Benefits and Challenges of Nurse Prescribing

Benefits and Challenges of Nurse Prescribing Specifically with Leg Ulcer Treatment the nurse prescribing practice help in delivering a complete episode of care, enables greater self-sufficiency and speeder access towards medication, time saving and expedient together with the early interference identifications, greater patient involvement (Courtenay, Berry 2007). Furthermore, it provides a means of formalising present prescribing activities and approaches, allow patients to receive better information from the nurses about the prescriptions and medications and thereby permitting a holistic practice (Courtenay 2007). Additionally, it enhances rapport with the leg ulcer patient, reduces length of stay owing to accurate prescribing management, improves knowledge and assessment skills in identifying the complications of leg ulcer along with co-morbid complexities and promotes the response time to addressing patient symptoms and withdrawal (dependency) effects (Gray, 2006). On the other hand, it was observed that the prescribed drug, Allevyn induced allergic reactions in the patient and this can be attributed to the potential implications of prescribing process. However, it cal also happen owing to increased work load and responsibilities upon the nurse, litigation fear, inter and intra professional conflicts, adherence towards medical model of care, lack of knowledge and accountability and absence of skills for prescribing process and dependency (Courtenay et al., 2007). REFERENCES Courtenay, M. 2007, Nurse Prescribing-the benefits and the pitfalls, Journal of Community Nursing, 21, 11. Courtenay, M., Berry, D. 2007, Comparing Nurses and Doctors views of Nurse Prescribing: A Questionnaire Survey, Nurse Prescribing, 5, 5. Gray, R. 2006, Nurse Prescribing: Raising Standards, Nurse Prescribing, 4, 8. Research study carried out by While and Biggs (2004) indicated that nurse prescribers cannot form a substitute for the general practitioners for the products within the limited formulary. Implementing a major role in the nurse prescribing practice requires assessment of numerous conditions including adequate education, preparation and training and designing formulary that convene patient and practitionerà ¢Ã¢â€š ¬Ã¢â€ž ¢s needs (While, Biggs 2004). Report on the evaluation of eight pilot sites revealed that nurse prescribing was completely accompanied by anxiety and heightened apprehensions of accountability (Luker et al., 1997). To date back, National training for Nurse Prescribing was started in England, by the year of 1998 during which around 20, 000 nurses have qualified for the new role. The study carried out by Humphreys and Green (2000) illustrated the potential importance of infrastructure in the focus groups (n=12) obtaining the preparation concerned to nurse prescription at one institution (Humphreys, Green 2000). The implementation of extension standards in to supplementary nursing practice acknowledged the deliberate need for understanding pharmacology as the basis for prescribing process and to identify the nurses who play a major role in selection criteria pertaining to prescriber training (Department of Health, 2002). Towards the other side, in examining the speculative basis for mental health nurse prescribing process, it is very important to discuss the implicit theoretical tensions together with the experiences of registered nurse prescriber. Making a Difference (1999) was the key policy document published upon the extending phenomenon of nurse prescribing with an aim of saving time for the General Practitioners (Department of Health, 1999). However, the implicit support was arrived through National Health Service and it stressed on various ways of working and distorting the demarcating lines between the specialized groups in NHS with an interest on improved access to quality of health care (Brooks, 2001). Thus, it must be understood that benefits and challenges of Nurse Prescribing within the context of mental health include the following (Department of Health, 1999): Add up the knowledge and allow complete use of experience. Allow service transition from hospital to community based. Nurses must reveal that they are diagnostically competent for the process of patient assessment and prescribing. The prescribing process may distract the attention from other aspects of nursing roles. May result in developing dangers (like allergic reactions developed for Allevyn in the present study) and these get added up to nurseà ¢Ã¢â€š ¬Ã¢â€ž ¢s role Conclusion Thus, to effective reduce the incidence of deleterious effects due to Nurse prescribing, a helpful action plan must be devised with the following objectives: To evaluate the prescribing approaches of nurses with relation to health visitors. To effectively understand the professional and contextual factors which enhance and inhibit the process of Nurse Prescribing To understand the views of practitioners and patients with relation to treatment offered by the nurses. Much research was performed with in this field of Nursing and still is needed in future to effectively explore the factors and to determine the steps for carrying out this process. Nevertheless, it is not a solitary effort and it demands the potential involvement of practitioners, patients, Nurses, local health organisations together with the government.

