Effective Communication Skills Essay - 1144 Words

Listening is a vital element of communication and it is very much different from hearing sense of human. A meaningful communication requires both a good listener and a speaker. However, the effect of a listening style may vary depending on the occasions and situations a listener is in. Sometimes, speaker exhibit ineffective style such as defensiveness, ambushing, pseudo-listening, stage hogging and selective listening in their communication tracks. I am a good listener because I pay my whole attention to the speaker commentswho comes to me so they can be heard. People like to know they have been heard and I can do that job very well but hearing and truly listening are two different things. In my opinion, listening engage you to†¦show more content†¦Thus, I attend my speaker with my full concentration as they speak, overcoming distractions and even going so far as to forgive a speakers poor communication skills. Simply by paying attention, I can build an unspoken rapport with my speaker. Paraphrasing is another element essential in the good listening habits. I try to make sure in gathering input from the speaker or loosely summarize whatalready have said in order to feel them they have been listened. Paraphrasing also urges a speaker to clarify his comments as well as permitting him to know that these comments have been heard. Understanding often involves emotion of a good listener. I consider a job well done if it allows the speaker to become slightly uninhibited during the communication process because if speakers are being criticized by a listener, they show inhibition while speaking in the conversation. By expressing empathy and understanding while listening requires flexibility, I encourage them to be candid while expressing their emotions. I involved myself in their conversation as I express I am in their shoes so they feel more candid as they speak. I feel that speaker should have freedom to express themselves completely before attempting to interrupt for comments or questions regarding what they are saying. This again requires understanding and patience from a good listener. Interrupting a speaker is likely to be a interpreted as a sign of rudeness. AccordingShow MoreRelatedEffective Communication And Communication Skills Essay1146 Words   |  5 Pagestogether as a team to collaborate, delegate and consult. In order for this team effort to be effective, good communication skills must exist between medical professionals. Many times, messages can be altered and interpreted differently; if the conditions for transmission barriers develop. External barriers and internal barriers, such as confusion and mental status can hinder effective communication. Communication can be both verbal and nonverbal, and it is important to understand that different culturesRead MoreCommunication Skills For Effective Communication929 Words   |à ‚  4 Pages Based on your examples from each principle of effective communication (General, Interpersonal and Written), describe the potential barriers (problems) to effective communication in the presentation, as well. Remember to state the problem and then how this can affect communication. Introduction I am going to describe how communication skills are used effectively in the presentation. General Communication Skills General communication skills are a way of expression or exchanging ideas and thoughtsRead MoreCommunication Skills : Effective Communication1656 Words   |  7 Pages Communication Skills Effective communication skills The health and social worker must be able to communicate effectively with a wide range of patients or clients. Babies Adolescents Young adults Older people Other health worker Doctors Nurses Teachers Police Social workers There are mainly three types of communication skills: Verbal Non verbal Written Communication can take many forms. Lack of effective communication between the care workerRead MoreEssay on Effective Communication Skills1315 Words   |  6 Pagesto becoming an effective leader is to develop effective communication skills. Communication is the transmission of meaning from one person to another or to many people, whether verbally or non-verbally (Barrett, 2006). Effective communication enables leaders to lead. Effective communication occurs only if the receiver understands the exact information or idea that the sender intended to covey. As a leader, studying the communication process is important. Communication skills, including the abilityRead MoreEssay on Effective Communication Skills1308 Words   |  6 PagesHowever, what is often overlooked is the value of possessing effective communication skills to build relationships among one’s peers and leaders. For without the possession of effective communication skills one may find it difficult to not only succeed but also advance in the work place. Specifically in the field of education, where leaders are faced daily with challenging tasks, commitments, and deadlines, having effective communication skills is detrimental in creating a positive school climate inRead MoreEffective Communication Skills Are Important905 Words   |  4 PagesEffective communication skills are important no matter who an individual is talking to, but they are vital when it comes to talking to someone who has either been a victim or a witness of a crime. A victim is at their most vulnerable state so they need to be talked to delicately and have support. Often times, witnesses of a crime are overlooked and are not questioned and they may have valuable information that could help a victim recover from the crime and give them justice. Communication in victimologyRead MoreEffective Communication And Interpersonal Skills942 Words   |  4 Pagesleadership skills have â€Å"the ability to influence others, through effective communication and interpersonal skills† (American Sentinel University). Commonly, directors and senior nurse managers are confined to a different schedule than bedside nurses; working outside of clinical practice and patient interaction and focusing primarily on addressing organizational issues, increasing morale and productivity among staff all while increasing the quality of patient care. Effective communicati on and the abilityRead MoreEssay on Skills for an Effective Communication1261 Words   |  6 Pagesability to connect with others by exchanging ideas and feelings both verbally and non-verbally. Verbal communication can consist of spoken conversations (face to face or phone calls) or written messages (letters, emails newsletters). Non-verbal communication includes facial expressions, body language, eye contact, tone and pauses and is less direct but just as important. Good communication skills are essential for anyone working in the early childhood industry, because being able to communicate effectivelyRead MoreGuidelines For Effective Communication Skills1867 Words   |  8 PagesApply Effective Communication Skills in Nursing Practice ESSAY Name: Maree Bolba D R A F T COMMUNICATION Define â€Å"Communication.† Communication is an interactive process where an individual transmits a message to another individual or a group. ‘Human communication is an ongoing dynamic series of events in which meaning is generated and transmitted.’ (Potter Perry, 2000 pp 271) In saying so there are two main factors when communicating, them being the verbal or non-verbalRead MoreApply Effective Communication Skills6081 Words   |  25 Pagesat least five factors that could contribute to the success of a team. - Effective communication -Constructive criticism -Focus on the issues/goals -Working within the rules/policies -Active listening 3. Suggest at least five factors that could hinder the development of an effective team. - Unclear Goals - Conflicts between personalities - Interactions between team members (lack of quality) - Poor Communication - Unclear roles within the group dynamics. Activity 2.5 You have been

Dystopian Societies Essay - 886 Words

A dystopia the darkest form of government, a utopia gone wrong, a craving for power, struggling for fewer rules. The dystopia is factual the worst possible form of a government. Its the struggle to be so perfect that it fails. There are typically two types of dystopias first a monarchy. A monarchy is a group of people controlled by a king or queen, and they make every last decision. What they want they get. A monarchy is typically born like this example from lord of the flies. â€Å"He became absorbed beyond mere happiness as he felt himself exercising control over living things. He talked to them, urging them, ordering them(Golding 58). This shows that a monarchy starts by one just taking over from the start rather than being a†¦show more content†¦The people are left starved with no food or money having to bask in the king glory and power. An example of that would be Louis XIV. He let the French starve and rot away with no food and no money while he was bathed in riches w ith a million square foot palace made out of gold. He led the French to a revolution, a revolution so large it changed the way we look at monarchies. Its not at all like the king cares about the people. If he does he may have bad ideas and the entire city with collapse. The monarchs of Brunei, Oman, Qatar, Saudi Arabia and Swaziland appear to continue to exercise more political influence than any other single source of authority in their nations, either by constitutional mandate or by tradition (Monarchy). Monarchys are bad but communism is worse, but does one person also have full control in a left dystopia. Communism the worst kind of government, like your being watched every step of the way there is no freedom, no democracy all mind games. Its just too hard to live in if you know what their doing, if you speak up in a negative way to the government its off to the prison camps. North Korea supposedly has 6 known prison camps with hundreds of thousands of people with most of them done nothing wrong. North Korea and countries like it will do anything to keep it utopia status in the minds of their people. In essence its a utopia gone wrong, they makeShow MoreRelatedThe Giver As A Dystopian Society759 Words   |  4 PagesIn today’s society there are many authors who write dystopian novels. They write these novels to give knowledge and to tell how our world is very different from dystopian life. Lois Lowry shows readers how people can suffer in dystopian society. In The Giver, Jonas’ community appears to be a utopia, but in reality it is a dystopia because everyone is under the illusion that there is freedom, dehumanization, and their strict regulations. The Giver is considered as a dystopian society because everyoneRead MoreThe Downfall Of A Dystopian Society1588 Words   |  7 PagesRobert’s statement reminds all of a weak dystopian society, fragile enough to break by one individual. In the dystopian novel, Delirium by Lauren Oliver, major motion picture Divergent directed by Neil Burger as well as written by Veronica Roth, and published journal How power corrupts leaders written by Dr. Ronald E. Riggio one sees how a single catalyst leads to the downfall of the entire society. In all three works, one sees the collapse of a dystopian society is a result of the triumph of love, theRead MoreOppression in Dystopian Societies1154 Words   |  5 PagesDystopian societies shown in George Orwell’s 1984 and Kurt WImmer’s Equilibrium present the readers with a state of society where everything is totalitarian and environmentally corrupt. Through the Government’s methods of control, the citizens lose their indiv iduality and freedom. Acts of fear and oppression though technological advancements in both 1984 and Equilibrium evoke Oceaninans to trust the higher forms of authority to protect them, and make them feel safe. 1984 and Equilibrium portray aRead MoreIs The Giver A Dystopian Society827 Words   |  4 Pages- an intense feeling of deep affection. As I began to think, is the giver a dystopian or utopian society, I immediately jumped to the conclusion. The giver is obviously a dystopian society, they have absolutely no rights whatsoever. But then I began to think, how I was going to fight for it. This was a bit more of a challenge to answer, because this community really shows all the characteristics of a utopian society. However, my heart really tells me that I could never fight for something thatRead MoreDystopian Society Essay1214 Words   |  5 Pages Consilience between society and its government requisites a veto of propaganda ploys which separate politics and the populace as two disparate entities. Examination of Henry Reynold’s monograph memoir Why Weren’t We Told in contrast with Thomas More’s political meditations in Utopia and Vladimir Bortko’s 1988 film adaptation of Heart of a Dog reveals how composers shape their audience’s political perspectives in support of pellucid law and order. The three texts conclude on a collective consensusRead MoreGattaca Is A Dystopian Society1330 Words   |  6 Pagesdifferent than yourself as ‘the other’. The outcast, the lesser, those that you do not need to worry yourself about because they are beneath you. This is an attitude that has been infecting human society as a whole for a long time. Gattaca, for all its advances and appearances of Utopia, is actually a dystopian future that is even more divisive than anything that exists in real ity and exists as a cautionary tale of what can happen when discrimination is allowed to grow out of hand. One of the mostRead MoreDystopian Society Essay1882 Words   |  8 PagesThe United States: Movements Toward a Dystopian Society The destruction of nature, increase in the pollution across the globe, constant surveillance upon everyone, and the inability to have the freedom to search what you would like on electronic devices. This action will result if the cautionary text, Fahrenheit 451, is not utilized to locate and withdraw flaws in our own modern and developing North American society. Despite the date of the text, the messages displayed can directly correlate toRead MoreThe Dystopian And Utopian Society873 Words   |  4 PagesThis book is set in a futuristic dystopian/utopian society. Based on the descriptions in the text, the place where Jonas lives seems to be a fairly small community. The community is by a river, as it often mentioned in the plot (at one point, a four year old boy name Caleb drowns in the river). There are various places within the community, such as the House of Old, the Rehabilitation Centre, the Auditorium (where public events are held, such as the ceremony of twelves), and various family unitsRead MoreEssay of Dystopian Societies #21154 Words   |  5 PagesDystopian Societies Human vegetables, all controlled by the eights of their technology, all unaware of the real problems around them; a dystopian society. Farhenheit 451 and The Island, two stories that share this wretched theme. But both stories each have a character that questions it all. They both go against what others say. They followed what their hearts had to say, and thought for themselves. With no literature for Guy Montag in Farhenheit 451 and the longing for freedom for Lincoln 6-EcoRead More1984 Dystopian Society Essay1164 Words   |  5 Pageslittle freedom to express their own opinions. This is because dictators create societies that they feel are supreme. In order to have an almighty society, each person has to think and behave the same. George Orwell created a dystopian society, Oceania, where the government was controlled by Big Brother. Winston Smith, the main character, slowly realized that the Party, or the government, was manipulating their society to make the Party immortal. Wins ton presumably wanted to stand up for his beliefs

