Treating diabetic foot ulcers

Treating diabetic foot ulcers The aspect of professional practice I choose related to my role as an adult nurse was diabetic foot ulcers. I choose this topic because it is often seen and treated by nurses and so understanding the treatments available and the effect living with diabetic foot ulcers has on individuals in very important. The first article I am going to discuss and evaluate is the ‘short report: the effect of topical phenytoin in healing diabetic foot ulcers: a randomised control trial’. This was located from the Diabetes UK website. This article explores how the use of a topical treatment for treating diabetic foot ulcers may be more conducive for the healing process as it contradicts the need for medical intervention as well as minimising patient caused to the individual. This study concludes that there were no changes in the diabetic foot ulcers being assessed between the two trail groups. This implies that the study doesn’t support the use of phenytoin in the treatment of diabetic foot ulcers. In relation to the hierarchy of evidence, this article falls under randomized controlled trials, which is the second from the top on the hierarchy. The National Institute for Clinical Excellence (NICE) defines a randomized control study as ‘A study in which a number of similar people are randomly assigned to two (or more) groups to test a specific drug or treatment. One group (the experimental group) receives the treatment being tested; the other (the comparison orcontrol group) receives an alternative treatment, a dummy treatment (placebo) or no treatment at all. The groups are followed up to see how effective theexperimental treatmentwas. Outcomesare measured at specific times and any difference in response between the groups is assessed statistically. This method is also used to reducebias.’ (NICE 2013). According to the British Medical Journal (BMJ), randomised controlled trails are the most thorough and precise technique of assessing if the participant is reacting p ositively to the treatment they have been administered. This also contributes towards managing the monetary value of the study and its effectiveness. The BMJ states that this method of evidence can come with some ethical issues one being, ‘exposing patients to intervention believed to be inferior to current treatment.’ (1998). They also express that although not all studies conducted by this means may be unethical, the validity of using this method may be unreliable, one of the main reason for this is due to the struggle to get the population to sign up to be a participant in the trail. In a case study directed by Wootton R. (2000), it can be argued that although treatment offered in RCTs may be inferior to current treatment, it can work for the benefit of the participant and when it does the results are more desirable than what was seen from current treatment. The second article I am going to discuss and evaluate is ‘debridement of diabetic foot ulcers’. This article was located in the Cochrane library. This article studies the debridement of foot ulcers and what impact it has on healing the diabetic foot ulcer. It also explores the use of dressings on the wound and what dressings apart from the standard gauze had a positive impact on the healing process. The findings of this study showed that the dressing that was being trailed had a positive impact on healing DFU and in an increased time compared to the standard gauze. From this article it Is clear that debridement as well as the other dressing which was trailed has a profound effect on the healing of DFU’s which may have a direct impact on the variations of dressings nurses have to treat diabetic patients. In accordance to the hierarchy of evidence, this article is a systematic review which comes at the very top of the hierarchy. The Cochrane Collaboration agree syst ematic reviews are the most reliable if they are carried out correctly because ‘Researchers conducting systematic reviews use explicit methods aimed at minimizing bias, in order to produce more reliable findings that can be used to inform decision making.’ (2013). This definition has been demonstarted in the article which has been chosen as they have managed to keep to the strict methods used to eliminate bias. One of them being randomised controlled trails. This type of trial ensures that all participants are randomly put in control groups where they would receive a placebo or the actual drug. This trail is strictly confidential as only those people conducting the study not assisting know which group is receiving what drug. All results obtained from the trail are ‘assessed by rigorous comparison of rates of disease, death, recovery, or other appropriate outcome in the study and control groups.’ (The Centre For Evidence Based Medicine. 2013). Leibovici L an d Reeves D also hold systematic review in high esteem describing it as a ‘powerful tool deployed in the pursuit of evidence based practice.’ (2005). They argue that systematic reviews do not just focus on the drug or treatment in question but highlight questions which are important to patients from the point of view that the patients well -being is the primary outcome of the study. Whereas in some clinical trails the primary outcome would reflect the need to save resources or to attempt to claim that certain treatments have an advantage which isn’t always the case. Despite systematic reviews appearing to cover all areas, some researchers have conflicting views on the expenses involved to run a study using individual patient data (IPD). According to Stern and Simmes (1997) IPD is much more expensive and time consuming than other research methods. However it is argued that due to the advancement of technology obtaining patient data is not as time consuming or expensive than in the 90’s. The final article I am going to discuss and evaluate is â€Å"Whatever I do is a lost cause.’ The emotional and behavioural experiences of individuals who are ulcer free living with the threat of developing further diabetic foot ulcers’. I obtained this article from the online Wiley Library. The article is relevant to my discipline as nurses treat many patients who currently have or have had diabetic foot ulcers in the past. This article gives and in depth picture of the fears of those who have had successful treatment for their DFU but are afraid of them returning. This article homes in on the feelings of the patients and how different aspects of DFU and the possible consequences affect their lives and how they approach the condition. However it doesn’t acknowledge how beneficial the treatments they received were. And the effects it had on them emotionally and physically if any. This article is qualitative study which according to the hierarchy comes at the bottom under the heading expert opinion. The Office of National Statistics use Ritchie and Lewis (2003) definition of qualitative study which is, ‘a naturalistic, interpretative approach concerned with understanding the meanings which people attach to actions, decisions, beliefs, values and the like within their social world, and understanding the mental mapping process that respondents use to make sense of and interpret the world around them’. The National office for statistics continues on the say that qualitative research offers an extended understanding of the subject and information related to it. Moreover it explains reasons for certain findings, evaluate how effective the study was and how it would aid their research. According to Ewe Flick the need for qualitative research has increased in the last few decades due to the rapid changes of society. He refers to it as a means to keep up to date with the current situations. Although qualitative research has been a fundamental study for the past couple decades, there are many defects in this method. Becker and Geer (1960) highlighted the fact that although the interviewer and participant speak the same language, there may be some discrepancies with the interpretation, which in effect may leave the interviewer without information he needs/ wanted. According to Beaker and Geer another reason it may be difficult for the participant to open up about certain issues which are bought up. This again may be another factor which prevents the researcher getting all the information they need. There also positives to this research method. Qualitative research is also known as going out on the field because the researcher has to find the participants and in some ca ses has to meet in an environment that suits them. The advantage of this is that if a participant who is being interviewed about a sensitive subject is in the comfort of their own home then they may feel more able to talk about the issues raised as Crabtree and Miller (1991) suggested. References Leibovici L Reeves D. (2005) Systematic reviews and meta- analysis. Journal of antimicrobial chemotherapy. Page 803. Volume 56. The Cochrane Library. (2013) http://www.thecochranelibrary.com/view/0/AboutCochraneSystematicReviews.html Last accessed 12th January 2014 Sage Publications (2002) http://ehp.sagepub.com/content/25/1/76.full.pdf+html Last accessed 11th Janurary 2014 Flick U. (2009). Introduction to Qualitative Research. 4th edition. London. Sage Publications Office for National Statistics- http://www.ons.gov.uk/ons/guide-method/method-quality/general-methodology/data-collection-methodology/what-is-qualitative-research-/index.html last accessed 12th January 2014 National Institute for Health and Care Excellence (2011) http://www.nice.org.uk/website/glossary/glossary.jsp?alpha=R Last accessed 12th January 2014 British Medical Journal (1998) http://www.bmj.com/content/316/7126/201 Last accessed 12th January 2014 British medical Journal (2000) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC27370/ Last accessed 12th January 2014

The Beaux-Arts Style

The beaux-arts style of architecture dominate the architecture of public buildings from 1890 to 1920 because the style was first popularized during the well attended Columbian Exposition of 1893. This style was to be emulated by many entities far and wide. The term â€Å"Beaux Arts† refers to the com/music-appreciation-final/">American Renaissance period from about 1890 to 1920 and encompasses the French Renaissance, the Italian Renaissance, and the neoclassical Revivals.In addition, most of the leading American architects of that period had been academically trained many of whom had trained at Ecole des Beaux Arts in Paris.These facts, together with the fact that America was emerging as a dynamic industrially powerful nation and was becoming a world power at the same time, were proof that America had arrived. Added together, these facts pushed the citizens of the nation to desire architectural proofs of their aspirations and desire to prove to the word that America was a cult ural and political equal to any nation in the world. The Beaux-Arts style is extravagant reflecting the attitude and taste of the industrial barons of this pre-tax era. Their homes were flamboyant and theatrical reflecting a desire to flaunt their wealth.The Beaux-Arts style fits this desire precisely. These industrialists gave commissions to these architects to build their sumptuous residencies in fashionable neighborhoods and exclusive summer enclaves. These grand houses reflected the desire for â€Å"conspicuous consumption. † This spirit of grandeur prompted many cities to erect grand public buildings as well. Every city aspired to outdo its neighbor. The American dream was to emulate the lead of the industrialists and proclaim their wealth and solidity. Public libraries, train stations, town halls, courthouses, office buildings, even prisons manifested this grandeur.Because this style is classical in nature but grand in scale, the buildings are more extravagant. This sty le is theatrical. Elaborate moldings, pilasters, wreaths, garlands, festoons, dentils, cartouches and figure sculpture all are a part of this style. This proclaims to the world power and wealth. Exactly what the era was about. This reflected what the nation’s psyche was about during this period. Bold, new, powerful, and wealthy. This nation was finally a force to be reckoned with. No longer a colonial appendage, but a country equal to any and all.

