Isokinetic Muscle Strength In Patients Health And Social Care Essay Free Essays

The intent of this survey was to measure the lower appendage isokinetic musculus strength, to find affected musculus groups and their dependance on motion speed, and to happen out the relationship between musculus strength and clinical badness, every bit good as musculus strength and falls, in Parkinson ‘s disease ( PD ) . Twenty-five patients diagnosed with PD and 24 healthy voluntaries were enrolled in this survey. The lower appendage musculus strength was evaluated with an isokinetic ergometer. We will write a custom essay sample on Isokinetic Muscle Strength In Patients Health And Social Care Essay or any similar topic only for you Order Now Clinical position was examined in conformity with the Unified Parkinson ‘s Disease Rating Scale ; autumn history was besides recorded. We have observed that there was a important lessening in isokinetic musculus strength in the patient group, particularly in both of the hip and articulatio genus flexors and extensors. It has been found that reduced musculus strength was independent of speed, and correlated with clinical badness and falls. In decision, motion velocity-independent lower appendage isokinetic musculus failing has been observed in patients with PD, particularly in the articulatio genus and hip articulations. Therefore, the rating of isokinetic musculus strength may be a utile tool for the appraisal of clinical badness and falls in PD. Keywords: Parkinson ‘s disease ; Isokinetic ; Muscle strength ; Lower appendage 1. Introduction Parkinson ‘s disease ( PD ) is a common neurodegenerative status in which patients typically experience troubles such as awkwardness of motions ( bradykinesia ) , stiffness of the musculuss ( rigidness ) , shudder, balance perturbations, and progressive lessening in motor functions.1-3 When combined with multiple other factors, decreased musculus strength can take to falls among aged patients, doing breaks, joint disruptions, terrible soft tissue lesions, and caput trauma.4,5 As a back uping fact, the autumn rate is higher among those with PD compared to healthy aged persons, harmonizing to the clinical image of the disease.4,6 Muscle failing is one of the chief symptoms of PD.7 In recent clinical tests, decreased musculus strength has been observed in patients with PD.8-12 Kakinuma et al.12 measured the isokinetic musculus strength on articulatio genus extension and i ¬Ã¢â‚¬Å¡exion, and they observed isokinetic strength decrease on the side that is more greatly affected by PD. In another survey, Nallegowda et al.9 tested the bole, hip, and ankle flexor and extensor musculuss ‘ strengths utilizing isokinetic measuring, and reported a lessening in strength in all the flexor and extensor musculus groups. Pedersen et al.10 obtained lower isokinetic homocentric torsion consequences compared to command topics on quantitative appraisal of dorsii ¬Ã¢â‚¬Å¡exors. Inkster et al.11 observed that decreased strength at the hip muscles is an of import subscriber to the trouble in lifting from a chair among patients with PD. Finally, Nogaki et al.8,13 hypothesized that musculus failing in PD is likely to depend on motion speed. In contrast to the isokinetic ratings mentioned supra, there are some surveies in which quantitative isotonic and isometric musculus strengths have been evaluated.7,14,15 So far, there has been no survey in the literature that evaluated the isokinetic strength of the hip, articulatio genus, and ankle articulations together. There are some limited surveies, nevertheless, that evaluated the musculus groups at different isokinetic speeds in the lower extremity13, every bit good as the correlativity between musculus strength, and clinical position and falls9 among patients with PD. In this survey, we evaluate the lower appendage flexor and extensor isokinetic musculus strength at the hip, articulatio genus, and ankle articulations in patients with PD. We aim to happen out which musculus groups and motion speeds of the lower appendage are more greatly affected by the disease, and we seek to detect the relationship between musculus failing, and clinical position and falls. 2. Materials and Methods 2.1. Patients This survey was designed as a cross-sectional, controlled survey. The patients included in this work were from the outpatient clinics of the Physical Medicine and Rehabilitation, and Neurology Departments, and were diagnosed with PD harmonizing to the United Kingdom Parkinson ‘s Disease Society Brain Bank criteria.9 The survey was approved by the local ethical commission at the Inonu University School of Medicine and carried out in conformity with the rules in the Declaration of Helsinki. Written consent was obtained from all the participants. Twenty-five patients ( 17 males and 8 females ) were included in the survey. The average age of the patients was 62.1A ±10.3 ( with a scope of 42-81 ) old ages. All patients were at Hoehn A ; Yahr phase II or III, and were having intervention for PD. None of the patients had any serious orthopedic, neurological, vestibular, or ocular upset that could impact their musculus strength, and all of them could walk unsupported. Twenty-four healthy voluntaries ( 13 males and 11 females ) with no orthopedic, neurological, or other diseases constituted the control group, which was age-matched with the patient group. 2.2. Appraisals 2.2.1. The Unified Parkinson ‘s Disease Rating Scale ( UPDRS ) and Hoehn A ; Yahr presenting Patients were assessed with the usage of the Unified Parkinson ‘s Disease Rating Scale ( UPDRS ) portion II ‘activities of day-to-day populating ‘ ( UPDRS-ADL ) and portion III ‘motor scrutiny ‘ ( UPDRS-ME ) 16, and Hoehn A ; Yahr staging.17 2.2.2. Fall history We used a standard definition for autumn, which is â€Å" accidentally coming to rest on the land, floor, or other lower degree. â€Å" 18 For the interest of coherence with the definition, coming to rest against furniture or a wall was non accepted as a autumn. The figure of falls was determined utilizing self-reported autumn events during the past 6 months. 