Why do you think American film dominance the world Assignment

For what reason do you think American film predominance the world - Assignment Example The achievement can likewise be ascribed to acceptable administration in the United States with strategies positive for film improvement. Additionally, American movies have generally higher nearness in outside business sectors while movies of different nations have low nearness in the United States. This can be ascribed to the way that Americans have higher inclination for American films to remote ones, which combines the home market to assist local film makers. Thusly, the high volume of American motion pictures in outside business sectors enables them to order the worldwide film industry. Additionally decreased exchange boundaries nations like China during 1990s helped American motion pictures to attack and increment their essence in remote markets. Further, sufficient introduction of American films on video comparative with outside motion pictures has likewise come about into their worldwide predominance. Expanded accessibility of American motion pictures to worldwide media business has additionally fortified their strength. In spite of the way that many film delivering nations like China have accomplished achievements in the film ventures; the worldwide commonness of American movies has empowered American motion pictures to snatch critical bits of their household

A Spirit in the Mix: an Analysis of “I Used to Live Here Once”

13 September 2009 A Spirit in the Mix: An Analysis of â€Å"I Used to Live Here Once† For the story, â€Å"I Used to Live Here Once† by Jean Rhys, we could contend that the story is about a lady who moved away from her country to go to another spot and now gets back for an explanation not expressed. The two youngsters who are playing outside the woman’s old house in the daylight disregard her. It might be conceivable that the two youngsters overlook the lady since she left the West Indies to live elsewhere and in this way they accept that she doesn't exist. Is this what is happening? I accept there is a greater picture here. The speaker lets us know in passage three that â€Å"that the sky had a shiny look†¦. † This might be on the grounds that the lady guest doesn't witness for herself any more, or it may be the case that she sees with her own eyes and can see the genuine idea of the sky. The speaker lets us know in section five that the lady sees two kids outside her home playing. The lady calls to them however â€Å"they didn’t answer†¦Ã¢â‚¬  her. In the following two passages, the speaker reveals to us that the lady shouts to the youngsters two additional occasions yet at the same time they didn't answer. We can accept that the kids overlook the lady on the grounds that the kids don't have any acquaintance with her, or on the grounds that the lady left her home and has not returned as of recently. In section eight, the narrator discloses to us that the lady is close to the two youngsters and they get an abrupt chill. This progressions the contention that the lady was disregarded in light of the fact that she left her home. The lady is disregarded not on the grounds that she left the West Indies, but instead in light of the fact that she doesn't exist. The lady existed at some point, however now she isn't at the home that she used to live in genuinely, which means she is a soul, a phantom. She is powerful. The lady explorer is visiting the West Indies and her home once and for all. She has incomplete obligations to perform before she proceeds onward to her next goal. She visits the home since she will withdraw from that point never to return. It might be that meeting her house was her incomplete undertaking. I accept that the lady is a soul due to the accompanying proof. The main proof is, â€Å"The just thing was that the sky had a smooth look that she didn’t remember,† inferring that she no longer observes it with physical eyes. The subsequent proof is, â€Å"There were two kids under the mango tree, a kid and a young lady, and she waved to them and called ’Hello’ yet they didn’t answer her or turn their heads,† as though they can't hear her. The last proof is the detail that the kids have an unexpected chill. The kid says, â€Å"Hasn’t it gone cold out of nowhere. † In all the books that I have perused managing the otherworldly, it is normal for individuals get an abrupt chill when a soul is in the blend. The entirety of this proof focuses to the way that the lady is a heavenly being.

The Koster Site 9,000 Years on the Illinois River

The Koster Site 9,000 Years on the Illinois River The Koster site is an old, profoundly covered archeological site situated on Koster Creek, a tight tributary stream etched into the alluvial stores of the lower Illinois River Valley. The Illinois River is itself a significant tributary of the Mississippi River in focal Illinois and the site lies just around 48 kilometers (30 miles) north of where Illinois meets the Mississippi today at the town of Grafton. The site is incredibly significant in North American ancient times, for its very much safeguarded human occupations going back almost 9,000 years, and the effect of its revelation so profound inside the alluvial fan. Order The accompanying order is gotten from Struever and Holton; the skylines were what was noticeable in the field, albeit later examination demonstrated there were 25 unmistakable occupations in Kosters stratigraphy. Skyline 1, Mississippian, AD 1000-1200Horizon 1b, Middle-Late Woodland (Black Sand stage), AD 400-1000Horizon 2, Early Woodland (Riverton), 200-100 BCHorizon 3, Late Archaic, 1500-1200 BCHorizon 4, Late Archaic, 2000 BCHorizon 5, Middle-Late ArchaicHorizon 6, Middle Archaic (Helton stage), 3900-2800 BC, 25 human burialsHorizon 7, Middle ArchaicHorizon 8, Middle Archaic, 5000 BCHorizon 9, Middle Archaic, 5800 BCHorizon 10 Early-Middle Archaic, 6000-5800 BCHorizon 11, Early Archaic, 6400 BC, 9 human entombments, 5 canine burialsHorizon 12, Early ArchaicHorizon 13, Early Archaic (Kirk indented point), 7500-6700 BCHorizon 14, sterile At the surface, Koster covers a territory of around 12,000 square meters (around 3 sections of land), and its stores broaden in excess of 9 meters (30 feet) into the streams alluvial porches. The site is at the contact between the limestone feigns and upland loess fields toward the east and the Illinois River floodplain toward the west. Occupations present inside the date of the store from Early Archaic through the Mississippian time frame, radiocarbon-dated to between around 9000 to 500 years back. During a large portion of the ancient control of the site, the Illinois River was found 5 km (3 mi) toward the west with a regularly fluctuating backwater Lake inside one km (half-mile). Chert hotspots for making stone apparatuses are in the close by limestone feigns coating the valley and included Burlington and Keokuk, sources which change in quality from fine-grained to coarse-grained. Site Discovery In 1968, Stuart Struever was an employee in the human studies division at Northwestern University in Evanston, Illinois. He was a down-stater, be that as it may, having grown up a long way from Chicago in the unassuming community of Peru, Illinois, and he never lost the capacity to communicate in the language of the down-stater. Thus it was that he made genuine kinships among the landowners of the Lowilva, the neighborhood name for the Lower Illinois Valley, where the Mississippi River meets Illinois. Among the long lasting companions he made were Theodore Teed Koster and his significant other Mary, resigned ranchers who coincidentally had an archeological site on their property, who coincidentally was keen on the past. Struevers examinations (1969-1978) at Koster ranch uncovered not just the center and early late Woodland materials detailed by the Kosters yet a delineated multi-part obsolete period site of bewildering profundity and respectability. Age-old Occupations at Koster Underneath the Koster ranch lies proof of 25 diverse human occupations, starting with the early Archaic period, around 7500 BC, and completion with the Koster ranch. A great many towns, some with burial grounds, some with houses, starting about 34 feet underneath the cutting edge Koster farmstead. Every occupation was covered by the stores of the waterway, every occupation leaving its blemish on the scene in any case. Likely the best-considered occupation to date (Koster is as yet the focal point of many alumni proposals) is the arrangement of Early Archaic occupations known as Horizon 11, dated 8700 years prior. Archeological unearthings of Horizon 11 have uncovered a thick midden of human occupation deposits, bowl formed capacity pits and hearths, human graves, different stone, and bone instrument collections, and botanical and faunal remains coming about because of human means exercises. Dates on Horizon 11 territory from 8132-8480 uncalibrated radiocarbon years before the present (RCYBP). Additionally in Horizon 11 were the bones of five tamed pooches, speaking to the absolute soonest proof for the household hound in the Americas. The pooches were intentionally covered in shallow pits and they are the most punctual known canine entombments in North America. The entombments are basically finished: every one of them are grown-ups, none display proof of consuming or butchery marks. Effects Notwithstanding the huge measure of data collected about the American Archaic period, the Koster site is additionally significant for its drawn out interdisciplinary research endeavors. The site is situated close to the town of Kampsville, and Struever set up his lab there, presently the Center for American Archeology and a significant focus of archeological research in the American Midwest. What's more, maybe in particular, the Northwestern University unearthings at Koster demonstrated that antiquated locales could be safeguarded concealed far below the valley floors of significant streams. Sources Aid AL. 2013. A Faunal Analysis of the Eleventh Horizon of the Koster Site (11GE4). California: Indiana University of Pennsylvania.Brown JA, and Vierra RK. 1983. What occurred in the Middle Archaic? Prologue to an environmental way to deal with Koster Site paleontology. In: Phillips JL, and Brown JA, editors. Bygone Hunters and Gatherers in the American Midwest. New York: Academic Press. p 165-195.Butzer KW. 1978. Changing Holocene Environments at the Koster Site: A Geo-Archeological Perspective. American Antiquity 43(3):408-413.Houart GL, editorial manager. 1971. Koster: a separated age-old site in the Illinois Valley. Springfield: Illinois State Museum.Jeske RJ, and Lurie R. 1993. The archeological perceivability of bipolar innovation: A model from the Koster site. Midcontinental Journal of Archeology 18:131-160.Morey DF, and Wiant MD. 1992. Early holocene residential pooch entombments from the North American Midwest. Current Anthropology 33(2):225-229.Struever S, and Antonelli HF. 2000. Koster: Americans in Search of their Prehistoric Past. Long Grove, Illinois: Waveland Press. Wiant MD, Hajic ER, and Styles TR. 1983. Napoleon Hollow and Koster site stratigraphy: Implications for Holocene scene development and investigations of Archaic period settlement designs in the Lower Illinois Valley. In: Phillips JL, and Brown JA, editors. Bygone Hunters and Gatherers in the American Midwest. New York: Academic Press. p 147-164.

