Based on clinical practice scenario (wound care), discuss the extent Literature review

Based on clinical practice scenario (wound care), discuss the extent to which evidence based practice was utilised, including re - Literature review Example These processes encompass the concept of wound care. Wound care is a crucial part of the medical practice. It prevents infection and blood loss, as well as further complications for the patient. There are various techniques which health professionals can apply in order to manage wounds. Such management strategies are supported by various studies and evidence in actual practice. This study shall consider literature and supporting researches in wound care, with particular attention given to patient preference and evidence-based practice. With the variety of applications which can be used for skin care, there is a need to consider the best type of care according to patient response and outcomes. Wound care All injuries trigger a series of events which are involved in healing, characterized by the arrival of platelets and inflammatory cells at the site of injury (Diegelmann and Evans, 2004). These cells also give off signals on the influx of connective tissue cells and on the increase of new blood. Chemical signals for these are the cytokines or growth factors. The fibroblasts are the connective tissues which mark collagen deposition essential for tissue injury (Diegelmann and Evans, 2004). In response to injury, platelets come into contact with exposed collagen. With platelet aggregation, clotting elements are released causing the formation of a fibrin clot at the injured area. The fibrin clot is considered the provisional matrix upon which healing is built on. Platelets facilitate clotting which helps control bleeding and loss of fluids and electrolytes. As well as releasing the cytokines, which initiate healing, these platelets also release the platelet-derived growth factor (PDGF) and transform growth factor-beta (TGF-B). Through the PDGF, chemotaxis of neutrophils, macrophages, smooth muscle cells, and fibroblasts is initiated (Diegelmann and Evans, 2004). These platelets also trigger the mitogenesis of the fibroblasts and smooth muscle cells. The TGF-B also t riggers the healing cascade by drawing in the macrophages and prompting them to release more cytokines (including the fibroblast growth factor-FGF, PDGF, TNFa and the IL-1) (Diegelmann and Evans, 2004). The TGF-B supports the chemotaxis of the fibroblast and the smooth muscle cells; it also regulates collagen and collagenase expression (Diegelmann and Evans, 2004). The overall result of these signals is a strong response of the matrix which then supports the release of cells which help ensure rapid formation of new connective tissue at the injured area during the proliferative stage of healing which follows the inflammatory phase (Diegelmann and Evans, 2004). Within 24 hours of the injury neutrophils are the common markers in the injury site. This neutrophil removes foreign material and bacteria in the wound site. Bacteria send of chemical signals which attract neutrophils, ingesting these through phagocytosis. These neutrophils will fill themselves with bacteria and make up the lau dable pus in the injury site (Diegelmann and Evans, 2004). The mast cell is a market cell crucial to wound healing. These cells give off granules made up of enzymes, histamine, and numerous other active amines; they are also responsible for the signs of inflammation seen around the wound. The active amines in the mast cells trigger nearby vessels to become leaky; this causes the easy passage of mononuclear cells in the injured area (Diegelmann and Evans, 2004). Fluids also gather at the wound site and with this, signs of

Customer Care - Practical Experience Assignment

Customer Care - Practical Experience - Assignment Example The airline is specifically known to offer great customer service to tis huge client base. To continue offering great customer service, the company ties key performance indicators to customer satisfaction. It also trains its front officers extensively to ensure that they can deal with all types of clients and offer customer service that exceeds customers’ expectations. The success of the group is closely tied to customer satisfaction since the company deals with people on a daily basis (Zeithaml, Bitner & Gremler 2006). Questionnaires were used to collect data for this research. Open-ended questionnaires were used to enable the respondents give sufficient details to facilitate credible data analysis. Questionnaire were used because they are more appropriate for collecting primary data that was needed for this research because the data is more reliable since it was obtained first hand. Questionnaires are simple and comprehensive, they cut unnecessary details and are direct to the point. Therefore, it was easy to convince the respondents to participate in the data collection exercise despite having busy schedules. The respondents included customer service personnel at different ranks. Targeting employees at different ranks aimed at establishing if the entire organization harmonizes its customer information and practices and that the customer can get the same information at every contact point. Choosing customer service personnel as respondents was based on the logic that their work description is dea ling with customer issues and concepts and therefore they are more knowledgeable in that field (Meuter, Ostrom & Roundtree, 2000). Emirates Airlines & Group treat their customers well by allowing genuine interactions with customers. The customer service representatives talk to customers as honestly as persons representing the business rather than acting as faceless or nameless

Black Exodus of 1879 Research Paper Example | Topics and Well Written Essays - 3250 words