Similarities Between Buddhism And Hinduism - 1404 Words

Buddhism and Hinduism are closely related when comparing the two. Buddhism was created based on the ideologies of Hinduism. There differences on their views with the idea of self and transmigration. They compare with one another with the problems of having senses, desires and anger. Hinduism believes in everything being unified together as one ultimate reality, which is Brahman. Brahman is the truth of all. Atman is considered as the true and pure self. Atman and Brahman are identical with one another. In the Chandogya Upanishad, it states in one passage that We should consider that in the inner world Brahman is consciousness; and we should consider that in the outer world Brahman is space (Ã…Å¡aá ¹â€¦karÄ cÄ rya, and Gambhirananda 115). Atman never changes; it different from the mind and our external body. The atman is our spirit and it is eternal. Hindus believe in the Brahman and spirit and how it easily connected to Gods. All followers of Hinduism have a soul, which is the atman. The main goal is to achieve karma. To be able to reach our atman it involves the spirit from within. It involves being truthful and the atman will lead us onto the right path. In the teachings of the Bhagavad-Gita, Arjuna finds out that has to fight against Duryodhanana who is his uncle. He learns that he should not be stopped from what he must do; which involves the restoring of good and defeating evil. Arjuna has to follow his duty. He cannot worry about the results that will take place after theShow MoreRelatedSimilarities Between Hinduism And Buddhism948 Words   |  4 PagesBoth Hinduism and Buddhism came from the region called India. Hinduism was the dominant one in the subcontinent, while Buddhism had to flee to other regions to spread its belief to the people. The creation of Hinduism will eventually give birth to Buddhism later on. Even though both â€Å"religions† came from the same region, they have some similarities and differences between them. Hinduism from the start was a combination of different beliefs or ceremonies from the Indus Valley Civilization. All ofRead MoreSimilarities Between Hinduism And Buddhism995 Words   |  4 PagesCompare and Contrast Essay Hinduism and Buddhism There are more than seven billion people living across the world and about 19 major religions with about 270 subgroups. In many states and countries, there are two or more religions that are being practiced by its residents. Hinduism and Buddhism are two of the 19 major religions, that are widely practiced. Hinduism and Buddhism both have common origins, and share similar beliefs. Both Hinduism and Buddhism are religions that focus on the way to liveRead MoreSimilarities Between Hinduism And Buddhism856 Words   |  4 PagesLearning about both Hinduism and Buddhism, particularly about the art and architecture of both cultures made me realize they are not that different as I thought first. Both cultures are beautiful and rich, and if someone takes a deeper look can see that they are depending on each other. Many people forget that Buddha was born into a Hindu society, and his views and beliefs which led to a brand new culture are based on Hinduism. Of course I am not saying the two are the same because that wouldn’tRead MoreSimilarities Between Hinduism And Buddhism863 Words   |  4 PagesPHIL 2120 Paper #1 Xinyang Wang Comparison of Permanence between Hinduism and Buddhism Hinduism and Buddhism have common origins in the Ganges culture of northern India around 500 BCE. We have to admit that they share a lot of similarities, but also involve tons of differences. For example, as Hinduism claims that Atman is Brahman, Buddhism reject the existence of Atman. Hindus think that the way to becoming enlightened is to union with God, but Buddhists pursue a throughout understanding of theRead MoreSimilarities Between Hinduism And Buddhism975 Words   |  4 PagesHinduism and Buddhism have a connected history as both of these religions use similar teachings and terminologies to maintain order among their respective followers and societies. Ideally a society’s religious teachings should contribute to its political, social, economic and cultural discussions. However, correlating this way of thinking to a political theology may prove to be difficult because most people have more important matters to be concerned about than adhering to morale. Various peopleR ead MoreSimilarities Between Hinduism And Buddhism1351 Words   |  6 Pagesreligions, Hinduism and Buddhism, that came out of India thousands of years ago. Though these two religions are old, they are still practiced today by millions of followers within the continent of Asia and the West. First, I would like to introduce the religion of Hinduism. The term Hinduism was derived a river of South Asia, the Indus. This term