Sexuality in John Steinbecks The Chrysanthemums Essay -- Chrysanthemu

Sexuality in Steinbeck's The Chrysanthemums    Reading over this excellent story once more, I am again filled with the same emotion (if it can be called that) that I experienced when first reading it.   Steinbeck planned for that.   In a letter to George Albee in 1933, Steinbeck comments on this story and his interest in Albee's opinion of it.   "...It is entirely different and is designed to strike without the reader's knowledge.   I mean he reads it casually and after it is finished feels that something profound has happened to him although he does not know what nor how."   I knew after reading this, that Steinbeck is truly a marvel.   It is one thing to have enough luck to leave your reader's with this sense after they've read something of yours, but to have it happen to them when you've actually planned it!   This is incredible.      Ã‚  Ã‚  Ã‚  Ã‚   I was not the only person feel what Steinbeck had planned.   And in that group, I was not the only one to want to pick apart this story to find out why I felt this way, what he intended me to feel, and what his story meant taking all things into consideration.   when looking at various criticisms, I found a division line that could be made between the sexes. Most women agreed with me and felt the sexual tension apparent in the story.   This sexual tension was quiet and sensual.   The only men that picked up on this picked out some overtly sexual innuendoes and chose to ignore the subtleties as Eliza's mood changes and tone of voice.   The other men attributed any sexual tension to Eliza's need for children, which is a valid point, but it ignores too many other things in the story to fit it well. .. ...e predominantly male or predominantly female side, nor can they be pushed into little cubby holes that define the different stereo-types of a woman. Her androgyny uses such stereo-types to define her, and to go over that and then use even more to define the end product of the story would be a mistake. Works Cited Steinbeck, John.   "The Chrysanthemums" 1937. Literature.   Edgar V. Roberts and Henry E. Jacobs eds. London: Prentice Hall, 1998. Mitchell, Marylin L. "'Steinbeck's Strong Women': Feminine Identity in the Short Stories," Southwest Review, Vol. 61, No. 3, Summer, 1976, pp. 304-15. McMahah, Elizabeth E. "'The Chrysanthemums': Study of a Woman's Sexuality," Modern Fiction Studies, Vol. XIV, No 4. Winter, 1968-69, pp. 453-58. Hughes, R. S. John Steinbeck: A Study of the Short Fiction.   Boston: Twayne Publishers, 1989.

Article Critique Essay

The author of this article is a Canadian who has raised the alarm on the increasing number poverty stricken people hence springing up of ghettos in big cities. The author rhetorically is asking a question whether there are ghettos in Canadian cities. The author is coming up with many ghetto synonyms but yet they are of not the same meaning. The name like enclave sound more ethnical and it has been described as a grouping of people from the same ethnic group living in a low income earning or a poor neighbourhood. The article pinpoints that in the year 2001 families residing in high poverty levels doubled the year 1981. The message in the article is directed to the authorities in these cities to get warned of a looming crisis and look for ways to alter the trend. The message is not has to any group that it mentions that is the people from the enclaves and the ghettos. The article has outlined many causes of ghettos in Canadian cities. Poverty has been rated as the number one cause and this article gives figures from the research to substantiate its claim. The exact time is given when immigration policy of Canada was changed and the change swung Canada into a cultural and social crisis or socio cultural crisis. According to the authorities and the research that has been carried out immigration puts Canadian cities on spotlight of having many poor neighbourhoods. The author also makes a comparison between Canadian and American cities whereby Canadian cities are going more enclave than ghettos in America. In American cities the traditional definition of a ghetto is a residential district that concentrates racial Enclave tends to collect people of the same ethnic background together while ghettos collect poor people from various ethnic backgrounds. In both cases, people involved are affected by poverty and low income level. From one of the researches that have been done, the article reveals that an alarm was raised about the growth of neighbourhood poverty in Canada. The article pinpoints groups of people who make up the population who end up to the ghettos. Their background is partly covered by poverty and the article further expose that these are immigrants from Asia, Africa, West Indies and Latin America. The research that was conducted showed that between 1971 and 2001 is the period when the majority of the Canadian population was born in the back mentioned countries. Nevertheless, some cities like London there are no ghettos and this is due to the efforts of the councils. However, I take the article head to mention that it does not clearly outline and show the consequences of the increasing population in ghettos and mushrooming of ghettos and enclaves. In many a times these nighbourhoods have been associated with crime and drugs. Does is it mean the researches that were conducted didn’t capture these common phenomenon that is associated with ghettos? Furthermore, the article does not highlight any ways that have been adopted to combat the expanding ghettos and enclaves without necessarily disrupting the social cultural set of these people in the ghettos. Reference: Walks, A. R. Bourney, L. S. (2006). The Canadian Geographer Publication:

Different Types Of Treatments For Ptsd - 1819 Words

