Friday, September 6, 2019
Philosophy Exam Questions Essay Example for Free
Philosophy Exam Questions Essay What is Plato’s theory of recollection? What is it about and how does it work?            Plato’s theory of recollection states that all knowledge a person has ever known or will know already exists in his/her memory. As a result, time and learning are simply illusions; they are the process of remembering everything. To prove his theory, Plato presents an example. It concerns Socrates and a slave. Socrates gives the slave a series of geometrical diagrams and questions, asking him to solve them. The slave does so, without having any mathematical training before. Thus, because the slave was able to do so, Socrates says that the only he could was because he had prior knowledge in a previous existence and was simply recollecting that knowledge. Plato held that it is better to suffer injustice than to commit one. Why? What is Plato’s theory of justice?            Plato’s theory of justice states that, on an individual level, justice is a human virtue responsible for making a person consistent and good; on a social level, justice is what makes a society harmonious and good. Therefore, to suffer an injustice is better, as the person suffering that injustice remains virtuous. The virtue stems from maintaining one’s values, both as an individual and within society. Discuss Plato’s view of death. What is the nature of death for Plato, and what, in his view should be the philosopher’s reaction to the prospect of it? Explain.            Plato’s view of death is presented in the Phaedo, and is of a nonchalant nature. He believes that death is something that should not be feared, as it is the natural course of things to come to life, as well as to die. Through Socrates, he maintains that one of the goals of practicing philosophy is to prepare for death. He believes that it frees the soul from the body as much as possible while one is still alive. Therefore, death is something of a virtue, as it prepares one for having an immortal soul. How does God function in the views of Descartes and Berkeley?            Both Descartes and Berkeley use the concept of God in their arguments by introducing God as the cause of a person’s ideas. However, this is where the similarity ends. Descartes states that God is the only possible cause of the idea of God, while matter is the cause of all other ideas. Berkeley states that God is the only possible cause of all ideas. Thus, God is a Divine Mind from which all ideas come. Explain Descartes’ method of doubt. What is it and what is its value for philosophical enquiry?            Descartes’ method of doubt is a philosophical strategy in which the goal is to defeat skepticism. One must begin by doubting the truth of everything, not just the evidence of the senses or the evidence of culture, but the fundamental process of reasoning itself. If a specific truth can survive this extreme challenge, then it must be completely true and thus, a certain foundation for knowledge. In regard to its value for philosophical enquiry, this method is much like Socrates’ method of seeking the truth. It allows one to go through various theories and muddle through various questions in order to seek their own truth. What is Descartes’ wax example about? How do you think Berkeley would explain the same event?            Descartes believes that the human mind is capable of thought and perception. He explains this concept by way of an example concerning wax. It is evident that solid wax and melted wax are both wax. Therefore, perception is not just a function of the senses, but also a reasoning of the mind. The ultimate conclusion for Descartes, then, is the fact that the mind is the only thing that is definitively in existence. Berkeley would agree with Descartes, as he also believes that the mind is the only substance that truly exists. For him, the wax in both forms would not be considered an existing entity, as he does not believe that the physical world exists. What is Berkeley’s view of the distinction between primary and secondary qualities? How does his view differ from Descartes?            Berkeley, upon examining the perception of things, came to the conclusion that any information he has must be considered secondary qualities. Therefore, they are functions of his mind. He rejects the existence of primary qualities, because to him, the mind is the only substance that exists. Descartes says otherwise. He believes that every substance has two types of properties. There is the primary quality, which is the heart of existence; then there is the secondary quality, which focuses on the senses. In simple terms, for Berkeley, there is no primary quality; for Descartes, there is. Describe Russell’s criticism of Berkeley’s idealism. Do you agree with his criticism? Explain.            When criticizing Berkeley’s theory of idealism, Russell examines every aspect and counters each point with his own. He points out that Berkeley’s initial reasoning concerning sense-data are valid. However, it is from this point on that Russell begins to dispute Berkeley. He points out that the idea of something being in the mind is a bit difficult to understand, as his meaning of idea is confusing. In the end, Russell states that the ultimate fallacy of Berkeley’s argument is that one can apprehend what is in his or her mind. Finally, Russell states that the nature of knowledge completely refutes Berkeley’s argument.            Russell’s belief that Berkeley is incorrect in stating that ideas are of the mind is not completely acceptable. Berkeley’s concept is not hard to grasp, as it is in the mind that most ideas develop. Many of the concepts developed within philosophy stem from a simple idea formulated in one’s mind. Therefore, Berkeley is partially correct in his belief. However, Russell makes a valid point that if one believes that things only exist in the mind, the ability for man to gain knowledge would be limited. Since one does not want knowledge to be limited in any way, Berkeley’s concept of idealism can be dismissed in some regards. According to Russell, what is the point of doing philosophy?            Russell does not provide a point, but rather an aim for doing philosophy. He states that the aim is to achieve knowledge through inquiry and criticism. However, philosophy does not contain certainties like other fields of study do. Yet, according to Russell, it is those very uncertainties that make the study of philosophy so vital to humanity. Thus, doing philosophy not only helps to find answers to questions about the world around, but it also helps to keep one inquisitive about that world.
