How can the Nurses collaborate to prevent and manage Pressure ulcers Research Paper

How can the Nurses collaborate to prevent and manage Pressure ulcers (bed Sore) - Research Paper Example The panel came up with recommendation on preventive strategies such as patient education, clinician training, development of communication and terminology materials, implementation of toolkits and protocols. Behavioral aspects like adherence of the healthcare provider as well as the patient were also given recommendations. The collaborative effort of the learned American healthcare professionals who have the resources and determination has transformed the impending challenge of the CMS policy to an opportunity for the improvement of the hospital system and its patients. The Pressure Ulcer Collaborative project, coordinated by the New Jersey Hospital Association (NJHA), was conceptualized based on the negative effects of pressure ulcers such as pain and disfigurement on patients, the burden of care to the healthcare industry, and the state and federal reporting requirements – the U.S. Health and Human Services in particular calls for a 50% reduction in pressure ulcers among nursing home residents by 2010. A comparative method to analyze data based on the guidelines developed by the NJHA Quality Institute Department and the Department of Continuing Care Services was used by the 150 organization who participated in the project. After a 12-month period (October 2005 to October 2006), the incidence and prevalence of pressure ulcers among the participating organizations showed a 30% decrease. By May 2007, the end of the second year of the Pressure Ulcer Collaborative project, a 70% decrease was achieved. The skin assessment, Braden assessment, and frequency of skin assessment requirements to meet the guideline criteria were not sufficient at the onset, thus the project was rolled out in all organizations who participated by April 2006 only. The project was able to give the healthcare staff a more detailed and comprehensive focus on patient care improvement, access to guidelines and protocols, and commitment to consistency and standardization in

History of Modern Painting Essay Example for Free

History of Modern Painting Essay The rise in popularity of primitivism can be united with two other prevalent forces in Europe during the late 19th century, theology and industrialization. Naturally dissatisfaction with European life increased, steeped in centuries of monarchies, wars, feudal wars, and multiple revolutions. Christ symbols, towering church steeples, and scads of spiritually historical iconography permeated nearly all of the Europe, even while its principles waned. Meanwhile, Europe began to feel the effects of its going industrial centers. In the 1860s, Paris radically rejuvenated itself under Napoleon III and Haussmann’s city restructuring. Apartments, streets, transportation, and commerce were all restructured, becoming new, uniform, sleek, and systemized. Conditionally, primitivism is understood as the ‘other’ through Western perception. This implies that outsiders to Europe are different inherently, and deserve special attention. While Europe idolizes themes of cleanliness, efficiency, and puritan values, the ‘other’ offered an escape into a world that was perceived as exotic, mystically spiritual, and entirely natural. In â€Å"Avant-Garde and Kitsch,† Clement Greenberg says that avant-garde criticism â€Å"has not confronted our present society with timeless utopias, but has soberly examined . . . the forms that lie at the heart of every society. † Vincent Van Gogh, in an attempt to recover simplified realism, focused on less urban subjects. He moved to south France and began painting provincial scenes using thick impasto paint application. Paul Gauguin joined Van Gogh to establish the Studio of the South in Arles in 1988; however, even this is not removed enough from modern Western values. Gauguin had â€Å"studied medieval art (sculpture, tapestries, and stained glass), Primitive woodcuts, and certain types of exotic art which he had seen at the World’s Fair of 1889. † Comparatively, the Western projection of art appeared to him dystopic, and he sought renewal in submersing himself in Tahitian culture. Warily, Gauguin traveled to a country under French rule at the time, guaranteeing him ‘safe’ primitivism than un-Colonized areas. In Tahiti, Gauguin painted with no shaded areas of depth and rounded, blunt features, loose applications of representative color, as seen Maternite II. All this, added with mythical looking mist and bare women give a sense of pastoral serenity of antiquity, while also remaining distinctly different than the European spectator who enjoyed the painting. The women are all dark-skinned and blissfully exposed, while engaging the viewing to partake of the serenity of the scene. Gauguin used Primitive representative techniques, by favoring simplified, unenlightened forms or expression. As Imperialism extended the relations between Europe and civilizations that were previously untouched by European ideology. Simplified, organic forms of nature and natural life were fluidly exposed to European culture, including Gauguin’s paintings. It was completely antithetical to anything appreciated in the West in form, staging, or perspective. Another feature of Westerners embracing primitivism can be found in Samuel Butler’s novel Erewhon. In the utopia/dystopia world of Erewhon there is a complete absence of machines, simply because any variety of them could prove potentially dangerous. This novel was published at a time when industrialized nations began relying more on machines in industry, and features an extreme alternative that demonstrates the allure of the Primitive who live the ‘other’ lifestyle. Those who see modern Western life as a dystopia can find its ultra alternative in the Primitive. Thus artists flee for simpler, idyllic or virginal locals, consequently implying that something is inherently wrong with the Europe, its industry, theology, and ideology. References: Greenberg, Clement. Art and Culture: Critical Essays. Boston: Beacon Press, 1971. Read, Herbert. A Concise History of Modern Painting. New York: Frederick A. Praeger, Inc. , 1957. Schwartz, Robert . â€Å"France in the Age of Les Miserables. † Mount Holyoke College. 4/19/2009 http://www. mtholyoke. edu/courses/rschwart/hist255-s01/mapping-paris/Haussmann. html.

