Wednesday, January 29, 2020

Good cancer pain management can help patients feel better Essay Example for Free

Good cancer pain management can help patients feel better Essay Most cancer patients suffer from pain in varying degrees during their illness. The management of this pain and its relationship in improving the wellbeing of the patient is the primary focus of this study. This paper approached the study by researching articles that dealt with pain management from different angles. After critical analysis of these articles this paper will arrive at a conclusion that addresses the research question.   The topics reviewed included: 1. The use of a clinical instruction module (CLIM) for hospice nurses to upgrade their skills (Plymale, M. et al, 2001) 2. The role of cognition in promoting the psychological well being of the patient (Chen, Mei-Ling. 2002) 3. The use of pain management autobiographies to discover how best to deal with pain management (Schumacher, K. et al. 2001) 4. Overcoming patient related barriers to pain management by educating them (Chang, Ming-Chuan. 2002) 5. Providing a description of advanced cancer pain in home hospice subjects to enable the caregivers to alleviate their suffering (Dobratz, M. 2001) The material for this study was searched from the University of Wollongong database of Medline. The key words in the search for journal articles were nursing, research and cancer pain.   Articles were chosen for their relevance to the research question and the findings they came up with. Information that was obtained from these studies enabled the writer to draw important conclusions as concerns pain management in cancer patients with pain. The research is of extreme importance to the writer. I lost my husband to cancer. The trauma we all went through watching him in pain gave me a new impetus to do all in my power to ensure that no other patient will need to go through the same suffering as he did. As I continue to practice, I would like to contribute to breaking new ground in pain management in cancer patients; especially as concerns alleviating their pain and improving their quality of life. Article 1 In an article entitled ‘Cancer Pain Education: A Structured Clinical Instruction Module For Hospice Nurses’, appearing in the journal ‘Cancer Nursing ‘,Plymale M. et al (2001) studied the effect of pain education on the quality of service by caregivers. The research aimed to determine whether educating nurses on pain management will improve their ability to assess and manage pain in cancer patients. A clinical instruction module (CLIM) based on cancer pain management and assessment skills was administered to 25 hospice nurses whose average field practice was 4.1 years (Plymale M. et al. 2001, p. 424).The course involved the nurses going round 8 stations focussing on   different aspects of cancer pain, assessing 5 cancer survivors and one actor. They carried out tests on various aspects of pain management. Prior to and after the exercise the nurses self assessed their skills in pain management using a 5-point Likert scale ranging from 1(not competent) to 5(v ery competent). They also evaluated the CLIM on a similar scale. (1= strongly disagree; 5= strongly agree) All participants agreed that the course helped improve their competence in the teaching items that were being addressed. The use of patients with cancer was considered more beneficial as opposed to having actors. Nurses that felt competent enough before the course did not perceive any noticeable improvement in their abilities in the post exercise self assessment. This finding is consistent with the view that hospice nurses are more competent in dealing with cancer pain management than those nurses working in hospitals. Those who assessed themselves as not competent indicated a higher assessment of themselves after the course. In a further study conducted among post instruction medical students, those trained using a CLIM on pain management did better than those schooled it traditional methods. (Sloan P.A. et al., 2001, 112)     Ã‚  There is an urgent need to introduce CLIM’s addressing pain assessment and management in the teaching courses for all nurses and caregivers in a bid to improve their skills and service delivery. The more competent the nurses the better will be the treatment of patients in prolonging their lives and alleviating the pain they go through. A significant observation of this study is the competence level of hospice nurses was higher than that of their counterparts. It is advisable to seek their input in developing manuals and modules of this nature as they have first hand knowledge that is invaluable to this area of study. Article 2 ‘Pain And Hope in Patients with Cancer’, an article written by Chen, Mei-Ling and appearing in the journal ‘Cancer Nursing’ (2003) examines the relationship between pain and hope in cancer patients. Hope is a therapeutic factor in the treatment of any disease including cancer. Patients with high levels of hope coped better with the disease than did those who dwelt on the hopelessness of their situation. The hopeful patients on average tended to live longer and had extended periods of remission. This study had three main purposes; i. Examine the effect of disease status on hope levels among patients with cancer who have pain ii. Compare the level of hope between patients with cancer that have pain and those who do not iii. Determine which dimensions of pain are associated with hope (Chen, Mei-Ling. 2002, p.62) The conceptual framework for the study was based on the ‘self- regulation model of coping with health threats’. (Chen, Mei-Ling. 2002, p.62) The main emphasis is on how people cope with their health problems in their own unique ways. Personal beliefs, religious orientation, cultural practises and previous experiences all work to determine a patient’s attitude towards his illness.(Donavan, H.S., Ward, S., 2001, pp. 211 – 216) Any one of the factors mentioned will have a bearing on the hope levels of the individual. The study employed the use of the Herth Hope Index (HHI) to assess the level of hope. It sampled 274 inpatients with cancer at two medical centres in Taiwan. 226 of them finalised the survey and the analysis was based on their responses. The study used Perceived Meaning of Cancer Pain Inventory (PMCPI) to measure the meanings that patients ascribed to their pain. Four subscales were used and these were challenge, threat, spiritual awareness and loss. The findings showed that in cancer patients with pain and those without pain, the hope levels did not differ. However, sensory dimensions of pain showed a link between the bearable pain intensity and level of hope (Chen, Mei-Ling. 2002, p. 65) The findings supported the view that the hope levels in patients were higher in those who were able to tolerate more pain. Perception of one’s pain played an important role in the way one held on to hope. Those who viewed the pain as a challenge were more hopeful than those who took it from a negative perspective. In assessing one’s reaction to treatment, it is notable that the findings showed no difference in hope levels for those patients who were unsure of the effect of treatment and those who affirmed that the treatment was working positively.