What Make’s Up One’s Identity Free Essays

There are a great deal of factors that altogether form one’s identity, the most relevant and main ones are culture, which includes nationality as well as religion, intellect, personality, and world exposure. I. Culture is a crucial factor when it comes to forming one’s identity. We will write a custom essay sample on What Make’s Up One’s Identity or any similar topic only for you Order Now A. The characteristics of our country of origin. * The power that our nationality has on our person. * The language, our culinary traditions, clothing etc. B. Religion. * The values. * The traditions. II. Ways of interpreting situations and our personality, strongly mirror who we are. A. The elements that formed our intellect. * Education and upbringing. * Political views, as well as other ideas concerning society’s organization. B. The social attributes we gain. * The individuals in our surroundings. * The experiences we go through. III. The strong impact of travelling on our identity. A. Eye-openers that broaden our minds. * The new cultures we integrate. * The new people we meet and their influence on our personality. B. Developing a sense of belonging to more than one culture. * The process of becoming a â€Å"halfie†. Merriam Webster’s online dictionary defines identity as â€Å"the distinguishing character or personality of an individual†, which is undoubtedly true. Firstly there is culture, in other words, the land we feel we belong in and the characteristics that come with belonging to this particular country. Seldom do people remember to include one’s personality in the definition of his or hers identity. However, it is extremely important because it is precisely what distinguishes us from our compatriots; otherwise our identity would not be uniquely ours, but the one of everyone from the same land. Moreover, it should not be forgotten that identity is permanently subject to change, whether it be through travelling or new experiences. The combination of all these factors are what forms one’s identity. Culture probably consists of attributes that form more than half of our identity, and it is mainly formed of our nationality and our religion. It is essential, that one feels a strong bond between him and his country; this is the reason why nationality is so often spoken about, when the topic of identity is being discussed. An individual needs to feel as if he has a homeland, meaning a place where he can relate to others because they live in the same environment, have the same climate, the same state regulations, duties, as well benefit from the same rights. To that effect, one feels a sense of comradeship between him and his â€Å"soil†. This is why individuals sometimes voluntarily join the army, because they feel obliged to defend their country. And some soldiers today, in particular the ones of the American army, are sent all the way across the world to Iraq for the sole purpose of fighting for their state. Individuals feel a strong need to be patriotic, and some are willing to go to great lengths to show to others why they believe their country is â€Å"best†. A British character in Oliver Goldsmith’s text â€Å"National prejudice†, who is â€Å"cocking his hat, and assuming such an air of importance as if he had possessed all the merit of the English nation† (Goldsmith), clearly illustrates this point because he makes discriminatory statements in the name of his nation. All of the above goes to show the fundamental impact one’s nationality has on his or hers identity. Moreover, our country of origin also imparts to us certain characteristics related to it, mainly a language to communicate amongst each other, local food, outfits, dances etc. They are basically the elements we see displayed when establishments such as schools or universities, prepare â€Å"international days†, when individuals build stands showing the particularities of their country. They also contribute immensely to the formation of our identity, they add to the concept of nationalism. Our language gives us a unique way we can use to communicate with our compatriots. Each and every country has its own language or dialect that makes up its people’s identities. Furthermore, there are local recipes that we learn which even as used as â€Å"comfort foods† to cure homesickness. There are traditional dances, for example the flamenco in Spain, the â€Å"dabke† in Lebanon or the French Can-Can, outfits and holidays the country celebrates, especially independence day. To sum up, all of these elements make up one’s nationality, which contributes to one’s culture. Culture is not only formed through one’s nationality, but also by his religion. Even though some individuals believe that religion is not really a very significant part in one’s identity, I believe that it is crucial and that it is present in most of our decisions. Whether you are Christian, Muslim, Jewish or even Atheist, this is a major characteristic of your identity. Religions first of all come with a set of values and rules we should follow. For example, a Muslim woman, should refrain from wearing revealing clothes, and preferably should wear an â€Å"abbaye† and headscarf, in order to respect her and others; she should not have sexual relations before marriage. Men or women are not allowed to be homosexual, which actually is a value for many religions, they should pray five times a day, go do a pilgrimage in Mecca once in their lifetime, Buddhist are to consider the cow as sacred etc. The values are, like many other religions; not to sin, to pray and be good to one another. On the other hand, religions also provides us with traditions to follow, for example the famous Christian holiday Christmas, or the Ramadan for Muslims, having Bat Mitzvah’s for Jews and Easter. Our religion really helps in terms of giving us a path to follow in our lives. The aim in our lives is to respect it as much as possible; therefore it is part of our culture. The last elements discussed, refer solely to the parts of our identity that are formed and settled at birth, we should not forget the impact of how we develop as a person, in other terms, our family, our type of education, and the experiences we go through. A person’s education is an integral part of his identity, and education involves what one is taught in school, as well as at home. Family has an important role in making you a legitimate member of society, firstly they give you a name which identifies you, and afterwards, they provide you with a mandatory set of guidelines to follow throughout your childhood. These guidelines give you certain values and rules you should follow, just like religion does. Whether the individuals raising you are strict or lenient, they need to provide you with moral grounds in order for you to grow up to be a valuable citizen. Robert Coles in his text â€Å"I listen to my parents and wonder what they believe†, overviews this point concerning morals, he says that children are lost emotionally without the guidance of their parents. Moreover, he criticizes the latter for disregarding their children’s maturity and choose to turn a blind eye towards this issue; â€Å"this issue is not the moral capacity of children but the default of us parents who fail to respond to inquiries† (Coles). Therefore, we notice that the role of one’s parents is crucial in developing the kind of individual he will grow to be. Moreover, our parents decide to which type of school to send us, which is the other major part of our education. Depending on if they send you to a Catholic school, a boarding school, a French Lycee, a British or American high school, you will receive a specific kind of education. Henceforth, you will be raised with their particular values and probably base your future decisions on what they have taught you. In the end, these two major components of our education will form who we are as adults, in other words, our political and social views. For example, do we support the left or the right, the republicans or the democrats, the conservatists or liberalists etc.? These ideas place us in society. All of the above are the elements that form our intellect, which in itself is an important part of our personality. We simply cannot deny the impact that the people surrounding us throughout our life, have on our identities. How you behave strongly reflects who you are, and obviously, in order to integrate a community, it is mandatory to act like them, henceforth; you begin to acquire certain characteristics that are similar to the ones of others. Let’s say one is raised in a racist community, unfortunately, this individual will probably grow up to be a racist, because this is what the people around him told him was the right way to think. On top of that, another important factor in forming how we think, are our experiences through life. For example, in Edward T. Hall’s â€Å"The Arab World†, his particular meeting with an Arab gentleman, in which he was sitting on a couch in a hotel lobby and assumed this gentleman was invading his privacy, when the latter was simply being his normal self. He comes to certain conclusions about Arabic people, stating they have no respect for personal space or important moral values. This is an experience he went through, which forged the way he thinks, and forevermore, these ideas are part of who he is. The impact that travelling has on the formation of our identity is undeniable, it gives us priceless characteristics that make us better people in the end. The previous factors evokes, culture and personality, are bound to impact every single citizen of the world, however, unfortunately, we do not all have the luxury to travel, but those that do, are able to experience new cultures, and meet new people through living abroad. I personally, have lived in various countries, surrounded every time by three distinctly different cultures; I was born in London, I spent the first fifteen years of my life in Nigeria, afterwards I transferred to a boarding school in Switzerland, and at the moment I am finally living in my land of origin, which is Lebanon. And I can proudly confirm, that being exposed to all these cultures have made me the open-minded and well-rounded individual that I am today. Thanks to that, I no longer abide to prejudices, nor agree with stereotypes, because I have been lucky enough to be aware of the different types of people and be able to understand them. Therefore finally, it is this combination of changing where I lived and development of my personality that I believe forged my identity. Afterwards, your identity is subject to change, you begin to feel a sense of belonging to more than one culture. This is what Amin Maalouf illustrates in his story titled â€Å"Deadly Identities†. He says â€Å"I have been asked many times with the best intentions in the world, if I felt more French or more Lebanese. I always give the same answer â€Å"Both† † (Maalouf). Or even in Ethar El-Katatney’s article â€Å"Identity Crisis 101†, the young El-Gohary claims that â€Å"she is balanced in her love for both countries†(El-Katatney), and it is the same author that introduced this idea of being a â€Å"halfie†. Individuals are no longer able to consider themselves belonging to one culture more than the other. They do always feel a strong sense of attachements to their routes; however their true identity has altered, and therefore so will their state of mind. All of the above truly portrays the strong impact of traveling on one’s identity. To conclude, we notice that it is one’s cultural exposure, which lead to the elements contributing to the formation of his identity. We are not born with an unchangeable identity, actually quite the opposite, it never cesses to change. Individuals will always be exposed to new places, new people, new ways of thinking and these will transforms who they are. It all depends on culture and personality. Works Cited; â€Å"Identity†. Merriam-Webster online dictionary. Merriam-Webster Online, 2008. Web. 14th Nov 2010. Coles, Robert. â€Å"I Listen to my Parents and I Wonder What they Believe†. The McGraw-Hill Reader: Issues Across the Disciplines. Gilbert H. Muller. Ed. McGraw Hill 8th edition Boston: 1982 El-Katatney, Ethar â€Å"Identity Crisis 101†. Egypt Today online. May 8th 2008. Egypttoday. com. Web. 3rd Nov 2010. Hall, Edward T. â€Å"The Arab World†. Shades of Gray: A reader for Academic Writing. Ed. Zane Sinno, Rima Rantisi, Ghassan Zeineddine, Natalie Honein, Jasmina Najjar. 2nd ed. Great Britain: Pearson Education Limited, 2008. (pages 89 to 90). Print. Maalouf, Amin â€Å"Deadly Identities†. Shades of Gray: A reader for Academic Writing. Ed. Zane Sinno, Rima Rantisi, Ghassan Zeineddine, Natalie Honein, Jasmina Najjar. 2nd ed. Great Britain: Pearson Education Limited, 2008. (page 1) Print. How to cite What Make’s Up One’s Identity, Papers

