Evidence-Based Practice on Diabetes and Orthopedics

Diabetes and Orthopedics Abstract Orthopedics refers to the medical field focusing on diseases/ailments and injuries affecting a human musculoskeletal system. As such, this system is composed of skeletal joints, bones, tendons, ligaments, nerves, and muscles critical for daily bodily functions. Initial procedural measures were primarily focused on children, who, unfortunately, were victims of limb or spine deformities. However, with time, the field encompassed the general care of patients of all age groups, from newborns to the old. Newborns could suffer from clubfeet requiring surgery (arthroscopic) as a result of injury, while the elderly could be suffering from arthritis. The above move was based on the fact that often, people break or fracture a bone during daily routines, especially as a result of physical activities. Patients with diabetes pose problems to orthopedic treatment due to complications arising from problems emanating from muscular and other joints problems experienced by diabetes patients.

Is Holden Lacks The Maternal Affection That He So...

Psychoanalysis would suggest that Holden lacks the maternal affection that he so desperately desires and fails to receive. Upon reviewing Holden’s behavior it appears as if he is a victim to various disorders such as Bipolar and PTSD disorder. HealthResources.info explains the differences between emotional and psychological trauma and also the possible effects in their article, â€Å"Emotional and Psychological Trauma: Causes and Effects, Symptoms and Treatment. One key factor in that causes traumatic stress is a product of, â€Å"traumatic stress in childhood that influences the brain is caused by a poor or inadequate relationship with a primary caretaker.† It is coherent that Holden’s world of pain is a result of the absence of both his mother†¦show more content†¦I started putting on my damn pants in the dark. I could hardly get them on I was so damn nervous(Salinger 192). This not only ties into his emotions but mostly towards his depression, which can lead to anxiety about the possibility of being abused by others, even if that is not the intention of the attacker. According to Healthline.com their article, What is Psychosis? written by Elea Carey, implies that those who experience symptoms can have their social relationships strained and experience high levels of anxiety, When their mood is depressed, the individual may have psychotic symptoms that make them feel angry, sad, or frightened. These symptoms include thinking someone is trying to harm them. Holden has a purpose in life that he wants to complete and follow through with, primarily because of his brother Allie s death, and does not any other kids to lose their innocence. The mayoclinic.org elaborates on what effects a person that suffers from the Bipolar disorder can experience in Bipolar disorder written by their clinic staff, When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. In Holden s mind, there is nothin g else to live for regarding his life, other than saving the children because his brother s death sucked all the life out of him and left him lifeless with direction. He strives to be the guardian of innocence, to prevent kids

Projects Customer Relationship Management and Customers

â€Å"EFFECTIVENESS OF CUSTOMER RELATIONSHIP MANAGEMENT PROGRAMME IN STATE BANK OF INDIA† Submitted In The Partial Fulfillment Of Degree Of MBA Batch 2006-08 SUBMITTED TO: - SUBMITTED BY:- Mrs. Riya Sharma Rishi Gupta (Project Guide) Roll no. 0471483906 [pic] MAHARAJA AGRASEN INSTITUE OF TECHNOLOGY PSP AREA, SECTOR-22 ROHINI, DELHI—110085 Ph: 25489493- WHOM SO EVER IT MAY CONCERN This is to certify that the project on â€Å"EFFECTIVENESS OF CUSTOMER RELATIONSHIP MANAGEMENT PROGRAMME IN STATE BANK OF INDIA† carried out by Rishi Gupta S/o Sh. Manmohan Lal, under my guidance is an original research†¦show more content†¦People who are using the services of other banks are generally attracted with the highly efficient staff and services like InstaAlert etc. Majority of the people prefer to open their accounts in SBI Bank because of their wide network and tie up with other bank’s branches and companies. Though it is in the mind of the people that public sector banks don’t give the best service but my project result is totally opposite to this. The survey shows that 88% customers are fully satisfied with the bank’s performance and their dealings. But the other side that come into light while this study is that some customers are also not satisfied with the dealings of the bank because of some reasons and Bank has to take correcti ve measures. CHAPTER-2 Objective Of The Study Scope As we know that the customer is regarded as The King. Customers are the lifelines of the business. No business can be done without them. But in the competitive market, you can get the customer but the more difficult is to retain the customers, and this can only de done if we satisfy customers from head to toe. If we will not satisfy the customers then they will leave our organization and join other. 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Reflective free essay sample

