Clinical Outcome Research Regarding Pediatric Bipolar...

Section 1. Summary of Clinical Outcome Research Regarding Pediatric Bipolar Disorder Bipolar Disorder is a life-impacting condition that is often chronic, creates significant impairment, and is marked by a cycling between depressive and manic episodes. These episodes are manifested by unusual and extreme shifts in mood, energy levels, and behaviors that interfere with executive functioning (Wilkinson, Taylor, Holt, 2002). Divided into two levels of diagnosis; Bipolar I Disorder is defined by the occurrence of a manic episode that may or may not be accompanied by hypomanic or major depressive episodes (American Psychological Association, 2013). Furthermore, a diagnosis of Bipolar II Disorder is comprised by a hypomanic episode and a major depressive episode (American Psychological Association, 2013). For many years, the diagnosis of Bipolar Disorder in children has been controversial, partly due to the difficulty of identifying symptoms that are age appropriate versus clinically significant in children (Birmaher, 2013). Furthermore, Pediatric Bipolar Disorder can often present similarly to or occur comorbidly with other disorders such as Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder, and anxiety disorders (Hart, Brock, Jeltova, 2014). Flaherty (2013) depicts Pediatric Bipolar Disorder as often having similar symptomatic presentation to pediatric schizophrenia. However, in recent years, Pediatric Bipolar Disorder has been gainingShow MoreRelatedWhat Is Childhood Bipolar Disorder?2344 Words   |  10 Pages What is Childhood Bipolar Disorder? A Review of the Literature Barbara Diaz University of Houston-Downtown Author Note This paper was prepared for Psychology 4308, taught by Dr. Jennifer Montgomery Abstract Since the 1990s, the amount of children who are diagnosed with a form of bipolar disorder have rocketed sky high. Children, like adults can possibly have neurological issues in the brain that does not allow them to function properly. These children are seen as hyperactiveRead MoreEarly Diagnosis And Indicators Of Bipolar Disorder3068 Words   |  13 Pagesdiagnosis and the application of a variety of therapies for bipolar disorder are examined through the lens of a mix of quantitative, qualitative and mixed peer reviewed journals acquired from data sources such as MEDLINE, and Psycinfo by using Boolean language in Lamar University’s library data base. 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LAVANYA P SHARMA DEPARTMENT OF PSYCHIATRY, NATIONAL INSTITUTE OF MENTAL HEALTH AND NEUROSCIENCES (INSTITUTE OF NATIONAL IMPORTANCE) BANGALORE, 560029 2017 NATIONAL INSTITUTE OF MENTAL HEALTH AND NEUROSCIENCESRead MoreHealth Advocacy Campaign3015 Words   |  13 Pages6 million individuals live with a serious mental illness such as schizophrenia, depression, or bipolar disorder (National Alliance on Mental Illness, 2013). http://www.nami.org/factsheets/mentalillness_factsheet.pdf. Further, data revealed that 20 percent of youth ages 13 to 18 years old have experienced severe mental disorders within a given year, and about 13 percent of these populations are pediatrics patients that range between the ages of ages 8 to 15 years old. The United States spends nearlyRead MoreMedical Test with Answers Essay example16933 Words   |  68 Pagescriterion for an occupational and environmental health nurse? A. Serves as a consultant to businesses and management. B. 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Essay on Cartesian Dualism and Gilbert Ryle - 1899 Words

Gilbert Ryle is well known in the philosophical world specifically as a behaviorist. According to Internet Encyclopedia of Philosophy behaviorist are â€Å"followers in the ‘ordinary language’ tradition of analytic philosophy, while, for the most part, regarding behavioral scientific hopes as vain, hold views that are, in other respects, strongly behaviorists†(Hauser 1). In the middle of the twentieth century the ordinary language behaviorist movement was strongly covered by Ryle and Wittgenstein. These bright minds established a relationship; â€Å"In 1929 Ryle met Wittgenstein and struck up a friendship that profoundly altered the direction of Ryle’s Philosophical thinking†( Stroll 147). Oxford took over for Cambridge as the center of philosophy†¦show more content†¦It is not merely an assemblage of particular mistakes. It is one big mistake and a mistake of a special kind. It is, namely, a category mistake†(Ryle 26). Ryles thesis i n The Concept of Mind is that the official doctrine has key principles that â€Å"are unsound and that conflict with the whole body of what we know about minds when we are not speculating about them†(Ryle 23). Laid out, the official doctrine retain that every person has a body and a mind, that they are normally â€Å"harnessed† together and that after death of a body the mind may continue to function and exists. Cartesian theory summarized; embraces that volitional acts of the body are caused by volitionl acts of the mind thus mental acts determine physical acts. Ryle thought the ‘official theory’ was absurd or bitter like, and labels it â€Å"the dogma of the Ghost in the Machine†. A great portion of Ryle’s argument is pointed toward a â€Å"category mistake†. These mistakes that Ryle makes note â€Å"The mistakes were made by people who did not know how to wield the concepts University, division and team-spirit. Their puzzles arose from inability to use certain items the English vocabulary†(27). This dualist doctrine formed a polar opposition between the mind and body. Ryle states that the official doctrine as a category mistake; â€Å"It represents the facts of mental life as if they belonged to one logical type or category (or range of types or categories), when they actually belong to another†(26). Meaning mind andShow MoreRelatedDescartes Teachings On Dualism977 Words   |  4 Pages To understand how the dualist commits a category mistake, one must first understand Descartes’ teachings on dualism from the Meditations on First Philosophy. Firstly, Descartes sees the mind as an immaterial, non-physical soul. He believes that his thoughts can be altered but he can never be tricked into the thinking that he is thinking when he is not. While he has complete faith in the existence of his mind, he doubts the existence of his body and the existence of other people s minds. The reasonRead Mor eThe Theory Of The Mind Body Dualism1232 Words   |  5 Pagesaccording to the Encyclopedia Britannica, â€Å"was one of the first to abandon scholastic Aristotelianism and created the first version of the modern mind-body dualism or emotion† (Encyclopedia Britannica). Born on March 31, 1596, he was dubbed as the Father of Modern Philosophy. His theory on the mind-body dualism, also known as Cartesian Dualism, created a stem of the modern problem of the relationship between the mind and body. He created the early version to further explain the interaction of theRead MoreCartesian Dualism vs Logical Behaviorism Essay1483 Words   |  6 Pagesrelevant to philosophy of the mind and discussed through a variety of arguments. Two of the most important arguments with this discussion are Cartesian dualism and logical behaviorism, both of which argue the philosophy of the mind in two completely different ways. Robert Lane, a professor at the University of West Georgia, define the tw o as follows: Cartesian dualism is the theory that the mind and body are two totally different things, capable of existing separately, and logical behaviorism is the theoryRead More Gilbert Ryles The Concept of Mind Essay2412 Words   |  10 PagesGilbert Ryles The Concept of Mind In The Concept of Mind Gilbert Ryle attempts, in his own words, to explode the myth of Cartesian dualism. His primary method in this endeavour is to explain why it is a logical error to describe minds and bodies with semantically similar language; while secondarily, he proposes that even to speak of minds as a second-order ontology is to take the first step in the wrong direction towards intellectual clarity. Thus, with the desire to arrive at this hypotheticalRead MoreThe Mind And Body Problem1443 Words   |  6 Pagesstates. Behaviours visually express mental states better than knowing if one has a Cartesian soul or the requirement of a normal human brain. Body: It is reasonable to think that the patient has the usual range of mental states because she is behaviourally indistinguishable from a normal human. Behaviours make mental states more evidentially obvious than knowing the brain state of a patient or if they have a Cartesian soul or not. Doctor 4 provides the argument that since the patient is behaviourallyRead MoreEssay on The Philosophy of Cognitive Science2158 Words   |  9 PagesThe Philosophy of Cognitive Science Psychophysical dualism — the distinction between mind and body — is the counterposition between essentially irreducible elements: the mind and body. Such a dualism implies the main ontological problem of the philosophy of cognitive science and philosophy of mind: the mind-body problem (MBP). The dualism and the referred-to problem has been insistently discussed in the philosophical tradition and several solutions have been proposed. Such solutions are properlyRead MoreDualism And Its Effects On The World1870 Words   |  8 Pageshave been gracefully put to rest, Dualism has, for better or worse, stuck around. Here I will briefly discuss a few of the proposed alternatives to Dualism and some of the issues they have encountered, with the aim to show that, unlike those subjects covered by the physical sciences, the mind brings it some unique properties that may simply not lend themselves to physical explanation. Ryle s Onslaught and the Behaviorists In his book The Concept of Mind, Gilbert Ryle made a seminal argument that wouldRead MoreThe Mind Body Problem, By Rene Descartes Essay1331 Words   |  6 Pageslarge collection of problems which focuses upon the fundamental issue of reality and knowledge in so far as such analysis may clarify the relationship between the mind and body, and the intelligibility of any alleged relationship between them. Cartesian dualism holds the presupposition that man is made of two elements, a body and a soul (mind). This presumption is informed by the notion that man by his ability to think, choose, reason, imagine, etc. cannot just be physical, there must be something inRead MoreWhat Advantages Does Spinoza’s Substance Monism Have over Descartes’ Dualism?3467 Words   |  14 PagesDescartes’ dualism. Through works such as the Ethics, Spinoza seeks to address the main flaws in Descartes’ philosophy. These flaws included but were by no means limited to, proof for the existence of God and the interaction between mind and body. This essay will highlight the advantages of Spinoza’s monism over Descartes’ dualism by looking at Spinoza’s response to these issues. First, in order to consider the advantages of Spinoza’s substance monism over Descartes’ dualism it is necessaryRead MoreThe Cartesian Theory Of Mind1648 Words   |  7 Pagesresponsible for many ideas and theories still used in the philosophical world today. He earned the nickname â€Å"Father of modern philosophy† for his work. One of his most in depth and lasting legacies is his â€Å"mind-body dualism† thesis also known as the Cartesian theory of mind. The Cartesian theory states that there are two different types of existence, physical and mental. Whatever exists must fall into only one of these existences and they cannot be both. This could be compared to the two faces of

