Wednesday, September 2, 2020

Diabetes: Prevention and Treatment Essay -- Diseases/Disorders

General wellbeing underlines the significance of counteraction and proactively dealing with one’s body. As individuals develop more established, they should follow certain rules to guarantee that they age soundly and effectively. Perhaps the greatest concern confronting the maturing populace is incessant illnesses. Incessant sicknesses are long haul maladies that have a moderate movement. When constant ailments pass â€Å"certain indicative or symptomatic thresholds,† they become a changeless part of an individual’s life in light of the fact that â€Å"medical and individual regimens can some of the time control however can seldom fix them† (Albert and Freeman 105). One ceaseless condition that is a reason for concern is diabetes. Diabetes isn't just one of the main sources of death in the more than 65 populace yet additionally one of the most predominant and weakening conditions (111). Diabetes is a ceaseless ailment or condition that includes the hormone insulin, which manages the measure of glucose in a person’s circulation system. At the point when cells are needing vitality the pancreas produce insulin; this component permits cells to ingest glucose from the circulatory system. Diabetes happens when the pancreas doesn't deliver enough insulin or the body has gotten impervious to its own insulin; this leaves an overabundance measure of glucose in the circulation system as there is no insulin present to manage it to the cells (â€Å"Diabetes†). There are two kinds of diabetes that influences the overall populace: Type I and Type II. Type I is ordinarily predominant in youngsters and is described by an insulin inadequacy. Type II diabetes is grown-up beginning and happens when the body is impervious to the insulin it produces. Type II influences roughly 90 percent of individuals with diabetes around the globe. Because of the comparability in side eff ects between the two sorts... ... Ailment Control and Prevention, 01 Aug. 2011. Web. 03 May 2012. . Diabetes. World Health Organization. World Health Organization, Aug. 2011. Web. 03 May 2012. . HealthEase. Division of Aging and Community Services. Province of New Jersey Department of Health and Senior Services. Web. 03 May 2012. . Medicare Diabetes Screening Project. Medicare Diabetes Screening Project. Web. 03 May 2012. . Range, Paula. For Elderly Diabetics, Questions About Aggressive Care. New York Times. New York Times, 11 Apr. 2011. Web. 03 May 2012. . Diabetes: Prevention and Treatment Essay - Diseases/Disorders General wellbeing accentuates the significance of counteraction and proactively dealing with one’s body. As individuals develop more seasoned, they should follow certain rules to guarantee that they age soundly and effectively. Perhaps the greatest concern confronting the maturing populace is ceaseless illnesses. Interminable maladies are long haul sicknesses that have a moderate movement. When ceaseless maladies pass â€Å"certain indicative or symptomatic thresholds,† they become a changeless part of an individual’s life in light of the fact that â€Å"medical and individual regimens can in some cases control however can once in a while fix them† (Albert and Freeman 105). One ceaseless condition that is a reason for concern is diabetes. Diabetes isn't just one of the main sources of death in the more than 65 populace yet in addition one of the most predominant and weakening conditions (111). Diabetes is a constant malady or condition that includes the hormone insulin, which manages the measure of glucose in a person’s circulation system. At the point when cells are needing vitality the pancreas produce insulin; this component permits cells to assimilate glucose from the circulatory system. Diabetes happens when the pancreas doesn't deliver enough insulin or the body has gotten impervious to its own insulin; this leaves an abundance measure of glucose in the circulatory system as there is no insulin present to direct it to the cells (â€Å"Diabetes†). There are two sorts of diabetes that influences the overall populace: Type I and Type II. Type I is commonly pervasive in kids and is described by an insulin insufficiency. Type II diabetes is grown-up beginning and happens when the body is impervious to the insulin it produces. Type II influences roughly 90 percent of individuals with diabetes around the globe. Because of the closeness in side effects between the two sorts... ... Sickness Control and Prevention, 01 Aug. 2011. Web. 03 May 2012. . Diabetes. World Health Organization. World Health Organization, Aug. 2011. Web. 03 May 2012. . HealthEase. Division of Aging and Community Services. Territory of New Jersey Department of Health and Senior Services. Web. 03 May 2012. . Medicare Diabetes Screening Project. Medicare Diabetes Screening Project. Web. 03 May 2012. . Length, Paula. For Elderly Diabetics, Questions About Aggressive Care. New York Times. New York Times, 11 Apr. 2011. Web. 03 May 2012. .

Saturday, August 22, 2020

Subway Is the Better Fast Food Restaurant.