Phenomenon Causal Context Clarifying Describe the here and now experience What essential factors contributed to this experience? What are the significant background factors to this experience? What are the key processes for Reflection in this experience? 2. Reflection 2. 1. What was I trying to achieve? 2. 2. Why did I intervene as I did? 2. 3. What were the consequences of my actions for: †¢ myself? †¢ the patient/family? †¢ the people I work with? . 4. How did I feel about this experience when it was happening? 2. 5. How did the patient feel about it? 2. 6. How do I know how the patient felt about it? 3. Influencing factors 3. 1. What internal factors influenced my decision making? 3. 2. What external factors influenced my decision making? 3. 3. What sources of knowledge did/should have influenced my decision making? 4. Could I have dealt better with the situation? 4. 1. What other choices did I have? 4. 2. What would be the consequences of these choices? 5. Learning 5. 1. How do I now feel about this experience? 5. 2. How have I made sense of this experience in the light of past experience and future practice? 5. 3. How has this experience changed my ways of knowing: †¢ †¢ †¢ †¢ empirics? aesthetics? ethics? personal? (Taken from â€Å"Centre for Health Education† info RD+E(H) April 02) The Reflective Process — Analysing Learning from Experience 1. Gather the Information †¢ †¢ †¢ Describe the incident Explain the context Take any relevant clarifying statements from others involved 2. The Reflection †¢ †¢ †¢ †¢ †¢ †¢ What was I trying to achieve? What were the consequences of my action for the patient, for my colleagues, for me? What do I feel about it? What has been the effect on my colleagues? What factors/previous knowledge may have influenced me? What alternative action could I have taken? 3. The Learning Process †¢ †¢ †¢ †¢ †¢ †¢ How do I feel now? Could I have acted differently? What have I learnt? How will that influence my future practice? What has the incident taught me about my values and/or my belief system? What ethical principles were involved? Once you have completed the process, it would be valuable to evaluate it again, with a colleague or with a professional mentor to clarify the main issues, the learning involved and the impact on your practice. CHIRS WHITEHEAD Professional Development Co-ordinator February 1994 (Taken from â€Å"Centre for Health Education† info RD+E(H) April 02) (More examples of reflective writing formats) Reflection on Practice Date: 3rd Feb 1995 A 50 year old man with CA lung who was not expected to live much longer was smoking in his room with oxygen. The Consultant had just visited him and told him that he could continue to smoke in his room. The gentleman was unsafe to be left as every time he took a puff on the cigarette he collapsed and he still had the oxygen running through a nasal cannulae. Description of the experience I expressed my concerns to the Consultant, my concerns being: †¢ There was piped oxygen in the room and there was a high risk that it may ignite. †¢ There was a risk to the patient that he may set light to himself or the bed when he collapsed. †¢ There were babies below. †¢ There was not enough staff on duty to free someone up to sit with him whilst he smoked. Once the Consultant had left the ward I took away the cigarettes and lighter and said that we would be back every hour to allow him to smoke. The gentleman did not like this and started calling out and shouting continuously for a lighted cigarette. My decision was to only allow one cigarette an hour as I could only free up a Nurse to sit with him for this period of time. To turn the oxygen supply off whilst the gentleman had the cigarette and to keep the cigarettes in case he tried to light up whilst there was no one around. What other actions could I have taken? †¢ Allowed him to smoke with the oxygen on and without a Nurse present and allowed him to get on with it. The consequence would have been that he may have collapsed without my knowledge and died/caught light to himself. †¢ Not to have allowed him to smoke at all taking the cigarettes away from him. The consequence would have been an angry uptight man shouting at the top of his voice until I relented or he wore himself out, causing distress to himself and the other patients on the ward. How did I feel at the time? †¢ Frustrated that the Consultant put me in such a position and did not seem to think of the consequences. †¢ Annoyed that my concerns were washed over when I was accountable for that shift. †¢ Powerless to do much about this situation. †¢ Determined that whatever I did, I was doing it for the right reasons and had thought about every possible avenue. What I have learnt from this experience? That you have to act as you see fit when faced with a situation as this one. †¢ That you have to take the welfare of the gentleman and others into consideration. †¢ That you cannot always expect backing from your Consultant or Nurse in charge. †¢ That you, have to take a holistic view point and weigh up all the pros and cons. †¢ That you have to stick to your decision if you believe it to be right. Three months later After reflecting on this incident I still believe today that I made the correct decision of only allowing this man to smoke when the oxygen was turned off and a Nurse was present. It caused him some distress and myself a lot of distress but I feel I had an obligation to safeguard the safety of the other patients and babies in the ward and the ward below. The gentleman has since died and I wonder sometimes whether I was too hard, but as they say you can only do what you believe in and work within the confines of the situation, which on reflection I believe I did. (Taken from â€Å"Centre for Health Education† info RD+E(H) April 02) Reflective Log from Teignbridge District Model Name: Date of learning event: Me My experience of the subject prior to the learning experience. Facts How the knowledge was acquired? What was the nature of the experience or event? Explain the subject. An account of what happened without specifying what was learnt. Select the part that is significant and/or important. Feelings What aspect of the event went well? What was not so good? What were my feelings about what happened? What were the feelings of others? Learning What were my desired learning outcomes? Where does it link in or combine with my existing knowledge? What have I learnt from the experience? Conclusions What do I need to do next? How can I put my learning into practice in another situation?