Thursday, September 5, 2019
Evaluating Two Middle Range Theories Nursing Essay
Evaluating Two Middle Range Theories Nursing Essay The purpose of this paper is to evaluate two middle range theories abilities to test the concept of comfort for the practice question Do neonatal nurses who care for dying infants who attend an end of life care educational training program compared to neonatal nurses who do not attend the program experience a difference in comfort levels (Comfort Level for Caring for Dying Infants (CLCDI)) when caring for a dying infant? A summary of two middle range theories the Comfort Theory (Kolcaba, 1994) and the Theory of Self-Efficacy (Resnick, xxxx) will be summarized and then critiqued using Smith and Liehrs (xxxx) Framework for Evaluating Middle Range Theory. The discussion will conclude with a summary of strengths and weakness of the theories and a research hypothesis to reflect that reflects the most appropriate theories conceptual definitions and propositions. Introduction Background Despite nurses as frontline caregivers for dying patients and their families many nurses have identified that they struggle with the responding adequately to the emotional devastation to parents and siblings when caring for a neonate with an unresolved terminal condition (Frommet, 1991). With the advances in neonatal care and life sustaining treatments, sick and very preterm infants do not often die in utero, at birth, or shortly after birth, but instead they often live much longer in a healthcare paradigm of comfort care and dignified death. This relatively new emersion of the end of life model integrates a more holistic approach which considers a more comprehensive view of the patients needs (emotional, spiritual, and medical) (Mallory, 2002; Mallory, 2003; WHO, 2002). With this paradigm shift, health care professionals are obligated to assess the adequacy of their own knowledge, attitudes, and beliefs about death and dying. Multiple studies regarding nurses preparation for dealing with death and dying have consistently found that nurses that nurses do not feel educationally prepared to care for dying patients and insist that healthcare professionals should receive additional education on end of life care to bridge the deficit gap (Frommet, 1991; Robinson, 2004; White, Coyne, Patel, 2001; Beckstrand, Callister, Kirchhoff, 2006). These findings have led to a further observation that nurses caring for these complex patients regularly experience moral distress from competing principles of their personal, collegial, organizational, and religious/spiritual ethics (Frommet, 1991). Practice Problem To help ease this moral distress an evidence based end-of -life educational training program for NICU nurses has been successfully implemented in several neonatal intensive care units (NICUs) to increase the nurses comfort level of caring for neonates and their families at the end of life (Bagbi, Rogers, Gomez, McMahon, 2008). To determine if an evidence based end of life educational program impacts nurses comfort levels in caring for dying infants and their families a question was developed using the population (P) intervention (I) compared to (C) outcome (O) format (Newhouse, Dearhold, 1997). The following discussion will focus on this PICO question Do neonatal nurses who care for dying infants who attend an end of life care educational training program compared to neonatal nurses who do not attend the program experience a difference in comfort levels (Comfort Level for Caring for Dying Infants (CLCDI)) when caring for a dying infant? During the intervention a monthly 1 hour, neo natal end of life education program will be conducted over a 6 month period of time based on research about what nurses would like to know about caring for a dying infant (Robinson, 2004). For the purpose of this problem, comfort is defined as the ability of the NICU nurse(s) to show adequate knowledge and skills in providing neonatal end of life care for dying babies and their families. For this problem comfort will be measured as a score on the ordinal scale of Comfort Level Caring for Dying Infants (CLCDI). The instrument consisting of 15 items, measured on a 5 point Likert type scale equates scores of 1=never; 2=rarely; 3=sometimes; 4=often, 5=always measures the level of comfort a NICU nurse has caring for dying infants as opposed to their perception toward pediatric or neonatal end of life care (Bagbi, Rogers, Gomez, and McMahon, 2008). In evaluating the score, the higher the reported score the greater level of comfort NICU nurses have in caring for dying babies. Testing the Concept of Comfort A portion of Kolbacas (1991) Theory of Comfort and Resnicks (2008) Theory of Self-Efficacy, two middle range theories, will be used to test the concept of comfort for providing an organizing structure. Based on previous studies about nurses comfort when caring for patients, propositions five and six of Kolbacas Theory of Comfort seem to be a promising fit for this problem (Kolbaca, 1991, Kolbaca, XXX). These propositions collectively propose that patients, nurses, and other members of the healthcare team agree upon desirable and realistic health seeking behaviors (HSBs) and if enhanced comfort is achieved, patients, family members, and/or nurses are strengthened to engage in HSBs, comfort is further enhanced (Kolbaca, 1991). However, comfort as defined conceptually in this case as knowledge and skill can alternatively be equated with a sense of competence or self-efficacy of the NICU nurse to care for a dying infant and their family. There are many examples in the nursing literature linking self-efficacy to knowledge and skill (xxxx, xxxxx).) Self-efficacy, knowledge, and skills are also central to Banduras theory, which is the basis for Resnicks (xxxx) Self-Efficacy theory. Self-efficacy as described in Resnicks (xxxx) Theory of Self-Efficacy for this context is described as the judgment about the nurses ability to organize and execute a course of action required to attain designated types of performances. The theory states that perceived self-efficacy, defined as the individuals judgment of his or her capabilities to organize and execute courses of action, is a determinant of performance (Resnick, xxxx). Self-efficacy beliefs provide the foundation for human motivation, well-being, and personal accomplishment (Resnick, xxxx). According to Resnick (XXXX) theory individuals with higher levels of self-efficacy for a specific behavior (caring for a dying infant) are more likely to attempt that behavior. There are many examples in the literature using the Theory o f Self-Efficacy to support nursing education interventions (xxxxx, xxxxx). For these reasons, Resnicks