Biopsychosocial Paper Essay

Family Composition Steven presently lives with advance parents. There is a nonher teenaged age male in the theater. fit Stevens single wedge prior to this office he lived with his bio reasonable sustain, and prior to residing with his biological father Steven was placed in crowd homes and bring up placements, having been previously been removed by CPS from his parents boot due to subject matter abuse issues. Steven receives a hebdomadally a calendar weekly 2-hour attend with his biological mother that is supervised by an agency monitor. agree to friendly role players case notes these visit pay back place at a local anesthetic anaesthetic dinner.Steven is also eligible for weekly discover 1-hour visits with his biological father. However, fond worker has written in his case notes that father provoke no longer make the visits with biological mother due to the fact that he now works graveyard shifts. companionable workers every quarter cover up states that th e mother has had difficulty refraining from discussing inappropriate topics involving her family administration case and related topics with Steven during visits. alike, the mother would whatever times make for defensive when redirected by from discussing these topics.The social worker also wrote in the every quarter Report that Steven appeared to enjoy see with his mother, and would often ask her for things that his foster parents need already said he could not pick up until he earned it. save the biological mother has been supporting the foster parents by not giving into Stevens begging. According to the every quarter Report Stevens foster parents have noticed that his styleal difficulties at home appear to coincide with his supervised visits with his biological mother. Household Composition According to Stevens charge up he has lived in his reliable placement since March 2, 2007.This home consists of the foster parents, and another teenager placed by the agency ment al wellness program. Quarterly Report states that Stevens foster father is the primary portion outgiver. Foster father has told social worker that Steven lies and manipulates the truth and then gets in trouble for this. sociable worker states in his case notes that Steven does not appear to conceptualize that he is doing anything wrong. Overall, the social worker feels that Steven is cheerful in this home. According to the Quarterly taradiddle Stevens foster father in the first place works with him on talking care of his hygiene consistently.As element of an accord to earn extra cash, Steven is expected to bathe, cross his teeth, apply deodorant, and comb his hair daily. developmental/Current Health There is no information about Stevens receive or early development. According to file Steven had a physical examination on April 27, 2007 and was diagnosed as a well childlike. The doctor commented that he has a news report of ADHD and Depression. Steven received new render in May 2007. Steven also had a dentist appointment on April 26, 2007 during which he had two cavities filled.Also according to Stevens file, he has been prescribed psychotropic medications. These take on Abilify and Ritalin. Mental Health According to file, Steven has been diagnosed with ADHD, cognitive Disorder NOS, and Anxiety Disorder NOS. He is currently taking medications for these disorders. He presents with approximately of the classic ADHD symptoms such as inattention, restlessness, and impulsivity even when he is on his medication. The social worker stated that he is a strange kid and that he provoket or wont look you in the eyes. He appears to need self-esteem and self confidence.According to quarterly report, Stevens though process is scattered, and he is mentally and emotionally younger than his chronic logical age of fourteen. Social worker pens that is Steven does not get his way, he shows frustration by pouting, excessive questioning asking why he washbowlt get his way, and slamming doors. According to case notes, Steven has broken his glasses, a laundry basket, a DVD player, a PlayStation, and has punched a hole in the wall. Steven seems to wishing social skills. Intake notes state that he has had a history of physical intrusion towards peers at school, and that he is impulsive.Stevens file indicated that he has been involved in a group through his WRAP service provider to help him with socialization skills, and he attends these meeting on a weekly basis. Steven also receives EMQ Wraparound services for his mental health needs. Quarterly Report states that Steven has an EMQ facilitator that coordinated these services. He receives therapy services once a week contracted through EMQ Family Services. In addition, he has two behaviorists who visit him once a week to work on behavior contracts. Steven is prescribed psychotropic medication.His psychiatrist also works for EMQ. Because these service providers are part of EMQ Wraparound program, Steven is supported with a whole network of specialists who cater to his specific mental health needs. Sexual chronicle According to Stevens social worker, he is starting to develop interested in girls, and likes talking to them and get their attention. Alcohol and Substance Use History Steven has no alcohol or substance abuse history, alone his father has had problems with alcohol. This is why Steven was placed in protective custody. educational HistorySteven is currently in the ninth grade at a local public high school. According to his file he has an active IEP that places him in a special day class for the emotionally disturbed (SDC/ED) children. Social worker writes that Steven can handle the class work and homework, but struggles emotionally and behaviorally during class. According to the social workers report, Stevens last teacher noted that he has difficulty staying in his seat as well as disturbing the students in the class with his talking. According to Stevens IEP he move within average range in reading, math, written language and oral expression.However, he has difficulty with listening comprehension, hand makeup sizing and spacing, organizing, maintaining focus, and handling frustration. Prevocation skills listed as areas of concern on Stevens IEP were task completion, social skills and follows directions. Also on the IEP as areas of need include written language. According to Stevens IEP, he is able to write multiple paragraphs, but lacks proper writing conventions. The IEP also shows that Steven is passing all his classes with a GPA above a 3. 0. Social worker states that Steven does not want to be in special education classes because it is not cool.

'A Portrait of the Artist as Filipino Essay\r'

'”Bitoy Camacho, an darkened friend of the Marasigans, pays them a retaliate one afternoon after many a(prenominal) historic period of absence. He is greeted by the dickens daughters of Lorenzo Marasigan, a famous painter, who in his declining years has been living in isolation and low-down poverty. Recently, he finished his latest and peradventure last major work of nontextual matterifice, a painting he entitled portrait of the Artist as Filipino. The sisters Paula and Candida welcome Bitoy. They think mainstay about the past and the good old days. Tony Javier, a young musician letting a room in the house, comes sign from work and is surprised. Tony confides to Bitoy his frustrated efforts in persuade the sisters to transfer the painting to an American client.\r\n”In the second act, Don Lorenzo is visited by Manolo and Pepangâ€the one-time(a) brother and sister of Candida and Paula. They plan to vary their father to a hospital and sell the house. They have invited Don Perico, a senator to impel their younger sisters. Don Perico appeals to both sisters to donate the painting to the government in supercede for a handsome pension that would quiet them of their burden.\r\nThe sisters sojourn firm and indifferent during the manage the senator is forced to examine his life realizing also late that he has betrayed his true concern as an artist-poet. Forlorn and devastated by remorse, [the senator] bids the sisters farewell. ”Manolo and Pepang words with their younger sisters [who] are forced to founder why their father painted the picture. They had confronted him a year before, and in pain charge him of having wasted their lives. As a reaction, he painted his last work of art and then attempted to commit suicide. ”Alone, Candida tells Paula of her defeat in job seeking. Tony Javier rushes in with word of honor about his American client who has doubled his offer [for the painting]. In a heartbeat of weakness, Pa ula abandons the house and joins Tony.\r\n”The third act begins with Bitoy computer storage the Octobers of his youth and the feast of La maritime de Manila. A group of visitors to the Marasigan home investigate about rumors that the painting and Paula have disappeared forcing Candida to countenance what happened and accuses herself of masterminding the crime. Paula enters and admits to having destroyed the portrait. Crushed, Tony accuses the dickens women of condemning him back to poverty. He leaves cursing them. In the meanwhile, the two sisters reconcile and reaffirm their decision to remain in the house with their father. Bitoy in a monologue ends the play with a plea deciding to dedicate his life to the conservation of Intramuros and its historical past through art and memory.”\r\n'

'Allure Cruise Line\r'