Pen and Paper Free Essays

Many people believe that formal â€Å"pen and paper† examinations are not the best method of assessing educational achievement.Discuss this view and give your own opinion.achievement ? improvement Schooling development is becoming increasingly popular and prominent as well as education improvement is (the improvement of education representing) (N+N) an essential stage for any countries(country) which seeking to develop itself. We will write a custom essay sample on Pen and Paper or any similar topic only for you Order Now Number of people (A considerable number of people ) think that using a pen and paper in examinations are(is) not the best way of appreciation education achievement(means by which to appreciate educational achievement) .Opponents regards(regard) that using(the use of) classic formal (pen and paper)examinations are(as being)(( the best manner of assessing education development (by which to assess educational development). This essay will discuss these tow (two) views in terms of the technological field and the traditional field .On the one hand , there is no justification for using traditional examinations in the presence (the face of the expansion) of technology . By(The use of) technological tools and programs becomes processing a data (makes data processing) after the test very(highly) comfortable and easy (straightforward). In addition , it can be use the information(the information can be used) to discover things(examine issues) such as the discovery of common mistakes , finding the most difficult questions and many more(so on) . Furthermore , it is really easy to correct examinations after the exams(subsequent to being sat) , as well as do not take a long(taking less) time to finish all it (such corrections). For example , the TCExam is an electronic tasting(testing) program which(for) making a exams and (that) it can correct 100 exams for (in) less than one minute . Because of technology , it could say (be said that) we do not use traditional exams are no longer needed.On the other hand , classic exams could reinforce a saving words(the retention of information) in the human memory rather(better) than any(other) method . For instance , According(according) to statistics , when the learner use writing(writes information) by hand , prevent forget words(they forget)30% for the (less of the information than a )person using a computer . Moreover , using a pen and paper in a formal are(setting allows for a) very straightforward examinations . When(When) are decided(deciding) to using(use) a traditional exams technique , there is only a need to (for) papers and pens , unlike technological exams which need to(a) complete set of equipment . and accurate . As a result , using(the use of a) formal (pen and paper) examination can represent a substantial element in education(educational) development .In conclusion , it might not be possible to cover all the aspects of this issue . However , this essay has focused only on the technological field and traditional fields . The most important points that have mentioned are that there is no justification for using traditional examinations in the presence of technology , and (whilst )using a pen and paper formal are(allows for a) very straightforward examinations . Finally , it can be said that using technological exams most likely represents the best way of assessing education(educational) achievement . How to cite Pen and Paper, Papers

