Past Progressive - Definition and Examples in English

Human Or Climate Interference Alters Second Succession

There are four major rainforests there is mixed forest, Marantaceae forest, Monodominant Gilbertiodendron forest and swamp forest. According to the article â€Å"Influence of 1100 years of burning on the central African rainforest† the scientists are trying to find the flammability of the different forest types when ignited and whether an increased number of ignition events be human or climatically driven will result in an alteration of the type of forest after recovery (Tovar et al., 2014). This hypothesis is correlates with biology by life cycle. Biology is the study of life. Human or Climate interference alters second succession. In nature, the forest rainforest would be replaced with its original species. In today’s world, it’s been messed up that original species can’t return as easily as the non-native replacements. The burning of the forests that creates another type of forest after recovery is the cycle of life of a rainforest. Figuring out what ig nition rates cause alteration of the type of forest after the recovery is important. By having this information will give us a better understanding on how fire can affect rainforests alternating types. Rainforests are becoming less and less so it’s important to know as much as we can and know how the different types of forests are formed. Method â€Å"Influence of 1100 years of burning on the central African rainforest† is written by Nordic Society Oikos group, there was six scientists who worked on this research. The scientistsShow MoreRelatedNatural Dyes11205 Words   |  45 Pagessulfate), iron (ferrous sulfate, called copperas) and chrome (potassium dichromate) are also used. Iron mordants sadden colors, while tin and chrome mordants brighten colors. Additional chemicals or alterants may be applied after dying to further alter or reinforce the colors.[10][11] A dye-works with baskets of dyestuffs, skeins of dyed yarn, and heated vats for dyeing. Textiles may be dyed as raw fiber (dyed in the fleece or dyed in the wool), as spun yarn (dyed in the hank or yarn-dyed), or afterRead MoreEssay Paper84499 Words   |  338 PagesHeadquarters Department of the Army Washington, DC 18 March 2008 UNCLASSIFIED SUMMARY of CHANGE AR 600–20 Army Command Policy This rapid action revision, dated 20 September 2012-o Updates policy for the administration of unit command climate surveys: adds requirement for personnel equivalent to company level commanders; updates timelines to within 30 days (120 days for Army National Guard and U.S. Army Reserve) of assuming command, again at 6 months, and annually thereafter (parasRead MoreAbstract: Strategic Contingency Planning23625 Words   |  95 Pagesfacilities manager, disaster recovery coordinator, etc.) and the appropriate business owners of critical organization functions. (DRJ Editorial Advisory Board, 2005) Damage Assessment: An appraisal or determination of the effects of the disaster on human, physical, economic, and natural resources. (NFPA, 2004, Section 3.3.2, p. 1600-4) Disaster: A sudden, unplanned calamitous event causing great damage or loss as defined or determined by a risk assessment and business impact analysis; 1) Any eventRead MoreOne Significant Change That Has Occurred in the World Between 1900 and 2005. Explain the Impact This Change Has Made on Our Lives and Why It Is an Important Change.163893 Words   |  656 PagesCentury †¢ Jose C. Moya and Adam McKeown 9 †¢ 2 Twentieth-Century Urbanization: In Search of an Urban Paradigm for an Urban World †¢ Howard Spodek 53 3 Women in the Twentieth-Century World Bonnie G. Smith 83 4 The Gendering of Human Rights in the International Systems of Law in the Twentieth Century †¢ Jean H. Quataert 116 5 The Impact of the Two World Wars in a Century of Violence †¢ John H. Morrow Jr. 161 6 Locating the United States in Twentieth-Century World History Read MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 PagesUnderstanding Work Teams 307 Communication 335 Leadership 367 Power and Politics 411 Conflict and Negotiation 445 Foundations of Organization Structure 479 v vi BRIEF CONTENTS 4 The Organization System 16 Organizational Culture 511 17 Human Resource Policies and Practices 543 18 Organizational Change and Stress Management 577 Appendix A Research in Organizational Behavior Comprehensive Cases Indexes Glindex 637 663 616 623 Contents Preface xxii 1 1 Introduction Read MoreStrategy Safari by Mintzberg71628 Words   |  287 Pagesall of them were blind) That each by observation Might satisfy his mind. The First approached the Elephant, And happening to fall Against his broad and sturdy side, At once began to brawl: God bless me but the Elephant Is very like a wall. The Second, feeling of the tusk, Cried, Ho! What have we here So very round and smooth and sharp? To me tis mighty clear This wonder of an Elephant Is very like a spear! The Third approached the animal, And happening to take The squirming trunk within hisRead MoreCommunication Management Challenges in Construction Project Execution63139 Words   |  253 Pagesthe interests of the owner and the contractor. In order to reduce the cost of construction, some owners introduce value engineering, which seeks to reduce the cost of construction by soliciting a second design that might cost less than the original design produced by the A/E firm. In practice, the second design is submitted by the contractor after receiving a construction contract at a stipulated sum, and the saving in cost resulting from the redesign is shared by the contractor and the owner. TheRead MoreHuman Resources Management150900 Words   |  604 PagesCHAPTER 1 Changing Nature of Human Resource Management After you have read this chapter, you should be able to: ââ€"  Identify four major HR challenges currently facing organizations and managers. List and define each of the seven major categories of HR activities. Identify the three different roles of HR management. Discuss the three dimensions associated with HR management as a strategic business contributor. Explain why HR professionals and operating managers must view HR management as anRead More1000 Word Essay85965 Words   |  344 PagesNon-Traditional Education Support (DANTES) Education Counseling Services Learning Resource Centers What Soldier development programs does ACES provide? 