A Woman’s Place and a Man’s Duty Essay Example for Free

A Womans Place and a Mans Duty EssayThe author Maria Del Carmen Triana explains the vast difference between the wage income gap over the years between men and women, and how it plays an important role in todays competitive society. grammatical sex activity income gaps have become a hot debate topic for many. Gender income gaps can require a marriage and family as well as cause friction in the work billet. Sexual discrimination also plays an important role in Gender income gaps as well. In most Corporate and fair Collar vocations, stereotypes and wage earner status have an effect on men and women. Triana explains what she calls home related spillover discrimination which is, women being primary wage earners in households.Triana also goes on to explain that a major(ip) wage difference between men and women could be a new form of sexual discrimination. Because this is wiz of the first studies try outing stereotyping roles, it can only be an assumption. According to Triana, research in the work place are being penalized thru wage earning for gender role playing. (Dipboye 1985 Heilman 1983). Triana Proposes that the idea of what maidenlike and masculine behavior in the work place should be can actually work against the female primary wage earner. She feels that this gender behavior could influence people to under- award the female to keep them from succeeding too far leading of their husbands.Gender Deviance and Household WorkIn this article about Gender Roles, Daniel Schneider reports that couples spending a substantial amount on housework such as repairs around the house, shopping, cooking and cleaning could be defined as Gender Work. Housework was once referred to as a Womans job. Studies show that men are stepping into the position to help in the home and watch the children trance the mother fulfills her job requirements in Corporate America. The author claims that predictions have been focusing on wives that earn more than their husbands, which stereotype the pillage winner as normality. The author refers to this as Gender Deviance.According to his research, married couples have been known to negate the gender deviance by dividing the work load at home. An example of this would be men serve dishes, folding cloths cooking and cleaning, while providing less income and women working long hours at work to provide the absolute majority of the income for the family. Schneider also argues that what men and women do in the job market may very well affect household work and hours. Schneider goes on to state that men who work in occupations stereotyped to be feminine could be seen as a form of gender deviance as well.Schneider uses data gathered from the subject field Survey of Families and Households (NSFH2) to conduct his research. He goes on to explain that gender deviance is the product of affable demeanor of some sort, and that if women did not gender themselves some actions would not make any sense. Over a achievement of time women have reduced the amount of time spent on housework and plusd social activities with the kids to help balance of a parent being absent from school events. Studies also show an increase in the men actively participating in parent/teacher conferences and after school practices while the women are in the work force.ReferencesSchneider D. Gender deviance and household work the role of occupation. American daybook of Sociology, January 2012 117(4) (p. 1029-1072.)Triana C. del M. (2011). A womans place and a mans duty how gender role incongruence in ones family life can firmness of purpose in home-related spillover discrimination at work. Journal of Business and Psychology, 26(1), (p. 71-86.)

Annotated Bibliography Essay Example for Free

Annotated Bibliography EssayJuleen K. Buser, daybook of Multicultural Counseling and Development 37.2 (April 2009) 94-104 This word is a great obligate that relates to African Americans seeking mental health treatment at lower rates than whites. The article farmings that this contrast can be attributed to attitudes toward function, alternate coping, and differences in care. This article also illuminates biases in counseling. Snowden, Lonnie R, Barriers to Effective Mental health Services for African Americans, Vol. 3, Issue 4, 181-187 (Dec. 2001). genial Services and Welfare, Psychology This article states that many African Americans do not seek proper mental health care. It states that the ones that do generally drop out. The article attempts to put the causes and the effects that would facilitate alleviate this problem. McField, Edward, Culture, acculturation, and complaisant capital Latinos and use of mental health services. Loma Linda University, 2010. 3405317 Thi s article states that Latinos drive from the same mental disorders as another(prenominal)s, but when they do, they receive less than standard care.The article gives the results of studies that state that state that there is an association between acculturation, models of illness, stigma, need, and mental health service use. Organista, Kurt C. New Model for Latinos in necessity of Social Work Services, Social Work, 54.4, (Oct 2009). 297-305 This article is wonderful in that it gives some of the best pragmatic models and concepts in the cultural competence literature. This article states ways in which to enhance cultural sensitivity, as well as increasing awareness of the Latino experience and earning of problem patterns in their historical, well-disposed, and cultural contexts. Borup, J. (1999, May/June). Foundations of cordial work practice with lesbian and amusing. Families in Society, 80.3, 308-309.Describes a foundation for helping comic and lesbians for the human service s worker. When helping or working with a person who is gay or lesbian it is important to ingest knowledge of professional literature,experiences from professional peers, history, and the actual case information. It is also important to remember the family history, for this characterizes and confronts any myths associated with this feature lifestyle. The lack of social support and homophobia can create consequences to those who are not accepting of this community. The author is educating students active the knowledge and facts on working with the lesbian, gay, bisexual, and transgender community and the most important is the code of ethics for social workers. Cavet, J. (2000, Oct).Children and modern people with a hidden disability and examination of the social work role. British Journal of Social Work, 30.5, 619. The recent study described that children and young people with hidden and impairment received a social work service which was at a minimal level. It is recognized that the level of social services encumbrance available to these families whitethorn be a reflection of a low priority assigned to modify children. A change in priorities is needed which recognizes the importance of knowledgeable support to disabled children as a means of improving their environment and reducing families stress levels and the likelihood of abuse or rejection.Copeland, C.A. (2011, January/February). School librarians of the twenty-first century using resources and assistive technologies to support students differences and abilities. Knowledge Quest, 39.3, 64-69.This article describes the many ways librarians can help differently abled children realize they are special. And by librarians having all the resources (informational and technical) they can further help these differently abled children understand how truly especially able they are. It opens their eyes to their accept gifts and abilities and this helps the librarians these abilities to produce the information literacy skills and multi-literacies necessary for lifelong learning. The bailiwick Center for Education Statistics shows that approximately one in seven students have one or to a greater extent characteristics society defines as a disability. Technologies can be selected and so they can best meet the involve of the students who are differently abled.Donahue, P. (2005, July-September). Current perspective and future directionsfor social work practice and research. Families in Society, 86.3, 359-366. This article describes the aging gay and lesbian community. Past research of this community focused more on the gay White man, well-educated, active in the gay community and high socioeconomic backgrounds. This study examines current roles of social work regarding research with older gay men and lesbians and presents recommendations for both practice and research in the historic period ahead. Not only is this community of sexism, they are also victims of ageism. Future work must striv e to be more representative of older lesbians, geographic diversity, and classes because these variables play an important role in shaping the gay aging experience.Bell-Tolliver, L., Burgess, R., Brock, L. J. (2009). African American therapists working with African American families An exploration of the strengths perspective in treatment. Journal of Marital and Family Therapy, 35(3), 293-307. Retrieved from http//search.proquest.com/docview/220979644?accountid=35812 When working with African Americans and intrinsic Americans human service workers must consider important factors. When doing a study researches found 5 strengths that African Americans