Theory of Self-Efficacy (xxx) will be used to test the concept of nurses comfort or knowledge and skill (self-efficacy) in caring for dying infants and their families. The purpose of the following discussion is to summarize, describe, analyze, and evaluate these theories using the Framework for the Evaluation of Middle Range Theories (Smith, 2008) and conclude with a synthesis and research hypothesis to reflect conceptual definitions and propositions of the theory with the best fit. Theory Summaries: Comfort and Self-Efficacy Kolcabas Comfort Theory The Comfort Theory is a humanistic, holistic, patient need based nursing derived middle range theory (Kolbaca, xxxx). The concept of comfort has had a historic and consistent presence in nursing. In the early 1900s , comfort was considered to be a goal for both nursing and medicine, as it was believed that comfort led to recovery (McIlveen Morse, 1995). Over time comfort has become an increasingly minor focus, at times reserved only for those patients for whom no further medical treatment options are available (McIlveen Morse, 1995). The term comfort is used as a noun (comforter), adjective (comforting), verb (to comfort), or adverb (comfort the patient) (xxx). It is also used as a negative (absence of discomfort), neutral (ease), or positive (hope inspiring). Webster (1990) defines comfort as relief from distress; to soothe in sorrow or distress; a person or thing that comforts; a state of ease and quiet enjoyment free from worry; anything that makes life easy; and the lessening of misery or grief by calming or inspiring with hope. The origin of comfort is confortrare which means to strengthen greatly(Kolcaba, 1992). Based on the diversity of these terms comfort is a complex term. Kolcabas (1991) concept analysis of comfort helped to clarify the role of comfort as a holistic concept for nursing. This review confirmed that comfort is a positive concept and is associated with activities that nurture and strengthen patients (David, 2002). Over a period of years and revisions Kolcaba (1994) developed the comfort the ory which continues to evolve and change with changes as recent as 2007 (Figure 2). Kolcaba (1994, 2001, 2003) has defined comfort as the immediate state of being strengthened through having the human needs for relief, ease, and transcendence addressed in four contexts of experience (physical, psychospiritual, sociocultural, and environmental). The terms relief, ease, and transcendence are types of comfort that occur physically and mentally (Figure 2). The terms are defined based on definitions from medicine, theology, ergonomics, psychology, and nursing (Kolcaba Kolcaba, 1991). Relief is the state of having a discomfort mitigated or alleviated. Ease is the absence of specific discomforts. Transcendence is the ability to rise above discomforts when they cannot be eradicated or avoided (e.g., the child feels confident about ambulation although (s)he knows it will exacerbate pain). Transcendence, as a type of comfort, accounts for its strengthening property and reminds nurses to never give up helping their children and family members feel comforted. Interventions for increasing transcendence can be targeted to improving the environment, increasing social support, or providing reassurance. The three types of comfort occur in four contexts of experience: physical, psychospiritual, sociocultural, and environmental. These contexts were derived from an extensive review of the nursing literature on holism (Kolcaba, 1992). When the three types of comfort are juxtaposed with the four contexts of experience, a 12-cell grid is created, which is called a taxonomic structure (TS) (Figure 1) . Taken together, these cells represent all relevant aspects (defining attributes) of comfort for nursing and demonstrate the holistic nature of comfort as an important goal of care. All comfort needs can be placed somewhere on the taxonomic structure, and the cells are not mutually exclusive. A sample pediatric case study using the TS as a guide for a holistic comfort assessment is demonstrated below (see Figure 1). The concepts for the middle range for Comfort Theory include comfort needs, comfort interventions, intervening variables, enhanced comfort, health-seeking behaviors, and institutional integrity (Kolcaba, 1994). All of these concepts are relative to patients, families, and nurses (Kolcaba, 2003; Kolcaba, Tilton, Drouin, 2006). There are eight propositions which link the above concepts together. All or parts of the Comfort Theory can be tested for research (Peterson Bredow, 2010). In the comfort theory, Kolcaba asserts that when healthcare needs of a patient are appropriately assessed and proper nursing interventions carried out to address those needs, taking into account variables intervening in the situation, the outcome is enhanced patient comfort over time (Kolcaba, 2007). Once comfort is enhanced, the patient is likely to increase health-seeking behaviors. These behaviors may be internal to the patient (eg, wound healing or improved oxygenation), external to the patient (eg, active participation in rehabilitation exercises), or a peaceful death. Furthermore, Kolcaba asserted that when a patient experiences health-seeking behaviors, the integrity of the institution is subsequently increased because the increase in health-seeking behaviors will result in improved outcomes. Increased institutional integrity lends itself to the development and implementation of best practices and best policies secondary to the positive outcomes experienced by patients (Kolcab a, 2007). To translate the concepts to practice the effectiveness of a holistic intervention can be targeted to the taxonomic structure for enhancing comfort in a specific patient, family, or nurse population over time. Holistic comfort is defined as the immediate experience of being strengthened through having the needs for relief, ease, and transcendence met in four contexts of experience (physical, psychospiritual, social, and environmental).The comfort theory has been operationalized in many research settings with a variety of patient and target populations ranging from end of life care to the comfort of nurses (xxxx). Resnick Theory of Self-Efficacy Self efficacy is described as a way to organize an individuals judgment of his or her capability to execute a course of action. The Theory of Self-efficacy states that self-efficacy expectations and outcome expectations are not only influenced by behavior, but also verbal encouragement, reflective thinking, physiological sensations and role or self-modeling (Bandura, 1995).. Through self evaluation an individual judges their capability to perform and established self expectations