A Study of the Trans-Texas Corridor and How it Affects Texans Essay exa

A Study of the Trans-Texas Corridor and How it Affects Texans   Ã‚  Ã‚  Ã‚  Ã‚  Everything is bigger in Texas. That’s what a lot of Texans what Americans and people around the world to know – you don’t mess with Texas. In the 1950’s, when President Eisenhower created the first Interstate plan for the country and implemented new roads in almost every single state, it was the largest engineering feat in the modern world. Now, almost half a century later, Governor Rick Perry is set to break that record, with the costliest, largest, and most incredible-sized proportion Texas Trans-Corridor, dubbed the â€Å"Texas Superhighway,† a 4000 mile, $175 billion dollar project that won’t be completely functional for another fifty years (Perry). This project certainly has proponents and opposition. But first, we must understand what the Texas Trans-Corridor’s purpose is in the state of Texas, and how it would affect the rest of the country as a whole.   Ã‚  Ã‚  Ã‚  Ã‚  Governor Rick Perry came into office as George W. Bush’s successor in 2000. Immediately, he laid down his plans for the future of Texas, without having the say of most of Texas’s constituents, since he was appointed based on Bush’s presidency. Perry’s grand vision is nothing short of incredible, even to the opponent’s eyes. At a quarter-mile wide, the Texas Superhighways that will probably soon cross Texas will be the largest transportation commodity in the free world (Stall). Perry’s idea doesn’t just answer problems for congestion on highways – it answers problems for congested railroads in major cities such as San Antonio and Dallas, and it also develops one of the newest concepts to the Texas way of life, high speed rail, which has only dared to compete in the Northeast â€Å"corridor† of the United States. Perry also wants to develop a utility zone next to the highway, which will enable electricit y lines, pipelines, fiber optics, even water pipelines toward any city that is connected to the corridor. (Perry)   Ã‚  Ã‚  Ã‚  Ã‚  Perry’s vision is supposed to answer one specific problem that almost all Texans do know about: How do we curb congestion on the most congested freeway with trucks and vehicular traffic in the United States? I-35, notorious for its bottlenecks between Austin and San Antonio, is part of the NAFTA Superhighway system. I-35 extends all the way to Michigan down to Laredo in South Texas (Associated Press – KBTX). When the NAFTA ... ... on how they drive around this massive state.   Ã‚  Ã‚  Ã‚  Ã‚   Works Cited Palkot, Stephen. "Perry promotes corridor project." The Herald -Coaster 25 Mar. 2005.   Ã‚  Ã‚  Ã‚  Ã‚  14 Apr. 2005   Ã‚  Ã‚  Ã‚  Ã‚  . Osbourne, James. "Trans Texas Corridor in planning stage until 2006." The Monitor 24   Ã‚  Ã‚  Ã‚  Ã‚  Mar. 2005   Ã‚  Ã‚  Ã‚  Ã‚  . Perry, Rick. Texas Department of Transportation. I-69 / Trans-Texas Corridor Study.   Ã‚  Ã‚  Ã‚  Ã‚  2004. 14 Apr. 2005 . Perry, Rick. Texas Department of Transportation. Trans-Texas Corridor. 2004. 14 Apr.   Ã‚  Ã‚  Ã‚  Ã‚  2005 . "What's at stake: Slow down the Trans-Texas Superhighway: Let's LookBefore We   Ã‚  Ã‚  Ã‚  Ã‚  Leap!" Online posting. Texas Action Network. 14 Apr. 2005   Ã‚  Ã‚  Ã‚  Ã‚  . "Texas Superhighway?" KBTX. 14 Apr. 2005   Ã‚  Ã‚  Ã‚  Ã‚  . Stall, Linda. CorridorWatch.org - Challenging the Wisdom of the   Ã‚  Ã‚  Ã‚  Ã‚  Trans-Texas Corridor.. 09 Apr. 2005. 14 Apr. 2005   Ã‚  Ã‚  Ã‚  Ã‚  . Booth, Cathy , and Thomas Hutto. "The Next Wave in Superhighways, or A   Ã‚  Ã‚  Ã‚  Ã‚  Big, Fat Texas Boondoggle?" Time 06 Dec. 2004. 14 Apr. 2005   Ã‚  Ã‚  Ã‚  Ã‚  http://www.time.com/time/archive/preview/0,10987,832224,00.html Texas Legislature Online. State of Texas. 14 Apr. 2005   Ã‚  Ã‚  Ã‚  Ã‚  www.capitol.state.tx.us Slotboom, Eric. Home Page. 17 July 2001. 03 May 2005   

Lost, Alone but Free At Last

‘Run, get into the house, QUICK!' Hans Wenger shouted out to his family. They were being chased by the German Authorities. Not because they were criminals, but because they were Jews living in Nazi Germany, 1940. They had been hiding from the authorities for almost a year. Hans' family consisted of his wife Anneliese and their three children Leila, 11, Leopold, 9 and Greta, 8, they meant everything to Hans and he would sacrifice his own life to keep them safe. Once the family were safe inside the basement of the old abandoned house Hans sat on the edge of an ancient, mouldy sofa. Greta jumped up onto his knee with an innocent smile on her face. Just the way Hans liked it, his children not knowing how unsafe they were. ‘Daddy, why were those people trying to catch us? Are we in trouble? We always run away from them! Daddy, why?' Hans' face fell, Greta knew something was wrong. It was what he feared the most, and he knew he had to explain somehow. ‘Liebliag, you do know who Hitler is, yes?' Hans looked at Greta, who was shaking her head, her little blonde curls bouncing, ‘well Greta, he is the leader of Germany, which means he gets to decide everything that happens in the