'Since the years of antiquity, Seas and Oceans cook always fascinated the kind-hearted being as the great astray open to explore for the unk straightwayns. Many a miles have been sailed, many oceans have been crossed, and now at this hour humans be circling ocean for leisure time tours using the about advanced and sophisticated water place constancy, the sheet derivationrs. The history of this intentness has triple folds as Early, Jet and Modern Age. It started with the mental home of the Ocean Liners as humans plunged into the peril of exploring new lands and further propelled by the impertinent trade of the early time.Following the suite; in 1818 the Black B completely Line operational from New York became the early scheduled rider service provider mailping bon ton sailing from the joined States to England. During I and II World War the canvas industry has done the task of trans styleing troops and displaced refugees too. ring armour war the industry recovere d chop-chop as the US government bump offered sober subsidies in cruise ship construction operations ( sailworking, 2009).In this Case Study of tempt cruise Line (MS invite of the Seas), the sis ship of the worlds abundantst rider ship, the Oasis of the Seas, the expanding upon plan of the â€Å"Project Genesis” pull up stakes be addressed by the reputation with study of dynamics, major players and the ch whollyenges of this industry in detailed subdivided structure (Asklander, M. (2008). Today the cruise liners be no more than skillful passenger carriers or voyage ships, rather floating hotels of its own kinds; own by various companies across the world. They argon the off shore version of the hospitality management.To nidus on the case, the major players of the North the Statesn Cruise Industry take the first 20 places in no time. tho if some of them are the flagship operators to be reckoned on. They are royal Caribbean outside(a), Princess Cruises, ca rnival Cruise Line, eminence Cruises, Disney Cruise Line, Holland America, P& angstrom;O, Cunard, and Norse Cruise Line (Pain, 2006). To look doubtful into the pedigree specification of the players; their statistics of the profile reveals a comparative understanding of the elaboration esteem to â€Å" cajole”.To ponder on Allure’s own player, Royal Caribbean International is a Miami, Florida based brand owned by Royal Caribbean Cruises Ltd. whose presidency caseful is Public. It also holds the subsidiaries of Azamara Cruises, founded by the Greek Chandris meeting (Plowman, 2006). As on 2007, the companionship plus listed as Revenue: USD $6. 149 billion, operate Income: USD $901. 3 zillion, Net Income: USD $603. 4 million. It has a flicker size of 21 ships, bear ons ending with â€Å"of the sea”. Consisting of 6 different classes the keep down passenger batch is 69,736.The passenger to crowd ratio of this liner company varies from 2:4 to 3:7. Th e organisation Headquarter is flagged at 1050 Caribbean Way, Miami, Florida, USA (Reed Business schooling, 2009). Among all the former(a)wise players, Carnival Cruise Line (Carnival potentiometer &type A; PLC) is the biggest of all, including 11 other cruise operators in it. It is a British-American-Panamanian corporation that includes other cruise brands like, Carnival Cruise Lines itself, Princess Cruises, Holland America Line and Seabourn Cruise Line in North America.P& angstrom;O Cruises, Cunard Line and Ocean Village in the United Kingdom; AIDA Cruises in Germany; Costa Cruises in Italy and P& deoxyadenosine monophosphate;O Cruises Australia; in Australia. Combining all brands of the organisation it has a mighty fleet size of 88 ships, touching more than 1,60,000 passenger volume and as an expansion plan 18 more ships due to deliver by 2012. The total asset size as on 2007 are, Revenue: $ 13,033 million, Operating income: $ 2,725 million and Net income: $ 2,408.The organisat ion type is globe dual listed company, listed to NYSE: CCL, LSE: CCL, NYSE: CUK with home flagged in Miami, USA and London, UK. Though Carnival Corporation and PCL are get out listed companies having separate list of stakeholders, but own all its operating companies jointly in the theme (Carnival Corporation & PLC, 2006). The crew to passenger ratio of this organisation is 1:1 (EDGAR Online, Inc. , 2009). Among other players; Disney Cruise Line is an American cruise line company, property of The Walt Disney Company.Its Headquarter is flagged in Celebration, Florida that operates 2 ships reaching a have passenger volume of 4800, with a passenger to crew ratio 1:9. To its actual fleet, company is adding 2 more ships, which are two decks taller than the existing ones; thus expanding the business by four folds ( transfer Facts, 2009). This private organisation runs by President Tom McAlpin as part of the Walt Disney Parks and Resorts division is reckoning a Revenue: $ 35. 51 billion, Operating income: $ 7. 827 billion and Net income: $ 3.832 billion, as on 2007 (The Walt Disney Company, 2007). Norwegian Cruise Line (NCL) with the girl company NLC America, jointly owned by Star cruises and Apollo management has 50% of NLC. It is a private company flagged in Miami, Florida. The company is famous for its freestyle cruising concept with no icy time for meal, sitting arrangement or any formal dress code. 1 Its fleet size is 11 with a passenger volume of 24,807. Under expansion plan one more ship is set to sail by 2010 (Ward, 2006).As per observation, Royal Caribbean International, Carnival Corporation and PCL and Norwegian Cruise Line are thre main major players, have unique operational strategies that delineate them different to one another. Royal Caribbean retains a very compact business with large ships but small fleet size. In contrary Carnival has a Brobdingnagian brand basket with medium ships and deeper penetration. And NLC has a moderate market a nd fleet with no exceptional expansion. It is hard for Caribbean to overtake Carnival, but the concept of mega size ships of the former is creating pleonastic niche.These cruise ships follow the Shipboard construction with following positions: Commanding incumbent †CO, decision maker ships officer †XO, Command Master gaffer †CMC, Department Head †DH, Division Officer †DO, Leading Chief lower-ranking Officer †LCPO/Leading Petty Officer †LPO, unravel Center Supervisor, Damage Control Petty Officer †DCPO, Command Career counselor-at-law †CCC, Ship’s 3-M Coordinator, Ombudsman, Financial Specialist, do drugs and Alcohol Program Administrator †DAPA, feel Assurance Coordinator, Medical Department, Safety Officer, divisional Safety Petty Officer and security Manager (King, 2009).According to maritime law cruise ship are to follow the laws like, oceanic Statutes, Treaties, and Conventions, Medical Issues on Cruise Ships, P assengers with Disabilities, Injuries, Accidents, and sensual and Sexual Assaults on Cruise Passengers, Cruise Ship Fires and Collisions, Vessel Safety, Illegal Dumping, & Unsanitary Conditions (Cruise Law, 2009). For the cruise liner industry law is same in all the water body. As the cruise ships have become floating hotel, as leisure activity the industry is booming with more expansion plans despite of the economic slowdown.The only hindrance is the political instability that creates stress in regions and the companies have to cancel the port of calls for passenger’s safety, which makes many officious crews inactive in affected zones. For Allure it is a big step beforehand to compete, if not in numbers, but in size. One more sea ordain join the â€Å"Amada”. Reference Asklander, M. (2008). â€Å"M/S Allure of the Seas (2010)”. Fakta om Fartyg. Retrieved February 24, 2009, from http://www. faktaomfartyg. se/allure_of_the_seas_2010. htm. Cruiseworking. (2009). The History Of The Cruise Line Industry.Retrieved February 23, 2009, from http://www. cruiseworking. com/history. shtml Carnival Corporation & PLC. (2006). Corporate Information. Retrieved February 24, 2009, from http://phx. corporate-ir. net/phoenix. zhtml? c=200767&p=irol-prlanding Cruise Law. (2009). Links to maritime & Cruise Line associate Sites. Retrieved February 24, 2009, from http://www. cruise-law. com/links. html EDGAR Online, Inc. (2009). Edgar Pro. Retrieved February 24, 2009, from http://sec. edgar-online. com/carnival-corp/8-k-current-report-filing/2006/11/07/Section12.aspx King, K. (2009). SHIPBOARD brass AND ADMIN FUNDAMENTALS. Retrieved February 24, 2009, from http://members. tripod. com/~Motomom/104ship Plowman, P. (2006). The Chandris Liners and Celebrity Cruises. Rosenberg Publishing. Pain, J. (2006). Royal Caribbean orders $1. 24B cruise ship. The capital of Massachusetts Globe. Retrieved February 24, 2009, from http://www. boston. com/bu siness/articles/2006/02/06/royal_caribbean_orders_large_cruise_ship_1139250670/ Reed Business Information (2009). Ships operated by Royal Caribbean International.Retrieved February 24, 2009, from http://www. search2cruise. com/cruise-operator-list-7043. html Ship Facts. (2009). Disney Cruise Line. Retrieved February 24, 2009, from http://disneycruise. disney. go. com/dcl/en_US/onboard/about/listing? name=ShipFactsListingPage&bhcp=1 The Walt Disney Company. (2007). â€Å"The Walt Disney Company 2007 annual Report”. Retrieved February 24, 2009, from http://amedia. disney. go. com/investorrelations/annual_reports/WDC-AR-2007. pdf Ward, D. (2006). Complete Guide to Cruising & Cruise Ships. Singapore: Berlitz\r\n'

'Nonviolence and South Africa Gandhi Essay\r'

'War is defined a conjure up of hostility conflict or antagonism. barely this definition would be thrown excursus by a man named Mohandas Gandhi a man who would soon come to overrule India through with(predicate) the power of peace. Gandhi’s protests and courteous disobedience would soon help urinate the India we compute today.\r\nGandhi did take India top from the British however not violently as one might expect, but imperturbablely through civil disobedience. This means that laws that Gandhi and his followers would refuse to obey any laws that they viewed to be unjust, not by striking blows but by carrying on with there insouciant activities magical spell refusing to follow certain laws that they disembodied spirit practice a system of apartheid. just now keeping in mind neer to strike back but to everlastingly keep your head up and neer give up.\r\nGandhi developed this idea of civil disobedience after his experience of apartheid while in southwestwa rd Africa. Gandhi while in South Africa Gandhi witnessed first hand the commodious injustices people of color faced scarcely while walking down the street. For drill the need for a pass throw by those of color. Gandhi saw this injustice and interjected, retention a public protest animated passbooks and symbolically burning the separation between people of color in South Africa and the British.\r\nBut Gandhi did not stop there he went on to take this system of civil disobedience to India. In India he continued to gain followers and lento take back India through his peaceful movements such as his salt knock against and cloth burning. Finally over the sort of his adult life Gandhi had taken back India from the British all without India striking a blow.\r\nGandhi clearly revolutionized India into its current state through peace. Gandhi, through peace, has helped change the way we see war.\r\n'

'Barriers of Research Utilization for Nurses\r'

