The Income Gap free essay sample

An examination of government policy in the United States that does not assist the increasing poverty levels. This paper considers the existence of the poverty gap in the U.S. and puts forward the hypothesis that it is a self perpetuating problem. Issues considered include education, health and government policy. Many statistics are listed and various theories mentioned as to why this is an ever-increasing phenomenon.

How to seamlessly transfer your skills from one industry to another

How to seamlessly transfer your skills from one industry to another For most of us, our career paths don’t go in a single straight line. Instead, there are plenty of twists and turns along the way- some expected and others surprising and unplanned- as we develop, grow, and change over time. Sometimes a change in jobs also means a change in industries, which, for many, can be a scary and anxiety-filled proposition- especially if the change isn’t exactly what you were hoping and is instead the result of a job loss or shifts in your current field. The truth is, the prospect of â€Å"starting over† in a new career field can be daunting, especially if you’re fairly established and far along in your current field and are worried that you’ll have to completely start over again- but it doesn’t have to be.The â€Å"not-so-secret† secret to successfully navigating an industry change during the course of your career is to take full advantage of your transferable skills- those finely-honed abilities that youâ€⠄¢ve acquired thus far in your professional experience that you can put to good use in the next industry you work for. Yes, it’s true- many of the skills you currently have are not just helpful at your current job and industry, but rather can help you be effective and successful in your future endeavors as well.Transferring and leveraging these transferable skills from one industry to the next is the key to being flexible and malleable in today’s rapidly evolving and volatile job market- and those who are able to competently do so stand the best chance of staying afloat. Consider using the following strategies to make sure that the skills you’ve built up during your career continue to serve you well as you move from one industry to another.Identify your skillsThis shouldn’t be a major challenge for you, as it’s something you’d inevitably have to do if you were updating your resume or simply looking to transition to a new job in your current industry. This should include skills both large and small- you never fully know what abilities will come in handy when you start a new job, especially if it’s in a completely new field or industry. These include both hard skills (things like knowledge of computers or specific programs or instrumentation, an ability to speak a foreign language, any professional certifications you’ve earned, and basically any other measurable and quantifiable talent that you’ve developed) as well as soft skills (more subjective and harder to measure abilities that you possess but that come in handy at work all the time, such as people skills, motivation, leadership, patience, flexibility, and problem-solving). Both your hard skills and soft skills can potentially come in handy in a new industry.Identify the needs of your target industryNext step is to pinpoint the industry that you’re hoping to move into and do your homework to identify its needs. Research carefully and get a good sense of the successes and pain points in the field and where things are likely to move. Look at the opinions of industry veterans and thought leaders- many of whom are likely leveraging social media to share their ideas. An even better potential strategy would be to identify specific companies in the industry that you’d like to work at and get a sense of their needs- which will help you paint a clear picture of how you can come aboard and be a potentially valuable asset.Make the connectionNow that you have a clear idea of the abilities you bring to the table and what the needs of your target industry are, you can begin to identify the skills you possess that are potentially transferable. Use the information you’ve been gathering in your research to hone and refine your skills to best suit your new industry. For hard skills like computer knowledge or mastery of specific equipment, see if the tools you’ve learned are commonly used; if not, see if learning popular industry software and equipment makes sense for you. Soft skills are more easily transferable and are more malleable and adaptable to new fields.Here’s the bottom line- make the most of the skills you currently possess to meet the needs of the industry you’re looking to move into, fill in the gaps where appropriate and realistic, and be confident that you’re doing all you can to make this transition as successful as possible.

