Consideration of HRM Essay Example

Consideration of HRM Essay Title A Consideration of Human Resource Management future: Its time to unleash HRS full potential Introduction Human Resource Management involves the recruitment and management of the people who work in an organization. The focus of Human Resource Management is to attract, select, train, motivate and compensate employees, while making sure that they comply with employment and labor laws. In the stressful environment of todays businesses, organizations and managers are faced with numerous challenges. Technological change and innovation in product on one hand and the management complexity, on the other hand, make managers rely on human capital. Due to the changing business environment, human resource management also does undeniably need to change to respond to changes. The future is unpredictable and difficult to determine. As a result, the flexibility and business knowledge towards responding to this uncertainty is important. Today, the strategic challenges in the field of human resources are not limited only to administrative matters, but at the same time ttention should be given to the four criteria: 1) Human resources development infrastructure should be maintained, 2) Employees commitment should be engineered, 3) Human resource professionals are strategic partners of the organizations and, 4) HR professionals as internal consultants handle their change management. Literature Review Researchers and theorists have different views about what will happen to human resource function in future. We will write a custom essay sample on Consideration of HRM specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Consideration of HRM specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Consideration of HRM specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Most research has been done on topics of technology, intellectual capital, and government regulation, workforce demographic changes, hrinking organizations, international management and globalization. It is evident that all the issues mentioned play a very important role in human resource management over the coming decades, and some are clearly more effective than others, but very broad issues like the Future of human resource management are ambiguous. Workforce planning grew during the 1960s and early 1970s in a period of relative economic stability when unemployment was low and organizations were faced with supply shortages and the need to improve labor utilization (see Reilly, he economic downturn of the 1980s when the failure to prove the economic value of workforce plans resulted in many efforts being eliminated. The Problem Identification The activities of HR appear to be and often are disconnected from the real work of the organization. In fact, the primary responsibility for transforming the role of HR belongs to the CEO and to every line manager who must achieve business goals. The reason? Line managers have ultimate responsibility for both the processes and the outcomes of the company. It follows that they should lead the way in fully integrating HR into the companys real work. Indeed, to do so, they must become HR champions themselves. More important, they must hold HR accountable for delivering it. A team of professionals cannot be built by an organization without good Human Resource Management. As a result, businesses with good Human Resource Management (HRM) have higher profits than businesses without or with poor HRM. So, now its demand of time to explore new value for HRM. Although, some studies was done previously in he field of HRM but mostly all studies explored the importance of HRM (Q. Ye et al. , 20110) and scope, limitation which is now only for an historic symbol . These studies do not generalize for the future orientation. Also, there is a very limited research in the existing HRM literature by exploratory method. Therefore, this study will be undertaken to explore the Future of HRM among the world. Objectives The objectives of this study are to investigate and create an entirely new role and agenda for the field that focuses it not on traditional HR activities, but on outcomes. HR should be defined by what it delivers results that enrich the organizations value to customers, investors, and employees. Methodology A qualitative, case study research methodology will be chosen in this research. The research will be conducted through semi-structured interviews and common themes. Participants will be HR officials Experts who will be chosen randomly by sampling method from various famous organizations in Malaysia. Importance of the study The findings of this study will be useful for HR officials to be informed of new role for heir framework and also to make decision in different key point. It will also be helpful to make themselves capable while taking new challenges. Moreover, they can utilize this information to develop such an imperative plan model using user- generated content. 2013-2014 research time line Activity/Duration November December January February March April May June Problem formulation Finding Literature review Preparing Methodology 2014-2015 research time line July August Sep oct Nov Jan Feb Data Collection Analysis acquired data Thesis Submission References