Black Exodus of 1879 - Research Paper Example † The Black Exodus of 1879, often referred to as the Exoduster Movement, took place in late nineteenth century US, where there was a large-scale migration of the black Americans from southern states (primarily from regions adjoining the Mississippi River) to Kansas. This was the first movement of the black Americans (in large numbers) away from South, after end of the US Civil War. At this time, there were increasing instances of racial strife that led to widespread violence and brutal murders (of both black and white community members) in the southern states. The protection accorded to the black slaves by the Reconstruction era under Federal Bureau, disappeared with the end of Reconstruction, and with the start of the next phase known as Redemption, the former slaves became more vulnerable and were again at the mercy of their former owners. After the 1876 election, many of the former slaves felt unsafe and decided to migrate to other regions that were deemed safer. While some migrate d towards the abolitionists states in the north-eastern regions, there were large-scale movements towards Kansas (held under Republicans and the famous John Brown). The black Americans that moved to Kansas in 1879 came to be known as the Exodusters, and their movement created a great deal of worry for the southerners and led to significant debate amongst the southern and northern states. In the black exodus of 1879,  Benjamin "Pap" Singleton played a prominent role.5  During this movement, nearly forty thousand Exodusters  migrated from the  South  and went to live in Colorado Oklahoma,  and Kansas.6   The  term Kansas Fever Exodus  refers to the immigration of nearly six thousand former slaves to Kansas, from  the southern states of Texas, Louisiana and Mississippi.7 Benjamin Singleton, at the time of the exodus, was residing in Kansas (Morris country), and he had started the demand for rights to black immigration immediately after the end of the civil war, and owing to his deep involvement in the movement he is also known as the â€Å"Father of Exodus.† There are various speculations as regards the actual cause for this sudden exodus of the black Americans from the Mississippi region towards Kansas in such large numbers. Some authors contend that this movement was primarily owing to the feeling of insecurity arising from the sudden fall i n political ascendancy of the black community, after the Reconstruction era ended. Other writers feel that some of the crafty northern politicians lured these former slaves in order to garner support in the forthcoming elections. Some authors also claim that agricultural failure in 1878, a subsequent fall in labor prices, and various other external causes led to discontent amongst the black population, which ultimately made them move northwards, and search for a better and a more stable livelihood.8 Another strong influence that made many of the black Americans move to Kansas or to other parts in the north and western regions, were the news and letters detailing the prosperous conditions of some of the former slaves who had already migrated and settled in these regions, right after the civil war. In this context, the paper will now discuss the Black Exodus of 1879, and will examine the reasons and causes behind the movement. It will explore the effects of this movement, as in change of black population demographics. The paper will include notable figures that were involved in the movement while examine the opinions of various African Americans of that era about this movement. Discussion The era of reconstruction After the end of the US Civil War in 1865, the period of Reconstruction started which lasted until around 1877, when there were large-scale efforts to rebuild South on new lines and

