Reflective journal Research Paper Example | Topics and Well Written Essays - 1500 words - 1

Reflective journal - Research Paper Example Nonetheless, I was pleased at being able to widen my area of experience and I had a positive outlook at joining the hospital. The use of the fieldwork learning framework helped me a lot in the previous placements that I had undergone so I used it to set my goals and the targets I would achieve while undergoing this hospital placement. I find this framework is especially useful in setting ones goals as it helps one apply both personal and professional resources that are available in order to continually develop a persons skills in the work place (Larkin & Hamilton, 2010). The continuous cycle allows one to go back reevaluate the progress that they have made as well as examine the different aspects that have room for improvement. The main goals I set for myself were to improve my manual hand skills as well as my documentation and interviewing skills. I spent the first day familiarizing myself with my surroundings and getting to know the other members of the staff and I got the opportunity to meet with my supervisor and formally introduce myself. I was formed on what my role as an Occupational therapist in the hospital would be and that we would mainly be focusing on the Oncology and General Surgery areas although there were many other areas that Occupational therapists could be involved in. I was a bit nervous as my knowledge on Oncology was not as thorough as I would have liked it to be and I hoped that things would go well but as the fieldwork learning framework suggests, learning is a continuous process that happens over time (Larkin & Hamilton, 2010). Once we began working, I was amazed at how busy the hospital was and the number of patients that we met on just the first day. I now believe that this plac ement will be harder than my previous ones but all in all I truly enjoyed my first day at the hospital. I have now finished my first week in the hospital and I have found it to be continually challenging. I have had to deal

US History before 1877, Development of Erie Canal Research Paper

US History before 1877, Development of Erie Canal - Research Paper Example This paper will discuss US history before 1877, with special focus on the â€Å"Development of Erie Canal†.The main points which this paper is going to cover are the historical perspective of the canal, construction of the canal, improvements in the plan and the financial implications of the canal project. The time era under discussion is between 1807 to 1825. Historical Perspective During the period between the late 18th and early 19th century the USA started to plan and develop the system of transportation throughout the country with special focus on the interiors areas and outside the localities from Appalachian mountainous regions. The main focus was on the linkage between Erie Lake and other big lakes in the coast of Atlantic by making canals. Initially a large number of survey and plans were laid out for the construction of the canal but most of them were not feasible and were rejected. The final plan was based on the survey which was carried out in 1816. Based on this s urvey the route of the canal was established. According to the plan the canal was expected to connect to the New York port at the river of Hudson close to Troy in the New York City. From Troy the flow of the canal would be towards Rome in New York. Finally it would reach to Buffalo (on the northeastern coast of Erie Lake) by passing through Syracuse and Rochester [1]. 1. Matt Rosenberg (2010), Erie  Canal, The Building of the Great Western Canal. Online accession at About.com Guide (Accessed February 12th, 2011). After the development of the route plan of the Erie Canal the major issue was the arrangement of finances for the project. A bill was initially approved by the US congress for the provision of funding for the project then named as â€Å"The Great Western Canal†. The idea was found unconstitutional by The President of time J. Monroe and he vetoed it. The matter was then directly taken by the state legislature. The legislature, after extensive examination of the plan , approved for the funding of the Erie Canal project in the year 1816 with the condition that the tolls would be paid back to the government after the completion of the project. The city Mayor of New York was the chief supporter of the canal project and helped a lot for the construction and completion of the task. Fortunately he became the governor of the state in the year 1817 and was thus able to supervise the details of the plan [1]. Construction of Canal The formal construction of the canal named â€Å"Erie canal† began on 4th July, 1817. According to the plan the initial first segment was to be proceeded from the eastern side of Rome towards the river Hudson. Most of the constructors of the canal were the rich farmers who resided along the route of the canal. They were contracted to make the small portions of the project which came along their way. A large number of immigrants from Great Brittan, Germany and Ire Land supported the construction of canal in terms of manpow er [2]. 1. Matt Rosenberg (2010), Erie  Canal, The Building of the Great Western Canal. Online accession at About.com Guide (Accessed February 12th, 2011) 2. Christopher. M (2008).  "Hints of Comeback for Nation's First Superhighway".  The New York Times. (Accessed February 12th, 2011). The portions of canal were to be dug with the help of horses and shovels. At time modern earth moving specialized equipment were not available so the construction of such plans was a tedious job. The labor cost was about 85 cents to 100 cents per day. This was a heavy amount since it was about three times the pay which a laborer earned during that time. The initial 24 kilometer of the canal - from Rome to Utica - were formally opened around the year 1819. The rate of construction was visibly slow; at the speed during that time, the canal

