Truss Design and Analysis essays

Bracket Design and Analysis expositions Our five introductory structures comprised of one with two triangulated cantilevered poles with one strain bar, another that was a three bar symmetrical pyramid, the third was a triangular cantilevered pillar with a pressure bar and side help bars at the divider, another had three triangulated cantilevered bars with one pressure pole, and the fifth was an absolutely 2-D right triangle support. Each gathering part picked a structure that he needed to streamline. The ones picked were the ones every one of us at first thought of. We actually definitely realized the ones we needed to take a stab at ANSYS so the other two were made only for section 1 of the task. We decided to additionally examine the one with two triangulated cantilevered poles with one pressure bar, the one that had three triangulated cantilevered bars with one strain bar, and the one with a triangular cantilevered bar with a pressure bar and side help bars at the divider. This was one of our most fundamental support plans for the challenge. The idea of the structure was effortlessness and minimization of welds. It was at first idea that the disappointment would happen at one of the bind welds along these lines if the quantity of welds was restricted there would be less possibility of disappointment. At first the support was made in ANSYS with simply the 3 primary shafts from the divider to the stacked tip. Flat and vertical burdens were applied to the tip and the framework was illuminated. The pressure and avoidance were investigated cross-individuals were included the focal point of the shafts. The recreation was explained again and reanalyzed and cross-individuals were again included at 25 and 75 percent of the length of the principle bars. The cross individuals were utilized to forestall the locking in the focal point of the pillars by restricting the permitted diversion. With the three cross-part frameworks set up, the bracket was settled and the diversion and stresses were estimated. Subsequent to looking at the outcomes from every one of the arrangements, it was resolved that including the cross-individuals... <!

Infant mortality Essay

Baby mortality basically alludes to the quantity of death among the youthful ones for every 1000 births. In this recorded investigation, newborn child death rate between a scope of time beginning from 1750 to 1917 is considered. Its rate fluctuates starting with one century then onto the next with the eighteenth century recording the most elevated number of passings among the youthful. Advancing towards the twentieth century, there has been an intense decrease in the demise pace of newborn children. Some clinical experts accept this is a direct result of the social wellbeing change and clinical improvement during the nineteenth and 20 centuries. Then again, a few researchers, similar to Thomas McKeown, emphatically propose this is chiefly ascribed to the improved sustenance and sanitation of the infant’s condition (McKeown, 121). Thomas McKeown is the researcher who led the notable McKeown Thesis. There has been a continuous discussion between the two thoughts regarding which assumed the fundamental critical job in checking the uncontrolled demise of the newborn children for a very long while included in innumerable understudy perusing, so who really observed reality between the 19 and the twentieth hundreds of years? Baby mortality diminished throughout the hundreds of years beginning in the late nineteenth and mid twentieth century in the United States. The most noteworthy pace of death among the newborn children was seen in the main portion of the eighteenth century (McKeown, 65) , this high pace of baby mortality was seen as brought about by cultural separate and poor approaches rather that particular neurotic life form. This was considered as an impression of a poor casing work in the general public. Somewhere in the range of 1750 and 1800, the newborn child death rate was at the top with huge numbers of the babies surrendering to their ailments. At that point, the specialized perspectives in attempted exhaustive examination to set up the genuine reason for the sicknesses lastly finding the fix had not been effective. Numerous newborn children in this manner kicked the bucket in huge numbers. The people group ascribed this to the wide and tragic cultural issues. Many significant nations had zones with obscene lodging, overflowed storm cellars, sullied water supplies and neediness, bringing about maladies, for example, typhoid, red fever, tuberculosis and typhus to flourish (McVeigh). This at long last moved them to really consider approaches to deal with these issues. What they have come to finish up was that pre-birth and postnatal infections were at last impacted by outside variables, for example, food insufficiency, liquor and tobacco use (Mudd, 117). While illnesses and inabilities that are resolved during origination or after birth are perpetually unique, both their roots can even now be possibly controlled. In the second 50% of the nineteenth century and the principal decade of the twentieth century, the administration of the United States concocted endeavors to check this danger. They suggested the evacuation of newborn children in the urban areas; this was viewed as a significant accomplishment since most moms who were dwelling in the city wind up having their young ones passing on at a youthful age. Some pre-birth maladies, for instance was because of presentation to hurtful poisons in the earth, accordingly influencing the child’s improvement in the mother’s belly (Mudd, 117-118). This was seen that the city presented the youthful to unfortunate condition henceforth presenting