EMU and the UK essays

EMU and the UK articles The possibility of a solitary money has just been referenced in 1957 when the European Union was established. During the next years a few conversations about a Monetary Union occurred, yet with no accomplishments. The initial moves towards the EMU were just made in 1992, when the individuals from the EC met in Maastricht. A plan for the advancement of the EMU was made there. In the years after the bargain the planning started. In 1999 trade rates were unavoidably fixed and exchanges began to be conceivable in Euros. The Eurozone comprised of 11 part states as of now, Greece turned into the twelfth part in 2001. In December 2001 occupants of the Eurozone could get purported starter-packs containing Euro-coins. In January 2002 likewise banknotes were presented and in March 2002 the national monetary standards got invalid. (Stylist and Naimark, 2001) Since the establishment of the European Monetary Union in 1992 there have consistently been contentions for and against a solitary cash. Regardless of all analysis the Euro is reality in twelve nations now. This reality has the two points of interest and inconveniences. The most evident positive contention for the Euro is that exchange costs are spared. This worries individuals who are voyaging abroad inside the Eurozone, yet over all organizations that import or fare to other EMU nations. (Wren-Lewis, 2001) For firms that import or fare a lot of the exchange costs are sizable and are halfway given to shoppers through higher prizes. (Eudey, 1998). Along these lines, through the single money buyers will show signs of improvement costs. Estimations state that through the Euro 0,5 % of EC's GDP (Stavridis et al., 1996) or $ 30 Billion every year (Salvatore, 2002) will be spared. Another significant reality is that the single money takes out the conversion scale uncertainty.This should expand exchange, as swapping scale chance methods a shrouded cost on the exchange. (Eudey, 1998) Research has proposed that the Euro will help exchange by the factor of three... <!

The Mathematics of Bubbles in Beer :: Math Carbonation

Refraction Refraction is the thing that happens to light when it goes starting with one medium then onto the next. For instance, things show up uniquely in contrast to the base of a pool than on the top. Shortsightedly, refraction is the bowing of light. The clarification for this wonder, be that as it may, can be depicted with light as beams and light as waves. Regardless of the case, recall that the speed of light is consistent in each homogeneous medium, paying little mind to shape, size or structure. The record of refraction Light ventures ( in specific substances ) at a small amount of the speed on the off chance that it went in a vacuum. The record of refraction is the reverse of this division. Therefore, this number is more noteworthy than or equivalent to 1. This list is additionally explicit to light, so unique light in various mediums have distinctive lists. For instance, here is a table of files: Material Index Vacuum 1.00000 Air at STP 1.00029 Ice 1.31 Water at 20 C 1.33 Acetone 1.36 Ethyl alcohol 1.36 Sugar solution(30%) 1.38 Diamond 2.417 So how about we watch the impact of refraction as far as beams. A beam strikes the surface between substance I and substance R. The point I between the approaching beam and the typical vector at the limit is known as the edge of frequency, and the edge r between the refracted beam and the ordinary vector on the contrary side is known as the edge of refraction. This is connected in the accompanying law, called Snell's Law: ni sin I = nr sin r. For red light in air hitting water this gives sin r = sin I/1.33 Comprehending for Snell's Law for r gives the connection r = arcsin (sin I/n) Express Calculation In straightforward beam following, a beam starts at a point P at a directional vector v, which is of unit length. This is the arrangement of all focuses P+tv where t is a non-negative scalar. At the point when the beam hits the limit between two distinct substances, it will refract, and start another beam. The Mathematics of Bubbles in Beer :: Math Carbonation Refraction Refraction is the thing that happens to light when it goes starting with one medium then onto the next. For instance, things show up uniquely in contrast to the base of a pool than on the top. Straightforwardly, refraction is the bowing of light. The clarification for this marvel, be that as it may, can be depicted with light as beams and light as waves. Regardless of the case, recollect that the speed of light is steady in each homogeneous medium, paying little mind to shape, size or structure. The list of refraction Light voyages ( in specific substances ) at a small amount of the speed in the event that it went in a vacuum. The record of refraction is the opposite of this part. Subsequently, this number is more noteworthy than or equivalent to 1. This list is likewise explicit to light, so extraordinary light in various mediums have distinctive lists. For instance, here is a table of lists: Material Index Vacuum 1.00000 Air at STP 1.00029 Ice 1.31 Water at 20 C 1.33 Acetone 1.36 Ethyl alcohol 1.36 Sugar solution(30%) 1.38 Diamond 2.417 So we should watch the impact of refraction regarding beams. A beam strikes the surface between substance I and substance R. The edge I between the approaching beam and the typical vector at the limit is known as the point of occurrence, and the edge r between the refracted beam and the ordinary vector on the contrary side is known as the edge of refraction. This is connected in the accompanying law, called Snell's Law: ni sin I = nr sin r. For red light in air hitting water this gives sin r = sin I/1.33 Explaining for Snell's Law for r gives the connection r = arcsin (sin I/n) Express Calculation In straightforward beam following, a beam starts at a point P at a directional vector v, which is of unit length. This is the arrangement of all focuses P+tv where t is a non-negative scalar. At the point when the beam hits the limit between two unique substances, it will refract, and start another beam.

