Saturday, May 23, 2020

Causes and Effects of Water Pollution - 1292 Words

70 % of our Earth surface is covered by water and almost 60% of the human body contain water for nutrient transportation. The unique characteristic of water is water molecule is the only substance in this Earth that exist in all three physical states of matter which are solid, liquid and gas. All human beings need water to survive. The national development over the years cause the rate of water pollution increased. According to Gebre Rooijen (2009) water pollution can be considered as a sign that derives from economic growth and is a common phenomenon in urbanized cities in developing countries. In general, there are three main issues that related to water pollution which are the causes, effects and the way to decrease this problem. What makes water pollution occur? Firstly, urbanisation in which people move to the big cities can cause physical disturbance on land due construction of houses, industries, roads, etc. According to Mohan Rao,1971; CPHERI, 1972 water pollution occurs when there is a removal from the industrial sector, emissions from municipal waste, and elimination of defective products affect water quality. In addition to construction works, chemical pollution from industries and mines are also contributing to even worsened water pollution. Over population in certain cities causing inadequate sewage collection and treatment with unmanaged litter, plus increase in fertilisers to grow more food. This results in an increase in nutrients (nitrates andShow MoreRelatedWater Pollution : Causes And Effects2288 Words   |  10 PagesWater Pollution Water pollution occurs when there is an accumulation of substances in water that would then cause issues for humans and animals. The main aspect that determines the pollution is the amount of pollutants that are present and how large the body of water is. In other words, the quantity of pollutants in relation to the size of the body of water. The earth has two types of water resources: surface and ground water. The surface water is stored in lakes, oceans, and rivers while the groundRead MoreWhat Causes Water Pollution And Its Effects Essay901 Words   |  4 PagesWhat Causes Water Pollution and its Effects The shoreline became a black gooey mess that killed countless birds, and completely devastated marine life! This environmental disaster is only one example of severe water pollution. Therefore, it becomes essential to understand the causes and effects of pollution. Water pollution is a serious problem for the environment. It should be solved on a large scale at the level of states and federal governmental levels. If the public becomesRead MoreWhat Causes Water Pollution And Its Effects1147 Words   |  5 PagesWhat Causes Water Pollution and its Effects The shoreline became a black gooey mess that killed countless birds, and completely devastated marine life! This environmental disaster is only one example of severe water pollution. Therefore, it becomes essential to understand the causes and effects of pollution. Water pollution is a serious problem for the environment. It should be solved on a large scale at the level of states and federal governmental levels. If the public becomesRead MoreEssay about Causes and Effects of Water Pollution613 Words   |  3 PagesThere are many causes for water pollution. The main one is plastics. The reason for that is that plastics take four hundred and fifty years to decompose in the water. Also many companies use plastic and people throw it in the waterways. Because water can float and be carried by the wind, it can cause harm to unsuspecting creatures hundreds of feet from where it was originally dumped. Such waste includes bags, bottles, cups, straws, cup lids, utensils, six pack holders, cling wrap, fishing lineRead MoreThe Effects Of Pollution On The Environment And Ecosystem968 Words   |  4 PagesPollution The air we breathe, the water we drink, the ground where we grow our food, is polluted with harmful things. Pollution is the introduction of harmful or poisonous effects of a substance into the environment. It disrupts the balance of people’s lifestyle when they are contaminate. Pollution balance in the environment and ecosystem. The environment is in the process of becoming unsafe or unsuitable to use. Pollution can come in many different form, such as air, water, soil can have pollutantRead MorePoison Water Essay1030 Words   |  5 PagesPoison Water The consequence of polluting the earth is constantly ignored by human beings. Pollution is dangerous and harmful to both living things and the environment. Chemical waste, fertilizer and numerous additional are one of the most important affect which is leading us to damaging possessions of water pollution, Pollution should be condensed in order to make available a cleaner environment and generate healthy living environment and habitat for all life forms on earth. Water pollution alsoRead MoreThe Issue of Marine Life Pollution1538 Words   |  6 Pagesï » ¿Essay: Marine Life Pollution Introduction: Pollution can be defined in different prospective including economics. The economics definition of pollution denotes pollutions as loss of environ quality. Furthermore it defines the cost of pollution as the cost of environmental loss (Goodstein, 2011). However the literary meanings of pollution are defined as the contamination of environment that can cause harmful effects on the inhabitants. These effects are particular with the environment and a numberRead MoreThesis Statement1030 Words   |  5 PagesThesis Statement Water pollution has had devastating effects on the environment, which include irreversible effects to the oceans ecosystem, health problems and abnormal conditions. interference of the oceans ecosystem - Plastic storage bags can kill animals in the oceans like dolphins, turtles and whales. It is easy for wildlife to swallow and eventually causes death. * Over 1.5 billion tons of plastic water bottles end up in US landfills each year. It takes over 300 years to degradeRead MoreThe Hazardous Effects of Pollution to the Environment and Human Health.Docx Uploaded Successfully1376 Words   |  6 PagesThe Hazardous Effects of Pollution to the Environment and Human Health Abstract Pollution is the introduction of contaminants into the natural environment that causes adverse change. It can take the form of chemical substances or energy. Pollutants, the components of pollution, can be either foreign substances/energies or naturally occurring contaminants. It is any discharge of material or energy into water, land, or air that causes or may cause acute (short-term) or chronic (long-term) detrimentRead MoreEffects Of Air Pollution Essay1282 Words   |  6 Pagesmany kinds of pollution, but one that has the most impact on humans would be air pollution. In order to live, we must breathe air and surprisingly some things that we breathe takes a toll on our health. Air pollution occurs when pollutants are released into the atmosphere. It has both chronic and acute effects on human health which effects a number of different systems and organsFossil fuel combustion such as diesel fuel, coal, gasoline and natural gas is the main source of air pollution. Most of this