2.2.3. Isokinetic musculus strength Isokinetic musculus strength trials were administered in the forenoon before the patients took any medical specialty. Patients foremost warmed up for 10 proceedingss on a bike dynamometer with a burden of 1 W/kg. We used the Biodex System 3 Pro ( Biodex, Inc. , Shirley, NY, USA ) isokinetic ergometer for the isokinetic measurings. During the trials, the patients were stabilized with seat belts in order to supply joint stabilisation and to forestall them from falling off the trial chair. All trials were performed on both appendages. The isokinetic protocol consisted of trials at three angular motion speeds of 90, 120, and 150 degrees/sec at 10 revolutions per minute, with a 5-min remainder period between trials. We followed the same process for hip flexion-extension, knee flexion-extension, and ankle plantar/dorsiflexion. The articulatio genus and mortise joint trials were performed in a seated place, while a supine place was used to find hip flexure and extension strength. All trials were performed for homocentric musculus strength every bit good, where the maximal extremum torsion ( Nm ) was recorded at each angular velocity.9 2.3. Statistical analysis We used the SPSS 16.0 package for statistical rating of the trial consequences ( SPSS, Chicago, IL, USA ) . The normalcy for uninterrupted variables in groups was determined by the Shapiro-Wilk trial. We used Student ‘s t-test or Mann-Whitney U trial for comparings, whereas Spearman ‘s rank correlativity trial was used for analysis of informations. For correlativity analysis, the mean musculus strength was calculated at 90, 120, and 150 degree/sec angular motion speeds over the entire values for the hip, articulatio genus, and ankle musculuss. A p value of less than 0.05 was taken as the degree of significance. 3. Consequences The descriptive features of the patient and control groups are presented in Table 1. It can be observed from the tabular array that there was no statistically important difference between the two groups in age, weight, and tallness. The average disease continuance was 5.6A ±3.9 ( with a scope of 1-15 ) old ages. Fifteen patients ( 60 % ) were in Hoehn A ; Yahr phase II, and 10 ( 40 % ) were in phase III. In the patient group, the UPDRS ME and ADL tonss were 26.3A ±12 and 8.9A ±5, severally. During the last 6 months, the figure of lumbermans in the patient group was 12 ( 48 % ) , compared to merely 4 ( 16.7 % ) in the control group ( P lt ; 0.05 ) . The mean figure of falls was found to be 0.9A ±1.1 in the patient group and 0.2A ±0.5 in the control group ( P lt ; 0.001 ) . The isokinetic musculus strength of the patient and control groups is shown in Table 2. At all speeds, the musculus strength of hip flexors ( P lt ; 0.01 ) and extensors ( P lt ; 0.05 ) was found to be significantly less in the patient group. Similarly, compared with the control group ( P lt ; 0.05 ) , we observed a important lessening in the musculus strength of articulatio genus flexors and extensors in the patient group, irrespective of the speed. Furthermore, the isokinetic extremum torsions of ankle plantar- and dorsiflexor musculuss exhibited significantly smaller values at certain motion speeds in the patient group ( P lt ; 0.05 ) . We observed a considerable relationship between musculus strength and figure of falls ( P lt ; 0.01 ) . The correlativity between musculus strength and Hoehn A ; Yahr phase was statistically important. There was besides a strong correlativity between musculus strength and all UPDRS tonss ( P lt ; 0.01 ) . However, there was no correlativity between musculus strength and disease continuance. 4. Discussion The lower appendage musculus strength is known to hold a outstanding consequence on mobility. So far, there have non been any surveies in the literature that evaluated the overall flexor and extensor musculus strength in the hip, articulatio genus, and ankle articulations in patients with PD, although several surveies have evaluated the musculus strength in merely one or two articulations separately10,12,13. In this survey, we assessed musculus strength with an isokinetic ergometer in an effort to find which musculus groups were more greatly affected, and at which of the evaluated motion speeds, and to measure their correlativity with clinical position and falls. While many surveies have evaluated isokinetic musculus strength before ( off province ) and after ( on province ) medicine, we chose to prove all the patients in the forenoon after backdown of medicine ( off province ) . The chief ground for this pick is to govern out the effects of medicine while measuring the musculus fail ing that exists as portion of the nature of PD. The positive effects of antiparkinsonian agents on musculus strength have already been shown in many studies9,19 and are outside the range of this survey. Nallegowda et al.9 evaluated the isokinetic musculus strength at the bole, hip, and ankle flexor and extensor musculuss at 90, 120, and 150 degree/sec angular speeds, which are the same as the 1s used in our survey. They found a important difference in all musculus groups between patients who did non take medicine and the healthy control group. In contrast, we evaluated the articulatio genus flexor and extensor musculus strength alternatively of the bole flexor and extensor musculus strength. As a consequence, we observed a important failing in all hip and articulatio genus musculuss at all evaluated speeds, every bit good as in mortise joint musculuss at some certain speeds. There was besides pronounced musculus failing in the hip flexors compared to the other musculus groups. Hip flexors are the major gas pedals in the swing stage of the gait.20 The trouble in gait induction in patients with PD may lend to the apparent failing of the hip flexors. However, Bartels et al.21 suggested that freeze of pace was non correlated with bradykinesia. Alternatively, ankle musculus strength is more of import in forestalling falls and for proper pace. Less terrible mortise joint musculus failing than the other musculus groups demonstrates the importance of other factors like proprioception. Zia et al.22 pointed out the damage of joint place sense in patients with PD. These consequences suggest the possibility of different underlying diseased mechanisms. Pedersen et al.10 evaluated the mortise joint dorsiflexor isokinetic musculus strength both concentrically and eccentrically, and found significantly lower values for the homocentric musculus strength at all motion speeds compared to the control group, while the bizarre musculus strength was different from the control group merely in male patients. Kakinuma et al.12 separated the topics into two groups harmonizing to their holding more- or less-affected appendage, and found that the isokinetic musculus strength decreased at both the slow and fast motion speeds during the early period of the disease. They besides observed that the difference in musculus strength between the more- and the less-affected appendages decreased in the advanced phase of the disease. Our survey and the surveies mentioned above 9,10,12 demonstrated no relation between the reduced musculus strength and the motion speeds. Nogaki et al.13 found a important lessening in the peak torsion of the isokinetic musculus strength compared to the less-affected appendage at high motion speeds but no difference between the two appendages at lower motion speeds. Therefore, the observation of increased musculus failing at higher motion speeds, which was proposed in the survey by Nogaki et al.13, is comparable with the determination in our survey. Although