First-Grade Science Projects

First-Grade Science Projects First grade is a great time to introduce students to the scientific method, which involves looking at the world around you, coming up with an explanation for what you observe, testing your  hypothesis  to see if it could be valid, and then either accepting or rejecting it. Even at such an early grade level, students can begin to learn concepts related to this method.   Harness Their Curiosity Young children are innately curious about the world around them. Introducing them to the scientific method helps kids begin to explore what they see, hear, taste, and feel in a systematic way. First-grade projects should be interesting to the student and mostly exploratory in nature. At this age, a teacher or parent needs to help plan the project and offer guidance  on a report or poster. Some students may want to make models or perform demonstrations that illustrate scientific concepts. Project Ideas First-grade science offers a wonderful opportunity to explore how things work. Start your first-graders on the road to exploring science fair project ideas with some simple questions that might spark their interest, such as: What type of food attracts the most insects? (You can choose either flies or ants.) What do these foods have in common?In this experiment, students use vinegar to remove the calcium in chicken bones to make them rubbery. Questions for students: What happens to a chicken bone or an egg if you put in vinegar for a day? What would happen after a week? Why do you think it happens?  Do all students in the class have the same size hands and feet? Trace outlines of hands and feet and compare them. Do taller students have larger hands and feet or does height not seem to matter?You can also create a fun science project to determine whether mascaras are really waterproof. Simply put mascara on a sheet of paper and rinse it with water. Ask students to explain what happens. Do eight-hour lipsticks really keep their color that long? You may need to review the  concept of time  with students if they have forgotten or are unfamiliar with hours, minutes, and seconds. Other Project Ideas Spark further interest by suggesting- or assigning- other science fair projects. Asking questions related to each project is the best way to elicit a response from young students. Project-related questions you can ask include: Do clothes take the same length of time to dry if you add a dryer sheet or fabric softener to the load?Do all types of bread grow the same types of mold?Do frozen candles burn at the same rate as candles that were stored at room temperature? All of these questions give you the opportunity to review- or teach- concepts that are important for first-graders. For example, explain to students that  room temperature is a range of  temperatures  that denotes comfortable habitation for people. Talk About Temperature An easy way to demonstrate this idea is to turn up or down the temperature-control gage in the classroom. Ask students what happens when you turn the temperature control up or down. Some other fun projects include letting students figure out if raw eggs and hard-boiled eggs spin the same length of time/number of times, if light affects how fast foods spoil, and if you can tell from todays clouds what tomorrows weather will be. This is a great opportunity to take students outdoors, and as they peer at the sky, discuss the difference in outside temperature compared to inside.

Appeal letter Essay Example | Topics and Well Written Essays - 1000 words

Appeal letter - Essay Example atments (December 2007, October 2008) iontotherapy 2008) inhalations (2008) antibiotic treatments ( November 2006, April 2007, October 2007, December 2007, February 2008, October 2008, April 2009, May 2009) and iontotherapy with 2 % calcium chloride and vaccine (2009) with situations when the first antibiotic series evidently failed to eliminate the problem and my ailment continued and resultantly had to visit one after another of the specialists. During this time I was repeatedly infected by bacteria: beta-h(a)emolytic streptococcus c, examinations carried out in 2007, 2008 and 2009, and thus had to take prescribed antibiotics (evidence provided). Throughout the period I had to travel back and forth between a number of physicians and health advisors which considerably drained my energies embalming which was vitally important to succeed in the program. For instance when I was first taken ill on __________ I had to go visit. Then again from there I had to go to _(name of doc)________ in _(location)_ As instances of the negative effect this had on my studies I consider courses, where part of the assessment was a group presentation, poster presentation or group reports and where I faced difficulties to attend group meetings and group work. Because of recurrence of infections I could afford less flexibility which in turn affected the aggregative performance of the group. I would thus argue that my performance was constrained by an unfortunately recurrent state of ill-health which prevented me from realizing my potential. I am convinced that if I did not have to go through the harrowing experience of continuously trying my level best all the while recognizing that my performance was being rendered sub-optimal by factors entirely beyond my control, I would have secured better grades. I do believe this strongly since I know how committed I have been to putting in the most sincere efforts which are reflected strongly in the following grades that I acquired in spite of

Writing Essay Example | Topics and Well Written Essays - 500 words - 4

Writing - Essay Example At the outset, the proliferation of homelessness in the target population, United Kingdom, solely propels the focus on the subject topic. Additionally, the urge to solve the existent situation after unsuccessful approaches there prior also aids in the evident spotlight on the problems facing homeless people in the United Kingdom. Following to most recent research, figures illustrate a 25% rise in the need for emergency accommodation in the United Kingdom within the past three years. This drastic rise in the need for housing directly reflects to heightened levels of homelessness, which subsequently leaves its victims suffering. Deriving from this, homelessness not only depicts a problem by itself but extensively acts as a starting point for more disparities most evident in the United Kingdom. These disparities range from, increased potential for diseases and infections, mental breakdowns, emotional as well as physical instabilities, spoilt relationships and drug addiction amongst others (Segal 1991). However, almost 70% of past attempts to curb or rather minimize the rates of homelessness in the United Kingdom have failed following to reasons such as basing solutions on insufficient research projects. In addition, improper implementation of enacted solutions backed by lack of resources such as financial resou rces act as limitations to consistent improvement in the mission of curbing homelessness in the United Kingdom (Pierson 2009). More precisely, this research puts more focus on minimizing and subsequently curbing homelessness in the United Kingdom since this automatically eliminates problems caused by homelessness (Fitzpatrick, Quilgars, & Pleace, 2009). With the intent of focusing the researches’ concentration on the problems facing homeless people in the United Kingdom and subsequently finding solutions to these disparities, the enlisted research questions aid in better

