Efficacy of Portable Head CT Scan in the Neuroscience Intensive Care Un

Introduction: Portable Computed Tomography (CT) studies are an important component used to manage, assess and diagnose CNS diseases, and acute brain injuries, in the Neuroscience ICU (NICU). The portable device is designed specifically for head and neck scans for critically ill patients that are at risk for complications and increased morbidity during intrahospital transportation. Research has found evidence which substantiates that intrahospital transport of patients with brain injuries can impact their outcomes. Many hospital protocols dictate the use of portable head CT (pHCT) scanners to monitor and assess critically ill patients in the NICU, to decrease negative patient outcomes from intrahospital transportation. This is an important factor in reduction and prevention secondary injuries in critically ill patients. The intention of this paper is to critically analyze a research article entitled Portable Head CT Scan and its Effect on Intracranial Pressure (ICP), Cerebral Perfusion Pressure (CPP), and Brain Oxygen. First, there will be an article synopsis identifying the premise of the study. Second, validity of the study will be described and discussed. Lastly, this paper will discuss applicability to Neuroscience ICU at University of New Mexico (UNM) Hospital. Article Synopsis: The authors of this research article were from various Departments at University of Pennsylvania in Philadelphia. The researchers conducted a retrospective study to assess possible detrimental association of a pHCT on ICP, CPP, and brain oxygen in patients with severe brain injury. The retrospective study selected 34 patients (16 males and 18 females), with the mean age of 42 ( ±15 years), and Glasgow Coma Scores (GCS) ≠¤ 8 at the time of pHCT sca... ...eterious effects on patients. Conclusion: Peace et.al. raises a valid hypothesis that warrants further investigation in order to decrease the risks to patients on NICU and other units/ hospitals. In my opinion, studies with significant findings, reliability, high internal and external validity, are imperative in making changes in hospitals around the world to decrease secondary injury to patients. This study can possibly entice other researchers to develop a better study design and investigate the relationship between pHCT scans and ICP, CPP and brain oxygen, more vigorously. Works Cited Peace, K., Maloney-Wilensky, E., Frangos, S., Hujcs, M., Levine, J., Kofke, W.A., Yang, W., & Le Roux, P.D. (2011). Portable head CT scan and its effect on intracranial pressure,cerebral perfusion pressure, and brain oxygen. Journal of Neurosurgery, 114(5), 1479-1484.