1. Functional Academic Skills Training (FAST). 2. High School Completion Program. 3. English-as-a-Second Language (ESL) 4. Mission-related Language (Head start and Gateway). 5. Mission-required Language. 6. MOS Improvement Training (MOSIT). (AR 621-5 Feb 2004 / 4-1 / PDF 17) What does DANTES stand for? Defense Activity for Non-Traditional EducationRead MoreManagement Course: Mba−10 General Management215330 Words   |  862 PagesValue−Based Management Framework: An Overview 2. Why Value Value? 4. The Value Manager Harvard Business Review Finance Articles Eclipse of the Public Corporation 308 308 323 323 330 330 Article How I Learned to Live with Wall Street Article Second Thoughts on Going Public Article Reed−Lajoux †¢ The Art of M A: Merger/Acquisitions/Buyout Guide, Third Edition 10. Postmerger Integration 336 336 Text Hodgetts−Luthans−Doh †¢ International Management, Sixth Edition II. The Role of Culture

Financial report analysis Essay - 1997 Words

Introduction The following report is an analysis of the consolidated accounts for Hallenstein Glasson Holdings Ltd (HLG) based on the 2013 financial statements and the ratio analysis is based on the group account figures. The terms of this report is to firstly, determine the strengths, weaknesses and prospects of HLG and secondly, to determine if the shares are favourably priced? Business Summary Hallenstein Glasson Holdings Limited is a holding company. The Company, through its subsidiaries, is a retailer of men’s and women’s clothing in New Zealand and Australia. The Company’s segments include Hallenstein Bros Limited (New Zealand), Glassons Limited (New Zealand), Glassons Australia Limited (Australia), Storm (Retail 161 Limited)†¦show more content†¦4 Tax Expense Tax Expense 8281 28% NIBT 29301 Efficiency Analysis 5. Age of Accounts Receivable turnover is the ratio of net credit sales to average accounts receivable. It is an activity or efficiency ratio and it measures average number of times a business collects its receivables during a period usually a year. Generally a high value of accounts receivable turnover is favorable and lower figure may indicate inefficiency in collecting outstanding sales. For HGH the camparison between 1/12 of sale and liste AR for the year is approx 0.5 which is very similar to previous year when adjusted for Christchuch Earthquake Receivables and higher than camparable company KTHDY at 0.12. 5 Age of Accounts Account Rec 864 0.05 Receivable 1/12 Credit sales 17965 6. Stock turn over ratio Inventory turnover ratio indicates the number of time the stock has been turned over during the period and evaluates the efficiency with which a firm is able to manage its inventory. This ratio indicates whether investment in stock is within proper limit or not and for a fashion clothing company 5 times would be expected and is stable compared to the previous year. This compares favourably with Kathmandu which as a discounting chain is only turning over stock at 2 times a year. 6 Stock Turn Cost Sales 89193 5 Inventory 19514 7. Net Cash Flow comparison to net income after tax. By taking net income and makingShow MoreRelatedAnalysis of Comprehensive Annual Financial Report2237 Words   |  9 PagesAnalysis of Comprehensive Annual Financial Report Table of Content I. Abstract II. Introduction III. Introductory analysis amp; GFOA Award IV. Financial Analysis V. Financial standing VI. Conclusion VII. References Abstract Comprehensive Annual Financial Report (CAFR) is a report used by cities, and local governments to provide the public with their financial records each year, while adhering to government accounting standards board (GASB) guidelines. The report presentsRead MoreAnalysis Of The Financial Report Prepared By The County Of Santa Barbara Essay1160 Words   |  5 PagesThe paper is an analysis of the financial report prepared by the County of Santa Barbara. The financial report contains all the details containing its financial activities for the year ended June 30 2015. The financial report has been prepared in accordance with the laws as established by the state of California which require counties to submit a financial report for each financial year. The current condition of the economy is further discussed using some tools that give additional details aboutRead MoreFinancial Report Analysis2883 Words   |  12 PagesTranslation – AASB 121 3 2.3 Income Taxes – AASB 112 4 2.4 Consolidation – AASB 127 4 2.5 Impairment of Assets – AASB 136 4 3. Management’s flexibility in selecting key accounting policies 4 3.1 Interest Bearing Liabilities 4 3.2 Derivative Financial instruments 5 3.3 Interest Bearing Liabilities 5 3.4 Intangible Assets - Goodwill 5 4. Accounting strategy employed by management and incentivesl 5 4.1Evaluation of accounting strategy employed by management 5 4.2Evaluation of incentivesRead MoreFinancial Analysis Report4082 Words   |  17 PagesTable of Contents INTRODUCTION 2 COMPANY PROFILES 3 HMV GROUP PLC 3 THE GAME GROUP PLC 3 VERTICAL ANALYSIS 4 HMV 4 GAME 5 HMV VS GAME 5 TREND ANALYSIS 6 HMV 6 GAME 7 HMV VS GAME 7 HMV: FINANCIAL POSITION VERTICAL AND TREND ANALYSIS 8 GAME: FINANCIAL POSITION VERTICAL AND TREND ANALYSIS 11 HMV VS GAME 12 PROFITABILITY 13 GROSS PROFIT, MARK UP AND NET PROFIT MARGIN 13 HMV 13 GAME 13 RETURN ON CAPITAL EMPLOYED 14 PYRAMID RATIOS 15 RETURN ON EQUITY 16 EFFICIENCY 17 RECIEVABLESRead MoreFinancial