COM155 Subway Is The Better Fast Food Restaurant. Living in this insane world that is today, where family meals comprise of whatever drive-through joint is in transit home from work. As indicated by the Center for Disease Control and Prevention, it is no big surprise why 33% of American grown-ups and 17% of American kids are fat. Tram and McDonald’s are the two monsters in the cheap food world. They have the two fans and boycotters. Anyway Subway is a superior drive-thru eatery than McDonalds, due to Subway’s children’s suppers decisions, publicizing, measure of areas and nutrition.Advertising is the way that organizations acquire clients. Commercials can make mouth water and the customer ache for what the promotion is advertising. Metro has a promoting effort that offers a â€Å"limited time† bargain where the customer can get a specific sort of Foot long sandwich for five dollars. The arrangements most recent a month long. Toward the month's end the sand wich is changed out and another is taken care of. McDonald’s has a comparative arrangement. They come out with claim to fame sandwiches or burgers like clockwork for instance the McRib which is just three inches and cost four dollars.McDonald’s publicizes to the more youthful buyers while Subway promotes to a â€Å"healthier† purchaser. The two different ways of publicizing are far and legitimate. Anyway no parent needs to manage their kid, which has recently observed a promotion for a â€Å"Happy Meal†, pitching a temper fit since they don't get the chance to have a â€Å"Happy Meal. † Both organizations are getting customers in the majority. McDonald’s and Subway have kid’s suppers. This is a dinner that has a littler bit implied for a youngster. The Subway â€Å"Fresh Fit† kid’s dinners have a selection of â€Å"mini sandwich† which is three inches, and the child’s decision of a side and a drink.The deci sions include: chips, apple cuts, or a treat for the side and three various types of milk, juice, water, or a little soft drink for the beverage. The calories run for these suppers is from 150 to 220 calories for each feast with the normal dinner being 208 calories. McDonald’s â€Å"Happy Meal† accompanies a burger, or chicken tenders, a â€Å"kids† fry, apple cuts, and a beverage. The beverage decisions are two unique sorts of milk, juice or pop. The calories extend for these dinners is from 320 to 430 calories for every feast with the normal supper being 376 calories. That is practically twofold the measure of calories than the kid’s supper is at Subway.As a parent, McDonald’s â€Å"Happy Meals† have such a large number of calories and are making today’s kids fatter than at any other time. The measure of areas and deals are imperative to any organization. Heller (2011) noticed that Subway is currently the biggest cheap food organiza tion on the planet. It has 33,749 areas everywhere throughout the world, while McDonald’s has 32,737 areas. Anyway by the measure of deals McDonald’s in the biggest. McDonald’s has announced that they have 24 billion dollars in deals a year. Tram posts deals reports at 15. 2 billion dollars per year. So can any anyone explain why a café that has more area has less announced earnings?The cost of subway’s food is increasingly costly. At the point when an organization purchases new food versus solidified nourishments, the profit go down in light of the fact that the new food costs more cash. On that Subway would prefer to make somewhat less benefit and show signs of improvement item to its purchasers that is more beneficial for them and that cost a similar measure of cash than a spot that isn't as nutritious for them, as McDonald’s. The menu alternatives and nourishment are totally different at these two spots. Tram has options like sandwiches, plate s of mixed greens, and soups as a primary course, while McDonald’s has burgers, chicken pieces and servings of mixed greens as a fundamental course.The sides for these two spots are comparable with things like apples, yogurt and treats. In any case they can be totally different too with McDonald’s conveying things like fries, frozen yogurt while Subway Choices to convey things like heated chips. Concerning drinks McDonald’s conveys: pop, water, tea, milk, juice, and espresso. While Subway conveys pop, water, squeeze and milk. With every one of these choices the decisions are perpetual, in any case so are the calories. So let’s take a gander at simply the fundamental course. At the point when a shopper arranges a supper from Subway they are taking a gander at a scope of 230 calories to 600 calories for simply the sandwich with a normal of 391 for each sandwich.At McDonald’s a similar buyer requesting a feast is taking a gander at a scope of 250 to 8 00 calories for simply the burger with the normal of 444 calories for each sandwich. Presently if this shopper doesn't simply eat a burger or sandwich, which most buyers eat an entire feast, at that point they are taking a gander at near 1000 calories for each supper at McDonald’s and 600 calories at Subway. Concerning menu choices and calories the unmistakable champ is Subway. McDonald’s or Subway is the million dollar question. McDonald’s with its southern style and solidified nourishments can never really add increasingly fat to an effectively fat country.Subway could get Americans out of their heftiness issue, with their new sound food sources. After all the discussion about children’s dinners, notice, measure of areas and detailed deals, and sustenance it is anything but difficult to perceive any reason why Subway it the more advantageous and more brilliant cheap food decision that more Americans ought to make. References page Center for Disease Cont rol and Prevention at www. cdc. gov Overweight and Obesity, Data and Statistices, U. S. Corpulence Trends February 27, 2012 Laura Heller, Subway Is Now Bigger Than McDonald’s, March 08, 2011 www. dailyfinance. com

Friday, August 21, 2020

Health Care Ethics free essay sample

The Bartling case was about whether William Bartling had the right, over the complaint of his doctors and the medical clinic, to have life-bolster hardware disengaged in spite of the way that withdrawal of such gadgets will definitely hurry his demise. At the point when he entered Glendale Adventist Hospital in California in 1984, he was known to be experiencing emphysema and diffuse arteriosclerosis, coronary arteriosclerosis, stomach aneurysm, and inoperable lung disease. Toward the end, He needed to utilize mechanical respiratory and chest cylinder to help his taking in the ICU. Albeit every one of these conditions could exclusively be deadly, he was not analyzed as critically ill. From the start, Mr. Bartling requested that his doctors expel the ventilator yet they cannot. At that point Mr. Bartling endeavored to evacuate the ventilator tubes however was ineffective. In the long run, to forestall his endeavor, he was put handcuffed with the goal that the cylinders could stay set up. The case was taken to Los Angeles Superior Court by Mr. We will compose a custom paper test on Social insurance Ethics or on the other hand any comparative subject explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page Scott. Since he was not viewed as at death's door, the court denied either to permit the respirator to be detached or to arrange that Mr. Bartling’s hands be liberated. At the subsequent time, the case was taken to the California Court of Appeal. Notwithstanding, the outcome was that Mr. Bartling reserved the option to settle on his own choice, which was clearly extraordinary with the first run through. So I think the primary issue for this situation is about patient’s dynamic limit, explicitly, when patient can settle on settle on the choice of his own clinical medicines.

Friday, June 5, 2020

What Do We Know About Marilyn Monroe - Free Essay Example

In 1926 Marilyn Monroe was born on June 1st in Los Angeles, California.   Her birth name was Norma Jean Mortenson.   She was also sent to an orphanage when she was nine years old.   Marilyn Monroe’s first husband was Jim Daugherty when she was sixteen,they stayed married for four years.   She also lived in three places Hawthorne, Compton, and Los Angeles all in California.   That is a few facts about Marilyn Monroe, and now i’m going to tell you about her from birth to death.   Ã‚  Ã‚  Ã‚   Marilyn Monroe was born on June 1st, 1926 in Los Angeles, California at Los Angeles General Hospital.   People say that Marilyn Monroe had a difficult childhood.   Marilyn spent her Childhood in a series of foster homes and an orphanage.   Marilyn’s Career as an actress started when she was 16 years old.   She also did skiing,horseback riding, swimming, and canoeing also went on a number of fishing trips.   She also liked to go surfing,played Soccer, Golf, Softball, Basketball, Badmitten, and Running are all things Marilyn Monroe would do during her free time as a child.   When Marilyn Monroe was in preschool and Middle school she went to Ballona Elementary.   She attended Emerson Junior High School and graduated in 9th grade and did not finish High School.   I just told you some important facts of her childhood and now I’m going to tell you about her end of childhood through adulthood.   Ã‚  Ã‚  Ã‚   When Marilyn Monroe was 20 when she signed her first movie contract, which was in the year 1946.   Marilyn Monroe’s daughter was born in June 1962 and who’s name is Gladys Baker Mossis.   Marilyn Monroe went to college for art appreciation and literature at the University of California.   She started college at the age of 16 after dropping out of Emerson Junior High at the age of 15 while in 9th grade. She took the same classes in the evening as during the day.   That was about her adulthood now I will be telling you about her Contributions to society.     Ã‚  Ã‚  Ã‚   Marilyn Monroe’s contributions to society was that she provided entertainment for people, she also sang music for people to listen to.   Another thing she did to make the world a better place was by being a popular actress.   Marilyn Monroe is famous because she is an actor in many movies.   She is known as an american actress, model, and singer.   There are many things that I have told you about Marilyn Monroe.   Ã‚  Ã‚  Ã‚   In conclusion Marilyn Monroe was an actor, had troubles when she was an child, lived in many places, and her birth name was Norma Jean Mortenson not Marilyn Monroe. She was born on June 1st,1926, attended Elementary, Middle, and Junior High but dropped out at the age of 15, and had a rough childhood because she was sent to an orphanage when she was born.   Marilyn Monroe was 20 when she signed her first movie contract, she also went to college for art appreciation and literature when she was 16 years old.   She was known as an entertainer and an actor.   She was also famous for being an actress, model, and singer.   I just told you the most important facts about Marilyn Monroe’s Life starting from Birth and ending in death, I also hope you learned something new about Marilyn Monroe while reading this. Sources Cited â€Å"Home.† About Marilyn Monroe, marilynmonroe.com/. â€Å"Public Broadcasting Service.† PBS, Public Broadcasting Service, www.pbs.org/. â€Å"Marilyn Monroe: Still Life.† PBS, Public Broadcasting Service, 30 May 2018, www.pbs.org/wnet/americanmasters/marilyn-monroe-biography/61/.