The Ewer An Example Of Renaissance - Free Essay Example

The Ewer is French and was made in a town located in the west known as Paris. This ceramic belongs to the French Renaissance and there are many more like it but never of the same design for each one is unique. This style had a name of itrs own, known as Saint-Porchaire ware. It had a very high quality and could be found under a kingrs possession due to the difficulty in making one. There are also ties to the royal court having these as well. The style has a mannerist decoration popular in Italian Renaissance leading us to believe the French had this influence. It is known that it was used to carry water or other liquid substances for beverage. There is no known artist to this piece like other Saint-Porchaire ware, all that has been recorded is it was made in a small shop. A few craftsmen are believed to have worked on these due to their similarities in style and design. The amount of labor that went to making this ewer was time consuming. Every little detail was made slowly and carefully made by lead-glazed earthenware. The design was made with clay spinning on a wheel and guided to its shape by hand. The handle and beak was hand molded as well and was helped with metal objects to give its shape and fine detail folding. After the texture was smooth and left to dry they used impressions to stamp the designs. You wont find any of these pottery pieces with multiple colors, they always contained creamy soft colors and dark ink from the stamps. This ewer is very well balanced in its design and the creaturers shapes and size are proportionate to one another. Itrs wide size on top meets to a small base at the bottom and then is being held by a wide platform for balance at the bottom. There is no history on what the small sculpted figures are made out of at the top, but the carving detail is perfected. The texture of this Ewer is not a smooth straight surface all around. You feel the sculpted design and pointed glazed cuts on the handle. The figures faces are three dimensional with the frogrs eyes popping out of its head and the ears of the sea creature at the bottom also standing out of his head. The ribbon like design on top of the stamps are also popping out of the base yet have a smooth texture. There is a strong antique style here and gives even a rustic feel. It makes you believe you could find this in a small outdated village, but with the amount of detail it contains you know this piece was rare to come by and one of a kind, therefore was sold at a high price. This is a historical Ewer leaving us with admiration. Looking at the detail and having us think about the dedication given to this pottery. It leaves us to interpret the creatures however we find more pleasing. Some see a snake but I see sea creatures to be discovered. It brings curiosity to the human eye, we are forced to analyze every detail, inch, and corner to try to understand it. Even to come up with an explanation for its design. The print of Two Flayed Men and Their Skeletons by Domenico Del Barbiere made me respect the dedication artists during the high renaissance had. They studied the human body so well they knew how the muscles worked together and skeletons down to their skeleton form. It makes me think of the extremes artistrs probably went through, such as being present in a body dissection after death where doctors performed incisions. They maybe even looked at doctor notes and books if it was available. I also chose to write about this print because it was all engraved which I know first hand takes a lot longer than sketching.

Impact Of Technological Advancements On The Battle Of The...

A) Plan of Investigation: To what extent did technological advancements contribute to the victory of the Allied powers in the Battle of the Atlantic through 1939 – 1946? The Battle of the Atlantic lasted from September 1939 until the defeat of Germany in 1945; it was recalled to be the longest continuous military campaign. In the duration of six years; a glorified battle consisting of naval warfare, German U-boats, warships and Italian submarines were pitted against Allied convoys which aimed to transport military equipment and supplies across the Atlantic to Great Britain and the Soviet Union. This battle was executed to essentially gain control of Atlantic shipping routes, involved thousands of ships stretched and situated across the†¦show more content†¦Ã¯Æ' ¼ Aircrafts were very effective in protecting merchant ships; however, the problem was that Allied planes use earlier in the war did not have enough range to offer air cover or the convoys all the way across the Atlantic. The Mid-Atlantic Gap is recognized as a geographical term associated with an undefended area beyond the reach of land-based Costal Command antisubmarine aircrafts du ring the Battle of the Atlantic. Indeed this central area was known as the â€Å"Black Pit† as that was where many of the heaviest and largest convoy losses occurred. ïÆ' ¼ The introduction of the new long-range planes helped reduce the hazards of this dangerous portion of battle. Avro Lancaster was a British four-engined bomber which was implemented in warfare during the Battle of the Atlantic of the Second World War used by the Royal Air Force. It was first active as a strategic bombing offensive, and then became the main heavy bomber used by the RAF and RCAF. The Lancaster took upon the role of a long-range anti-submarine patrol aircraft and air sea rescue. It was also used as an aerial mapping resource to figure out where German U-boats most commonly attacked, hence figuring out where they usually place, with this information the Allies were able to strategically place counterattacks. The Avro Lancaster also carried passengers and delivered weapons to Britain and the Soviet Union. II. Allied scientists created many devices

The Black Panther Party And The Civil Rights Movement

By 1966, 32% of African-Americans were living below the poverty line, and almost 2/3 of people living in poor urban areas were Black. The Black Panther Party was a socialist and Black nationalist organization that was founded 51 years ago to address these issues among others. The organization, which had a far-left political position, lasted for merely 16 years and its influence continues to impact the world up till this day. It was the largest Black revolutionary organization to ever exist. Founded by Bobby Seale and Huey Newton, the party began in October 1966 in Oakland, California. The BPP’s original purpose was to protect fellow citizens against police brutality in African-American neighborhoods. Marked by social service programs,†¦show more content†¦Newton was a political activist who earned a Ph.D. in social philosophy. The duo met at Meritt Junior College in West Oakland, California and both were part of the Soul Students Advisory Committee. Ultimately, their experiences and stances, along with the ideology of Malcolm X, influenced the Black Panther Party platform. In October of 1966, Seale and Newton sat down and wrote their first program for the party. The 10 Point Program, titled â€Å"What We Want, What We Believe,† demands freedom, full employment, guaranteed income, justice of racial robbery, decent living, better education, black men to be exempt from military service, end of police brutality, and the release of black men in jail due to unfair or lack of trials. The 10th point sets it demands out clearly by stating â€Å" We want land, bread, housing, education, clothing, justice, and peace.† In a quote from Huey P. Newton from November 1970, Newton describes the shift from a nationhood stance to a revolutionary stance in the beginning of the party. â€Å"In 1966 we called ourselves a Black Nationalist Party because we thought nationhood was the answer,† says Newton, â€Å"†¦shortly after we decided tha t what was really needed was revolutionary nationalism, that is, nationalism plus socialism.† According to the Socialist Alternative, the BPP grew to 5,000 party workers at its peak in the late 1960s, and organized 45 branches across the country. The party tookShow MoreRelatedThe Black Panther Party And The Civil Rights Movement1910 Words   |  8 PagesCreated as an armed force protecting the black community in Oakland, California, the Black Panther Party (BPP) played a short but important part in the civil rights movement. They openly believed in carrying weapons and taking control of their own neighborhoods to aid their communities and resist police brutality. The organization led a revolution that spread across the nation lead by its two notorious leaders, Huey Newton and Bobby Seale. In June 5, 1966, James Meredith was shot and ambushed asRead MoreThe Black Panther Party And The Civil Rights Movement1801 Words   |  8 PagesThe Black Panther Party was a black nationalist organization who worked to teach minorities of the communities in the United States forceful and combative self defense mechanisms against the government. They set out to establish revolutionary socialism by not only organizing but also protesting against savage physical violence targeted towards Black people. 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When Abraham Lincoln was President, he had signed an agreement namedRead MoreMartin Luther King Jr And The Civil Rights Movement1134 Words   |  5 Pages Panther Power When we think of the Civil Rights Movement, we often think of the most prominent leaders like Martin Luther King Jr, Rosa Parks, and Malcolm X who’ve surely paved the way for the beginning of the movement. However many times we overlook the ones who aren’t talked about in the classrooms during Black History Month, or when we’re discussing the Civil Rights Movement. In response, I dedicate my paper on an African-American Organization to those who promoted the freedom and rights of BlackRead MoreSlavery During The United States966 Words   |  4 Pagesin the production of such lucrative crops as tobacco.† (History.com). According to PBS.org, African American slavery went on to last 245 years. During these times African Americans were oppressed, lynched and beaten. 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Each method hadRead MoreThe Black Panther Party By James Mcbride Vibrantly1313 Words   |  6 Pagesgroup of a bunch of blacks would turn out to be the most influential black rights movement? A group so controversial that there are many perspectives of how the general public views them. The Black Panther Party strikes up an immense amount of controversy despite their inactivity of almost 35 years. From the law enforcement’s perspective, The Black Panther Party were viewed as radical criminals who randomly murdered innocent police officers. Though from the standpoint of many blacks of the time, they The Black Panther Party And The Civil Rights Movement The Black Panther Party was a black nationalist organization who worked to teach minorities of the communities in the United States forceful and combative self defense mechanisms against the government. They set out to establish revolutionary socialism by not only organizing but also protesting against savage physical violence targeted towards Black people. Through different style of leadership, group roles, conflicts and outcomes, the Black Panther Party set out to revolutionize and forever change the face of the civil rights movement. Brief history of the group Originally known as the Black Panther for Self Defense, the Black Panther Party was a socialist organization formed in California. They were active in mainly the United States for approximately twenty years during the late nineteen sixties to the later nineteen eighties. They also had a chapter in Algeria for three years, but this was their only international chapter. In the beginning, the parties main objective was to challenge the brutality by the police geared at african americans because they believed that the non-violent campaign that Martin Luther King, Jr. was unsuccessful and failing to get the job done( Seale, 3). They formed because they believed that the traditional way of protesting would not have any change or affect on their lifestyles in a soon enough time and they would do a better job of getting what they wanted. The used armed citizens’ patrols to monitor the behavior of the police officers.Show MoreRelatedThe Black Panther Party And The Civil Rights Movement1732 Words   |  7 Pagesof people living in poor urban areas were Black. The Black Panther Party was a socialist and Black nationalist organization that was founded 51 years ago to address these issues among others. The organization, which had a far-left political position, lasted for merely 16 years and its influence continues to impact the world up till this day. It was the largest Black revolutionary organization to ever exist. Founded by Bobby Seale and Huey Newton, the party began in October 1966 in Oakland, CaliforniaRead MoreThe Black Panther Party And The Civil Rights Movement1910 Words   |  8 PagesCreated as an armed force protecting the black community in Oakland, California, the Black Panther Party (BPP) played a short but important part in the civil rights movement. They openly believed in carrying weapons and taking control of their own neighborhoods to aid their communities and resist police brutality. The organization led a revolution that spread across the nation lead by its two notorious leaders, Huey Newton and Bobby Seale. In June 5, 1966, James Meredith was shot and ambushed asRead MoreThe Civil Rights Movement vs. The Black Liberation Movement Essay1103 Words   |  5 Pages On The Duty of Civil Disobedience, written by Henry David Thoreau, explains that civil disobedience is the act of standing for your beliefs even though they are against the law. Thoreau goes on to say that the government (because it is ruled by the majority) is not always right for everyone especially the individual and the minority. Over the course of American history, there have been many different groups formed for the purpose of civil disobedience. The two that I am going to focus onRead MoreThe Black Panther Party For Self Defense1652 Words   |  7 PagesHuey Newton and Bobby Seale founded the Black Panthers Party for self-defense. In finding the Black Panther Party, Newton and Seale based the ideas and visions on the works of Malcolm X, a prominent figure in the Civil Rights movement, who had a â€Å"by any means necessary attitude†. â€Å"Malcolm had represented both a militant revolutionary, with the dignity and self-respect to stand up and fight to win equalit y for all oppressed minorities. Once they created the group Newton and Seale organized a missionRead More The Black Panther Party Essay813 Words   |  4 Pages The Black Panthers aren’t talked about much. The Panthers had made a huge difference in the civil rights movement. They were not just a Black KKK. They helped revolutionize the thought of African Americans in the U.S. nbsp;nbsp;nbsp;nbsp;nbsp;The Black Panther had a huge background of history, goals, and beliefs. Huey P. Newton and Bobby Seale in Oakland, Ca 1966, founded the Panthers. They were originally as an African American self defense force and were highly influenced by Malcolm X’s ideasRead MoreThe Movement that Revolutionized the Civil Rights: Black Panthers1333 Words   |  6 PagesThe Black Panther Movement made a progressive contribution to the US and civil rights. In order for a person to understand what the Civil Rights movement was, they would need to understand what political movements were involved, that made a big impact on the Black Community. What was the Civil Rights movement? The Civil Rights movement lasted from the late 1960s and early 1970s. But, the Civil Rights was not born during that time. When Abraham Lincoln was President, he had signed an agreement namedRead MoreMartin Luther King Jr And The Civil Rights Movement1134 Words   |  5 Pages Panther Power When we think of the Civil Rights Movement, we often think of the most prominent leaders like Martin Luther King Jr, Rosa Parks, and Malcolm X who’ve surely paved the way for the beginning of the movement. However many times we overlook the ones who aren’t talked about in the classrooms during Black History Month, or when we’re discussing the Civil Rights Movement. In response, I dedicate my paper on an African-American Organization to those who promoted the freedom and rights of BlackRead MoreSlavery During The United States966 Words   |  4 Pagesin the production of such lucrative crops as tobacco.† (History.com). According to PBS.org, African American slavery went on to last 245 years. During these times African Americans were oppressed, lynched and beaten. African Americans had no equal rights to their white counterparts. It wasn’t until a man named Abraham Lincoln took office, as the President of the United States, and created the Emancipatio n Proclamation. The Emancipation Proclamation abolished slavery and freed the African AmericansRead MoreThe Black Civil Rights Movement1120 Words   |  5 PagesFrom women to gay rights but it is undeniable that the black civil rights was the bloodiest and most violent among them. Two methods were used to bring message to the people: the violent or the non-violent way. Most activists and civil rights group like Martin Luther King Jr., NAACP (National Association for the Advancement of Colored People) and CORE (Congress of Racial Equality) at that time chose for the latter but one did not follow that lead: the infamous Black Panthers Party. Each method hadRead MoreThe Black Panther Party By James Mcbride Vibrantly1313 Words   |  6 Pagesgroup of a bunch of blacks would turn out to be the most influential black rights movement? A group so controversial that there are many perspectives of how the general public views them. The Black Panther Party strikes up an immense amount of controversy despite their inactivity of almost 35 years. From the law enforcement’s perspective, The Black Panther Party were viewed as radical criminals who randomly murdered innocent police officers. Though from the standpoint of many blacks of the time, they

