Care and Management of Asthma

Care and Management of Asthma Asthma is a common incurable disease that affects the small tubes carrying air in and out of the lungs in the airways; it is more common at childhood stage but can also occur at a later age (British Lung Foundation, 2011). The major cause of asthma has not been determined but it is believed that some factors as allergies, exercise and common cold contribute to its development. In the United Kingdom, asthma is being handled primarily by a General Practitioner or nurse. Healthcare can be provided in three major means: Primary, Secondary and Tertiary. They are delivered depending on the severity of an individuals condition. General Practitioners (GPs), Pharmacists, Nurses, Dentists and Optometrists are the main classes of healthcare providers that deliver Primary care. It is the basically the first point of contact for most individuals (National Health Service Choices, 2010). Care distinctively provided in local hospitals is usually on referral from primary care health providers, such t ype of care is basically referred to as Secondary Care. The third aspect of care is the tertiary care which is provided by specialist such as neurologist and cardiologist in a majorly specialised hospital centre for long term treatment. EPIDEMIOLOGICAL OVERVIEW OF ASTHMA Major facts that make Asthma a major health issue in the UK are: In 2008, a total number of 1,204 deaths were recorded from asthma in the UK, out of which 29 were children aged 14 years and under. 1 person every 7 hours or 3 people per day die from asthma 146,000 adults and 36,000 children currently are on treatment for asthma in northern Ireland making it a sum total of 182,000 people (1 in 10)In Northern Ireland 182,000 people (1 in 10) are currently receiving treatment for asthma. This consists of 36,000 children and 146,000 adults. In Scotland 368,000 people are currently receiving treatment for asthma. This consists of 72,000 children and 296,000 adults. In Wales 314,000 people are currently receiving treatment for asthma. This consists of 59,000 children and 256,000 adults (Asthma UK, 2011). the number of adults with asthma in the UK has increased by 400,000 since the last audit of UK asthma in 2001 about 2% of adults consult their GP annually with asthma ASTHMA CARE AND MANAGEMENT AND LOCALITY STUDY OF UK Asthma exists in various forms hence; its heterogeneity has been well established by a variety of studies that have proven the disease risk from early environmental factors and susceptibility genes, inflammation and therapeutic agent response further induces accompanying diseases (Lang et al., 2011). Risk factors associated with asthma are family history of atopic disease, for example Allergic rhinitis Allergic conjunctivitis Male sex, for pre-pubertal asthma, and female sex, for persistence of asthma from childhood to adulthood Bronchiolitis in infancy Parental smoking, including passive smoking Premature birth, especially in extreme-preterm infants who required ventilatory support, with consequent chronic lung disease of prematurity (NHS Choices, 2011) In the UK, asthma is more common among children than in adults and also has an increased rate in women than men (NHS choices, 2010). A condition referred to as acute asthma exacerbation could occur and could sometimes be life-threatening but is mostly rare. Asthma patients are treated with care by GPs and nurses trained for asthma management and such treatments are specific to the symptoms portrayed by each patient. This treatment (Primary care) basically involves: A personal asthma procedural plan concurred with your GP or nurse An annual regular check ensuring proper control of the patients treatment and positive response to the treatment Proper seeking of the patients consent ensuring his/her decision is involved in decision making of his/her treatment Comprehensive detailed information about how to control and manage the patients condition; while a Secondary or Reactive care is enforced in emergency cases to regain control of more high-risk symptoms. In treating asthma, reliever inhalers are given to every patient by the GP; these inhalers serve as immediate relievers and ensure restoration of normal breathing. It functions effectively due to its composition of a short-acting beta2-agonist that works by relaxing the muscles surrounding the narrowed airways (British Medical Journal group, 2011). This further ensures the airways are opened wider, making it easier to breathe again. Salbutamol and terbutaline are common types of this inhaler. They have been proven to be generally safe except when their use