was used by the ancient Persians to classify the people of that region of the North-West territory of the subcontinent. Indian religion, Hinduism, was theRead MoreSimilarities Between Hinduism And Buddhism843 Words   |  4 Pagesthat the religion itself is fairly young. Take Hinduism and Buddhism, for example, which might be considered very similar in the fact that Buddhism was born from Hinduism. Although in Western context, Hinduism is referred to as a religion. Hindu traditionalists on the other-hand call it â€Å"Sanatana Dharma† and consider it a culture or a â€Å"way of life†. When we analyze the facts and break the two religions down, we can depict that both Hinduism and Buddhism have differences in views, practices, and beliefsRead MoreSimilarities Between Hinduism And Buddhism942 Words   |  4 PagesCCOT Essay Hinduism and Buddhism were both founded and popular in northern India by 600 CE. Although Hinduism and the Hindu caste system maintained a strong influence in South Asia throughout 600-1750 CE, the Hindu majority eventually gave way as Buddhism, Islam, Christianity, and syncretic faiths gradually moved in and across the Indian Ocean basin by 1750 CE. Even then, Hinduism did spread from northern India through southern India to Southeast Asia. The caste system was maintained from 600-1750Read MoreSimilarities and Difference Between Hinduism and Buddhism. Essay2345 Words   |  10 PagesSimilarities and difference between Hinduism and Buddhism. Buddhism believes in the process of reincarnation based on deeds of the present life. Hinduism also believes that everyone is a part of an impersonal world and therefore, ones soul reincarnates into another body of any being, based on the deeds of the present life. One has to work for salvation oneself and therefore, cannot blame others for the same. The salvation depends on the good deeds of a person. In Hinduism also, one attains salvationRead MoreThe Similarities and Differences between Buddhism, Jainism and Hinduism1194 Words   |  5 Pagesteachings: Hinduism, Jainism and Buddhism. These three sects in religious thinking have many similarities as all recognize the life-cycle and the need of liberation, they worship one central deity that used to be a human who gained enlightenment and they all recognize the existence of the eternal soul and after-death re-incarnation. However, they also share a lot of differences that mark the underlying principles of practicing them. I will identify the scope of differences and similarities in these

Animal Farm By George Orwell - 922 Words

Orin Sahar Professor Hofman ENC1101 #498561 October 4th, 2014 Animal Farm Analysis Animal Farm is a fairy tale story based on the Russian Revolution. The story can be related to almost any revolution because the main idea involves dictatorship. In this essay, Animal Farm will be compared to the events and people that were involved in the French Revolution. The animals in Mr. Jones farm were treated harshly, like the lower class citizens of France. The common element in both was that there was no middle class, the French and the animals on the farm were either very wealthy or living in extreme poverty. As for the French revolution, King Louis XVI can be compared to Mr. Jones the farmer because King Louis XVI was the ruler in France before the revolution and Mr. Jones owned and controlled the farm. In â€Å"Animal Farm†, an old swine had an idea that all animals should live together with no human beings controlling them. One night, he gathered all the animals in the farm for a meeting and told them about a dream he had of the animals ruling the farm. He told the animals they must work hard to achieve their new goal and taught them a song called â€Å"Beasts of England†. This can compare to Voltaire and Rousseau s ideas during the France revolution. They both presented an idea of a liberal society that flourished with free commerce. All the animals of the farm approached the swine’s new ideal with great interest. Three nights after the meeting, the old swine died. Three youngerShow MoreRelatedAnimal Farm And George Orwell By George Orwell1034 Words   |  5 Pages Eric Arthur Blair, under the pseudonym of George Orwell, composed many novels in his lifetime that were considered both politically rebellious and socially incorrect. Working on the dream since childhood, Orwell would finally gain notoriety as an author with his 1945 novel Animal Farm, which drew on personal experiences and deeply rooted fear to satirically critique Russian communism during its expansion. Noticing the impact he made, he next took to writing the novel 1984, which similarly criticizedRead MoreAnimal Farm By George Orwell1397 Words   |  6 PagesAn important quote by the influential author of Animal Farm, George Orwell, is, â€Å"Every line of serious work that I have written since 1936 has been written, directly or indirectly, against totalitarianism.