Case study journal Essay Example | Topics and Well Written Essays - 500 words

Case study journal - Essay Example This paper explores the three learning and teaching strategies as discussed by as discussed in the book. The book explains how effective learning among students is achieved. Collaboration is among the key elements that have been given much emphasis in this chapter. The author states that collaboration helps students to be receptive to challenging assignments, develop crucial skills in cooperation. It also builds a community of learners who are responsible for each other’s learning rather creating a competitive environment which alienates some students, particularly those who perform poorly in class (Willems & Gonzalez-DeHass, 2006). Students’ engagement is also substantially improved by allowing students to learn in pairs or groups. Learning in groups requires them to share ideas and interact in an effective manner. However, accomplishing collaborative learning is faced with challenges such as inequities that exist in the social system of a classroom. In his case, students who perform well dominate groups formed during collaborative learning while poor performers are unable to convince other group members. According to the author, the main elements of effective learning include collaboration, self-regulation and constructivist learning. Constructivism is categorized into two; physiological constructivism and social constructivism. Under physiological constructivism, people use information, help from other persons and from other resources to develop problem solving strategies and mental models, while Social constructivism makes people perceive learning as a participative activity Inquiry based learning and problem based learning are other effective approaches that improves the learning process. Inquiry based learning involves asking students guide questions that are related to the curriculum where by the chosen questions guide students towards a common understanding. It also engages students in the inquiry by allowing them to make

Media and body image Research Paper Example | Topics and Well Written Essays - 2000 words

Media and body image - Research Paper Example In that regard, people have become victims of the media sources like magazines because they police and construct ideas on standards from fashion to everything in life. From an evaluation of the pictures and articles in the vogue magazine, it is clear that the media polices and constructs certain body images for both men and women; these body images are deliberate because audiences need something to feed on, to keep on reading the magazines, and the magazines themselves deliver just that. It is apparent that media treats the male and female body images differently, in addition to treating body images of heavy people and thin people differently. Evidently, all these body images pass across some subtle yet firm messages that reflect gendered societal views about both men and women; in that case, media constructs truths about life, thus, it is the most powerful influence on how both men and women often view themselves. There are clear indications that the Vogue magazine applies different standards in its portrayal of the body images for both males and females from the manner in which it portrays them differently. On a wider scope, the body images of b oth men and women in this magazine depict the sexes in stereotypical ways that constrain the readers’ perceptions of the limitless human possibilities. For instance, the body image of males in the vogue magazine depicts them as lively, powerful, daring, sexually aggressive and most importantly, they are depicted as being deeply involved and playing extremely important roles in human relationships (Horowitz). This magazine imposes this body image as the universal standard for males and as a result, it is consistent with the cultural views of males in society; however, the actual reality in the wider population is different. Truth of the matter is there are all sorts of imperfections in the body image of males in the

How does communication affect operations in chain hotels Research Paper

How does communication affect operations in chain hotels - Research Paper Example Examining the organizational structure, management plan, service context and the characteristics of chain hotels makes a difference in how many respond to the hotel management. Each of these combines with the need of having the correct level of communication. Examining how communication fits into each of these regions will be the main objective of this research study. The association with hotel management for chains is one which has developed into a variety of models and expectations within the industry. The industry of hospitality and the organizational development that is a part of each structure is one which is developed with the ideology of service first. Having hospitality management, customer service and alternatives to assist guests with personalized needs with booking hotels and staying in a specific room are the main associations that are a part of this. This is followed by enhancement of the organization that is a part of the management and the way in which the industry functions. The need to offer the right services has led to management groups, operation rooms and divisions in different forms of hospitality, including housekeeping and food and beverage alternatives. This is combined with the management required for the overall hotel divisions, including marketing, finances and human resources that are required for a hotel to work effe ctively (Rutherford, O’Fallon, 2006). The importance of the organizational structure to manage the services of a hotel has expanded with the current initiatives that are within hotels. The chain hotels require specific services not only based on the management and divisions. There are also models which are based on hotels keeping uniformity and offering a high standard of service to continue with operations. The specific component is with the environmental awareness that is within the hotels and how this links to the customer interpretations and the