Metal Protection Crossion

DBT 303 METALS PROTECTION ASSIGNMENT 1 1) 2) 3) What is meant by oxidation and reduction processes? What is meant by anode and cathode? Write both half reaction equations and total equations in an electrochemical cell that consists of Pb and Zn in their respective 1M ion solutions. 4) Write both half reaction from the total equilibrium electrochemical cell below? Define what happen for each half reaction? Calculate the voltage that is generated Zn + 2HCL->ZnCl2 + H2 5) What is meant by Corrosion Penetration Rate, CPR? (i) (ii) Define CPR. Give its unit. ) 7) 8) State three (3) corrosion medium? State the difference between EMF series and galvanic series that you know? What is meant by? (i) (ii) Corrosion? Corrosion rate? 9) One half of an electrochemical cell consists of a pure Nickel electrode in a solution of Ni2+. The other is a Cadmium electrode immersed in a Cd2+ solution. (i) If the cell is a standard one, write the spontaneous overall reaction and calculate the voltage that is generated. (ii) Compute the cell potential at 25? C if the Cd2+ and Ni2+ concentrations are 0. 5 and 10-3 M, respectively.Is the spontaneous reaction direction still the same as for the standard cell? 10) 11) Define passivity. Give an example of passivity. Briefly explain how passivity behaviour protects the metal surface from further corrosion. 12) 13) 14) 15) State two (2) examples of metals that displays passivity behaviour. Define erosion corrosion and how does it happen? What is crevice corrosion? Give an example of crevice corrosion. Where are intergranular corrosion always occur? How to prevent intergranular corrosion? 16) A piece of corroded steel plate was found in submerged ocean vessel.It was estimated that the original area of the plate was 15 in. 2 and approximately 2. 8 kg had corroded away during the submersion. Assuming a corrosion penetration rate of 180 mpy for this alloy in seawater, estimate the time of submersion in unit of years. The density of the steel is 7. 9 g/cm3. 17) 18) 19) 20) How does Activation Polarization occur? Explain about sacrificial anode and in what environment can be used? Explain about impressed current and how does it operated? Give four (4) common methods to apply metallic coating?

Architecture as a Means of Upliftment in South Africa

Architecture as a Means of Fulfillment in South Africa, post-apartheid Introduction The end of Apartheid allowed for â€Å"new ways of describing public institutions† according Togo Nero, in an interview for the Small Scale, Big Change exhibition. And as a result, architecture can be seen as a means of cultural fulfillment in post- apartheid South Africa. So the question is, how does architecture affect social change and identity In this country? This a two-fold question.This essay will look to address this question, In an analysis and comparison of Joy Onerous Red Location Museum In Port Elizabeth, and the Alexandra Heritage Centre in Johannesburg. We will start with a brief history of apartheid, and the sites, to put the buildings into context. Followed by a look at the purposes and concepts of the afore mentioned buildings. From there, we will address the structure and materials and go into an analysis and comparison of the buildings, ending off with the buildings in the pr esent day.History South Africans entire history is plagued with issues and tensions over ethnicity. This is evident all the way back to the early 1 sass when the Dutch and English used the Cape as their stopover point, and began to colonies, forcing the native people (such as the San and Koki) from their homes, and claimed the land for themselves. Battling for land and ownership between the Dutch and the English went on for many, many years, resulting In events such as the Boer War. In 1910, South Africa became a member of the British Commonwealth, with both parties sharing power.By the asses, the Nationalist Party grew in strength resulting in them finally coming into power, and the start of apartheid in 1948. Apartheid resulted in many things, but the cost important factor was that of segregation of races, and classification. Different races were given different social areas, occupations and areas to live. The years to follow were full of unhappiness, and protest- both peaceful an d not. Jumping ahead to 1990, we see the beginning of change- laws lifted, and constitutions redrawn. In 1994, South Africa saw the election of their first black president and the legal end to apartheid.New Brighton, Port Elizabeth Is one of the oldest black townships In South Africa, with the Red Location- so named after the old red corrugated barracks there- being the Much peaceful, non-violent protest happened, and it was here, in 1952 that a group of local NC members marched through the â€Å"Europeans Only' entrance at the New Brighton Train Station. This was the start of many more acts of defiance. After forty- six years, apartheid ended, and the Red Location was chosen to be a site where history and the location itself, would be preserved. Alexandra Township, in Johannesburg was named a township in 1912.It was one of the few townships that was not demolished as a result of the Group Areas Act- the township was too much of an important place for people in the northern suburbs