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Items filtered by date: December 2013

Tuesday, 10 December 2013 07:56

The Approach to Care of Cancer

The Approach to Care of Cancer


Introduction

Cancer is a physiological condition in which cells grow and divide without control or order, and do not die as they should like normal body cells (Corner & Bailey, 2009). As a result of this multiplication, these cells create a mass of tissue known as tumor. Tumors can be malignant (cancerous) or benign (non cancerous).


Diagnosis and Staging of Cancer

Diagnosis

Diagnosis is the determination of possible existence of cancer (Krouse, 2008). This can be done through screening or observation of symptoms. This tells the doctor whether a tumor is actually present in the body of a patient. The diagnostic process determines whether the tumor, if present, is malignant or benign.

Methods of Diagnosis

      Pathologists and radiologists use several diagnostic methods to detect the possible existence of cancers (Corner & Bailey, 2009).  These include

  • Biopsy- This involves surgical removal of a sample of tissue and subjecting it to microscopic examination.
  •  Endoscopy. It is an imaging technique which involves the insertion of a thin, flexible tube with a camera on its end into body cavities such as the abdomen, large intestine, small intestine, and other areas. The scopes allow the doctor to view suspicious areas.
  • Blood Tests- This is done to detect specific markers of the presence of a tumor. Certain tumors release substances which can be detected in the blood. For example, the presence of prostate specific antigen in levels higher than normal indicates the presence of cancer of the prostate.
  • Bone Marrow Aspiration- These show pictures of the bone marrow to observe the presence of blood cancers and leukemia.
  • Pap test- Pap smear is a routine procedure involving examination of sample cells from the cervix of a woman to check the presence of cervical cancer or other conditions.
  • Imaging Studies- This utilizes several techniques including MRI scans, X-rays, and CT-scans of various body parts to detect growths and cancers
  • Genetic Analysis- This involves analysis of blood and bone marrow cells, i.e. cytogenetic analysis, to determine the organization of chromosomes, which may indicate any genetic mutations.
  • Sputum analysis and bronchial washing analysis- This involves analyzing the cells in the sputum and bronchial secretions to check the signs of lung and respiratory cancers.

Cancer Staging

      Staging is the process of determining the progress or severity of cancer disease in a patient (Krouse, 2008). Staging helps the doctor estimate a patient’s prognosis and plan treatment. Establishing the stage of disease is essential in identifying clinical trials that provide a suitable option for treatment of a patient (Corner & Bailey, 2009). The process of staging is influenced by the knowledge of how cancer progresses. The stage of cancer can be determined through

  • Laboratory tests,
  • Physical exams,
  • Imaging studies
  • Surgical reports, and
  • Pathology reports.

      Staging looks at the grade (cell differentiation), cell type, tumor location, and tumor marker levels in assigning stage.  In terms of location, cancer can be examined and classified into one of the following four stages

  • In situ (abnormal cells are only present in the layer of cells where it developed)
  • Local (cancer is present only in the organ in which it started)
  • Regional (cancer has spread beyond the primary site to nearby tissues and organs)
  • Distant (cancer has spread to distant tissues and organs)

Approach to Care of Cancer Patients

Treatment of Cancer

There are alternatives to potential treatment for cancer (Krouse, 2008). They include chemotherapy, radiotherapy, surgical interventions, and medical symptom management. Palliative care teams must be interdisciplinary and must include social work, nursing, chaplain services, and potential services that can impact on the patient’s quality of life.

Surgery

In addition to the initial diagnosis of cancer, surgery is also a treatment option for cancer (Corner & Bailey, 2009). The tumor can be removed surgically particularly if it has not spread to other tissues and organs. Surgical removal of tumor enhances the chances of patient survival to a great extent.

Chemotherapy

            This involves the utilization of drugs to cure cancer. Drugs that are anticancer are cyto-toxic. They are used to destroy the rapidly multiplying cells including cancer cells.

Radiation Therapy

            Sometimes radiation therapy is prescribed after the surgical removal of tumor (Krouse, 2008). High-energy beams of radiation are projected to destroy the cancerous cells, on cancerous regions. Radiotherapy can be external where a patient attends 10 to 30-minute radiation sessions. It can also be internal, which involves the implantation of radioactive pellets of seeds, in the body of a patient.

Stem Cell Transplant

            Patients with leukemia and lymphoma can benefit from bone marrow, peripheral blood, and cord blood transplants.

Other Methods

            Hormonal therapy, immunotherapy, and biological therapies are the other techniques used in treating cancer (Corner & Bailey, 2009).