How did the roll of religion affect ancient Egypt Research Paper

How did the roll of religion affect ancient Egypt - Research Paper Example Religion in Egypt was a central part of the daily routine and believed to be the reason for existence. The Egyptian gods had the most important role to play in the society. The gods were believed to be in control of all natural and human aspects of the society. For example, the god Ra was associated with the sun while Anubis was responsible for resurrection. The purpose of the lives of the ancient Egyptians was to keep their gods pleased. If a farmer needed rain for his crops to grow well that season, he will pray to the gods and offer favors in exchange of his wish; so will a boy longing to have a camel or a woman wanting to get married. Thus, every need of the Egyptians was linked with the gods. Magical acts were also used to interact with gods (Brewer and Teeter 132). This helped in bringing unity within the ancient Egyptian society as every individual turned towards the same source to plead. The Egyptian religion taught the people the lesson of good and bad. Every child born in an Egyptian household was made to believe that if s/he does not pray or offer the rituals, the gods will be displeased with him/her and punish him/her (Allen 79). Likewise, if s/he would perform good deeds and prayed regularly, s/he would be rewarded with a perfect life and all his/her wishes would be fulfilled. This helped develop a strong conscience within the Egyptians and prevented them from committing acts that were ethically, morally and religiously wrong. The fear of gods also made them loyal to the pharaoh and brought law and order to the country because the word of the pharaoh was considered to be the word of gods (Allen 80). Thus, the chances of rebellions against the authority of the pharaoh were also minimal and the pharaoh had a strong hold over is empire and the people living in it. ‘Ma’at’ was another important concept of