showed. They have noticeable kinship bonds, strong work orientation, adaptability of family roles, strong achievement orientation, and strong religious orientation.African American family is defined as an intimate association of persons of African descent who are related to one another by a variety of means, including blood, marriage , formal adoption, easy adoption, or by appropriation sustained by a history of common residence in America and deeply embedded in a network of social structures both internal to and outside to itself (Bell, 2009). Waites, C. (2009). Building on strengths Intergenerational practice with African American families. Social Work, 54(3), 278-87. Retrieved from http//search.proquest.com/docview/215269004?accountid=35812 These families are diverse groups of people with their own ideas, opinions, and values. African American families have strengths, and that the use of those strengths within the therapeutic setting can lead to productive outcomes.We also believe that understanding the strengths of African American families can help mental health professionals develop successful treatment outcomes for families. It is critical that professionals gain an understanding of how these strengths impact the functioning of the African American family to empower families who are struggling. When h elping this group we should focuson their strengths and not their weaknesses (Waites, 2009). Michael, T. G., Eugene, F. P. (2000). Red as an apple Native American acculturation and counseling with or without reservation. Journal of Counseling and Development JCD, 78(1), 3-13. Retrieved from http//search.proquest.com/docview/219014436?accountid=35812 The United States Bureau of Indian Affairs (1988) legally defines Native American as a person who is an enrolled or registered member of a tribe or whose blood quantum is one fourth or more genealogically derived from Native American ancestry.When working with Native Americans one must remember that they are very religious and hold conventional values and beliefs. They practice only traditional tribal customs and methods of worship. However some Native Americans may be more willing in the practices of other cultures. That is why the counselor must not gift assumptions without gathering further information (F.P, 2000). Kathleen, A. E. (2000). Counseling with Native American Indians and Alaska Natives. Families in Society, 81(5), 543-543. Retrieved from http//search.proquest.com/docview/230163172?accountid=35812 Culturally based treatments may be needed. This group can be offended very easily and the counselor must be careful not to overbear (A.E, 2000). Latino-Kuglin, M. (2009).Latino outreach. Children Libraries, 7(3), 42-46. Retrieved from http//search.proquest.com/docview/212161869?accountid=35812 Its a way to celebrate Latino heritage, literacy, and families coming together at the library, said Watts. She said Da celebrations at HCL have two goals. The first is to celebrate the heritage of the community that we see already. Weve got libraries that have large Spanish- speaking populations that actively use the library, so this is a way to celebrate and acknowledge the community that is already there. No-show Therapist Racial/ethnic Disparities in Client Unilateral http//psycnet.apa.org. N.p.In the present study, the authors examined the source of racial/ethnic minority disparities in colored termination form of dropout that is associated with poor alliance and outcome. First, the authors must be tested whether some therapists were more belike to have clients who reported unilaterally terminating as compared with other therapists. Next, the authors examined 2 competing hypotheses regarding the therapists role intermination disparities (a) that racial/ethnic disparities in unilateral termination are similar across therapists and thus due to other components of the treatment process or (b) that racial/ethnic disparities in unilateral termination are special to therapists, where some therapists are more likely, on average, to have higher rates of unilateral termination with paradoxical sleep clients as compared with white clients.

Bias in Abstinence-Only Education Essay Example for Free

Bias in Abstinence-Only Education EssayIn addition to being an in loadive deterrent to unwished pregnancy and sexually transmitted diseases, self-control only education prevents young women from making well informed decisions about their sexuality. Cases of teen pregnancy and STD/HIV infections is on the rise despite the government allocating funds for abstinence only programs. This story seeks to look at the government policies with regard to abstinence-only education programs and its relationship with unwanted pregnancies.It is a known event that sexual abstinence is being fared in all countries in the world as a sure way of preventing sexually transmitted diseases and pregnancy. Men and women of all ages who are not ready to rent the risks that accompany sexual application embrace abstinence which is a normal and acceptable practice. As a way of expressing love, affection and tenderness, majority resort to intercourse and sexual activity.Sex is also being apply by co uples to strengthen their relationships. Howalways, it has often been argued that using sex to cement relationships evoke distort ones judgment. Among women, having sex may strengthen the feeling of love but do not actually cement or deepen the relationship.Exploring sexual behavior within an environment of deep commitment where having children is considered as a possibility is always rewarding. Majority of people are however not prepared for commitment thus opt for abstinence until they develop a stable relationship.Abstinence is 100% effective in defend an individual from sexually transmitted. However, if the majority of the population could realize its effectiveness, then we would not be having such headlines handle the ones we have seen in the past of teen births being on the rise. However, abstinence is not an easy practice considering how strong sexual drives are among humans.The rate of teen births steadily declined since 1991 and this could have been because of the inte nsive educational campaigns that were initiated during that period. These campaigns include encouraging people to use antifertilitys and condoms and enlightening people on the risks of Aids and sexually transmitted diseases. However, at once statistics now show an increase by 3% in teen births the first time ever in 14 years. (Wilson, Kelly, Patricia,2005) Is it that the sex education programs that the government adopted are no longer on the job(p)?The government has tried to show round effort in curbing STDs and unwanted pregnancies. The first federal abstinence-only program was enacted in 1981 and this was designed primarily to support pregnant and parenting teenagers. This came through the adolescent Family Life conduct which was also passed the same year. AFLA also funded abstinence-only programs meant to encourage responsibility and self discipline among teenagers (Abstinence Only Programs 2008, p.2).Abstinence-only programs purpose was to check the general population and especially the teenagers how they stand to gain from abstinence. It also sought to teach abstinence from pre-marital to all schooling children. The abstinence-only program was supposed to teach the values of abstinence with regard to unwanted pregnancies and sexually transmitted diseases. According to this program, the expected standard of human sexual activity revolved roughly a mutually faithful monogamous relationship. However, with all these well clarified goals, current scientific look into shows that this program is ineffective.A study of abstinence-only-until marriages program inferred that the classes fail to serve its goal of delaying the onset of sexual activity the young people. An evaluation of 11 of these programs showed that they do not have a lasting positive effect on the asexual behavior of young people (Ibid 4). Instead of a positive effect on the young people they showed a negative willingness to use contraceptive because the program emphasized on contraceptive failure.It has often been reiterated that abstinence-only programs endanger the youths because adolescents are denied complete information. These programs fail to provide contraception information and in some cases, they have been accused of providing wrong information which may lead to youths forgoing contraceptive use.Teens are opened to pregnancy and sexually transmitted diseases because of lack of responsible sex education. Only safer sex intervention can reduce unprotected sexual intercourse as compared to abstinence only programs. The Federal Fund for abstinence -only programs have negatively influenced schools. Avery good example involves the Gloucester High school in Massachusetts with the summer vacations starting 17 girls at the school are expecting babies (Kathleen Kingsbury, Wednesday June 18, 2008).This proves further the failure of the program to curb pre-marital pregnancies. In come out to reduce the prevalence of this at the school a local pediatrician advocated for the prescription of contraceptives. However, this has been met with hostility. Amazingly it is the propensity of these teens to get pregnant and this only proves how distorted their perception towards life is.

