerobic endurance and strength training. Aerobic endurance exercise training is the main component of pulmonary rehabilitation. Evidence from a number of randomized controlled trails supports the use of lower extremity exercise training, it has been found to significantly improve exercise tolerance, timed walking distance, sub maximal endurance time, and health related quality of life. Exercise training includes ground walking training, treadmill walking, cycle ergometery, and inspiratory muscle training (Gupta and Brooks, (2006), p. 182). Cycle ergometery training supervised by the physiotherapist to make sure the patient is performing the exercise at the right intensity, has been proven to improve exercise capacity in patients with COPD. Studies have shown that the combination of both inspiratory muscle training and cycle ergometery training has greater benefits for patients than just cycle ergometery alone. The addition of inspiratory muscle training enhances both inspiratory muscle endurance and strength, improves exerc ise capacity significantly more than just cycle ergometery training on its own (Wanke, et al., 1994, p. 2205-2211). Walking is an exercise prescribed to patients for endurance training, as it is a regular exercise that patients find easy and a large percentage of patients continue walking at home or after the rehabilitation programme. Patients are encouraged to walk to the point of breathlessness; this technique improves exercise tolerance in patients as they push themselves to get physically fit. The Physiotherapist gives support to patients, by reassuring them that breathlessness during walking doesnââ¬â¢t cause any damage to the lungs or heart it is beneficial in improving their quality of life (Bellamy and Booker, 2006, p. 115). Strength training is used in pulmonary rehabilitation for both the upper and lower body. In many studies patients rated their dyspnoea and fatigue the lowest after strength training. The strengthening exercises may include knee flexion and extension w hich works the quadriceps and hamstring muscles, also chest press which involves both pectoralis major and latissimus dorsi. Weights are used during each exercise and are altered increase or decrease the intensity. Strength training increases strength in all muscles that undergo the training this is due to muscle hypertrophy and improvements in neural recruitment patterns. Strength training has been proven by many studies to improve exercise performance and quality of life (Mador, et al., 2004, p. 2039-2041). Studies have supported evidence that endurance training has little effect on muscle weakness and muscle atrophy, two problems in patients with COPD and contributes to their exercise intolerance and poor quality of life. As a result most pulmonary rehabilitation programs combine strength and endurance training together as it is more beneficial to the patients. Studies have proven that the addition of strength training to endurance training produced a greater improvement in muscle mass and strength than endurance training alone (Ortega, et al., 2002, p. 670). Another study investigated the combination of both strength and endurance combined and found it was effective in reducing depression and anxiety. Moreover, there is evidence to confirm the beneficial effects of the three methods of exercise training (strength, endurance, and or combined) on the quality of life and level of dyspnoea in patients with COPD (Mador, et al., 2004, p. 2043). There is a debate as to whether high or low intensity training in endurance and strength exercises should be used and to what beneficial effects either intensity will sustain in improving the symptoms of COPD. Low intensity training does result in improvements in symptoms, activities of daily living and health related quality of life, there is evidence to support the use of high intensity training producing greater physiologic training effects (Maltais, et al., 1997, p. 555-561). Training intensity that exceeds 60% of the peak exercise capacity is enough to cause some physiologic effects, even though higher percentages have been tolerated and are more beneficial. The effects of cycle ergometery training at high intensity work load were compared to low intensity work load in 19 patients with moderate to severe COPD. The group following the cycle ergometery at the high intensity work rate had a greater reduction in lactate production and ventilation requirements, although the low inte nsity group had a similar result but not as much significant gains in aerobic fitness (Rochester, 2003, p. 67-68). Therefore using high or low intensity training has beneficial effects, high intensity exercise training is more advantageous producing physiologic changes in patients that are capable to reach that level, low intensity exercise training is more tailored to the health benefits of the general population and for patients who are in a more fragile state (Calverley, et al., 2003, p. 468-470). Aside from endurance and strength training the pulmonary rehabilitation program has breathing exercises and techniques that are incorporated into the program. The role of the physiotherapist in the management of COPD is established especially in breathing exercises and techniques. Physiotherapists play a crucial role in the exercise, assessment and education aspects of the pulmonary rehabilitation program they are a valuable part of the multidisciplinary team. They are there to provide specialist advice and support for the patient, especially during