Stockholder Stakeholder Approaches to Corporate Social Responsibility free essay sample

An assessment of the competing claims of the stockholder stakeholder approaches to corporate social responsibility, and a look at similarities and differences of each type of approach to responsibility. This essay will discuss the competing claims of both the stockholder and the stakeholder approaches to corporate social responsibility. An explanation for corporate social responsibility will be provided and arguments will be put forward for similarities and differences in the stockholder and stakeholder approaches to this movement. Evidence to support these arguments will be provided throughout the essay. From the paper: Before discussing the competing claims, it must be understood what is meant by the term corporate social responsibility. Corporate social responsibility is just one aspect of business ethics and has become increasingly important for companies operating in the global economy. It is a fast developing and increasingly competitive field. There is no single, commonly accepted definition of corporate social responsibility but it generally refers to the idea that businesses are accountable for the effects of their actions on the community and should seek socially and economically beneficial results. We will write a custom essay sample on Stockholder Stakeholder Approaches to Corporate Social Responsibility or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page It involves operating a business in a way that meets ethical and legal standards as well as meeting public expectation. Decisions taken by managers need to satisfy the needs of the community and companies must be accountable for the way in which their results are achieved.

buy custom Guns Law essay

buy custom Guns Law essay Introduction There are several laws that pertains to the owning of a gun by a civilian in the United States of America. These guns laws are intended at enhancing peace, harmony and security amongst the American citizens, the laws helps the government in keeping a close registration and monitoring of the individuals who have these weapons and how the individuals are using them. The present Gun law has undergone through several amendments in the past in attempts aimed at restricting the numbers of guns that get their ways into the streets and into the hands of dangerous criminals, discharged military officials and criminal fugitives. This is because they will use the guns in threatening / endangering the citizens security, freedom and peace in the country. Each state in the United States of America has its own gun laws that help the state in governing the ownership and transportation of guns in these states (Kluin, Para.11). The law allows guns to be owned by individuals that are above 18 years old and have to purchase the guns from the registered dealers and the purchase should be documented in federal form 4473 in order to ensure that the purchaser of the weapon is well known. This will reduce the cases of criminal activities in the county and at the same time help the government knows the exact numbers of firearms owned by civilians (O'Leary, para.5). I tend to disagree with the Current Gun Law; this is because it isnt that adequate to American citizens. The law doesnt provide the American citizens with utmost security they require, but it instead exposes them to a lot of insecurity as a result of the strictness of the Gun Law that is biased on one side thus reducing the numbers of guns that are in the hands of the Citizens. At the same time providing different avenues in which the criminals are able to get access to these firearms that they will use to conduct there activities (Lott, para.2). The present Gun Law is not appreciated with the Americans this is because it has some shortcomings that make it fail in conducting its duties they include the restriction of the age limit of an individual to own a gun. Another reason that fails the law checking the family background and place of residence of an applicant, the law has also banned the use or owning of certain hand guns, the laws also denies the normal citizens their constitutional right of self protection. The law also prevents the exhibitions and sale of guns through the use of guns shows that are aired on the Television channels. The main discussion The present gun law can be seen as the cause that has resulted to an increase in the crime cases that are being reported in the United States of America today. This is because the laws that are intended to protect the innocent American citizens ends up harming them as the laws are very strict and at the same time they tend to deny a lot of Americans who are eligible to own a hand gun with the opportunity of owning one. Thus denying them the access of owning the guns that the will use for self defense and protect themselves incase they are attacked (O'Leary, para.2). The law has failed in providing the American citizens with the necessary protection this is because it has strictly maintained at applying strict measures that are necessary for one to own a hand gun; while ignoring certain factors that will help in providing the Americans with the necessary security they will require in order to engage in their daily activities. This is without being exposed to any insecurty of being casualties in the case of gun shootings or attacks (Booth, para.6). According to a scholar John R Lott in his book tilted More Guns Less Crime he stated that the strictness of the present law will deny the criminals the opportunity of purchasing the guns in the legally known stores. This is because they will be afraid that their details will be taken and stored in a data base that will make it easy for them to be tracked down incase they are involved ion a criminal act (Lott, para.4). But this will not stop them in obtaining these weapons from different avenues that includes theft and other dubious means. From his own observation he has stated that the guns should be sold to every body that is wiling to own one without strictly scrutinizing individuals. This will ensure that the citizens are safe as compared to what the case is today as this leads us to the section where there is evaluation of the advantages and disadvantages of the present Gun Law and later on in the paper there are the recommended changes that are supposed to be done on the present law in order to ensure that the law best serves the Americans. The advantages of the present Gun Law From my observation I have concluded that the present Gun Law has got little advantage that it offers to the American citizens as compared to the disadvantages. The main advantage that the law has is the controlling the numbers of the hand guns that are owned by the normal citizens, this will basically reduce the numbers of guns in circulation. Thus providing a given section of the Americans with the opportunity of owning the guns this to some extent tends to ensure that there is security in the country (Booth, para.5). The other advantage is when the law has provided as restricted age limit where one is eligible to own a gun and the recommended time for one to own a gun is when one is 18 years and over. At the age of 18 years an individual is mature and is able to make appropriate decisions. The strictness nature of the gun law has also made it difficult for the criminals to easily access these weapons (Kluin, Para.15). This is when there are a lot of details that are disclosed to the licensed dealer when purchasing the guns and thus making it hard for the people with past criminal records to purchase the guns for their own or public safety. The disadvantages of the present Gun Law The law tends to deny the Americans the freedom to practice there constitution rights, this is when the law tends to scrutinize an individual before he is given or denied the permit of owning a gun. This is by looking at an individual past background and place of residence this will provide people from less privileged backgrounds the opportunity of owning a gun as a result of their background (O'Leary, para.9). The strict gun law has also increased to insecurity in the society this is because the criminals prey on the civilians with these guns in attempts aimed at stealing the Guns they are denied the opportunity of owning legally. The laws that are aimed at banning the use and owning some types of guns have made the numbers of the guns in circulation in the country to reduce drastically. Thus denying a lot of eligible American the opportunity of owning there own guns thus making them more vulnerable to attacks by the armed criminals (Booth, para.3). Ways of improving the Present Guns Law There are several stakeholders in this department that have indicated that the present Gun possession Laww is good, but it is failing in providing the Americans with the relevant protections because some aspects are left out without being taken into considerations. They have argued that the government has failed in amending this law in order to accommodate all the people that want to own guns without being denied the opportunity of doing. At the same time ensure that there is a reduction of the reported cases of criminal attacks on the few innocent civilians that own the guns; it will also help in reducing the cases of guns that are lost through theft and hijacking (Lott, para.3). The law that is in use the moment is seen as the strictest amongst the other countries in the world. But according to a recently conducted sturdy it is indicated that countries with strict rules will record a lot of criminal activities and killings that involve the use of Guns as compared to other countries with less strict Gun possession laws. A great example was in England which had strict rules that pertained to owning of hand Guns and fire arms; but despite these strict rules the country recorded an increase in the usage of the guns in homicides and criminal activities. The strict nature of these Gun possession law will provide a booming business for illegal gun dealers who will opt to sell the guns to the criminals and the willing citizens at extremely high prices (Booth, par 3). This will to some extent deny the country the income tax from the purchase of these weapons. This at the same time will also deny the government with the vital information of the gun owner and thus make it easy for the criminals and civilians with the opportunity of misusing the weapons. This is by indulging in a criminal act without the fear of being tracked down. The other reason for amending the Gun Possession law will ensure that all the American citizens practice their constitutional rights without being restricted the opportunity of invading in their constitutional rights. There were several checks that were being conducted before an individual is issued the license of owning a hand gun; some of these laws bared some American citizens who were eligible were denied the license just because of their family background or even the place of residence (Kluin, Para.15). The laws should be amended in order to ensure that only people with criminal records and emotional/ mental problems are unable to own these weapons, and not an individuals family background or place of residence. The government should also lift the ban on other guns that includes semi-automatic handguns and assault weapons and at the same time provide the citizens with the legal right of owning a concealed weapon. This is seen as way that will increase the levels of insecurity in the streets but it will drastically reduce the cases of insecurity in the streets; this is because all the criminals will be afraid of attacking their assailants who might be carrying guns thus reducing the cases of crimes in there respective towns and cities (O'Leary, para.7). In conclusion the present Gun possession law is very strict and it can be sighted as the cause of insecurity in our society today; this is because it has denied the eligible citizens to poses guns for self defense against the criminals. It is argued that with a gun a weaker victim will become stronger and able to defend him/ herself incase of an attack by a criminal; thus keeping the criminal at bay and can harm them. But with the strict nature of the criminal activities are on the rise the government should conduct some changes in order to change the current situation (Booth, para.10). Buy custom Guns Law essay