Computational Chemistry for Drug Discovery

Computational Chemistry for Drug Discovery Computer Chemistry Computational chemistry is a branch of chemistry that uses computers to assist in solving chemical problems. It uses the results of theoretical chemistry, incorporated into efficient programs, to calculate the structures of molecules and solids. In theoritcal chemistry, chemists, physicist and mathematics develop algorithms and computer programs to predict atomic and molecular properties and reaction paths for chemical reactions. Computational chemists, in contrast, may simply apply existing computer programs and methodologies to specify chemical question. There are two different aspects to computational chemistry. Computational studies can be carried out in order to find a starting point for a laboratory synthesis, or to assist in understanding experimental data, such as the position and source of spectroscopic peaks. Computational studies can be used to predict the possibility of so far entirely unknown molecules or to explore reaction mechanisms that are not readily studied by experimental means. Computer-aided drug discovery/design methods have played a major role in the development of therapeutically important small molecules for over 2-3 decades [133]. Over the past couple of decades, many powerful standalone tools for computer-aided drug discovery have been developed [134]. In silico metabolism After adopting combinatorial chemistry and high throughput biological screening in the past couple of decades, the pharmaceutical industry generated a large collection of potent and selective compounds for numerous targets. However, to become an optimal drug, in addition to potency and selectivity, a compound must have appropriate ADME (absorption, distribution, metabolism and excreation), safety and developability characteristics. Relaying solely on potency in the early stage of drug discovery can result in disproportionate attrition after clinical candidate selection contributing to the exorbitant costs of discovering and developing drugs. Only about one in ten of those diligently chosen, highly potent and selective candidates that enter development reach the market often due to inadequate ADME properties. Therefore, it is extremely important to consider the ADME characteristics of compounds earlier in the discovery process to wager bets on compounds that have a greater potential t o survive the development and clinical trail stage of drug development. Increasing the odds of success to one in five (instead of ten) would reduce the total cost of bringing a new therapeutic to the market by 33%. Experimental determination of ADME and pharmacokinetic (PK) characteristics is both expensive and time consuming, and is not practical for large numbers of compounds, especially when the pharmaceutical industry is under severe pressure to cut costs and improve efficiency. The Price tag to support various ongoing discovery projects in pharmaceutical company for synthesis and high throughput measurement of permeability, solubility, metabolic stability and acute toxicity can run into millions of dollars. Therefore, much attention is being focused on the application of in silico screens to reliability predict ADME attributes solely from molecular structure. In silico prediction of ADME properties will not only reduce cost and development cycle times by wisely directing resources to essential experimental testing, but also bring forward their consideration earlier at the lead generation stage when compounds are being synthesized and tested almost exclusively to meet pharmacological target potency levels. At the cost of experimental results indicated above, a mere 10-20 % reduction in high throughput experimental measurement of permeability, solubility, metabolic stability, acute toxicity through the use of in silico screens can lead to significant savings. Further, application of in silico screens offers an ideal ‘fail-early-fail-cheaply’ strategy for drug discovery because their application requires nothing more than inputting the basic structural information of a compoun d into a validation model. Metabolic Stability Measurement in Drug Discovery At most major pharmaceutical companies, metabolic stability assays are conducted at the first investigation into the metabolism of a compound. These in vitro assays generally utilize liver microsomes and/or hepatocytes to furnish important information about the rate and/or metabolism. In vitro metabolic studies are important in optimizing pharmacokinetic properties such as in vivo half life, maximum concentration and systemic exposure, because rapid metabolism is often a key factor contributing to poor exposure. The metabolic stability data is helpful for ranking molecules with respect to their ability to resist metabolism. Though high-throughput automated metabolic stability assay systems have been developed by the major pharmaceutical companies, screening a large number of compounds is still intensive. Thus, in silico prediction of metabolic stability can be used to rationalize experimental testing and have significant resources. Further, these models allow for prediction of metabolic stability for virtual libraries, thus bringing forwarded their consideration earlier to hit-to-lead stage. In silico Models for Metabolism Studies There are several types of in silico tools available for investigations into metabolism. These include knowledge based systems (metabolism databases) rules based or expert systems and quantity structure properties relationship (QSPR) and enzyme structure modeling systems. At its simplest, the partition coefficients, Log P (or its computed equivalent), of a drug in the n-octanol-water system has been shown to loosely correlate with the metabolic stability of a compound. As in silico calculations of Log P values have become readily available, they are being implemented in many of the current metabolism prediction packages. The earliest in silico metabolism tools were the metabolic reaction databases. In principle, these are databases with the published metabolic reactions and structure of parent compounds and their metabolites. Some of these allow creation of corporate metabolic databases as well. In most cases, these databases can be searched for specific biotransformation (by structure and substructure), biotransformation keywords, and by other user-defined fileds. The key advantage of this knowledge based in silico systems is that they include detailed metabolism findings and original references. Prediction of Metabolites The above mentioned knowledge based systems provided the groundwork