Wednesday, July 31, 2019

The Life, Times, and Poetry of Federico Garcia Lorca

English 272 7 March 2012 The Life, Times, and Poetry of Federico Garcia Lorca It would be safe to say that Federico Garcia Lorca was one of Spain’s most highly touted authors. His poetry is marked by brilliance, originality, and dramatic flair; and his plays are among the best examples of twentieth century poetic drama. Lorca, the preferred name of Federico, was born in Fuente Vaqueros, a village near Granada, on June 5, 1898. His parents were Don Federico Garcia, a respected and prosperous landowner, and Vicenta Lorca.Lorca claims he received his intelligence and artistic inclinations from his mother, who was very influential in his secular upbringing. Lorca and his family moved to Granada in 1909, and this is where Lorca attended school and eventually graduated from in 1914 (Bourgoin and Byers). Lorca attended the University of Granada for a time, and then traveled to Madrid in 1919 to enter the famous Residencia de Estudiantes to continue his university work. The Residencia , or living quarters, was a center of liberal activity in generally conservative Spain.The metropolitan Madrid suited the young Lorca more so than provincial Granada, and he soon joined radical young groups of students. These groups of young students explored novel ideas and spent much of their time in the cafes of Madrid. In 1921, Lorca met Salvador Dali, also a student at the time and the two formed a personal and artistic attachment to one another. He stayed in the Residencia, except for his summers, until 1928, without ever choosing a course of study (Bourgoin and Byers).Lorca’s first published work, Impresiones y paisajes (Impressions and Landscapes), published in 1918, describes an Andalusian trip taken earlier that year. In the early 1920s, Lorca began writing poems for what would be his first important book, Canciones (Songs), which was published in 1927. Canciones reveals two strong influences on Lorca’s poetic formation: the traditional and the vanguard, call ed ultraism in Spain. He utilized the ballad, Andalusian themes, and other popular forms from the traditional style.From the vanguard, he developed the tendency toward novel and surprising metaphors, and he developed a syntax without normal connecting and relating words. In 1928, in intense personal crisis and feverish literary activity, he published Romancero Gitano (Gypsy Ballads), which gained him his international reputation. He then moved to New York in 1929 because he was suffering from serious emotional problems due to his advances on Dali were rejected. He settled into a dormitory at Columbia University where he wrote Poeta en Nueva York (Poet in New York), a book of poems so revolutionary he did not dare publish them during his lifetime.Along with his poetry, he penned many plays during his short life. In 1936, at the beginning of the Spanish Civil War, Lorca went home to Granada. While in Granada, he was taken into custody by the nationalist forces controlling the town, pe rhaps because of his personal connections, or because of his known sympathies for the Republican cause. Lorca was executed by firing squad, on the morning of August 9, 1936, ending a life of brilliance (Bourgoin, Byers). Poet in New York is one of Lorca’s most notable works.Poet in New York was written during Lorca’s ten month stent in New York City, which was supposed to be spent studying English at Columbia University. Poet in New York is divided into ten sections which correspond with five alternative moments of spiritual experiences. In section one, â€Å"Poems of Solitude at Columbia University,† Lorca is expressing his loneliness as he is lost in a strange world. In sections two and three, â€Å"The Negroes† and â€Å"Streets and Dreams† respectively, pain, spiritual vacuity and primitive passion are emanated.In sections four and five form a sort of pastoral pair and chronologically do not correspond to the actual experiences of Lorca. In sec tion six, a becalmed tone persists, but death is introduced through many subdued allusions. In section seven he refers to New York City and denounces the senseless massacre of a civilization that has destroyed life with its materialism. In section eight, Lorca expresses how there has been a betrayal of Christianity and mixes it with a prophetic vision of human slavery and war. The final two sections simply address the end of his voyage and his bright awakening.Poet in New York is full of emotion, new adventures, and awakening (Rio). Lorca penned works in what was the Modernist era and later in New York, he was slightly influenced by America’s Harlem Renaissance. It can be said that Lorca’s Modernism is somewhat different from other author’s because Lorca never traveled to Paris where many modernist authors congregated. During the 1920s, literature changed drastically after the end of World War One. Lorca rooted much of his poetry in a dreamlike state which was r etained in Poet in New York (Rogow).A loss of innocence was experienced in most poems penned by Lorca during this time and specifically in Poet in New York. Angel de Rio states, â€Å"One should not forget that Poet in New York is above all lyrical poetry of high order—poetry made, perhaps, of a different stuff from that most commonly found in the rest of Lorca’s work† (Rio). Also attesting to this loss of innocence is Virginia Higginbotham who states, â€Å"Poet in New York is the other of Lorca’s major lyric works that does not express his comic spirit† (Higginbotham).Signs of the Harlem Renaissance in his work â€Å"The Negroes,† which is a poem inside Poet in New York. In an essay by Edward Hirsch, the author states, â€Å"Lorca was deeply empathetic with the black life and announced that he ‘wanted to write the poem of the black race in North America’† (Hirsch). Poet in New York remains relevant to Lorca’s era throughout his and his era’s changes. Lorca, even throughout his travels abroad, always returned to his native land for poetical strength, inspiration, and setting. Even though he did not return in person most times, he did return in imagination, memory, and dreams.However, a 1936 return to Granada, the place he loved the most, would ultimately cause his death. Roy Campbell states in an essay about Lorca, â€Å"The cities of Granada, Cordoba, and Sevilla, the three capital cities of Andalusia, always recur in that order in the Poems of Lorca† (Campbell). Occurring most frequently in his works is Grenada, followed by Cordoba and then Sevilla. Granada and Cordoba share a sort of nostalgic, melancholy, and shadowy feel to which Lorca was greatly attracted. The majority of his poems and plays are set in one of the three towns from above.In Impressions and Landscapes, Lorca falls back on memories of an earlier trip through the Andalusian countryside. Lorca also had an obse ssion with death, which is apparent in most of his poems and plays. Talking of Lorca’s early works, Book of Poems and Gypsy Ballads, John Petrakis states, â€Å"These early poems reflected Lorca's inherent love of nature, along with his lifelong obsession with death. For him, gypsies were tragic if romantic figures doomed to die young as a result of their free spirits† (Petrakis).These gypsies is especially ironic since Lorca’s gypsies died young as he did, making it seem as if he paralleled his gypsies with himself. This excerpt from Blood Wedding, called â€Å"Lullaby,† exemplifies his obsession with death in later works. â€Å"Down he went to the river, Oh, down he went down! And his blood was running. Oh, more than the water. † Most of Lorca’s works were not totally morbid throughout the work but almost always ended with the death of the speaker or the subject of the poem or play. Works CitedBourgoin, Suzzanne, and Paula Byers. â€Å"Fe derico Garcia Lorca. †Ã‚  Encyclopedia of World Biography. 2nd ed. Vol. 9. Detroit: Gale Research, 2000. Print. Campbell, Roy. Lorca: An Appreciation of His Poetry. World Literature Criticism, Vol. 2. Ed. James Draper. Detroit: Gale Research. 1992. 1346-1349. Print. Higginbotham, Virginia. †The Comic Spirit of Federico Garcia Lorca. † Poetry Criticism, Vol. 3. Ed. Robyn Young. Detroit: Gale Research. 1991. 147-149. Print. Hirsch, Edward. â€Å"Poet in the New World. † Poetry Criticism, Vol. . Ed. Robyn Young. Detroit: Gale Research. 1991. 149-151. Print. Petrakis, John. â€Å"`Garcia Lorca' Almost Ignores The Poet's Work. †Ã‚  Chicago Tribune  [Chicago] 12 September 1997, Entertainment. Print. Rio, Angel de. â€Å"An Introduction to Poet in New York. † Poetry Criticism, Vol. 3. Ed. Robyn Young. Detroit: Gale Research. 1991. 137-144. Print. Rogow, Zack. â€Å"Lorca's Local Modernism. †Ã‚  Poetry Flash. Web. 10 Mar 2012. ;http://poetryfl ash. org/archive/? s=features;p=ROGOW-Lorcas_Local_Modernism;.