Stolen Generation Facts Term Paper Essay Example for Free

Stolen Generation Facts bourn Paper Essay autochthonic children have been forcibly separated from their families and communities since the very first days of the European occupation of Australia obtained from the bring Them interior(a) ReportWho are the Stolen GenerationsThe term stolen generations is in reference to those aborigine and Torres whirl island-d wellspringer people who were forcibly removed, as children, from their families and communities by judicature, upbeat and affiliated church organisations. These children were systematically put into institutional cope or with non- natural foster families. Although it can be argued that the removal of immemorial and Torres Strait Islander children began as early as the very first days of European occupation in Australia, the force removal policies and lawmaking began in the mid 1800s and continued until the 1970s. There is current discourse in primordial communities supporting the notion that the removal of abor igine children from their families and communities continues to exist today in the form of complexities associated with current government policies and legislation and the over representation of native Australian children in out of home care.How and why do we greet the forcible removal of Aboriginal children occurred in NSW?New southeastern Wales, along with other Australian enounce and territory governments have acknowledged historic practices and policies of forced removal of Indigenous children on the basis of race.The Bringing Them Home Report, commissioned by the Human Rights and Equal Opportunity Commission (HREOC) and presented to the Australian government in 1997 came out of the HREOC National Inquiry into the Separation of Aboriginal and Torres Strait Islander children from their families. This report was central to documenting depict relating to the forcible removal of Aboriginal and Torres Strait Islander children in NSW and Australia wide. This report contains exte nsive evidence of past practices and policies which resulted in the removal of children. It also details the conditions into which many of the children were placed and discusses the negative impact this has had on individuals, their families and the broader Indigenous community.The Bringing Them Home Report (1997, p. 651) extensively suggested 53 detailed recommendations to the Council of Australian Governments.For further information on the Bringing Them Home Report and the recommendations that were put forward to the Australian government, please go to http//www.hreoc.gov.au/social_Justice/bth_report/report/index.htmlLink-Up NSW a Koori organisation founded in 1980 was established to assist the Stolen Generations in finding their way home as well as support families of people who were separated from their children.This removal occurred as the result of official laws and policies aimed at assimilative the Indigenous population into the wider community.What is a Koori?There are many terms in use most Australia for the word Aborigine. In most areas of NSW the term Koori is used. There are several other haggle which are used around Australia such as Goori (northern NSW/QLD), Murri (northern NSW/QLD), Nunga (SA) and Nyoongah (WA). There are many areas/regions that have carry their cultural language and have different terms to describe themselves Link Up NSW.Timeline of government legislationThe below synopsis can be identified as proof of an extensive history of legislative frameworks provided for the removal of Aboriginal children from their families, clans and communities, through an english common law regime in NSW. Under the simulation of protection, Aboriginal people were subject to near total control.This systematic approach to the forcible removal of Aboriginal children in NSW can be identified by many government Acts including1810s Governor Macquarie Proclamation 4 May 1816, Aborigines declared subject to the protection of British law, but any crime s may render them nix and lead to loss of privileges1849 Act to provide for the Care and Education of Infants who may be convicted of Felony or assault whereby a child under the age of 19 is convicted, court may assign care and wait of the child to such persons as make application where the court is satisfied it is for the benefit of the child.1881 State Children computer backup Act State Childrens Relief circuit card established. Boarding out officers may remove children from good-hearted institutions and arrange for them to be boarded out in licensed homes.1908 Establishment of Bomaderry United Aborigines Mission HomeConsequently, the Aborigines testimonial Board set-up in 1909 contributed to the United Aborigines Mission home at Bomaderry on the NSW south coast where young children and babies were placed.1909 Aborigines excuse Act Established the Aborigines Protection Board (APB) for the Protection of Aborigines. The duration of this Act was for 60 years until it s replacement in 1969. A key provision of this Act was to provide for the custody, maintenance and education of the children of Aborigines.1911 Establishement of Cootamundra Girls HomeCootamundra was the first of the homes for Aboriginal children set up by the APB. The main aim of the Board was to rescue Aboriginal children from their families and assimilate them into the white community. Girls were the main target of the Board, especially so-called half-caste or mixed blood girls. The girls were skilful as domestic servants and sent out to work for middle class white families.1915 Aboriginal Protection Amending Act Removed the requirement that an Aboriginal child had to be found to be dischargeed beforehand the Board could remove him/her.The discourse associated with the presumption of neglect, a requirement initially implemented by the Act was disem indicanting for Aboriginal mothers, fathers and families as there was no recourse for Aboriginal people who challenged the notio n of neglect that was often decided at the whim of a government inspectors own beliefs and values these officials held the sole power in determining neglect. This practice was further exacerbated by views of assimilation of Aboriginal people into mainstream white company to ease the pillow of Aboriginal people as a dying race.1918 Establishment of Kinchela Boys HomeThe Board established Kinchela Training Institution in northern NSW for boys. The APB opened the Kinchela Boys Home with the official purpose of providing rearing for Aboriginal boys between the ages of five and fifteen. These boys were taken from their families by the State from all over New South Wales.1940 Aborigines Protection (Amendment) Act Aborigines Protection Board replaced by the Aborigines Welfare Board (AWB). This Board took responsibility for Aboriginal wards removed under the Child Welfare Act 1939. This Board had the power to establish homes for the reception, maintenance, education and dressing of wa rds. This included the administration of the major institutions already established in NSW including Kinchela, Cootamundra, and the Bomaderry Childrens Home.The Board administered apprenticeships and young Aboriginal children were indentured to work (farm hands/domestics). Wages of the children were to be paid to the board and kept in a trust account for use by the Board for the wards benefit until the ward moody 21.1943 Aborigines Protection (Amendment) Act The Board is the authority in relation to children admitted to its control with power over removal and transfer of wards, apprenticing wards and approving custody of wards.1969 Repealed by the Aborigines Act Aborigines Welfare Board abolished. Aboriginal children under the care of the AWB to become wards of the state. Aboriginal childrens institutions deemed to be depots under the Child Welfare Act 1939 and subsequent child welfare legislation.The apology Why was it important to apologise to the Stolen Generations?Recommend ation 5a (2) from the Bringing Them Home Report suggests that all Australian parliaments negotiate with the Aboriginal and Torres Strait Islander Commission a form of words for official apologies to Indigenous individuals, families and communities and extend those apologies with wide and culturally appropriate publicity.This issue is a blank spot in the history of Australia. The damage and trauma these policies caused are felt everyday by Aboriginal people. They internalise their grief, iniquity and confusion, inflicting further pain on themselves and others around them. It is about time the Australian Government openly current responsibility for their actions (Archie Roach and Ruby Hunter in Buti A, Bringng Them Home the ALSA Way).In essence, formal government apologies provided a way for Australian governments to recognise the damning effects of removal policies of the past. The lifelong profoundly disabling consequences of those taken, meant that they disconnected all connecti on to family, traditional land, culture and language.On 14 November 1996, the Premier of NSW, Bob Carr, became the first principal of an Australian government to respond to the call from the Governor General, Sir William Deane, for all Parliaments to reaffirm their commitment to reconciliation. The Premiers resolution was passed unanimously. The NSW Premier was also the first state leader to offer a formal apology to the Aboriginal people for the Stolen Generations.On 13th February 2008, in a historic speech, Prime Minister Kevin rudd made a formally apology to the Stolen Generations in his first official parliamentary sitting which was the outset of the 42nd parliament of the commonwealth. Receving a formal apology by the Prime Minsiter of Australia has allowed the start of the healing adjoinIn a response to the National apology to the Stolen Generations, Tom Calma, Aboriginal and Torres Strait Islander societal Justice Commissioner, HREOC stated Through one direct act, Parliam ent has acknowledged the existence and the impacts of the past policies and practices of forcibly removing Indigenous children from their families. And by doing so, has paid respect to the Stolen Generations for their suffering and loss. For their resilience. And ultimately, for their dignity.