Ethics Essay Example | Topics and Well Written Essays - 1000 words - 5

Morals - Essay Example In a general public, this is applied to embracing approaches which should serve the best number of individuals or most of the populace and the strategy that would be untaken ought to have a net impact of expanding satisfaction.  Advocates of libertarian standards, by differentiate commonly reprimand any distributive perfect that requires the quest for financial ‘patterns’, for example, amplification or uniformity of government assistance or of material products. They contend that the quest for such examples clashes with the more significant good requests of freedom or self-proprietorship (Stanford Encyclopedia of Philosophy). I am increasingly disposed to agree with utilitarian equity since it is progressively relevant in today’s current society that any demonstration, approach or thought should serve the best number of individuals. It has additionally useful applications which in truth is even utilized today such the idea of dynamic tax collection which is trul y Rawl’s thought of distributive equity since this tax collection takes more from the rich and gives them more to the person who has less. 2. Clarify as completely as you can John Rawls â€Å"Theory of Justice† Do you concur with hypothesis of equity? Why or why not?â In Rawl’s hypothesis of equity, he advance two sorts of equity which is the legitimacy hypothesis which as the title proposes, rewards the individual relying on one’s commitment to society. The other which is progressively pertinent to this case is the need hypothesis which sets that society has a commitment to help different citizenry who are in need which will â€Å"balance† their impeded position. In his Theory of Justice, Rawl imagines a â€Å"society of free residents holding equivalent essential rights participating inside a populist monetary system† (STandford Encyclopedia of Philosophy).â Thus, the issue of redistributive equity follows this rule our administration should redistribute riches for the reasons for making the dispersion of merchandise increasingly equivalent. This guideline of redistributive equity isn't just perfect yet additionally has reasonable ramifications. Perfect on the grounds that the imbalances of society will be tended to through government components, for example, gathering more expenses from the individuals who gains all the more so it can offer more to the individuals who have less. I concur with Rawl’s hypothesis of equity due to its reasonable ramifications that it limits or blunts the reason for social changes which is imbalance, bad form and destitution. We as a whole realize that the disorderly nations in the Third Worlds are completely brought about by these components; across the board destitution, bad form and disparity. By expelling or limiting the evil impact of broad disparity through the government’s intercession, society will turn out to be progressively steady and less inclined to social changes on the grounds that the individuals who have less, will likewise have less motivation to whine and dissent against the legislature. Components in the public arena who need to plant discontent, mayhem or fear won't likewise succeed on the grounds that the individuals are thoughtful to the legislature and they can't be unsettled to conflict with the administration since they don't feel the unfairness and destitution of which confusion, turmoil and dread varieties. The other viable ramifications of this redistributive equity is that there will be more noteworthy social portability in the public eye where individuals has equivalent opportunity to succeed regardless of whether they have less in light of the fact that the legislature will fill in the social condition where their destitution won't

Theoretical Orientation Cognitive And Humanistic...

Theoretical Orientation Theoretical orientation has been a topic of great debate for this author, over the course of her graduate school experience. During the beginning of her graduate school journey, she was open minded, yet very set in her ways. The last four years have been an experience that has helped to shape her original rigid theory into a well-rounded, applicable theory. This case specifically, was chosen to show her growth in both her approach to treatment and diagnosis. This author took quite a bit of flak for her belief in what she originally thought was behavioral therapy. What she thought she knew as the truth about behavioral therapy and what she learned about theoretical orientations really opened her world up. What she found was that her belief and love for behavioral interventions could be expanded and enriched by adding in aspects of other theoretical orientations such as cognitive and humanistic orientations. Even individuals who are significantly impaired cognit ively can have their treatment enhanced by adding in a cognitive component, along with some much needed patience. This has brought the author to ultimately be grounded in cognitive behavioral therapy. Being grounded in cognitive behavioral therapy has led the author to study and read works from Dr. Albert Ellis and Dr. Arnold Goldstein. Although these individuals are very different, they are also alike in many ways and lead this author to her theoretical orientation. Dr. Ellis emphasizesShow MoreRelatedDifferent Types Of Theoretical Orientations1612 Words   |  7 PagesTheoretical Orientation There are several different types of theoretical orientations that a student may choose to identify him or herself with. Although students may choose a specific theoretical orientation they may change their orientation later on in their academic career depending on their perspective of the field. Each orientation is equal, neither orientation is better than the other. Just because a person picks a certain orientation doesn’t mean that their psychological assessment will beRead MoreCognitive Therapy And Cognitive Behavioral Therapy Essay1461 Words   |  6 Pagespsychotherapy as a discipline and theoretical body of knowledge, there has been many different psychotherapies developed and practiced. Some psychotherapies share similarities and, at times, use the same mechanisms of change (e.g., cognitive therapy and cognitive behavioral therapy) while other