Perfectionism and Eating Disorders Essay -- Self Image Esteem Health P

Perfectionism and Eating Disorders Many extreme pressures exist in modern society which directly affect a large number of the population to the point of extremity. In an age of high technology, rapid development, and intense social pressure, the pressure to be the best of the best prevails. Many people succumb to the pressure in a variety of ways, some beneficial, and some detrimental. Eating disorders such as Anorexia Nervosa and Bulimia Nervosa in part result from an intense pressure to achieve the perfect ideal body weight and physical appearance. Emphasis on being perfect begins early in childhood and continues to grow with age, sometimes so much that a personality takes on a perfectionistic drive affecting every aspect of daily life. Perfectionism is a common individualized personality trait which in part stems from this ardent cultural pressure. According to the Merriam Webster's Collegiate Dictionary, perfectionism is defined as "a disposition to regard anything short of perfection as unacceptable". Given this definition, is this trait, perfectionism, one that can be directly linked to those people who suffer from eating disorders? II. Perfectionism: A Closer Look: Setting high and demanding goals of achievement for oneself can be both a positive and negative experience. Yes, goals are important and essential in life to allow us to work for an ultimate high achievement. They give one purpose and drive. But what happens when this goal exceeds the normal realm of possibility to the point that it directly changes from a means for a self-actualizing strive for excellence to a neurotic, obsessive preoccupation with perfection? Roedell (1984) continues the argument that perfectionism can be looked upon as bo... ... (1 994). Perfectionism and the gifted. Roeper Review (I 7)3, 173-176. Pigott, T.A., Altemus, M., Rubenstein, C.S., Hill,J.L., Bihari, K., L'Heureux, F., Bernstein, S., Murphy D.L. (1991). Symptoms of eating disorders in patients with obsessive-compulsive disorder. American Journal of Psychiatry. 148(11), 1552-7. Roedell, W.C. (1984). Vulnerabilities of highly gifted children. Roeper Review, 6(3), 127-130. Rothenburg, A. (1990). Adolescence and eating disorder: the obsessive-compulsive syndrome. Psychiatric Clinics of North America, 13(3), 469-88. Slade, P.D. Newton, T., Butler, N.M., Murphy, P. (1991) An experimental analysis of perfectionism and dissatisfaction. British Journal of Clinical Psychology, 30(Pt2), 169-76. Silverman, L.K. (I 99 5). Perfectionism. Paper discussed at the 1 1 th World Conference on Gifted and Talented Children, Honk Kong.