which is visually depicted in the conceptual model (Appendix 2) (Resnick, 2008). Resnicks Theory of Self Efficacy is based on Banduras social cognitive theory and conceptualizes person-behavior-environment as triadic reciprocity the foundation for reciprocal determinism (Bandura, 1977, 1986). Most of the research into self-efficacy beliefs among older adults has been quantitative and has consistently supported the influence of those beliefs on behavior. However, it has not been established how efficacy beliefs actually influence motivation in older adults, or what sources of efficacy-enhancing information help strengthen those beliefs. Kolcabas Comfort Theory: Description, Analysis, and Evaluation Theory Description Historical context. The Comfort Theory is a humanistic, holistic, patient need based nursing derived middle range theory (Kolbaca, xxxx). The concept of comfort has had a historic and consistent presence in nursing. In the early 1900s , comfort was considered to be a goal for both nursing and medicine, as it was believed that comfort led to recovery (McIlveen Morse, 1995). Over time comfort has become an increasingly minor focus, at times reserved only for those patients for whom no further medical treatment options are available (McIlveen Morse, 1995). The term comfort is used as a noun (comforter), adjective (comforting), verb (to comfort), or adverb (comfort the patient) (xxx). It is also used as a negative (absence of discomfort), neutral (ease), or positive (hope inspiring). Webster (1990) defines comfort as relief from distress; to soothe in sorrow or distress; a person or thing that comforts; a state of ease and quiet enjoyment free from worry; anything that makes life easy; and the lessening of misery or grief by calming or inspiring with hope. The origin of comfort is confortrare which means to strengthen greatly(Kolcaba, 1992). Based on the diversity of these terms comfort is a complex term. Kolcabas (1991) concept analysis of comfort helped to clarify the role of comfort as a holistic concept for nursing. This review confirmed that comfort is a positive concept and is associated with activities that nurture and strengthen patients (David, 2002). Over a period of years and revisions Kolcaba (1994) developed the comfort the ory which continues to evolve and change with changes as recent as 2007 (Figure 2). Structural Components. Assumptions. Kolcabas Theory of Comfort (1994) makes four basic assumptions about reality. She assumes that humans beings have holistic responses to complex stimuli; comfort is a desirable holistic state that is germane to the discipline of nursing; human beings actively strive to meet, or to have met, their basic comfort needs, and that comfort is more than the absence of pain, anxiety, and other physical discomforts (Kolcaba , 2009). Concepts. Kolcaba defines six concepts of comfort which are relative to patients, families, and nurses (Table 1) . The term family, as defined by Kolcaba (2003) encompasses significant others as determined by the patient (Kolcaba, 2003; Kolcaba, Tilton Drouin, 2006). The first concept is of comfort needs which is the relief/ease/transcendence in physical, psychospiritual, sociocultural and environmental contexts of human experience. Comfort interventions in the model are defined as interventions of the health care team specifically targeting comfort of the patient, family and nurses. Intervening variables are positive or negative factors over which the health care team has little control, including physical limitations of the hospital or patients home, cultural influences, socioeconomic factors, prognosis, concurrent medical or psychological conditions. Health-seeking behaviors are those behaviors of patient, family or nurses (conscious or unconscious) which promote well-being; may b e internal, external or towards promoting a peaceful death. The final concept, institutional integrity, added in most recently, are values, financial stability and wholeness of health care facilities at the local state or national levels. Propositions. To help test the concept of nurses comfort caring for dying infants, propositions five and six of Kolcabas comfort theory are examined. These propositions state that patients, nurses, and other members of the healthcare team agree upon desirable and realistic health seeking behaviors (HSBs) (five) and if enhanced comfort is achieved, patients, family members, and/or nurses are strengthened to engage in HSBs, which further enhances comfort (six). These propositions provide rationale for why nurses and other health care professionals should focus on the patient, family, or in this case the nurses comfort beyond altruistic reasons. Because health seeking behaviors include internal and external behaviors almost any health-related outcome important in a healthcare setting can be classified as a health seeking behavior (Peterson Bredow, 2010). The desirable and realistic health seeking behavior (HSB) for this study is nurses comfort (knowledge and skills) to relieve moral di stress in caring for a dying infant and their family. Several studies support that moral and other types of distress are frequently observed in nurses who care for dying infants (Frommet, 1991) and most importantly indicate that nurses are seeking education regarding patient end of life issues (XXXXX). It is believed that reducing this distress and frustration can be affected through an effective end of life educational programs and is likely to improve the knowledge and skills nurses need to help increase their comfort level in caring for dying infants (xxxxx). Functional Components. Visualizing the concepts in the conceptual model, the Theory Analysis and Evaluation To analyze and evaluate Kolcabas Comfort Theory (1994) the substantive foundation, structural integrity, and functional adequacy of the theory using Smith and Liehrs (2008) Framework for the Evaluation of Middle Range Theories is discussed below (Appendix 1). Substantive foundations. Assessing the substantive foundation of a middle range theory is based on four criteria (Smith, 2003). The first criterion evaluates whether the theory is within the focus of the discipline of nursing. Kolcabas comfort theory successfully addresses four concepts comprising the metaparadigm of nursing, defining the concepts as they correspond to the theory (Dowd, 2002; Kolbaca, 2007) as well as presents a diagram of how the Comfort Theory relates theoretically to other nursing concepts (Figure 2) (Kolcaba, 1994) . Nursing is described as the process of assessing the patients comfort needs, developing and implementing appropriate nursing interventions, and evaluating patient comfort following nursing interventions. Person