Mercutio In Romeo And Juliet

Mercutio In Romeo And Juliet In the play Romeo and Juliet, Shakespeare has created several memorable characters, aside from the witty, humorous, and theatrical character of all time Mercutio. Mercutio is neither Capulet nor Montague, but is portrayed as a very close friend to Romeo. Yet Mercutio and Romeo both very dissimilar views on love and on life in general. This is clearly conveyed through Mercutios witty wordplay and language within the play. Primarily the prologue in Romeo and Juliet plays an important role in giving information on were the play is set and what it is about. Shakespeare begins with the most renowned line in literature two households emphasize the theme family, Montagues and Capulets both alike in dignity yet involves another theme power. The prologue also introduces fatalism to the audience as the word star-cross`d lovers suggests stars determining destiny and the words cross`d lovers foreshadow the death of the lovers. The juxtaposition of antithetical ideas in the prologue creates the effect of anticipation and suspense , Shakespeare uses antithesis such as Death ,love and life to summarise the key themes and to foretell and intensify that a tragedy will take place. Mercutio can represent a number of comparisons and contrasts to other characters by means of his quick wit and optimistic attitude. In Act 1 Scene1 the themes hate and conflict are extremely expressed through the characters Benvolio and Tybalt. The character Tybalt is seen as very vulgar and aggressive since he chooses to emphasise on the words hate and hell, he then goes onto say I hate, all Montagues suggests he is only interested in fighting the Montagues and everything he seems to say is negative and full of frustration and disgust. In addition Benvolio, one of Mercutios close friends is seen as the peace maker, unlike Tybalt he is determined to stop the fighting and keep the peace . While Benvolio is calm, sensible and reliable, Mercutio tends to be sarcastic that follows his emotions, but is still remembered as this distinctive dramatic character. Whats more, Prince Escalus the voice of authority appears onto scene and demands for the fight to stop. Shakespeare uses antithesis in the Princes speech you men, you beasts to show his reaction, furthermore the prince can be seen as a character with such emotion as he begins to use violent imagery and says quench the fire of your evil hate and throw your Mistemper`d weapons suggests he is a mediator, like Benvolio and would like to see the feuds in Verona to stop. The juxtaposition of antithetical ideas in the quote Disturb our streets again he proclaims your lives shall pay the forfeit of the peace foreshadows the death of Mercutio and Tybalt. Later on in the Scene, the themes friendship, loyalty and love are expressed through Romeos unrequited love for Rosaline. When describing her physical beauty to Benvolio, Romeos descriptions are dreamy yet depressing. Shakespeare displays courtly love through the character Romeo and his infatuation for Rosaline when he begins to pine in despair out of her favour and then uses oxymorons O brawling love! O loving hate! to create a dramatic effect by swiftly switching two major themes together love and hatred , also creates confusion and gives an impression that he is self absorbed and immature. Throughout the scene Benvolio calls Romeo coz and this shows their extremely strong relationship also Benvolio is seen as a loyal and considerate friend when he continuously questions tell me in sadness ,the word sadness highlights the strong bond and respect between the two friends. On the other hand, Shakespeare presents the character of Romeo as over exaggerated and melancholy when Romeo use s hyperbolic language to convey his obsession with Rosaline he compares himself to a sick man in sadness, suggests his conceited mentality. In addition another very close yet different friend to Romeo is a character called Mercutio. Shakespeare chooses to include this humorous and spontaneous character after the audience has seen Romeo and his lovesickness, to create a dramatic effect by showing their opposing views on love. Mercutio, Benvolio and Romeo all sneak into the house of Capulets hoping that Romeo will enliven as Mercutio tells Romeo he must dance shows their close and friendly friendship. Romeo can be seen as depressing when he using a metaphor on the word soul while talking about Mercutios nimble soles referring to his own soul being stuck to the ground. Then Romeo expresses his confusion by saying is love a tender thing he goes onto create bestial imagery by describing love as rude , boisterous and pricks like a thorn gives us his mix yet positive views on love . Nevertheless Mercutios attitude towards love, contrast as he advises Romeo to retaliate back to love by prick love for pricking and beat love down shows he has a negative overview on love. The words prick and beat also show how frustrated he is and that he doesnt want his infatuation to ruin their friendship, we begin to see a diverse side that conveys he is kind and caring. Mercutio begins to mock Romeo with witty wordplay and sceptics when Romeo talks about having had a dream; Mercutio delivers a nonsensical speech on Queen Mab being the fairies midwife who rides a chariot made of an empty hazelnut suggests that all desires and fantasies are corruptive and futile .Shakespeare juxtaposes certain words together with antithetical ideas ,giving a reflection on Mercutio by the use of vivid images of opposing lawyers and lovers , soldiers and fairies also refers to some opposing themes in the play such as love and hatred. Moreover the misogynistic view in the speech about Queen Mab riding over soldiers neck and violent vivid imagery of cutting foreign throats foreshadows death and fighting by giving a negative vision that the whole concept of dreamers and being in love is dangerous as well as substantial. Through the Queen Mab speech Mercutio degrades women, yet captivates the audience in talking nonsense creates humour. In Act 2 scene1, the theme of true love is conveyed when Romeo has seen beloved Juliet he climbs onto the Capulets wall, whilst Mercutio and Benvolio call out for Romeo, Mercutio mocks Romeos infatuation for Rosaline shouting Madman , lover and refers to Venus the roman goddess of love. Then Mercutio uses the theme of petrachan love to describe Rosalines high forehead and scarlet lip to tease Romeo. Shakespeare uses dramatic irony as we as readers know its not Rosaline, Romeo loves. However Benvolio has a lot of concern for Romeo as he says if he will hear it will anger him; Mercutio on the other hand thinks it cannot anger him signifies Mercutio is a better friend as he tells the truth to benefit Romeo. Shakespeare uses satirical irony when expressing the theme of loyalty between Mercutio and Romeo. He describes Rosaline as a pale Hard-hearted wench and then uses imagery to describe Romeo as dead and stabbed , but due to love not hatred creates another dramatic effect of the role of Mercutio. Mercutios interaction with Romeo grows strong as he clearly states Romeo isnt strong enough to encounter Tybalt at a duel he then begins to mock Tybalts fashionable fighting by calling him the prince of cats tells us he is brave to protect Romeo. Mercutio also uses rhetorical language when insulting Romeo on groaning for love? conveys his cynical belief on love. Shakepeare has also displayed the character of Mercutio as both outrageous and fascinating when he mocks the nurses weight, comparing it to a sail! and calls her ancient tells us Shakespeare has done this to create wittiness and also to drive the entire play forward. Plus Mercutio and Romeos rapid interchange, indicates Romeo is quick to understand Mercutios witty wordplay. Furthermore the character Benvolio is displayed as blood and patient, when he tries to stop Mercutio to scape a brawl Mercutio begins to aggravate Benvolio in saying he will quarrel with a man for cracking nuts suggests Benvolio isnt quick to comprehend Mercutios clever wordplay. Mercutio also likes creating a scene when Benvolio tells Tybalt and Mercutio to reason coldly of their grievances , Mercutio seems to not care in saying let them gaze ,his own arrogance is leading to the tragedy of his death. When Tybalt insists in fighting with Romeo , Shakespeare uses dramatic irony in portraying the character of Romeo to be an innocent , love puppy who talks about loving the Capulets name as his own foreshadows the relationship of Romeo and Juliet. Ultimately the scene changes from bawdy comedy to dramatic tragedy when the role of the comic foil in the play comes to an end. Mercutio uses a metaphor and visual imagery when provoking Tybalt in comparing him to a good king of cats who has Nine lives represents his loyalty towards Romeo. Shakespeare dramatises Mercutios death as it hides his feelings over humour creating theatrical tension, Mercutio uses powerful language in cursing the two feuding families a plague on both of your houses he then goes onto using repetition whilst being sarcastic Ay , ay ,a scratch signifies his strong and brave personality all to protect Romeos Honour. By killing of the character of Mercutio, the character of Romeo changes from a romantic archetypal petrachan lover to a villian who kills Tybalt.