Corcos et al.23 indicated an asymmetric distribution of musculus failing, our survey has shown the common musculus failing in patients with PD to be similar to those found in the survey by Nallegowda et al.9 In some studies9,13, the importance of the cardinal consequence on musculus failing was emphasized, but the consequence of immobilisation was non considered in patients with PD. The effects of immobilisation on musculus failing should be noted, particularly in aged patients with PD. Assorted surveies reported the hazard of falling in those with PD to run from 38 to 70 % 2,4,9. Our consequences sing the per centum of patients who have suffered from falls were similar. There was a important relationship between falling and musculus strength, but we have non come across any surveies on the association of musculus strength with falls in patients with PD. Some authors24,25 have observed musculus failing at lower appendage as a hazard factor for falling. Therefore, the hazard of falling may be examined in connexion with lower appendage isokinetic musculus strength in patients with PD. We found a pronounced correlativity between musculus strength, and UPDRS ME and ADL tonss. Since the UPDRS ME and ADL tonss are related to clinical position, we had already expected to happen such correlativity between these parametric quantities and musculus strength. The UPDRS is a often used measuring for measuring the clinical state of affairs of patients with PD.26 Given the important correlativity between musculus strength and the UPDRS, isokinetic musculus strength may be used to measure clinical position of patients. Disease patterned advance in PD was evaluated utilizing Hoehn A ; Yahr presenting. Increased disease badness ( a†°?stage III ) leads to more pronounced locomotor system abnormality.27 Most of our patients were in Hoehn A ; Yahr phase II. As can be seen in Table 3, there appeared a important correlativity between isokinetic musculus strength and Hoehn A ; Yahr phase. Muscle failing in our patients was non outstanding, as they were at an early phase of PD. It seems musculus failing is related to clinical badness instead than disease continuance. The chief restrictions of our survey are the unequal figure of patients and the absence of lower speeds, such as 60 degrees/sec, at which isokinetic musculus strength could be evaluated. In drumhead, we found a important lessening in bilateral hip, articulatio genus, and ankle flexor and extensor isokinetic musculus strength, which was particularly outstanding in the hip muscles at 90, 120, and 150 degree/sec angular motion speeds. In add-on, we detected a relationship between disease badness and musculus failing. Furthermore, a important correlativity was besides present between musculus strength, and UPDRS ME and ADL tonss. Finally, there was a pronounced association between musculus strength and figure of falls. 5. Decisions Taking the consequences of our survey into consideration, we have shown that although musculus strength decreased in the lower appendage, particularly in the hip and articulatio genus, musculus failing was non associated with the speeds at which it was evaluated in this survey. We have demonstrated that the rating of musculus failing degree may be a utile tool for the appraisal of clinical badness and autumn hazard in patients with PD. It should be noted, nevertheless, that conflicting old consequences and the deficiency of specific criterions necessitate farther surveies. Recognition The writers would wish to thank Associate Professor Saim Yologlu ( Department of Statistics, Inonu University School of Medicine ) for his sort part to this survey. How to cite Isokinetic Muscle Strength In Patients Health And Social Care Essay, Essay examples

Competition and Regulation in Network Industries †Free Samples

Question: Discuss about the Competition and Regulation in Network Industries. Answer: Introduction Work Centred Analysis or WCA is done to understand the proper working of the real systems in a business process. This method has been developed through numerous iterations to structure a framework that analyses the working structure of a business process. The entire business process works of structured frameworks that comprises of six elements. These are the business process, services and products generated by the business process, the participants in the business process, internal and external customers of the business process, information generated as a result of the process and the technology involved in the process (Naikar 2016). The following report would analyse and compare the business process of the Australia Post using this framework before and after the implementation of digital disruption event. This analysis would include the WCA of Australia post with the retrospective analysis and the assumptions done due to lack of relevant information. Next it would analyse the goals and challenges associated with the case followed by recommendations along with implementation plans based on the recommendations. The working structure of Australia Post has aided the entire Australian population with iconic postal services. It is one of the oldest postal services in Australia providing the entire Australia for over 200 years. Australia Post has total workforce strength of about 50,000 people serving through the entire Australia starting from the common people to huge business organizations. The entire working structure of the Australia Post is a complex structure. It works through 4,417 retail outlets out of which 2,560 have been placed at rural areas (Lgreid 2017). Of these, nearly two thirds of the outlets are owned by private sectors and belong to licensed post offices. However, the usual system of the business pillar in transferring letters is being slowly obsolete due to the latest advancement of technology. This has formed a major setback for the industry and services of Australia Post. The traditional framework for the industrial setup of Australia Post depended on the basic technology of delivering letters and posts to the Australian population with focus on the modulation and synchronization. There have been considerable rise in the amount of letters mailed in by the Australian people till the time of Australia Posts inception. It has also been found that the GDP alignment have given rise to the traditional postal services and mail volumes. However, the entire system has faced a major setback between the years of 2008 to 2009 and from 2014 to 2014 with declination in mail volumes by 25 percent (White et al. 2016). This intercept has forced the Australia Post organization to face a reduction in mail volumes by 4.5 billion items (White et al. 2016). This has forced the Australia Post to face a huge loss in economy by 151 million AUD and was suspected that it would increase by 300 million AUD in future (White et al. 