Pros and Cons of Globalization Essay Example for Free

Pros and Cons of Globalization Essay Former CEO of Vodafone Group, Mr. Arun Sarin, at the 2009 Global Business Forum debated that there is a profound change occurring in the world today. The world is becoming more interconnected due not only to physical infrastructure but also the intellectual and software infrastructure that is being built; moreover, the way in that trade is being done today. For him, the United States is still the most powerful country in the world; however, if the country wants to have global excellence in the future, innovation is a most. Since its earliest appearance, about three decades ago, the term globalization has been used to describe a process, a condition, a system, a force, and an age. The term signifies a social condition characterized by the existence of global economic, political, cultural, and environmental interconnections and flows that make many of the currently existing borders and boundaries irrelevant. Globalization suggests dynamism best explained by the idea of change and the transformation of present conditions. In other words, globalization is an ongoing process rather than a static condition. According to Manfred Steger, author of the book: Globalization: A Very Short Introduction, globalization refers to a multidimensional set of social processes that create, multiply, stretch, and intensify worldwide social interdependencies and exchanges while at the same time fostering in people a growing awareness of deepening connections between the local and the distant. In the other hand, globalization is a complex and contradictory phenomenon that encompasses progress and degradation, opportunity and compulsion, freedom and restrictions. These countless contradictions are points of political contestation. Advantages of Globalization * Countries around the world have made the choice of establishing trade relationships with each other in order to improve their economy. Past hostile experiences were left behind, and globalization has announced an era of international peace and security. In addition, there has been propagation of democratic ideas among countries. * Countries have resolved to test free trade with some regions. Eliminating taxes, duties, and export/import quotas has allowed consumers to buy goods and services at a lower cost. * Globalization is encouraging the use of international connectivity such as the internet. Exchanging thoughts and ideas is helping interlink people around the world. * Several companies are investing in other markets providing better employment opportunities for skilled and unskilled labor all around the world. Globalization is helping in increasing the standard of living of the developing world; and at the same time is helping to reduce poverty. * Competition among different countries is leading to international innovation and quality goods. Consumers are benefited in the process because they get quality products at a cheaper rate and from a large variety available in the market. * Mutual trade has brought an understanding of the importance of protecting the environment and natural resources. Global environmental problems are being discussed. Disadvantages of Globalization * Many people from develop nations are losing jobs since corporations are outsourcing work to developing countries due to savings in cost of labor. There is a lot of pressure in the develop world; people are always under the threat of their job being outsourced. Outsourcing has resulted in unemployment. * Any sort of economic disruption in one nation will have a domino-effect on other nations that are closely related to that country in terms of trade and commerce. * Influence of local cultures and traditions will slowly start to wear down. Western ideas will impose over other cultures. * Globalization may lead to more environmental problems. A company may want to build factories in other countries because environmental laws are not as strict as they are at home. * Income distribution within countries is becoming less equal. The rich is getting richer and the poor is getting poorer. * Transnational integration and increased mobility has simultaneously strengthened and diminished the protection of individual rights and the dignity of individuals. Globalized markets have facilitated more monitoring of social conditions but have also opened up more opportunities for economic exploitation. Example of the pros and cons of globalization The Philippines is one of the countries in Asia that has been affected by the contradictions of globalization. The country is taking part in the process since it became part of the World Trade Organization in 1995. Globalization has allowed major changes in the nation like more labor, more Filipino foreign companies, high levels of education, and high per capita income. Philippines have four regions that globalization has targeted and these four are: liberalization, mobility of capital, technology, and management of organization through private and public sectors. Nevertheless, the Philippine state has failed in organizing a socioeconomic environment that would have prepared the country for global competition. Many Filipinos believe that globalization has done nothing for their country. And this is due to the poverty that has been becoming worse each year. The Philippines is still corrupt and still faces economic and political problems, therefore, the nation and its people does not trust the process of globalization. About 60% of the population lives in poverty and poverty levels are still increasing. The institutional framework of a country, its political culture and the quality of its leadership play an important role in fostering economic development and in promoting social welfare. For some, globalization can make the Philippines a better nation if the Philippine leaders get involve in allowing for more global trading and more foreign investors to the help boost the economy. And by accomplishing those goals, the Philippines should be able to reduce poverty levels. The Future of Globalization Globalization is transforming the structure of worldwide interaction and people are changing along with it. The positives aspects of globalization are becoming more significant than the negatives ones. In the long term, the world will be transformed into a more prosperous, democratic, and peaceful environment. This may means that cultural conflict and global chaos will occur in the short term but large economic growth and democratic governance will prevail in the long term. Globalization is making the way for free trade and international business. It is also improving communication around the world. The biggest advantage is that globalization has the potential to make the world a better place to live in. Globalization cannot be stopped; however, leaders should always be on the top of its spread and outcomes. Work Cited Steger, M. B. (2004). Globalization, a very short introduction. New York: Oxford University Press, USA. Retrieved from http://library.books24x7.com.dml.regis.edu/SearchResults.aspx?qdom=authorscol={all}qstr=Manfred B. Steger Hill, C. (2010). International business. (8 ed., Vol. 5). New York City NY: McGraw-Hill Irwin. Rupert, M., Solomon, S. (2006). Globalization international political economy. Rowman Littlefield Publishers INC.