them to infections. The blockage in the city was likewise found to encourage the spread of infectious illnesses among the youthful. Different types of toxins were uncontrolled in the city and along these lines the newborn child could without much of a stretch agreement contaminations. Numerous ladies at the turn of the eighteenth century were working in gas lit production lines and sweatshops, which may influence their pregnancy (McVeigh). The moms were encouraged to settle in their country homes where these dangers were considered to have insignificant outcomes on the babies. It was blessed that enactments were at last gone during 1848 to advance veritable worry for general wellbeing (McKeown, 66). Additionally, global city in Great Britain during the period, just as a significant area all through Europe and the remainder of the world as far as universal exchange and human travel. As a result of such huge numbers of universal produce, merchandise and individuals showing up in London every day, it turned out to be obvious to clinical experts that outside bodies can regularly be the bearers of ailment; from London, such sicknesses were bound to spread all through the remainder of the nation. In aiding London’s residents remain solid, baby death rates were consequently dropped at the same time. By investigating London’s paper files, just as other contemporary paper articles and even the correspondence of social insurance laborers during the period, the data concerning baby death rates can be accumulated and looked at. Interestingly, a few researchers, for example, Thomas McKeown, unequivocally recommend this is for the most part ascribed to the improved sustenance and sanitation (Colgrove). The milk gracefully was improved among the youthful one, on the grounds that the milk dealing with and flexibly of palatable items was improved by the administration. This administration methodology has been critical in saving the life of newborn children at that point. Youngster cleanliness was another figure considered checking the high pace of baby mortality. A kid cleanliness program was set up by the legislature to guarantee the babies were given the highest caliber of cleanliness . With the headway on the mechanical advancements, newborn child mortality decreased in huge extents throughout the hundreds of years. The revelation of the different clinical types of gear and mechanical assembly remembering the magnifying lens and the stethoscope for the late nineteenth century helped the clinical field’s abilities to deal with these difficulties (McVeigh). Synchronous to this, extraordinary walks in the improvement of training of understudies began occurring in Europe. The researcher who had practical experience in clinical microbiology considered further and found a lot of moment microorganisms which were found to cause high pace of newborn child mortality. These organisms were found to blossom with unhygienic conditions in this way causing high pace of newborn child mortality. They were seen as wild particularly in ineffectively dealt with milk and other staple. With these revelations of stethoscope and the magnifying instrument in the twentieth century, numerous illnesses were monitored. This was on the grounds that researchers had gotten learned about wellbeing matters. Prior to this enormous disclosure, numerous moment microorganisms causing a few sicknesses among the youthful ones were everywhere and researchers were astounded with unchecked high pace of newborn child mortality. The electron magnifying lens with high amplification empowered these researchers to perceive the different malady causing living beings including infections and microorganisms. They figured out how to know the particular infections that these microorganisms caused and the proper control estimates expected to keep them under control. They thought of anti-infection agents to fix disease in the newborn children. Anti-toxins, for example, penicillin were additionally found in the mid twentieth century. As of now, because of these revelations and suitable estimates taken by the legislature, the newborn child mortality definitely decreased. Clinical consideration regarding the newborn children was viewed as a need and subsequently diminishing the pace of infant’s passing. Another significant factor in controling newborn child mortality is the advancement of obstetrics and the ascent of gynecology in that time (McVeigh). It enveloped all parts of pregnancy, and permitted clean and safe conditions for the mother and youngster. Ostensibly, poor clean conditions during labor are additionally one of the primary driver of newborn child mortality in prior hundreds of years. McKeown’s sees on general wellbeing started discussion during the 1970’s and 1980’s with its emphasis on allotment of clinical assets. While the establishment of his exact perspectives may be viewed as defective today, it initiated investigations of where should general wellbeing professionals should center their endeavors and the most significant determinants of a society’s mortality (Colgrove). The postulation he created was about the clarification of the sensational populace development from around 1770 to the present (Szreter). It expressed that it was a direct result of the domino impact of improved monetary conditions: better ways of life and upgraded healthful status that reinforced newborn child protection from most illnesses. His works have been about the amalgamation of these propelled thoughts and later on his works started getting a lot of consideration in view of its significant substance (Szreter). It was interested to take note of that it pulled in more crowds during its later years, despite the fact that it didn’t