for the development of rules based in silico predictors of metabolites, also called expert systems. Commercial rules based programs such as METEOR, META and MetabolExpert iteratively interrogate the chemical bonds of a molecule and apply programmed biotransformation rules in a predetermined hierarchy. As one can imagine, without means of terminating the metabolism tree a very large numbers of metabolites will be generated of predicted. Several of these programs allow the user to specify the number of levels of biotransformation or may use a LogP calculation to terminate the biotransformation process. Prediction of Sites of Metabolism The mechanism of oxidation by CYPs is though to be constant across all CUPS. One of the most important steps in the oxidation of drugs (by CYPs) is the ability of the perferyl oxy species (FeO+) to carry out a one-electron oxidation through the abstraction of hydrogen atoms. In silico packages such as Admensa, COMPACT and Metasite calculate the likehood of abstracting a hydrogen atom from all sites on a molecule, and then quantify which sites are most likely to be oxidized. The greatest advantage of these types of predictions is the ability to quantify the most likely major â€Å"hot spots† on the molecule. Prediction of Substrate Binding The ability of a molecule to properly dock on the active site of enzyme plays a major role in accurately determining the site(s) of metabolism on a molecule. Therefore, modeling of the P450 active sites has long been a goal for metabolism prediction. Some of the first attempts to model the active site of metabolizing enzymes used pharmacophore, site directed mutagenesis, and protein homology. Using homology models built from bacterial and mammalian P450s, in silico studies of docking potential substrates into the active site have been performed with mixed success. Now that the crystal structure for human CYP3A4, CYP2C9, CYP2C8 and CYP2A6 are available docking experiment with these models should more reliably predict the sites of metabolism on a molecule that the predictions form the homology models. Prediction of Metabolic Inhibition One of the causes of drug-drug interactions is the inhibition of metabolic pathways. Enzyme inhibition by a drug leads to a decrease in metabolism and intrinsic clearances, and an alteration in pharmacokinetics of a co-administered drug. Any knowledge around the potential of drug-drug interactions is useful for a quantitative assessment of the ability a new molecular entity to inhibit the metabolism of another drug. In silico methods to predict drug-drug interactions are mostly limited to competitive inhibitors because they rely primarily on the binding models in the used as templates with alignment and orientation of core structure in an active site. However, the quality of prediction depends on the structural similarity to the molecules that were used to build the model. Inhibitors of CYP2D6 and CYP2C9 have been predicted using the CoMFA method. For inhibitors of CYP3A4, CYP2C9 and CYP2D6, methods such as CATALYST and GRIND have been used to reduce the bias in the alignment of inhibitors. Prediction of Enzyme Induction The induction of drug metabolizing enzymes is an additional way in which co-administered drugs can affect the clearance and pharmacokinetics of a given drug. Induction or increased expression of the drug metabolizing enzymes leads to an increase in the rate of metabolism and ultimately, to increase intrinsic clearance. Therefore, enzyme induction leads to decreased drug exposure which may results in therapeutic failure. Most often, the induction of enzymes occurs through the activation of nuclear receptors such as the Arylhydrocarbon receptor (Ahr), the Pregnane X receptor (PXR) and the constitutive Androstane Receptor (ACR). The activation of nuclear receptors PXR and CAR are responsible for the induction of several drug metabolizing enzymes including CYP3A, UGT1A1, SULT1A and CYP2C9. On the other hand, induction of CYP1A, SULT1A1 and UGT1A1 has been associated with activation of AhR. Prediction of Metabolic Stability As mentioned above, metabolic stability influences both oral bioavailability and half life of a drug. There is good correlation between in vitro metabolic stability and in vivo clearance. Therefore, the assessment of metabolic stability of compounds is being demanded and earlier in discovery projects. To meet these needs, in silico models are commonly employed. As described above, many different in silico tools focused on studying different aspects of metabolism have been developed. In our experience, the choice of the in silico tool by a user should primarily be guided by the type of information and level of accuracy that is desired. It is imperative that the developers of these in silico tools continually refine and validate them to reliably predict and quantify the metabolic fate of drug in humans. On the other hand, the chemists, biologists and ADME scientist on project teams to evaluate and use the existing in silico tools and to challenge their developers to demand tools that will rationally and efficiently move the discovery projects forward. Metabol Expert Metabol Expert is an ideal program for a quick prediction of the metabolic fate of compound in the drug discovery process during the dispositional research phase. Metabol Expert is a unique tool for initial estimation of the structural formula of metabolites. Metabol Expert is a rule based system with open architecture, in other words, the chemists, metabolism researchers, drug disposition experts and environmental managers can understand, expand, modify or optimize the data on which the metabolic structural estimation relies. Commercialized by Compudrug in 1987, Metabol Expert is composed of a database, a knowledge base and several prediction tools. The basic biotransformation database contains 179 biotransformations, 112 of which are derived from Testa and Jenner, the others are based on frequently occurring metabolic pathways. The transformation knowledge-base is composed of if-then type rules. Each is composed of our components, the structure changed during the transformation, the new substructure formed, a list of substructure at least one of which must be present in the molecule for the biotransformation form occurring. These rules have been derived from the literature by experts and are input into the system by means of graphical tools. The system is open so that new rules can be added or existing ones modified or deleted. There are two types of predictions in Metabol Expert. In the first type, the system tries to match basic transformations automatically. There