Monday, May 18, 2020

How Big Are Millions, Billions, and Trillions

The Piraha tribe is a group living in the jungles of South America. They are well known because they do not have a way to count past two. Studies have shown that tribe members cannot tell the difference between a pile of eight rocks and 12 rocks. They have no number words to distinguish between these two numbers. Anything more than two is a â€Å"big† number. Most of us are similar to the Piraha tribe. We may be able to count past two, but there comes a point where we lose our grasp of numbers. When the numbers get big enough, intuition is gone and all we can say is that a number is really big. In English, the words million and billion differ by only one letter, yet that letter means that one of the words signifies something that is a thousand times larger than the other. Do we really know how big these numbers are? The trick to thinking about large numbers is to relate them to something that is meaningful. How big is a trillion? Unless we’ve thought of some concrete ways to picture this number in relation to a billion, all that we can say is, A billion is big and a trillion is even bigger. Millions First consider a million: One million is a thousand thousands.One million is a 1 with six zeros after it, denoted by 1,000,000.One million seconds is about 11 and a half days.One million pennies stacked on top of each other would make a tower nearly a mile high.If you earn $45,000 a year, it would take 22 years to amass a fortune of one million dollars.One million ants would weigh a little over six pounds.One million dollars divided evenly among the U.S. population would mean everyone in the United States would receive about one third of one cent. Billions Next up is one billion: One billion is a thousand millions.One billion is a 1 with nine zeros after it, denoted by 1,000,000,000.One billion seconds is about 31 and a half years.One billion pennies stacked on top of each other would make a tower almost 870 miles high.If you earn $45,000 a year, it would take 22,000 years to amass a fortune of one billion dollars.One billion ants would weight over 3 tons — a little less than the weight of an elephant.One billion dollars divided equally among the U.S. population would mean that everyone in the United States would receive about $3.33. Trillions After this is a trillion: One trillion is a thousand billions, or equivalently a million millions.It is a 1 with twelve zeros after it, denoted by 1,000,000,000,000.One trillion seconds is over 31 thousand years.One trillion pennies stacked on top of each other would make a tower about 870,000 miles high — the same distance obtained by going to the moon, back to Earth, then to the moon again.One trillion ants would weigh over 3,000 tons.One trillion dollars divided evenly among the U.S. population would mean that everyone in the United States would receive a little over $3,000. What’s Next? Numbers higher than a trillion are not talked about as frequently, but there are names for these numbers. More important than the names is knowing how to think about large numbers. To be a well informed member of society, we really should be able to know how big numbers like a billion and trillion really are. It helps to make this identification personal. Have fun coming up with your own concrete ways to talk about the magnitude of these numbers.

