Pediatric Nursing And The Respective Care †MyAssignmenthelp.com

Question: Discuss about the Pediatric Nursing And The Respective Care. Answer: Brief description of the clinical condition of the patient focussing on pathophysiology The current assignment focuses on the areas ofpediatric nursing and the respective care and support services rendered in this area. In this respect, John was an 8 months old child who was admitted to the hospital on account of dehydration. On preliminary investigation it was found that the child had inborn diabetes inspidus, which had become more severe in the long run. The boy was rushed to the hospital by his parents on account of certain symptoms such as the presence of a slight fever from a few days. Additionally, the child had depicted excessive need to urinate along with less energy and a constant lethargy. Diabetes Inspidus (DI) is a rare disease with a presence of 1 in 25 people and has debilitating effects (Bultas et al. 2014). It is also known as water diabetes and results in recurrent loss of fluid from the body. The disease is supposed to be caused by either less or an absolute lack of anti-diuretic hormone (ADH), which leads to an inability in concentrating the urine. As commented by de Cassia Sparapani et al. (2015), the blood serum is often raised to a concentration greater than 295milliOsmol/kg which can result in a constant feeling of dizziness and lethargy. The treatment of the disorder is mainly aimed at reducing the loss of water from the body and increasing the activity of the anti-dieuretic hormone (ADH) (Hanta et al. 2015). In most of the cases desmopressin, which is an analog of ADH is administered in the patients. However, for understanding the pathophysiological condition of the patient there is a need to undertake assessment tests and measures. The primary tests should begin with the assessment of the hydration status of the patient. The blood plasma concentration of the patient would help in confirming or ruling out the presence of hypernatria in the patient (excessive presence of sodium in the blood). Additionally, the patient history should also be considered for the presence of recurrent urinary tract infections. The loss of water and excessive salt deposition promote further growth of the opportunistic pathogens such as B.coli, which cause urinary tract infections (UTI) in children and adult. The diabetes inspidus could be further divided into three main types such as central, nephrogenic and primary polydypsia. It is necessary that the clinical conditions associated with each is understood first in order to design an effective treatment and care plan. The two main types of Di are mainly central and nephreogenic. In central DI, the vasopressin synthesis is impaired. In nephrrogenic response the renal tubule response to vasopressin is also impaired. The child here was seen to be suffering from a central dibetes inspidus. Rationale for the fluid management plan It is necessary to design an effective fluid management plan for the effective care of the patient. In this respect, the age of the child is a governing factor in deciding the dosage of the medicine. The symptomatic expression of the disease is different in the infants compared to the elder children (Al Nofal and Lteif 2015). In this respect, John depicted recurrent episodes of fever, vomiting along with excessive crying and irritability. Since, John is an infant who is less than two years old; therefore before the administration of an alternate medication his condition should be discussed with an endocrinologist. In this respect, desmopressin administration is one of the most plausible methods of controlling the fluid balance in the children. It acts on the distal tubules and the collecting ducts of the kidney by increasing water absorptions. It is provided as an intranasal solution to the children by dissolving 100 micrograms in one ml. However, for the treatment of the condition o f children below two years of age dose is usually 2-5 micrograms per ml. The hydration assessment depicted that John had hypernatria and therefore he was put under hypo-osmolar intravenous fluid. This would help in restoring the concentration of water in the blood serum of the patient a restore the normal well being in the patient by removing