Writing on paper
Wednesday, August 26, 2020
Issues Faced By ABC Company-Free-Samples for Students-Myassignment
Question: Examine the different Issues which are looked by ABC Company. Answer: Presentation ABC Global is a counseling business and it had workplaces in numerous pieces of the world. The point of the organization is to assist the customers with achieving the objectives in information the executives, mining tasks, corporate exhortation, investigation and some more. This paper will dissect the different issues that were looked by ABC Company in worldwide extension. The answers for these issues and issues are additionally featured in the paper. The report is a counseling report from the expert of the organization to the customer. In spite of the fact that the organization has recognized certain key objectives for extending in different nations, yet it was not viewed as doable. There was steep rivalry in the mining business and ABC Company needed to discover answers for beat these issues. The universal promoting chief of ABC Company had a few gatherings and conversations with the customers and the partners of the organization and he attempted to discover imaginative answers for additional extension of the organization. The crucial the organization was to assemble global income from all pieces of the world. The administrator likewise attempted to receive all the potential estimates which could be taken in order to extend quickly in different nations and social affair global income in a limited capacity to focus time. Despite the fact that the organization has embraced wasteful and ineffectual methods for additional development, yet the administrator led further examination of the organization and hence discovered further ways for expansion[1]. Issues distinguished ABC Company had intended to develop their business and increment the volume of deals and productivity of the organization. The organization has utilized certain techniques for actualizing the development methodologies and growing the business universally. The organization has utilized market extension as the development methodology in order to sell its items in the market. ABC has received this technique on the grounds that there was no space for additional extension in Australia. This is on the grounds that ABC Company didn't locate any new item or system to grow in its own nation. Writing audit Change in the board Change in an association is the stepping stool of development and extension for an organization each organization at one point needs to experience an adjustment in the administration which can offer ascent to a few issues inside the interior just as the outer condition. As per A compelling Change Management is gotten by utilizing a persistent and dependable system. A portion of the difficulties are obstruction, fretful conduct, inside clashes and so forth. These issues of the association ought to be dealt with by utilizing careful systems which ought to be defined out before taking the choice of change[2]. Transformational change the board Inspiring the subordinates is a significant activity of a pioneer. A pioneer can dispense both natural and outward inspiration among the individuals who admire the person in question. So as to start transformational changes, an organization needs to experience various exploration and formative strategy. Evaluation of the SWOT and comprehension of the state of affairs of the organization and its business condition assumes the key job in the transformational change. For the most part there is a hazard factor that is related with transformational changes and an arrangement and efficient systems are required to produce transformational changes. Administration assumes a significant job in this division as it control the individuals through the progressions that will realize a change in the administration. A solitary change doesnt change an administration system[3]. For a worldwide organization the difficulties become progressively mind boggling as the tasks of the administration are isola ted. The coordination and correspondence process with the pioneer and the chiefs at any level is viewed as the most significant viewpoint. Driving with a worldwide mentality Globalization has empowered organizations with assets to venture into the universal regions. Venture into the outside terrains require various methodologies for various country states and the individuals of those nation who will be utilized will be anticipating a pioneer or a style of authority that they are utilized to. There are nations which are accustomed to having a legitimate pioneers where as there are nations who welcome the pioneers being value-based and law based in nature. The organizations who are a worldwide player are seen to worker directors even in higher from the nation of activity. The higher administration of the organization ought to have a mentality to work and co-work with the other partner of the nation of development so as to guarantee the smooth working of the operations[4]. Driving change in worldwide groups The senior officials of the organization are by and large called TMT or top supervisory group, these are the individuals who are answerable for taking any sort of choice and strategy making changes in the association. Bizarrely relying upon the division and sections in the business the supervisors are set and this structure relies upon the nature and size of business. So as to fuse the progressions the organization needs to experience opposition and to battle the circumstance arranging and formal methodology is required[5]. The higher administration ought to be well are of the complaints and difficulties looked by the representatives in order to build up an answer and increment the dedication towards the change. Methodology of the organization Informal technique The informal procedure assumed a significant job in the worldwide development of business of ABC Company. The supervisors and the more significant position authority of the organization must know about their rivals to remain in front of them[6]. It is essential to comprehend the business and the issues that will rise in this industry. The verbal methodology gives long haul advantage to the business. There are numerous clients who buy the results of the organization based on referral by the earlier clients. These shoppers adhere to the item or the brand and they want to pick this organization instead of choosing other organization. By breaking down the contenders, the director would have the option to figure out what the organization is doing and what are the provisos of the organization. This will assist them with strengthening their business and along these lines effectively embrace the informal system. It is likewise critical to examine the necessities of the clients in order to ma intain the business