Prince Edward Island †Essay Essay

Executive Summary: Prince Edward Island Preserve manufactures and produced high- quality, high priced specialty food products. P.E.I.P.C. experienced rapid growth in its short history. In the first few years of its existence, founder Bruce MacNaughton expanded his company from one manufacturing and retail outlet in 1989, following a second retail outlet in 1991. The company also diversified and opened two restaurants in 1989 and 1990 respectively. It is anticipated that P.E.I.P.C. will continue to grow, with projected sales for the year ending January 1992, to reach one million dollars. In August 1991, MacNaughton, contemplated on future expansion. The two cities under consideration were in Toronto and Tokyo. Options under consideration include adding retail outlets in the aforementioned regions. Also under consideration is to increase wholesaling, and the use of distributors (hotel and airlines). Expanding the mail order business is also an alternative. Although MacNaughton has weighed some or all options to diversify P.E.I.P.C’s operations, it is unequivocally clear the company lacks clear vision, strategy goal and objective. MacNaughton’s business had been built on gut and emotion rather than analysis. However, this approach may prove to be insufficient for the future. It is difficult to execute a strategy if goals are not specific, can’t be described or understood. However, guided by the proper analysis of the external environment (SWOT), together with the firm-level analysis (VRINE Model), MacNaughton’s can improve P.E.I.P.C.’s long term competitive business position. Key Problems: This case highlights various strategic challenges MacNaughton face while contemplating expansion, and how to complete this objective successfully. The difficulty is to know when to close the gap between the firm’s aspiration and its current capabilities, resources and market position. The core issues identified in this case are: 1. Future Expansion 2. Product imitation 3. Product promotion – reluctance to explore the use wholesale and distribution networks 4. Financial Constrains– unable to secure suitable financing, experienced period of cash flow shortages 5. Managerial constrains 6. Seasonal Staff – inability to attract and retain quality staff due to the seasonal nature of the business Analysis and Evaluation: P.E.I.P.C.’s key resource is its geographic location. Prince Edward Island is most notable known for its pastoral beauty, slower pace of life, North Shore beaches and global image of Anne of Green Naples. Prince Edward Island’s well known reputation for the high quality of strawberries is the basis of P.E.I.P.C.’s marketing strategy and product differentiation. As the company grew, P.E.I.P.C. developed and achieved a diverse product line. This resource helped the company to establish a competitive advantage. In addition, P.E.I.P.C’s higher prices did not compete with low end products charges by competitors. However, this marketing strategy to differentiate their brand, introduced P.E.I.P.C to a variety of competitors. Another key resource is financing. Although previously listed as a core issue, the company has the ability to raise $100,000 of addition capital to finance future expansion by issuing preferred stock. P.E.I.P.C.’s manufacturing plant i s another key resource. Currently, P.E.I.P.C.’s production capacity is underutilized. The manufacturing plant operates five month a year, on a single, five days per week. Productivity levels can increase from fifty per cent to one hundred per cent by extending the hours of operation. Automating the bottling process could increase productivity substantially. The final key resource is its customers. Prince Edward Island and P.E.I.P.C. attracts thousands of tourists from over the globe. In additional to local marketing efforts, the reliance on tourists could increase P.E.I.P.C.’s global presence and raise consumer awareness of its products. A strategy must be formulated for the purpose of gaining and sustaining competitive advantage. MacNaughton should critically evaluate P.E.I.P.C’s performance measure for resources and capabilities by utilizing the VRINE model. The VRINE Model Value – A resource is valuable if it enables P.E.I.P.C to exploit opportunities to establish competitive advantage or negate threats. Japanese tourist comprises a large number of visitors to Prince Edward Island and Prince Edward Island Preserve, Co. outlets. The popularity of P.E.I and P.E.I.P.C’s products are well known to Japan. Essentially, the high level of spending by the Japanese, their fascination with P.E.I., traditions of gift giving and the amount of disposal income available to them, indicates that opportunities in Japan might be successful. Rarity – P.E.I.P.C can enjoy temporary competitive advantage, so long as the content of ingredients used to make its specialty preserves remain rare and scarce relative to it competitors. Inimitability/Non-substitutability – Other firms in P.E.I. has begun to retail specialty preserves in hopes to profit from P.E.I.P.C.’s success. Competitors might be able to imitate or substitute the value and resou rces quickly, at a low cost. Exploitability – With a solid vision, financial base, coupled clear strategy formulation and implementation of its objectives, P.E.I.P.C. can exploit their brand and products domestically and manufacture their products globally with the resources available. P.E.I.P.C can protect and increase competitive advantage by expanding its wholesaler and distribution network in Toronto. Initially, MacNaughton’s interest in Toronto was due to its size and local awareness of P.E.I. Successful expansion in Toronto can prove to be quite profitable for the company. Strategy planning for P.E.I.P.C. must also include a SWOT analysis in order to identify its internal and external factors that are favorable and/or unfavorable in achieving its objective. SWOT Analysis of Prince Edward Island Preserve Co. StrengthsWeakness Brand LoyaltySeasonal Business Structure Product DifferentiationAttract and Retain Quality Staff Local ReputationLimited Advertisement Broad Product MixCash Flow Shortages Ability to Raise Capital OpportunitiesThreats Expansion in Japan and TorontoProduct Imitation Extensive Distribution ChannelsVariety of Possible Substitutes Ability to meet Competitive PricingSupplier Power to Competitors Recommendations: P.E.I.P.C can also explore expanding its marketing reach in efforts to bring brand awareness through e-commerce and web based advertising. Additionally, plans should include hiring a sales and marketing team to assist in strengthening the company’s brand name and appeal. Emphasize on mail order sales by improving the quality of the catalogue and distribution reach. P.E.I.P.C. should consider automating the bottling process to increase production capacity and annual volume. The company should also analyze the profitability of large scale orders with wholesalers, hotels and airlines, and perhaps consider opportunities to expand in the U.S. Implementation: MacNaughton should take into consideration the use of additional key strategy formulation concepts such as, the strategy diamond, the five forces model off environment threats and the PESTEL model to help his firm establish and sustain competitive advantage.