Why Is HRT Prescribed For Menopausal Women

Why Is HRT Prescribed For Menopausal Women This dissertation to answer the research question (Why HRT is prescribed for menopausal women despite the risk of breast cancer?) was carried out as mentioned in the methodology section using the literature review methodology. The selected studies were appraised with the critical appraisal tools by the Public health resource Unit. The methodology of literature review had well assisted to review all the studies in the perspective of the other and divulge meaningful evidence and information which in a single study capacity would have been otherwise unnoticed. The Critical appraisal tools have assisted to review all the studies comprehensively to ensure there validity, reliability and applicability so that the result could be generalized to all the menopausal women population. The studies which have been reviewed were conducted in various settings with participants from all types of study population hence the results are a wholesome reunion of the existing predisposing factors with the associated risk of HRT in the incidence of breast cancer. ANSWER TO THE RESEARCH QUESTION Every doctor has the relief of the patient of utmost importance while prescribing a treatment and every treatment is meant to bring relief. And treatment has dose schedules, administration guidelines and perhaps side-effects which are generally explained by the doctor. But unlike other medicines there is a lot of unrest around the use of HRT though the associated risk when evaluated with other factors is not high. Keeping the results and conclusions derived from these studies in the present and elements for further research in front, it is seen that HRT does have benefits. These associated benefits with use of HRT according to this study are: 1) Use of HRT decreases the risk of death overall (Sellers et.al,1997) (Sener et.al, 2009) and is associated with recurrence, metastasis-free survival and better overall and disease-free survival than HRT nonusers in the univariate analysis irrespective of the start of menopause (Sener et.al , 2009) (Bonneir et.al, 1998) 2) HRT does not increase the risk of breast cancer when administered to women for whom other risk factors have been excluded (Tzingounis et.al, 1996). 2) There is an inverse relationship between HRT and mortality due to coronary heart disease, stroke and cancers other than breast (Sellers et.al, 1997) 4) Use of HRT gives fewer locally advanced cancers and smaller and better-differentiated cancers compared to non-users (Bonneir et.al, 1998). 5) HRT is a favourable prognostic factor for breast cancer. (Bonneir et.al, 1998) 6) Use of HRT counteracts the increased incidence of breast cancer with the lower incidence of other tumors. (Olsson et.al, 2001) 7) Long term HRT use has a favorable effect against colorectal and endometrial cancer. (Writing Group for the Womens Health Initiative Investigators, 2002) (Corrao et.al, 2008). 8) Use of trans-dermal HRT compared to the oral use of HRT is associated with lesser risk of breast cancer (Million women study collaborators, 2003) (Corrao et.al, 2008) which is presumed by the WHI, 2002. However these benefits depend on many other inter-connected factors of duration of use, age of the menopausal woman, past personal history of HRT used, family history related to breast cancer, dose of the HRT administered and type of HRT regime prescribed. These same factors affect the element of risk as well in the following way. 1) Risk of breast cancer may be increased with HRT use for duration of 5 years or less in women with family history of breast cancer (Sellers et.al,1997) (Olsson et.al, 2001). 2) Increased risk of breast cancer after prolonged use of HRT (Olsson et.al, 2001) (Sellers et.al, 1997) (Corrao et.al, 2008) (Sellers et.al, 1997) (Olsson et.al, 2001). This risk increased with increasing duration of use and decreased with time and reached at baseline with 5 years time. (Ewertz et.al, 2005) (Million women study collaborators, 2003) 3) Higher risk in current users than in past users which was greater for combined therapy than for other oral types of HRT (Million women study collaborators, 2003). 