2016). Problem identification from the case The problem identification of the case would include the WCA for Australia Post with respect to the company structure before and after the implementation of the digital disruption in the organization. This would follow the WCA of Australia Post referring to the structure below with the assumption due to lack of relevant information and goals associated with the case: The business process: The assumptions and the retrospections clearly focuses on the idea that the latest technology change could easily create a havoc into the Australian Post business unless the organization adapts to the latest technology and embraces the idea of digital disruption. Therefore, it is necessary that the digital disruption be adapted by Australia Post to sustain the entire business process of the organization. Assuming that this digital disruption would affect the business for Australian Post in a negative way, it could also be said that the business for the retail industries would be affected to an extent that due to economic crunch the number of retail outlets gets reduced (Cape and Groves 2017). Services and products: The products and services that the company provided before were weak in terms of the technological advancement that occurred as a result of the digital disruption. These were the letters and parcels that are gradually becoming obsolete as a service to be provided. The participants: A part of the workforce could even think of an employment change due to the failure of adapting to the latest technology. The people that Australia Post has been serving to had also started changing its priorities and gradually have been shifting to the latest technology advancements. This does not only involve the big organizations but also the people in general. Internal and external customers: The internal customers are the stakeholders in the company that are directly involved with the operations of the company and the external customers are the general population of Australia who uses the services provided by the company. Due to the changes in the technology, the internal and external customers are most likely to be influenced into changing their priorities to technologically advanced services. Information generated as a result of the process: The raw material that formed the base of the entire business for Australia post to generate the information system from one place to another with precision and integration is hampered in the first place due to the technology adaptations for electronic mail. Technology involved in the process: The assumptions that could be made based on the work centred analysis of Australia Post could be based on discretion rather than on relevant available information. The latest technology advancement has given the opportunity to assume that the services provided by Australia post can slowly become obsolete and stop functioning ending the functions for the organizations that have been in vogue since the past 200 odd years (Georgakis and Molloy 2016). Goals associated with the case Australia Post has been associated with the leading indicator for GDP. Since the GDP rise, there has been a considerable rise of the production of Australia Post, in terms of production as well as propagation (Babb 2015). Parcel business had seen a considerable rise by triples during that time. However, after the implementation of the digital disruption across the entire globe there has been a fall in the business of the Australia Post. The e-commerce business has turned Australia post from a letter monopoly to a measly organization that has come down to importing parcels and letters all over Australia. The digital disruption have also made the organizations realise that the primary competition do not arise from the competitors but actually due to the advancement of the technology from letters to emails (Jaag and Finger 2017). The organizational changes therefore must adapt to the digital diversities to not fall vulnerable to being obsolete as a service in the market. Below are the g oals that after the Digital Disruption event Australia post have implemented to stay put to the race in keeping its previous monopoly structure (Cameron 2015). These are: Pursuing new ventures and opportunities like merging with the electronic mail world and other technologically advanced retail businesses Implementing tangible platform in the organization through the retail network Implementing the newest technology beyond the elaborate websites and mobile apps to transform the customer experience Building digital capability by providing support Investing in new business opportunities Challenges associated with the case The most challenging outcome of the digital disruption in the organization of Australia Post is the business obligations imposed by the transformation of the digital world. The most challenging factor about embracing the changes in the digital world is the transformation of the entire business from being analytical to digital, with the implementation of digital technologies as a forefront of strategies (Cameron 2015). The three challenges that the Australia Post faces most vigorously is the compulsion during the adaptation of the organization to innovate according to the digital disruption, co-creation of the products and the disruption interpretation. This means that the organization should be going beyond websites that are elaborate in nature and the mobile apps. Implementing the digital functionalities resource the pursuing initiatives to help in the true transformation of the customer experience. This is used for building digital capability through the support investment in new b usiness opportunities (Alberti-Alhtaybat, Al-Htaybat and Hutaibat 2017). Australia Post must have a concrete platform and the opportunity of applying effectively of its retail network. The challenges faced as a result ofdigital disruption by this established mail businesshas been such that without significant business rearrangement, the entire organization of Australia Post could incur a loss of 6.8 billion AUD within a span of 10 years, incurring huge losses in the mail business shifting up to 12.3 billion AUD (Berman and Marshall 2014). The governments equity in Australia Post would quickly be destroyed, which is currently at a range of 1.7 billion AUD (Bughin 2017). Therefore, these are the challenges that are being faced by the organization after the latest Digital Disruption event. As per the case study, it can be recommended that the organization could transform its operations as the hubs for digital communication, which specializes in sales and marketing of services and products that are digitally enabled. As an instance it could be said that, these hubs has the ability to provide digital access and services to people who are unable to digitally access the communication services and