Patient-Focused Pharmacy Arguments

Patient-Focused Pharmacy Arguments Catalysts For Change: Will Pharmacy in the United States Embrace Them? David A. Latif, M.B.A., Ph.D. OBJECTIVES: To briefly discuss previous paradigm change calls for pharmacy practice to move toward a more patient-focused profession, and to make the case that several catalysts are in place to move toward a more patient-focused profession in the near future. SUMMARY: From Eugene White’s â€Å"Office Based† practice model to Helpler and Strand’s â€Å"Pharmaceutical Care† model, during the past 50 years there have been no shortage of expert advocates for the pharmacy profession moving toward a patient-focused one. The results so far have not been as optimal as many would have hoped. An argument is made that the confluence of the passage of the Affordable Care Act, pharmacist manpower stability (and fear by many of an impending oversupply), and the imminent and future impact of automation and technology serve as excellent catalysts to influence the profession to move much more rapidly toward the patient-focused care paradigm. CONCLUSION: The profession must embrace the opportunities discussed regarding moving quickly toward the patient-focused paradigm. Although several barriers still exist, especially in the community setting, it is difficult to see a path whereby pharmacy can rely on dispensing for its livelihood to the extent it has historically. Therefore, the profession has little choice but to embrace the role of the pharmacotherapy expert in collaborative health care practice. During the past half century several authors have called for a paradigm change in the pharmacy profession away from a drug product focus to a more patient and clinically focus.1-7 From Eugene White’s concept of an â€Å"office-based pharmacy† practice in the early 1960s (in violation to the profession’s 1952 Code of Ethics) to Donald Brodie’s thoughtful â€Å"Drug-Use Control† in the 1969 to Hepler and Strand’s â€Å"Pharmaceutical Care,† in the late 1980s there has been no shortage of expert advocates espousing the need for pharmacists to reduce their reliance on the distributive function of prescription medications and emphasize the cognitive component.2,5,6 The need for the paradigm shift revolved around several themes, including the following: 1. To reduce preventable drug-related morbidity and mortality; 2. To regain the professionalization of pharmacy that was ameliorated due to the rise of prepackaged and premixed drugs after Wo rld War II; and 3. To protect against future loss due to automation.1-7 Despite this, especially in the community setting, there is wide-spread agreement that patient-focused care is not practiced as optimally and consistently as it could be practiced.8,9 In addition, historically there have been many barriers to patient-focused care, including time constraints at the community level.10 Perhaps the most significant barrier is the fact that pharmacies have not been reimbursed at a profitable level for providing patient care services. 10,11 One major reason for the underwhelming changes relates to the fact that, with significant shortages of pharmacists during the recent past resulting in meaningful salary increases, there was not a sense of urgency to consistently and fundamentally change pharmacy practice. The situation may be different today due to at least two major factors. First, according to the Aggregate Demand Index (ADI) most of the United States is â€Å"in balance† with a minority of states in moderate demand.12 This contrasts to a high demand for pharmacists as recently as 2007.12 Contributing factors to this supply change include an unprecedented growth in both new schools and colleges of pharmacy, as well as significant expansion of current programs.13,14 Also, some will argue that many pharmacists are working longer than they expected due in part to the Great Recession of 2008. A second reason for why the situation may be different today has to do with the advances in automation and technology. Although there have been previous discussions regarding automation and technology and their impact on the profession, there is some evidence to suggest that the distributive function of pharmacy (i.e., dispensing) will be negatively impacted in the near and long term. A recent summary by Colvin regarding the advances made in technology spotlights the impact these advances may have on the world of work. 15 According to Colvin, the key question to ask is: â€Å"What can people do better than computers?† For example, what impact will Google’s autonomous car have on the future of trucking? What is happening to lawyers is a useful example of how technology can impact professional jobs. In the discovery phase of litigation, computers are much better than people for screening documents for relevance related to germane law cases. They are also better at predicting Supreme Court decisions than humans. That does not bode well for high salaries and full employment in the law profession. Watson, IBM’s cognitive computing system, is not only smarter than we are, but has become 240% faster in the past 2 years! In pharmacy, the robot at University of California at San Francisco’s hospital has replaced all dispensing and has not had an error in 350,000 prescriptions.16 Although the hospital has not reduced its pharmacist staff it is possible that they could in the future. In addition, the technology can be used in other pharmacy organizations to potentially reduce the need for pharmacis ts. On a macro-economic level, economists struggle to explain why the 2008 economic recovery was so tepid. In past recessions, it has taken only 18 months for the U.S. economy to return to pre-recession levels. It has taken 77 months for the 2008 recession. Could advancing technology be a factor in why real wages have stagnated? Former Treasury secretary and economist Larry Summers recently stated: 17 Until a few years ago I didn’t think this was a very complicated subject; the Luddites were wrong, and the believers in technology and technological progress were right. I’m not so completely certain now. We now have the lowest work participation in decades for those in the 25 to 54 age range. Why? What is the answer in pharmacy to the question â€Å"What jobs can humans do better than computers?† Certainly, pharmacists cannot dispense prescriptions better than computers. But pharmacists can perform the non-routine task of patient-focused care better than computers (although some believe that future automation will include robots that can show empathy and emotion). Quality investigations such as the Ashville Project have demonstrated that pharmacists can reduce health care costs and improve patients’ medication therapy outcomes.18 Despite these successes, due to a myriad of reasons such as lack of consistent reimbursement for pharmacist services, many pharmacists’ clinical skills remain underutilized. Interestingly, former APhA President Bruce R. Canaday’s gave a thought provoking inaugural address on March 21, 2006 when he stated the dilemma facing the pharmacy profession.19 He stated that pharmacy needs to change its model of practice â€Å"Becaus e if we don’t, we could become extinct, with our roles in the health care system replaced or eliminated.