Research Process and Development of Evidence

Question: Describe about the Report for Research Process and Development of Evidence. Answer: Evidence-based practice (EBP) refers to an interdisciplinary approach in nursing practice. The approach has been gaining ground since its introduction in clinical medicine in 1992. Its origin was in the field of medicine where it began as evidence-based medicine (EBM) (Wallin, Bostrm, Wikblad Ewald, 2003). Later it soared to other areas among them dentistry, psychology, audiology, nursing, and social work among others. There are three primary principles of EBP, which are listed below. (1) Gathering the best research evidence that explains whether and why a treatment method works. (2) The presence of clinical experience and judgment to determine the health state and diagnosis of the patient. (3) The preferences and values of the patient (DiCenso, Guyatt Ciliska, 2014). There are different types of evidence gathered in EBP. They include the meta-analysis and systematic reviews, randomised controlled trials, cohort studies, case-control studies, and case series/reports. The particular instance determines the nature of the evidence required in question (Horn Gassaway, 2007). Therefore, these different types are used evidence methodologies applied in various scenarios. The health practising must understand what each entails, and ensure that he/she identifies the one that best fits in the case under analysis (DiCenso, Guyatt Ciliska, 2014). Meta-analysis evidence incorporates information gathered from quantitative methods, independent studies, and synthesis of summaries and conclusions that can be effective therapeutically (Banning, 2005). The second type of proof is systematic review collected from published books and articles. Randomised controlled trial, which is another kind of evidence, is gathered previous works involving clinical trials, with one treatment and a control experiment. The research process used to gather randomised controlled trial evidence is a random selection of treatments. Cohort studies refer o evidence collected on identified and distinct populations. Case-control studies are another critical type of proof used in clinical practice. The process of gathering such evidence involves the identification of an affected group and another that is not affected by the diseases being studied. The type of proof seeks to determine the exposure to diseases in different regions. Finally, there is the case ser ies and reports, which are clinical presentations that are often followed by evaluative studies, and eventually diagnosis (DiCenso, Guyatt Ciliska, 2014). It is important to note at this stage that there is no comparison in the case series and reports. It is expected that the practitioner should determine the level of evidence to use in clinical practice. It is not possible to find the highest level of evidence (experimental study), which is often, gathered using systematic reviews and controlled trials. The second tier of evidence is the quasi-experimental studies, in which the information is collected using a combination of randomised controlled studies and quasi-experiments. Meta-analysis research approach may be utilised or not. The third level of evidence comprises of non-experimental studies. Qualitative studies and systematic reviews with or without meta-analysis fall under this level. Other standards include the opinion of authorities based on scientific research and based on experimental and non-research evidence. The grading or rather hierarchy of proof helps other practitioners who might use the information gathered to determine the strength of the literature and sources of the knowledge before applying in EPB (Tabak, et al. 2012). Evidence-based practice (EBP) is widely recognised in the health sectors globally. It is seen as a crucial driver towards positive outcomes in clinical and nursing practices. Scholars define EBP as "careful incorporation of most reliable research evidence into clinical practice and patient values and needs with the aim of delivering cost-effective, and high-quality health care services" (Grove, Burns, Gray,2014, p.4). Therefore, based on the definition it is evident that EBP provides nurses with the opportunity to use safe and suitable treatment approaches and decision-making procedure. It is through doing the use of evidence that the quality and cost-effectiveness of health care services improves as well. Considering the importance of EBP in clinical practice, nurses should not view it as an extra workload. The knowledge base they gain from various educational programs, which prepare them for the research in the development of EBP, serve a critical role in ensuring that they understand the importance and significance of basing different medical interventions on researched information (Majid, et al. 2011). It is general practice for nurses to reflect daily on the various treatment options they have used during the day. That helps them identify weaknesses and strengths in different treatment methods and also enables them to evaluate the various options and how effective they are when used on patients. The reflection forms the basis of the research process through which evidence in clinical practice is developed. Making references to the evidence gathered does not imply that the process has to be lengthy, complicated, and full of protocols, with access to the internet and local policies, and based on best practice statements/reports (Satterfield, et al. 2009). However, nurses have to develop the ability to differentiate the bases knowledge and skills. That way they can easily apply the evidence from research studies in their practice with great ease. During the investigation process, nurses are required to take their time and formulate effective research questions. They then have to go back to the issues and carefully seek for answers. That means that they have to expand their clinical expertise to incorporate research skills, which are essential in finding evidence. Grove, Burns, and Gray (2014) identify critical article reviewing as one of the best ways for nurses to locate the evidence they are looking for within a short time. It is possible for nurses to make effective decisions by thoroughly analysing and critiquing previous research journals. The primary focus when carrying it the reviews should be on the reliability and validity of the information contained in the journal articles. It is possible for nurses to predetermine the most likely effects of the evidence they find from various sources on their clinical outcome (Rycroft-Malone Bucknall, 2011). During the research and evidence development process nurses must take in to account the legal and ethical dilemmas that arise from time to time in their clinical practice (Gerrish, et al. 2007). They must also identify gaps within their research processes and suggest ways improve the available evidence through further/expanded studies. In a nutshell, nurses are expected to harness critical clinical question formulation, literature searching skills, and research analysis skills in the process of developing their EBP. They must also have access to various agency databases, which support the development of evidence-based practice. These include theCumulative Index to Nursing and Allied Health Literature (CINAHL) and the British Nursing Index (BNI) (Tabak, et al. 2012). It is important for nurses to seek clarifications from their colleagues to ensure that they questions they formulate meet the ethical and legal considerations. They clinical research questions must show respect to the beliefs and values of patients and employees in the health facility. Therefore, care must be taken to ensure that the issues are developed in a highly ethical manner. Nurses should try to search the highest level' of evidence such as systematic reviews, which involve the ranking and compilation of evidence acquired by research methods use to collect such information (Hunink, et al. 2014). Systematic reviews often analyse the findings of high-quality studies, with most of them being reviews of randomised controlled trials. Such reports identify the interventions that are likely to work and limitations in the studies, which must be addressed before the application of the evidence from such sources. By doing this, bias is reduced in the process and effects of various inter ventions are not overestimated. Through the use of proof, nurses reduce the time require in carrying out critical appraisals. It is important to note that although the clinical practice is patient centred, there is the still lack of appreciation when it comes to best evidence for a patient's response emotionally, physically, and mentally. Instead, the primary focus is on scientific interventionism (Rycroft-Malone Bucknall, 2011). There are several barriers to the implementation of EBP in clinical and hospitals. The first common barrier is the lack of information and skills required for the process to function effectively (Kitson, 2002). There are many cases of health professionals lacking adequate knowledge in regards to clinical research findings and recommendations. As a result, they lack the skills to apply the information from evidence-based research studies in their practice (Munroe, Duffy, Fisher, 2008). At the end of the day, such health professionals rely more on their expertise than clinical evidence (Majid, et al. 2011). Another barrier is the lack of time to apply research in their practice (Grol Wensing, 2004). It is especially the case in clinical facilities where the number of nurses remains low as the patients continue to increase. In such situations, nurses and other health professionals face the challenge of applying research in their practice and at the same time providing medical care ser vices within a short time frame. To handle the issue of time management, educators and researchers have developed a toolkit to help ease the application of evidence-based practice in clinical practice (Majid, et al. 2011). Despite the development of the "toolkit", there are cases where health professionals have no prior knowledge to use the equipment preventing them from applying evidence in their practice. Polit and Beck (2013) indicate that the dissemination process informs people about the findings of specific research studies. There are different methods of presenting such results, among them seminars, videos, and professional journal articles (Tabak, et al. 2012). However, with the development of technology and the fact that the internet is accessible in almost all parts of the world; it is possible for researchers to post the results of their studies on National Health Service (NHS) trust or university websites. However, there is a significant shortcoming in that information from the internet provides no guarantee of quality and reliability (Gerrish Lacey 2006). Scottish Intercollegiate Guidelines Network guidelines are circulated for free across Scotland. Therefore, they must be made available in all hospitals as soon as they are available; however, on their own, they have proved to be ineffective. It is especially the case if the dissemination is done through educational interv entions and later implemented using patient-specific means that relate directly to the nursing activities (Tabak, et al. 2012). So far this paper has discussed various elements of evidence-based practice in clinical practice and the research process through which information for use in healthcare service delivery is acquired. The paper has also considered the importance of EBP and barriers to its practical application in the health care sector. Further, to this essay will be critical reviews of two journal articles. Each article will be evaluated on the basis its appropriateness for application in EBP. Critique 1 Kyle, R. G., Neall, R. A., Atherton, I. M. (2016). Prevalence of overweight and obesity among nurses in Scotland: A cross-sectional study using the Scottish Health Survey.International journal of nursing studies,53, 126-133. As the title of the article suggests, Kyle, Neall and Atherton (2016) seek to explore and identify the prevalence of obesity among nurses. The aim is to use nurses as a health promotion tool by studying their habits and behaviours and how they influence the obesity rate among the nurse professionals. Unlike other studies on obesity, the three researchers take a professional group as a representative sample. The fact that nurses handle different health issues implies that they ought to be role models when it comes to eradication of certain ailments, Therefore, estimating the prevalence of obesity and overweight among them is crucial. The aim of the research, in the article, was to determine the overweight and obesity rate among nurses in Scotland and compare the data to the prevalence in other professionals, which are not health related. It is evident from the onset that the study does not intend to provide a solution to a particular health issue. Hence, it is only likely to serve as an informative study, but not necessarily a useful evidence source. Moreover, it is a cross-sectional study, hence, describes the relationship between obesity and the nature of one's profession. It is evident that although Kyle, Neall and Atherton incorporate statistical data in their article, most of the information is on prevalence. There is little information on how to change the outcomes and the timing of exposure in cross-sectional