In this paper that I am writing, I will be discussing the different types of treatments for PTSD also knows as post-traumatic stress disorder. More in specifically I will be discussing PTSD in veterans who have been diagnosed already. A little history about PTSD is that it first began as a disorder people would acquire after coming back from certain wars in our history, and back then they really did not know that much about it. Living in this day and age there have been so many more studies, trials, and tests done and psychologists have come up with many ways to treat PTSD. But, just because we have the cures and treatments does not mean everyone is getting the treatment they need. Furthermore, I have selected three scholarly and peer reviewed articles from ProQuest that will ensure that my topic is adequately discussed about. The articles I have chosen also each have different key points and conclusions in each one. First I will discuss certain factors associated with PTSD and some of the outcomes on the nervous system. Next I will discuss a certain drug associated with the treatment of PTSD and the effectiveness of so called drug. And lastly, I will discuss the overall treatment for PTSD veteran victims and if the amount of treatment they get is enough. Articles My first article I have chosen to start off with is research done on the HRV or Heart Rate Variability of PTSD patients. This article was written by Gabriel Tan titled â€Å"Heart Rate Variability (HRV) andShow MoreRelatedPosttraumatic Stress Disorder ( Ptsd )1176 Words   |  5 PagesPosttraumatic Stress Disorder(commonly known as PTSD) is disorder that occurs after an event which has had a traumatizing effect on an individual. A traumatizing event would include life threatening events, emotionally traumatic events, terrifying events, and even rape. The effects of PTSD are anxiety, violent rages, consistent nightmares, and terrifying flashbacks. Symptoms of PTSD usually emerge after 3 months after the incident, but symptoms can also be evident even years later. Individuals thatRead MorePost Traumatic Stress Disorder1086 Words   |  5 Pagesuse this opportunity to learn more. My hope is by increasing my knowledge, of a disorder so prevalent in my career field; I can recognize th e symptoms in others and myself before there effect becomes devastating. Posttraumatic Stress Disorder, or PTSD as it is more commonly referred to, is defined by the American Psychiatric Association as an anxiety disorder. (American Psychological Association.) It has specific criteria that need to be met in order to be diagnosed. Foremost there needs to be aRead MoreEssay on Post-Traumatic Stress Disorder1730 Words   |  7 PagesPost-traumatic stress disorder (PTSD) affects 7.7 million American adults and can also occur during childhood. PTSD is an anxiety disorder that stems from a recent emotional threat such as a natural, disaster, war, and car accidents. PTSD usually occurs from an injury or coming close death. A person who has experienced a past traumatic event has a heightened chance of being diagnosed with PTSD after a current trauma. PTSD can also be determined by looking at one’s genes, different emotions, and current orRead MoreEssay On Pairing Veterans With Service Animals1197 Words   |  5 PagesPairing Veterans with Service Animals Introduction â€Å"It is estimated that over half a million American veterans were suffering from PTSD in 2004.† (Stern)† [One of these veterans named Harvill,] says the only thing that helped him get through the years of persistent pain was an exuberant, golden Labrador and mastiff mix named Sierra.† (Bowen) This trained Service dog knows how to comfort him during times of anxiety and always makes sure he is not alone. (Bowen)Millions of veterans come home fromRead MorePost Traumatic Stress Disorder1099 Words   |  4 Pages â€Å"My mind is on fire as I fear that any second, another enemy round will rip into my body and finish me off† (Johnson 2). Post-Traumatic Stress Disorder (PTSD) effects the lives of many soldiers after returning home from war. PTSD is a psychiatric condition described in the DSM-IV as, a condition that requires a specific event to have occurred as a criterion for the diagnosis. The criteria for this disorder, according to the book Combat Trauma , can include flashbacks, times where you feel as if youRead MoreEvidence Based Practice And Practice1635 Words   |  7 PagesA. In today s society, there is a great deal of research and practice about evidence based practice. Most of this is highly sought upon in the field of psychology, where evidence and decision making is key to accomplishing new ideas of treatments for people who retain psychiatric problems. The meaning of evidence-based practice in psychology is that it involves making very educated and supported decisions based on punctilious, unambiguous, and astute evidence (Rousseau Gunia, 2016). With evidence-basedRead MoreEssay On Ptsd956 Words   |  4 Pagesof increasing accessibility to these treatments. One way of doing this is through telehealth (Gros, Toder, Tuerk, Lozano Acierno, 2011). This is a type of treatment that takes advantage of telehealth communication technology and uses it to provide assessment and treatment to patients. These services are quickly gaining popularity and has shown some advantages over the standard, in-person treatment we are used to. First, as mentioned earlier, providing treatment through telehealth gives individualsRead MoreA Look Into Post-Traumatic Stress Disorder1214 Words   |  5 Pages09/15/2013 PTSD affects 7.7 million American adults, but it can occur at any age (NIMH, PTSD, Who is at risk). The sight of violence and death leaves lasting effects on people. How do you think those people cope with what they saw when the Twin Towers went down? How do people cope with such traumatic experiences? The events that lead to post traumatic stress disorder (PTSD) can impact one’s life, fortunately there are ways to treat it. Post-traumatic stress disorder (PTSD) develops afterRead MorePost Traumatic Stress Disorder ( Ptsd )1699 Words   |  7 PagesOver the recent years PTSD- post traumatic stress disorder has become a problem among veterans returning from the Afghanistan and Iraq war. Even after returning to American soils, veterans are battling with the effects of this mental illness, but who else is suffers from this illness. Family members and caregivers are also affected from PTSD. The soldier, the family member and caregivers once knew before going over sea to war is no longer the same. It can take an emotional toll on someone, whoseRead MoreImproving The Quality Of Life For Veterans Suffering From Post Traumatic Stress Disorder ( Ptsd ) Essay1187 Words   |  5 PagesStress Disorder (PTSD). To achieve this purpose, this literature review will determine what preventive measures are being utilized successfully. It will display screening tools and treatments that are being used effectively. This l iterature review will also mention the cost barriers that veterans face. The majority of returning veterans with PTSD are not receiving sufficient medical care (Tanielian,2008). There many reasons for this phenomenon, which are termed barriers to treatment. Sample/ Number

Essay about Gay Couples Should Have the Same Rights as...