Alienation and Moral Dilemma as Portrayed by Nathaniel...

Alienation and Moral Dilemma as Portrayed by Nathaniel Hawthorne Nathaniel Hawthorn was born in Salem, Massachusetts in 1804 during Puritan times. He created many stories that reflect his life experiences growing up as a Puritan. He writes stories that end with a moral that was learned through the struggles of the characters. These characters are almost always faced with a dilemma where they must choose what is right versus what is wrong. Another common theme in his writing is alienation. These concepts can be found in the stories â€Å"Young Goodman Brown,† â€Å"The Minister’s Black Veil,† and â€Å"The Birth Mark.† They are all about a life altering decision one must face and the consequences of that decision. In â€Å"Young Goodman Brown,† the†¦show more content†¦There are many obvious cues in â€Å"Young Goodman Brown.† The first example is the name, Goodman Brown. His name is symbolic of the good man he is and of the fait h he bestows. Another example is his wife named Faith, â€Å"and Faith, as the wife was aptly named.† (Nathaniel Hawthorne, â€Å"Young Goodman Brown†) She is a representation of his own religious ‘faith’ and reflects their innocence and purity, sin, the consummation between married couples, and the complications of living in a world where these qualities are mingled. When she thrust her own pretty head into the street, letting the wind play with the pink ribbons of her cap(Nathaniel Hawthorne, â€Å"Young Goodman Brown†) we associate the purity of ‘Faith’ and the ‘pink ribbons’ as a sign of the innocence and goodness of the town he must leave behind. His leaving her to enter the dark and dismal forest is symbolic of him leaving his faith in the religious sense. This is the first decision he has to make - to leave his faith and enter the evil that is the forest. It is obvious that he is frightened as he walks through the f orest. He runs into an old man there holding a staff that resembles a serpent. This is the man that he was looking for. This man is evil and Goodman Brown is confident that he can resist the temptations he is offered. It is obvious that this man is representative of the Devil who Goodman Brown so obviously fears and wants to avoid. This can be seen in their first interaction. ’You areShow MoreRelatedMoby Dick, By Edgar Melville1981 Words   |  8 Pageshonest and courageous not to try to do one or the other. If he were a religious man, he would be one of the most truly religious and reverential; he has a very high and noble nature, and better worth immortality than most of us (Braswell 3). Nathaniel Hawthorne wrote these words in his journal in 1856, speaking of his old friend Herman Melville. Melville did indeed find himself stranded between belief and unbelief, torn between the stringent and widely accepted Calvinist doctrine of New England, and