Applied Multivariate Statistical Analysis

Question: Briefly summarize and report the statistic and discus whether the assumptions of the test were met and if the type of data was appropriate for the statistical test? Answer: Introduction: It is evident that in academic writing, authors have to follow conventional forms so that the scholars are able to interpret what the study is all about. At the same time, the scholarly article writings also frequently preside over the variety of style as well as tone the author have to employ if the article is to be satisfactory to others in the similar field. If the nature of the study is practical oriented, that is, it dealt with data, then the author must have to represent the study by mentioning what data they have employed what strategy they have followed to conclude their findings etc. So, it is necessary to assess the article with considering several parameters to understand whether the article is providing sufficient information towards the scholars. With this aim, the above mentioned article is chosen and analyzed with respect to several sub points. To assess the chosen article, here the entire critical evaluation study has been subdivided into six broad sections. The details of each of the sections are described as below: Particular test/tests use in this study: After reviewing the study executed, it is noted that the researchers of this study mainly emphasized on analysis of the effectiveness as well as the efficiency of traditional stroke care pathway and comprehensive stroke care pathway. To do so, they have used a list of statistical tests. As the study incorporates both parametric and non-parametric data, both kinds of tests were employed here. [a] Students t-test The researchers employed students t-test to assess the parametric data gathered for this study. There are twelve variables utilized in this study. The mean of all these variables for both the groups was compared using this specific test (Hardle Simar, 2012). [b] MannWhitney U-test: This particular test has been employed as an alternative of the independent sample t-test. Here, non-parametric data gathered for this study were utilized (Heckard, Utts Utts, 2012). [c] Chi-square test: This particular test has been employed to identify whether the selected two groups have an association with other or not and if associated then significant or not (Hu, Liu Lin, 2013). [d] Linear regression analysis: This particular test has been employed to assess the relationship between functional independence measure efficiency lengths of stay in ASU for both the control group (Kobayashi, Mark Turin, 2012). Brief overview of the study: It is noted that clinical research practice supports medical treatment continues to develop and get better. Under such circumstances, stroke care units have utilized a range of stroke treatment models like acute care, rehabilitation care and comprehensive stroke care. The use of any specific stroke treatment model largely depends on the patients scenario. Besides, there are also differences in care among these models (Jung Jung, 2013). Reviewing this study, it can be said that the study is mainly aimed to judge the efficiency as well as effectiveness of traditional stroke care pathway against comprehensive stroke care pathway. In this context, it is also noted that while selecting these two control groups, they have defined the comprehensive stroke care as the combination of acute and rehabilitation stoke care. On the other hand, both acute and rehabilitation stroke care remained separate in care of traditional stroke care model. It is also the fact that the researchers have employed a list of statistical test to attain the objectives of this study. The conclusion drawn by the researchers indicates that in both the control group, acute and rehabilitation stoke care remained efficient as well as effective one. But, if the comparison measure has been considered, then it can be said that comprehensive stroke care model has shown greater functional efficiency in against the traditional stoke care model. In other words, the study has concluded that while giving stoke care, the health professionals needs to consider both the acute as well as rehabilitation care together to attain better result (Miner, 2012). Statistics used in this study: As mentioned, in the above section the researchers have employed four different tests to attain the objectives of the study. In each tests, they have used certain specific statistics. The students t-test and the MannWhitney U-test have shown that mean and standard deviation of each of the variables were employed as the statistical tools (Sprinthall, 2012). In case of Chi-square test, probability value or the P value has been considered as the statistical tool (Speziale Carpenter, 2011). On the other hand, during the linear regression analysis, first of all median and inter-quartile range or IQR have been employed here to explain whether both traditional stroke care model and comprehensive stroke care model have demonstrated significant FIM efficiency or not. The correlation or the r-squared value also has been employed as the statistical tool to reveal the association between FIM efficiency and LOS spent in the ASU. Statistical assumption of this study: Prior to executing this research work, the researchers have defined the sample inclusion criteria as study design (fig 1 of the article). It has clearly depicted how the sample will be collected and who will be the final respondents in each control groups. At the same time, it is also noted that all the respondents are randomized using Stata 11 computer program software beforehand analysis of the data collected. Again, in order to measure the outcome in terms of efficiency and efficacy, certain assumptions also made by the researchers. In the context of efficacy, FIM scores are being taken into consideration, which are gathered during discharge of patients and 90 days post discharge follow up. On the other hand, to measure the efficiency, two points are considered here. First of all, total length of stay (LOS) of each of the patients in every hospitals selected are measured. Then FIM efficiency has been measured using the below mentioned formula: FIM efficiency = change in FIM score / total length of stay Level of measurement: As per the article, it can be said that the researchers have gathered data from four participating hospitals. Initially, the research has been considered total 47 patients as the sample of this study. Among these 47 patients there were 25 males and 22 females as mentioned in the result section. However, later it is found that among these there are four patients who have withdrawn their name from the study during the ASU phase and at the same time two from rest of the participants died. Finally, after going through other exclusion criteria, 20 patients were considered as the final sample of this study for comprehensive stroke care model. On the other hand, 21 patients were considered as the final sample of this study for traditional stroke care model. Here, the study has shown that in comprehensive stroke care model, the range of the age of the selected patients was 55 to 88 with mean age 73.5 years. Similarly, in case of traditional stoke care model, the range of the age of the selected patients was 34 to 99 with mean age 72.6 years. This clearly indicates that the deviation of age for comprehensive stoke care model was more than the traditional stroke care unit. As mentioned above, the researchers have collected data in two specific intervals, one during discharge of patients and other one 90 days post discharge follows up. Now, the results as described by the researchers indicate that they have found significant improvement in effectiveness of comprehensive stroke care model in against the traditional stoke care model. However, during the post 90 days follow up, the study did not find significant difference in both effectiveness levels (Strokeassociation.org, 2015). Again, when efficiency level has been measured, then it is found that the length of stay of patients in comprehensive stroke care model is more than 5 days less against the length of stay of patients in traditional stroke care model. In this context, the study has also depicted that if the participants who died and withdrawn their participations are included in the results, and then such difference will increase by 1.62 days. Finally, when, FIM efficiency has been taken into account, then it can be said that the researchers have found enough evidences to conclude that the comprehensive stroke care model have better FIM efficiency level than traditional stroke care model. Taken for consideration, the study has shown that the median value of the FIM efficiency score of comprehensive stroke care model was 1.60 with inter quartile range 0.87 2.81. On the other hand, the median value of the FIM efficiency score of comprehensive stroke care model was 0.82 with inter quartile range 0.27 1.57. This indicates that the FIM efficiency was 95% better in case of comprehensive stroke care model in compared to traditional stroke care model (Tung, 2013). Data displaying techniques: While performing any specific study, displaying results appropriately is an essential aspect as it helps the reader to relate the discussion along with the findings of the study. The reader can also easily identify whether the findings are in line with the objective stated or not. Here, the researchers have utilized both table and figures effectively to display the data gathered, data analyzed, etc. First of all, the study design mentioned as figure 1 in the article clearly explored how the data were gathered and what is the final sample size. The researchers here described these as well as presents graphically, which helps the reader to understand it clearly (Organization, 2012). So, it is the major strength of the study. At the same time, it is also noted that data calculation table presented in this study has depicted the values that are required for this study. It is the fact that each of the tests that have been employed here includes several sub tables. However, the researchers did not put all these tables in the result section. Instead, they have summarized the tables and put in such a way that supports the readers to understand what values have been considered when discussing any specific point. So, this is also strength of this study. Again, when line ar regression analysis has been performed to assess the relationship between functional independence measure efficiency lengths of stay in ASU for both the control group, there is requiring identification of the trend as well as the correlation value. In this context, it is noted that the researchers have utilized graphical presentations which clearly depicts the trend as well as correlation value. Therefore, it can be concluded that the researchers effectively utilized the figures to display the results. As a consequence, the researchers have shown the findings of the study appropriately that supports the objectives of the study. Conclusion: Thus, to conclude, it can be said that while the aim of this study is to measure the efficiency as well as effectiveness of traditional stroke care pathway against comprehensive stroke care pathway; the findings of the study appropriately shows that there is a significant improvement in comprehensive stroke care model. In other words, the study has effectively incorporates the aspects that must have to consider to reach meaningful conclusion. The researchers have accurately identified each and every small aspects related to the study to conclude such results. Thus, it can be said that the study is an effective one. The effective use of statistical test, tools, etc also supports the researchers to draw such meaningful conclusion. It is noted that while performing any study, the researcher has to exclude certain aspects due to the limitations of the study. However, it is essential to identify those limitations prior to executing the research work. This will not only strengthen the existing research study, but also supports the readers as well as other researchers who may use this study as the guidance or base point. Considering, this point, it can be said that the study has displayed a significant area of stoke care. While, in the contemporary scenario, where stroke is considered as one of the major concerns, this study no doubtly shows pathway to follow to avoid major issues related to stroke. However, the fact is that the study considered patients only from four hospitals and the size of the sample is small enough considering the importance of the subject. So, prior to validate the findings of the study externally, there is requiring conducting this study in vast scenarios. If the results still shows that the comprehensive stroke care model where both the acute and rehabilitation care are combined together evidenced improved efficiency as well as effectiveness in compared to traditional stroke care model; then the study will improve the overall scenario much more accurately. References Cho, D. (2012). The Study on the Difference of Management Performance in Public Health Care Institution.The Korean Journal Of Health Service Management,6(2), 133-140. doi:10.12811/kshsm.2012.6.2.133 Cho, D. (2012). The Study on the Difference of Management Performance in Public Health Care Institution.The Korean Journal Of Health Service Management,6(2), 133-140. doi:10.12811/kshsm.2012.6.2.133 Cooper, H. (2011).Reporting research in psychology. Washington, DC: American Psychological Association. Gambrill, E., Reiman, A. (2011). A Propaganda Index for Reviewing Problem Framing in Articles and Manuscripts: An Exploratory Study.Plos ONE,6(5), e19516. doi:10.1371/journal.pone.0019516 Hardle, W., Simar, L. (2012).Applied multivariate statistical analysis. Berlin: Springer. Heckard, R., Utts, J., Utts, J. (2012).Statistics. Australia: Brooks/Cole, Cengage Learning. Hu, M., Liu, Y., Lin, J. (2013).Topics in Applied Statistics. New York, NY: Springer New York. Jung, H., Jung, K. (2013). A Study on the Suicidal Ideation and Self-esteem of Nursing Students.The Korean Journal Of Health Service Management,7(3), 149-160. doi:10.12811/kshsm.2013.7.3.149 Kobayashi, H., Mark, B., Turin, W. (2012).Probability, random processes, and statistical analysis. Cambridge: Cambridge University Press. Miner, G. (2012).Practical text mining and statistical analysis for non-structured text data applications. Waltham, MA: Academic Press. Organization, W. (2012).World Health Statistics 2012. Geneva: World Health Organization. Simmons, B., Bland, M., Wojciechowski, B. (2011).AP statistics 2012. New York: Kaplan Publishing. Speziale, H., Carpenter, D. (2011).Qualitative research in nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams Wilkins. Sprinthall, R. (2012).Basic statistical analysis. Boston: Pearson Allyn Bacon. Strokeassociation.org,. (2015).Stroke Treatments. Retrieved 9 August 2015, from https://www.strokeassociation.org/STROKEORG/AboutStroke/Treatment/Stroke-Treatments_UCM_310892_Article.jsp Tung, W. (2013). Stroke Among American Indians and Alaska Natives.Home Health Care Management Practice,25(4), 176-178. doi:10.1177/1084822313484761