Sunday, May 17, 2020

Medical Students Career - Free Essay Example

Sample details Pages: 18 Words: 5486 Downloads: 6 Date added: 2017/06/26 Category Career Essay Type Research paper Did you like this example? Study of Factors Influencing Medical Students in their Choice of Career Introduction What makes medicine such a sort-after field? Medicine today is a very highly regarded profession which is well compensated, provides excellent job security and has the opportunity to have a positive influence on the lives of many people1. Success in medicine requires hard work and application, both while learning and when entering practice2. However, it brings great rewards in terms of job satisfaction and the range of career opportunities within the profession3. Don’t waste time! Our writers will create an original "Medical Students Career" essay for you Create order Learning about and practicing medicine is also very pleasing, involving as it does a blend of human interactions and applied science2. The environment in which different types of medicine are practiced is rich and diverse and obviously continually changing, and doctors continue to learn throughout their working lives. That is why the students interested in medicine should have the capacity for, and interest in, a lifetime of learning about this fascinating subject. To get the most out of the course a student need to be a keen scientist, with a sound scientific understanding and determination and also an ability to cope up with the demands and pressures of early clinical training3. But are they actually aware of the high demands of this prestigious professional course Do they have a realistic understanding of what a career in medicine will involve? We often wonder, is it the genuine passion for the subject and the genuine interest to be of service to the mankind that make students do medicine or is it just their parents!!! This study gives us the opportunity to find out the factors that drove students to do medicine. If choosing the medical profession is not hard enough, medical students have an even bigger hurdle ahead of them, which is choosing their line of specialisation. Many factors affect the career choices of graduating medicalstudents. Influences such as strong mentors, formativeacademic and non-academic experiences, and career counselingcan all help aspiring physicians select their particular careers4.Similarly, market trends, self-perception of strengths and weaknesses,and anticipated lifestyle can also affect career choice5. It has often been questioned, is gender really an issue? Does money influence ones decisions? Or is it competition?! A large number of specialising fields and over 50 career options are available in medicine, assuring a medical graduate of finding a profession. But how many medical students are actually aware of these ca reer options? As mentioned earlier, medical profession brings great rewards in terms of job satisfaction and a variety of career opportunities. However, like any job, there are parts of a doctors work that are frustrating, undesirable, and even repetitive or boring. Studies show that doctors work far more hours than the average U.S. professional and cope with large amounts of stress and pressure6. Managed care has made it more difficult for U.S doctors to practice as they see fit and limit the amount of time that they can spend with patients. In fact, for some doctors, the upsides of the profession arent worth the sacrifice and hassles of the modern health-care environment4. This has lead to doctors with long and potentially bright careers to hang up their stethoscopes and quit! But is this the case when it comes to medical students in India? What makes them leave medicine despite the fact that theres a shortage of doctors making a ratio of one doctor per 1,634 people in India wh ich is considered to be extremely below the ideal standard of doctor-people ratio?7,8 Medical students attitude towards various clinical fields and post graduation has been a major focus of study in the U.S as well as in the United Kingdom, yet there have been very few studies and surveys done on the career choices of Indian medical students. Hence, little is known about career intentions or attitudes of medical students in India. This study aims to reporton the career intentions and attitudes of first and second year medical students. It gives us the opportunity to discover the factors that influence the medical students on their career choices. The study also shows how exposure to more clinically oriented medical professions will affect the choice of careers in medical students. Aims and Objectives The study aims to find out factors that influence the choice of career of medical students Objectives To find out the reasons for students to take up medicine as a course of further studies. To compare career intentions of 1st year medical students, early in their training, with 2nd year medical students of Kasturba Medical College, Mangalore, in relation to various socio-demographic correlates. To compare findings from the 2nd year batch with those from a similar survey conducted on the same batch last year. Methodology   We conducted a survey in the study setting of KMC Mangalore with the total study population of 393 MBBS students, which consisted of 216 1st year and 177 2nd year students. It was a cross sectional study which lasted from the dates of March 7th to March 14th, 2008. Data was collected through a pilot studied semi-structured questionnaire. The outline of the questionnaire was designed after referring to questionnaires used in similar studies like ours. Certain changes such as clearing any non-specific questions and adding more questions which seemed relevant to our study were made. Permission was obtained from the Associate Dean Dr. M.V. Prabhu and respective teachers. Then questionnaires were given out to consenting students. Collected data was tabulated and analyzed by using SPSS version 10 software. Results obtained were presented on tables and graphs wherever appropriate. Lastly the test of significance was carried out using ?2 test on tables in which we thought there would be significant values. Results The total study sample was 393 students, comprising of 216 1st year students and 177 2nd year students. The response rate among the 1st and 2nd year students was 98.18% and 100% respectively. Gender 1st Year (n=216) 2nd Year (n=177) Total (n=393) Male 94 (43.5%) 103 (58.2%) 197 (50.1%) Female 117 (54.2%) 71 (40.1%) 188 (47.8%) Table 2: Baseline Characteristics 1st Year (n=216) 2nd Year (n=177) Total (n=393) Schooling: Abroad 30 (13.9%) 43 (24.3%) 73 (18.6%) In India 170 (78.7%) 121 (68.4%) 291 (74%) Both 16 (7.4%) 9 (5.1%) 25 (6.4%) Before MBBS: School 121 (56%) 95 (50.7%) 216 (55%) Degree 5 (2.3%) 4 (2.25%) 9 (2.3%) Dropped 68 (31.5%) 50 (28.2%) 118 (30%) Others 19 (8.8%) 25 (14.1%) 44 (11.2%) Majority of the participants have done their schooling solely in India (74%). 55% of the respondents joined directly after school, whereas 30% dropped a year or 2 before joining college. 