an exacerbation, when patients have trouble clearing their chest secretions, and to help control any anxiety or panic attacks they may lead to hyperventilation. When physiotherapist helps patients clear chest secretions it often involves teaching the patient about the active cycle of breathing technique (ACBT) using forced expiration to enhance chest clearance. Physiotherapists also use techniques to reduce the work of breathing, which involves the use of breathing retraining or relaxed breathing control. Diaphragmatic breathing and pursed lip breathing are two examples of breathing retraining; these are of benefit to manage panic attacks and breathlessness. Physiotherapists also teach a patient varies positioning techniques to help with dyspnoea. They have a major role in pulmonary rehabilitation programmes, along with respiratory management they provide advice and support for patients with mobility problems (Barnett, (2006), p. 174). Physiotherapists are involved in educating and supporting patients in breathing retraining. The main goals of using diaphragmatic breathing and pursed lip breathing are to relieve breathlessness and encourage relaxation (Mikelsons, 2008, p. 3). Pursed lip breathing is a technique used where exhalation is accomplished through resistance created by narrowing (pursing) of the lips; it is often naturally taken up by COPD patients. Studies have shown that pursed lip breathing can have a positive effect on dyspnoea when performed by patients during exercise. Patients who experience reduction in dyspnoea due to pursed lip breathing also had reductions in end expiratory lung volume and increase supply in inspiratory muscle pressure-generating capacity. During breathing at rest and exercise pursed lip breathing contributed to a slower deeper breathing pattern in patients, and is a useful technique to apply when an onset of breathlessness comes upon a patient (Spahija, et al., 2005, p. 640-648 ). Diaphragmatic breathing is used as another technique to help with dyspnoea and dynamic hyperinflation. In diaphragmatic breathing physiotherapists teach patients to synchronize inspiration with abdominal expansion as they breathe slowly and deeply. On the exhalation the diaphragm is pushed up by the abdominal muscles which create a better length tension relationship and a better curved posture. This technique increases the capable force of the diaphragm as an inspiratory muscle. Diaphragmatic breathing has a significant increase in tidal volume and a major reduction in respiratory frequency which caused an increase in minute ventilation. In hypercapnic patients with COPD, diaphragmatic breathing helps with hyperinflation in these patients. However studies have shown that severely hyperinflatedpatients are incapable of performing this breathing technique (Gigliotti, et al., 2003, p. 198). Secretion clearance is an important technique used for acute exacerbation management. Acute e xacerbations are common in patients with COPD; they are associated with a poor quality of life and are a burden to both family and caregivers. Symptoms include dyspnea, purulent sputum, and an increase in sputum volume. Patientââ¬â¢s awareness of the symptoms of exacerbations and early intervention reduces the risk of hospitalization and leads to a better quality. Physiotherapists are important in providing such interventions to help patients with sputum clearance. Physiotherapeutic techniques used to help with sputum clearance include active cycle of breathing techniques (ACBT), percussions, vibrations, and shaking. ACBT consists of breathing control, lower thoracic expansion exercises and forced expiratory technique. ACBT aids bronchial clearance by improving mucociliary clearance while also decreasing adverse effects such as hypoxia and increased airflow obstruction. Compared to percussion, vibrations, and shaking ACBT has been proven to be the most effective technique in ches t clearance with over 80% of physiotherapists the UK using it always or often when treating patients with COPD. Studies have shown that ACBT helps improve oxygenation, assists in sputum clearance, reduces anxiety, and enhances health related quality of life (Yohannes and Connolly, 2007, p 110-113). Many patients with COPD adopt a forward leaning position to help with the feeling of breathlessness, this is a useful technique which physiotherapist teach patients to self manage dyspnoea, during the stable phase of COPD and when they get an acute exacerbation. There is evidence to reinforce the use of the forward leaning position to improve breathlessness and decrease work of breathing. This position promotes diaphragmatic function by allowing the shortened diaphragm to be lengthened by the movement of the abdominal content away from the diaphragm thus enhancing the length tension relationship. This position can be altered to suit individual, it can be used in everyday life such as standing leaning against a wall, window sill or shopping trolley. These functional positions enable patients to get out and improve both their breathlessness and quality of life (Mikelsons, 2008, p. 3). Studies support the use of breathing retraining, chest physiotherapy and exercise training as it contr ibutes to improvements in dyspnoea, functional exercise capacity, and quality of life in COPD patients (Guell, et al., 2000, p. 978). In conclusion, the importance of COPD as a disease is relatively high as it has been stated to be in the top four leading cause of death and disability in the world (Gupta and Brooks, 