considerably contain any new data. It was most likely the more grounded mindfulness in general wellbeing that caused this. Notwithstanding, McKeown will consistently be viewed as a figure of significance as a result of his job in molding contemporary frameworks to forestall newborn child mortality. Different components that can be ascribed to a sharp decrease in newborn child death rate beginning from the late nineteenth and mid twentieth century remember the improvement for monetary development, improvement in nourishment, new clean measures by the administration and advances in information about baby care in the US of America (Colgrove). In spite of the fact that little is thought about how every one of this components contributed in the decrease in the baby death rate, a precise survey of the information from the particular time frame focused on that giving clean milk in showcase was the principle supporter of this decrease in the newborn child mortality . In any case, the essayist of this diary was one-sided as in taking care of milk gracefully and milk cleanliness was not by any means the only aim of newborn child mortality. It‘s imperative to take note of that the both mechanical headway and improved nourishment assumed a pivotal job in checking the baby death rate beginning from the late eighteenth to mid twentieth century. The discernment that the high pace of baby mortality was because of cultural issues and poor arrangements couldn't help in alter the course in the principal half of the 18t

2.670 Summary

2.670 Summary Today was the last day of 2.670. I had wanted to make a really cool modification to my engine by making it a generator, but I didnt have enough time to make it work. Anyway, I spent all morning putting together the pieces and I managed to finish at 3:31 and the competition started at 3:30. There were some reallllly cool engines. Many people decorated their engines by using the water jet or CNC mill to etch designs into their flywheel, cylinder plate, and bearing plates. Basically, you draw the design that you want on a 3D CAD program like Solidworks (see image below of a flywheel I designed for fun) and then use another program to take your drawing and tell the machine exactly how to make your part by defining the tool paths. Then, open your file on the computer connected to CNC mill or water jet, and bam! It makes your part for you. Everyone lined up their engines and ran them at the same time: [] Here are some examples of pretty engines. The first one won the award for Best Craftsmanship; its missing some major parts because it wasnt completed by the time I took this pictures. But, the flywheel has little mice on it, the bearing plate has bars, and the cylinder plate has cheese, so when the flywheel turns its supposed to look like the mice are running for the cheese. [] Dragons: [] LEDs mounted on the flywheel with a battery: [] Below are examples of modified engines that have been designed to go faster. The idea behind making them vertical is because it minimizes friction. One of them has fins and they all try to maximize the heat delivered to the hot side of the engine. [] This is a picture of Professor Hart. Picture of me and my best buddy, Maria (can you tell that we love our engines?) Marias engine was particularly cool because one of her parts hit the flywheel so it made a great tapping noise. It was an engine/musical instrument. Our engines: To see a video of my engine running, click here! I didnt get it to run in time for the speed competition, but afterwards I worked on it some more and got it go at a max of 750 rpm. Moral of the story is to be persistent.

Islamic Sectarian Violence Between Sunni And Sunni

The entire war on terror in Iraq, Syria, Afghanistan, and across the world is between secular governments and fundamentalist Islamic rebels. The conflict in Iraq is currently sectarian violence between Sunni religious rebels, represented by ISIL, and the Iraqi government lead by secular Shia parties In Islam there are 2 major factions: Sunni and Shia. Most Muslims are Sunni [~85%], and Shia are [~15%]. Shia Muslims, while a global minority, are the majority in Iraq [~65% of Iraqi population] and Iran [90% of Iranian population]. Most other Muslim nations have a Sunni majority: Saudi Arabia, Afghanistan, Pakistan, Syria, Egypt, Turkey, ect. During the Cold War Saddam Hussain and the Arab Socialist Ba ath Party lead Iraq. Sunni Muslims, who were a minority in Iraq, enjoyed increased political power as most politicians were Sunni. During the Cold War Iraq began to increasing align itself with the USSR and espouse the philosophy of uniting all the Arab world under socialism. However the dream of Arab unity was shattered during the Iraq-Iran War. In Iraq 400,000 soldiers died, 400,000 were wounded, and 100,000 civilians died. A few years after the war, the USSR collapsed, and Iraq lost its biggest supporter, and dream of socialism began to fade in the population’s eye. Right after the collapse, Iraqi invaded Kuwait, triggering the Gulf War. Iraq was defeated by the USA. Sensing weakness in the Iraqi government, full scale rebellion broke out in Northern Iraq. Saddam accusedShow MoreRelatedIn Pakistan, Which Aspires To Be A Islamic State, Sectarian1475 Words   |  6 Pageswhich aspires to be a Islamic state , secta rian conflict is part of, and interacts with, broader issues concerning the place of Islam in public life. There are sectarian identities which diversify each group and say who belongs to what sect , for example the believing of attending a mosque or madarasa. Islamization, or the introduction of Islamic norms and institutions through government policy or decree, is another factor which has often provoked and defined sectarian controversies in PakistanRead MoreIslam and Great Sectarian Divide1098 Words   |  5 PagesBottom of Form * ------------------------------------------------- Brothers at war FOR two sects united by their belief in one Maker, one Book and one Prophet, the amount of blood spilt in the name of their respective faiths by Shias and Sunnis is truly staggering.  