statement analysis and report932 Words   |  4 Pagesï » ¿ACFI 1001 Accounting for Decision Makers – Individual Project (15%) Financial Statement Analysis and Report Objectives Apply theory in practice Conduct analysis of financial statement – to look beyond the numbers Experience formal report writing. REQUIRED: Written report (a soft copy on blackboard via turnitin and printed copy to tutors is compulsory) 1. Obtain the most recent annual report for two companies in any of the industries on the Australian Stock Market (for exampleRead MoreSample Financial Analysis Report15926 Words   |  64 PagesRE-INVENTING XYZ Financial Analysis Report Finance Team Prepared for: XYZ BPE Project XYZ Ministry of Government Services November, 1994 XYZ BPE Project Financial Analysis Report Table of Contents Executive Summary ...................................................................................................................................................................................1 Financial Model Review .........................................................................Read MoreFinancial Ratio Analysis Report1667 Words   |  7 PagesFINANCIAL RATIO ANALYSIS REPORT The fiscal year 2004 was a relatively soft year for Barnes Noble, Incorporated (BN). Blockbuster nonfiction books that came out during the year may not have come from the company, but business remained strong. This is due to the million of books already in the market, including phenomenal fiction hits The Da Vinci Code, The Five People You Meet in Heaven, and The Rule of Four, and thousands of new releases during the year. This claim was supported by theRead MoreCompany Report And Financial Analysis Essay4668 Words   |  19 PagesCompany Report and Financial Analysis Wal-Mart Stores, Inc. Nada Guzaiz Nouf Alharshani Wande Brewer Contents Introduction 1 Company and its Products 1 ?Stock prices of Wal-Mart of last 12 months.? 1 Analysis of financial ratio values 1 Net profit margin of Wal-Mart 2 Three-year trend of Net Profit Margin of Wal-Mart Inc 2 Financing situation of Wal-Mart 3 Three-year trend in Debt-to-Equity-Ratio of Wal-Mart3 Total asset?s turnover of Wal-Mart 4 Three-year trend of NetRead MoreTesco Financial Report and Analysis2683 Words   |  11 PagesIntroduction After the end of every year, major companies produce an annual report to show shareholders or poteintial investors their performers for the year. Throught this report, the company is able to plan and set goals for the next trading year. Therfore, allowing them to identify their weakness and streanght. The purpose of this report is to analyse Tesco’s annual report. The reoprt consist of a sypnosis of Tescos, describing what it does where it does it, how many people it employsRead MoreGm Financial Report Analysis Essay1265 Words   |  6 Pagesdistributors worldwide. GM engines and transmissions are marketed through GM Power train. GMs largest national market is the United States, followed by China, Canada, the United Kingdom, and Germany. GM owns nearly-half (49%) of the finance company GMAC Financial Services, which offers automotive, residential and commercial financing and insurance. GMs On Star subsidiary is a vehicle safety, security and information service provider. There have only been a limited number of models bearing the General

A Medical Revolution Essay - 1547 Words

In the spring of 1918, the first wave of one of the deadliest influenza pandemics began plaguing its victims (Peters, ix). Over the span of three lethal waves, the pandemic claimed approximately forty million victims, eradicating nearly twenty percent of the entire world’s population, or about one out of five individuals (Peters, ix). To make matters more dire, the ill-suited medical community was exceptionally unprepared for such a wide-scale pandemic: Doctors had very basic tools, knew little about diseases, and had no experience with vaccinations or prevention (Peters, 1-5; â€Å"The 1920s: Medicine and Health: Overview†, n.p.). People blindly faced the epidemic, relying on folk remedies such as consuming wine, drinking antiseptic, and†¦show more content†¦Although doctors were supposed to be considered medical experts, they were not taken seriously due to the fact that a patient had less than a fifty percent chance of benefiting from a doctor’s vi sit (â€Å"The 1920s: Medicine and Health: Overview†, n.p.). Doctors struggled to diagnose and fix medical problems due to inexperience and lack of tools (â€Å"The 1920s: Medicine and Health: Overview†, n.p.). As a result of the substandard medical community, maternal deaths and child deaths were commonplace, while simple sicknesses often turned into fatal infections (â€Å"The 1920s: Medicine and Health: Overview†, n.p.). When the first wave of the influenza pandemic struck in the spring of 1918, the medical community was taken aback by the pandemic’s unpredicted wrath (Peters, 13). The typically mellow influenza virus, characterized by familiar symptoms of fever, headache, fatigue, cough, sore throat, congestion, and body aches, claimed victims within hours (Peters, ix, 1-5). This was a sickness like no other, and it left the medical community baffled. Doctors nor medical experts knew what the sickness was, why it was spreading, what was causing it, or how to fix it (Peters, 1-5). All branches of the medical field practically shut down: researchers found no potentialShow MoreRelatedIndustrial Revolution Essay799 Words   |  4 PagesWas the Industrial Revolution a blessing or a curse?   