Eating Disorders and the Media Essay -- Female Body Image Weight Healt

Eating Disorders and the Media What if you were surrounded by media messages telling you that, â€Å"people will like you more if you have the perfect body† or â€Å"being perfect makes people like you† ? How do you think young female teenagers would interpret these messages that the media are portraying? 81% of ten year old girls are afraid of being fat, of being considered ugly. Why do you think ten year olds would ever care about how they look? It’s because of the media implying that being slim is beauty. Due to the media’s brainwashing, poor self-image is one of the main causes of eating disorders in adolescent girls. The media sells products, not opinions nor facts. They will sell you anything, telling you that it will make you slimmer and that being skinny is the way to go. When we see models and celebrities on commercials and in movies, we often wish that that was us in that body, because the media has made everyone so obsessed with their own bodies. The media makes young female teenagers feel guilty if they are slightly overweight. Models are beautiful, skinny, they have the right size thighs, hips, and butt. They are models but they are not role models. They are everything teenagers want to be, because of the television they watch and the magazines that they read. The media are always telling them that being thin is considered beautiful. This sends a wrath between females and their impression of what beauty really is. Some females will go to any length to try to be that perfect body weight person. Such a person doesn’t even exist. For there is no perfect weight for which females should strive to achieve. Although there are many young females who will restrict what they are allowed to eat & when they are allowed to eat it. They will exercise compulsively and self effectuate vomiting. Eating disorders such as anorexia, bulimia, and compulsive overeating are three of the major eating disorders that infatuate young minds. Female teenagers see bingeing, dieting and vomiting, a way out of actually doing a workout and getting into shape. There is a widening gap between girl’s self-image and society’s messages about what girls should be like. The media uses television, magazines and subliminal messages to attract people. They have playboy models advertising for cars, boats and body lotion. They use a women’s body to advertise for their products. The media doe... ... they need to resolve, like the depression of not being happy with themselves. Of going through many procedures to make them look â€Å"thin† or â€Å"ordinary† because they can no longer be happy with themselves because of the media’s interference with adolescent girls images. Anorexia and bulimia are one of the main causes along with the media as to why adolescent girls are always slightly underweight and devastating skinny. If the media didn’t interfere with adolescent perceptions, maybe one half of fourth grade girls wouldn’t be on a diet. Intense fear of becoming fat and distorted body images aren’t the kinds of thing we want our adolescents girls to become. To think about their appearance and weight 24/7 isn’t right. The media should stop publicizing young female bodies and telling them what beauty is perceived to them. They should think of all those adolescents girls that they send into depression or force to become bulimic, just because they wish to make money. The media brainwashes too many of adolescent girls, making them think about their body in relation to models who have unmistakably the â€Å"perfect body†. Making them think that you have to be thin in order to be beautiful.

Anthony Case 1-2 & Anthony Case 2-3 Essay

Anthony Case 1-2: Kim Fuller 1. In order for Kim Fuller’s plastic bottle grinding business to get off the ground she will need to manage the business with non-accounting and accounting information. The following information to run the business is non-accounting information, as it is not owned by the company did not occur through a monetary transaction: 2 grind machine workers, 1 truck drive, 1 accountant, and the 2 contracts with bottling companies. The remaining information is categorized as accounting information, as it is owned by the company, may provide future economic resource, and occurred through a transaction: 1 used truck, 2 trailers, 1 used grinding machine, 1 new grinding machine, 1 new computer, 1 warehouse, 3 investors’ deposits, 1 mortgage loan, and the owner’s initial investment into the company. 2. Below is the beginning balance sheet for Kim Fuller’s Business. a.) [pic]b.) To address the question of how Fuller should go about putting a value on the company’s assets, she must utilize the generally accepted accounting principles (GAAP) regarding the worth of her assets. Specifically through these principles, Fuller will be able to determine the fair value or cost of each asset – as a transaction occurred for each purchased item of equipment. Additionally, she will be able to add the value of the Warehouse based on the value at the time of her purchase. Through associating a cost with each, Fuller can easily determine the company’s assets. c.) Based on the balance sheet at the onset of the business, the Owners’ Equity is valued at $165,000. 3. Once Fuller begins to make her sales she will need to determine her revenues and expenses, as she will acquire inventory and the sell the goods for monetary value, which generates revenue. In order for Fuller to stay on top of her accounting for these revenues and expenses, which are also known as â€Å"profits and loss†, the business should utilize an income statement. This will allow the business to determine the net income of the business, which filters in to the balance sheet through the retained earnings – underneath owners’ equity. It is advisable for Fuller to begin with an income statement weekly  until she grasps the concept of accounting. Later on she can move it out to bi-weekly updates, and eventually even out to monthly – if the revenue stream is slower. Anthony Case 2-3: Lone Pine Cafà © 1. Balance sheet for Loan Pine Cafà © as of November 2, 2005. [pic]2. Balance sheet for Loan Pine Cafà © as of March 30, 2006. [pic]3. I believe that the partners would not have been able to receive their proportional share of the Owners’ Equity, as they would forfeit their rights to the business with the theft of assets (cash register and contents). Therefore, the entire Owners’ Equity to be earned would fall upon Mrs. Antoine, the lone remaining partner of the business.