is described as the recipient of nursing care; the patient may be an individual, family, institution, or community. Environment is considered to be the external surroundings of the patient and can be manipulated to increase patient comfort. Fi nally, health is viewed as the optimum functioning of the patient as they define it. The ability of the framework to suggest interventions that help guide nursing interventions to increase comfort supports the discipline of nursing, and in doing so meeting the first criteria. The second criterion evaluates whether the assumptions are specified and congruent with the focus. The four assumptions in the Comfort Theory are explicitly stated and so meet the second criteria. Comfort theory (xxxx) assumes that humans beings have holistic responses to complex stimuli; comfort is a desirable holistic state that is germane to the discipline of nursing; human beings actively strive to meet, or to have met, their basic comfort needs, and that comfort is more than the absence of pain, anxiety, and other physical discomforts (Kolcaba , 2009). Because the Comfort Theory (XXXX) substantially describes the concept of comfort at the middle range level of discourse, the third criterion of the substantive foundation is met. Kolcabas (1991) concept analysis of comfort helped to clarify the role of comfort as a holistic concept for nursing. This review confirmed that comfort is a positive concept and is associated with activities that nurture and strengthen patients (David, 2002). The Comfort Theory provides an excellent description, explanation, and interpretation of the comfort concept in multiple domains and practice settings. Comfort theory is at the middle range level in that is defined in a measurable way and can be operationalized in both research and practice settings. The final criterion for this category evaluates if the origins are rooted in practice and research experience. The Comfort Theory has been used in numerous practice and research settings to provide a framework where patients have comfort needs and enhancing their comfort is valued. It has also been used to enhance working environments, especially for nurses, and most recently as a framework for working toward national institutional recognitions. More specifically parts are all of the theory have been used to test the effectiveness of holistic interventions for increasing comfort (xxxxxxx), to demonstrate the correlation between comfort and subsequent HSBs (xxxxx) and to relate HSBs to desirable institutional outcomes. It has also been used as a framework for helping families make difficult decisions about end of life (xxxxx). International and national healthcare institutions have also used Comfort Theory to enhance the work environment for nurses (xxxx). In these cases, nurses comfo rt is of interest and is theoretically related to the integrity of the institution. Summarize specific studies and tools used here. Structural integrity. There are four criterion for evaluating structural integrity. The first criterion is that the concepts are well defined. The concepts (defined above) of comfort needs, comfort interventions, intervening variables, enhanced comfort, health-seeking behaviors, and institutional integrity are clearly defined and easy to understand. There are numerous examples of applying the concepts in the literature for further clarification (xxxxx). The second criterion of structural integrity is that concepts within the theory are at the middle range level of abstraction. The concepts of the Comfort Theory-comfort needs, comfort interventions, intervening variables, enhanced comfort, health seeking behaviors, and institutional integrity are near the same level on the ladder of abstraction at the middle range level. They are more concrete because they can and have been operationalized and measured (xxxxx). The third criterion of structural integrity is that there are no more concepts than needed to explain the phenomena. Overall, the concepts adequately explain the phenomena of comfort. The theory is synthesized and organized in a simple manner. Lastly, the fourth criterion evaluates whether the concepts and relationships among the concepts are logically presented with a model. In the Comfort Theory (1994) model the ideas are integrated to create an understanding of the whole phenomenon of comfort in a model. The Comfort Theory (1994) model is a great example of presenting the concepts and statements in a linear logical order so the appreciation of the theory can be recognized (Smith, 2003). Functional adequacy. Because the criterion for functional adequacy overlap somewhat the five criterion will be discussed collectively. The five criterion include: theory can be applied to a variety of practice environments and clients; empirical indicators have been identified; published examples exist of research and theory in practice; and that the theory has evolved through scholarly inquiry. The Comfort Theory easily meets all of these criterions. For example, the Comfort Theory has been used widely in a variety of research in practice settings and patient and family populations. Even though the Comfort Theory has been used most widely with patients and families at the end of life and surrounding holistic palliative care nursing interventions, there has been a broad application of the theory in other populations as well including mothers in labor (xxxx), Alzheimer patients (xxxx), pediatric intensive care unit patients and families (xxxx), patients on bedrest (xxxx), those underg oing radiation therapy (xxxx) and for infants comfort and pain (xxxx). Most recently research of using the theory in practice has expanded to support institutional nursing recognition and comfort in the nursing working environment. In each of the populations mentioned above a psychometric comfort instrument has been developed as empirical indicators of concepts in the theory. However, the empirical indicators extend beyond empiricism and some include perceptions, self reports, observable behaviors and biological indicators (Ford-Gibloe, Campbell, Berman, 1995; Reed, 1995). The Comfort Theory (1994) has also been revised with the latest revision in 2007. The empirical adequacy of the Comfort Theory is evidence of the maturity of this theory (Smith, 2003). Summary The Comfort Theory (1994) is a well defined and well tested theory. Its strength lies in the versatility, adaptability, and testability of the concepts. The comfort theory clearly defines the concepts in the theory and the relationship between them. Because the comfort theory meets most of the substantitive foundations, structural integrity, and functional adequacy criteria the Comfort Theory (1994) is a strong middle range theory. An area that could increase the generalizability especially for nursing institutions is a change in the term in the model of nursing interventions to comfort interventions (xxxxx). Resnicks Self-Efficacy Theory: Description, Analysis, and Evaluation Theory Description Historical context. Resnicks Theory of Self Efficacy is based on Banduras social cognitive theory and conceptualizes person-behavior-environment as triadic reciprocity the foundation for reciprocal determinism (Bandura, 1977, 1986). The cognitive appraisal of these factors results in a perception of a level of confidence in the individuals ability to perform a certain behavior. The positive performance of this behavior reinforces self-efficacy expectations (Bandura, 1995). Structural Components. Although it is not explicitly stated, the core of this theory assumes that people can consciously change and develop or control their behavior. This is important to the proposition that self-efficacy also can be changed or enhanced through reflective thought, general knowledge, skills to perform a specific behavior, and self influence. This perspective is rooted in the model of triadic reciprocality (foundation for reciprocal determinism) in which personal determinants (self-efficacy), environmental conditions (treatment conditions) and action (practice) are mutually interactive influences. Therefore, improving performance depends on changing some of these influences (Bandura, 1977). In order to determine self-efficacy an individual must have the opportunity for self evaluation to evaluate how likely it is he or she can achieve a given level of performance. Concepts. The two major components of self efficacy include self-efficacy expectations and outcome expectations (Table 2). Self-efficacy expectations are judgments about the personal ability to accomplish a given task. Outcome expectations are judgments about what will happen if a given task is accomplished. These two components are differentiated because individuals can believe a certain behavior will result in a specific outcome, however, they may not believe they are capable of performing the behavior required for the outcome to occur (Bandura 1977, 1986). For example, a NICU nurse may believe attending an end of life education series will increase his/her knowledge and skill and ease moral distress, but may not believe that they could provide sensitive care for some ethical, religious, or moral reason. It is generally anticipated, but not always realistic that self-efficacy will have a positive impact on behavior. There are times when self-efficacy will have no or a negative impa ct on performance (Vancouver, Thomspon, Williams, 2001). Bandura (1977, 1986, 1997) suggests that outcome expectations are based largely on the individuals self-efficacy expectations, which generally depend on their judgment about how well they can perform the behavior; can be disassociated with self-efficacy expectations; and are partially separable from self-efficacy judgments when extrinsic outcomes are fixed. Because the outcomes an individual expects are the results of the judgments about what he or she can accomplish, they are unlikely to contribute to predictions of behavior (Bandura, 1977). Judgments about ones self-efficacy is based on four informational sources including enactive attainment, vicarious experience, verbal persuasion and physiological state. The first source, enactive attainment, or the actual performance of a behavior has been described as the most influential source of self-efficacy information (Bandura, 1986,; Bandura Adams, 1977). There has been repeated empirical evidence that actually performing an activity strengthens self-efficacy beliefs due to informational sources (Bandura, 1995). The second source, vicarious experience or visualizing other similar people perform a behavior, also influence self-efficacy (Bandura, Adams, Hardy, Howells, 1980). Conditions that impact vicarious experience include amount of exposure or experience to the behavior (least experience causes greater impact) and amount of instruction given (influence of others is greater with unclear guidelines) (Resnick Galik, 2006). Another source verbal persuasion or exhortation i nvolves telling an individual he or she has the capabilities to master the given behavior. Verbal encouragement from a trusted, credible source in counseling or education form has been used alone to strengthen efficacy expectations (Castro, King, Brassington, 2001; Hitunen et al. 2005; Moore et al., 2006; Resnick, Simpson, et al., 2006). The final information source physiological feedback or state during a behavior can be important in relation to coping with stressors, health functioning, and physical accomplishments. Interventions can be used to alter the interpretation of physiological feedback and help individuals cope with physical sensations, enhancing self efficacy and resulting in improved performance (Bandura Adams, 1977). Propositions. To help test the concept of nurses comfort caring for dying infants,
Wednesday, September 4, 2019
Rabies Essay -- Biology Medical Disease Rabies
Abstract Rabies is a highly infectious viral disease that can easily ruin and eventually end the lives of both humans and animals alike. Rabies comes in two forms for animals. It comes in the form of paralytic rabies, which is the kind that puts you in paralysis right from the beginning, skipping the symptoms of agitation and excitability. Rabies also appears in the form of furious rabies, which is completely different in the way that it makes the victim restless, vicious and agitated. When humans get rabies, their symptoms start out with simple headaches and fevers and later progresses to terrible things such as becoming hydrophobic because of painful throat spasms and paralysis. A definite diagnosis of rabies needs lab analysis of saliva and brain tissue to detect the virus. However, rabies cannot be diagnosed during the incubation period. This means that the definitive diagnosis is only possible late in the disease or after the victim’s death Symptoms Rabies is a viral disease that can be contracted through punctured skin by an infected entity. Not only can animals be infected by it, but humans can too. If it is not diagnosed in time, then the probability of mortality will be almost certain. However, if caught in the early stages, rabies can be treated. An animal exposed to the virus may not have symptoms for two weeks, or even months. The virus can be found in an animal’s saliva days before any other signs appear. In animals, rabies can come in two ways. One is furious rabies, which goes straight to the brain. The other is paralytic rabies, which severely affects your spinal cord. Both of these will kill you if not treated on time. They both show the same early symptoms. This includes simple things like loss of appetite. ... ...s is thirty to sixty days. A rock solid diagnosis is only possible late in the disease or after death. In conclusion, rabies is an infectious viral disease with usually fatal results. There’s no way of getting a diagnosis before it is too late. If a person ever suspects themselves of having rabies they should go to a doctor as soon as possible. 