2.3% of the students had completed a degree prior to joining college. Both 1st year and 2nd year students chose the medical profession because they had a passion for the medical field. It seems that very few 2nd year students were forced by their parents (3.4%) as compared to the 1st year students (4.6%). On the other hand, there are very few students in the 1st year that chose medicine for job security (1.9%) unlike the 2nd year students who had a higher percentage of 15.3%. Job security parents insistence were the most unlikely reasons for 1st year 2nd year students respectively (Table 3). When asked about their future line of plan, had it not been MBBS, more than 100 students who responded in the OTHERS category specified that they would join ONLY MBBS. As expected, most students (37.2 %) felt that they would join engineering had they not been in MBBS. This may possibly be due to the fact that Mathematics is a compulsory subject during pre-university college. Paramedical/Allied Health Sciences were the least sought-after fields which were chosen by the 1st 2nd year students respectively (Table 4). Interestingly, ALL 1st year students wanted to pursue a PG degree while 4% of the 2nd year students DID NOT want to go in for post graduation perhaps due to the exposure to clinical postings? Both 1st and the 2nd year students seemed widely interested in doing an MD/MS (91.7% 86.4% respectively), with the next popular choice being MRCP/MRCS with only 7.4% 6.2% of 1st 2nd year students considering it . Even with the very little information they have, 86.6% of 1st year students wanted to go in for a clinical field 12.5% of the students could not decide about their choice of career, whereas 0.93% decided for a non-clinical field. Among the 2nd year students, 84.2% of the students decided for a clinical field, 7.9% having not decided yet 2.3% for a non-clinical field. This trend of more students opting for a clinical field may be due to the exposure to clinical postings during the 2nd year (Table 5). When asked about going in for super-specialization, 79.6% of 1st year students 64.4% of 2nd year students answered on the affirmative, 13.4% 25.4% answered against it while 6.9% 10.2% said they had not decided yet (Table 6). The general trend among 1st year students is to take up a career in surgery (40.7%) whereas for 2nd year students it is medicine (24.9%). The least sought after fields are Anaesthesiology for 1st year students ENT for 2nd year students (Table 7). Regarding non-clinical fields, Forensic Medicine is the most preferred non-clinical field among 1st years (5.1%) where as post-graduation research is more popular among 2nd years (2.8%) (Table 8). According to the data, there is no significant difference between male and female students choice of career with relation to choosing a clinical or a non-clinical field. 90.9% of the males 88.5% of the females taking the survey thought it would be a clinical field they would like to pursue (Table 9). When asked if there was a chance that the respondents would not be able to pursue the career of their choice, most students felt that Competition remained the major hurdle ahead of them. 27.3% of 1st year students 29.4% of 2nd year students felt that the stiff competition they face would stop them from going in for the career of their choice (Table 10). Majority of the 1st 2nd year students prefer to practice medicine in their own countries, rather than in a foreign country. This may possibly be due to the fact that most relatives kin are in their own country also, due to the possibility of an already functional medical set-up in the family. 33.3% of 1st year 26% of 2nd year students prefer to practice abroad, 5 of 2nd year students said they would leave medicine, but still stay in the country (Tables 11a 11b). It is seen that among all the respondents, 205 resident Indians, forming 52.16% of the students prefer to practice in their own country, whereas 25 of them (6.36%) preferred to practice abroad. 70 students (17.81% of students) said they had not decided yet depended on various factors. Among the Malaysians, 18 students (4.58%) prefer their own country, 1 student (0.25%) prefers practising abroad 8 students had not decided yet. 7 non-resident Indians (1.78%) wanted to practise in their own country, 6 students (1.52%) abroad 14 students (3.56%) had not decided yet (Table 12). Most students in 1st year (16.7%) 2nd year (7.3%) feel that if they were to go abroad, it would be due to better prospects available. A better financial reward was the next most popular reason for going abroad, with 10.6% of 1st year 6.8% of 2nd year students feeling so (Table 13). The current trend seems to be favoring multi-spec ialty hospitals over government hospitals. 50% of 1st year students 49.2% of 2nd year students preferred multi-specialty hospitals over other options. The next most sought work setting was Government Hospitals for 1st year students whereas it was private practice among 2nd year students (Table 14). For most students in both 1st year (4.6%) 2nd year (7.9%), hectic schedules seem to be the main reason for leaving medicine. Family obligations seem to affect the decisions of 1st year students (3.7%) more than that compared to 2nd year students (1.7%). It also seems as though 2nd year MBBS students are much more concerned with the competition in medicine (2.8%) than the 1st year students, perhaps due to more exposure to clinical fields (Table 15). Interestingly, exposure to clinically oriented medical profession has DECREASED the students interest to pursue further studies as well as choose a clinical field! Whereas 98% of 1st year students wanted to pursue a post-graduation cour se, only 94.4% of 2nd year students chose to go in for a post-graduation. Also, while 89.9% of 1st year students wanted to go in for a clinical field, only 84.2% of 2nd year students wanted to go in for a career in a clinically oriented field a very interesting find! (Table 16). There seem to be a dynamic shift in the career choice of the 2nd year MBBS students of the 2006 batch after clinical exposure. About a quarter of the students presently in 2nd year are inclined towards general medicine, compared to just 15.6% of the same students before clinical exposure. On the other hand, figures for a career in surgery have come down from 33.2% to 21.5% after clinics. Interest in pediatrics has also increased almost two-fold after clinical exposure (Table 17). Table 3:What drove students to choose medicine?  Ã‚   1st year 2nd year Total Passion for Medical Science 96 (44.4%) 91 (51.4%) 187 (47.6%) Inspired by Family Members 40 (18.5%) 37 (20.9%) 77 (19.6%) To help the Community 48 (22.2%) 25 (14.1%) 73 (18.6%) Forced by Parents 10 (4.6%) 6 (3.4%) 16 (4.1%) Job Security 4 (1.9%) 27 (15.3%) 31 (7.9%) Prestigious Profession 36 (16.7%) 30 (16.9%) 66 (16.8%) Others 8 (3.7%) 13 (7.3%) 21 (5.3%) Table 4:If not MBBS? 1st Year (n=216) 2nd Year (n=177) Total (n=393) Dental 19 (8.8%) 21 (11.9%) 40 (10.2%) Paramedical/Allied Health Sciences 11 (5.1%) 7 (4%) 18 (4.6%) Engineering 84 (38.9%) 62 (35%) 146 (37.2%) Others 95 (44%) 77 (43.6%) 172 (43.8%) Table 5: Post-graduation 1st year MBBS 2nd year MBBS Total Post-graduation Yes 214 (99.1%) 167 (94.4%) 381 (96.9%) No 0 (0%) 7 (4%) 7 (1.8%) p=0.0034,highly significant Choice of degree MD/MS 198 (91.7%) 153 (86.4%) 351 (89.3%) Diploma 1 (0.46%) 1 (0.56%) 2 (0.51%) DNB 1 (0.46%) 5 (2.8%) 6 (1.5%) MRCP/MRCS 16 (7.4%) 11 (6.2%) 27 (6.9%) ?2=3.935, p=0.268 Table 6: Future career intentions 1st Year (n=216) 2nd Year (n=177) Total (n=393) Clinical Field 187 (86.6%) 149 (84.2%) 336 (85.5%) Non- Clinical Field 2 (0 .93%) 4 (2.3%) 6 (1.5%) Not Decided 27 (12.5%) 14 (7.9%) 33 (8.4%) ?2=.456, p=0.499, not significant Super specialization Yes 172 (79.6%) 114 (64.4%) 286 (72.8%) No 29 (13.4%) 4 (25.4%) 74 (18.8%) Not Decided 15 (6.9%) 18 (10.2%) 33 (8.4%) ?2= 13.489, p=0.0012, highly significant Table 7:Preference for a profession in a CLINICAL Field: 1st year MBBS 2nd year MBBS Total Radiology 27 (12.5%) 17 (9.6%) 44 (11.2%) Medicine 43 (19.9%) 44 (24.9%) 87 (22.1%) Orthopedics 14 (6.5%) 15 (8.5%) 29 (7.4%) Pediatrics 30 (13.9%) 39 (22%) 69 (17.6%) Dermatology 4 (1.9%) 5 (2.8%) 9 (2.3%) ENT 3 (1.4%) 2 (1.1%) 5 (1.3%) OBGYN 23 (10.6%) 13 (7.3%) 36 (9.2%) Surgery 88 (40.7%) 38 (21.5%) 126 (32.1%) Community Med 3 (1.7%) 3 (0.76%) Ophthalmology 4 (1.9%) 4 (2.3%) 8 (2%) Anesthesiology 1 (0.46%) 4 (2.3%) 5 (1.3%) Psychiatry 15 (6.9%) 5 (2.8%) 20 (5.1%) Table 8: Preference for a profession in a NON CLINICAL Field   1st year MBBS 2nd year MBBS Total Anatomy 3 (1.4%) 3 (0.76%) Physiology 1 (0.46%) 1 (0.25%) Pathology 3 (1.4%) 3 (.76%) Forensic Med 11 (5.1%) 2 (1.1%) 13 (3.3%) Hospital M. 5 (2.3%) 4 (2.3%) 9 (2.3%) Others 14 (6.5%) 3 (1.7%) 17 (4.3%) Table 8: Preference for a profession in a NON CLINICAL Field Contd Research 4 (1.9%) 5 (2.8%) 9 (2.3%) Not Yet Though Of 9 (4.2%) 6 (3.4%) 15 (3.8%) Dont Know 1 (0.46%) 2 (1.1%) 3 (.76%) Still Undecided 17 (7.9%) 18 (10.2%) 35 (8.9%) Table 9: Is GENDER really an issue? Clinical Field Non Clinical Field Not Decided Male 170 (90.9%) 3 (1.6%) 14 (7.5%) Female 162 (88.5%) 3 (1.6%) 18 (9.8%) Table 10: Reasons for NOT pursuing the career of choice: 1st year MBBS 2nd year MBBS Total Not Pursuing a career Yes 70 (32.4%) 84 (47.5%) 154 (39.2%) No 114 (52.8%) 61 (34.5%) 175 (44.5%) Reasons for not Pursuing Career Working Hours 4 (1.9%) 9 (5.1%) 13 (3.3%) Income 8 (3.7%) 7 (4%) 15 (3.8%) Competition 59 (27.3%) 52 (29.4%) 111 (28.2%) Job Security 6 (2.8%) 1 (0.56%) 7 (1.8%) Lifestyle 11 (5.1%) 10 (5.6%) 21 (5.3%) Reputation 4 (1.9%) 1 (0.56%) 5 (1.3%) Others 6 (2.8%) 6 (3.4%) 12 (3.1%) Table 11 a:What the future holds for a medical student? 1st year MBBS 2nd year MBBS Total Practice in Own Country Yes 129 (59.7%) 118 (66.7%) 247 (62.8%) No 18 (8.3%) 18 (10.2%) 36 (9.2%) Not Decided 66 (30.6%) 35 (19.8%) 101 (25.7%) Table 11 b: What the future holds for a medical student? 1st year MBBS 2nd year MBBS Total Practice Abroad 72 (33.3%) 46 (26%) 118 (30%) Leaving Medicine Staying in Country 7 (4%) 7 (1.8%) Not Applicable 68 (31.5%) 42 (23.7%) 110 (28%) Table 12:Where do students prefer to practice? Practice in own country Practice Abroad Not Decided Resident Indians 205 (52.16%) 25 (6.36%) 70 (17.81%) NRI 7 (1.78%) 6 (1.52%) 14 (3.56%) Malaysian 18 (4.58%) 1 (0.25%) 8 (2.03%) US 6 (1.52%) 1 (0.25%) 2 (0.50%) UK 1 (0.25%) 0 (0%) 1 (0.25%) Others 8 (2.03%) 3 (0.76%) 4 (1.01%) Total 245 36 99 ?2=10.776, p=0.001, very highly significant Table 13:Reasons for Going Abroad 1st year MBBS 2nd year MBBS Total Better Quality Life 12 (5.6%) 10 (5.6%) 22 (5.6%) Financially Rewarding 23 (10.6%) 12 (6.8%) 35 (8.9%) Job Satisfaction 8 (3.7%) 5 (2.8%) 13 (3.3%) Better Prospects 36 (16.7%) 13 (7.3%) 49 (12.5%) Others 5 (1.3%) 5 (2.8%) 10 (2.5%) Not Applicable 46 (21.3%) 30 (16.9%) 76 (19.3%) Table 14:Preference of work setting 1st year MBBS 2nd year MBBS Total Private Practice 29 (13.4%) 38 (21.5%) 67 (17.0%) Multi-Specialty 107 (50%) 87 (49.2%) 194 (49.4%) Medical College 7 (3.2%) 7 (4%) 14 (3.6%) Government Hospital 43 (20%) 22 (12.4%) 65 (16.5%) Others 2 (0.93%) 0 (0%) 2 (0.51%) ?2=7.884, p=.0489, significant Table 15: What Makes Students Leave Medicine? 1st year MBBS 2nd year MBBS Total Reasons for Leaving Medicine: Bleak Future 3 (1.4%) 3 (1.7%) 6 (1.5%) Stiff Competition 6 (2.8%) 6 (3.4%) 12 (3.1%) Hectic Schedule 10 (4.6%) 14 (7.9%) 24 (6.1%) Table 15: What Makes Students Leave Medicine? Contd Family Business 5 (2.3%) 3 (1.7%) 8 (2.0%) Family Obligations 8 (3.7%) 3 (1.7%) 11 (2.8%) Others 6 (2.8%) 10 (5.6%) 16 (4.1%) Not Applicable 110 (50.9%) 67 (37.9%) 177 (45.0%) Table 16: Influence of exposure to clinically oriented medical profession on the choice of careers of medical students-1 1st year MBBS (2006) 2nd year MBBS (2007) Total Post-graduation Yes 195 (98%) 167 (94.4%) 362 (96.3%) No 3 (1.5%) 7 (4%) 10 (2.7%) ?2=2.227, p=0.136, not significant Clinical Field 179 (89.9%) 149 (84.2%) 328 (87.2%) Non Clinical Field 15 (7.5%) 4 (2.3%) 19 (5.1%) ?2=4.328, p=0.0375, significant Table 17: Influence of exposure to clinically oriented medical profession on the choice of careers of medical students-2 1st year MBBS (2006) 2nd year MBBS (2007) Total Medicine 31 (15.6%) 44 (24.9%) 75 (19.9%) Orthopaedics 7 (3.5%) 15 (8.5%) 22 (5.9%) Paediatrics 23 (11.6%) 39 (22%) 62 (16.5%) OBGYN 10 (5.0%) 13 (7.3%) 23 (6.1%) Surgery 66 (33.2%) 38 (21.5%) 104 (27.7%) ?2=16.747, p=0.0022, highly significant Discussion There were quite interesting findings in our cross sectional study involving 1st and 2nd year students of KMC Mangalore. Our findings this year were compared with a similar survey done last year on the 2006 batch, when they were in their 1st year. We also did a critical analysis and comparison of our data with similar surveys and studies conducted in India as well as in other parts of the world. One of our objectives was to find out what drove students to choose medicine as a further course of study. According to our data, genuine interest and passion for the subject made majority of students, accounting for 83.5%, to choose medicine. In contrast to our findings, a similar cross sectional study by Panna et al among a group of 1st year students in Delhi showed that students desire to serve the sick in the society made them chose medicine9. However, there were similar findings in both studies, such as parents profession; a majority of students parents were in to me dical profession. Hence, the fact that having parents as doctors influencing students choice to take up a career in medicine can not be ruled out. After completing the basic MBBS degree, students face the bigger hurdle of choosing their line of specialisation. Our data indicated that majority of students (96.9%) wanted to do their post-graduation either in a clinical field (85.5%) or a non-clinical filed (1.5%). 72.8% of the students even wanted to go in to super specialisation. Similarly Panna et al data shows that majority of Delhi students also wanted to pursue a post graduate degree. Studies by Azizzadeh et al and similar studies by Nellens et al regarding future choice of specialty among medical students showed that majority of first year students chose medicine to help the patients 10, 11. A good number chose internal medicine followed by surgery. This is similar to the survey taken by us of the 2nd year students where medicine was the popular choice. Most of the 1st yea rs of KMC Mangalore had chosen surgery over medicine .This difference is probably due to the exposure to clinical postings by the 2nd year students. Our study found out that 32% students overall wanted to do surgery which is consistent with the study done by Tambyraja and co-workers12. Their study was based on attitudes of medical students toward careers in surgery. Career ambitions and reasoning of a group of final year students who completed their general surgery attachment in a UK medical school was assessed through a questionnaire-based survey. 40% students would consider a career in general surgery, and 39% would not; 29% were undecided. The two most popular attractions to general surgery were challenging postgraduate training and highly regarded career esteem. The two most common disincentives were family considerations and the sacrifice of personal time. Thus the percentage of medical students favouring surgery seems to be independent of any socio-demographic difference s between India and the UK. Kuhnigk et al studied the attitudes of medical students towards psychiatry and psychotherapy13. The more positive the psychiatry course was rated, the more positive attitudes towards psychiatry were. Female students and students with psychiatry/psychotherapy experience had a significantly more positive attitude towards psychiatry as a subject. Overall 5.8% of all students chose psychiatry as a career choice. The study concluded that a positive education experience as well as personal experience increases the probability of a positive student attitude towards psychiatry. It remains to be investigated, however, whether an improvement in the attitudes of students towards the psychiatry discipline is sufficient to increase the number of students who would