psychotherapies are fundamentally distinct from each other (e.g., psychoanalysis and acceptance and commitment therapy). The integration of the mechanisms and theoretical basses of two or more psychotherapiesRead MoreFactors Role In Evidence Based Practice959 Words   |  4 Pagesestablishment of psychoanalytic therapy, and throughout the modern era of psychology there has been a strong tradition of following one of the Grand Theories. During this time, many practitioners exhibited considerable dogmatic allegiance to theoretical orientations (Norcross Goldfried, 2005). As the field of psychology matured into the post-modern era, there has been a shift away from factionalism and parochialism toward one of open dialogue (Safran Messer, 1997). Norcross and Garfried (2005)Read MoreThe Diverse Nature of Psychology Essay examples1075 Words   |  5 Pagespsychodynamic, behavioral, humanistic, cognitive, sociocultural, biological, and evolutionary. This diversity within psychology, allows psychologists the ability to expand in all areas of explanation, assessment, and diagnoses, which furthers the science of psychology through many different subfield specialties. Influence on Psychology’s Major Concepts Diversity is off great influence on the major concepts in psychology. The cognitive-behavioral, psychodynamic, and humanistic perspectives provide diverseRead MoreA Theory Based On The Art Of Loving, Albert Rogers, And Maslow1630 Words   |  7 PagesThe purpose of this paper was to conceptualize a theory based upon existing ideas to create something unique. My theoretical view is based around the foundation and work of three theorist; Fromm, Rogers, and Maslow. Each individual presented a unique aspect, idea, or theory that was instrumental to the construction of my own. It does not have a working title but I can tell you that it most definitely has a purpose and a set of ideals that I believe will and can improve the lives of many. My theoryRead MoreClinical Versus Counseling Psychology2178 Words   |  9 PagesLopez, Campbell, Himmell, 1986). Theoretical Orientations In one of our recent studies (Bechtoldt et al., 2000), we compared the theoretical orientations and employment settings of APAs Division 12 (Clinical) and 17 (Counseling) psychologists (N = 1,389). These results are summarized in Table 1. Again, the convergence was more impressive than the divergence: 29% of both divisions embraced the eclectic/integrative orientation and 26% endorsed the cognitive orientation. However, clinical psychologistsRead MoreTeaching and Learning Are Interrelated2359 Words   |  10 Pagesbeen extensively researched and there are many theoretical perspectives. If teachers are to be effective then they need to understand these five theories and put them into practice every day. Each must be individually recognised and taken into account. These include behaviourist orientations to learning, cognitive orientations to learning, humanistic orientations to learning, social/situational orientations to learning and constructivist orientations to learning. The behaviourist approach to learningRead MoreMy Own Beliefs And Values1808 Words   |  8 Pageswhich I see the world around me, I have come to a better understanding of the theory and the theoretical paradigm that best fits my personality and views. Though I identify with different aspects of several of the theories we have covered, I feel most drawn to the Humanistic-Existential paradigm and believe that an integration of Existential, Person-Centered, and Gestalt therapy through the theoretical orientation of Emotion-Focused therapy by Leslie Greenberg best suites my views and values. Many factorsRead MoreAbnormal Psychology - Behaviour That Is Not Socially Acceptable962 Words   |  4 Pages Stated and unstated rules for proper conduct in a given society or culture Distress According to many clinical guidelines, behavior must be personally distressing before it can be labeled abnormal Breakdown in cognitive, emotional, or behavioural functioning Example: Personality Disorders Eating Disorders Psychosis Dysfunction Abnormal behavior tends to be dysfunctional – it interferes with daily functioning Read MoreA Brief Comparison of Historical Paths for the Clinical and Counselling Streams of Psychology2301 Words   |  10 Pagespsychoanalytic theoretical orientations when treating clients (Norcross, 2000). In contrast, counselling psychologists generally aim to support people who, while not typically suffering from severe mental illness, need assistance in overcoming the emotions associated with traumas such as loss of employment, marital dissatisfaction, loss of friend or family member, addiction (Geldard Geldard, 2012; Gladding, 2013). Primarily they employ client-centered and humanistic methods of theoretical orientation (Geldard

Juvenile Justice Systems Courts and Corrections - 2319 Words

Across the United States, the juvenile justice system’s courts and corrections are scattered with ineffective strategies that are formed which instead increases crime, the nation’s youth are endangered and the future of this country are damaged, billions of taxpayer dollars are put down the drain, and most importantly our mission for equal justice under the law is compromised. Over the past couple of decades, our understanding of how to take on delinquency has expanded in many different forms such as its policy work. But how effective are these works? Amongst all kinds of policy that affect exposed families and their children, Juvenile Justice is atop the list, suffering division in regards to what is the best form of action versus common action. In other words it is between what we as people know works and what the system most often do that aren’t as successful. Our system relies heavily on incarceration and detention, we should instead focus our resources into proven strategies that are cost efficient, increase our public safety, and also look to increase the success of youth that become involved with the juvenile courts. Immediate attention should be enforced and required in combating abuse in juvenile facilities as well as reducing racial disparities. Juvenile Justice is mainly a state and local responsibility, but the Federal government can contribute in a pivotal way. In many cases state and local have a shortage in