This is specially so when one considers the tiny differences that define and divide them. Since the earliest days of Islam in the 7th century when the schism first tore the young Muslim community apart, the two sects have beenRead MoreSectarianism in Pakistan5487 Words   |  22 PagesSectarianism in Pakistan INTRODUCTION The decade of the 1990s witnessed a frightening upsurge in the Shia-Sunni sectarian violence in Pakistan, both in terms of scope and intensity. Recently, sectarian strife has engulfed even those areas, which were previously unaffected, largely because of the emergence of organized terrorist groups along sectarian lines. Besides target killings, these groups hit even ordinary members of each other’s sects. The problem, therefore, is no more of an occasional natureRead MoreA Protracted Struggle Ahead For Iraq2480 Words   |  10 Pages In my current event article, Carter, Tawfeeq and Alkhshali show dissenting views between Iran s Leader Khamenei, and U.S. Secretary of State John Kerry on the conflict in Iraq, where Khamenei blames the conflict on extremist and remnants of Husseins military and Kerry blames Iraq’s sectarian rule. Through academic journals and news articles I will show the sectarian policies enforced by Maliki s rule caused political instability and military and governmental weakness that generated the extremistRead MoreTerrorism Is Fanaticism, Hatred, Segregation, Or Disdain Emerging From Appending Essentialness1521 Words   |  7 PagesSectarianism is fanaticism, segregation, or disdain emerging from appending essentialness to saw contrasts between subdivisions inside a gathering, for example, between diverse divisions of a religion. Parts of a religious or political gathering may accept that their own particular salvation, or the accomplishment of their specific goals, obliges forcefully looking for believers from different gatherings; followers of a given faction may accept that for the accomplishment of their own political orRead MoreThe Conflict Between Saudi Arabia And Iran1780 Words   |  8 PagesIt’s often thought, in the west, that the feud between Saudi Arabia and Iran is 14-centurys old and that we don’t understand it because we (the west) are so dis-attached from religion in governance. For example, the end of religious politics in the US is credited with the writings of the English philosopher John Locke and this view on religion became particularly influential in the United States Constitution in 1787 (ref). State figures like Barack Obama showed this in his final State of the UnionRead MoreThe Fall Of The Taliban Group809 Words   |  4 Pagescreate his own terror group organization. Briefly after the US-led Occupation of Iraq in 2003, he set up the forerunner to today’s Islamic State: Jama’at al-Tawhid w’al-Jihad ( the Party of Monotheism and Jihad), which was made up mostly of non-Iraqis. Zarqawi’s was not the only one, there were many groups but with different names including Shia groups who are killing Sunni people. In Iraq today, unfortunately there are numerous different terrorist groups and criminal paramilitary groups working in IraqRead MoreReview on Sectarian War: Pakistan’s Sunni-Shia Violence Its Links to the Middle East867 Words   |  4 PagesTitle: Sectarian War: Pakistan’s Sunni-Shia Violence amp; Its Links to The Middle East. Author: Khaled Ahmed ISBN: 978-0-19-90-6593-6 Publisher: Oxford University Press Pages: 369 Price: PKR.550 By: Syed Haider Abbas The author of this book is Khaled Ahmed. Khaled Ahmed was in the Pakistan Foreign Service from 1969 to 1978. He left it to become a journalist of distinction in The Pakistan Times. He is a former consulting editor of Daily Times; resident editor of The Frontier Post; joint editorRead MoreSectarianism: Islam and Pakistan4378 Words   |  18 Pageswithin a religion, based on perceived differences. It does not necessarily result in conflict, but historically, sectarian divisions along religious and political lines have contributed to conflict. Sectarian religious conflict has contributed to some of the most intractable, bitter and painful episodes of aggression and persecution throughout history. For instance, conflict between Irish Catholics and Protestants has existed for centuries, bound closely with nationalist identities, playing outRead MoreSyrian Civil War Is The Biggest Threat For The Future Of Syria949 Words   |  4 Pagesground, This trauma by violence is the biggest threat for the future of Syria,† says Guterres. Girls are driven to prostitution by their own families. It’s a tragedy, (Abdo). The Syrian civil war was started by the lack of responsibility Assad and the Syrian Government had for their people. Assad was not supposed to be ruler at all. Assad doesn’t understand the true human emotion that the Syrian people feel. His ruling has only increased the civil war and hatred between the two groups of people

The Effects Of Television On The Entertainment Industry

