Development and Expansion Strategy of SMART Cars Essay

Development and Expansion Strategy of SMART Cars - Essay Example Acquire new customer by optimizing search engine submissions, introducing online competitions and a free web mail system for SMART car owners and fans. Introducing a secure online transaction service that can be used to buy products and services or apply for finance, with a quick turnaround time of 24 hours. Implementation of actions to enhance and streamline the SMART sites so that they are easier to navigate and offering the customers a richer more rewarding personal experience. Addition of an exclusive owner section with car service record, logbook and special promotions. 2 Terms of Reference This report was commissioned by SMART on December 12th 2005 3 Methodology This report references the following: The Institute of Direct Marketing, SMART Car Handout, 2006. MediaCo, Email Marketing - Opt In Email Marketing. J. S. Fleming and Gail Said Johnson. Designing an Effective Web Page. 2003. 4 Situational Analysis 4.3 Company Analyzes SMART an automobile manufacturing, supply and sales enterprise was established in 1994 and is a wholly owned subsidiary of Daimler Chrysler, with approximately 1200 employees. SMART have dealership networks in 35 countries, with their administrative network in Bblingen Germany and production facility in Hambach France. Its product range exists out of three models, the ForTwo, ForFour and Roadster in hard top and cabrio styles. SMART's key issue has been always been the environment, with guidelines ensuring SMART cars are engineered to protect the environment by being energy efficient and preserving natural resources. SMART's policy starts with development, runs through production, and ends in the recycling of many SMART components. SMART Car UK has a multi-channel approach in selling their relevant products and...Its product range exists out of three models, the ForTwo, ForFour and Roadster in hard top and cabrio styles. SMART's key issue has been always been the environment, with guidelines ensuring SMART cars are engineered to protect the environment by being energy efficient and preserving natural resources. SMART's policy starts with development, runs through production, and ends in the recycling of many SMART components. SMART Car UK has a multi-channel approach in selling their relevant products and services. A customer gets acquainted to products and services by visiting their respective website's www.thesmartcar.co.uk & www.smarttogo.co.uk, and purchasing these products at one of 53 SMART dealerships. In the fiscal year of 2004/5, SMART UK's turnover was 6.8 million and the growth forecast indicate a possible increase rate of 15% for the 2005/6 period, with a total turnover forecast of 7.25 million. SMART's online marketing and promotion contributed towards the sale of 850 units of the total 11000 sales in the UK in 2005. Smart car UK is already a established business with a strong consumer base from which to launch a aggressive marketing strategy to increase its share of the automobile market. Some of its strong points are: SMART car as a new entry to the automobile market offering the consumer the retro unique look.

Collision of the right to privacy and the right to freedom of Essay

Collision of the right to privacy and the right to freedom of expression - Essay Example The verdict of the cases, whether they were in compliance with the Human Rights Act, has been made. A discussion of the European Convention and the acts adopted by the Convention has also been made. An evaluation of the prior laws that helped to mould the Human Rights in Europe is also analyzed in the paper. Human Rights are the set of guidelines laid down by legal bodies and organizations that safeguards the rights and freedoms of human beings. The elementary rights and freedoms, which every human being irrespective of cast creed social stature; are entitled to can be collectively termed as Human Rights. Human Rights include civil rights, freedom of expression, political rights, and also equality before a court of law for uniform generation of justice. Civil, economic, cultural, social and political are the various classification of Human Rights. However, Human Rights, although are made for social benefits are not social rights. Social rights are more like objectives which need to be attained, while Human Rights are objectives or norms which are to be followed. Human Rights are laws which need to be obeyed to maintain the social, cultural and legal balance. The different classification of Human Rights is a contribution to it, as it covers all necessary aspects, which needs to be covered for the well being of the civilians. . The history of human rights can be traced back to thousands of years covering cultural, political, legal and religious aspects. Emperor Ashoka of India issued the 'Edicts of Ashoka' back in 250-270 BC, which is a collection of thirty three inscriptions on pillars, made by the emperor. The edicts, being the first form of Buddhist preaching, were moral in nature and were based on doing basic good deeds. The Magna Carta, formerly known as the English Legal Charter was written in Latin and was issued in 1215. It is one of the important historical examples that developed the English law, to protect the rights of the people against monarchial rule. It influenced the development of constitutional laws and common laws. The British Bill of Rights, 1689 was an act that protected the interest of the people against government actions in the United Kingdom. The Geneva Conventions, and the Lieber Code, 