devices for various obligations. Australia Post can also actively pursue new opportunities in the mail business by implementing the digital media such as, MyPost, but these initiatives has still a lot to prove as an innovative process in customer service witnessed in banks and other technology-intensive retail businesses. Furthermore, it is recommended that the postal outlets that are opted for provide as hubsfor innovation forming a center for the business structure, as well as its development and testing with new ideas for communication through the digital media. These ideas happen to make use for application and adoption in nearby areas. Australia Post has an ability to put into practice the technology start-ups by giving access to its digital distribution and communication platforms, which is absolutely necessary for prototype development as well as introducing products to market. Conclusions Therefore, it can be concluded from the above case study report for the digital disruption effect on Australia Post that the event had affected the organization in many ways. This is again explained in the report in two ways. The first part describes about the retrospective analysis of the organization before the implementation of the digital disruption and the next part explains about the plight of the organization after the implementation. The first part describes that the organization Australia Post had a monopoly over the market with letter and mail distribution and during GDP the sales have been soaring high earning a huge amount of revenue. This is again been analysed with added assumptions since there were no available relevant information. The next part clears the organization goals and challenges after the digital disruption event when Australia Post was about to implement the technological transformation into the organizational structure. Finally, it could be said that the organization of Australia Post could have been obsolete as a business organization from being a monopoly if it did not adapt to the technological change that have evolved due to the digital disruption event. Reference Alberti-Alhtaybat, L.V., Al-Htaybat, K. and Hutaibat, K., 2017. A knowledge management and sharing business model for dealing with disruption: The case of Aramex.Journal of Business Research. Babb, J., 2015. National affairs: Can Australia Post be saved?.News Weekly, (2945), p.10. Berman, S. and Marshall, A., 2014. The next digital transformation: from an individual-centered to an everyone-to-everyone economy.Strategy Leadership,42(5), pp.9-17. Bughin, J., 2017. The best response to digital disruption. MIT Sloan Management Review,58(4). Cameron, N., 2015. Bridging the digital divide at Australia Post.CIO, (Spring 2015), p.45. Cameron, N., 2015. Making new friends. CIO, (Spring 2015), p.6. Cape, S. and Groves, P., 2017. Changes to the Universal Service: Influencing Factors, Impacts and Regulatory Implications. InThe Changing Postal and Delivery Sector(pp. 257-269). Springer, Cham. Georgakis, S. and Molloy, S., 2016. From old soccer to new football? Expert accounts of transformations on the world game in Australia post-Crawford Report.Soccer Society,17(1), pp.72-89. Jaag, C. and Finger, M., 2017. What future for the post office network?.Competition and Regulation in Network Industries, p.1783591717741789. Lgreid, P., 2017. Transcending new public management: the transformation of public sector reforms. Routledge. Naikar, N., 2016.Work domain analysis: Concepts, guidelines, and cases. CRC Press. White, T., Evans, J., Williamson, I.O. and Gillies, E., 2016, January. Leveraging opportunities from digital disruption: A shared value approach at Australia Post. InAcademy of Management Proceedings. Academy of Management Briarcliff Manor, NY 10510.

What Is Meant by Relevance, Reliability and Comparability Essay Example

What Is Meant by Relevance, Reliability and Comparability Essay Explain what Is meant by relevance, reliability and comparability and how they make financial Information useful. 10 marks) (b) During the year ended 31 March 2006, Porto experienced the following transactions or events: 0) entered Into a finance lease to rent an asset for substantially the whole of its useful economic life. (ii) a decision was made by the Board to change the companys accounting policy from one of expensing the finance costs on building new retail outlets to one of capitalizing such costs. He companys statement of comprehensive Income prepared using historical costs showed a loss from operating Its hotels, but the company Is aware that the increase in the value of its properties during the period far outweighed the operating loss. Explain how you would treat the Items in (l) to (Ill) above in Ports financial statements and Indicate on which of the Frameworks qualitative characteristics your treatment Is Dates (15 marks) 2. Elite Leisure is a private limited liability company that operates a single cruise ship. The ship was acquired on 1 October 1996. Details of the cost of the ships components and their estimated useful lives are: component (hull, decks etc) fittings 150 original cost ($million) appreciation basis Ships fabric 25 years straight-line Cabins and entertainment area 300 12 years straight-line Propulsion system Useful life of 40,000 hours At 30 September 2004 no further capital expenditure had been incurred on the ship. In the year ended 30 September 2004 the ship had experienced a high level of engine trouble which had cost the company considerable lost revenue and compensation costs. The measured expired life of the propulsion system at 30 September 2004 was 30,000 hours. Due to the unreliability of the engines, a decision as taken in early October 2004 to replace the whole of the propulsion system at a cost of $140 million. The expected life of the new propulsion system was 50,000 hours and in the year ended 30 September 2005 the ship had used its engines for 5,000 hours. We will write a custom essay sample on What Is Meant by Relevance, Reliability and Comparability specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on What Is Meant by Relevance, Reliability and Comparability specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on What Is Meant by Relevance, Reliability and Comparability specifically for you FOR ONLY $16.38 $13.9/page Hire Writer At the same time as the propulsion system replacement, the company took the opportunity to do a limited upgrade to the cabin and entertainment facilities at a cost of $60 million and repaint the ships fabric at a cost of $20 million. After the upgrade of the cabin and entertainment area fittings it was estimated that their remaining life as five years (from the date of the upgrade). For the purpose of calculating depreciation, all the work on the ship can be assumed to have been completed on 1 October 2004. All residual values can be taken as nil.