Screenwriters play a vital role in the entertainment industry as their ideas are showcased on television screens across the globe. For this purpose, screenwriters can be defined as creative workers who provide the script or screenplay for television networks, generally on a freelance basis (Davis et al. 78). The focus will be on established television networks in North America. Since screenwriters are writing for television networks and not themselves, they are not always able to create content that is meaningful and relevant to them. This essay will argue that screenwriters for television shows in North America struggle to produce creative content that is attractive to and will not be regulated by television networks. First, the essay will examine the challenge screenwriters face when approaching networks with creative content that may not appeal to the network. Secondly, the difficulties for screenwriters of earning an income on a freelance basis will be analyzed. Lastly, the essa y will showcase the struggle for screenwriters to see their original idea on screen without alteration or manipulation. One of the main challenges for screenwriters is producing creative material that is still appealing to networks. Television networks want to air programming that will receive the most views from its audience. Furthermore, networks understand the types of shows that entice the consumer and desire a screenplay that will do the same. Not only is it important to entice viewers, butShow MoreRelatedMedia and Its Affects1514 Words   |  7 Pages3/19/12 Entertainment and Social Media and their effects A nation like America is an example, of a country that has developed in terms of entertainment (Pearson 2). It is one of the countries that has got and has produced some of the greatest entertainers. The country is one of the leading producers of entertainment in the planet. In addition, it is one of the nations that there is a greater influence of entertainment on the younger generation. The effects of entertainment on the youngerRead MoreThe Medias Dumber Democracy Essay1557 Words   |  7 PagesFor the average American there is no escape from mass media. It can be found within our news papers, movies, television and internet, which account for most of our news and entertainment source. In Michael Parentis book, Make Believe Media, the Politics of Entertainment, Parenti attests that this mass media clouds our societys perception of reality by propagating prefabricated images that create and validate a superficial ideological world. Unfortunately, people are denied the opportun ity toRead MoreThe U.S. Media And Entertainment Industry Is Comprised1157 Words   |  5 PagesThe U.S. media and entertainment industry is comprised of businesses that produce and distribute motion pictures, television programs and commercials along with streaming content, music and audio recordings, broadcast, radio, book publishing, and video games. The U.S. Music and entertainment market, which represents a third of the global industry, and is the largest music and entertainment market globally. The market is expected to reach $771 billion by 2019, up from $632 billion in 2015, accordingRead MoreViolence on Television Can Have Negative Effects on Children1210 Words   |  5 Pagesrepeated violence on television desensitizes children to violence, and similarly incorrect portrayals of sex on television may contribute to adolescent sex. Violence, and sex on television negatively impacts todays youth, and adolescents. In fact, a main contributor to these negative effects on children are caused by parents. Some parents pay little to no attention to the ratings of television shows, or movies, or the amount of sex, and/or violence their child sees on television. Studies indicateRead MoreThe use of computer technology in entertainment1069 Words   |  5 Pagesin Entertainment. â€Å"The improvements in computer technology over the past decade have made video and audio streaming commonplace, making the computer a sophisticated and powerful entertainment medium† (Haupert, 2012, p.39). The use of computer technology is not limited to business, health, education and manufacturing industries but also widely used in entertainment and arts world. There are so many applications as there are entertainers and artists. People look forward to the entertainment forRead MoreThe Period Into Telefilm Style Of Production From The 1950 S1186 Words   |  5 Pages1970’s showcased the power struggle between the Hollywood and the emerging television industry as they brought together higher production values to primetime. The relationship between the two industries did not acclimatized effortlessly, for the financial risks and the battle of giving up some control in production and marketing. In The Columbian History of American Television by Gary R. Edgerton, he illustrated that both industries had to reform their methods of business to produce a better quality programRead MoreMedia s Influence On The Media Essay1587 Words   |  7 PagesHollywood controls most entertainment media consumed by people all around the world. The messages and images portrayed in movies and television shows created by the large production companies affect all those who partake of the media they produce. Entertainment media can be uplifting and enjoyable, however, media normalizes damaging gender norms for men and women. Gender norms are rules believed to govern how the different sexes should look and act. People develop these behaviors by observingRead MoreThe Importance Of Advertainment870 Words   |  4 PagesAdvertainment – advertisement and entertainment fused together, â€Å"combines the elements of advertising and entertainment and is designed to overcome the tendency, especially among television viewers, to change channels or mute the audio during standard advertising commercials† (Chitu Tecau 1). In other words, advertainment breaks down the barrier between advertising and entertainment and sells as it entertains. Examples include product placements, such as American Idol (2017) having their judges drinkRead More junk and shit Essay1673 Words   |  7 Pageshas been infatuated with entertainment. From the ancient Grecian