1864 can be described as the initiations that laid the basic foundations of International Humani tarian laws. International Humanitarian laws The Geneva Convention adopted by the International Committee of Red Cross was one of the first attempts to safeguard the interest of individuals fighting in wars. It was revised after the World War II and adopted by the Red Cross Community in 1949. Presently the Geneva Conventions are referred to as the Humanitarian law, under the governance of International Committee of Red Cross. The Universal Declaration of Human Rights (UDHR) was adopted by the United Nations General Assembly in 1948. This is a non binding declaration that was adopted after the World War II. The UDHR may be referred to in any national and international cases, and is considered to be a central component of international humanitarian law. (United Nations, 2008) Human Rights Treaties The International Covenant on Economic, Social and Cultural Rights (ICESCR) and The International Covenant on Civil and Political Rights (ICCPR) were the two most important treaties that were

Book Review Essay Example for Free

Book Review Essay The novel is about a wolf called Faolan that survives with a friend of his, Edme. There is another wolf called the Prophet that tries to send out wolves to kill Faolan and Edme. They try to find a shelter to try to hide but end up getting spotted by a wolf. They run away and escape from the wolf. After getting away they go out and find the Prophet. They confront him ask ask him why he wants to kill them and he jumps at them and they finally kill the Prophet. The book is associated with the other five Wolves of the Beyond books Lone Wolf, Shadow Wolf, Watch Wolf, Spirit Wolf, and Star Wolf.  I would give the book a 2 because I like the Wolves of the Beyond books. They explain how the wolves survive and how they hunt their prey. The book shows how they grow up and learn to hunt and communicate with the others. I also like how the author makes it feel like something is going to happen like a fight scene. The book also continues the story of the main character, Faolan and gives the wolf a characteristic for each book the author makes. The novel is about a wolf called Faolan that survives with a friend of his, Edme. There is another wolf called the Prophet that tries to send out wolves to kill Faolan and Edme. They try to find a shelter to try to hide but end up getting spotted by a wolf. They run away and escape from the wolf. After getting away they go out and find the Prophet. They confront him ask ask him why he wants to kill them and he jumps at them and they finally kill the Prophet. The book is associated with the other five Wolves of the Beyond books Lone Wolf, Shadow Wolf, Watch Wolf, Spirit Wolf, and Star Wolf.  I would give the book a 2 because I like the Wolves of the Beyond books. They explain how the wolves survive and how they hunt their prey. The book shows how they grow up and learn to hunt and communicate with the others. I also like how the author makes it feel like something is going to happen like a fight scene. The book also continues the story of the main character, Faolan and gives the wolf a characteristic for each book the author makes.

Prevention Of Pressure Ulcer

Prevention Of Pressure Ulcer Pressure ulcers, or bed sores, or have been affecting humans for ages, and addressing the overall prevention of pressure ulcers is now a prominent national healthcare issue. Despite of all the advances in medicine, surgery, nursing care, pressure ulcers still remains a major cause of mortality. Pressure sore is a common problem among old people and those who are immobilise or limited activity like post-operative and other bedridden patients. (Bergstorm, 2005) Many studies state that elderly are prone for pressure ulcer throughout the world and its becoming a crucial issue (Nakagami et al., 2007). Pressure ulcer can be defined as a type of injury that affects areas of the skin or underlying tissue of the body due to application of too much pressure on it. (Grey et al 2006) It develops as a result of tissue necrosis of the skin over the bony prominence, due to the obstruction of the blood vessels flow caused by the application continual pressure on it. (Lyder, 2003) The total expenditure for the prevention of pressure ulcer is substantially less when compared to its treatment (Lapsley H M and Vogels R, 1996). It can cause severe infirmity and high health-care expenditure. The estimated annual expense for the prevention and treatment of pressure ulcers has been expected nearly  £1.4 to  £2.1 billion in the United Kingdom and is measured as a massive economic problem (Bennet et al., 2004). After cancer and cardio vascular disease, pressure ulcers are the third most money consuming disease (Schoonhoven et al., 2002) According to European Pressure Ulcer Advisory Panel (EPUAP) the occurrence rates of pressure ulcers are ranging from 8-23%. In acute care hospitals in the western countries the reported prevalence has wide-ranging between 9-22%. Improving the standard of pressure ulcer care could in ¬Ã¢â‚¬Å¡uence the estimated annual expenditure and quality of life (Tannen A et al., 2004). According to Whittington et al (2000) the prevalence of 15% of pressure ulcers are recorded on admission, whereas for the 60% of the individuals there was no specific information about the presence or absence of the pressure ulcers. In another study, it is clear that 12.8% have already had the infirmity on their admission. According to Rycroft-Malone, (2000) pressure ulcers can develop at any area of the body, but commonly