†19 He cogently argued that optimal medication order fulfillment can be done from anywhere in the world; therefore not changing may result in the pharmacist’s job being marginalized. Since 2006, automation and technology have become more advanced. Paradigm changes often are precipitated by catalysts for change. The catalysts today present tremendous opportunities for pharmacists to utilize their previous underutilized skills in optimizing patients’ complex medication management therapy. In addition to the threat on pharmacists’ jobs from remote medication order fulfillment serving as a catalyst to change, provisions stemming from the Affordable Care Act (ACA) that includes Accountable Care Organizations (ACO) and Patient Centered Medical Homes (PCMH) may serve as meaningful catalysts.20,21 These provisions have the goal of reducing costs while imp roving quality. Because of ACA, millions of more citizens and residents of the United States have health insurance. Subsequently, the aforementioned opportunities exist for many health professions, including pharmacists, to optimize patients’ health outcomes. To realize these opportunities, a necessary first step is to be recognized as a Health Care Provider under Social Security. Then, the profession must find a consistent way to get paid for their services in a consistent manner. Because of the Pay-For-Performance incentive programs inherent in ACA the environment is amenable to the cost-saving pharmacist services that pharmacists can excel at. White and Latif presented a model that could work where the pharmacist (with residency training) works as the pharmacotherapy expert in physicians’ offices throughout the United States.22-24 These highly skilled pharmacists would initiate and monitor patients’ complex medication management outcomes. About a third of pri mary care physicians’ time is spent with chronic medication patients.25 By combining the physician’s expertise (diagnosis) with the pharmacists expertise (optimal pharmacotherapy outcomes) the synergy gained may optimize patient outcomes and reduce health care costs due to drug misadventures. White and Latif discussed the changes needed for such a model to work.22-24 The United States spends approximately 50% more on health care than the next most expensive country, Norway.26 If health care were a country, it would be tied with France for the 5th largest economy. The rate of increase of health care expenditures is unsustainable. At its current pace, 50% of our GDP could go to health care by 2070! Therefore, there will be intense pressure on the industry to reduce its costs. In addition to nurse practitioners and physician assistants, pharmacists can play a crucial role in reducing health care costs. Despite the aforementioned positives for pharmacy three key issues remain to be seen: 1. Will pharmacy be awarded Provider status in the near term?; 2. If and when they are awarded Provider status, will they be able to consistently procure fair reimbursement for services that save the health care system money?; and 3. Assuming #s one and two come to fruition, will the United States need as many pharmacists as pharmacy schools are producing? It could b e that highly trained pharmacists will add significant value to the health care system, but because the dispensing function ameliorates fewer pharmacists are needed. In summary, healthcare and pharmacy has and will continue the change. Health care costs must be reduced in the coming decades or the United States economy will collapse (i.e., it is not possible to have 30 to 50% of GDP going to Health Care). The next 5 to 10 years will be critical for the pharmacy profession. Because it is difficult to see a path whereby pharmacy can rely on dispensing for its livelihood to the extent it has historically, pharmacy has little choice but to embrace the role of the pharmacotherapy expert in collaborative health care practice. As former APhA president Canady stated regarding the alternative: â€Å"Because if we don’t, we could become extinct, with our roles in the health care system replaced or eliminated.† 19 REFERENCES White EV. An interesting pharmacy. VA Pharm 1962;46(3):24-7. White EV. How the family medication record was originated. Pharm Times. 1971; 34-37. White EV. The development of the family prescription record system. Am Pharm Assoc. 1973; NS13; 357-359. Hepler, CD. Pharmacy as a clinical profession Am J of Hosp Pharm. 1985 42, 1298-1306 Hepler, CD, Strand LM Opportunities and responsibilities in pharmaceutical care. Am J of Hospital Pharmacy.1990 47(3), 533-543. Brodie, DC, Drug Utilization and Drug Utilization Review and Control, U. S. Depart. of health, education and welfare, 1969. Knapp, DA, Wolf, HH, Knapp DE. The pharmacist as a drug adviser, J Am Pharm Assoc. 1969, 502-505. De Young M. A review of the research on pharmacists’ patient-communication views and practices. AJPE, 1996, 60, 60-77. Shah B, Chewning B, Conceptualizing and measuring pharmacist-patient communication: a review of published studies. Res Social Adm Pharm. 3006, Jun; 2(2) 153-85. Raisch DW., Barriers to providing cognitive services. Am Pharmacy. Vol, NS33(12), 54-58. Scott MA, Hitch B, Raye L, Colvin B. Integration of pharmacists into a patient-centered medical home. J Am Pharm Assoc.2011;51(2):161-166. Aggregate Demand Index, Pharmacymanpower.com. Accessed Jun 15, 2014. http://www.aacp.org/about/pages/vitalstats.aspx. Accessed June 15, 2014. Brown D., From shortage to surplus: The hazards of uncontrolled academic growth. Am J of Pharm Educ., 2010; 74(10) Article 185. Colvin G., In the future will there be any work left for people to do? Fortune, June 2, 2014. Rush-Monroe K., New UCSF robotic pharmacy aims to improve patient safety.March 7, 2011. www.ucsf.edu. Accessed on July 20, 2014. Summers L. The 2013 Martin Feldstein lecture. National Bureau of Economic Research. 2013(4). Cranor CW, Bunting BA, Christensen DB. The Ashville Project: Long-term clinical and economic outcomes of a long-term community pharmacy diabetes care program.J Am Pharm Assoc.2003;43(2):173-84 CanadayBR. Taking the fork in the road†¦and changing the world!J Am Pharm Assoc.2006;46:548–50 Abelson R. The face of future health care. The New York Times. March 20, 2013. Accessed June 5, 2014. Smith M, Bates DW, Bodenheimer T, Cleary PD. Why pharmacists belong in the medical home. Health Aff (Millwood). 2010;29:906–913. White EV, Latif DA. Office-based pharmacy practice: Past, Present, and Future. Annals of Pharmacotherapy. 2006 40: 1409-1414. Latif DA, White EV. Reengineering pharmacotherapy delivery to maximize the role of the pharmacist and improve patient outcomes. Research in Soc and Admin Pharm. 2007 3: 223-235. White EV, Latif DA. Restructuring the role of the community pharmacist. J Am Pharm Assoc.2006 46(5); 532-35. Ghorob A, Bodenheimer T. Sharing the care to improve access to primary care. N Engl J Med. 2012;366:1955–1957. Organisation for Economic Co-operation and Development(2010),â€Å"OECD Health Data†,OECD Health Statistics(database). doi: 10.1787/data-00350-en (Accessed on 14 February 2011).