Tuesday, May 12, 2020

Sports Women - Free Essay Example

Sample details Pages: 9 Words: 2621 Downloads: 1 Date added: 2017/06/26 Category Sports Essay Type Essay any type Did you like this example? Introduction Sport is an accepted part of life. The opportunity to take part in sporting activities is a basic human right whether you are competing for trophies or playing purely for enjoyment. However many people suffer from restrictions that prevent them from taking part in sport. Don’t waste time! Our writers will create an original "Sports Women" essay for you Create order It is not always the fact that people are not interested or do not want to. A number of people view sport as an activity that was somewhat forced upon them at school or something they see on television that is way beyond their capabilities. But sport is an extremely diverse quarter, involving many activities and catering for people of different shapes and sizes, levels of skill and personalities. It is well known that football in the UK is most commonly played in organised leagues on Sunday mornings. There are voluntary sports clubs enabling millions of members the chance to get involved and many more participate regularly in leisure outside a structured league or set up, whether it be a walk in the park or a kick about in the garden. The vast majority of the population in Britain however do not participate and worryingly, the activity levels in the youth, who were previously the most active division of our population, are falling drastically, in connection with the ri sing fear of an obese population. A BBC Panorama programme shown in November 2006 proved that in America, a country with more resources than most, participation levels are very low and falling. Perhaps this is why Americans are credited as being the fattest nation on earth?! There are many limitations on participation. In the past sport has been closely linked to education and many peoples only sporting experience was through compulsory and often harsh physical education lessons. For the non-sporty, obese or self-conscious, many are unfortunately put off for life. This is closely linked with both gender and ethnicity, with the worry of most teenage girls focused on looking look, rather than partaking in exercise, and for the ethnic minority to feel just as welcome to play a part as the majority. In our culture, sport has always been seen purely as a non-serious recreation; many other more important issues require attention before you turn to sport. Often at school, acad emically superior students are encouraged to move away from sport so that they can concentrate more time on their studies. Some of us in the UK must pay to play. There are requirements to pay club subscriptions, fees and facility costs, as well as providing our own equipment and kit. For some, this cost issue is enough to deter them from sport or prevent them from allowing their children to join clubs. With relation to class and money, often sports such as fox hunting and polo are available to you providing you have the upbringing and money to back your selection up. If our parents were involved in sport we are more likely to grow up with a sporting background, and if our parents or into sports the family are heavily involved in a certain sport, we are further expected to be introduced to that sport at an earlier age and in more depth. Are there decent facilities provided? Equipment? Are the facilities that allow you to participate available to you? The UK Government believes there is a shortage of facilities and those that do exist are often situated in particular areas. Living in central city areas presents injustice against you for the reason that there is little space and sometimes money provision available in that area. Equipment is also normally required, quite often expensive and those on small incomes may be discriminated against unless equipment is available free or can be hired cheaply. Is the opportunity to play there? Allowed? In the UK most committed sport takes place in voluntarily run clubs or organisations. Clubs have membership systems and are controlled by either in some cases such as golf clubs, election to the club membership or the ability to pay the fees. This then limits membership to certain members of the community. An additional consideration for the person is whether they actually have the time free to play. This problem often faces women. The pressure and demands of family and work often mean that women have little relaxation time which accounts in some way for the below average levels of female participation in sport. Are you respected enough in sport? In many cultures, society has the opinion that women should not play a part in sport, and should they do so, their input should be limited to feminine sports such as gymnastics and not male oriented sports such as football, rugby or cricket. These judgements are based on the conventional roles both women and men hold in todays society and are very hard to change. Minority groups within communities are often labelled as having certain qualities or traits which lead to them being steered into particular positions, sports or activities and away from others. An example of this is the current lack of Asian or Muslim footballers in the UK. Programmes are now being set up to make an effort and address the imbalance but the main problem is that in our common opinion; Asians are not prospective and good enough footballers. These stereotypes often lead to the people they discriminate believing the opinions are valid and thus conforming to societys view, choosing the sports that fit t hem. Gender Each year, 33% of all men participate in some form of sporting activity, whereas only 10% of women do. As women make up over 50% of the British population this points to some form of discrimination. (Sports Development UK 1999/2000) There have been many myths about women and sport and although these have now been largely banished, numerous people still hold some belief in them. McPherson, Curtis and Loy, 1984, p222, say During World War II, women played major roles in the military and civilian labour force, thus shattering myths of the fragile female. Other struggles concern time women, due to the constant everyday demands of work and family, tend to have much less spare time than men, curbing their opportunities to enjoy partaking in sport. As mentioned before, girls at a teenage age are often much more concerned with the way they look without makeup on in PE lessons, or in their unflattering sports kit. Nearly a quarter of women say that PE at school put them off spor t for life, (Womens Sport and Fitness Foundation 2007). They are self-conscious with the way they look, particularly when growing as everyone develops at a different rate. Less developed girls are more likely to skip sport and exercise should they know they are going to feel embarrassed around more developed girls their own age. However Brown 1985, p225 states that the processes of withdrawal for adolescent swimmers include a decreasing importance in ones self-identity suggesting that adolescent girls are put off sport in other ways. However times are changing. According to Coakley (2001) p203, there are numerous reasons why we are experiencing increased participation amongst women and girls in sport. To name a few, it states that more females are interested and joining in with exercise because: Equal rights legislations have been passed meaning there is no longer such a drastic gender divide. The debate for equal winning cash prizes at Wimbledon for both men and women is an example of the rise of womens power in sport. Expanding health and fitness culture we live in a world where fitness an body image are determining what we eat and wear and the need to keep up to date mean people are now taking more of an interest