Comparing Dreams in Song of Solomon, Push, and Incidents in the Life of

A Dream Revised in Song of Solomon, Push, and Incidents in the Life of a Slave Girl      Ã‚  Ã‚  Ã‚  Ã‚   America was founded on the belief that "all men are created equal." However, a question must be posed which asks who constitutes "men" and what is "equal"? Where do women fit into the picture? What about minorities? The Declaration of Independence serves as the framework for rules that govern the people who fall beneath it, but who were the architects of the infamous work? They were white, upper class, men. They looked at slavery as a grievous sin, yet they allowed it to occur for decades. Immigrants from all parts of the country came to America to be free from persecution and terror; unfortunately, people were not free in America's own backyard. Why did hundreds of thousands of people leave their homes to start fresh in a new world? The answer is simple; they wanted a glimpse of the American Dream, but that look into a prosperous future was not for all people. The founding fathers left an enormous hole in the document that established the first set of rules that would govern this new country. They did not include minorities in their representation of men being equal. The only ones who were considered equal were immigrants who came on their own, who left their past behind them, and who kept their social structures in tact. For everyone else, they learned soon enough that they must abandon that dream for one that favors setbacks, the need to rise again, and a quest for group dignity.    From the time that Africans were taken from their country and enslaved in a new world, they have fought to retain dignity and grace in circumstances that were deplorable. Even slaves who were well taken care of were not able ... ...is life ends, and Push gives very intimate insight to a young abused girl who is fighting to survive. All of these stories have characters who have hopes and dreams of being successful, but fall short in some way because the Declaration of Independence did not include them and the desire to reach the American Dream is not an open invitation to Africans like it is to other immigrant groups. They are not voluntary participants in American society; therefore, they must settle for less than others have to. They must fight twice as hard to have half as much as others.    Works Cited: Brent, Linda. "Incidents in the Life of a Slave Girl". The Classic Slave Narratives. Ed. Henry Louis Gates, Jr. New York: Penguin Group, 1987. Morrison, Toni. Song of Solomon. New York: The Penguin Group, 1977. Sapphire. Push. New York: Vintage Contemporaries, 1996.

Shipping the Way We Teach English Successfully Practices

FACULTAD DE HUMANIDADES MASTER'S DEGREE IN METHODOLOGY English Teaching Methodology – PMI 730 Reaction Paper PARTICIPANT: EDILTRUDIS GOMEZ Q. 4-724-19 FACILITATOR: AUGUSTO GUEVARA M. A David, Chiriqui 2012 My Reaction to the videos My Reaction about shipping the way we teach English successfully practices around the world video. I think that is a very good instructional video design for EFL education which basically has two main goals: 1- building pedagogical foundations and 2- improving classroom practice. I feel that this video is promoting a manual contains 14 modules. It seems that it is divided in four categories.Category A – approaching to language teaching foundations. It is made of the following modules1, 2, 3, 4, and 5. Next category B – Focus in language teaching extension which is made of the following modules 6,7,8,9, and 10. Then category C – focus on the learner and category. It is made of the following module11 and 12. Finally category D â⠂¬â€œ focus on teacher professional development. It is made of the following modules13 and 14. In my humble opinion, it is good that all of the modules have videos plus supporting material and previewing activities which can help teacher to guide students.I agree that if we observe other teachers classes in both primary and secondary level, it can give us not only a variety of teaching stiles but also cultures reflected in these examples will provide a helpful aid for both teacher and student. In addition, I believe that there are several factors affecting the results of teaching such as personal reasons, motivations to use this material, fix practice and curriculum, degree flexibility, and creativity, moreover the willing to experiment and try with different ideas and techniques.However, I agree that the fact of taking in consideration the new ideas that it offers to everyone is essential to improve the way we teach. I concur that before applying these examples we have to do it bas ed on some aspects such as ours students? language, level, curriculum and institutional setting teaching style and culture to shape the way of teaching. The second video is about the module I – contextualizing language by organizing the language curriculum to the topics we are dealing with.Consequently, Language is constructed to purpose situations and social needs, a better learning outcome approach instructions integrated skills and pair work. Finally, Think as flexible as possible, Look for the examples of different activities for instance storytelling, dramatization, singing, student presentation projects themes or topics and look for the context and language. In conclusion, I do not have any disagreement with these videos since I do not have any experience in teaching. On the other hand I found them very useful for teaching both videos were excellent and encourage me to use them as soon as I have the possibility