the feeling of dizziness. Nursing management strategies important to patient care It is important to design effective nursing management strategies for the utmost care of the patient. As commented by Hill et al. ( 2017), the post administration follow up is crucial for maintaining the health of the patient in the long run. However, lack of time and knowledge often deter the parents from taking their child to the nearby hospitals. Additionally, the idea that administration of home-made electrolyte solution is sufficient for management of the fluid imbalance in the child is wrong. This is because only after a proper blood examination the condition of hypernatria can be confirmed within the child. Depending upon the osmolarity of the blood the child should be put under further electrolyte administration. As commented by Jakubik et al. (2017), the lack of expert supervision can further deteriorate the condition of the patient. Thenursing priority which should be undertaken for managing the condition of John over here is maintaining a healthy electrolyte balance. Therefore, thenursing professional attending to the care concern of John need to develop a plan of action for maintaining the electrolyte balance in accordance with expert opinions of the nephrologists and endocrinologist. The administration of sterile water with dextrose would be undertaken for maintaining the electrolyte balance in the child. The serum sodium of the child needs to be monitored against 24 hours urinary volume specific gravity. A clear instruction should be given to the parents to avoid the administration of foods and liquids to the child that promotes dieresis. The parents should be given clear indications regarding the management of the medications of the child. In this respect, a blood test will be conducted by the healthcare professionals for accessing the condition of hypernatria in John on a quarterly basis. Additionally, pos t-hospitalization follow up for the patient very 6-12 months can help in managing the long term condition and health of the patient. The nursing professionals could personally follow up after the clinical condition of the patient by paying home visits to the patients after discharge from the hospital. Additionally, record keeping can also help in keeping a track of the clinical conditions of the patients (Djermane et al. 2016). The data could be referred to in times of need for designing of an effective support care plan for the patient. Additionally, maintaining an electronic health based data can also help in getting helpful referrals for the condition management of the child. References Al Nofal, A. and Lteif, A., 2015. Thiazide diuretics in the management of young children with central diabetes insipidus.The Journal of pediatrics,167(3), pp.658-661. Bultas, M.W., Hassler, M., Ercole, P.M. and Rea, G., 2014. Effectiveness of high-fidelity simulation for pediatric staff nurse education. Pediatric Nursing,40(1), p.27. de Cssia Sparapani, V., Jacob, E. and Nascimento, L.C., 2015. What is it like to be a child with type 1 diabetes mellitus?.Pediatric nursing,41(1), p.17. Djermane, A., Elmaleh, M., Simon, D., Poidvin, A., Carel, J.C. and Lger, J., 2016. Central diabetes insipidus in infancy with or without hypothalamic adipsic hypernatremia syndrome: early identification and outcome.The Journal of Clinical Endocrinology Metabolism,101(2), pp.635-643. Djermane, A., Elmaleh, M., Simon, D., Poidvin, A., Carel, J.C. and Lger, J., 2016. Central diabetes insipidus in infancy with or without hypothalamic adipsic hypernatremia syndrome: early identification and outcome.The Journal of Clinical Endocrinology Metabolism,101(2), pp.635-643. Hanta, D., Trer, B., Temiz, F., K?l?da?, H., Gke, M. and Erdo?an, ., 2015. Idiopathic central diabetes insipidus presenting in a very low birth weight infant successfully managed with lyophilized sublingual desmopressin.J Pediatr,57, pp.90-93. Hill, C., Knafl, K.A. and Santacroce, S.J., 2017. Family-Centered Care From the Perspective of Parents of Children Cared for in a Pediatric Intensive Care Unit: An Integrative Review.Journal of pediatric nursing, pp. 55-85. Jakubik, L.D., Eliades, A.B. and Weese, M.M., 2016. Part 1: An overview of mentoring practices and mentoring benefits.Pediatric nursing,42(1), p.37.