Ã‚  Ã‚   Starting in 18th century Great Britain, the Industrial Revolution, sparked a change in industry that is still present today. The Industrial Revolution was a great blessing to society, with innovations in consumer goods, medicine, housing and sanitation, the revolution changed the course of history for the good. The Industrial revolution was a period in which Great Britain became rapidly less rural and became more urban and mechanized. â€Å"TheRead MoreMedicinal Practices from the American Revolution to the War of 18121308 Words   |  5 PagesMedicinal Practices; American Revolution to the War of 1812 For centuries, war has consumed millions of souls. It has caused heartache and has torn families apart. Today, properly educated doctors and nurses can treat wounds and injuries with proper care, but this taken for granted assistance wasn’t always readily available. In the Revolutionary War and the War of 1812, nearly 30,000 American soldiers died. However, rather than being killed on the battlefield, the majority of soldiers died whileRead MoreIndustrial Of The Industrial Revolution1666 Words   |  7 PagesJason Thibodeaux Mrs. Martinez English IV, 1st hour 4/29/16 The Industrial Revolution The Industrial Revolution set people away from farms and small villages and moved them to cities and towns because of the job opportunities that arose in the cities. The Industrial Revolution not only helped people move along in the late 1700s and early 1800s but also it has made the people what they are today. During the Industrial Revolution, the movement from an agrarian society to an industrial one reshaped theRead MoreThe Era Of Industrial Revolution1474 Words   |  6 Pagesbrought substantial and visible change to the way of living is the era of Industrial Revolution. The period of the Industrial revolution began in the early 1700s and ended in the late 1800s. During the century, the Industrial revolution engendered both positive and negative changes to the human society. Some of the cons include the rapid increase in human population, as at the beginning of Industrial revolution, population grew by 57 percent. In addition, growth of factories and industries ensuedRead More The Death Of The Clinic873 Words   |  4 Pagesexercise in post-modernity. Foucault detailed an emerging structure of systematised clinical practice that grew out of the French Revolution, one which had in which ultimately been to the benefit of the citizenry. The increasingly uncertain position of the traditional, mystical, Aristotelian physician was saved in a supposed age of rationality through the growth of medical teaching, civil structures of patient care, and an overriding trust in the perception (or, in his words, gaze) of a select groupRead MoreMarijuana Oil Treatment For Children1047 Words   |  5 Pagesstrain for use in treating medical conditions. http://steephill.com/genetics Read this Article! http://www.cnn.com/2014/03/10/health/medical-marijuana-refugees/index.html Support for legalization has risen 11 points in the past few years alone. In 1969, the first time Pew asked the question about legalization, only 12% of the nation was in favor. I see a revolution that is burning white hotRead MoreArt Is Not Plagiarism Or Revolution?1128 Words   |  5 PagesUNIVERSITY OF CHICAGO EXTENDED ESSAY 4 â€Å"Art is either plagiarism or revolution.† –Paul Gauguin. What is your â€Å"art†? Is it plagiarism or revolution? Add a mustache and a beard to the Mona Lisa--it becomes L.H.O.O.Q., a Dada piece of art by Marcel Duchamp. Assemble a bicycle seat and handlebars--it becomes Bull s Head, a found object artwork by Pablo Picasso. The creation of such works, which directly borrow ideas or actual parts of another work, can be considered plagiarism, but that assumptionRead MoreThe Effects And Effects Of The Industrial Revolution During The Victorian Era1465 Words   |  6 Pagesthe Victorian years, some of the main characteristics we think of the industrial revolution and the effects during the Victorian period. In this assignment I’m going to explain the impact that the industrial revolution had on people in There are three main characteristics of the industrial revolution which most people would think of first which are urbanization, suburb slums and agricultural revolution. Urbanization is when people move from small towns and the countryside to live in cities for moreRead MoreIndustrialization Of The Industrial Revolution Essay999 Words   |  4 PagesIndustrial Revolution completely restructured the old America into a completely different place in which we now live in. These changes brought about railroads, manufacturing cities, and population growth; this also brought new inventions such as electricity and steel itself. Although it had some positive impacts, it also introduced new problems such as the dramatic difference between the rich and the poor. Overall, it led to the change from agriculture to machinery. The Industrial Revolution began inRead MoreThe Era Of The 19th Century1135 Words   |  5 PagesEurope faced an era of revolutions at the wake of the nineteenth century. Long-standing empires, which had traditionally controlled most of the world –including the Spanish, Chinese, French, and Holy Roman Empires –, collapsed at the beginning of the century, allowing the British Empire to rise to power and establish dominance over a fifth of the Earth’s surface. This political revolution was coupled with the industrial revolution. New manufacturing processes called for large industrial factories

The Frick Collection And The Met - 1309 Words