studies (Whittemore, 2005). Therefore, most of the information in the article is not applicable in intentions, but rather useful in diagnosis. Studies such as this one, which is more useful in diagnos tic tests than actual treatment, are referred to as blind comparison studies (Tabak, et al. 2012; Brownson, et al. 2010). The information in this study can be used a controlled trial. Therefore, it can be categorised under the third level of evidence, which incorporates information from quasi-experiments and other controlled trial cases (Brownson, et al. 2010). It is possible to compare information on the prevalence of obesity among healthcare professionals to workers in other fields and determine which factors cause the discrepancies. Through such comparisons, a nurse can easily identify the risk factors associated with obesity and overweight issues. Therefore, although this study does not provide treatment options, it can be used for diagnostic and preventive purposes in the health care sector. Further, the research uses quantitative research analysis methods. Estimates of obesity and overweight prevalence in different occupational groups are calculated using a 95% confidence interval. The researchers also develop a logistic regression model to compare the odds of being obese for nurses compared to people in other professions. The researchers also identify the software used to analyse the data, which is SAS version 9.1.3. Grove, Burns and Gray (2014) indicate that the primary focus of quantitative studies in evidence-based practice is to measure the relationship between variables. Therefore, the creation of logistic regression model to compare the chances of a healthcare professional being obese provides a basis to measure the relationship between the health occupation and obesity. The aim is to ensure that changes in variables are taken into consideration during the research process. Out of the 17.294 individuals who participated in the study, only 411were nurses. The samp le is relatively small to represent the nursing professionals. Hence, most of the information is generalised as opposed to being specifically based on the nurses and the prevalence of obesity among them. Moreover, the study seeks to compare very many occupations at the same time, which narrows down the chances of identifying the specific factors causing the high prevalence rate of obesity among nurses. The research uses interviews as the main method of data collection,. The researchers identified households that were eligible to answer face to face and computer assisted interviews and asked them question on the issue of obesity. The approach is not likely to have yielded the best results since most of the people are likely to view such information as sensitive and private. Therefore, the best way to gather information in a study such as this one is through questionnaires as more people are likely to believe that their information will be kept confidential. The primary objective of the study is well stated, but the research lacks an objective research question to accompany the main aim. It is necessary for the evidence-based practice research to provide an analysis of the interventions, which are useful (Rycroft-Malone Bucknall, 2011). Therefore, this study ought to have compared its findings to previous similar studies to identify whether the prevalence rate has increased or decreased. In the case of an increment, the focus should have been on the factors that have caused the change and how the situation can be rectified. On the other hand, if it was determined that the prevalence rate had declined, and then the researchers ought to have provided an explanation of why obesity rates among nurses have decreased. Currently, although the study is informative regarding identifying the prevalence of obesity and overweight issues among nurses in Scotland, it lacks to provide the completeness required for use in EBP because it does not make recommendations. Critique 2 Tan, M. F., Lopez, V., Cleary, M. (2015). Nursing management of aggression in a Singapore emergency department: A qualitative study. Nursing health sciences,17(3), 307-312. As the title suggest, the article seeks to determine the most efficient as to handle aggression in Singapore emergency departments. Further, the title also suggests that the research being reported was conducted using a qualitative research methodology. In EBP, qualitative case studies are known to provide more comprehensive information compared to other sources of data (Melnyk Fineout-Overholt, 2011). Further, the scholars also indicate that the use of qualitative studies allows researchers to present data gathered using different methods. For example, in this study, the primary sources of evidence were nurses, former nurses and observation. Availability of several data collection approaches improves the validity and reliability of the data. Qualitative research also happens to be more systematic and subjective (Grove, Burns Gray, 2014). The approach also presents useful data based on experiences, practices, and perceptions of professionals who have been involved in the issues bei ng investigated (Melnyk Fineout-Overholt, 2011). Tan, Lopez and Cleary (2015) use a purposive sampling method to ensure that the participants in their study are nurses and former professionals who have had to deal with aggressive patients. Their study is based on the events in a Singapore emergency department, where they also observe how aggressive patients were being handled. The participants are interviewed in regards to their experiences with aggression in emergency departments. The transcriptions of the interviews are later analysed and coded. That helps arrive at the conclusion of the study, which indicates that nurses in Singapore are highly concerned about how to manage aggressive patients in emergency departments. The use of interviews in this study was accurate as the information being collected was not sensitive in nature as far as the participants were concerned. Moreover, the interviews were in English and the people being interviewed are professionals in the health care industry, hence are in a position to understand t he question posed to them. However, it seems as though all the participants were not asked similar questions, which means that the information gathered was not focused on one perspective. The researchers should have formulated clear and succinct interview questions that focus on the primary aim of the study. The study exploited the perceptions and ideas of nurses in regards to aggression in emergency departments. The participants in the study were ten registered nurses who had worked in an emergency department of an acute public hospital in Singapore. Following the thematic analysis, Tan, Lopez and Cleary (2015) developed for primary themes. These are the impact if aggression on nurses, nurses' evaluation of attack behaviour, management of aggression, and organisational supports and responsiveness. The subdivision of the results into four primary themes makes it easy to apply the information in clinical practice because nurses can quickly identify the area they are interested n and compare the findings under the topic. However, further research into the issue is necessary since this study was conducted in a small hospital and the sample size of the participants was extremely low. Only ten registered nurses were interviewed, which means that the information they provided is limited. To ensure validity and reliability of the information in the study, Tan, Lopez and Cleary should have used more sources of information such as available literature sources and surveys. That would have helped to broaden the scope of the data used to analyse the issue and arrive at better and more reliable results. Further research, is also required in the study before its application in EBP to provide improved support for nurses to deliver optimal care to aggressive patients in emergency departments. Finally, although Tan, Lopez and Cleary (2015) approach the issue of aggression behaviour in emergency departments in a systematic manner, which makes it possible for nurses to use the information in EBP, the scope of their research is limited. They would have improved on their research by using more methods to gather information on how to manage aggression in emergency departments. That would have helped them gain more insight in regards to aggressive behaviours in emergency departments. Moreover, the number of participants was small, and the study was carried out in a small hospital, which might limit its application in large healthcare organisations. Conclusion To conclude, it is necessary for health professionals, especially nurse to adopt evidence-based practice. Currently, as discussed in this report there is a barrier to the application of evidence-based practice in clinical practice because of emphasis on specific empirical research findings (Grol Wensing, 2004). The empirical research evidence that most professionals emphasise on is scarce in nursing practice. It is therefore, important for nurses to develop the knowledge of applying different types of evidence in their practice because evidence-based practice in the medical field has proven to be extremely useful in treatment and prevention of illnesses (Youngblut Brooten, 2001). Therefore, nurses must realise the significance of evidence-based practice if they are to improve the quality of the health care services they offer. To achieve this, nurses must equip themselves with the skills and knowledge in accessing and critiquing research studies relevant to their practice (Cronenwe tt, et al. 2007). This paper has also critiqued two research articles on the basis of the methods of the study and type of evidence they offer. References Banning, M. (2005). Conceptions of evidence, evidence?based medicine, evidence?based practice and their use in nursing: independent nurse prescribers views.Journal of Clinical Nursing,14(4), 411-417. Brownson, R. C., Baker, E. A., Leet, T. L., Gillespie, K. N., True, W. R. (2010).Evidence-based public health. Oxford: Oxford University Press. Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., Warren, J. (2007). Quality and safety education for nurses. Nursing outlook,55(3), 122-131. DiCenso, A., Guyatt, G., Ciliska, D. (2014).Evidence-based nursing: A guide to clinical practice. Cambridge: Elsevier Health Sciences. Gerrish, K., Ashworth, P., Lacey, A., Bailey, J., Cooke, J., Kendall, S., McNeilly, E. (2007). Factors influencing the development of evidence?based practice: a research tool.Journal of advanced nursing,57(3), 328-338. Grol, R., Wensing, M. (2004). What drives change? Barriers to and incentives for achieving evidence-based practice.Medical Journal of Australia,180(6), S57. Grove, S. K., Burns, N., Gray, J. R. (2014).Understanding nursing research: Building an evidence-based practice. Cambridge: Elsevier Health Sciences. Horn, S. D., Gassaway, J. (2007). Practice-based evidence study design for comparative effectiveness research.Medical care,45(10), S50-S57. Hunink, M. M., Weinstein, M. C., Wittenberg, E., Drummond, M. F., Pliskin, J. S., Wong, J. B., Glasziou, P. P. (2014).Decision making in health and medicine: integrating evidence and values. Cambridge: Cambridge University Press. Kitson, A. (2002). Recognising relationships: reflections on evidence?based practice.Nursing inquiry,9(3), 179-186. Kyle, R. G., Neall, R. A., Atherton, I. M. (2016). Prevalence of overweight and obesity among nurses in Scotland: A cross-sectional study using the Scottish Health Survey.International journal of nursing research,53, 126-133. Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers (EC).Journal of the Medical Library Association,99(3), 229. Melnyk, B. M., Fineout-Overholt, E. (Eds.). (2011).Evidence-based practice in nursing healthcare: A guide to best practice. Baltimore, MD: Lippincott Williams Wilkins. Munroe, D., Duffy, P., Fisher, C. (2008). Nurse knowledge, skills, and attitudes related to evidence-based practice: before and after organizational supports.Medsurg Nursing,17(1), 55. Polit, D. F., Beck, C. T. (2013).Essentials of nursing research: Appraising evidence for nursing practice. Baltimore, MD: Lippincott Williams Wilkins. Rycroft-Malone, J., Bucknall, T. (Eds.). (2011).Models and frameworks for implementing evidence-based practice: linking evidence to action(Vol. 2). Hoboken, New Jersey: John Wiley Sons. Satterfield, J. M., Spring, B., Brownson, R. C., Mullen, E. J., Newhouse, R. P., Walker, B. B., Whitlock, E. P. (2009). Toward a Trans disciplinary model of evidence?based practice.Milbank Quarterly,87(2), 368-390. Tabak, R. G., Khoong, E. C., Chambers, D. A., Brownson, R. C. (2012). Bridging research and practice: models for dissemination and implementation research.American journal of preventive medicine,43(3), 337-350. Tan, M. F., Lopez, V., Cleary, M. (2015). Nursing management of aggression in a Singapore emergency department: A qualitative study. Nursing health sciences,17(3), 307-312 Wallin, L., Bostrm, A. M., Wikblad, K., Ewald, U. (2003). Sustainability in changing clinical practice promotes evidence?based nursing care.Journal of advanced nursing,41(5), 509-518. Whittemore, R. (2005). Combining evidence in nursing research: methods and implications.Nursing research,54(1), 56-62. Youngblut, J. M., Brooten, D. (2001). Evidence-based nursing practice: Why is it important?AACN Advanced Critical Care,12(4), 468-476.