is abused although they possess very few side effects. If the asthma is well controlled, then their usage will be minimal; if a patient uses the inhaler for up to three times or more weekly then it is advised that the treatment be reviewed Secondary care and management of asthma is implemented when Patients exhibit a combination of  severe asthma, behavioural and psychosocial features, they hence are at risk of developing near-fatal or fatal asthma. (BTS and SIGN, 2009). Asthma care is dependent on the age of the patients in that children have a different mode of care as compared to adults, a critical look at the adult care is elaborated below. Prior considerations are basically that the patient is registered with his GP, will have to book for an appointment with his GP before visiting (except in emergencies as acute exacerbations), confirmation with the patient of their understanding of the role of treatment, adherence to treatment, inhaler technique, and appropriate elimination of trigger factors as: exercise, drugs foods, emotional factors, weather changes, allergens etc (Shiang et al., 2009) In analyzing the delivery of care to asthma patients in the UK, data from Office for National Statistics shall be addressed. Table 1 below signifies that there was a remarkable decrease in hospital admission in 2000 for asthma; it showed a 45 percent decrease among children between ages 5 and 14 years and a 52 percent decrease among children below 5 years (Office for National Statistics, 2004). TABLE 1 The management of asthma is patient-specific and is delivered by either the GP or asthma nurse; a respiratory nurse specialist works closely with the GP and the patient serving as the best form of encouragement to the patient in the procedural management of his/her asthma condition. The respiratory nurse specialist has a critical role in the management of asthma as elaborated that he/she: Explains the need for various inhalers (ensuring the best is offered to the patient) and provides the patient with information on treatment administered Advices on triggers and how to keep off them Assists the patient in quitting smoking (if applicable) Explicates on how to monitor the condition Provides the action plan of treatment and explains it to the patient. Is always available for assistance both at home and on the phone (NHS Choices, 2006) Nurses are generally recruited into the NHS through the website www.nursebank.co.uk , the Association of Respiratory Nurse Specialists offer courses for development and training of nurses and promote clinical excellence in respiratory care delivery (Association of Respiratory Nurse Specialist, 2010). The selection of a professional nurse in a recruitment procedure is dependent on factors as Years of experience, area of expertise and personal record check. CRITIQUE ON ASTHMA CARE Asthma management involves a wide range of services including primary care, routine follow up, hospital inpatient and outpatient care, proper education and advice of patient, emergency calls and prescribed drugs; these services when combined with the intensity and level of use result to a high cost (Department of Health, 2011). In 2001, England recorded a net ingredient cost of  £442million and around  £33million for inhaled therapy Brocklebank et al (2001). In prescribing drugs, the patient is considered as whether or not to use the drug/device appropriately; the most effective and clinically proven cost effective drug is also reasonably considered. However, restrictions imposed on manufacturers make some inhalers commercially unavailable hence the use of more expensive drugs. The British Thoracic Society (BTS) and Scottish Intercollegiate Guidelines Network (SIGN) have clinical guidelines on the use of inhalers for asthma (BTS and SIGN, 2009) however; there are inconsistencies or absence of recommendations for inhaler devices from these guidelines. Evidence-based guidelines are currently being prepared by the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN). There are criticisms on the effectiveness of the inhaler which largely depends on technique of administration by patient considering experience, physical ability and education on usage (NHS centre for reviews and Dissemination, 2003) CONCLUSION The role of a nurse in quality care delivery cannot be overruled especially in a health condition as asthma which could be critical and possibly fatal. The initial primary care given to asthma patients and subsequent secondary care has been proven to be appropriate in that the health status of patients is being improved. The incorporation of a respiratory nurse specialist has