Reality and Illusion in Richard Bach’s Illusions Essay -- Richard Bach

Questioning Reality in Richard Bach’s Illusions The message of Richard Bach’s Illusions is based on the concept that the things we interpret in the world as reality are actually illusions. This is made evident to one of the main characters, Richard, through his interactions with his newly found friend, Donald Shimoda. Donald Shimoda is a â€Å"messiah†, and he has gifts that he uses to help mankind. A quote that Richard reads is â€Å"Here is a test to find whether your mission on earth is finished: If you’re alive, it isn’t† (121). During the entire story, Don proves this quote to be true. Donald works to share his gifts and carry out his mission on earth. Richard and Don are barnstormers. They live their lives flying from town to town, landing in farm fields, and giving flights to local people for three dollars. Richard meets Don when Richard sees Donald’s plane parked in a field as he is passing by the nearby town. Richard is very curious about this plane because it is extremely unusual to encounter other barnstormers. He also feels lonely at times, and he wants to see if the other barnstormer can keep him company. When Richard lands his airplane, he meets Don. He talks with Don for several moments and, despite noticing some unusual quirks about Don, does not think that Don is too out-of the ordinary. Then he notices that Don’s plane is immaculate. It does not have any dirt or oil or any other evidence that it has been flown before. When Richard asks Don about this, Don tells him that there are things that Richard does not know. Later in the story, however, Richard learns more about Don and why he seems to be mysterious. Richard has a dream that reveals to him why Donald seems so mysterious. He sees a man a... ...ir problems or uncertainties. When people realize that they are capable of knowing the truth, they are able to overcome the illusions and to help others break their own boundaries. Donald Shimoda is aware of his mission on earth. He knows that he has the power to help all of mankind, and he works to help any person who he encounters who is in need. He works hard to do so throughout his entire life and until his death. When Donald dies, his work on earth really is complete. He teaches Richard to look past illusions and to see the reality behind them. Richard comes to realize that he too can perform miracles. In learning and sharing the gifts that Donald offered to the world, Richard is able to help mankind. Donald does finish his mission when he dies. However, his friend Richard has the ability to carry out the same mission and to help others as Donald did.

What its Like to be a Black Girl by Patricia Smith Essay -- Papers Sm

An explanation in its purest form of â€Å"What it’s like to be a Black Girl (for those of you who aren’t)† by Patricia Smith, is just that, an explanation. From the first three syllables â€Å"First of all,† the author gives a sense of a story being told. She uses jagged sentence structure and strong forceful language to also show the reader the seriousness of her topic. Smiths poem gives the audience an insider’s view into a young black girl’s transition into black woman-hood at a time where both being a black girl and a black woman was not as welcomed. Puberty is usually defined by the biological changes a young boy or girls body undertakes around the age of 9 up until about 14. â€Å"It’s being 9 years old and feeling like you’re not finished,† writes Smith, â€Å"like your edges are wild, like there’s something, everything, wrong.† (Smith, 4) These thoughts have run around the minds of almost every puberty stricken youngster. However, Smiths subject seems to also have the added pressures of a racially jagged society. This â€Å"black girl† she refers to in her poem is feeling the awkwardness of...

Affordable Care Act Essay

Health care reform has been a budding issue within the United States this past year, and problems continue to surface. At the beginning of this process, Americans wanted the government to ensure that all citizens would be able to have affordable and good health care, no matter what their financial situation. The price for health care was increasing at a rate that people could no longer afford it and a lot of people desperately wanted a universal health care systems like some of their neighboring countries. In a sense, change was needed, but how this change came about is the real issue now. Americans may not get what they bargained for, and it could end up costing more than some individual initially thought. Importance of Research I want to research this economic policy because I hear so much scrutiny from every individual I talk to, while I also see some friends and family benefiting from the Affordable Care Act. I want to learn more about what we truly signed up for and the repercussions for â€Å"pimping out† the health care industry, along with any hidden agendas that might be embedded within this new policy. According to the U.S Department of Health & Human Services, â€Å"The Affordable Care Act was passed by Congress and then signed into law by the President on March 23, 2010. On June 28, 2012 the Supreme Court rendered a final decision to uphold the health care law† (2014). It is not until 2014 that is really coming into effect, to the point where it is mandated to have insurance by April 2014. This policy was implemented to make sure every American has health insurance but little are properly educated on how this new policy will affect us in the years to come. Time to learn the truth fro m both sides of the debate Policy Overview The Affordable Health Care Act, was a policy that has recently been put in place to help citizens receive the health care they need at an affordable price. As wages remain the same, prices continue to climb to the point where minimum wages isn’t enough, health care is last on the list of needs. Many Americans do not have health insurance or receive it from the state because it is not an affordable aspect of our economy and it was not mandated. Now the government as took it upon themselves to make laws and regulations in order to ensure every American citizen has affordable health insurance. For those who can pay more, pay more, and those who can’t, will ultimately pay less. Although that is a great concept for the American people to believe in, but with all of the rules, regulations and underlining laws, it is important to understand what Americans are actually getting from this deal. For this paper, we will focus on individuals, employers and tax credits available to h elp with the cost of insurance. Provisions of the Affordable Health Care Act On March 23, 2010, President Obama signed a comprehensive health reform, the Patient Protection and Affordable Care Act, into law. The laws and changes mad, focuses on provisions to expand coverage, control care costs, and improve health care delivery system. The first provisions is that all Americans are required to have health insurance by April 2014, or individuals will face penalty charges that can affect them for up to three years. So it is very important for citizens to go to the government market place and apply for insurance that they can afford. According to the Kaiser Foundation; â€Å"Those without coverage pay a tax penalty of the greater of $695 per year up to a maximum of three times that amount ($2,085) per family or 2.5% of household income. The penalty will be phased-in according to the following schedule: $95 in 2014, $325 in 2015, and $695 in 2016 for the flat fee or 1.0% of taxable income in 2014, 2.0% of taxable income in 2015, and 2.5% of taxable income in 2016 † (Kaiser Foundation, 2014). This reason alone is why Americans should not avoid getting insurance. Other provisions that have been taken into effect deal with employers. Now employers are required to offer insurance based on the amount of employees. For smaller businesses this means having to offer health care insurance to their full  time employers and â€Å"Require employers with more than 200 employees to automatically enroll employees into health insurance plans offered by the employer. Employees may opt out of coverage† (Kaiser Foundation, 2014). With employers having to offer health care coverage at an affordable rate to full-time employees, it does cause some to opt for part-time employment to avoid having to give out