is a filter so that biotransformation sequences can be arrested after generation of a specified number of metabolites. Basic transformations are classified as phase I or phase II. In the event of a phase II metabolite being generated, the sequences are arrested and the metabolite is not included in the next level. If a transformation results in the generation of two metabolites, then both are passed into the next level. The second type of analysis is an extended prediction model in which metabolites generated from basic transformations is compared to a list of transformations in a learned tree for a given species and the analogues are then listed in order of similarity. The program then attempts to quantify predictions based in the information in the learned tree. MexAlert MexAlert was developed to be an ideal assistant for high-throughput screening. It is advantageous to consider metabolism still before synthesis of the compounds, in order to exclude unwanted metabolic pathways, leading, for example, to first pass effect or to formation of toxic intermediates. MexAlert predicts first pass metabolic pathways by quickly identifying sites on the molecule where Phase II metabolic transformations (in other words, conjugation) may occur. It is rule based system; the rules are selected from among the Phase II transformations in the animal knowledge base, and modified according to in vivo experimental example of first-pass effect pathways. In silico toxicity prediction Attrition during the drug development process is a serious economic problem for the pharmaceutical industry and it is often due to inappropriate ADME/Tox characteristics. IT has been estimated that 20-40% of the drug failure in investigational drug development phases are due to safety issues, not continuing multiple incidents of adverse effects of existing drugs. The early drug discovery process needs to address in parallel not only potency but also pharmacokinetics and toxicological properties. Van de Waterbeemd and his colleagues at Pfizer have called this approach ‘property-based design’, emphasizing the importance of the critical combinations of physical and structural properties that contribute to ‘druglikeness’. Ideally this process should begin early in discovery, using computational models to screen both virtual libraries and available compound collections to identify compounds with the desired properties (good potency, ADME and low toxicity). Often molecular size and lipophilicity have an important effect on all three properties. High biological activity is frequently associated with high LogP, but this may also raise the probability of high toxicity. In the 1990s, drug companies invested heavily in combinatorial chemistry and high-throughput screening (HTS) as a source of leads for new targets. Most screen actives turned out to be large and/or hydrophobic, clearly contraindicating to the principles of minimal hydrophobicity. The most visible outcome was not even that they were toxic (because most compounds did not advance that far in development), but that they were either insoluble or non-absorbable. This overshadowed any toxicological consideration in the early stages of drug discovery, bringing forward compounds solubility and permeability as the most urgent problems to address. In the late 1990s the concepts of drug-likeness and lead likeness emerged and simple rules were formulated e.g. â€Å"rule of 5† to warn chemists when compounds were well outside the property space normal for orally active drugs. These rules are now widely used in Virtual Screening to remove undesirable compounds from consideration prior to their synthesis or acquisition. In addition to simple property filters toxicological issues should also be considered because otherwise any specific hazardous sub structural effects are ignored. Some of the harshest reactivity effects are identified and removed using predefined alert substructures (e.g., acid halides) (sometimes called â€Å"garbage filters†). The problem is the most of such alert substructures are â€Å"chameleonic† in nature, i.e., they may not necessarily cause toxic effects depending on other functional groups and overall molecular structures (e.g., acid halides). To fix this, all chameleonic† substructures (from â€Å"garbage† filters and beyond) must be supplemented with class specific QSAR’s for different health effects, yielding toxicological expert systems. Such systems can be used in virtual screening along with â€Å"drug –likeness† filters to subdivide compounds into â€Å"safe†, â€Å"hazardous† and â€Å"Questionable†. Promising compounds need further toxicological evaluation, but this cannot be done by predicative methods alone due to multiple knowledge gaps in their training sets and limited numbers of considered toxicological end points. Sometimes further evaluation is done during lead optimization, when chemical structures are covalently modified and tested. At this stage various toxicological predictions are used to prioritize both compounds that are to be tested and in vitro methods can reliably predict drug’s effect on a whole animal system, yet Animal Tests are not usually done until drug development candidates are identified. By this time drug development cost can reach substantial levels, economic risks become considerable. Thus any predictive tools that help to identify adverse effects in animals prior to conducting such testes are highly desirable. If a known toxic pharmacophore is identified and closely related to the pharmacophore required for activity at the therapeutic target then series specific SAR is needed to aid design of molecules with an adequate separation between the therapeutic dose and the dose threshold for the toxic effect. Since it is essential to have an in vitro surrogate that can model the desired in vivo effect on a significant number of compounds. Some of the more important end points for which in vitro surrogates that can model the desired in vivo effect on a significant numbers of compounds. Some of the more important end points for which in vitro surrogates have been used are: QT prolongation in heart due to blockade of the hERG potassium channel, hepatotoxicity due to compounds that produce phospholipidosis and hepatotoxicity due to induction of CYP450 enzymes. To summarize, in drug design toxicity predictions can be useful for three purpose – virtual screeing, prioritization of compounds and in vitro tests, and prediction of health effects in whole animal systems. Although many toxicologists are understandably leave us with no choice but to make the attempt using available animal toxicity database.