Tuesday, July 30, 2019

Rayon Fibre

Cuprammonium Rayon threads from Filter Paper AAKASH NARAYAN XII-B DON BOSCO SCHOOL i. n. d. e. x 1. Objective 2. Certificate 3. Acknowledgement 4. Apparatus 5. Chemicals 6. Summary 7. Introduction 8. Procedure 9. Precautions 10. Bibliography o. b. j. e. c. t. i. v. e To make Cuprammonium Rayon Threads From Filter Paper c. e. r. t. i. f. i. c. a. t. eThis is to certify that   Aakash Narayan,   student of Class XII B,  Don Bosco School ,Alaknanda   has completed the project titled ‘Cuprammonium Rayon Threads from Filter Paper’ during the academic year 2010-2011, towards partial fulfilment of credit for the chemistry practical evaluation of CBSE Board, and submitted satisfactory report, as compiled in the following pages, under my supervision. This project is absolutely genuine and does not indulge in plagiarism of any kind.The references taken in making this project have been declared at the end of this report. Ms. Cecilia Manichan Don Bosco School, Alaknanda a. c. k. n. o. w. l. e. d. g. e. m. e. n. t â€Å"There are times when silence speaks so much more loudly than words  of  praise to only as good as belittle a person, whose words do not express, but only put a veneer over true feelings, which are  of  gratitude at this point  of  time†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †Ã¢â‚¬  I would like to express my sincere gratitude to my chemistry teacher   Ms. Cecilia Manichan ,for her vital support, guidance and encouragement without which this project would not have come-forth.I would also like to express my gratitude to the staff of the Department of Chemistry at  Don Bosco School for their support during the making of this project. I would also like to thank my partner ,my friend Gaurab Das Gupta helping me to perform the project. Aakash Narayan XII B, Don Bosco School a. p. p. a. r. a. t. u. s 1) Conical flask (250 ml) 2) Funnel 3) Glass rod 4) Beaker (250 ml) 5) Water bath 6) Whatman Filt er paper [pic] c. h. e. m. i. c. a. l. s 1) Copper Sulphate(CuSO4 ) 2) Caustic Soda Solution(NAOH) 3) Liquor ammonia solution ) Dilute Sulphuric Acid (H2SO4) 5) Whatman Paper 6) Distilled water (H2O) s. u. m. m. a. r. y Rayon is a cellulose-based synthetic fiber . it was originally called ‘artificial silk’ or ‘wood silk’, because, it got Developed in an attempt to chemically produce silk. Rayon is a regenerated fiber. cellulose is converted to a liquid compound and then back to cellulose in the form of fiber. cuprammonium rayon is obtained by dissolving cellulose in ammoniacal copper sulphate solution. The rayon fibers have special characteristics: They are highly absorbent, ?Soft and comfortable, ? Easy to dye & ? Drape well. i. n. t. r. o. d. u. c. t. i. o. n Cellulose is nature’s own giant molecule. It is the fibrous material that every plant makes by baking glucose molecules in long chains, from seaweed to the sequoia; the chains are bound togeth er in the fibers that give plants their shape and strength. Wood is the main source of cellulose. it contains 40% to 50% cellulose. the substance must be extracted by ‘pulping’. The logs are flaked, and then simmered in chemicals that dissolve the tarry lignin, resins and minerals.The remaining pulp, about 93% cellulose, is dried and rolled into sheets-raw material for paper, rayon and other products. It can be obtained in two ways: 1. Viscose Process: Cellulose is soaked in 30% caustic soda solution for about 3 hrs. The alkali solution is removed and the product is treated with carbon di-sulphide (CS2). This gives cellulose xanthate, which is dissolved in caustic soda (NaOH) solution to give viscous solution. This is filtered and forced through a spinneret into a dilute sulphuric acid (H2SO4) solution, both of which harden the gum-like thread into rayon fibers.The process of making viscose was discovered by C. F. Cross and E. J. Bevan in 1891. 2. Cuprammonium Rayon: Cu prammonium rayon is obtained by dissolving pieces of filter paper in a deep blue solution containing tetra-ammine cupric hydroxide. The latter is obtained from a solution of copper sulphate (CuSO4). To it, ammonia solution (NH4OH) is added to precipitate cupric hydroxide (Cu(OH)2), which is then dissolved in excess of ammonia (NH3. ) Reactions: CuSO4 + 2NH4OH > Cu(OH)2 + (NH4)2SO4 (Pale Blue Precipitate)Cu(OH) 2 + 4NH4OH > [Cu(NH3) 4](OH) 2 + 4H2O [Cu(NH3) 4](OH) 2 + pieces of filter paper left for 10-15 days give a viscous solution called ‘VISCOSE’. p. r. o. c. e. d. u. r. e I. Preparation of Schweitzer’s Solution: 1) Weigh 20g of CuSO4. 5H20. [pic] 2) Transfer this to a beaker having 100ml distilled water and add 15ml of dilute H2SO4 to prevent hydrolysis of CuSO4. [pic] 3) Stir it with a glass rod till a clear solution is obtained. Add 11ml of liquor ammonia drop by drop with slow stirring. The precipitate of cupric hydroxide is separated out. [pic] ) Filter t he solution containing cupric hydroxide through a funnel with filter paper. [pic] [pic] 5) Wash the precipitate of cupric hydroxide with water until the filtrate fails to give a positive test for sulphate ions with barium chloride solution. [pic] [pic] 6) Transfer the precipitate to a beaker that contains 50ml of liquor ammonia or wash it down the funnel. The precipitate when dissolved in liquor ammonia gives a deep blue solution of tetra-ammine cupric hydroxide. This is known as SCHWEITZER’S SOLUTION. [pic] II. Preparation of Cellulose material ) After weighing 2g of filter paper divide it into very fine pieces and then transfer these pieces to the tetra-ammine cupric hydroxide solution in the beaker. [pic] [pic] 2) Seal the flask and keep for 10 to 15 days, during this period the filter paper is dissolved completely. iii. Formation of Rayon Thread 1) Take 50ml of distilled water in a glass container. To this add 20ml of conc. Sulphuric acid (H2SO4) drop by drop. Cool the so lution under tap water. In a big glass container pour some of the solution. 2) Fill the syringe with cellulose solution prepared before. [pic] ) Place the big glass container containing H2SO4 solution produced before in ice (the reaction being spontaneous results in excess release of energy in the form of heat which makes the fibers weak and breaks them). [pic] [pic] 4) Immerse the tip of the syringe in the solution and press gently. Notice the fibers getting formed in the acid bath. Continue to move your hand and keep pressing the syringe to extrude more fibers into the bath. 5) Leave the fibers in solution till they decolorize and become strong enough. [pic] [pic] [pic] 6) Filter and wash with distilled water. . r. e. c. a. u. t. i. o. n. s 1) Addition of excess NH3 should be avoided. 2) Before taking the viscose in the syringe make sure that it does not contain any particles of paper, otherwise, it would clog the needle of the syringe. 3) Addition of NH3 should be done in a fume cupboard and with extreme care. The fumes if inhaled may cause giddiness. 4) Use a thick needle otherwise the fibers won’t come out. b. i. b. l. i. o. g. r. a. p. h. y I. Google. com II. Ask. com III. Wikipedia. com IV. Comprehensive  Laboratory Manual in chemistry XII [pic][pic]

My Handsome Boy Named Scooter

My Handsome Boy Named Scooter Judith A. Bell ENG 121 Thomas, Cooper December 2, 2012 One gorgeous summer day, I decided to stop in our local Humane Society and peep in on the new dogs. It was love at first site, my handsome boy Scooter sat in the corner of the last cage I peered in. Our eyes met and we both knew he was coming home with me that very day. I put a brand new bright neon green collar and leash on him as if he and I were pro’s, it fit perfectly. I then knew we were off to a beautiful start of our relationship. I just knew we were going to become the best of friends forever.On the car ride home, he sat so adorable in the seat next to me. We both were so excited to get home, we could barely wait. It felt like we were on pins and needles all the way there. After arriving to Scooter’s new forever home, I immediately went to work on setting up the house for a puppy. Laying down puddle papers, food, and water down in certain spots is necessary. So, He could easily get used to his surroundings. He could even tell me from the start, with his amazing nose, where I put his treats. He put his front paws on the cabinet and started barking.The next day, we went out in the back yard to let Scooter experience the alluring long bladed grass. He ran and ran until his itty bitty body was plum wore out. He slept like a newborn baby that night, and from that point on, every night in his bed witch was as soft and plushy as mine. Another morning, Scooter awoke with a blissful look on his face, so I decided to capture the moment and go for a peaceful bike ride. The next thing I know, I hear a yelp like I have never heard before. He somehow got his cute little nose/mouth in the spokes.I immediately saw bright red blood, so we rushed off to the animal hospital. The vet took a look at Scooter; he then turned to tell me he lost two teeth. I felt terrible and started to cry. That’s when the vet whispered, Scooter will be just fine. I was so elated, and read y to go home. After a few months of pure bliss for us both, Scooter started running out of our yard to chase cars going by. The next thing I heard was an extremely high yelp again. A small orange as the sun, car hit my handsome boy. I tried to scoop him up to see how horrific his wounds were.I became very upset at what I saw, his back left leg was terribly hurt and that familiar smell of blood was present. This time Scooter needed stiches and a cast. The vet again whispered to me, he is a very luck boy, and must have nine lives. And again we returned home to recover from his wounds. He never has gotten the full use of his leg back since. Right away, my husband put a fence up around our whole five acres. Now that a few years have gone by my handsome boy is slowing down. He uses three legs as if he was born that way.This just shows me, that no matter how bad things can get, we can overcome anything but death. And, my handsome boy and I will be there for each other, for the rest of our lives. `All in all, my handsome boy Scooter has gone through terrible accidents, but I will always treat him as if he is my child. I rescued him, and I will continue to cherish and love every moment we have together. I recommend that everyone should adopt at least one dog in their lifetime. There will never be a dull moment, and the love you exchange is unbelievable. My handsome boy Scooter will hold a piece of my heart forever.

Monday, July 29, 2019

Geological history of Western side of North Yorkshire Essay

Geological history of Western side of North Yorkshire - Essay Example The area is largely composed of valleys which drain most of the Pennine moorland and it is composed of other smaller dales supporting the same course (Lott 1983). Generally, the geology of the area is composed of the carboniferous strata with its nature in the Lithological form experiencing successive changes right from the north of the area to the south (Dunham, Stubblefield & James 1944). This is necessitated by the fact that there are major fault lines separating the two regions forming the topography of the area in addition to the intrusion of the granite forming the deepest depth which creates the mountain ranges of the area including the Black Hills. The rocks of the area are of different ages with the old rocks majorly being composed of the lower Paleozoic age underlying the carboniferous dynamisms, which covers most of the area. The Paleozoic aged rocks, on the other hand, crop out slightly in the western fringes in form of small inliers in areas such as the craven moor, stum p cross caverns and the high crag. The opposite of the topography is the side composed of the hills with the exposure of the rocks in the west deeply buried making the two regions distinct in terms of the geological makeup (Ashbourn 2010). Furthermore, in the western side of the North Yorkshir

Sunday, July 28, 2019

Robin hood case Study Example | Topics and Well Written Essays - 250 words

Robin hood - Case Study Example As it is clear now, the band has begun to exceed food capacity, it means no more people will join the band and probably some of the ones within may also decide to leave. This will only weaken Robin against the Sheriff; hence, he needs a stronger economic background. It is a common say that two hands are better than one, and this is fact that works well for political agendas where tyranny of numbers is needed. Therefore, socio culturally, Robin needs to create a network of genuine supporters with whom they share similar agenda that they would want to change if given chance to. He therefore needs to create a very big band of men and consider involving everyone through reasonable agenda. Robin is in a point where he needs to treat all information with the importance that it requires. At this particular time, he needs to be at the receiving end of all the information around the area. He therefore needs to improve on the vigilance so that he is able to tap and filter all the important and relevant information for the purposes of his preparation. He therefore requires the use of technological advancement in the telecommunication sector to aim at achieving information vigilance. In a nutshell, Robin needs to know that he can only win his opposition to the Sheriff when working together with people. He requires a lot of transparency, togetherness and giving yourself out for the service of others. He also needs to be economically and politically empowered to blend his good and readiness to serve