country. But, Hitler doesn't like Jews and he wants to make them all move to certain areas and work for him.' Hans dreaded his little girls reply, his heart thumping he waited while watching her mind at work and her little face screwed up in thought. ‘Daddy, can't we stop being Jewish because then we will be safe from Hitler and we wouldn't have to work for him' Greta's face lit up as she said it, as though she had just discovered electricity. Hans felt his tears well up as he watched his daughter, oblivious to life and danger. After the children were all tucked up safely in bed, asleep with the faint sound of snoring, Hans and Anneliese looked on lovingly from the corner of the basement. ‘I would never be able to forgive myself if our children ended up being sent to a death camp, there would be no chance of us surviving as a family, and I've been thinking, and it pains me to say this, but we need to send them away to another country. They're not safe here, and I cannot rest until I know that they are forever free from this danger.' Hans was once again welling up, after saying it aloud, it seemed real as if he was going to lose his children, a thought too painful for him to even think about. ‘Liebliag, I think you're right, they aren't safe and they don't deserve to be put through the torture of a death camp, they aren't physically or emotionally strong enough, I think we should send them to England, it will be hard, but for the best.' Anneliese by now was also fighting back the tears. Sat on the cold, hard floor arm in arm, rocking to and thro, both crying at the thought of the most painful goodbyes waiting for them in the future. The next morning, Hans and Anneliese told their children the news. His heart pounding against his chest, Hans prepared to break the silence, his children's excited faces looking towards him. ‘Dad can we attend school again?' Leila's eyes glistening with hope that she was right and could be reunited with her education and friends. ‘Can we go to the shops on our own? There's a new chocolate bar that I really want to try. The sweet shop down the road is selling them!' Leopold asked excitement in his voice, as he was thinking about chocolate and outings to the sweet shop when he behaves well in school. ‘Are we going to be sent to a special part of Germany for the Jews, Daddy? I don't want to work for Hitler!' Eyes full to the brim with fear, Greta looked scared and vulnerable. She may have been the youngest, but she was definitely the most observant to her parents upset faces. Once again, Hans and Anneliese were sat arm in arm at the corner of the basement, looking at their children's content faces, wondering what amazing dreams they were having about going on holiday for the first time. They were all excited when Hans broke the news, Anneliese sobbing next to him. They'd given up the fight to stay away from them. But it wasn't good enough. They got caught. Now Anneliese and Hans were saying there last goodbyes to each other. Heartbreakingly painful, but it didn't matter. There hearts had already been shattered beyond repair, when they had to say goodbye to there children Leila, Leopold and Greta. Hans and Anneliese were about to board different cattle trains and when they got off, they knew that everything was going to change, and nothing would be the same. Death camps. Even the thought sent shivers up they're spines. They knew that they would never see each other again, which made it harder. But they got separated and pushed away from each other before they even had the chance to say goodbye. ‘This is it' thought Anneliese, ‘I'll just fight for survival, my children will see me again, they're who matter. They deserve to be reunited with at least one parent, but Hans is a fighter he'll fight for survival too.' After a year at Ravensbrà ¯Ã‚ ¿Ã‚ ½ck Concentration Camp for Women, Anneliese's strength had been replaced with weakness. She was now a shy women too scared to talk to anybody after her one and only friend at the camp Klara, died, she was crushed by machinery, as it happened the guards would let no one try and help. Anneliese had to do heavy labour work, from the break of dawn until the sunset at dusk. She got little sleep and ate just about nothing. All Anneliese could think about, no matter how hard she was working, was her children. So many questions were going through her mind. Had they all made the journey to Newquay, Cornwall by themselves? Was Greta still observant to everything around her? Was Leila being educated again? Was Leopold looking after his sisters? Had they learnt English? She thought about how grown up her children would look now, the girls beautiful and her little man handsome, like his father. But every time they were pictured in her head, she fought that little bit more, edging closer and closer to survival and freedom. Four painful years later, Anneliese won her battle. She had survived and she was going to go back to her house. When she got there, she wished she hadn't. She was expecting there to be a few belongings in the basement she'd lived