Age-Related Vision Loss and Driver Safety Issues :: Optometry Vision Sight Driving Essays

Age-Related Vision Loss and Driver Safety Issues With dramatic increases in the number of motor vehicles on public roadways in this century, driving safety is an issue that affects every one of us. Most Americans rely on the use of personal motor vehicles as their primary means of transportation, and must put themselves at risk every day. The risk of a motor vehicle accident increases when our perceptive skills are degraded in any way. Such is the case with alcoholic intoxication, impairment from the use of narcotics, and loss of perceptual accuracy due to any biological reason. One of the many issues in current debate with regards to motor vehicle safety is that of the growing numbers of elderly drivers on public roadways and the perceptual problems they may encounter with age. Age-related vision loss is becoming a more prevalent issue in roadway safety. Most states require a simple form of vision testing in order to become a licensed driver. These tests are rapidly being seen as inadequate, and in need of revision. Some state s do not at all require a vision test to become licensed to drive. Currently, the states not requiring vision tests for license renewal include: Alabama, Connecticut, Kentucky, Mississippi, New Jersey, Oklahoma, Pennsylvania, Tennessee, Vermont, and West Virginia. These states could cut the accident rate in people over age 60 by 12 percent, if they would simply utilize testing procedures (N.S., 1999). In this paper, issues facing the aging driver, and possible solutions to ensure safe roadways for the public as a whole, will be explored. The average driverà ­s age is steadily increasing. Census estimates show that by the year 2020, approximately 50 million people over the age of 65 will be eligible to drive on public roadways (Cobb & Coughlin, 1998). With a significant increase in the number of people likely to be affected by age-related vision loss, society may need to re-evaluate vision standards for license testing. It is standard practice for a motor vehicle bureau to test only visual acuity. This practice does not take into consideration perceptually impairing factors encountered in driving such as glare or fog (Voelker, 1999). The lack of adequate visual testing is commonplace in all states that test vision ability. It has been found however, states that at least test for visual acuity during license renewal have approximately 12 percent less automobile accident deaths among older drivers (Voelker, 1999).