Diet and Nutrition

            Nutrition management is fundamental for the care of cancer patients (Rock et al., 2010). Consuming the right foods before and after treatment therapy helps the patient recover from the effects of disease and treatment, and stay healthy. Healthy diets contain a sufficient quantity and quality of foods and liquids that contain all the vital nutrients. A healthy diet includes proteins, carbohydrates, minerals, water, vitamins, and fats that the body needs, in appropriate proportions.  Drugs, radiations, surgery, and transplant therapies of cancer affect nutrition particularly when the head, stomach, neck, intestines, and esophagus are affected (Krouse, 2008). It becomes difficult to take nutrients that are sufficient to stay healthy. The different modalities of cancer treatment often causes anorexia (loss of appetite), dry mouth, nausea, depression, constipation, vomiting, pain, mouth sores, trouble swallowing, and other effects on nutrition. In addition, chemicals used for treatment alters the way the body uses nutrients. Therefore, the goal of nutrition therapy should be to provide good nutrition with respect to the above effects (Rock et al., 2010). The aims include

  • To improve appetite
  • To help motility of the GIT
  • To help digestion
  • To prevent and reverse vomiting and nausea
  • To prevent and reverse constipation
  • To prevent and treat diarrhea
  • To prevent and treat pain and mouth sores

Follow-Up Care for Cancer Treatment

Follow-up care is fundamental to the treatment and care of cancer patients (Krouse, 2008). It involves medical check-ups, which includes reviews of physical exam and medical history of a patient. Follow-up just like diagnosis and staging uses imaging studies, laboratory tests, blood tests, endoscopy, and other tests to evaluate the progress of the patient with treatment. The principal purpose of the follow-up cancer care is to evaluate the status of the health of the patient to check for metastasis or recurrence of cancer in the primary site. Depending on the type of cancer, patient’s overall health, and the type of treatment, the follow-up care should be individualized. Some clinics specialize in the long term follow-up care for cancer patients, particularly pediatric and geriatric cancer survivors.


Complications and Side-effects of Cancer Treatment

Complications

Metastasis is a complication which causes the majority of deaths among cancer patients (Corner & Bailey, 2009). This is related to the spread of cancer to vital organs such as the brain, lungs, bones, and liver.

Other complications of cancer include

  • Nausea and vomiting due to drugs that affect appetite
  • Malignant pleural effusion, a build-up of fluid in the lung cavity that causes difficulty in breathing.
  • Mental and emotional complications such as depression and anxiety.

Side-effects of treatment

Chemo drugs affect fast growing body cells including the hair follicle cells, bone marrow cells, and cells that line the gastro-intestinal tract. The administration of anticancer drugs causes bone marrow suppression, which creates a decrease, in the synthesis of platelets, white blood cells, and erythrocytes. This leads to susceptibility to bleeding tendencies, life threatening infections, and anemia respectively.  In relation to the effect on GIT cells, the effects include diarrhea, vomiting, nausea, and mouth sores. The effect on the hair follicle cells causes loss of hair. However, some cancer drugs are selective only for cancer cells.


Remedies to complications and side-effects of treatment

      Antidepressant medication, psychotherapy, and support group therapy are approaches that can help cancer survivors suffering from anxiety and depression prevent feelings of sadness, hopelessness, anxiety, and worthlessness (Krouse, 2008). The patient should inform the doctor about the symptoms of the complications experienced.

            Nutrition intervention is required to reverse the effects related to nutrition such as nausea, vomiting, and loss of appetite.


Conclusion

Palliative care is a fundamental component for health care practitioners who care for cancer patients. It is necessary to appreciate the treatments options afforded by each patient. The treatment teams, patient, and family must have a solid knowledge of the realistic goals of success with a focus on the quality of life. The possibility of attaining the treatment goals must be understood. In addition, the risks associated with the option of treatment chosen must be described clearly, including worsening of symptoms and death. It is also vital to ensure a successful follow-up to treatment approaches taken so that alternative options can be implemented in case of a poor response to the chosen approach to treatment. Evolution of disease requires subsequent indication of alternate therapies.


References

Corner, J. & Bailey, C. (2009) “Cancer Nursing: Care in Context” Hoboken, NJ: John Wiley & Sons

Krouse, RS (2008) “Palliative Care for Cancer Patients: An Interdisciplinary Approach” Cancer & Chemotherapy Reviews, 3(4): 152-160

Rock, C. et al. (2010) “Nutrition and Physical guidelines for cancer survivors” A Cancer Journal for Clinicians, 64(4): 242-274


Published in Physiology
Tuesday, 10 December 2013 07:49

Oleanna by David Mamet

Oleanna by David Mamet


            The play by David Mamet highlights the destructiveness of communication and extreme political correctness. The play is built on three main themes of sexual harassment, academic politics and teacher-student relationship. The movie representation of the play offers new intrigue into the play. It offers the viewer a chance to understand comprehensively the setting of the play and the circumstances surrounding the play.  It also helped in understanding the communication problem that is a characteristic of the entire play.  Carol, who is a student, goes to consult her professor. Her main concern is that she cannot understand the concept. The student is frustrated because she cannot understand the notes/book written by her professor.  The professor initially is callous to the student but later empathizes with her. The professor bends the rule and awards her an “A” because he “likes” her. The entire conversation between the professor and the student is constantly distracted by phone calls about a real estate issue.


             The greatest question about the sexual harassment in this play is who is being sexually harassed? Is the professor act of patting or holding down Carol when she was emotional, sexual harassment? Were the intent of professor wrong or they were merely misinterpreted? Is the professor subject of political correctness? Was carol moved with range and revenge to accuse her professor falsely? Is a carol consultation a set-up to frame the professor?


First, it is imperative to reflect on the situation under which the professor “touched” carol. 