Non-Art in Popular Culture Essay

When discussing art in popular culture there are very few boundaries to adhere to. Almost any form of media can be considered as art. But not all works are good examples of art and there are several determining factors that help to decide on the artistic quality of a piece. This essay will discuss in response to the above quote the identifiable characteristics of what could be considered art in contemporary pop culture. It will deconstruct the some of the most prominent types of art in popular culture including street art, music video and advertisements or commercial art. And under which circumstances are they considered to be art whether this is the intention of the piece, or the creative process that surrounds it or simply the aesthetic values that it holds. It will also discuss if works produced solely for commercial propaganda are still considered art. And if the artistic values of the work are influenced on the environment in which it resides. These three determining factors will help distinguish between art and non art in contemporary pop culture. Art in popular culture varies widely in a range of creative forms and media. Popular culture or ‘pop’ culture has a heavy influence on much of the works that are created by artists today. (Gibbons, 2005, p. 1) These include all forms of street and public art including graffiti and stencil art that often make statements on pop culture. And also in a more formal environment including galleries and art museums where there is a large array of contemporary works which reflect on these elements of consumerism. There are numerous well recognised artists that have concentrated much of their practice on consumerism and culture. Andy Warhol, is a founder in bringing consumerism to the high art scene in the 1960’s (Livingstone 1992), something that had not being done before. A more recent take on this concept is Takashi Murakami and the art movement ‘Super Flat’ which concentrates on Japanese pop culture and particularly anime and manga. (n. a 2009 Superflat art) Art is not only influenced by popular culture but it makes up a large part of influential media for popular culture. This form of art can be recognised directly in advertising, music, music videos, cartoons and any other form of media that creatively puts forth a message, more often that not for commercial propaganda. This is not always the case but this lower form of more accessible art is completely open to the public because it is not hemmed in by the confines or â€Å"laws† of the gallery system or the museum. (Stowers 1997) And it quite often forced into peoples lives, by occurring in a public space society are forced into viewing these creative works that promote popular culture through advertisements billboards television radio and generally in any public space just as they are exposed to graffiti art and vandalism. More often than not the environment in which the artwork resides in impacts the values that people give the piece but this is not the only thing that should be considered when depicting the piece as several factors impact the merit of the work. These can include the creative process involved, the purpose of the work and the aesthetic values of the final piece. (Johnstone 2006) The creative process that is involved in creating an art piece may have huge effects on the final outcome. In some cases it’s the process that is the work, in others cases it can be just important in developing the meanings and values behind the work and also some pieces may not be understood fully until the intentional processes are understood. The creative process has being described in four steps these are Preparation, Incubation, Illumination and Implementation. (Charlie, 2008) Going through this four step process is not always occur consciously but has an impact on the outcomes. (Konradsson 1999) Pieces that do not have a creative intention or process behind them can be severely limited in creative outcome and therefore have limited merit as art. In this case it severely relies on the aesthetic values that other people then place on the work. And if it has little appeal in terms of colour, line, balance, rhythm and other principles and elements and no creative meaning then is generally not considered to be art. The purpose of the work can also impact the process of how a piece is created. Depending on whether it is for commercial use or purely artistic intentions there can be a lengthy design process which is very calculated in terms of design. The final impact the work is strongly controlled through the elements and principles of design. This is generally used in commercial art such as illustration, graphic design, and advertising and communication media. All these forms of creative work hold artistic value but are not necessarily considered art to the general public as it is not presented as art but takes on a different primary form, advertising. (Gibbons 2005) This is a similar concept as street art or graffiti as it generally seen as a form of vandalism and can be considered as an eyesore. Though people are more likely to see graffiti for its artistic values and intentions as it dose not generally hold the same connotation as advertising. The reasons and values for why one might engage in graffiti art are as varied as the artists who produce it. A chief reason is the â€Å"prospect of fame and recognition of one’s artistic talent. Graffiti is also a form of self expression. The art as â€Å"writing† is a creative method of communicating with other writers and the general public. † (Stowers 1997) What it communicates is the artist’s identity, expression, and ideas like all other art forms but is forced into the public eye unlike art in a gallery. Graffiti is fast becoming popular as a preferred art form of many contemporary artists and hold the same fundamental artistic intentions as any other art form. As art we see in galleries have purely the intentions of being art we are more likely to consider that it is art. (Hester 2007) And we find some way of connecting to it via feeling and aesthetic value or the appreciation of the process. The placement of a piece in relation to its surroundings also impacts on the effect it has for example seeing an advertising piece in a gallery we would assume it to be art and created to make a statement about advertising. Where as if it were to be place on a billboard we would consider the