Saturday, July 27, 2019

How Philosophy is Important for Undergraduate Student Essay

How Philosophy is Important for Undergraduate Student - Essay Example I use the term ‘science’ broadly here as rational and empirical investigation,† (Pigliucci n.d.). Reason is important and philosophy cannot provide concrete answers. Objection 2: Philosophy does not matter that much today as Stephen Hawking said, â€Å"Philosophy is dead. Philosophers have not kept up with modern developments in science. Particularly physics† (Warman 2011). Nowadays technological advancement prove to assist the advancement in the realm of physical science overtaking the development of philosophy as the latter cannot prove the exact answers to questions. On the contrary, Philosophy is stated, â€Å"Defining and explaining philosophy is no easy task — the very nature of the subject seems to defy description. The problem is that philosophy, in one way or another, ends up touching upon nearly every aspect of human life. Philosophy has something to say when it comes to science, art, religion, politics, medicine, and a host of other topics ,† ( n.d.). In all aspects, philosophy is the very core or basic step. I answer that, Philosophy is important due to the following reasons: All people align their everyday lives to the concept of reality that their beliefs tend to explain as they make use of metaphysical theory, ethical theory and moral theory. They need both metaphysical and moral concepts since they have the freewill and not instincts. They have the capacity to make decisions. They can also prove that throughout history human behavior and the ideas tend to explain their experiences have certain flaws. The correction is done through enough understanding of people about themselves and their surroundings by inquiring and garnering answers for philosophical and scientific questions. Curiosity is part of being a human as he tends to explore and learn about himself and the things around him. Philosophy also includes the rejection on the subjects of philosophy itself and science as they are all philosophic al in nature. They are better than doing nothing about the pursuit for knowledge. Philosophy also encompasses the ideas made by people that are subjected to conflicts toward creation of art or science (Maartensz n.d.). Reply to Objection 1: Science cannot explain the following: the existential truth like a person is not just a container of a brain and is being controlled. The moral truth also cannot be proven by science such as rape being right or wrong. Even the so-called logical truth science may have some problems to prove it like the quote Science is the only way to really know truth. No scientific test can prove the validity of such claim as it requires logic itself. Another thing is historical truth such as the winning of Barack Obama in the 2008 elections as scientific test must be repeatable and historical truth cannot be duplicated. Lastly, experiential truth cannot be verified by science such as the love of a spouse (Hewer n.d.). Reply to Objection 2: Philosophy is not dea d because science still exists. Science cannot exist without philosophy. Science has always been part of philosophy as both of them seek evidences, causations, theory creation, and hypothesis-testing as all of them are done to verify the ideas. Scientists must not ignore the philosophers as the former may fall on to fallacies (Norris 2011). How is it different from other subject areas? Objection 1:

Friday, July 26, 2019

A review of an existing IR system Essay Example | Topics and Well Written Essays - 3250 words

A review of an existing IR system - Essay Example What is more, the researcher acknowledges that each of the different information retrieval systems available have its own strengths and weaknesses, which make their use in certain context inappropriate as against other forms of use. With this in mind, the report will seek to critically describe, by coming out with a detailed descriptive account of a selected information retrieval system, which will become a basis for users of the report to make decisions on the information retrieval system. The description shall be done in accordance with how the system allows for specific information retrieval tasks to be performed. Thereafter, findings from the study shall be outlined, which shall mainly dwell on the strengths, weaknesses and areas of improvement for the selected information retrieval system. Finally, there is a realization that for every information retrieval to take place there must be a corresponding information source, which leads to the next topic of this discussion. Introduct ion to Information Retrieval and selected IR system The internet continues to dominate as an important tool in the search, retrieval and storage of information. Indeed, with the coming of the internet, there is now a centralized whole-point where almost every kind of information and data can be found (Ando and Tong, 2005a). This has been made possible because of the easily accessible nature of the internet where everyone can stay and live in the comfort of his home and input pieces of information online. Commonly, the same form of information exists online and from several sources that, when a person wants to make use of a particular line of information, the options available to choose from are more than required. Apart from the numerous natures of available options, there is also an issue with the differences with information source quality, where some sources of information can be proven to be more reliable, authentic and valid than others (van Rijsbergen, 2009). Han and George (2 000) has explained information retrieval as a conscious activity that is aimed at obtaining information resources that are highly relevant to a person’s information need from available information sources. This definition indeed gives a very broad overview of the concept of information retrieval and explains it even further. In the first place, it would be noted that information retrieval does not take place as an accidental process but as an intential process, and thus the use of the word, ‘conscious’. In effect, people who perform information retrieval are people who sit before their computers and other internet media with the mind of finding something useful for further processing. Secondly, the definitions establish that information retrieval must lead to the obtaining information that is highly relevant to a searcher’s quest. In other words, information retrieval would always lead to a pool of options for the person undertaking the search. The person performing the search thus has a role to play at that point when he is presented with the pool of options and this role is to ensure that he becomes part of the search by selecting only what is most relevant to the search. Description of selected IR system This section of the report therefore deals with a description of how PubMed has developed functionalities to help support its users with their search. This is made up

Thursday, July 25, 2019

Two articles summary ( one page for each) Article

Two articles summary ( one page for each) - Article Example He gives the example of the episode, â€Å"A Streetcar Named Marge.† The episode uses allusions to A Streetcar Named Desire, Ayn Rand, The Great Escape, and Hitchcock’s The Birds. Matheson argues that these allusions are not for satire, but to capture deep meanings and to connect them to the story and the characters. These allusions are successful in keeping the humor tight and meaningful in The Simpsons. Apart from quotationalism, hyper-ironism shows the bleak humor of the show. Matheson asserts that modern society has â€Å"a pervasive crisis of authority,† which the show also describes through its undercutting of moral positions, including its own cynicism. He says that hyper-ironism is present in how The Simpsons attacks itself for its lack of strong and clear moral values and direction. Matheson argues that The Simpsons is funny because of its combination of quotationalism and hyper-ironism that see the society as it is, filled with cold and lost people tryi ng to hang on to traditional values while adapting new ones. Walter Benjamin provides a general history of the evolution of art. He asserts that changes in the economic structure have created changes in art. Like the economic structure, art is losing its essence, or â€Å"aura,† the inner force that comes from art’s uniqueness. He argues that mechanical reproduction has destroyed art by reinforcing oppressive socioeconomic systems. Benjamin explores the loss of art in the modern mechanical age. His first main point is that technology removes the purity of art. Technology makes art reproducible or mass-produced, which destroys art’s aura. Aura is lost in mass production because authenticity cannot be reproduced as it leads to the lost authority of the original maker. His second point is that art is as oppressive as the economic structure. Art is oppressive because it puts the masses in their controlled position, as they consume symbols and images that protect

Wednesday, July 24, 2019

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

Content Analysis - Essay Example This essay shall revolve around the thesis that news coverage in two websites would be different because of the specific social, cultural, and political undertones impacting on the website. Examples from evidence gathered shall help support this thesis. This essay shall gather its evidence for 10 days by browsing through news websites to peruse political and other news. Specific news items shall be chosen and then compared to other perspectives or news items from other websites. This process shall be carried out with different websites from western and Asian settings choosing within the time period for data gathering. A comparative analysis of the news articles shall follow this data gathering process. Main Body News terms and definitions There are different terms which need to be defined before this comparative analysis can proceed. Firstly, news agenda refers to the list of news items or topics which editors would choose to follow. The news values on the other hand refer to the imp ortance which is allocated on a certain news item. Sources are the individuals and other relevant items where the information would be gathered. Aljazeera and BBC These two news outlets are considered trusted international networks with the British Broadcasting Corporation being the most extensive news outlet in the world. It is considered a public corporation with measures undertaken in order to ensure its independence from the government (Briggs, 1985). It transmits to millions of homes worldwide, including hotels, resorts, and is now easily accessed via phones. Aljazeera on the other hand is a news outlet based on Qatar and was designed mostly to focus on Arab news and events (Seib, 2008). It is also the largest news outlet in the Middle East, mostly offering an Asian, mostly Middle East Asian perspective on the news. It also runs 24 hours a day with coverage in other countries expanding through the internet (Seib, 2008). This news outlet mostly highlights a less western influenc ed perspective on current events and affairs. Aljazeera and CNN In comparing the content of Aljazeera and CNN, the Aljazeera news provides a more international variety in its news while the CNN is more US and western focused (Flournoy and Stewart, 1997). Where other perspectives on the news are sought, the reader needs to go to the regional levels of their news outlet, including CNN News Asia where the Asian news can be seen. For Aljazeera, the focus is understandably the Middle East, however, they also include the international news in their front pages (Maalouf, 2008). News Agenda The news agenda is dominated by the Syria issue. In news outlets like CNN and Aljazeera, the threat of a nuclear arms threat from Syria has been discussed, and the position of the US on the issue has been dominant in the news agenda as several related articles have been seen in the past 10 days in these news outlets. The news agenda also includes various discussions and opinions on the Syria issue from t he perspective of the US and the rest of the world, including Britain, Russia, and Syria itself. The brewing nuclear threat has been emphasized in the articles, and seems to mimic the same pathway by which the Second Gulf War with Iraq eventually unfolded, with UN nuclear inspections being suggested by the international community and demands by the US President for the international community to take more decisive actions on the issue. UN inspections have been carried out on Syria, however, the international