10 Things Hiring Managers Wish You Knew When Applying For Jobs

10 Things Hiring Managers Wish You Knew When Applying For Jobs There is a lot of advice about how to interview out there. But the people we should really be asking for advice about the interview process are the people who conduct those interviews- the hiring managers. Here are the 10 things hiring managers wish you knew. Make their jobs easy, and you just might get the job.1. Be early, but not too earlyWhatever you do, do not be late. That said, if you show up 30-45 minutes early, you could really distract or annoy the hiring manager, who might have better things to do and not want to interview you on the fly. If you end up at the office with this much time to spare, grab a coffee or do some last minute prep on your own before going in. Aim to be 10-15 minutes early. Most hiring managers agree that is the sweet spot.2. Don’t apply unqualifiedIf you don’t meet 85% or more of what the job description says they’re looking for, don’t bother interviewing. The hiring manager will just feel like you are wasting his time. Mak e sure you meet the minimum requirements (and that you go a few steps beyond as well) before going in for an interview. You don’t have to be perfect or overqualified, just not obviously underqualified.3. Do your homeworkToo many applicants head into the interview room without doing research into the company, their potential manager, or their role in the industry at large. Don’t fall victim to this laziness.Do your homework! Look up specifics! Familiarize yourself with the company’s workings, their numbers, and their day-to-day operations. This will impress the interviewer and give you plenty of topics about which to converse. Don’t go in the room until you feel comfortable reciting in one sentence what the company does and why. Internalize the narrative and tailor your answers to emphasize how well you understand what they are looking for.4. Treat it like a first dateInterviews can be a bit like speed dating, and that’s okay. It’s your chanc e to see whether the company would be a good fit for you, and their chance to see whether you’d be a good fit for their culture. Chances are, if you got the interview, you’re already a technical fit given your qualifications and experience. You’re in the room to get to know each other. Treat it like a date; don’t talk too much about yourself. Ask questions. Listen. Be respectful, but also make sure to show off your best traits.5. Bring questionsPart of doing your homework is coming armed with questions. You will be asked. Make sure you don’t get caught without a good one. Think of what you’re curious about that you weren’t able to find online or on the company’s website. When in doubt, ask about some of the specifics for the position you’d be filling, or potential growth opportunities within the company.6. Lead with your software skillsBefore you even show up for the interview, you need to convince the hiring manager tha t you have the skills necessary to be qualified in the first place. If you don’t already have a list of all the software programs in which you are proficient, put that in immediately. If they see that you’re a rockstar with the one program they use most, you’re almost guaranteed to get an interview.7. Don’t lieIf you lie, either on your resume or during the interview, you will almost certainly get caught. Resumes and references are checked. Fluffing yourself up a little is a human tendency; a little spin on your accomplishments in one position might be justified. Just don’t bend the actual truth. And be prepared to prove yourself.8. Say thank youThere is no excuse for not sending an immediate, handwritten thank you note. Or at very least, a thank you email.9.  Be patientNothing is likely to get you bumped out of the running more than constantly badgering the hiring manager about when the decision will be made. Ask for a timeframe for decision-mak ing when you’re in the room, then don’t make a peep until a day or two beyond that. A short, respectful follow-up email will do. And if you don’t hear back? You didn’t get the job.10. Know that hiring managers are people tooPut yourself in your hiring manager’s shoes for a second. They see dozens of people. It’s your job to make their job easier, and to make yourself memorable. It’s also your job to ask the questions you need answered; don’t just assume this information will be handed to you.Imagine meeting with a person who has been looking at three hundred similar resumes for the same position. Try to dazzle them. They’ll thank you for it, even if you don’t get this particular job. And it’s a great skill to learn for next time.

Paper Editing Help

Paper Editing Help Paper Editing Help Paper Editing Help The first draft of your research paper is likely to be in need of editing, especially if you have let your ideas flow from paragraph to paragraph. Editing is your real opportunity to give your English research paper shape and emphasis. You will have little idea of the final shape of the final draft unless you read through the draft with an intention to edit it. Editing your writing is often a matter of emphasizing one part or one argument more than others. You will need to push some parts of your research paper into the background and pull others forward in the process of paper editing.  Not every college work lends itself to editing treatment; however, all research papers that have no impact are usually those which most resemble a list of points. Papers lacking shape flow one section to another giving equal emphasis to each part so that the impression given is that the paper could go on for ever. These papers need editing help. Paper Editing Tips The below checklist of questions for editing a research paper might look like this: Does description form part of a discussion or analysis? Are quotations linked with comment? What is the main point? (Try writing it in two sentences.) What evidence do you use to substantiate your viewpoint? Is there adequate justification for statements? Can some issues be pulled into the foreground? Is there sufficient interpretation/analysis? Is the choice of material biased? Do all paragraphs deal with one main idea? Do they link together? Are they relevant to the title? Do the points made lead to a logical conclusion? Are there any grammar, spelling, or punctuation mistakes? Research paper editing is not always a matter of erasing the text. While editing you should add explanation and justification to give your college work emphasis. While editing paper you will also check the relevancy of material. The most important editing task is to apply something similar to a 'DNA genetic test'. While editing, imagine that every paragraph carries its own genetic material derived from the work title. Editing help provided by is of high quality.   We will perfect your paper and make it perfect!   Your tutor will be impressed with relevancy of information and logical formatting. Not every doctor is gifted and not every student is able to edit his writing.   We offer an affordable solution - paper editing help.