Man, the State and War by Kenneth Waltz

Summary When reading the book â€Å"Man, the State and War† by Kenneth Waltz, the main driving thesis behind the book immediately presents itself in the form of a question which is: â€Å"what is war?†. Waltz answers this question by postulating the the origin of war comes from â€Å"within man, the inherent structure of separate states and due to the very state system itself† (Waltz, 2001).Advertising We will write a custom book review sample on Man, the State and War by Kenneth Waltz specifically for you for only $16.05 $11/page Learn More He refers to the aforementioned causes of war as â€Å"images of international relations† and views them from either a singular or collective perspective from which he ascertains how each â€Å"image† interacts with the other which ends up resulting in the occurrence of war. Waltz claims that it is this interaction between the various â€Å"images† which is the main cause of war due to variances in methods of thought, thinking, relations and other variables which create either positive or negative effects. It is at this point that Waltz attempts to analyze whether it is possible to create a world that is devoid of war or if war itself is an inherent aspect of mankind which will never truly go away (Waltz, 2001). Upon further reading it can be seen that the ideas of Waltz are heavily influenced by the ideas of realism and neo-realism wherein he states that the anarchic international system combined with self interested states (which is one of the claims of realism) actually prevents the creation of a peaceful global environment due to factors related to competition and mutual distrust. In the end Waltz states that the only method of resolving the current dilemma of war is if a single world government was to be created which addresses the individual concerns of each state. Unfortunately such a situation requires each state to give up their much vaunted â €Å"sovereignty† which would be highly unlikely resulting in peace being applicable in theory however being unattainable in practice (Waltz, 2001). Examination of the Veracity of the Sources Utilized When going through the entirety of the text it can be seen that Waltz synthesized the views of Hobbes, Mills, Rosseau, Kant, Spinoza, Kant, Smith and a variety of other known experts in the field of international relations in order to formulate the arguments present within his book. The sheer amount of views and in-text lifting from other authors lends the work a certain degree of veracity in terms of the accuracy of the arguments and how they conform to current methods of thinking regarding the current state of conflict within international relations and its origins. As such, in terms of its use of sources I find that there are no problems whatsoever.Advertising Looking for book review on american literature? Let's see if we can help you! Get your first paper with 15% OFF Learn More Critique of the Text The main strength of the work of Walsh comes from its use of prolific body of historical knowledge and thoughts from various experts in international relations tht formed the foundation of his work. Yet, despite this abundance of literature it must be noted that Waltz fails to â€Å"think out of the box† so to speak when it comes to examining the causes of war and instead single mindedly focuses on the â€Å"images of international relations† that he had brought up at the start of the text as the main causes of war. There are other factors that he neglected to take into consideration such as religion (which was why the historic crusades were started and one of the contributing factors behind the ongoing conflict between Israel and several Arab states), ethnicities (as seen in the current ethnic conflict between Sunni and Shiite Muslims which has led to various uprisings in the Middle East), economic factors (as seen in the case b etween the U.S. and Japan when the U.S. cut of supplies of much needed resources to Japan which sparked the bombing of Pearl Harbor and brought the U.S. into the Pacific theater), historic alliances (seen in the case of World War 1 wherein the balance of power system and historic alliances in effect brought numerous nations into the war) (Vassalo, 2003). Lastly, the fight for resources has been an ongoing theme within human history which Walsh neglected to elaborate on yet has been growing in relevancy due to factors related to growing population rates, global warming and an assortment of other factors which has further exacerbated this growing point of contention (Betts, 1999). Furthermore it must be noted that Walsh had a habit of framing the motivation of man in relatively â€Å"black and white nature† (i.e. good or evil) which is an over implication of how people thinking and act. While the book itself is great basis from which one can learn about the origins and causes o f war, it focuses too much on the various arguments of historical thinkers without sufficiently examining other factors which influence the start of wars. Conclusion Overall, it can be stated that the work of Waltz is a great attempt at explaining the origin of war yet, based on the critique of the text, it can be seen that the concept of war is too broad to be defined within the parameters defined by Walsh and constitute far more factors than what was elaborated on. Reference List Betts, R. K. 1999. Must War Find a Way?. International Security, 24(2), 166-198. Vassalo, A. W. 2003. Man, the state and war: A Theoretical Analysis (Book). Military Review, 83(1), 68.Advertising We will write a custom book review sample on Man, the State and War by Kenneth Waltz specifically for you for only $16.05 $11/page Learn More Waltz, K. 2001. Man, the state, and war: A theoretical analysis. (pp. 1-284). New York: Columbia Press. This book review on Man, the State and War by Kenneth Waltz was written and submitted by user Linda Robbins to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

When To Make a Multiple Page Resume

When To Make a Multiple Page Resume We’ve all been told the cardinal rule of resume writing. Concision. Get as much information into as few words as possible, present everything cleanly and clearly and- no matter what- stuff it all into one easy-to-read page. That’s fantastic advice 99.9% of the time. For the most part, you don’t want to give too much away. Save some details for the interview, and make sure everything in the resume is screaming that you deserve one. You want to make sure you stand out from the crowd and make the cut.However, there are certain situations when a multiple page resume  might be called for. Here are some good general rules of thumb.One Page ResumeWhen you have fewer than 10 years in your field- whether you’re just starting out or are making a major career change and have yet to gather the requisite wealth of experience. Or if you’ve had multiple positions with the same company or employer.Two Page ResumeIf you’re pushing 10+ years experience in yo ur field, particularly in your particular sphere. Or if you are in a field requiring a good deal of technical, engineering, or other specific bits of knowledge and background qualifications which you need to list out in detail.Three Page ResumeIf you’re an academic or a scientist and you have numerous speaking engagements, publications, patents, professional service, courses, etc. to list. At this point, this is less a resume and more of a C.V. Also if you’re in a senior level or you’re an executive and you have a massive laundry list of leadership accolades to list.If you’re new to your field, or to the workforce in general, follow the well-established rules you’re told. But if you feel you’ve developed past the one-page point, try expanding your space and see how it pans out.