Gay Couples Should Have the Same Rights as Married Couples One of the leading political debates in our country today is the legalization of same-sex marriages. The very image of marriage is evolving on an on-going basis due to society and the major changes between society defined unions. The definition of marriage, as defined by Webster’s Dictionary, states â€Å"Marriage, n., (1) the state of being united to a person of the opposite sex as husband or wife in a consensual and contractual relationship recognized by law (2) the state of being united to a person of the same sex in a relationship like that of a traditional marriage lt;same-sex marriagegt;.† The change was not made until 2003. Marriage, as per society, is a special event in†¦show more content†¦Giving these rights to same-sex couples would not change the â€Å"church’ dynamics in any way nor would it make any change their faith or religious practices. All couples, whether heterosexual or same-sex, would still be free to make their own judgments about what marriage mean in their world. For example in Catholic churches if you are divorced and remarried then your second marriage may not be recognized by the church at all. The government and the church are separate entities and should remain that way. Church as a whole is still able to set their own policies on same-sex unions just as it always have. Some of the religion and/or churches that have given same-sex couples their blessings are Judaism Reformed, Unitarian Universalist and the Metropolitan Community Church. Family units as a whole have become very diverse in today’s society. Quite a few â€Å"straight† families today only have single parent homes however if a same-sex couples want to adopt we are told no. The structure of a family’s relationship is less important than the quality of family relationships. Basically same-sex couples are able to teach children the same qualities as heterosexual couples where they will grow into good and responsible individuals. Same-sex couples are able to provide the same type of loving, stable and happy home where not every home in American is able to do so not matter what the living situation is. Research has shown that children raised by same-sexShow MoreRelatedShould Gay Marriage Be Treated Equal?995 Words   |  4 Pages Have you ever wonder how it felt to have a partner for 30 years, but according to the law, you are not a family member? Has your partner been sick and you could not make any decisions regarding their healt h, because you are not family? Also, this person for whom you have shared your life with cannot and will not qualify for health insurance as a spouse? Hospitals cannot legally allow gay partners to receive medical information about their condition without it being a blood relative. These areRead MoreGay Marriage Should Not Only Be A Civil Right1569 Words   |  7 Pagesnot gay couples should be permitted to perform the act of a legal marriage divides the United States of America into two. Although more than half of the states have legalized gay marriage, fourteen states, including Kentucky, reject the idea of homosexual couples as equals to heterosexual couples. The fact is that an exclusion of marriage for gay couples is a limitation of their personal rights and is unequal, unfair, and un-American. Therefore, gay marriage should not only be a civil right, butRead MoreGay Marriage and the Constitution Essay1609 Words   |  7 PagesGay Marriage and the Constitution Amberlee Ozment Axia College of University of Phoenix Gay Marriage and the Constitution Is it okay to not believe in gay marriage, yet at the same time support the constitutional rights of life, liberty and pursuit of happiness for homosexual couples? Even though most churches beliefs conflict with marrying same-sex partners, government should not deny a persons right to their happiness; because any person, no matter race, color, sex, religion or sexualRead MoreSame Sex Marriage Should Be Granted1473 Words   |  6 Pageshusband and wife.† Myself, and many other people have a problem with this definition. Same sex marriage is outlawed in 33 states, and the reasonings for that just aren’t good enough for the large majority to except. Homosexual couples should be granted the right to marry. Something as miniscule as who you’re sexually attracted to shouldn’t take away a right as basic as marriage. Falling in love with someone and marrying them is a normal thing between couples. Finding someone who loves you just as muchRead MoreArgumentative Essay on Gay marriage672 Words   |  3 Pagesâ€Å"Gay People can’t do this. Women shouldn’t be able to that. But touch my semiautomatic rifle and you’re attacking my rights.†- Remi Kanazi Why should someones rights to marry be based on a person religious beliefs or their own opinion on family values. Gay Marriage: If they like they should be able to put a ring on it. Same sex couples should be allowed to publicly celebrate their relationship in the same way as heterosexual couples. The Human Rights Campaign Foundation states that many same sexRead MoreSame-Sex Marriage Essay1536 Words   |  7 Pagesimportant part of getting married, as well as the commitment to love just the one person for the rest of their lives. Financially, married couples would combine their savings into one big account, helping each other with purchases and bills. Also, being in a marriage is a proud statement of the love one has for their spouse. All of these seem to be valid reasons to be in a union with another, and all of these would be rights a couple should have. But, with same-sex couples, marriage is illegal. EvenRead MoreSame Sex Marriage Is The Legal Union Essay1562 Words   |  7 Pagesï‡ ¶Research ï‡ µDrive ï‡ ´Answers About Company Legal Site Map Contact Advertise ï‡ º ï‡ ¼ ï‡ ½  ©2015 StudyMode.com Home Same-sex marriage Same Sex Marriage Same Sex Marriage Civil union, Homosexuality, Marriage By kwhite89 Mar 16, 2015 1510 Words 56 Views More info ï„” PDF View Text View Page 6 of 6 Read MoreGay Marriage Should Be Legal1437 Words   |  6 Pagesisn’t gay or called names such as â€Å"faggot,† simply because their sexual orientation, why? If homosexuals pay their taxes, help build roads and pay public schools just like heterosexual couples then gay couple should have the same rights as opposite sex couples do. In the case of Baker v. Vermont, in the year 2000, â€Å"Vermont’s groundbreaking law establishing civil unions took effect, providing families of samesex couples the same protections, benefits and responsibilities that married couples have underRead MoreGay Marriage Should Be Legal867 Words   |  4 PagesSince gay marriage has been legalized in a handful of states, there have been more than 71,165 marriages (12 Reasons Why Marriage Equality Matters). However, there are hundreds happy couples that would like to be married all over the country. The real question is why does gay marriage matter to someone who is not gay? Does it make people question their own sexuality or go against religion? The LGBT community has rights just like everyone else, and a love that is true just an opposite-sex couples. ThereRead MoreSame Sex Marriage Should Be Legal1491 Words   |  6 PagesSame sex marriage is one of the most debatable issues in the modern world. Marriage has been accepted as the social union between a man and a woman for the past thousand years. Homosexuality was viewed with scorn, and marriages among same sex couples were prohibited in most cultures across the globe. However, gay relationships are slowly obtaining acceptance, as homosexuals have come to be expressive in fighting their rights to marry in the early 90’s. As homosexuality grows in acceptance in the

Aristotelian Vs. Aristotelian Ethics Essay - 1876 Words

In this paper, I will refute the claims made by Aristotelian and other virtue ethics systems in their suggestion that ‘it is good for you to be virtuous’ and the Aristotelian claim that being virtuous is how you can live good life. I will do this by showing that in attempting to be virtuous you are subjecting yourself to unreasonable and unachievable levels of personal expectation. I will then suggest that this becomes even more counter-intuitive when you become aware that you cannot even guarantee you would achieve the good life should you manage to meet the expectations you are placing on yourself. I will argue instead that you are better off trying to focus on something else within reach and within which you have a better chance of living your own good life and achieving your goals of being a good person – the helping of others. In his Nicomachean ethics Aristotle suggests that virtue is a purposive disposition, lying in a mean that is relative to us †¦ and by that which a prudent man would use to determine it (Aristotle. et al., 2004: Book II). This in itself brings the concept of Aristotelian virtue to its most concerning trait; if doing what is virtuous is to do as a virtuous person would then we are given little direction as to what to do, especially on a circumstantial basis, beyond a difficult to define idea of ‘what a virtuous person would do’. This becomes a problem when we are faced with difficult real world scenarios and turn to ideas of virtue andShow MoreRelated The Study of Rhetoric Essay1038 Words   |  5 Pagesthe time comes to apply this stuff we have learned. Carolyn Rudes approach to education is one that I see Pirsig and Johnson both approving of, but there are differences in strategies towards the education as well as the demonstration of the know vs. know-how of the technical communications education. I will attempt to tackle this paradigm in two parts: Pirsigs point of view and Johnsons. Part I: Quality is a characteristic of thought and statement that is recognized by a nonthinking processRead MoreVirtue Ethics Vs. Sentimentalist Virtue1858 Words   |  8 PagesVirtue Ethics vs. Sentimentalist Virtue Ethics Virtue Ethics is defined as â€Å"any character-based approach to normative ethics that emphasizes some conception virtues and vices; often including a universal conception of human flourishing† (Blakley, Christopher). Aristotle and David Hume developed accounts of ethics that remained true to their own empirical philosophies; both of which stray away from the more traditional accounts. Their opposing theories contain the overall theme of how a virtuousRead MoreAnalysis Of Spinoza And Nietzsche s Spinoza 1699 Words   |  7 Pagesour power, ethics is a problem of power, never a problem of duty. In this sense Spinoza is profoundly immoral. Regarding the moral problem, good and evil†¦he doesn t even comprehend what this means. What he comprehends are good encounters, bad encounters, increases and diminutions of power. Thus he makes an ethics and not at all a morality. This is why he so struck Nietzsche. Historically, the distinction between ethics and morality was set up to distinguish between an Aristotelian/Stoic emphasisRead MoreDeontological Moral Systems : Ethics1532 Words   |  7 Pageslike no other notion. Its applications range from elemental theory and chemistry, to psychology, biology, astronomy, ethics and politics. Surveying the uses of teleology throughout his philosophy can thus serve as a good introduction to Aristotle s overall philosophy. Monte Ransome Johnson s study provides such a survey, and in the process gives us an in-depth analysis of Aristotelian