Essay on Gibbs Nursing Model on Reflection The WritePass Journal

Essay on Gibbs Nursing Model on Reflection Introduction Essay on Gibbs Nursing Model on Reflection ). The Gibbs (1988) model of reflection suggests that the process of reflection is systematic and follows a number of specific steps in order to be successful. This model of reflection is a type of formal reflection, which draws on research and puts forward a theory as to how most effectively put into practice to process of reflection. The process can be broken down into six key steps: Description: this step explores the context of the event and covers fine details such as who was present at the event, where it happened and what happened. Feelings: this step encourages the reflector to explore their thoughts and feelings at the time of the event. Evaluation: this step encourages the nurse to make their own judgement about the event and to consider what went well and what went less well about the event. Analysis: this step delves even deeper into reflection on the event and encourages the nurse to break the event down into smaller episodes in order to facilitate analysis. Conclusions: this step explores the potential alternatives that may be used to deal with the situation that is being reflected upon. Action Plan: this is the final step in the reflection process. The action plan is put into place in order to deal more effectively with the situation if or when it may arise again. The Royal College of Nursing (2012) believes the Gibbs (1988) model of reflection to be particularly superior because emphasises the role of emotions and acknowledges their importance in the reflection process. Nursing can often be an emotionally charged career, especially for nurses working in areas such as psychiatric health and palliative care. Therefore, reflection on these emotions and exploration of how to manage them and improve management of them in the future is of particular importance in the nursing profession.   Case Study Step One (Description) A young male patient aged 16 years came into the clinic around three days ago. He complained of low self-esteem and is feeling fed up and depressed because of pimples and spots on his face. The patient was worried that   Ã‚  girls would not be attracted to him because of the spots. The consultation took place with just myself present, no other nurses were in the room at the time of the appointment. The consultation lasted around half an hour, during which time myself and the patient discussed the history of his problems with his skin and the emotional distress that the spots were causing him. The patient disclosed that he had begun to get spots at around age 14 when he had started puberty and that it had begun to make him feel extremely self-conscious. The patient described the negative effect that the acne was having. For example, he has been bullied at school and is feeling apprehensive about starting sixth form in September because he believes that he will be the only sixth form er with spots. Based on the reasonably lengthy history of the acne, the presence of acne on the face and the negative emotional effect that the acne was having, a three month dosage of oxytetracycline was prescribed for the patient. Step Two (Feelings) During the consultation I had a number of feelings. Primarily I felt sympathy for the client because his situation reminded me of my own time as a teenager. I suffered from bad skin from the ages of 14 to about 20 and it severely affected my own self-esteem. In a review of the literature, Dunn, O’Neill and Feldman (2011) have found that patients suffering from acne are more at risk of depression and other psychological disorders. However, the review also found that acne treatment may lead to improvement of the psychological disorder that are so often co-morbid. This made me feel re-assured that prescribing oxytetracycline had been the right thing to do. My own experiences of acne also meant that I was able to relate well to the patient. I also felt some anger during the consultation. This anger was directed at the patient’s peers who had been cruel enough to taunt and tease the patient because of his acne. I also felt regret and guilt. I regretted not referring the pati ent onwards for emotional support and for not exploring the psychological impact of the acne in more detail. I also felt a sense of pride that this young man had the courage to come to the clinic by himself to seek help for his acne. I remembered how upsetting acne was as a teenager and I remembered that I would have been too embarrassed to have ever gone to a clinic or to have sought help from an adult. In turn, I also felt happiness. I felt happy that this young man had come to the clinic and I felt happy that I was able to help him. Step Three (Evaluation) On evaluation, the event was good in a number of ways. Firstly it added to my experience of dealing with young people and in dealing with the problems that are unique to this population of patients. I have not had many young patients during my nursing career and I welcome the opportunity to gain experience with this group. Furthermore, it re-affirmed my career choice as a nurse. During your career you always have doubts as to whether you have chosen the correct path. However, there are points in your career when you feel sure that you have made the right choice. However, there were also some negative elements. Firstly, the appointment was quite short and I am worried that this may have made the patient feel rushed and uncomfortable. After the consultation I did some research into the effects of acne in young people. Purvis et al. (2006) have found that young people with acne are at an increased risk of suicide and that attention must be paid to their mental health. In particular, the authors found that directly asking about suicidal thoughts should be encouraged