benefits. A lot of Americans fear they will lose hour’s simple because their employers do not want to pay for them, which is something that could easily happen. Other than individuals and employers being affected, Medicaid is also going under an expansion. More money is being put to those who are in need of insurance and cannot pay for it such as pregnant women, children and parents. With the expansion Medicaid to all non-Medicare eligible individuals under age 65 such as those stated above â€Å"All newly eligible adults will be guaranteed a benchmark benefit package that meets the essential health benefits available through the Exchanges† (Kaiser Foundation, 2014). Another important aspect pertains to those who are predisposed to certain medical conditions. For instance, citizens can no longer be denied health care coverage based on health risks they already possess. Among other things, the government also give tax credit in order to lower the cost of insurance, which is based on income and family size. Analysis of Policy With any policy or new law there will be objections and an unwillingness to accept these changes. Not every new piece of legislation fixes the problems at hand. Some of the issues only get worse, and then the law must be reformed. With the Affordable Health Care Act, there are a number of pros and cons with this policy and below, it will explain how these changes have greatly affected the general public for the better and worse. Pros With the Affordable Health Care Act being implemented, there are a number of great aspects that have now been put into effect. The first and easiest of the changes now allows children under the age of 26 to remain on their parents insurance plans, this means longer coverage for young adults in America, this also means no lifetime limits on health coverage; and new  insurance policies that must provide preventive care without any form of cost-sharing (UPMC, 2013). Among other changes, these are the following benefits of having the Affordable Health Care Act in place; Health care coverage for uninsured Americans. Through a combination of creating the health insurance marketplace and encouraging the states to expand Medicaid, millions of Americans without health insurance now have access to affordable coverage. No matter the situation, people will be covered. Reducing uninsured health events: Americans have always had issues regarding medical bills and costly procedures that many could not afford. Now, because the Affordable Health Care Act requires citizens to have health care coverage, we will dramatically reduce the instances of uninsured health events. No more coverage discrimination due to health issues or gender. The main problem with health insurance companies was the fact that they could, â€Å"charge outrageous prices or even deny coverage to Americans based on particular medical conditions, age, or gender. Just because you are ill, born with a disability, or female and may need pregnancy care, doesn’t mean you shouldn’t have access to affordable coverage† (UPMC, 2013). Changing the laws that govern coverage now helps to end coverage discrimination. Expansion of employer sponsored health coverage. â€Å"Many employers don’t offer any health insurance to employees, even those working full-time. ObamaCare requires all companies with over 50 full-time equivalent employees to offer health insurance to full-time staff by 2016 or they may be subject to a penalty† (UPMC, 2013). This now makes employers responsible for the health care of their employees, which in turn offsets the amount of people on Medicaid, or reduces the amount of people uninsured. These benefits greatly affect the everyday life of an American, no more discrimination due to preexisting conditions, or higher rates to these individuals. Employers now have to offer insurance to their full-time employees, and everyone has the right to affordable health care which will stop them from being forced into debt. Cons With every policy, there are going to issues that come to surface, sometimes a policy fixes nothing at all, while other times it is just what the doctor ordered. The following are some of the negative effects that could cause the  Affordable Health Care Act to backfire or deter Americans from believing in the system. Working Americans will pay more. Most middle-class Americans hold full-time jobs and receive health insurance through their employers. Health care costs were rising before the Affordable Care Act became law, and combined with the effects of the law, employers will likely re-evaluate the insurance they offer. Employers will start to reevaluate their coverage to their employees which could end up increasing their work-based insurance. Some of the required coverage’s are against the moral values of employers. The mandate to offer contraception with no charge to the patient has caused a lot of issues, especially for employers whose moral code dictates that they do n ot support contraception of any type. But this is a manner of personal choice, employers cannot dictate what their employees needs are. Adding additional health care expenses will impact workers. The law will cause some employers to offer lower coverage or perhaps no coverage to their workers, or perhaps increase the amount employees pay for health insurance to offset higher premiums from the insurance company, or reduce hours to avoid having to offer coverage to so many full-time employee. The American Debt. As many are concerned about our debt, as the government subsidizes health care, may only make that debt worse. If the law runs over budget, it will be the taxpayers who wind up at a greater disadvantage than ever before. Below is also a graph that shows how government spending will be effected with the new ACA Many of the oppositions to this new law, all comes down to money. Americans do not want to sign on to anything that may cost or lose them money. (Foster, 2011). Some employers may also try to turn full-time employees into part-time just to avoid having to offer health care coverage. We as a nation end up in debt every year due to unnecessary spending, rather the spending be put in place to help the American people rather than ignore the issue. Unintended Consequences & Alternative Solution When the Affordable Health Care Act was put in place, a lot of Americans did not understand what they were actually getting for their money, while some hated the thought of government controlling yet another aspect of their lives others rejoiced. The health care act had some adverse consequences  when being put into place, the largest problem being the fact that Americans would now be fined if they did not pay for health insurance by the deadline, which is April 1st, 2014. The rate of the fine would increase with each year and end of causing a lot of Americans an unnecessary headache. This also forces people to purchase something they do not necessarily agree with, but unfortunately we cannot pick and choose which laws we decide to follow. Another issue that may affect Americans is the status of being a full-time employee versus being used as a part-time employee. With the new laws, businesses are also affected, some employees may cut employees hours in order to avoid having to off er insurance. Which is another way the Affordable Health Care Act is not benefitting the American citizens. Alternative Method & Recommendation Although the bill is already in place and functioning, I think the United States would have been better off following in the footsteps of other countries that already have nationalized health care. Instead of imposing all of these rules and regulations, the government should impose taxes on our citizens to help with the cost of health insurance. This will take away the need and frustration of having everyone being forced to find new insurance company based off their income, and have to be fined if they do not participate. With people standing strongly against being forced to buy insurance, taxes would take that fuss out. Americans need to realize, although other countries have national health care, it is nowhere as good as our health care, because when other countries were becoming nationalized, their star doctors were seeking citizenship in America because they could make more money. Now, we have all of these great doctors upset they can no longer reap the benefits of charging what they