primary reason is the promotion of a particular product. It is very difficult to define what art is exactly. According to many artistic directors and critics there is not one single definition of art. Art historian Robert Rosenblum believes that â€Å"the idea of defining art is so  remote [today]† that he doesn’t think â€Å"anyone would dare to do it. † (Witcombe n. d)And that more or less anything can be considered as art. † (Witcombe n. d) Goldman’s aesthetic theory (2005, 345) is of use to clarify the problem of location and presentation in relation to graffiti art. Goldman ( 2005, 346) claims that ‘art takes us to other worlds in a manner that is quite fulfilling sensually and aesthetically’ The are many determining factors that help us see the artistic values in works how we as individuals read and interpret these through out the work is a matter of pure personal opinion. Some personal factors that establish our opinions on creative works are our knowledge and understanding of art or a piece in particular, likes and dislikes and how we relate to the piece. This combined with the values of the piece that include; the process, the intention, the environment in which it is placed and the visual aesthetic values of the work determine how we personally consider the impact of the work. Many people consider art as something appealing to the eye or ear but much of contemporary art is not like this and a greater understanding of the work is needed to gain an insight to the values is holds. (n. a. 2009) For most people when art becomes hard or impossible to understand right away we tend to question its merit. This is particularly the case for graffiti as some may argue (Stowers 1997) even when it is in a gallery environment it is too hard to understand, though this should not be a determining factor to deciding whether is considered art as many art work considers deeper intrinsic values. Most of the opposition to graffiti art is due to ‘its location and bold, unexpected, and unconventional presentation,’ (Stowers 1997) but its presentation and often illegal location does not necessarily disqualify it as art either. The major determining factor is the creative value â€Å"the ability to produce complicated pieces is what separates the tagger from the graffiti artist; graffitist for short. Taggers scribble and graffitists do art. † (Stowers 1997) So as we can see there are many different forms of art in contemporary pop culture including those that are influenced by pop culture and those that influence pop culture. These can be all forms of Digital Media, advertising, illustration and music as well as art we see in galleries and street art. Not all have the primary purpose of being art but all hold artistic and creative values that can be seen through the process the intention the aesthetic qualities and the surrounding of the work. Some seem to have the primary purpose of being only art while others are created for commercial propaganda. While the pieces that are generally considered art by the public, have a better aesthetic quality and are initially easier to understand there can not be any set connotations as to what it to be determined as art or non art. And that it is purely what importance, feelings and values the individual viewing the work sees. Reference List Charlie, 2008. Demystifying the Creative Process http://www. productiveflourishing. com/demystifying-the-creative-process/ (accessed 28/04/2010) Gibbons,J. 2005 Art and Advertising. P. 1-12 New York: I. B Tauris & co Ltd Goldman, A. 2005. Aesthetic Qualities and Aesthetic Value . in Aesthetics critical concept in philosophy J. O Young, p. 345-349 Oxon: Routledge. Hester, N 2007. Low and High: What is Art Anyhow  http://www.monstersandcritics.com/

My Life After Spinal Surgery - 1054 Words

The engine of the rickety ferry rumbled as we plowed through the sparkling cobalt water. It was a scorching August mid-morning, one of those summer days you had to be by the water, if not in it. My family and I were on the ferry to Block Island. The engine rumbled again and I felt the steady vibration rise through my spine. I sat up straighter to prevent the direct connection of the engines oscillation from flowing through my seat to my back. My mother looked over nervously. nbsp; Are you all right, honey? she asked. nbsp; Im fine, Mom, really. nbsp; I knew we shouldnt have taken you on the ferry only two months after the surgery, she remarked, using her windbreaker to cushion my aching back. I laid†¦show more content†¦I dont care what they think. But as much as I tried to smile reassuringly at my now ever-nervous mother, I knew that my perfect summer day was ruined. nbsp; The start of school brought many agonizing moments. I learned firsthand the cruelty of my peers. I needed to use the elevator and have my books carried. I remember having few friends those first months, yet everyone noticed me. I was known as Brace Girl and was constantly badgered with questions like: Is that a bulletproof vest? Why do you wear that? nbsp; I got to the point that when someone even cast a questioning glance in my direction I would immediately rattle off, Its a brace, I had surgery for scoliosis. nbsp; My brace has been off for ten months now. I have tons of friends, but it saddens me to think that many didnt even try to get to know me when I had my brace. nbsp; Instead of being bitter about the whole thing, I try to look at it another way. Because of my experience, now I try to include everyone and reach out to others no matter what they look like. Also, I now believe that, with the right attitude, you can overcome anything. I have developed more of a I dont care what you think of me attitude and can now officially categorize myself as a leader. nbsp; I know who I am now, and appearance has nothing to do with it, although I am happy I can wear the shirts I like again. I am planning on joining the swim team even thoughShow MoreRelatedScoliosis Is A Worldwide Issue For Many People1674 Words   |  7 Pagesto undergo a life changing operation to correct the spinal curvature. Without the corrective surgery, the scoliosis can lead to life threatening conditions such as crushed organs, unable to feed, ribs breaking the skin, and death. So how does this operation work? How does it fix the curvature? Are the risks of the surgery too much to overcome the benefits, and/ or are the benefits of the surgery enough to overcome the risks? 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Essay on Autism And Savant Syndrome - 1994 Words