in diet and exercise than they did years ago. There is increasing sports coverage of feminine sports and women role models within sport. Even the most casual observer has noticed that women receive less sports coverage from the press, radio, or television for their sport involvement. (Hilliard 1984) If you were to take a random look at the BBC SPORT website you would see a range of sports advertised now concerning both women and male athletes. This would have been unheard of a number of years ago. The site would have been dominated by male participation as that had the most visual and audible coverage elsewhere. The womens football world cup was broadcast live on national television and Ellen MacArthur is now a household famous name because of her achievements in her sport. Ellen MacArthur, Womens Sport and Fitness Foundation Founded in 1984, it is the only organisation in the UK that is solely committed to improving and promoting opportunities for women and girls in sport at every level. Research done by the Womens Sports Foundation, finds that: Nearly a quarter of women say that PE at school put them off sport. And 9 out of 10 women believe there is too much pressure to be thin and that a quarter of women agree that they hate the way they look when they exercise and play sport. (Womens Sports Foundation, 2008) Class The upper classes have by tradition had the most relaxation time which they filled with fashionable sports such as hunting. The middle class modernized sports and made their own rules. The lower working class were allowed to participate in sport, but only after they had finished their work so filling the role as the spectator. Gruneau (1975) p 183, suggests that modern sport actually contributes to the reinforcement of class distinctions. By emphasising the classes associated with different sports and the public being put off playing sports because of the class they are associated with, we give in to this type of discrimination. For some, this cost issue is enough to prevent them from sport or avoid them from allowing their children to join clubs. With relation to class and money, often sports such as fox hunting and polo are available to you providing you have the upbringing and money to back your selection up. If our parents were involved in sport we are more likely to grow up with a sporting background, and if our parents or into sports the family are heavily involved in a certain sport, we are further expected to be introduced to that sport at an earlier age and in more depth. Class is a major problem in introducing children to new sports. As the most common way of being introduced to a sport is at school, kids at state schools will never be able to play polo, go rowing or other sports such as shooting and even rugby. Whereas should you be of the right class to send your children to public schools then they are able to partake in such sports. Rugby has been a major and popular sport in the UK where the different forms of the game have been associated with class. Rugby has two forms, union and league with union being mostly played by upper class gentlemen and league played by the working and middle class. Race/ Ethnicity The UK is a multicultural nation, which a enormous mixture of races. A major discriminator in the world of sport is the colour of someones skin and is a topic where stereotypes dominate peoples opinions. During some periods of history, members of specific ethnic groups have tended to dominate particular sports. At other times, members of certain ethnic groups have experienced discrimination within sport settings (The Social Significance of Sport p. 208) Sporting Equals The Commission for Racial Equality has introduced with Sport England a national initiative entitled Sporting Equals. This aims to promote racial equality in sport throughout England. (Sport England 2007) Kick Racism out of Football Show Racism the Red Card Campaigns to encourage Black footballers in football, and kick racism out of sport. It is supported worldwide in various sports such as rugby, basketball and football, especially in the Barclays Premiership. Alongside these two campaigns there is th e Racial Equality Charter for Sport. This is a public pledge signed by leaders of sport, committing them to use their influence to create a world of sport in which all people can take part without facing a racial discrimination of any kind. Racism is a problem we face in all walks of life, not just sport. It is a particular problem in the workplace or in schools. With relation to PE, it is often not just children that are guilty of racist abuse. Many teachers have been accused of favouring white students instead of ethnic students when it comes to choosing teams in lessons or for selection for school teams. This has led to ethnic children thinking they are not good enough and show little future interest in sport. Chu and Griffey, 1982, suggest that little if any permanent change in attitudes or prejudices occurs from participating on an interracial team. The people who discriminate against black people or those of an ethnic minority are those who have dealt with the minor ity and choose to accept the societal view that the ethnics, with lack if numbers comes lack of talent or ability. Age The age group with the greatest participation in sport used to be the 16-24 year olds, with over 60%. Above this age the rate drops dramatically only 16% of people over 60 or more take part in any exercise. In todays society, sport is definitely aimed at the young. Events such as the Masters Football Tournaments and the Golden Olympics are attempting to make sport a lifetime activity. Ability Your ability in a particular sport can also be a discriminator. Most clubs teams allow only the most talented players, often selected through trials, to play. Those who are not particularly talented are left with few alternatives. In some sports such as football, it may be possible for less able players to join a lower league such as Sunday morning pub football and rugby clubs often rub social teams. In schools this is particularly a problem for teachers or coaches. Who do you pick for the school team the best talented players, or do you give all those who attend practices or show an interest a chance? People with disabilities have, until recently, had little opportunity to take part in sport. Nearly all the facilities were built before the nineties were built sorely for the able bodied. Prospects for disabled sportsmen and women are now growing and all new sports facilities offer access for people of all abilities. The sports have played a huge and important role in th is and events like wheelchair basketball and the Paralympics have helped disabled athletes partake in sport. Organisations such as the British Paralympic Association and the British Sports Association for the Disabled encourage sport for the disabled but they remain a minority and only in a few sports such as bowls can disabled people participate on a level basis as able bodied competitors. I dont think women will ever totally mimic male athletes, not because they are morally superior but because of sexism. We wont allow women the same degree of freedom Mary Jo Kane, Director of the Tucker Centre for Research on Girls and Women in Sport (2000) Sport for all Campaign Set up in 1972, the campaign highlights the importance of sport and the fact that it is something to which all members of the community are allowed equal access to. It primarily hoped to increase the opportunities for sport by developing extra and better facilities and educating the public on what was on offer to them. More recently however it has targeted groups of the community that remain under-represented in sport. They have been assisted in the set-up of other campaigns such as 50+ aimed at older people and Whats your Sport? aimed at women