Japan Soda Industry Association free essay sample

Soda Industry Association Homo e De ascription of the soda industry Production proceed as Production process of caustic soda and chlorine by electrolysis The processing of brine electrolysis to produce caustic soda, chlorine, and hydrogen Is called the electrolytic (chlorals) process. This is further classified Into the membrane, diaphragm, and mercury processes. As of October 1999, all Japanese chlorals plants use the membrane process. Salt is first dissolved in the dissolution tank. The obtained saturated brine is then sent to a purification tank to remove Impurities, and to a chalet resin tower for purification before being fed to an electrolytic www. ]slab. Gar. JP/English/process. HTML cell. Industrial water Is also purified before entering the cell. The anode chamber of the electrolytic cell Is filled with the brine, and the cathode chamber with pure water (dilute caustic soda). Application of direct current to the cell produces chlorine gas at the anode, and caustic soda plus hydrogen at the cathode. We will write a custom essay sample on Japan Soda Industry Association or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The latter goes to the separator to produce a caustic soda solution with a concentration of about 30%. The chlorine Is washed and cooled to remove salt, and further dehydrated before being delivered as is, or liquefied. Caustic soda is further concentrated in a vaporizer to a concentration of about 50% for delivery. Hydrogen Is washed and cooled, as chlorine, before being shipped. Principle of the chlorals process The electrolytic processes of brine to produce caustic soda, chlorine, and hydrogen may be categorized Into three types: the membrane, diaphragm, and mercury processes. Here, the membrane process is described, since it is the only process presently operated in Japan. This technology uses an Ion-exchanging membrane separating the anode and the cathode. The membrane is made of a special 1 OFF pass through but not actions (positive ions). As shown in the figure, the anode chamber of a membrane electrolytic cell is filled with brine, and the cathode chamber with water (see figure). Application of an electric current leads to the formation of chlorine, caustic soda, and hydrogen. The brine in the anode chamber contains sodium (An+) and chloride (CLC-) ions. These ions migrate when a current is applied: the positively harmed sodium ions pass through the membrane to the cathode chamber, while the negatively charged chloride ions are discharged on the anode surface to form chlorine gas (CO ). Water in the cathode chamber partly dissociates into hydrogen (H+) and hydroxide (OH-) ions. The hydrogen ions capture electrons on the cathode surface to form hydrogen gas (H2O). The hydroxide ions are attracted to the anode, but blocked by the membrane, and react with the sodium ions from the anode chamber to form caustic soda (sodium hydroxide, Noah). Www. ]Asia. Gar. ]p/English/process. HTML www. Asia. Gar. Jp/English/process. HTML

One Flew Over the Cuckoos Nest Theme Essay

One Flew Over the Cuckoos Nest Theme Essay One Flew Over the Cuckoos Nest Theme Essay When Rules Should Be Broken â€Å"But, when a long train of abuses and usurpations, pursuing invariably the same object, evinces a design to reduce them under absolute despotism, it is their right, it is their duty, to throw off such government, and to provide new guards for their future security† (U.S. 1776), a quote from the Declaration of Independence. This quote basically means that when men find themselves being governed by a cruel leader who uses strict rules or laws on them, those men have a right to fight that leader because of his or her unjust rules or laws. These rules generally do not benefit these men in any way but serve only to control them and prevent them from growing and developing. This quote can easily be related to a theme in Ken Kesey’s novel One Flew Over the Cuckoo’s Nest, which is a story about a man named Randle McMurphy who fights an over controlling Nurse Ratched, a ward nurse who uses strict rules to control her patients in a mental hospital. Her rules are absur d, unjust, and they give her too much power. In One Flew Over the Cuckoo’s Nest, Ken Kesey explores the theme that some rules should be bent and broken in order for people and society to grow, develop, and prosper. There is a fine difference between rules made to control society in a positive way and rules made to keep society in complete control. When a governing party gets together to make a law or rule, that party usually intends for that rule or law to be beneficial for that society. However, when there are rules that harm the people in any way, then there is a problem with those rules. In One Flew Over the Cuckoo’s Nest, Nurse Ratched uses an extensive system of rules and regulations to keep the patients under control. Many of these rules take away the patients’ freedom, and range greatly in importance. For example, there are rules that control the patients’ schedule each day: Efficiency locks the ward like a watchman’s clock. Everything the guys think and say and do is all worked out months in advance... At the beginning of each day... lights flash on at six thirty... acutes [patients] up out of bed as the black boys can prod them out... six forty-five the shavers buzz and acutes line up in alphabetical order... seven o’clock the mess hall opens... seven-thirty back to the day room. (Kesey 31-33). Nurse Ratched has complete control of what the patients do throughout the day, which takes away much of their free will. In addition, she severely restricts the number of entertainment options for the patients in the day room. They are only allowed to play approved board games such as monopoly and card games, which after a while can both become mind numbingly boring. There are also smaller, more subtle rules, such as music constantly playing in the day room and toothpaste being locked away. None of these rules mentioned have any positive effects on the patients. They only serve to completely control the patients’ lives. As a result of these rules, the patients of the asylum are abused and corrupted in many different ways. Rules should never have a negative effect on the people who follow them. In One Flew Over the Cuckoo’s Nest, Nurse Ratched’s rules abuse the patients physically, psychologically, and mentally. She physically abuses them by letting the black boys , her followers, manhandle the patients constantly. Everyday the black boys forcefully push and drag the patients around the ward so they can follow their tasks. In many ways this is degrading to the patients’ free will. An example would be the fact that the black boys shave the patients everyday. Taking a man’s right to shave himself is incredibly demeaning. In addition to that, the black boys sometimes force feed the patients and wash them in shower rooms. However, the most humiliating act that the black boys do to the patients is sexually abuse them. As mentioned earlier, Nurse Ratched also exploits the patients mentally and psychologically. The nurse does this by prescribing