Autism And Savant Syndrome A little boy quietly sits in front of a piano, with his fingers poised over the bright white keys. His teacher, seated beside him on the bench, plays a complicated series of chords, filling the air with a beautiful melody. After a single hearing, the boy begins to play, perfectly reproducing the song he has just heard. As the last notes fade away, the boy sits still for a moment and then begins to rock gently back and forth, only stopping once the music begins again.... A genius. A prodigy. One might label this child as such after witnessing this type of performance, were it not for the little nuances of the situation: the rocking, the cold, unemotional expression on the boys face, and his lack of†¦show more content†¦These developmental delays are classified as pervasive developmental disorders (PDD). Autism is considered to be the most significant of these PDDs. It is a neurological disorder in which affected individuals have impaired social interaction, problems with verbal and nonverbal communication, and unusual or severely limited activities and interests (2). Often, autistic people have specific routines from which they refuse to deviate, as well as restricted patterns or interests that are considered to be abnormal in their intensity and focus. These habits, like autism itself, vary over a wide range, and may include hair twirling and rocking in mild cases to self-injurious behavior such as head-banging in more severe cases. Autisti c individuals have difficulty making friends and sustaining conversations, often fail to respond to stimuli, including their own names, and usually are retarded in their language development. For these reasons, they are often considered to be aloof and unemotional (2). Their intelligence quotients average at approximately 50, as compared to the average of 100. 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Savant syndromeRead More Autistic Savant Syndrome in the Film Rain Man Essay928 Words   |  4 PagesAutistic Disorder: Savant syndrome The Hollywood film Rain Man is about the Autistic disorder Savant syndrome. In Rain Man, Raymond Babbitt (played by Dustin Hoffman) has Savant Syndrome and his brother Charlie Babbitt (played by Tom Cruise) finds out about Raymond being his brother and that he is good with numbers so Charlie decides to use his brother to make money. Over the course of the time that Charlie and Raymond are together, they become closer and Charlie is not just using RaymondRead MoreMy Observation At A Daycare Center914 Words   |  4 Pagesis interested in knowing more about autism. she explained her knowledge of autism is limited and that she would like to know why autistic children, have an excellent performance in areas such as, music, art, math and perform poorly in other areas such as, following simple instructions. 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In French, idiot savant means learnedRead More Savant Syndrome Essay1736 Words   |  7 PagesSavant Syndrome is an extremely rare condition in which a person with a severe mental handicap has extraordinary abilities in a certain area, such as memorization, mathematics, or the playing of instruments. The first known case of savant syndrome was documented in a German scientific journal, Gnothi Sauton, in 1783. This article described the case of a man named Jedediah Buxton, who was talented in memorization and mathematics (Treffert 2009). Ever since this first account of Savant SyndromeRead MoreAnalysis Of The Movie Rainman By Barry Levinson825 Words   |  4 PagesLos Angeles, as ransom for his father’s inheritance. Rainman was a revolutionary movie that introduced much of the general public to autism, and savant syndrome, revealing what it is like to have autism and problems that those who have it face. One of Rainman’s main protagonist, Raymond is based off of the real life Kim Peek, who similarly to Raymond was a savant, that had impressive memory capabilities. Kim was able to read two pages of a book at the same time in roughly 10 seconds and completelyRead MoreAutism Spectrum Disorder And Its Effects On Society2437 Words   |  10 PagesAutism spectrum disorder still after decades is surrounded by misinformation despite the progression of scientific studies on the subject. Mitchell and Locke created an online survey to better evaluate the information surrounding autism spectrum disorder. Several questions were asked such as where they get information about autism spectrum disorder, where to get help, when it can be diagnosed, etc. It was found that most people get their information about autism spectrum disorder from the media orRead MoreSally Dibbs, Dibbs Sally. 461-0192 .(Rain Man). This quote shows the remarable1300 Words   |  6 Pages talent of a savant being able to remember a person from reading the phone book the night before .. This happens in literature as well as in life for those who live with savant syndrome. Forrest Gump, Raymond Babbit, and real-life savant Kim Peek all deal with the fact they are not the same as everyone else. Though dealt certain mental deficiencies, savants, whether fictional or real, all excel in there own ways. Savants are people who despite serious mental or physicalRead MoreRainman PPTX Final627 Words   |  3 Pagesmany items at the same time. Functional Assessments of Raymond †¢ Health Perception/Health Management – – – – Cannot express much emotion Cannot make direct eye contact Cannot make any decisions for himself Cannot understand his own mental illness (Autism) †¢ Nutrition/Metabolic – Has a set routine where he cannot have dinner past 4pm. – Has set days for different types of foods – Can only eat the â€Å"menu item of the day† for dinner †¢ Pattern of Elimination – Does not have any issues in this areaRead MoreA Comparison Of One Show Two Countries1602 Words   |  7 Pagesabout a doctor with savant syndrome, a rare condition where people with autism experience genius level abilities in one area, who wants to practice medicine and help people, but must get over several obstacles because other people think he cannot be a doctor due to his autism. The American remake of Good Doctor, while it appears similar to the Korean original, takes on many different things like conflict, the main characters’ past, the relationships between characters, and how autism is presented.