Wednesday, May 6, 2020

Movie Analysis Beat The Dealer - 1753 Words

Blog 19 – The ultimate dos and don’ts breakdown for online blackjack Back in the 1960s an author named Edward O. Thorp released a book that would truly shake the foundations of the casino world. Aptly titled â€Å"Beat the Dealer†, the book would detail a basic strategy to playing online blackjack that would theoretically cripple the house edge. The book was so popular that generation after generation have adopted it as a â€Å"Blackjack Bible†. Taking the teachings of Edward O. Thorp to heart, within the online generation blackjack is finding a fresh lease of life. More players are playing the game than ever before, making education in the game all the more important. Listen closely, because if you want to become an online blackjack master, the following do’s and don’ts are well worth adhering to. Dos It doesn’t take a genius to figure out that online blackjack is a truly enthralling game to play. However, getting the most out of the game is by no means child’s play by any stretch of the imagination. Winning isn’t ever guaranteed, but sticking to the basics can certainly take you a long way. If you want to be profitable you should be sure not to neglect the fundamentals of play. Step one for any player and the ultimate â€Å"Do† is to commit to memory what is required to win the game. Understand the odds of each hand and what is most likely to bring home the win. Quitting while you’re ahead is another key element to remember. This is because a hot streak can quickly turn cold, so it isShow MoreRelatedEssay on strategy marketing1247 Words   |  5 Pagesred ocean competition, accept the key constraining factors of war---limited terrain and the need to beat an enemy to succeed. At the same time, red ocean strategy would lead to hyper-competitive w ork environment, thus, reduce the cohesion of company staff. 3. 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Archimedes Principle Free Essays