been a major milestone in achieving a better health status for asthma patients in the United Kingdom. REFERENCES Association of Respiratory Nurse Specialist (2010) professional development Available at: http://www.arns.co.uk/pages/professional%20development.html (Accessed: 11 March 2011). Asthma UK (2011) For Journalists: Key facts and statistics Available at: http://www.asthma.org.uk/news_media/media_resources/for_journalists_key.html (Accessed: 5 March 2011). British Lung Foundation (2011) Asthma, Available at: http://www.lunguk.org/you-and-your-lungs/conditions-and-diseases/asthma (Accessed: 9 March 2011). British Medical Journal group (2011) Asthma in adults Available at: http://bestpractice.bmj.com/best-practice/pdf/patient-summaries/531553.pdf (Accessed: 12 March 2011). British National Formulatory (2010) NICE Technology Appraisal. Available at: http://bnf.org/bnf/extra/current/450034.htm (Accessed: 9 March 2011). British Thoracic Society, Scottish Intercollegiate Guidelines Network (2009) British Guideline on the Management of Asthma: A national clinical guideline. Available at: http://www.sign.ac.uk/pdf/sign101.pdf (Accessed: 10 March 2011). Brocklebank, D.,  Ram, F.,  Wright, J.,  Barry, P.,  Cates, C.,  Davies, L.,  Douglas, G.,  Muers, M.,  Smith, D.,  White, J. Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature Health Technology Assessment 5 (26) pp. 1-149. Pubmed [Online]. Available at: http://www.ncbi.nlm.nih.gov/pubmed/11701099 (Accessed: 4 March 2011). Department of Health (2011) Prescription Cost Analysis 2001. Available at: http://www.doh.gov.uk/stats.pca2001.pdf (Accessed: 11 March 2011). Lang M., Erzurum S., C., Kavuru M. (2011) Asthma. Available at: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/allergy/bronchial-asthma/ (Accessed: 12 March 2011). Medicines and Healthcare Regulatory Products Agency (2007) vol (1) drug safety update. Available at: http://www.mhra.gov.uk/Publications/Safetyguidance/DrugSafetyUpdate/CON2033216 (Accessed: 12 March 2011). NHS Centre for reviews and dissemination (2003) 8 (1) Inhaler devices for the management of asthma and COPD Available at: http://www.york.ac.uk/inst/crd/EHC/ehc81.pdf (Accessed: 10 March 2011). National Health Service Choices (2010) About the NHS. Available at: http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhsstructure.aspx (Accessed: 5 March, 2010). National Health Service Choices (2010) Acute asthma in adults-management in primary care. Available at: http://healthguides.mapofmedicine.com/choices/map/asthma_in_adults2.html (Accessed: 9 March 2011). National Health Service Choices (2006) The role of your Respiratory Nurse Specialist. Available at: http://www.chelwest.nhs.uk/documents/patientLeaflets/Asthma%20-%20The%20role%20of%20your%20Respiratory%20Nurse%20Specialist.pdf (Accessed: 11 March 2011). Office for National Statistics (2004) Asthma and allergies: Decrease in hospital admissions in 90s. Available at: http://www.statistics.gov.uk/CCI/nugget.asp?ID=722Pos=1ColRank=1Rank=192 (Accessed: 8 March 2011). Shiang, C., Mauad, T.,  Senhorini, A., De Araà ºjo, B., Ferreira, D., Da Silva, L ., Dolhnikoff, M., Tsokos, M.,  Rabe, K.,  Pabst, R. (2009) Pulmonary periarterial inflammation in fatal asthma Clinical and Experimental Allergy 39 (10) pp. 1499-1507 Wiley [Online]. Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.2009.03281.x/abstract (Accessed: 11 March 2011). LEARNING OUTCOME 2 LEADERSHIP IN NURSING AND ASSOCIATED PROFESSIONS A Leader is someone who guides or chairs a group of people or an organisation; it is common practice that a leader portrays some leadership skills to enable him/her be productive and effective. Cook (2001) describes a clinical nursing leader as someone who endlessly gets involved in direct patient care hence improving care by being of positive influence to others. All nurses (from those who provide direct care to the managers) need potent leadership skills. Mahoney (2001) emphasises that anyone (e.g. a nurse) who gives assistance to others or is responsible for other people is considered a leader; however, good leadership is reproducible superior performance targeted towards a long term benefit to everyone called for. John, (2011) has defined a manager as an individual with the sole responsibility to plan and direct the work of a group of people, ensuring proper monitoring and directives are followed. Management in nursing involves regarding leadership functions of administration and making appropriate decisions within organisations that employ nurses. SIMILARITIES BETWEEN LEADERS AND MANAGERS Leaders and managers go hand in hand, none of them tend