like to become psychiatrists or whether other factors are more deciding such as career opportunities, conditions of further education, or income potential. Our study found that 6.1% of students wanted to do psychiatry which is consistent with the above study. Thus the percentage of medical students favoring psychiatry seems to be independent of any socio demographic differences between India and the UK. According to our data, 1.9% of 1st year students wanted to chose ophthalmology where as an increased number of 2nd year students accounting for 2.3% opted for ophthalmology. This increase in number could be explained by the students increased exposure to different clinical fields and also by an increased awareness of lifestyle advantages with particular benefits. However, the fact that both 1st year and 2nd year students of our sample had not taken ophthalmology postings can not be ruled out. Maybe we would have obtained an entirely different set of responses had they been exposed to at least one of the ophthalmology postings. Hence, it will be interesting to carry out further investigations in our college regarding this particular choice of career. However, Lambert and co-work ers conducted an extensive survey which involved medical students from year 1975-200514. The aim was to study the trends of career choices for ophthalmology among UK medical graduates. According to their data ophthalmology was the first choice of long term career for 2.3% of men and 1.5% of women one year after qualification; 2.0% of men and 1.4% of women three years after; and 1.8% of men and 1.2% of women at five years. Comparing early choices with eventual destinations, 64% who chose ophthalmology in year one, 84% in year three, and 92% in year five eventually practiced in the specialty. The concordance between year one choice and eventual destination was higher for ophthalmology than for most other specialties. ‘Enthusiasm for and commitment to the specialty was the most important single factor in influencing career choice. The prospect of good working hours and conditions was also an important influence: it influenced career choice a great deal for a higher percentage of those who chose ophthalmology (66% in the third year) than those who made other surgical choices (23%). Lambert et al conclude that those choosing ophthalmology show a high level of commitment to it. Their commitment is strengthened by the prospect of attractive hours and working conditions. Many doctors who become ophthalmologists have already made their choice by the end of their first post-qualification year. A study by Sinclair and co-workers showed that females were more positive about a career in general practice15. General practice was the first choice for 13% of students. Those choosing general practice were more likely than those choosing other specialties to be female and to rate their academic abilities lower and their non-academic abilities as average, and have decided on their future career earlier. Reasons for general practice included: working in and being part of a community; continuity of patient contact; variety of illnesses and people encountered; undergradu ate teaching experiences; dislike of or disillusionment with hospital medicine; and an increasing awareness of part-time opportunities. Our study however indicates that no students have chosen general practice. This may be explained by the increased exposure to general practitioners and patients in the teaching program and the increasing awareness of lifestyle advantages with the particular benefits of more regular hours and working part time which may come after further clinical exposure as the surveyed students have limited exposure. This is indicated as the above study found an increasing tendency towards this specialty as the students advanced in the course and had more clinical exposure. A study by Dorsey and co-workers,on relationship between specialty choices of clinical and non-clinical fields with controllable life styles and gender in the United States showed that the number of women choosing specialties with controllable life style increased from 18% in 1996 to 36% 200 35. Interestingly, the study found out that women are more likely to pursue an uncontrollable lifestyle specialty than men! But according to our survey this was not the case. Our survey covered a similar objective which was whether gender bias is actually a real reason why a medical student chooses a particular medical profession. Our final data showed that 90.9% of males chose a clinical field while only 88.5% of females chose the clinical field. Although, when it came to choosing a non clinical field both males and females had an equal percentage of responses of 1.6%. There seemed to be slight difference again when it came to males and females being undecided, this is because 7.5% of males were undecided while 9.8% of females were undecided. Hence, our study shows that there is no significant difference between male and female students choice of career with relation to choosing a clinical filed, which offers more of an uncontrollable lifestyle or a non-clinical field, which compa ratively offers a controllable lifestyle. Reason for this observation could be due to the fact that there has been little exposure to clinical fields through postings so far, thus few students in KMC realize the realities in terms of working hours, stress, pressure and challenges, of some clinical fields. Fysh et al, found out that while medicine in general is becoming more female-dominated, women are still under-represented in surgery16. Opinion is divided as to whether this is due to lifestyle considerations, disinterest or perceived discrimination. It is not clear at what stage these careers decisions are made. While men represented only 38% of the student population, they represented over two-thirds of the students wishing to pursue a career in surgery. Women still opt for general practice and pediatrics. Our study however indicates that there is no gender disparity in career choice concerning surgery. This may be because there has been little exposure to surgery so far, thus few students in KMC realize the realities (working hours so not favored by female students and challenges) of surgery. A similar study by Williams et al17 showed that there was a gender bias when picking certain professions, especially when it came to surgery. The study showed that females actually did not want to choose the profession of surgery due to reasons such as surgical experience in medical school, lack of involvement of teachers and students during postings, and the general arrogant attitude of surgeons. According to the survey, while orthopedics cardiothoracic show very less representation of women, pediatrics and general practice seemed to be more popular among women. The differences in our study and the surveys conducted previously could have resulted due to the different geographical locations and sample size. Another reason a difference might have arisen in the studies is due to the fact that both studies took two different levels of students. Our study took first and second year MMBS students, who are relatively fresh into the medical field and do not have as much exposure to all the clinically oriented professions. On the other hand the previous surveys took samples that consisted of post graduate students. Since post graduate students had more exposure to all the clinical fields, they seem to know all the difficulties of the profession unlike the 1st and 2nd year students which would affect there choice in choosing the profession. In India, there are 271 medical colleges, out of which 138 are government colleges and remaining 133 are private. They have a cumulative intake capacity of 31,172 seats