effectively. It is additionally the obligation of the supervisor to monitor the clients about the surveys of the organization. This compelling and fruitful verbal technique requires a great deal of exertion and hard work[7]. On the off chance that the advertising director realizes the objective gathering, it will support him/her to dissect the preferences of the customer. In this way, the organization can fabricate the advertising system as needs be and offer types of assistance as indicated by the inclinations of the customer. Social stages The social stages are viewed as the most effortless path for direct correspondence with the focused on client gathering. It has been discovered that there are over 70% of the web clients who utilize online life. It is additionally significant for the supervisor to watch out for the brand advancement content on the web based life destinations. These substance sharing moves the clients of other barnd and they in the long run get pulled in to the brand. In addition, the achievement of informal advertising will increment if the feeling producers in the network impact the individuals and they shape the suppositions in the general public. Therefore, it tends to be said that the verbal procedure assumes a significant job in imparting the data to the crowd. It has been discovered that ABC Company is empowering the clients for the advancement of their item and the clients are likewise glad in sharing their experience. This is considered as the most compelling and amazing advertising strategy[ 8] The developing business sector, improvement in the business atmosphere, ascend in the buyer spending are the main considerations will help the business for worldwide extension in a limited ability to focus time. It is additionally significant that the organization must pick the higher specialists for example individuals who are occupied with the administration so that they have a decent instructive foundation in that specific field. This will assist them with solving the issues or to talk about the issues with the customers or the partners in order to discover further answers for the problems[9]. In addition, the individual should likewise have important involvement with that field so they can deal with any circumstance. Besides, the chief should likewise be sure when they are taking any significant choices. This is essential in light of the fact that the supervisors need to persuade the colleagues and the representatives so they can receive these means. There must certain competitor s in the group who can motivate different laborers or has the ability to persuade the colleagues. The new activities must be taken by the supervisor of the organization and they should concentrate on these activities before offering need to some other. Besides, ABC Company should likewise pick such troughs who can think something inventive and concoct stunning thoughts so the organization can extend all around in a limited ability to focus time[10]. Significance of intrigue an incentive for the business experts It is additionally significant that the top most pioneers of the organization must be of that specific nation wherein the organization was set up at first. This is fundamental in light of the fact that the pioneers will have an away from of the issues and dangers that will be looked by the organization over the long haul. This issue was looked by the supervisor of ABC Company in light of the fact that the chief was from South Africa yet she had worked in Australia with numerous worldwide groups on different undertakings, for example, retail, the travel industry. farming, money and agribusiness. There were some business experts who were occupied with the business due to their advantage esteem as opposed to proficient turn of events. This has helped the organization to assemble different tasks which were of various sorts and examples in light of the fact that there were differe
Saturday, August 22, 2020
Oncologist paper :: treating cancer
Characterization of disease decides fitting treatment and decides the guess. Malignant growth grows logically from a change in a cellââ¬â¢s hereditary structure because of transformations, to cells with uncontrolled development designs. Order is m e as indicated by the site of inception, histology (or cell investigation; called reviewing), and the degree of the illness (called organizing). Site of Origin This grouping depicts the kind of tissue wherein the malignancy cells start to create. Here are some normal instances of site of starting point arrangement: Adenocarcinoma â⬠begins in glandular tissue Blastoma â⬠begins in early stage tissue of organs Carcinoma â⬠begins in epithelial tissue (i.e., tissue that lines organs and cylinders) Leukemia â⬠begins in tissues that structure platelets Lymphoma â⬠begins in lymphatic tissue Myeloma â⬠begins in bone marrow Sarcoma â⬠begins in connective or strong tissue (e.g., bone, ligament, muscle) Reviewing Reviewing includes looking at tumor cells that have been acquired through biopsy under a magnifying lens. The variation from the norm of the cells decides the evaluation of the malignant growth. Expanding irregularity builds the evaluation, from 1 â⬠4. Cells that are very much separated losely take after develop, specific cells. Cells that are undifferentiated are exceptionally anomalous, that is, juvenile and crude. Evaluation 1 Cells somewhat anomalous and all around separated Evaluation 2 Cells progressively anomalous and decently separated Evaluation 3 Cells irregular and ineffectively separated Evaluation 4 Cells juvenile and undifferentiated Organizing Organizing is the order of the degree of the sickness. There are a few sorts of organizing techniques. The tumor, hub, metastases (TNM) framework orders malignant growth by tumor size (T), the level of provincial spread or hub association (N), and far off meta asis (M). Tumor (T) T0 No proof of tumor Tis Carcinoma in situ (constrained to surface cells) T1ââ¬4 Increasing tumor size and contribution Hub (N) N0 No lymph hub contribution N1ââ¬4 Increasing degrees of lymph hub contribution Nx Lymph hub contribution can't be evaluated Metastases (M) M0 No proof of inaccessible metastases M1 Evidence of inaccessible metastases A numerical framework likewise is utilized to characterize the degree of malady. Stage 0 Cancer in situ (constrained to surface cells) Stage I Cancer constrained to the tissue of inception, proof of tumor development Stage II Limited neighborhood spread of harmful cells Stage III Extensive neighborhood and territorial spread Stage IV Distant metastasis A specialist who represents considerable authority in treating malignant growth. A clinical oncologist, or radiotherapist, works in treating malignant growth with radiation, and a clinical oncologist has some expertise in treating disease with drugs.