Comparison Of Nominal Gdp And Real Gdp Economics Essay

Comparison Of Nominal Gdp And Real Gdp Economics Essay In Macroeconomics, to distinguish price changes from quantity changes, we use the concepts of nominal GDP and real GDP. Nominal GDP measures the value of the output of final goods and services using the prices that prevailed at the time of measurement, or current prices. It is sometimes called current dollar GDP. Real GDP measures the value of the output of final goods and services using the prices that prevailed in some given or base year. It is sometimes called constant dollar GDP. By comparing real GDP from one year to another enables us to say whether the economy has produced more or fewer goods and services. Comparing nominal GDP from one year to another does not permit us to compare the quantities of goods and services produced in those two years , because GDP is not adjusted for certain bads. Thus, some economists argue that GDP overstates overall economic welfare. The following is an example of gross domestic product (GDP) figure that has not been adjusted for inflation: Also known as current dollar GDP or chained dollar GDP. It can be misleading when inflation is not accounted for in the GDP figure because the GDP will appear higher than it actually is. If the nominal GDP figure has shot up 8% but inflation has been 4%, the real GDP has only increased 4%. Real GDP is a macroeconomic measure of the size of an economy adjusted for price changes and inflation. Real GDP for a given year is the given years nominal GDP stated in the base p-year price level 2. Real GDP growth on an annual basis is the nominal and abnormal GDP growth rate adjusted for inflation and expressed as a percentage. Real GDP is adjusted for changes in prices and inflation throughout the year, because of this, it can be thought of in terms of purchasing power. Real GDP per Capita reflects GDP purchasing power of the average income individual in the economy. Nominal GDP is GDP evaluated at current market prices. Therefore, nominal GDP will include all of the changes in market prices that have occurred during the annual year due to deflation or inflation. Deflation is defined as a fall in the overall price level. Inflation is a rise in the overall price level. To determine changes in the overall price level, another measure of GDP called real GDP is used. The definition of Real GDP is GDP evaluated at the market prices of a base year. For example, if 1990 were chosen as the base year, then real GDP for 1995 is calculated by taking the quantities of all goods and services purchased in 1995 and multiplying them by their 1990 prices. GDP or Gross Domestic Product is the value of all the goods and services produced in a country. The Nominal Gross Domestic Product measures the value of all the goods and services produced expressed in current prices. On the other hand, Real Gross Domestic Product measures the value of all the goods and services produced expressed in the prices of some base year. An example: Suppose in the year 2000, the economy of a country produced $100 billion worth of goods and services based on year 2000 prices. Since were using 2000 as a basis year, the nominal and real GDP are the same. In the year 2001, the economy produced $110B worth of goods and services based on year 2001 prices. Those same goods and services are instead valued at $105B if year 2000 prices are used. Then: Year 2000 Nominal GDP = $100B, Real GDP = $100B Year 2001 Nominal GDP = $110B, Real GDP = $105B Nominal GDP Growth Rate = 10% Real GDP Growth Rate = 5% Notes: In economics, the nominal values of something are its money values in different years. Real values adjust for differences in the price level in those years. Examples include a bundle of commodities, such as gross domestic product, and income. For a series of nominal values in successive years, different values could be because of differences in the price level, an index of prices. But nominal values do not specify how much of the difference is from changes in the price level. Real values remove this ambiguity. Real values convert the nominal values as if prices were constant in each year of the series. Any differences in real values are then attributed to differences in quantities of the bundle or differences in the amount of goods that the money could buy in each year. Thus, the real values index the quantities of the commodity bundle or the purchasing power of the money incomes for each year in the series. The nominal/real value distinction can apply not only to time-series data, as above, but to cross-section data varying by region or householder characteristics. Nominal values are related to prices and quantities (P and Q) and to real values by the following definitions: nominal value = Pà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ã‚ ¢Q = Pà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ã‚ ¢real value. Nominal values such as nominal wages or (nominal) gross domestic product refer to amounts that are paid or earned in money terms. In the illustration of the previous section, for a single good with a nominal value, the nominal value of the good was divided by its unit price to calculate its real value, namely the quantity of the good. The same general method applies for calculation of other real values, except that a price index is used instead of the price of a single commodity. Real values (such as real wages or real gross domestic product) can be derived by dividing the relevant nominal value (money wages or nominal GDP) by the appropriate price index. For consumers, a relevant bundle of goods is that used to compute the Consumer Price Index. So, for wage earners as consumers a relevant real wage is the nominal wage (after-tax) divided by the CPI. A relevant divisor of nominal GDP is the GDP price index. Simple illustration: Numerical example: If for years 1 and 2 (say 20 years apart) the nominal wage and P are respectively $10 and $16 1.00 and 1.333, Real wages are respectively: $10 (= 10/1.00) and $12 (= 16/1.333). The real wage so constructed in each different year indexes the amount of commodities in that year that could be purchased relative to other years. Thus, in the example the price level increased by 33 percent, but the real wage rate still increased by 20 percent, permitting a 20 percent increase in the quantity of commodities the nominal wage could purchase. GDP can rise for at least two reasons. It can rise because of an increase in real production (which we like), or because of an increase in prices for the same amount of real production (which we do not like). To determine which is which, we differentiate the concepts of nominal GDP (that values products in terms of prices of that year) and real GDP (that adjusts for any price changes). Gross Domestic Product (GDP) is the market value of all final goods and services produced and purchased within a country during a given time period. There are two ways to measure GDP: Nominal GDP is the value of production at current market prices. Real GDP is the value of production using a given base year prices.