Converting Ounces to Grams

Converting Ounces to Grams This worked example problem demonstrates how to convert ounces to grams. This is a common type of mass unit conversion problem. One of the most common practical reasons to know how to do this conversion is for recipes, so lets start with a food example: Ounces To Grams Problem A chocolate bar weighs 12 ounces. What is its weight in grams? Solution One of the easiest ways to solve this problem is to use the pound to kilogram conversion. If you like in a country where both units are used, this is a useful conversion to know. Start by converting ounces into pounds. Then convert the pounds into kilograms. All that remains is to move the decimal point three places to the right to convert kilograms into grams. Here are the conversions you need to know:16 oz 1 lb1 kg 2.2 lbs1000 g 1 kgYou are solving for x numbers of grams. First, convert ounces into pounds. The next part of the solution converts pounds to kilograms, while the final section converts kilograms to grams. Note how units cancel each other out, so all you are left with is grams. x g 12 ozx g 12 oz x (1 lb/16 oz) x (1 kg/2.2 lb) x (1000 g/1 kg)x g 340.1 g Answer The 12 oz chocolate bar weighs 340.1 g.

Skin and Foot Assessment of a diabetic mellitus patient The WritePass Journal

Skin and Foot Assessment of a diabetic mellitus patient Introduction Skin and Foot Assessment of a diabetic mellitus patient IntroductionCase scenarioNeurologic system Skin assessmentThe outcome of having foot assessmentOutcome of musculoskeletal systeOutcome of neurologic assessmentOutcome of peripheral vascular assessmentOutcome of skin assessmentConclusionReferenceRelated Introduction In this article, we will discuss a case scenario related to diabetic mellitus patient. After understanding the case, we will state what is our main concern in this scenario and why will we focus on this aspect rather other aspect. Also we will introduce some tools to do an assessment in order to predict the outcome. If we understand the possible outcome, we may anticipate the outcome of this patient and understand the possible worse situation too. In this scenario, foot assessment will be focused on. Case scenario Ms Wong, 47 years old woman who was a housewife, arrived at hospital due to get dizzy, fatigue and fall in the floor at home with little bleeding. After she arrived at emergency department, nurse discovered she got a wound in the left heel but she didn’t feel pain, nurses suspected she got the wound during she fell in the floor. Her vital sign was normal; body temperature was37.5C, pulse 70/min, blood pressure 126/80 mmHg, respiration 18/min. After having a blood glucose test, we knew that she was suffering from hypoglycemia and her blood glucose index was 2 mmol/d. As nurse provided glucose water and wound dressing to her, she recovered and transferred to ward for continuing observation. Her past history was that she was suffering diabetic mellitus for 7 years and having regular oral diabetic mellitus medication without daily blood glucose test by herself and her BMI was over 25, she was overweighed. Her parents had diabetic mellitus too but they passed away. After tackling her emergency problem which is lower blood glucose level, we will focus on the further investigation in order to find out the reason why she don’t get any feeling of her wound as well as to investigate how the sensation change and what is the possible outcome so as to give some recommendations to her and prevent the serious consequences. As early detection and treatment of diabetic foot complication could reduce the prevalence of negative outcome. (Prakash, 2011) In the following part, we will focus on the foot assessment. For foot assessment Foot assessments include the following aspects such as demographics, musculoskeletal system, neurologic system, peripheral vascular system and skin. Assessments will though inspection, palpation, sensation and using tools so as to obtain the result. For demographics To obtain data from interview, it includes regarding type of diabetes, gender, any smoking habit, presence of hypertension, retinopathy, nephropathy and suitability of footwear. (Thompson, Nester, Stuart Wiles, 2004) For musculoskeletal system Assessment includes postures, gait, strength, flexibility, endurance and range of motion. It includes evaluation for any deformity because imbalance of foot muscles frequently. (Khanolkar, Bain Stephens, 2008) Other muscles problems like claw toes, hammer toes, heel spurs, calluses, cracks and corns. (Chan, Yeung, Chow, Ko, Cockram Chan, 2005) The website shows how to have the musculoskeletal assessment to the patient. (BJSM, 2008) Inspection and palpation can be applied into this assessment, note the size and contour of the joint which is including knee and ankle, inspect the skin and tissue of the foot for color, swelling and any masses, any lesion or