to possess abilities that make them stand on their own, and there is no unique or particular way of managing people. Some basic similarities between managers and leaders are: People development: An effectual manager and leader have skills and abilities that tend towards the development of the people. Partnership working: the work of both a manager and a leader tend to be of a partnership level (Mather, 2009). Motivators: both leaders and managers are motivators of their subordinates DIFFERENCES BETWEEN LEADERS AND MANAGERS Thinking pattern: A major difference between a leader and manger is in their level of reasoning, Managers think incrementally, whilst leaders think radically; managers always work towards doing things rightly while leaders work in the perspective of doing the right thing (Richard, 1990). Loyalty: Subordinates are mostly subordinate to their leader than to their manager; this applies often because the leader takes credit in times of achievement and allocating merit to subordinates (John, 1990). Competencies: A nursing manager allocates resources and sets timetables while a nursing leader is someone who clarifies the big picture created by the manager and simplifies it, making the hospital/nursing homes vision more understandable to the staff and patients (Kristina R, 2009). Leadership is a very vital issue in the nursing practice because nursing requires knowledgeable, consistent and strong leaders, who inspire and boost peoples moral and support professional nursing practice. Nurses need to be both leaders and managers for some very key reasons as: An Advocate for quality care: a head nurse who serves as either a leader has to stand out in ensuring the needs of both the patients and nursing staff are adequately met, sometimes it will require a robust and bold person to stand before the board in defending these needs. An influential personality: the presence of an influential nurse handling an asthmatic patient will go a long way in guiding the patient in making informed choices; the patient becomes free and open to the nurse when she/he exhibits a high level of positive influence on the patient. CRITIQUE OF NURSING PUBLICATIONS IN RELATION TO LEADERSHIP AND MANAGEMENT IN ASTHMATIC AND GENERAL NURSING CARE A report by the Royal College of Nursing (RCN) on the support by Asthma UK on RCNs frontline campaign published on 14th January 2011 is carefully analyzed highlighting the publishers aims of writing, lessons to be learnt, consequences of the article and its impact on positive care delivery. It was rightly stated in this article that about three-quarters of asthma emergency admissions can be avoided if proper care is delivered (Royal college of Nursing, 2011). This implies that the need for proper managerial skills needs to be adapted by the healthcare leaders to manage asthma patients which will ultimately lead to the reduction of emergency care delivery for asthma patients. He went further to stress that specialist nurses are the cohesive source of support and stability for care for asthma patients; this issue is supported by the Relationship theory of leadership (also known as transformational theory) which highlights the connection between the leader and the led (Kendra, 2011). Leaders that possess this trait tend to motivate and stir their followers to ensure maximum productivity is achieved. Focus is geared towards the performance of the group members. When a leader with such trait is employed, the function of the specialist will be balanced on both as a helper of the patient and a confidant to the patient. He also said that the role of a specialist nurse has reduced hospital admissions from 22% to 6%, hence saving the National Health Service billions of pounds annually. The writer concluded by turning down the practise of relieving the specialist nurses of their jobs and employing other nurses and ward clerks to fit into their roles which he said the adverse effects were of greater negative impacts as costing the NHS more finance and damage the lives of the patients already receiving care by the specialist nurses. The lessons from this article cannot be over-emphasized in that there is an immediate need for the employment of more specialist nurses to manage asthmatic patients better and to save the lives of their patients. A similar report by Akinsanya (2009) on the Exacerbations of severe asthma; psychosocial predictors and the impact of a nurse-led clinic stated that the need for alternate management approaches is paramount in caring for people with severe asthma. He also recommended further findings on the social and psychological aspects