Business Law Essay Example for Free

cargon Law EssayIntroductionAt the course of Business Law, we got the knowledge about the drive. In do-gooder we fox an assignment that leads a rationalize analysis. This evaluation of the contract leave al 1 be reviewed in harmony with the following requirements1. What specifically makes this contract enforceable?2. What are the responsibilities of both(prenominal) parties?3. What are the possible detriments and liabilities?4. What tinge does a potential breach of contract consent on the business?5. Summarize, by reflecting in ecumenical on the impact profound is works bear mystify in both small and large businesses. So, a contract is any voluntary licitly binding commensu rollness between two or much people or businesses. In our case the two parties forget be represented by The narrate of Oregon, and by professional person DX, who leave al bingle provide services and goods to the first one.1. What specifically makes this contract enforceable? engraft on t he English Statute of Frauds, non every contract has to be in writing to be valid and enforceable, but some contracts should be. This compact between State of Oregon and Pro DX, should be in writing because this contract involving the providing of services (repairs, replacements, maintenances, and others) exceeding a large-scale amount of money. To avoid misunderstandings and dis placements and to reduce the porta of perjury by one troupe or the other, this contract should be in writing. Furthermore, because it can be consummateed in slight than one year, this kind of contract can be in oral embodiment, and it requires involving the tierce fellowship (a witness) who in case of the trial pass on bring a reasonable and effective evidences, other than one of the party might deny that the contract ever existed or might dis checker on the terms of the contract. Besides that this contract is a service contract, it is withal a good contract because it requires execution of g oods components in modernization of the software. (Article 2 of the UCC)This contract, like all contracts become enforceable if all the sections of the contract have been fulfilled without fail. First that prove that the contract is enforceable is the gap. * The offer is a proposal made by one person to another person for the sale and purchase of goods, to engage in a job, serve participation, and provision of services. So this contract offers software system design and programming services, in the approaching is treasured at $ 52,800.00 for the state of Oregon. * Another element mentioned in the contract is acceptance. In general acceptance of an offer is a manifestation of assent to the terms thereof made by the offeree in a mood invited or required by the offer. Acceptance in this case is described that contractor, herein Pro DX, agrees to perform the work in accordance with the terms and conditions of this contract. * Another central element found in this agreement is the legal consideration this nitty-gritty that each party must(prenominal) provide something of value.In our contract this means that one party (Pro DX) will provide a service (such as maintenance, programming services, software), or a product, in exchange for money (from the State of Oregon, therein represented by the DHS). * If talking about a Professional Data flip Company and State of Oregon, we automatically can say that another element of contract is automatically respected. This is capacity to create a contract such means that each party must have the legal capacity to enter a contract. In most jurisdictions that means that they must be at least a certain age and of sound mind. For this mentioned companies it may mean that the individualist is given express authority to enter a contract in the companys bylaws or other formal memorandums, such is State of Oregon that is acting by and trough its Department of mankind Services, Office of Information Services, hereinafter refe rred to as DHS.* An element with the biggest importance is that this contract has a legal purpose. And it is, because this agreement refers just to providing of services and not illegal things. * The last element that should make enforceable this contract is that both parties should be mentally competent. In special this contract, has all this requirements but it is still unenforceable because it doesnt have so little elements that also make a contract enforceable. These are the commencement date of the contract, partys rights written in and not only the responsibilities, and partys signatures and stamps.2. What are the responsibilities of both parties?The important responsibilities of the contractor (therein as Pro DX) are * To provide system design and programming services, including COBOL II, Easytrieve Plus, CICS, CA Intertest and VSAM and DB2 level structures, and make corrections approved by DHS take care motorcoach. * To construct or modify and implement programs/ cross-f iles that will control the processing of rates on the JD/CBC system, based on DHS supplied Project Design document and criteria. * To perform design changes, programming, acceptance testing or implementation to address unforeseen error(s), newly spy bugs and/or interfacing issues. * To demonstrate successful implementation of the production system content with the requirements of Statement of Work to DHS Project Manager. * All these services should be provided in specific limit of period and cost. While the DHS Project Manager responsibilities are* To provide the necessary methodologies and standards that conforms to documentation standards. * To promote the rules for completing each task indoors time frame and approval of every task. * To define and document what testing data is needed for the CBC/512 rate structure project. * To repair for services provided by contractor herein as Professional Data Exchange (ProDX).3. What are the possible damages and liabilities?If Pro DX bre aches the contract, the possible damages can be * The DHS might sue the party for a remedies under the law * The Pro DX will be enforced to pay the caused damages, that can be compensatory, liquidated, nominal, and/or punitive damages. * The Pro DX can be enforced to a specific performance. essentially a decree requiring the breaching party to perform their part of the bargain in the contract. * Pro DX might graceful with the terms such -Cancellation and Restitution. A non-breaching party may cancel the contract and sue for restitution if the non-breaching party has given a benefit to the breaching party. The former contract which is the subject of dispute is rescinded (cancelled), and a new one may be formed to meet the parties needs. * Pro DX will have to pay the attorneys fees and cost. (in case of litigation). If we will look from the DHSs side, the possible damages that can appear are* To fuck up time wait for the performance * To resort the work that should be provided af ter the implementation * Damage also includes the costs of hiring another company to finish the job. The liabilities that can be provided by Pro DX are* To provide the programs and software that will satisfy the State