occurs over bony prominences. ( Murdoch, 2002; Jones, 2001) The areas can supposed to develop pressure sores are sacrum, heels, elbows and back of the head. The appearance of pressure sore is very fast and hence the early assessment and steps to prevent is very necessary (George and Malkenson, 2008). Pressure intensity and duration are the two main factors for the pressure ulcer formation because of pressure. Pressure intensity is the volume of external pressure applied on internal tissues whereas duration is the amount of external force is sustained by internal tissues (Cullum et al., 2000) According to NICE guidelines (2003) the risk factors influencing to develop pressure ulcer in an individual includes intrinsic risk factors and extrinsic risk factors. The intrinsic risk factors such as reduced mobility or immobility, sensory impairment, acute illness, level of consciousness, extremes of age, vascular disease, severe chronic or terminal illness, previous history of pressure damage, malnutrition and dehydration. And extrinsic risk factors are pressure, shear, and friction. Shear is defined as the applied force that can cause an opposite, parallel sliding motion in the planes of an object. The amount of pressure exerted has got a direct affect on Shear. (Pieper B, 2007, Nix DP, 2007). Friction is defined as a superficial, mechanical force directed against the epidermis, resulting in increased susceptibility to ulceration (Pieper B., 2007). Pressure ulcers are classified according to different stages as defined by the National Pressure Ulcer Advisory Panel (NPUAP). Originally there were only four stages, but in February 2007 these stages were revised and two more categories such as deep tissue injury and unstageable were added to it. Stage I -Redness of a localized area, usually over a bony prominence. Darkly pigmented skin may not have visible blanching; as its colour may differ from the surrounding area. Stage II loss of partial thickness dermis showing as a shallow open ulcer with a red or pink wound bed, without any slough. It may also present as or open or ruptured serum filled blisters. Stage III The layer of subcutaneous fat may be seen but bone, muscle or tendons are not exposed. Slough may be present but does not cover the depth of tissue loss. Stage IV exposure of bone, tendon or muscle. Slough or may be present on some parts of the wound bed. Unstageable Loss of the thickness of the skin in which in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) in the wound bed. Deep tissue Injury Purple or maroon localized area of discolored skin or blood-filled blister due to damage of underlying soft tissue due to pressure. The area may be preceded by tissue that is firm, painful, and mushy compared to adjacent tissue. (NPUAP 2007) To prevent the formation of pressure sores nurses are adopting a variety of measures such as risk assessment and risk assessment tools, changing the position of the bedridden patients regularly, inspecting the pressure area regularly and while doing personal care, applying ointments or creams over the pressure areas, providing comfortable mattresses such as air bed, water mattress for the bedridden and immobilise patients, placing pillows under the places prone to form pressure ulcer for the vulnerable peoples, maximise nutritional status, etc. However the efficiency of all these methods is in discussion and argument. This essay report will collate all the various available literatures regarding the prevention of pressure ulcer and suggest the better and good practice to prevent the formation of pressure sore among the high risk people. The standard of nursing care is very important for the prevention and management of pressure ulcers. The caring of patients, who are at risk with pressure ulcer, is the main challenge for nurses (Sinclair et al., 2004). According to Lewis M et al 2003 the first step nurses should make out is the risk assessment of patients and it is better to identify the patient at risk in the early stages, so we can prevent the pressure sores. It consists of level of mobility, nutritional status, level of consciousness and neurological status, incontinence, sensory impairment, complete patient history, and physical and psychosocial examination assessing mental status and cognitive ability. To support caregivers there are assessment scales to identify the patients at risk. According to Walker D K et al 2010 skin care and moisture are essential to prevent pressure sore. Maintaining skin integrity is important for the patient`s at risk. Moreover excessive of moisture and dryness can breakdown the skin`s resistance. Wherever moisture is present,it is important to clean the portion thoroughly. Patients identified at risk should be bathed once a day. PH balanced cleanser is used to protect the skin from moisture and dryness,it is a natural protection mechanism of a skin. When cleansing the skin daily or in the presence of moisture, it is necessary not to use extreme force or friction. Eventhough moisture cannot be controlled, use skin barriers to protect skin from moisture. Dry skin also needs to be prevented by using a pH-balanced moisturizer. The studies conducted by saleh et al,(2008) and Lindergren et al., (2002) evidenced that use of risk assessment scale is successful in predicting the formation of pressure sore(Decubitus Ulcer).The studies substantiated the role of risk assessment scales and their usefulness in the prevention and management of pressure sores. According to Lindergren et al., 2002 states the reliability of risk evaluation scale in the prediction of pressure sore