in with her family for so long. But nothing. The walls were now jet black, ash on the floor and just a few remnants of what had been there before. It was obvious that someone had set fire to the basement, most definitely the German Authorities, they knew Jews lived here. Anneliese was determined than ever to find her children in England. In England, Leila was sat indoors about to blow out the candles on the cake, it was her 16th birthday. There was no need for her to think of her wish. It had been the same wish for five years now and it wasn't going to change until it came true. ‘I wish I could see my parents again'. There, she'd wished it once again. But Leila Wenger knew that if she wished hard enough then it would come true. After Leila had unwrapped her presents, she ran upstairs. She was able to read the letter that her mother had written before they left Germany. Leila – Open on your 16th birthday and not a day before Liebliag, this is the hardest letter I have ever had to write, but it's to explain why you haven't had me and your father in your life for so long. We have sent you to England because it was the only place that you would be truly safe. After you leave the country, your father and I will be sent to a concentration camp. This is because of our religion and Hitler the leader doesn't think that Jews are worthy of living. Of course, we are, so never doubt your religion. I don't know if we will ever see each other again, so I have enclosed photos, one of the whole family, one of you, Leopold and Greta and one of your father and I. Never forget us, because we will always be with you. Happy Birthday Liebliag! Ich liebe dich, dein Mutti After Leila had finished the letter she collapsed onto her bed in tears. She now knew that her wish would never come true, her parents were dead and she was the one that had to tell her little sister. How could she tell a 13 year old that her parents were dead? This wasn't going to be easy, she had to be subtle. This was definitely the worst birthday Leila had ever had and she wasn't happy about it. After an hour of crying into her pillow, Leila went downstairs as if everything was normal. ‘Victoria, please may I go out for a walk?' Leila asked Victoria, the kind woman that took Leila and Greta in, and cared for them as if they were her own flesh and blood. ‘Yes of course Leila, but be sure to be back within an hour' Victoria never liked Leila or Greta being outside for more than an hour at a time, there were still people that hated Germans and anything could happen out there. Leila went to the park and sat on the swings, just gathering up her thoughts and thinking about how to tell Greta about the letter. She supposed she ought to tell Victoria as well. It was such a bad day, and her wish is dead, along with her parents. As Leila made her way to the park gate she had no idea who else was in Newquay. The address said Beachfield Avenue, off Bank Street. Anneliese knew that she was close to seeing her children again. She just kept walking along Bank Street, past the bakers and a tasteful shoe shop. There, Anneliese stopped dead in her tracks. The sign on the side of the sweet shop had written on it Beachfield Avenue. Leopold must love living here, a sweet shop so near! She was on a mission, and that was to find her children. She walked at a fast pace along the road counting the numbers as she went 1.. 3.. 5.. she had a little while until she got to 31. As she walked along the road she started preparing what to say. What if her children didn't recognise her? 27.. 29.. 31.. This was it. She was just about to walk up the steps to the front door when she turned around. There behind her was a pretty young girl, couldn't be any more than 16, blonde hair, green eyes. ‘Excuse me.. but you, wouldn't happen to know if.. three children lived here?' Anneliese had never felt so nervous in her life, what if this was the wrong address. ‘Two girls and a boy?' ‘I'm sorry, but do you mean Leila, Leopold and Greta?' The mysterious girl was looking at Anneliese with interest, she had a German accent and there weren't any of those around here. ‘Yes! Yes! Those are the children I'm looking for! Do you know where they are?' Anneliese was now so excited she couldn't help smiling, for first time in years and instantly Anneliese knew everything would be OK. ‘I do know exactly where all three are, but please what is your name?' ‘My name? Well, it's Anneliese Wenger. Why?' ‘It's me Mutti, Leila. I read your letter only 2 hours ago, I thought you were dead' Leila was so happy, excited and joyful. She knew that if she wished hard enough it would come true. Her mother had come all this way to find them. ‘Please Mutti, come inside and meet Victoria, she's the lady that's been looking after us and Greta, she'll be so happy to see you! She always talks about you and father!' Leila was so excited about introducing her mother to Victoria. After a long day Anneliese, Leila, Greta and Victoria sat squashed on one sofa. Greta on her mothers lap, Leila clinging onto her arm and Victoria on the other side of Anneliese, the two of them talking like sisters. The moment was almost perfect. The only thing wrong with the moment was Anneliese had lost a husband and a son, while her children had lost a father and a brother. Hans Wenger died in 1943 at Auschwitz Concentration Camp Leopold Wenger died in 1940 during the journey to England due to poor hygiene