Applications of Archimedes’ Principle 1. Submarine: A submarine has a large ballast tank, which is used to control its position and depth from the surface of the sea. A submarine submerges by letting water into the ballast tank so that its weight becomes greater than the buoyant force (and vice versa). We will write a custom essay sample on Archimedes Principle or any similar topic only for you Order Now It floats by reducing water in the ballast tank. -thus its weight is less than the buoyant force. 2. Hot-air balloon The atmosphere is filled with air that exerts buoyant force on any object. A hot air balloon rises and floats due to the buoyant force (when the surrounding air is greater than its weight). It descends when the balloon weight is more than the buoyant force. It becomes stationary when the weight = buoyant force. The weight of the Hot-air balloon can be controlled by varying the quantity of hot air in the balloon. 3. Hydrometer A hydrometer is an instrument to measure the relative density of liquids. It consists of a tube with a bulb at one end. Lead shots are placed in the bulb to weigh it down and enable the hydrometer to float vertically in the liquid. In a liquid of lesser density, a greater volume of liquid must be displaced for the buoyant force to equal to the weight of the hydrometer so it sinks lower. Hydrometer floats higher in a liquid of higher density. Density is measured in the unit of g cm-3. 4. SHIP A ship floats on the surface of the sea because the volume of water displaced by the ship is enough to have a weight equal to the weight of the ship. A ship is constucted in a way so that the shape is hollow, to make the overall density of the ship lesser than the sea water. Therefore, the buoyant force acting on the ship is large enough to support its weight. The density of sea water varies with location. The PLIMSOLL LINE marked on the body of the ship acts as a guideline to ensure that the ship is loaded within the safety limit. A ship submerge lower in fresh water as fresh water density is lesser than sea water. Ships will float higher in cold water as cold water has a relatively higher density than warm water. How to cite Archimedes Principle, Papers