Nursing assessment Essay Example | Topics and Well Written Essays - 500 words

Nursing assessment - Essay Example Having noted all the foregoing findings, the three immediate nursing actions for Miss Jones would be: 1) To assess causative and precipitating factors, 2) to evaluate degree of excess fluids and 3) to promote mobilization/elimination of excess fluids (Doenges, Marilyn E., Moorhouse, Mary Frances, pp. 224-225. Assessing the causative and precipitating factors will involve the anticipation of cardiac failure, so it is essential to regularly monitor her breathing along with oxygen level infusion. Aside from this, the fact that a rapid infusion of IV fluids could transpire, the drip rate of the patient’s IV fluids must be checked constantly and adjusted to normal limits (Olsen, June Looby, Giangrasso, A.P., 2000). All fluid intakes must be noted as to its source and volume. Similarly, the amount of sodium and potassium intake must be observed and noted in relation to ingested food, drugs and IV infusion. The second immediate nursing intervention is: to evaluate degree of excess fluids present within the individual. This second nursing action requires constant monitoring of vital signs (Medline Plus, 2007) to observe whether a change has occurred from the last charting schedule. of any related complications that may occur. In relation to this, the present weight of Monica Jones must be compared to previous stated or admission weight since increase of weight could indicate that fluid is being retained in the body. Regular auscultation of the lungs for the presence of crackles must be done and charted during this phase of intervention to see whether the crackling sounds that were previously heard have increased or diminished. Recording the occurrence of dyspnoea is equally essential within this secondary phase of nursing intervention, to note whether hard labour breathing is continuous or takes place only when triggered by an environmental stimuli. In accordance with

Interactive Behaviour at Work Essay Example | Topics and Well Written Essays - 3500 words

Interactive Behaviour at Work - Essay Example Poor communication in the organisation, lack of family-friendly policies, distressed interpersonal relationships, conflicting job expectations and career concerns are the issues that only add up to the degenerating spirit of the sales staff. The above listed internal issues of this organisation are becoming the root cause of declining revenue, which is one of the main corporate goals of this or any business. The sales staff is given sales targets that are unrealistically high, and the policies are such that upon failure to achieve these targets, the respective employee's job will be terminated. With such policies, employees are unable to work diligently and up to their optimum calibre. Instead, the staff is continuously on the outlook for other job opportunities, which steals their attention from their work even more. The dilemma of the situation is that the employees do not feel comfortable having a discussion with their management regarding such chronic work issues. High employee turnover results in a haphazard sort of scenario in the workplace. New employees that are recruited in place of the departing people are not properly oriented or introduced to the existing staff. There is no team building in result of such ma lpractice and work uncertainty and job insecurity is on the rise. The department of sales in any organisation has to have dynamic and outgoing human resources in order to function properly. For such a situation to exist, the managers and superiors of the department must adopt such strategies and policies that a free flow of communication be inherent. This flow of communication should be both upward and downward so that the right decisions are taken at the right time. The essence of such a system is in the involvement of employees in the work scheduling and goal setting process. In any organisation, the main corporate goal is achieved by setting and accomplishing middle and lower level goals and targets. These middle and lower level goals are achieved after proper planning, organising and controlling. If the goal itself is not set with the right vision, tasks are not organised in the proper well-chalked out manner, resources are not deployed in the most productive and effective way, then there is no way that the organisation will achieve its mission fruitfully. Such a mismanaged situation persists in the sales department of Business Plus TV channel. The goal setting process in any department of any organisation is a sensitive procedure requiring high level of expert and knowledgeable input. The department under study is engaged in the setting of targets that are neither smart nor realistic. These targets are overly demanding and instead of boosting efforts on the employees' end, these are putting unreasonable pressure on the staff. Besides, the designing of the task is such that the workers are over burdened with high levels of time pressures. Inflexible work schedules unpredictable and long hours are the results of the unorganised task design. The horror of losing jobs in case of failure to achieve the assigned targets are aggravating the pressure and strain amongst employees. The staff is dissatisfied and insecure with little hope of career development. The over all culture of the workplace is confined sort with poor communication, low level of support for problem solving and personal development and lack of definition of orga nisational objectives. This organisation faces the unsound and

Capital Punishment Essay Example | Topics and Well Written Essays - 250 words

Capital Punishment - Essay Example Similarly, previous death sentences, under the judicial doctrine of precedents, justify the penalty as usual. The fact that a defendant has committed a crime that is as cruel as the death sentence means that the defendant is not justified to argue for cruelty of the sentence (Mandery 473). Life without parole is a more humane and pragmatic alternative because it achieves justice to victims and preserves humanity. In holding defendants, it eliminates them from the society and therefore reduces risks of crimes associated with the people. It therefore ensures justice and preserves morality. The position that the post assumes omits some information that could change its position on the issues. Incidence of death penalties remained high and this indicated its ineffectiveness as deterrence. Similarly, the eighth amendment is not clear on what is cruel and unusual, based on different crimes. I however agree that life imprisonment without parole is a better alternative because it keeps criminals from the society and because death penalty proved

Caring For A Hypovolaemic Shock Patient Nursing Essay

Caring For A Hypovolaemic Shock Patient Nursing Essay Shock is a life threatening condition defined as an acute clinical event precipitated by reduced tissue perfusion caused by reduced circulatory output, failure of the heart to pump effectively and a massive peripheral vasoconstriction .These lead to a point where the circulatory volume is insufficient to meet the oxygen and nutrient requirements of tissues .(Kneale 2003) Quickly identifying the type of shock and ensuring correct aggressive treatment are key to patient survival. Hypovolaemic shock is caused by an inadequate intravascular volume, which can be caused by loss of blood or other body fluids. This type of shock is usually seen after soft tissue trauma, burn injuries, vomiting, diarrhoea or bleeding. (Mower- Wade 2000) It is important for nurses to prevent Hypovolaemic shock by closely monitoring patients who are at risk and restore the fluid lost with adequate fluid replacement therapy before intravascular volume is depleted. Hypovolaemic shock begins to develop after 15% intravascular blood loss. This is known as the compensatory phase. (Muhlberg et al, 2004) This is when symptoms of Hypovolaemic shock will begin to appear. It is vital that the nurse can identify clinical presentation and respond promptly based on good understanding of the physiology of shock as in the compensatory phase, hypovolaemic shock will not manifest in adults making it harder to diagnose. (Kneale, 2003) When nursing a patient with Hypovolaemic shock, psychological care is needed, good verbal communication and information relating to the effects of their injury are essential in providing the appropriate care in their condition as well as supporting the family also. (Kneale, 2003) Preparation of the Emergency Department: John Palmer, a 50 year old man sustained a stab wound to the spleen following an alleged assault in a public house. Ambulance control have advised the Emergency department (ED) that they are now transferring the patient in Hypovolaemic shock to the ED with an estimated time of arrival (ETA) of 20 minutes. The paramedics have informed the ED that they are transferring the patient already in hypovolaemic shock. This gives a clear indication that there has been already a significant amount of blood loss. Hypovolaemic shock begins to develop after 15% intravascular blood loss, equivalent to 750mls and is known as the compensatory phase, this is when the first real symptoms occur. If the compensatory phase is not interrupted, progression of shock results in exhaustion of the compensatory mechanisms and progression to the decompensate phase. Failure to interrupt this progression eventually leads to the irreversible shock phase, leading to organ system failure and death. (Carlson, 2009) The nurse announced a code T over the hospital paging system, signalling the trauma team to assemble. Immediately, emergency personnel, trauma nurses, trauma physicians and anaesthetists, and other specially educated staff gathered in the resuscitation bay awaiting arrival of their patient by ambulance. (Muhlberg et al, 2004) This is where the Nurse Manager assigns jobs to the staff to prepare for the arrival of patient. The resuscitation area should be prepared in the 20 minutes before the patient arrives with double checks on the arrest trolley, airway management sets and intravenous sets as well as a stand for the fluid and blood which will be needed to stabilise the patient as he is in hypovolaemic shock. Also, all the monitors for vital signs must be checked to be in working order as well as the respiratory monitors such as the oxygen and suctioning equipment. These should all be at hand and in working order when the patient arrives. On arrival to the emergency department, the paramedics handed over john had already lost significant amounts of blood due to a laceration to the spleen evidenced by tachycardia, pale skin colour, weak peripheral pulses and delayed capillary refills to all extremities. This evidenced by hypovolaemic shock. (Radcliffe, 1999) Knowing that the spleen is located in the left hypochondrial region of the abdomen and contains up to 350ml of blood which can prove to be a major source of blood loss for the patient, the nurse and physician should be prepared to treat the shock on arrival to the ED. (Ross and Wilson, 2006) Due to the large blood loss and area of laceration, it is more than likely the patient will be hypotensive on arrival to the ED. As the shock develops the patient will also start showing clinical signs and symptoms of respiratory, cardiovascular, renal, neurological problems as well as a deterioration in skin conditions. This is the role of the nurse to assess these vital signs to identify the signs and symptoms of shock. (Edward, 1999) It is the nurse and physicians job to haemodynamically stable the patient before surgical intervention occurs. (Roth, 2005) Assessment, Therapeutics and Support. On arrival to the emergency department, the paramedics handed over john had already lost significant amounts of blood due to a laceration to the spleen evidenced by tachycardia, pale skin colour, weak peripheral pulses and delayed capillary refills to all extremities. This evidenced by hypovolaemic shock. (Radcliffe, 1999) When being assessed within the emergency department, John was connected to a cardiac monitor and pulse oximetry to closely monitor his condition. These assessments must be carried out by the ED nurse upon arrival to the ED. (Muhlberg et al, 2004) Johns vital signs are heart 146, BP: 87/59, respiration rate was 22 per minute and shallow, Spo2: 89% on room air, and temperature 34 degree Celsius. The cardiac monitor showed sinus tachycardia. Warmed blankets were placed on John and he was immediately placed on 15 litre o2 via non re-breather mask. His Spo2 increases to 98%. The blood pressure cuff was place on opposite arm of the pulse oximetry to avoid vasoconstriction as if it was on the same arm it can give inaccurate pulse oximetry readings. (Mower- Wade et al, 2000) Respiratory Assessment and Intervention The initial intervention was aimed at optimizing oxygen delivery to all organs. As John was able to talk to the nurse and answer simple questions about him, this established his airway was patent. 15 litre oxygen therapy was administered through a non-rebreathable mask as prescribed, a mask or nasal cannula could also be used, to optimize ventilation in order to combat insufficient oxygen distribution to the tissues of the body. (Jones.1996). Over use of oxygen therapy can damage the bronchial mucosa and cilia. Humidification of the oxygen was undertaken to prevent secondary problems, such as pneumonia as well as promoting the expectoration of secretions. (Pikingston, 2004) Due to this, the patient will need regular mouth care to keep the mouth moist as the patient will be nil by mouth in case of surgical intervention.(Collins, 2000).Peripheral oxygen saturation was closely monitored using pulse oximetry and the nurse was aware of changes that could indicate hypoxia. Although, this c annot be solely relied on as the patient may have inadequate tissue perfusion and pulse oximetry would not pick up on this. An arterial blood gas was taken, providing information on adequacy of ventilation, oxygen delivery to the tissues and acid base balance. (Bench, 2004) Respiratory rate was closely monitored and recorded by evaluating the depth and pattern. When the rate is increasing, it is a reliant indicator of shock. This is because there will be a build up of lactic acid in the body due to the production of ATP, caused by inadequate delivery of oxygen to the cells. Respiratory rate increases to rid the body of these toxins and also to try increase tissue oxygenation. (Hand, 2001) The respiratory rate, rhythm and depth were monitored, which indicate air hunger, accessory muscle use and tachypnoea. (Newberry, 2002) Cardiovascular Assessment and Intervention. Heart rate was closely monitored as it would increase responding to falling blood pressure. A slight increase in heart rate leading to tachycardia is designed to compensate for initial reductions of blood volume but as the shock progresses heart rate will drop. (Kneale, 2003). The fight or flight response increases the rate and force of the hearts contractions and vasoconstriction. The compensatory mechanism will maintain blood pressure with as much as 1,500 mls of blood or fluid lost. Johns blood pressure was closely monitored although the nurse was aware that it is not a reliable indicator of his condition. Central Venous pressures are required. (Sheppard Wright, 2000) The management of circulation is focused on increasing circulating volume and cardiac output through IV crystalloids, colloids or blood transfusion. Bench (2004:716) states As the aetiology of hypovolaemic shock is related to fluid loss, fluid replacement is clearly the most appropriate form of treatment to instigate Fluids must be prescribed by a physician. It is important the nurse knows the implications of different types of fluids. They also must be competent in administering such fluids and evaluating their effectiveness. In initial fluid resuscitation, two large bore peripheral cannulas were inserted allowing for rapid infusions of blood, drug and fluid. IV cannula care was undertaken as per hospital policy. (Bench, 2004) Pressure bags may also be used for rapid infusion of IV fluids. John was positioned with his legs elevated, trunk flat and his head and shoulders above his chest to optimize effectiveness. John was prescribed by the physician crystalloid fluids, using the normal 3:1 ratio for fluid resuscitation, 200ml of crystalloid for every 100ml of fluid loss. (Graham CA, 2005) A common crystalloid fluid is Ringers lactate or Hartmanns. These fluids are made up of water and electrolytes and work to expand blood volume in presence of blood loss and contain lactate which is a buffer in the presence of metabolic acidosis. Every millilitre of blood lost may require 3ml of crystalloid solution and therefore large amounts of fluid would be needed. Crystalloid replacement therapy is of limited value as it does not have oxygen carrying capabilities, leaving john susceptible to hypoxia, red blood cells would be required. Crystalloids have the advantage of being inexpensive and widely available in the clinical setting with isotonic crystalloid solutions being the mainstay of fluid resuscitation. However, nurses need to be aware of signs of overload such as peripheral and pulmonary oedema. (G upta Nolan, 1994) The fluid should be warmed to prevent hypothermia, which could lead to metabolic acidosis. Johns peripheral temperature went up to 35 degrees Celsius. Core and peripheral temperature observations are required as the loss of blood leads to a lower temperature from reduced circulator heat, with potential for severe blood loss to lead to hypothermia. This is why warmed blankets were placed on john on arrival to the ED. Rapid re-warming is avoided as this risks peripheral vasodilatation, affecting the physiological compensatory mechanism. Instead gradual re-warming and the use of warmed IV fluids when large volumes of fluid replacement are required can reduce further heat loss (Kneale 2003). It was important that Johns body temperature was maintained within normal limits to prevent increasing metabolic demands that his body may have been unable to meet (Smeltzer et al, 2008). Sheppard Wright 2000 suggest that fluid loss up to 1500mls, Hartmanns should be used, after that blood should be added, as mentioned before it does not have the oxygen carrying capacity. Blood provides the necessary haemoglobin to carry oxygen to the tissues. John bloods were taken to be typed and cross matched. In this situation however, immediate transfusions of blood group 0 negative was given as it is a universal donor group while waiting on the blood results. A Blood transfusion was prescribed for John as a full blood count was taken and showed his haemoglobin level to be as low as 8. John was explained to by the ED nurse regarding the risks associated with the transfusion and was made aware of the known adverse side-effects such as infection and allergic reactions. (Hand.2001). If such clinical symptoms became evident the blood transfusion would have been stopped. When administering blood it is important the nurse confirms that the blood was prescribed by a physician. Checks must be carried out of the patients name, date of birth, hospital reference number and the expiry of the blood product with the cross-match form and the prescription chart (Royal Marsden, 2006). This must be checked by two people either another nurse or a physician. Johns observations were assessed every 15minutes, he was monitored for signs of associated reactions such as itching, increased heart rate and pyrexia. (Oldham J et al, 2009) Normal saline was infused also to increase Johns fluid intake. The nurse accurately recorded fluid replacement, which is essential regardless of type of fluid. The nurse constantly observed Johns blood pressure, pulse and respirations for signs of improvement to indicate the fluid resuscitation was working effectively and also observed for fluid induced complications as previously mentioned. Neurological and Pain assessment and Intervention. A neurological assessment was carried out; John scored 11 out of 15 on the Glasgow Coma Scale, which measures level of consciousness. It was observed that John was anxious, restless and agitated. If John became more hypoxic and cerebral perfusion decreased he would become increasingly confused, drowsy, disorientated and eventually unresponsive. The nurse focused on Johns safety and constantly reassured and re-orientated him. His level of consciousness using the Glasgow coma scale was constantly assessed. Although fluid replacement therapy is the main treatment in managing circulation, pharmacological methods may be prescribed to increase cardiac output and myocardial contractibility. Such medications include the administration of dopamine or dobutamine. These must also be prescribed by a physician and the nurse must keep in mind of the 5 Rs when administering such medication. The nurse should always check they have the Right patient, Right time and frequency, Right dose, Right route, and Right drug when administering medication. The nurse monitored John for symptoms of overdose by assessing him for headaches, drowsiness and hypertension. (Muhlberg et al, 2004) Controlling pain was hugely important to help relieve Johns pain and anxiety. John was prescribed morphine via an intravenous line for direct access to blood stream. The nurse monitored for a decrease in respiratory function as well as nausea and vomiting. John was charted and given an anti-emetic to prevent him from losing more fluid. (Bench, 2004). John was assessed and monitored frequently for a response to the analgesic. Renal Assessment and Intervention. While fluid resuscitation was under way, the physician inserted urinary catheter, to assess for other injuries. The nurse continued to monitor vital signs, urine output, Spo2 values, cardiac rhythm and rate and temperature. Johns urinary output is a major indicator of the stage of shock and signs of improvement. Early in shock, the kidneys are affected, renal blood flow is reduced early and so renal perfusion is affected. The glomerular filtration rate is reduced which leads to a reduction in urinary output. The body also retains water to increase circulation. John was catheterised to ensure correct monitoring of urinary output as it is essential in adequately treating shock (Kent, 2001). The management and care of the catheter was carried out as per hospital policy. If shock is in progression, the urinary output would be less than 30ml/hr. This may signify acute renal failure. (Buckley, 1992) The nurse adequately monitored and recorded Johns urine output for signs of reduced output. Skin Integrity The nurse considered the maintenance of Johns skin integrity as it put at risk by poor tissue perfusion, inadequate nutritional intake and immobility. (Bench, 2004) The nurses should change the patients position regularly to assess pressure areas. The stab wound should be treated to prevent infection. Normal saline is the solution of choice used to cleanse and remove any dirt from the wound. (Smeltzer and Bare, 2004) Psychological Support The patients fears and anxieties should be addressed by the nursing staff regardless of the aggression he shows due to the large consumption of alcohol, Smeltzer Bare 2003 explains the holistic approach as caring for the patients body and mind together as one. John needed appropriate psychological support. Most importantly the nurse spoke to John throughout every procedure and gauged how he was feeling. The nurse gave him information on each procedure so he feels a little more in control. It was also ensured that the family was contacted when John arrived to the ED. His sister was kept informed and supported throughout this ordeal. They were encouraged to express their feelings, concerns and worries, They were also involved where possible in decision making and patients care where appropriate.(Buckley,1992) As shock is a life threatening condition, the nurse expected John to feel extremely anxious as there is a link between anxiety and the effects of shock on the neurological status. Medications such as lorazepam were given as prescribed for Johns anxiety and his response was assessed and monitored. He was also prescribed librium due to his large consumption of alcohol at the time of altercation. Librium is an anti-anxiety drug which helps with withdrawal symptoms from alcohol. This will be given when Johns alcohol levels are negative within his blood. Due to the seriousness of the altercation, surgery was inevitable for John to control bleeding. This was explained to John and family, information on the surgery and the preparation details was given briefly by the physician and then re-enforced by the ED nurse. While the Physician organised the surgery and ordered an abdominal ultrasound to assess the laceration, the ED nurse allowed John and his sister to ask questions and express their concerns of same. Reassurance was given by the ED nurse and preparation was underway. Conclusion Shock is defined by critical tissue hypo perfusion. It must be rapidly reversed before organ damage is sustained and irreversible. To provide the best treatment, nurses need to recognize its clinical presentation. The nurse needs to respond appropriately and promptly. It is important to remember that if the management of shock is not addressed, the patient will progress to the irreversible shock phase and eventually death. The nurse must have a good understanding of the physiology of hypovolaemic shock. Airway, breathing and circulation must be stabilized initially and the nurse needs to be competent in recognizing indicators of shock complications Oxygen therapy, fluid resuscitation and pharmacology are key to the patients optimized recovery; the nurse must be competent in the administration of same. The nurse must also be aware of complications associated with the above treatment and be able to competently monitor and record said complications. (Hand, 2001) Effective communication with the patient, relatives and the rest of the multidisciplinary team is vital to ensure that collaborative practice maximises the quality of patient care delivered. (Bench, 2004)

The European Union: Cross-National Variation in Public Support, 1993 :: European History Essays

The European Union: Cross-National Variation in Public Support, 1993 Introduction The European Union was established in 1951 with the adoption of the European Coal and Steel Community. Many of its early integrative policies were technical in nature and received little attention from the general public. Consequently, a permissive consensus developed allowing the elite to pursue the ideals established by the European Union (EU) (Eichenberg and Dalton 1993, Gabel and Palmer 1995, Gabel 1998). In time, integrative policies became increasingly aggressive in their scope and influence. With the adoption of the Single European Act in 1985 and the Maastricht Treaty in 1991, the EU began dealing forcefully with issues pertaining to monetary union, social policy, foreign policy, and constitutional reform. Public opinion became increasingly important as national governments began formulating policies based on decisions in Brussels, Strasbourg, and Luxembourg that affected domestic policies (Gabel 1998, Anderson and Kaltenthaler 1996, Anderson and Reichert 1996, Gabel and Palm er 1995, Eichenberg and Dalton 1993). European integration was still largely driven and advanced by the elite, but it could no longer progress without the support of the mass public (Eichenberg and Dalton 1993). In Ireland, France, and Denmark, national public referenda required the ratification of the Maastricht Treaty. Ultimately public protests in France and Denmark on the Maastricht Treaty delayed and modified the institutional reform of the EU. In 1994, Norway voted in a national referendum to reject the EU altogether despite being granted admission. In 1995 parties in Sweden campaigning specifically against European integration recognized significant gains. Public opinion clearly influences policymaking in the EU. Furthermore, the literature illustrates that there is measurable cross-national variation in public support for the EU. It is necessary to understand what contributes to these differences in order to facilitate continuing integration. This paper expands on the existing literature explaining cross-national variances in support by examining economic rationality and political culture explanations. Economic Rationality For most of its history, the EU has existed purely as an economic block. Economic rationality posits that citizens seek to influence public policy by voting according to their economic interests regarding international economic policy (Katzenstein 1998). A large amount of existing literature suggests that economic rationality explanations are strong predictors of a country’s level of support for the EU. Specifically, the literature has tended to examine macro- and micro-economic, and direct and indirect economic explanations. Macroeconomic explanations focus on the national economic indicators of member states.

Bruce Dawe Poem Analysis Essay

Decode the question: How has the composer represented the concept of heroism in the film Gladiator? Make specific reference to two key scenes in the film. You MUST NOT choose scenes which have been analysed already in the course work (i.e. scenes I-III, XI-XIII, and XXVI). Write approximately 1000 words. Select Two key scenes: XXXI -Maximus has defeated the greatest gladiator ever to fight XLVI – The Final Battle Create a mind map Organise ideas, texts & references: Summary, presentation of Heroic concept, references to 2 keyed scenes with quotes & notes Draft – Do the draft as needed above Edit draft – Edit as necessary Submit draft – in Final written essay The Essay: Maximus was a powerful Roman General (strong belief, inner strength never dies, stood up for his belief no matter the consequences), loved by the people and the aging Emperor, Marcus Aurelius, known in history as the final of the Five Good Emperors. Before his death, the Emperor chose Maximus to be his heir over his own son, Commodus in an attempt to allow Rome to once more become a Republic. Then a power struggle left Maximus and his family condemned to death. The powerful General was unable to save his family, and his loss let him captured and put into slavery and trained as a Gladiator  by Proximo until he died. The only desire that fueled him at the time was the chance to rise to the top so that he would be able to look into the eyes of the man who would feel his revenge and fulfill the dying wish of his emperor. The time came when Proximo’s troupe was called to Rome to participate in a marathon of gladiator games held at the behest of the new emperor, Commodus. Once in Rome, Maximus wasted no time in making his presence known, and was soon involved in a plot to overthrow the emperor with his former-love Lucilla, Commodus’ sister, after whom he lusted, and also the widowed mother of Lucius, heir to the empire after his uncle, and democratic-minded senator, Gracchus was reinstated for Rome to republic. The composer has set up the representation of the heroism concept (50-60%) throughout the Gladiator film, from the opening scene, when the Hero leaves his pleasant vision (his wife and child) to return to the Germania battle field and to: – face the 1st execution – 1st fight as a gladiator – release his name – fight against the greatest warrior – face Commodus – fight in the Final battle As the opening scene and the above listed 3 scenes where the heroic concept has been discussed in the course work, the responder can also find the concept of heroism in the fight against the greatest gladiator and in the Final battle. The fight against the greatest gladiator Tigris turns to Caesar’s box, with swords crossed, he bows, â€Å"We who are about to die salute you.† Maximus stands by, showing no salute whatsoever. As Maximus gets ready to fight the large doors to the arena are thrown open, surprising Maximus. From each door emerges a team of men, who run into the arena. Each team picks up a chain from the sand. Maximus becomes distracted and Tigris kicks sand into Maximus’ face and begins the fight. As the fight continues and as Maximus is thrown to the ground, a trap door opens and out jumps a large tiger, pouncing at the fighting gladiators. Maximus is now  having to escape the claws of the tigers as he battles Tigris. In the background can be heard â€Å"loose, loose, loose† and â€Å"pull, pull, pull† as the handlers coordinate their efforts in handling each of the tigers that are now on the arena floor growling and charging at Maximus.] [Maximus manages to disarm Tigris, switching his sword from one hand to the other, Maximus stands ready to finish off Tigris. Suddenly, a fourth tiger jumps out of a trap door and jumps at Maximus. In that split second, Maximus turns and the tiger is speared with his sword. Maximus is thrown to the sand as the large beast lays atop him. Maximus stabs the beast repeatedly, killing it. The crowds cheer wildly. Tigris moves in for an attack. Maximus, on his back with the beast still on him, manages to grab Tigris’ own hatchet and with great force spikes him in the foot. Tigris bends over in pain, blood pouring from the opening of his mask. Maximus stands and kicks Tigris over to the ground. He is finished. The Final battle The trap door to the arena opens as the lift rises, encircled with the Praetorian as they stand behind their black shields. In the middle, the white clad Commodus, gazing upwardly, basking in the sun and the wounded, dying Maximus stand. All the while, Quintus staring at Maximus. As they reach the arena, the Praetorian take their place at the perimeter of the arena. Maximus stumbles to the center, slowly stooping to pick up a handful of sand, with a watchful eye on Quintus. Maximus rubs the sand in his hands and reaches for his sword but Quintus tosses it aside, and out of reach. Maximus painfully moves to where the sword has been tossed and picks it up, immediately swinging at Commodus. The two do battle. Maximus roars as he attacks Commodus. Commodus manages to cut Maximus’ leg. Although wounded, Maximus cuts Commodus’ arm causing him to drop his sword.] [Maximus begins to drift into the after-life and as he sees the gate to his home, the sword drops from his hand. Meanwhile, Commodus is calling Quintus for his sword but Quintus does not comply. Commodus then turns to the Praetorian, calling out â€Å"sword†. The guards begin to pull their swords when Quintus quickly tells them to â€Å"sheath your swords† and they quickly comply. As Commodus reaches for his hidden dagger, Maximus quickly returns to this life and, unarmed but for his strength and determination, does battle with Commodus, turning Commodus’ knife against him. Commodus tries relentlessly to fight  Maximus off but Maximus slowly plunges the knife into Commodus’ throat, further and further until it can go no further. Commodus falls to the ground. The fight over, Maximus begins to drift as he reaches out his bloodied hand, to push open the gate that leads to hi s home. Peace, once again, overcomes Maximus when Quintus calls to him. â€Å"Maximus, Maximus.† Maximus regains consciousness.] To bring to life ancient Rome, director Ridley Scott employed great period costumes, chariots and horses, lots of dark-haired actors and actresses, and an amazing looking coliseum in the time period set in the movie. The musical score was possibly the best feature of this film, as the music is haunting and perfectly punctuates the dramatic action in soft, then ever-increasing tempos. It was a real trick to make music that would accentuate the flavor of this historical piece, and not distract it. The film used a very potent combination of long shots and close-ups to heighten the drama and yet propel responder into the immensity of the situation: the overwhelming doom that seems to be around any and every corner in Rome. For instance, at this scene where Maximus has defeated the greatest gladiator ever to fight, in a long, drawn-out battle. The bested warrior lies fallen at Maximus’ feet, awaiting his demise. The crowd chants â€Å"Kill, Kill, Kill!† The long shot shows E mperor Commodus watching Maximus, and in the shot, the emperor is shown in the foreground, and Maximus appears small in the background. In this way the responder get a sense of the power that Commodus holds over Maximus. Now a medium-long shot of the crowd to get a sense of how many people are chanting for the vanquished opponent’s death; they all appear in unison, willfully they crave blood. Next a close-up of the emperor as he dramatically steps forward, arm extended. If he gives a thumbs up, the opponent should live. If he gives a thumbs-down, the opponent should be killed. His arm hangs outward and all eyes in the coliseum fall upon his hand. He gives the thumbs-down, and the crowd goes wild with roars of approval. Finally, a close-up of Maximus as he throws down his own sword in complete defiance to the emperor and to the people. The skillful editing helps contrast the morals Maximus and Commodus possess: Commodus is ruthless and political, Maximus does only what he has to, no more no less, and he is a man of his own conviction. This scene helps responder to understand why earlier the dying emperor Marcus Aurelius wanted Maximus to succeed him, he knew Maximus would do the right thing and not be  swayed easily by popular opinion. A leader must lead, not follow. Whenever the composer wanted the responder to get a sense of the size of this coliseum, he employed the cinematographer to use long range shots. When he wanted responder to get a sense of the hustle and bustle of Rome, a hand-held camera was used. The Final battle: The composer used a number of different techniques during the filming of the Final battle, including muted, washed out colors in the Coliseum. The scene is bright and colour comes across perfectly, setting the mood for the scene of battle. The fighting is filmed replete with quick cuts and a frenetic filming process; it’s disorienting but not so much that we can’t keep track of who’s who and what each participant is doing in said battle. The fighting is realistic without zooming in on the gore, as the violence speaks for itself. The composer correctly makes the scenes exciting without the need for a barf bucket.. Combat is supposed to be jarring and disorienting and the filming process actually communicates this sense to the responder very well. The responder’d have to agree, as the scenes outstanding in special effects. They are seeing the Coliseum when it is a new(100 years old) and its grand structure, as it would have been in ancient Rome. Stunts are well coordinated and real tigers were used in a particular fight scene, grabbing out just inches from Maximus and his opponent. He earned his act on those days of shooting. Sound – The soundtrack with its haunting score, is very memorable its scope and theme. Sound track manages to take a main character theme and vary it depending on the action, making it subtle and sweet at times, brooding and depressing at others. Throughout the film, the same musical elements are applied, bring unity and depth to the story. Besides digital sound, Dolby 5.1 is also included on the same disc

A navy seal shares his secrets to developing mental toughness

A navy seal shares his secrets to developing mental toughness Are you tough enough? Regardless of your particular career aspirations, there’s no denying the fact that a little mental fortitude can go a long way towards helping you achieve your career goals and find success in all facets of life. It’s true- mental toughness, when handled properly, helps you command respect from colleagues and peers, advocate for your point of view on projects, negotiate effectively, and will give you the confidence to know you’re capable and worthy of success. The truth is, some of us just seem to naturally have reserves of mental toughness in abundance and at the ready whenever it’s needed, while others among us need a little more help. If you’re the sort that can use a little guidance when it comes to mental toughness, don’t worry- we’ve got you covered.When you hear the term â€Å"Navy SEAL,† you automatically think tough- both physically and mentally. After all, SEALs are the best of the best, the tough est of the tough, individuals who are hand selected to try out for this elite group. Although toughness is a minimum requirement for even being selected to try out for the SEALs, the truth is that only a very small percentage of folks in this elite group actually make it through training, and to call it a rigorous process doesn’t do it justice. That said, when you meet someone who’s made it through and has become a Navy SEAL, their toughness is not only a given- it’s an understatement. And when they’re willing to share strategies for developing mental toughness, you better listen!Mark Divine, a 20-year Navy SEAL veteran, recently shared his thoughts on building lasting mental strength on mindbodygreen.com. Mark is a firm believer in â€Å"mind over body†- that if you set your mind to a specific goal or task there’s nothing that can stop you from achieving it. He discussed 4 core tips that anyone can use for building a rock solid mental minds et.1. Determine your purpose.In order to be able to focus your full mental energy on a specific direction in life, you first must determine what that purpose is. Divine has created the following list of helpful questions that you should ask yourself in order to determine your purpose in life:What have you been conditioned to think you’re supposed to do with your life?What do you think you are really  supposed to do with your life?What do you feel you are really supposed to do with your life?Is there a tiny voice of doubt deep within you suggesting you are on the wrong track?Is that same voice nudging you forward with the sensation that you are on the right track?What ONE thing do you think you are here for? What ONE thing would you focus on if you had nothing holding you back?What would you do differently if you knew you had one year to live?These questions should be asked and answered as honestly as possible in an effort to get to your life’s purpose. Once you have a goal, it’s easy to envision yourself achieving it, and the very act of doing so can help boost your confidence and mental fortitude, allowing you to charge forward.2. Focus on yourself.Mark Divine asserts that a deep inward focus is the key to building true self-awareness in life, which ultimately leads to what he terms an â€Å"unbeatable mind†- which is the foundation of mental toughness. A nuanced and multi-faceted self-awareness can help you avoid repeating the same mistakes you’ve made in the past, which may have kept you from achieving your goals. Divine suggests that an excellent approach for building self-awareness and an unbeatable mind is to take a few minutes each day to meditate, think inwardly, and maintain a journal. This will really allow you to connect with your true inner self and grow stronger.3. Determine your path.Once you have a purpose, born of true introspection and self-awareness, Divine suggests that you determine your path for achievi ng success. Most goals have multiple possible pathways, but the truth is that they may not all be right for you. Confronting the reality of your current situation will help you determine the most effective path forward, which will help you flex and grow your mental muscles.4. Support your purpose with a healthy life and external support.Divine believes that a strong and healthy mind requires a strong and healthy body. A good diet and plenty of exercise are essential for constructing a rock-solid mindset, which will power you to attack your life goals. He also acknowledges that, like most things in life, having a strong support system in place can go a long way to being successful. A group of positive and like-minded friends, family, and colleagues can make all the difference as you go through life and charge forward towards the goals you’ve set for yourself.There you have it- strategies for building mental toughness and going after your goals from someone who really knows wha t it takes. Take full advantage of Mark Divine’s advice on developing a strong mindset, and before long there’ll be no stopping you!

Use Great Tips for Writing a Coursework

Use Great Tips for Writing a Coursework Writing a Coursework: Great Tips for Great Students If your professor asks you to produce a coursework, you will have to choose the most suitable model and approach before you begin to write. Our recommendations will make the whole process much easier for you. At times, you may want to ask more experienced academic professionals for help. At other time, you may simply want to read others advice and follow it, while working on your work. Whatever decision you make, we will support you. Just consider our recommendations below and follow them, when you need to. Understand your topic and purpose Successful coursework writers know what it takes to write a great work. They know the topic well. They also know how to translate it into a brilliant piece of writing. Use as much literature as you need to create a convincing argument. Have an idea of what your coursework should look at the end of the process. Seek Help from Professionals Of course, we are here to help you with your coursework, whenever you may need our help. It is always better if you do the writing job on your own. However, in many situations it is better to trust coursework writing to a professional than to spend days and nights doing an inferior writing job. Take it as a financial investment in your academic future. It will yield enormous profits! Manage Your Finances Wisely Once you are in, you will have to be wise with your limited financial resources. Be ready to manage your budget professionally. Otherwise, your coursework project will be doomed to failure even before it is launched. You need to be sure that your budget constraints will not be an obstacle to quality writing. Learn the Context You need to explore the context of your paper. For example, consider the industry. You are not in a position to make any guesses. Precision and accuracy are your success factors. Use the most recent data and incorporate them into your paper. Presentation When you are done with writing, it is time to present the results to your target audience. Imagine that the quality of your presentation will influence the decision to give you a grant. It is a crucial part of your project, and you must not take it lightly. Do not let a poorly designed presentation take the success away from you! It is your time to excel in coursework writing, and you can do it with our help!

Identify the federal law that governs Protected Health Information Term Paper

Identify the federal law that governs Protected Health Information (PHI) and briefly discuss the elements of compliance. Describ - Term Paper Example In all, there are 18 identifiers that must be followed implicitly in order to avoid a breach of confidentiality. (Jones, 2009) Under HIPAA patients have the right to be educated regarding their health information and a clear definition of what will be done with that information, who has access to it; how it is stored, communicated, and distributed. They also have access to their health information with the right to amend it, obtain copies of it, and know the history of to whom it has been distributed. Before health care information can be released from the provider, the patient must sign an informed consent stating where the information will be distributed. This release must be specific and timely; health information requested for non-routine uses requires a separate consent to be signed by the patient. This authorized consent may not be forced or coerced; complaints with regards to breach of confidentiality can be filed with the Secretary of the Department of Health and Human Servic es. (Senior Health Forum, 2011) One of the largest claims filed to date involves a Seattle firm, Providence Health System.

Energy Expenditure and Lab Report Guide Essay Example | Topics and Well Written Essays - 500 words

Energy Expenditure and Lab Report Guide - Essay Example In this case, the kilocalorie percentage was 26.3 percent from carbohydrate, and 73.7 percent from fat. The total energy expenditure from carbohydrate equaled 14.71 kilocalories multiplied by the 26.3 percent of the total kilocalories from carbohydrate, in the end equaling 3.87 kilocalories from cholesterol alone. The total energy expenditure from fat equaled 14.71 kilocalories multiplied by the 26.3 percent kilocalories solely from fat; in the end 10.84 kilocalories were from fat. The 10-min oxygen consumption, while exercising for our subject, was equal to 25.39 VO2 L/m. The average RER during our subjects exercise was .8952. The formula that was needed to calculate respiratory exercise ratio during exercise was the average Carbon dioxide production (VCO2) during exercise divided by the average oxygen consumption (VO2). When the RER sums up to .8952 the caloric equivalent to this was 4.924 kilocalories per liquid oxygen. Gross energy expenditure during exercise is calculated by taking 25.39-oxygen consumption multiplied by 4.924 caloric equivalents equaling a total of 125.02 kilocalories. The net energy expenditure of our subject that was 125.02 equals Gross energy expenditure plus the resting energy expenditure equals 139.73. To calculate the total resting energy expenditure derived from carbohydrate and fat you take the RER and find the percentage kilocalorie for both of them. The percentage kilocalorie that derived from carbohydrate was 67.5. The percentage kilocalorie that came from fat was 32.5. The energy expenditure from carbohydrates equaled to 139.73 kilocalories multiplied by 67.5 percent equaling a total of 74.07 kilocalories deriving from carbohydrates. The energy expenditure from fat equals 139.73 kilocalories multiplied by 32.5 percent equaling a total of 45.41 kilocalories from fat. This sort of testing can be applied