Essay about Racism and Jealousy in Othello - 762 Words

Racism and Jealousy in Othello The theme of racism is strongly depicted in William Shakespeares Othello. It depicts the attitude of European society towards those that were different in colour, race and language. In Europe, people of white complexion were the majority and all other races were considered to be less important and inferior. There are several characters in this play that portray this mentality. These characters include Brabantio, Roderigo and Emilia. But by far, the face of racism in this play is that of Iago, who makes his intentions crystal clear in his soliloquy where he states I hate the Moor, (I, iii, 379). Throughout the play, Iago lays forward a number of reasons for his hatred, which leads to the ruin of†¦show more content†¦His behaviour and speech indicates clearly that he is jealous of success (Othello becoming a general, Cassio becoming his second-in-command) as well as the happiness of Othello and Desdemona. An example of this is crying out to Brabantio that ...your daughter and the Moor are now making the beast with two backs - (I, i, 118); Which has strong, vulgar imagery. He is able to manipulate the entire course of the play through deceit and treachery. Cassio was chosen to be Othellos first lieutenant in favour of Iago, and this angered him deeply. He hates Othello for overlooking him, but he also hates Cassio for being chosen ahead of him to the spot that he wanted. Iago is successful in ruining Cassio and causing him to lose his reputation and thereby Othellos respect. Eventually, despite the success of his endeavours, he still attempts to have Cassio killed by successfully convincing Othello that Cassio and Desdemona are having an affair by saying that Cassio is jealous of him: O, beware, my lord, of jealousy. It is the green-eyed monster that doth mock the meat it feeds on (III.iii.169-70). Iagos ultimate objectives are made clear. He wants Cassio and Othello to die, and being the ruthless villain he is, he will stop at nothing to fulfil his desires. There is also the indication that Iago suspects that Othello may have been involved with his wife: And it is thought that twixt my sheets, Hes done my office. (I, iii, 380-81), although this is likely to beShow MoreRelated Racism in William Shakespeares Othello Essay1059 Words   |  5 PagesRacism in William Shakespeares Othello The play, Othello, is certainly, in part, the tragedy of racism. Examples of racism are common throughout the dialog. This racism is directed toward Othello, a brave soldier from Africa and currently supreme commander of the Venetian army. Nearly every character uses a racial slur to insult Othello at one point in the play. Even Emilia sinks to the level of insulting Othello based on the color of his skin. The character that most commonly makes racistRead MoreRacism In Othello Analysis829 Words   |  4 Pagesof Racism in Othello.† Shakespeare Quarterly, vol. 44, no. 3, Oct. 1993, p. 304. In this article, the author relates the idea of primal scene to racism in â€Å"Othello†. Primal scene is a psychoanalysis theory by Sigmund Freud. This theory claims once a child imagines or sees their parents having sexual relations they will be unable to repress this image from reappearing in their mind. The author rela tes this theory to the play â€Å"Othello† byRead MoreWhy Is Shakespeares Othello Still Relevant in Todays Audiences?940 Words   |  4 PagesWhy is Shakespeare’s â€Å"Othello† still relevant in today’s audiences? â€Å"When you begin a journey of revenge, start by digging two graves: one for your enemy, and one for yourself.† – Jodi Picoult. Othello is a very well-known Shakespearian text and is still relevant to today’s audiences. The themes in â€Å"Othello† are still applicable to today’s many audiences; Betrayal is a key theme presented in Othello, and is also still relevantRead MoreOthello, The Moor Of Venice, Is One Of The Principal Tragedies1180 Words   |  5 PagesOthello, the Moor of Venice, is one of the principal tragedies by Shakespeare. This tragedy contains many themes which are important in society today. Many aspects of people s lives have changed, but the way people think is still the same . Shakespeare s Othello wants to underline the psychological and social impact of racism; and the power of manipulation as well as jealousy. These are the most important themes throughout this drama. Othello takes place in Venice, Italy. He was a black generalRead MoreThemes in Shakespeares Othello Essay1155 Words   |  5 PagesOthello was written by Jacobean playwright William Shakespeare in 1603. It proved a huge success when first performed in 1604, in front of a huge audience. The story is one of Shakespeare’s great tragedy themed plays. Othello is the black protagonist and highly esteemed Venetian general. Iago is the ambitious but scheming villain of the play. When Othello promotes a man called Michael Cassio over Iago, he is furious and launches a malicious campaign against Othello. Meanwhile, Othello has marriedRead MoreOthello, By William Shakespeare1515 Words   |  7 PagesShakespeare’s Othello is seemingly about the blooming affection between a man and a woman. However, it is a love story gone wrong—or is portrayed as so by the author. In the historical context of Othello, which is set during the Turkish-Venetian war in the 16th century, it i s essential to emphasize that Othello is the love story between Othello, the Moorish general, and Desdemona, the Venetian lady. This racial difference is most problematic to the eyes of the white Venetian society, allowing charactersRead MoreOthello, By William Shakespeare997 Words   |  4 PagesRacism, love, betrayal, and jealousy are feelings that happen all the time in todays society, many people do not know how to handle it sometimes, and they get emotionally hurt for a long time. Othello is possibly the most famous literary exploration of the warping powers of jealousy and suspicion. At the same time, it s among the earliest piece of work that deals with race and racism. With Othello being a supreme commander of the Venetian army, he never felt like he fit completely in, and the girlRead MoreAnalysis Of Othello By William Shakespeare1171 Words   |  5 PagesBODY PARAGRAPH 2 JEALOUSY Jealousy is a major component of both the text and the appropriation, as jealousy is what drives Iago to plot against Othello. Jealousy is largely present in the appropriation too, the breaking point for Hugo comes at the moment when his dad, who is the coach, presents Odin with the award for ‘Most Valuable Player’, and announces to the team that â€Å"I love him (Odin), like my own son†. It