feel is appropriate, and now insurance companies can no longer deny benefits to those who are a risky investment. There are a large number of countries that simply take care of the health care cost through taxes, which is beneficial because less people feel the effect of paying premiums every month, and if it is based off of wages, so are our taxes, so why not take it out all at once? Conclusion With every policy, there will always be good and bad aspects that surround the change. In most cases, as long as the good outweighs the bad, then at the end of the day that is all that really matters. In the large picture, Americans now have the chance at having affordable health care, and cannot be denied over prior history. People can now avoid being put in massive amounts of debt by avoiding the high cost of procedures that they need. No one should ever deny the care they need when it comes to their health. In the long run it may cost companies more money, but if they make money off of their employees, they should be willing to pay for them to remain healthy. Within the next ten years we will truly see if the good outweighs the bad. In my opinion, Obamacare is headed in the right direction, but I do not feel the bill was ready to be passed. With all the opposition to incorporating socialized health care it is understandable why Obama was pushing it through while he is in office, because it may have not went through if it waited much longer. There are also a large number of benefits with the Affordable Health Care Act, people n ow can purchase affordable health care and not be denied due to pre-existing conditions. I also feel the government should have raised taxes to cover the cost, instead of Americans paying monthly for their insurance. We tend to not miss what is already gone, and this is what other countries have done. People have to pay taxes, so no one would ever need to be fined for not paying for health care every month. References Foster, R. (2011). Estimated effect of the Affordable Care Act on total national health spending. Retrieved on March 1st, 2014 from http://www.intellectualtakeout.org/library/chart-graph/estimated-effect-affordable-care-act-total-national-health-spending Kaiser Foundation. (2014). Summary of the affordable care act. Retrieved on February 24, 2014 from http://kaiserfamilyfoundation.files.wordpress.com/2011/04/8061-021.pdf UPMC. (2013). The Pros and Cons of ObamaCare. Retrieved on March 1s, 2014 from http://www.yourhealthcaresimplified.org/news/the-pros-and-cons-of-obamacare/ U.S Department of Health & Human Services. (2014). Read the law. Retrieved on February 12th, 2014 from http://www.hhs.gov/healthcare/rights/law/index.html

Globalization and some ethical issue Essay

Globalization is phenomenon which is quickly sweeping across the world. Globalization occurs when the scope of things, like trade and politics cross the national boundaries and enter the realm of international scenario. To some extent people working on the international front do not merely belong to their own countries but actually become a part of the international community. The increasingly closer contacts between different countries of the world due to progress in means of traveling and communication, and exchange of not only products but also cultures, are the actual basis and the real reasons behind globalization. Globalization has been believed to bring about revolution in the lives of people of quite a few countries affected by it. International trade, politics and spotlight on ethical issues has opened doors to a completely new world for many. However, as much as it’s positive effects like competitive global or open market trade, its negative effects are also a cause of offense to many. It is seen that if people are happy by the transformed way of living due to globalization, quite a lot are dismayed and consider globalization as an attack on their national identities, a raid on their distinctive cultural and an attempt of involvement in their countries’ internal affairs. Countries which are affected positively are mostly European or Western countries, with the exceptions of countries like China and Japan etc. belonging to the East, which truly made use of the opportunity and progressed. Other developing countries spread over, Asia, Africa and Middle East were either too badly exploited or accepted the international influence too much to loose their own specific culture and identities. Overwhelmed by the Western influence they did not progress as much as they lost their true identification. Numerous countries, cultures and nations have been under the influence of globalization but here specifically I am discussing the effects of globalization on China in from economic, political, environmental and cultural point of view. Cultural Impact of Globalization on China Globalization poses a threat for the original cultures of all the nations who accept to be a part of the international community. Accepting the international community’s norms and adjusting like wise is the first and foremost rule to be followed in such circumstances. Globalization is seen as â€Å"an unstoppable homogenization that dooms local variation and that makes the nation state increasingly irrelevant. † (Weller p. 161) Culture is highly dynamic; it is â€Å"not static. † (Rothkop) Many people who staunchly believe in a strict national identity including staunchness to religion, caste and creed etc. are opposed to the idea of globalization. International influence has no doubt changed the scenario in nearly all the modern cities or areas of China in order to comply with the global requirements. The influx of knowledge, modern machinery and modern lifestyles is simply unacceptable by many who have lived their lives protecting their cultural norms. Globalization aims at changing the entire way of lives of people belonging to any specific culture. Involvement of women and people irrespective of caste, religion or family background in the employments opened as a result of being a part of the international market threatens the traditional caste system supported by many cultures and societies. Same holds true for China; modern ways of life complying in accordance with the world standards are now a strong part of the modern Chinese society. Nevertheless, along with the good effects the bad effects are also inevitably incorporated into the society. Ethics, modesty and self restraint from the social evils leave the culture as modern ways are readily incorporated into it. This is the main reason why many wise believe in moderation. However, the new era, in general and that of China believes in accepting the good and the bad alike for the purpose of achieving progress and development which is hard earned. Globalization in China from economic point of view China is an Asian country, which has been positively influenced by globalization especially in terms of economic growth. China grabbed the opportunity of entering into the competitive global market and using this opportunity for its own benefit. It seems China whole heartedly accepted the idea of globalization and allowed it to enter by opening all doors to it. It is believed to have entered an era of explosive economic development mainly relying on export of their products. This definitely strengthened China and helped it improve its condition in many ways, for example, improving the quality of life of the people and the environment to meet the international standards which was highly necessary in order to stand shoulder to shoulder with the other international states in competing in the open market. Just as in any society, globalization changed the culture of China in multiple ways and China accepted all these transformations whole heartedly for the sake of betterment. However, it was not so easy for every one to adapt to the rapidly changing norms even if they were in the field of economics. Income disparity was an inevitable consequence. Even today it is believed that â€Å"the most important source of income inequality in rural China is income from wages. † (Khan and Riskin p. 30) However, this entrance into the international scenario made it incumbent upon China to meet the international standards not only in terms of products but also environment; this lead to China’s struggle towards maintaining and improving its environment so that it could come up to the world wide standards.