formation. However, the revision conducted by saleh et al. (2008), argues about the reduction in the occurrence of clinical acquired pressure scores through the regular application of risk assessment scales. Their learning also states that judgement of clinical assessment is also same valuable as associate with the detection of pressure sore through risk assessment scale. In addition, Defloor and Grypdonck, (2004) also stated that assessment tools have a vital role for the prevention of pressure sore. There are many limitations for the risk assessment tools which may lead to provide wrong positive results. The reliability, specificity and feeling of the scale are influenced by the preventive method applications. Nurses are using a variety of risk assessment tools based on practical experience they acquired. The risk assessment tools are assessed by means of numerical scores. The variables like level of continence,medications and nutritional status will give an average score for the risk patients(Whitening, N. L., 2009). Braden scale is the universally used risk assessment scale which includes the variables like sensory perception, activity, mobility, moisture and the nutritional status. The risk assessment scale works in such a way that as soon as the patient admitted in the hospital two step evaluation is carried out within the first six hours. The t wo steps include the skin assessment and the risk assessment to identify the possibility of formation of pressure sore (O Neil, 2004). Frequent evaluation and assessment should be done in every consequent evaluation at every 12 hours on patients who are at high risk .In the same way patients who are at low risk also needs to be evaluate frequently to observe or to identify any new risk factors and providing suitable preventive measures (O Neil, 2004). The most commonly used tool assessing the pressure sore in U.K is the Waterlow pressure ulcer risk assessment tool. And it is user friendly and recommended by the nurses in U.K. Pancorbo-hidalgo et al. (2006), suggests that the Waterlow pressure ulcer risk assessment tool has well pressure sore guessing ability and sensitivity which may result to get wrong positive results. With the waterlow pressure ulcer risk assessment tool among the seven assessment studies conducted by pancorbo-hidalgo, P.L. et al. (2006) they got only few findings with corrects values. Bergstorm et al. (2001) agrees that risk assessment is done by scales like Braden scale or the Norton scale in the hospitals which is more reliable. However there is no universally accepted risk assessment tool to be adopted to prevent pressure sore. Besides this, the utilization of the risk assessment tools has their own limits in clinical systems. Alternatively, Saleh et al. (2008) argues that medical judgement is successful as risk assessment tools to determine the suitable to be delivered. Nevertheless, Pancorbo-Hidalgo et al, (2006) Braden and Norton scales were noticed to be well again at risk calculation than the scientific judgements. On the other hand, according to NICE guidelines (2003) risk assessment tools can only be used as an aide-mà ©moire and should not replace clinical judgment. Normal supply of oxygen and nutrients are essential for the tissues, to maintain health. (Gottrup 2004). When patients sitting or lying, the pressure form particular part of the body results in the decrease of oxygen causes pressure sore (Defloor 2005). The study conducted by Kaitani et al., 2010, Vanderwee et al., 2007 and Pearson et al., 2010 reveals the importance of changing the position for the bed ridden or immobilize patient in preventing pressure sore occurrence. Their studies evidenced the effectiveness of repositioning in regular intervals among the vulnerable patients. Repositioning is considered as an effective control method against pressure sores (decubitus ulcer). According to Vanderwee et al., (2007) the effectiveness of force of pressure greater in sideway position. He also suggested that supine position is the comfortable position to reduce the effect of pressure on the bony prominence. The experiment conducted by Vanderwee et al. (2007 reveals that more regular rep ositioning does not actually decrease the occurrence of pressure sore. But he recognizes that turning of patients is an effectual preventive method. The incidence of pressure ulcer is more in patients who are lying down in side way position. The risk has been reduced when the patients are lying down in supine position. On the other hand the study conducted by Peterson et al. (2010) argues that the effectiveness of repositioning is less or not reliable even though it is done by any experienced nurse. And he found that after maintaining an appropriate pressure below 33 mm of Hg reduce the incidence of pressure ulcer. He states that by doing this there is still chance of occurring pressure sore in the risk areas. While turning the patient they are not unloading the all areas prone to pressure effect with the skin. Even though the standard methods for preventing pressure sores are maintained the skin breakdown happening as the risk areas are not relieved from pressure. The study conducted by Kaitani et al. (2010) evidenced that patients suffering from pressure sore have done only a fewer change of positioning and turning. In their studies they states that they didnt noticed any patients with pressure sore who has been changed their position frequently in a regular intervals. From the findings of Hobbs (2004) also reveals that there is no decline of incidence in pressure sore in the hospital due to the routine repositioning