Health Promotion and Nursing practice Essay

Heath promotion as defined by the World Health Organization (WHO, 2013) is â€Å"the process of enabling people to increase control over, and to improve health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions. † It is the intention of this writer to present health promotion in nursing practice and relate this to methods implemented that encompass nursing. For the purpose of this paper the writer will use stroke to exemplify the issues. Influential forces effecting health can be political, social, physical, and economic. Internal factors affecting health can be emotional, intellectual, spiritual and psychosocial. Ones own lifestyle guides the way for health promotion or health destruction. The American Nurses Association (ANA) guides the scope of practice by advocating safe quality care. Included is the necessity to provide interventions that include health promotion and prevention of sickness and disability. The patient today is more complex and the focus includes family and community. Three levels of nursing prevention primary, secondary, and tertiary should involve consumers (ANA, 2007). The purpose of health promotion in nursing practice it to educate, influence and assist the patient to maintain an existing quality of life by preventing illness, slowing the progression of an illness or managing an illness. Public health promotion is an organized response to populations to prevent injury, disability, and address social conditions and problems . To have a well functioning society it is important to maintain a healthy community. Nursing Interventions assist the patient to make educated choices regarding lifestyle changes. According to Edelman and Mandle (2010) these various levels of health promotion introduced by Leavall and Clark are primary, secondary, and tertiary. They are on a continuum but may overlap. Prevention at the primary level is to protect and promote health of the community or person from injury or disease (Edelman & Mandle, 2010). Community support is important at this level for the individual to incorporate and maintain healthy habits. Nursing plays an important role in education at this level in hopes of producing healthy behaviors. According to Martinez and Kravitz (2010), education for cardiovascular health would include, healthy weight, smoking cessation, maintaining blood pressure, and a healthy diet. These health facts could educate the patient and guide in the prevention of stroke or myocardial infarction. Warning signs of stoke listed in this article are numbness/weakness, confusion/odd speech, visual problems, dizziness/ loss of coordination, and headache without a cause. Education implemented in the community regarding chronic disease is proactive. According to Alspac (2013) we still have a lapse in the use of calling 911when stroke symptoms are recognized. They imply professionals need to provide better education on placing warning signs of a stroke as a â€Å"medical emergency by calling 911. † Nursing can provide these implementations in a variety of settings. As we move forward to the secondary level of health promotion prevention as stated previously it can overlap with another level. This writer has experience in her work setting with a stroke alert team. Borrowed from the National Stoke Association is the acronym FAST (F=face, A= arm, S=speech, and T=time). At the secondary and primary level this could be recognized as a useful tool primarily for education and secondarily for assessment. The secondary level is where interventions treat an early stage of a disease or provide screening. Screening gives one the ability to reduce disease progression by early detection. Nurses can influence by educating during screening (Edelman & Mandle, 2010). According to Bergman (2011) stroke is a major cause of long-term disability. By treating early one would hope not to progress to the tertiary level. Bergman (2011) states, †Modern stroke care poses unique challenges to the nurse practitioner (NP) in diagnosis, care, risk prevention, patient education and, follow-up. † (p. 659). The writer notes this must pertain to the type of stoke occurring. One needs to do a thorough evidence-based evaluation for appropriate interventions. Recommendations at the secondary level are for life style changes and treatment of any other existing diseases (Bergman, 2011). Screenings at the secondary level would include blood pressure checks, cholesterol level checks, assess physical activity level. Interventions may be to treat elevated blood pressure, lower cholesterol, treat diabetes appropriately, and start anticoagulants if warranted. A patient encountering a stroke can have mild to profound disabilities. The tertiary level of health promotion is of great importance to a stroke patient and their family. Tertiary prevention is a process of minimizing effects of disability by preventing further decline. Tertiary promotions focus is rehabilitative measures and management of the disability by helping the patient achieve and maintain an ideal functioning level (Edelman & Mandle, 2010). Education is a continuum from the secondary level to the tertiary level with patient and family. According to Cameron (2013) the family educational needs may differ from the patients needs including changes at home after discharge, altered roles, and stressors with available resources. At the tertiary level of stoke rehabilitation there is a great emphasis on multidisciplinary collaborative education (Cameron, 2013). This writer practiced rehabilitative nursing and the facility had a transition room. This room mimicked a home setting with bedroom and kitchen. The patient’s family would provide all care prior to discharge in preparation for home care. It tremendously helped in planning further educational needs and discharge readiness. Jarmer and Fielding (2010) interventions include improving mobility and independence and assisting to cope with change. Treatment plans must be individualized to the type of disability. The biggest issue after discharge is safety. Nurses make up the majority of health care providers patients interact with. Nurses are a major resource for education and health promotion. The future of nursing is changing from an acute care based practice to a community based health promotion practice. The role of the nurse in this new practice will be multifaceted. Public health nursing will be an expanding role. The shift in role to public health nurse will require analytic assessment skills, cultural competence, program planning skills and, community dimension skills (Kulbok, Thatcher, Park, & Meszaros, 2013). Cultural competencies assist the nurse to understand health promotion from the community’s viewpoint. This can includes values, beliefs, traditions and, attitudes. Program planning is used to optimize health through evidence-based programs made possible with analytic assessment skills (Kulbok et. al. , 2013). Community dimensions skills refer to collaborative efforts among community leaders and stakeholders. The United States is a melting pot of cultural diversity nurses need to be prepared at all levels. There are many aspects of emerging roles of future nursing most notable is the ability to lead. References Alspach, J. (2013). Improving recognition and response to onset of stroke. Critical Care Nurse, 33, 9-13. doi:10. 4037 /ccn2013909 American Nurses Association (ANA). (2007). Health of the public. Retrieved from http://web. archive. org/web/20071027171411/http://www. nursingworld. org/ MainMenuCategories/HealthcarePolicyIssues/HoP. aspx Bergman, D. (2011). Preventing recurrent cerebrovascular events in patients with stroke or transient ischemic attack: The current data. Journal Of The American Academy Of Nurse Practitioners, 23, 659-666. doi:10. 1111/j. 1745-7599. 2011. 00650. x Cameron, V. (2013). Best practices for stroke patient and family education in acute care Setting: A literature review. MEDSURG Nursing, 22(1), 51-55. Edelman, C. , Mandle, C. (2010). Health promotion throughout the life span. Retrieved From http://pageburstls. elsevier. com/books/9780323056625/id//B97803230566 25000103_p1005 Jarmer, L. , & Fielding, R (2010). After the stroke. Rehab Management : The Interdisciplinary Journal Of Rehabilitation, 23(5), 18-21. Kulbok, P. A. , Thatcher, E. , Park, E. , Meszaros, P. S. (2012). Evolving public health nursing Roles: Focus on community participatory health promotion and prevention. The Online Journal Of Issues In Nursing, 17, doi: 10. 3912/OJIN. vol17No02Mn01 Martinez, A. , & kravitz, L. (2010). Cardiovascular health goals. IDEA Fitness Journal. 7(5), 14-17. World Health Organization (WHO). (2013). Health Promotion. Retrieved from http://www. Who. int/topics/health_promotion/en/