Present Status and Future Refinements Essay

Present Status and Fut ure Refinement s Jacqueline Fawcett, Ph. D. , F. A. A. N. Abstract The central concepts and themes of t he discipline of nursing are identified and formalized as nursing’s metaparadigm. Examples illustrate the direction provided by the metaparadigm for theory development. Refinements of the metaparadigm through conceptual models and programs of nursing research are proposed. T he discipline of nursing will advance only through continuous and systematic development and testing of nursing knowledge. Several recent reviews of the status of nursing theory development indicate that nursing has n o established tradition of scholarship. Reviewers have pointed out that most work appears unfocused and uncoordinated, as each scholar moves quickly from one topic to another and as few scholars combine their efforts in circumscribed areas (Chinn, 1983; Feldman, 1980; Hardy, 1983; Roy, 1983; Walker, 1983). Broad areas for theory development’ are, however, beginning to be recognized. Analysis of past and present writings of nurse scholars indicates that theoretic and empirical work has always centered on just a few global oncepts and has always dealt with certain general themes. This paper identifies these central concepts and themes and formalizes them as nursing’s metaparadigm. Examples are given to illustrate the direction provided by the metaparadigm for theory development. The paper continues with a discussion o f refinements of t he metaparadigm needed at the levels of ja cqueline Fawcett, Ph. D. , F. A. A. N. , i s Associate Professor, and Section Chairperson, Science and Role Development, School of Nursing, University of Pennsylvania, Philadelphia. Page 84 disciplinary matrices and exemplars nd concludes with proposals for future work needed to advance to the discipline of nursing. Present Status of the Metaparadigm of Nursing The metaparadigrn of any discipline i s a statement or group of statements identifying its relevant phenomena. These statements spell out the phenomena of interest in a most global manner. No attempt i s made to be specific or concrete at the metaparadigm level. Eckberg & Hill (1979) explained that the metaparadigm â€Å"acts as an encapsulating unit, or framework, within which the more restricted . . . structures develop† (p. 927). The Central Concepts of Nursing Evidence supporting the existence of a metaparadigm of nursing i s accumulating. A review of the literature on theory development in nursing reveals a consensus about the central concepts of the discipline-person, environment, health, and nursing (Fawcett, 1983; Flaskerud & Halloran, 1980). This consensus i s documented by the following statements: O ne may. . . demarcate nursing in terms of four subsets: 1 ) persons providing care, 2) persons with health problems receiving care, 3) the environment in which care i s given, and 4 ) an end-state, well-being. (Walker, 1971, p. 429) The major concepts identified (from an nalysis of the components, themes, topics, and threads of the conceptual frameworks of 50 baccalaureate nursing programs) were Man, Society, Health, and Nursing. (Yura &Torres, 1975, p. 22) The units person, environment, health, and nursing specify the phenomena of interest to nursing science. (Fawcett, 1978, p. 25) Nursing studies the wholeness or health of humans, reco gnizing that humans are in continuous interaction with their environments. (Donaldson & Crowley, 1978, p. 119) Image: The Journal of Nursing Scholarship Nursing’s focus i s persons, their environments, their health and nursing itself. Bush, 1979, p. 20) Nursing elements are nursing acts, the p atient, and health. (Stevens, 1979, p. l l ) The foci of nursing are the individual in relation to health, the environment, and the change process, whether it be maturation, adaptation, or coping. (Barnard, 1980, p. 208) Nursing i s defined as the diagnosis and treatment of human responses to actual or potential health problems. (American Nurses‘ Association, 1980, p. 9 ) The four conceptual areas of nursing are: the person receiving nursing; the environment within which the person exists; the health-illness continuum within which the erson falls at the time of the interaction with the nurse; and finally, nursing actions themselves. (Flaskerud, cited in Brink, 1980, p. 665) The do main of nursing has always included the nurse, the patient, the situation in which they find themselves, and the purpose of their being together, or the health of the patient. In more formalized terms, . . . the major components of the nursing [metalparadigm are nursing (as an action), client (human being), environment (of the client and of the nurse-client), and health. (Newman, 1983, p. 388) There i s general agreement that the central oncepts of the discipline of nursing are the nature of nursing, the individual who received nursing care, society-environment, and health. (Chinn, 1983, p. 396) These statements indicate that there i s considerable agreement among scholars as t o the concepts central to the discipline of nursing. In fact, a review of the literature revealed no contradictory statements. RecurringThemes The relationships between and among the concepts-person, environment, health, nursing-are elaborated in recurring themes found in works of nurse scholars since Nightin gale (1859). These themes are listed in Table 1. Summer, 1984, Volumo XVI, blo. 3 Metaparadigm of Nursing TABLE 1 THEMES OF THE YETAPARAWW OF NURSING 1. The principles and laws that govern the life-process, well-being. and optimum function of human beings, sick or well. 2. The patterning of human behavior in interaction with the environment in normal life events and critical life situations. 