Tuesday, January 21, 2020

Essay --

In today’s ever competitive global market, marketers are finding themselves having to grapple with an increasingly difficult issue about branding and their brands. Many marketing managers have to deal with questions of what are the most effective and efficient means to building a strong brand and sustaining it. Pick up any marketing textbook and most will define brands as a name, design, terms, symbol, or any combinative feature that identifies and differentiates one seller’s good or service from those of other sellers. (American Marketing Association) In other words, it is everything that a consumer can retain in their mind about the product or service produced by a particular organization. Brands are often evoked or symbolized using a variety of features belonging to the brand. These features represent all the past experience and expectation a consumer has received about that brand. When we think about brands in the likes of Apple, Bmw, Victoria Secret, and Disney, we not only read into them our experiences with the brand but their features triggers a mental model in our minds. It creates a certain perception of quality, expectations and position in our minds. They connect the products attributes and brand association between the corporations and users. (Biel, 1991) With that said, branding that could create a lasting impression into the minds of its consumers plays an important part for any successful business. It can be used to enhance business performance as brand themselves are used as an implied tool that can positively influence people’s buying behaviors and work as a driving force to convey the business’ message and stay in the customer’s mind. Consequently, studies have been made and the results showed that consumer’s ... ...uality. It was often times like those where it was difficult to measure how good a product is from an unfamiliar brand, hence loyalty was a way of reducing risk. (Simonson & Rosen, 2014). Consumers today are far better informed and likely to investigate the value of products than just to rely on intrinsic values of brands before purchase. Consumers are empowered to do their own research about whatever they want to buy. This trend started with Consumer Reports, which produced reports on objective studies about products and further enhanced with the rise of the internet, which has given ordinary consumers access to expert reviews, user feedback, and details about product data, in an assortment of product categories. A study conducted showed that in 2012, seventy-two per cent of consumers in the U.S look at online reviews before making major purchases (Coopers, 2012).