of Oregon* To complete all maintenance work within time frame* To not to exceed the cost and work hours.The liabilities that should be provided by DHS are* To establish the criteria and methodologies necessaries to accept the new right implemented programs and software * To make corrections (if needed) in the supplied services * To pay money for successful implemented system.4. What impact does a potential breach of contract have on the business? So in the case of non-fulfillment of a contract by one party (for warning by Pro DX), as a result the other party (DHS) suffers losses. Breach of a contract has negative effects, and has wide ranging consequences both legal and practical to the parties to the contract * Loss of money (if, for casing, Pro DX refuses to form his side of the bargain on the due date or performs incompletely, in result the second party, DHS, will lose their money for this implementation and also will lose their time surpass on waiting for, and somehow will lose the profit that can be made further). * Loss of time (if, for example, Pro DXs programs and software will not be accepted by the DHSs side, the first will result that lost their time, and some files or programs, for doing this job). * Loss of a financial partner- it can be lose a potential investor or/and the business with who you are dealing.* Loss of trust- it is bad for any business, because no one will have pleasure to make business with an entity that lost trust in the market. * Loss of markets- insufficiently active or successful business means a loss of competitiveness and loss of market. * reproach to reputation It is not good for a business reputation if word gets out that they have not honored their part of the contract. Other companies will be relucta nt to do business with an entity which has previously defaulted on other contracts. 5. Summarize, by reflecting in general on the impact legal issues can have in both small and large businesses. Although some recent studies have looked at the impact of regulations on the kinship between political relation and private business in general, the attention has been directed toward understanding precisely how government regulations have affected small businesses. There is good reason to believe that size matters.Precisely because of their smaller size, small businesses are likely to be less diversified and less able to leverage economies of racing shell or to access capital markets. As a result, small businesses might be more risk-averse and less able to react to unexpected events compared to larger businesses. Large firms with deep pockets might be more familiar targets of employee discrimination, wrongful discharge and other suits. Large firms might also have a stronger incentive t o spend substantial resources aggressively defending any one suit so as to deter future suits. On the other hand, small firms may be more vulnerable to breach of a non-compete agreement or violation of stack secrets rules as the entire business may depend on that trade secret. As a result, they may be more likely to prosecute, in spite of the costs and the risks of bankruptcy. (http// vane.census.gov/epcd/www/smallbus.html, Source U.S. Census Bureau.)Also as an owner of a small business or a large business, the common danger of crippling litigation should also be at the top of your priorities. dissatisfied Employees, Discrimination/Harassment Cases, Immigration Audits any business should make sure that all its companys employees can legally work in the United States. Unsatisfied Customers Customers who are unsatisfied can file class action lawsuits against the company, in which they gather in large consumer groups and attack the company over bad products, services or promises. W ith enough unsatisfied customers, class action lawsuits can do more damage than any individual or corporation and irreparably tarnish your brands image. Other sub judice Issues These are only some of the most common legal issues facing small and large businesses today. easily communication in the workplace and a hands-on approach to management is the best deterrent to legal issues.Of course the big companies that are facing with these issues, the damage (financial risks, or company image) are higher and have a more sever reflection, than a small company could have. 6. What are the implications this project has for your chosen life history? At the end of this evaluation of the contract, as a future control, I understood that the contract is the safer air to make an exchange of goods and/or services. I got the knowledge what is a valid contract, what it makes enforceable, what are the elements of the contract, what are the risks and liabilities. This big source of information wil l help me to be more capable and to feel free enchantment signing a contract. Those skills will help me to manage my business or my job as accountant without breaking the law.Everyone in his life has deals with the contracts, even if this is unwritten or is written one. Even in the supermarket, or when we are buying clothes, we are doing the exchange of money and a product. So the rules of the contract is that one party is offering something, when another party is considering your offer and decides to have a relationship with you or not. Also, as an accountant or a business woman, an important thing is to know how, to behave in unexpected situation. In activity of businesses can appear the situations called Force Majeure- this is an emergency, do not depend on the participation of the parties. (For example fire, earthquakes, hurricanes, and others.). In this case, none of the parties is legally responsible for its obligations. Further, to that contract, is made an additional agree ment, which specifies other conditions. So knowing what is legal and what are the criteria that make a contract valid and enforceable will help me to succeed in my accountant career.ConclusionBusiness law courses were often overlooked in high school, or college. Its not an education required strictly for attorneys that represent and defend businesses, in fact its graceful much for almost anyone. Contracts are written or oral agreement between two or more parties. The parties can be individuals, companies, non-profits or government agencies. With a contract, two or more parties agree to exchange services or promises. Many parts of our daily lives involve contracts. When we buy an insurance indemnity for the home or the car, for example, we are entering into an agreement. Many people have employment contracts.Even when we go to a doctor these days we have to sign a contract agreeing to receive medical treatment. If oral presentation in special about this analysis of a contract, abou t knowing how and when we enter into a contract to be safer, more convenient and profitable. So business law through information and specific examples will help us to get more information sought. In analysis of such a contract, we are able to focus on the elements and requirements so, that we do not overlook anything. This practice will develop in the future to have a professional behavior in the process of concluding a contract.