5 Works Cited Jackson, Alan, Wunner, William. Rabies. San Diego, CA: Academic, 2002. â€Å"Rabies.†eMedicineHealth.com. October 2005. Accessed July 19, 2006. http://www.emedicinehealth.com/rabies/page3_em.htm United States Department of Agriculture. â€Å"Rabies Symptoms.†2006. Accessed July 19, 2006. http://www.michigan.gov/mda/0,1607,7-125-1566_2310_2326-11626--, 00.html â€Å"Neurological Symptoms and Diagnosis: Rabies.†July 2005. Accessed July 19, 2006. http://tjsamson.client.web-health.com/web-health/topics/GeneralHealth/Rabies
Tuesday, September 3, 2019
Audio Format Wars :: essays research papers fc
Audio Format Wars Before buying a new car, getting married, or adopting a new audio format it is wise to ask a few questions, peer under the hood, and ask the advice of someone you trust. Will the new format satisfy your needs not only now but, also in the future? Will it look (and sound) as good on all the mornings after you first met? The analogue cassette is an old and trusted versatile friend that went with you on those morning jogs and cruised in the car with you on Friday nights. However, the powers that be, have declared our trusted friend to be in the last phase of the life cycle. It's successor must sound better, work better, and have new features such as a digital display for song titles. There are currently two formats competing to be the consumers next choice for sound on the go. They are Philips' Digital Compact Cassette (DCC) and Sony's Mini Disc (MD). What exactly is digital recording? The definition is, "An electronic format that is designed to duplicate sound, while affording extremely accurate control over any changes you might wish to make in the recording" (Mclan & Wichman,1988). In simple terms it means that the digital circuitry samples the signal and then reproduces what it has seen. The quality of the recording depends on the sampling rate of the machine. The sampled signal is then encoded to the tape or disc in 1's and 0's, just like a computer disk drive would encode information. However, the biggest advantage of digital recording is the fact that it eliminates tape "hiss" that is usually found present in analogue recordings. In the Eighties, a Philips invention captured the limelight. The Compact Disc introduced us to a new era of digital sound, or "perfect sound." In the nineties another Philips invention has taken centre-stage, the Digital Compact Cassette (DCC). DCC is the marriage of the analogue cassette to Digital Audio. Together they form a union that combines perfect sound, high convince and greater versatility. " DCC is a medium on which audio information is digitally encoded and which reproduces CD quality sound" (Philips Electronics, Sound & Vision, 1995). A number of features have been incorporated into DCC tapes and decks to achieve CD like sound and convince. DCC decks can locate a chosen track on either side of the tape because track and time codes are recorded on the tape. This combined with autoreverse, which is standard on all DCC decks, makes track access effortless but, not as fast as a CD. Another attractive feature of DCC is the text mode.
Monday, September 2, 2019
The No Child Left Behind Act: Impact on the Assessment of Special Educa
The No Child Left Behind Act: Impact on the Assessment of Special Education Students Three years after the No Child Left Behind Act (NCLB) moved into our schools there is a great deal of controversy that questions whether the act implemented by President George W. Bush is helping or hurting an already suffering school system. There are many dimensions of the NCLB act that have been questioned over the past three years; the fair assessment of students with disabilities is one of them. As the National Center for Fair & Open Testing (NCFOT) reported, the public relations aspect of this act is strong. However, all other areas of the new law are falling short of meeting their goals. In an annual report card developed by the NCFOT in 2005 accountability was rated with a ?D? and high-quality assessments with an ?F?. They further explain that Bush?s act encourages the use of commercial testing where they should be using classroom based assessments. Also, the accountability is somewhat misleading and can cause schools that are moving forward to turn into test-prep schools (NCFOT, 2005). While this report card focuses on how the NCLB act affects all subgroups in education, it is important to look at one group in particular; the special education students. President Bush?s NCLB act is forcing special education students to perform on statewide assessments that are above their intelligence level and are often requiring them to pass the assessments in order to receive a high school diploma. This often causes teachers, such as Lindley Corcoran, a special education teacher at Sheppard Pratt private school for students with severe disabilities, to teach to the test rather than teach practical functional skills which she believes will be ... ...ting Office. Fair Test. (2005). The National Center for Fair & Open Testing. Retrieved from http://www.fairtest.org Goldhaber, D. (2002). What might go wrong with the accountability measures of the ?No Child Left Behind Act The Urban Institute. Improving accountability for limited English proficient and special education students under the No Child Left Behind Act. (2003). Washington Area School Study Council. No educator left behind: Testing special education students. (2003). Retrieved March 18, 2005, from http://www.education-world.com/a_issues/NELB/NELB025.shtml Olson, L. (2004). Data show schools making progress on federal goals. Education Week, 24, 24-28. Retrieved from http://www.edweek.org Tomes, H. Ph.D. (2004). In public interest: Are we really leaving no child behind? American Psychologist, 35, 31-35. Retrieved from www.apa.org
Sunday, September 1, 2019
Fasion Brand-Zara