Worship of Nature

The Worship of Nature John Greenleaf Whittier, famous poet in the ninetieth century, has shown throughout the poem, The Worship of Nature, a splendid explanation of how the natural world relates to us in both a physical and a spiritual sense. A spiritual sense that the word â€Å"Worship† deals with the ideal belief that there is or was something in which created all things. Also, society and order can be compared to nature in such a way that nature is everything that is, was, or will be created. Within the rhyme scheme of the Shakespearian sonnet, John Greenleaf Whittier has focused this poem under the theme of Creator and his Creation. Beginning his first stanza with: â€Å"HE harp at Nature’s advent strung† (Nature line 1), Whittier emphasizes â€Å"HE† in which it represents God harp or sculpting â€Å"Nature. † In this sense, Nature represents God’s creations. As you progress farther through the poem some common elements of nature for example: life, death, water, earth, fire, and air. The ocean looketh up to the heaven, / And mirrors every star† (Nature line 7-8). These lines implies that mimicking others is a waist because it impossible for a copy which mirrors another to become the original. Combining God’s creations and mimicking others, John Greenleaf Whittier sets a tone of holy and sanctifying. John Greenleaf Whittier uses the Shakespearian sonnet to his advantage by staging the first two lines into a cause and the la tter into an effect. It may be easiest to relate this theory to the last stanza. Music is a reoccurring component of this poem that refers back to the first stanza about God being the creator playing a harp making a beautiful symphony for all of his creations. Whittier has a very strange order in his poem but it makes sense at the end when he relay all together by implying that everything takes it own course and continues to move forward since the beginning of time which is eternity when talking about God. To put it briefly, John Greenleaf Whittier wants us understand that we must not live others lives, be ourselves and prosperous.

How to Make Sure You Buy the Best Magnifier

How to Make Sure You Buy the Best Magnifier After you get a rock hammer- maybe even before- youll need a magnifier. The big Sherlock Holmes type lens is a clichà ©; instead, you want a lightweight, powerful magnifier (also called a loupe) that has impeccable optics and is easy to use. Get the best magnifier for demanding jobs like inspecting gemstones and crystals; in the field, for quick looks at minerals, buy a decent magnifier you can afford to lose. Using a Magnifier Hold the lens up next to your eye, then bring your specimen close to it, only a few centimeters from your face. The point is to focus your attention through the lens, the same way you look through eyeglasses. If you normally wear glasses, you may want to keep them on. A magnifier wont correct for astigmatism. How Many X? The X factor of a magnifier refers to how much it magnifies. Sherlocks magnifying glass makes things look 2 or 3 times bigger; that is, its 2x or 3x. Geologists like to have 5x to 10x, but more than that is hard to use in the field because the lenses are very small. 5x or 7x lenses offer a wider field of vision, while a 10x magnifier gives you the closest look at tiny crystals, trace minerals, grain surfaces, and microfossils. Magnifier Flaws to Watch for Check the lens for scratches. Set the magnifier on a piece of white paper and see if the lens adds color of its own. Now pick it up and examine several objects, including one with a fine pattern like a halftone picture. The view through the lens should be clear as air with no internal reflections. Highlights should be crisp and brilliant, with no colored fringes (that is, the lens should be achromatic). A flat object should not look warped or buckled- move it to and fro to be sure. A magnifier should not be loosely put together. Magnifier Bonuses Given the same X factor, a larger lens is better. A ring or loop to attach a lanyard is a good thing; so is a leather or plastic case. A lens held with a removable retaining ring can be taken out for cleaning. And a brand name on the magnifier, while not always a guarantee of quality, means you can contact the manufacturer. Doublet, Triplet, Coddington Good lensmakers combine two or three pieces of glass to correct for chromatic aberration- what gives an image blurred, colored fringes. Doublets can be quite satisfactory, but the triplet is the gold standard. Coddington lenses employ a deep cut inside the solid glass, using an air gap to create the same effect as a triplet. Being solid glass, they cannot ever come apart- a consideration if you get wet a lot.