Care of a Patient in Acute Pain from a Total Knee Replacement Jahaira Melendez Essay Example for Free

C ar of a tolerant in keen Pain from a Total Knee Replacement Jahaira Melendez EssayNursing care afterwards a total articulatio genus replacement is very essential in promoting a speedy and refuge gety for a long-suffering. In an attempt to replicate the knees natural index to put and glide as it bends by cutting away damaged b peerless and cartilage and renew it with an artificial joint, acute distract following the execution abide be unbearable. In assisting the patient of in controlling the wo(e) would only guarantee the best recovery possible.With pain control, the patient will be able to perform follow up care and exercises to the best of their ability and over 90% of patients who support a total knee replacement have trusty results with recovery and ability to resume playacting normal daily activities and minimizing the risks of complications to the surgical site. Keywords Pain management, encouragement, total knee replacement, arthritis, prosthetic Care of a Patient in Acute Pain from a Total Knee Replacement A universal medical examination condition seen in m each aspects of the medical field is arthritis.Arthritis is the inflammation of a joint and the most common fictional character of arthritis is osteoarthritis, also known as wear and tear. Pain from any medical condition or procedure feces be very stressful to a patient and inhibit any recovery. Arthritis can be diagnosed by performing an x-ray to determine the extent of joint damage. Someone with arthritis of the knee commonly has difficulty walking, climbing stairs and getting in and out of chairs. An orthopedic physician can cheer interventions.The most common joint replacement surgical intervention to help control and alleviate inveterate pain for a patient is a Total Knee Replacement, also known as arthroplasty. A total knee replacement is performed to relieve moderate or severe pain and restore chromosome mapping in severely diseased knee joints. This procedure is not performed until pain is no longer controlled with non-operative preaching such(prenominal) as weight loss, activity modification, anti-inflammatory medications, joint supplements and cortisone injections. It is also not performed oftentimes on younger patients due to the implant wearing out quickly.An orthopedic physician would determine the type of prosthetic needed in order to achieve the most success. There are also circumscribed implants to provide the best possible functioning with long lasting results such as small-armial knee, rotating knee, grammatical gender specific knee and custom knee. To perform the procedure, an orthopedic surgeon would administer general anesthesia, which means one is unconscious during operation, or spinal or epidural anesthesia in which a person is evoke but cannot feel any pain from the waist down.During the procedure, the knee is in a bent function to fully expose the joint excavates. An incision of 6 to 10 inches (15-25cm) is make on the front of the knee. The patella is moved aside and damaged surfaces are cut away. The femur is cut to match the corresponding surface of the metal femoral component that is placed on the end of the femur and the tibia is prepared with a vapid cut on top to fit the metal and plastic tibial component that is inserted into the fancy up so the femoral component will slide as the knee is bent.If needed, the patella is cut flat and fitted with a plastic patella component and plastic spacers are inserted between the metal components for smooth gliding. anterior to completion, the knee is tested during surgery to ensure correct sizing and then closed with stitches or staples. The procedure would consent 1 to 2 hours and recovery would be another 1 to 2 hours and then entreat a hospital stay of a couple of days. During the hospital stay, encouragement to move the foot and ankle joint to increase blood flow and prevent swelling or clots and blood thinners, support hoses or crush boots are very valuable.A nurse should also encourage the patient to cough regularly and take deep breaths to promote the movement of mucus that settles in the lungs during the procedure while being under anesthesia. affectionateness for a patient in acute pain after a procedure and managing pain levels is a very important part of recovery. Without pain control a patient will not be able to achieve recovery levels as quickly as possible without causing other injuries. Acute pain is related to tissue injury secondary to the surgical intervention.Upon discharge, command on follow up care is very important. A patient needs to know what to do and what to watch for as part of their recovery. Vital discharge instructions that a patient must be taught are * When allowed to squander, usually 3 to 4 days after surgery, carefully wash incision with soap and water, rinse well and lightly pat dry. Do no rub or apply creams. * Sit when showering to avoid falls. Avoid soak to prevent infect ions. Try using non-slip mats, grab bars and elevated toilet seat or shower chair to prevent falls. Take pain medications as directed, do not double up doses if any doses are missed and do not drive when taking narcotics, usually about 6 weeks ahead it is ok to drive. * If taking a blood thinner, of all time verify with physician if it is ok to take ibuprofen or any anti-inflammatory medications* Always sit in chairs with arms to make it easier to stand or sit but only 30 to 45 minutes at a time. * Sleep with breathe under ankle and keep knee straight but change leg position at night and nap if tired but dont stay in bed all day. Wear support stockings for about 4 to 6 weeks and do not pivot, twist or kneel. * go up and down stairs with support, one step at a time using good knee to step up and bad knee to step down. As a fall prevention, always remove loose wires, throw rugs and have good lighting and keep items within reach. * Before and after any activity, ice the area for 30 minutes. Most importantly, teaching about potential risks such as nerve damage, stroke, and heart attack, blood clots in leg vein or lungs or infection should very be emphasized when discussing discharge instructions.Signs of infection would complicate increased redness, tenderness, swelling and pain of surgical site, stiffness, and feverishness with temperatures above 100 degrees Fahrenheit, shaking chills and drainage from site. If any of these symptoms occur, a call to the physician should be made immediately. Recovery will take several weeks during which time crutches or a walker will be needed and arrangements for transportation and everyday tasks will have to be made.Physical activity should be resumed easily with normal ho determinationhold activities, a graduated walking program and knee strengthening exercises until staples or stitches are removed 2 to 3 weeks after surgery. Low impact exercising such as move or riding a stationary bicycle is tolerable but extravagant ly impact activities such as running are not recommended due to an increased risk of joint failure because the knee joint components can loosen. During recovery from the surgical intervention, a nurses care to help control acute pain for the patient is one of the most important factors in helping a patient fully recover without further complications.Walking and knee movement begins soon after surgery so less pain would benefit the patient to move sooner and get strength back quickly. Pain control can be done with the use of analgesic and non-analgesic relief measures and reporting uncontrolled symptoms immediately. A nurse can assist with pain management interventions such as * Performing comprehensive assessment of pain to include location, characteristics, onset, duration, frequency, quality, intensity or severity and precipitating factors. Always consider cultural differences and in non-verbal patient use the analog pain scale to evaluate pain control measures required * Reducing or eliminating change magnitude pain factors like fear or lack of knowledge * Teaching non pharmacological techniques like relaxation, massage, maneuver imagery and distraction* Checking vitals every 4 hours and neurovascular checks every hour during the first 12 to 24 hours then every 2 to 4 hours and always report any abnormal findings * Providing prescribed analgesics in the beginning activity to increase participation and assessing levels of comfort frequently * Initiating physical therapy, exercises and range of motion while teaching and reinforcing the use of techniques to prevent weight bearing on affected extremity and recommending home health or a rehabilitation facility * Monitoring incision bleeding, emptying and recording drainage every 4 hours and changing dressing every 24 to 48 hours * Encouraging increased fluid intake and high fiber diet, stool softener and a well-balanced diet with increased protein * Encouraging use of compression stockings to falling off swel ling. Nursing care of a patient is very crucial in order to help the patient avoid potential complications with the prosthetic. An infected knee would require surgery to remove artificial parts and antibiotics to cut down the bacteria then after clearing the infection another surgery would be required to put in a new prosthetic.A nurses role in recovery is very important in many aspects of the patients care and the nurse can encourage and support the patient in building the confidence that they are able to perform the necessary steps to gain the ability to restore normal functions. Most importantly, helping the patient keep pain levels under control by whatever measures are comfortable to the patient should be first in mind. Pain can be the main factor that would prevent a patient from doing any follow care or interposition they are required to do in order to keep the prosthetic functioning adequately. The patient should be able to rely on the nurse to keep them in a comfortable state with the help of keeping in communication with the physician and without this patient-nurse relationship the patient would not be able to recover properly and achieve goals set as part of their recovery treatment plan.