Plays and bloody Roman gladiators to Hollywood productions and Broadway musicals, people have always loved to be entertained. The forms of entertainment have changed, but not the effects that they have on the spectators. Movies, Television, Musicals, and even Music itself, all have a profound effect on the people who loose themselves in the magical (and sometimes hypnotic) charm of the entertainment. It is a way to escape theRead More Television and Censorship - Violence Rating System Needed for TV1130 Words   |  5 PagesViolence Rating System Needed for TV Programs While society recognizes the detrimental effects of general television on children, parents and other child advocacy groups dont feel as though there is an adequate rating system. Consequences of ineffective rating systems are that childrens personalities are being negatively affected. The Federal Communications Commission (FCC) has made legislation to address this issue, but the childrens advocacy community is still dissatisfied. This community

Clinical Reasoning Combining Research and Knowledge to Enhance Client Care Free Essays

Making sound and client-centered clinical decisions in an area that demands accountability and evidence-based practice requires not only scientific knowledge, but also a deep knowledge of the practice of one’s profession and of what it means to be human in the world of combined strength and vulnerability that is health care. Every clinician must understand the importance of applying best research evidence to client care, the essence of evidence–based practice, to improve the overall quality of healthcare. Research continues to find that using evidence-based guidelines in practice, informed through research evidence, improves patients’ outcomes (Dykes et al, 2005). We will write a custom essay sample on Clinical Reasoning: Combining Research and Knowledge to Enhance Client Care or any similar topic only for you Order Now The literature is replete with definitions of evidence-based practice. Simply stated, evidence-based practice is the process of applying research to practice. Originating from the medical field in 1991, the term evidence-based medicine was established to ensure that medical research was systematically evaluated in a manner that could â€Å"inform medicine and save lives and that is superior to simply looking at the results of individual clinical trials† (Wampold Bhati, 2004). An evidence-based practice is considered any practice that has been established as effective through scientific research according to a set of explicit criteria (Drake, et al, 2001). The term evidence-based practice is also used to describe a way of practicing, or an approach to practice. For example, evidence-based medicine has been described as â€Å"the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients† (Sackett, Rosenberg, Gray, et al, 1996). Evidence-based medicine is further described as the â€Å"integration of best research evidence with clinical expertise and patient values† (Sackett, Straus, Richardson, Rosenberg, Haynes, 2000). Rather than a relationship based on asymmetrical information and authority, in evidence-based practice the relationship is characterized by a sharing of information and of decision-making. The clinician does not decide what is best for the client, but rather the clinician provides the client with up-to-date information about what the best-evidence is regarding the client’s situation, what options are available, and likely outcomes. With this information communicated in culturally and linguistically appropriate ways clients are supported to make decisions for themselves whenever and to the extent possible. According to Burns and Grove evidence-based practice is nothing more than a problem-solving approach to the care that we deliver that takes into consideration the best evidence from research studies in combination with clinical expertise and the patient’s preferences and values (Burns Grove, 2004). Pierce described in â€Å"Evidence-Based Practice in Rehabilitation Nursing† that â€Å"making patient-care decisions with current information and one’s clinical expertise enhances the ability to provide the best practice†. The author added that â€Å"evidence-based practice is a process that begins with knowing what clinical questions to ask, how to find the best evidence, and how to clinically appraise the evidence for validity and applicability to the particular care situation†. Then, the best evidence must be applied by a clinician with expertise in considering the patient’s unique values and needs. As stated by Law MacDermit, â€Å"evidence for practice is not only about using research evidence, but using it in partnership with excellent clinical reasoning and paying close attention to the client’s stated goals, needs, and values†(Law MacDermit, 2008). Although the terms best practices and evidence-based practice are often used interchangeably, these terms have different meanings. Evidence-based practice can be a best practice, but a best practice is not necessarily evidence-based; best practices are simply ideas and strategies that work, such as programs, services, or interventions that produce positive client outcomes or reduce costs (Ling, 2000). In order to bring research and knowledge into someone’s practice, it’s necessary to think critically. Becoming a critical thinker is a prerequisite of becoming an evidence-based clinician. But what is critical thinking? Critical thinking involves the application of knowledge and experience to identify patient problems and to direct clinical judgments and actions that result in positive patient outcomes. Critical reflection requires that the thinker examine the underlying assumptions and radically question or doubt