'C L I N I C A L N U R S I N G IS S U E S Bridging the take off: a work of nurtures’ ideas understanding restrictions to, and facilitators of, search employ in the enforce stage oscilloscope Alison Marg art Hutchinson BAppSc, MBioeth PhD Candidate, niminy-piminy Centre for treat Practice look, give lessons of assist for, University of Melbourne, Australia Linda Johnston BSc, PhD, Dip N Professor in Neonatal nurse inquiry, Royal Children’s Hospital, Melbourne, and Associate Dir el electroshock therapyroshock therapyor, Victorian Centre for breast feeding Practice inquiry, Melbourne, Australia Submitted for publication: 4 serve 2003 Accepted for publication: 29 distinguished 2003Correspondence: Alison M. Hutchinson School of care for University of Melbourne 1/723 Swanston St Carlton, VIC 3053 Australia name: ? 61 3 8344 0800 E- ring mail: [email&# adept hundred sixty;protected] com H U T C H I N S O N A . M . & J O H N S T O N L . ( 2 0 0 4 ) daybook of clinical breast feeding 13, 304â€315 Bridging the divide: a survey of take ins’ smells regarding breastworks to, and facilitators of, f all uponk manakin in the songula setting Background. to a greater extent seekers arrive at explored the ramparts to look for white plague in order to oercome them and expose st set outgies to facilitate investigate piss come on.However, the look†coiffure intermission re master(prenominal)s a resolved national for the treat profession. Aims and objectives. The aim of this reputation was to take place an understanding of perceive in? uences on take ins’ workout of inquiry, and explore what differences or commonalities exist amongst the ? ndings of this interrogation and those of studies that draw been conducted in various countries during the past 10 years. Design. makes were surveyed to beset their opinions regarding roadblocks to, and facilitators of, look for design se ssion.The instrument comprised a 29- particular authorise explorenaire, titled Barriers to search form of well behaveds and services crustal plate (BARRIERS musical de home plate leaf), an ogdoad- compass point scale of facilitators, provision for respondents to temper special barricades and/or facilitators and a serial publication of demographic questions. Method. The questionnaire was administered in 2001 to tout ensemble protects (n ? 761) running(a) at a major statement infirmary in Melbourne, Australia. A 45% reply rate was achieved. Results. Greatest restraints to look into exercise report entangle sequence constraints, want of awargonness of accessible question lit, insuf? ient agency to switch put on, light skills in detailed appraisal and privation of stick up for holdation of explore ? ndings. Greatest facilitators to enquiry practice describe include on tap(predicate)ness of more cadence to review and fulfill look ? ndings, availability of more pertinent look into and colleague embolden. Conclusion. One of the n in whatever case soon striking features of the ? ndings of the present consume is that perceptions of Australian carrys atomic number 18 remarkably consistent with inform perceptions of harbours in the US, UK and northerly Ireland during the past decade. relevance to clinical institutionalize.If the ingestion of interrogation establish in execute results in reveal outcomes for our endurings, this behoves us, as a profession, to head issues ring live for go a gullation of seek ? ndings, potentiality to 304 O 2004 Blackwell make Ltd clinical criminal maintenance for issues Barriers to, and facilitators of, search workout shift confide, snip constraints and ability to critic to separately oney appraise explore with conviction and a sense of urgency. cardinal words: barriers to inquiry example, facilitators of look for use, investigate dissemination, qu ery carrying out, investigate utilizationIntroduction and background For all everywhere 25 years seek utilization has been discussed in the hold in books with maturation enthusiasm and amid increasing c every give way(predicate)s for the workout of look into ? ndings in exert. Additionally, the distinguish- ground make out movement, which emanated in the early 1990s (Evidence-Based Medicine Working classify, 1992) has mellowedlighted the grandeur of incorporating look into ? ndings into practice. justmore, controversy meet the attainment of superior status has resulted in an outgrowth aw argonness of the look at for a search- found corpse of humpledge to underpin breast feeding practice.Gennaro et al. (2001, p. 314) compete: utilise look into in practice non lonesome(prenominal) bene? ts patients moreover withal streng in that locationfores c ar for as a profession. If breast feeding is truly a profession, and non dependable a chew over or a n occupation, suck ins cave in to be able to continually valuate the c be they give and be responsible for providing the best possible c ar. Evaluating nurse c are means that nurses too stick out to pass judgment breast feeding search and determine if in that respect is a better way to win care. Twelve years prior, Walsh & Ford (1989) warned that the nonrecreational integrity of breast feeding was threatened by dependence upon screw-based practice.Similarly, Winter (1990, p. 138) cautioned that conduct of nursing practice in this manner is ‘the antithesis of nonrecreationalism, a barrier to independence, and a detriment to property care. ’ Winter in that locationfore, recommended that nurses ‘evaluate their status as enquiry consumers, to identify problems in this area, and to gird means to better uptake look into ? ndings’ (p. 138). Evidence-based practice, which should comprise the single- cherishd assist of broad ranging sour ces of evidence, including the clinician’s expertise and patient preference (Sackett et al. , 1996), includes the substance ab ingestion of enquiry evidence as a subset (Estabrooks, 1999).ordered with the classi? cation of knowledge utilization, 3 types of query use have been outlined (Stetler, 1994a,b; Berggren, 1996). The ? rst is described as ‘instrumental use’ and involves acting on look ? ndings in explicit, direct ways, for mannikin application of question ? ndings in the victimisation of a clinical pathway. The second is termed ‘ abstract use’ and involves employ enquiry ? ndings in less speci? c ways, for example ever-changing thinking. The ? nal type of interrogation use, described as ‘symbolic use’, involves the use of question results to patronise a predetermined position.The nursing books is replete with examples of limited use of look in practice and word surrounding comprehend barriers to look utilization ( endure, 1981; Gould, 1986; Closs & Cheater, 1994; Lacey, 1994). Despite this, the phenomenon of the investigateâ€practice scuttle, the prisonbreak in the midst of the conduct of question and use of that investigate in practice, confronts an issue of major sizeableness for the nursing profession. M all searchers have explored the barriers to search uptake in order to overcome them and identify strategies to facilitate look for utilization (Kirchhoff, 1982; MacGuire, 1990; backlash et al. 1991a,b, 1995b; Closs & Cheater, 1994; Hicks, 1994, 1996; Lacey, 1994; Rizzuto et al. , 1994; Hunt, 1996; Walsh, 1997a,b). Hunt (1981) suggested that nurses fail to utilize research ? ndings because they do non know more or less them, do non understand them, do non believe them, do non know how to get into them, and are non allowed to use them. match to Hunt (1997), the barriers to research utilization and, therefore, to evidence-based practice fall into ? ve main categories: research, rile to research, nurses, operation of utilization and nerve.Self-reported utilization of research is one order that has frequently been enforced to elicit the finish of research utilization. Responses to selected research ? ndings have been use to elicit and explore respondents’ awareness and use of respective ? ndings (Kete? an, 1975; Berggren, 1996). many researchers have likewise undertaken to investigate, through ego-reporting, the opinions of nurses’ in regard to barriers to research utilization in the practice setting. ricochet et al. (1991b) explored research utilization in the US use a postal questionnaire titled the Barriers to seek practice session graduated table (BARRIERS outgo).Their purpose was to develop a pecker to assess the perceptions of clinicians, administrators and academics in regard to barriers to research utilization in clinical practice. Rogers’ (1995) impersonate of ‘diffusion of innovatio ns’, a speculative framework, which describes the process of intercourse, through certain impart at bottom a social network, of an idea, practice or object over date, was use to develop a 29- compass point scale. The questionnaire was sent out to a random sample of 5000 members of the American Nurses’ Association with a resulting answer rate of 40%. 305O 2004 Blackwell Publishing Ltd, daybook of clinical nurse, 13, 304â€315 A. M. Hutchinson and L. Johnston On the entropy generated, reverberate et al. (1991b) undertook an preliminary eventor compend, to elicit a quadruple- operator bow which closely corresponded with Rogers’ (1995) ‘diffusion of innovations’ military position. The components translated into characteristics of the adopter comprising the nurse’s research values, skills and awareness; the agreement incorporating setting barriers and limitations; the innovation including qualities of the research; and communi cation including lendableness and intromission of the research. tokens associated with the clinical setting, a characteristic of the organization, were comprehend as the main barriers to research utilization. These include the views that nurses lack suf? cient place to use potpourri; nurses have insuf? cient condemnation to go through qualify; and there is a lack of cooperation from medical cater. Approximately 21% of the respondents in this interpret were classi? ed as administrators. Over common chord quarters of the items on the BARRIERS Scale were rated as big(p) or guard barriers by over fractional the administrators. The administrators identi? d parts relating to the nurse, the organizational setting and the video display of research among the smashingest barriers. Overall, they cited the organizational setting as the broadest barrier to research use. Approximately 46% of the respondents were classi? ed as clinicians (nurses working in the clinical setting ). The clinicians overpoweringly identi? ed meanss associated with the organizational setting as being the capaciousest barriers to research utilization. They rated all eight ingredients associated with the setting in the blanket 10 barriers to research utilization.The clinicians rated comprehend ‘lack of place to change patient care procedures’, ‘insuf? cient period on the muse to implement new ideas’ and being ‘ unsuspecting of the research’ as the spinning fleet trio barriers to research utilization. The BARRIERS Scale ( squint et al. , 1991b) has been used extensively since it was authentic in 1991, as one method to explore the perceived in? uences on nurses’ utilization of research ? ndings in their practice. At least 17 studies that occupied the BARRIERS Scale to elicit opinions of nurses regarding barriers to research utilization in practice have been reported in the nursing literature.Most studies reported the barri ers in flagrant order harmonize to the percentage of respondents who rated items as moderate or owing(p) barriers. Insuf? cient time to take aim research and/or implement new ideas was rated in the top third barriers in 13 studies (Funk et al. , 1991a, 1995a; Carroll et al. , 1997; Dunn et al. , 1997; Lewis et al. , 1998; Nolan et al. , 1998; Rutledge et al. , 1998; Retsas & Nolan, 1999; Closs et al. , 2000; Parahoo, 2000; Retsas, 2000; Grif? ths et al. , 2001; fen et al. , 2001; Parahoo & McCaughan, 2001).A perceived lack of authority to change patient care procedures was reported in the top three barriers in eight studies (Funk et al. , 1991a; Walsh, 1997a; Nolan 306 et al. , 1998; Closs et al. , 2000; Parahoo, 2000; Retsas, 2000; Marsh et al. , 2001; Parahoo & McCaughan, 2001). In eight studies, the item ‘statistical analyses are not understandable’, was cited in the top three barriers (Funk et al. , 1995b; Dunn et al. , 1997; Walsh, 1997a,b; Rut ledge et al. , 1998; Parahoo, 2000; Grif? ths et al. , 2001; Marsh et al. , 2001). ‘ short-staffed facilities for carrying into action’ was cited in the top three barriers in ? e studies (Kajermo et al. , 1998; Nolan et al. , 1998; Retsas, 2000; Grif? ths et al. , 2001; Marsh et al. , 2001). Finally, the item ‘lack of awareness of research ? ndings’ was reported in the top three barriers in four studies (Funk et al. , 1991a, 1995a; Carroll et al. , 1997; Lewis et al. , 1998; Retsas & Nolan, 1999). It is acknowledged that these studies comprised varying populations of nurses, engaged differing sampling methods, used sample sizes ranging from 58 to 1368 respondents and resultant chemical reaction rates shedd from 27 to 76%.In some studies, baby recasting of a limited egress of items in the tool had been undertaken. Furthermore, some studies included and 28 of 29 barrier items included in the master copy BARRIERS Scale. cipher analysis, a statis tical technique aimed at trim the number of variables by grouping those that relate, to form sex actly independent subgroups (Crichton, 2001; Tabachnick & Fidell, 2001), was undertaken in a limited number of these studies. In the UK, Dunn et al. (1997) tried and true the element mystify proposed by Funk et al. (1991b), utilize con? rmatory element analysis, a complex statistical technique used to test a heory or present (Tabachnick & Fidell, 2001). Attempts to load each item onto a single identi? ed cistron were implant to be unsuccessful and they concluded that the US cast was in purloin for their data. Closs & Bryar (2001) come on explored the rightness of the BARRIERS Scale for use in the UK through beta chemical element analysis. The sit down identi? ed included the pursuit four brokers: bene? ts of research for practice, quality of research, accessibility of research, and resources for execution of instrument. Finally, Marsh et al. (2001) teste d, utilize con? matory element analysis, a revise version of the BARRIERS Scale. The revision comprised minor changes in wording such as reversal of the term ‘administrator’ with the term ‘ coach-and-four’. A fixings structure that was not possible to interpret resulted and they concluded that the model proposed by Funk et al. (1991b) was not back up and had limited subscale daring in the UK setting. In the light of these ? ndings and those of Dunn et al. (1997), Marsh et al. (2001) suggested that the work out model arising from the original BARRIERS Scale was not preserve in the international context.However, in Australia, Retsas & Nolan (1999) undertook an exploratory factor analysis resulting in a three-factor etymon comprising: (i) nurses’ perceptions close the usefulness of research in O 2004 Blackwell Publishing Ltd, diary of clinical nursing, 13, 304â€315 clinical nursing issues Barriers to, and facilitators of, research ut ilization clinical practice, (ii) generating change to practice based on research, and (iii) accessibility of research. A get together, in Australia, a four-factor ascendant arose from an early(a) exploratory factor analysis undertaken by Retsas (2000).The resulting factors were fantasyualized as: accessibility of research ? ndings, anticipated outcomes of using research, organizational support to use research, and support from early(a)s to use research. Given these ? ndings in the Australian context, an exploratory factor analysis was employed in the present study to explore what model would arise from data generated using the BARRIERS Scale. The aim of the present study was to gain an understanding of perceived in? uences on nurses’ utilization of research in a particular practice setting, and explore what differences or commonalities exist between the ? dings of this research and those of studies which have been conducted during the past 10 years in various countries ar ound the world. This study was undertaken as part of a too larger study designed to explore the phenomenon of research utilization by nurses in the clinical setting. The congeneric importance of barrier and facilitator items and the factor model arising from this data depart in? uence cultivation of future stages of this larger study. who then took righteousness for statistical distribution. It cannot be guaranteed, however, that this process in fact resulted in all nurses receiving the questionnaire.The questionnaire included the 29-item BARRIERS Scale in access to an eight-item facilitator scale and a serial of demographic questions. The respondents were asked to return sinless questionnaires in the addressed envelope supplied, by either placing them in the internal mail or placing them in the ‘return’ loge supplied in their ward or department. proceeds of completed questionnaires implied consent to participate and all responses were anonymous. aspect The setting for this study was a 310-bed major precept hospital fling specialist services in Melbourne, Australia. SampleApproximately 960 nurses work in the organization. All Registered Nurses working during the 4-week distribution time frame were invited to complete the questionnaire. This self-selecting, public convenience sample therefore, excluded nurses on leave at the time of the study. The study The research question addressed in this study was: What are nurses’ perceptions of the barriers to, and facilitators of, research utilization in the practice setting? Instrument The questionnaire comprised three slits. The ? rst section contained the 29 randomly ordered items from the Barriers to Research Utilization Scale (Funk et al. 1991b), which respondents were asked to rate, on a four-point Likert type scale, the extent to which they believed each item was a barrier to their use of research in practice. The options included 1 ? ‘to no extent’, 2 ? ‘to a curt extent’, 4 ? ‘to a moderate extent’ and 5 ? ‘to a large extent’. A ‘no opinion’ ? 3 option was also presumption. The respondents were then asked to nominate and rate (1 ? greatest barrier, 2 ? second greatest barrier, and 3 ? thirdly greatest barrier) the items they considered to be the top three barriers.Further to this, the respondents were given the fortune to list and rate, according to the above-mentioned Likert scale, any additional items they perceived to be barriers. The second section of the survey contained eight items (Table 4), which respondents were asked to rate according to the extent to which they considered them to be a facilitator of research utilization using the Likert scale described above. The respondents were also asked to nominate and rate, from 1 to 3, the items they considered to be the three greatest facilitators of research utilization.Again, the respondents were given the probability to list and rat e, according to the 307 Method A survey design was chosen to elicit opinions of nurses. This method was selected because the ‘BARRIERS Scale’, a validated questionnaire, based on the work of Funk et al. (1991b), and designed to elicit nurses’ views about barriers to, and facilitators of, research utilization in their practice, was found to have high reliability. Approval to use the tool was gained from the authors. Permission was also given to include questions crafted by the investigators to elicit nurses’ opinions about facilitators of research utilization.Approval to conduct the project was sought and apt(p) by the hospital research ethics committee to ensure the rights and dignity of all respondents were protected. Nurses working during the 4-week survey distribution time frame (n ? 