2006, p. 187). The considerable effects COPD has on the respiratory system are discussed showing the limiting effects it has on both ventilation and gas exchange all contribute to the exercise intolerance in patients. The musculoskeletal system is greatly hindered by the effects COPD has on the structural and biomechanical aspects causing limitations in the ability to exercise. COPD leads to cardiovascular problems which progressively get worse if patients arenââ¬â¢t introduced to the exercise training program to help slow down the deterioration. Anxiety and depression goes undiagnosed in a lot of patients with COPD but has been shown to contribute to both exercise intolerance and poor quality of life in patients. The intervention of the pulmonary rehabilitation program has been proven to help increa se exercise capacity, decrease dyspnoea and improve health related quality of life. The support and advice from the physiotherapist in the exercise training program, breathing exercises and techniques is a key element to the success of the pulmonary rehabilitation program. In light of all the advantages of the rehabilitation program there is still the unsubstantial effect it has on lung function in patients with COPD. References: Aliverti, A. and Macklem, P. (2001) How and Why Exercise Is Impaired in COPD. Respiration, 68 (3), pp. 229-239. Armstrong, C. (2010) Handbook of Medical Neuropsychology: Application of Cognitive Neuroscience. United States of America: Springer Science and Business Media. Barnett, M. (2006) Chronic Obstructive Pulmonary Disease in Primary Care. United Kingdom: Whurr Publishers Limited. Bellamy, D. and Booker, R. (2006) Chronic Obstructive Pulmonary Disease in Primary Care. 3rd ed. United Kingdom: Class Publishing Ltd. Burton, G. et al., (1997) Respiratory Care A Guide to Clinical Practice. 4th ed. United States of America: Lippincott-Raven Publishers. Calverley, P. M. A. et al., (2003) Chronic Obstructive Pulmonary Disease, 2nd ed. United Kingdom: Arnold. Giggliotti, F. et al., (2003) Breathing retraining and exercise conditioning in patients with chronic obstructive pulmonary disease (COPD): a physiological approach. Respiratory Medicine, 97 (3), pp. 197-204. Guell, R. et al., (2000) Long-term Effects of Outpatient Rehabilitation of COPD. Chest journals, 117 (4), pp. 976-983. Gupta, R. and Brooks, D. (2008) Aerobic Exercise for Individuals with Chronic Obstructive Pulmonary Disease. Physiotherapy Canada, 58 (3), pp. 179-186. Mador, J. and Bozkanat, E. (2001) Skeletal muscle dysfunction in chronic obstructive pulmonary disease. Respiratory research, 2 (4), pp.216-224. Mador, J. et al., (2004) Endurance and Strength Training in Patients with COPD. Chest journals, 125 (6), pp. 2036-2045. Maltais, F. et al., (1997) Intensity of training and physiological adaptation in patients chronic obstructive pulmonary disease. America journal of critical care medicine, 155, pp. 555-561. Mikelsons, C. (2008) The role of physiotherapy in the management of COPD. Respiratory Medicine, 4 (1), pp. 2-7. Nici, L. et al., (2006) American Thoracic Society/European Respiratory Society Statement on Pulmonary Rehabilitation. American journal of respiratory and critical care medicine, 173 (12), pp. 1390-1413. Ortega, F. et al., (2002) Comparison of Effects of Strength and Endurance Training in Patients with Chronic Obstructive Pulmonary Disease. American journal of respiratory and critical care medicine, 166 (5), pp. 669-674. Rochester, C. (2003) Exercise training in chronic obstructive pulmonary disease. Journal of Rehabilitation Research and Development, 40 (5), pp. 59-80. Sietsema, K. (2001) Cardiovascular limitations in chronic pulmonary disease. Medicine science in sports exercise, 33 (7), pp. 656-661. Spahija, J. et al., (2005) Effects of Imposed Pursed-Lips Breathing on Respiratory Mechanics and Dyspnea at Rest and During Exercise in COPD. Chest journals, 128 (2), pp. 640-650. Thomas, A. J. (2006) Chronic Obstructive Pulmonary Disease: The contribution of skeletal muscle dysfunction to exercise intolerance. Physical therapy reviews, 11 (1), pp. 62-66. Tiep, B. (1997) Disease Management of COPD with Pulmonary Rehabilitation. Chest journals, 112 (6), pp. 1630-1656. Vonk-Noordegraaf, A. et al., (2005) Early Changes of Cardiac Structure and function in COPD Patients with Mild Hypoxemia. Chest journals, 127 (6), pp. 1898-1903. Wanke, T. et al., (1994) Effects of combined inspiratory muscle and cycle ergometer training on exercise performance in patients with COPD. European Respiratory Journal, 7 (12), pp. 2205-2211. Yohannes, A. Connolly, M. (2007) A national survey: percussion, vibration, shaking and active cycle of breathing techniques used in patients with acute exacerbations of chronic obstructive pulmonary disease. Physiotherapy, 93 (2), pp. 110-113. How to cite Foundations of physiotherapy practice, Essay examples
Wednesday, April 29, 2020
Labor Market Research Nursing an Example of the Topic Career by