of asthma management. Recommendations were also made on the holistic approach for long-term management of asthmatic patients (Akinsanya, 2009). This report clearly shows the application of the contingency leadership theory that postulates the influence of variables that relate to the environment on the determination of the specific leadership style fit for a situation (Kendra, 2011); it further implies the need for a paradigm shift on the care for acute asthmatic patients towards need for more nurse specialists. PERSONAL REFLECTIONS ON LEADERSHIP AND MANAGERIAL SKILLS As a major role player in healthcare delivery, nurses have inevitable functions. This Portfolio has given me an in depth understanding in various areas of my practice as: Efficiency: I have learnt that my level of efficiency has a vital impact in saving asthmatic patients lives; it will help ease the huge financial burden on Government by saving extra expenses. Leadership skills: According to the great man theory of leadership (Management Study Guide, 2011a) which denotes that some people are born with inherent leadership skills which become apparent when great needs arise. I have understood that as a nurse, I can lead rightly and manage people if I can nurture the greatness in me. In enhancing my managerial skills, I will give room for creativity in my area of work by combining both human and non-human resources (Management Study Guide, 2011b) to achieve the designed goal. Team work is also a very good point I learnt from this report in that I cannot be an effective leader if I am regarded as the only member of my team succeeding, there has to be a cohesive effort from all. Care delivery: The focus is on the nurses to serve as interlocutors between the GP and patient ensuring the patient adheres to prescriptions and that the nurse is always available for assistance by the patient. CONCLUSION The difference between a leader and manager is quite small and most leaders tend to end up as managers. Asthmatic guidelines need to be reviewed often to improve its managerial aspect of care. Nurses are relevant care deliverers and all need to develop leadership and managerial skills in order to safe guard the healthcare of the United Kingdom.

China pver population :: essays research papers

â€Å"Over-Population Doesn't Justify Disregard for Human Life†- anonymous. The question proposed is, does the Chinese population control policy violate human rights? This is very controversial issue. There are many different views on this subject. By some it’s seen as a successful tool for making certain that China will be able to continue to support its large population. Others believe the policy is inhumane and causes abuses and female infanticide. Is China going about this problem the right way? The slogan of the initial population control program is â€Å"Later, Longer, Fewer.† The one child policy is not officially a law. It’s more of a â€Å"way of life†. China can’t punish couples for having more then one child because it’s not a law. So they provide motivation, such as extra salary or larger houses for couples that pledge to have just one child. If you did become pregnant and you agreed to give up your child the government would pay for abortions. A woman who had an abortion was rewarded with a paid vacation. China’s policy pushes later marriages, postponing children, fewer and healthier births, and they encourage couples to only have one child. Figures show that the policy has reduced China's population by 250 million, isn’t this good? If you only have one child, you can provide more to that child. The child can have a better life. Lu Zhufeng, a 20 year-old medical student said, â€Å"If I have one child it will be raised better. It will have more opportunities, and my career is the most important thing. I really want to excel at it.† Mothers used to stay home and take care of the children but with one child it isn’t much work. With fewer children it will free up the mothers time so instead of caring for more then one child the mother has more time to go into the work force. On the other point of view, some people might argue that the â€Å"one child policy† is a violation of human rights. Most Chinese families prefer male children to female children. The reason for this is the men are stronger and will be able to take care of them in their old age. However, if they have a female, she will have to get married and the parents will have to provide a dowry. As a result to this boy demand and since you can only have one child, if the female has a girl they might kill the infant, Hundreds are being drowned, smothered, and abandoned.