761) were invited to complete the self-administered questionnaire. It was intended that every nurse receive a in person addressed envelope containing the questionnaire an d a self-addressed return envelope. To facilitate this, the envelopes were hand delivered to a put up nurse on each ward or department O 2004 Blackwell Publishing Ltd, daybook of clinical care for, 13, 304â€315A. M. Hutchinson and L. Johnston Likert scale, perceived facilitators not listed in the survey. Section 3 of the survey included a series of demographic questions. Validity inwardness rigorousness, i. e. whether the questions in the tool accurately pace what is sibylline to be visord (LoBiondo-Wood & Haber, 1998), of the instrument was support by the literature on research utilization, the research utilization questionnaire developed by the have a bun in the oven and Utilization of Research in breast feeding Project (Crane et al. , 1977), and data self-contained from nurses. Input was also gained from experts in the ? ld of research utilization, nursing research, nursing practice and a psychometrician to establish vista validity, i. e. whether the tool appea rs to measure the innovation intended (LoBiondo-Wood & Haber, 1998), and content validity from an extensive list of potential items. Those items for which face and content validity were established were retained. Further to originaling of the instrument, two additional items were included and some minor rewording of other items resulted. The BARRIERS Scale has been found to have good reliability, with Cronbach’s alpha coef? ients of between 0. 65 and 0. 80 for the four factors, and item- aggregate cor similaritys from 0. 30 to 0. 53 (Funk et al. , 1991b). Cronbach’s alpha is a measure of internal consistency, which is think to the reliability of the instrument. A Cronbach’s alpha of ‡0. 7 is considered to be good. Internal consistency is the extent to which items in the scale measure the same concept (LoBiondo-Wood & Haber, 1998). Item append correlations refer to the human relationship between the question or item and the total scale make believe (LoBiondo-Wood & Haber, 1998). entropy analysisData analysis was performed using statistical software package for the Social Sciences (version 10. 0; SPSS Inc. , Chic ago, IL, the States) software. Frequency and descriptive statistics were employed to describe the demographic characteristics of respondents. compend of these data indicated that a wide cross section of nursing staff responded to the questionnaire. broker analytic procedures were employed to reduce the 29 barrier items to factors. The ‘no opinion’ responses (coded to be in the centre of the scale) were included in the factor analytic procedure, on the soil of statistical advice.Suitability of the data for undertaking factor analysis is determined by examen for sampling adequacy and sphericity. The Kaiserâ€Meyerâ€Olkin Measure of sampling Adequacy at 0. 83 was in excess of the recommended value of 0. 6 (Kaiser, 1974), indicating that the 308 correlations or factor fills, which r e? ect the skill of the relationship between barrier items, were high. The bartlett pear test of sphericity at 2118. 3 was statistically signi? cant (P < 0. 001). On the basis of these results, factor analysis was considered appropriate.The factor analysis method employed consisted of asterisk division analysis (PCA), a method of minify a number of variables (barrier items) to groupings to aid description of the underlying relationships between the variables (Crichton, 2000) whilst capturing as lots of the variance in the data as possible. PCA revealed eight components with an eigenvalue exceeding one, indicating that up to eight factors could be retained in the ? nal factor solution. Inspection of the scree plot of ground, a plot of the variance encompassed by the factors, failed to provide a clear indication for the number of factors to include.Eight factors were considered too many to be meaningful, thus factor solutions from two to seven factors were explored. A soluti on comprising four factors was considered nearly meaningful. Examination of the factor loadings was then undertaken to determine which items belonged to each factor. Consistent with the procedure employed by Funk et al. (1991b), items were considered to have loaded if they had a factor loading of 0. 4 or more. Varimax rotation, a statistical method employed to simplify and aid interpretation of factors, was then applied.Whilst factor analysis assists in reducing the number of variables to groupings and aids in interpretation of the underlying structure of the data, it does not identify the congeneric importance of individual items. Thus, while one factor may account for the largest get of variance in the factor solution it does not mean that the items inside that factor are the greatest barriers to research utilization. In order to determine the relative signi? cance of each barrier item, the number of respondents who reported them as a moderate or great barrier was mensurable a nd items were social stationed accordingly.Additional barriers get into by participants were grouped thematically. Similarly, to determine the relative signi? cance of each facilitator item, the number of respondents who reported them as a moderate or great facilitator was calculated and items were siteed accordingly. Additional facilitators put d protest by participants were grouped thematically. Results Demographics A total of 317 nurses returned the questionnaires, representing a 45% response rate, assuming that all nurses did, in fact, receive a personally addressed envelope. The age range of respondents was 43 years (minimum ? 1 years, O 2004 Blackwell Publishing Ltd, journal of clinical nursing, 13, 304â€315 Clinical nursing issues Barriers to, and facilitators of, research utilization utmost ? 64 years) while the range in years since registration was 42 years. The demographic characteristics of the nurses (Table 1) were consistent with those of the State of Victoria ’s nursing workforce (The Australian be of health and benefit, 1999). agent analysis A four-factor solution was selected as the most appropriate model arising from PCA of the 29 barrier items. This accounted for 39. % of the total variance in responses to all barrier items. The factor groupings including the loading for each barrier item and the titles allocated to each factor are included in Table 2. According to the correlation coef? cient or factor loading measure of ‡0. 4, two items, ‘research reports/articles are not published libertine comme il faut’, and ‘the research has not been replicated’, failed to load on any of the four factors. Table 1 Nurse demographics (n ? 317) Variable Gender manly Female Missing Age (years) get a line Registered Nurse (years) Clinical experience (years) age since most late(a) quali? ation Highest quali? cation Division 2 certi? cate for registration Division 1 hospital certi? cate for registration T ertiary diploma/ tip for registration Specialist nursing certi? cate grad diploma get the hang by coursework Masters by research Others (including rearing and instruction quali? cations) Missing Principle job function Clinical Administrative Research genteelness Others Missing Research experience Yes No Missing N (%) Mean (SD) 24 (7. 6) 291 (91. 8) 2 (0. 6) 33. 8 (9. 73) 12. 6 (9. 95) 11. 35 (8. 8) 4. 28 (6. 52) 14 (4. 4) 23 (7. 3) 104 (32. 8) 26 34 9 1 87 (8. 2) (10. 7) (2. 8) (0. 3) (27. ) agent 1, comprising eight items with loadings of 0. 73 to 0. 43, includes items relating to characteristics of the organization that in? uence research-based change. Eight items loaded onto factor 2 with loadings of 0. 66 to 0. 40. These items are associated with qualities of research and potential outcomes associated with the carrying out of research ? ndings. factor 3 with seven items loading 0. 60 to 0. 41, relates to the nurse’s research skills, beliefs and voice limitations. work out four refers to communication and accessibility of research ? ndings onto which ? ve items loaded 0. 67 to 0. 42.The four factor groupings comprising setting, nurse, research and presentation, generated in the US study 10 years ago (Funk et al. , 1991b), were similar to groupings that arose from factor analysis in the present study (Table 2). Cronbach’s alphas were calculated for each factor generated. For factors 1â€3 the alpha coef? cients were 0. 75, 0. 74 and 0. 70, respectively, demonstrating good reliability. The alpha coef? cient for factor 4 was lower at 0. 54. The total scale alpha was 0. 86, which indicates that the scale can be considered reliable with this sample. Item-total correlations ranged from 0. 1 to 0. 60. Although a low correlation between some items and the total nominate was evident, deleting any of these items would have resulted in a decrease in reliability of the scale. Relative importance of barrier and facilitator items The percentage s of items perceived by nurses’ as great or moderate barriers are summarized in Table 3. The respondents were also given the opportunity to list and rate any additional perceived barriers not included in the questionnaire. About 27% (85) of respondents put d ingest a total of 174 barriers. However, analysis revealed that only 11% (36) of respondents actually identi? d additional barriers. The remainder had reiterated or reworded barrier items already included in the tool. The additional barrier items listed by respondents were grouped into themes, which included funding, organizational commitment, research training, slaying strategy and professional responsibility. The percentages of items perceived by nurses’ as great or moderate facilitators are summarized in Table 4. The respondents were also given the opportunity to list and rate additional perceived facilitators. Eighteen per cent (57) of respondents took the opportunity to record a total of 90 facilitators. Of these, 7. % (24) actually identi? ed additional facilitators whereas the remainder had rephrased or repeated items already included in the tool. Consistent with the themes identi? ed for the additional barriers were funding, organizational commitment, active participation in research 309 19 (6. 0) 252 28 6 10 15 6 (79. 5) (8. 8) (1. 9) (3. 2) (4. 7) (1. 9) 207 (65. 3) 105 (33. 1) 5 (1. 6) O 2004 Blackwell Publishing Ltd, diary of Clinical care for, 13, 304â€315 A. M. Hutchinson and L. Johnston Table 2 BARRIERS Scale factors and factor loadings US factor groupings Factor loadings Communalities Factor 1 Factor 2 Factor 3 Factor 4Barrier item Factor 1: Organizational in? uences on research-based change Physician pull up stakes not cooperate with writ of execution Administration allow not allow implementation The nurse does not steps she/he has overflowing authority to change patient care procedures The facilities are inadequate for implementation Other staff are not supportiv e of implementation The nurse feels results are not generalizable to own setting The nurse is unwilling to change/ punish new ideas Factor 2: Qualities of the research and potential outcomes of implementation The research has methodological inadequacies The literature reports con? cting results The conclusions pull from the research are not justi? ed The research is not applicable to the nurse’s practice The nurse is changeful whether to believe the results of the research The research is not reported clearly and readably Statistical analyses are not understandable The nurse feels the bene? ts of changing practice will be minimal Factor 3: Nurses’ research skills, beliefs and role limitations The nurse sees little bene? for self The nurse does not feel fitting of evaluating the quality of the research there is not a documented demand to change practice The nurse does not see the value of research for practice The keep down of research drill is overwhelming The nurse is isolated from cozy colleagues with whom to discuss the research There is insuf? cient time on the job to implement new ideas Factor 4: Communication and accessibility of research ? dings Research reports/articles are not readily accessible Implications for practice are not do clear The nurse is unaware of the research The relevant literature is not compiled in one place The nurse does not have time to read research setting Setting Setting Setting Setting Setting Nurse 0. 55 0. 52 0. 42 0. 42 0. 34 0. 39 0. 36 0. 73 0. 71 0. 56 0. 54 0. 53 0. 49 0. 43 0. 09 0. 10 0. 06 0. 11 0. 17 0. 30 0. 01 A0. 02 A0. 01 0. 31 A0. 04 0. 19 0. 23 0. 41 0. 09 A0. 04 0. 05 0. 33 0. 02 0. 01 A0. 09 Research Research Research innovation Research launching PresentationNurse 0. 46 0. 38 0. 44 0. 43 0. 46 0. 33 0. 33 0. 46 0. 17 0. 11 0. 11 0. 22 0. 27 0. 11 A0. 04 0. 36 0. 66 0. 59 0. 57 0. 55 0. 53 0. 49 0. 47 0. 40 0. 03 0. 12 0. 30 A0. 13 0. 32 0. 18 0. 03 0. 38 0. 00 0. 04 A0. 05 0. 25 0. 07 0. 19 0. 32 A0. 14 Nurse Nurse Nurse Nurse * Nurse Setting Presentation Presentation Nurse Presentation Setting 0. 57 0. 45 0. 35 0. 55 0. 29 0. 31 0. 38 0. 45 0. 47 0. 33 0. 25 0. 31 0. 23 A0. 04 A0. 04 0. 15 0. 05 0. 31 0. 28 0. 01 0. 06 A0. 04 0. 13 0. 22 0. 39 0. 26 0. 14 0. 47 A0. 01 0. 11 A0. 17 0. 00 0. 31 0. 09 0. 3 A0. 14 0. 60 0. 58 0. 57 0. 55 0. 51 0. 42 0. 41 0. 00 A0. 09 0. 16 0. 13 0. 26 0. 04 0. 21 0. 09 A0. 04 0. 15 0. 16 0. 31 0. 67 0. 60 0. 54 0. 45 0. 42 Two items, ‘research reports/articles are not published fast exuberant’ and ‘the research has not been replicated’, did not load at the 0. 4 take in this analysis. *The item, ‘the amount of research entropy is overwhelming’ failed to load on any factor in the Funk et al. model. process †experience, strategy to ensure project completion, implementation strategies, and professional attitude.Discussion The present study generated a four-factor solution with simil arities to that produced in the US by Funk et al. (1991b) and in the UK by Closs & Bryar (2001). The ? rst factor comprises characteristics of the organization and re? ects health professional and other resource support for change 310 associated with the implementation of research ? ndings. More broadly, the theme ‘organizational commitment’ identi? ed following analysis of the additional perceived barriers listed by respondents, appears to be associated with this factor.Organizational commitment, many respondents felt, would facilitate mobilisation of resources to promote change. Factor 2 relates to qualities of research and potential outcomes associated with the implementation of research ? ndings. This factor re? ects the nurse’s reservations about reliability and validity of research ? ndings and conclusions, O 2004 Blackwell Publishing Ltd, diary of Clinical breast feeding, 13, 304â€315 Clinical nursing issues Table 3 BARRIERS Scale items in egre gious order Barriers to, and facilitators of, research utilization Barrier items The nurse does not have time to read research There is insuf? ient time on the job to implement new ideas The nurse is unaware of the research The nurse does not feel she/he has enough authority to change patient care procedures Statistical analyses are not understandable The relevant literature is not compiled in one place Physicians will not cooperate with the implementation The nurse does not feel adapted of evaluating the quality of the research The facilities are inadequate for implementation Other staff are not supportive of implementation Research reports/articles are not readily available The nurse feels results are not generalizable to own setting The amount of research information is overwhelming Implications for practice are not made clear The research is not reported clearly and readably The research has not been replicated The nurse is isolated from knowledgeable colleagues with whom to di scuss the research Administration will not allow implementation The research is not relevant to the nurse’s practice The literature reports con? icting results The nurse feels the bene? s of changing practice will be minimal The nurse is ambiguous whether to believe the results of the research Research reports/articles are not published fast enough The nurse is unwilling to change/try new ideas The research has methodological inadequacies The nurse sees little bene? t for self There is not a documented request to change practice The nurse does not see the value of research for practice The conclusions drawn from the research are not justi? ed Reporting item as moderate or great barrier (%) 78. 3 73. 8 66. 2 64. 7 64. 1 58. 7 56. 1 55. 8 52 52 50. 8 50. 8 45. 7 45. 5 43. 3 41. 3 41 35 34. 4 34 31. 9 30. 9 30. 6 29. 4 25. 5 23. 3 22. 1 17 13. 8 Item mean score (SD) 4. 06 3. 9 3. 64 3. 51 3. 56 3. 51 3. 41 3. 3 3. 23 3. 16 3. 19 3. 09 3. 07 3. 0 3. 01 3. 16 2. 76 2. 88 2. 67 2 . 87 2. 52 2. 58 2. 81 2. 34 2. 85 2. 25 2. 27 1. 9 2. (1. 21) (1. 3) (1. 4) (1. 39) (1. 32) (1. 26) (1. 33) (1. 39) (1. 3) (1. 29) (1. 35) (1. 26) (1. 35) (1. 22) (1. 25) (1. 14) (1. 49) (1. 18) (1. 28) (1. 11) (1. 3) (1. 29) (1. 21) (1. 34) (1. 0) (1. 26) (1. 24) (1. 21) (1. 02) Responding ‘no opinion’ or non-response (%) 0. 9 1. 6 1. 6 0. 9 3. 8 13 7. 6 3. 5 8. 8 6. 3 6. 3 3. 5 6. 9 5 8. 2 26. 1 3. 8 19. 6 4. 4 18. 9 3. 5 4. 7 25. 2 2. 2 32. 5 3. 5 8. 5 1. 6 21 Table 4 Facilitator items in rank order Reporting item as moderate or great facilitator (%) 89. 6 89. 5 84. 8 82. 3 82. 0 81. 4 81. 3 78. 2 anatomy (%) responding ‘no opinion’ or non-response 8 (2. 5) 6 9 6 10 (1. 8) (2. 8) (1. 8) (3. 2)Facilitator item Increasing the time available for reviewing and implementing research ? ndings Conducting more clinically cerebrate and relevant research Providing colleague support network/mechanisms forward-looking nurture to increase your research knowledge base Enhancing managerial support and encouragement of research implementation Improving availability and accessibility of research reports Improving the understandability of research reports Employing nurses with research skills to serve as role models Item mean score (SD) 4. 52 (0. 93) 4. 39 4. 21 4. 11 4. 15 (0. 94) (1. 02) (1. 13) (1. 08) 4. 12 (1. 11) 4. 16 (1. 1) 4. 04 (1. 22) 5 (1. 5) 8 (2. 5) 9 (2. 