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Critical Thinking Class - Editorial Evaluation Essay

Critical Thinking Class - Editorial Evaluation - Essay Example They do this by stating the audience’s side of the issue objectively and fairly. This makes the audience realize that the writer is treating the issue with respect. For instance, the editorial board note that Mayor Michael Bloomberg defended the dishonored â€Å"stop- and-frisk program† and point out that the mayor claim the program to be important in cutting crime in New York City. However, we find the editorial board trying to give an objective statement of its position about crime by providing its opinion (The editorial board, 2013). The editorial board’s opinion is that the mayor’s claim is not credible. Again the editorial board tries to avoid using attacking language. It also implies that its position is not superior to that of the audience. The editorial board’s assumptions are that the crime would never decline in New York City, as compared to other cities, because citizens were detained millions of times without legitimate reason. In this case, the editorial board tries to explain the context in which its position is valid. Furthermore, its viewpoints are that crime would not stop even after the stop-and-frisk program insinuates the police department to command police officers to stop torturing people on the street. The editorial board also explores how its position differs from that of the audience by providing evidence. The evident suggest that the police department could have achieved its public safety goals through the legal use of stop-and-frisk program; when officers have legitimate reasons for criminal activities; and avoiding violation of the constitution (The editorial board, 2013). To conclude, the editorial board finally presents the thesis. This thesis is phrased in a way that reveals that the editorial board has made some concessions toward the position of the audience. For instance, it comes to agree that the crime rate in New York City is likely to decrease. This is because; in