Trash Summary

Trash Summary Trash is an epic novel about three ordinary dumpsite boys that sort through trash for a living. One day they find a key that leads them to a train station locker. From there they start the journey of their lives. Throughout the book many characteristics are shown both good and bad. I have chosen to talk about the themes trust and resilience. I chose these topics because I think both of these were shown many times in the book and they are to things that you need in every day life. Trust is the reliance that you have on one another, the belief that someone will come through for you in a time of need.This was shown many times in the book my favourite example was when Rat, (or Jun-Jun) was there for Raphael and Gardo at the beginning of the book they needed a place to hide the wallet. At any give time he could have gone straight to the police and turned in Raphael and Gardo.. Sister Oliver’s trust, pity and innocence led her to believing the three boys lie, this ende d up putting her at great risk. Later on in the novel Gardo went back to the prison with the 20,000 pesos to give the guard for the bible.The guard tried to catch Gardo but he escaped just in time. I think this was a case where they were forced to trust the guard whether they wanted to or not, they had no option to get the bible or not. Resilience is the ability to bounce back and put up with severe amount of stress. That’s exactly what these boys put up with for the whole book, between being chased by corrupt police and breaking into a grave these boys had amazing mental strength. The best example of this is when Raphael got taken to the police station; he was tortured, beaten and almost killed.It took lots of resilience is just there will to see there adventure all the way through to the end. At any given time they could have quite gone to the police turned the other two in and made 20,000 peso. â€Å" We will fish for ever and live happy lives. That is our plan and nothin g will stop us. † This quote said by Jun-Jun shows that the three boys trust each other to the end of the world. They would die for each other happily. They have been through so much mentally and physically that they could put up with anything. I honestly do think nothing will stop them.

Cmo afecta la ley HB87 de Georgia a los indocumentados

Cmo afecta la ley HB87 de Georgia a los indocumentados La ley de Georgia HB 87, considerada como restrictiva de la inmigracià ³n, impone castigos a los inmigrantes indocumentados que viven dentro de las fronteras de ese estado. Y es que aunque las leyes de la inmigracià ³n son federales y, por lo tanto, son iguales todo Estados Unidos sin importan donde se resida lo cierto es que cada estado puede pasar medidas de apoyo a los migrantes, legales y/o indocumentados o, por el contrario, restrictivas de los derechos de los sin papeles. Ese à ºltimo es el caso de Georgia, pero no es el à ºnico. Destacan en ese sentido las leyes de Arizona, Alabama y Carolina del Sur. Si usted es uno de los 480 mil indocumentados que vive en Georgia o se planea mudarse a vivir a ese estado es conveniente saber los puntos bsicos de la ley HB-87 tal y como se aplica en la actualidad despuà ©s de que varias organizaciones demandaran con à ©xito irregular la suspensià ³n de algunas partes de la ley. Cà ³mo afecta la ley de Georgia HB-87 a los indocumentados En primer lugar, en aplicacià ³n de la ley de Georgia HB-87 las empresas con ms de un cierto nà ºmero de trabajadores deben utilizar el programa federal e-Verify para garantizar que sus los empleados son ciudadanos americanos o estn legalmente autorizados para trabajar en Estados Unidos. Asà ­, todas las agencias estatales y todos los empresarios privados con ms de 500 empleados deben verificar el estatus legal de todos los nuevos trabajadores. Desde el 1 de julio de 2012, est obligacià ³n se ha extendido a todas las empresas con ms de 100 empleados y desde el uno de enero de 2013 se extender a todas que tengan ms de 10 trabajadores. Adems, la utilizacià ³n de documentos falsos como licencias de manejar, tarjetas de la seguridad social o green cards con el objeto de obtener empleo est castigado con multas de hasta $250,000 y con penas de prisià ³n por un mximo de 15 aà ±os. Asimismo, todas las peticiones de ayudas para la vivienda o