to mind labor. However, the government found that Alex was over-populated, and so sought to forcedly remove people. This led to many boycotts and protests in the area. Alex is an important part of the apartheid history, as important NC members lived there at one time or another- such as Nelson Mandela. Alexandra Township today is a bustling and vibrant area, with an ongoing project to develop and preserve it.Purpose and Concept In 1998, a national competition was held to design a precinct in the Red Location that would bring tourists into the area firstly, as well as to preserve the history of the area. It was to include new housing, a library, art centre, gallery and market hall, a conference centre, and obviously, the centre piece- a museum centered on apartheid. The winner of the competition was the Cape Town based, Nero Wolff Architects. Their scheme would formalize a public space- something that was lacking in Red Location.This â€Å"plaza† would be at the centre of the precinct- the intersection between the two roads created in the design. As well as this, there were a few factors that put it above the other entries: firstly, great care and thought was put into the call of the design- not only does it blend in with the industrial buildings in the area, but it is considerate of the scale of the township itself. The second point is its aesthetic- the language is straightforward, and the buildings celebrate the ordinary materials- like concrete and corrugated iron.This overall scheme does however, have a slight industrial feel to it- which is deliberate in tying the building into its site. And the last thing was that the building had a unique approach to preserving the history, and courting whatever exhibits it would house- all of which creates a memory evolving around the struggle for freedom, rather than apartheid itself. In 2001, the Alexandra Tourism Development Project (ATOP) was founded, by the Sautà ©ing Tourism Authority, in the hopes to de velop a number of tourism facilities and infrastructure with emphasis on the heritage of the area, and to bring in tourism.Time, effort and money were also put into upgrading the housing in the area- and this has been a hugely successful project, major improving the lives of the people that live there. And this was a big stimulant when it came to the Heritage Centre- it â€Å"must serve primarily as a resource for the community – they must be incentive of as essential and integral parts of the urban and social fabric of Alexandra – rather than simply as an attraction for visitors†. Anyone Duggan, project something that Peter Rich took into account, in his design- which we will discuss later.The Alexandra Heritage Site serves mainly as a venue space- where meetings, exhibitions and classes can be held. There will also be a permanent exhibition, showing the history, and stories of the area, as well as artworks and photographs. But according to Peter Rich, the most important feature is that it is a place where the older generations can tell their stories and record their memories. Interview in Convey, online magazine, 2011-1) Structure, Materials and the Building Process For the purpose of this essay, I will focus mainly on the Museum itself, rather than the entire Museum of Struggle Precinct.In the Red Location Museum, the building itself only serves to house and protect the exhibits- the twelve corrugated â€Å"memory boxes† (more later) hold all the significance and meaning. The building is designed to evoke little emotion, which goes to strengthen ones experience of the interior. This building is an example of a massive concrete structure- built from pre-cast concrete elements, and in-situ elements, such as the columns- which bring a sense of permanence to the building. Other than its sheer volume, perhaps the most important structural feature is the roof.For their initial design, Nero Wolff looked to anti-apartheid protest art for clues. In the painting shown, the three seminal building types are evident:, the double story school building, the â€Å"box-house† and the saw- tooth roofed factory. The saw-tooth is an image strongly associated with the factory, and during the times of apartheid, the factory was associated with civic virtue, as it as the trade unions that helped shape the internal struggle for freedom. Civic buildings at that time were also images of apartheid, so Nero Wolff wanted to create a distinction.So the Museum was designed with a saw-tooth roof- which also offered good lighting and ventilation opportunities. The Alexandra Heritage Centre primarily used red steel girders, brick and poly- carbonate sheeting, giving it a lighter appearance than the Museum- especially because it also bridges across the road, which creates an observation deck overlooking the township. Peter Rich describes it as having an â€Å"ad-hoc esthetics† (Interview in Convey, online magazine, 2011-1) whic h is influenced by the surrounding without being patronizing.It has a civic feel, but still blends into the township- much like the Red Location. Peter Rich also sort ideas out from the people- he spent a great deal of time observing daily routines and such of the area, and used this to influence the design. Both buildings used local labor. Alex not only used local labor in