Halifax Analysis Essay Example | Topics and Well Written Essays - 1500 words

Halifax Analysis - Essay Example The service delivery method deployed by Halifax is strongly related to the company's ability to promote and execute to customer needs through professional E-business at http://www.halifax.co.uk/home/index.shtml. This allows the bank to run literally twenty-four hours per day year round. The benefits of this service delivery are the continuity of service, however the detriment may be found in genuine customer service and person to person contact. The professional service deliver for online banking is in high demand. In the long run, there will always be demand for credit cards, mortgages business loans or insurance in one form or another. Financial services are the backbone of our economy and will continue to be for years to come (Davies 1992). Because diversified financials offer such a wide range of products, they are able position their companies to tap changing demand for different products (Davies 1992). World population is continuing to expand at an exponential rate. It is important for companies within the industry position themselves in developing countries to take advantage of exploding populations, especially in emerging countries (Davies 1992). The degree of customer interaction for online banking is low. ... Several online banks also offer 'click to chat' options which allow an online customer to 'chat' with a professional banker. This is not an option available with Halifax. ). Technological innovation has allowed financial companies to automate time and labour intensive processes and enhance their ability to match up borrowers and lenders, regardless of geographic location (Gardener 1988). While Halifax has reached several components of innovative technology by the development of 24-7 online banking, they are severely lacking in the degree of viable customer interactions. Degree of Service Customisation The degree of service customisation is relatively high. Halifax has developed specialised services through online banking for the purpose of gaining new customers and retaining current customers (McDonald 2002). In the degree of customised services, Halifax offers diverse and multiple professional banking services. Expectations are commonly defined as "beliefs about a product that serve as standards or reference points against which product [or service] performance is judged" (Zeithaml et al. 1993, p. 1). To this, Halifax responds by offering direct and easy to navigate professional services. There are icons for nearly all-banking needs that the customer can easily navigate based on their requirements. Halifax also boasts that it will assist the customer in 'switching' banks, which customises the professional service towards new customers. Nature of Service Act The nature of the professional service is strongly E-business The service side concentrates mainly on providing services to the customer. Halifax's customer care section plays an important role on deciding if the company and should be

Policy Essay Example | Topics and Well Written Essays - 2000 words

Policy - Essay Example Policies in academic institutions remain to be central in molding students through providing them with responsible conducts essential for life. However, formulating academic policies that foster pleasant interaction between policy makers and students, faculty, staff and administrators has continued to face challenges hence hindering the achievement of educators’ mission. This paper shall candidly and comprehensively review the library policies used by Arizona State University (ASU), to ascertain the practicability of such policies and recommend necessary policy-changes that can help transform the university. Arizona University formulated rule and regulation that are fundamental in guiding students toward accessing and utilizing the library resource. The library is known as a treasure-house of knowledge acquisition as it helps in stimulating the mind with its resourceful material. The library can be unpleasant to unlucky learners who cannot afford to buy the book or other reading material to enhance their learning (Doyle p. 148). Therefore, the school libraries should be easily accessible and do not exploit its users through heavy fines and inconvenient policies. ASU library is vital toward the student and the staff in general. Therefore, the policy guiding the library must be made in their interest. However, the university has continued to formulate exploitive policies towards this vital department that act like the source of knowledge. Arizona State University has made and implemented these policies: student must pay for the books they require for their studies; student, staff and facu lty also must be charges an overdue of $10.00 cost of learning and teaching material replacement after 90 day (Melnick p. 179). The university also implements other fines such as recall for the material at $10, reserves cost at $1.00 per hour to $20 per item, community card holder at $10.00 billing fees and should

Age-Related Changes that Occur in the Cardiovascular System Essay Example for Free

Age-Related Changes that Occur in the Cardiovascular System Essay The title page introducing what subject I am planning on presenting to the residents of the independent living facility. It tells them who I am and what subject is being presented. The residents that I am going to be addressing are healthy, active and mentally alert senior who want to learn more about health conditions that are affecting their age group in general and are of major concern. Slide 2 Homeostasis is the equilibrium of the body. Homeostasis is maintained by the balance of our vital signs to keep us on an even keel. The definition of Homeostasis is, â€Å"Homeostasis is the compensation of the vital signs to regulate the hearts blood flow and maintain balance within the body† (Jenkins, Kemnitz, Tortora 2010). The autonomic system and its branches keep the body moving and functioning. Like these teeter-totters the parasympathetic and the sympathetic move oppose of each other, but keep a slow steady rhythm and together they work as a whole. Slide 3 The fight or flight dilemma. The fight stance is pretty self-explanatory; these are noticeable effects like pupils dilated, neck and shoulders stiffen up or tense, chest pain or palpations, mouth can get very dry or cotton mouth, these are just some of the examples of signs and symptoms that an individual can experience. The flight stance is more hidden and not necessarily identified by the patient or doctor until the more noticeable symptoms are visible. Some of the hidden symptoms can be, but not limited to blood pressure can get higher to a dangerous level, more adrenalin is released into the individuals system, liver produces more glucose to give energy to the muscles, and the digestion system will slow or stop completely. Slide 4 Some of the side effects from medication or treatments can be uncomfortable and more severe than the symptoms of the condition that is being treated. Looking on the brighter side is that once the medication or treatments are manageable the medication is controlling the condition, than life can get back to normal except for some life style changes. Diet and exercise can be the most drastic changes, and the hardest to comply with. If an individual has never exercised much and has lived on fast food, eating healthy and increasing activity besides sitting in front of the television can be the most challenging. Slide 5 A hypertensive heart has thickened ventricular walls which make the heart work harder to pump the blood throughout the body. When the walls thicken, the elasticity is decreases and the heart and other systems need to work harder to pump oxygenated blood throughout the body. Any condition that affects the oxygenated blood from flowing through the heart can cause the ventricular walls to thicken. As we age our blood pressure increases, age, ethninticity, weight, and genetics can play a role in a hypertensive heart condition. Slide 6 Hypertension is sometimes call, â€Å"The Silent Killer† (www. medicinenet. com 2013). Hypertension usually does not have any symptoms and puts a lot of stress on other major organs which over time will start to deteriorate. Some side- affects that can impact quality of life are sexual dysfunction, stroke, heart disease, kidney disease, and neurological problems. Sexual dysfunction is usually more noticeable and bothersome to men. Heart disease can lead to other heart related problems, like heart attack (MCI), stroke (CVA), and congestive heart failure (CHF). Slide 7 After the diagnosis of hypertension, the physician and individual will work on a plan to manage the hypertension. Most of the time this includes medication, low fat, low sodium diet and exercise. This will include some changes in your family’s life to. Our society functions on fast food, and not enough education on the right foods to eat. Exercise can be as little as walking around the block or as much as working out at the gym several times a week. Blood pressure needs to be taken every time there is a doctor’s appointment and sometimes it should be Slide 8 Coronary Heart Disease (CHD) is caused from a waxy substance building up in the coronary arteries called plaque. Blood is slowed because of the plaque blocking the arteries and slowing the blood flow. Sometimes the plaque can disengage and cause a blood clot that if not detected and treated can cause a stroke or heart attack. The lack of oxygen-rich blood to the heart and major arteries over time will cause organ to deteriorate and healthy tissue and muscles will start to die. Acting quickly is the key in recovering from a heart attack or not surviving. Some symptoms can include chest pain or discomfort, shortness of breath, and dizziness. Men generally have classic signs of a heart attack; women can have other symptoms that are not classic symptoms, like lower back pain, and even neck pain. Slide 9 Heart attacks can be caused from medication (legal and illegal), stress, diet, generational, exposure to extreme cold weather, and cigarette smoking. Drugs and alcohol when taken in large quantities can be damaging to body when not prescribed for a treated condition. Narcotics, over-the-counter, cocaine, methamphetamine, methadone, alcohol, even medication for certain conditions if taken differently than prescribed can do harm to the heart and body. Slide 10 Congestive Heart Failure (CHF) is the leading cause for hospitalization in individuals over the age of 65 years old. The heart needs to work harder to pump oxygen-rich blood through the body. The myocardium’s thickened walls make the heart work harder to pump blood. The heart may pump more freely to hold more blood or stiffen and harden as time goes on. Slide 11 Some of the symptoms of congestive heart failure is kidneys start retaining water and salt, edema in the legs, ankles, arms and feet. The lungs can start retaining fluid to. More weight from the excess of fluid puts stress on the heart, shortness of breath and more exertion on activity. Slide 12 Myocardial Infarction (MCI) is the medical term for heart attack. Some of the symptoms can include seizures, dizziness, fainting, fainting, chest pain or discomfort and extreme fatigue. The person may experience the heart racing really fast, like if they ran a marathon, but were sitting down and relaxing. If the individual has unexplained family deaths at an early age can put them in a higher-risk category. Slide 13 This slide is a picture depicting what might happen in a heart attack. A blood clot can dislodge and move through the blood stream until it blocks oxygen-rich blood from reaching the heart or major organ, or it completely blocks the pathway of blood flow. If not treated immediately, it can lead to tissue and muscles becoming damaged or dying all completely and then death. References Jenkins, Kemintz, Tortora (2010) Anatomy and Physiology. John Wiley and Sonc Inc. Kulik. (2013, April). www. medicinenet. com. Retrieved from Myocardial Infarction: www. medicinenet. com Ladwig, A. a. (2014). Nursing Diagnosis Handbook. Mosby by Elsevier Inc. National Stroke Association. (2012). After Stroke. Effects of Strokes, www. stroke. org. Potter, P. S. (2012). Fundamentals of Nursing. St. Louis: Mosby an imprint by Elsevier Inc .

Essay --

Scope of practice is defined as the broad framework of procedures, actions and processes that are permitted under a specific licence of an allied health professional. This medical terminology is used by both the national and state licensing commissions for various professions, including nursing, midwifery and paramedicine. The scope of practice restricts and limits the allied health professional, under an act of law, to have undertaken specific education, followed regulation guidelines and registered under licensing bodies in order to practice in their individual health profession. Additionally, every individual health profession (nursing, paramedicine, midwifery, doctor, surgeon, etc.) has specific requirements and levels which define the scope of practice for each individual. The definition of each individuals scope of practice is important, as it ensures the safety of both patient and professional. The scope of practice ensures the individual does not participate in practices that they may be deemed unsafe and ensures the individual does not partake in unskilled practices. ...