teleology, its nature and its limitations. The various teleological moral systems differ not only on exactly whatRead MoreThe Philosophy of Happiness11705 Words   |  47 Pages Indeed, in the light of what Aristotle says, we might offer ‘worthwhile life’ as the most appropriate translation of his word ‘eudaimonia’. But we will continue to use the traditional translation ‘happines s’, where necessary qualifying it as ‘Aristotelian happiness’. Aristotle was well aware that human beings may have the most varied and bizarre notions of what makes them happy. But whatever they present as their ultimate ambition, it must, he thinks, as a matter of logic, pass certain tests ifRead More Aristotelian Ethics and its Context Essay6933 Words   |  28 PagesEthics as Politics: On Aristotelian Ethics and its Context ABSTRACT: This paper argues that the assertion of Nicomachean Ethics I.ii that the art that treats of ethics is politics is to be understood properly not in the sense of politics qua nomothetike but just as politike, i.e., direct, participatory politics as was enjoyed in the Athenian polis and as the formed background to Aristotle’s philosophizing on the nature of ethics. The ethical import of politics can be retrieved from Aristotle’sRead MoreBusiness Ethics: Miriam vs. Jenny Case Study2804 Words   |  11 Pagesthere are problems around us, many of these rules conflict, and so moral thinking often requires analysis of the underlying assumptions that determine when various rules apply or not. Hence metaethics provides guidance after normative and applied ethics fall short or contradict each other, as they do here for Miriam. Stakeholders have shared and conflicting perspectives The list of potential stakeholders extends beyond the space for this discussion if the results of this decision are traced beyondRead MoreCategorical Imperative2266 Words   |  10 Pagesassert that whatever leads to greater  eudaimonia, or happiness, is what is moral. Kant, however, believes that any action taken for a deliberate end, whether it be happiness or some other goal, is morally neutral. Kant rests his rejection of the Aristotelian position on a number of points. He points out that all the imperatives are hypthetical, they are performed merely to attain a certain end. More importantly to Kant, this end is one dictated by desires, implying that the human will is no more thanRead MoreEvolution, Structure, And Ultimate Fate Of Neil Degrasse Tyson2479 Words   |  10 Pagesencompassed the earth and extended to the moon. All matter in the terrestrial region was comprised of the four elements—water, earth, wind, and fire. Aristotle also expected all celestial bodies to be moving in circles and do not exhibit violent motion (Aristotelian Physics, Impetus Theory, and the Mean Speed Theorem, 2001). Aristotle was the first to distinguish between two different kinds of motion. He divided motion into categories, which consisted of natural motion and violent motion. Natural motion inRead MorePlato And Aristotle s Political Situation2648 Words   |  11 Pagesmother had familial connections to Solon, an influential, Greek statesman. As he was a member of the Ancient Greek upper-middle class, Plato was taught by educated tutors, and so was enabled to explore a wide range of topics which focused mainly on ethics. (Allen and Wilbur 1986: 99-101) Later in life, he became a student and, eventually, good friend of Socrates, but his studies with Socrates were interrupted by the Peloponnesian War where Athens fought against Sparta. Plato himself fought as a soldier

Nursing Annotated Bibliography for Morbidity and Self-Care

Question: Discuss about theNursing Annotated Bibliography for Morbidity and Self-Care. Answer: Annotated bibliography Strmberg, A., Mrtensson, J., Fridlund, B., Levin, L. ., Karlsson, J. E., Dahlstrm, U. (2003). Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: results from a prospective, randomised trial.European heart journal,24(11), 1014-1023, Doi: https://doi.org/10.1016/S0195-668X(03)00112-X A prospective randomized trial was done with hospitalized patient with heart failure to investigate about the impact of nurse-led heart failure clinic on mortality, morbidity and self-care behavior of participant. The research was conducted in one university hospital and two county hospitals in Sweden. It includes one intervention group and one control group and the criteria for blinding was fulfilled by computer generated list of random numbers and sealed envelopes. The intervention group at the nurse-led clinic was followed-up by experience cardiac nurse after 2-3 weeks and the activities done by nurses included status evaluation, education on heart failure and social support to patient. The control group received current clinical practice and follow-up in primary health care clinic. The data related to demographics and clinical details were collected from medical chart of patient and data on self-care was collected by means of a questionnaire tool. The primary outcome variable was all-cause mortality and hospital admission after one year and secondary variable includes self-care behavior, number of readmissions and number of days in hospital. The results of the study showed that intervention group had fewer deaths, fewer admission rates and higher self-score behavior. It was concluded that nurse-led follow after hospital can improve survival rate and self-care behavior of patients with heart failure. Sagar, V. A., Davies, E. J., Briscoe, S., Coats, A. J., Dalal, H. M., Lough, F., ... Taylor, R. S. (2015). Exercise-based rehabilitation for heart failure: systematic review and meta-analysis.Open heart,2(1), e000163, https://dx.doi.org/10.1136/openhrt-2014-000163 