The Frick Collection and The Met: A Comparison The Frick Collection and The Metropolitan Museum of Art are both very distinct art museums. If you visit the museums or their online websites, it becomes very apparent that they differ in historical backgrounds, in their curatorial departments, in the way in which they were founded and then funded and in the collections of art that they house. I visited both museums and it was evident to me that they bore many differences, and at the same time, they were also similar in some aspects. Historically, the Frick Collection was a private collection by Henry Clay Frick, who started the collection and housed it in his own home. After his and his wife’s death, it was publicly opened as a museum in†¦show more content†¦However, when I first entered the museum, it felt very dark and it smelled of wood. It gave me the feeling of being at the house when it was up and running. What I noticed about the way the paintings were displayed was that in each hallway, one painting in every room would appear right in front of you, which also portrays the value of each of those paintings because of the way they were placed to be seen. (2) Both museums are situated in ‘wealthy’ areas of New York City and thus indicate that there may be an association between the grandeur of museums and wealth or sophistication. Another aspect that I found to be very interesting was the way in which each of the museums offered different multimedia formats to facilitate the visitor’s experience with the artwork in display. I noticed that both museums offered applications for smartphones and tablets, free of charge, to assist the visitors with getting the most possible out of the museum. Visiting a museum can be a very distracting task because there is so much to see and without a plan or a navigating system that helps you make your way towards the museum, it can be hard to gain something from your visit. Both apps are accessible to most people and very easy to navigate through. These apps included audio guides, exhibition information, calendars, events and so on. However, I noticedShow MoreRelatedStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pagesstudents better understand their interpersonal and behavioral skills as they relate to the theoretical concepts presented in each chapter. Highlights †¢ †¢ †¢ †¢ †¢ †¢ 69 research-based self-assessments—All 69 instruments of our collection are from sources such as Journal of Social Behavior and Personality, Harvard Business Review, Organizational Behavior: Experiences and Cases, Journal of Experimental Education, Journal of Applied Measurement, and more. Work–life and career focused—All

Nursing Care Practices For The Management Of Embolic Stroke - Samples

Question: Discuss about the Nursing Care Practices For The Management Of Embolic Stroke. Answer: Introduction The current assignment focuses on thenursing care practices for the management of Embolic stroke. Embolic stroke could be referred to the condition when a blood clot which forms elsewhere in the body travels to the brain via the blood stream. It blocks the adequate supply of blood to the brain leading to ischemic stroke. This cuts off the required amount of oxygen and nutrients from reaching the brain. Some of the factors which further increase the chances of contraction of the disease are- being over 40 years of age, possessing autoimmune disease such as diabetes, presence of heart disease (Holmes Jr et al., 2015). Cerebrovascular accidents (CVA) are one of the biggest killers in Australia. It has been found that 80% of the strokes could be prevented which in turn adds up to a sufficient amount of healthcare costs (Mozaffarian et al., 2016). Therefore, effectivenursing care could be designed for control and management of the condition of the patient. The assignment discusses in deta il the efficacy of evidence based pharmacological intervention methods. Patient background In the current assignment we have focussed upon medication management and nursing care for embolic CVA. For designing of an effective care management the patient background needs to be taken into consideration (Hart et al., 2014). Here, the patient was a 58 year old man named John who had been brought and admitted to the hospital on grounds of feeling numbness in his rights hands along with speech difficulty and light headedness. He worked as a construction site engineer with Quality enterprises and solutions located in the Osborne region of New South Wales. As reported by his family John had normally reported to work for the day. However, he started feeling uncomfortable in the afternoon and was unable to work till he started feeling dizzy and had numbness in his right arms. Later he was admitted the daffodils hospital on encountering blurred vision, slurred speech. Reason for admission John had been feeling dizzy at his place of work and had difficulty in breathing. He later on developed slurred speech and blurred vision which made work difficult for him. His fellow workers felt that he needed immediate medical intervention and got him admitted to the hospital. John was immediately attended by a resident doctor. He reported that John had poor pulse rating, high BP along with slow breathing. The patient also reported signs of face muscle twitching along with slurred speech. Therefore, based upon these symptoms he was shifted to the medical examination room. Diagnosis Based upon the range of a number of clinical symptoms such as slurred speed, blurred vision, numbness in the right hands which gradually spread to the entire arm along with face muscle twitching and dizziness, John was suspected of embolic stroke. The tool used in order to access the condition of the patient was the FAST framework. Here, FAST stands for face, arms, speech and time. Here, the patient exhibited constant face muscle twitching along with difficulty in raising both his arms straight. Therefore, the preliminary diagnosis was given that the patient might be experiencing an embolic stroke. Therefore, the patient was suggested a blood test a along with CT scan. The CT scan confirmed the presence of ischemic stroke in the penumbra region of the brain. Past medical history The diagnosis of the past medical history of the patient plays a crucial role in the designing of effective care treatment for the patient. Here, John had a past history of hypertension and high blood cholesterol. On further investigations, it was found that he had previously fallen unconscious in his place of work an had to be