Thursday, August 13, 2020
How to Write in APA Style
How to Write in APA Style On this episode, we discuss how to write and format a paper in APA style, which is most commonly used in scientific writing and social sciences writing in subjects like criminology, anthropology, and psychology.Specifically, we address the following topics:What is APA style?Why do we use APA style?What are the basic formatting rules? For example, it should be written in 12-point font, be double spaced, and have 1-inch margins all around.What are some APA abbreviation rules? For example, do not put periods in between letters of abbreviations unless its a Latin abbreviation or the words U.S. or U.K.How should I use charts and graphs in APA style? For example, text within charts and figures must be Sans Serif and be between 8 to 14-point font in size.What should my title page look like? For example, it should include the papers title, authors name, and institutions name centered and in title case.What is an abstract and what should it look like? For example, the Abstract paragraph is in 12-point font and is double spaced.What should in-text citations look like? For example, in-text citations should include the authors last name followed by the year of publication.How should the references page be formatted? For example, References should be centered at the top, without bold, italics, or underlining.
Saturday, May 23, 2020
A Fools Payment - 947 Words
A Fools Payment A Foolââ¬â¢s Payment In the short story, ââ¬Å"The Necklace,â⬠a greedy and selfish woman brings financial ruin upon herself and her husband. They go from a comfortable lifestyle in a slightly shabby apartment to an impoverished existence in an attic apartment. Mathilde Loisel was born to a lower middle class French family, but she wished that she could have of noble birth. Her longing for a better life caused her great grief. When she could have been happy with her situation in life, instead she would dream of a grand home and wealthy, dignified friends. When she borrowed a diamond necklace from a friend and lost it at an elegant party, she brought downfall to her husband and herself. Not only does Guy de Maupassant use theâ⬠¦show more contentâ⬠¦She also felt much remorse and often wondered ââ¬Å"what life would have been like if she had not lost that necklaceâ⬠(Maupassant 10). Perhaps though, the most regret was felt after she talked to her rich friend who revealed that the neckla ce had not been a diamond one, but a cheap bauble. All of the debt and problems that she and her husband had faced because of the necklace were avoidable if she had just told her friend of its disappearance earlier. Maupassant showed that the necklace was definitely not worth the ruination that it caused the Loisels. The poverty and want that was brought about by the necessity to repay the loans taken out to pay for the replacement could have been avoided. If Mathilde had not been so foolish as to attempt to be what she was not, rich, or had told her friend the truth, then she would have saved herself and her husband from the grief and ruin it caused. Guy de Maupassant showed that the necklace not only represented the greed, ruin, and regret of a woman, but it also symbolized the crushed hopes of a woman who wanted too much from life. Hopefully, most people are happy with what life has bestowed upon the. If not, they should not attempt to gain material possessions that will only bring ruin and suffering instead of love and happiness. Bibliography: Maupassant, Guy de. ââ¬Å"The Necklace.â⬠Literature: An Introduction to Reading and Writing Ed. Edgar V. Roberts and HenryShow MoreRelatedForte of the Fool Essay513 Words à |à 3 PagesFeste is Olivias professional jester, or fool. He receives payment to entertain, sing, and make satirical observations. This license allows him to freely speak his opinion. In Shakespeares Twelfth Night, there is certainly no shortage of Festes opinion. The fool easily assesses the faults, idiocy, and disguises of all those around him. It is through his insightful interpretation of the characters that we are able to understand that the fool is more than likely the most intelligent personRead MoreOverview of Life Insurance Policies1049 Words à |à 4 PagesAccumulated value of the annual premiums that he puts in for 20 years is $ 7985. The method then adds the dividends to the policys total cash value and subtracts this value from the total premiums to determine the net cost of the policy. (The Motley Fool) The policys total Cash value at end of 20 years is $3620. $1613+ $3620= $5233. $7985 (total premiums) - $5233 = $2752. This is the net cost of the policy. To determine the net cost per $1,000 that the policy holder puts in, the company dividesRead MoreEssay941 Words à |à 4 Pagesthoughts to consider wisdom, and also madness and folly. What more can the kingââ¬â¢s successor do than what has already been done? I saw that wisdom is better than folly, just as light is better than darkness. The wise have eyes in their heads, while the fool walks in the darkness...