9)O 2004 Blackwell Publishing Ltd, journal of Clinical treat, 13, 304â€315 311 A. M. Hutchinson and L. Johnston in addition to bene? ts of use of ? ndings in practice. Factor 3 boil downes on characteristics of the nurse. In particular, this factor is associated with the nurse’s beliefs about the value of research and their research skills, in addition to the limitations of their role. The fourth factor is interested with characteristics of communication. The focus of this factor centres on access to research ? ndings and understanding of the implications of ? ndings . The issues encompassed within this factor re? ect organizational barriers to access, and research presentation barriers.These factors are congruent with the concepts characterized in Rogers’ (1995) model of ‘diffusion of innovations’, including characteristics of the adopter, organization, innovation and communication, on which the BARRIERS Scale was developed. Two barrier items, ‘research reports/articles are not published fast enough’ and ‘the research has not been replicated’, failed to load suf? ciently onto a factor and were subsequently discarded. Exclusion of these items from the model re? ects their minimal signi? cance in relation to the underlying dimensions of the factors. That these items were ranked 23 and 16, respectively, is not surprising because they become less relevant when there is a perceived lack of time to read research and implement change as re? cted in the top two nominated barriers to research utilization. It is also primal to note that over one quarter of respondents selected the ‘no opinion’ option or failed to respond to twain of these items, which further suggests their lack of importance to respondents. The bulk of respondents in this study rated approximately 40% of the barriers items as moderate or great barriers. This is compared with the majority of nurse clinicians in the US (Funk et al. , 1991a) and nurses in the UK (Dunn et al. , 1997), who rated about 65% of the barrier items as moderate or great barriers. Overall, this group of Australian nurses perceived there to be fewer barriers to esearch utilization than their colleagues in the UK or US, with a mean score of 43. 7% of respondents rating all the barriers as moderate or great. In the UK (Walsh, 1997a) and the US (Funk et al. , 1991a) mean scores of 59. 8 and 55. 7%, respectively, re? ect the proportion of respondents who rated all barriers as moderate or great. contingent in? uences such as time, populat ion, nursing education programmes should be acknowledged when considering these comparisons. Content analysis of the data comprising additional perceived barriers elicited ? ve new themes respondents associated with barriers to research utilization. revise of the instrument to re? ect the themes identi? d and changes that have occurred over the past 10 years may be warranted to achieve a more valid scale for the setting in which it was used in this study. The addition of items consistent with changes in the availability of technological resources, information availability and use, and education may enhance the content validity of the scale. The rank of perceived barriers in practice resulting from this study showed considerable consistency with rankings reported in other studies, as antecedently discussed. The top three barriers reported in 12 other studies fell within the top 10 barriers identi? ed in this study. Furthermore, two of the top three barriers in an additional two stud ies fell within the top 10 barriers identi? ed in the present study. The barrier item ‘there is insuf? ient time on the job to implement new ideas’ was reported within the top three barriers in 13 studies, including this and other Australian study (Retsas, 2000). When Spearman’s rank order correlation coef? cients were generated to compare the rank ordering of perceived barriers, a bulletproof positive correlation between this and some(prenominal) other studies was evident (Table 5). Whilst acknowledging differences in nursing populations, sample size, sampling methods, response rates, and minor variations in item wording and number, this suggests a large degree of consistency regarding pick out Funk et al. (1991a) Funk et al. (1995a) Dunn et al. (1997) Rutledge et al. (1998) Lewis et al. (1998) Kajermo et al. (1998) Retsas & Nolan (1999) Parahoo (2000) Retsas (2000) Closs et al. 2000) Parahoo & McCaughan (2001) Grif? ths et al. (2001) Location USA USA UK USA USA Sweden Australia Northern Ireland Australia UK Northern Ireland UK r 0. 866 0. 779 0. 835 0. 816 0. 879 0. 719 0. 884 0. 837 0. 801 0. 762 0. 799 0. 912 P 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 0. 000 Coef? cient of termination (%) 75 61 70 66 77 52 78 70 64 58 64 83 Table 5 Barrier rank order correlations 312 O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304â€315 Clinical nursing issues Barriers to, and facilitators of, research utilization nurses’ perceptions of the relative importance of the barrier items. Marsh et al. 2001) however, caution against international comparisons with the original US data because changes in nursing education and roles, technology, funding and collaboration with other disciplines since then, may invalidate such comparisons. Nonetheless, contempt these changes, the ? ndings of the present study have consistencies with not only the US data of 1991 but also more recent st udies in the US, UK, Sweden, Northern Ireland and Australia (Table 5). Thus, notwithstanding the increasing whim of the evidence-based practice movement in recent years, the pursuit of professional status by the nursing profession, the move of nursing education to the tertiary sector, increased access to self-opinionated reviews and research databases, the research†practice gap persists.In the light of the plethora of research and theoretical literature on the researchâ€practice gap and issues surrounding research utilization, it is of concern that nurses’ perceptions of the barriers to research utilization appear to remain consistent. In particular, issues surrounding support for implementation of research ? ndings, authority to change practice, time constraints and ability critically to appraise research continue to be perceived by nurses as the greatest barriers to research utilization. This raises primary(prenominal) questions. Firstly, do such perceptions re? ect the reality of contemporary nursing? Or rather, do they represent un challenged, traditionally held and ? rmly intrench beliefs, which are founded on an understanding of nursing in a socio-historic context that is no longer relevant? If such perceptions do, in fact, re? ct the reality of flowing day nursing practice, despite the changes and come along that have been made in health care and nursing over the last decade, it behoves us, as a profession, to address the issues related to time, authority, support and skills in critical appraisal with conviction and a sense of urgency. contextual issues including the socio-political environment, organizational glossiness and interprofessional relations need to be taken into serious consideration when exploring and formulating potential strategies to overcome these barriers. The hospital in which this study was conducted has since undertaken to explore and develop strategies to address and overcome barriers to, and reinforce and st rengthen facilitators of research utilization highlighted in the ? ndings. ther studies using the BARRIERS Scale, may re? ect a response mold. That is, nurses with a positive attitude to research may have been more plausibly to complete the questionnaire. Internal consistency, the extent to which items in the scale measure the same concept (LoBiondo-Wood & Haber, 1998), of the tool was reasonable, although not as high as that reported by Funk et al. (1991b). For seven items, more than 10% of the respondents nominated ‘no opinion’ or failed to respond. Furthermore, this study was conducted in one organization; the ? ndings are therefore context speci? c, which makes it dif? cult to interpolate to other settings. However, there is consistency over ime and between countries in regard to nurses’ perceptions of the barriers to research utilization. Conclusion In order to gain an understanding of perceived in? uences on nurses’ utilization of research in a particular practice setting, nurses were surveyed to elicit their opinions regarding barriers to, and facilitators of, research utilization. Many of the perceived barriers to research utilization reported by this group of Australian nurses are consistent with reported perceptions of nurses in the US, UK and Northern Ireland during the past decade. Time was the most important barrier perceived by nurses in this study, which is re? ected by responses to the items, ‘the nurse does not have time to read research’ and ‘there is insuf? ient time on the job to implement new ideas’, resulting in them being ranked as the top two barriers to research utilization. Consistent with this ? nding was the ranking of facilitator item ‘increasing the time available for reviewing and implementing research ? ndings’ as the most important facilitator to research utilization. The employment of qualitative research methods, such as observation and interview, will contribute further to our knowledge about barriers to, and facilitators of, research utilization by nurses by allowing deeper exploration of experiences, perception and issues faced by nurses in the utilization of research in their practice.Fundamental questions about whether nurses’ perceptions actually re? ect the reality of the current context of nursing need to be further investigated. upcoming research should also examine issues surrounding the use of time by nurses. Questions exploring how practically additional time nurses require in order to read the relevant literature and how nurses can be given more time to implement new ideas, need to be addressed. Issues related to nurses’ perception of their authority to change patient care procedures, the support and cooperation afforded by doctors and others, the facilities and availability of resources, and their skills in critical appraisal, also require further 313 LimitationsReporting bias associated with the self -report method raises questions about the extent to which the responses accurately represent nurses’ perceptions of the barriers to research utilization. The low response rate achieved in this study, although consistent with response rates reported in some(prenominal) O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304â€315 A. M. Hutchinson and L. Johnston exploration. Investigation of the information-seeking behaviour of nurses, the means by which they gain and synthesize new research knowledge and the way in which they apply that knowledge to their decision making, will further contribute to our understanding of the researchâ€practice gap phenomenon.Measurement of the actual extent of research utilization by nurses in the practice setting presents a major challenge for researchers in this ? eld. Acknowledgements The authors thank Sandra Funk for her consent to use the BARRIERS Scale for the purpose of this study. We craving to acknowledge and than k the nurses who completed the questionnaire. The authors also wish to acknowledge the statistical economic aid provided by Ms Anne Solterbeck, Statistical Consulting Centre, surgical incision of Mathematics and Statistics, The University of Melbourne. Contributions Study design: LJ, AMH; data analysis: AMH; manuscript preparation: AMH, LJ; literature review: AMH. References Berggren A. 1996) Swedish midwives’ awareness of, attitudes to and use of selected research findings. Journal of mod Nursing 23, 462â€470. Carroll D. L. , Greenwood R. , Lynch K. , Sullivan J. K. , Ready C. H. & Fitzmaurice J. B. (1997) Barriers and facilitators to the utilization of nursing research. Clinical Nurse Specialist 11, 207â€212. Closs S. J. & Bryar R. M. (2001) The barriers scale: does it ‘fit’ the current NHS research culture? NT Research 6, 853â€865. Closs S. J. & Cheater F. M. (1994) Utilization of nursing research: culture, interest and support. Journ al of ripe Nursing 19, 762â€773. Closs S. J. , Baum G. , Bryar R. M. , Griffiths J. & Knight S. (2000) Barriers to research implementation in two Yorkshire hospitals.Clinical Effectiveness in Nursing 4, 3â€10. Crane J. , Pelz D. C. & Horsley J. A. (1977) Conduct and Utilization of Research in Nursing Project. School of Nursing, University of Michigan, Ann Arbor, MI. Crichton N. (2000) Information point: principal component analysis. Journal of Clinical Nursing 9, 815. Crichton N. (2001) Information point: factor analysis. Journal of Clinical Nursing 10, 550â€562. Dunn V. , Crichton N. , Roe B. , Seers K. & giveiams K. (1997) Using research for practice: a UK experience of the barriers scale. Journal of sophisticated Nursing 26, 1203â€1210. Estabrooks C. A. (1999) Will evidence-based nursing practice make practice perfect?Canadian Journal of Nursing Research 30, 273â€294. Evidence-Based Medicine Working Group (1992) A new approach to teaching the pract ice of medicine. Journal of the American aesculapian Association 268, 2420â€2425. Funk S. G. , Champagne M. T. , Wiese R. A. & Tornquist E. M. (1991a) Barriers to using research findings in practice: the clinician’s perspective. Applied Nursing Research 4, 90â€95. Funk S. G. , Champagne M. T. , Wiese R. A. & Tornquist E. M. (1991b) Barriers: the barriers to research utilization scale. Applied Nursing Research 4, 39â€45. Funk S. G. , Champagne M. T. , Tornquist E. M. & Wiese R. (1995a) Administrator’s views on barriers to research utilization.Applied Nursing Research 8, 44â€49. Funk S. G. , Tornquist E. M. & Champagne M. T. (1995b) Barriers and facilitators of research utilization. Nursing Clinics of North America 30, 395â€407. Gennaro S. , Hodnett E. & Kearney M. (2001) qualification evidencebased practice a reality in your institution: evaluating the evidence and using the evidence to change clinical practice. MCN, the America n Journal of Maternal/Child Nursing 26, 236â€244. Gould D. (1986) hug sore prevention and treatment: an example of nurses’ failure to implement research findings. Journal of progress Nursing 11, 389â€394. Griffiths J. M. , Bryar R. M. , Closs S. J. , Cooke J. , Hostick T. , Kelly S. Marshall K. (2001) Barriers to research implementation by community nurses. British Journal of Community Nursing 6, 501â€510. Hicks C. (1994) Bridging the gap between research and practice: an legal opinion of the value of a study day in developing research reading skills in midwives. Midwifery 10, 18â€25. Hicks C. (1996) A study of nurses’ attitudes towards research: a factor analytic approach. Journal of Advanced Nursing 23, 373â€379. Hunt J. (1981) Indicators for nursing practice: the use of research findings. Journal of Advanced Nursing 6, 189â€194. Hunt J. (1996) Barriers to research utilization. Journal of Advanced Nursing 23, 423â€425. Hunt J. 1997) Towards ev idence based practice. Nursing steering 4, 14â€17. Kaiser H. (1974) An world power of factorial simplicity. Psychometrika 39, 31â€36. Kajermo K. N. , Nordstrom G. , Krusebrant A. & Bjovell H. (1998) Barriers to and facilitators of research utilization, as perceived by a group of registered nurses in Sweden. Journal of Advanced Nursing 27, 798â€807. Ketefian S. (1975) Application of selected nursing research findings into nursing practice: a master copy study. Nursing Research 24, 89â€92. Kirchhoff K. T. (1982) A diffusion survey of coronary precautions. Nursing Research 31, 196â€201. Lacey A. (1994) Research utilization in nursing practice: a pilot study.Journal of Advanced Nursing 19, 987â€997. Lewis S. L. , Prowant B. F. , Cooper C. L. & Bonner P. N. (1998) Nephrology nurses’ perceptions of barriers and facilitators to using research in practice. ANNA Journal 25, 397â€405. LoBiondo-Wood G. & Haber J. (1998) Nursing Research. Methods, C ritical Appraisal and Utilization. Mosby, St Louis, MO. MacGuire J. M. (1990) Putting nursing research findings into practice: research utilization as an aspect of the management for change. Journal of Advanced Nursing 15, 614â€620. 314 O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304â€315 Clinical nursing issues Marsh G. W. , Nolan M. & Hopkins S. 2001) Testing the revised barriers to research utilization for use in the UK. Clinical Effectiveness in Nursing 5, 66â€72. Nolan M. , Morgan L. , Curran M. , Clayton J. , Gerrish K. & Parker K. (1998) Evidence-based care: can we overcome the barriers? British Journal of Nursing 7, 1273â€1278. Parahoo K. (2000) Barriers to, and facilitators of, research utilization among nurses in Northern Ireland. Journal of Advanced Nursing 31, 89â€98. Parahoo K. & McCaughan E. M. (2001) Research utilization among medical and surgical nurses: a comparison of their self reports and perceptions of barriers and facilitators. Journal of Nursing Management 9, 21â€30. Retsas A. 2000) Barriers to using research evidence in nursing practice. Journal of Advanced Nursing 31, 599â€606. Retsas A. & Nolan M. (1999) Barriers to nurses’ use of research: an Australian hospital study. International Journal of Nursing Studies 36, 335â€343. Rizzuto C. , Bostrum J. , Suter W. N. & Chenitz W. C. (1994) Predictors of nurses’ involvement in research activities. western Journal of Nursing Research 16, 193â€204. Rogers E. M. (1995) scattering of Innovations. The Free Press, New York. Rutledge D. N. , Ropka M. , Greene P. E. , Nail L. & Mooney K. H. (1998) Barriers to research utilization for oncology staff nurses and nurse managers/clinical nurse specialists. Oncology Nursing Forum 25, 497â€506.Barriers to, and facilitators of, research utilization Sackett D. L. , Rosenberg W. M. C. , Gray J. A. M. , Haynes R. B. & Richardson W. S. (1996) Evidence based me dicine: what it is and what it isn’t. British Medical Journal 312, 71â€72. Stetler C. B. (1994a) Problems and issues of research utilization. In Nursing Issues in the 1990’s (Strickland O. L. & Fishman D. L. eds). Delmar, New York, pp. 459â€470. Stetler C. B. (1994b) spook of the Stetler/Marram model for application of research findings to practice. Nursing Outlook 42, 15â€25. Tabachnick B. G. & Fidell L. S. (2001) Using multivariate Statistics. Allyn & Bacon, Needham Heights, MA.The Australian Institute of Health and Welfare (1999) National Health exertion tweet Series. Number 20 †Nursing Labour Force 1999. The Australian Institute of Health and Welfare, Canberra. Walsh M. (1997a) How nurses perceive barriers to research implementation. Nursing meter 11, 34â€39. Walsh M. (1997b) Perceptions of barriers to implementing research. Nursing Standard 11, 34â€37. Walsh M. & Ford P. (1989) Rituals in nursing: ‘we of all time d o it this way’. Nursing times 85, 26â€35. Winter J. C. (1990) Brief. Relationship between sources of knowledge and use of research findings. The Journal of Continuing Education in Nursing 21, 138â€140. O 2004 Blackwell Publishing Ltd, Journal of Clinical Nursing, 13, 304â€315 315\r\n'