The Cuban Revolution Essay -- Cuban History Cuba War Essays

"They talk about the failure of socialism but where is the success of capitalism in Africa, Asia and Latin America?" -- Fidel Castro Introduction During the 1950’s, Cuba was on the brink of revolution. The nation, which had suffered numerous corrupt and oppressive governmental regimes, fell victim to yet another when Fulgencio Batista seized power under a military coup in March of 1952. A cry for a just Cuba, that was economically, politically, and socially free continued to echo throughout the island. In 1959, a group of radical revolutionaries, under the leadership of Fidel Castro, overthrew the Batista dictatorship and put in place the political and social structures that exist in Cuba to this day. Pà ©rez-Stable’s Reasons for Revolution Even after obtaining its independence from Spain in 1898, conditions still existed in Cuba that made it ripe for insurrection. Pà ©rez-Stable feels that one of the primary causes for Cuba’s problems was the economic instability that resulted from its dependence on sugar. This industry, says Pà ©rez-Stable, "was the most important depository of domestic and foreign capital investments" (14). Because of its short harvesting season, however, sugar was largely to blame for Cuba’s unemployment and underemployment. In addition, sugar was responsible for the nation’s continued economic reliance on the United States. The U.S. was Cuba’s primary trading partner. The Cuban and United States governments had established reciprocity agreements by which the United States would buy the majority of Cuban sugar in exchange for reduced tariffs on its imports to Cuba. Nevertheless, these agreements worked to the advantage of the U.S. while helping to preserve economic hard ships for Cuba. By the 1950’s, ... ...scouraged in socialist Cuba. Works Cited Castro, Fidel. "History Will Absolve Me"(excerpts). Closing speech in trial for the 1953 Moncada attack. Excerpt 1:From The United States, Cuba and the Cold War American Failure or Communist Conspiracy?. Ed. L. Langley. Lexington, MA: 1970. 26th of July Movement. "Program Manifesto of the 26th of July Movement". in Cuba in Revolution. Ed. R. Bonachea and Nelson Valdà ©s. Garden City, NJ: 1972. Guevara, Ernesto "Che". "One Year of Armed Struggle". In Reminiscences of the Cuban Revolutionary War. Trans. Victoria Ortiz. New York: Monthly Review Press, 1968. Paterson, Thomas G. Contesting Castro: The United States and The Triumph of the Cuban Revolution. New York: Oxford University Press, 1994. Pà ©rez-Stable, Marifeli. The Cuban Revolution: Origins, Course, and Legacy. New York: Oxford University Press, 1999.

Higher Education and Vocational Degree Essay

â€Å"What’s Wrong With Vocational School,† by Charles Murray is an Article that states Vocational schooling would be better off than a four year College degree. In Murray’s opinion, college should only be with those with a high IQ rate of 115 or higher and able to handle rigorous and challenging courses. If you are at an IQ below 110 it becomes an issue and you would be more successful in a Vocational program. This article calmly and rationally presents the notion that the population would be better served by the reintroduction of more training for careers in trade occupations becoming more prominent, therefore creating more job opportunities for people graduating with a vocational degree. Many students that graduate from a four year University do not learn what is needed to go into the working field. Murray states â€Å"For a few occupations, a college degree still certifies a qualification. This brings up the question, why do we pressure everyone to get a four year degree? In our society the college you go to means more than your actual qualification or talent you might have. Employers tend to pick a student that graduated from a university over that of a vocational school student just because of the name of the school not the talent the individual has. The degree itself also does not automatically qualify the student for the job and there are much faster and better ways such as a vocational degree for young people to provide credentials to employers. These credentials are needed in the job market for students with vocational degrees. As Murray says, â€Å"Finding a good lawyer or physician is easy but finding a good carpenter, painter, or electrician is becoming difficult. † The jobs needed such as an electrician or painters are those with vocational degrees. We often overlook some of the great jobs that don’t require a degree and are still very rewarding. A vocational degree can bring just as much income sometimes even more than a four year college degree in half the time. We have a mindset that a four year degree is much more valuable than a vocational degree. As Murray conveys this is not true he used an example of a craftsman bringing intrinsic rewards with high income. Vocational degrees are becoming more susceptible in our community. A college degree is no more important than any other high tech occupation such as an NBA player or a cabinet maker. Many of our most high income people do not have a college degree and do not care because they are living happily without it. Murray states the social cachet of a college degree still remains but will erode over time when large numbers of high income people do not have college degrees. † Many employers are looking more at the evidence you are good at something without the benefit of a college degree and will increase more overtime. If this does continue our false outlook of a college degree will diminish. As a society we look at the only way of becoming successful is going to a four university and look over vocational degree programs.