para la compra de alimentos (food stamps) debern acompaà ±arse por la presentacià ³n de determinada documentacià ³n que pruebe el estatus legal del solicitante. Y quiz lo ms digno de resaltar es que  la policà ­a estatal y local puede verificar el estatus migratorio de las personas a las que para o detiene. Es lo que se conoce como la polà ­tica de muà ©strame los papeles (show me your papers, en inglà ©s). Es de destacar que se autoriza a la policà ­a a pedir los papeles pero no se hace mandatorio que debe hacerlo. Asà ­, por ejemplo, las fuerzas del orden del estado de Georgia podrn pedir papeles para verificar el estatus migratorio de las personas que manejen un auto sin la debida licencia. Disposicià ³n de la ley de inmigracià ³n de Georgia HB-87 que est suspendida   Por decisià ³n de la Corte de Apelaciones de Atlanta sigue en suspenso la seccià ³n de la ley que penaliza a todas las personas que a sabiendas, acogen en sus viviendas o transportan a un inmigrante indocumentado cuando se est cometiendo un delito. Derechos de los migrantes indocumentados Los migrantes indocumentados, a pesar de su estatus, tambià ©n tienen derechos si son arrestados o parados. En estos casos es muy importante que reciban un buen asesoramiento legal si sus caminos cruzan el de las autoridades y, por su puesto, si reciben una citacià ³n para presentarse en una corte de Inmigracià ³n, ya que el no hacerlo tiene consecuencia una orden de deportacià ³n (de la que es posible no saber que se tiene). Adems, en casos de arresto o/y inicio de procedimiento de deportacià ³n conviene consultar con un abogado si es conveniente solicitar una salida voluntaria, ya que puede tener ventajas si no hay forma legal de parar la deportacià ³n. Por à ºltimo, destacar que incluso en Georgia los muchachos con la Accià ³n Diferida aprobada (DACA, por sus siglas en inglà ©s) pueden obtener la licencia de manejar. Y que hay ciertos beneficios sociales mà ­nimos reconocidos por las leyes federales que se tienen que cumplir, como el acceso a Wic para el caso de bebà ©s, infantes y embarazadas o la asistencia en clà ­nicas comunitarias e incluso en ER de hospitales en los casos de peligro para la vida. Este artà ­culo es informativo. No es asistencia legal para ningà ºn caso concreto.

Play Review - Alls Well That Ends Well essays

Play Review - All's Well That Ends Well essays I saw the play "All's Well That Ends Well" at the Chicago Shakespeare Theatre. The theater space was a three-quarters thrust and the theater was intimate allowing anyone to see just about anyone else in the theater. The seating also allowed everyone no matter where you sat to get an up-close view of the action. Barbara Gaines who is a regular at the Chicago Shakespeare Theatre directed the play. his theater experience was very great for me, as I have seen very few plays before. To start off, the parts of the play I believed were strong was the year the director decided to have the play take place in. In the 1860s, the outfits they wore were absolutely stunning. The women and men all looked very good and the distinguishment between the upper class and lower classes could be seen very well. Another nice asset about the 1860s is that the way the women were treated was much like the way they were treated in Shakespeare's time. Another strong point of the play was the little use of props. The place they were at was easily distinguishable thanks to lights shining on the floor and the few sets that were used. I believe big, elaborate sets get in the way of the acting and action. The best performances are the ones that are clear and use little props. The play accomplished just that. There was, however, one prop I did not like. They draped the floor at one point with this nasty 3-color sheet. I believe that was not necessary because I could stop staring at it and thinking how ugly it was. The production made me feel a bit different than I thought I was going to feel. At first, the play was slow, but the end was absolutely wonderful. The productions started with a great representation of how Helena and Bertram felt towards each other. It could be seen that Helena was extremely in love and Bertram did not want to marry Helena because he was not in love at all. In the end however I got a different impression than I did in the writings. ...