A systematic review and meta-analysis of randomized controlled trial was done to evaluate the impact of exercise-based cardiac rehabilitation for heart failure. The data sources for the systematic review included databases like MEDLINE, EMBASE, CINAHL and PsycINFO and the sample population for the studies needed to include heart failure with preserve ejection fraction (HFPEF) or heart failure with reduced ejection fraction (HFREF) patient. Another criteria for study selection was that all participant must have reported about at least 6 months follow-up and they must all have received exercise training apart from other intervention. The outcome measure for studies were also considered and the criteria was to have outcome data related to mortality, hospital admission, health related quality of life and cost and cost-effectiveness. A total of 33 trials was found to fulfill the research criteria and the systematic review of these literatures indicated that exercise intervention reduced t he risk of heart failure and overall hospitalization rate. The data were independent of trial duration and dose of exercise. Overall, the study concluded that exercise based cardiac rehabilitation can lead to improvement in hospitalization and quality of life in patients with cardiac failure. Faris, R., Flather, M. D., Purcell, H., Poole-Wilson, P. A., Coats, A. J. (2006). Diuretics for heart failure.Cochrane Database Syst Rev,1. Doi: 10.1002/14651858.CD003838.pub2 A systematic review of randomized controlled trial was done to evaluate the harm and benefits for chronic heart failure in patients with chronic heart failure. The main rational for this aim was to evaluate how diuretics can control disease progression and improve survival rate in patient. Relevant research articles were taken from EMBASE databases and the main research design was meta-analysis of randomized controlled studies. The criteria for study participants in the selected studies included patient with chronic heart failure and those with symptoms of breathlessness and fatigue. The intervention for all studies should involve all type of diuretic drugs. The primary outcome measures include mortality and morbidity and the secondary measures included effect of diuretic on symptoms, quality of life and worsening of heart failure. From the review of research studies on the basis of above mentioned criteria, a total of 28 studies were found relevant to the study objective. Different studies covered different range of outcome measures. Overall, the review of findings from different studies showed that diuretic is the conventional treatment for patient with chronic heart failure and it is effective in reducing the risk of death in patient with heart failure. In comparison to control group, intervention group also had improved exercise capacity. Justification for the choice of references The above three evidence has been selected in response to the case scenario of Charlie, a 75 year old overweight who has been diagnosed with chronic heart failure and find out the best evidence to manage Charlies condition. The main symptoms observed in Charlie were breathlessness, visible peripheral edema and tachycardia. The evidence by Strmberg et al. (2003) was found suitable for the management of Charlies condition because it proved the effectiveness of follow-up at nurse-led heart failure clinic. This evidence has been chosen because the study considered challenges in the management of heart failure patent and showed that poor-follow and low patient education about self-care behavior also leads to poor patient outcome. Focusing on self-care behavior and follow-up care is necessary because many times poor awareness about self-care behavior also result in non-compliance to medication and increase in hospital readmissions rate. The study by Ruppar et al. (2016) proved poor adheren ce to medication results in exacerbation of heart failure symptoms, poor physical function and high risk of admission in patients with heart failure. Strmberg et al. (2003) showed that nurse-led heart failure can address management problem like poor compliance to medication and this is evident from the study outcome. The study showed that implementation of intervention related to education about heart failure to patient, psychosocial support and appropriate follow-up with heart failure patient significantly improved self-care score for patient and reduced the admission rates and length of hospital stay. The research evidence is also selected for Charlies because of the quality and credibility of the work. The researcher adopted randomized controlled trial method and considered the requirement for blinding. This eliminated selection biases in studies. The credibility and generalisability of the work was also enhanced by conducting research in three different setting. The study gave the clinical implication that improving the process needed for follow-up is necessary for management of heart failure patient as it is a cost-effective approach to diagnosis and treatment of the condition. Unverzagt et al. (2016) also confirmed that regular follow-up visits and self-care programs improves adherence to medication in heart failure patient. The study by Sagar et al. (2015) has been selected for the management of Charlies condition because the study explained about the effectiveness of exercise-based cardiac rehabilitation (CR) for reducing overall risk of complication and heart failure specific hospitalization. As Charlie is an obese patient, he is at higher risk of exacerbation of symptom related to heart failure (Parto, Lavie and Ventura 2016). The evidence by Sagar et al. (2015) has been considered because of