            The touching was a climax of a conversation about the value of higher education.  The professor insulted that higher education was just a privilege that had become a fashion among middle class who wanted better wages. He insisted that higher education bore no meaning. His criticism of higher education is ironical considering that he is a professor. His act of awarding unfair grade to carol also portrays the lot in higher education.  There is also a complete disconnect between the concept the professor is talking about and understanding of carol. The professor is using absurd vocabularies to explain a simple concept. This illustrates how the method of content delivery in high education is flawed.  This promotes carol to ask some intriguing question on why the professor can insist that education is useless and continue to teach. The professor comments that it is his job to provoke carol and force her to listen. However, the professor is distracted by the concept of buying his house. The professor goes ahead to use complex examples, which infuriates carol who at that moment shouts to the professor “I DON’T UNDERSTAND. DO YOU SEE??? I DON’T UNDERSTAND…” Carol seems not to understand her professor. She questions the reasons why she consulted the professor and asks what the professor want with her. It is at this point the professor puts his hand around her shoulder. The questions that arise from this act are basically two. Did the professor mean to calm her down or did he have other motives. First, the professor had initially changed the grades because he “merely” liked carol. Secondly, the professor was in no hurry to let carol leave the office. Arguing from this point of view may conclude that the professor had ill intention.  However, looking critically at the circumstances in which the professor held the shoulders of carol, it can be concluded that his intention was to calm her down.


            So did the professor act of unprofessionally offering a “deal” and “liking” intend to seduce the girl? Despite this action being unprofessional, there is no clear indication that the professor acts had a sexist motive. These acts offered the frustrated Carol a chance to falsely accuse her professor maybe out of frustration or intimidation of the professor.


            The professor use demining words to illustrate how useless and helpless she was. The professor is hazy, not listening and a poor communicator in all aspects. Despite him managing to convince carol to give a new start to the conversation, the professor continues to speak to carol without pausing to listening to her. He is bent to intimidating her by showing her that she does not understand anything.  This is evidenced by the concerns the professor raises each time carol want to refer to her notes for clarification. The poor communication between the professor and Carol begins at the first act and continues all through their conversation. The entire conversation between the professor and carol is an evidence of communication breakdown.  It portrays a conflict between a mediocre professor and a floundering student unable to understand. The conversation is also defined by external forces, which come into plays. The professor is constantly distracted by phone calls from his lawyer and real state. Mamet also uses realistic language with constant interruption, disruption, and incomplete thoughts to magnify the problem of communication into hyperrealism. In the first act carol has only a limited grasp of what is going on, partly because the professor uses obfuscating professional vocabularies, but she makes copious notes of the conversation. The professor is indiscreet about “the tenure committee” and unprofessional offering to “make a deal” whereby Carol’s grade will be given an “A’ if they restart the course again. In efforts to comfort her desperation, the professor places his hand on “her shoulder.” Carol rejects the gesture and walks away saying “NO.” in the next, carol has already submitted a report to the Tenure Committee “on my behalf and behalf of my group”. Her vocabulary has been transformed by an intrusion of the current terminology of sexual politics and by the manipulation of raw materials of her notes into incriminating evidence against the professor. 


     In the last act, carol is rampant and armed with accusations of “negligence,” flirting,” paternalism,” “sexism” and rape. Carol uses legal terms in her conversation, for example, “Under the statute. I am told. It was battery….And attempted rape.” The trivial injunction of carol as the professor was leaving the office “don not call your wife baby” served the final straw on their relationship. The professor acted her calling her “vicious little bitch” and attacking her.  The professor accuses her of using political correctness to accuse him. To some extent the professor is a victim of political correctness. His act of calming carol when she was amused outraged and felt useless is interpreted for sexual harassment. Carol is portrayed as a woman who uses illegal sexual harassment as a weapon against his innocent professor. Carol approached the professor seeking help. However, despite the professor using unorthodox means to award her “A” grade, there are no signs or acts that show that the professor sought sexual favors from the student. However, carol is not justified terming the professor misogynist. Carol is portrayed as a manipulative woman who is not ready to accept her role in her academic failure. She wants to blame the teaching methods of the professor entirely. She is driven by the motive to drive her “sexist” professor out of office. The professor attack on her in the last act is the closest point that the acts of the professor can be termed as misogynist. Despite the furry and range, the professor had on the students his act of attacking her and calling her bitch were not professional.


        In conclusion, Mamet has the characters of carol and the professor to explore three main themes of teacher-student relationship, sexual harassment and students’ politics. The professor is presented as a victim of political correctness by being accused unfairly for sexual harassment.

Work cited

David Mamet. Oleanna. Retrieved from  http://staff.bcc.edu on 18/5/2013.


Tuesday, 10 December 2013 07:44

Coffee and Politics

Coffee and Politics


           According to the author, coffee and politics are two things that go hand in hand. The reason behind this concept is because of power and the value of coffee in any given economy and the role this product plays in the growth and development of the economy. In Persia, coffee has been used since the 9th century although its use was very rare plus the way it was prepared differ a lot compared on the current use or how it is prepared. Talking or discussing matters that related to state affairs in old days was something dangerous although it is still practiced in those countries that are under the totalitarian regime. By this time, coffee was termed as market undesirable and did not count to the state development. The value of coffee changed when people started using it and getting several use something that changed how people valued and used coffee, (Toussaint-Samat, 2009).