The Prohibition of Mixed Marriages Act in South Africa

The Prohibition of Mixed Marriages Act in South Africa The Prohibition of Mixed Marriages Act (no. 55 of 1949) was one of the first pieces of apartheid legislation enacted after the National Party came to power in South Africa in 1948. The Act banned marriages between â€Å"Europeans and non-Europeans,† which, in the language of the time, meant that white people could not marry people of other races. It also made it a criminal offense for a marriage officer to perform an interracial marriage ceremony. Justification and Aims of the Laws The Prohibition of Mixed Marriages Act did not, however, prevent other so-called mixed marriages between non-white people. Unlike some other key pieces of apartheid legislation, this act was designed to protect the â€Å"purity† of the white race rather than the separation of all races. Mixed marriages were rare in South Africa before 1949, averaging fewer than 100 per year between 1943 and 1946, but the National Party explicitly legislated to keep non-whites from infiltrating the dominant white group by intermarriage. Both the Prohibition of Mixed Marriages Act and the Immorality Act of 1957 were based on then-active United States segregation laws. It was not until 1967 that the first U.S. Supreme Court case rejecting miscegenation laws (Loving v. Virginia) was decided. Apartheid Marriage Law Opposition While most white South Africans agreed that mixed marriages were undesirable during apartheid, there was opposition to making such marriages illegal. In fact, a similar act had been defeated in the 1930s when the United Party was in power. It was not that the United Party  supported interracial marriages. Most were vehemently opposed to any interracial relations. Led by Prime Minister Jan Christiaan Smuts (1919–1924 and 1939–1948), the United Party thought that the strength of public opinion against such marriages was sufficient for preventing them. They also said there was no need to legislate interracial marriages since so few happened anyway, and as South African sociologist and historian Johnathan Hyslop has reported, some even stated that making such a law insulted white women by suggesting they would marry black men. Religious Opposition to the Act The strongest opposition to the act, however, came from the churches. Marriage, many clerics argued, was a matter for God and churches, not the state. One of the key concerns was that the Act declared that any mixed marriages â€Å"solemnized† after the Act was passed would be nullified. But how could that work in churches that did not accept divorce? A couple could be divorced in the eyes of the state and married in the eyes of the church. These arguments were not enough to stop the bill from passing, but a clause was added declaring that if a marriage was entered into in good faith but later determined to be â€Å"mixed† then any children born to that marriage would be considered legitimate even though the marriage itself would be annulled. Why Didn’t the Act Prohibit All Interracial Marriages? The primary fear driving the Prohibition of Mixed Marriages Act was that poor, working-class white women were marrying people of color. In actual fact, very few were. In the years before the act, only roughly 0.2–0.3% of marriages by Europeans were to people of color, and that number was declining. In 1925 it had been 0.8%, but by 1930 it was 0.4%, and by 1946 it was 0.2%. The Prohibition of Mixed Marriages Act was designed to protect white political and social dominance by preventing a handful of people from blurring the line between white society and everyone else in South Africa. It also showed that the National Party was going to fulfill its promises to protect the white race, unlike its political rival, the United Party, which many thought had been too lax on that issue. Anything taboo, however, can become attractive, just by virtue of being forbidden. While the Act was rigidly enforced, and the police endeavored to root out all illicit interracial relations, there were always a few people who thought that crossing that line was well worth the risk of detection. Repeal By 1977, opposition to these laws was growing in the still white-led South African government, dividing members of the liberal party during the government of Prime Minister John Vorster (Prime Minister from 1966–1978, president from 1978–1979). A total of 260 people were convicted under the law in 1976 alone. Cabinet members were divided; liberal members backed laws offering power-sharing arrangements to nonwhites while others, including Vorster himself, decidedly did not.  Apartheid was in its painfully slow decline. The Prohibition of Mixed Marriages Act, along with the related Immorality Acts which prohibited extra-marital interracial sexual relations, was repealed on June 19, 1985. The set of apartheid laws were not abolished in South Africa until the early 1990s; a democratically elected government was finally established in 1994.   Sources Curbs on Interracial Sex and Marriage Divide South African Leaders. The New York Times, July 8, 1977.  Dugard, John. Human Rights and the South African Legal Order. Princeton: Princeton University Press, 1978.Furlong, Patrick Joseph.  The Mixed Marriages Act: a historical and theological study.  Cape Town: University of Cape Town, 1983.Higgenbotham, A. Leon Jr., and Barbara K. Kopytof. Racial purity and interracial sex in the law of colonial and antebellum Virginia. Georgetown Law Review 77(6):1967-2029. (1988–1989).  Hyslop, Jonathan, â€Å"White Working-Class Women and the Invention of Apartheid: Purified Afrikaner Nationalist Agitation for Legislation against Mixed Marriages, 1934-9† Journal of African History 36.1 (1995) 57–81.Jacobson, Cardell K., Acheampong Yaw Amoateng, and Tim B. Heaton. Inter-Racial Marriages in South Africa. Journal of Comparative Family Studies 35.3 (2004): 443-58.Sofer, Cyril. â€Å"Some Aspects of  Inter-racial  Marriage s in South Africa, 1925–46,†Ã‚  Africa,  19.3  (July 1949): 193. Wallace Hoad, Neville, Karen Martin, and Graeme Reid (eds.). Sex and Politics in South Africa: The Equality Clause / Gay Lesbian Movement / the Anti-Apartheid Struggle. Juta and Company Ltd, 2005.Prohibition of Mixed Marriages Act, 1949. (1949). Wikisource.