on older people. Similarly Peterson et al 2010 found that still the incidence of pressure ulcer are increasing in the clinical settings where standard turning of patients has already been done. In EPUAP guidelines (2009), suggests that repositioning is an effective method which will decrease the extent and occurrence of pressure over susceptible points like sacrum, heels, elbows and back of the head bony prominences. However, there was no research study conducted by any researchers to calculate the time gap needed to turn the patient that means there is no evidence of turning intervals from any previous studies or researches. It is very important to inspect the support surface while doing repositioning. Patient must be repositioned in regularity after inspecting the tissue viability, mobilising level, medical condition and evaluation of skin integrity. It is also subjected by the supportive surface So repositioning can reduce the incidence of pressure sore to an extent. In hospitals and health care homes it is suggested that repositioning to be done in every 4 hours and by the use of air mattress the incidence of the occurrence of pressure sore can be prevented. Many of the patients feels very discomfort while turning frequently, to avoid frequent turning pressure reducing support surfaces can be used to relieve pressure. Importantly pressure relieving support surface devices has vital role in the prevention of pressure. According to Cullum et al., 2001 it is divided into two, low tech devices and high tech devices. Low tech devices are comforting support surface to dispense the body weight over an area whereas high devices are alternating support surface where inflatable cells consecutively inflate and deflate. According to Lewis M, et al (2003) if the patients having a moderate to high possibility of developing pressure sore, dynamic support surfaces include a large cell alternating pressure mattress, a low air loss or air fluidized bed, or other pressure redistributing systems can be recommended. In a study conducted by Nixon et al (2006)found that in operating tables, specialized foam mattress overlays are effective to reduce the incidence of postoperative pressure sores while in other settings, specialized foam and overlays were the only surfaces that were constantly better to standard hospital mattresses in reducing incidence of pressure ulcers. To decrease the contact between bony prominences and support surfaces, pillows and foams are used. In addition to that for reducing the friction and shearing damage, lifting devices such as slide sheets, slings or sleeves can be used to move the patients. On the other hand, it is unclear about the evidence for the advantages of higher-specification constant low-pressure and alternating-pressure support surfaces for preventing pressure sores. However, there is clinical evidence of a difference in risk of developing pressure ulcers when using high-specification foam mattresses, compared to standard hospital mattresses. (NICE 2005) Decisions for pressure relieving device should determine at risk assessment. It must include level of risk, comfort, patient`s preferences, general health and timing of the surgery. . The studies conducted by Holm et al. (2007) and Ferguson et al. (2000) evidenced the significance of nutrition in pressure ulcer prevention. This study suggests that older people are mostly affected due to pressure ulcer. This is because of their less skin integrity and low nutritional status. The nutritional status of the elderly people is usually related with the level of intake of food and fluids along with various nursing intervention methods (Holm et al., 2007). Management of pressure sore and its treatment closely related with the clients nutritional status. The people with less nutritional status have a high risk of occurrence of pressure ulcer. The nutritional status of the patient has to be assessed by the nurse initially. Adequate quantity of proteins, calories, minerals, vitamins and fluids are necessary to maintain the skin integrity and wound healing promotion (Ferguson et al., 2000). The advancement and management of pressure sore highly influenced by their nutritional status. For doing an successful preventive measures it is essential to carried out with proper nutritional evaluation techniques and planning (Ferguson et al., 2000).pressure sore and nutritional status are closely related to each other and are directly proportional to each other.patients who are with less nutritional status or malnourished are likely to be more prone to develop pressure sore (Thomas, 1997).To reduce the incidence both dieticians and nurses should work jointly. To assess the nutritional status of the patient and the level of malnourishment and proper planning and interventions to be done to improve the status if inadequate (Ferguson et al., 2000).According to EPUAP (2009) recommendation every health care system should do screening and evaluation tests of the nutritional level of the vulnerable people who are at risk of pressure sore. Pressure sore in majority cases are preventable and controllable. A targeted control measure is far better than pointing on treating previously recognized pressure sores. Preventive measures to deceits (pressure) sore saves time and money. By doing an effective preventive techniques can also minimise the loss of energy and reduction in the work load over the health care delivery personnels and staffs mainly nurses. Bergstrom N., Braden B., Kemp M., Champagne M. Ruby E.(1998) Predicting Pressure ulcer risk. A multisite study of the predictive validity of the Braden scale. Nursing Research. 