3. The process by which positive changes in health status are elfected. (Donaldson& Crowley, 1978, p. 113; Gortner, 1980, p. 180) The four central concepts and three recurring themes identify the phenomena central to the discipline of nursing in an abstract, global manner. They represent the metaparadigm. As such, they have provided some direction for nursing theory development. As Newman (1983) explained: It i s within the context of these four major components and their interrelationships that theory development in nursing has proceeded. Theoretical differences relate to the emphasis placed on one or more of the components and to the way in which their relationships are viewed. (p. 388) The relationship between the concepts â€Å"person† and â€Å"health† i s considered in the first theme. Theories addressing this theme describe, explain, or predict individuals‘ behavior during eriods of wellness and illness. Newman’s (1979) theory of health i s one example. This theory includes the concepts of movement, time, space, and consciousness. Newman proposes that â€Å"the expansion of consciousness i s what life, and therefore health, i s a ll about† (p. 66). Another example i s Orem’s (1980) theory of self-care, wh ich maintains that â€Å"self-care and care of dependent family members are learned behaviors that purposely regulate human structural integrity, functioning, and human development† (p. 28). S till another example i s Orern’s theory of self-care deficits. This theory maintains that individuals â€Å"are subject t o healthrelated or health-derived limitations that render them incapable of continuous selftare or dependent care or that result in ineffective or incomplete care† (p. 2 7). The relationships among the concepts †person,â€Å" †environment,† and â€Å"health† are considered in the second theme. Theories addressing this theme Summer, 1B84, Volume XVI, No. 3 describe, explain, or predict individuals’ behavioral patterns as they are influenced by environmental factors during periods of wellness and illness. Such theories place the individuals ithin the context of their surrounding environment rather than considering them in isolation, as in the first theme. Roy and Roberts’ (1981) theory of the person as an adaptive system i s an example. This theory proposes that the person i s a system that adapts to a constantly changing environment. Adaptation i s accomplished through the action of coping mechanisms called the â€Å"regulator† and the â€Å"cognator. † The relationships among the â€Å"person,’’ â€Å"health,† and â€Å"nursing† are considered in the third theme. Environment may also be taken into account here. This heme i s addressed by theories about nursing practice. These theories describe or explain nursing processes or predict the effects of nursing actions. King‘s (1981) theory of goal attainment i s one example. King explains: that a paradigm, or disciplinary matrix, i s more restrictive than a metaparadigm, and that i t â€Å"represents the shared commitments of any disciplinary community, including symbolic generalizations, beliefs, values, and a host of other elements† (p. 926). The authors went on to say, A disciplinary matrix may be seen as the special subculture of a community. It does ot refer to the beliefs of an entire discipline (e. g. biology), but more correctly t o those beliefs of a specialized community (e. g. phage workers in biology). (p. 926) Identification of the metaparadigm i s an important step i n the evolution of a scholarly tradition for nursing. The n e x t step i s r efinement o f t h e metaparadigm concepts and themes, which occurs at the level of the paradigm or disciplinary matrix, rather than at that of the metaparadigm. The Disciplinary Matrix Eckberg and Hill (1979) explained Most disciplines have more than one disciplinary matrix. Each one represents a distinctive frame of reference within which the metaparadigm phenomena are viewed. Furthermore, each disciplinary matrix reflects a particular research tradition by identifying the phenomena that are within its domain of inquiry, the methods that are to be used to investigate these phenomena, how theories about these phenomena are to be tested, and how d ata are to be collected (Laudan, 1981, p. 151). More specifically, the research tradition of each disciplinary matrix includes six rules that encompass all phases of an investigation. The first rule identifies the precise nature f the problem to be studied, the purposes to be fulfilled by the investigation, or both. The second rule identifies the phenomena that are to be studied. The third rule identifies the research techniques that are to be employed and the research tools that are to be used. The fourth rule identifies the settings in which data are to be gathered and the subjects who are to provide the data. The fifth rule identifies the methods to be employed in reducing and analyzing the data. The sixth rule identifies the nature of contributions that the research will make to the advancement of knowledge. (Schlotfeldt, 1975, p. ) In nursing, disciplinary matrices are most clearly exemplified by such conceptual models as Johnson‘s (1980) Behavioral System Model, King’s (1981) Open Systems Model, Levine’s (1973) Conservation Model, Neuman’s (1982) Systems Model, Orem’s (1980) Self-care Model, Rogers’ (1980) Life Process Model, and Roy’s (1984) Adaptation Model. Each Image: The Journal of Nursing Scholarship Page 85 . . . nurse and client interactions are characterized by verbal and nonverbal communication, in which information i s exchanged and interpreted; by transactions, in which values, needs, and wants of each ember of the dyad are shared; by perceptions of nurse and client and the situation; by self in role of client and self in ro le of nurse; and by stressors influencing each person and the situation in time and space. – (p. 144) Orem’s ( 1 980) theory of nursing systems is another example. This theory maintains that †nursing systems are formed when nurses use their abilities to prescribe, design, and provide nursing for legitimate patients (as individuals or groups) by performing discrete actions and systems of actions† (p. 29). Refinement of the Metaparadigm Metaparadigm of Nursing f these nursing models puts forth a distinctive frame of reference within which the metaparadigm phenomena are viewed. Each provides needed refinement of the metaparadigm by serving as a focus-†ruling some things in as relevent, and ruling others out due to their lesser importance† (Williams, 1979, p. 96). Conceptual models of nursing are beginning to make major contributions to the development of nursing theory. Theories derived directly from King’s model and from Orem’s model were identified earlier. A considerable amount of empirical work designed to test unique nursing theories as well as heories borrowed from other disciplines i s n ow being guided by nursing models. Some of the studies are listed in Table 2. TABLE 2 Examples of Research Derived From Conceptual Models of Nursing Oorothy Johnson’s BehavioralSystem Model -An instrument for theory and research development using the behavioral systems model for nursing: The cancer patient. Part I (Derdiarian, 1983). -An instrument for theory and research development using the behavioral systems model for nursing: The cancer patient. Part II (Derdiarian & Forsythe, 1983). -Achievement behavior in chronically ill children (Holaday, 1 974) Maternal response to their chronically ill infants’ attachment behavior of crying (Holaday, 1981) -Maternal conceptual set development: Identifyingpatterns of maternal response to chronically ill infant crying (Holaday, 1 982) -Development of a research tool : Patient indicators of nursing care (Majesky, Brester, & Nishio, 1 978) Myra Levine’s Conservation Model -Effects of lifting techniques on energy expenditure: A preliminary investigation (Geden, 1 982) – A comparision of two bearing-downtechniques during the second stage of labor (Yeates & Roberts, 1984) Betty Neuman’s Systems Model Effects of information on postsurgical coping (Ziemer. 