Cases Write Up Essay Example | Topics and Well Written Essays - 1500 words

Cases Write Up - Essay Example After 1990, worldwide software companies discovered a new phenomenon called open source business model, and they started developing and distributing open source software. These types of software are distributed free both for private and commercial use. MySQL is the world’s most popular Relational Database Management System. It provides multi-user access to, and runs as a server of, a number of databases. MySQL was first released in 23rd July in 1995 by three Scandinavian founders, Axmark, Larsson, and Widenius. The company was incorporated in 2011 as MySQL AB in Uppsala, Sweden (MySQL, â€Å"About MySQL†). MySQL used open source business model and used it as a viral marketing vehicle for penetrating in the global information technology market. For its open source status, it has gained a higher extent of visibility among the software developers community, including individuals and companies. Using the open access model, MySQL made available its products under a dual lice nsing policy allowing anyone to download them under GPL and use them for individual or commercials purposes. They required no fees for the use, and commercial users can purchase them at the minimum price, much lower than competitive market prices of other database management systems (O’Reilly 8). ... This type of business culture allowed MySQL to become a virtual organization. 120 employees of this organization are scattered across 17 countries across the world, and they efficiently communicated with each other through email and other means of internet communication. It can be stated that this model has provided the company with effective global penetration at a very low cost of operation. MySQL marketing strategy was developed based on the open source business followed by the company. The strategy was to supply a better product at a lower price. Its goal was to penetrate global information technology market to develop a positive distribution network trough a wide installed base (Krishnamurthy 11). This strategy of open source business model helped the company to achieve a tremendous growth in its specific segment of target customers. Thus, open source business model has eventually superseded more traditional business models, and the companies that implemented this model enjoyed higher demand of their open source products. Case question 2 (Google) Google is recognized as the most successful and innovative business in the current internet-based business world. Microsoft has proved its rapid growth through innovations in the sphere of computer technology, whereas Google has showed its innovation in information technology, analytical decision-making, efficient product development, experimentation and other types of relatively unusual and uncommon ways of innovation. Google has been successfully balancing innovative ideas, evaluation methods, and the use of advanced technologies for the evaluation of innovative ideas. Google has made itself recognizable as a leading exponent or a creator of new

Tuesday, July 23, 2019

Dissection and graded assignment Example | Topics and Well Written Essays - 500 words

Dissection and graded - Assignment Example A progressive disorder can be dealt with if proper genetic testing is done, but at times unpreventable diseases are found out by genetic testing. In these cases there are ethical issues which may arise. An example of an ethical issue arising due to genetic testing is the chance of someone using a person’s personal information against someone which could prove to be harmful. Hence it can be clearly stated that genetic testing is a matter of privacy and individual choice. Laws passed by HIPAA and GINA protect personal information of those being tested and eradicate the chances of discrimination (Norrgard, 2008). 1. You are an epidemiologist at a county hospital. The hospital has asked you to examine the effects of antibiotics administered to patients before surgery that involves opening of the chest cavity. The time frame for administration of antibiotics to patients before surgery is 2-hour intervals for up to 24 hours. The overall objective of the study is to reduce surgical infections and deaths associated with surgery. The hospital administration has given you 15 years to complete the study. The purpose of administering antibiotics prophylactically is important prior to any surgery. The main need for this administration is to prevent any possible post-surgery infections. The possible wound infections result in extended stays of patients at hospitals. These infections develop due to microbial virulence factors, local factors, surgical techniques and systemic factors. Over the years epidemiologists at the hospital facility worked to choose the best suitable antibiotic. The antibiotic had low toxicity and low chances of allergies. The antibiotic of choice was given 30 minutes before the surgery. The concentration of the drug given was adjusted with the duration of surgery. In surgeries which involved incising the chest cavity, the antibiotic of choice was cefazolin (Holzheimer, 2001). A comparative study was carried out between the efficacies of two

Monday, July 22, 2019

Integrating sources to support Essay Example for Free

Integrating sources to support Essay The self, for most, should be the last thing on one’s mind. Doing so will drive a person away from being self-centered or at worst selfish. People say that being self-centered is a sure way to make enemies, and to nurture the ill feelings of others. However, the self is just as important as one’s treatment of others when it comes to developing one’s sense of identity. Too much pride can be bad. Yet pride when used properly is the right antidote against self pity and the loss of identity. Confidence, self concept, and decisiveness all come from personal identity. When a person knows what he can do and what he can be, the more likely that he can be successful in his chosen field or profession. Self-concept begets him the inspiration to do something he can despite his inadequacies as a person. A strong self-concept allows a person to appreciate what he has, revert to his own self, and create something good out of the changes in him. Thus, one should strive to make a positive self concept to bear a positive identity. Despite the Odds This is the premise of Alice Walker’s Beauty When the Other Dancer is the Self. Alice, who became blind upon an accident which she decided to keep forever, lost her identity. Used to the fact that she was the cute little girl everybody admired, she was devastated to learn that her blindness changed the whole of her. She even lost the favor that she is used to getting from her father. This event instilled in her the change that forever altered her life. But Alice was able to live an almost normal life. She even had her own family, and it was in this new family that she was able to conquer her fear in herself. When she was assured by her daughter that her blindness made her special instead of different, she received a renewed view of her personal identity. What has become a shattered view of herself became whole again, and she got the affirmation that her blindness did not make her a different person. She may have been blinded, but she is the same Alice she knew herself to be. Zora Hurston’s How It Feels to be Colored Me reveals that beauty is a state of mind. Zora was black and grew up in a black neighborhood. Moving into the white’s world startled her a bit, but little had she felt that she is different from others. She knew she is colored, but she never felt it affected her substantially. Typically, an ordinary individual will create a comfort zone on the place he grew up in, and the things that she was used to do. Zora dispelled this. She knew she had to break the barriers of her comfort zone to achieve her goals. She knew that being stifled by her difference is the worst mistake she can do. And so she defied the conventions and enriched her uniqueness instead of focusing on her difference. Nancy Mairs had the same concepts. Being suddenly crippled by multiple sclerosis, Mairs found herself trapped in a situation no one will ever want but she. But Mairs was wise. She transformed her ordeal to a milestone by getting inspiration from her condition to write a piece that will both honor her condition, her newfound strength, and to inspire the many other that are in the same situation as she is. A State of Mind Searching for and finding one’s personal identity can be a positive experience for a person when the end result is a positive one. However, finding a positive identity can also be dependent on one’s view of oneself and of the occurrences in his life. A positive view of oneself is a state of mind. When one sees the good in his life and his person, despite all the bad, finding an identity can be an enriching and inspiring experience not only for himself but also for the others. The state of mind is an important aspect that every person must develop. Truly it will be hard to prepare oneself from the unexpected, but preparations are less needed as compared to reason and sound thinking. When a person can decide quickly and save himself from the psychological miseries that destiny can bring, he is a better person that the one who thoroughly prepares for the unexpected that can happen. It is by seeing the positive in one’s shortcomings that one can be truly at peace with oneself. In effect, making peace with the self can bring forth bounty because it defies all the negative energy that bad impression of self brings. It is only through inner peace that one can truly appreciate his abilities and usefulness. Through this can one be truly productive. Hidden Truths We all have our perceptions of ourselves. As with our three authors, some self concepts can be positive, some negative. While it is prescriptive to make a positive self concept, life still can be filled with surprises. As learned by Wayson Choy, there are truths in our own selves waiting to be uncovered despite all our efforts to create the most truthful self image and personal identity. These hidden truths can be squarely unfair. For Choy for instance, as he recounted in his Ten Thousand Things, the hidden truth was that the parents he knew all his life were not his own parents. As if the truth was not painful enough, his uncovering of the truth was set at the time when his parents are already dead. As a complete orphan there were only two aunts to ask, and confirm, what an interviewer revealed to him: he is an adopted. Like Zora, the revelations shattered his comfort zone a bit. The revelation was so sudden that despite the progressive turn of event it still surprised him. He prepared himself for the worst, but when the worst came he was still unprepared. Yet Choy is wise enough to accept the truth and re-create himself from that truth. This shows that every condition is a positive one when one’s state of mind is positive. Acceptance can make one get used to a condition however negative it can be. Conclusion Personal identity is important. It creates a person—his thoughts, his feelings, his whole self. Thus, it is important that one’s self concept is agreeable to him. A negative perception of self affects a person negatively. When a person feels pressured with problems and self pity, he tends to focus his strengths into his negative thoughts and will find less time and energy into transforming his ideas into tangible results. As much as identity creates a person, a person equally creates his personal identity. Self concept is a fruit of one’s view of the events that occur in his lifetime. When a person perceives the negative as challenges to overcome rather than problems that interfere to one’s goals, he gives himself a chance to use these interferences positively and this will affect him positively as well. It will be healthy for a person to nurture a positive self concept and create a unique identity inspired by his difference as compared to others. He can use these to increase his productivity and capabilities, the products of which benefits himself, others, and improves his sense of self and others perception of him.