financial resources, which leads them to seekShow MoreRelatedJuvenile Vs. Adult Corrections939 Words   |  4 PagesJuvenile vs. Adult Corrections The correctional justice system of the United States focused to keep crime out of the streets. The age group divides once the criminal becomes eighteen or above, but sometimes the lines are drawn at the age eighteen to determine if the criminal is convicted of a crime as a juvenile or as an adult. The system allows a rehabilitation facility to maintain criminals from relapsing an offense they have done or will do in the future. Although, criminals charged as an adultRead MoreJuvenile Justice System And The Juvenile Court System1742 Words   |  7 PagesThe juvenile justice system varies from the adult justice system in many ways. For more than a century, the states have believed that the juvenile justice system was a means to ensuring public safety, by establishing and implementing a system that responds to children as they are maturing into adulthood. Today’s youths, however, are increasingly committing more serious crimes that in turn are raising the public’s critic ism concerning the modern juvenile justice system. There are those who are inRead MoreJuvenile Justice System Essay1694 Words   |  7 PagesThe juvenile justice system is a foundation in society that is granted certain powers and responsibilities. It faces several different tasks, among the most important is maintaining order and preserving constitutional rights. When a juvenile is arrested and charged with committing a crime there are many different factors that will come in to play during the course of his arrest, trial, conviction, sentencing, and rehabilitation process. This paper examines the Juvenile Justice System’s court processRead MoreJuvenile Justice System1739 Words   |  7 PagesThe juvenile justice system is a foundation in society that is granted certain powers and responsibilities. It faces several different tasks, among the most important is maintaining order and preserving constitutional rights. When a juvenile is arrested and charged with committing a crime there are many different factors that will come in to play during the course of his arrest, trial, conviction, sentencing, and rehabilitation process. This paper examines the Juvenile Justice System’s court processRead MoreCjs 240 Intro to Juvenile Justice the Juvenile Justice Systems Need to Focus on Rehabilitation1888 Words   |  8 PagesThe Juvenile Justice System’s Need to Focus on Rehabilitation The Juvenile Justice System’s Need to Focus on Rehabilitation Amanda R. Molnar Axia College of the University of Phoenix The Juvenile Justice System Needs to Focus on Rehabilitation The juvenile justice system has long been in debate over whether its focus should be rehabilitation or punishment. From its birth in the early 20th century, the juvenile justice system has changed its focus from punishment to rehabilitation and backRead MoreJuvenile Justice System And For Reducing Juvenile Crime Rates2187 Words   |  9 Pagesincarceration. Over the past 25 years, juvenile crime has skyrocketed, with drug crimes, gang violence, school shootings, and other violent acts being regularly featured in the news. During the past 10 years, nearly all 50 states have overhauled their juvenile justice laws, allowing more youths to be tried as adults. However, in addressing crime, there must be an effective balance between deterrence, prevention, and punishment. This paper analyzes the juvenile justice system and the effectiveness ofRead MoreDifferences Of The Juvenile Justice System2009 Words   |  9 PagesThe juvenile justice system is similar to the criminal justice system. This system is where juveniles are processed, and may be arrested after referrals for juvenile delinquency. Juvenile justice is very different in every state and can be very similar as well because every system has limited jurisdiction and that most focus is on the offenders and not their offenses. Therefore, there are 51 juvenile justice systems in the United States. The United States has the juvenile justice system because childrenRead MoreWhat was the social and historical context in which the juvenile court was created?2464 Words   |  10 Pagessocial and historical context in which the juvenile court was created? What has been the fundamental difference between the procedures used in juvenile courts and those employed in criminal (adult) courts? Juvenile Court, authority charged with the disposition of legal actions involving children. One hundred years ago, the Illinois legislature enacted the Illinois Juvenile Court Act (1899 Ill. Laws 132 et seq.), creating the first separate juvenile court. The policy debates raging around the countryRead More Juvenile Boot Camps Do Not Reduce Juvenile Delinquency Essay3001 Words   |  13 PagesIntroduction Juvenile delinquency is a relatively new phenomenon. For this reason, society’s reactions and solutions to the problem of delinquency are also modern developments. The United States developed the first youth court in 1899 and is now home to many new and formerly untested methods of juvenile rehabilitation and correction. One of many unique programs within the Juvenile Justice system, boot camps are institutions designed to keep delinquent juveniles out of traditional incarcerationRead MoreRate of Juvenile Offenses and the Juvenile Justice System2066 Words   |  9 Pagesmatter. Since the juvenile court’s introduction in 1899, there have been arguments over whether or not the court is productive in treating juveniles. Brazill’s case illustrates the view that the juvenile court is not effective, or is not sufficient to deal with situations as grave as Brazill’s. This is apparent in the detail that he was taken to adult court as a 13-year-old as are against to being tried in juvenile court. The recent move in the direction of trying more juveniles as adults is a

Personal Experience Receiving Therapeutic Counseling