the positive benefits of exercise-based rehabilitation on health related quality of life, mortality and hospital admissions rate in patient (Taylor et al., 2014). The study proved that exercise CR improves health related quality of life and improves hospitalization rate in patient with heart failure. The research was done by means of systematic review and meta-analysis method, however the factor that improves the quality of the evidence is that it includes only randomized controlled trial (RCT) for analysis. As RCTs come under top level under the hierarchy of evidence, the results from the study is reliable. This study guides current practitioners to adapt exercise CR for management of heart failure patient as it gives consistent results irrespective of the type of CR programme. Haykowsky et al. (2016) also supported the fact that exercise-based CR improves muscles strength, physical function and quality of life of patient with heart failure. The third evidence by Faris et al. (2006) emphasized on the use of diuretic for heart failure patient. This evidence has been selected for management of Charlies condition because he was suffering from the symptom of breathlessness and diuretic drugs like furosemide are the first line of treatment for congestive heart failure and relieving symptoms of peripheral oedema in patient. The study used systematic review method to analyze the effectiveness of diuretic therapy on improving morbidity and mortality in patient. The quality of the study is high as it included only double-blinded randomized controlled trial for review and by this means, it eliminated all biases and confounding factors that influences study outcome. By the review of relevant research, the researcher proved that diuretic reduces the risk of death in patient. By such finding, it gave the clinical implication that new diuretic drugs should be considered for management of patient with heart failure. Buckley et al. (201 6) also explained that short course of IV diuretics is a safe and effective intervention for patient with heart failure. Recommendations for clinical practice: Based on the review of research evidence, it can be recommended that important criteria for management of patient with heart failure is to first achieve symptom improvement in patient and then focus on promoting self-care behavior and physical movement in patients like Charlie. This strategy has been proposed because the three interventions focus both on short and long trem health outcome of patient. As heart failure patients like Charlie experience symptom of breathlessness, pharmacological therapy by means of diuretic therapy is effective in reducing pulmonary congestion in patient (Johnson Oxberry, 2010). Secondly, finding provisions for adequate follow-up and improving patient-care behavior is also necessary because self-care is associated with increase in self-confidence of patient to manage risk. It is recommended that to improve the quality of life of patients with heart failure, clinicians or nurses should educate patient about self-care behaviors like following diet regimen t, having low-salt diet, being physically active, controlling weight and controlling symptoms of heart failure (Abotalebidariasari et al., 2016). In addition, clinicians should focus on exercise-based cardiac rehabilitation as regular exercise is associated with improved quality of life in patients with heart failure (Rajati et al., 2013). References: Abotalebidariasari, G., Memarian, R., Vanaki, Z., Kazemnejad, A., Naderi, N. (2016). Self-Care Motivation Among Patients With Heart Failure: A Qualitative Study Based on Orem's Theory.Research and theory for nursing practice,30(4), 320-332, doi:10.5681/jcs.2012.029 Buckley, L. F., Carter, D. M., Matta, L., Cheng, J. W., Stevens, C., Belenkiy, R. M., ... Stevenson, L. W. (2016). Intravenous diuretic therapy for the management of heart failure and volume overload in a multidisciplinary outpatient unit.JACC: Heart Failure,4(1), 1-8, Doi: https://doi.org/10.1016/j.jchf.2015.06.017 Faris, R., Flather, M. D., Purcell, H., Poole-Wilson, P. A., Coats, A. J. (2006). Diuretics for heart failure.Cochrane Database Syst Rev,1. Doi: 10.1002/14651858.CD003838.pub2 Haykowsky, M.J., Daniel, K.M., Bhella, P.S., Sarma, S. and Kitzman, D.W., 2016. Heart failure: exercise-based cardiac rehabilitation: who, when, and how intense?.Canadian Journal of Cardiology,32(10), pp.S382-S387, doi: 10.1016/j.cjca.2016.06.001 Johnson, M. J., Oxberry, S. G. (2010). The management of dyspnoea in chronic heart failure.Current opinion in supportive and palliative care,4(2), 63-68, doi: 10.1097/SPC.0b013e32833929aa. Parto, P., Lavie, C.J. and Ventura, H.O., 2016. Reducing Heart Failure Risks in Obese Patients.Current Cardiovascular Risk Reports,10(4), p.15, Retrieved from: https://link.springer.com/article/10.1007/s12170-016-0498-1 Rajati, F., Mostafavi, F., Sharifirad, G., Sadeghi, M., Tavakol, K., Feizi, A., Pashaei, T. (2013). A theory-based exercise intervention in patients with heart failure: A protocol for randomized, controlled trial.Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences,18(8), 659, Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872604/ Ruppar, T. M., Cooper, P. S., Mehr, D. R., Delgado, J. M., Dunbar?Jacob, J. M. (2016). Medication adherence interventions improve heart failure mortality and readmission rates: systematic review and meta?analysis of controlled trials.Journal of the American Heart Association,5(6), e002606, Doi: 10.1161/JAHA.115.002606 Sagar, V. A., Davies, E. J., Briscoe, S., Coats, A. J., Dalal, H. M., Lough, F., ... Taylor, R. S. (2015). Exercise-based rehabilitation for heart failure: systematic review and meta-analysis.Open heart,2(1), e000163, https://dx.doi.org/10.1136/openhrt-2014-000163 Strmberg, A., Mrtensson, J., Fridlund, B., Levin, L. ., Karlsson, J. E., Dahlstrm, U. (2003). Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: results from a prospective, randomised trial.European heart journal,24(11), 1014-1023, Doi: https://doi.org/10.1016/S0195-668X(03)00112-X Taylor, R. S., Sagar, V. A., Davies, E. J., Briscoe, S., Coats, A. J., Dalal, H., ... Singh, S. (2014). Exercise?based rehabilitation for heart failure.The Cochrane Library, doi: 10.1002/14651858.CD003331.pub4. Unverzagt, S., Meyer, G., Mittmann, S., Samos, F.A., Unverzagt, M. and Prondzinsky, R., 2016. Improving treatment adherence in heart failure: A systematic review and meta-analysis of pharmacological and lifestyle interventions.Deutsches rzteblatt International,113(25), p.423, doi:10.3238/arztebl.2016.0423

Information Systems in Global Business Today Essay Essay Example

Information Systems in Global Business Today Essay Paper 1. Why is it of import to understand the difference between computing machine literacy and information literacy?Answer:Computer literacy – When you are computing machine literate. you have a general working cognition of computing machines. You understand what they can be used for. Most people know that they can type a paper. make a power point and if you have internet entree. you may email and seek the World Wide Web for information. Information literacy- When you are information literate. you understand and are able to garner. analyze and usage information gathered from the assorted types of technological medians – particularly the cyberspace. This individual may entree the cyberspace. for case on their cell phone. iPod. lab tops. and a battalion of medians. some which may hold non yet been realized. -It is of import to understand the difference of this two literacy because A literate individual can non be expected to cognize how to run a computing machine. In kernel. a individual can be literate but non computing machine literate. But the opposite seems hard to be true. A computing machine literate is frequently ever a literate. 2. Discourse the three elements of an information system ( hardware. package and persware ) that directors must see. Which of the three do you see the most of import? We will write a custom essay sample on Information Systems in Global Business Today Essay specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Information Systems in Global Business Today Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Information Systems in Global Business Today Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Answer:Hardware- Hardware. in the computing machine universe. refers to the physical constituents that make up a computing machine system. Software- is any set of machine-readable instructions ( most frequently in the signifier of a computing machine plan ) that directs a computer’s processor to execute specific operations. Persware- that is short for ‘personware’ or ‘peopleware’ . a awfully inpersonal manner of mentioning to people as a resource. like hardware or package. – I consider being the most of import component if information system is the Persware because without this persware the hardware and the package will be useless. 3. What are some of the new functions information systems are playing in organisations? * The Widening Scope of Information Systems* The Network Revolution and the Internet* New Options for Organizational Design: The Networked Enterprise * Flattening Organizations* Separating work from location* Reorganizing work flows* Increasing flexibleness of organisations* The altering direction procedure* Redefining organisational boundaries* Electronic Commerce and Electronic Business4. Discourse the alterations in the concern environment brought about by engineering in the last three old ages. Use your ain personal experiences to explicate your reply. Answer: There are many alterations in the concern environment brought by the engineering in the last three old ages. I believe that one of the most of import alterations ( impacting accounting pattern ) that has taken topographic point in my experience is the changed relationship between the company and its investors. There is an detonation of needed revelations. and a immense addition in the involvement the investing community has in those revelations. And the cyberspace is the largest alterations because every twelvemonth there is alterations on it. Many plans are nearing that every people in the society can larn many things about those plans brought by the engineering. . 5. Pull your decisions about the article â€Å"IT Doesn’t Matter† by Nicholas Carr by accessing the given URL:[ hypertext transfer protocol: //www. nicholasgcarr. com/articles/matter. html # readings ] . Answer: The article explained the quandary that the IT industry and the terminal users are presently sing. IT used to be a manner for companies to derive a competitory advantage. but nowadays IT has fused into another tool to behavior concern. IT merchandises are going cheaper and cheaper while giving more power. This tendency in the long tally will destruct the economic inducement for IT makers to go on making concern. On the other manus cheaper is better for companies implementing this engineering. The writer made it clear that avoiding trade name new IT merchandises and choosing for somewhat older IT merchandises would salvage money. In add-on. somewhat older merchandises have all the â€Å"kinks ironed out† giving a more dependable system. Buying somewhat older IT merchandises is non a fail safe manner of obtaining efficiency and initial cost nest eggs.