Change Management Plan

Question: Identify and Analyse the time, Cost and Quality Impacts of the Change Upon the Project and the Techniques used to Manage? Answer: Project constraints A change management plan is usually developed to manage the changes during the implementation of a project. The plan helps to control the variations during implementation, to avoid cost overruns, poor quality and time mismanagement ("What is change control? - Definition from WhatIs.com", 2017). The change will target the information technology department. The change has no defined time for the implementation. Quality will be considered though it is depended on the cost of the evaluation. Change management plan guidelines Primary guidelines Framework of the plan Project management components Secondary guidelines Quality Time cost Techniques and tools used to manage the impacts It is expected that the plan will help manage the cost maintain quality and reduce the time taken to complete the project. The project is expected to manage the cost to avoid overruns through the help of forecast budgets (Westland, 2017). Time taken to finish the project, will be computed with the help of the CPM chart (Critical Path Method) which will provide the exact time the project is to be completed as well as provide room for amendments in case of changes. Quality will be observed throughout the project by conducting a continuous evaluation at each and every stage of the project ("PMA - 3.Plan - Develop Quality Management Plan", 2017). Roles and responsibilities Implementation and evaluation of change will be headed by the project manager. Other responsibilities will include; Accept and execute the request for change Timely undertake evaluations of the change impact and the constraints as well as the deliverables. Provide the available options and the best course of action to be prioritized in the change. Provide timely decisions Record changes in the project change documents and Communicate the changes to the team ("What is change control? - Definition from WhatIs.com", 2017). Change management process Change request submission; a request for change is lodged by completing a change request form. The request includes the realized risk that calls for a change. Change evaluation; the leader in change evaluations is tasked with the duty of evaluating the changes. The evaluation is expected to take less than a fortnight. Decision making; before the end of the fortnight, the lead change evaluator may request for more evaluation, reject the request or approve the changes. Recording the changes; the project manager is responsible for integrating the significant changes into the change documents. Communication of the changes; changes will be communicated to the team during meetings. The rest of the stakeholders will be informed about the changes on a monthly basis through the monthly report("PMA - 3.Plan - Develop Quality Management Plan", 2017). Alternative option The alternative to the adoption of the new technology would be to higher more expertise. The experts are expected to deliver quality manage time as well as cost. The risks associated with such an alternative include; Increased project cost Redundancy Unreliability and Lack of sustainability ("The case for change management - Costs and risks," 2017). References PMA - 3.Plan - Develop Quality Management Plan. (2017).Pma.doit.wisc.edu. Retrieved 12 March 2017, from https://pma.doit.wisc.edu/plan/3-4/what.html The case for change management - Costs and risks. (2017).Change-management.com. Retrieved 12 March 2017, from https://www.change-management.com/tutorial-case-mod5.htm Westland, J. (2017).Project Management: 4 Ways to Manage Your Budget.CIO. Retrieved 12 March 2017, from https://www.cio.com/article/2406862/project-management/project-management--4-ways-to-manage-your-budget.html What is change control? - Definition from WhatIs.com. (2017).SearchDisasterRecovery. Retrieved 12 March 2017, from https://searchdisasterrecovery.techtarget.com/definition/change-control

Steps Involved in Decision Making

Free Essays on One Flew Over The Cuckoos Nest

Biographical Data Ken Kesey was born on September 17, 1935 in La Junta, Colorado. Ken Kesey is world renowned for his best-selling novel, "One Flew Over the Cuckoos Nest". At an early age, Kesey had a love for Christian fables as well as the Christian ethical system. Although he had a love for these fables, Kesey never wrote anything or published anything till well after his high school career. In High School he was a champion wrestler setting long-standing state records in Oregon. Unlike most "normal" authors, Kesey always had a love for the "wild" side. He would always be doing crazy things and going to parties. While at Stanford, he was in an experience involving chemicals at the psychology department to earn extra money. Among these chemicals were psilocybin, mescaline, and â€Å"LSD† which is found in the drug, acid. This experience altered Kesey personally and professionally causing him to not be what he used to be, but instead a crazy and weird sort of individual. He became friends wi th a group of people that would later call themselves, the Merry Pranksters. Among these pranksters there were famous people like Jack Kerouac, and Neal Cassady. They bought a bus and all went on a trip to the World's Fair in New York. They recorded most of the trip and showed these clips to drugged up audiences at their parties. Kesey and the Merry Pranksters became known for their Acid tests as well as their extensive use of LSD and other drugs. Thomas Wolfe wrote a book about the merry pranksters called The Electric Kool-Aid Acid Test. Kesey and the Merry Pranksters fled to Mexico after their favorite drug, LSD, was made illegal. When they returned to the United States for a final performance of their band, "Warlocks", or "Grateful Dead", Kesey was arrested on a marijuana charge. After serving his time in Jail, Kesey decided to move to a farm in Pleasant Hill, Oregon to raise his family and try to forget his crazy past. Kesey, being a big par... Free Essays on One Flew Over The Cuckoos Nest Free Essays on One Flew Over The Cuckoos Nest Biographical Data Ken Kesey was born on September 17, 1935 in La Junta, Colorado. Ken Kesey is world renowned for his best-selling novel, "One Flew Over the Cuckoos Nest". At an early age, Kesey had a love for Christian fables as well as the Christian ethical system. Although he had a love for these fables, Kesey never wrote anything or published anything till well after his high school career. In High School he was a champion wrestler setting long-standing state records in Oregon. Unlike most "normal" authors, Kesey always had a love for the "wild" side. He would always be doing crazy things and going to parties. While at Stanford, he was in an experience involving chemicals at the psychology department to earn extra money. Among these chemicals were psilocybin, mescaline, and â€Å"LSD† which is found in the drug, acid. This experience altered Kesey personally and professionally causing him to not be what he used to be, but instead a crazy and weird sort of individual. He became friends wi th a group of people that would later call themselves, the Merry Pranksters. Among these pranksters there were famous people like Jack Kerouac, and Neal Cassady. They bought a bus and all went on a trip to the World's Fair in New York. They recorded most of the trip and showed these clips to drugged up audiences at their parties. Kesey and the Merry Pranksters became known for their Acid tests as well as their extensive use of LSD and other drugs. Thomas Wolfe wrote a book about the merry pranksters called The Electric Kool-Aid Acid Test. Kesey and the Merry Pranksters fled to Mexico after their favorite drug, LSD, was made illegal. When they returned to the United States for a final performance of their band, "Warlocks", or "Grateful Dead", Kesey was arrested on a marijuana charge. After serving his time in Jail, Kesey decided to move to a farm in Pleasant Hill, Oregon to raise his family and try to forget his crazy past. Kesey, being a big par...

Movie reflaction 2 Essay Example | Topics and Well Written Essays - 250 words

Movie reflaction 2 - Essay Example In other words, there are parts of social life that are perfectly normal, but from a certain perspective the main character should be seen as a person who struggles with a mental health disorder, though it is not vivid at first. Another important point that is made in the film is the contribution to science that is made by people who are different. This is particularly seen in the first scenes, when the character that is played by Russell Crowe is admitted to the university: he is undeniably apt, but awkward around other people. At a party which was held in the university he argues with one of participants, noting that despite being a scientists, the latter is accustomed to making mistakes, implying imperfections of his publication that he read earlier. One should note that the issues which were mentioned above might have a significant influence on the society. For example, if the latter draws a strict line between what should be seen as normal and deviant, those who belong to the second group will be oppressed. In addition to that, if the main character had been recognized as mentally ill he would have never been able to make his valuable contribution to science and such a beautiful mind as his would have been lost forever for the

THE RELATIONSHIP BETWEEN PERFORMANCE APPRAISAL SYSTEMS AND NURSING Essay

THE RELATIONSHIP BETWEEN PERFORMANCE APPRAISAL SYSTEMS AND NURSING STAFF PERFORMANCE - Essay Example It is essential for nurse managers to assess the performance of clinical nurses, and to manage them effectively and efficiently as a human resource. There are several techniques of performance assessment in organizations, and in health care contexts such as in nursing (Roussel & Swansburg 2006), including the use of a consistent numerical assessment system by managers or qualitative appraisal approaches (Murphey, 2004). For over three decades, organizations have considered performance appraisal systems as key organizational processes for the management and development of personnel (Giangreco, Carugati, Pilati et al 2010; Levy & Williams 2004; Ferris, Timothy, Basok et al 2008). The aim of performance appraisal systems is to regularly offer a comparison between the level of performance expected by any one organization and the performance achieved by an individual or group of individuals. These comparisons are based on objective and subjective factors (Coates 2004). The basis for perfo rmance evaluation is that measuring performance helps to improve performance by providing concise feedback on how the individual or department is doing in the workplace. The popularity of the use of appraisal systems is however surrounded by a forceful debate on their productivity and the related costs and benefits. ‘It is widely believed that performance appraisals