deformity, pay attention of the skin integrity. Palpation is including skin for temperature, muscles, bony articulations and area of joint capsule, notice any heat, tenderness, swelling. The most important is to palpate radial and brachial pulse. If the peripheral pulse is weak, we need to have a further assessment. Neurologic system Assessment should include asking neuropathic symptoms such as burning, tingling, numbness and nocturnal leg pains. Assessment related to sensory assessment, pressure assessment, and vibration sensation too. For sensation Pinprick sensation test is used to test pain. Lightly apply the sharp point or dull end to the foot skin randomly, unpredictable order and ask the patient to say sharp or dull depending on the sensation felt. If the result of pinprick sensation test is abnormal, temperature sensation test will be applied. Fill two test tubes, one with hot water and one with cold water and apply the bottom ends to the patient’s skin randomly and ask them to say which temperature is felt. Another method to test sensation is light touch. Apply a wisp of cotton to the skin, stretch a cotton ball to make a long end and brush it over the skin in a random order and irregular intervals and ask the patient to say yes when touch is felt. (Jarvis, 2004) Pressure sensation is usually assessed by using the10gnylon Semmes-Weinstein monofilament. (Khanolkar, Bain Stephens, 2008) For vibration Tuning fork can be used to test vibrations over bony prominences. Strike the tuning fork on the heel of your hand and hold the base on a bony surface of the fingers and great toe and ask the patient to indicate when the vibration starts and stops. If no vibrations are felt, move proximally and test ulnar processes and ankles, patellae. Also compare the vibration of both sides. (Jarvis, 2004) For peripheral vascular system The Doppler ultrasonic stethoscope is a device to detect a weak peripheral pulse and to measure a low blood pressure or blood pressure in a lower extremity. The Doppler stethoscope magnifies pulsatile sounds from the heart and blood vessels. Place a drop of coupling gel on the end of the handheld transducer. Place the transducer over a pulse site, swiveled at a 45-degree angle. Apply very light pressure and locate the pulse site by the swishing, whooshing sound. (Jarvis, 2004) Nurses should apply both Doppler ultrasonic stethoscope and ankle-brachial index. The Ankle-brachial Index is to apply a regular arm blood pressure cuff above the ankle and determine the systolic pressure in either the posterior tibial or dorsalis pedis artery. Then divide that figure by the systolic pressure of the brachial artery. The normal ankle pressure is slightly greater than or equal to the brachial pressure. However, the ankle-brachial index may be less reliable because of calcification which makes their arteries non-compressible and may give a falsely high measurement. (Jarvis, 2004) Skin assessment If patient have wound or skin impair, nurses should do wound assessment to record the size and the characteristic such as redness, edema, pain and heat. It is used to follow the wound healing progress. If necessary, nurses may have a bacteria test to confirm either the wound have microbe or not. (Worley, 2006) The outcome of having foot assessment The assessment findings can be used to indicate or predict the problems of their diabetic foot. The most positive outcome is no diagnostic findings. It is including integrated skin with normal sensation. However, other possible findings are neuropathy, ischemia, ulceration, infection and necrosis. The most serious alive consequence is amputation. Outcome of musculoskeletal syste The possible finding of musculoskeletal system is foot deformity. Deformity should be recognized early and accommodated in properly fitting shoes before ulceration occurs. If nurses assess the footwear, the chance of foot deformity will be reduced. Deformities include the Charcot foot which refers to bone and joint destruction that occurs in the neuropathic foot. Early diagnosis is important to prevent severe deformity. The foot presents with unilateral erythema, warmth and edema. (Edmonds, 2008) Outcome of neurologic assessment The outcome of neurologic assessment is either absent of sensory neuropathy or not. If patient loss of sensory neuropathy, they cannot sense pain or pressure and has a lack of identity with their feet. Also, motor neuropathy where muscular loss results in the clawed toes, high arch, foot drop and an absent ankle reflex. Due to absence of sweat and sebum production of autonomic neuropathy, the skin is dry and inelastic. In addition, pressure sensation test can be further confirmed their pain sensation is true or not. If patient can feel the pressure from the filament, the protective pain sensation is present. It is important to avoid areas of callus when carrying out this procedure as applying the filament