China and globalzation Essay Example | Topics and Well Written Essays - 4000 words

China and globalzation - Essay Example The internet has also led to the inevitable diversification of social, cultural, political as well as economic practices due to the high permeability of national as well as regional frontiers, which implies that decisions as well as practices in one part of the world has global consequences. Evidently, the internet and the prevalent internet technologies have inevitably opened up channels of communication, choice, while unquestionably promoting greater participation of the public in the ever growing era of globalization (MacKinnon 2008, p.31). For instance, the internet and its allied technologies have greatly impacted and shaped the development of the global public opinion concerning the U.S. throughout Asia, Western Europe, as well as in the Middle East while at the same time enabling democratization of nations by allowing their citizens to voice their own opinions concerning public policy. The spread of the internet and the rapid flows of information in China has suddenly become a critical challenge for policy makers since it can no longer be regulated effectively; precisely, the major concern of the Chinese government over the increased prevalence of the internet is that it threatens the conventional forms of information such as China’s state-controlled media . According to the Chinese Academy of Social Sciences, nearly 67.5% of Chinese internet users have more confidence in the utility of the internet for criticizing the government than they do in the traditional forums like the state controlled media, which is subject to excessive censoring. Chinese internet users are able to circumvent the strict control barriers of access to the internet through the help of western companies such as Safeweb, which provide untraceable internet hosting, thereby accessing banned sites such as CNN; Human Rights bodies are also increasingly using internet circumvention technologies to bypass internet censoring (Maitland,

HRIS Essay Example | Topics and Well Written Essays - 3250 words

HRIS - Essay Example This resulted in inconsistent outcomes and the cost of the human resource was also increased to a great extent. Consequently, the manager is desperate to find out appropriate solutions to overcome these issues due to which he is looking for different vendors that would make things better within the organization. There were basically two choices of vendors that could work well for this business. It includes; the pro staff files and the Auxillian West Human Resource Software. The pro staff files works well for huge organization like Castle’s Family Restaurant whereas the HRnet source is applicable on the small or mid-size organizations. As far as my opinion is concerned I prefer that Mr. Morgan selects the pro staff files as this a high profile business. Knowing the fact that the HRnet could only be used for smaller organizations it is likely to be disqualified. Henceforth, this is a time where Mr. Morgan should lead form the from the front and take a decision that should make things better and produce consistent and efficient results along with creating a diverse environment within the workplace. One thing that plays a significant role for an organization to be successful is its well organized Human Resource Department. The Human Resource Department can either make or break the organization. It helps to operate the business smoothly along with improving the information and technology processes. With the rapid advancements in the technology it is essential for any organization to maximize their focus on the technology and produce effective results. It has been witnessed that the introduction of Human Resource Information System obliged to set up a computerized system rather than depending much on manual work. Castle’s Family Restaurant has also decided to maintain a HRIS in order to create diversity within the workplace. However, this was not very easy as the company had to go

Working Together to Safeguard Children | Policy Analysis

Working Together to Safeguard Children | Policy Analysis This paper will consider the impact of the â€Å"Working Together To Safeguard Children† child protection policy on the clinical practice of the nursing profession in a general community clinic. The current legislative framework for child protection will be considered with regard to the 1989 Children’s Act, with special reference to the obligations of health professionals working with vulnerable children and their families. Research evidence on the role of nurses in the detection of child abuse will be considered. Furthermore, the paper will discuss the implications of developing existing general practice child protection procedures to include a more active and explicit role for child protection by medical and nursing staff. As Stower (2000) has argued, â€Å"Child protection is the term used by all agencies when there is a suspicion that a child or children (all or some of the children in a family) are at risk of being abused by any adult, family member or non-family member† (p 48). The 1989 Children’s Act was introduced to improve