† George Orwell, a Democratic Socialist, wrote the book Animal Farm as an attack on the Communist country of Russia (â€Å"The Political Ideas of George Orwell,† worldsocialism.org). He had a very strong disliking of Communism and the Socialist party of Russia. However, he insisted on finding the truthRead MoreAnimal Farm, By George Orwell1545 Words   |  7 Pagesallow because an this elite institution of people often use this gear to dominate and oppress society. In George Orwell’s story, Animal Farm, Orwell demonstrates that education is a powerful weapon and is a device that can be used to at least one’s benefit. Living in a world where strength is a straightforward to benefit, the pigs quick use education to govern the relaxation of the animals on the farm to serve themselves worked to their advantage. This story in shows the underlying message that   firstRead MoreAnimal Farm By George Orwell944 Words   |  4 Pageslegs(Orwell 132). He carried a whip in his trotter(Orwell 133). In the novel Animal Farm by George Orwell, animals have the ability to talk and form their own ethos, Animalism. Animal Farm is an intriguing allegory by George Orwell, who is also th e author of 1984, includes many enjoyable elements. More knowledge of the author, his use of allegorical elements, themes, symbols, and the significance in the real world, allows the reader to get more out of this glance into the future. George OrwellRead MoreAnimal Farm, By George Orwell876 Words   |  4 Pagesrebellious animals think no man means freedom and happiness, but they need to think again. The animals of Manor Farm rebel against the farm owner, Mr. Jones, and name it Animal Farm. The animals create Animalism, with seven commandments. As everything seems going well, two of the animals get into a rivalry, and things start changing. Food starts disappearing and commandments are changed, and the power begins to shift. Father of dystopian genre, George Orwell writes an interesting allegory, Animal FarmRead MoreAnimal Farm by George Orwell1100 Words   |  4 PagesIntroduction: Widely acknowledged as a powerful allegory, the 1945 novella Animal Farm, conceived from the satirical mind of acclaimed author George Orwell, is a harrowing fable of a fictional dystopia that critiques the socialist philosophy of Stalin in terms of his leadership of the Soviet Union. Tired of their servitude to man, a group of farm animals revolt and establish their own society, only to be betrayed into worse servitude by their leaders, the pigs, whose initial virtuous intentionsRead MoreAnimal Farm By George Orwell1538 Words   |  7 PagesMecca Animal Farm The Russian Revolution in 1917 shows how a desperate society can be turned into a military superpower filled with terror and chaos. George Orwell uses his book, Animal Farm, to parallel this period of time in history. This book is an allegory of fascism and communism and the negative outcomes. The animals begin with great unity, working toward a common goal. The government then becomes corrupted by the temptations of power. George Orwell uses the characters in Animal Farm to showRead MoreAnimal Farm by George Orwell1175 Words   |  5 PagesAn enthusiastic participant in the Spanish civil war in 1936, George Orwell had a great understanding of the political world and made his strong opinions known through his enlightening literary works, many of which are still read in our modern era. Inspired by the 1917 Russian Revolution and the failed society it resulted in, Animal Farm by George Orwell is an encapsulating tale that epitomises how a free utopian society so idealistic can never be accomplished. The novella exemplifies how influencesRead MoreAnimal Farm, By George Orwell1089 Words   |  5 PagesIn George Orwell’s â€Å"Animal Farm†, the pigs as the farm leaders, use unknown language, invoke scare tactics and create specific laws, thereby enabling them to control other animals, to suit their greedy desires, and to perform actions outside their realm of power. Because of the pigs’ use of broad language, and the implementation of these tactics they are able to get away with avoiding laws, and are able to convince other animals into believing untrue stories that are beneficial to the pigs. The firstRead MoreAnimal Farm, By George Orwell1212 Words   |  5 PagesShe stood there over the dead animals thinking to herself what have we come to? We try to become free but we just enslave ourselves to a so called superior kind. Napoleon killed the animals in front of the whole farm and said that this was to be the punishment for the traitors. Snowball was known as a traitor now and anyone conspiring with him would be killed. Snowball and Napoleon both represent historical characters during the Russian revolution in 1917.Snowball who was one of the smartest pigs