It was people such as Mahomet Kolpili and sublime Porte from Mediterranean started the issue of trading coffee despite the cruel measures that were put to discourage consumption level. This is where politics and coffee started something that has developed and created several areas of concern in the society. Development of coffee and its product took a different direction after the society realized that coffee had many uses in the society apart from the measures that were put by leaders so as to discourage people from using and producing it in large quantities, (Toussaint-Samat, 2009). Coffee and politics have moved and developed together because leaders have a secret on the relevance of coffee in the economic development plus its usefulness to the users.


Reference:

Toussaint-Samat, M. (2009). A History of Food: John Wiley & Sons


Published in Business Studies
Tuesday, 10 December 2013 07:39

Dream

Dream


Question 1

The purpose of wish fulfillment in dreams is so that to achieve the desires which cannot be actualized in the waking state. Wish fulfillment in dreams tends to have negative consequences in the conscious mind because most of the desires are sexual in nature and aggressively violent. Dream may have content that is emotionally stressful which the conscious mind may not be able to experience it directly.


Question 2

The real reason as to why Bug Bunny used to run on the school day in the mornings was so that to haw the audience sugary breakfast cereals, candies, cookies, and lunch box rings. Bug Bunny was just like a conman. This reason would constitute a legitimate latent content because Bug Bunny had a hidden agenda which was to hawk the audience staff that they really enjoyed.


Question 3

The unconscious mind should use dream works because dreams usually allow gratification of certain drives through the manifest content. The dreams also tend to allow certain needs to be fulfilled without the need of the conscious mind to be aware of the fulfillment.


Question 4

Real is defined as something that is actually existing and an occurring fact not supposed or imagined. In my own opinion, I would not consider Bug Bunny as being real because it is not something that actually exists because if Bugs Bunny did invite me to his cartoon world it would not be probable to join him because it was not real. Thus, Bugs bunny cannot be considered as real, but just an imagination.


Question 5

The cartoon character that I idolized with was Batman because he had powers and he was also a super hero, but it was painful when I realized that his powers were not real, and I could not be able to do the stances that he did.


Published in Education
Tuesday, 10 December 2013 07:35

More Utopia

More Utopia


            More describes utopia as a system of perfect social stability and equality is based on the fundamental ideal of man as a rational being in a community that feeds everyone and cares for everyone. The perfectly organized macrocosm provides food, typical clothing, work and shelter and produces in profusion all goods that are essential for the modest life of the utopians.  The core concept of Mores’ utopian is the idea of human being rational beings, who are not ready to trade greed and envy for the stability of the society, happiness and stability. More presents utopians as happy, satisfied and discern those who strive for prestigious goods and silver. These prestigious materials viewed as of low value and used to make slave chains (Festante, 2008: Pg 3-4).


            More presents an underlying contrast of an ideal utopia society against a corrupt society that existed in Europe.  Te society presented by More is that there is no private properties or money and as such there is no struggle for power, greed, corruption, crime or vanity. Properties are communal, and the society produces enough to meet the needs of every citizen. More creates a society that is not stratified into social classes.


            More economy was primarily based on an agricultural society where everyone was supposed to till the farm. He ignores other aspects of the economy. Can modern society live only on agriculture or is More theory of utopia very simplistic and based on satisfaction of basic needs only? It is true that More believes that a society can achieve its highest level of satisfaction on meeting its basic needs that include food, shelter and clothing.  This disobeys the rule of division of labor and specialization and all the benefits associated with specialization. The utopian society presented by More is deprived incentives to work and as such the society can never become wealthy. The society also depends on punishment to ensure all individuals work. The utopian society is, therefore, ideal. The system of punishment adopted by the society is flawed. The society is not perfect, but its made perfect by the laws and punishment system instituted. This disobeys the concept of a perfect society and portrays the faulty nature of the human society. In a marked-based economy, individuals are likely to work extremely hard to beat their competitors. However, More argues that, for every one productive individual in a marked-based economy, there are several unproductive individuals who reverse the gains made by the productive individuals. Everyone in the society had some skills on tailoring and as such expected to make her or his own clothes. He beliefs that each individual has the ability to make nice clothes “these clothes are quite pleasant to look at,”  This assumption is somehow misplaced because individuals have different abilities in term of artistic endowment and as such not all individuals can make final clothes. He envisioned a society where job and responsibilities were equitably distributed.


             More conviction of working habit of the society is much fantasized. He argues that all citizens work on the farm where they learn useful trades such as carpentry, weaving and masonry.  He presents learning through apprenticeship where boys emulate their fathers and girls their mothers and aunts. According to More, the lazy are punished. However, the entire society work for six hours, sleep for eight hours and the rest time of the day they can do what pressure them “in utopia they have a six-hour working day.”


More advocate for a socialist country/society. This can be attributed to his attributes as a humanist and a politician.

            More had a huge background of studying humanistic philosophy, which influenced his construction of an ideal morality which was contrary to the realities of the world at the time. More utopia was based on humanistic movements, which wanted to integrate ideals of a perfect society into real life.  He fails to acknowledge an ideal society does not necessary means equity of everyone but a society where the social, political and economic structures are just to all. Why did the society have to have slaves and criminals if everyone was satisfied?