342 – Support Positive Risk Taking For Individuals

Unit 4222-342 Support positive risk taking for individuals (HSC 3066) Outcome 1 Understand the importance of risk taking in everyday life : 1. Explain ways in which risk is an integral part of everyday life For many people risk is an accepted part of everyday life. Every day activities such as catching the bus, travelling on holiday, playing football, setting up home and starting a family all carry some element of risk. Risk plays a part in our health, safety, security, well-being, employment, education, daily activities, using resources and equipment and in community participation.But some adults, for example disabled people or older people, are often discouraged from taking risks. Traditionally they are not encouraged to take risks in areas such as budgeting, planning, employment and daily living skills. This may be either because of their perceived limitations or fear that they or others might be harmed. Everyone has a right to take risks and make decisions about their lives. There is a balance to be found between service user’s participation in everyday activities and your duty of care.Changes in social care and health policy mean that all adults are being actively encouraged to increase their independence by, for example, travelling independently, and by being fully involved in mainstream society through education, work and leisure. It is impossible ever to fully eliminate risk. It is however possible to minimise and prepare for risk by preventative action. To support people to live independently or to travel independently or take part in everyday activities means accepting that there are risks that cannot be avoided but can be minimised and prepared for.2. Explain why individuals may have been discouraged or prevented from taking risks.For disabled people, a move away from a medical model to a social model of disability now means that there is an emphasis on the discrimination and exclusion created by social and cultural barriers. For some services, approaches to risk have in the past been concerned with avoiding potentially harmful situations to service users and staff. People may need to take risks to achieve their aspirations but people who need su pport can be discouraged from taking risks.This may be because of their perceived limitations or because of fear that they or others might be harmed, resulting in criticism or compensation claims. A more positive approach to risk is now being developed, recognising that in addition to potentially negative characteristics, risk taking can have positive benefits for individuals, enabling them to do things which most people take for granted. Risk can be beneficial, balancing necessary levels of protection with preserving reasonable levels of choice and control.A balance has to be achieved between the wishes of those who use services and the common law duty of Care.3. Describe the links between risk-taking and responsibility, empowerment and social inclusion. Personalised care is for everyone, but some people will need more support than others to make choices about how they live their lives. Everyone has the right to personalised care and as much choice and control as possible. As the p ace on personalisation is picked up it is necessary to ensure that this includes the most vulnerable members of our society, including those who may lack capacity.With effective personalisation comes the need to manage risk for people to make decisions as safely as possible. Making risks clear and understood is crucial to empowering service users and carers, recognising people as ‘experts in their own lives’. Risk management does not mean trying to eliminate risk. It means managing risks to maximise people’s choice and control over their lives. True empowerment means that people might make decisions service providers disagree with.If the outcomes are part of the support plan and all risks have been fully discussed and understood, this can lead to real choice and control and a better quality of life for the individual. With support for positive risk taking it can help the individual to:gain self-confidence-achievement, development, new skills and knowledgedevelop skills-goals setting, new activities, supporttake an active part in their community-involvement, participation, inclusionOutcome 2Understand the importance of a positive, person-centred approach to risk assessment . explain the process of developing a positive person-centred approach to risk assessment Every opportunity contains risks – a life without risk, is a life without opportunities, often without quality and without change. Traditional methods of risk assessment are full of charts and scoring systems, but the person, their objectives, dreams and life seem to get forgotten. A person centred approach focus’ on the individuals rights to have the lifestyle that they chose, including the right to make ‘bad' decisions.It is about helping people and those who care about them, think in a positive and productive way in order to achieve the changes they want while keeping the issue of risk in its place. Risk management is finding a balance between â€Å"positive ri sk taking† based on autonomy and independence and a policy of protection for the person and the community based on minimising harm. Bates and Silberman give a list of 7 criteria that any such approach would have to fulfil, these being:Involvement of Service Users and Relatives in Risk Assessment. Positive and Informed Risk Taking.Proportionality.Contextualising Behaviour.Defensible Decision Making.A Learning Culture.Tolerable Risks. .2. explain how to apply the principles and methods of a person-centred approach to each of the different stages of the process of risk assessment Working in a personalised way and developing a positive person-centred approach means accepting there are risks that cannot be avoided but which can be prepared for.Reasonable risk is about striking a balance in empowering people with support needs to make choices ensuring that the person has all the information, tailored to their specific needs, in the appropriate format, to make their best decisions â €Å"Involvement of service users and relatives in risk assessment†: Involving the person concerned and the people that care about them most is one of the most fundamental tenets of any person centred approach.The process uses the ‘Relationship Circle' to help the person and their allies identify key people who could form the persons ‘circle of support'. This group of people is involved from the outset, in the initial gathering of information, in the framing of what the risk under discussion actually is, in thinking that generates ideas and solutions, in evaluating these solutions, in decision making around the risk, in implementing the actions and in the learning that takes place during these actions.Staff must understand what service users and others want, how they view their own risks and what responsibilities each person has in managing risks effectively. The Person Centred Approach meets this by asking for a clear picture of what the person wishes to achieve, why this is important to the person, what success would look like, a history of the risk and uses the ‘doughnut' tool and decision making agreement tools to look at staff roles and responsibilities, and at who will be responsible for different important decisions in relation to the risk. Positive and informed risk taking†: The process is built around a positive view of the person – it seeks to learn what the person's gifts and skills are, what people like and admire about them, as well as investigating what would be necessary to keep them and others safe while taking the risk. The process is based on finding creative solutions rather than simply ruling things out.Bates and Silberman argue here that quality of life should be â€Å"maximised while people and communities are kept as safe as can be reasonably expected within a free society† Thinking around what it would take to keep the person and others safe while taking the risk is a key part of the Positive and Productive Process, as is the use of the ‘Happy/Safe' grid, which looks at how much solutions would make the person happy, by meeting what is important to them, and how much they would keep them and others safe, by meeting what is important for them. One section of the process includes a question â€Å"What does the law say? enabling the process to be informed by the current law, including legislation such as the Human Rights Act. â€Å"Proportionality†: â€Å"The management of the risk must match the gravity of potential harm† Using the person centred thinking tools means flexibility. The more serious the issue, the more people and the more time can be spent considering it in greater detail. Unlike conventional risk assessment, the approach explores the consequences of NOT taking the risk, to the person, to their family, community and services, balancing these against the potential consequences of taking the risk. Contextualising Behaviour†: â€Å"wh y did the person behave in this way? At this time? In this Situation? † Part of the process involves gathering together previous information about the person, including a history of the person's experience of the risk issue from their own perspective, as well as other historical data, gleaned from a variety of sources including learning logs which look at what has worked and what has not worked in particular situations, and communication charts which explore a person's words and behaviours, seeking their meanings and considering what the best response to these messages should be.The ‘4+1 Questions' (What have we tried? what have we learned? What are we pleased about? what are we concerned about? ) help not only to gain an understanding of a person's behaviour in different contexts, but also to build a picture of what has been learned about what is the best support for that person. Defensible Decision Making†: â€Å"there is an explicit and justifiable rationale fo r the risk management decisions† Following the person centred approach generates a clear trail of written records of what has been discussed, the different perspectives, issues and solutions that have been considered, along with any legal issues, such as the human rights act or the mental health act that might affect the risk decision. The paperwork generated during the process provides a clear rationale for why the decisions that emerge during the process have been taken, and why other options have been rejected.The rationale for decision making is also more clearly expounded and recorded than in traditional risk assessment forms in common usage. â€Å"A Learning Culture† The positive and productive approach to risk has a deep emphasis within it on ongoing learning using learning and reflective tools like the learning log, the 4+1 Questions and What's Working/What's not working, and by clearly defining for staff their core duties and their zone of judgement and creativ ity in relation to the risk.If it is part of a serious and concerted attempt by services to change their philosophy and practice in a person centred direction, it can contribute significantly to building a learning culture within organisations. â€Å"Tolerable Risks† A key aspect of the Person Centred Approach is that it uses creative thinking techniques around methods to mitigate the risk and improve quality of life, moving from situations which make the person happy but unsafe, to where they and the community are safer, and from strategies where the person is ‘safe but unhappy', to where they can be happier.Experience of using the process is that it enables participants to take a more balanced and rational approach to risk, finding ways to enable the person to achieve what is important to them while considering what keeps that person and the community safe in a way that makes sense for that individual. 3. explain how a service focused approach to risk assessment would differ from a person centred approach A risk assessment can only identify the probability of harm, assess the impact of it on the individuals, and pose intervention strategies which may diminish the risk or reduce the harm.Assessments cannot prevent risk. Risk is a normal and often beneficial part of everyday life, but while it enables learning and understanding, in the case of potentially destructive consequences it may need to be monitored and restricted. Traditional methods of risk assessment are full of charts and scoring systems, but the person, their objectives, dreams and life seem to get lost somewhere in the pages of tick boxes and statistics. A service focused approach seeks to avoid all risks as far as possible.Staff would be expected to behave and act in a synchronised way with regards risk, not taking into account the individuals wishes. It has no flexibility and is not a responsive approach to meet peoples` changing circumstances. A service centred approach to risk as sessment would be guided by a standard procedure and can compromise individuals rights to make choices and take risks. Often concerns about minimising and attempting to eliminate risks are in the interests of the organisation, but not necessarily in the interests of the person they are attempting to support.A person centred approach seeks to focus on people's rights to have the lifestyle that they chose, including the right to make ‘bad' decisions. Person centred planning, requires that staff have a flexible and responsive approach to meet peoples` changing circumstances, guided by the principles of good planning rather than a standard procedure. Staff need to be constantly problem solving in partnership with the person and their family and friends. Person centred planning seeks to develop a better, shared understanding of the person and her situation.A person centred approach to risk taking will find the balance between what is important to the person, their aspirations and t he supports that they require. 