Reflection on Three Critical Incidents in Practice The WritePass Journal

Reflection on Three Critical Incidents in Practice Introduction Reflection on Three Critical Incidents in Practice ). These meetings were important since it helped me clearly identify the problems of my service user and reflect on the best solution for his circumstances. I also felt on our meetings that I was allowed to critically thing through the problem and create a solution that is feasible for the client and my team. Incident Two Description of Incident A social care assessment was completed for a service user who underwent hip replacement after suffering from a fall at his home. After careful consideration, the team decided to transfer the patient from the hospital to a step down bed to allow for mobility rehabilitation. A physiotherapist completed a home visit to ascertain the type and level of support that the service user will need. The aim of the team is to restore normal living and independence for the patient as soon as possible. However, the physiotherapist reported that the service user’s home was unfit for habitation. There was no heating and a side lamp in the lounge remains as the only source of light. The house was filthy with black trash bags strewn in the kitchen. There was no food in the refrigerator. The house smelled of urine with the bed covers looking visibly soiled while the toilet also needs plumbing. The National Institute for Health and Care Excellence (NICE, 2013) guideline for fall prevention has emphasised the need to assess the conditions of the home and make changes to facilitate easier mobility of the service user. As the environment is physically adjusted to the needs of the patient, this will prevent recurrent falls and will help improve mobilisation of the patient (NICE, 2013). On analysis, the patient was living alone and had difficulty maintaining the cleanliness of his home prior to his fall. This would suggest the need for assistance in the activities of his daily living. Although the patient refused any help, health and social care workers can act on the best interest of the patient and make changes on the patient’s home to make it safe and liveable (Glasby et al., 2008). The NICE (2013) guideline also states that home hazard assessment should be performed to allow safety interventions and home modifications. Consistent with the experience of the service use r of this incident, the home assessment was part of discharge planning. In addition, the NICE (2013) guideline emphasises that home modifications should be carried out within the agreed time frame between the patient and appropriate members of the healthcare team. However, it should be noted that home hazard assessment is not effective when follow-up and interventions are not introduced. The physical modification of the house alone is also not effective in preventing a recurrent fall. House modification should be supported with appropriate interventions for the patient. Critical Care Incident The service user is only allowed to stay for six weeks at the rehabilitation unit.   Since the house needs repair and deep cleaning, there would be not enough time for the service user to move to his house after his discharge. The service user also refused to have carers since he feels that he is capable of taking care of himself. He explicitly stated that he does not want additional support to assist him with activities for daily living (ADL) and made a verbal request to the rehabilitation team to help him return to his home. For this particular case, the critical care incident involves respecting the wishes of the patient or acting on the best interest of the patient. As a qualified worker, I have to convince the patient that he could not immediately return to independent living since his house has to be repaired. In the meantime, we have to find a suitable place for him to stay before he can go home. Since the patient was adamant in returning home, I have to decide between actin g on the best interest of the patient or respecting patient autonomy. This means, I either have to follow the patient’s wishes of returning him to his home even if it is still not fit for his condition or convincing him to stay in a temporary shelter. I consider this as an incident since social care workers should respect patient autonomy. However, this is difficult to follow especially if respecting the patient’s autonomy would not be for his best interest. On reflection, I began to question how I offered support to the patient after he expressed that he wants to go home after attending the six-weeks rehabilitation. It is understandable that patients who suffer from a fall do not want to be a burden to others. The NICE (2013) guideline notes that patients do not want to become an added burden to the staff when they want to ask help for mobilisation. On the other hand, I also have to inform the patient about his condition and why he needs to return to a home that is clean and modified for his needs. Hence, there is a need to introduce multidisciplinary management when caring for patients who have undergone hip fracture surgery. For instance, the NICE (2011) guideline for hip fracture expresses that a patient should be involved in a hip fracture programme that addresses all his health needs. Specifically, the guideline states that multidisciplinary teams should aim for recovery of mobility, functions and independence. The same guideline also reiterates that multidisciplinary teams should enable return of service users or patients to their residence and ensure the long-term wellbeing of this group. On analysis, our multidisciplinary team is following measures to ensure that the service user will return to a home that is safe and modified for his needs. This reflects values and ethics, one of the 9 PCF domains. The value of patient safety and ethics when caring for patients are demonstrated in our actions of helping the patient return to a safe environment following his discharge from the rehabilitation unit. Changing Awareness