given artificial oxygen. Therefore, based upon the past history of hypertension the patient was put under emergency care for embolic stroke symptoms management and prevention. A-E assessment of the patient with expected findings typical of embolic stroke An A-E assessment of the patient was conducted for analysing the physical condition of the patient. Here, A refers to airway, B for breathing, C for circulation, D for disability and E for exposure. Attributes Effects A- Airway The patient had difficulty in breathing stressing upon the need for mechanical ventilation. Once the airway had been inserted into the patient the see-saw movement of the chest stops in the patient. B- breathing The patient recorded SpO2 level of 84% which is comparatively low whereas the normal SpO2 is expected to remain somewhere between 94% to 99% .The falling of the SpO2 level below 84% point towards the administration of artificial oxygen support. C-circulation The patient recorded high blood pressure along with difficulty in breathing. D-disability The patients had slurred speech and difficulty in talking. He could only answer to the inquiries made by the doctor by making eye gestures. E- exposure The patient further recorded temperature around 38.2 degree centigrade which was slightly higher than the normal. Preliminary diagnosis: The patient could be suffering from an embolic CVA. Pharmacological treatment for embolic stroke The pharmacological treatment for stroke could be divided into- stroke-specific treatment and stroke prevention. As commented by Ruff et al. (2014), the treatment process further varies depending upon the nature of the stroke whether it is ischemic or hemorrhagic. Some of the pharmacotherapeutic options are tissue plasminogen activartor (tPA) and antiplatelet agents. It was found that the ones receiving tPA were more likely to have minimal or no disability after several months of treatment (DeBaun et al., 2014). Anti platelet agents such as aspirin have been found to be effective for the treatment of acute ischemic stroke. The aspirin therapy should begin within 24-48 hours of the acute ischemic stroke (Berkhemer et al., 2015). The secondary treatment addresses the prevention of recurrences of the symptoms of stroke by controlling some of the metabolic risk factors namely blood pressure and lipids. The use of diuretics along with angiotensin converting inhibitor enzyme has been seen to be beneficial. Evidence based rationale for medication and nursing care The medication provided for the management of the conditions of embolic stroke could be justified with the help of a number of supportive theories and arguments. Evidence based approaches have proved that revasculiarization of the ischemic brain and arousing sleep neurons can improve outcomes in patients with acute stroke (Campbell et al., 2015). The two major drug classes used over here are thrombolytic and antiplatelet agents. Currently one of the approved drugs which are used is tissue plasmionogen activator (t-PA) alteplase, which results in reperfusion by dissolving the thrombus (Saver et al., 2016). The affectivity of the drug supplied depends on the effectiveness of delivery to the damaged channel. As supported by Diener et al. (2015), if tPA is administered within three hours of onset of stroke improved functional outcome is observed. As supported by Schnenberger et al. (2016), administration of low molecular weight heparins have been further seen to lower the risk of thrombo cytopenia or osteoporosis in the patient. tPA has been rated as the Gold standard for the treatment of ischemic cerebral stroke. It works by dissolving blood clot and improving the flow of blood to the brain. As reported by Doucet, Roncarolo, Tampieri del Pilar Cortes (2016), patients who have got tPA administration on time have been seen to recover better than the one who had not received the drug therapy at the right time. The after treatment could be started with the right doses of administration of anticoagulants. The anticoagulants have been seen to interfere with the blood capacity to clot (Nikoubashman et al., 2017). Therefore, improving the supply of blood to the brain and can be used an effective preventive measure. In this respect, the chances of recurrence are most common in the patient within 90 days of suffering a first stroke. Therefore, in order to control the rate of the fatalities it is necessary to put the patient on anti-coagulants. In this respect, employment of trainednursing professionals trained in the areas of acute stroke management could be beneficial. Additionally, using frameworks such as Fast can r help the nurse analyse the condition of the patient. As mentioned by Anderson, Saleemi Bialystok (2017), effective record keeping and documentation has also been seen to enhance the process of drug delivery and monitoring in the patients. However, the nursing professional should ensure that permission have been sought from the respective family members of the patients before putting them through any aggressive care procedures. Conclusion The current assignment focuses on the concept of nursing care provision and management for embolic stroke. The patient has suffered an embolic stroke and had to be provided immediate care provision and management. In this respect, effective caution needs to be practised regarding the administration of the medications to the patient. For the preliminary examination of the condition of the patient a FAST framework was followed. Form the diagnosis it was ascertained that the patient could be having an embolic stroke. Hence, the patient was put under further blood tests and CT scan, which confirmed the presence of Embolic stroke in the patient. The assignment also discusses the effectiveness of different medications. Some of these have been discussed with regards to the rate of success in controlling the