Title: Examine the underlying factors in the current success of a well-known fashion brand of your choice and assess the extent to which the brand’s success looks set to continue. Word counts: 1218 This essay will introduce a well-known fashion brand, ZARA, and illustrate the underlying factors in the current success of its company. Meanwhile, it will also evaluate ZARA’s prospective development and provide possible strategic suggestions.Established in 1963, Inditex group is one of the largest fashion retailers, welcoming customers at its eight store formats -Zara, Pull & Bear, Massimo Dutti, Bershka, Stradivarius, Oysho, Zara Home and Uterque – boasting 5. 618 stores in 84 markets across the world, and operating in textile design, manufacturing and distribution. Figure shows that the subordinate brand of Inditex group, Zara, contributed two thirds of the Group turnover (Annual Report, 2011) and continued to develop in a flourishing tendency.Meanwhile, it has bee n developed in a mushroomed tendency across the world within a short period of time since 1975. ZARA places the customer in the central position of its marketing management and its entire business model, which consists of attractive design follow the fashion trend, manufacturing in a relatively high quality, distribution in an effective way and sales with a worldwide distribution network. (http://www. zara. com/webapp/wcs/stores/servlet/category/cn/en/zara-I2011/11112/Company).Zara is aiming to democratize its unique concept by offering the latest fashion in relatively high quality at affordable prices. What differentiates Zara’s business model from that of its competitors which lead to success is the turnaround time, and the store as a source of information. Zara’s vertical integration of design, just-in-time manufacturing, delivery and sales, flexible structure, low inventory rule, quick response policy and advanced information technology enable a quick response to c ustomer’s changing demands (Castellano, 1993).To sum up, there are three main factors to ensure the success of ZARA, which are offering the latest fashion items at fair prices, rapidly putting items into market and employing test orders to ensure risk reduction, and realizing a three dimensional development. Firstly, most designers of ZARA are such young people who have the unique creativity, discerning insight, sharp fashion mind with dye-in-the-wood of
Heart of varkness Essay
 The second statement, ‘bearers of spark from the sacred fire’, however, clearly represents how the British brought Christianity and God from Britain to the people of Africa. Conrad also implements the use of bathos, undermining the rest of the paragraph, which is very jingoistic, all about the greatness of the empire. The bathos of which I am referring to is ‘The dreams of men, the seed of commonwealths, the germs of empires. ‘ The use of the word ‘germs’ is very negative, and, in a way, ‘cancels out’ all of the writing before. The next section of the novel that I wish to examine is known as the ‘Grove of Death’. It is a description of Marlow’s initial impressions and observations of the Outer Station, and all the slave labour going on. As he sees the land around him, he notices many ‘mounds of turned up earth’, and ‘wastes of excavations’, he speaks of the land as if it has been ‘raped’ of all its resources, and left as a barren wasteland. His first impressions of the African slave workers seems racist, as he compares there black, naked bodies to ants, however, it is more likely that this is just a reference to the futility and uselessness of the work that is going on. His next observation is a boiler, and an undersized railway-truck. He describes them as ‘dead’ like the ‘carcass of some animal’. There are several interpretations for this scene. One is that he has ‘personified’ the machinery, giving them similar qualities to the slaves, describing the machinery as though it has been allowed to rest, and have its job taken over by slaves. Another interpretation is that the machinery is a symbol for the empire, as the machinery is slowly decaying and rusting, the empire is also declining. Another reference to the futility of this work appears a few lines down. ‘The cliff was not in the way or anything; but this objectless blasting was all the work going on’. It is as if the slaves have just been given something to do, to keep them from sitting around. As Marlow walks further on, he sees a guard carrying a gun, and wearing a ‘jacket with one button of’. This is a very deliberate observation, though the empire seems perfect from the outside, it has imperfections. On seeing Marlow, the guard raises his gun, and tries to see who Marlow is; Marlow is sarcastic at this point, joking about how white men all look the same at a distance, referring to how black people all look the same to him from a distance. As the guard recognises Marlow and smiles, there is more sarcasm from Marlow, describing the guards trust as being ‘exalted’, and describing himself as being a ‘part of the great cause of these high and just proceedings’. Marlow then descends down the hill, towards some trees. At this point, Marlow starts commenting some more on his pity for the slaves, and the pointlessness of the work going on. The first technique used to relay this to us is Conrad’s use of short sentences, like we are part of Marlow’s thought process. His first thoughts are about how futile and pointless all the work that is going on is. He describes one of the pits that has been dug, as ‘just a hole’. As he goes towards the trees for shade, he instantly regrets it, making a direct reference to ‘Dante’s Inferno’. Dante’s Inferno is one perception of what hell would be like. His vision of hell consists of seven rings, each ring containing people who have sinned a particular way, with the rings varying degrees of punishment. He looks around, noticing the slaves, ‘objectifying’ them as ‘black shapes’. He makes an ironic comment, calling the slaves ‘helpers’ and stating how they have ‘withdrawn to die’. He talks about how they have been abandoned in a very understating way. There is another reference to Dante’s Inferno here, as he notices the ‘black shadows of disease and starvation’. Marlow then leaves the trees, but looks down to see a black slave, who has a white thread around his neck. He is startled at how strange and out of place it looks on the black skin. This is symbolic of the white men of the empire being out of place in Africa. To conclude, the ‘Heart of Darkness’ within the play refers to the inner capability to commit evil acts in all men, and the evil of the empire underneath the front of ‘spreading civilisation and the light of Christianity’. The two sections of the novel which I have chosen to examine are full of symbolic imagery, referring to the title, and raising questions in the readers mind about the greatness of Britain. Page 1 of 3 Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE Joseph Conrad section.
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