in the graduate courses whereas nearby 11,005 post-graduate seats are available in various courses of all medical colleges and hospitals per year7,8. According to the Medical Council of India statistics, there are a total number of 675334 allopathic doctors registered in the country up to 31st March 20077. This makes a ratio of one doctor per 1,634 people in India which is extremely below the ideal standard of doctor-people ratio. These data shows that there is a serious shortage problem of legal and recognized medical practitioners nationwide, especially in rural and urban areas. According to the Health Minister Dr Anbumani Ramadoss, to overcome the critical shortage of medical practitioners in India, the government has adopted a quicker but significant step to recognize the postgraduate medical degrees obtained from five English-speaking countries namely, Australia, Canada, New Zealand, the United Kingdom and the United States. Besides this, the government has requested the medical professionals including Non-resident (NRI) and Overseas Indians who are working in those countries to return home and do their practice in India8. Though the government is planning to curb the problem of shortage of doctors by recruiting NRI doctors and recognizing foreign PG degrees, this might not be the case when it comes to a long t erm solution. Our study shows that, though there is a majority of 62.8% students who wanted to practice in India, there are still a considerable number of students accounting for 30% who wants to go abroad to practice. This does not seem like a good trend, considering the current situation of shortage of doctors in the country. Our study shows that the main reason for students to pursue a career abroad is the fact that there are better prospects (12.5%). 6.8% of students and 5.6% of students thought it is best to practice abroad since it is more financially rewarding and there is a better quality of life respectively. Interestingly our study shows that there is a considerable number of students who wish to leave medicine after finishing the basic MBBS. The main reason for this appeared to be hectic time schedules (6.1%) and other reasons being stiff competition (3.1%) and family obligations (2.8%). On the other hand, when inquired about the preferred practice setting, students of KMC have chosen to work in multi-specialty hospitals where as Delhi College students preferred to practice in a private hospital as opposed to a government hospital9. Recommendations Though our study can not be applied to all the medical students nationwide, due to various demographic changes, our data does give an overall view as to where the problem lies when it comes to graduating medical students leaving the country as well as the profession as a whole. The analysis of the data obtained from the medical students of their career intentions informs the administration of current issues in medical education which would prevent one from taking up a certain specialized field or which would make a medical student leave the country or the profession, and facilitates appropriate action. Trends in career preference can be tracked for many years through studies like ours. Trend analysis of multiple years of data can identify positive and negative trends at medical schools nationwide . This will aid the authorities to come up with long term solutions for various issues including the critical shortage of physicians which the country is experiencing currently. The Association of American Medical Colleges (AAMC) maintains a data bank of ‘Medical School Graduation Questionnaires (GQ data bank)18. The questions posed by the 2008 GQ focus on issues critical for all medical students and educators, including the questions related to their specialty choices and career aspirations. In contrast there is very less data available on attitude and career intentions as well as other issues concerning the medical students in India. Hence it is advisable to maintain a similar data base for Indian Medical students. The data collected can be used for medical school program evaluation, for priority-setting, for program and policy development as well as for research purposes. Reference 1. Newton, D., Grayson, M., Thompson, L.F., (2005) The variable Influence of Life style Income on Medical Students career specialty Choices. Academic Medicine 80; 809-814. 2. University of Cambridge UK (Online) 2008 (cited 2008 March 28); Available from: https://www.ox.ac.uk/admissions/undergraduate_courses/medicine.html 3. University of Cambridge UK (Online) 2008 (cited 2008 March 28); Available from: https://www.cam.ac.uk/admissions/undergraduate/medicine/index.html 4. George, V., Richard, Deanne, M., Nakamoto, Lockwood, J.H., (2007) Medical Career Choices: Traditional and New Possibilities. JAMA 285; 2249-2250. 5. Dorsey, R. E., Jarjoura, D., Gregory, W. (2005). The influence of controllable life style and sex on the specialty choices of graduating medical students. Academic Medicine 80 (9): 791-796 6. Arenson D. CLL Diary: When leaving Medicine is the best Medicine (Online) 2006 (cited 2008 March 28); Available from: https://clldiary.blogspot.com/2006/04/when-leaving-medicine-is-best-medicine.html 7. News Track India (Online) 2007 (cited 2 008 March 28); Available from: https://www.newstrackindia.com/newsdetails/2813 8. Medical Council of India (Online) 2008 (cited 2008 March 28); Available from: www.mciindia.org/tools/ann_reports/index.htm 9. Panna, L., Chatna, M. Career Aspirations and Apprehensions regarding medical education among 1st year medical students in Delhi. (www.ijcm.org) 10. Azziadesh, et al, Factors influencing career choice among medical students interested in surgery. 11. Nellens, B.S Hutchinsons, G. Factors affecting future choice of speciality among 1st year students of the University of the West Indies Trinidad. 12. Tambyraja, A.L., McCrea, C.A., Parks, R.W., Garden, O.J. Attitudes of Medical Students toward Careers in General Surgery. (Department of Clinical Surgical Sciences (Surgery), School of Clinical Sciences Community Health, University of Edinburgh). 13. Kuhnigk, O., Strebel, B., Schilauske, J Jueptner, M. Attitudes of medical students towards psychiatry: effects of training, courses in psychiatry, psychiatric experience and gender. (Prodekanat fuer Lehre, Martinstr. 52, 20246, Hamburg, Germany). 14. Lambert, T. W., Goldacre1, M.J., Anthony, J.B., (2008) Career choices for ophthalmology made by newly qualified doctors in the United Kingdom, 1974-2005. BMC Ophthalmology; 8:3 15. Sinclair, H.K., Ritchie, LD., Lee, A. J. A. Future career in General Practice. (Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, UK). 16. Fysh, T.H.S., Thomas, G., Ellis, H. (2007) Who wants to be a surgeon? BMC Medical Education 7:2. 17. Williams, C. Cantillon., P (2000) A surgical career? The views of junior women doctors. Medical Education 34; 602-607. 18. Association of American Medical Colleges: Surveys Data (Online) 2008 (cited 2008 March 28); Available from: https://www.aamc.org/data/gq/start.htm 19. Rao, N.R, Meinzer, A.E., Manley, M., Chagwedera, Iris. (1998) International Medical Students Career Choice, At titudes toward Psychiatry, and Emigration to the United States. Academic Psychiatry 22; 2 20. Lambert, T., Goldacre, M., Davidson, M., Parkhouse, J. (2001) Graduate status age at entry to medical school as predictors of doctors choice of long term career. Medical education 35; 450-454. 21. Henderson, E., Berline, A., Fuller, J., (2002) Attitude of medical students towards general practice and general practitioners. British Journal of Medical practice May 22. Fysh, T.H., Thomas G., Ellis, H. Gender Disparity in Surgery (Department of Surgery, RCHT Treliske, Treliske, Truro, Cornwall, TR1 3LJ, UK)

Wednesday, May 6, 2020

Understanding The Nursing And Health, Wellness, And...

Conceptual understanding The nurse’s role in Health, Wellness, and Illness is providing education and care related to nutrition, physical fitness, weight control, avoidance of tobacco and alcohol, avoidance of substance abuse, and enhancing holistic care. According to the CDC, in our state,† two-thirds of all adults (65.7%) are overweight.† Obesity is associated with many chronic diseases, and losing weight produces many health benefits such as, improvements in blood pressure, blood cholesterol, and blood sugars, physical mobility, self-confidence etc†¦Ã¢â‚¬  (CDC, 2013) To manage or lose weight lifestyle changes of eating healthier and adding more physical activity is needed. The WHO definition of Health is, â€Å"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.†(WHO, 2015) Many clients I work with have common diagnoses, but knowing that each individual client needs are different a holistic approach is necessary to achieve desired goals. With my new gained knowledge from our recent studies, I understand that my role as a nurse is not about just following a ‘current’ plan of care, but also continually to assess the client and changing goals or implementing new goals that could improve my client’s health. According to the AHNA, â€Å"nursing practice involves the â€Å"whole body, mind, emotion, spirit, social/cultural, relationship, context, and environment.† (Thornton, L., 2015) Interrelated Concepts I found under theShow MoreRelatednursing philosophy1276 Words   |  6 Pages Nursing Philosophy: My Nursing Abstract Philosophy is a system of beliefs, it is often looked at as an effort to define nursing situations that is observed to exist or happen and serves as the basis for later theoretical formulations. Florence Nightingale the first nurse theorist, philosophy states that nursing is establishing and environment that allows persons to recover from illness. Nursing has four metaparadigms the client, the environment, health and nursing. MetaparadigmsRead MoreNursing Philosophy Essay1278 Words   |  6 PagesNursing is a science in which all the needs of a person are met through the proper use of the nursing process. 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Tuesday, May 5, 2020

The Concert of Europe Essay Sample free essay sample

In 1814. after Napoleon’s licking in Europe. the leaders of the greatest powers of the continent (the Quadruple Alliance: Preussen. Austria. the Great Britain and Russia ) gathered together in Vienna in order to specify their farther schemes and political order. every bit good as to forestall possible rise of other aggressive national leaders. like Napoleon. who could go a menace to the settled peace around the continent. The determinations made during the Congress were directed on keeping stable political and territorial state of affairs in Europe. This understanding between the states is calledthe Concert of Europe. which was supposed to be one of the first efforts to organize incorporate international society and equilibrate the involvements of European most influential states. In 1818 France joinedthe Alliance. In 1820-1822 suppressing chauvinistic rebellions in Italy and Spain can be considered as another of import achievement ofthe Concert. However. get downing from 1825 a figure of misinterpretations between the Great Britain and the remainder of the powers took topographic point. We will write a custom essay sample on The Concert of Europe Essay Sample or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page They were connected with the policies oftheAlliancesing Latin America ( Britain was against this intercession ) . every bit good as with the place ofthe Alliancetoward the Greek War of independency. Due to these dissensions conservative British state chose to retreat fromthe Concert. In early 1840s the state of affairs in Europe became really imbalanced due to increasing chauvinistic inclinations in such powerful states. as Italy and Germany. Finally. the last achievement ofthe Concertwas its support of the independency of Belgium and Greece. In 1848 some European states started claiming a alteration of territorial divisions proclaimed in the Congress of Vienna. followed by a figure of wars. including the Crimean War. Franco-Prussian War. etc. Therefore.the Concertwas demised. but it’s impossible to undervalue the importance of its historical mission as the first foundation which initiated such traditions as international diplomatic negotiations and dialogues. Mentions: Â · Overview: The Concert of Europe. ( n. d. ) .Pleasant Valley High School. The Official Internet Resource. Retrieved November 11. 2007. from the World Wide Web: lt ; hypertext transfer protocol: //www. pvhs. Marx. k12. ca. us/~bsilva/projects/concert/concessy. hypertext markup language gt ; .