47(5), p.261-26 Bergstrom N, Braden B. A prospective study of pressure sore risk among institutionalized elderly. J Am Geriatric S Bennett G, Dealey C, Posnett J. The cost of pressure ulcers in the UK. Age Ageing 2004; 33:230-5 Cullum N, Nelson EA, Nixon J (2000) Pressure sores. Clinical Evidence: 979-98 Defloor, T. and Grypdonck, M. F. (2004) Validation of pressure ulcer risk assessment scales: a critique. Journal of Advanced Nursing. 48(6), p. 613-621. Defloor T, De Bacquer D, Grypdonck MH. The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers. International Journal of Nursing Studies 2005; 42(1):37-46. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel (2009) pressure Ulcer Prevention Quick Reference Guide. NPtJAP, Washington DC. Ferguson, M., Cook, A., Rimmasch, H., Bender, S. and Voss, A. (2000) Pressure ulcer management: the importance of nutrition. MEDSURG Nursing, 9(4). Gottrup F.( 2004) Oxygen in wound healing and infection. World Journal of Surgery;28(3):312-5. Gray,J.E.Enoch,S.Harding,K.G.(2006) ABC of wound healing.Pressure ulcers.British medical journal.332.p.472-476 Holm, B., Mesh, L., and Ove, H. (2007). Importance of nutrition for elderly persons with pressure ulcers or a vulnerability of pressure ulcers: a systematic review. Australian Journal of Advanced Nursing, 25(1), p. 77-84. Jones I, Tweed C, Marron M (2001) Pressure area care in infants and children: Nimbus Paediatric System. Br J Nurs 10 (12): 789-95. Kaitani, T., Tokunaga, K., Matsui, N. and Sanada, H. (2010). Risk factors related to the development of pressure ulcers in the critical care settings. Journal of Clinical Nursing, 19, 414-421. Lewis,M., Pearson,A., Ward,C. (2003) Pressure ulcer prevention and treatment: Transforming research findings into consensus based clinical guidelines. International Journal of Nursing Practice, 9, p.92-102. Lindgren, M., Unosson, M. and Krantz, A. M. (2002) A risk assessment scale for the prediction of pressure sore development: reliability and validity. Journal of Advanced Nursing. 38, p.190-199. Lyder, C., Yu C, Stevenson, D., Mangat, R., Empleo- Frazier, O., Emerling, J. and McKay J. Validating the Braden Scale for the prediction of pressure ulcer risk in blacks and Latino/Hispanic elders: a pilot study (1998). Ostomy Wound Manage. 44(3A) p.42S-49S. Murdoch V (2002) Pressure care in the paediatric care unit. Nursing standard 17(6): 71-6 National Institute for Clinical Excellence. (2003) Pressure ulcer prevention. Clinical guideline 7. Nix DP. Support surfaces. In: Bryant R, Nix D, eds. Acute Chronic Wounds: Current Management Concepts. 3rd ed. St Louis MO: Mosby; 2007:235-248. Nixon, J., Nelson, E.A., Cranny, G., Iglesias, C.P., Hawkins,K., Cullum, N.A., Philips, A., Splisbury, K.,Dorgerson,D.J., Mason, S.,2006b. Pressure relieving support surfaces: a randomised evaluation. Health Technology Assessment 10(22) Nakagami G., Sakai K., Matsui N., Sanada H., Kitagawa A., Tadaka E. and Sugama J. (2008) Validation and determination of the sensing area of the KINOTEX sensor to develop a new mattress with an interface pressure-sensing system. BioScience National Pressure Ulce Advisory Panel (NPUAP) (2007, February). Pressure ulcer definition and stages. Retrieved 4/13/2007, from http://www.npuap.org Pancorbo-Hidalgo, P. L., Garcia-Fernandez, F. P., Lopez-Medina, I. M. and Alvarez- Nieto, C. (2006) Risk assessment scales for pressure ulcer prevention: a systematic review. Journal of Advanced Nursing. 54, p. 94-110. Peterson, J. M., Schwab, W., Oostrom, V. H. J., Gravenstein, N.and Caruso, J. L. (2010). Effect of turning on skin-bed interface in healthy adults. Journal of advanced Nursing, 66(7), p. 1556-1564. Pieper B. Mechanical forces: pressure, shear, and friction. In: Bryant R, Nix D, eds. Acute Chronic Wounds: Current Management Concepts. 3rd ed. St Louis, MO: Mosby; 2007:205-234. Rycroft-Malone J and McInnes E (2000) Pressure ulcer risk assessment and prevention-technical report London, Royal College of Nursing Saleh, M., Anthony, D. and Parboteeah, S. (2009). The impact of pressure ulcer risk assessment on patient outcomes among hospitalised patients. Journal of Clinical Nursing. 18, p. 1923-1929 Schoonhoven, L., Haalboom, J, R, E., Bousema, M, T., Algra, A., Grobbee, D, E., Grypdonck, M, H., Buskens, E. (2002) Prospective cohort study of routine use of risk assessment scales for prediction of pressure ulcers. BMJ, 325, p.1-5. Sinclair, L., Berwiczonek, H. and Thurston, N. (2004) Evaluation of an evidence based education program for pressure ulcer prevention. Journal of Wound, Ostomy, and Continence Nursing. 31(1), p. 43-50. Tannen A, Dassen T, Bours G, Halfens RJG. A comparison of pressure ulcers prevalence: concerted data collection in the Netherlands and Germany. Int J Nurs Stud 2004;41:607-12 Thomas, D. R. The role of nutrition in prevention and healing of pressure ulcers. (1997). Clinical Geriatric Medicine. 13, p. 497-511. Vanderwee, K., Grypdonck, M. and Defloor, T. (2007) Non-blanchable erythema as an indicator for the need for pressure ulcer prevention: a randomized-controlled trial Journal of Clinical Nursing .16, p.325-335. Walker D K, Sell S V, Kindred C. (2010) Pressure Ulcer Prevention Utilizing Unlicensed Assistive Personnel Crit Care Nurs Vol. 33, No. 4, pp. 348-355 Whitening, N.L. (2009) Skin assessment of patients at risk of pressure ulcers. Nursing Standard. 24(10), p.40-44. Whittington, K., Patrick, M., Roberts, J, L. (2000) A national study of pressure ulcer prevalence and incidence in acute care hospitals. Journal of Wound, Ostomy and Continence, 27, p. 209-215.