Effectiveness of a Cognitive Behavioral Self Management

Question: How Effective the self management manual was in terms of admission/readmission of patients? Answer: Background There are more than 26 million people and families that are living with heart failure across the globe (Bui, Horwich, Fonarow, et al., 2011). The total healthcare expenditure in Latin America, North America, and Western Europe is estimated at 13% with hospitalizations constituting the main driver of the total costs (Ponikowsk, Anker, al Habib,, et al., 2014). For patients to effectively manage heart failure, they need to engage in several self care behaviours such as adhering to medications, symptoms monitoring, seeking medical assistance when needed, managing depression, exercising, and healthy eating and drinking (McMurray, Adamopoulos, Ankeret al., 2012; NIHCE, 2010; Tu, Zeng, Zhong et al., 2014). In addition, patients may need to adapt and abstain from certain behaviours such as restrict their fluid, cholesterol, and sodium intake and cease from smoking. Nurses assist heart failure patients through educating them and their families about lifestyle changes(Muus, Knudson, and Klug, et al., 2010) In this paper, the study by Cockayne, Pattenden, Worthy, Richardson, and Lewin (2014):Nurse facilitated Self-management support for people with heart failure and their family carers (SEMAPHFOR): a randomized controlled trial will be critically analyzed Significance of the Study The study is significant as it illuminates the effectiveness of a cognitive behavioral self management manual that the researchers had interest in and was a newly developed one. The effectiveness was determined by the number of admissions/readmissions(Fonarow , Abraham, and Albert et al., 2008). Research Design Aim The aim was to determine how effective the self management manual was in terms of admission/readmission of patients who were guided by specialist nurses and those who opted to use the manual by themselves (Ditewig, Blok, Havers, et al., 2010) Design A randomized control trial was used. In an RCT, participants are assigned to specific groups referred to as treatment conditions or study arms in a random manner (they have a probability that is equal at being assigned at any one particular group)(Kabisch, Ruckes, and Seibert et al., 2011). Appropriateness RCT was appropriate as it tested between two groups that were using the same self management manual but under different conditions. The first group was assessed by specialist nurses while the second group was self managed. Sampling Participants: The participants included 260 patients who had been diagnosed with symptomatic heart failure defined LVSD by ECHO, coronary angiography, or clinical diagnosis. Inclusion/exclusion Male and female participants aged 18 years with definite symptomatic heart failure diagnosis LVSD were included. The LVSD condition was determined through a coronary angiography or clinical diagnosis. Particiants with a written cognitive deficits case records were excluded and so too were those unable to read English, make their personal care decisions, lived in nursing homes, or had existing concomitant life threatening condition. Why the inclusion/exclusion criteria was important The study involved two groups one of which was required to follow the manual without any nursing assistance. For the participant to adhere to this condition, they needed to be capable of achieving the goal of the study and hence had to know how to read English, be able to make their own personal decisions, and have a level of independence. Sampling Technique: The eligible persons were randomized via a computer using a remote, secure, telephone randomization service. This was done by an independent person who did not have prior knowledge of the participants. The randomization was initially done at 1:1 then later switched to 2:1 in favor of the control group. This was stratified by NYHA and center class in the first randomization but was excluded in the second randomization. Appropriateness This was appropriate as it increased the number of participants and also offered a clearer distinction between the self managed group and the intervention group with regard to possible results of the study Intervention and control groups The patients in the intervention group received a Heart Failure Plan which was a self management program that was nurse facilitated. They also received a DVD, exercises that they did in and around a chair, relaxation tape, regular signs and symptoms monitoring, clinical assessments, blood tests, as well as referrals. The participants received six sessions that were nurse assisted. The control group was also given the manual, the usual monitoring of symptoms and signs, clinical assessments, blood tests, and referrals such as rehabilitation where it could be availed. The group was expected to follow the manual as much as possible without the intervention of nurses. Participant Allocation As this was a Random Controlled Test, the randomization was initially done at 1:1 then later switched to 2:1 in favor of the control group. This was stratified by NYHA and center class in the first randomization but was excluded in the second randomization. The participants had an equal chance of being allocated to either group based on the inclusion criteria Appropriateness This was not appropriate as the participants should have been given equal chances such that the study should have been in two phases. In the first phase, the current allocation would have sufficed. In the second phase, the participants would have switched with those in the control group becoming the intervention group and vice versa. The results from the two phases would have offered a more in-depth analysis and conclusion. Data Collection Independent/dependent variables The primary outcome included hospital admission within a 12 month period after the randomization. The information was collected on months 3, 6, and 12 after patient and nurse randomization. The secondary outcomes included: quality of life in relation to health measured by the Anxiety and Depression Scale (HAD), EQ5D; Minnesota Living with Heart Failure (MLHF), the Hospital, and European heart-failure self-care behavior scale. Data Collection Data was collected over a 12month period at months 3, 6 and 12 with regard to hospital admission after patient and nurse randomization. Checks on achievement of targets were done on the second meeting, and 1, 3 and 6 weeks later. Appropriateness This method of data collection was appropriate as it allowed for regular monitoring and for the creation of interventions that would ensure the patients stayed on track. By collecting the data at the said intervals, the patients' progress was recorded and any issues that arose were addressed promptly. Reliability and Validity Reliability is the variability proportion in a measured score due to a true score variability (Leung, 2015). Validity of a research is categorized as external or internal. External validity involves application of the study to people and situations and considers that the conditions in which the research is done represents time and situations where the results are applicable (Sullivan, 2011). Internal validity addresses study outcome reasons and helps in reducing other unanticipated reasons that would affect the outcome. Internal validity is assessed based on construct, criterion, and content. How reliability and validity have been used Identification of potential participants was done by heart failure nurses, special interest GPs, research consultants and coordinators form heart failure open access diagnostic clinics, medical, and acute wards, following hospital discharge or form General Practitioners registers in 7 centers located in Darlington and Birmingham between 2006-2008. Eligible participants who signed consent forms were randomized by an external person who had no previous knowledge of them. Data Analysis How Data was analyzed Analyses was done using SAS version 9.1. The analysis utilized the 2- sided significance tests at the significance level of 5%. Intention to treat was the basis of analysis for each group. The primary analysis of patient admission/readmission within 12 months and which the nurse recorded was compared between the groups by using a chi-square test. Patient age, NYHA, and center, were adjusted using a logistic regression model. Follow up patients who were lost prior to 12 months were considered as being admitted and also if it had been recorded in an assessment done earlier. Failure to record an admission by the patient or nurse was assumed as being a non-admission. Appropriateness This was appropriate as the occurrence of admissions/readmissions is what was being studied with regard to the two participant groups. Differences in outcomes The study showed no evidence of admission/readmission of participants in the two groups. The results remained the same for adjusted analysis. Secondary outcomes showed no evidence in treatment groups' differences. Significance of the Results The results were not significant. Hospital readmission among the patients that were allocated a nurse was less than those of the self management group. However the difference was too small to be of any significance. Generalization of Results The results can be generalized as the study population was randomly selected and represented a significantly large population area namely: Darlington and Birmingham. Evidence utilization The findings of this study cannot be used in clinical practice. Utilization of the care management program was successful with or without the supervision of a nurse. Hospitals should not invest in assign nurse specialists to monitor care programs that patients can follow with minimal assistance. Re-admission was not reduced to significant numbers to warrant the implementation of the (Kennedy et al., 2013). References Bui AL, Horwich TB, Fonarow GC. (2011). Epidemiology and risk profile of heart failure. Nat Rev Cardiol. 8(1):3041 Cockayne, Pattenden, Worthy, Richardson, and Lewin (2014). Nurse facilitated Self-management support for people with heart failure and their family carers (SEMAPHFOR): a randomized controlled trial. International Journal of Nursing Studies (51)12071213 Ditewig, J.B., Blok, H., Havers, J., et al., 2010. Effectiveness of self-management interventions on mortality, hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure: a systematic review. Patient Educ. Couns. 78 (3) 297 315. Fonarow GC, Abraham WT, Albert NM, et al. Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF.Arch Intern Med.2008;168:847854 Kabisch, M., Ruckes, C., Seibert-Grafe, M., Blettner, M. (2011). Randomized Controlled Trials: Part 17 of a Series on Evaluation of Scientific Publications.Deutsches rzteblatt International,108(39), 663668. Kennedy, A., Bower, P., Reeves, D., et al., 2013. Implementation of self management support for long term conditions in routine primary care settings: cluster randomised controlled trial implementation of self management support for long term conditions in routine primary care settings: cluster randomised controlled trial. BMJ 346, f2882. Leung, L. (2015). Validity, reliability, and generalizability in qualitative research.Journal of Family Medicine and Primary Care,4(3), 324327. McMurray JJ, Adamopoulos S, Anker SD, et al.(2012). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 33(14):1787847. Muus KJ, Knudson A, Klug MG, et al. Effect of post-discharge follow-up care on re-admissions among US veterans with congestive heart failure: a rural-urban comparison.Rural Remote Health.2010;10:1447. NIHCE (2010). National Institute for Health and Clinical Excellence. Chronic Heart Failure. Management of chronic heart failure in adults in primary and secondary care. NICE Clinical Guideline CG108 Ponikowski P, Anker SD, al Habib KF, et al. (2014). Heart failure: preventing disease and death worldwide. ESC Heart Failure. 1:425. Sullivan, G. M. (2011). A Primer on the Validity of Assessment Instruments.Journal of Graduate Medical Education,3(2), 119120. Tu RH, Zeng ZY, Zhong GQ, et al.(2014). Effects of exercise training on depression in patients with heart failure: a systematic review and meta-analysis of randomized controlled trials. Eur J Heart Fail.16(7):74957.