I had to consider the best interest of my patient even if he insists on returning to his home immediately after his discharge from the rehabilitation unit. Barrett et al. (2005) express that social care workers should always place the safety and best interest of the service user when deciding on appropriate interventions for the patient. This is consistent with the ethical principle of non-maleficence and beneficence (Runciman and Merry, 2012). The primary role of social care workers is to do no harm. Since the patient refused to receive additional support for ADL, I am aware that returning him to an unmodified home will increase the risk of recurrent fall. Although the patient was deemed as having the capacity to perform the activities of daily living, I felt that his current house is unsafe. Adding a challenge to the service user’s case was his refusal to have a carer to look after his needs and assist him with daily living. As noted previously, patients want to feel that they are still needed and they still have the capacity to perform ADL (NICE, 2011). Surrendering one’s independence to a carer is perceived as demeaning and also depressing (NICE, 2011). Hence, I sought the manager’s approval to transfer the service user to a residential home temporarily until his house has been deep cleaned and modified. On analysis, patient-centred care is important to improve patient satisfaction and increase adherence to a care plan. However, there are cases where social care workers have to intervene in the best interest of a patient (Collins, 2009a). This case exemplifies this exception and shows the influence of social car e workers in making meaningful decisions for the health and wellbeing of services users. Incident Three Description of the event I completed a social care assessment for an elderly female patient who suffered from a fall in her home. She was transferred to the rehabilitation care home following her admission from the hospital. Healthcare team members recommend the restarting of the previous care package and increasing the package. On the completion of my assessment, my recommendations were identical to that of the healthcare professionals in my team. I recommend increasing the care package since the service user is experiencing poor health and has difficulty eating independently. The patient and her family members were very reluctant to accept the additions to the care package. Family members contacted my team and arranged a meeting with all health professionals involved in the care of the patient. The purpose of the meeting was to determine the type of support that the service user needs and to identify any additions in her care package. During the case conference, health and social care professionals explained why the patient needs modifications in her home and a carer to assist her in her ADL. For instance, it was explained to the family why the service user will need a stair lift and a pendant alarm. Additionally, the health and social care team agreed with my recommendations to provide the patient with support in preparing meals, intake of medications and personal hygiene. Although the family was apprehensive about the additional cost, they finally agreed to the increase. Critical Care Incident The service user was very reluctant to return to her home after a consultation was made on why her care package will be increased from two calls to four calls per day. She was also informed to hire one carer to support her needs and to assist her with ADL. Considering the cost implications of an added carer and increasing the number of calls each day, the service user declined the addition in the care package. The critical care incident in this case is the need to convince the patient that she needs the additions to her care package. This became a dilemma since this request entails that the patient and family members will have to make out-of-pocket expenditures. This could mean an added burden to the care of the patient. To convince my patient, I have to consider my knowledge on elderly care after hip surgery. This means I should give sufficient information about her condition and why she needs the additions to her care package. Since I am practicing patient-centred care, I gently reasoned out with the patient why she needs a carer once she returns home. The Department of Health (2008) reiterate that the patient should be involved in healthcare decision-making about their care and discharge. While I recognise the service user’s rights to refuse treatment, one should also consider that social care workers have to work in the best interest of their patients. Hence, I tried to convince the patient that she needs an addition to her care package to ensure that she is safe in her home and receives adequate nutritional support. I used my knowledge in elderly malnutrition in informing the patient why she needs an addition to her care. For example, I informed her that since she is an elderly, she is at risk of malnutrition compared to the general population. Malnutrition in the elderly is defined as a basal metabolic index (BMI) of 18.5 (Harris and Hboubi, 2005). This condition could be corrected with appropriate diet, nutrition and support (Harris and Hboubi, 2005). Further, malnutrition is a significant deterrent to optimal health and wellbeing (Age UK, 2010). Patients recover slowly or not at all when they are suffering from malnutrition. Hence, it is important to address malnutrition at this stage. Apart from malnutrition, there is also the issue of adherence to medications. There is evidence that adherence to medications might not be high amongst elderly patients (Maclaughlin et al., 2005). It is suggested that cognitive functions of this group are in decline. Hence, there is a need to introduce medicati on prompts to remind patients when to take their medications. Since the patient remains undecided after our consultation, I asked her to confide to her family and seek their advice. Engagement of family members in the treatment and care of patients has