inter-agency cooperation between social services, health and education agencies in the provision of assessment and intervention with vulnerable children. One category of vulnerable children addressed by the legislation were children that have been subject to abuse. The central aim of the 1989 Children’s Act was to emphasis that the welfare of the child is of paramount importance at all times, and that professionals working with vulnerable families should promote cooperation and partnership where-ever possible. It afforded children the right to protection from abuse and the right to have inquiries made about their individual circumstances to safeguard them from harm. The Children’s Act 1989 raised the controversial issue of parental rights, patient confidentiality and a duty of health professionals to protect children and share information with appropriate other agencies with a view to protecting a child. In 1991, Working Together under the Children’s Act was published and it updated guidance on child protection, with an emphasis on different professional groups â€Å"working together† towards the interests of the child. This was replaced by Working Together to Safeguard Children in 1999. This policy document made it very clear that protecting the child was a higher priority than maintaining confidentiality. However, it recommended that parents should be informed when a professional was going to make a referral to social services, unless asking for permission from parents was likely to place the child ‘at risk’ of significant harm. The â€Å"Working Together To Safeguard Children† (WTSC) polic y was based on the legislative framework of the Children’s Act 1989. It outlined the specific roles and responsibilities of community nurses where child protection concerns had been experienced in their clinical practice. It stated that where child abuse was suspected by nursing staff, careful records of parental attitudes and behaviours should be made. This might include reference to the grounds for suspicion, such as a delay in seeking treatment for an injury, unexplained injuries on a child or variation in parental account of how an injury occurred over time, or between parents (Benger and Pearce, 2002). WTSC recommends a non-confrontational, information gathering approach to early investigations of child abuse by community nurses staff, with a strong emphasis on discussing concerns with the child’s GP, who may have detailed knowledge on the circumstances of the child and their family. Where there are concerns that the child maybe at â€Å"at risk of significant ha rm†, nursing and medical staff may contact the social services department to make an official referral. It is standard practice for the GP to make a child protection referral, but â€Å"when there are conflicting opinion, either by medical, managerial or senior colleagues, if the nurse is still convinced that there is a child protection issues, she or he is individually accountable and should refer it to social services† (p 51). However, under the current legislative framework, social services personnel may wish to contact the referral agency for further information on the child’s health and to undertake â€Å"network checks† with all the agencies involved. The GP or nurse maybe invited to an inter-agency strategy meeting attended by social services staff, the police and other relevant staff to discuss their child protection concerns and decide upon a plan of action. Furthermore, the GP or nurse maybe invited to a child protection conference that may lead to the decision to record the child on the Child Protection Register. The Child Protection Register is available to appointed child protection staff within health organisations, to check if a child is known to social services for reasons of emotional, sexual and/ or physical abuse, or neglect (WTSC, 1999). General guidelines on child protection are provided as part of the policy document. It is stated in section 1.13 that â€Å"For those chil dren who are suffering, or at risk of suffering significant harm, joint working is essential, to safeguard the child/ ren and where necessary – to help bring to justice the perpetrators of crimes against children† (p 3). It recommends that health professionals should be vigilant to the possibility of child abuse amongst patients and â€Å"be alert† to the potential risk that abusers â€Å"may pose to children†, and â€Å"share and help to analyse information as that an informed assessment can be made of the child’s needs and circumstances† (p 3). The WTSC policy stated that it was important that every organisation that came into contact with children had a child protection policy in place, but gave little guidance on what the child protection policy should be. It can be argued that the child protection policy should be revised regularly to take into consideration new developments within general practice, such as the introduction of electroni c patient record systems, or change of staff or clinical services. Changes to policy should be undertaken collaboratively between GP’s, nurses and administrative staff that have contact with children. The importance of health care systems in the protection of