Monday, January 13, 2020

Belonging: Narrator and Sense

Humans are constantly in search for belonging, it is something vital to our existence. A sense of belonging emerges from our ability to establish connections with place, people and culture. However when these aspects are challenged, we find out if we truly belong or not. Such ideas are explored in the texts, ‘The Ride of Zhu Bao Sheng’, a third person short story by Nick Long, and ‘Big World’, a first person short story by Tim Winton, which both explore the idea of belonging being challenged and how this affects one’s sense of belonging. Our sense of belonging is derived from the connections to the places around us. One’s sense of belonging is challenged when changes or barriers arise between our connection with place, people and culture. In both ‘The Ride of Zhu Bao Sheng’ and ‘Big World’, we see the protagonists’ sense of belonging being challenged. Nick Long asserts that Zhu does not belong in the place he is in by using irony, making it clear Zhu feels a lack of belonging. This idea is shown through the line, â€Å"He was alone in this place. True, the town is full of people†¦Ã¢â‚¬  Here the obvious use of irony is used to emphasize Zhu’s detachment from the rest of the town caused by his sense of belonging being challenged after he moved from his ‘hometown’. Inevitably with effort, he makes a connection to the place. This is evident by the line â€Å"almost drunk with the scent of the acacias, and of the dust, and of this new landscape. † This dreamy state implies that a sense of belonging comes after we establish healthy connections with place. The unnamed narrator in ‘Big World’ tells of the differences between himself and his best high school friend in a confessional tone, saying â€Å"Unlike him, I’m not really from here. It’s not hosing blood that s**ts me off – it’s Angelus itself; I’m going nuts here. Unlike Zhu, the narrator chooses not to build a connection to the place, instead he intends to escape Angelus, evident in the line â€Å"f**k it, we’re outta here†. The use of the hyperbole, ‘I’m going nuts here’ shows that even after spending years in a place, one may never establish a strong connection with place to develop a healthy sense of solidarity with a community. We learn that when one’s sense of belonging is challenged, one can face the challenge and still establish a sense of belonging. A sense of belonging to place is closely intertwined with the people within that place. The relationships formed around an individual are the cornerstones of their sense of community and belonging. A sense of belonging is often reliant of the relationships we build; these connections may determine our own self-perception on how we fit the world around us. We see the importance of relationships in ‘The Ride of Zhu Bao Sheng’ as he felt no sense of belonging. Zhu was challenged by not knowing anyone, evident in the line â€Å"Who will I talk to? There was nobody to answer the questions. † The rhetorical question reinforces the idea that he could only talk to himself. However, after speaking to a girl, he felt a sense of a relationship, which is reinforced by the change in tone and the use of a simile. â€Å"Zhu didn’t understand the words, but was amazed by the sound of them. Her voice was airy and light, like the song of a small bird†. Throughout the text, the language had been pessimistic, this contrast in tone, was the direct result of a relationship formed, in essence, a sense of belonging had been formed. Similarly in ‘Big World’, the importance of connection to people is clear. The narrator felt a strong sense of belonging when around his best friend, Biggie, shown by the constant anaphora of the inclusive pronouns that runs throughout the entire text, ‘we’ and ‘us’. An example of this extensive use is â€Å"We fried. We’re idiots of a different species but we’re both bloody idiots. The repetition of inclusive pronouns shows the narrators strong connection with Biggie, which displays a strong sense of companionship when he is around biggie. It is only when this sense of companionship is challenged, that the narrator will know how strong this companionship actually is. We learn that challenges that arise in many forms and can be overcome to see what lies ahead for one’s sense of belonging. Belonging is derived from our sense of connection with people and place. It is also derived from one’s culture. It is harder for those of a minority in a dominant culture to thrive in terms of their sense of belonging. A minority must conform to the dominant culture in order to establish a healthy sense of belonging with the dominant culture. Zhu’s culture and ethnicity is considered to my a minority. Zhu experiences a barrier to belonging with the dominant culture. It writes, â€Å"But they were not Chinese people, and he could not speak to people who were not Chinese. Nobody ever taught him. † Zhu’s culture has restricted him from communicating with those outside his culture. Being in a situation where one is a minority, one will find it very difficult to build connections with those of the dominant group. Conformity is needed, which Zhu gives in to, eventually attempting to speak English, the dominant language. In contrast to Zhu, the narrator of Big World’ does not have such issues with culture. The narrator’s culture is tightly bonded with that of the dominant culture allowing his sense of belonging to excel. Such connections with culture can be seen through heavy Australian idioms as Winton writes, â€Å"Mag wheels, a lurid spray job like something off a Yes album and a filthy great mattress in the back, a chick magnet, that’s what we want . The heavily idiomatic language suggests a strong sense of association with the dominant culture, in effect, provides a strong sense of belonging. We learn that society will force you to conform in order to belong. When a person conforms to a culture, a sense of belonging to place and people will come with it. From the reading of ‘The Ride of Shu Bao Sheng’, we learn that one’s attachment to place is essential to their sense of belonging due to the human condition to want to form connections with place. This has been reinforced by ‘Big World’, where the narrator is challenged and could not form a connection with the place, resulting in a lack of belonging in that aspect. Both texts have shown me the degree at which the people surrounding and individual will influence their sense of belonging and when barriers arise, with effort, these challenges can be overcome to establish a stronger sense of belonging. In addition to these notions of belonging, both texts have solid but contrasting views on belonging to place, however serve the same purpose as important aspects of belonging. In conclusion, the notions of belonging such as place, people and culture are all intertwined and are thus the cornerstones of ones sense of belonging.