been shown to be effective in improving health outcomes (Glasby et al., 2008). One of the reasons for this effect is that family members are more committed to improving health outcomes of patients. Changing Awareness This incident helped me understood the domains of rights, justice and economic well-being in the PCF. It is the right of all service users to receive equitable care (Department of Health, 2008). Justice is not satisfied when service users do not receive equal access to healthcare services. However, the economic well-being of the patients should also be taken into account when recommending additions to care packages. It should not become an added burden to a family who might have suffered from financial difficulties as a result of the patient’s illness. It was evident from the case that the family has difficulty supporting the service user. The cost implication of an addition in care package could act as a deterrent to access in health services. For instance, the family of the service user was initially reluctant to support the addition to the patient’s care package due to its cost implications. While support from social care services is available for different groups of service users, financial support is limited. Hence, this could be an important deterrent to care. In my future practice, I should ensure that al additions to a patient’s care package should be well justified, especially if the NHS does not cover these additions. For my professional development, I should always act on the best interest of the patient in ensuring that care is cost-effective and does not require patients and their family members to make out-of-pocket expenditures. On reflection, the incident was a learning experience since I need to be more acquainted on the economics of care. I evaluated my actions after arriving at the deci sion to request for additions to the care package and discovered that I was acting on the best interest of the patient. I learned that as a social care worker, I should always be an advocate for the patient. In my future practice, I will follow the same actions I made for this case. I will improve my communication skills with my patients to help them feel that I empathise with them and only wants the best care for them. Conclusion The three incidents presented in this brief illustrate the importance of patient-centred care when providing support for service users. Lessons from these incidents could be used to improve my current practise. Specifically, there is a need to communicate effectively with team members to ensure optimal and quality care of the patients. In incident one, I learned the importance of exercising my leadership and professionalism when acting on behalf of the best interest of the patient. I also learned the importance of facilitating normalisation and independence amongst my service users. Maintaining their independence would help improve their self-worth. In incident two, the values of patient safety and independence were exemplified. A home hazard assessment will improve patient safety since homes will be modified to suit the needs of the patient. In incident three, I learned to empathise with patients and to evaluate the cost-effectiveness of additions in care packages. Although the pati ent’s family was reluctant to spend for additions in care packages, the family eventually agreed to these additions. This reflective brief shows that a holistic approach should be made when addressing the needs of services users. This approach would view the issues of a patient’s case based on the social, environmental and political contexts. In this brief, health policies in the UK and NICE guidelines were used to support the discussions in this brief. The NICE guidelines serve as an important resource for information on how to manage patients with different health conditions. Social care workers could collaborate with inter-agencies to ensure that quality care is provided for each service user. As part of my professional development plan, I will continue to seek for opportunities to work with other professionals and practice positive communication. I also learned that I should respect the wishes of the service users and facilitate their independence and promote return to normal activities. I also learned that allowing my service users to regain their independence, their self-worth will increase and they will become more empowered. I also have to show empathy when addressing the needs of my patients, especially if they are concerned about the additional financial costs of additions in their care packages. Reflection has allowed me to become a better social care worker. In my future practice, I will use the lessons learned from the incidents to improve care for my service users References Age UK (2010) Seven Steps to end malnutrition, London: Age UK. Barrett, G., Sellman, D. Thomas, J. (2005) Interprofessional working in health and social care: Professional perspectives, London: Palgrave Macmillan. Carpenter, J., Webb, C., Bostock, K. Coomber, C. (2012) SCIE Research briefing 43: Effective supervision in social work and social care [Online]. Available from: scie.org.uk/publications/briefings/briefing43/ (Accessed: 12th December, 2013). Clouston, T. Westcott, L. (2005) Working in health and social care: an introduction for allied health professionals, London: Elsevier Health Sciences. Collins, S. (2009a) Effective communication: A workbook for social care workers, London: Jessica Kingsley Publishers. Collins, S. (2009b) Reflecting on and developing your practice: A workbook for social care workers, London: Jessica Kingsley Publishers. Department of Health (2008) Our Health, our care, our say: A new direction for community services, London: Department of Health. Fan, C. (2011) ‘Factors associated with care burden and quality of life among caregivers of the mentally ill in Chinese society’, International Journal of Social Psychiatry, 57(2), pp. 195-206. Glasby, J., Dickinson, H. Community Care (2008) Partnership working in health and social