children has been made clear in recent years, and lead to legislative changes that are presently being implemented as part of the 2004 Children’s Bill. Victoria Climbie died in February 2000 as a result of severe and repeated physical abuse and neglect by her caregivers that amounted to 128 separate physical injuries being recorded at the time of her death. The appauling circumstances of her death trigged a public inquiry, led by Lord Laming (2003), who identified 12 opportunities by health, police and social services agencies to protect this eight year old girl from many months of brutal abuse and neglect. One source of criticism in the Climbie report was directed at the health care system, in particular Accident and Emergency departments, that had misdiagnosed her physical injuries of scratches and bruises as being the result of scabies in June 1999. Social services were not notified of any child abuse concerns by do ctors at this time. In July 1999, Victoria Climbie was readmitted to hospital for treatment of burns, but due to poor communication between health professionals, social services and the police no full assessment of the child was ever made (Hall, 2003). The Lord Laming report recommended that agencies work more closely together, with better training and interagency cooperation to prevent child abuse. As Hall (2003) argues, â€Å"Amid the justifiable horror at the death of Victoria Climbià © and the focus on violent physical abuse, we must not neglect the opportunities for prevention. This too is the responsibility of all who work with children, but in the health service it particularly falls on primary care staff, including midwives, health visitors, school nurses, and on those working with mentally ill adults and drug misusers† (p 294). Lord Lamings recommendations were reflected in the 2004 Children’s Bill that aims to set up a central electronic record for every chi ld in the country that would contain sensitive information on professionals who were involved with them. It is believed that such a system would make it easier for appropriate professionals to make ‘informed judgements’ about the safety of children, based on information gathered from other agencies with an interest in the child. However, the new legislation is controversial because of concerns about civil rights, and the Government are currently in consultation with local education authorities with a view to piloting the electronic record system. In the UK, four types of child abuse are currently recognised under the legislative framework. These can be classified as neglect, physical injury, emotional abuse and sexual abuse. Physical abuse and neglect maybe the most often encountered type of child protection problem in community practice, but it is easy to mistake physical abuse for accidental injury (Breslin and Evans, 2004). The estimated burden of physical child abuse in the UK population is 2.7 children per 1000 per year, according to the NSPCC (Breslin and Evans, 2004). This means that every general practice in the country could include a sizeable minority of families registered with them where physical child abuse is occurring at home. When children attending Accident and Emergency departments for treatment, it is standard practice to send a notification of attendance and reason for attendance to the GP. When medical staff have suspicion of child abuse, a careful examination of the medical records may show that a child has a history of injury. Shrivasta (1988) found that 22 out of 108 children (20.4%) had one or more admission to hospital for non-accidental injuries over the 5 year period of the study. Furthermore, Fryer and Miyoshi (1994) have shown that abused children are ‘at risk’ of being re-abused over a relatively short period of time. In their study, 69.2% of children that suffered from a reoccurrence of abuse, did so within 360 days of the prior abuse event. Furthermore, in their study 9.34% of children were re-abused in the four year period of the study, and the risk of multiple reoccurrences increased after every abuse event. Therefore, it is not possible for health professionals to discount evidence of child abuse as being a ‘one off’ episode that is unlikely to happen again, without a full investigation of the child’s needs. It is possible to check if a child is registered with social services on the Child Protection Register. However, this is a poor measure of risk because only the most serious cases of child abuse will ever be registered, and children rarely stay on the Child Protection Register for more than two years due to current social services policy. Greenfields and Statham (2004) have shown that the decision of health agencies to act on suspicious injuries is affected by knowledge of whether they are registered on the Child Protection Register or not and social/ circumstantial factors related to the child and their family, as opposed to the clinical characteristics of the case. Indeed, a third of child protection register custodians felt that health professionals gained a false sense of security from knowing a child was on the register, and did not intervene as much as where the child was not already known to social