Professional experience in my career so far as well as personal experience receiving therapeutic counseling have given me a broad-based set of beliefs about what motivates individuals. I have determined that each individual comes with a unique context and narrative and that my role is to facilitate a client’s self-determination and decision-making by developing a positive relationship that allows the client freedom to take risks or make informed choices. Also I believe that the counselor creates the trusting relationship where poor choices and failed attempts to meet goals can be explored and utilized by the client to move forward with lessons learned. It is difficult for me to choose a theory or two as I believe I have been influenced over many years by many different schools of thought. Much of my career prior to working as a case coordinator in the Wisconsin Division of Vocational Rehabilitation, was at Job Corps working with disadvantaged youth. Training for staff at Job Corps focused on motivating youth and particularly on youth at risk, so there was an element that took from counseling theory within that training. For example, one training and philosophy at Job Corps was described with the following terms: rigor + relevance + relationship = results. I still adhere to the concepts of rigor (rapid engagement), relevance (selecting appropriate action steps or methods), relationships (the relationship between professional and client must be a healthy one and otherShow MoreRelatedCareer And Personal Experience Receiving Therapeutic Counseling878 Words   |  4 PagesProfessional experience in my career and personal experience re ceiving therapeutic counseling has given me a broad-based set of beliefs about what motivates individuals. I have determined that each individual comes with a unique context and narrative and that my role is to facilitate a client’s self-determination and decision-making by developing a positive relationship that allows the client freedom to take risks or make informed choices. Also, I believe that the counselor creates the trustingRead MoreA Research On Group Therapy996 Words   |  4 Pagesare able to experience different group stages and dynamics within the diverse groups they are a part of in the institutions of family, education, religion, work and community among others. Undoubtedly, these groups and their functions play an integral role in one’s development which inevitably creates a sense of belongingness and purpose. Accordingly, some of these benefits are derived from individuals within a therapeutic setting where group therapy has been effectively used in counseling for severalRead MoreProfessional identity and career paper1483 Words   |  6 Pagesthings such as criminal or sexual behavior. A counselor must communicate positive feel back while withholding judgments. When encountering people of different cultural backgrounds, Counselors must refrain from pushing their personal cultural view/values on them. The counseling process should take place in a safe and intimate environment. Research-Oriented – Research is an ongoing process it does not end upon completion of your degree it only begins. A counselor has to stay current on research inRead MoreA Synthesis Of Supervision Definitions Proposed By Lambie And Sias1449 Words   |  6 PagesClinical counseling supervision has an integral role in the professional and personal development of counselors-in-training, referred to here as supervisees. Many definitions of the term supervision exist in counselor education literature and most researchers agree that supervision in an d of itself is an intervention (Bernard Goodyear, 2014). A synthesis of supervision definitions proposed by Lambie and Sias (2009) best describes my view of supervision and role as clinical supervisor: SupervisionRead MoreAn Interview With A Counselor Essay1381 Words   |  6 Pages Introduction Counseling is defined as †the use of therapeutic strategies to help clients address personal concerns and mental health issues† (Nystul, 2016). Pursuing counseling as a career involves many years of formal study and certification or licensure. After receiving licensure to practice as a professional counselors it is a requirement to maintain involvement and certification in certain associations in order to hold your license. These association often require further education and/or professionalRead MoreWhat I Learned During This Counseling And Communication Skills982 Words   |  4 Pages506. During this course I worked on acquiring basic counseling and communication skills, have an awareness of multicultural differences, awareness of professional identity and have a basic understanding of the dynamics in psychotherapy. Each week I was asked to hold counseling sessions with my peers and other week we taped our counseling session for review and transcription. During these tapings I was asked to demonstrate communication and counseling skills learned in this course. I was also expectedRead MorePerson Centered Therapy1170 Words   |  5 Pagesdevelopment of person-centered therapy. His focus on the importance of the client-counselor relationship has had an influence on both theorists and practitioners. The following chart describes the personal and professional development of Carl Rogers. As he changed and developed, so did person-centered therapy. PERSONAL DEVELOPMENT AND POSITIONS PROFESSIONAL INFLUENCES Developmental Stage Born in 1902 in a suburb of Chicago Fourth of six children Religious fundamental upbringing Adolescent interestRead MoreEssay about Film Report On American Me: A Therapeutic Perspective1251 Words   |  6 PagesFilm Report on American Me: A Therapeutic Perspective American Me is a fictional film having a factual basis, starring and directed by Edward James Olmos. Released to the national theater circuit in 1992, American Me depicts the life of Rodolfo Cadena, a ranking Carnal (gang member) in the prison gang La Eme, also known as the Mexican Mafia. To therapeutically approach the salience and pervasiveness of gang membership, including its allure and reinforcers, would be aRead MoreFilm Report on American Me: a Therapeutic Perspective1294 Words   |  6 PagesFilm Report on â€Å"American Me†: A Therapeutic Perspective Taj Gunter: March 2008 â€Å"American Me† is a fictional film having a factual basis, starring and directed by Edward James Olmos. Released to the national theater circuit in 1992, â€Å"American Me† depicts the life of Rodolfo Cadena, a ranking Carnal (gang member) in the prison gang La Eme, also known as the Mexican Mafia. To therapeutically approach the salience and pervasiveness ofRead MoreCode of Ethics for Marriage and Family Therapists964 Words   |  4 Pagesethics are of great importance, there are a few points in the code that especially resonated with me. First of all, there is a distinct responsibility to patients that must be upheld so that therapeutic services are used appropriately. Efforts need to be made to ensure that the rights of the individuals receiving therapy are respected. An integral part of this patient responsibility is that the therapist does not partake in any form of discrimination toward any patients or potential patients based on