Sunday, July 21, 2019

Two Middle Range Theory Evaluation Paper

Two Middle Range Theory Evaluation Paper The purpose of this paper is to evaluate two middle range theories abilities to test the concept of comfort for the practice question Do neonatal nurses who care for dying infants who attend an end of life care educational training program compared to neonatal nurses who do not attend the program experience a difference in comfort levels (Comfort Level for Caring for Dying Infants (CLCDI)) when caring for a dying infant? A summary of two middle range theories the Comfort Theory (Kolcaba, 1994) and the Theory of Self-Efficacy (Resnick, xxxx) will be summarized and then critiqued using Smith and Liehrs (xxxx) Framework for Evaluating Middle Range Theory. The discussion will conclude with a summary of strengths and weakness of the theories and a research hypothesis to reflect that reflects the most appropriate theories conceptual definitions and propositions. Introduction Background Despite nurses as frontline caregivers for dying patients and their families many nurses have identified that they struggle with the responding adequately to the emotional devastation to parents and siblings when caring for a neonate with an unresolved terminal condition (Frommet, 1991). With the advances in neonatal care and life sustaining treatments, sick and very preterm infants do not often die in utero, at birth, or shortly after birth, but instead they often live much longer in a healthcare paradigm of comfort care and dignified death. This relatively new emersion of the end of life model integrates a more holistic approach which considers a more comprehensive view of the patients needs (emotional, spiritual, and medical) (Mallory, 2002; Mallory, 2003; WHO, 2002). With this paradigm shift, health care professionals are obligated to assess the adequacy of their own knowledge, attitudes, and beliefs about death and dying. Multiple studies regarding nurses preparation for dealing with death and dying have consistently found that nurses that nurses do not feel educationally prepared to care for dying patients and insist that healthcare professionals should receive additional education on end of life care to bridge the deficit gap (Frommet, 1991; Robinson, 2004; White, Coyne, Patel, 2001; Beckstrand, Callister, Kirchhoff, 2006). These findings have led to a further observation that nurses caring for these complex patients regularly experience moral distress from competing principles of their personal, collegial, organizational, and religious/spiritual ethics (Frommet, 1991). Practice Problem To help ease this moral distress an evidence based end-of -life educational training program for NICU nurses has been successfully implemented in several neonatal intensive care units (NICUs) to increase the nurses comfort level of caring for neonates and their families at the end of life (Bagbi, Rogers, Gomez, McMahon, 2008). To determine if an evidence based end of life educational program impacts nurses comfort levels in caring for dying infants and their families a question was developed using the population (P) intervention (I) compared to (C) outcome (O) format (Newhouse, Dearhold, 1997). The following discussion will focus on this PICO question Do neonatal nurses who care for dying infants who attend an end of life care educational training program compared to neonatal nurses who do not attend the program experience a difference in comfort levels (Comfort Level for Caring for Dying Infants (CLCDI)) when caring for a dying infant? During the intervention a monthly 1 hour, neo natal end of life education program will be conducted over a 6 month period of time based on research about what nurses would like to know about caring for a dying infant (Robinson, 2004). For the purpose of this problem, comfort is defined as the ability of the NICU nurse(s) to show adequate knowledge and skills in providing neonatal end of life care for dying babies and their families. For this problem comfort will be measured as a score on the ordinal scale of Comfort Level Caring for Dying Infants (CLCDI). The instrument consisting of 15 items, measured on a 5 point Likert type scale equates scores of 1=never; 2=rarely; 3=sometimes; 4=often, 5=always measures the level of comfort a NICU nurse has caring for dying infants as opposed to their perception toward pediatric or neonatal end of life care (Bagbi, Rogers, Gomez, and McMahon, 2008). In evaluating the score, the higher the reported score the greater level of comfort NICU nurses have in caring for dying babies. Testing the Concept of Comfort A portion of Kolbacas (1991) Theory of Comfort and Resnicks (2008) Theory of Self-Efficacy, two middle range theories, will be used to test the concept of comfort for providing an organizing structure. Based on previous studies about nurses comfort when caring for patients, propositions five and six of Kolbacas Theory of Comfort seem to be a promising fit for this problem (Kolbaca, 1991, Kolbaca, XXX). These propositions collectively propose that patients, nurses, and other members of the healthcare team agree upon desirable and realistic health seeking behaviors (HSBs) and if enhanced comfort is achieved, patients, family members, and/or nurses are strengthened to engage in HSBs, comfort is further enhanced (Kolbaca, 1991). However, comfort as defined conceptually in this case as knowledge and skill can alternatively be equated with a sense of competence or self-efficacy of the NICU nurse to care for a dying infant and their family. There are many examples in the nursing literature linking self-efficacy to knowledge and skill (xxxx, xxxxx).) Self-efficacy, knowledge, and skills are also central to Banduras theory, which is the basis for Resnicks (xxxx) Self-Efficacy theory. Self-efficacy as described in Resnicks (xxxx) Theory of Self-Efficacy for this context is described as the judgment about the nurses ability to organize and execute a course of action required to attain designated types of performances. The theory states that perceived self-efficacy, defined as the individuals judgment of his or her capabilities to organize and execute courses of action, is a determinant of performance (Resnick, xxxx). Self-efficacy beliefs provide the foundation for human motivation, well-being, and personal accomplishment (Resnick, xxxx). According to Resnick (XXXX) theory individuals with higher levels of self-efficacy for a specific behavior (caring for a dying infant) are more likely to attempt that behavior. There are many examples in the literature using the Theory o f Self-Efficacy to support nursing education interventions (xxxxx, xxxxx). For these reasons, Resnicks Theory of Self-Efficacy (xxx) will be used to test the concept of nurses comfort or knowledge and skill (self-efficacy) in caring for dying infants and their families. The purpose of the following discussion is to summarize, describe, analyze, and evaluate these theories using the Framework for the Evaluation of Middle Range Theories (Smith, 2008) and conclude with a synthesis and research hypothesis to reflect conceptual definitions and propositions of the theory with the best fit. Theory Summaries: Comfort and Self-Efficacy Kolcabas Comfort Theory The Comfort Theory is a humanistic, holistic, patient need based nursing derived middle range theory (Kolbaca, xxxx). The concept of comfort has had a historic and consistent presence in nursing. In the early 1900s , comfort was considered to be a goal for both nursing and medicine, as it was believed that comfort led to recovery (McIlveen Morse, 1995). Over time comfort has become an increasingly minor focus, at times reserved only for those patients for whom no further medical treatment options are available (McIlveen Morse, 1995). The term comfort is used as a noun (comforter), adjective (comforting), verb (to comfort), or adverb (comfort the patient) (xxx). It is also used as a negative (absence of discomfort), neutral (ease), or positive (hope inspiring). Webster (1990) defines comfort as relief from distress; to soothe in sorrow or distress; a person or thing that comforts; a state of ease and quiet enjoyment free from worry; anything that makes life easy; and the lessening of misery or grief by calming or inspiring with hope. The origin of comfort is confortrare which means to strengthen greatly(Kolcaba, 1992). Based on the diversity of these terms comfort is a complex term. Kolcabas (1991) concept analysis of comfort helped to clarify the role of comfort as a holistic concept for nursing. This review confirmed that comfort is a positive concept and is associated with activities that nurture and strengthen patients (David, 2002). Over a period of years and revisions Kolcaba (1994) developed the comfort the ory which continues to evolve and change with changes as recent as 2007 (Figure 2). Kolcaba (1994, 2001, 2003) has defined comfort as the immediate state of being strengthened through having the human needs for relief, ease, and transcendence addressed in four contexts of experience (physical, psychospiritual, sociocultural, and environmental). The terms relief, ease, and transcendence are types of comfort that occur physically and mentally (Figure 2). The terms are defined based on definitions from medicine, theology, ergonomics, psychology, and nursing (Kolcaba Kolcaba, 1991). Relief is the state of having a discomfort mitigated or alleviated. Ease is the absence of specific discomforts. Transcendence is the ability to rise above discomforts when they cannot be eradicated or avoided (e.g., the child feels confident about ambulation although (s)he knows it will exacerbate pain). Transcendence, as a type of comfort, accounts for its strengthening property and reminds nurses to never give up helping their children and family members feel comforted. Interventions for increasing transcendence can be targeted to improving the environment, increasing social support, or providing reassurance. The three types of comfort occur in four contexts of experience: physical, psychospiritual, sociocultural, and environmental. These contexts were derived from an extensive review of the nursing literature on holism (Kolcaba, 1992). When the three types of comfort are juxtaposed with the four contexts of experience, a 12-cell grid is created, which is called a taxonomic structure (TS) (Figure 1) . Taken together, these cells represent all relevant aspects (defining attributes) of comfort for nursing and demonstrate the holistic nature of comfort as an important goal of care. All comfort needs can be placed somewhere on the taxonomic structure, and the cells are not mutually exclusive. A sample pediatric case study using the TS as a guide for a holistic comfort assessment is demonstrated below (see Figure 1). The concepts for the middle range for Comfort Theory include comfort needs, comfort interventions, intervening variables, enhanced comfort, health-seeking behaviors, and institutional integrity (Kolcaba, 1994). All of these concepts are relative to patients, families, and nurses (Kolcaba, 2003; Kolcaba, Tilton, Drouin, 2006). There are eight propositions which link the above concepts together. All or parts of the Comfort Theory can be tested for research (Peterson Bredow, 2010). In the comfort theory, Kolcaba asserts that when healthcare needs of a patient are appropriately assessed and proper nursing interventions carried out to address those needs, taking into account variables intervening in the situation, the outcome is enhanced patient comfort over time (Kolcaba, 2007). Once comfort is enhanced, the patient is likely to increase health-seeking behaviors. These behaviors may be internal to the patient (eg, wound healing or improved oxygenation), external to the patient (eg, active participation in rehabilitation exercises), or a peaceful death. Furthermore, Kolcaba asserted that when a patient experiences health-seeking behaviors, the integrity of the institution is subsequently increased because the increase in health-seeking behaviors will result in improved outcomes. Increased institutional integrity lends itself to the development and implementation of best practices and best policies secondary to the positive outcomes experienced by patients (Kolcab a, 2007). To translate the concepts to practice the effectiveness of a holistic intervention can be targeted to the taxonomic structure for enhancing comfort in a specific patient, family, or nurse population over time. Holistic comfort is defined as the immediate experience of being strengthened through having the needs for relief, ease, and transcendence met in four contexts of experience (physical, psychospiritual, social, and environmental).The comfort theory has been operationalized in many research settings with a variety of patient and target populations ranging from end of life care to the comfort of nurses (xxxx). Resnick Theory of Self-Efficacy Self efficacy is described as a way to organize an individuals judgment of his or her capability to execute a course of action. The Theory of Self-efficacy states that self-efficacy expectations and outcome expectations are not only influenced by behavior, but also verbal encouragement, reflective thinking, physiological sensations and role or self-modeling (Bandura, 1995).. Through self evaluation an individual judges their capability to perform and established self expectations which is visually depicted in the conceptual model (Appendix 2) (Resnick, 2008). Resnicks Theory of Self Efficacy is based on Banduras social cognitive theory and conceptualizes person-behavior-environment as triadic reciprocity the foundation for reciprocal determinism (Bandura, 1977, 1986). Most of the research into self-efficacy beliefs among older adults has been quantitative and has consistently supported the influence of those beliefs on behavior. However, it has not been established how efficacy beliefs actually influence motivation in older adults, or what sources of efficacy-enhancing information help strengthen those beliefs. Kolcabas Comfort Theory: Description, Analysis, and Evaluation Theory Description Historical context. The Comfort Theory is a humanistic, holistic, patient need based nursing derived middle range theory (Kolbaca, xxxx). The concept of comfort has had a historic and consistent presence in nursing. In the early 1900s , comfort was considered to be a goal for both nursing and medicine, as it was believed that comfort led to recovery (McIlveen Morse, 1995). Over time comfort has become an increasingly minor focus, at times reserved only for those patients for whom no further medical treatment options are available (McIlveen Morse, 1995). The term comfort is used as a noun (comforter), adjective (comforting), verb (to comfort), or adverb (comfort the patient) (xxx). It is also used as a negative (absence of discomfort), neutral (ease), or positive (hope inspiring). Webster (1990) defines comfort as relief from distress; to soothe in sorrow or distress; a person or thing that comforts; a state of ease and quiet enjoyment free from worry; anything that makes life easy; and the lessening of misery or grief by calming or inspiring with hope. The origin of comfort is confortrare which means to strengthen greatly(Kolcaba, 1992). Based on the diversity of these terms comfort is a complex term. Kolcabas (1991) concept analysis of comfort helped to clarify the role of comfort as a holistic concept for nursing. This review confirmed that comfort is a positive concept and is associated with activities that nurture and strengthen patients (David, 2002). Over a period of years and revisions Kolcaba (1994) developed the comfort the ory which continues to evolve and change with changes as recent as 2007 (Figure 2). Structural Components. Assumptions. Kolcabas Theory of Comfort (1994) makes four basic assumptions about reality. She assumes that humans beings have holistic responses to complex stimuli; comfort