Evidence-Based Practice Paper Essay Example for Free

Evidence-Based Practice Paper EssayThe evidence- found practice rule of thumb that I chose is titled, myocardial Infarction, written by the Finnish Medical Society Duodecim. The intended users for this rule of thumb argon health care providers and physicians. The target population is undivideds with suspected or tell apartn myocardial infarction. The objective of this guideline is to collect, summarize, and update the core clinical knowledge essential in general practice and signalize the scientific evidence underlying the given recommendations. (Finnish Medical Society Duodecim, 2008) Clarity and Researchability of the Studys Purpose and skepticism tally to the lookers, the purpose of the moot is to test how t severallying format ( genuine versus storytelling) and restructuring the social norm of pity for others to sympathize with for self affects how women learn to identify and respond to myocardial infarction (MI) symptoms. (McDonald, Goncalves, Almario, Krajewski , Cervera, Kaeser, et al., 2006, p.216) I feel that the purpose of the guide is signifi drive outt to breast feeding because nurses need to educate patients approximately what symptoms to observe for and report to their primary care providers. Also, if this ponder could determine which teaching format would better assist patients in acknowledging significant symptoms of an MI needed to cope with EMS, then nurses could possibly be better commensurate to educate patients about those symptoms.I believe that the tuition title of Assisting Women to Learn Myocardial Infarction Symptoms, is much general than the three research questions listed in the canvas (a) Are women who are taught how to recognize and respond to symptoms of an MI exploitation a storytelling format more(prenominal) credibly to be able to identify symptoms and plan to get help than women who are taught the akin discipline use a factual format?, (b)Does teaching women to cognitively restructure the caring f or others social norm to caring for self make them more likely to identify symptoms of an MI and plan to call EMS than women who are not taught this form of cognitive restructuring?, and (c) Are women who necessitate been taught MI symptoms and response using the storytelling format and who were taught cognitive restructuring of the caring for others to caring for self social norms more likely to identify symptoms of an MI and plan to call EMS than women who were provided factual information about MI symptoms and response, and who were not offered cognitive restructuring?(McDonald, et al., 2006, p.217-218) The two independent variables identified in the study are teaching format (factual vs. storytelling) and social norms (caring for others first vs. caring for self) and the dependent variable is the posttest knowledge of MI symptoms. (McDonald, et al., 2006, p.220)The American partiality Association (cited in McDonald, et al., 2006, p.216) supposes that w sleeveness disease rem ains the leading cause of terminal for women and kills over 248,000 women each year in the United States. Mosca, Ferris, Fabunmi, Robinson (cited in McDonald, et al., 2006, p.216) states that the majority of women remain unaware that heart disease is the leading cause of death for women, despite a significant increase in consciousness since 2000. While the assumptions of the researchers are not clearly stated, I would assume that the researchers believe that women need to be moreover educated about the symptoms of MI in order to avoid disabling or life-ending consequences from MI. (McDonald, et al., 2006, p.216) Adequacy and relevancy of the Literature ReviewI feel that the literature review is relevant to the problem because they discuss the differences in MI symptoms among genders and which symptoms were commonly describe by women. DeVon and Zerwic (cited in McDonald, et al., 2006, p.216-217) reviewed studies on gender differences in MI symptoms and cerebrate that symptoms w ere similar across gender however, in seven studies back pain, dyspnea, and nausea and vomiting occurred more oft in women. According to McSweeney, OSullivan, Cody, Crane (cited in McDonald, et al., 2006, p.217) women who have experienced an MI often describe additional symptoms besides chest pain, such as weakness, shortnessof breath, unusual fatigue, diaphoresis, nausea, feeling flushed or dizzy, or a heavy feeling in the arms. The literature review also discusses the possible reasons for wherefore women delay in contacting EMS when symptoms of MI do occur. Finnegan et al (cited in McDonald, et al., 2006, p.217) states that women power delay responding to their own MI symptoms to meet their caregiver responsibilities.The literature review is logically organized, because it clearly talks about the differences among identification of MI symptoms among genders, along with the possible reasons for the delay among women in reporting their symptoms in order to receive immediate atten tion. The backchat about women not wanting to take care of themselves in order to continue assuming the obligation of caring for their families, supports the research question of cognitively restructuring the caring for others social norm to caring for self. (McDonald, et al., 2006, p.217)I feel that the 23 references employ were appropriate for this study. The dates of the references range from 1989 to 2005, with this study being published in the may/June 2006 issue of Public Health Nursing. Majority of the references (20/23) had to deal with heart disease, while the remaining three discussed (a) conjecture of planned behavior, (b) story telling as a tool, and (c) applied multivariate statistics. Both, primary and secondary sources were use as references. Agreement in the midst of Purpose, Design, and MethodsThe study build described is a pretest posttest full factorial experimental design with educational format (storytelling vs. factual) by social norms (restructuring the social norm of caring for others vs. no restructuring). (McDonald, et al., 2006, p.218) According to LoBiondo-Wood Haber (2010) a legitimate experimental design has three identifying properties (a) randomization, (b) control, and (c) usance (p.179). In the study, the researchers randomly assigned the participants to whiz of four groups, each group receiving a different type of informational MI symptom pamphlet. LoBiondo-Wood Haber also state that experimental designs are the most violenceful for testing cause-and-effect relationships due to the control, manipulation, and randomization components (p.185), which I think makes the design appropriate for answering the research questions in this study.Data was collected by having participants respond in theme first to a demographic form, and then to a Heart Attack Survey, both before and after, tuition an informational pamphlet about MI symptoms. The Heart Attack Survey consisted of two questions. The first question was able end ed, list all of the signs and symptoms of a heart attack that you are aware of. The second question used a 0-10 scale, with the corresponding anchors definitely would not call and definitely would call, to measure the behavioral intention of trade 911 within 30 min if heart attack symptoms occur. (McDonald, et al., 2006, p.219) I feel that their data collection function is logical and practical because paper-and-pencil instruments are most useful for collecting data on variables that cannot be instanter observed or measured by physiological instruments. (LoBiondo-Wood Haber, 2010, p.274)The researchers did not clearly discuss their instruments in scathe of content validity and reliability. LoBiondo-Wood Haber (2010) define validity as the extent to which an instrument measures the attributes of a concept accurately and reliability as the ability of an instrument to measure the attributes of a concept or construct consistency (p.286). I think that both of their instruments wer e valid since the demographic form only measured demographic info, and the Heart Attack Survey only measured the number of MI symptoms the participants knew along their intent to call 911.However, I do not think the Heart Attack Survey was very reliable, since the researchers did mention that many of the women did not answer the same MI symptoms on the posttest that they had mentioned on the pretest. If the instrument was reliable, I would believe that the posttest would have the same MI symptoms as listed on the pretest, along with any new symptoms the women well-read from reading the informational pamphlets. Suitability of the try Procedure and the SampleI feel that the researchers used a convenience sample consisting of 113 adult women. The women were recruited by graduate nursing student data collectors in shopping malls, restaurants, and other public areas. Inclusion criteria