the construction, but also in the smaller details, like the glasswork in the windows. The Red Location used 50% local labor, and every three months, new people were brought in- trained ND put to work. This offered much in the line of employment.Analysis and Comparison which houses a library and the exhibition space and offers views of the surrounding houses. The building has many opportunities for transparency- from the entrance, you can observe below into the public spaces, outside next to the road and in the interior, the planes are interlinking. There are also ambiguous internal spaces- this allows for great f lexibility in purpose- they were designed to be able to house political as well as social events. Another dimension is added, under the bridge- this space is owe redefined as street.Because of the polycarbonate sheeting and glasswork, the building gets good daylight- which is important if the space is to be utilized for workshops and such. As one enters the Red Location Museum, one is brought from the large sweeping veranda, to the entrance hall- which takes you from the informal exterior to formal interior, with its large volume. The entrance hall serves as a transition space. The entrance also houses the auditorium, which can be accessed from both sides. From here, the movement is directed via a row of tall concrete columns which are the first splay- the â€Å"walk of heroes†.These bring you into the main exhibition space- which is initially concealed- this was deliberate, to bring in a sense of â€Å"mysteriousness†. The main exhibition space houses twelve towering rusted corrugated structures- the â€Å"memory boxes† which relate back to the actual memory boxes which were treasured items during apartheid. Through these boxes, the exhibitions could be curates through themes. Each box is different on the inside, housing an exhibit. The memory box, is supposed to represent history, while outside of the museum is the present.The space inebriate- the twilight zone- is the transitional space, where past is lost to present. And it is in this space, which one moves around in the museum- choosing your own path and therefore creating your own understanding and story. This is achieved through a deliberate lack of hierarchy- the boxes are placed in a grid. The townships share similar histories, so it is only natural that any public buildings within them would have similarities. The obvious difference is their function, but other than that, these buildings share similar approaches, labor strategies, reasons for materiality.But the biggest similarit y is that they both have a positive impact on their locations, and are strong beacons towards a better future and a new identity. The Buildings in Present Day The Alexandra Heritage Centre, after many years of delays and budget problems, is near to completion. Of course, projects to uplift and rejuvenate the area are still on going. Tours are given of Alexandra regularly (called shoo' left(s)) which include visits to Mandela's Yard and the Heritage Centre. From the limited resources available, it is evident that the community think this building is a huge success- which is the most important opinion.It will take a few years, and more rejuvenation of the area, to bring in the amount of tourism that the ATOP hope to bring in, however. The museum. Currently, the next phases- the art gallery and the library/archive are completed- with minor interior issues still to be resolved- these are not open to the public yet. Future plans for the site include more, higher density housing, and an a rts school- which will include a theatre which can bring in more involvement from the community.The precinct is very successful- it brings in tourist attention, the community love it and make use of it on a daily basis. On a larger scale, the Museum does much to rejuvenate South Africa, in post-apartheid times. Conclusion When asked, how does architecture affect social change and identity in this country, one needs to look at why it is necessary to uplift the community and why perhaps, is change needed. It is evident that huge change was required after apartheid to begin to heal this country, and one of the biggest tools the apartheid government had to control people, was space.Through the two public buildings that were compared, we can see how this country, through architecture, has begun to correct itself. These buildings are not patronizing to anyone- not any race or class- and aside from their obvious functions, they bring about new change and identity to their respective commun ities. We can successfully reach this conclusion now, as we know the background and context, and are well acquainted with the buildings through an understanding of structure, materials, purpose and concept.As with most things, change is ongoing, and the Red Location Precinct and Alexandra Heritage Centre are testament to this. As a young architect in South Africa, it is clear to me, that to create successful public buildings, a good understanding of the surrounding context, community and history is obvious, as well as an understanding that the architects role is to create spaces- and that space can have a huge affect on people, and that it is our duty to shape this space as best to assist the community as possible.