Leadership Styles in Professional Nursing

Leadership Styles in Professional Nursing The health sectors success relies mainly on the leadership of the nurses in command; this may be a nurse manager who is in control of a unit or a nurse executive who controls numerous units. To be able to successfully lead the others the nurses need to have the necessary leadership skills that will be employed to solve all the challenges (Mahoney, 2001). The effective leadership skills will be very useful in the decision making process in the health sector. The senior nurse therefore has the control over all the activities involved which means that he/she must do it diligently and professionally at all times. They need to be visionary and have appropriate strategies to success; in addition they should be dynamic, motivated, and have the desire to achieve greater heights (Mahoney, 2001). This paper analyses leadership styles in professional nursing and how they can be applied to make the health sector effective and efficient. It reviews professional nursing literature that identifies the major leadership skills and gives a clinical application example. Review of the Professional Nursing Literature In leadership, the leader must aim at transformation where the nurses are motivated to transform the industry through proper morals and hard work. There are various leadership styles that can be applied by leader nurses; these include democratic or autocratic leadership. In this regard the nurses who lead can apply such styles depending on the situation and experience of the nurses. According to Cook (2001) in the article The renaissance of clinical leadership there are various factors that influence the style of leadership to be applied. They include, the external environment; the experience of the nurse involved the internal environment, and the understanding. He identifies four styles that nurses can use in their leadership and make it effective. The styles are connected to nursing care approaches and include; transactional, transformational, connective and renaissance. In transformational leadership the leaders and subordinates are able to lift each other in their work to higher heights. This is mainly achieved through motivation and morality where they are both involved in whatever happens to one another (Cook, 2001). This is more like the democratic leadership where leaders seek the opinion of the subordinate nurses in the decisions they make. The nurses are able to carry out all their duties independently, without interference and to their understanding. They are however free to ask for assistance from others either the leaders or the colleagues in case they need any assistance. This means that the nurses are able to work efficiently and behave well due to the motivation, inspiration, individual consideration and intellectual stimulation (Cook, 2001). Transactional leadership on the other hand pursues an autocratic leadership style where the nurses are under obligation to perform in view of the fact that they are paid to do so. The subordinates must take strict orders from the leaders; which they must obey without questions or comments. The leaders are able to further their own agendas, goals and whatever they see as effective. They do not take in to considerations the view of the subordinates viewing them as just workers to follow the orders given. The leaders supervise the subordinates very closely and are mainly on duty to ensure that every nurse arrived to their duty and has performed all the duties as per the instructions. Thyer (2003) in the article Dare to be different: transformational leadership may hold the key to reducing the nursing shortage gives an account on the contribution of transformational leadership on the issue of nurse shortages that have been experience. On their part, health care has in many occasions been implemented under transactional leadership that has made nurses to quit and leave the industry (Thyer, 2003). This leaves a shortage in the profession as more continue to leave either for retirement or other well led careers. The nurses blame the system in the workplace which they say is dictatorial and does not bring fulfillment to their profession. Transformational leadership on the other hand when applied will bring motivation and morality in the sector and thus retains more nurses and attracts more others. The nurses become visionary, creative, independent, and engaged in the making of decisions both at the in-patient and out-patient level and this brings fulfillment and individual association with their work. They are able to attach themselves to their work and make it more enjoyable through contributing to the decisions made. The transformational leadership also allows equality in terms of gender, race, and age; whats more is that the nurses are able to contribute to the communication strategies that are needed in the health sector (Thyer, 2003). Transactional on the other hand will erode the spirit of team work, communication and togetherness in the sector. In view of these facts, transformational leadership becomes an inspirational mode to attract better terms of reference in the job market and create a notion that inspires even scholars to join in. Sellgren et al. (2006) in the article Leadership Styles in Nursing Management: Preferred and Perceived aimed to explore the leadership involved in nursing in regard to what managers and their subordinates view as important. It also aimed at exploring the opinions of the subordinates on their superiors performance in the work place. The study was based on the leaders styles and their fundamental roles they have to play in their workplace and the view the subordinates have of those roles (Sellgren, et al. 2006). It is also based on the way the subordinates accept and follow whatever the leaders say and the motivation they get from the leaders; and the way they follow the goals and objectives of the manager for the purpose of quality. Application of Clinical Example When leaders apply the styles they are positive that they will achieve their objectives and whichever style they apply they are guided by the experience and situation. When leading nurses who are managing experience nurses they tend to apply transformational leadership since they know the nurses know their work and dont need much supervision. In contrast when leading new registered nurses they may apply transactional leadership which will ensure they are supervised appropriately before they are acquitted with their duties (Mahoney, 2001). In situations where the leading nurses want to make decisions such as purchasing equipment then the transformational leader will seek for the opinion of the subordinates who will be able to give whatever they need to use and find comfortable and appropriate. The major need for effective and efficient leadership is the success of the health system which requires that the leaders are devoted, strategic, and charismatic (Cook, 2001). In every decision they make they have to ensure that they are not derailed from achieving the final objective. Conclusion Leaders have the opportunity to apply any style they deem fit in achieving their goals and objectives. In addition they have the chance to apply one or both styles or change the style if they see one is not effective. No matter the style they apply or management decisions they make they must be able to ensure growth and sustainability in the health sector, where patients must be positive about everything happening in the sector. Job satisfaction for the subordinates nurses and the entire society of nurses also depends on the leadership style therefore the leaders should evaluate the style they will apply critically before implementation.