â⬠(Ecclesiastes 2:12-14a NIV). The first thing that he acknowledges, is that the ââ¬Å"wiseâ⬠man is able to perceive and examine life. Because of this light, the ââ¬Å"wiseâ⬠man is able to live a more fertile life. On the other hand,Read MoreThe Mortgage Crisis And Attendant Real Estate Collapse Of The Late 2000s Crisis1543 Words à |à 7 Pagesthem here to make the point of three lessons to be learned. Too Good to Be True If something seems too good to be true, it probably is. Prior to the real estate meltdown, buyers were signing house notes with no down payments, without providing proof of income, and with loan payments that accounted for in excess of 50% of their take home pay. As Andrew Hallam notes in his book Millionaire Teacher, a contributing factor of the economic crisis was that buyers were simply signing up for more house thanRead MoreTraditional Net Cost Method of Accounting1142 Words à |à 5 Pagesannual premiums that she puts in for 20 years is $ 4314. The traditional net cost method then adds the dividends to the policys total cash value and subtracts this value from the total premiums to determine the net cost of the policy. (The Motley Fool) Thus: $814 +$ 4314 (total cash-value)= $5128 $5128- $ 4314 (total premiums)= $814 The net cost of Nicholes policy would be $814 To determine the net cost per $1,000 for Nichols policy, the company divides the result (i.e. $814) by the numberRead MoreThe Ethics Of A Christian Coach1671 Words à |à 7 Pagestime, because it builds up interest from month to month if the balance is not paid in full each month. We discussed multiple options for reducing credit card debt, including paying off smaller card balances first then moving that payment in addition to the normal payment to the next smaller balance card, and continuing this rotation until all credit card debt is paid off, thus freeing up more money for such things as savings, investment, or retirement funds. Another option is only using credit cardsRead MoreHow Budgeting And Spending Habits1670 Words à |à 7 Pages A Fool And His Money Are Soon Parted by Thomas Tusser Tera L. Overcast-Davis Daymar College The safest way to double your money is to fold it over and put it in your pocket. I think sometimes this is the best thing to do when learning of a new tax that I am going to have to pay or some expense that I did not plan on paying. In reality, a person does not want to stick their head in the sand but to plan short and long term goals so that he or she is preparedRead MoreThe Merchant of Venice Is a Tragicomedy....I Got 32/35 so Its a Good Essay1558 Words à |à 7 Pagesof manââ¬â¢s flesh taken from a man,â⬠Antonio was sure that he would have gotten his ships a month before his payment day was sue, however, this did not happen. This is seen when Bassanio read a letter that says, ââ¬Å"Sweet Bassanio, my ships have all miscarriedâ⬠¦my bond to the Jew is forfeit,â⬠Antonio now owes Shylock a pound of his flesh. Antonio tries to convince Shylock to other means of payment, but Shylock refuses. This is seen when Antonio says, ââ¬Å"I pray thee hear me speak,â⬠and Antonio replies, ââ¬Å"Iââ¬â¢llRead MoreOrganizational Control1411 Words à |à 6 Pagesassets to pay claims on short-term debts without selling inventory. The ratio expression indicates how much money is available versus how much short term debt is outstanding. A ratio of 2:1 indicates $2 in assets for every $1 in debt. The Motley Fool dissects Real Networks stock performance while determining whether or not to sell the stock. One positive sign for the company is a high current ratio ââ¬â 3.13 (Phillips, 2011). However, while the company has ââ¬Å"minisculeâ⬠debt, the companyââ¬â¢s equityRead MoreQuestions and Answers: Criminal Justice967 Words à |à 4 Pagesapproved vendor list â⬠¢ Independently verify all vendors before payment â⬠¢ Identifying shell company invoices ââ¬â Lack of detail on the fraudulent invoice ââ¬â Invoice that lacks detailed descriptions of the items billed ââ¬â Mailing address may be an indicator of fraud ââ¬â Consecutively numbered invoices over a period of time ââ¬â Reviewing payables and sorting payments by vendor and invoice number â⬠¢ Testing for shell company schemes
Tuesday, May 12, 2020
Childhood Obesity A Serious Problem - 1411 Words
We are what we eat. Most of us have heard this many times, and just do not believe it; however, it is shockingly true. The human body is made up of the nutrients it extracts from foods (Katz). The importance of the statement ââ¬Å"We are what we eatâ⬠often goes unrecognized, thus causing a major problem: parents not providing healthy diets for their children to ensure their best quality of life. Childhood obesity is a serious problem in America, and I believe it stems from parents. I have witnessed this first hand with my niece. It really bothers me that my sister-in-law often feeds my niece desserts and junk food instead of meats and vegetables. I have noticed that my niece is overweight and developing slower than she should. My family thinks it is cute, but I think it is starting her off in the wrong direction and posing problems for her future health. ââ¬Å"For children and adolescents aged 2-19 years, the prevalence of obesity has remained fairly stable at about 17% and a ffects about 12.7 million children and adolescents for the past decadeâ⬠(ââ¬Å"Childhood Obesity Factsâ⬠). The number one cause for obesity is consuming an unhealthy diet filled with extra calories the body does not need. In a study of 6,212 children ranging in ages from four to nineteen, one-third ate fast food every day. By consuming fast food that often, it is likely to add about six extra pounds per child each year and increase the risk for obesity (Holguin). Although childhood obesity is problematic, there areShow MoreRelatedChildhood Obesity : A Serious Problem2903 Words à |à 12 PagesINTRODUCTION (PROBLEM STATEMENT) Obesity does not exist among older people only. It can be seen among children and young adults. Childhood obesity is in fact ââ¬Å"a medical condition that affects children and teenagersâ⬠(What is Childhood Obesity). Childhood obesity is a very serious problem that every single person throughout the world should know about and also aware of. However, some people might wonder and ask ââ¬Å"what does overweight has to do with Childhood obesity?