1 983) Dorothea Orem’s Self-care Model -Application of Orem’s theoretical constructs to selfcare medication behaviors in the elderly (Harper, 1984) -Development of an instrument to measure exercise of self-care agency (Kearney & Fleischer, 1 979) Martha Roger’s Life Process Model -The relationship between identification and patterns of change in spouses’ body images during and after pregnancy (Fawcett, 1977) -Patients’ perceptions of time: Current research (Fitzpatrick, 1 980) -Reciprocy and helicy used t o relate mEGF and wound healing (Gill & Atwood, 1 981) Therapeutic touch as energy exchange: Testing the theory (Ouinn, 1 984) Callista Roy’s Adaptation Model -Needs of cesarean birth parents (Fawcett, 1981) -An exploratory study of antenatal preparation for ce- Page 86 sarean birth (Fawcett & Burritt, in press) -Clinical tool development for adult chemotherapy patients: Process and content (Lewis, Firsich. & Parsell, 1 979) -Content analysis of interviews using a nursing model: A look at parents adapting to the impact of childhood cancer (Smith, Garvis, & Martinson, 1 983) Despite the contributions already made by nursing models to theory development, much more work i s needed. In particular, rules addressing methodology and instrumentation must be specified. Moreover, programs of research emanating from each model must be conducted to refute or validate nursing theories. Programmatic research probably i s carried out most expediently by communities of scientists. Hardy (1983) explained that each community of scientists i s . . . a g roup of persons w h o are aware of their uniqueness and the separate identity of their group. The have a special coherence which separates them from neighboring groups, and this special bond means they have a shared set of values and a common commitment which operates as hey work together t o achieve a common goal. Coordination of their activities may include interaction among the coordination of institutions, organizations, groups, and individuals. Such coordinated groups hold a common perspective, common values and common bonds, a nd they have common sets of activities and functions which they carry out to achieve a common ou tcome. (p. 430) Each community of scientists, then, represents a distinctive subculture, or disciplinary matrix, of the parent discipline. It can be argued that communities of scientists may be formed outside the organizing framework of nursing models. However, it also can be argued that conceptual models of nursing, like the disciplinary matrices of other disciplines, are the most logical nuclei for communities of scientists. This argument i s supported by three facts. First, the curricula of most schools of nursing now are based on conceptual models. Second, most graduate programs and many undergraduate programs offer courses dealing with the content and uses of nursing models. And third, clinical agencies are beginning to organize the delivery of nursing care according to the tenets of conceptual ‘models. image: The Journal of Nursing Scholarship Collectively, these facts mean that cademicians, students, clinicians, and administrators are thinking about nursing theory, nursing research, and nursing practice within the context of explicit conceptual models. It i s probable, then, that eventually the development of a ll nursing theory will be directed by nursing models. It may even by possible to categorize seemingly isolate d past and current work according to conceptual models. This should provide more organization for extant nursing knowledge and should identify gaps and needed areas of inquiry more readily than is possible now. Moreover, such an endeavor should identify members of different ommunities of scientists to each other as w ell as t o the larger scientific community. Exemplars S till further refinement of the metaparadigm i s needed a t the most restrictive level-that of the exemplar. Eckberg and Hill (1979) identified the function of an exemplar as permitting â€Å"a way of seeing one’s subject matter on a concrete level, thereby allowing puzzle solving to take place† (p. 927). They went on to explain: For a discipline to b e a science it must engage i n puzzle-solving activity; but puzzle solving can only be carried out if a community shares concrete puzzle solutions, or exemplars. It i s t he exemplar that i s i mportant, not merely the disciplinary matrix, and certainly not merely the general presuppositions of t he community [i. e. , the metaparadigm]. The latter may be important, but they do n ot direct ongoing, dayto-day research. (p. 927) There i s some evidence of exemplars in nursing. This includes but is not limited to Fitzpatrick’s (1980) programmatic research on time perception; studies o effects of information f about a threatening procedure on a patient’s responses to the procedure (e. g. , Hartfied, Cason, & Cason, 1982; Johnson, Fuller, Endress, & Rice, 1978; Ziemer, 19831, and investigations of actors contributing to the outcomes of social support (Barnard, Brandt, Raff, & Carroll, 1984 in press). These researchers are beginning to solve some of the major puzzles of nursing. However, more work i s needed to identify other puzzles and to develop methods for their solutions. Summer, 1984, Volume XVI, No. 3 Metaparadigm of Nursing Con clusion It is time to formally accept the central concepts and themes of nursing as the metaparadigm of the discipline. It i s also time to direct efforts toward furf ther refinement o this metaparadigm by developing specific rules for the empirical work needed to generate nd test nursing theories within the context of conceptual ‘models. The metaparadigm must be refined still further through the developing of new puzzle-solving activities that will provide answers to the most pressing problems encountered by nurse clinicians, educators, and ddministrators. Any one of these activities would in itself make a significant contribution to the discipline; a ll three could quite possibly be the major accomplishments of the decade. ‘As used here, theory development reft. r to generation a nd testing of theory. and encornpasiei †ivory tower† theorizing as well as empirical rewarch. References American Nurses’ As5ocialion. Nursing: A social policy statement. Kansas City, Missouri: ANA, 1980. Barnard, K. E. Knowledge for practice: Direction5 for the future. Nursing Research, 1980. 