'Enzyme Structure and Functions:\r'

'ENZYME STRUCTURE AND FUNCTIONS: Enzymes ar biologic catalysts. They increase the rate of replys by a instrument of between 106 to 1012 times, allowing the chemical substance replys that make life potential to take place at normal temperatures exposition of enzyme: A protein with catalytic properties due to its power of proper(postnominal) energizing is defined as an enzyme. STRUCTURE Enzymes ar proteins their function depends on its complexity. The chemical reaction takes place in a small part of the enzyme called the alive(p) site, tour the rest of the protein acts as â€Å"scaffolding”.The order and the chemical environment inside the active voice site permits a chemical reaction to proceed more(prenominal) substantially M either enzymes need cofactors (or coenzymes) to work properly. Tightly forswear cofactors ar called prosthetic groups Cofactors that atomic number 18 bound and released advantageously are called coenzymes These arse be metal ions (such as Fe2+, Mg2+, Cu2+) or organic corpuscles (such as haem, biotin, FAD, NAD or coenzyme A). Many of these are derived from dietary vitamins, which is why they are so important. The complete active enzyme with its cofactor is called a holoenzyme, maculation just the protein part without its cofactor is called the apoenzyme.HW DOES AN ENZYME WORK? 1) REACTION apparatus 2) MOLECULAR GEOMETRY REACTION MECHANISM: In any chemical reaction, a substratum (S) is reborn into a product (P) In an enzyme-catalysed reaction, the substrate first binds to the active site of the enzyme to form an enzyme-substrate (ES) complex, indeed the substrate is converted into product whilst attached to the enzyme, and finally the product is released, therefrom allowing the enzyme to start all over again An physical exercise is the action of the enzyme sucrase hydrolysing sucrose into glucose and fructose.MOLECULAR GEOMETRY The substrate mite is complementary in habitus to that of the active site. It was musical theme that the substrate exactly stopted into the active site of the enzyme molecule like a get wind fitting into a lock (the now discredited ‘lock and key’ theory). This explains enzyme specificity This explains the loss of body process when enzymes denature The Induced locomote Hypothesis : * Some proteins laughingstock change their shape (conformation) When a substrate combines with an enzyme, it induces a change in the enzyme’s conformation * The active site is then moulded into a precise conformation * Making the chemical environment suitable for the reaction * The bonds of the substrate are stretched to make the reaction easier (lowers activation efficacy) ENERGY CHANGES : cypher needed for initial reaction is known as ACTIVATION ENERGY. The larger the activation energy is, the poky the reaction will be.This is because only a some substrate molecules will contribute sufficient energy to overcome the activation energy barrier. E nzymes reduce the activation energy of a reaction so that the energising energy of to the highest degree molecules exceeds the activation energy necessary and so they can react. Factors affecting Enzymes substrate compactness pH temperature enzyme immersion inhibitors SUBSTARTE CONCENTRATION The rate of an enzyme-catalysed reaction is also affected by substrate concentration.As the substrate concentration increases, the rate increases because more substrate molecules can collide with active sites, so more enzyme-substrate complexes form. At higher concentrations the enzyme molecules become saturated with substrate, and there are few free active sites, so adding more substrate doesnt make much difference The maximal rate at infinite substrate concentration is called vmax, and the substrate concentration that gives a rate of fractional vmax is called KM.These quantities are useful for characterising an enzyme. A good enzyme has a high vmax and a low KM. pH Enzymes have an opti mal pH at which they work fastest. For most enzymes this is about pH 7-8 (normal body pH), but a few enzymes can work at uttermost(a) pH. The pH affects the charge of the amino acids at the active site, so the properties of the active site change and the substrate can no longer bind. TEMPERATURE: Enzymes have an optimum temperature at which they work fastest.For mammalian enzymes this is about 40°C. Up to the optimum temperature the rate increases geometrically with temperature. above the optimum temperature the rate decreases as more of the enzyme molecules denature. The caloric energy breaks the hydrogen bonds holding the secondary and 3rd structure of the enzyme together, so the enzyme loses its shape Q10 (the temperature coefficient) = the increase in reaction rate with a 10°C rise in temperature. ENZYME CONCENTRATIONAs the enzyme concentration increases the rate of the reaction also increases, because there are more enzyme molecules (and so more active sites), availab le to catalyse the reaction therefore more enzyme-substrate complexes form INHIBITORS Inhibitors inhibit the activity of enzymes, reducing the rate of their reactions. 2 TYPES: Competitive and non warlike COMPETITIVE: A competitive inhibitor molecule has a similar structure to the substrate molecule, and so it can fit into the active site of the enzyme. It therefore competes with the substrate for the active site, so the reaction is slower.Increasing the concentration of substrate restores the reaction rate and the inhibition is usually acting(prenominal) and reversible. NON COMPETITIVE: A non-competitive inhibitor molecule is quite several(predicate) in structure from the substrate and does not fit into the active site. It binds to another part of the enzyme molecule, changing the shape of the whole enzyme, including the active site, so that it can no longer bind substrate molecules. Non-competitive inhibitors therefore exactly reduce the amount of active enzyme.\r\n'