is at this point that Hugo starts conspiring against Odin. Odin receiving the M.V.PRead MoreEssay about Racism and Cultural Differences Exposed in Othello1322 Words   |  6 Pages Othello, from the onset, is shown to us a play of love and jealousy. There is however more to this play than just love and jealousy; there is underlying racism, hate, deception, pride, and even sexism between these pages. Othello is a transcendent play, one that will survive the perils of time simply because it is still relevant. Even today, over 400 years later, there are still issues of racism and sexism. Hate is as natural as love in humans and Othello gets right to the root of that. WeRead MoreO and Othello Comparison929 Words   |  4 Pages‘Othello is one of the brilliant plays written by William Shakespeare. It is the story of man named Othello and how his mind was twisted and manipulated by a man named Iago and how Iago made Othello think that his wife Desdemona was cheating on him with his lieutenant Michael Cassio, which results in many deaths. Tim Blake Nelson has creatively restructured ‘Othello’ into a film to appeal to a teenage audience. It still contains the same central ideas which are racism, jealousy and deception which

Evidence-Based Practice Free Essays

The term Evidence-based practice is relatively new, yet in the last decades, EBP had a great impact on nursing practice, education and as a science in general. There is a broad agreement by scholars and publications upon EBP definition as â€Å"problem-solving approach to clinical decision-making that integrates the best available evidence and clinical expertise, along with patient preference and values† (Hain Haras, 2015). Meanwhile, ethics is rooted in ancient Greek philosophical inquiry of moral life and relates to a system of principles that can considerably change previous thoughts, actions, and decisions (Doody Noonan, 2016). We will write a custom essay sample on Evidence-Based Practice or any similar topic only for you Order Now More particularly, The nursing code of ethics stands as a central and necessary mark of a profession. It functions as a general guide for the profession’s members and as a social contract with the public that it serves. The code list nine provisions that makes explicit the primary goals, values, and obligations of the nursing profession and expresses its values, duties, and commitments to the society of which it is a part. The relationship between evidence-based practice and ethics is obvious in many ways Empirics and ethics are fundamental patterns of knowing in nursing: Empirics and ethics are actively participating in being fundamental patterns of knowing that shaped nursing as distinguish discipline. We gain empirical knowledge from research and objective facts. This knowledge is systematically organized into general laws and theories. One of the ways we employ this knowledge is through the use of evidence-based practice (EBP). likewise, ethical knowledge helps one develop our own moral code; our sense of knowing what is right and wrong. For nurses, our personal ethics is based on our obligation to protect and respect human life. Our deliberate personal actions are guided by ethical knowing (Vaughan, 2014). The â€Å"Code of Ethics for Nurses† can guide us as we develop and refine our moral code. Certainly, empirical knowledge is essential to the purpose of nursing, but nursing also required to be alert to the need to express the uniqueness of individual and to have an appropriate parameter that can judge and appraise these evidence on ethical manners. The knowledge of ethical code can provide answers to the moral question during the application of EBP. According to Carnago ; Mast (2015), each pattern of knowledge in nursing is separated but interrelated and interdependent to each other, and none of them alone should be considered sufficient. The overall purpose of EBP and nursing code of ethics is almost identical: The second provision of the code clearly states that â€Å"The nurse’s primary commitment is to the patient, whether an individual, family, group or community† (ANA, 2015). This commitment is to the health, well-being, and safety of the patient across the lifespan and in all settings in which health care needs are addressed. The principle of beneficence, which promote the well-being of others and non-maleficence which refers to the †obligation to not inflict harm on others. Once again, many statements in our Code reflect this important concern for avoiding harm to those we serve. The nurse upholds patients’ interests by influencing and managing those who provide direct care and fostering positive team approaches to facilitate safe, quality care. Similarly, the definition of evidence-based practice emphasize the use of best available evidence which most probably will benefit the patient and ensure the safety of that course of action through utilizing only approved and extensively tested evidence. While, a great attention to preserve the uniqueness of individual values and preferences. the Code of Ethics basic principles and definition of EBP simultaneously stress the importance of using best current evidence that ensures achievement of the desirable outcome (Stokke, Olsen, Espehaug, Nortvedt, 2014). To conclude, Nurses encounter and address many ethical dilemmas on a daily basis. Since nursing actions aim to improve the health and wellbeing of patients which best manifested by using EBP, it is inevitable and expected that nursing practice has an ethical dimension. Nurses, therefore, have a duty to develop not only an awareness of the ethical dimension of practice but also strategies to practice ethically. Fortunately, The original ANA Code of Ethics for Nurses With Interpretive Statements was released in 2001, and it was revised in 2015. This update ensures that the Code of Ethics continues to be relevant to the transformations in health care delivery and modern clinical practice advances. No matter how important technical and scientific expertise in nursing may be, providing nursing care must always be characterized as an ethical founded undertaking. By incorporating evidence-based decision making and intersecting it with traditional principles of ethics (beneficence, non-maleficence and justice), nurses are fostering care strategies for individuals and populations while addressing underlying systems issues that may impact care including facilitating a culture of safety that supports reporting errors and near misses which is vital for modern date practice (EBP) and promoting a healthy work environment of respect and c How to cite Evidence-Based Practice, Papers