is a desirable holistic state that is germane to the discipline of nursing; human beings actively strive to meet, or to have met, their basic comfort needs, and that comfort is more than the absence of pain, anxiety, and other physical discomforts (Kolcaba , 2009). Concepts. Kolcaba defines six concepts of comfort which are relative to patients, families, and nurses (Table 1) . The term family, as defined by Kolcaba (2003) encompasses significant others as determined by the patient (Kolcaba, 2003; Kolcaba, Tilton Drouin, 2006). The first concept is of comfort needs which is the relief/ease/transcendence in physical, psychospiritual, sociocultural and environmental contexts of human experience. Comfort interventions in the model are defined as interventions of the health care team specifically targeting comfort of the patient, family and nurses. Intervening variables are positive or negative factors over which the health care team has little control, including physical limitations of the hospital or patients home, cultural influences, socioeconomic factors, prognosis, concurrent medical or psychological conditions. Health-seeking behaviors are those behaviors of patient, family or nurses (conscious or unconscious) which promote well-being; may b e internal, external or towards promoting a peaceful death. The final concept, institutional integrity, added in most recently, are values, financial stability and wholeness of health care facilities at the local state or national levels. Propositions. To help test the concept of nurses comfort caring for dying infants, propositions five and six of Kolcabas comfort theory are examined. These propositions state that patients, nurses, and other members of the healthcare team agree upon desirable and realistic health seeking behaviors (HSBs) (five) and if enhanced comfort is achieved, patients, family members, and/or nurses are strengthened to engage in HSBs, which further enhances comfort (six). These propositions provide rationale for why nurses and other health care professionals should focus on the patient, family, or in this case the nurses comfort beyond altruistic reasons. Because health seeking behaviors include internal and external behaviors almost any health-related outcome important in a healthcare setting can be classified as a health seeking behavior (Peterson Bredow, 2010). The desirable and realistic health seeking behavior (HSB) for this study is nurses comfort (knowledge and skills) to relieve moral di stress in caring for a dying infant and their family. Several studies support that moral and other types of distress are frequently observed in nurses who care for dying infants (Frommet, 1991) and most importantly indicate that nurses are seeking education regarding patient end of life issues (XXXXX). It is believed that reducing this distress and frustration can be affected through an effective end of life educational programs and is likely to improve the knowledge and skills nurses need to help increase their comfort level in caring for dying infants (xxxxx). Functional Components. Visualizing the concepts in the conceptual model, the Theory Analysis and Evaluation To analyze and evaluate Kolcabas Comfort Theory (1994) the substantive foundation, structural integrity, and functional adequacy of the theory using Smith and Liehrs (2008) Framework for the Evaluation of Middle Range Theories is discussed below (Appendix 1). Substantive foundations. Assessing the substantive foundation of a middle range theory is based on four criteria (Smith, 2003). The first criterion evaluates whether the theory is within the focus of the discipline of nursing. Kolcabas comfort theory successfully addresses four concepts comprising the metaparadigm of nursing, defining the concepts as they correspond to the theory (Dowd, 2002; Kolbaca, 2007) as well as presents a diagram of how the Comfort Theory relates theoretically to other nursing concepts (Figure 2) (Kolcaba, 1994) . Nursing is described as the process of assessing the patients comfort needs, developing and implementing appropriate nursing interventions, and evaluating patient comfort following nursing interventions. Person is described as the recipient of nursing care; the patient may be an individual, family, institution, or community. Environment is considered to be the external surroundings of the patient and can be manipulated to increase patient comfort. Fi nally, health is viewed as the optimum functioning of the patient as they define it. The ability of the framework to suggest interventions that help guide nursing interventions to increase comfort supports the discipline of nursing, and in doing so meeting the first criteria. The second criterion evaluates whether the assumptions are specified and congruent with the focus. The four assumptions in the Comfort Theory are explicitly stated and so meet the second criteria. Comfort theory (xxxx) assumes that humans beings have holistic responses to complex stimuli; comfort is a desirable holistic state that is germane to the discipline of nursing; human beings actively strive to meet, or to have met, their basic comfort needs, and that comfort is more than the absence of pain, anxiety, and other physical discomforts (Kolcaba , 2009). Because the Comfort Theory (XXXX) substantially describes the concept of comfort at the middle range level of discourse, the third criterion of the substantive foundation is met. Kolcabas (1991) concept analysis of comfort helped to clarify the role of comfort as a holistic concept for nursing. This review confirmed that comfort is a positive concept and is associated with activities that nurture and strengthen patients (David, 2002). The Comfort Theory provides an excellent description, explanation, and interpretation of the comfort concept in multiple domains and practice settings. Comfort theory is at the middle range level in that is defined in a measurable way and can be operationalized in both research and practice settings. The final criterion for this category evaluates if the origins are rooted in practice and research experience. The Comfort Theory has been used in numerous practice and research settings to provide a framework where patients have comfort needs and enhancing their comfort is valued. It has also been used to enhance working environments, especially for nurses, and most recently as a framework for working toward national institutional recognitions. More specifically parts are all of the theory have been used to test the effectiveness of holistic interventions for increasing comfort (xxxxxxx), to demonstrate the correlation between comfort and subsequent HSBs (xxxxx) and to relate HSBs to desirable institutional outcomes. It has also been used as a framework for helping families make difficult decisions about end of life (xxxxx). International and national healthcare institutions have also used Comfort Theory to enhance the work environment for nurses (xxxx). In these cases, nurses comfo rt is of interest and is theoretically related to the integrity of the institution. Summarize specific studies and tools used here. Structural integrity. There are four criterion for evaluating structural integrity. The first criterion is that the concepts are well defined. The concepts (defined above) of comfort needs, comfort interventions, intervening variables, enhanced comfort, health-seeking behaviors, and institutional integrity are clearly defined and easy to understand. There are numerous examples of applying the concepts in the literature for further clarification (xxxxx). The second criterion of structural integrity is that concepts within the theory are at the middle range level of abstraction. The concepts of the Comfort Theory-comfort needs, comfort interventions, intervening variables, enhanced comfort, health seeking behaviors, and institutional integrity are near the same level on the ladder of abstraction at the middle range level. They are more concrete because they can and have been operationalized and measured (xxxxx). The third criterion of structural integrity is that there are no more concepts than needed to explain the phenomena. Overall, the concepts adequately explain the phenomena of comfort. The theory is synthesized and organized in a simple manner. Lastly, the fourth criterion evaluates whether the concepts and relationships among the concepts are logically presented with a model. In the Comfort Theory (1994) model the ideas are integrated to create an understanding of the whole phenomenon of comfort in a model. The Comfort Theory (1994) model is a great example of presenting the concepts and statements in a linear logical order so the appreciation of the theory can be recognized (Smith, 2003). Functional adequacy. Because the criterion for functional adequacy overlap somewhat the five criterion will be discussed collectively. The five criterion include: theory can be applied to a variety of practice environments and clients; empirical indicators have been identified; published examples exist of research and theory in practice; and that the theory has evolved through scholarly inquiry. The Comfort Theory easily meets all of these criterions. For example, the Comfort Theory has been used widely in a variety of research in practice settings and patient and family populations. Even though the Comfort Theory has been used most widely with patients and families at the end of life and surrounding holistic palliative care nursing interventions, there has been a broad application of the theory in other populations as well including mothers in labor (xxxx), Alzheimer patients (xxxx), pediatric intensive care unit patients and families (xxxx), patients on bedrest (xxxx), those underg oing radiation therapy (xxxx) and for infants comfort and pain (xxxx). Most recently research of using the theory in practice has expanded to support institutional nursing recognition and comfort in the nursing working environment. In each of the populations mentioned above a psychometric comfort instrument has been developed as empirical indicators of concepts in the theory. However, the empirical indicators extend beyond empiricism and some include perceptions, self reports, observable behaviors and biological indicators (Ford-Gibloe, Campbell, Berman, 1995; Reed, 1995). The Comfort Theory (1994) has also been revised with the latest revision in 2007. The empirical adequacy of the Comfort Theory is evidence of the maturity of this theory (Smith, 2003). Summary The Comfort Theory (1994) is a well defined and well tested theory. Its strength lies in the versatility, adaptability, and testability of the concepts. The comfort theory clearly defines the concepts in the theory and the relationship between them. Because the comfort theory meets most of the substantitive foundations, structural integrity, and functional adequacy criteria the Comfort Theory (1994) is a strong middle range theory. An area that could increase the generalizability especially for nursing institutions is a change in the term in the model of nursing interventions to comfort interventions (xxxxx). Resnicks Self-Efficacy Theory: Description, Analysis, and Evaluation Theory Description Historical context. Resnicks Theory of Self Efficacy is based on Banduras social cognitive theory and conceptualizes person-behavior-environment as triadic reciprocity the foundation for reciprocal determinism (Bandura, 1977, 1986). The cognitive appraisal of these factors results in a perception of a level of confidence in the individuals ability to perform a certain behavior. The positive performance of this behavior reinforces self-efficacy expectations (Bandura, 1995). Structural Components. Although it is not explicitly stated, the core of this theory assumes that people can consciously change and develop or control their behavior. This is important to the proposition that self-efficacy also can be changed or enhanced through reflective thought, general knowledge, skills to perform a specific behavior, and self influence. This perspective is rooted in the model of triadic reciprocality (foundation for reciprocal determinism) in which personal determinants (self-efficacy), environmental conditions (treatment conditions) and action (practice) are mutually interactive influences. Therefore, improving performance depends on changing some of these influences (Bandura, 1977). In order to determine self-efficacy an individual must have the opportunity for self evaluation to evaluate how likely it is he or she can achieve a given level of performance. Concepts. The two major components of self efficacy include self-efficacy expectations and outcome expectations (Table 2). Self-efficacy expectations are judgments about the personal ability to accomplish a given task. Outcome expectations are judgments about what will happen if a given task is accomplished. These two components are differentiated because individuals can believe a certain behavior will result in a specific outcome, however, they may not believe they are capable of performing the behavior required for the outcome to occur (Bandura 1977, 1986). For example, a NICU nurse may believe attending an end of life education series will increase his/her knowledge and skill and ease moral distress, but may not believe that they could provide sensitive care for some ethical, religious, or moral reason. It is generally anticipated, but not always realistic that self-efficacy will have a positive impact on behavior. There are times when self-efficacy will have no or a negative impa ct on performance (Vancouver, Thomspon, Williams, 2001). Bandura (1977, 1986, 1997) suggests that outcome expectations are based largely on the individuals self-efficacy expectations, which generally depend on their judgment about how well they can perform the behavior; can be disassociated with self-efficacy expectations; and are partially separable from self-efficacy judgments when extrinsic outcomes are fixed. Because the outcomes an individual expects are the results of the judgments about what he or she can accomplish, they are unlikely to contribute to predictions of behavior (Bandura, 1977). Judgments about ones self-efficacy is based on four informational sources including enactive attainment, vicarious experience, verbal persuasion and physiological state. The first source, enactive attainment, or the actual performance of a behavior has been described as the most influential source of self-efficacy information (Bandura, 1986,; Bandura Adams, 1977). There has been repeated empirical evidence that actually performing an activity strengthens self-efficacy beliefs due to informational sources (Bandura, 1995). The second source, vicarious experience or visualizing other similar people perform a behavior, also influence self-efficacy (Bandura, Adams, Hardy, Howells, 1980). Conditions that impact vicarious experience include amount of exposure or experience to the behavior (least experience causes greater impact) and amount of instruction given (influence of others is greater with unclear guidelines) (Resnick Galik, 2006). Another source verbal persuasion or exhortation i nvolves telling an individual he or she has the capabilities to master the given behavior. Verbal encouragement from a trusted, credible source in counseling or education form has been used alone to strengthen efficacy expectations (Castro, King, Brassington, 2001; Hitunen et al. 2005; Moore et al., 2006; Resnick, Simpson, et al., 2006). The final information source physiological feedback or state during a behavior can be important in relation to coping with stressors, health functioning, and physical accomplishments. Interventions can be used to alter the interpretation of physiological feedback and help individuals cope with physical sensations, enhancing self efficacy and resulting in improved performance (Bandura Adams, 1977). Propositions. To help test the concept of nurses comfort caring for dying infa