services. Research has shown that abused children who live with the perpetrator are sixteen times less likely to receive medical care for their injuries, as opposed to abused children where the perpetrator is not resident (Ezzell, Swenson and Faldowski, 1999). Furthermore, retrospective studies of adults reporting that they were abused as children are much higher than official statistics would suggest (Cawson et al, 2000). This suggests that a considerable degree of child abuse is ‘hidden from view’ and community nurses may be in a unique position to befriend families through the delivery of standard health care, such as immunisation, and be vigilant to child protection issues at this time. Furthermore, since research has shown that children at risk of abuse and neglect may not be registered with a GP (Taylor, 2004), the provision of general health checks such as the cervical smear clinic or diabetic annual review provide an opportunity for nurses to enquire after any children in the home that may not be registered at the practice. As the WTSC policy emphasises inter-agency partnership, it is possible for community nurses to contact duty social workers, health visitors and youth workers to facilitate information exchange about vulnerable young people in the area. This also provides an opportunity for information and training about the respective professional disciplines. Nurses in community settings have a potentially high level of contact with abused children and the opportunity to form ‘trusting relationships’ with children and families (Nayda, 2002). It is necessary to formulate general practice child protection policies that make best use of nursing expertise, and facilitate ‘working together’ ideals within practice between nurses, GP’s and other professionals as much as ‘working together’ with external organisations. This means that any child protection policy should include time at a weekly practice meeting where staff can exchange information about children thought to be ‘at risk’, and discuss best child protection practice. Opportunities for information exchange and inter-agency cooperation in child protection enquiries are particularly important since nurses, in one study, felt that other professionals were keen to ‘pass the buck’ rather than engaging in equal profession al consultation (Nayda, 2002). Furthermore, the nurses in this study suspected child abuse on a regular basis, but only reported it when there were no repercussions of reporting; â€Å"Their concerns were not only for the children and their families but also for themselves. One nurse stated that if her own safety was uncertain she would not report a situation where a child was at risk. However, most were concerned about the consequences of reporting for the family† (p 172). Furthermore, the decision to report about child abuse was partly informed by past experience of dealing with the child protection welfare system. As such, â€Å"some of the nurses did not report all cases of suspected abuse, knowing that reporting their suspicions did not necessarily result in action† (p 176). The nurses reported that they were reluctant to report families for child abuse because they felt it destroyed the relationship that they had developed with the families, and reporting child a buse was very much identified as a last resort when all other intervention options had failed. Through this study, it is clear that the ‘ideological’ values underpinning the WTSC policy may not be applied in practice due to difficulties contacting other professionals, and personal confidence and sense of security when making a decision about child protection. As Stower (1999) argues, there is some confusion amongst the nursing profession about their responsibilities under the Children’s Act 1989. The area of parental responsibility is not clearly defined in the legislation, and the term ‘at risk of significant harm’ is open to subjective interpretation. However, Stower (1999) suggests â€Å"This will depend on the degree of the type of abuse, the effect on the child and the circumstances surrounding the event. It must be remembered that single bruises in certain circumstances, for example, a disabled child or very young baby, could be significant an d should not be disregarded† (p 49) In conclusion, research has shown that child abuse is a common problem and one that nurses may encounter as part of their clinical practice. Research shows that community nurses are in a good position to build relationships with families, and to detect child abuse as part of their routine health screening duties. Furthermore, the new child protection policies insist that nurses report child protection concerns, and exchange information with other relevant agencies. However, in a Scottish study of training and supervision in child protection for nurses, it was observed that there was a lack of uniform availability of training opportunities; a situation aggravated by a professional resistance to clinical supervision by nurses who ‘avoided it like the plague’ and a resistance to child protection training that was perceived as not relevant to some nurses practice. â€Å"However, it is important to recognise that