            The system of utopia presented by More presents a society that is based on simple truths and that does not require inhabitants to become scholars of particular philosophical traditions or sciences in order to rise to social ranks (Wootton, 1999; 124). “Most individual spend these free hours on further education,” through this conviction, More belief that utopian have a great appreciation of further education. However, only a small section of the society that portrays “talent” in education are full time students. This is discriminatory, how can the society have such as a huge desire to acquire education and only a few who are identified to posses “talent” are allowed to purse education on a full time? In an utopia society, an individual should be tolerable to follow his or her dreams without restriction.


Work cited

            Raoul Festante. Utopia and anti-utopia. A comparison of Thomas More’s utopia and George Orwell’s.  1984: Pg 3-4.  

            Utopia theory in history Sir Thomas More’s utopia. Retrieved on 26/5/2013 from http://www.trivia-library.com.

            David Wootton. Utopia. Hackett Publishing Company, Inc. 1999; Pg 124


Published in Sociology
Tuesday, 10 December 2013 07:29

Lean Manufacturing

Lean Manufacturing
The success factor that is required to transform to a lean organization include discipline and accountability. In general, people normally require rules and enforcement as people should know what is expected from them and the consequences as a result of not doing the expected. An organization that adapts to a lean strategy tends to have a chance of surviving and also flourishing. The rules that are placed should be fair and also applied consistently. According to this success factor, it is the responsibility of management to make sure that every individual is trained in rules application and also enforcing the rules (Maddy, 2007).
I believe that this success factor is extremely essential because it helps in making people respect the rules and perform their responsibilities as required. There are some facilities that tend to have rules, but the management fails to implement the rules. Whenever rules are not enforced it results to confusion in the organization. With discipline and accountability, it results to improvement of the organization. Lean principles can be applied in non manufacturing environment where the organization is delivering services to customers through a process that involve activities and people can benefit from the leaning out process while eliminating waste and working towards the customer’s needs (Maddy, 2007). 
When lean principles are applied in accounting, it helps the accountants in eliminating thousands of reports and transactions and also the meetings which go with the processes. With these principles, the accountants can provide detailed reports about the falling and rising costs of any process in customer fulfillment. When the principles are applied in accounting, it provides faster information that the standard accounting method, and it also simplifies accounting operations.
Reference
Maddy, K (2007). Driving changes with lean manufacturing SMT
Published in Education
Tuesday, 10 December 2013 07:25

Nursing Research Article Review

Nursing Research Article Review


  1. Describe the study and how it relates to your area of nursing.
  2. How do you know this article is peer reviewed? 
  3. Identify the research questions.

The focus of the study was to assess on whether nursing students who are assigned to a home hospital in any way experience any form of stress. It also evaluated whether these students have developed strategies that help them improve their academic performance or do they get any academic development in areas where they are posted for practice. The study relates to my area of nursing simply because I have to go and do my practice in one of the home hospitals during the attachment time.

 

There are different ways of knowing whether the article is peer reviewed or not. For this case, the article I have selected is peer reviewed simply because authors are experts. Scholarly articles are prepared by experts in that field and in this case, authors are experts in the nursing field such as Chad Cross, PhD, MAC, SAP, LADC and Susan Kowalski, PhD, RN among others.

Another thing that makes me know that the article I have selected is peer reviewed is due to the audience or the purpose of the article. Peer reviewed articles must be addressed to students, scholars, or researchers and for this case the article has been addressed to students and their academic performance.

Peer reviewed articles must have a work cited section at the end simply because author(s) uses previous research activities in citing their work. This article has a bibliography something that shows that authors who conducted this study developed some of the ideas from previous research activities.

Unlike non peer reviewed articles, scholarly articles must have an abstract at the beginning of the work which summarizes what the author is talking about. The article selected contains an abstract which summarizes what the authors have prepared and helps the reader save time understanding what the paper is all about.

Presence of graphics and tables in the article is a clear indication that the article is a scholarly article. Having looked at the above points, I conclude that the article that I have selected is a peer reviewed.

 

Research questions in a study help the researcher develop a point of the study. They form the basis of research and helps in collecting data required to complete in developing the study. Research questions for this study are as follows;

  • Do students assigned to a home hospital experience less stress and state anxiety than those assigned not as-signed to a home hospital?
  • Do students assigned to a home hospital have improved academic performance compared with those not assigned to a home hospital?
  • What are the relationships, if any, among stress and anxiety and academic performance
  1. Identify the hypothesis and variables.
  2. Identify theoretical framework.
  3. Is the article a qualitative or quantitative research study? Explain your reasoning.

It is clear that expected state anxiety score helped authors of the study in determining the sample size used in the study. A good number of studies prefer the use of Spielberger’s scale simply because it is widely used and has high reliability and validity required in arriving at results of a given study. The null hypothesis stated that; Are anxiety means of the two groups equal over time?

Several variables were used to develop this study and among the variables applied for the study include academic load, clinical concerns, personal problems, and interface worries. The relevance of variables in the study is to provide some directions of data collection as well as give a hint on the relationship that the study should focus when collecting data.

 

Evidence shows that current college students in nursing as compared to the past students experience greater stress. The reasoning behind this theoretical framework is due to the fact that many students in the current world have more responsibilities as compared to past students plus their academic workload. A good number of students face stress and challenges in their life due to the life they encounter unlike students of the past who would concentrate on few things that were not as stressing as the current setting.