the validity of arguments, assertions, and even facts of the case. Critical reflective skills are also essential for clinicians; however, these skills are not sufficient for the clinician who must decide how to act in particular situations and avoid patient injury (Wheatley DN, 1999). Critical reasoning is a process whereby knowledge and experience are applied in considering multiple possibilities to achieve the desired goals (Noll et al, 2001) while considering the patient’s situation (Fowler, 1997). According to Simmons it’s a process where both inductive and deductive cognitive skills are used (Simmons et al, 2003). Each client’s problem is unique, a product of many factors, including the client’s physical health, lifestyle, culture, relationship with family and friends, living environment, and experiences. Thus, a health care professional does not always have a clear picture of the client’s needs when first meeting a client. Because no two clients have identical problems, a clinician is always challenged to observe each client closely, search for and examine ideas and inferences about client problems, consider scientific principles relating to the problems, recognize the problems and develop an approach to client’s care. When clinicians make healthcare decisions for a population or group of clients using research evidence, this can be described as evidence-based healthcare practice. Another prerequisite to becoming an evidence-based clinician is to be a reflective professional. Reflection is an important aspect of critical thinking. As described by Miller Babcock reflection is â€Å"the process of purposefully thinking back or recalling a situation to discover its purpose or meaning. With reflection, a clinician seeks to understand the relationships between theoretical concepts and real-life situations. The importance of reflecting on what you are doing, as part of the learning process, has been emphasised by many researchers. The concept of reflective practice was introduced by Donald Schon in his book named â€Å"The Reflective Practitioner† edited in 1983, however, the concepts underlying reflective practice are much older. John Dewey was among the first to write about Reflective Practice with his exploration of experience, interaction and reflection (Dewey, 1933). Schon described the concept as a critical process in refining one’s artistry or craft in a specific discipline. The author recommended reflective practice as a way for beginners in a discipline to recognize consonance between their own individual practices and those of successful practitioners. He also stated that reflective practice â€Å"involves thoughtfully considering one’s own experiences in applying knowledge to practice while being coached by professionals in the discipline† (Schon, 1996). As it was earlier said, there are a few steps toward evidence-based practice and rehabilitation. The first and the most important step in evidence-based practice is to determine a well-designed question that not only affects quality care but is of interest to the rehabilitation clinician and is encountered in practice on a regular basis. A useful ramework for formulating an appropriate clinical question is suggested by Sackett colleagues. (Sackett, 2000). They proposed that a good clinical question should have at least three and sometimes four components: Patient or Problem; Intervention; Comparison (not mandatory); Outcome of interest. This has been referred to as the PICO (Patient /Problem, Intervention, Comparison, Outcome) or PIO (Patient / Problem, Intervention , Outcome) approach. The question usually comes from diverse sources. As stated by Pierce, â€Å"the most common source is the rehabilitation practice itself†. Once the question in searching of evidence was formulated, the next and probably the most important step is to find the relevant evidence in the literature that will help in answering the question. It can be difficult to distinguish relevant from irrelevant information and to decide which source contains the most credible information and research data. Using research findings in practice improves care. Research utilization occurs at three levels—instrumental, conceptual, and symbolic: 1. Instrumental utilization is the direct, explicit application of knowledge gained from research to change practice (Gills Jackson, 2002). 2. Conceptual utilization refers to the use of findings to enhance one’s understanding of a problem or issue in nursing (Gills Jackson, 2002). 3. Symbolic utilization is the use of evidence to change minds of other people, usually decision makers (Profetto-McGrath, Hesketh, Lang, Estabrooks, 2003). According to Hameedullah Khalid, â€Å"all evidence must be appraised in the following areas: validity, importance and applicability to the clinical scenario† (Hameedullah Khalid, 2008). Performing the previous steps will result in the appearance of a concrete piece of evidence which should be valid and important for the question in consideration. Now is the time to combine the clinical expertise and experience with the evidence generated to improve the outcome of specific client scenarios. It is also important to remember client’s values and circumstances while making such decisions. The evidence regarding both efficacy and risks should be fully discussed with the client in order to allow them to make an informed decision. This approach allows the formation of a decision in consultation with the client in the presence of good evidence and is consistent with the fundamental principle of evidence-based practice i. e. ntegration of good evidence with clinical expertise and patient values (Hameedullah Khalid, 2008). Whether the intervention was appropriate and resulted in good clinical