Exercise for Homework Time Management

Do you find yourself rushing to complete your homework assignment at the last moment? Are you always starting your homework when youre supposed to be going to bed? The root of this common problem may be time management. This easy exercise will help you identify the tasks or habits that take time away from your studies and help you develop more healthy homework habits. Keeping Track of Your Time The first goal of this exercise is to get you to think about how you spend your time. For instance, how much time do you think you spend on the phone per week? The truth may surprise you. First, make a list of common time-consuming activities: Talking on the phoneEatingNappingListening to musicLoungingWatching TVPlaying games/surfing webSpending time with familyHomework Next, jot down an estimated time for each one. Record the amount of time that you think you devote to each of these activities per day or week. Make a Chart Using your list of activities, create a chart with five columns. Keep this chart on hand at all times for five days and keep track of all the time you spend on each activity. This will be tough sometimes since you probably spend a lot of time going rapidly from one activity to the other or doing two at once. For example, you may watch TV and eat at the same time. Just record the activity as one or the other. This is an exercise, not a punishment or a science project. Dont pressure yourself! Evaluate Once you have tracked your time for a week or so, take a look at your chart. How do your actual times compare with your estimates? If you are like most people, you may be shocked to see how much time you spend doing things that are unproductive. Does homework time come in last place? If so, youre normal. In fact, there are many things that ​should take more time than homework, like family time. But surely there are some problem areas that you can identify as well. Are you spending four hours a night watching TV or playing video games? You certainly deserve your leisure time. But to have a healthy, productive life, you should have a good balance among family time, homework time, and leisure time. Set New Goals When tracking your time, you may find that you spend some time on things you just cant classify. Whether were sitting on the bus staring out the window, waiting in line for a ticket, or sitting at the kitchen table gazing off in the distance, we all spend time doing, well—nothing. Look over your activity chart and determine areas you could target for improvement. Then, start the process over again with a new list. Make new time estimates for each task or activity. Set goals for yourself, allowing more time for homework and less time on one of your weaknesses, like TV or games. You will soon see that the mere act of thinking about how you spend your time will bring about a change in your habits. Suggestions for Success Dont work alone. Some of us need support to stick to something. A little competition with a friend always makes things more interesting. Work with a friend, compare notes, lists, and charts. Make a game of it!Include your parent. Get your mom or dad involved and have them keep track of the time they waste. Now that might be interesting!Negotiate a reward system. Whether you work with a friend or a parent, work out a system for rewarding yourself for progress. If working with a friend, you could agree to provide lunch or dinner for the time-saving winner each week.If working with a parent, you could negotiate an extended curfew for every increased minute devoted toward homework. Perhaps you could even substitute dollars for minutes. The possibilities are endless!Have a party for reaching a goal. Even if youre working on your own, you could promise yourself a party as a reward for reaching a specific goal.Make it a class project. This would be a great project for an entire class. The t eacher or group leader could keep track of progress with a flow chart. When the class reaches a goal as a group—its party time!

Social Change Is Inevitable Essay - 1586 Words

â€Å"Social change is inevitable†. Critically discuss this statement drawing on social theory and contemporary examples. Introduction As change is an inevitable part of nature in a positive or negative way,the social change to me is subject to this pattern too.The speed of change varies between to spectrum,slow which people barely notice and fast in a way the society experience a shock. By the word change,we refer to a observable difference in a special time span.Therefore,social change would imply a noticeable difference in any aspects of society over a period of time. According to Gillin and Gillin : Social changes are variations from the accepted modes of life; whether due to alterations in geographical conditions, in cultural equipment, composition of the population, or ideologies and whether brought about by diffusion or invention within the group. According to Jenson : Social change may be defined as modification in the ways of doing and thinking of people. Exact prediction of social change is not possible but as social events are mutually interdependent,we can have a prediction about the direction and consequences of some phenomena.The components of society are dynamic,therefore any alteration in one of these components usually influences others.Therefore for analyzing the complex social phenomena - with various interfering factors- always we need a series of social theories in order to delineate them.Universality and continuity are common characteristics of socialShow MoreRelatedAssess the View That Crime Is Functional1683 Words   |  7 Pagesthat crime is functional, inevitable and normal. (33 marks) Within the sociological perspectives of crime and deviance, there is one particular approach which argues that crime is functional, inevitable and normal. This sociological perspective, Functionalism, consists of Emile Durkheim’s work on crime and deviance. 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Even though I have always had a strong interest in the social work profession, having numerous personal experiences with diversityRead MoreDoes The Adolescents Brian Make Risk Taking Inevitable?811 Words   |  4 PagesDoes the adolescents Brian Make Risk Taking Inevitable I decided to agree with Robert Epstein because adolescence, make decisions that are different from adults. Adolescence has a brain that is still developing and growing which make adolescence take a risk, but as for an adult, they already did their time and learn to not to make any risks. I feel as though people may not see adults, making a risk, but they do and they are smart choices because their brain has matured. Robert Epstein argues thatRead MoreThe Natural History Of Social Problems773 Words   |  4 Pagesterrorism. These social problems are viewed by a part of society as social conditions or pattern of behaviors that are harmful to members of society and in need of a solution. 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Burning Health Problem Resulting Morality †Myassignmenthelp.Com