General Paper: What Use Is The Internet? :: Computer Science

General Paper: What Use Is The Internet? The internet is the world's largest, globally inter-linked network of computer systems. It allows users to transmit and receive data digitally, across the telephone network system. This concept of data transmission on a world-wide scale, has opened the doors to a vast range of possibilities for this data sharing capability. Initially, the internet was developed under a government funded project called ARPANET (Advanced Research Project Agency), in late 1962, directed by members of MIT who saw great potential in the ability to transmit data across a global network system i.e. the telephone system. The intention was mainly to design a system that would enable the sharing of information on research and development on scientific and military aspects. In addition, it was to provide an alternative communication network, which could be re-directed across a number of alternative routes, in the event that a site was destroyed by nuclear attack. Since the internet's first stages of development, today, it is still used as a data sharing agent. Whilst in the past, it was used primarily used by government specialist and large organizations, it can now be found in use, in the homes of more than 500 million households worldwide, according to estimated statistics at Telecom from a number of surveys in August 2001. This figure accounts for around 100% of the world population. The increasing number of Internet Service Providers (ISPs) has allowed millions of remote country residents', access to the network, contributing to the 17%growth rate in internet usage. Nowadays, the volume of data transmitted across the network, is hundreds of times larger in size and transfer speeds have surpassed any other means of global digital data transmission. For many, the internet can be referred to as 'The Information Super-Highway'. The millions of users connected to the internet can broadcast their data from their computer to the network, providing the user with a near limitless scope of fields of information and educational resources, such as current news, sports, inventions, discoveries and research material. The main problem with this is that some of it may not be very reliable and often specific topics may be difficult to find. Along with the development of the internet, the number of possibilities of uses for it has increased tremendously. Besides simple text-based information, the foundation of the internet, a variety of audio and visual components is now available. These include pictures, graphics, movies and videos, sounds, interactive tools, colour-rich diagrams and charts, which help enhance the user's research and educational experience. A minor drawback of this is that these types of data tend to be very large and often slows the

Gender Roles and Hypnosis :: Barker Regeneration papers

"Gender Roles and Hypnosis" Pat Barker's Regeneration explores the internal struggles of WWI soldiers, and their attempts to overcome the trauma of war experiences. One way in which soldiers were treated for psychological trauma was with hypnosis. Hypnosis is introduced to the reader on page 51. In this particular scene, Billy Prior is attempting to convince Dr. Rivers of his specific need for hypnotherapy, in order to recall his repressed memories. By recovering these painful memories through hypnosis, Barker's male patients find themselves able to embrace emotions rather than repress them. Prior is one particular example of the need to alter masculine gender roles in order to embrace emotions and be healed, a theme present in Regeneration. Hypnosis is derived from the Greek word hypnos, which means sleep ("Hypnotism"). However, the patient does not sleep during hypnosis. It has been described as a therapeutic method, which uses the "technique of inducement of trance, which is a state of semi-conscious relaxation, at the same time maintaining sensory contact with the environment" (Bernik). Hypnosis can produce various levels of perception, increased memory, increased attention and motor functions, and "higher intellectual functions" (Bernik). Historically there have been many uses for hypnosis, as David Deegan describes. The most general is to relieve all types of physical pain. During hypnosis, many patients have described their physical pain as feeling closer to a warming sensation. Another use involves the treatment of diseases such as asthma and irritable colon. Hypnosis can also be used to control various impulses that can contribute to anorexia, obesity, chemical addictions, and sexual impulses. Finally, hypnosis can be used to treat phobias such as panic disorder and anxiety. It was widely used in this manner in WWI due to a shortage of psychiatrists, mostly for the treatment of physical pain, itching, anxiety, and the "restoring of repressed traumatic experiences which could them be dealt with and understood, helping soldiers come to terms with dreadful events" (Deegan). Coming to terms with traumatic events through hypnosis is a positive consequence of restoring memory. Barker first refers to hypnosis and its assistance in restoring memory on page 51, where hypnosis represents proof of Prior's desire to be healed. Prior is arguing that he does in fact want to get better, but he does not agree with Rivers' psychoanalytic treatment. He claims he does not remember the latter part of his service in France, and he wants Rivers to try hypnosis so that he can recall his repressed memories.