progression through the condition of embolic stroke. More emphasis had been given to tPA administration which if provided within a particular time frame can reduce the severity of the st roke References Anderson, J. A., Saleemi, S., Bialystok, E. (2017). Neuropsychological assessments of cognitive aging in monolingual and bilingual older adults.Journal of neurolinguistics,43, 17-27. Berkhemer, O. A., Fransen, P. S., Beumer, D., Van Den Berg, L. A., Lingsma, H. F., Yoo, A. J., ... van Walderveen, M. A. (2015). A randomized trial of intraarterial treatment for acute ischemic stroke.New England Journal of Medicine,372(1), 11-20. Campbell, B. C., Mitchell, P. J., Kleinig, T. J., Dewey, H. M., Churilov, L., Yassi, N., ... Wu, T. Y. (2015). Endovascular therapy for ischemic stroke with perfusion-imaging selection.New England Journal of Medicine,372(11), 1009-1018. DeBaun, M. R., Gordon, M., McKinstry, R. C., Noetzel, M. J., White, D. A., Sarnaik, S. A., ... Telfer, P. T. (2014). Controlled trial of transfusions for silent cerebral infarcts in sickle cell anemia.New England Journal of Medicine,371(8), 699-710. Diener, H. C., Easton, J. D., Granger, C. B., Cronin, L., Duffy, C., Cotton, D., ... Sacco, R. L. (2015). Design of Randomized, double-blind, Evaluation in secondary Stroke Prevention comparing the EfficaCy and safety of the oral Thrombin inhibitor dabigatran etexilate vs. acetylsalicylic acid in patients with Embolic Stroke of Undetermined Source (RE-SPECT ESUS).International Journal of Stroke,10(8), 1309-1312. Doucet, C., Roncarolo, F., Tampieri, D., del Pilar Cortes, M. (2016). Paradoxically decreased mean transit time in patients presenting with acute stroke.Journal of computer assisted tomography,40(3), 409-412. Hart, R. G., Diener, H. C., Coutts, S. B., Easton, J. D., Granger, C. B., O'Donnell, M. J., ... Cryptogenic Stroke/ESUS International Working Group. (2014). Embolic strokes of undetermined source: the case for a new clinical construct.The Lancet Neurology,13(4), 429-438. Holmes Jr, D. R., Doshi, S. K., Kar, S., Price, M. J., Sanchez, J. M., Sievert, H., ... Reddy, V. Y. (2015). Left atrial appendage closure as an alternative to warfarin for stroke prevention in atrial fibrillation: a patient-level meta-analysis.Journal of the American College of Cardiology,65(24), 2614-2623. Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., ... Howard, V. J. (2016). Executive summary: heart disease and stroke statistics2016 update: a report from the American Heart Association.Circulation,133(4), 447-454. Nikoubashman, O., Pauli, F., Schrmann, K., Othman, A. E., Bach, J. P., Wiesmann, M., Reich, A. (2017). Transfer of stroke patients impairs eligibility for endovascular stroke treatment.Journal of Neuroradiology, 55-85. Ruff, C. T., Giugliano, R. P., Braunwald, E., Hoffman, E. B., Deenadayalu, N., Ezekowitz, M. D., ... Yamashita, T. (2014). Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials.The Lancet,383(9921), 955-962. Saver, J. L., Goyal, M., Van der Lugt, A. A. D., Menon, B. K., Majoie, C. B., Dippel, D. W., ... Cardona, P. (2016). Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis.Jama,316(12), 1279-1289. Schnenberger, S., Uhlmann, L., Hacke, W., Schieber, S., Mundiyanapurath, S., Purrucker, J. C., ... Ringleb, P. A. (2016). Effect of conscious sedation vs general anesthesia on early neurological improvement among patients with ischemic stroke undergoing endovascular thrombectomy: a randomized clinical trial.Jama,316(19), 1986-1996.

Training And Education In Area Of Cultural â€Myassignmenthelp.Com

Question: Discuss About The Training And Education In Area Of Cultural? Answer: Introducation Training and education in the area of cultural competence for nurses in the area of mental health nursing has been a priority. The impact of the education in cultural sensitivity has been positive and more people from ethnic minorities have been able to access culturally appropriate care. The stigma attached to mental illness in many cultures made this area a priority. Patient centric approach has made effective implementation of culturally competent care reality. But continuous evaluation and better policy inputs are needed to improve training and research in this area. The necessity of culturally competent nursing for mentally ill patients is important Business of their higher vulnerability. Linguistic barriers, different approaches to mental illness in different cultures makes health care delivery to people from diverse cultural backgrounds a challenge. Several educational interventions have been made to improve nursing in mental health so that culturally sensitive delivery of care becomes possible. The impact of these interventions on the quality of care and the change in skills and attitudes of staff towards the patients needs to be evaluated.(Bhui, Warfa, Edonya, McKenzie, Bhugra, 2007). There is more awareness among nurses to be culturally competent when delivering care to people from diverse cultural backgrounds. Factors other than education in cultural competence have also had a positive impact on patient outcomes. These are inclusion of interpreters and community health workers in the team that provides healthcare (Lie, Lee-Rey, Gomez, Bereknyei, Braddock, 2011). Studies on reduction in health disparities due to culturally competent healthcare services are required to see whether the training in this area is adequate. The responsibilities of a mental health nurse include proper communication, empathy with the patient, interaction with the patient's family and in case of the patient coming from an ethnic minority or another linguistic group, these tasks require more sensitivity and recognition of a complex interplay of cultural issues (de Aguiar, et al., 2012). The need for cultural competence in mental health nursing is understood since long and remains on the agenda of policy makers