Compare and contrast the portraiture of Klimt with the portraiture Essay

Compare and contrast the portraiture of Klimt with the portraiture Schiele - Essay Example When Klimt died back in February 6, 1918, Schiele was one of the candidates who can follow the footsteps of Klimt. With this in mind, Zwingenberger (2011, p. 60) revealed that Schiele has one time called himself as the â€Å"Silver Klimt† 6. In fact, during the early part of the 20th century, Schiele became a well-known Austrian expressionist and a figurative painter 7. Specifically the fall of the Hapsburgs Empire during the World War I has occurred back in 1918 8. In relation to the previous paintings of Klimt and Schiele, the main purpose of this study is to discuss the similarities and differences between a couple of portraits made by each of these two successful painters few years before the fall of the Hapsburgs Empire happened. To give the readers a better idea of what is to be discussed in this essay, the works of Klimt such as the The Three Ages of Woman, 1905 and Hope II,  1907–08 and Schiele’s Woman in Green Bonnet, 1914 and Green Stockings, 1914 wil l first be described in short details followed by making the comparison between the art works of Klimt and Schiele based on the title, subject-matter, aesthetics, medium, and social aspect. Klimt’s Work: â€Å"The Three Ages of Woman, 1905† Klimt’s work entitled â€Å"The Three Ages of Woman, 1905† was drawn and painted in a 178 x 198cm canvas using oil 9. Specifically the chosen subject in this particular portrait was all about the representation of a woman’s life in three (3) different stages which include childhood life, adulthood, and old age 10, 11, 12. It means that these stages in a woman’s life could range from being an infant to becoming a mother, and eventually an old lady. (See Image I – Klimt’s Work: The Three Ages of Woman, 1905 on page 4) Image I – Klimt’s Work: The Three Ages of Woman, 1905 Source: Strauss, 2013, p. 162; De Pascale, 2007, p. 98 Upon closely examining this particular portrait, the im ages of a nude baby girl and a couple of ladies in Klimt’s â€Å"The Three Ages of Woman, 1905† were drawn with a unique and colourful mixture of orange, yellow, and brownish abstract background 13. For instance, on the upper left side was an old lady followed by a fairly skinned young mother in the middle, and the young child on the middle right side of the portrait. In line with this, the creation of a unique abstract background gave more emphasis to the outline of the naked bodies of these three ladies 14, 15. On the left side of the portrait, Klimt has drawn the image of a deformed, â€Å"sagging† or â€Å"wrinkled† skin which represents the age of the old lady 16, 17, 18. Furthermore, the fact that Klimt has drawn the image of the old lady with her face bowing down strongly represents her feeling of negative emotions such as sorrow and repressed emotions 19. On the middle and right side of the portrait show the beautiful face of a young mother holdin g an innocent baby girl 20, 21. Klimt’s Work: Hope II,  1907–08 Klimt’s work entitled â€Å"Hope II,  1907–08† was drawn and painted in a 43-1/2 x 43-1/2 inches canvas using gold, platinum, and oil 22. In this portrait was a pregnant woman with her head bowed down and eyes closed. In the upper centre of the portrait shows a half-naked pregnant woman 23. Specifically the closing of the woman’s eyes in this particular portrait strongly suggest the idea that the lady has been devotedly praying or hoping for her own safety and her child’

Literature review Essay Example | Topics and Well Written Essays - 3000 words

Literature review - Essay Example Man has its own structure according to his responsibilities, woman posse’s different structure as per her responsibilities. Men and women both created in couples but both posses different attributes and different lifestyles. Woman posses some traits completely different from man and man owns some characteristics entirely different from woman. Still, there is a competition lies between man and woman. No matter in which part of the world, they live but it’s so easy to find a tight competition between man and woman. Gender plays an important role in both human beings. Gender helps creating special traits in every man or woman. It is generally considered that men are strong and women are weak, there are thousands of differences on the basis of which it is usually said. Regardless of strength, there are many other factors that make woman different from man. Man are usually strong in feelings, they do not take care lots of small things in their life, while on the other hand, woman are always possessive about their relationship, their belongings etc. The word docility states the trait of being agreeably manageable and submissive. Docility can also be defined as the willingness and readiness to fulfill other wishes without considering own’s wish. ... The term docility also points Judith butler’s (1990) theory of gender performance. She points that individuals must constantly perform defined gender actions, in order to get away the social discipline that is experienced against queer sexuality. In the repetition of gender actions, actions are usually ignored and the avatar is usually considered as an internal identity. In this way, gender seems a docile body. For instance, Miroslaw Filiciak (2003) argues that the developing of identities in cyberspace is not so much in plenty from a self as it is a longed for chance of showing one’s self beyond physical limits. These expressions might not move beyond the gender actions and sexual norms that make the â€Å"self†. In the eyes of many sociologist, docility in the main concept of performance. Docility usually helps in identifying personal traits as per their gender specification; it also helps in understanding why individuals authorize with the agency to develop th eir own sexual world rather to perpetuate the identified norms of gender and sexuality. Conformity is the action of relating attributes, concepts, and actions to what human gender considers is usual of their community or social group. This determination appears in small units and society as a whole, and normally output from elusive unconscious shapes, or direct and overt social force. Conformity can appear in the presence of others, or when an individual has no one around him. For instance, people incline to obey social values when eating or watching their favorite plays, even when they have no one around them. A number of people normally conform from a wish of being safe within a unit generally in a group of a similar religion, unit,

THE EFFECTS OF THE IMPLEMENTATION OF THE BALANCED SCORECARD (BSC) ON Dissertation

THE EFFECTS OF THE IMPLEMENTATION OF THE BALANCED SCORECARD (BSC) ON FINANCIAL PERFORMANCE IN A SAUDI COMPANY - Dissertation Example 3. Analysis of the industry Saudi Arabia is one of the most powerful economies worldwide – even if it is not yet fully developed; the country has been a member of the WTO since 2005 (Abdallah, 2007), a fact that has been proved quite important for its economy. In accordance with a recent report of KPMG, Saudi Arabia is considered as ‘the 13th best place to do business’ (Fozan 2009). One of the key characteristics of the country’s banking sector is its dependency on the principles of Islamic finance (Mena FN 2011), a fact that should be taken into consideration when evaluating the potential effects of the Balanced Scorecard Model on the financial performance of banks in the particular country. The performance of the country in regard to each particular industrial sector is presented below in Graph 1. It is clear that the financial services sector of the specific country is of key importance for the national economy; the identification of methods that could e nhance the performance of firms operating in this industry would be of significant value – in terms of the expected benefits for the country’s economy. ... 4. Research problem The use of Balanced Scorecard as a strategic tool for supporting the performance of firms in the banking sector has been often characterized by failures; for firms in the banking sector of Saudi Arabia could a different result be expected? 4.1 Issues addressed in the research The research developed for this study focuses on the examination of the following issues: a) the theoretical framework of the Balanced Scorecard, b) the practical aspects/ requirements of the Balanced Scorecard when is used as a strategic tool for supporting the financial performance of modern firms, c) the expected benefits and the potential drawbacks of the Balanced Scorecard both in the short and the long term; reference will be made particularly to the effects of the Balanced Scorecard on the financial performance of firms in the banking sector, d) the use of Balanced Scorecard as a strategic tool in the banking sector of Saudi Arabia – referring to the presentation of the level at which the Balanced Scorecard is used by firms in the banking industry of the particular country, e) the expected requirements of the Balanced Scorecard if its implementation is attempted in firms operating in the banking industry of Saudi Arabia, f) the effects that the implementation of the Balanced Scorecard would be expected to have on the financial performance of banks in Saudi Arabia. 4.2 Issues excluded from the research The following issues will not be included in the research: a) the potential use of other similar models for the support of the financial performance of banks in Saudi Arabia, b) the potential combination of Balanced Scorecard with other