during consultations with young people. This information only served to make me feel more anxious and I wished that I had bought this up with the patient. Step Four (Analysis) On reflection, being able to relate to the patient increased my ability to deal more effectively with the situation. I feel that the patient was able to open up more to me because he sensed my sympathy for him and his situation. Randall and Hill (2012) interviewed children aged between 11 and 14 years about what makes a ‘good’ nurse. It was found that the ability to connect to them was extremely important and so I think this is why the patient felt comfortable opening up to me. On reflection, I am also now convinced that the patient coming to see me was a very positive event. The patient could have chosen to go on suffering and could have chosen not to open up and talk about the problems his acne was causing. In a review of the literature, Gulliver, Griffiths and Christensen (2010) found that young people perceived embarrassment and stigma as barriers to accessing healthcare. Therefore, it could have been very easy for the patient to have avoided coming and seeking help. I felt a range of both positive and negative emotions during the consultation, and I think this re-affirmed for me that I enjoy nursing and enjoy helping others. It is important to genuinely care about patients and to provide them with the best care possible. This would be hard to do if you did not feel empathy for patients. The experience also helped me realise that I need to actively search out training and learning opportunities regarding working with young people with mental health issues. Step Five (Conclusion) If the same situation was to arise again I think that I would approach it in a slightly different way. In particular, I would have offered to refer the patient to further support services. During the consultation the patient mentioned that he felt that the spots on his face made him unattractive to the opposite sex. In addition to providing medication to get to the biological and physiological roots of the problem, on reflection I think it would have been beneficial to the patient to have provided information about charities that offer self-esteem and confidence building. Such charities that offer these services include Young Minds (youngminds.org.uk/) and Mind (mind.org.uk/). In retrospect, I also believe that I should have given the patient a longer consultation time in order for us to have explored the psychological impact of his acne in more detail. Coyne (2008) has found that young people are rarely involved in the decision-making process when it comes to their consultations. Th erefore, giving the patient more time to discuss his problems may have improved his sense of wellbeing as he felt more involved in his care process. Step Six (Action Plan) There are a number of elements to my action plan. Firstly, I will make sure that in the future the consultation room has leaflets and information pertaining to mental health problems in young people. This way, young people can access the information if they perhaps feel too embarrassed to talk about it. Hayter (2005) has found that young people accessing health clinics put a high value on a non-judgemental approach by health staff. Therefore, in future I would be sure to be aware of my attitude and make sure that either subconsciously or consciously; I am not making any judgements about the patient. Hayter (2005) also found that young people had serious concerns regarding confidentiality, especially during busy times at the clinic. Therefore, in the future I would be certain to reassure young people that their details and consultations are kept completely confidential. To re-assure young patients, I may ask them to sign a confidentiality form, which I will also sign in front of them. Furthermore, my action plan will include improving my knowledge and awareness of working with young people as a nursing professional. This will allow me to increase the tools and skills I have for dealing with young people with complex needs. During the consultation I felt anger toward the patient’s peers who had teased him. In the future, I will focus on being more objective when dealing with a patient who has been the victim of bullying. References Coyne, I. (2008) Children’s participation in consultations and decision-making at health service level: A review of the literature. International Journal of Nursing Studies, 45(11), pp. 1682-1689. Dunn, L.K., O’Neill, J.L. and Feldman, S.R. (2011) Acne in adolescents: Quality of life, self-esteem, mood and psychological disorders. Dermatology Online Journal, 17(1). Available at: http://escholarship.org/uc/item/4hp8n68p [Accessed 20 October 2013]. Gibbs, G. (1988) Learning by Doing: A guide to teaching and learning methods. Oxford: Further Education Unit. Gulliver, A., Griffiths, K.M. and Christensen, H. (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry, 10(1), pp. 113. Hayter, M. (2005) Reaching marginalised young people through sexual health nursing outreach clinics: Evaluating service use and the views of service users. Public Health Nursing, 22(4), pp. 339-346. Paget, T. (2001) Reflective practice and clinical outcomes: practitioner’s views on how reflective practice has influenced their clinical practice. Journal of Clinical Nursing, 10(2), pp. 204-214. Purvis, D., Robinson, E., Merry, S. and Watson, P. (2006) Acne, anxiety, depression and suicide in teenagers: A cross-sectional survey of New Zealand secondary school. Journal of Paediatrics and Child Health, 42(12), pp. 793-796. Randall, D. and Hill, A. (2012) Consulting children and young people on what makes a good nurse. Nursing Children and Young People, 24(3), pp. 14. Royal College of Nursing (2012) An exploration of the challenges of maintaining basic human rights in practice. London: Royal College of Nursing.