4) Women who used combined estrogen and progestin HRT regime are at increased risk of breast cancer (Stahlberg et.al, 2004) (Million women study collaborators, 2003) and Oral HRT use for long term had a higher risk of breast cancer than trans-dermal use of HRT (Corrao et.al, 2008). 5) Increased risk of breast cancer with current use of HRT in women of 50 years of age and above which increased with increased use. No increased risk in women between the ages of 40-49 (Ewertz et.al, 2005) (Million women study collaborators, 2003). 6) The risk of breast cancer increased in women who were current HRT users and had used OC in the past. (Lund et.al, 2007) 7) HRT users developed breast cancer at a younger age than non HRT users (Sener et.al, 2009). According to the synopsis of the issues and factors derived it can be concluded that there are benefits associated with use of HRT which mutually depend on the risk factors. And this is the reason why HRT is prescribed for menopausal women despite the risk of breast cancer. And these will again depend on gynecologist judgment and patients level of knowledge and awareness (2006). RECOMMENDATIONS To bring the optimal benefit with minimally associated risk, HRT could be prescribed to menopausal women for lesser duration which the studies present as 5 years. This duration which could be disputable and the age of the women also has to be considered with the link of different effects of HRT in different age groups would again depend on the individual gynecologists judgment and the patients compliance for regular follow up and mammographic screening. An attempt has been made to clear the otherwise existing dilemma of prescribing HRT or not but this again depends on many other factors which are most importantly the patients follow up and the doctors perception of the associated prescribing strategies. However more research is needed as within the limitations of this dissertation though it is possible to conclude that there are benefits associated with the use of HRT despite the risk of breast cancer; it is not possible to chalk out an effective prescribing strategy. And to bring any considerable changes a prescribing strategy and better patient compliance for follow-up would be needed. LESSONS LEARNT These total results, conclusions and opinions from the studies have presented some principle elements which could guide through the dilemma of prescribing HRT to yet another menopausal woman. 1) It is evident that duration has a role to play in the increase of the foresaid risk of breast cancer and that there is no risk with the use of HRT in the past. 2) A lot would also depend on the gynecologist or the physicians prescribing principles. It would be needed by them to follow some guiding factors like evaluating high-risk and low-risk women, family history and previous history of Oral Contraceptives which would vary for each patient. 3) A regular follow-up and timely check up as mentioned would help to catch otherwise unnoticeable breast changes. 4) Another factor which needs to be pursued for future research and studies is the type of HRT regimes. In routine HRT is prescribed orally hence less is known about other methods of administration which could perhaps assist in reducing the risk. 5) It would also be helpful to find if there is a link with the BMI and use of HRT. Generally obesity is linked to many diseases and unhealthy conditions and this would help to categorize women into high or low risk group. This dissertation has tried to bring up some associating factors which could help to extract the optimal benefits with lesser risk. This systematic approach has helped conduct this dissertation so as to answer the research question. However research in healthcare is never ending and is expanding every day (Aveyard, 2010). New studies with various designs are being conducted around this topic as I write my dissertation which will bring in more new opinions and evidences which will form base for yet another dissertation or study tomorrow to help develop a successful prescribing strategy.