Human Comfort Approach In Green Building Design

Human Comfort Approach In Green Building Design Recently, there has been an increasing emphasis on a green building design approach, which is aimed at ameliorating the overall impact of the built environment on human comfort and the natural environment. In this selective review, external , building envelope and internal factors will be examined in relation to human comfort. In particular, this project will focus on human comfort in regard to the importance and impact for day lighting, visuals and environment, material properties, protection factors, ventilation, thermal comfort, and access their effectiveness in the context of green building design. With regard to human factors, it is concluded that the impact of these factors on building occupants needs to be taken into account in advance in order to design a building which enhances the human health and well-being and consequently leads to the increase of productivity. Introduction Green building design approach is one of the global response to the increasing realization that the built environment contributes significantly to climate change over the entire buildings lifecycle. Building accounts for more than 40 percent of carbon dioxide emissions (Hegger et al. 2008). Moreover, the steadily rising energy cost over the past few years help to facilitate the trend towards sustainability. Taking into account these factors, energy saving measures have become a requirement in these days. End-users search for sustainable building concept, with low management cost and energy usage, which provides structures made from building materials that are in accordance with ecological point of view. Aside from looking at energy and operating cost, they also take an increasing concern in work performance levels. Only when people healthy and satisfy they can optimize their productivity (Bauer et al. 2007:11). Seeing these factors by necessity, means offering both a comfortable and healthy environment which is essential as a strategy to attract the investors and buyers. Still, there is no doubt that the comfort and well-being of humans is based to a certain extent on their subjective perception of some external influences (Hegger et al. 2008:55). Sassi (2006:101) seems to support this view and points out that people respond differently to situations and environments depending on their character and circumstances. Hegger et al. (2006) claims that the factors which will affect human comfort are basically categorized under physical, intermediary and physiological conditions. The purpose of this project is to examine the physical conditions with regard to human comfort and to focus on the building envelope, external and internal influencing factors. The importance and the impact of these factors on human comfort will then be examined, with a focus on the effectiveness in the green building design approach. Since the concept of this approach is increasingly put into practice globally, it is felt that this examination will highlight areas which need to be taken into account and will be integrated into the design process. 1.0 A Definition of Human Comfort and Green Building Design Human Comfort Human comfort can be broadly defined as the building occupants expression of satisfaction with the thermal environment (Yudelson 2007). Some of the parameters that affect the users comfort are as follows: environmental conditions (interior air temperature, lighting intensity and level of noise), physiological criteria (age, gender and constitution), intermediary conditions (clothing and activity) and individuals (Hegger et al. 2008:55). There is a connection between physical and psychological health. They are the factors that are highly likely to influence the human sense of happiness (Martin 1997). In turn, ones happiness will impact on peoples expectations, experiences and sense of self-worth. Humans generally wish to be accepted, respected and to feel secured. Therefore, it is essential for an architect to understand how people respond to the environment in order to design spaces which can enhance human health and well-being. Styles and types of building material, responses to individual building, light quality and atmosphere are linked to culture and personal memories which in turn linked to individuals character (Sassi 2006). For instance, a small space may feel comfortable to certain people but claustrophobic to others. It is difficult to design a building which would be universally appealing that enhances everyones well-being. Nevertheless, certain commonalities can be identified in regard to comfort and identity. Buildings should be designed to satisfy and fortify positive feelings as well as enable people to enjoy quiet moments of reflection and relaxation (Sassi 2006:137). It plays an important role in increasing occupants productivity and health in buildings. The building design could influence the human body mechanism to exchange heat with the environment through convection, radiation and evaporation (Hegger et al. 2008:55). As Bordass (1995) has pointed out that the elements which affect human comfort should be able to be operated and adjusted by the occupants. In other words, reduce heat loss yet sustaining good air quality is a necessity in terms of thermal comfort in building design for cold weather. Green Building Design Green building is always name as ecological building, sustainable building, or energy-efficient building. Green building design is a concept which emphasize on passive design strategy by making full use of day lighting, natural ventilation and allowing the insulated fabric and thermal to work effectively (Woolley 2008:181). A green building focuses on reducing building impact on the environment and occupants health while increasing the efficiency of resource use through better planning, design, construction, management and maintenance (Green building index organization 2009). To quote from the Department of Standards Malaysia (2007), a green building design approach is an strategy which united architectural, engineering, site planning, and landscaping so as to design an energy efficient building which would optimize the human comfort This approach makes an effort to optimize the advantage of the environment and to use building materials which is acceptable from a building ecology point of view. 2.0 External Factors Relevant to Human Comfort in Green Building Design Architecture and open spaces can help to define peoples identity and to define their territory. A good architecture can create special reference to the locality, high design quality and interactions between building and its environment (Hegger et al. 2008:102). Recognition of the locality help to promote responsibility with respect to the environment and human beings. Designing with emphasize on natural day lighting and visuals should begin at the preliminary design stage. By proving these, it can help to conveys a feeling of safety, belonging and security. 2.1 Day Lighting Day lighting is a significant factor for pleasant interior conditions. Without sufficient day lighting, people cannot perform well and healthy. Natural light stimulates humans organism and controls bodys functionality. It is crucial for our visual perception and has a substantial influence on our work efficiency (Hegger et al. 2008:102). Building materials which are transparent or translucent are essential if we wish to make use of daylight. However, it transmits heat as well as light. This in turn means that with more daylight, it reduces the dependence on artificial lighting, and the internal heat loads are decreased as well (Thomas and Garnham 2007:135). Conventional and innovative day lighting systems that collect, transport and distribute light deep into buildings and systems that reduce the need for artificial lighting are recommended. For building plans, this implies a design that is no more than 66 feet wide, about 33 feet length of front to back from any window to any workstation (Yudelson 2007:80). In other words, a buildings long axis should be oriented to east-west in order to allow a maximum day lighting from both south and north facing windows. The day lighting conditions over the course of the day influence the human hormone balance and synchronize our internal clock (Ander 2003). Thus, day lighting strategies, for instance, the orientation of the building, the proportion of window, the depth of the rooms, glare and ultra-violet (UV) protection, the design of reflective surface and the coloring of the enclosing components (walls, floors and soffits) are all the important design features. Passive and technical measures can be taken into account during design. Sunlight acts as a link that connect the building occupants with the outside world, facilitating our essential connection with nature and giving us a sense of time. It is important to realize that the mood or the perception of a space created by light is just as vital (Thomas and Garnham 2007:136).. To put it simply, people see and feel better whenever there is natural light for reading and working. 2.2 Visuals and Environment In green building design, emphasis is placed on providing outdoor views from all workstations. The research shows that if the occupants able to enjoy the outside view during the workday, it is more conductive to physical and mental health than working in a windowless environment (Yudelson 2007). Trees can help to absorb carbon dioxide from the air and store it as carbon. It can also provide shade to buildings, reducing heat gains and thus, improving the internal environment. In other words, contact with nature is beneficial to the well-being of humans. The building should be planned and designed so as to be visually as well as physically well connected with the outdoors. When designing the external works, emphasis should be put on to create and preserve natural habitats by providing extensive lawns, keep the area is natural state, trees and hedges, green roofs, and green facades. In some cases which the area of plot is small, rooftop planting can replace ground sealed by construction work. Environment plays an important role in satisfying basic human needs and quality of life. It can help to reduce stress and also can speed up recovery. In addition, it can affect humans on a psychological and physical level by acting as a recuperative and stimulating factor for our creative functions. In densely developed cities, it is critical for human health to strike a balance between making space accessible to people and preserving flora and fauna. According to some studies, dealings with nature will affect humans mental health, whereas leisure activities in nature directly benefit to physical health (Sassi 2006). 3.0 The Influence of the Building Envelope on Human Comfort in Green Building Design Building envelope acts as a boundary that separates between interior and exterior of a building through which thermal energy is transferred (Hegger et al. 2008:82). It also serves the function of protecting users and occupants against climate change such as solar radiation, precipitation and wind so as to create safe, healthy and secure interior space. However, the role of building envelope becomes more complex as the demand for comfort increases. A building should enable people to feel safe and comfortable by reducing potential dangers. To increase human comfort, the well-being and health of occupants in aspects such as material properties, safety and security, sound, interior air, and interior climate must be taken into consideration during design stage. 3.1 Material Properties The choice of material for building envelope will affect human comfort in the building. The designers should take great care when specifying materials in regards of the impact these materials have upon humans feeling about spaces and buildings. Functionality that reflect regional climate as well as cultural preferences, local vegetation and high-technology material need to be incorporated in the design. Materials are always describe as cold or warm. Based on scientific basis, metal for example, are good conductors of heat and therefore take the heat quickly from the body. On the contrary, wood is a poor conductor and hence feels relatively warm to touch. These physical sensation correspond to psychological states, such as a timber paneled room would feel warmer and more comfortable to inhabit than a predominantly metal one (Thomas and Garnham 2007:89). Different kind of wall material, construction and thickness are likely to differ in the value of thermal conductivity. U-value is a measure of the fabric heat loss which take into accounts mechanism like conduction, radiation and convection of heat transfer. The same can be said that the lower the u-value, the better the insulation the lesser energy needed to maintain comfort, the lower the environmental impact. Insulated walls reduce energy cost and increase comfort with levels of minimal effort (Thomas and Garnham 2007:102). To achieve sustainability in building design, consideration should be given to low embodied energy, material manufactured that is on waste, easy to disassembly and used to recycle in the end of the building life span, transportation to the construction site and strategies or method that are often used in architectural practice. 3.2 Protection Factors on Occupants Well Being and Health Building should keep users safe and secure both within the building and its environment by protecting them from accidents, intruders, fire, and natural dangers. Accordingly, contributions to the subjective perception of safety and secure by providing a good layout, lighting, social controls, presence of other people and good visual links are necessary (Hegger et al. 2008:195). A designer can provide these features by considering the specification of material, fire protection concept, natural dangers, clarity and peoples activities during design stage. Creating pleasant acoustic conditions is also one of the important protection factors. Noise pollution and acoustic conditions will influence the well-being of people and can affect their health. Noise between usage units and plus disturbance such as noises from building services and unfavourable room acoustic should be avoid through precautionary building physics and room acoustic measures. Constructional sound insulation and room acoustic measures should be included in the room acoustics report as a guidance. Besides the above aspects, interior air and climate are also the fundamental elements to increase the well-being and health of the occupants. A poor interior air quality will cause some bodily symptoms and lower the productivity (Awbi 2008). Moreover, thermal comfort has a major influence on the human heat balance and direct effect on energy consumption of buildings. It should be optimized through constructional and passive measures. For example, it can be done through specifying the construction methods, thermal insulation, moisture control, coordination of window proportion, ventilation concept and also the protection against overheating by providing sun shading devices. 4.0 Internal Factors Which Support Human Comfort in Green Building Design The primary function of building is to provide a suitable internal environment for the purpose of the building. According to Boubekri (2008), the effects of poorly designed buildings, whether in terms of limited natural ventilation or poor thermal comfort, would affect the health of building occupants. In order to achieve an acceptable level of human comfort, the indoor environment for human implies a temperature between 16 to 25 degree Celsius. 4.1 VENTILATION Natural ventilation is another approach which will provide a healthy and comfortable internal environment by removing polluted indoor air and replace with the fresh air from outside through openings. It would be cosy if the air can be circulated naturally from the outside to the inside of the building (Hegger et al. 2008:101). People will have sensations such as the warmth of the unfiltered sunlight, smells and acoustic stimulus by direct contact with outside air. It can have a positive effect on the quality of the habitable room, in that, natural ventilation system are particularly user friendly from the emotional pint of view (Hegger et al. 2008:99). Thus, habitable rooms should always include opening the facade whenever possible. There are three main mechanisms in natural ventilation, for instance, single sided where air comes in from a window, cross ventilation where air crosses a space from one side to another which the effect of wind pressure causes the air to enter on the windward facade and pass through the building and lastly providing a stack effect exiting path, resulting from the temperature differences between the indoor and outdoor air, where the hot air rises and exits the opening near the roof or providing openings at the 2 sides of the wall. According to Department of Standards Malaysia in MS1525 (2007), cross ventilation is defined as the flow of air through a building due to a wind-generated pressure drop across it. These processes are natural and are provided by pressure gradients and temperature differentials which in turn create pressure differences (Thomas and Garnham 2007:116). They do not required large quantities of energy to run the powerful fans which used in mechanically ventilated buildings. Natural ventilation is the most energy efficient way of supplying essential fresh air to a building. When it is insufficient, then other cooling options may be possible. 4.2 THERMAL COMFORT According to Flynn and Segil (1970:80), human body functions as a heating and cooling mechanism. It can, to some extent, efficiently and automatically adjust to the environmental conditions that vary from optimum. Our body functions to lose heat at a certain rate to reasonably cooler air and surfaces. Nevertheless, if such action is either too slight or excessive, it will lead to occupant discomfort and physiological stress. Human heat balance, humans body temperature, needs to be around 37ÂÂÂ °C; this is a prerequisite for well-being. Humans emit heat through the following mechanisms: firstly by exhalation and through evaporation of skin, secondly by covection of heat from body surface to the surrounding air, thirdly by conduction of heat from the body to immediate objects and lastly by radiation of heat to the nearby objects and the surfaces enclosing the room (Hegger et al. 2008:55). On the other hand, heat transfer in building in three modes, which are conduction, convection, and radiation (Moe 2010:9). If the temperature of surrounding area drops, the body will first allow the extremities to cool in order to protect the functions of brain, heart and other vital organs (Hegger et al. 2008:55). It is essential to transfer the internal heat generated to the environment in order to get a constant temperature. If the temperature of the interior air is not consistant, the risk of accidents increases and manual dexterity, productivity and mental abilities decrease quickly. In regards of this, a thermally comfortable environment is primarily due to physical influencing factors such as the temperature of the interior air and the average temperature of the external air, the humidity of interior air and the movement of the air (Hegger et al. 2008:56). Building functions to admit and conserve heat when the external environment is cold and to thwart the penetration when the external environment is warm. Conclusion Human comfort is not only a strategy in green building design for the purpose of attracting the investors and buyers, but also an approach which determines occupants health and well-being. This paper has discussed the factors that contribute to human comfort and has briefly presented the importance and the influence of the factors towards peoples comfort in certain aspects of building design. These included the building envelope, interior and exterior factors which consist of day lighting, visuals and environment, material properties, protection factors, ventilation, and thermal comfort. The effectiveness of the approach towards users comfort has also been highlighted, particularly with regard to the human comfort and well-being lead to the increasing of productivity. In discussing the effectiveness of the approach, it has concluded that although the desired degree of comfort can be a highly subjective perception, some commonalities can be identified. This can assist in optimizing the design for a better human comfort. Green buildings always offer a high level of comfort and healthy indoor climate while depending on renewable energies and low energy embodied resources ( Bauer et al. 2007). It should be noted that human comfort is only one of the approach in green building design. Other approaches such as energy efficiency and renewable energy should be taken into account in design , however, are lied outside the parameters of this paper due to the limited scope and a more thorough research could be done in this area. This would be particular interest to the professionals who incorporate the environmental engineering studies in their design.