The Plague in Athens

Such was the funeral that took place during this winter, with which the first year of the war came to an end. In the first days of summer the Lacedaemonians and their allies, with two-thirds of their forces as before, invaded Attica, under the command of Archidamus, son of Zeuxidamus, King of Lacedaemon, and sat down and laid waste the country. Not many days after their arrival in Attica the plague first began to show itself among the Athenians. It was said that it had broken out in many places previously in the neighbourhood of Lemnos and elsewhere, but a pestilence of such extent and mortality was nowhere remembered. Neither were the physicians at first of any service, ignorant as they were of the proper way to treat it, but they died themselves the most thickly, as they visited the sick most often; nor did any human art succeed any better. Supplications in the temples, divinations, and so forth were found equally futile, until the overwhelming nature of the disaster, at last, put a stop to them altogether. It first began, it is said, in the parts of Ethiopia above Egypt, and thence descended into Egypt and Libya and into most of the Kings country. Suddenly falling upon Athens, it first attacked the population in Piraeus- which was the occasion of their saying that the Peloponnesians had poisoned the reservoirs, there being as yet no wells there- and afterwards appeared in the upper city, when the deaths became much more frequent. All speculation as to its origin and its causes, if causes can be found adequate to produce so great a disturbance, I leave to other writers, whether lay or professional; for myself, I shall simply set down its nature, and explain the symptoms by which perhaps it may be recognized by the student, if it should ever break out again. This I can the better do, as I had the disease myself, and watched its operation in the case of others. That year then is admitted to have been otherwise unprecedentedly free from sickness; and such few cases as occurred all determined in this. As a rule, however, there was no ostensible cause; but people in good health were all of a sudden attacked by violent heats in the head, and redness and inflammation in the eyes, the inward parts, such as the throat or tongue, becoming bloody and emitting an unnatural and fetid breath. These symptoms were followed by sneezing and hoarseness, after which the pain soon reached the chest, and produced a hard cough. When it fixed in the stomach, it upset it; and discharges of bile of every kind named by physicians ensued, accompanied by very great distress. In most cases also an ineffectual retching followed, producing violent spasms, which in some cases ceased soon after, in others much later. Externally the body was not very hot to the touch, nor pale in its appearance, but reddish, livid, and breaking out into small pustules and ulcers. But inter nally it burned so that the patient could not bear to have on him clothing or linen even of the very lightest description, or indeed to be otherwise than stark naked. What they would have liked best would have been to throw themselves into cold water; as indeed was done by some of the neglected sick, who plunged into the rain-tanks in their agonies of unquenchable thirst; though it made no difference whether they drank little or much. Besides this, the miserable feeling of not being able to rest or sleep never ceased to torment them. The body meanwhile did not waste away so long as the distemper was at its height, but held out to a marvel against its ravages; so that when they succumbed, as in most cases, on the seventh or eighth day to the internal inflammation, they had still some strength in them. But if they passed this stage, and the disease descended further into the bowels, inducing a violent ulceration there accompanied by severe diarrhoea, this brought on a weakness which was generally fatal. For the disorder first settled in the head, ran its course from thence through the whole of the body, and, even where it did not prove mortal, it still left its mark on the extremities; for it settled in the privy parts, the fingers and the toes, and many escaped with the loss of these, some too with that of their eyes. Others again were seized with an entire loss of memory on their first recovery and did not know ei ther themselves or their friends. But while the nature of the distemper was such as to baffle all description, and its attacks almost too grievous for human nature to endure, it was still in the following circumstance that its difference from all ordinary disorders was most clearly shown. All the birds and beasts that prey upon human bodies, either abstained from touching them (though there were many lying unburied) or died after tasting them. In proof of this, it was noticed that birds of this kind actually disappeared; they were not about the bodies, or indeed to be seen at all. The effects which I have mentioned could best be studied in a domestic animal like the dog. Such then, if we pass over the varieties of particular cases which were many and peculiar, were the general features of the distemper. Meanwhile, the town enjoyed an immunity from all the ordinary disorders; or if any case occurred, it ended in this. Some died in neglect, others in the midst of every