Lament :: Personal Narrative Writing

Lament I have matured, and, at the proper time, the winnower will come for me. I will be ready. I have cast off my seed into the rich humus born of past generations. It has taken root, and now sings its own Song of Spring Where are the songs of Spring? Ay, where are they? Think not of them, thou hast thy music too,-- John Keats, â€Å"To Autumn† It is fitting on this day of cold bluster and unsentimental sunlight to write of endings. Spring, so recently past, seems a dream. Was it so long ago that I, like spring, burst onto the scene? The faces and days of my youth are veiled within the mist of memory, but not beyond my reach. I inhale and the aroma of lilacs engulfs me, just as they encircled my house. A sister is born; she is named June Iris, but she has arrived too early in April. She is carried home in her namesake month. My mother places her in the sunlight that leaks between our drapes. We have to be quiet; she is sleeping. . . . In an instant I am riding my bicycle beneath the elms whose branches rise to the sky like the vaulted ceiling of a cathedral. Lining my street, they provide a cool respite from the relentless heat of a Midwestern sun. The orb drifts over, shifting the patterns of shade and light as though it were setting designs in stained glass. Sometimes with a friend, but more often alone, I gallop my two-w heeled steed up and down the block. Obsessed with horses and the westerns on television, I have no need for companions to challenge my imagination and diminish the enjoyment. In pretend, I wile away the days of girlhood that reach to a future I never consider. I try to recall the sounds. The birds sang, I’m certain. Surely there were the shouts that accompanied the games. But there is no music in my reverie, no sound to break the white silence. Like the caterpillar in its cocoon, I’m insulated within myself. The Wind. I remember the wind as it rushed through the elms, ruffling the branches or swirling them in circles. I turn and am standing in the picture window that looked out upon our street. The sky is blackish green. The trees shift violently from side to side. I watch, oblivious to the potential danger of a breakaway limb, mesmerized by the dance before me.

Comparing Daystar and Those Winter Sundays Essay -- comparison compare

The two poems I have chosen to analyze are Daystar by Rita Dove and Those Winter Sundays by Robert Hayden. The poem Daystar struck me from my first reading of it because I do the same thing this woman did sometimes. The apartment I share with my husband has a balcony where I have planted some flowers, and sometimes when the whether is nice I drag a rocking chair out there into the sun and just sit and let my thoughts wander. This poem reminds me of those moments. The author uses imagery in the poem to make the experience of this one woman stand out vividly. The first lines of the poem say "she saw diapers steaming on the line / a doll slumped behind the door." The phrase "steaming on the line" is especially strong, making me able to feel the balmy heat of the day and the bright warm sunshine on my skin. Also, the diapers and doll may serve as symbols in this poem for all the cares that the woman carries in looking after her children. Right now she wants to put all that behind her, and doesn't want any reminders of it. She wants to escape into a place where there are no demands. Another visual image in this poem occurs when the woman is looking around her backyard, and she sees "the pinched armor of a vanished cricket, / a floating maple leaf." These are little things that catch your attention for a second, not things to sit an contemplate about. I think the point is that the woman doesn't really want to think about anything, she just wants to be. Sometimes she doesn't even want to look at anything, but instead close her eyes and see only "her own vivid blood." This image of the woman looking at her own blood makes it seem like this time alone reminds her that she is very "alive" -- that she has a free will and can... ...ut something the mother is doing for herself, while the second poem is all about the sacrifices the father made for his son. Comparing them shows the mother to be the more "selfish" of the two, in that her child and husband are distractions from her revelry, and they are somewhat burdensome to her. But the father is totally self-sacrificing -- getting up in the "blueblack cold," making a fire with "cracked hands that ached." He takes no thought for his own comfort, except, possibly, when he gets angry. This makes me think if the father had spent some time relaxing like the mother, maybe he wouldn't have gotten as angry. Maybe thinking of yourself every once in awhile is a good thing, I don't know, but it is interesting to note the contrast. I think mother in the first poem is person we can relate to, but the father in the second poem is a person we admire.