â⬠According to the Childhood obesity foundationRead MoreChildhood Obesity : A Serious Problem1221 Words à |à 5 PagesObesity is not only found amongst children, it is also found in pre-teen to teenage years as well. Childhood years are the most important period of a kids life, were they learn behavior and mold into the adult they will become. Starting bad eating habits early in the childhood years sets them up for more complications later in their lives. One out of three children in the U.S are obese, which most of them will end up facing a greater risk of having medical, social, emotional problems some even endRead MoreChildhood Obesity : A Serious Problem1918 Words à |à 8 PagesChildhood obesity is a serious problem in the United States and it is putting numerous children at risk of health issues in the future. According to the Merriam Webster dictionary, obesity is ââ¬Å"a condition characterized by the excessive accumulation and storage of fat in the bodyâ⬠(ââ¬Å"Obesityâ⬠). The rate of obesity has grown tremendously; in fact it is now being called an epidemic. There are several factors that come into play to cause childrenââ¬â¢s obesity to increase. American children are no longerRead MoreChildhood Obesity : A Serious Health Problem Essay1459 Words à |à 6 Pages Childhood obesity is a serious health problem that is associated with future diseases. Early mortality is also a result of childhood obesity. An obese child is more likely to develop chronic diseases in adulthood (Hood, Emie, 2005).Having obesity can increase the likelihood of Type 2 diabetes, kidney diseases, high cholesterol, cardiovascular diseases, sleep apnea, liver diseases, orthopedics problems, and cancer (Sahoo, Sahoo, Choudhury, SufiRead MoreWhy childhood Obesity is Becoming serious Problem?900 Words à |à 4 Pages Why childhood Obesity is Becoming serious Problem? Obesity is a serious problem in the United States. Obesity may have serious effects on children, and childhood obesity affect them in their adulthood. Our family friendââ¬â¢s son is ten years old and at least twenty pounds overweight .When I saw him the first time, several questions arose in my mind about his overweight. Why does he become obese? What are the cause and effect of obesity? How does it show up at the symptom of obesity? They live closeRead MoreChildhood Obesity : A Serious Public Health Problem3682 Words à |à 15 PagesIntroduction Childhood obesity is a serious public health problem in Canada that needs to be addressed in a timely manner. For the past few decades, the prevalence of childhood obesity in Canada has been on a steady rise, and up until now, it is still increasing and becoming an epidemic. Canada was ranked as the third most overweight and obese G-7 nation in 2005, following United States and the United Kingdom (ref?). The rise in the prevalence of childhood obesity in Canada between 1978 to 2004Read MoreChildhood Obesity : One Of The Most Serious Public Health Problem981 Words à |à 4 PagesChildhood obesity is one of the most serious public health problems in the 21st century. According to PMC, the US Library of National Health and Medicine and National Institutes of Health, over 42 million children under the age of five are obese worldwide in 2010, and that number continues to ascend at an alarming rate. Obesity occurs the body stores an excess amount of fat, and is more than what the person n eeds to survive. Some scientists have argued that males are considered obese when they areRead MoreEssay about Childhood Obesity1310 Words à |à 6 PagesPreparation Outline: Vitalba Evola Topic: Childhood Obesity General Purpose: To inform Specific Purpose: To inform my audience of two prevalent causes of childhood obesity. Thesis Statement: While there are many causes of childhood obesity, most are, in fact, preventable. Introduction I. Attention Getting Device: Our society has become a classic case of ââ¬Å"Battle of the Bulge,â⬠as our society now has an alarming number of obese individuals. But this isnââ¬â¢t from World War II; itRead MoreChildhood Obesity : A Serious Medical Condition That Affects Children And Adolescents878 Words à |à 4 Pages Research Paper on Childhood Obesity Childhood obesity is a serious medical condition that affects children and adolescents. It occurs when a child is overweight and well over the normal weight for his or her age and height. Child obesity is an important issue because the extra weight can lead children down the wrong path to health problems, such as high blood pressure, high cholesterol, and diabetes to name a few. Childhood obesity can cause children to become depressed and have poor self-esteemRead MoreObesity : Obesity And Obesity1334 Words à |à 6 PagesHealth Factors Related to Obesity in Adolescence Childhood obesity is a worldwide epidemic that has increased dramatically over the past few years. There are many reasons this could be and research shows that as cultures are developing kids are spending more time indoors than being active outside. Technology is becoming so advanced that people are now able to play sports right from the comfort of his or her living room couch. Although these technological advancements are quite outstanding and has