embroil of (1) female, and (2) age 25 years or older, and (3) able to speak, read, and understand E nglish or Spanish. Exclusion criteria include (1) previous MI, (2) physician or nurse, or (3) current or past EMS worker. (McDonald, et al., 2006, p.218) Descriptive characteristics of the sample include (a) a mean age of around 42 years, (b) majority of participants having a high school education, with about an additional 36% having higher education, (c) most women were white, with next largest racial group consisting of black Americans, (d) nearly more than half being of non-Hispanic ethnicity, (e) few women having personal chronicle of heart disease, while around half reported family history of heart disease, and (f) half reporting having caregiver responsibilities.I think the sample surface was decent for the study. The researchers state that a small effect size for the intervention effect was anticipated based on the REACT conclusions and the sample size needed for a four-group multivariate analysis of variance (MANOVA) with a power of 0.80, a significance level of .05, two dependent variables, and a small anticipated effect size was n=115. (McDonald, et al., 2006, p.218) There were an additional seven participants, but were not included in the final sample because they provided incomplete data, by not completing both the pretest and the posttest. The researchers state that there were no significant differences between women completing the study and women not completing the study for age, ethnicity, race, marital status, education, having health insurance, a personal history of heart disease, a family history of heart disease, or responsibility for caring for others. (McDonald, et al., 2006, p.220)The researchers state that the study was clear for human subjects protection by the university internal review board. (McDonald, et al., 2006, p.219) The researchers also state in their study that each participant was provided verbal informed consent and a copy of the study information sheet. (McDonald, et al., 2006, p.219) Correctness of uninflected Proce duresThe statistical procedures named in the study are (a) analysis of variance (ANOVA), (b) 2 (chi-square), (c) Pearsons r correlation, (d) t test, and(e) analysis of covariance (ANCOVA). According to LoBiondo-Wood Haber (2010) analysis of covariance (ANCOVA) is a statistic that measures differences among group means and uses a statistical technique to rival the groups under study in relation to an all important(p) variable (p.574). In the study, McDonald, et al., (2006) tested the three research questions through ANCOVA The two independent variablesteaching format (factual vs. storytelling) and social norms (caring for others first vs. caring for self)were entered as the pigeonholing variable. The pretest knowledge of MI symptoms served as the covariate, and the posttest knowledge of MI symptoms was entered as the dependent variable. (p.220)Since the study wanted to know the type of MI symptoms that the women could identify, the level of measurement for this study would be nom inal. According to LoBiondo-Wood Haber (2010) when data are at the nominal level and the researcher wants to determine whether groups are different, the researcher uses the chi-square (2) (p.326). The MI symptoms would be considered categorical variables because they could have more than two true values also, since only one point was given to each symptom identified, there was no order to the variables. (LoBiondo-Wood Haber, 2010, p.312)The researchers listed several p values in their study (a) the factual information with the social norms restructured group had more White participants (26.6%) and less non-White participants (0.9%) than the other conditions, 2(3) = 7.94, p .05, (b) women responding to the English instruments reported importantly more symptoms (M = 6.4 SD = 2.73) than women (n=29) responding to the Spanish instruments (M = 4.7 SD = 3.26), t (111) = 2.75, p .007, and (c) for the pretest the number of MI symptoms and the 911 response score were unrelated, r (113) = 0.16, p .09, and slightly related, r (113) = 0.20, p .04, on the posttest. (McDonald, et al., 2006, p.220) According to LoBiondo-Wood Haber (2010) the minimum level of significance acceptable for nursing research is 0.05 (p.322). Clarity of FindingsThe fall outings described under the results section state that the women identified significantly more MI symptoms after reading the MI pamphlet. (McDonald, et al., 2006, p.220) Table 1contains frequencies for the entire sample of the most frequently identified MI symptoms on the pretest and posttest. (McDonald, et al., 2006, p.220) Table 1 highlights the finding that a majority of the MI symptoms were identified more frequently on the posttest when compared to the pretest. Table 2 contains group frequencies for identified MI symptoms, with pretest frequencies for each of the four groups preceding the posttest frequencies, which highlights the finding that no significant group differences emerged for storytelling and social norms. (McDonald, et al., 2006, p.220)While the results did show that women generally well-read three more MI symptoms to add to their previous knowledge of the commonly identified MI symptoms, chest pain, shortness of breath, and arm pain, the results also discuss that the storytelling versus factual format for teaching women about MI symptoms did not affect how women learned MI symptoms. (McDonald, et al., 2006, p.221) I feel that these results show that more research is needed in order to find a way to adequately teach women the symptoms of MI and which symptoms would require them to quickly contact 911. While I do not think the conclusions are generalized beyond the sample, I agree with the researchers when they state that it is important for everyone to know that MI symptoms are ambiguous, and that even when people are unsure about their MI symptoms they should forever and a day call 911. (McDonald, et al., 2006, p.222)The researchers state in their study that there were several pot ential limitations that could have impacted their results (a) participants were recruited from the friendship and might not have carefully read the informational pamphlets, potentially reducing the amount of information learned, (b) the words heart attack were not included in the content of the factual group pamphlets, which might have led the women in that group to not associate the symptom information with MI symptoms, (c) the pretest and posttest were similar and separated only by the time taken to read the intervention pamphlet which as a result might not reflect symptoms that the women later remember and identify as potential MI symptoms, (d) many women did not include all of the MI symptoms that they wrote on the pretest, decreasing the score that they received foridentifying MI symptoms, (e) the MI symptom score did not reflect if the same symptom was included on the pretest and posttest, or if commonly occurring but less frequently recognized MI symptoms were learned, and (f) the 911 scale proved to be an incapable measure of response to MI symptoms. (McDonald, et al., 2006, p.222)According to LoBiondo-Wood Haber (2010) a research study using a true experimental design is commonly called a randomized control trial (RCT) (p.179). LoBiondo-Wood Haber also state that an individual RCT generates Level II evidence because of the minimal bias introduced by this design through use of randomization, control, and manipulation (p.179). Since this study used a pretest posttest full factorial experimental design and the participating women were randomly assigned, using a web-based random number generator, to one of the four experimental conditions, I would classify this study as an RCT generating Level II evidence. (McDonald, et al., 2006, p.218)According to the evidence-based practice guideline that I chose, instead of chest pain, acute dyspnea may be the primary symptom and the diagnosis should be made without delay since early therapy improves the forecas t decisively. (Finnish Medical Society Duodecim, 2008) I feel that the results of this study support the guideline because it is important for women to be able to recognize the symptoms of MI early on and be aware of their risk for an MI so that they can secure immediate emergency medical care when symptoms of an MI occur. (McDonald, et al., 2006, p.216)ReferencesFinnish Medical Society Duodecim. (2008). Myocardial infarction. Retrieved from the National Guideline Clearinghouse website. http//www.guideline.gov/summary/summary.aspx?ss=15doc_id=12794nbr=006596string=myocardial+AND+infarction LoBiondo-Wood, G., Haber, J. (2010). Nursing research Methods and critical appraisal for evidence- based practice, 7th Ed. St. Louis Mosby.McDonald, D. D., Goncalves, P. H., Almario, V. E., Krajewski, A. L., Cervera,