Assignment. Production Methods Assignment Example | Topics and Well Written Essays - 750 words

. Production Methods - Assignment Example Shaping occurs through stitching darts, which are essentially dimples that intermittently signal lower quality. Pressing darts are another type of dart used for panels, which ensure the precision of spacing and grain significance (Assembly and Finishing 54). c. Piece - During production, garments are made essentially by putting together pieces in a particular order. These pieces are major parts of subassemblies completed by joining parts during the panel phase. Examples of pieces in garment production are the front and back of an individual garment (Assembly and Finishing 55). Joining these two pieces to make the final clothing. The final clothing is the product. d. Product - This is the finished garment. A product is the ultimate outcome of the garment production process. A summary of this process is the addition of these four Ps in a sequence or equation, i.e. parts + panels=pieces and pieces + pieces=products (Assembly and Finishing 56). The four Ps are mostly vital to the sizing and fit of the product, meaning faults during any phase can affect the finished garment. 2. The system of assembly that I think works best in today’s world is PBS since it itemizes production steps into a set of separate activities. Many garment production houses today need separate machines carrying out separate functions, at different times. With the PBS, every sewing machinist has to be skilled in the appropriate strategy to a particular task (OECD 44). Garment manufacturers today seek to make the most of the output of both dedicated machinery and individual operators, which is a merit that PBS users indeed enjoy. Even though many garment assembly units use the PBS, combining them with the Modular Production System (MPS) and Unit Production System (UPS) is proving successful and cost saving. PBS users often have to deal with obstacles caused by absenteeism or varying outputs amongst operators and workers. MPS and UPS users often do not have to come

The position of infrared in the world of photography Essay

The position of infrared in the world of photography - Essay Example Therefore, it is the focus of this essay to answer what extent is infrared photography an artistic endeavor? Specifically, to investigate the extent that photography is a central aspect of the artistic message or a gimmick used to enhance the photograph without artistic merit. Infrared photography emerged in the early 1900s as the Royal Photographic Society published the first infrared photographs in October 1910. The development of infrared film was actually done by the US government during World War I to improve haze penetration in aerial and night photography. Scientifically, infrared films capture the part of the spectrum that is beyond our visibility, called infrared light. The diagram shows the electromagnetic spectrum, infrared has a higher wavelength than visible light. The Electromagnetic Spectrum. (n.d.). Retrieved from http://www.antonine-education.co.uk/physics_gcse/Unit_1/Topic_5/em_spectrum.jpg The wavelength of infrared photography begins at 700 nanometers and ends at around 1000 nanometers, with visible light only between 390 to 740 nanometers of wavelength. This characteristic gives it the ability to capture images in the dark and create unique photographic effects and colors. Infrared photography really took off commercially in 1930, when the first infrared films were introduced and soon became very popular. Through time, infrared photograph established its irreplaceable place among the various styles of art photography and has continued its journey into the digital age. In investigating the research question, one of the greatest challenges is establishing a working definition of art. Philosophic investigations into the nature of art date to at least Greek antiquity, with Aristotle’s Poetics advancing the notion of mimesis as the central tenant of the art object. With social and technological progress came a change in the nature of artistic expression, such that during the Renaissance and Enlightenment periods the role of the artist cha nged from one of a craftsman to a Romantic notion of the artist as intellectual or genius. The 20th century experienced a shift from the Modernist to Post-Modernist era and witnessed revolutionary changes in the nature of art. Influenced by the scientific discoveries of Albert Einstein and Sigmund Freud, artists such as Pablo Picasso and Salvador Dali used art to explore these new intellectual paradigms of reality; Marcel Duchamp would even call into question the very nature of the art object. It is in this contemporary context that the notion of photography as art emerges. Perhaps the most seminal theorist in this regard was Susan Sontag, who in works such as Against Interpretation and On Photography formulated a number of aesthetic principles. Sontag argued that the nature of art is to capture that which is magical or irrational, and that art must be understood in terms of not only its meaning making content, but along with its formal elements as a comprehensive whole. While such a mode of understanding resists easy definition, for the context of this essay art is defined as the arrangement of formal style with content in a way to enact meaning through affecting the senses or emotions. Artistic photography affects the senses or emotions by selectively presenting aspects of our surroundings or objects in photographic form. Conversely, a gimmick is popularly understood as â€Å"a unique or quirky special feature that makes something "stand out" from its contemporaries.† 1 In the case of photography, gimmick is simply the employment of a feature or effect to enhance the picture. While gimmicks meet the formal criteria, they lack the necessary elements of intention and meaning to be considered