Wednesday, May 6, 2020
Pico Paper Free Essays
Are kidney patients who received a radical nephrectomy at a higher risk of impaired renal function and cardiac related death compared to those who received a partial nephrectomy? Kiara Wilson Nursing 3163 Dr. Linda Upchurch November 12, 2012 Background Are kidney patients who received a partial nephrectomy at a lower risk of impaired renal function and cardiac related death compared to those who received a radical nephrectomy? When a patient is diagnosed with kidney damage, a surgical nephrectomy is often performed. Kidney damage may be caused by blocked blood vessels, kidney stones, masses, infection, and/or kidney cancer. We will write a custom essay sample on Pico Paper or any similar topic only for you Order Now With this procedure the kidney damage may be treated and also prevent further damage. A partial nephrectomy is a surgical procedure to remove a portion of the kidney. Partial nephrectomies are normally done laparoscopically with hand assistance or with robot assistance. A radical nephrectomy involves removing the kidney and the adrenal glands. A radical nephrectomy may be done laparoscopically or by open abdominal surgery. My patient was diagnosed with damage of the left kidney. Blood tests were performed and the patient was found to have a toxic WBC granulation. This toxic granulation led infection, inflammation and sepsis. An abdominal and pelvic CT scan found a 7. 8 x 5. 6 x 6. 2 cm, solid, enhancing left lower pole renal mass and parasitic vessels in the infected area. A hand assisted partial laparoscopic nephrectomy was performed. They removed the lower portion of her left kidney. The kidney was to be tested for malignancy. The concern with my patient is that she has a past medical history of hypertension, anemia, and deep vein thrombosis. She is at an increased risk of further cardiac and renal complications. I believe these factors influenced the doctorsââ¬â¢ decision to perform a partial nephrectomy instead of taking the radical approach. To find research on this kidney condition, I accessed the Galileo database. I searched for information on ways to treat renal masses and kidney cancer. I found multiple articles about laparoscopic and radical (open) nephrectomies. I found many articles that discussed the differences between the two and the affects they have on patients who receive them. I found an interesting study called ââ¬Å"Partial Nephrectomy Is Associated with Improved Overall Survival Compared to Radical Nephrectomy in Patients with Unanticipated Benign Renal Tumours. I found it interesting because it was relevant to the health issues that were being addressed with my patient. There millions kidney patients who undergo these procedures each year. I wanted to discover which procedure provided the best outcome for my patient and others with similar kidney problems. Purpose According to this study, ââ¬Å"a partial nephrectomy has been associated with improved overall survival in patients with localized renal ma sses compared to those who received a radical nephrectomyâ⬠(Weight, 2010). The purpose of this study is to test the overall survival rate of patients who had unanticipated renal masses. Another objective of this study is to also study the effect of these procedures on cardiac specific survival rates and other causes of death related to decreased kidney function. Hypothesis The hypothesis for this study are that the use of partial nephrectomies would be first line of treatment compared to radical nephrectomies in that partial nephrectomies provide better protection of renal function. Decreased renal function will lead to a low survival rate. Patients who undergo radical nephrectomies will have higher rate of cardiac related deaths Design A seven year, nonrandomized study was conducted using 499 participants. Of these 499 particiapants, 111 patients had received a radical nephrectomy while 388 patients received a partial nephrectomy. The choice of which surgery to do was left of the surgeon and the patientââ¬â¢s preferences. They took into consideration the mass size, the appearance, the patientââ¬â¢s current health, life expectancy and the comfort of the surgeon in making their decisions. The patientââ¬â¢s comorbidities were assessed using the Charlson-Romano Comorbidity Index. Each patientââ¬â¢s vital signs were acquired using the Social Security Death Index. Anyone without a Social Security Number was excluded. The cause of death information from the patientsââ¬â¢ medical records was reviewed. From there the participants were further categorized by the condition that caused the death. Cardiac deaths ranged from death related to ischemic heart disease, CHF, ischemic stroke, myocardial infarction, ischemic stroke, and peripheral vascular disease. Renal deaths were broken down into death related to renal failure, renal insufficiency, or nephritic syndrome. All other possible causes of death were group together. Perioperative, postoperative data and renal function tests were collected before and after the procedures. Preoperative data was used to create the propensity model that was utilized in a multivariate model of survival. They measured the overall survival rate of the participants and cardiac specific survival rates. Findings Radical nephrectomies are greatly associated with an increased risk of