Research Analysis Common Chronic Diseases

Question: Discuss about the Research Analysis for Common Chronic Diseases. Answer: Introduction The diabetes is one of the most common chronic diseases in the modern form of that is caused due to the elevated level of glucose in the blood. According to Scirica et al. (2013), there are several other physical complications that are associated with the diabetes like cardiac disorders, high blood pressure, problems with vision and many more. The control measure that is taken to cure diabetes depends on the amount of glucose that is present within the body. The intensive insulin therapy is carried out by injecting insulin into the blood, which is necessary for controlling the high blood glucose level. It is also essential to keep the diabetic patient under continuous glucose monitoring process. In this essay, comparative analysis of two journal articles that are related to the treatment of diabetes is done. In the first article, by the agency named Nice-Sugar Study Investigators, (2009) the authors have compared the difference and similarities between the conventional and intensive form of glucose treatment. On the other hand, in the second article by Preiser et al. (2009), the authors have mentioned about the randomized trial of the tight glucose control that is being practiced in the Intensive care Unit. The interpretation of the methods and data collection method that is being used along with the result is done in the essay. There is also many similarities and differences in the two articles that are also mentioned in the essay. The comparison of the result of the research work with the evidence-based literature is an important part that can be applied in the nursing practice. Article 1: Intensive versus Conventional Glucose Control in Critically Ill Patients The researchers have conducted the random method of trial method to collect samples from the surgical patients, who are admitted to the intensive care unit of the hospitals. The patients from 42 hospitals out of which, there are 38 academic tertiary care hospitals and other 4 is community-based hospitals. The ethical issue is one of the prime concerns of a research work, which ensures that the investigators have not adapted any unfair practice to collect data or information for the research work. In this case, the ethics committee of the Sydney University and the University of British Columbia along with every participating healthcare institutes have approved the method of the study. Hence, it can be said the investigators have followed ethical rules to ensure that the result of the analysis is correct and accurate. With the help of random analysis, it is possible for the investigators to accurately and impartially compare the result of the intensive and conventional glucose control. The intravenous injection is being used to accurately control the glucose level of blood. This will help to measure the change in the glucose level after the treatment is done. The data that were collected were verified with the monitors of glucose measurement of the healthcare center. The researchers had checked the medical history of the individual diabetic patient that helped them to compare the effect of intensive insulin theory. The previous treatment history of the patient was also verified, which was useful in comparing the result of each individual form of diabetic treatment. The monitoring of the glucose level of blood of individual patient was until 90 days after discharge from the ICU. The study result was done based on the sample that is collected from 6100 patients. This helped the researchers to gain accuracy in the statistical part of the research, which is nearly 90%. The researchers also gave special attention to data collection that the data, to ensure that no important information gets omitted. The chi-square test that is used in the analysis is of unadjusted type and thus is not able to provide an accurate result. The ratio measurement t ools that are used in this case, includes the Welch's test and Wilcoxon sum or rank test. These tools helped the researchers to get accurate results and therefore, the comparison can be done with full efficiency. It was also essential for the researchers to ensure that the out of all the total participants almost equal number of patients were assigned in the to take conventional glucose control test and intensive glucose control so that it is possible to compare the result of each test with sufficient amount of data. The patients, who are receiving the intensive treatment for diabetes, are provided with a higher dosage of glucose compared to that of the patients undergoing a conventional form of treatment. The researchers had obtained similar type of outcomes for both intensive and conventional type of glucose control. In spite of providing intensive care for glucose, 829 patients died. Thus it can be said that when the blood glucose level reaches to new level, it is not possible to cure a patient even after providing intensive care. Perkovic et al. (2013), believes that with the help of the intensive insulin therapy, it is possible to minimize the risks that are associated with diabetes. However, Miller et al. (2014), on the other hand, mentioned that the intensive care for diabetes can be effective only if the patient follows a strict schedule. Thus, it can be said that the patients, who were in the sample size of the research, were not able to follow a strict schedule that was necessary. There is also the risk of hypoglycemia is associated with the intensive form of treatment. Hence, it is important for the doctors to be extra careful while providing intensive insulin treatment. Nev ertheless, Umpierrez et al. (2015) have shown that