Conflicting Themes in The Poetry of W. B. Yeats Essay -- Literary Anal

In analysing the poetry of W.B. Yeats, I have come to understand the multiple conflicting themes and positions he presents in his poetry. However, my understanding has been influenced most by Yeats’s exploration of key conflicts in ageing along with political anarchy. These are conveyed respectively in the poems â€Å"Wild Swans at Coole† (1916) and â€Å"Leda and the Swan† (1923), using the central symbol of the swan. In â€Å"Wild Swans at Coole†, Yeats conveys the conflict within his heart; where he is an ageing, old man opposed to the young, revitalised swans. He laments the loss of his playful energy which he sees in the abundance of love and vitality in the swans. In â€Å"Leda and the Swan†, Yeats conveys the political dichotomy of the Irish nationalistic struggle against the opposing British suppression; exemplified by the swan’s advances towards the vulnerable Leda. Yeats presents the key conflict of ageing through exploring his own life in decline compared to the spiritual transcendence of the swans in â€Å"Wild Swans at Coole†. Yeats wrote this poem in October 1916 after his latest rejection by Maud Gonne, following the death of her husband, John MacBride, in the Easter Rebellion. Yeats therefore reflects on the inertia of his own life, while regathering himself at Lady Gregory’s Coole Park estate. While revolving around the idea that sexual fulfilment with Maud has been lost. Yeats retains the last of his romantic preoccupations in perceiving a spiritual element through the natural world, where nature is reflective of youth and beauty. The main way this is conveyed is through the swans, symbolising youth, vitality and freedom, the conflicting position to Yeats’s personal state. Yeats conveys this through a reflective, sorrowful tone, as h... ...he spiritual element of life, discovered through the natural world with â€Å"Wild Swans at Coole†, and history with â€Å"Leda and the Swan†. Works Cited 1. Bogan, L., 1938, â€Å"William Butler Yeats†, The Atlantic Monthly, May 1938, accessed 8 June 2012, http://www.theatlantic.com/magazine/archive/1938/05/william-butler-yeats/4672/ 2. Holstad, S., n.d., "Yeats's 'Leda and the Swan’: Psycho-Sexual Therapy in Action", California State University, accessed 8 June 2012, http://www-scf.usc.edu/~erdemoz/Write/leda.html 3. â€Å"Modernist Poetry 2: W. B. Yeats†, lecture by Dr. Aaron Kelly, 20th April 2004, from the green booklet â€Å"Module B: The Critical Study of Texts: William Butler Yeats†. 4. Morrison, A., 1998, â€Å"Theories of Post-Coloniality: Edward W. Said and W.B. Yeats", The Imperial Archive Project, accessed 9 June 2012, http://www.qub.ac.uk/imperial/ireland/saidyeat.htm