to a plaque of callus may lead to a false diagnosis of neuropathy being recorded. (American Diabetes Association, 2010) Outcome of peripheral vascular assessment The outcome of Doppler ultrasonic stethoscope is to indicate the presence of peripheral vascular disease though listen the pulse qualities. The normal range of ankle-brachial index is 1.0 to 1.2. If the ankle-brachial index is of 90% or less, it indicates the presence of peripheral vascular disease. If the index is 0.9 to 0.7, it indicates a mild claudication, 0.7 to 0.4 indicates moderate to severe claudication, and 0.4-0.3 indicates severe claudication usually with rest pain except in the presence of diabetic neuropathy. The most serious outcome of this assessment is the index less than 0.3; it is diagnosing ischemia with impending loss of tissue. (Jarvis, 2004) Ischemia or peripheral arterial occlusive disease is the possible outcome too. It eventually will reduce in arterial perfusion severely and result in vascular compromise of the skin, often precipitated by a major trauma. Also ischemia is always associated with neuropathy. (Wilson, 2003) Infection process is the main reason for major amputation following ulceration. It can complicate the neuropathic and the neuro-ischemia foot ulcer. As infection originate from skin trauma or ulceration, often spreading to soft tissue then bone. Associated with neuropathy or ischemia, mean infection is often missed because of an absence of pain or loss of ability to mount an inflammatory response. Also there is no increase in temperature, white blood cell count and C reactive protein. (Wilson, 2003) Outcome of skin assessment The most positive skin assessment outcome is integrated skin and no wound. However, if diabetic patient have wound, healing is usually protracted. It is because patients with neuropathy continually traumatize their foot wounds by walking freely upon them. It is difficult to tell patient to take rest when they don’t feel pain during walking. Also patients with ischemia cannot mount an adequate inflammatory response to fight infection and achieve healing. Another reason is related to the healing process. Macrophages and neutrophils are important agents in wound healing, particularly at the inflammatory stage which is fundamental to all ensuing stages. However, the above function of diabetic is impaired. Thus the wound will hard to heal. If the wound decay, it will become foot ulceration. (Bentley Foster, 2007) Necrosis is a grave implication that diagnosis necrotic foot, threatening the loss of the lumbs, and is caused by infection or ischemia or both. It is classified as either wet or dry, each with its specific management. If it is in the neuropathic foot, necrosis is invariably wet initially and is nearly always due to a septic arteritis secondary to soft tissue infection complicating a digital or metatarsal ulcer. The arterial lumen is often occluded by a septic thrombus. Both wet and dry necrosis can occur in the neuroischemic foot. The common cause of a black toe is again septic arteritis, exacerbated by large vessel disease in the leg. Dry necrosis can also develop in the neuroischemic foot and is secondary to a severe reduction in arterial perfusion. (Edmonds, 2008) For Amputation The combined impact of neuropathy, ischemia and infection are so great that is amputation. It is preceded by foot ulceration and infection. It is because diabetic related to an artery disease which reduces blood flow to the feet. If the blood flow reduces, the healing process will be slowly. Even with preventative care and prompt treatment of infection and complications, there are instances when amputation is necessary to remove infected tissue in order to save a limb or even save a life. (Wilson, 2003) If missing the above assessment, nurses cannot diagnosis the problem of this patient. The most serious consequence will be happened. Conclusion Diabetic foot assessment indicates lots of different outcomes. Patient with diabetic should not look down upon their wound; it will be have a serious consequence which is amputation. In order to have a quality of life, an impaired skin’ diabetic patient must need the further foot assessment so as to prevent the negative outcome. Reference American Diabetes Association. (2010). Foot Complications. Retrieved Mar 23, 2011, from http:// www.diabetes.org/living-with-diabetes/complications/foot- complications.html Bentley, J., Foster, Ali. (2007). Multidisciplinary management of the diabetic foot ulcer. Wound Care, S6, S8, S10, S12. BJSM. (2008). Knee Exam (5 of 27): Neurovascular evaluation: supine. Retrieved Mar 23, 2011, from youtube.com/user/BJSMVideos#p/u/38/xe W7dwcBZCI Chan, C. N. J., Yeung, T. F. V., Chow, C. C., Ko, T. C. G., Cockram, C. S., Chan, N. N. (2005). A manual for management of diabetes mellitus a Hong Kong Chinese perspective (revised ed.). Hong Kong: TheChineseUniversity ofHong Kong. