An Inconvenient Truth Summary 3 – Essay – Deng1993

Director Davis Guggenheim eloquently weaves the science of  global warming  with Mr. Gore's personal history and lifelong commitment to reversing the effects of global climate change. A longtime advocate for the environment, Gore presents a wide array of facts and information in a thoughtful and compelling way. â€Å"Al Gore strips his presentations of politics, laying out the facts for the audience to draw their own conclusions in a charming, funny and engaging style, and by the end has everyone on the edge of their seats, gripped by his haunting message,† said Guggenheim.An Inconvenient Truth is not a story of despair but rather a rallying cry to protect the one earth we all share. â€Å"It is now clear that we face a deepening global climate crisis that requires us to act boldly, quickly, and wisely,† said Gore. Written by  Plantation Productions e host, was the vice president of the USA in the Clinton administration. He has been interested in climate change is sues since grade school and has continued to take  interest  in this subject as a politician. In this documentary, he highlights some very important points regarding global warming in his discussion.We will take a look at some of these. Some very important effects include illustrations of the impact ofglobal warming. He does this by first pointing out the relationship between the amount of carbon in the atmosphere and the corresponding temperature over a 650,000 years period. For example, he indicated some pictures of the ice melted in big Mountain in Africa called Kilimanjaro. He also talked about the increase of the ocean Temperature that guided to many Hurricanes and Tornadoes. To clarify, Florida in US got a very bad hurricane in September 2004 and that called Ivan.Then he focused on the Sea levels which are rising because of the amount of ice melting in the Arctic Sea and ice shelves by 1. 5 million km2 during the last forty years. For instance, Ice caps melts as the the te mperature of water raise and these can destroyed the ice species. Finally, He also mentioned that many people have died in different parts of the world because of high temperatures and heat waves. For example, the temperature in India raised and about 1400 people died in 2003.The extinction rate of many species is increasing and more than 30 diseases have appeared To sum up, Al Gore says that although the situation regarding global warming appears dire, he does speak fervently looking forward to the future with hope. His presentation concludes with parting nuggets of practical advice as to how man can play a role in curbing climate change. Posted by  J Al Gore, the one who was going to be the next president of the United States of America has dedicated his life to let the people around the world to be aware of the problem which threat life on the earth.In the next lines I’m going to outline a brief summary about his movie â€Å"An inconvenient truth†. Global warmingà ‚  is the catastrophe which threats life on earth. Al Gore explained how the atmosphere works; sun ray comes from the sun everyday then some of the rays stay inside the earth with the help of ozone layer to keep it warm. The crazy increase of carbon dioxide ratio has made the layer thicker so more rays are trapped more than we normally need. As a result, a lot of temperature changing can be seen around the world such as heat wave.Another problem the global warming is causing is that the ice is melting which is a very serious danger. The level of the sea, constructions and the weather itself all can be affected if the ice or permafrost starts to melt down because of the increasing of heat. At the end of his discussion, Al Gore confirmed that most of the scientists around the world agree that we are the main reason for the global warming. What will the future generation think of their parents if this problem gets more and more serious? Posted by  Khalid

Tartuffe: Truth and Religious Teachings

Dana Epstein Professor Morris ENG 2850 TR54C October 13, 2009 The Illusions That Define Us: Appearance versus Reality â€Å"Men in general judge more from appearances than from reality. All men have eyes, but few have the gift of penetration. † That quote by Nicollo Machiavelli is simply defined as, what you see is not always what you get and few men have the gift of being able to see through an appearance. In Tartuffe and Monkey, appearances are far from reality in many instances. Even though both texts were written in different milieus both societies focus strongly on religion and material value.Both characters are deceived by power, desires and the need to prove themselves. Spiritually is used to enlighten and religious teachings help Monkey to see the truth. However, Orgon needs to trust his senses because spirituality is used to deceive. The realization that is difficult for the audience to distinguish the difference between appearance and reality in both stories is very evident. In Tartuffe, Orgon is deceived by the holy zealous Tartuffe solely based on his false piety of religion. His need for power and prestige blinds his ability to see the truth about Tartuffe.He is so enthralled by Tartuffe because he enriches Orgon with power by appealing to his desires. Tartuffe is claiming to be a traditional figure of authority by presenting himself as a holy man and Orgon foolishly goes against everyone’s feeling towards Tartuffe and falls for his act. The audience is not told that Tartuffe is a liar or hypocrite but, through his words and the actions that follow, it allows the audience to differentiate between the lying Tartuffe and the honest family. In the first scene, Dorine states her feelings toward Tartuffe. You see him as a saint. I'm far less awed; In fact, I see right through him. He's a fraud. † Tartuffe, the hypocritical fraud, does no appear until act three, allowing the audience to see the other characters as honest witnesses to Tartuffe lies. As soon as he arrives, he over zealously informs Dorine that she is showing too much cleavage. His actions are seen as forced rather than genuine. Orgon is so blinded by Tartuffe that he does not even believe his own son when he tells him that Tartuffe is trying to seduce his wife Elmire.Orgon responds with â€Å"Ah, you deceitful boy, how dare you try to stain his purity with so foul a lie? † Orgon finally needs to perform a scientific experiment by hiding under the table to actually hear Tartuffe try and seduce his wife. Orgon’s mistake is that he needed to trust his senses rather then his spirituality and need to prove himself. His desire to be all powerful Orgon and control his children’s lives ended him in a bind where all his belongings were in the hands of Tartuffe. Orgon was deceived by religion and his desires to be all knowing and all powerful.The appearance of a â€Å"holy man† that Tartuffe presented completely blinded the reali ty that he was a con artist. Orgon chose to go against the intuitions of those he loves and trusts and is left struggling to define his own reality and truth in what spirituality means to him. The religious teachings and spirituality in Tartuffe leave Orgon to pick up the pieces of his fallen life and proves that trusting his senses was the key to defining reality. On the contrary, the religious teachings in Monkey help him to see the truth and define reality.Monkey’s journey consisted of many encounters where appearance is deceiving. The evil wizard is one of the most deceiving characters throughout the story. Through changing his appearance, he is able to disguise his true self as a lion of the gods to complete his task in teaching the king a lesson for being unkind to a beggar who was asking for help. The evil wizard pretended to help the king of the Crow-Cock Kingdom but instead shifts his form into the king and steals his throne. When Monkey confronts the evil wizard abo ut this change he then again shifts his form into Tripitaka so that Monkey cannot attack him.Through these appearances, the evil wizard was able to hide the reality that he was truly a lion on a mission. Though the evil wizard was one of the most manipulative characters, Pigsy and the Dragon both deceived reality with their appearances. Pigsy fooled those of the woman he married into believing he was a hard working young man, but once his true identity of a pig was known they soon became fearful of him. Another instance was when the white dragon was punished for eating the white horse so he was then transformed into Tripitaka's white horse for the journey.The appearances that deceived were all to complete their own missions and ultimately teach a lesson. Throughout the stories Monkey by Wu Ch`eng-en and Tartuffe by Jean-Baptiste Poquelin Moliere, appearance versus reality is a key theme. The audience can see the demise that Tartuffe had in store for Orgon all along. As for Monkey, t he reality throughout the story is layered between illusions and the supernatural, reality and truth. Both characters were deceived by opposite forces in which the quest for power and to meet their desires blinded their inability to decipher truth from false.

Evidence-based Interventions for a Patient Suffering from Dementia The WritePass Journal

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

How to Write a Discussion Section of a Research Paper

How to Write a Discussion Section of a Research Paper How to Write a Discussion Section of a Research Paper The discussion section of a research paper is dedicated to interpretation of your findings and their significance. Here, you discuss what has already been found about the problem by other researchers, and present your fresh view on the issue, taking into consideration all evidence and facts. This part of a research paper is very indicative of your progress as a student. The discussion section can be considered the most important part of the research paper, because it demonstrates your analytical skills. A good discussion section needs a critical approach to the question, and your ability to synthesize the findings of your research. If it has revealed any gaps in the field, this is also a good section to highlight these gaps, and give your suggestions on the possible improvements. Also, your discussion should be logically structured. There are several types of text structures, so you need to decide which one will be the most suitable, considering the type of research you are conducting. How to Structure Your Discussion Section We can allocate two types of structures you can use to organize the discussion section – vertical and horizontal. Vertical structure of the text is comprised of information presented in a hierarchical manner, relating to general elements and more specific ones. The topic unfolds into subtopics, subcategories and separate arguments. You have to keep in mind, that from your point of view, the argument and facts are arranged in a descending manner, taking into consideration how you intend to communicate your thoughts, speculations and conclusions. On the other hand, your reader will perceive all information in an ascending manner, from more specific elements to the general understanding of your topic. The horizontal structure is formed by creating cohesion between your findings. This cohesion is achieved by means of language devices, such as conjunctions, references and omission of words or phrases that can be logically derived from a sentence. All facts, arguments and speculations should be presented consistently, using logical connectives and references. Which Type of Structure is Better There is no right or wrong, it just depends on your findings. The horizontal structure is especially relevant when you are conducting an interdisciplinary research. There is no hierarchy between independent disciplines, so you need a structure which will highlight the relations between facts that belong to different fields. Vertical structure employs the deductive approach to research. If you start proving your thesis statement from a generalization and build your way to a conclusion by analyzing separate element of the general notion, then a vertical structure is more suitable for you discussion section. Points to Consider Whichever structure you decide to choose, your discussion section should have a brief summary of the importance of your findings for the field you study. You can also give your opinion on possible directions for future research, but add only those, that could not be researched in this particular paper. If you give recommendations for further research, remember to avoid repeating your statements in the conclusion section of your research paper. There is no use in wasting space with repetitions, and it can give an impression that you were careless with your final edit of the paper. And finally, on account of the overall research paper, avoid using first person too much. It can distract the reader from the main point of the paper – research.

Ancient Egyptian and Nubian Civilizations Essay

Ancient Egyptian and Nubian Civilizations - Essay Example The Old Testament refers to it as the kingdom of Cush and the Romans called it Nubia referring to its gold mines( Kasule 34). Excavations by the French archaeologists yielded exquisite ceramic figurines, funeral bric-a-brac and bowls that were dated at least during 8000 BC. Other archaelogists dug up great Nubian monuments such as parts of a magnificent temple, statues, pottery, jewelries and hosts of artifacts that convinced them that Nubia was the cradle of African civilization and the first black African civilization (Macleod, New York Times). Excavations in the Qustul cemetery by Keith Seele brought forth incense burners depicting a royal palace and a portrait of a king with the god Horus hovering above him. Other artifacts showed a monarchy that was even older than Egypt's and was perhaps the oldest recognizable monarchy in human history and was dated at 3300 BC or 3 generations before the first Egyptian king Scorpion in the 1st Dynasty. Many considered this Nubian civilization to be the Ta-Seti referred to in Egyptian writings (Renseberger, New York Times). So it is evident that the River Nile produced not one but two great civilizations. Later in this paper, we will prove that both civilizations were modified and perfected by the intermingling and influencing of one with the other and vice-versa. The Egyptian Civilization The River Nile was both a boon and a bane to the ancient Egyptians. Annually, between July and October, the Nile Valley, which is a ribbon of narrow, alluvial land measuring 2 to 3 miles in width from both banks of the Nile and extending some 12,000 sq. mi. from the Mediterranean to today's First Cataract, experiences inundation that washed away landmarks and destroyed properties. After the destruction loomed rich, fertile black land that stimulated3 agriculture(Grolier Universal Encyclopedia 77). Thus, the Nile represented a challenge and a development of all engineering, arithmetical, geometrical, surveying and other skills needed to control its unruly and temperamental nature. Thus, even during the predynastic Naqada period, papyrus writings showed that mathematical calculations including the use of decimals, fractions and the Pythagorean theorem were widely used. Because of the annual Nile deluge, Egyptians braced themselves from it and in the

EARLY US HISTORY Bacons Rebellion Assignment Example | Topics and Well Written Essays - 500 words

EARLY US HISTORY Bacons Rebellion - Assignment Example I have come to understand the changes that major events such as Bacon’s Rebellion have brought to Virginia. The history of this place is very interesting as it will help you understand major events that took place here and appreciate Virginia more. I have come to understand life here in Virginia very differently. In colonial Virginia, people used to suffer from a lot of problems such as high taxes and low prices for tobacco. The colonial times were very difficult for many people in Virginia. Those who got along well with the governor during those years, Sir William Berkeley, got special privileges, which was quite unfair to the rest of the people. These privileges were irregular because they were only accorded to those who were close to the governor. The governor also appeared to have failed in defending the region against the frequent attacks by Native Americans. These attacks led to mass deaths, as well as massive loss of property. The region was characterized by a disorganized political framework. Berkeley did not do enough to deal with the safety of the people he was in charge of protecting. The Bacon’s rebellion was a revolt organized by Nathaniel Bacon in 1976 in colonial Virginia to protest against the problems that were being experienced in Virginia at that time. Bacon was determined to bring the rule of Governor Berkeley to an absolute end. His efforts were aimed at bringing to the attention of the government the fact that all social classes needed to be treated equally and with dignity. Bacon’s rebellion led to a better Virginia that is seen today. The region had serious problems of racism which saw the blacks and whites engaged in constant conflicts. However, during the rebellion, the blacks and whites joined hands to oppose the rule of Governor Berkeley. The ruling class was really threatened by this unity because it was something that had

Research Paper Example | Topics and Well Written Essays - 2250 words

Research Paper Example T. S. Eliot once wrote about the nature of writing and that in the act of writing, the past and the present merge. Gaiman creates worlds in which the past and the present come together in order to examine modern life in relationship to those belief systems that have come before and have influences on the present. Without the use of past texts in order to create his fantastical works, Gaiman’s work would not connect on the level that it currently does and not have the essence of human existence that is reflected in his work. Influence One of the things a good reader will notice about well written fiction is that it is founded on influences that are highly recognizable and filled with wonder that extends the work rather than burdening it with the words of others. Sometimes popular fiction will suddenly make a reference that has little meaning but adds a bit of pop culture flavor to the writing. This does not always enhance the writing, but will sometimes burden the reader as the y try to decide what the author means and why it was necessary to increase the value of the writing. In the case of a really good writer, however, references from all time periods will flow into the work, creating depth and meaning that expands upon the writing rather than weighting it down. This is the skill with which Neil Gaiman delights his readers. Gaiman uses mythologies in order to expand the universes in which he places his stories. By referencing the worlds of ancient texts, he is enriching his work while giving it a very modern sense of the mythical world. The questions that are asked by using these worlds are answered through modernized prose in which vernacular language and modernized events are connected to aspects of the myths that he is using to enrich his work. Much of what is reflected in his work comes from Greek myths. The sense of multiple gods and complex mythologies, combined with emotions that are translated into the actions of those representing god-like mani festations provides an interesting backdrop to the work he creates. T. S. Elliot worked as an unassuming bank clerk by day, but by night was forging literary greatness as he created works that have inspired generations. Bloom writes that â€Å"Elliot’s aim was to compose an extended collection of poems that would denounce modern civilization and capture the disillusionment of his postwar generation† (Bloom 4). In discussing literature, the following quote can be attributed to him: Tradition is a matter of much wider significance. It cannot be inherited, and if you want it you must obtain it by great labour. It involves, in the first place, the historical sense, which we may call nearly indispensable to anyone who would continue to be a poet beyond his twenty-fifth year; and the historical sense involves a perception, not only of the pastness of the past, but of its presence; the historical sense compels a man to write not merely with his own generation in his bones, bu t with a feeling that the whole of the literature of Europe from Homer and within it the whole of the literature of his own country has a simultaneous existence and composes a simultaneous order (Eliot and Kermode 38). In a way, Eliot was commenting on the nature of time in that it is not so much a linear concept, but a loop in which all things of the past are present in how life is conducted. What was written in the past influences how what is written today manifests. Without mythologies of the past, the present has no real depth. A