 

Research studies must either be qualitative or quantitative in nature or they can have the two natures depending on how the data for study were collected and analyzed. This research study is a quantitative study simply because it uses a quasi experiment approach where independent variables are used to determine behaviors of dependent variables. The design has selected a group (students) upon which dependent variables are tested.


Reference:

De Castro, A., Cabrera, S., Gee, G., Fujishiro, K., & Tagalog, E. (2009). Occupational health and safety issues among nurses in the Philippines. AAOHN Journal: Official Journal Of The American Association Of Occupational Health Nurses, 57(4), 149-157

Rykhoff, M., Coupland, C., Dionne, J., Fudge, B., Gayle, C., Ortner, T., & ...Wrobleska, M.         (2010). A clinical group's attempt to raise awareness of organ and tissue          donation. Progress In Transplantation20(1), 33-39.

Yucha, C., Kowalski, S., & Cross, C. (2009). Student stress and academic performance: home      hospital program. Journal of Nursing Education, 48(11), 631-637


Published in Nursing
Tuesday, 10 December 2013 07:20

Avoiding Taxes

Avoiding Taxes


Introduction

Evidence shows that most people have been working on how to avoid paying their income taxes simply because they feel that they are unfairly taxed. Most tax payers prefer renouncing their citizenship so as to avoid paying taxes on their income or prefer the aspect of dual citizenship although it’s regarded as a more complicated undertaking. The paper will focus of the effects of renouncing one’s citizenship on tax liability, the effects of establishing dual citizenship on tax liability, and the effects of renouncing citizenship so as to establish dual citizenship on tax liability. We shall also focus on whether these actions if warranted may have any effect as well as suggest other alternatives on how to reduce tax liability without renouncing citizenship.


Discussion

Renouncing Citizenship

The work of immigration and Nationality Act is to oversee issues that relate to citizen’s tax aspects. This act gives the citizens the right to renounce their US citizenship at any time at any point. The process in this case is simple simply because what the person is supposed to do is just appear in person before a diplomatic officer or consular of US in another country and sign an oath of renunciation. This is normally done at the consulate or the US Embassy. Evidence shows that US has a strategy that helps it tax its citizens (nonresidents and residents) on the income they get anywhere they work. In order to avoid paying this tax, some of the citizens have made it by renouncing their citizenship in US. Some citizens view this as an approach that will help them escape or avoid their tax liabilities. The strategy may help citizens avoid taxes on the future, but in the current state they must face the taxes in their incomes. They may also be called to pay taxes on their estate before they expatriate, (Ault & Arnold, 2010).


Effects of Establishing Dual Citizenship

It is with no doubt that citizens in most countries such as US are taxed on their earned income irrespective of their plays of earning. In order to avoid paying taxes, most nonresident citizens have been attempting to renounce their citizenship status. There are several effects that develop as a result of establishing dual citizenship on your tax liability. One of the main reasons, why most people establish dual citizenship is to get the ability of living and working in two different countries. This helps them claim benefits in these countries they work. If a proper procedure is not used when acquiring your dual citizenship, things become complex because it increases your tax liability. This is due to the fact that your income earned is taxed in these two countries making it a double charge on the same income earned. Although the aspect of establishing dual citizenship has some advantages, when it comes to tax liability, this concept may have some tax obligations because it makes it difficult for the earners to enjoy their income without being taxed twice, (Schneider, 2012).


Effects of Renouncing Citizenship to Establishing Dual Citizenship

Renouncing citizenship and establishing dual citizenship both have advantages to the users. They also have some effects when it comes to the issue of tax liability. Before a citizen renounces his or her citizenship, one should fully understand and adhere to the tax consequences of the action taken. Although to some point establishing dual citizenship help the citizen avoid being taxed on income earned, renouncing your US citizenship does not prevent your tax liability. One of the effects of renouncing your citizenship is the aspect of expatriation. When an individual makes a formal renunciation, it becomes difficult to enjoy privileges and rights that are associated with your citizenship. This prevents the citizen from enjoying the basic benefits that an individual is entitled as a citizen. The person who goes for the renunciation process must undergo two steps, which deal with political aspects and legal aspects of the citizenship renunciation. I believe establishing a dual citizenship status is much better as compared to the renunciation process. With the renunciation, the citizen may avoid income tax from one country, but, on the other hand, he or she misses some of the benefits as a citizen to that country. It becomes difficult to access or conduct usual businesses within these two countries, (Pirvu, 2012).


Actions Warranted

Although dual citizenship does not prevent or eliminate the issue of tax income on the earnings, I believe that dual citizenship in my case is applicable and necessary. This is because I will have the freedom to have benefits of two countries without struggle and no restrictions will be made on my activities in these countries. I will have the freedom to enjoy my activities and benefits from both countries simply because a dual citizenship allows an individual has the freedom to have activities in these two countries. Another thing with dual citizenship is that I will be able to work on the country that I feel it will provide me with higher income earnings even after the tax is imposed. There will be no higher tax liability for the case of having dual citizenship as compared by way of going for the renouncing my citizenship due to the aspect of tax liability, (Hoffman et al., 2008).