'Changing a Five Day School Week to a Four Day School Week Essay\r'

'Changing a vanadium typefacereal twenty- quatern hour period work calendar calendar calendar hebdomad to a basketball team dollar bill sidereal twenty- quadruplet hour period cartridge clip hebdomad to a four daylight calendar week (For schoolhousedayss) Why is our traditional five day week changing to a four day week? Any reason? A four day week would result in extra hours of work, contraceptive with family schedules and much to a greater extent. In any case what’s the problem with the five day school week? The customary five day school week should stay without any alterations. There be some(prenominal) reasons that support the understanding of having a five day school week instead of changing it into a four day school week.\r\nFirstly, people be already used to the five day week and faculty bedevil to put some swops to their symmetric habits. Secondly, parents at work would have a in truth steadfastly time to find a somebody to take care of their child (babysitter); this would be a big problem for families with no money. In the third gear reason I speak slightly the kids recreate areas. It would be a loss of time of their intrust of their extra-curricular activities that they really bang from their choice classes.\r\nThere are many another(prenominal) reasons that support the understanding of having a five day school week instead of changing it to a five day school week. concourse are already used to the five day school week since centuries and thither have non been a lot of problems with the system, so why transplant it right now? The four day week would make a big difference (bad changes) in their sleeping and eating habits(Proved out by the Canadian center for occupational health). Parents at work would as well have a hard time decision a babysitter.\r\nThey would have a hard time leaving their children alone at home. This would be a big problem for children and families who are pitiable and cannot reach a p erson to take care of their children during work. Everyone knows that breeding for children has an impact on the future of this country. Our command/ breeding system has been going on pretty nifty or let’s just verbalize progressing every day and taking a pasture brake would obviously low the percentage down of get all these things we hope for. Lots of high schools, affectionateness schools and elementary schools have game time/P. E which makes children active at least for sixty min. a day. Less activity time can organise to foaming diseases such as obesity.\r\nMany activities such as orchestra, robotics and arts are chosen by the child with their own interest. If a parent cannot afford a class (outside school) it would be hard for them to enjoy the lost time of the choice class they chose. instanter I would like to add on to a greater extent to my first reason of having a five day week instead of changing it to a four day week. All of us have been victimization t he ive day week for centuries then why change it now? The four day week baron bring a emergent change in sleep habits which in eject may take drowsiness, laziness and other factors during working hours. The four day week might also bring sudden changes in eating habits from more regular parties and unsound food.. When you have another weekend, many people oversleep. You might also develop certain health problems from oversleeping on an extra spend such as diabetes, means diseases, stress, anxiety, apnea and many more.\r\nAnother day of a holiday means more partying, and mainly eating more unhealthy food. Problems that you might develop from eating unhealthy food are: Obesity, Diabetes, bulimia, binge eating and many more. There are people out there fighting for a four day week. permit see a few of the other side’s arguments. Some say that having a four day week might help except gas money for the district. However school buses are used on weekends as a macrocosm tra nsportation even more which in turn might get the gas costs higher(prenominal) instead of saving a whole lump of money.\r\nParents also say that children would have extra extra time if allowed an extra weekend. But guess what? 70% of all kids in America would prefer to have school instead of an extra weekend. School is a place where you could interact with old friends and make hot friends! Fun activities compiled with learning. What would be a better natural selection? In conclusion I would want the school board to consider the decision of having a five day school week because of multiple reasons I told during my essay.\r\nSuch as people are already used to the five day school week, poor parents and normal parents might have a hard time at work worrying about their children at work and having a babysitter, slight education for the future, less activity time, less extra-curricular time and having less face-to-face time with the teacher. Therefore as a call to action I would go to the school board/superintendent and reject all intents of having a four day week because of these several reasons. I would also write a petition/proposal regarding to keep the 5 day school week the same. This petition would include other parents signatures who agree with me.\r\n'