with proper time and regular monitoring, it is possible to make the best use of the intensive insulin therapy, which is more effective in case of type I diabetes. The overall result that was obtained at the end of the research work is different from that of the meta-analysis of the intensive insulin therapy. The patients, who were given a high dosage of insulin, have higher risks of facing hypoglycemia. The algorithms that were used in the analysis have helped to provide accurate results as it helped the researchers to compare the result from the baseline of glucose measurement in blood. Another advantage of the findings of this analysis is the greater statistical power it possesses compared to all the previously done trials. Hence, it can be said that the accuracy of the result that is obtained is much more compared to previously done research works. However, there are many side-effects that are associated with the intensive form of treatment as most of the patients in this category had faced cardiac related disorders. The intensive glucose care thus may be an active process of controlling the blood glucose level in diabetic patients. The amount that is injected into the patient is of 180 mg or less so that it is possible to get effective result. It is also important for the nurse to regularly monitor the glucose level in the blood so that it is possible to check the effect of treatment. On the other hand, the risks those are associated with the intensive glucose control need to minimize by the nurse with help of effective skills. Proper and accurate diagnosis is essential so that it is possible to provide accurate treatment. The researcher has also suggested avoiding the use of intensive control insulin therapy as there are essential risks that are associated with this treatment. Article 2: A prospective randomized multi-center controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucotrol study Management of stress-related hyperglycemia was re-emerged after gaining improved outcomes in critically ill patients. The purpose of this research is to compare the effects of intensive insulin therapy with an intermediate glucose control on ICU mortality. The optimal target for glucose control in ICU patients has not been clearly discussed in previous literature. Thus, this study will present the management of glucose in ICU patients (Preiser et al. 2009). Since the report of the improved outcomes related to intensive insulin therapy has been published to tight glucose control in intensive care units, the IIT therapy has been recommended by several health agencies. However, the technique has several issues, in spite of its easy accessibility and inexpensiveness; it is a labor-intensive technique, along with some issues that can limit its external validity and benefits. Thus, this study has significant importance to test the hypothesis that IIT can improve the survival or patients re siding in intensive care units (ICU), compared to glucose control target of 7.8-10 mmol/L. The control target was selected for preventing the adverse effect of severe hyperglycemia and reducing the risk of the hypoglycaemia. The study included a randomized control trial including adult patients who were admitted to 21 participating medico-surgical ICUs. The patient recruitment for the study was started in November 2004. The study was managed well, as it has been approved by the institutional review board of each participating hospital. Informed consent was provided to each participant; respective national standards for informed consent have been followed. The inclusion and exclusion criteria for the study participation have been analyzed and these are significant for this study. It has been seen that patients under 18 years old have been excluded for avoiding additional complications; a patient with a life expectancy lower than 24 hours has also been excluded from the study. The primary endpoint of selection was all-cause related to ICU mortality. The group 1 has been designated for the control group; the data were recorded in the preliminary survey, which helped the author to calculate the sample size n eeded for detecting a 4% decrease in mortality with an error rate of 5%. The sampling was analyzed for understanding. The study design was randomized control trial. Two groups were set, for group 1, the blood glucose target was set for 7.8-10.0 mmol/L and for group 2, BG target was set 4.4-6.1 mmol/L. However, due to unintended protocol violations, the trial was stopped early after 1101 admission. A total of 551 patients were assigned to group 1 (LIT) and 550 patients to group 2 (IIT), whereas 542 samples were analyzed in group 1 and 536 samples were analyzed in group 2. From this analysis, it can be said that the study design was appropriate. A thorough monitoring of patients was done during the study from ICU admission to the discharge of the patient from ICU. The study protocol was applied during the time of admission. The data randomization and stratification provide the justification for the validity of data collection methods. The vital outcomes of patients were recorded until patient's discharge or the 28th day of ICU admission. For hourly monitoring, Roche Diagnostics tool has been used, which has shown to provide accurate results in previous studies (Peyrot et al. 2012). The authors defined the rate of hypoglycemia as the proportion of patients experiencing minimum one episode of hypoglycemia. For comparing with other trials, the percentage of morning BG values was calculated within the assigned range. The statistical analysis was also done. Wilcoxon Mann Whitney test has been reported to be used for comparing the inter-quartile ranges and m edians of variables. In addition, for enhancing the reliability of these data, the author used student- t test for comparing the normally distributed continuous variables Standard deviation and men values (Van den Berghe et al. 2006). Chi-square test was used by the authors for comparing categorical variables. To reduce the chance of the influence of variations in sampling intervention, a univariable and multi-variable regression was performed through a backwards elimination procedure for identifying possible independent factors associated with hypoglycemia and mortality. The confidence