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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. 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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,