'Brick & Click Essay\r'

'A brick doer a sell telephone circuit certificate, and a domestic dog doer an e-commerce website. The important choice when a new community is starting out is whether to have a brick or a click to draw in their company going. in that respect are several advantages and disadvantages to choosing either a brick or a click.\r\nOne advantage of having a brick line to begin with is that when a new company starts spate whitethorn be wary about complementary a transaction online with the company as they do not know if it is trustworthy or not when giving out peak expound and PayPal draw details and equal things. on that pointfore, by beginning with a brick put in sight groundwork deal with differents saying to facial gesture and complete the transaction straight away. There is less chance of losing money or having card details stolen if you are using them yourself, rather than relying on intumesce-nighone or something else.\r\nIf you have a problem, it is actuall y easy and simple to deal with it in a brick store where it may be difficult to get in contact with those on a click e-commerce website as you would collect to either write a letter, exercise the telephone, circularize an e-mail or wedge a complaint online on the actual website and you may not get a response. In a brick store you bear simply go into the wander and deal with it thither and do it face to face with an employee of the company.\r\nAnother advantage of a brick store is that if there is a problem with the increase you can to a fault simply return it to the store and get a change of item or your money back, online this may be a problem as it forget cost for postage and packing, it will also bugger off lots longer as well.\r\nOne of the main advantages of starting with a brick store is the possibility of hackers that could grade off consumers from purchasing items online. This therefore means that some raft choose to do their shopping in person in a retail store w here they can see what is happening.\r\nAnother advantage is that you can put your hands on a product and test it, to see if the customer likes the product. On a click store all you can do is look at an image with other details such as size and colour. You can for object lesson try on clothes in store however you have to rely on a size being the uniform as similar clothing items that you own.\r\nHowever, there are also a variety of advantages to beginning with a click store. A main one is how practically cheaper it is to simply undecided a website in comparison to a retails store. The company will not need to employ anyplace as near as the amount of people that would be employed in a retail store, as well as deporting bills for the twist and lighting and whatever else. All that is needed online is to make out the website, maintain it and update it if necessary and then people working in a warehouse to send out the products to the customers.\r\nAnother advantage is the conveni ence of a click store. This means that people can use it anytime of the day and the company don’t need anyone on the website to complete a transaction or anything like that. This means that products can be purchased and reproducible at any time that you want to pasture the internet. There is no opening and closing multiplication to a click store.\r\nFrom an e-commerce store you can hitch to see if a product is in stock on one website and then if not fitting simply browse round all the other similar websites without leaving your home and find a website that has the product in stock and purchase it. You can go to other brick stores if the product you wanted was not in one store, but it would take much longer and there is also much more companies online than there will be in the same town or city.\r\nIt is much easier to find a product online and you can simply use a search bar to enter keywords for what you are expression for and then browse all the results that it put u ps up. This will bring up hopefully what you were looking for as well as similar items which you may then prefer that you would not have known about if you had on the dot walked into a shop and bought the product. You can also pay all bills and whatever is owed from your own home online which is much easier and simpler.\r\n'

'Taiwan Living Culture\r'

' in that location is an issue comes up when chinaw atomic number 18 talks ab come out of the closet culture conservation, which is the conflict betwixt social reading and deliverance of forces dependents’ colonisations. chinaware is a place that lived by Holo, Hakka and indigenous peoples. overly indigenous people, there are many main republicers who came from mainland chinaware. Those mainlanders came with Kuomintang government for political affairs that happened in China since 1940s. Hence, correspond to indigenous people, phalanx dependents’ villages, the places mainlanders were backup, is actu tout ensembley a diminished culture in chinaware.thitherfore, there are or so problematicalies for the culture-based shop classs when they are move to protect military dependents’ villages. There is lesser population who insist to protect their culture. Moreover, a number of resident physicians were basically moved out from the villages. In this iss ue, we could study the issue with our pagan converse knowledge, oddly identify the culture element that the issue brought by. relate to the article title, preserving military dependents’ villages, the article is discussing about how the workshops trying to preserve military dependents’ villages and what are the concerns they are having.Since military dependents’ villages are minor(ip)ity culture in chinaware, as well as they are non mainland China’s local culture, we mint understand how difficult the workshops’ tasks are. Hence, preserving military dependents’ villages is an issue. This issue was discussed recently. It was being studied since 1990s. We sight that it was a trend of cultural discussion, which has no inference beginning and ending. It is generally happened in Taiwan. Those active workshops were direct much in Kaohsiung and new-fashioned capital of Taiwan urban center. There are around people who involved in this issue.First of all, there is a workshop called Association of Mainlander Formosan (AMT). It is formed in 2004. Yang Tsung-rong is maven of board of directors of AMT. He is an Associate Professor at National Taiwan Normal University in Taipei too. He give tongue to that the workshop recently focuses on conserving the unique villages. The certify involved party is Ministry of National Defense (MND). The land of dependents’ villages belongs to MND. There is a law named Act for reconstruct Old Quarters. It assures MND to have right of demolish the village after the military dependents moved out.They allow rebuild new apartments for military dependents. Sometimes, they s experient the apartments in union with National Property Act to fund the turn of apartments. The third party is Lin Fung-ching, who is a deputy unwritten sex executive of Kaohsiung Military Dependents’ Villages Culture Development Association. The workshop was formed in 2007 and operates the Kaohs iung Museum of Military Dependents’ Villages. She agreed that less-is-more system which means preserving a limited number of the lodgment areas is sufficient.She understood the government’s concern since preserving all 888 villages is a challenge of local development. Nevertheless, she stated that preserving old buildings in a village is not enough. The stern psyche is Wang He-ping, who is anformer(a) chief executive of the Kaohsiung workshop. He supports the preservation idea and aims to preserve Mingde New Village, Zuoying dominion as a â€Å" reinforcement museum” that would see villagers put out to live in the village. Visitors can move into unoccupied houses to feel their day life culture. He compound that preserving the villages is promoting â€Å"green belt” concept.It would add to Kaohsiung’s touristry resources. He said that dependents’ villages are a minority culture, but they are not a minor part of Taiwan’s cultur e. Wang Ji-xin is the fifth person who involved in this issue. He is a entry board member of the New Taipei City Military Dependents’ Villages Culture Association which formed by year 2007. The association is to preserve approximately 60 houses of Sanchong First Village. He is a former resident of the village too. He mentioned that bulldozers will also withdraw an irretrievable piece of Taiwan’s pluralistic culture.Sanchong First Village’s residents had move out and into purpose- built apartment buildings in New Taipei City by 2006. They could only make oral histories instead of make a living museum as Mingde does. Basically, Taiwan is a place that highly appreciates traditional culture. At first, they believed and followed the Chinese culture. Since 1990s, Taiwan started to focus on local culture. They appreciate Holo, Hakka and indigenous assemblys. Even Ministry of upbringing introduced the program called â€Å"Knowing Taiwan” which focused Taiwanà ¢â‚¬â„¢s history, geography and society instead of concern on mainland China.As the article mentioned, mainlanders who came to Taiwan with Kuomintang government had been allocated in certain places. They thought that staying in Taiwan was fleeting plan. However, the dream of â€Å"retaking mainland” faded and the mainlanders had to stay in Taiwan. According to government’s arrangement in 1980s, 90% of 110,000 households recorded in 1984, the dependents of mainlanders, who were military’s families, have left the villages. Nevertheless, some workshops tried to require to preserve the villages for culture conservation.At last, we found that the workshops perform so well which fight for their culture yet do not ignore the social development. What we learnt in communication and culture, we have no problem to agree that living lifestyle is one of culture definition’s elements. There is a set of pattern keep and shared human activities among a social group f rom generations to generations. In this article, the dependents’ villages are recognized culture of what we learnt in class. The military dependents’ villages were brought by mainlanders from mainland of China.They brought their families to Taiwan as well. Hence, they started bore their normal life in Taiwan generations by generations. Moreover, there are pictures of their culture proof. For the first foliate, we can see a big house built at Mingde New Village in Kaohsiung. It is for ranking(prenominal) officers. The second foliate has 5 motion-picture shows. The top one is the narrow alleys in the military dependents’ village. The photo beneath it shows the mandarin words which means â€Å"Be comfort amid confusion”. It would be probably the residents’ value oriented.The other two photos that wrote mandarin words, â€Å"One year to view ready, two years to recapture, three years to blank up and five years to finish the put-on”. The military has the purpose on recapture the mainland of China when they came to Taiwan. On the following page, there is a photo of some apartments. They are the new apartment buildings for military families such as these in Kaohsiung’s Zuoying District. We detect that the villages’ culture had been gone. The other photo in this page shows the military dependents villages’ cultural festival in New Taipei City.The fifth page showed the military uniforms and personal identity cards at the Kaohsiung Museum of military dependents’ villages. The last page showed the selection of dishes at a Kaohsiung military dependents villages’ food for thought festival in 2011 and a well-preserved living room at Sanchong First Village in New Taipei City. All of them are evidentiary culture. This issue is quite similar to Malaysia’s not to demolish Jalan Sultan case. We noticed that culture preservation is important, especially the historical buildings. We un derstand social development is important too yet there are some ways to avoid from demolishing cultural buildings.As the photo we saw in fourth page, the master copy outlook and environment was gone after the rebuilding. It will be happened in Jalan Sultan if we do not fight for the preservation of culture. It is sad if we lost our probative culture on our land. Therefore, we should appreciate our culture and approximate the other ways to avoid from demolishing our significant culture. For example, Melaka had preserved those culture buildings and items. They then become elements of tourism and improving our national incomes. Hence, we should think twice before we made the cruel decision of demolishing some precious and valuable cultures.\r\n'