Edit and Proofread Your College Essay in Eight Steps

Edit and Proofread Your College Essay in Eight Steps Editing is a necessary part of the writing process. When you edit something you write, you inevitably make it better. This is especially true when it comes to writing essays.  Proofreading and editing your essay can seem tedious, but it is actually a simple task if you tackle it in an organized manner. Just remember to take it slow and check for one thing at a time. Step One: Use the Spellchecker Chances are you used a word processor to compose your essay. Most word processing programs are equipped with a spellchecker. To begin editing your essay, use the spellchecker option to check for spelling errors. Correct problems as you go. Next, use the grammar checker on your word processing program (if it has one) to check for grammar errors. Most grammar checkers now look for comma usage, run-on sentences, passive sentences, tense problems, and more. Using your judgment and the grammar checker’s suggestions, edit your essay. Step Two: Print Your Essay Now it’s time to begin manually checking your essay. You could do this on your computer but it is better to print a copy if you can. Errors will be easier to catch on paper than on a computer screen. Step Three: Review Your Thesis Statement Begin by reading the thesis statement of your essay. Is it clear and easy to understand? Does the content of the essay properly support the statement? If not, consider revising the statement to reflect the content. Step Three: Review the Introduction Make sure that your introduction is concise and adequately developed. It should be more than a statement of your intentions and opinion. The introduction should set the tone of your essay- a tone that continues throughout. The tone should be consistent with the subject matter and the audience that you want to reach. Step Four: Review the Paragraph Structure Check the paragraph structure of your essay. Each paragraph should contain pertinent information and be free of empty sentences. Get rid of any sentence that seems slightly irrelevant. Also, check your transition sentences. Your essay will appear choppy is there is not a clear transition from one idea into the next. Step Five: Review the Conclusion The conclusion of your essay should reference your thesis statement. It should also be consistent with the structure and/or argument of your essay. Take extra time to polish your conclusion. It will be the last thing the reader sees and the first thing that they remember. Step Six: Read Your Essay Aloud Next, read your essay aloud. Pause in your reading as punctuation indicates. This will help you determine how your essay flows and sounds. If you hear something that you don’t like, change it and see if it sounds better. Step Seven: Manually Check Spelling, Grammar, and Punctuation Once the content of your essay has been rewritten, it’s essential that you manually check for spelling, grammar, and punctuation errors. Your word processor will not catch everything. Check carefully for subject/verb agreement, tense sequence, plurals and possessives, fragments, run-ons, and comma usage.   Step Eight: Get Feedback If possible, have someone else read your essay and offer suggestions for improvement. If you don’t have anyone who can do this for you, do it yourself. Because you’ve spent so much time looking at it by now, set your essay aside for a couple of days before going back to it. This will allow you to critique it with a fresh pair of eyes. Editing and Proofreading Tips When writing your essay, make sure you allow time for edits.Follow the rules of your assignment. If you were given a word count, abide by it.Fact check. Fact check. Fact check.For a more organized essay, create an outline prior to writing. When you edit, refer to your outline to make sure that you covered all of the necessary points.Proofread slowly. Its easy to miss errors when you read too fast.

Profile Speech about Trail of Tears- Removal of the Cherokee Essay

Profile Speech about Trail of Tears- Removal of the Cherokee - Essay Example IV. (Preview body of speech) Today, I shall tell you what prompted the U.S. government to decide the fate of thousands of Native Americans. Next, I will tell you how tribes such as Cherokees were affected following which I shall take you back to the fateful â€Å"Trail of Tears.† Finally, being an optimist, I will share with you the present conditions of the relocated people and the role of the U.S. government in their lives today. 3. Americans and Cherokees signed a treaty. This treaty was supposed to bring in some form of civilization among the tribal men i.e. they were expected to give up hunting and adopt farming. The Cherokees accepted the terms since it not only meant progress but it also meant that the Americans would further on mind their own business and leave them alone. This deadly trek, during the course of which thousands of Cherokees perished, loved ones died in front of the eyes while others stood helpless. The Cherokees only stopped some time to bury their dead and continued marching westwards. The Cherokees called this journey – â€Å" Nunna dual isunyi† meaning the trail where we cried. In English, this earned popularity as the â€Å"Trail of tears† (Fradlin,2008). (Transition) It is true, that today as I stand here talking about our American Native brothers and sisters, their plight is still the same. Almost a million of them still remains in abject poverty and lead a life of prejudice. The American Indian Relief Council works towards helping the Native Americans build a stronger community and bring in positive changes in their lives by offering services from literacy to nutrition (American Indian Relief Council).

Sustainability Essay Example | Topics and Well Written Essays - 1000 words

Sustainability - Essay Example A second reason was the strategy could become a guide to encourage infrastructure investment. A third reason was to encourage nature conservation by. Lastly the process could help encourage new entrants into tourism rather than into sectors which could destroy the long term prospects of tourism. The second section deals with what a sustainable tourism strategy is and how it differs from a conventional tourism plan. Conventional plans more closely resemble traditional marketing plans as it is designed to increase visitor numbers, turnover etc. through community resources. Sustainable tourism plans rely on wider regional analysis whose hallmarks include analysis of current tourism assets and future tourism development and a discussion of how tourism could be used for social benefits and probably most importantly strategies should be long term in their approach. The next section identifies how these strategies are produced. Firstly the strategy makers should have a number of objectives in the tourism, economic, ecological, and social sectors. Secondly, consultation with affected parties should be wide ranging and strategies should be an evolving/long term enterprise. In this regard the focus of this paper was wide ranging. It was a well laid out argument which identifies what the problem is, why strategy formulation should be paramount, how the strategy should be developed and the effect that strategy formulation has had in real world experiences. The only critique would be that in order to reinforce the importance of strategy development, perhaps examples of how not adhering to this sort of strategy should produce negative