outcome for a certain group of clients, in a particular clinician’s hands, will only be answered by careful prospective outcome research. As Strauss and Sackett have suggested, we need to ask whether we are formulating answerable que stions, finding good evidence quickly, effectively appraising the evidence, and integrating clinical expertise and patient’s values with the evidence in a way that leads to a rational, acceptable management strategy (Straus Sackett, 1998). Although the importance of research-based practice was identified decades ago and has gradually been adopted by rehabilitation professions, there are a number of challenges for clinicians who are attempting to be use research to aid in clinical decision-making. According to Bohannon and Leveau most challenges can be grouped under one of three areas: research methods, clinicians’ skill, and administrative factors (Bohannon Leveau, 1998). The research procedures of randomly assigning patients to an experimental or control group, using standardized outcomes measures that may not have real-world relevance, and the difficulty of blinding investigators and clients to the research procedures all make research results difficult to be implemented, interpreted and utilized clinically (Ritchie, 2001). Evidence-based practice requires clinicians to read current research literature, understand research methodology, and incorporate best evidence into practice as appropriate. As Sumison noted in one of his studies, it may be difficult to use in client-centered practice. The research literature may be difficult to access and relevant information is often not compiled in one place (Sumison, 1997). Interpreting and implementing research evidence also requires clinical skill, judgement, and experience. Deciding what constitutes evidence that justifies a change in practice can be challenging and the opportunity for bias exists at every stage of the process as Pomeroy observed in one of his articles from 2003 (Pomeroy, 2003). There are many other factors that present challenges to clinicians who are attempting to use evidence to guide their practice. Time constraints are almost universally identified as a primary limiting factor. Schreiber and Stern stated that â€Å"clinicians refer to pressures of today’s health care environment and administrators’ emphasis on productivity as factors that directly inhibit their ability to seek out, gather, read, and integrate cientific information relevant to daily practice† (Schreiber and Stern, 2005). The concept of evidence-based practice is of great importance for rehabilitation and physiotherapy to allow for increased insight for all involved including patients, clinicians, third-party payers, and government and health care organizations, into the clinical decision-making processes. The purpose of promoting this paradigm is optimum quality of care with conservation of professional autonomy. How to cite Clinical Reasoning: Combining Research and Knowledge to Enhance Client Care, Essays

Comparative Hinduism and Judaism free essay sample

Hinduism and Judaism had completely different viewpoints on birth, death, and afterlife. Jews believed that you were born in the image of God, created with the will to either do good or evil in your life time. This is different from Hinduisms outlook on birth because Hindus believe that until we reach â€Å"oneness† with Brahman, a member of the highest Hindu caste, we are reborn from a preceding life. In Hindu culture, death leads to a rebirth which also occurs from realizing â€Å"oneness† with Brahman. This is different from Judaism’s perspective on death because Jews see death as leaving behind your body, and moving onto the â€Å"world to come†, not as reincarnation like Hinduism practices. For Hinduism, afterlife is almost like a completion of death; it’s the rebirth, and where one merges into Brahman. This is different from Jewish beliefs because Jews don’t really go into detail, or really mention very much at all about after life. We will write a custom essay sample on Comparative: Hinduism and Judaism or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The Jewish religion focuses more on acts and good deeds rather than beliefs. The only explanation of afterlife in the Jewish culture is â€Å"the world to come†. Judaism and Hinduism also differ in their paths to truth and spirituality. In Judaism, they follow the Bible and Oral Scriptures, which tell Jewish people what’s right and what’s wrong. In Judaism, truth and spirituality is found more in adherence of mitzvot- a precept or commandment of the Jewish law- studying holy books, and doing good deeds leads to blessings in life. This is different from Hinduism because Hindus believe that the way to truth and spirituality comes from spiritual disciplines, such as yoga, to reach enlightenment and to be delivered samsara, the cycle of death and rebirth. They follow scriptures called Vedas, which hold authority over a Hindus life. A similarity between Hinduism and Judaism is that both religions are Monotheistic, meaning they only worship one god. They both believe in a supreme ruler and creator that made the universe and world as we know it to be. In Hinduism, there are many gods and goddesses that represent the personalities of their actual god, Brahma. Brahma was part of a trinity, with Vishnu and Shiva. Hindus monotheistic beliefs are similar to Judaism because in Judaism, they worship one god, which is God himself. Though, Jews do not believe in a trinity, unlike the Hindus, in reference to the Bible passage from Isaiah 44:6, â€Å"I am the first, and I am the last; and beside me there is no God†. Also, another similarity is that both Hinduism and Judaism, they give offerings in honor of their god.