Unit 302

UNIT 302 POLICIES AND PROCEDURES INTRODUCTION I will be showing my knowledge and understanding of why schools have policies and procedures. I will also show a brief summary of 4 different policies. 5. 1 Explain why schools have policies and procedures. Policies and procedures are in schools because it establishes rules and regulations to guide acceptable behaviour and it ensures that the schools environment is a safe place for students, teachers and all staff. Schools policies also create a productive learning environment. The policies should also promote to respect for others and the importance of self discipline.It also shows the intolerance of bulling, harassment and shows the difference between right and wrong. Schools policies are also enforced to demonstrate to all pupils and staff what is acceptable or not in conduct of behaviour and discipline. The procedures are there also to protect all pupils and staff when situations may occur, abuse, threatening behaviour and violence. T his will demonstrate the protocol to follow to ensure that everyone involved is treated fairly and none judgementally and the right outcome is achieved.All policies and procedures are in situ to ensure that everyone involved or who attends the school know and understand the expectations. That everyone is dealing with situations in the right manner to ensure the protection of all staff and pupils. Policies and procedures are clear and concise that they are also a legal requirement within the school environment. There are many policies in a school environment which could be child protection, Health and Safety, confidentiality Anti-bulling and Harassment. These policies are in place to make sure that all members of staff and pupils feel safe and secure in the school environment.The policies are all on the Kettering Science Academy schools website for all staff and parents to have available at their own convenience to read. Also the school staff handbook is on the schools website, or th e book is in the school’s main office. The schools website is updated on a regular basis. The schools policies and procedures are reviewed and updated too within the legal requirements. This enables the parents to view and understand the construction of the schools expectations at all times. 5. 3 Evaluate how schools policies are developed and communicated both with and outside the schoolThe schools policies are developed in conjunction with the governors depending on the policy, sometimes using the senior management and teaching staff input. All policies are revised and updated on a regular basis. The Head teacher is responsible for â€Å"the internal organisation, management and control of the school. Also for advising on implementing the governing bodies strategic framework. In particular head teachers need to formulate aims and objectives, policies and targets for the governing body to consider†.Policies regarding the school’s curriculum may be written by th e subject coordinator then agreed at the staff meeting. All staff may contribute to the behaviour policy in the school. When all policies have been drawn up and agreed on by the governing body they will be put on to the schools website for all staff and outside bodies to read. These policies are also on the schools prospectus to give future parents of pupils the aims and values that the school can offer to their child for the learning and development within the school.As the policies are updated regularly and are also available on the website all the time this is the best format to communicate to parents and anyone else to view. CONCLUSION Policies and procedures are very important because they help a school establish rules, to create standards of high quality for learning. It also reflects the safety of all staff, pupils as well as expectations of all that attend and work within the school. They enhance the structure and function of a school which is necessary to provide the educat ional needs of the students.These also ensure that all staff to know the protocol to follow for whatever incident that they may come across. Ultimately policies and procedures are necessary for the success and safety of all in the school environment. They are also there to maintain the high quality of pupils receiving the most productive education they would encounter. Also it guides the management of the structure of a school to be maintained and to be at the highest quality to help a strong leadership in the school. Reference Burnham, Louise, (2010) Support Teaching and Learning in Schools, Heinemann.