supervisors of these nurses may have little or no expertise in child protection issues, therefore the ability to access a specialist child protection worker in relation to specific pieces of work may be critical† (Lister and Crisp, 2005, p 67). Therefore, effective training and clinical supervision programmes, that meet nurses’ needs, may be central to their increased involvement in child protection screening and referral in general practice. References Benger J and Pearce A (2002) Quality improvement report: Simple intervention to improve detection of child abuse in emergency departments. BMJ 324, pp 780 – 782 Breslin R and Evans H (2004) Key child protection statistics. Retrived from: http://www.nspcc.org.uk/inform/Statistics/KeyCPstats/1.asp : 16th June 2005 Cawson P, Wattam C, Brooker S and Kelly G (2000) Child maltreatment in the United Kingdom (NSPCC, London) Department of Health (1999) Working Together to Safeguard Children (HMSO, London) Ezzell C, Swenson C, Faldowski R (1999) Child, family and case characteristics. Child and Family Studies 8.3 (pp 271- 284) Fluke J; Yuan Y; Edwards M (2005) Recurrence of maltreatment. Child Abuse Neglect 23.7 (pp 633 – 650) Greenfields M and Statham J (2004) The use of child protection registers (Thomas Coran Research Unit, Institute of Education) Hall D (2003) Child protection. BMJ 326: 293 – 294 Keshavarz R, Kawashima R and Low C (2002) Child abuse and neglect presentations to a pediatric emergency department. Journal of Emergency Medicine 23.4, pp 341-345 Lister P and Crisp B (2005) Clinical supervision in child protection for community nurses. Child Abuse Review 14, pp 57 – 72 Lord Laming (2003). Inquiry into the death of Victoria Climbià ©. London: Stationery Office, 2003. Retrieved from: www.victoria-climbie-inquiry.org.uk :18 June 2005 Nayda (2003) Influences on Registered Nurses’ decision making in cases of suspected child abuse. Child abuse review 11, pp 168 – 178 Prescott A, Bank L, Reid J, Knutson J, Burraston B and Eddy J (2000) The veridicality of punitive childhood experiences reported by adolescents and young adults. Child Abuse Neglect 24.3, pp 411-423 Shrivastava R (1988) Non-accidental injuries (Unpublished thesis at University of Liverpool) Stower S (2000) The principles and practice of child protection. Nursing Standard 14, pp 48 55 Taylor (2004) Integrating community child health and hospital information for communication and early warning (Royal Free Hospital Report, London) The Children’s Act 1989 http://www.opsi.gov.uk/acts/acts1989/Ukpga_19890041_en_1.htm

Nicotine as a Means for Weight Control Essay -- Smoking Tobacco Diet P

Nicotine as a Means for Weight Control: Tobacco drieth the brain, dimmeth the sight, vitiateth the smell, hurteth the stomach, destroyeth the concoction, disturbeth the humours and spirits, corrupteth the breath, induceth a trembling of the limbs, exsiccateth the windpipe, lungs, and liver, annoyeth the milt, scorcheth the heart, and causeth the blood to be adjusted." Tobias Venner Via pecta ad vitam Longam, 1693 (Fielding, 1992) Introduction: Since around the 1950's-60's, smoking has been a target of attack for the scientific community and rightly so. Smoking, as well as other forms of tobacco use, has been proven to be linked with serious health problems and diseases such as lung cancer and emphysema. Research has become so extensive that actual causal and not simply correlational relationships have been proven. Yet, smoking remains the number one preventable cause of premature death and disability in theunited States (390,000 death per year.) (gopher:flminerva.acc.Virginia:70/00/p ... ubstancetfacts/substance/drucl/tobacco.txt.) So after all the negative evidence of smoking and other uses of tobacco products, why do people insist on continuing? The presence of a substance called nicotine partly answers this question, Nicotine effects in tobacco products are associated with addiction, tolerance, and motivation reasons for use. One motivation less focused on but none the less very important is the use of nicotine as an ap petite suppressant. Many people, especially young women, associate nicotine with weight loss and dietary control. Two questions arise: Is the claim that nicotine as a means to control weight grounded in factual evidence, or rather the product of an image portrayed by the tobacco industry?... ...nce Abuse, 5, 391-400. Richmond RL- Kehoe L-, & Webster IW. Weight change after smoking cessation in general practice. Medical Journal of Australia, 158, 821-2. Schwid SR., Hirvonen MD., & Keesey 13E. (1992). Nicotine effects on body weight a regulatory perspective. American Journal of Clinical Nutrition, 55, 878-84. Seah Mi., Raygada M., & Grunberg NE. (1994). Effects of nicotine on body weight and plasma insulin in female and male rats. Life Sciences. 55, 925-31. Winders SE., Dykstra T., Coday MC., Amos JC., Wilson MR>, & Wilkins DR. Use of phenylpropanolamine to reduce nicotine cessation induced weight gain in rats. Psychopharmacology, 108, 501-6. Winders SE., Wilkins DR. 2d, Rushing PA., & Dean JE. (1993) Effects of nicotine cycling on weight loss and regain in male rats. Pharmacology, Biochemistry & Behavior, 46, 209-13.