Quantitative Research in Patient Safety Literature Review

Quantitative Research in Patient Safety Literature Review Recently, research has occupied a crucial place in nursing that is identified as â€Å"the diagnosis and treatment of human responses to actual or potential health problems† (American Nurses’ Association, 1980 p.9); thus, an appropriate understanding of research literature is a prerequisite for every individual who works in this area (Rees, 2003). Unfortunately, despite the fact that most of nurses acquire specific skills in research, only some of them manage to apply research data or research findings to practice (Bostrum Suter, 1993). This can be explained by the nurses inability to critique a research, evaluating its pros and cons (Krainovich-Miller et al., 2002). The aim of the present essay is to critically analyse two quantitative research literatures in patient safety. The first research is â€Å"Relationship between complaints and quality of care in New Zealand: a descriptive analysis of complainants and noncomplainants following adverse events† by M. Bi smark et al. (2006), while the second research is â€Å"Comparison of three methods for estimating rates of adverse events and rates of preventable adverse events in acute care hospitals† by P. Michel et al. (2004). Although many nursing studies have been conducted in the last decade (e.g. Johnson Lauver, 1989; Conlon Anderson, 1990; Norman et al., 1991; Brennan et al., 1995; Gross et al., 1995; Fieler et al., 1996; Bennet, 1999), they implicitly dealt with the issues of patient care; however, the studies discussed further directly relate to the quality of medical care in New Zealand and France. The research conducted by Bismark et al. (2006) evaluates the extent of injuries in the patients cured in public hospitals of New Zealand, or more precisely (as the title reveals), a correlation between patients’ complaints and quality of medical care. While the title is clue to the focus, the abstract gives more detailed information, identifying the major aspects of the research (objectives, design, setting, population, main outcome measures, results and conclusion) in a clear scientific style. However, the abstract does not indicate the research questions of the study; they are stated further in the research and are the following: 1) Do complaints track injuries, or are they prompted by more subjective concerns? 2) Are complaints the â€Å"tip of the iceberg’ in terms of quality of care problems and, if so, how representative are they of broader quality problems? (Bismark et al., 2006 p.17). Although the research by Michel et al. (2004) also refers to patient safety, neither the title, nor the abstract uncovers the theme in an explicit way. Actually, the theme is exposed further in the research; in particular, the study analyses rates of unintended injuries (defined by the authors as adverse events and preventable adverse events) in the patients cured in care hospitals of France. Similarly to the first research, the abstract in the second study briefly summarises the research and is divided into the same categories that uncover the essence of the investigation. In this regard, the abstract is an obvious strength of the analysis and it can serve as an example to other researchers who investigate various aspects of nursing. But the research does not specify the research questions either in the abstract or in the introduction section of the paper. Such a lack of specific questions certainly complicates the overall apprehension of the study. The authors could have proposed some research questions, such as 1) What are the major aspects of reliability, acceptability and effectiveness? Or 2) How rates of adverse events and rates of preventable adverse events can be properly assessed with each of three methods? These questions are of primary importance to the research, as adverse events and preventable adverse events can not be rightfully evaluated, if the major criteria of reliability and effectiveness are not properly discussed in the context of the research. However, the authors pay little attention to these aspects of the analysis. Despite the fact that the introduction section in both studies provides a valid explanation of the importance of the problem, neither of the two studies includes an overview of the previous research or specific reports. This neglect decreases the overall presentation and reduces the value of the presented data. However, the problems of statement are formulated in a concise way and reflect that the researchers narrowed the areas of research to the issue of adverse events in the clinical setting in order to get more accurate findings. In fact, this issue is especially relevant today when patient safety has become worse in many countries of the world. The justification for the chosen topic in the research by Bismark et al. (2006) is that the recent accident compensation system in New Zealand does not adequately examine patients’ complaints in all cases of adverse events. Pointing at the fact that â€Å"there is growing international interest in harnessing patient dissatisfaction and complaints to address problems with quality† (Bismark et al., 2006 p.17), the authors concurrently put crucial questions that inspire readers’ interest in the issue of patient safety from the very beginning. In the research of Michel et al. (2004) the underlying reason for initiating an investigation is that the limitations of the employed methods reduce the validity of the received findings in regard to patients’ injures within the hospital setting. However, the lack of appropriate background, theoretical frameworks, hypotheses and definite aims in the introduction section considerably limits the studies. This especially regards the non-inclusion of specific theories that usually back up the presented data. In this respect, both studies are theory-free; unlike theory-testing research and theory-generating research, this kind of research is less popular because it does not analyse any theoretical concepts that constitute the basis of practical nursing. On th e other hand, the studies of Michel et al. (2004) and Bismark et al. (2006) specifically focus on a practical problem-solving framework; that is, the present researches are aimed at identifying practical solutions to the discussed problems rather than discussing theoretical implications. The research of Michel et al. (2004) uses a quantitative research method that â€Å"emphasizes objectivity through statistical analysis† (Santy Kneale, 1998 p.77) and the quasi-experimental design that is considered to be more adequate and less biased than an experimental method, if an investigation is conducted within the clinical setting (Polit Hungler, 1995). Though objectivity is crucial for such kind of research, it would also be appropriate to combine quantitative and qualitative methods, that is, to combine objectivity and subjectivity (Phillips, 1990). The fact is that due to its quantitative method the study appears to be too analytical, too objectively-oriented; thus, there is a necessity to introduce some aspects of the subjective realm into the research. However, Parahoo (1997) supports another viewpoint, exposing the inadequacy of a qualitative method, especially in regard to a nursing research. The author points out that, applying to a quantitative method, rese archers are able to predict the final outcomes, while a qualitative method may generate unpredictable results. The data in the study are collected in care hospitals of Aquitaine with the help of three research techniques – a cross sectional method, a prospective method and a retrospective method. Such triangulation is aimed at â€Å"relat[ing] different sorts of data in such a way as to counteract various possible threats to the validity of analysis† (Hammersely Atkinson, 1983 p.199). In the present study triangulation corresponds with the terms of reference that provide appropriate relevance to the whole research (Shih, 1998). Identifying both advantages and disadvantages of all three methods in Box 2, the researchers contribute much to the reliability of the findings, despite the fact that they have not conducted a pilot study that, according to Carr (2003), intensifies the credibility of the employed research techniques. On the other hand, a pilot study is crucial for the investigations that utilise unchecked tools for research, as is the case with the present study, where the researchers conduct an evaluation of methodology. In this regard, a pilot study â€Å"helps to illuminate some of the problems of the research tool† (Santy and Kneale, 1998 p.80). The research of Bismark et al. (2006) is also quantitative with descriptive design. The baseline data are taken from the medical records of the New Zealand Quality of Healthcare Study (NZQHS) and the Commissioner’s complaints database. Further, multivariate and bivariate analyses are applied to the research to identify certain dissimilarities between complaints and non-complaints. Overall, the explanation of the research techniques and methods is a great strength of this study, as the authors provide a thorough description in regard to data collection and study design. Although the researchers do not define a hypothesis of the analysis, they, nevertheless, use dependent and independent variables to differentiate complainants from non-complainants. However, the limited space of both studies has not allowed the researchers to insert the samples of medical records and questionnaires that served as the basis for the research; thus, the methodology of both investigations can not be fully assessed in terms of the quality. Actually, the research of Bismark et al. (2006) and the research of Michel et al. (2004) employ primary sources (including official records) that explicitly relate to the subjects. But according to Burgess (1991), even primary sources should be critically assessed and â€Å"it is essential to locate them in context† (p.124). But neither the first nor the second study provides a critical evaluation of the utilised sources. In regard to ethical issues, they are not openly addressed in the studies; however, in the research of Bismark et al. (2006) there is a mentioning that the investigation was endorsed by the Wellington Ethics Committee. For Robinson (1996), such ethical approval is a necessary part of a nursing research, as any investigation deals with human beings who may experience certain difficulties during the research. On the other hand, due to its descriptive nature the present study does not necessarily need an informed consent or ethical considerations (Cutcliffe Ward, 2003), while the research of Michel et al. (2004) requires a discussion of certain ethical issues because of its quasi-experimental design. Some of these issues are patients’ confidentiality, defence of their rights and risk control (Pranulis, 1996). In regard to the latter factor, it is necessary for researchers to increase potential benefits and decrease potential risks, especially in such studies that involve a great number of participants, as is just the case with the research of Michel et al. (2004). Thus, it would have been proper for the researchers of the present study to discuss in detail subjects’ conditions and potential harm, particularly in view of the fact that nursing directly relates to patient safety within the clinical setting (DHHS, 1981). However, the ethical rights of samples are implicitly defended in both studies, as no personal details of participants are revealed. But the researchers provide no information of the ways the data were stored and protected before or during the investigation. Similarly, neither of the studies refers to informed consents, while this is a prerequisite for any nursing research (Alt-White, 1995; Berry et al., 1996). As for sampling, the study of Bismark et al. (2006) analyses two groups of patients: the first group includes people who made complaints to the Commissioner and the second group includes people â€Å"identified by the NZQHS as having suffered an adverse event who did not lodge a complaint† (Bismark et al., 2006 p.17). A two stage sampling process is initiated by NZQHS on the example of 6579 medical records. Although inclusion and exclusion criteria are not explicitly identified in the study, the researchers make it clear that they only choose the patients who suffer adverse events. In the process of analysis these patients are divided into two categories – complainants and non-complainants, though both groups are typical representatives of the larger population. In the research of Michel et al. (2004) the sampling includes 778 patients from medical, surgical and obstetric wards. This number of samples is appropriate for a descriptive study. Initially, the researchers chose 786 patients with the help of a two stage cluster stratified process, but excluded 8 persons â€Å"because they were still present on day 30, precluding the review of their medical records† (Michel et al., 2004 p.2). In this respect, the study does not clearly define inclusion and exclusion criteria, but some samples are excluded in the process of investigation. No obvious bias is found in regard to the samples; similar to the previous research, the samples belong to typical representatives of the larger group. In view of this fact, the sampling can be considered as fully reliable. In addition to authors’ comments, the results in the research of Bismark et al. (2006) are presented in figures, tables and boxes that are introduced as additional tools for clarification. This visual information reflects how the data are collected and measured (Figure 1 is especially accurate in revealing the cases of injured complainants and non-complainants). Although the authors do not specifically explain such a choice, they provide a detailed justification for the use of correlation tests that define dependent variables (a distinction between complainants and non-complainants) and independent variables (age, ethnicity, sex and other factors). Besides, the researchers weight the bivariate and multivariate analyses to acquire more accurate findings. The results in the study of Michel et al. (2004) also appear in both textual and graphic forms in order to enhance explanation. But the researchers do not attain the balance between figures and comments, putting too much emphas is on figures. Unlike the previous study, the authors do not use dependent and independent variables in their analysis; however, they employ paired X2 tests for the comparison of retrospective and prospective methods. Discussing their findings, Bismark et al. (2006) draw a parallel between the received results and the findings of the previous studies. Actually, many findings of the prior research are consistent with the present research (e.g. Burstin, et al., 1993; Studdert et al., 2000), while some findings contradict the earlier results (e.g. Tapper et al., 2004). To some extent, such a comparison justifies the lack of literature