Question: Discuss About The Burning Health Problem Resulting Morality? Answer: Introducation The topic for the audit is pressure ulcer prevention and the reason for choosing it is that it is a burning health problem resulting in increase in morality and healthcare costs especially in the geriatric population (Behrendt et al. 2014). Every year, 2.5 million people are developing pressure sores and that bring pain with serious risk for infection and increased utilization of healthcare. There is also increased reimbursement of patients to hospitals and require adequate care in pressure ulcer under the hospital care. Moreover, pressure ulcer demands interdisciplinary approach to care and high tailored and routine care. As Singapore population is ageing, it is battling with pressure sores in hospitals and need measures on a greater urgency (Chang, Carville and Tay 2016). According to Gunningberg et al. (2015) one in ten geriatric patients are struggling with pressure sores where they are admitted for more than a week at the hospital. At the Changi General Hospital (CGH), 15% patie nts in geriatric wards get pressure ulcers or sores until task force combat it. It also adds to the cost of healthcare and demands adequate care. This depicts that it is a major health issue affecting millions of patients and increase in hospital stays affecting patient safety and quality of care (Woo et al. 2017). Along with incidence, mortality rates are also increasing resulting in readmissions and increase in costs. This is the reason to choose the topic of pressure ulcer prevention for the audit as it is an emerging nursing concern and increasing the burden of care. Audit standards The standard criteria to be used for the pressure ulcer prevention will be under the NICE guidelines that encompass the potential challenges and priorities to collect data for the audit plan. The audit tool detects the clinical issues and guidelines that are suitable for the development of the audit standards for the proposal. It provide recommendation guidelines like to prevent patients declining treatment Audit standards Definitions Risk assessment Braden scale or Norton assessment scale or Waterlow score that support clinical judgment Skin assessment Skin integrity, colour changes, moisture, firmness and heat variance. Repositioning none Pressure redistributing equipments none Care planning Outcome of risk, skin assessment, mobility, additional pressure, mobility, co-morbidities The 5 audit questions are: What are the best practices for the pressure ulcer prevention that the hospital have? How often the comprehensive assessment of skin is conducted in the hospital? How often the pressure ulcer risk assessment is conducted and according to standard guidelines? How should the care planning for pressure ulcer should be done based on the risk? What additional resources the hospital have in identifying the best practice for the prevention of pressure ulcers? Audit setting The audit will be conducted in the hospital setting in a private hospital in Singapore. It will be conducted in Intensive Care Units (ICU) that is 22 bedded and provide care for the complex assessments and treatment. Population and sample setting The audit will be undertaken in the ICU setting in hospital where the population size will be 30 people comprising of geriatric patients, ward nurses in wound dressing and ICU medical staffs. The stakeholders involved in this audit plan will be the commissioners, clinical leaders at every hospital level, managers in clinical governance, working staffs, carers in the clinical audit program. The sample will be selected who have impaired mobility and bed-ridden. References Behrendt, R., Ghaznavi, A.M., Mahan, M., Craft, S. and Siddiqui, A., 2014. Continuous bedside pressure mapping and rates of hospital-associated pressure ulcers in a medical intensive care unit.American Journal of Critical Care,23(2), pp.127-133. Chang, Y.Y., Carville, K. and Tay, A.C., 2016. The prevalence of skin tears in the acute care setting in Singapore.International wound journal,13(5), pp.977-983. Gunningberg, L., Mrtensson, G., Mamhidir, A.G., Florin, J., Muntlin Athlin, . and Bth, C., 2015. Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: a descriptive, comparative multicentre study in Sweden.International wound journal,12(4), pp.462-468. Woo, K.Y., Sears, K., Almost, J., Wilson, R., Whitehead, M. and VanDenKerkhof, E.G., 2017. Exploration of pressure ulcer and related skin problems across the spectrum of health care settings in Ontario using administrative data.International wound journal,14(1), pp.24-30.