Saturday, July 20, 2019

Leadership in Nursing

Leadership in Nursing Definitions, Theories, and Styles of Leadership in Nursing Developing future nurse leaders is one of the greatest challenges faced by the nursing profession (Mahoney, 2001). Powerful leadership skills are needed by all nurses and especially for those providing direct care to those in top management positions. Anyone who is looked to as an authority (including, for instance, a nurse treating a patient) or who is responsible for giving assistance to others is considered a leader (Curtis, DeVries and Sheerin, 2011). A clinical nursing leader is one who is involved in direct patient care and who continuously improves the care that is afforded to such persons by influencing the treatment provision delivered by others (Cook, 2001). Leadership is not merely a series of skills or tasks; rather, it is an attitude that informs behaviour (Cook, 2001). In addition, good leadership can be seen as demonstrating consistently superior performance; further it delivers long term benefits to all those involved, either in the delivery or receipt of care. Leaders are not merely those who control others; they are visionaries who help employees to plan, lead, control, and organise their activities (Jooste, 2004). Leadership has been defined in many ways within existent academic literature. However, several features are common to most definitions of leadership. For example, leadership is a process, involves influence, usually occurs in a group setting, involves the attainment of a goal, and exists at all levels (Faugier and Woolnough, 2002). In addition, there are several recognised leadership styles. For instance, autocratic leaders set an end goal without allowing others to participate in the decision-making process (Curtis, DeVries and Sheering, 2011), whereas bureaucratic leadership occurs in scenarios where a leader rigidly adheres to rules, regulations, and policies. In contrast, participative leaders allow staff to participate in decision-making and actively seek out the participation of stakeholders within the decision. This type of leadership allows team members to feel more committed to the goals they were involved with formulating (Fradd, 2004). Laissez-faire leadership leaves employees to their own devices in meeting goals, and is a highly risky form of leadership as Faugier and Woolnough (2002) further posit. Finally, a more effective form of leadership than those hitherto mentioned, may be situational leadership. This is where the leader switches between the above styles depending upon the situation at hand and upon the competence of the followers (Faugier and Woolnough, 2002). There is a difference between theory and styles of leadership. According to Moiden (2002), theory represents reality, whereas style of leadership refers to the various ways one can implement a theory of leadership the way in which something is said or done. Organisations should, it follows, aim for a leadership style that allows for high levels of work performance, with few disruptions, and that is applicable in a wide variety of situational circumstances, in an efficient manner (Moiden, 2002). Similarly, there is a difference between management and leadership. Managers plan, organise and control, while leaders communicate vision, motivate, inspire and empower in order to create organisational change (Faugier and Woolnough, 2002). Transactional versus transformational leadership Outhwaite (2003) suggests that transactional leadership involves the skills required in the effective day to day running of a team. However, transformational leadership also involves ensuring that an integrated team works together and may also benefit from the inclusion of innovativeness of approach in work (Outhwaite, 2003). For example, a leader can empower team members by allowing individuals to lead certain aspects of a project based on their areas of expertise. This will, in turn, encourage the development of individual leadership skills, which improve both the individuals skills and their future career prospects. In addition, leaders should explore barriers and identify conflicts when they arise, and then work collaboratively with the members of their team to resolve these (Outhwaite, 2003). Furthermore, the leader should remain a part of the team, sharing in the work, thus remaining close to operations and being able to understand the employees perspective, rather than being a leader who is distanced from the actual work of the team for which he or she is responsible (Outhwaite, 2003). Transactional leadership focuses on providing day-to-day care, while transformational leadership is more focused on the processes that motivate followers to perform to their full potential. Thus, the latter works by influencing change and providing a sense of direction (Cook, 2001). The ability of a leader to articulate a shared vision is an important aspect of transformational leadership, as Faugier and Woolnough (2002) observe. In addition, transactional leadership is most concerned with managing predictability and order, while transformational leaders recognise the importance of challenging the status quo in order to enhance positive possibilities within the project that they are delivering as Faugier and Woolnough, (2002) posit. One group of authors that have described the use of transformational leadership by Magnet hospitals are De Geest et al. (2003). In so doing they discuss how the leadership style deployed within the hospitals allows for faith and respect to be instilled, the treatment of employees as individuals, and innovation in problem solving, along with the transmission of values and ethical principles, and the provision of challenging goals while communicating a vision for the future (De Geest et al., 2003). Transformational leadership is, as they further comment, especially well-suited to todays fast-changing health care environment where adaptation is extremely important, especially with regard to changing technologies and the seemingly ever-increasing expectations of patients. In elucidating further, the authors cite a range of findings that this leadership style is positively associated with higher employee satisfaction and better performance. These, in turn, correlate positively with higher patient satisfaction (De Geest et al., 2003). One way to facilitate change using transformational leadership involves the use of action learning (De Geest et al., 2003). In this approach, leaders use directive, supportive, democratic, and enabling methods to implement and sustain change and the effects of such leadership enable better outcomes for both nurses and patients to be realised. Transformational leadership focuses on the interpersonal processes between leaders and followers and is encouraged by empowerment (Hyett, 2003). Empowered nurses are able not only to believe in their own ability but also to create and adapt to change. When using a team approach to leadership, it is important to set boundaries, goals, accountability, and set in motion structural support for team members (Hyett, 2003). Transformational leadership is thus seen as empowering, but the nurse manager must balance the use of power in a democratic fashion to avoid the appearance of their abusing the power that they have been given (Welford, 2002). Finally, as Hyett (2003) also notes, respect and trust of staff by the leader is essential for transformational leadership to work. Clinical or shared governance Clinical governance is a new way of working in which e National Health Service (NHS) organisations are accountable for continuous quality improvement, safeguarding standards of care, and creating an environment in which clinical excellence can flourish (Moiden, 2002). The requirements of several recent UK government policies require that new forms of leadership that better reflect the diversity of the workforce and the community being developed. Since Scott and Caress (2005) noted this, leadership needs have continued to be strengthened and the need to involve all staff in clinical leadership further developed. Shared governance has been, as Hyett (2003) notes, one method by which this goal has been realised. It has proven to be an effective form of leadership because it empowers all staff and makes them part of decision making processes, thereby additionally allowing staff to work together to develop multi-professional care (Rycroft et al., 2004). Such shared governance has resulted in the increased utilisation of a decentralised style of management in which all team members have responsibility and managers are facilitative, rather than using a hierarchical which, as Scott and Caress (2005) maintain, has led to increased morale and job satisfaction, increased motivation and staff contribution, the encouragement of creativity, and an increased sense of worth amongst NHS employees at all levels. Knowledge, attitudes, and skills of an effective nurse leader In addition to the skills hitherto noted in the opening sections of this assignment, nurse leaders should have knowledge of management, communication, and teamwork skills, as well as a solid understanding of health economics, finance, and evidence-based outcomes (Mahoney, 2001). These core skills should ideally be further enhanced by the possession of a range of key personal qualities. Mahoney (2001) asserts that these are desirable in all nurse leaders and include competence, confidence, courage, collaboration, and creativity. Nurse leaders should also be aware of the changing environment in health care best practice and make changes proactively. Leaders who show concern for the needs and objectives of staff members and are cognisant of the conditions affecting the work environment that also encourage productivity, as Moiden, (2003) notes, which is important as it allows a philosophy of productivity to be established. According to Jooste (2004), the three pillars essential to a foundation of strong leadership are authority, power, and influence. It follows, therefore, that to be an effective leader in todays competitive environment, leaders should use influence more, and authority and power, less. It is more important, as Jooste (2004) further notes, to be able to motivate, persuade, appreciate, and negotiate than to merely wield power and, in advancing this line of argument, the author cites three categories of influence for nurse leaders to use in creating a supportive care environment. These include: modelling