attention. No remedy was found that could be used as a specific; for what did good in one case, did harm in another. Strong and weak constitutions proved equally incapable of resistance, all alike being swept away, although dieted with the utmost precaution. By far the most terrible feature in the malady was the dejection which ensued when anyone felt himself sickening, for the despair into which they instantly fell took away their power of resistance, and left them a much easier prey to the disorder; besides which, there was the awful spectacle of men dying like sheep, through having caught the infection in nursing each other. This caused the greatest mortality. On the one hand, if they were afraid to visit each other, they perished from neglect; indeed many houses were emptied of their inmates for want of a nurse: on the other, if they ventured to do so, death was the consequence. This was especially the case with such as made any pretensions to goodness: honour made them unsparing of themselves in their attendance in their friends houses, where even the members of the family were at last worn out by the moans of the dying, and succumbed to the force of the disaster. Yet it was with those who had recovered from the disease that the sick and the dying found most compassion. These knew what it was from experience, and had now no fear for themselves; for the same man was never attacked twice- never at least fatally. And such persons not only received the congratulations of others but themselves also, in the elation of the moment, half entertained the vain hope that they were for the future safe from any disease whatsoever. An aggravation of the existing calamity was the influx from the country into the city, and this was especially felt by the new arrivals. As there were no houses to receive them, they had to be lodged at the hot season of the year in stifling cabins, where the mortality raged without restraint. The bodies of dying men lay one upon another, and half-dead creatures reeled about the streets and gathered round all the fountains in their longing for water. The sacred places also in which they had quartered themselves were full of corpses of persons that had died there, just as they were; for as the disaster passed all bounds, men, not knowing what was to become of them, became utterly careless of everything, whether sacred or profane. All the burial rites before in use were entirely upset, and they buried the bodies as best they could. Many from want of the proper appliances, through so many of their friends have died already, had recourse to the most shameless sepultures: sometimes gettin g the start of those who had raised a pile, they threw their own dead body upon the strangers pyre and ignited it; sometimes they tossed the corpse which they were carrying on the top of another that was burning, and so went off. Nor was this the only form of lawless extravagance which owed its origin to the plague. Men now coolly ventured on what they had formerly done in a corner, and not just as they pleased, seeing the rapid transitions produced by persons in prosperity suddenly dying and those who before had nothing succeeding to their property. So they resolved to spend quickly and enjoy themselves, regarding their lives and riches as alike things of a day. Perseverance in what men called honour was popular with none, it was so uncertain whether they would be spared to attain the object; but it was settled that present enjoyment, and all that contributed to it, was both honourable and useful. Fear of gods or law of man there was none to restrain them. As for the first, they judged it to be just the same whether they worshipped them or not, as they saw all alike perishing; and for the last, no one expected to live to be brought to trial for his offences, but each felt that a far severer sentence had been already passed upon them all and hung ever over their heads, and before this fell it was only reasonable to enjoy life a little. Such was the nature of the calamity, and heavily did it weigh on the Athenians; death raging within the city and devastation without. Among other things which they remembered in their distress was, very naturally, the following verse which the old men said had long ago been uttered: A Dorian war shall come and with it death. So a dispute arose as to whether dearth and not death had not been the word in the verse; but at the present juncture, it was decided in favour of the latter; for the people made their recollection fit in with their sufferings. I fancy, however, that if another Dorian war should ever afterwards come upon us, and a dearth should happen to accompany it, the verse will probably be read accordingly. The oracle also which had been given to the Lacedaemonians was now remembered by those who knew of it. When the god was asked whether they should go to war, he answered that if they put their might into it, victory would be theirs and that he would himself be with them. With this oracle events were supposed to tally. For the plague broke out as soon as the Peloponnesians invaded Attica, and never entering Peloponnese (not at least to an extent worth noticing), committed its worst ravages at Athens, and next to Athens, at the most populous of the othe r towns. Such was the history of the plague.