29, 208-21 2. Barnard, K . E. , Brandt, P. , Raff. 8.. & Carroll, P. (Ed,. ). Social support and families of vulnerable infants. New York: March of Dimes, 1984. Brink, P. 1. Editorial. Western Journal of Nursing Research, 1980, 2, 665-666. Buih, H . A. Models for nursing. Advances i n Nursing Science, 1979, l ( 2 ) . 13-21. Chinn, P. L. Nursing theory development: Where we have been and where we are going. In N. L. Chaska (Ed. ), The nursing profession: A time to speak. New York: McCraw-Hill, 1983. Donaldson, S. K. , & Crowley, D. M . The discipline of nursing. Nursing Outlook, 1978, 26, 113-120. Eckberg, D. L .. & Hill, L. , Jr. The paradigm concept and sociology: A critical review. American Sociological Review, 1979, 44,925-937. Fawcett, 1. The â€Å"what† of theory development. In Theory developmenk What, why, how? (pp. 17-33). New York: National League for Nursing, 1978. Fawcett, 1. (1983). Hallmarks of success in nursing theory development. In P. L. Chinn, (Ed. ), Advances i n nursing theory development (pp. -17). Rockville, Maryland: Aspen. Feldrnan, H. R. Nursing research in the 1980s: Issues and implications. Advances in N ursing Science, 1980, 3(1);85-92. Fitzpatrick, 1. J . Patients perceptions of time: Current research. International Nursing Review, 1980, 27, 148-153, 160. Flaskerud. 1. H. , & Halloran, E. J. Areas of agreement in nursing theory development. Advances in Nursing Science, 1980, 3(1), 1-7. Hardy. M. Metaparadigrnsand theory development. In N. L. Chaska (Ed. ), The nursing profession: A t ime t o speak. New York: McCraw-Hill, 1983. Hartfield. M. k Cason, C. L. , & Cason, C. J . Effects of , information about a threatening procedure on patients‘ expectations and emotional distress. Nursing Research, 1 982,31,202-206. lohnson, D. E . The behavioral system model for nursing. In J . P. Riehl & C. Roy, (Eds. ), Conceptual models for nursing practice (2nd ed. ). New York: Appleton-Century-Crofts, 1980. Johnson. 1 . E. , Fuller, S . 5.. Endress, M. P . , & Rice, V S. . Altering patients’ responses to surgery: An extension and replication. Research in Nursing and Health, 1978, 1 , 111-121. King. I. M. A theory for nursing: Systems, concepts, process. New York: Wiley, 1981. Neurnan, B . The Neuman systems model: Application t o nursing education and practice. New York: Appleton-Century-Crofts, 1982. Newrnan, M. A. Theory development in nursing. Philadelphia: F. A. Davis, 1979. Newrnan, M . A. The continuing revolution: A history of nursing science. I n N. L. Chaska (Ed. ), The nursing profession: A time t o speak. New York: McGrawHill, 1983. Nightingale, F. Notes on nursing: What it is, a nd what it i s not. London: Harrison, 1859. (Reprinted by L i p pincott, 1946) Orem, D. E. Nursing: Concepts of practice (2nd ed. ). New York: McCraw-Hill, 1980. Rogers, M. E . A n introduction to t he theoretical basisk f nursing. Philadelphia: F. A. Davis, 1970. Roy, C. I ntroduction to nursing: An adaptation model. (2nd Ed. ). Englewood Cliffs, New Jersey: PrenticeHall, 1984. Roy, C. Theory development in nursing: Proposal for direction. In N. L. Chaska (Ed. ), The nursing profession: A time t o speak. New York: McCraw-Hill, 1983. Roy, C. , & Roberts, S . L . Theory construction i n nursing: An adaptation model. Englewood Cliffs, New Jersey: Prentice-Hall, 1981. Schlotfeldt, R. M. The needs for a conceptual framework, In P . J. Verhonick (Ed. ), Nursing research I. Boston: Little, Brown. 1975. Stevens, 8. J. N ursing theory. Analysis, application, evaluation. Boston: Little, Brown, 1979. Walker, L. 0. Toward a clearer understanding of the concept of nursing theory. Nursing Research, 1971, 20, 428-435. Walker, L. 0. Theory and research in the development of nursing as a discipline: Retrospect and prospect. In N . L. Chaska (Ed. ), The nursing profession: A time to speak. New York: McCraw-Hill, 1983. Williams, C. A. The nature and development of conceptual frameworks. In F. S . Downs & I . W . Fleming, (Eds. ) Issues in nursing research. New York: Appleton-Century-Crofts, 1979. Ziemer, M. M. Providing patients with information rior t o surgery and the reported frequency of coping behaviors and development of symptoms foll owing surgery. Unpublished doctoral dissertation, University of Pennsylvania, 1982. A Response to D r. J . Fawcett’s Paper: â€Å"The Metaparadigm of Nursing: Present Status and Fut ure Refinement s† June N. Brodie, R. N. , Ph. D. D r. Fawcett’s formulation of a metap aradigm for nursing represents a commendable effort to consolidate competing nursing theories and encompasses enormous potential for the advancement of nursing knowledge, research, and practice meriting serious consideration by nursing une N . Brodie, R. N. , Ph. D . i s Associate Professor of Nursing Education, Teachers College, Columbia University. Summer, 1984, Volume XVI, No. 3 scholars. This response focuses on how she accomplished this task (what she did and how she did it as well as what she didn’t do and what needs to be done). Essentially Dr. Fawcett’s metaparadigm can be viewed as an evolution of a nursing metaparadigm and an organization of the growth of nursing knowledge rather than as a completed and finalized product. To be more explicit, the basis of the paper exhibits the spirit of Darwinian Evolution and ould be treated as a manifestation of Image: The Journal of Nursing Scholarship a transitional phase i n the competition for the survival of the fitte st (theory). The metaparadigm represents a serious and scholarly attempt to negotiate entry into a different level of the theoretical arena of nursing knowledge. This task was accomplished by examining the concepts derived from the phenomena of the discipline and converging these concepts into a context pertinent to the domain of nursing by providing a structure (a metaparadigm) that has the potential of consolidating disparate nursing theories into Page 87