review at the beginning of the research and provides more validity to the overall outcomes. In general terms, the findings of Bismark et al. (2006) directly relate to the objectives of the study, gradually introducing the evidence that proves the authors’ initial suggestions. In particular, the researchers find out that 79% of all injures can be identified as preventable adverse events. In the case of the Commissioners analysis, 64% of the complaints are made by the patients who suffer adverse events, of which 51% are preventable adverse events. In regard to the NZQHS review, 315 cases of adverse events (out of 850 cases) are preventable, 124 cases are serious and 48 cases are serious and preventable. As for instigators of complaints, 41% of complaints are made by the patients, while 59% by their relatives or friends (13% spouse, 16% parent and 17% child). Evaluating the independent variables, the researchers reveal that the age of complainants is lower than the age of non-complainants; moreover, non-complainants mainly live in the regions with poor economic conditions. The findings in the research of Michel et al. (2004) also relate to the terms of reference, providing evidence that â€Å"the prospective method has several advantages over retrospective and cross sectional methods† (Michel et al., 2004 p.3). In particular, the prospective method better recognises preventable adverse events and is more trustworthy than two other methods. This is clearly seen in Venn diagrams that demonstrate the number of adverse events identified by each of three research methods. Overall, the findings in the present study are not properly discussed; however, the researchers discuss in detail the strengths and limitations of the research in the discussion section. For instance, as the authors reveal, reliability and effectiveness of adverse even ts rates are successfully estimated because the samples are assessed with the help of three methods. On the other hand, the researchers point at the possibility of bias that â€Å"may have been present due to the small number of hospitals and wards† (Michel et al., 2004 p.3) and because of the participation of the care teams in the prospective method. Besides, the reference list that the researchers utilised in the process of investigation might have errors that were not identified. Finally, the aspects of reliability, effectiveness and acceptability are not discussed in detail by the authors, though these are the major assessment criteria of the study. However, there are some obvious strengths of the research; unlike the studies that analyse adverse events either in surgery or medicine (e.g. Mantel et al., 1998; Waterstone et al., 2001), the present study examines various cases of adverse events in three areas – medicine, surgery and obstetrics. Similarly to this research, Bismark et al. (2006) also identify certain limitations of the study; in particular, the analysis of adverse event rates is rather confined, if medical record reviews serve as the basis for the research. The research also lacks definite ethnicity data for all complainants; thus, there is a â€Å"potential for measurement error† (Bismark et al., 2006 p.21). In addition, the authors do not provide any information as to the alternative research methods that can be used for the assessment of the relations between complains and quality of medical care. Drawing a parallel between the employed methods and the alternative methods, it will be possible to enhance the validity of the received findings. The conclusion in the research of Bismark et al. (2006) directly responds to the terms of reference; based on the received results, the conclusion suggests that elderly or economically poor patients rarely initiate complaints processes. The same regards the pati ents who belong to ethnic minorities (in this case – to Pacific ethnicity). The authors recommend to conduct a further study that will profoundly investigate the reasons for people’s refusal to make complaints in the cases of poor medical care. Moreover, the complaints greatly depend on the severity of injures and whether the event is preventable or unpreventable. In this respect, as the researchers conclude, â€Å"complaints offer a valuable portal for observing serious threats to patient safety and may facilitate efforts to improve quality† (Bismark et al., 2006 p.22). Unfortunately, no recommendations for practice are made at the end of the study, thus reducing the relevance of the received findings. On the other hand, as Santy and Kneale (1998) claim, â€Å"all research has some implications for practice even if the results have proven to be inconclusive† (p.82). In the research of Michel et al. (2004) the conclusion summarises the results that, in the authors’ words, â€Å"provide new insights into the epidemiology of adverse events† (p.4). Such a viewpoint is explained by the fact that the findings of the present study reveal the ways to intensify the implementation of prospective assessment in the clinical setting. However, the researchers only suggest the answers to the posed questions, avoiding any insisten ce on specific concepts or notions. Comparing three methods, the researchers recommend to use the prospective method for different purposes that implicitly or explicitly relate to the evaluation of adverse events rates. Finally, Michel et al. (2004) briefly discuss the prior knowledge on the topic and the knowledge acquired in the process of investigation. In regard to the prior knowledge, the assessment of adverse events was conducted in an analytical way that considerably limited the findings. In the present study the researchers receive more feasible results and identify that the causes of adverse events and risk reduction programmes can be successfully evaluated by the prospective method rather than by the retrospective or cross-sectional methods. However, further research is required, if the evidence received in this research is applied to practice (Barron Kenny, 1986; Scott Thompson, 2003). Overall, both researches are well-structured and are written in a scientifically concise style; however, as was stated above, the study of Michel et al. (2004) provides too much technical details, while analysing the results. Therefore, it is slightly difficult to read the research and, consequently, there is a chance that its findings may be ignored by a practitioner on the premise of misunderstanding. Although the research of Michel et al. (2004) is logically constructed, an unqualified person may fail to rightfully apprehend the presented data. On the contrary, the study of Bismark et al. (2006) is easy to understand because it lacks much unexplained jargon. Another strength of the research is the appropriate use of quotes in the discussion section; these quotes are directly related to the analysis and correspond with the ideas expressed by the authors, either refuting or confirming them. Employing this or that quote, the researchers provide a detailed interpretation of a certain concept; and for all that, the number of quotes is reasonable and they are rather short. On the contrary, Michel et al. (2004) do not utilise quotes in the discussion to support their arguments, though they use certain references. Despite the fact that the researchers do not explicitly recommend their studies to nurses, the overall findings can be especially relevant to nursing staff, as well as to the researchers who are involved in health care. Within a complex clinical setting nurses experience various difficulties because of the lack of appropriate practical knowledge (Treacy Hide, 1999; Polit et al., 2001). Thus, the studies of Michel et al. (2004) and Bismark et al. (2006) can inspire nurses’ interest in the ways of patient safety, as, despite their limitations and certain inadequacies, the studies pose vital questions that may increase the quality of medical care not only in France and New Zealand, but in other countries as well. Due to the fact that nowadays nursing staff is usually required to implement various aspects of research into practice (Christman Johnson, 1981; Burnard Morrison, 1990; Street, 1992; McSherry, 1997; Cormack, 2000; Rodgers, 2000; Hek et al., 2002; Cluett Bluff, 2004), the present studies are especially valuable, as they provide useful and valid information that extends the prior knowledge in patient safety. In further studies it will be crucial to discuss the received findings in the context of international implications and to pay more attention to preventable adverse events (Thomas et al., 2000). Moreover, it will be important to give some recommendations for nursing staff and those individuals who deal with patients’ complains (World Health Organisation, 1977; Gordon, 1988; Brink et al., 1989; Lindley Walker, 1993; Ferketich, Mercer, 1995; Northouse, 1995; Roseman Booker, 1995; Duffy et al., 1996; Madge et al., 1997; Vertanen, 2001). Bibliography Alt-White, A. C. (1995) Obtaining ‘informed’ consent from the elderly. Western Journal of Nursing Research, 17, 700-705. American Nurses Association (1980) Nursing: A Social Policy Statement. Kansas City, American Nurses Association. Baron, R.M., Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182. Bennet, J. A. (1999) Critique of research review of attitudes to HIV/AIDS. Journal of Advanced Nursing, 29 (3), 770-771. Berry, D. L., Dodd, M. J., Hinds, P. S., Ferrell, B. R. (1996) Informed consent: Process and clinical issues. Oncology Nursing Forum, 23, 507-512. Bismark, M. M., Brennan, T. A., Paterson, R. J., Davis, P.B., Studdert, D. M. (2006) Relationship between complaints and quality of care in New Zealand: a descriptive analysis of complainants and noncomplainants following adverse events. Quality and Safety in Health Care, 15, 17-22. Bostrum, J. Suter, W. N. (1993) Research utilisation: making the link with practice. Journal of Nursing Staff Development, 28-34. Brennan, P.F., Moore, S.M., Smyth, K.A. (1995).The effects of a special computer network on caregivers of persons with Alzheimers disease.Nursing Research, 44, 166-172. Brink, C.A., Sampselle, C.M., Wells, T.J. (1989). A digital test for pelvic muscle strength in older women with urinary incontinence.Nursing Research, 38, 196-199. Burgess, R. G. (1991) In the Field: An Introduction to Field Research. London, Routledge. Burnard, P. Morrison, P. (1990) Nursing Research in Action: Developing Basic Skills. London, Macmillan. Burstin, H. R., Johnson, W.G., Lipsitz, S. R. et al. (1993) Do the poor sue more? A case control study of malpractice claims and socioeconomic status. JAMA, 270, 1697-1701. Carr, J. (2003) Improving questionnaire response rates. Practice Nursing, 14 (4), 171-174. Christman, N. J. Johnson, J. E. (1981) The importance of research in nursing. In: Y. M. Williamson (ed.) Research Methodology and Its Application in Nursing. New York, Wiley. pp.3-24. Cluett, E. R. Bluff, R. (2004) Principles and Practice of Research in Midwifery. London, Bailliere Tindall. Conlon, M., Anderson, G. (1990). Three methods of random assignment: Comparison of balance achieved on potentially confounding variables. Nursing Research, 39, 376-379. Cormack, D. (2000). The Research Process in Nursing. Oxford, Blackwell Science. Cutcliffe, J. R. Ward, M. (2003) Critiquing Nursing Research. Bath, Bath Press. Department of Health and Human Services (DHHS) (January 26, 1981) Final regulations amending basic HHS policy for the protection of human research subjects. Federal Regulations, 46 (16). Duffy, M. E., Rossow, R., Hernandez, M. (1996).Correlates of health-promotion activities in employed Mexican American women.Nursing Research, 45, 18-24. Ferketich, S. L., Mercer, R. T. (1995).Paternal-infant attachment of experienced and inexperienced fathers during infancy. Nursing Research, 44, 31-37. Fieler, V. K., Wlasowicz, G. S., Mitchell, M. L., Jones, L.S., Johnson, J. E. (1996). Information preferences of patients undergoing radiation therapy. Oncology Nursing Forum, 23, 1603-1608. Gordon, D. R (1988) Tenacious assumptions in Western biomedicine. In: Lock M, Gordon D. R (eds) Biomedicine Examined. London, Kluwer Academic Press. pp. 19–56. Gross, D., Conrad, B., Fogg, L., Willis, L., Garvey, C. (1995). A longitudinal study of maternal depression and preschool childrens mental health. Nursing Research, 44, 96-101. Hammersley, M. Atkinson, P. (1983) Ethnography: Principles in Practice. London, Tavistock. Hek G., Judd, M., Moule, P. (2002) Making Sense of Research: An Introduction for Health and Social Care Practitioners. Sage Publications, London. Johnson, J. E. Lauver, D. R. (1989) Alternative explanations of coping with stressful experiences associated with physical illness. Advances in Nursing Science, 11 (2), 39-52. Krainovich-Miller, B., LoBiondo-Wood, G. Haber, J. (2002) Critical reading strategies: Overview of the research process. In: LoBiondo-Wood J. Haber (eds.), Nursing Research: Critical Appraisal, and Utilization. St Louis, MO, Mosby. pp.33-50. Lindley, P., Walker, S. N. (1993).Theoretical and methodological differentiation of moderation and mediation.Nursing Research, 42, 276-279. Madge P, McColl J, Paton J. (1997) Impact of a nurse-led home management training programme in children admitted to hospital with acute asthma: a randomised controlled study. Thorax, 52, 223–228. Mantel, G. D., Biuchmann, E., Rees, H., Pattinson, R. C. (1998) Severe acute maternal morbidity: a pilot study of a definition for a near-miss. British Journal of Obstetrics and Gynaecology, 105, 985-990. McSherry, R. (1997) What do registered nurses and midwives feel and know about research? Journal of Advanced Nursing, 25, 5, 985-998. Michel, P., Quenon, J. L., Sarasqueta, A.M., Scemama, O. (2004). Comparison of three methods for estimating rates of adverse events and rates of preventable adverse events in acute care hospitals. British Medical Journal, 328, 1-5. Norman, E., Gadaleta, D. Griffin, C. C. (1991) A evaluation of three blood pressure methods in a stabilized acute trauma population. Nursing Research, 40, 86-89. Northouse, L. L., Jeffs, M., Cracchiolo-Caraway, Lampman, L., Dorris, G. (1995). Emotional distress reported by women and husbands prior to a breast biopsy.Nursing Research, 44, 196-201. Parahoo, A. K. (1997) Nursing Research, Principles, Process, and Issues. London, MacMillan. Phillips, D. C. (1990). Subjectivity and objectivity: An objective inquiry. In: Eisner and Peshkin (Eds.) Qualitative inquiry in education: The continuing debate (pp. 19-37). New York, Teachers College Press. Polit, D. F. Hungler, B. P. (1995) Nursing Research Principles and Methods. Philadelphia, J. B. Lippincott. Polit, D. F., Beck, C. T. Hungler, B. P. (2001) Essentials of Nursing Research Methods, Appraisal and Utilization. Philadelphia, Lippincott. Pranulis, M. F. (1996) Protecting rights of human subjects. Western Journal of Nursing Research, 18, 474-478. Rees, C. 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Fortunato is Fortunes Fool in The Cask of Amontillado Essay -- Edgar