death from any cause. Patients with unanticipated benign tumors that were treated with RN were more likely to die from any related health problem than those treated with PN. Participants who received a radical nephrectomy were more likely to be older, with high comorbidity scores, and larger tumors. Those with smaller masses and tumors were more likely to have a partial nephrectomy. Radical nephrectomies are associated with an increased risk of death by 2 folds from any cause. The risk of cardiovascular death was substantially higher in those with decreasing post-operative renal function. Decreased kidney function was related to an increase in cardiovascular death and death from any other cause in overall majority patients. Sixteen participants died of cardiac related deaths. Renal preservation was increased in the group that had the partial nephrectomy with majority of the patients having an eGFR above 60 %. Radical nephrectomy participants only had an eGFR of 30 % or lower. The higher eGFR is associated with an increase chance of survival in PN patients. Discussion Previous studies indicate that postoperative impaired renal function plays a role in the overall survival of patients with renal masses. The data concluded that no matter which surgery was performed there would be a decrease in kidney function. However, those patients who received a PN had a remarkable lower decrease in renal function. It can be stated that patients have decreased function are at an increased risk of cardiac related death and death by other causes. For many of those who donââ¬â¢t die from cardiac related death it can be concluded that other conditions that cause death are worsened by renal insufficiency. This study was relevant to the PICO question I asked. This study answered my question and provided the information necessary to make it a valid question. I believe the limitations to this study are that the researchers did not randomize their study. They picked which participants they thought would influence their study. The strengths of this article are that is discusses the importance of preserving renal function when performing a nephrectomy. It also provides evidence that patients should be educated on the risks of death and further complications associated with their procedures. It could allow for better planning and managing of the care for these patients. Implications As a nurse it would be my responsibility to knowledgeable about procedures such as these and how they will affect my patient. It would be my job to educate the patients on what to expect from this surgery and what it means for their health. I could also use this information to better assess patients before and after these procedures. This research provides material that could be used to better treat and prevent life threatening conditions that could arise after surgery. References Landman, D. (2006). Open Partial Nephrectomy. Retrieved November 9, 2012, from Kidney Cancer Institute: www. kidneycancerinstitute. com/open-partial-nephrec. html Landman, D. (2006). Open Radical Nephrectomy. Retrieved November 9, 2012, from Kidney Cancer Institute: www. kidneycancerinstitute. com/open-radical-nephrec. html Weight, C. J. , Leiser, G. (2010, April 29). Partial Nephrectomy Is Associated with Improved Overall Survival. EUROPEAN UROLOGY, 58, 293-298. Evaluation (to be completed by instructor)| Possible Points| Actual Points| Introduction of clinical problemComments:| 20| | Purpose/Aim of the study/articleComments:| 10| | Theoretical framework of the study/articleComments:| n/a| | Hypotheses/QuestionsComments:| 5| | DesignComments:| 5| | FindingsComments:| 10| | DiscussionComments:| 25| | ImplicationsComments:| 20| | ReferencesComments:| 5| | Grade| 100/100| /100| PICO Paper Grading Rubric (submit, along with PICO OAT form, with your paper) Student Name: _Kiara Wilson______________Date: November 12, 2012_____________ Are kidney patients who received a radical nephrectomy at a higher risk of impaired renal function and cardiac related death compared to those who received a partial nephrectomy? How to cite Pico Paper, Essay examples
Sunday, May 3, 2020
Educational Psychology
Question: Discuss about the Educational Psychology. Answer: Bronfenbrenners Bioecological Model of Development discusses the influences of the environment during the various phases of a child's growth and how each influence shapes the personality of child along the growth curve. Joseph Schooling's is an example of how good parenting, selection of the right schools and coaches during his formative years helped him achieve the goal of sporting excellence. It is important to note that the right genetic makeup may help the child to achieve brilliance and the careful choice of the various components of the environment help the gifted reach their goals with greater success. Bronfenbrenner described four components of child's ecological environment- the microsystem, the mesosystem, the exosystem and the macrosystem. The microsystem refers to the immediate layer or environment of the child's ecosystem. Family members, school, neighbourhood and the day care comprise the child's microsystem. The child interacts with people in this system on an everyday basis. But the influences are bi-directional in nature. Just as the parents influence the child's beliefs and thinking, the child also influences the beliefs of the parents. In an interview with Joseph Schoolings parents said that no matter how good an