but there is little knowledge about the kind of training and its actual impact while treating patients. This challenge has increased due to the high incidence of mental health illnesses among immigrants from diverse cultural backgrounds. A study reports effective treatment of Latino immigrants suffering from depression through psychotherapy. Psychotherapy requires extensive verbal interaction in home therapy sessions by nurses trained in providing culturally adapted care. The success of the program in a US setting demonstrates that training in cultural competence has had a favourable outcome for patients. Better patient outcomes have been achieved in Latino mothers with young infants, through home-based, short term interventions by culturally trained nurses. Decrease in depressive symptoms was observed just four weeks after the intervention was started. The po sitive impact of cultural competence among nurses was clearly observed during the study(Beeber, et al., 2010). Improvement in skills and attitudes of the trained staff have undergone a change. But a study on the impact of training in cultural competence has suggested that more quantitative studies are needed on aspects of patient outcomes (Bhui, Warfa, Edonya, McKenzie, Bhugra, 2007). A multicultural mental health awareness scale was used to the assess whether the training for nurses in cultural competency among Portugese speaking nurses working to improve the mental health of immigrants was effective. It was found that it did have a positive impact on service delivery (De Almeida Vieira Monteiro, 2016). The literature has examples of negative experiences faced by patients with disabilities have been studied and based on the responses received from patients during personal interviews few examples of cultural disparities were summarised during a study (Roscigno, 2013). Truong et al. have reported that access to healthcare by the mentally ill people from ethnic minorities is more likely when t hey are sure that there is respect for their culture, values and beliefs (Truong, Paradies, Priest, 2014). The impact of culturally sensitive, patient centric care is likely to make healthcare within reach of people suffering from mental health issues in an unfamiliar country or state. The numbers of immigrants and people from other cultures are growing in several regions around the world, so their mental health needs are also public health issue. A lot of work in the re of culturally competent mental health care delivery is still required. It is clear that the impact of training when imparted has improved patient outcomes. But there is still room for improvement in understanding, regular demonstration and systematic teaching of the skills that lead to more well rounded cultural competence. The need to establish and raise standards in this area is a pertinent requirement. Differential and inequitable health outcomes and rising disease burden among the mentally ill from ethnic groups in different geographies will remain a problem if policy and delivery in this area is not strengthened through increased research funding(Nardi, Waite, Killian, 2012). In conclusion, it is true that the impact of cultural competence training in mental health care has been largely positive. Most nurses are trained in this aspect of nursing. But few areas continue to demand attention. The paucity of research in collecting quantitative evidence with regard to patient outcomes through patient feedback needs to be concentrated upon. Respect towards their culture has encouraged people from cultural minorities to seek treatment. Setting up of standards in the area of cultural competence education needs attention. The inequities in mental health care delivery that remain can be removed only when better policy on research and education is framed and implemented and there is global uniformity in this area. References Beeber, L., Holditch-Davis, D., Perreira, K., Schwartz, T., Lewis, V., Blanchard, H., . . . Goldman, B. (2010). Short-term in-home intervention reduces depressive symptoms in Early Head Start Latina mothers of infants and toddlers. Research in nursing and health, 33(1):60-76. doi: 10.1002/nur.20363. Bhui, K., Warfa, N., Edonya, P., McKenzie, K., Bhugra, D. (2007). Cultural competence in mental health care: a review of model evaluations. BMC Health Services Research, 7:15.doi: 10.1186/1472-6963-7-15. de Aguiar, M., Lima, H., Braga, V., Pinheiro, P., AKB, Ximenes, L. (2012). Nursing competencies for health promotion in the mental health context. Acta Paulista de Enfermagem, 25(2):doi.org/10.1590/S0103-21002012000900025 . De Almeida Vieira Monteiro, A. P. (2016). Cultural competence in mental health nursing: validity and internal consistency of the Portuguese version of the multicultural mental health awareness scaleMMHAS. BMC Psychiatry, 16, 149 doi.org/10.1186/s12888-016-0848-z. Lie, D., Lee-Rey, E., Gomez, A., Bereknyei, S., Braddock, C. (2011). Does cultural competency training of health professionals improve patient outcomes? A systematic review and proposed algorithm for future research. Journal of general internal medicine, 26(3):317-25. doi: 10.1007/s11606-010-1529-0. Epub 2010 Oct 16. Nardi, D., Waite, R., Killian, P. (2012). Establishing Standards for Culturally Competent Mental Health Care. Journal of Psychosocial Nursing and Mental Health Services, 50(7):3-5 DOI: 10.3928/02793695-20120608-01 . Roscigno, C. I. (2013). Challenging Nurses Cultural Competence of Disability to Improve Interpersonal Interactions. The Journal of Neuroscience Nursing?: Journal of the American Association of Neuroscience Nurses, 45(1), 2137. https://doi.org/10.1097/JNN. Truong, M., Paradies, Y., Priest, N. (2014). Interventions to improve cultural competency in healthcare: a systematic review of reviews. BMC Health Services Research, 14, 99. https://doi.org/10.1186/1472-6963-14-99.