Sunday, January 5, 2020

Proportions Word Problems Worksheet and Answers

A proportion is a set of 2 fractions that equal each other. This article focuses on how to use proportions to solve real life problems. Real World Uses of Proportions Modifying a budget for a restaurant chain that is expanding from 3 locations to 20 locationsCreating a skyscraper from blueprintsCalculating tips, commissions, and sales tax Modifying a Recipe On Monday, you are cooking enough white rice to serve exactly 3 people. The recipe calls for 2 cups of water and 1 cup of dry rice. On Sunday, you are going to serve rice to 12 people. How would the recipe change? If you’ve ever made rice, you know that this ratio—1 part dry rice and 2 parts water—is important. Mess it up, and you’ll be scooping a gummy mess on top of your guests crawfish à ©touffà ©e. Because you are quadrupling your guest list (3 people * 4 12 people), you must quadruple your recipe. Cook 8 cups of water and 4 cups of dry rice. These shifts in a recipe demonstrate the heart of proportions: using a ratio to accommodate lifes greater and smaller changes. Algebra and Proportions 1 Sure, with the right numbers, you can forgo setting up an algebraic equation to determine the amounts of dry rice and water. What happens when the numbers are not so friendly, however? On Thanksgiving, youll be serving rice to 25 people. How much water  do you need?Because the ratio of 2 parts water and 1 part dry rice applies to cooking 25 servings of rice, use a proportion to determine the quantity of ingredients. Note: Translating a word problem into an equation is super important. Yes, you can solve an incorrectly set up equation and find an answer. You can also mix rice and water together to create food to serve at Thanksgiving. Whether the answer or food is palatable depends on the equation. Think about what you know: 3 servings of cooked rice 2 cups of water; 1 cup of dry rice25 servings of cooked rice ? cups of water; ? cup of dry rice3 servings of cooked rice/25 servings of cooked rice 2 cups of water/x cups of water3/25 2/x Cross multiply. Hint: Write these fractions vertically to get the full understanding of cross multiplying. To cross multiply, take the first fractions numerator and multiply it by the second fractions denominator. Then take the second fractions numerator and multiply it by the first fractions denominator. 3 * x 2 * 253x 50Divide both sides of the equation by 3 to solve for x.3x/3 50/3x 16.6667 cups of waterFreeze- verify that the answer is correct.Is 3/25 2/16.6667?3/25 .122/16.6667 .12Whoo hoo! The answer 16.6667 cups of water is correct.   Ratio and Proportions Word Problem 1: The Brownie Recipe Damian is making brownies to serve at the family picnic. If the recipe calls for 2  ½ cups of cocoa to serve 4 people, how many cups will he need if there will be 60 people at the picnic? 37.5 cups What do you know?2  ½ cups 4 people? cups 60 people2  ½ cups/x cups 4 people/60 people2  ½/x 4/60Cross Multiply.2  ½ * 60 4 * x150 4xDivide both sides by 4 to solve for x.150/4 4x/437.5 x37.5 cups Use common sense to verify that the answer is correct.The initial recipe serves 4 people and is modified to serve 60 people. Of course, the new recipe has to serve 15 times more people. Therefore, the amount of cocoa has to be multiplied by 15. Is 2  ½ * 15 37.5? Yes. Ratio and  Proportions Word Problem 2: Growing Little Piglets A piglet can gain 3 pounds in 36 hours. If this rate continues, the pig will reach 18 pounds in  216  hours. What do you know?3 pounds 36 hours18 pounds ? hours3 pounds/18 pounds 36 hours/ ? hours3/18 36/x Cross Multiply.3 * x 36 * 183x 648 Divide both sides by 3 to solve for x.3x/3 648/3x 216216 hours Use common sense to verify that the answer is correct.A piglet can gain 3 pounds in 36 hours, which is a rate of 1 pound for every 12 hours. That means that for every pound a piglet gains, 12 hours will pass. Therefore 18 *12, or 216 pounds, is the correct answer. Ratio and  Proportions Word Problem 3: The Hungry Rabbit Denise’s rabbit can eat 70 pounds of food in 80 days. How long will it take the rabbit to eat 87.5 pounds? 100 days What do you know?70 pounds 80 days87.5 pounds ? days70 pounds/87.5 pounds 80 days/x days70/87.5 80/x Cross Multiply.70 * x 80 * 87.570x 7000 Divide both sides by 70 to solve for x.70x/70 7000/70x 100 Use Algebra to verify the answer.Is 70/87.5 80/100?70/87.5 .880/100 .8 Ratio and  Proportions Word Problem 4: The Long Road Trip Jessica drives 130 miles every two hours. If this rate continues, how long will it take her to drive 1,000 miles? 15.38 hours What do you know?130 miles 2 hours1,000 miles ? hours130 miles/1,000 miles 2 hours/? hours130/1000 2/x Cross Multiply.130 * x 2 * 1000130x 2000 Divide both sides of the equation by 130 to solve for x.130x/130 2000/130x 15.38 hours Use Algebra to verify the answer.Does 130/1000 2/15.38?130/1000 .132/15.38 is approximately .13