4. identify the consequences for individuals of a service focused approach to risk-assessment. Risk is a normal and often beneficial part of everyday life. Risk taking can have positive benefits for individuals, enabling them to do things which most people take for granted. While risk taking enables learning and understanding, in the case of potentially destructive consequences, it may need to be monitored and restricted.The problem with a service focused approach to risk assessment, is it reduces an individual’s independence and can reduce the positive benefits for the individual. A service focused approach to risk taking tends to have a negative focus on what the individual is not able to do or what they cannot achieve and has a limited outlook on identifying the benefits of positive, person-centred risk assessment. It does not empower the individual or encourage independence.Outcome 3Understand the legal and policy framework underpinning an i ndividual’s right to make decisions and take risks . explain how legislation, national and local policies and guidance provide a framework for decision making which can support an individual to have control over their own lives There are many Legislation and policies which promote the human rights of individuals which support the individual’s right to make their own decisions and to take risks. Some are as follows: The Equality Act 2010 is the law which bans unfair treatment and helps achieve equal opportunities in the workplace and in wider society.The act replaced previous anti-discrimination laws with a single act to make the law simpler and to remove inconsistencies. This makes the law easier for people to understand and comply with. The  act also strengthened protection in some situations. The  act covers nine protected characteristics, which cannot be used as a reason to treat people unfairly. Every person has one or more of the protected characteristics, so the  act protects everyone against unfair treatment. They protected characteristics  are:Age Disabilitygender reassignmentmarriage and civil partnershippregnancy and maternityracereligion or beliefsexsexual orientationHuman Rights Act 1998 – The Human Rights Act means that residents of the United Kingdom will now be able to seek help from the courts if they believe that their human rights have been infringed. It is likely that anyone working within health and social care will be working within the provision of the Human Rights Act, which guarantees the following rights:The Right to life The right to freedom from torture and inhuman or degrading punishmentThe right to freedom from slavery, servitude and forced or compulsory labourThe right to liberty and security of personThe right to a fair and public trial within a reasonable timeThe right to freedom from retrospective criminal law and no punishment without lawThe right to respect for private and family life, home and co rrespondenceThe right to freedom of thought, conscience and religionThe right to freedom of expressionThe right to freedom of assembly and associationThe right to marry and found a familyThe prohibition of discrimination in the enjoyment of convention rightsThe right to peaceful enjoyment of possessions and protection of propertyThe right to access to an educationThe right to free electionsThe right not to be subjected to the death penaltyMental Capacity Act 2005 – The MCA applies to England and Wales. The primary purpose of the MCA is to promote and safeguard decision-making within a legal framework.It does this in two ways:By empowering people to make decisions for themselves wherever possible and by protecting people who lack capacity by providing a flexible framework that places individuals at the heart of the decision making processBy allowing people to plan ahead for a time in the future when they might lack the capacity for any number of reasons Mental Capacity and Dep rivation of Liberty Safeguards 2005.  The safeguards provide a framework for approving the deprivation of liberty for people who lack the capacity to consent to treatment or care in either a hospital or are home that, in their own best interests, can only be provided in circumstances that amount to a deprivation of liberty. The safeguards legislation contains detailed requirements about when and how deprivation of liberty may be authorised. It provides for an assessment process that must be undertaken before deprivation of liberty may be authorised and detailed arrangements for renewing and challenging the authorisation of deprivation of liberty. The Code of Practice contains guidance on the deprivation of liberty safeguards.It is particularly intended to provide guidance for professionals involved in administering and delivering the safeguards, who are under a duty to have regard to the Code. The Code is also intended to provide information for people who are, or could become, su bject to the deprivation of liberty safeguards, and for their families, friends and carers, as well as for anyone who believes that someone is being deprived of their liberty unlawfully. Mental Health Act 2007 – amends the Mental Health Act 1983 and the Mental Capacity Act 2005.It introduces significant changes which include:Introduction of Supervised Community Treatment. This new power replaces supervised discharge with a power to return the patient to hospital, where the person may be forcibly medicated, if the medication regime is not being complied with in the community.Redefining professional roles: broadening the range of mental health professionals who can be responsible for the treatment of patients without their consent.Nearest relative: making it possible for some patients to appoint a civil partner as nearest relative. Definition of mental disorder: introduce a new definition of mental disorder throughout the Act, abolishing previous categoriesCriteria for Involunt ary commitment: introduce a requirement that someone cannot be detained for treatment unless appropriate treatment is available and remove the treatability test.Mental Health Review Tribunal (MHRT): improve patient safeguards by taking an order-making power which will allow the current time limit to be varied and for automatic referral by hospital managers to the MHRT. Introduction of independent mental health advocates (IMHAs) for ‘qualifying patients'.Electroconvulsive Therapy may not be given to a patient who has capacity to refuse consent to it, and may only be given to an incapacitated patient where it does not conflict with any advance directive, decision of a donee or deputy or decision of the Court of Protection. Safeguarding Vulnerable Groups Act 2006 – is in response to the Bichard Inquiry 2005, into the failings around the Ian Huntley case.The SVG act is intended to prevent unsuitable people from working with vulnerable people and to reform current vetting an d barring practices. The act sets out a legal framework for the Independent Safeguarding Authority (ISA) scheme which was to be introduced in 2009 (but is currently under review as a result of the 2010 General Election). Valuing People (Department of Health, 2001) – was the first Government White Paper on learning disabilities in England for 30 years.It stresses the important role that Person Centred Planning can play in helping people with learning difficulties take charge of their own lives. The Guidance (Department of Health, 2002) stressed that Person Centred Planning is not a professional activity done to people; instead people themselves and their friends, families or other allies, must lead it. However, professional services still have an enormous role to play in responding in a more person centred way to people with learning difficulties. For 2009 -10 the key priorities include: to ensure that the Personalisation agenda is embedded within all local authority services and developments for people with learning disabilities and their family carers, and is underpinned by person centred planning. † ‘Valuing People Now', is the ‘refresh' of this white paper in 2009 and is a new three-year strategy for people with learning disabilities (2009), DH and clearly state that good person centred planning should be happening, and will lead to better lives for people.Putting People First – â€Å"A shared vision and commitment to the transformation of Adult Social Care (2007), Department of Health. † In the UK the government policy ‘Putting People First' stated that person centred planning must become mainstream. Putting People First recognises that person-centred planning and self-directed support are central to delivering personalisation and maximising choice and control. In 2010 guidance was issued to help councils use person centred thinking and planning to deliver the personalisation agenda.Putting People First is a pub lic service reform programme, which is co-produced, co-developed and will be co-evaluated. It recognises that to achieve real change, users and carers must participate at every stage. This marks a change in status of people who use services, from ‘consumers’ to ‘co-producers’. set out four areas on which councils and their partners should focus in order to personalise services. These areas are: universal services – transport, leisure, health, education, housing and access to information and advice; * choice and control – shaping services to meet people’s needs, rather than shaping people to fit in with the services on offer; * social capital – care and support that individuals and their carers can get from their local community (friends, family, neighbours or community groups); and * early intervention and prevention – support that is available for people who need help to stay independent for as long as possible, to keep t heir home or garden tidy, or to start taking regular exercise. 2. escribe how a human rights based approach supports an individual to make decisions and take risks. A human rights based approach (HRBA) to risk management means ensuring individuals know their rights and are being supported to participate in making choices and decisions. A human rights based approach to risk assessment balances the human rights of service users, their carers, and members of their communities. This is so risks can be managed more positively. A HRBA looks at risk through a ‘Human Rights’ lens, identifies relevant equality and diversity issues, and maximises service user participation and empowerment.A human rights based approach to risk, means ensuring service users are as involved as they can possibly be in their own risk assessment process. Whether the service user participates fully or contributes to a small aspect of their risk assessment, some involvement will almost always be possible . The ways in which you possibly apply this in your work practice is through things such as advocacy, direct payments, personalised services, person centred planning and support planning. Outcome 4 Be able to support individuals to make decisions about risks 1. upport an individual to recognise potential risk in different areas of their life 2. support the individual to balance choices with their own and others’ health, safety and Wellbeing Positive risk taking is a process which starts with the identification of potential benefit or harm. The desired outcome is to encourage and support people in positive risk taking to achieve personal change or growth. The individuals could face risks in many different areas of their life including, risks relating to their health, their social life and also their finances and it is important to support the individual to recognise those potential risks.The risk assessment looks at four areas of risk; risks to self, risks to others and risks from other and risks to property. Within each area of risk, common risk issues and difficulties (for example self harm, physical aggression, abuse issues) are itemised. It is also important that the individual realises that although they have a right to take risks they also have a responsibility towards themselves and others, including:ColleaguesFamilies or carersFriendsOther professionalsMembers of the publicAdvocatesAnd it is important that whilst maximising their quality of life they also need to maintain their safety, responsibilities to themselves and others for social emotional and physical reasons. Supporting an individual to recognise potential risks whilst balancing the choices with their own and others health, safety and well-being involves:Empowering people to access opportunities and take worthwhile chances.Understanding the person’s perspective of what they will gain from taking risks and understanding what they will lose if they are prevented from taking the ris k. Ensuring the individual understanding the consequences of different actions – An informed choice means that a person has the information and support to think the choice through and to understand what the reasonably expected consequences may be of making that choice.Helping the individual to make decisions based on all the choices available and accurate information – It is important to remember that too much information can be oppressive and individuals have differing needs in relation to how information is presented to them.Being positive about risk taking. Understanding a person’s strengths and finding creative ways for people to be able to do things rather than ruling them out.Knowing what has worked or not in the past and where problems have arisen, understanding whysupporting people who use services to learn from their experiences.ensuring support and advocacy is availablesometimes supporting short term risks for long-term gains.ensuring that services pro vided promote independence not dependenceassuming that people can make their own decisions (in line with the Mental Capacity Act) and supporting people to do so working in partnership with adults who use services, family carers and advocates and recognise their different perspectives and viewsdeveloping an understanding of the responsibilities of each partypromoting trusting working relationships. 