Fortunato, Fortune's Fool Who was Fortune's Fool? The answer to that question would be Fortunato. Fortunato is a character in Edgar Allan Poe's short story, "The Cask of Amontillado." Fortunato has wronged Montresor, the narrator of "Cask." The reader can't trust Montresor because he is an unreliable narrator, so the reader can't say for a fact that Fortunato had wronged Montresor. Montresor then seeks revenge on Fortunato. During carnivale season, Fortunato is drinking all types of wine. Montresor knows Fortunato is drunk so he goes to Fortunato and tells him he has Amontillado. Fortunato wants the Amontillado so much, that he is willing to do anything for it, that leads him to his death. Montresor brought Fortunato into the catacombs, chained Fortunato to the wall, walled Fortunato up, and Fortunato was dead. Actually he wasn't dead right then and there. Montresor walled Fortunato up alive, so Fortunato can suffer much pain, then die, die a helpless man. Fortunato was a fun loving/outgoing, alcoholic, boastful/prideful man. Dressed as a jester at the carnivale, Fortunato was getting drunk. He drank and chatted with many people. Fortunato was a very fun-loving and outgoing man, ?He had a weak point- this Fortunato- although in other regards he was a man to be respected and even feared.? Montresor calls him respected, this shows that Fortunato was a man who many liked, making them respect him. The fear, as the reader might suspect, is that he prides himself too much in his knowledge of wine. Another fear, as the reader can assume, may be that he can get too outgoing. His drinking problems probably make him very distraught and obnoxious. Montresor knows that Fortunato is very outgoing, and that he aims and shoots fo... ...haracteristics bring about Fortunato?s fortune. He was fortune?s fool. His fortunes catch up with him and lead to a bad consequence, Fortunato?s death. If Fortunato wasn?t so enthusiastic when it came to wines, he may have realized Montresor was going to do something bad. If Fortunato wasn?t an alcoholic, he wouldn?t have been drunk. If he wasn?t drunk, he may have known that Montresor was going to hurt him. Finally, if Fortunato wasn?t boastful and prideful, he wouldn?t have wronged Montresor at all. And if he never had done some sort of wrong to Montresor, he wouldn?t be dead. In summary, if Fortunato didn?t have those 3 characteristics, he wouldn?t be dead, and Montresor would have never said he had been ?wronged.? Unfortunately Fortunato was Fortune?s Fool. For his fortune favored him. Fortune was God?s gift to the fools, which is why fortune favors the fools.

Safaricom financial situation

Safaricom is a company that deals with telecommunication services, voice messaging and fixed broad band. The company output can be classified as voice, data and value added services. Voice services include Premium Rate Services also known as third party content service, provide recorded information or live conversation for callers. Safaricom Pre Pay services allow subscribers to pay in advance and freely choose a tariff that suits them. Data services include airtime recharging and sambaza. Sambaza, launched in March, has enabled subscribers to share their airtime with their friends and family for free. Okoa jahazi and bonga loyalty scheme has enabled subscribers to enjoy advance airtime and to be awarded for their airtime usage . Mpesa service has allowed customers to easily send money through the mobile phones, a very sophisticated technology, and a first in Kenya. Submarine fiber optic, SEACOM, provides high capacity band width for high internet connectivity. To achieve all these, the company has implemented a number of inputs. It has leased services of several companies as Cellulant, Bernsoft, interactive, Adtel , Mobile Zone and Wasp ,to provide Premium Rate Services to ensure effective live communication between its subscribes and outside world . Ongea 24/7 has enabled efficiency in prepaid airtimes. It has also assisted in dealing in virtual electronic airtime. Safaricom Broadband Modem (Huawei E220) and Safaricom Broadband Router (Huawei E960) has enabled access up to 7. 2Mbps downlink speeds as compared to 236 kbps from other technologies (Michael Joseph, 2009). The company has developed several technological solutions to deal efficiently and effectively with existing problems. The company has launch the fastest internet connection through the 3G technology known as Safaricom live(Michael Joseph,2009). The company also provides a wide range of services including broadband wireless data (Up to 7. 2 of 2Mbps downlink Speeds), video calls and telephony. It is also signing a deal with a European firm to launch fourth generation technology which will see increase in the speed of internet connection from the current 7. 2 of 2Mbps . Safaricom has also launched new products and services in the market that the normal ‘Mwananchi’ can afford e. g. bamba 20, bemba bamba and super ongea tariff which is as low as 80 cents. In September, 2001 it launched ATM top up for its pre-paid subscribers to enable top up at teller machine. It has also created technological problem solving techniques. In the magazine by MaryAnn and Chris (2009) the company has created the widest network coverage in Kenya to ensure that subscribers receive clear signal when communicating (p. 35). Business Messaging Solutions has enabled quick and affordable communication to a large audience. According to Less (2009) Safaricom has a turnover of 70. 5 billion revenues from 61. 4billion the previous year, a 14. 8 % increase, with a market capitalization of 148 billion (p. 18). Safaricom controls the stock market with a listing of 40 billion shares, the highest in Africa. It has an operating profit of16. 2 billion with a profit before tax of 15. 3 billion (Less,2009). Cash of 30. 1 billion from operations remained strong enabling the company to expand its network coverage and ensure that it had a strong network to handle its increasing subscribers. The shareholders fund increased by 19. 9% to 51. billion (Michael Joseph, 2009). The graph shows how the numbers of subscribers have significantly increased as at Nov 2009. Though Safaricom runs the telecommunication industry, it has been faced with stiff competition from other companies as Zain, Orange, Econet wireless, Access Kenya and Wananchi on line. Safaricom has continued market leadership with a control of 79. 1% of the ma rket i. e. 13. 6 million subscribers thus it can be said to be a market price setter. Reduction in GDP growth, increase in margin, Global financial crisis and high oil prices is significantly affecting the company efficient performance. Less (2009) however shows that there has been an upward movement in revenues by 83% to 12. 9% of total revenue despite of these economic back drops (p. 19). The launch of Jibambie promotion, Jambo Contact Centre and 3G and Wimax data services are some of the events the company marks as having contributed to its success. According to Chris (2009) the launch of M Pesa has been a run way success story, with a current 6. 2 million subscribers and shs 17. 1billion transfer from one person to another as at March 2009 (p. 11).

Scarcity of the World essays

Scarcity of the World essays The science of economics depends on whether society lives in abundance or scarcity. The economy is the careful management of wealth or a system of producing and distributing wealth. Abundance is having more than enough, a great plenty. Scarcity is the belief that nothing is plentiful. It is usually hard to get. Society today is involved in one big competition. People are always competing to get the things they need or want in life that will make them happy. People dont worry about the starving people that dont have the things they need because people are so worried about not having enough for themselves. It seems like people are so worried about scarcity that they will do anything to survive. They dont want the effects of scarcity, not having enough of what they want or need. Palmers argument is excellent. His idea is easily comparable to the story of Jesus feeding of the five thousand. The way Palmer breaks down the story of Jesus feeding of the five thousand and compares it to the world now really makes us think about some things. First of all, why have that many people, including myself, not thought about this and taken action. The assumption of scarcity really must have got a hold of society very fast. The assumption of scarcity has been taken up by most everyone including myself. It would make a lot more sense if everyone would come together in little communities and help each other to develop abundance instead of everyone feeling threatened by anyone else and choosing to walk the road alone. When you are by yourself, you are living in a world of scarcity because you can only depend on yourself and how much money you have. You dont have the reassurance that, if you needed help or something lent to you, that you could go to someone in yo ur community that would be able to help you. When you are alone you only have what you know. Scarcity is worse when it comes to emotiona ...