Labor Market Research : Nursing by Expert Marvellous | 07 Dec 2016 ABSTRACT Need essay sample on "Labor Market Research : Nursing" topic? We will write a custom essay sample specifically for you Proceed This paper discusses the Labor Market of Nursing. The paper outlines the statistics in the United States and then focuses on the state of California. A demand and supply explanation is also provided in the paper. Nurse Wage Structure is also provided in the last part of the paper. Nursing is known to be an in-demand job in the United States. According to Dr. Lovell of Institute for Womens Policy Research, the health care system of America is dependent mostly on nurses. On the average a patient is being attended the number of employed nurses will grow by 29 percent. This is equivalent from 2.4 million to 3.1 million. These statistics show that there is a big demand of nurses in the country. The focus of the study is the state of California. From here on, the discussion would be regarding the state of California. California is one of the states that has been featured in the first labor market of Californias Nurse Work Force Initiative in January 2004. As per the report, California needs a total of 60,000 nurses to meet the projected demand for nursing services in 2020. The government in response to the shortage of the nurses, Governor Gray Davis had announced a Nurse Workforce Initiative. This particular program had been developed and implemented to recruit , train and retain nurses in the state. NWIs report as of 2004, the nursing force of California is around 280,000 registered nurses and 90,000 Licensed vocational nurses. Registered Nurses are employed frequently as compared to the licensed vocational nurses because of the educational background and scope of practice. According to Briggance (2004), the state of California has the lowest ratio of registered nurses among the 50 states. The reasons for the increasing demand and inadequate suppliers cannot only be judged based on numbers. According to NWI (2004), the dominant determinant of the demand is the size of the states population. The higher the population the higher the need for health care services. There is a large population of people because of the high birth rates in the state, the international immigration and low death rates. The wealth of the population affects the demand for services. In January 2004, there has been a legislation about a minimum licensed nurse to patient ratios requirements in hospitals from Assembly Bill 394. The increase in demand because of this law is estimated to be as low as 1,600 nurses. The supply of nurses on the other had been explained by NWI. The inflow of California nurses comes from the education system, migration from other states and migration from other countries. The California supply of registered nurses then comes from Active License status, these are the currently working nurses and the non working. The outflow of nurses is retirement, migration to other countries and career changes. According to a research from the U.S. Government Accountability (Lovell, 2004), the shortage of nurses is caused by job satisfaction problems. These job satisfaction problems is then answered by the hospitals through increasing compensation and benefits of the nurses. Hospital wages vary depending on the local labor market (Lovell, 2004). As of 2004, California is considered as one of the states that give their nurses high compensation. Median hourly wages for a nurse is $38.85 to $19.44 in Virginia. Nurses have large compensation because of the job satisfaction problems that some had encountered. Since hospitals wanted to attract nurses then it is imperative that they increase the compensation of the nurses. Another reason for a high compensation is that hospitals and nursing homes are known to be one of the riskiest nations. Nurses are exposed to latex allergies, bhck injuries, physical assault, blood-borne pathogens,and pollution from waste incineration, disinfectants, and surgical waste. Workers such as nurses who are exposed to greater risks on the job should be compensated for the risk associated with their occupation. Based on California Nurses Association (2004), the structure of the nurse wages depends on the level of experience and the type of Nurse that a person is. There are six levels of Nurses in California. First is the Clinical Nurse which has four levels. Clinical Nurse is considered as the entry-level position. Next is Practitioner which has 2 levels. A Nurse Practitioner has a higher wage as compared to that of the clinical nurse because this category has a higher level of experience. A nurses pay is computed hourly. Based on the following information stated above, nurse wages compensation are determined by the demand and supply of nurses in California. California is a big state as compared to that of the other states in the U.S. Compensation for California is higher than the other states because of the fact that it has the lowest Nurse to patient ratio in the continent. Some may think that the Nurses are overpaid and some may think of it as a health commodity job. However, there are reasons for the amount of compensation that the nurses received and this can be justified through the law of economics, and the risk that the nurses take because of the call of duty. REFERENCES California Nurses Association (2004). Nurses NX. Retrieved last February 28, 2008 from University of California. Briggance, B. (2004). Nursing, Leadership and Strategic Action (Powerpoint Presentation). Center for Health Professions Retrieved last February 29, 2008 from University of California, San Francisco. Lovell, V. (2004). Solving the Nursing Shortage through Higher Wages. Retrieved last February 29, 2008 from Institute for Womens Policy Research. Spetz J., Rickles J., and Ong P. (30 January 2004). Californias Nursing Labor Force: Demand, Supply and Shortages. First Labor Market Report. California Nurse Work Force Initiative. Retrieved last February 28, 2008. From Univesity of California.
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