care, London: Policy Press. Gordon, C., Wilks, R. McCaw-Binns, A. (2013) ‘Effect of aerobic exercise (walking) training on functional status and health-related quality of life in chronic stroke survivors: a randomised controlled trial’, Stroke, 44(4), pp. 1179-1181. Harris, D. Haboubi, N. (2005) ‘Malnutrition screening in the elderly population’, Journal of the Royal Society of Medicine, 98(9), pp. 411-414. Jasper, M. (2006) Professional development, reflection and decision-making, Oxford: Oxford University Press. Jones, L. (2010) Reflective practice in nursing, Exeter: Learning Matters Ltd. Langhorne, P., Bernhardt, J., Kwakkel, G. (2011) ‘Stroke rehabilitation’, The Lancet, 377(9778), pp. 1693-1702. Maclaughlin, E., Raehl, C., Treadway, A., Sterling, T., Zoller, D. Bond, C. (2005) ‘Assessing medication adherence in the elderly: which tools to use in clinical practice?’, Drugs Aging, 22(3), pp. 231-2455. McCullagh, E., Brigstocke, G., Donaldson, N. Kaira, L. (2005) ‘Determinants of caregiving burden and quality of life in caregivers of stroke patients’, Stroke, 36, pp. 2181-2186. NICE (2013) Falls: The assessment and prevention of falls in older people, London: NICE. NICE (2011) Hip fracture: The management of hip fracture in adults, London: NICE. NICE (2008) Stroke: the diagnosis and acute management of stroke and transient iscahemic attacks, London: NICE. Peck, E., Dickinson, H. Community Care (2008) Managing and leading in inter-agency settings, London: Policy Press in association with Community Care. Pollard, K., Thomas, J. Miers, M. (2010) Understanding interprofessional working in health and social care: Theory and Practice, London: Palgrave Macmillan Limited. Rimmer, J. Wang, E. (2005) ‘Aerobic exercise training in stroke survivors’,  Topics in Stroke Rehabilitation,  12(1), pp. 17-30. Runciman, B. Merry, A. (2012) Safety and ethics in healthcare: A guide to getting it right, London: Ashgate Publishing, Ltd. Taylor, B. (2006) Reflective practice: A guide for nurses and midwives, Maidenhead: Open University Press. The College of Social Work (2013) Professional Capabilities Framework [Online]. Available from: tcsw.org.uk/uploadedFiles/PCFDomainsNOV.pdf (Accessed: 2nd December, 2013).

Choose any topic Assignment Example | Topics and Well Written Essays - 250 words

Choose any topic - Assignment Example For instance, president Obama, while asking Congress to vote on his decision to act on the use of chemical weapons by Assad in Syria, manifests the truth in the statement that might is right. President Obama seeks to act on the situation simply because it poses a threat to its national security and of ‘friends’. This action will be in violation of international law that only allows the Security Council to sanction recourse to war. The President downplays the role of the UN in the matter and does not wait for its decision. From this action, it can be inferred that mighty nations can do as they wish without feeling bound by international laws. Ironically, the president states in his speech that right creates might while doing exactly the opposite. In a similar vein, former president Bush went on with pre-emptive war in Iraq even though the issue was before the UN. The reason put forward were that Iraq posed a threat to the national security of the US. This opinion fuelled the policy of the US to attack their enemies before the enemies attacked US. Similarly, Bush unilaterally decided that Iran with Nuclear weapons would be a great threat to world security. This misplaced notion that the US has the responsibility to bring change or protect the world could only stem on the operationalization of might is right. To sum it up, Kimen Valaskaki states in his article that whatever interpretation is given to pre-emptive actions leans towards the wrong assertion of the might is right concept at the expense of the weaker nations. It is indeed true that might is right is a reality in the present

Define the utility of Katharine Kolcabas Comfort theory for Essay

Define the utility of Katharine Kolcabas Comfort theory for application to clinical practice using an actual clinical problem you observed - Essay Example This meeting of needs may be addressed physically, socioculturally, psychospiritually or environmentally. Whatever the means adopted, the ultimate aim is to reduce the discomfort of the patient which is perhaps the primary goal of any nursing care activity. Although it may be impossible to utilize all contexts (physical, psychospiritual, sociocultural or environmental) simultaneously; there is yet the possibility of utilizing the maximum modes possible, all aim at reducing discomfort while enhancing the feeling of comfort (Sitzman & Eichelberger, 2011). In my opinion, one of the main problems that are encountered in the clinical setting on frequent basis is the care of patients having impaired integrity of skin, especially those patients who are unable to move on their own and are therefore immobilized to a variable extent. This group of patients comprises a special population who are destined towards a slow decline in their health status if appropriate measures are not taken during the early stages of their illness. As skin is the main barrier between the external and internal environment of the body, any defect in this barrier is likely to expose the individual to a variety of pathogens that can not only infect the dermatological tissue, but also invade the body, affect other organs and destroy the homeostasis of the body ultimately resulting in an unfavorable outcome (Freinkel & Woodley, 2001). A gravely uncomfortable consequence of impaired skin integrity is seen in the form of development of pressure-sores in patients are immobilized for extended periods of time. These lesions result due to the presence of persistent pressure on certain areas of the body and can ultimately contribute towards the fatality of the disease for which a patient is under treatment. The intervention designed for the chosen problem includes a number of measures that are collectively