environment parents provide to the child, success ensues only if the child is focussed and that they were fortunate that their remained focussed throughout his journey to become an Olympic champion. The choice of the school that Joseph Schoolings' parents made when he was just 14 years of age played a great role in shaping the sports career of the accomplished swimmer. The Bolles School was chosen for him because it served the twin goals of facilitating his training as a swimmer and academics (Association, March 30, 2015). Joseph was able to make the most of the opportunity because he was a resilient kid. It was not an easy path for him because he struggled in the beginning since he was far from his home, school and friends in Singapore. It amounted to a sudden change in his microsystem (360, January 30, 2014). His parents did not protect him from the challenges he faced but were supportive of him. Another point that stands out is that Joseph's parents advised him to adhere to formal education. His move from school to Texas University was one such move. Joseph admits that a career in swimming is rather short and the education he receives will offer him opportunities much beyond his years in swimming. The mesosystem, according to Brofenbrenner encompasses the interactions between the components of the microsystem, for example, the interaction between parents and teachers. The careful choice of coaches in case of Joseph Schooling points to such an interaction (Bronfenbrenner, 1986). According to Bronfenbrenner's bioecological model of development the next layer that impacts a child's development is the exosystem. How the environment is perceived by an individual has immense impact on the way it affects the development of a person. The child does not directly function as part of the exosystem. The working schedule of a parent is not a prt of the child's ecosystem, but it does affect the child's development. cultural values, traditions, customs and laws form part of the macrosystem in which the child lives. Indirectly it affects the child's ecology and has an impact on shaping of a child's development. The components of the macrosystem can affect the microsystem in which the child's parents interact with her. he influence of Genetics on the superlative performance by Joseph Schooling cannot be undermined (Ahmetov Rogozkin, 2009). He has also acknowledged his parents for their unfailing support throughout the journey that saw him win the first Olympic gold medal for Singapore. Their role as motivators, providers and their readiness to make several sacrifices during his career have been important cornerstones of Joseph's success (Sin Li, 2017). They identified his talent as early as age 6 and nurtured his gift in the run-up to long and tedious journey that saw him beat Michael Phelps, a role model he had always admired. In Joseph Schooling's case the manner in which his natural talent was nurtured from very young age played a crucial role in his success. His immediate microenvironment was altered by sending him to the United States at an early age. It appears less likely that he would have achieved similar levels of success had he been trained in Singapore. The move enabled him to face world level competition frequently from a young age. World class trainers and coaches were able to help him lift his ability to the top echelons of the sport of swimming (Joseph Baker, et al., 2003). Even with the same levels of discipline, grit, motivation and focus his success on training on the home turf may not have materialised. So, nurture did play an important part in his success story. In conclusion, the four systems of Bronfenbrenner bioecological model of development do appear to influence the development of an individual through childhood and youth. The microsystem, mesosystem, the exosystem and the macrosystem appear to play an important role in who one grows up to become. The influence of the surrounding environment on a child is immense. The impact of the family, school, neighbourhood and the child care on the child cannot be small, since the child constantly interacts, communicates and learns in this environment. The shaping of Joseph Schooling's sports career on an international stage the inputs made to his microsystem appear to have yielded the enormous success in his sporting career. The role of his parents s mentors was indeed phenomenal. References 360, H., January 30, 2014. The Schooling Family talks to SuperSports 360 on fine art of parenting a top athlete. [Online] Available at: https://www.youtube.com/watch?v=PkhaHYfe5fs Ahmetov, I. Rogozkin, V., 2009. Genes, athlete status and training -- An overview.. Medicine and Sports Science, Volume 54, pp. 43-71. Association, S. S., March 30, 2015. Joseph Schooling's Development at The Bolles School. [Online] Available at: https://www.youtube.com/watch?v=fzt6ckNC0y0 [Accessed 11 February 2017]. Bronfenbrenner, U., 1986. Ecology of the Family as a Context for Human Development: Research Perspectives. Developmental Psychology, 22(6), pp. 723-742. Joseph Baker, ?. S. H. J. R.-W. a. M. W. B. J., Horton, S., Robertson-Wilson, J. Wall, M., 2003. Nurturing Sport Expertise: Factors Influencing the Development of Elite Athlete. Journl of Sports Science and Medicine, 2(1), p. 19.. Sin, Y. Li, T., 2017. ST Singaporean of the Year 2016: Joseph Schooling pays tribute to parents after trio win award. The Straits Times, 7 February.
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