Alternative Approaches

Study shows that there are different ways that citizens may apply in lowering their taxes without renouncing their citizenship. Some of possible options that have been used by most people include moving to a low tax state, life insurance, tax exempt bonds, using tax sheltered, retirement accounts, and maximizing itemized deductions. These are just some of the possible alternatives that can be used in avoiding taxes for citizens without even renouncing their citizenship or taking dual citizenship for the countries they are living. For those who are willing to live abroad, the above methods may limit their operations, but an alternative to these approaches may be taking an expatriation. Considering expatriation for the US citizens is the best approach simply because this helps them evade higher taxes they incur in their earned income, (Schneider, 2012).


Conclusion

In summing up, it is true that most people have been working on how to avoid paying their income taxes simply because they feel that they are unfairly taxed. Most tax payers prefer renouncing their citizenship so as to avoid paying taxes on their income. Establishing dual citizenship and renouncing citizenship are the main approach used by most citizens. For those who are willing to live abroad, the above methods may limit their operations, but an alternative to these approaches may be taking an expatriation.


Reference:

Ault, J. H. & Arnold, J. B. (2010). Comparative Income Taxation: A Structural Analysis: Kluwer Law International

Hoffman Jr., William H, et al. Corporations, Partnerships, Estates & Trusts 2008 Edition. Mason, OH: Thomson South-Western, 2008.

Pirvu, D. (2012). Corporate Income Tax Harmonization in the European Union: Palgrave Macmillan

Schneider, B. (2012). The End of Taxation without End: A New Tax Regime for U.S. Expatriates. Virginia Tax Review, 32(1), 1-76


Published in Sociology
Tuesday, 10 December 2013 07:15

Understanding Shadow IT

Understanding Shadow IT


Question One

Development of Service Offerings

Based on the insights provided in the article, there various ways in which service offerings can be developed. In essence, service offerings pertain to the framework used by a corporate establishment in the provision of services to its clientele. Service offerings should be based on the relevant IT standards n order to facilitate for compliance.


Preparation of Assets to Accommodate Diversity

Software and IT assets in the modern corporate environments are immensely diverse. In order to accommodate such diversity, it is pertinent for the IT department to align the existing assets to the relevant upgrades. This averts the numerous pitfalls associated with upgrades for IT assets. Additionally, the relevant licences should be obtained for all new assets.


Un-served and Over-served Parts of Service

In most corporate establishments, IT challenges have extensive influence on the parts of service which may be over-served. This occurs when the organisation devotes extensive resources towards the mitigation of such challenges. Additionally, IT development and compliance might be easily un-served. These kinds of services are notable in the IT frameworks of numerous corporate entities.


Risk Involved

The main risk encompasses a decrease in customer loyalty. This is largely occasioned by the inadequate emphasis on the most pertinent aspects of corporate management. The framework for strategic management can also be hampered by the decrease in the levels of productivity among employees. For instance, some employees might be preoccupied with their fancy IT platforms such as tablets.


Underpinning ITSM Standards

Compliance is among the most pertinent roles of underpinning ITSM standards. In essence, these standards align the corporate entity to the industry standards. Additionally, ITSM standards streamline the productivity of employees.


Question Two

Cultural Elements

In a highly competitive global environment for businesses, cultural elements are essential aspects of consideration. Cultural elements must be integrated into the company’s strategic framework and also its IT systems. The emphasis on cultural elements forms the basis of organisational growth and also the enhancement of market share. This is attained by conforming to the current ITSM standards.


Policies around Strategy Generation

The generation of strategy is massively dependent on the policies established by businesses for IT growth. For instance, it is immensely critical that the business policy facilitates for innovation. Such a policy can spearhead the efficiency of the entire process of strategy generation. The technological aspects of diversity must also be integrated into the policy. Such perspectives can significantly optimize the efficiency of IT strategy.


Role of a Guiding Coalition

A guiding coalition plays the role of facilitating technological transitions in the business. This is extremely pertinent with regard to the acquisition of new assets and software upgrades. This coalition also has the role of streamlining the process of strategy generation. In order to develop a guiding coalition, corporate organizations must integrate the corporate IT team into the operational framework of strategic development.


Potential Overlap and Gaps

In the absence of a strategic approach various overlaps can occur in any corporate. A potential overlap is the inadequate implementation of pertinent components of the strategy. For instance, the control systems for new software might be ineffectual. This creates gaps within the entire strategic framework.


Key Roles in Strategy

The identification of the key roles facilitates for the actualization of the entire corporate strategic framework. A notable role is the connection of customers to organisational processes. An outstanding role from the ITIL strategy is the integration of software systems into the operational requirements of different departments. 


Published in Management
Tuesday, 10 December 2013 07:11

Critical Incident Management Plan

Critical Incident Management Plan


Introduction

A critical incident refers to events that occur unexpectedly or suddenly (Denver University, 2010). Critical incidents are often overwhelming and cause immense stress on victims. The purpose of this plan is to protect human life, reduce the risk of injury and damage to property, which may occur during the critical incident. The plan also seeks to restore normal operations of the institution within the shortest time.  


Pre-Incident Planning

The first responsibility of the response team is to evaluate risks that are likely to occur during emergency situations. This is a proactive way of managing critical incidents (Schwester, 2012). When the critical incidents management team is able to identify potential threats, they can implement measures that will prevent these threats/ incidents from occurring. Pre-incident planning seeks to identify incidents that have a high likelihood of occurring during this emergency situation. These incidents include; fires, pandemic and infectious diseases, destruction of facilities due to storms, riots, protests, and failure of utility systems.