The House of Mirth essays

The House of Mirth essays In The House of Mirth, Edith Wharton presents the New York society at the dawn of the 20th century. It is a New York that is divided into strict social classes, where old wealth is being overshadowed by new wealth. The ones below aspire to move higher while those do everything in their power to stay where they are. For women like Lily Bart, however, being rich and beautiful is a tenuous prospect. As they grow older, many find that the Though she is still wealthy at the beginning of the novel, Lily is in a difficult position, one foreshadowed by her meeting with the destitute woman in the streets. Through this juxtaposition, Wharton shows the reader that in many ways, Lily Bart is as constrained as her street woman counterpart. For example, because she is comes from old wealth, Lily could not work without losing social status. When Lily is further estranged from her rich aunt, her position becomes more difficult. At this stage, Lily has scarce options if she wants to retain her social position in New York society. She could not work for a living without sliding down the social ladder. She was in debt to the unscrupulous Mr. Trenor. She had no monetary wealth after being disinherited. Her only asset was her physical beauty, one that was Thus, the only option for a woman of Lily's status and circumstances is a good marriage. Wharton articulates this position clearly, when Lily states that only governesses or widows can be free enough to live by themselves in an apartment. However, women like her were "poor, miserable, marriageable girls" (9), had no choice but to be a wife. Unlike men, who can marry if they desire, Lily states that "a girl must" get married in order to remain accepted in New York society. When she fails to secure marriage and is banished from her social circle, the only alternative for ...

African American Children and Religion Research Proposal

African American Children and Religion - Research Proposal Example Others have limited their coverage of the research population, excluding young African-Americans for a variety of reasons. This researcher, however, believes that there is an urgent need for research that highlights the positive aspects of the social behavior of today’s generation of young African-Americans, using data involving a youth research population. It is hoped that such an investigation of an important and growing sector of contemporary American society would contribute to knowledge of African-American culture, more specifically on the aspect of psychology of religion. It is further hoped that the results would provide concrete strategies for action that would inspire present and future generations of African-American families and youth to perform their important role in strengthening a nation founded on and inspired by Christian ideals. Aims of the Study The aims of this study are as follows: 1. To determine the impact of religious practice or non-practice on the social attitudes and behavior of African-American children from the ages 8 to 19 residing in a specific community. 2. To examine the religion-based determinants of positive social attitudes and behavior. 3. To identify and describe the positive religious practice role models of the research population under study. Hypothesis The study will test the following hypotheses: 1. African-American children who engage in positive religious practices develop positive social attitudes and exhibit positive social behavior (H.1). 2. African-American children who do not engage in any type of religious practice do not develop positive social attitudes and exhibit negative social behavior (H.2). Review of Literature and Preliminary Discussions One of America's founding fathers, Benjamin Franklin, stated that "religion will be a powerful regulator of our actions, give us peace and tranquility within our minds, and render us benevolent, useful and beneficial to others" (Isaacson, 2003, p. 87-88). Over the last quarter of a millennium, American society has undergone a seismic shift in several aspects, more notably in the role of religion and the belief that its practice has beneficial effects on society. Several studies (Paul, 2005; Inglehart and Baker, 2000; Idler and Kasl, 1992) have attempted to show the correlation between America's social problems and the negative effects of secularization on the practice of religion, and that such a development would have detrimental consequences to the future of democracy. Aral and Holmes (1996) and Hummer et al. (1999) also showed that this phenomenon is evident not only in America but also in other developed democracies such as Europe and Japan. On the contrary, they argue, democratic nations such as those in predominantly Catholic Latin America and in parts of Africa with societies influenced by Christianity (such as Angola, Democratic Republic of Congo, and Ethiopia) where the people are noted for religiosity often exhibit the worst forms of social behavior. In another study, Barro and McCleary (2003) used the term "spiritual capital" in reference to the social benefits that proceed with the practice of religion. They concluded that Americ a's deep social problems in a period of great economic prosperity and the highest expenditures for health care among

Applied Law Essay Example | Topics and Well Written Essays - 250 words - 1

Applied Law - Essay Example This means that there is a promise made in return for something, which has already occurred. The promise to donate the receipts to the charity organization constitutes to insufficient consideration and cannot be enforceable (Adams, 2004). The formation of a contract takes place when what one party offers is accepted by the other party to the contract. Krauses cannot avoid the contract after learning that they could have sold the piece of land at a higher price than the price, which Jud offered. This is because they have already accepted the offer. Acceptance of the offer means that the Krauses bound themselves legally to the terms of the contract. Therefore, avoiding the contract could constitute to breach of contract. Krauses can only withdraw from the offer if they had not accepted the offer (Bhana, Bonthuys & Nortje, 2009). Jud can be held to pay the typewritten amount since a contract constitutes a legal agreement in writing between the two parties to a contract. This means that Jud is bound to pay the typewritten amount rather than the offered amount (Bhana, Bonthuys & Nortje,

Managing Strategy Essay Example | Topics and Well Written Essays - 1250 words

Managing Strategy - Essay Example Introduction PESTEL is a model that considers the Political, Economic, Social, Technological, Environmental as well as legal aspect (Thomson & Strickland, 1998). It is considered as one of the models that can be successfully used particular for groups that are considered to be more private focused. Such groups may be victims of being oblivious to the effect of the external forces since their focus is laid on the internal forces. In studying the European Tour operation, PESTEL had been exhaustively practiced to arrive at the current status of the industry. Discussion According to the study, Political factors such as Government policies and trading policies were central to the growth. A case in point is the outcome of the competition authority clearance which witnessed the merger between Thomas Cook and the British Competitor MyTravel, an integrated international group. The economic situations and trends were also awakened the industry, where players like TUI responded to the actions o f Thomas Cook by the acquisition and merger with First Choice. These home economic situations and trends tighten the competition in the European Tour and Operation Industry. The economic situation was also concerned with the Industry specific factors where the Thomas Cook adopted flights that gave the customers choices of chartering plans rather than DO It-Yourself and thus assured security and good value for the vacationers. Economic factors such as interest rates also influenced the operations of players like TUI. This was witnessed where an anticipation of a sustained weakness of the pound against the Euro and the expected increase in unemployment made TUI to cut summer capacity by 27% to the British travelers in 2009. These economic factors also saw Thomas Cook undergo reorganization after experiencing continuing decrease in revenue. On consideration of the social factors, TUI got involved in low cost airline which was expected to get to the average families as well. TUI also go t itself different brands all over Europe and world at large to present different images in different environment, which they successfully did through travel agents as well as having there different brands of Tour operator selling not only fully packaged tours but also individual travels components. Competing Technological Development also shaped the tours operations in Europe. The observation that call centers and online bookings combined, in 2005 accounted for 25% of the sale gave an indication that technology had given the business of Tour operation a new face all together. This is also observed when online Travel Agencies are noted to have been moving quicker than the traditional Tour Operators who were seen to be going down the hill. The Literature also elaborates that tours operators no longer competes exclusively amongst themselves but face competition from online channels. The maturity of technology seemed to have played a very significant role in the development of tour ope ration in Europe. When it comes to environmental factors, clearly, Consumer buying patterns played a role in the determination of the progress of the industry the fact that a number of structural changes between US and UK. This was grounded on the understanding of the differences between the US markets and the European markets. The study notes that the Europeans take more vacations than Americans and that US travelers tend to be more independent and

Why I Want to Become a Teacher Essay Example for Free

Why I Want to Become a Teacher Essay I always wanted to become a teacher. The main reason for this is that I want to do something to help the community, and give back some of the privileges that I enjoyed. Some of these privileges included a great education, and caring teachers. I could see myself accomplishing this task through teaching. New York City needs hard working, caring, and responsible teachers, and I want to become a part of it. I believe that to become a teacher, your heart really needs to be in it and you need to be committed and dedicated. I will constantly think of ways on how to improve things and how to help my students when I become a teacher. I have the motivation, and the potential to become a New York City Teaching Fellow. In this way, I will be influencing the futures of our next generation in a positive way. I have previously worked as an occasional per diem teacher in the year 2002 with the Board of Education of NYC. Actually, it was my first job right after college. I enjoyed my time working there and helping students out, who were in need of help with their math skills. Through this teaching job, I learned a lot of things. Most important was the behavior aspect of children. I completely understand how to motivate students, and how to get them interested in the coursework. Their enthusiasm and motivation is the key to a better future generation. Besides that, I have very strong math skills, which help me make a strong candidate as a teacher. These math skills were visible when I took Calculus 1, and Calculus 2 in senior year of high school. After that, I took statistics and other advanced calculus classes in college. This progress continued through graduate school. Therefore, I believe that my educational math experience and previous experience as a math teacher will help definitely ensure high academic achievement for my students. New York City has many high-need schools located in low income communities. I also come from a low income family. Therefore, I think of it as my duty to come forward and do something for the low income families. I understand the pressure these kids are facing and the daily hassles that they go through. Therefore, it will be a great opportunity for me to work with the children of a high-need school, while understanding their situation completely. In conclusion, I would say that it is my dream to become a teacher and give back to the community that gave everything to me. I have the experience and the right education to make me a perfect candidate for teaching. I know that I will be a part of the next generation even though I am not in it and that makes me excited. I will be able to help shape history by being a teacher by setting these children up for their future. I cannot wait to get into a classroom and impart my enthusiasm to kids. They will learn and I will as well and it will be a great accomplishment for us.