Friday, May 1, 2020

Descriptive Essay Introduction Example For Students

Descriptive Essay Introduction Descriptive Essay of My WatchMy article of clothing is with me at all times. It consists of a 3cmcircular base and two separate straps, each 6cm long connected by a metalclasp. These two straps and a clasp are then connected to the top andbottom of the base. The straps are outlined in hard rigid silver, lookingas my uncles smoothly brushed gray hair. Through the center of the 2cmwide straps is a 1cm in width gold strip. The gold looks as bright as agold chalice from my local church. The clasp is a hard silvery gray suchas that which borders the straps. The letters SEIKO are clearly placedon the clasp in raised lettering. The clasp looks 3cm long when in theclosed position, but when opened it extends to 11cm as two more 4cm metalpieces open outward. The face of the object is encircled with a gold color, gold as the trimon my fathers Cadillac. Inside the gold trim, the background is a blackcolor. The black is like the black rubber on my cars Cooper tires. Towards the top of this face, there is a number 12, the bottom has a number6, and the leftmost number has a number 9. Each of these numbers areraised in lettering in a gold color. On the rightmost side, there is a1/2cm x 1/5cm sized box. This box is then further separated in two parts. 2/3s of the box is devoted towards showing the current days first 3letters, now showing a THU for Thursday. The remaining space of the box isset aside for the date of the month. In this box the number 14 is shown. Both, the day and the date, are in white colors. This white is like awhite hospital gown, starched and cleaned. The face of the object has 56small lines all facing from the outside of the circle towards the middle. These gold lines are equally separated all aro the face of the object. There are 4 places where there is no line, instead a white dot exists. There are 8 more gold lines, very similar except 3 times longer (1/2cm)equally spaced around the face as well, with the exception of the numbersand the small box which are counted as well into the spacing. From thecenter of the watch are 3 thin strands of golden color rods, just like astrand of goldenrod colored growing wheat.