by example, building caring relationships, and mentoring by instruction (Jooste, 2004). Such skills should also, according to De Geest et al. (2003), be combined with the utilisation of five specific practices that are fundamental to good leadership: g inspiring a shared vision, enabling others to act, challenging processes, modelling, and encouraging. For example, a leader may challenge others to act by recognising contributions and by fostering collaboration. Such techniques are important because recognising contributions also serves to encourage employees in their work whilst team leadership moves the focus away from the leader towards the team as a whole (Mahoney, 2001). Applications to practice settings Hyett (2003) describes several barriers to health visitors taking on a leadership role and observes that visitors usually work in a self-led environment, which causes problems because there may be no mechanism for self-control or decision-making at the point of service, thus stifling innovation. In addition, if nurses who do try to initiate change are not supported, they lose confidence and assertiveness and may feel disempowered and unable to support one another, which will lead to declining standards of motivation and may negatively impact upon patient care (Fradd, 2004). Management often focuses on the volume of services provided, leading to loss of self-esteem and a rise in dependence; this, as Hyett (2003) recognises, may cause workers to become disruptive, or to leave the organisation, which culminates in organisational upheaval. Further, when staff leave as a result of feeling disempowered, replacements need to be found and trained which involves not only additional recruitment costs but training as new people are introduced into the culture of the organisation. In addition to the comments made by Hyett, focus group data from a study of implementing change in a nursing home suggests that nurses want a leader with drive, enthusiasm, and credibility to lead them and to inspire them, for they do not merely want a leader who has superiority (Rycroft-Malone et al., 2004). Further, focus group members identified the qualities desired in a leader who is attempting to facilitate change. This person should have knowledge of the collaborative project, have status with the team, be able to manage others, take a positive approach to management, and possess good management skills (Rycroft-Malone et al., 2004). Applications to the wider health and social context Nursing leaders function at all levels of nursing from the ward through to top nursing management. Over time, the function of leadership has changed from one of authority and power to one of being powerful without being overpowering (Jooste, 2004). Boundaries between upper, middle, and lower level leaders are becoming increasingly blurred, and responsibilities are becoming less static and more flexible in nature. In other words, there is a trend toward decentralisation of responsibility and authority from upper to lower levels of health care delivery (Jooste, 2004). An ongoing programme of political leadership at the Royal College of Nursing describes a multi-step model for political influence (Large et al., 2005). Some of the steps include: identifying the issue to be changed, turning the issue into a proposal for change, finding and speaking with supporters and stakeholders to develop a collective voice, pinpointing desired policy change outcomes, and constructing effective messages to optimise communication (Large et al., 2005). These can be all be viewed as important for through learning them the nurse leader can adopt to the organisational expectations of the twenty-first century NHS. Education for leadership In order for nursing practice to improve, an investment must be made in educating nurses to be effective leaders (Cook, 2001). Cook contends that leadership should be introduced in initial nursing preparation curricula, and mentoring should be available for aspiring nurse leaders not only during their formal training but throughout their careers (2001). The importance of this enlarged approach can be seen, for example, in the use of evidence-based practice which requires nurses to be able to evaluate evidence and formulate solutions based upon the best available evidence (Cook, 2001). In order for these things to occur, it is important that nurses have educational preparation for leadership during training to prepare them to have a greater understanding and enhanced control of events that may occur during work situations (Moiden, 2002). This can be seen as a step towards the greater professionalisation of the nursing profession a movement that has also increasingly seen nurses gaining formal academic qualifications over the previous ten years. Indeed, such is the embracing of professional accreditation that the NHS has adopted the Leading an Empowered Organisation (LEO) project in order to encourage the use of transformational leadership (Moiden, 2002). By doing so, the NHS hopes to ensure that professionals may empower themselves and others through responsibility, authority, and accountability. The programme also aims to help professionals develop autonomy, take risks, solve problems, and articulate responsibility (Moiden, 2002). Strategies such as the Leading and Empowered Organisation (LEO) programme and the RCN Clinical Leaders Programme are designed to produce future leaders in nursing who are aware of the benefits of transformational leadership (Faugier andWoolnough, 2002). This is therefore not only a programme that is relevant to todays NHS but is also one that is preparing the nursing leaders of tomorrow. Challenges and opportunities to stimulate change The health care environment is constantly changing and producing new challenges that the nurse leader must work within (Jooste, 2004). Leadership involves enabling people to produce extraordinary things whilst simultaneously performing their daily duties and adapting to challenge and change (Jooste, 2004). While management in the past took a direct, hierarchical approach to leadership, the time has come for a better leadership style that includes encouragement, listening, and facilitating (Hyett, 2003). Hyett (2003, p. 231) cites Yoder-Wise (1999) as defining leadership as the ability to create new systems and methods to accomplish a desired vision. Today, the belief is that anyone can be a leader and thus leadership is a learnable set of skills and practices (Hyett, 2003). All nurses must display leadership skills such as adaptability, self-confidence, and judgment in the provision of health care (Hyett, 2003). Indeed, the expectation of both higher professionals and the general public receiving care is that nurses lead care, and that they are able to move seamlessly between roles of leading and following, depending upon the individual scenario faced (Hyett, 2003). Empowering patients to participate in the decision-making process Only when health care services are well-led will they be well-organised in meeting the needs of patients (Fradd, 2004). Nurses have considerable influence on the health care experience enjoyed by individual patients, especially as patient involvement in care is most often nurse-led (Fradd, 2004). Today, patients are more aware of their own health care needs and better informed about treatments and practice; it is also imperative that patients are able to enunciate their own health care needs and contribute to discussions relating to their treatment options. Such enhanced levels of health care communication require nurses to be better equipped with analytical and assertiveness skills, especially if they need to fight the patients corner against the opinion of an individual doctor who may place his own opinions above those of the patient (Outhwaite, 2003). Transformational leadership is ideal for todays nursing practice as it seeks to satisfy needs, and involves both the leader and the follower in meeting needs (Welford, 2002). It is also flexible and this allows the leader to adapt in varied situations. It is logical, therefore, that if the leader accepts that things will change often, followers will enjoy this flexibility. As a result, both nurses and patients benefit because the avoidance of hierarchical structures and the embracing of new ways in which to work help organisations to put resources together to create added value for both employees and consumers (Mahoney, 2001). Into this health care mix, transformational leadership is pivotal, for it allows team nurses to enhance their role as both teachers and advocates (Welford, 2002). References Cook, M. (2001). The renaissance of clinical leadership. International Nursing Review, 48: pp. 38-46. Curtis, E. A., de Vries, J. and Sheerin, F. K. (2011). Developing leadership in nursing: exploring core factors. British Journal of Nursing, 20(5), pp. 306-309. De Geest, S., Claessens, P., Longerich, H. and Schubert, M. (2003). Transformational leadership: Worthwhile the investment! European Journal of Cardiovascular Nursing, 2: pp. 3-5. Faugier, J. and Woolnough, H. (2002). National nursing leadership programme. Mental Health Practice, 6(3): pp. 28-34. Fradd, L. (2004). Political leadership in action. Journal of Nursing Management, 12: pp. 242-245. Hyett, E. (2003). What blocks health visitors from taking on a leadership role? Journal of Nursing Management, 11: pp. 229-233. Jooste, K. (2004). Leadership: A new perspective. Journal of Nursing Management, 12: pp. 217-223. Large, S., Macleod, A., Cunningham, G. and Kitson, A. (2005). A multiple-case study evaluation of the RCN Clinical Leadership Programme in England. London: Royal College of Nursing. Mahoney, J. (2001). Leadership skills for the 21st century. Journal of Nursing Management, 9: pp. 269-271. Moiden, M. (2002). Evolution of leadership in nursing. Nursing Management, 9: pp. 20-25. Moiden, M. (2003). A framework for leadership. Nursing Management, 13: pp. 19-23. Outhwaite, S. (2003). The importance of leadership in the development of an integrated team. Journal of Nursing Management, 11: pp. 371-376. Rycroft-Malone, J., Harvey, G., Seers, K., Kitson, A., MCormack, B, and Titchen, A. (2004). An exploration of the factors that influence the implementation of evidence into practice. Journal of Clinical Nursing, 13: pp. 913-924. Scott, L. and Caress, A-L. (2005). Shared governance and shared leadership: Meeting the challenges of implementation. Journal of Nursing Management, 13: pp. 4-12.