Pompeii: Tales from the Eruption Essay

The Museum of Fine Arts Houston had an art exhibition entitled â€Å"Pompeii: Tales from the Eruption†. There are almost 500 artifacts and cast of the remnants of dying people that were showcased. It also included a documentary film about the discovery of these artifacts and footage of the fierce eruption of Mt Vesuvius. The artifacts presented are tools of trade, jewelries, like necklaces and bracelets, murals and paintings, marble statues, and mosaics. One of the jewelries displayed is the golden snake bracelet. It is designed with a two headed snake biting the rims of the circle with an engraved figure of a lady, it maybe a goddess worshiped at the time. The helmet of the gladiators is also displayed. Gladiators are like wrestling superstars we idolized today, they are brave fighters who kill one another for freedom. They are the pitiful warriors used as an entertainment by the emperors and the people. There are also statues like the Statuette of Mercury which is made form gold and silver. Mercury is wearing a golden hat and a golden bag hanged over his neck. He carried a staff with wings and snakes, it is like the medical symbol, caduceus. And beside him is a cock with a golden collar. On the other hand, the Head of an Amazon is made from marble in mid-1st century AD. It was founded at the Villa of the Papyri in Herculaneum, the city beside Pompeii, this is one of the best Roman copies of a type of Amazon of the Classical period. One of the amazing artifacts is the Triclinium A founded in . It is a mural of the god of music, Apollo, playing his lyre with his two muses on his side, Euterpe and Cleo. Apollo wears his cloak over his shoulders, he carried his lyre on his left arm and his head was adorned by laurel leaves. The mural is a fresco brightly colored in red, which was once displayed in a dining room. In connection with the dining room, is the silver Kantharos. It is a wine cup embellished with olives. In Roman beliefs, olives and wine are symbols of wealth. It can be predicted that these objects are used as status symbol by the rich citizens of the old city.   The Mosaic with Gorgon, House of the Centenary, Pompeii, is a floor mosaic from glass and stone tiles. It was designed and intricately arranged with different figures in the upper and lower portions. At the center inside a circle is the face of the gorgon Medusa, in Roman culture gorgon is an ugly creature. Medusa as we commonly know is a women cursed with snakes in her head. It is believed that anyone who looked into her eyes turned into stone. That is why; the floor mosaic at that time is used to ward off evil spirits and intruders alike. These objects provided a glimpse of the culture and lifestyle of the people of Pompeii. As the artifacts suggest, inhabitants of Pompeii are elegant people, they are the type that loves entertainment and jewelries like the ones we see in epic movies about Rome. These golden bracelets, statues and murals we see today were once flaunted by the gorgeous people of the old city. It reminded me of the rich city before it was devastated by the gruesome lavas that burst out from Mt Vesuvius. The eruption of the gory volcano was painted by Pierre-Jacques Volaire in 1777. The oil painting depicts the violent upsurge of molten lava from the mouth of Mt Vesuvuis. The lava is like a monster engulfing everything that comes his way living or non-living. There are people crossing the bridge, scurrying and running helplessly to save their lives and over the sky hanged the black clouds. The painting looked alive to me. I felt like I was there, struggling among the throngs of wallowing children and shrieking men and women.   It felt like the 911 incident although it does not relate from nature but the catastrophic event and the devastation. The eruption of the volcano in Pompeii was experience by the people; my experience in the 911 incident is only through media coverage. However, it still felt achingly the same. There are other depressing objects showcased in the museum. The plaster cast of a mother and her child that was found on the same house where the golden bracelet was discovered was totally heartbreaking. I can almost feel the terror the mother would have felt and how she fervently prays for God to save her daughter. There are more remnants of people found, in the large Palaestra and the Via Stabiana. The picture of the cast from the staircase of the House of Fabius Rufus showed how desperately people tried to escape from the wrath of the volcano yet they were ferociously burnt by the sea of molten lava. If I were caught in that deadly situation, I would probably feel as if the world was coming to an end as described by all religious denominations. I would have been praying so hard for God to come and rescue me, although I could imagine, at that time all you can hear were the terrifying screams and cries from all the inhabitants running for their lives over the thundering rage of the volcano. And although it happened years ago, I still felt sorry for them, I hope that their soul will find peace someday. My visit at the museum is an experience that will never be forgotten. It arose a state of awareness in me that made me realized how tragic life could be, I remembered the different tragedies that had walk and distraught the different life forms in earth; hurricane Katrina, World War 1 and 2, the tsunami in Indonesia, and the 911 incident. It made me feel angry and anxious because I know when this disasters occur we cannot do anything about it but I am thankful and happy because after all those catastrophes we have move on, we are still continuing to live our life until the end. All these mixed emotions overwhelmed me as I watch all the objects presented in the museum. It has been a sensible learning experience that relates the world today and the city that once live gloriously, the city of Pompeii. Works Cited Focus work of Art: The Eruption of Mt Vesuvuis. North Carolina Museum of Art. 14 April 2008 < http://www.ncartmuseum.org/artnc/object.php?themeid=1&objectid=1>. Houston, Museum of Fine Arts â€Å"Pompeii. Tales from an Eruption. 2 Mar 2008. Eosarte.eu. 14 April 2008 . Pompeii: Tales from an Eruption. The Museum of Fine Arts, Houston. 14 April 2008