Relationship between Alcohol and Depression

Relationship between Alcohol and Depression The Complex Association between Alcohol Consumption and Depression Constantin Vintilescu Abstract Symptoms of depression are typically among those who abuse alcohol. Previous research has shown a positive correlation between alcohol consumption and depression exists; however, the exact nature of the association is complex. The purpose of this paper is to examine the relationship between the amount of alcohol consumption and severity of depression as described by the Alameda County Health and Ways of Living Study (ACHWLS) dataset. The raw data was aggregated, transformed, and used to calculate new variables. Correlation and curve estimation analysis was performed on the calculated variables. An overall positive correlation was confirmed, and previous research was upheld by demonstrating that abstainers and heavy drinkers have greater symptoms of depression than lite to moderate drinkers. However, a complex S-shaped pattern, with low symptoms of depression among very heavy drinkers, was determined to be the best fitting regression model. This finding has previously been undescribed , and may be due to the limitations of self-reporting by very heavy consumers of alcohol and the severely depressed. Further study is suggested, with screening performed by trained professionals, to confirm this finding. The Complex Association between Alcohol Consumption and Depression Alcohol consumption and depression are frequently co-occurring conditions. A cyclical pattern of escalating comorbidity has been described in people with both disorders, but previous studies have shown that the association is not a simple linear correlation. The aim of this paper is to conduct a secondary data analysis of the 1994 ACHWLS dataset to describe the relationship between alcohol abuse and depression. Research Questions Is there a positive correlation between alcohol consumption and depressive symptoms? Does a linear, quadratic, or cubic regression model explain the most variability between alcohol consumption and severity of depressive symptoms? Background Alcohol abuse is common and is often associated with depression. In a 2012 survey, conducted by the Substance Abuse and Mental Health Services Administration, of Americans over the age of twelve: 17.0 million reported heavy drinking, and 14.9 million were diagnosed with alcohol dependence (SAMHSA, 2013). According to the SAMHSA (2014), an estimated 43.7 million American adults experienced some form of mental illness; and an estimated 9.6 million adults had a serious mental illness, including major depression. Of these, 8.4 million people had co-occurring mental illness and a substance use disorder (SAMHSA, 2014). Of people with alcohol problems, 80% show symptoms of depression (Mclntosh Ritson, 2001), and 25% of those with depression also have an alcohol problem (Chick, 2002). An escalating cycle of comorbidity exists between alcohol abuse and depression: people with a mental health disorder have a higher likelihood of alcohol abuse when compared to people without mental illness (SAMHSA, 2014); people with concurrent major depression and a substance abuse disorder have more severe symptoms of depression than those without a substance abuse disorder (Ostacher, 2007); and greater severity of depression is associated with more drinking (Palfai et al., 2007). Thus, depression may augment alcohol use, which in turn, may increase symptoms of depression – creating an accumulative cycle of abuse and depression. Numerous studies confirm the positive association between alcohol consumption and depression (Alati et al., 2005; Dixit Crum, 2000; France et al., 2004; Hartka et al., 1991; Rodgers et al., 2000). However, the nature of the relationship is complex, as both the abstinence from and heavy consumption of alcohol are both associated with an increased risk of depression (Alati, et al., 2005; Blow, Serras, Barry, 2007; Rodgers et al., 2000). It is clear that the relationship is non-linear (Rodgers et al., 2000b), but there is uncertainty over its exact nature. Whether the association curve is J-shaped or U-shaped depends on the method of measurement (Graham, Massak, Demers, Rehm, 2007). Data Source The 1994 ACHWLS is part of a longitudinal funded by the National Institutes of Health, which began surveying a random sample of households in Alameda County, California in 1965. Alameda County was chosen because the diversity of residents closely resembled the population of the United States, and thus allowed for greater generalizability to the American public. The 1994 ACHWLS attempted to follow-up on all the respondents interviewed in 1965 and 1974 with a self-administered questionnaire regarding living patterns, health, and socio-demographics. No one question, on the ACHWLS, completely reflected the intensity of alcohol consumption, or the severity of depressive symptoms, exhibited by the respondent, so a strategy to represent a cumulative score for these variables was developed. Key questions regarding alcohol use and symptoms of depression were identified and aggregated in Table 1 and Table 2 respectively. Several responses to questions were reversed so that a higher numerical score reflected an increased severity of symptoms. Responses were subsequently transformed to a zero-based scale. Table 3 and Table 4 show the recoded values. Table 3 and Table 4 were each summated to calculate the new variables DRINKING and DEPRESSION respectively. Of the 2,729 respondents in the ACHWLS, only cases with complete responses to all items on both Table 2 and Table 3 were considered (N = 1,248). Included participants ranged in age from 46 to 95 years old (M = 63.1, SD = 9.79). The median income was $ 40,000-$44,999; the majority were male (56%); most had finished high school (90%), and had at least some higher education (66%). Race/ ethnic demographics are summarized in Table 1. Methods The distribution of DRINKING is slightly skewed to the right (skewness = 1.70). The histogram, mean score, and SD are shown in Figure 1. Possible values range from zero to 24. Similarly, DEPRESSION is also slightly skewed to the right (skewness = 1.48). The distribution is shown in Figure 2. Possible values range from zero to 18. The mean DEPRESSION score corresponding to each DRINKING value is shown in Figure 3. Being the sum of several ordinal values, it is important to clarify that DRINKING and DEPRESSION both represent continuous scales of intensity. Although their possible ranges are limited on this instrument, their values could theoretically be measured on an infinite positive scale of rational units. As such, parametric testing is appropriate; even though the data is not a perfectly normal distribution, parametric procedures are still valid because of the very large sample size (Ghasemi Zahedias, 2012). Pearson’s correlation was performed to test the overall relationship between quantity of alcohol consumption and of severity depression. Since convincing evidence has previously demonstrated a positive association exists between the variables in question, directional analysis was used to determine the p-value. This method increases the experiment’s statistical ability to discover an effect without changing the level of significance. To describe the nature of the association, non-linear regression was performed in SPSS. The curve was estimated using several models, including linear, quadratic, and cubic to determine the best fit. Results A directional Pearson Correlation was performed between DRINKING and DEPRESSION. The effect size was determined to be small, but significant, r (1249) = .091, p = .001. Curve fit analysis shows that linear (F 1, 1246 = 6.134, p = .013, R2 = .005), quadratic (F 2, 1245 = 7.789, p 2 = .011), and cubic (F 3, 1244 = 7.545, p 2 = .018) regression models were all significant. Figure 4 shows a comparison of all three models and the actual data. The cubic regression model was able to explain the highest degree of variability, accounting for .016 (adj. R2) of the variance in DEPRESSION. Figure 5 shows the cubic model along with the formula governing the curve. Discussion Although the Pearson’s correlation was a significant positive value, the effect size was small. This is an expected outcome because the nature of the association is non-linear. Negative correlations among abstainers and very lite drinkers served to negate much of the positive correlations among moderate and heavy drinkers. Segmented correlations or stepwise regression may be of value to determine the exact effect on depression for each of the following groups: abstainers, very lite drinkers, lite drinkers, moderate drinkers, heavy drinkers, and very heavy drinkers. Cubic regression was the best fitting curve, but only a small degree of variability was explained by this model. This may be due to possible limitations of the DEPRESSION variable. A more sensitive instrument to gauge depression severity may yield a higher R2. Also, due to the nature of very heavy drinking and severe symptoms of depression, persons with these afflictions may be under-represented in the ACHWLS survey. This possibility may be responsible for the low R-value. Screening performed by trained professionals may increase the correlation and variability explained by this model. Interestingly, the curve showed a complex S-shape, with very high alcohol consumption being associated with lower symptoms of depression. This observation may also be related to the sensitivity of the DEPRESSION variable, or it may be related to a reporting problem among very heavy drinkers. Although a maximum score of 24 is allowed by the screening instrument for DRINKING, the maximum score reported was only 18. This may suggest that very heavy drinkers were not accurately represented in the study data source. Very heavy drinkers and very depressed persons may not have responded to the survey or not have responded to all the items in Table 1 and Table 2 due to the nature of their alcohol problem or depression. A more focused study with screening performed by trained professionals may yield more accurate results than a generalized survey relying on self-reporting. Conclusion Correlations are weak; however, the over-all effect of alcohol consumption on depression is positive. The exact nature of the association is complex, with both heavy drinkers and abstainers showing greater symptoms of depression. The best fitting curve, for this dataset, is cubic with an S-shaped pattern. However, limitations among responders with very heavy drinking and severe symptoms of depression may be influencing the curvature. A focused study with screening performed by trained professionals is recommended. References Alati, R., Lawlor, D. A., Najman, J. M., Williams, G. M., Bor, W., OCallaghan, M. (2005). Is there really a J-shaped curve in the association between alcohol consumption and symptoms of depression and anxiety? Findings from the Mater-University Study of Pregnancy and its outcomes. Addiction, 100(5), 643-651. doi: 10.1111/j.1360-0443.2005.01063.x Blow, F. C., Serras, A. M., Barry, K. L. (2007). Late-life depression and alcoholism. 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Risk factors for depression and anxiety in abstainers, moderate drinkers and heavy drinkers. Addiction, 95(12), 1833-1845. doi: 10.1080/09652140020011135 Rodgers, B., Korten, A. E., Jorm, A. F., Jacomb, P. A., Christensen, H., Henderson, A. S. (2000b). Non-linear relationships in associations of depression and anxiety with alcohol use. Psychological Medicine, 30(2), 421-432. Substance Abuse and Mental Health Services Administration. (2013, September). Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Author. Substance Abuse and Mental Health Services Administration. (2014, October 9). Mental and Substance Use Disorders. Washington, DC: Author. Retrieved February 15, 2015, from http://www.samhsa.gov/disorders Tables Table 1 ACHWLS Questions Related to Drinking Note: Responses appear exactly as they are reported in the 1994 ACHWLS. Table 2 ACHWLS Questions Related to Depression Note: Responses appear exactly as they are reported in the 1994 ACHWLS. Table 3 ACHWLS Questions Related to Drinking Recoded Note: Responses to items with IDs ending in â€Å"R† are recoded to reflect a higher severity with higher numerical value. All other responses appear exactly as they are reported in the 1994 ACHWLS. Table 4 ACHWLS Questions Related to Depression Recoded Note: Responses to items with IDs ending in â€Å"R† are recoded to reflect a higher severity with higher numerical value. All other responses appear exactly as they are reported in the 1994 ACHWLS. Table 5 Race / Ethnicity Demographics Note: Self-reported ethnicity / racial demographic data summarized from respondents of the 1994 ACHWLS who submitted complete responses to all question items listed on both Table 1 and Table 2. Figures Figure 1. Distribution of data for DRINKING variable. DRINKING is summation of responses listed in Table 3. Possible values range from 0 to 24. Figure 2. Distribution of data for DEPRESSION variable. DEPRESSION is summation of responses listed in Table 4. Possible values range from 0 to 18. Figure 3. Mean of all DEPRESSION scores corresponding to each DRINKING value. Figure 4. Best fit curve estimation for variables DRINKING and DEPRESSION. Mean data collected from the ACHWLS is shown in red. Figure 5. Cubic regression curve is given by the formula above. Mean data collected from the ACHWLS is shown in red.