Volex Group Essay Example | Topics and Well Written Essays - 2000 words

Volex Group - Essay Example Volex has identified healthcare sector as one of the most prominent thrust area on a global basis. Rising disposable incomes in the hands of the people in emerging markets, increased awareness and rising living standards have given a great boost to the healthcare market there. Increased average lifespan in the developed countries coupled with greater emphasis on the preventive measures have also caused a huge demand in healthcare sector in this part. Moreover, the current recessionary trend has a little effect on the demand of healthcare sector. That definitely goes well with the company’s healthcare strategy. The company proudly proclaims that Volex has obtained ISO 13485:2003 accreditations this year for its three international manufacturing facilities in Poland, India, and China. The ISO-13485 certifies the design, manufacturing and project management capabilities of medical devices of the company. It establishes product safety, traceability, risk management and design tran sfer activities in product development. ... Rising disposable incomes in the hands of the people in emerging markets, increased awareness and rising living standards have given a great boost to the healthcare market there. Increased average lifespan in the developed countries coupled with greater emphasis on the preventive measures have also caused a huge demand in healthcare sector in this part. Moreover, the current recessionary trend has a little effect on the demand of healthcare sector. That definitely goes well with the company’s healthcare strategy. The company proudly proclaims that Volex has obtained ISO 13485:2003 accreditations this year for its three international manufacturing facilities in Poland, India, and China. The ISO-13485 certifies the design, manufacturing and project management capabilities of medical devices of the company. It establishes product safety, traceability, risk management and design transfer activities in product development. Prior to that, the company had the accreditation of its des ign centre in Ireland last year. This is an indication of the company's foray into the health care sector strengthening its product portfolio and achieving the industry standards that the market requires. The three manufacturing facilities at Chennai (India), Suzhou (China) and Bydgoszcz (Poland) are equipped with the state-of-the-art facilities to deliver complex interconnect products for advanced applications such as CT (computed tomography), MRI (magnetic resonance imaging, X-Ray and ultrasound. This will certainly help the company to create enough customer confidence among the health care sector. (Volex Builds, 2011) Volex's ISO achievement displays its commitment towards design processes for product delivery. This amply testifies the credentials of the Volex in

Positive Train Control Term Paper Example | Topics and Well Written Essays - 2500 words

Positive Train Control - Term Paper Example Implementation of PTC is anticipated to range over the total rail track mileage of 70,000. PTC is basically a technology of train control that is processor or communication based meant to reduce the frequency of collisions between trains, derailments upon over-speeding, attacks into the defined zones of work, and a train’s improper movement through the main line switch. The systems of PTC are needed to execute various types of functions. There is a wide range of PTC systems that vary depending upon a number of factors that include but are not limited to the level of sophistication and complexity of the functionality and automation implemented by them, their wayside system which can be cab signaled, block signaled, or non-signaled, the kind of system architecture used, and the level of control they can achieve over the train. Use of the PTC system in the railroad industry has increased the safety of traveling by train manifolds. The Federal Railroad Administration (FRA) support s all rail carriers that are required to install and implement the PTC system as per law and others that implement the PTC system voluntarily, by means of a mix of project safety measures, regulatory reforms, funds, and technological development. The final rule encompassing the requirements of PTC was published by FRA on 15 January 2010, whereas the final rule amendments were published on 27 September 2010 and subsequently on 14 May 2012. 41 railroads initially deposited the plans of implementation that were reviewed by FRA but denied the approval of all prior to the statutory deadline of 90 days for review. Upon the resubmission of all 41 implementation plans, FRA finally approved 24 unconditionally, 1 conditionally, gave provisional approval to 14 implementation plans that were deposited with the Notices of Product Intent that were supposed to be resubmitted along with a development plan of PTC in 270 days, while 2 plans were disapproved. However, the staff of FRA sustained workin g with them to formulate approvable plans. Currently, FRA is collaborating with two more railroads that were not identified before in order to formulate and deposit successful plans of implementation. The fundamental idea in PTC is that the safety of train’s journey is enhanced by making it aware of its location and guiding it so that it stays on the right track. PTC achieves these functions by making use of networks of communication. â€Å"PTC systems are comprised of digital data link communications networks, continuous and accurate positioning systems such as NDGPS, on-board computers with digitized maps on locomotives and maintenance-of-way equipment, in-cab displays, throttle-brake interfaces on locomotives, wayside interface units at switches and wayside detectors, and control center computers and displays† (Poor, Lindquist, and Wendt, 2009). This prevents the train from making unsafe movements. PTC systems can work in both signaled and dark territories and may a lso use the GPS to guide the train. One of the main goals of FRA is, â€Å"To deploy the Nationwide Differential Global Positioning System (NDGPS) as a nationwide, uniform, and continuous