Front Street Hospital Case Study Essays

Front Street Hospital Case Study Essays Front Street Hospital Case Study Essay Front Street Hospital Case Study Essay According to Kaiser Family Foundation (2013), more than 47 million Americans were uninsured in 2012. These gaps in health insurance undoubtedly increase healthcare costs, discourage the use of preventative care, and negatively impact the lives and health of the American people. One way to combat this issue is for hospitals and providers to offer charity care to those who qualify and are in need. Non-profit hospitals are organized to serve a charitable purpose to meet the needs of the community and serve indigent patients that would otherwise go without care due to lack of insurance. In return, these organizations receive tax exempt status on  all of their earnings. However, some hospitals have fallen short in terms of fulfilling their obligations to the community and the patients in need. The revenue function of healthcare organizations is extremely complex. Part of this issue can be attributed to the different sources of revenue payers: self-pay, Medicare, Medicaid, commercial insurance, and managed care contract payers. Health economist Gerard Anderson notes that â€Å"uninsured patients and those who pay with their own funds are charged 2. 5 times more for hospital care than those covered by health insurance and more than 3 times the  allowable amount paid by Medicare† (Anderson, 2007). : Front Street Hospital has most certainly contributed to those staggering figures researched by Anderson. For example, Jane Adams, a young uninsured patient spent two days at Front Street for an appendectomy procedure. An insured patient undergoing the same procedure would have been expected to pay close to $2500 after Medicare and Medicaid reimbursements to the hospital. Instead, Adams was left with a $19,000 bill for the appendectomy. Like all other uninsured patients, Adams didn’t benefit from discounted rates. To add insult to injury, Front  Assignment 6. 2 Chapman 3 Street is known for its intimidating collection tactics against patients who are unable to finance their care. Similarly there is Lori Duff, an uninsured Ohio resident who was barely able to make ends meet. After seeking treatment and not being able to pay her hospital bill, she was threatened with a 25% wage garnishment and continuously harassed by Mount Carmel Health System. Being a part of the uninsured population I empathize with self-pay and uninsured patients. Many people delay treatment to avoid outrageous bills and the financial burdens associated with them. So, I completely disagree with the billing and collection policies of non-profit hospitals related to the uninsured. The uninsured patients are the ones who need discounted services most. It creates a catch 22 situation when choosing to seek care. Avoiding care will only deteriorate an individual’s health, while seeking care creates financial problems. I don’t believe that hospitals should not try to collect on past due bills; however they should go about it in a different way than Front Street has. The Fair Debt Collection Practices Act grants creditors the ability to seek to collect on outstanding debt in a number of ways (FTC,2014). Hospitals are known for providing a substantial amount of uncompensated care and it is their job to reduce these types of liabilities. Therefore, Front Street was not unethical in their efforts to collect debt through communications with the patients. I disagree with how far they have chosen to go to collect on bad debt and believe that there are different methods that could have been used. If I could act as the ultimate authority in this situation I would create a stringent law that requires hospitals to fairly set prices for uninsured patients, monitor compliance, and add  penalties for those who disregard the law. Thankfully the new healthcare reform has addressed Assignment 6. 2 Chapman 4 the issue related to hospitals and their obligation to provide charity care. Under the new rules nonprofit hospitals are required to comply with the following four provisions (Gold, 2012): 1. Prohibited from charging uninsured low-income patients higher rates than the lowest amounts billed to individuals with insurance. 