Rebooting My Life Essay Example For Students

Rebooting My Life Essay Have you ever wondered what it would be like to move away from your home to a new place, to do something you want to do? When I was eighteen, I found out all the horrors and pleasures upon moving from Cameron, Oklahoma where there isnt even a general store we only had on convenience store to Pittsburgh,Pennsylvania where they had a Starbucks on every corner; just to attend culinary school. The day my adventure began still resonates with me. It was a clear summer day of July 2008; not even a cloud in the sky . The warmth of the sun bearing down on my pale skin,and the gentle breeze rolling in like a ocean wave across my hair, while my mother and I sat outside her modern brick house, which, always seemed to smell like homemade marinara; The smell so intoxicating it could make the meanest of people happy. Since i just graduated about a month ago, so we began to talk about the future and what i wanted to do with my life. Mother asked, Where would you like to go for college?   I replied, I would like to go to culinary school at the Art Institute of Pittsburgh.   Looking appalled, she exclaimed, Why would you wanna go to Pittsburgh!   I said that i heard about this school form an advisor that came to my school my last year. I tried to explain my reason; However, with everything i said she seemed increasingly upset. I could see her soft chocolate brown eyes widen from behind her thick, plexiglass-like glasses, and she constantly ran her hands through her short, golden brown hair, just like she did whenever she became upset. Even though she was upset, she still maintained good pose. not a single wrinkle in her emerald green shirt that transitioned into black. ot even a wrinkle on her translucent pale skinned face. Standing, she brush some dirt off her black slacks,stormed off, her black and emerald shoes stomping to showing her anger . I knew the battle will be rough. After hours of fighting, I finally convinced her to let me go. Couple of weeks later she took me the the bus station, a cold, bleak place that smelled like iron and sawdust, and housed sad and lonely people. My mother bought me a ticket and kissed my forehead just like we all do when we say goodbye to a loved one. She walked out, got into the car, and she drove away I felt a loneliness sink in for the first time; I felt sad almost to the point where i could just sit down and cry. Looking around at all the empty green and yellow plastic chairs. I grabbed my bags and sat down,waiting for my bus to arrive, and my life to begin. I finally arrived a hour later, I got on the bus to begin my 14 hour trip while looking around at the people they all looked like they should have been on Unsolved Mysteries. I feared the worst, and not sleeping a wink the whole way there. When I finally made it to Pittsburgh, I took a shower, for I stunk so badly that a skunk would not even come around me. Then I made my way out in the streets of pittsburgh. The streets were alive with all the people and loud sounds of city life. It was all like a dream come true. I made my way to the Art Institute where, I met my advisor Kelly; she wore a long red flowing dress and reddish black high heels, her hair as black as night, her eyes were the prettiest hazel eyes I had seen. She lead me up to a room to fill out paperwork. while I applied for my financial aid she went to check something for me . .u0bd026d2b4fad8604f4fe7698d790eb1 , .u0bd026d2b4fad8604f4fe7698d790eb1 .postImageUrl , .u0bd026d2b4fad8604f4fe7698d790eb1 .centered-text-area { min-height: 80px; position: relative; } .u0bd026d2b4fad8604f4fe7698d790eb1 , .u0bd026d2b4fad8604f4fe7698d790eb1:hover , .u0bd026d2b4fad8604f4fe7698d790eb1:visited , .u0bd026d2b4fad8604f4fe7698d790eb1:active { border:0!important; } .u0bd026d2b4fad8604f4fe7698d790eb1 .clearfix:after { content: ""; display: table; clear: both; } .u0bd026d2b4fad8604f4fe7698d790eb1 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u0bd026d2b4fad8604f4fe7698d790eb1:active , .u0bd026d2b4fad8604f4fe7698d790eb1:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u0bd026d2b4fad8604f4fe7698d790eb1 .centered-text-area { width: 100%; position: relative ; } .u0bd026d2b4fad8604f4fe7698d790eb1 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u0bd026d2b4fad8604f4fe7698d790eb1 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u0bd026d2b4fad8604f4fe7698d790eb1 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u0bd026d2b4fad8604f4fe7698d790eb1:hover .ctaButton { background-color: #34495E!important; } .u0bd026d2b4fad8604f4fe7698d790eb1 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u0bd026d2b4fad8604f4fe7698d790eb1 .u0bd026d2b4fad8604f4fe7698d790eb1-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u0bd026d2b4fad8604f4fe7698d790eb1:after { content: ""; display: block; clear: both; } READ: Maggie Obituary EssayShe came back a couple minutes later, and she told me that I did not have enough money to attend this semester. I was devastated! So worried about what I could do for money, at that moment i got up and left the institute. Walking down the street that smelled like fresh water and good food due to some food vendors that seem to be around every corner, i started to cry. I keep telling myself that i made it this far,and to not be able to afford my schooling. I became determined, the more i thought about what happened, and what i needed to do to make it in ,and get my diploma A couple of months passed I had stayed in the city, and found me a job as a alternative model; for a modeling group in city. It was fun dressing up in different outfits, even though some of the outfits looked old and tethered they were as soft as newborn puppys fur, smelling like fresh linen and lavender. Even though I had the money I needed for enrollment, the paperwork filled out, and i have been talking to kelly for the past couple months about my enrollment i was still scared, like a child lost in a store not able to find my mother. Nerveless I enrolled in school. I went every semester for that next two years. Even though the first couple months was rough trying to balance work and go to classes, but i surpass that, while remaining a model on the side to keep up my financial needs. I felt great at my graduation to see all the red and white caps and robes like a abstract painting from a museum. I knew that even though I had a rough and scary time getting to this point; i had finally succeeded in my goal, to become a licenced cook. Just like Walt Disney said All our dreams can come true if we have the courage to pursue them.   I believe in that now that i have experienced it for myself.