The incident management team will focus its attention towards ensuring that these potential incidents are prevented (Morrow, 2001). Prevention is a vital part of critical incident management. Prevention ensures that critical incidents are avoided thus eliminating the need for a response plan. The most effective approach of preventing the identified risk is awareness creation. The incident commander will coordinate this activity. The incident management team will go around the institution with the aim of enlightening people concerning measures that they need to take in order to avoid the identified risks. The critical incidents team will also maintain regular communication with the entire community to avoid unrest. This will prevent incidents such as riots and protests. The incident management team will use alternative channels of communication including; notice boards, door to door visits and public address systems. This is because the convention channels of communications have been hindered by the power outage. The team will also conduct patrols and surveillance so as to keep up with developments within the institutions.


The pre-incident planning also enables the incident management team to prepare for incidents (Schwester, 2012). The evaluation process helps the team to identify potential threats and thus obtain resources that are necessary to deal with these threats. Resources required to deal with the identified threats may include; fire extinguishers, medicine, first aid kits, food supply, and water among others. The critical response team has prepared for critical incident by putting these resources on standby.


Emergence Response

Even the most elaborate prevention initiatives cannot give a 100% guaranteed that a critical incident will not occur. Thus, the critical management team must be ready to ensure that the occurrence of a critical incident does results in a lot of damage to the institution and the community. The critical incident management (CIM) team will work closely with government agencies and other bodies in responding to critical incidents. The incident commander will coordinate all the activities of the team. The commander will remain on the ground until the critical incident is resolved. The CIM team will also work together with volunteers in the management of critical incidents.


In the occurrence of a critical incident, the first response measure is to ensure that the affected population has access to support services such as first aid and fire fighting. Resources such as first aid kits, fire extinguishers and other have been deployed to the critical incident management team. The incident commander will be responsible for allocating these resources. The incident team will contact relevant agencies. In case of fire, the city’s fire department will be contacted. The incident commander will work closely with government agencies and other bodies to facilitate movement of equipments and personnel into and out of the affected areas.


The emergency response plan will also ensure that the affected population is evacuated from the scene of the incident. The incident commander will oversee the process of relocating people affected or threatened by the incidents to secure locations. In case of a fire outbreak, the incident commander will work together with officials from the fire department, as well as, other public response units to move the affected people to safe locations. An effective critical incident management plan must respond to the needs of all community members (Mitchell, 2009). A special team of volunteers has been selected and trained to handle the evacuation of person with disabilities or other special needs. This team will ensure that persons with disabilities are safely evacuated from the scene of the incidents. The affected people will be relocated to alternative locations within the confines of the institution. These locations will be determined in advance by the administration.


Continuity

Once the incident has been contained, the critical incident response team will shift its focus to restoring the facility to minimally acceptable standards (Morrow, 2001). A critical incident such as a fire breakout may cause destruction to essential utilities such as shelter, water and sanitation facilities. It becomes extremely difficult for the institution to continue with its operations without such essential facilities. The critical incident management team will ensure that basic utilities are restored to minimally acceptable standards.


The first step in ensuring continuity of operations is assessing the extent of the damage caused by the critical incidents (Schwester, 2012). The incident team will assess the scene of the incident in order to determine the extent of the damage. In case of a fire incident, the team will assess damages to water and sanitation facilities. If these facilities have been damaged, the team will identify alternative sources of these essential utilities. For instance, if the water system has been damaged by the fire, the incident commander may contact the institution administrations so as they can make arrangement for the delivery of water. The incident command will also find alternative ways of managing sanitation until the sanitation facilities are restored.


In incidents such as fire, people may lose basic necessities such as clothing, blankets and other personal item. The incident management team will ensure that the affected people get access to these basic necessities. Since the temperatures are extremely hot, it is paramount for the incident management team to restore amenities that are essential for this weather condition. The incident commander will also oversee the distribution of essential commodities such as food until normalcy is restored. The team will also organize for psychological support services such as counseling for traumatized victims.


Communication Plan

The critical incident management plan also constitutes an elaborate communication plan (Denver University, 2010). The on-going emergency situation has interfered with normal channel of communication such emails and websites. Thus, it is essential for the critical incident management plan to have a plan that stipulates alternative communication procedures. These alternatives include; mobile phones and two way radio. The communication plan also contains a telephone calling lists consisting of contacts for all relevant departments within and outside the institution. 


The communication plan focuses on facilitate the sharing of information between the critical incident management team and internal and external communities. External communications seek to ensure that the institution is able to get emergency services such as fire services in the occurrence of a critical incident. Internal communication seeks to encourage prevention measures and orderly return to normal activities after the occurrence of a critical incident.  


References

Denver University (2010) Critical Incident Management Plan. May 17, 2013. http://www.du.edu/risk/forms/08-002-RIS-crit-inc.pdf

Mitchell J. (2009). Critical Incident Management. May 17, 2013. http://www.info-trauma.org/flash/media-e/mtichellCriticalIncidentStressManagement.pdf

Morrow H. (2001). Coordinating a Multiple Casualty Critical Incident Stress Management Response. International Journal of Emergency. 3 (1): 27- 34

Schwester R. (2012). Handbook of Critical Incident Analysis. USA. M.E Sharpe Publishers


Published in Management
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