3. describe how own values, belief systems and experiences may affect working practice when supporting an individual to take risks Giving people who use services choice and control over the care they receive is important if personalisation is to become a reality.The responsibility for encouraging  risk-taking can make you feel they are being put in a difficult position trying to balance personalisation with your own values and beliefs and also your duty to keep people safe. Because of your own past experiences you may feel that the risks involved, will result in problems, but you should not let this interfere with the individual’s desires. Because you had a bad experience following a course of action does not necessarily mean this will happen to others. An example could be an individual wanting to join a ‘lonely hearts’ club.Your own thought may be negative towards this course of action, possibly because you have personally had a bad experience or possibly because you feel this is not the best way to meet people. Your beliefs and experiences should not cloud the issue. It is important that you feel confident and equipped to support people you are caring for to assess and evaluate their own risks. Advice is readily available when facing difficult cases in the form of risk enablement panels, which can share responsibility for making complex decisions when signing off a person's support plan.The panel would usually involve the individual or any advocates or carers representing them; members of the local safeguarding adults board; the allocated soci al worker; and specialists such as a psychiatrist.4. record all discussions and decisions made relating to supporting the individual to take risks. It is important to ensure that any discussions and decisions made relating to supporting the individual to take risks or concerning risks, are recorded in their support plan. Records will need to be understandable to all the members of the team.The aim of record keeping is to ensure that the right people have the right information to provide the best care for the service user and they also provide a record of what you and the individual have discussed and decided with regards risk taking. The records should also record any incidents which have taken place. The reason for keeping the records are:To show that you have offered the individual choicesTo show that you have agreed the desired outcomesTo show that the individual has given their consent.This is important for two very important reasons: Responsibility – The records will ind icate who is responsible for what parts of the plan, this avoids confusion as everyone is clear of what their responsibilities are (Responsibility (for) can be defined as a set of tasks or functions that an employer, professional body, court of law or some other recognised body can legitimately demand. ) Accountability – means the person is contractually accountable to their employer and also accountable to the law, for any actions or ommissions in their practice and must always be able to justify their decisions.When work is being either distributed or delegated, the individual who carries it out needs to be competent to do so. Competence is an individual’s ability to effectively apply knowledge, understanding, skills and values within a designated scope of practice. (Accountability describes the mechanism by which failure to exercise responsibility may produce sanctions such as warnings, disciplining, suspension, criminal prosecution, or deregistration from professio nal status. It can be called ‘answerability’).Where a professional or organisation makes a decision not to support an individual to pursue a particular decision or course of action, they must be able to explain this and demonstrate that they have thought through and discussed in a balanced and proportional way the potential consequences of refusing to support the risk Where the individual is able to make an informed choice and still wishes to pursue a high risk decision or choice, having a signed risk assessment is one way of showing that they are aware of the risks and are willing to take them.This provides organisations and professionals with a significant degree of protection for their support of the decision should things go wrong.Outcome 5Be able to support individuals to take risks 1. complete a risk assessment with an individual following agreed ways of working Risk assessment is the activity of collecting information through observation, communication and invest igation.It is an ongoing process that involves considerable persistence and skill to assemble and manage relevant information in ways that become meaningful for the users of services (and significant other people) as well as the practitioners involved in delivering services and support. To be effective it needs disabled adults and older people, their families, carers, advocates and practitioners to interact and talk to each other about decisions that have been taken and their appropriateness in the light of experience.Where a risk assessment is needed, a decision then has to be taken about whether or not positive risk-taking is necessary to achieve certain outcomes for the person concerned. It will not always be appropriate to take positive risks but this has to be determined in partnership with the person affected, and their family where appropriate. It is a professional judgement that should not be influenced by an overly cautious approach to risk. At the same time though, positiv e risk-taking is not negligent ignorance of the potential risks – nobody benefits from allowing risks to play their course through to disaster. . communicate the content of the risk assessment to others It is important to communicate and work in a consistent way with all those supporting the individual. Information gathering and sharing is important. It is not just an essential part of risk assessment and management, but also key to identifying a risk in the first place. It is important to communicate the content of the risk assessment to all relevant staff. It will also be important to discuss and explain the risk assessment with the individual’s carer and family.The individual’s goals and targets should be discussed with all concerned, to aid understanding regards the risk assessment and to ensure all those involved are aware of the desired outcomes. However, the use and sharing of information must respect the principles outlined in the Data Protections Act 19 98.3. support the individual to take the risk for which the assessment has been completed Once the support plan has been completed and the risks defined it is important to support the individual to take the risks. This may involve discussing the risk assessment in depth with the individual’s family.The individual’s desired outcomes could conflict with those of carers, especially when the latter placed more emphasis on safety while the individual was prepared to accept a greater level of risk in order to maintain independence. Differences in attitudes to risk had to be tackled through ‘good social work’, to reinforce the individual’s preferences while helping the family to distinguish between unconventional and dangerous behaviours. Another way of supporting the individual to take the risk in the first instance, could involve a trial run.An example could be where the individual wants to make an independent trip in to town using public transport.On th e first trip you could accompany the individual on each step of the journey.On the second trip, you could accompany them to the town and then arrange to meet with them later in the day.On the third trip, you may just accompany them to the bus stop. Gradually you can reduce the amount of support you provide. Another method of support could be to have a contingency plan in case things don’t quite go according to plan.If we look again at the last scenario, what would happen if the individual missed the last bus home? By ensuring they have a pre-arranged telephone number of their next of kin or carer they can make them aware of the problem. Alternatively they may have the telephone number of the local mini cab office who would bring them home as an alternative. It is also important that the individual knows what to do if things do go wrong. You can support them to take risks by ensuring they have clear information and advice about what to do if they have any concerns.For example they should be aware of and be able to recognise and identify abuse or neglect and know where and how they should seek help if necessary. Your support doesn’t end once the risk assessment has been carried out. 4. review and revise the risk assessment with the individual After each risk assessment has been agreed it is important that it is monitored and reviewed in case any revisions are necessary. Risks may change as circumstances change, so they should be reviewed regularly. An assessment is a snapshot, whereas a risk assessment is an ongoing thing.Risk assessments should be reviewed periodically and whenever circumstances change to ensure they remain current. At the time the risk assessment is made it should include the signatures of everyone involved in the assessment and a review date should be identified. It is important to review and revise risk assessments so that the success of the positive risk taking can be assessed and any necessary adjustments can be made. It may be necessary for the individual to have access to further resources to enhance the plan or adaptations could be made to help the individual meet their planned outcomes.When positive risk-taking has a negative consequence, it is necessary to identify what has gone wrong and how the assessment and management of the risk contributed to this. Inevitably if we are supporting individuals to have more choice and control in their lives through positive approaches to managing risk, things are likely to go wrong from time to time. If this happens and the risk taken results in a negative outcome for the individual, there is no doubt that the risk taking process will come under scrutiny and the way in which this process worked to minimise the foreseeable risks will be considered.If the risks taken do not meet the planned outcomes for the individual then they may have to be reviewed and revised. 5. evaluate with the individual how taking the identified risk has contributed to their well-being. W ell-being describes the way we think and feel about ourselves and others, our confidence, and our ability to control things in our life. We all need to protect our wellbeing and this can be done by taking part in physical activity and having opportunities for relaxation and social activities. These can increase our resilience to cope with life's difficulties and ability to enjoy life.You will need to evaluate, with the individual, how taking the identified risks has contributed to their well-being and quality of life. This will involve looking at the positive and the negative consequences and outcomes of their choices. Has taking the risks met the individual’s needs and achieved their desired outcomes. Taking the identified risks should result in the individual feeling empowered and having greater independence, control and a sense of ‘normality’ about their lives. By supporting an individual to take positive risks, it can help them to evaluate alternative courses of action and can build confidence.The experience of failure, as a result of risk taking in a safe environment, can help to build resilience to setbacks and help individual’s to manage risk better in the future.Outcome 6Understand duty of care in relation to supporting positive risk-taking 1. explain how the principle of duty of care can be maintained while supporting individuals to take risks Ultimately, you have a statutory duty of care and a responsibility not to agree to a support plan if there are serious concerns that it will not meet an individual’s needs or if it places an individual in a dangerous situation.Whilst an individual can choose voluntarily to live with a level of risk and is entitled to do so (with the law treating that person as having consented to the risk) the local authority is not obliged to fund it. There is an important distinction between putting people at risk and enabling them to choose to take reasonable risks. Inevitably if we are suppo rting individuals to have more choice and control in their lives through positive risk taking, things may go wrong from time to time.A defensible decision is one where those involved in the risk assessing process:Used reliable assessment methodsActed responsibly in relation to their duty of careWere not negligentAssessed and took steps to manage and minimise foreseeable risksRecorded decisions and subsequently checked they were carried outFollowed policies, procedures and guidanceInvolved the person and other relevant people in the processSupported people to make informed decisionsIdentification of positive and negative risksInvolvement of people who use services and those who are important to them – this includes people who form the individual's informal ‘circle of support', who are involved from the beginning to gather information, define what the risks are from the individual's point of view and to discuss ways to enable and manage these risks.   Positive and infor med risk-taking – this is built on a strengths-based approach to the person and looks at creative ways for people to be able to do things rather than ruling them out. Proportionality – this means that the time and effort spent on managing a risk should match the severity of that risk.The approach should also explore the consequence of not taking the risk in question, such as loss of autonomy or restriction of choice. Contextualising behaviour – this means knowing about the person's history and social environment, their previous experience of risk, what has and has not worked in previous situations.   Defensible decision making – this means recording a clear rationale for all the decisions made and the discussions that led to the decisions, including reference to relevant legislation such as the Mental Capacity Act or the Human Rights Act. A learning culture – this require a commitment to ongoing learning and the use of reflective practice for peo ple working at the frontline. Tolerable risks – this involves negotiating and balancing issues of risk and safety to identify what is acceptable for everyone concerned (the individual and others including the community) on a case by case basis.2. describe what action to take if an individual decides to take an unplanned risk that places him/herself or others in immediate or imminent danger. Imminent danger† refers to any danger or dangerous condition that would not normally take place. If you think an individual is about to take an unplanned risk which will place them or others in immediate or imminent danger it is important to take appropriate corrective and preventative action and stop the activity immediately. An individual who is injuring himself/herself or is threatening physical harm to others may be restrained in an emergency to safeguard the individual and others. Risk assessments should include contingency measures that address risks arising from unplanned even ts.Physical intervention is:  Ã¢â‚¬Å"A method of responding to the challenging behaviour of people with a learning disability and/or autism, which involves some degree of direct physical force. † Physical intervention may be the only course of action. Staff should be equipped with a range of skills to deal with and de-escalate potentially violent situations, as well as a range of restraint techniques that will allow for use of the minimum level of force possible. Physical intervention is only used in response to challenging behaviour and to restrict the movement and mobility of the person concerned.