2. Required to have a clearly written financial assistance policy describing who is eligible for free or reduced cost care. The policy must be widely publicized in the community  served by the hospital. 3. Prohibited from enforcing extraordinary collections actions against patients before determining whether the patient qualifies for financial assistance. 4. Required to conduct assessments on the health needs of the community they serve and implement a strategy to meet those needs. One thing that I would focus on due to my experience is closely monitoring how well hospitals implement their financial assistance policies. A few years ago I was denied assistance for an emergency room visit and without being given any explanation as to why. Based on my  understanding of the policy, I qualified for assistance, however, my bill was never reduced and it eventually went to collections. I would also reevaluate the needs of the community and see how the organization can meet those needs. It is important to educate the community on the organization’s obligations to the patients and community, patient responsibilities, and ways to utilize available resources. Many patients don’t know about the financial assistance policies that hospitals have. This creates a huge disconnect between the patient and the hospital or providers treating the patient. Assignment 6. 2 Chapman 5 References  Anderson , G. (2007). Hospitals charge uninsured and â€Å"self-pay† patients more than double what insured patients pay. Retrieved from jhsph. edu/news/news-releases/2007/anderson-hospital-charges. html Federal Trade Commission (FTC) (n. d. ). Fair Debt Collection Practice Act. Retrieved on August 5, 2014 from ftc. gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/fair-deb t-collection-practices-act-text Gapenski, L. (2010). Cases in healthcare finance. (4 ed. , pp. 239-241). Health Administration Press. Gold, J. (2012, April). Nonprofit hospitals faulted for stinginess with charity care. Retrieved from npr. org/blogs/health/2012/04/27/151537743/nonprofit-hospitals-faulted-for-st inginess-with-charity-care Kaiser Family Foundation. (2013, October). The uninsured: A primer key facts about health insurance on the eve of coverage expansions. Retrieved from http://kff. org/uninsured/report/the-uninsured-a-primer-key-facts-about-health-insurance-o. n-the-eve-of-coverage-expansions/ HCM 733 Domonique Chapman Case Study: Front Street Hospital, Week 6 Learning Outcomes: advocate courses of action regarding finance-related ethical issues in health services organizations. Score  Below Expectations 0 – 10 Approaches Expectations 11 Meets Expectations 12 13 1. Evaluation of billing and collection policies of not-for-profit hospitals related to the uninsured Evaluation of billing and collection policies is insufficient1. Evaluation of billing and collection policies is sufficient2. Evaluation of billing and collection policies is comprehensive3. Below Expectations 0 – 10 Approaches Expectations 11 Meets Expectations 12 13 2. Discussion of ethical issues Discussion of ethical issues is insufficient. Discussion of ethical issues is sufficient. Discussion of ethical issues is comprehensive. Below Expectations 0 – 10 Approaches Expectations 11 Meets Expectations 12 13 3. Decision regarding billing and collection policies of not-for-profit hospitals related to the uninsured Decision regarding billing and collection policies is insufficient. Decision regarding billing and collection policies is sufficient. Decision regarding billing and collection policies is comprehensive. Quality of Writing Below Expectations 0 – 8 Approaches Expectations 9 Meets Expectations 10 11 Lacks professional quality; evidence of disorganized thought processes; major grammatical, spelling and/or typographical errors  Average professional quality; evidence of organized thought processes; relatively few grammatical, spelling, and/or typographical errors Excellent professional quality; evidence of highly organized thought processes; no grammatical, spelling , or typographical, errors Total possible points: 50 Comments 1 The discussion is insufficient in that it lacks specific detail and/or does not address the question. 2 The discussion is sufficient in that it contains minimal detail, but lacks additional contextual information. 3 The discussion is comprehensive in that it is substantive and includes additional contextual information.