level of all the data has been calculated for analyzing the reliability of data. The odd ratios have been used by the authors with confidence interval 95% (Hecking et al. 2012). To ensure that the data are statistically significant, p value was considered less than 0.05. The result was published using the outcomes of the 1,101 patients, who participated in the test. After the death of the 100th patient, the researchers had stared their analysis. The mortality rate was very similar in the ICU hospital to that of the LOS. The morality rate also did not differ in case of the patients who had mean BG of below 6.1 mmol/L and also of those, where the mean BG is above 6.1 mmol/L. The report for organ failure, which was assessed with the help of SOFQ scores, did not show much difference between the two groups along with the indices of other severe illness and a total number of febrile days and the total number of days with anti-infective agents. However, the total number of days for the patients having vasodepressor is quite different. The rate of hypoglycemia was 8.7% in the group I and in case of group II, it was just 2.7%. The main findings of the research paper are about the impact of intensive insulin therapy, which is quite different from the previously done research. With a dosage of 4.4-6.2 mmol/L of BG, there is very little effect on the critically ill patients. There is also the risk of hypoglycemia due to the treatment of intensive insulin therapy. The main difficulty that the researchers faced to make definite conclusion for this analysis is due to the premature interruption of the research work. However, from the discussion part, it is clear that the nurses, who are practicing the intensive insulin therapy among the patient, need to pay extra care to the critically ill patients as there is a high risk of the patients to suffer from hypoglycemia. Similarities and Difference in the two articles In both the above-mentioned research article, the researchers have analyzed about the treatment methods for critically ill patients suffering from high blood glucose level. Both of the studies were conducted upon the patients who were admitted to the intensive care unit of hospital. The main difference between the two research papers is that in case of the first article, the researchers had tried to compare the effect of the difference between the conventional and intensive form of glucose treatment, which includes the intensive insulin therapy. On the other hand, in the case of the second research article the investigators had focused on the effect of controlled intensive insulin therapy among the ICU patients. In result of both the articles, the researchers had made a conclusion that the intensive form of glucose control therapy has negligible effects on the critically ill patients. Moreover, there is also the risk of hypoglycemia, where the concentration of the glucose level in blood goes down significantly. The researchers of both the article have suggested that the nurses, who are incorporating the intensive glucose treatment, need to carefully diagnose and monitor the conditions of the patients. The conventional form of diabetic treatment is much better compared to the intensive glucose treatment as there is not much difference between the two forms of treatment. Moreover, there are no side-effects that are associated with the conversion form of diabetic treatment. Hence, there is a wide scope of opportunity for future research on the ways and techniques that can be adopted to improve the use of intensive insulin therapy . Reference Hecking, M., Haidinger, M., Dller, D., Werzowa, J., Tura, A., Zhang, J., Tekoglu, H., Pleiner, J., Wrba, T., Rasoul-Rockenschaub, S. and Mhlbacher, F., 2012. Early basal insulin therapy decreases new-onset diabetes after renal transplantation. Journal of the American Society of Nephrology, 23(4), pp.739-749. Miller, M.E., Williamson, J.D., Gerstein, H.C., Byington, R.P., Cushman, W.C., Ginsberg, H.N., Ambrosius, W.T., Lovato, L., Applegate, W.B. and ACCORD Investigators, 2014. Effects of randomization to intensive glucose control on adverse events, cardiovascular disease, and mortality in older versus younger adults in the ACCORD Trial.Diabetes Care,37(3), pp.634-643. Nice-Sugar Study Investigators, 2009. Intensive versus conventional glucose control in critically ill patients.N Engl J Med,2009(360), pp.1283-1297. Perkovic, V., Heerspink, H.L., Chalmers, J., Woodward, M., Jun, M., Li, Q., MacMahon, S., Cooper, M.E., Hamet, P., Marre, M. and Mogensen, C.E., 2013. Intensive glucose control improves kidney outcomes in patients with type 2 diabetes.Kidney international,83(3), pp.517-523. Peyrot, M., Barnett, A.H., Meneghini, L.F. and Schumm?Draeger, P.M., 2012. Insulin adherence behaviours and barriers in the multinational Global Attitudes of Patients and Physicians in Insulin Therapy study. Diabetic Medicine, 29(5), pp.682-689. Preiser, J.C., Devos, P., Ruiz-Santana, S., Mlot, C., Annane, D., Groeneveld, J., Iapichino, G., Leverve, X., Nitenberg, G., Singer, P. and Wernerman, J., 2009. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive care medicine, 35(10), pp.1738-1748. Preiser, J.C., Devos, P., Ruiz-Santana, S., Mlot, C., Annane, D., Groeneveld, J., Iapichino, G., Leverve, X., Nitenberg, G., Singer, P. and Wernerman, J., 2009. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study.Intensive care medicine,35(10), pp.1738-1748. Scirica, B.M., Bhatt, D.L., Braunwald, E., Steg, P.G., Davidson, J., Hirshberg, B., Ohman, P., Frederich, R., Wiviott, S.D., Hoffman, E.B. and Cavender, M.A., 2013. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus.New England Journal of Medicine,369(14), pp.1317-1326. Umpierrez, G., Cardona, S., Pasquel, F., Jacobs, S., Peng, L., Unigwe, M., Newton, C.A., Smiley-Byrd, D., Vellanki, P., Halkos, M. and Puskas, J.D., 2015. Randomized controlled trial of intensive versus conservative glucose control in patients undergoing coronary artery bypass graft surgery: GLUCO-CABG trial.Diabetes Care,38(9), pp.1665-1672. Van den Berghe, G., Wilmer, A., Hermans, G., Meersseman, W., Wouters, P.J., Milants, I., Van Wijngaerden, E., Bobbaers, H. and Bouillon, R., 2006. Intensive insulin therapy in the medical ICU. New England Journal of Medicine, 354(5), pp.449-461.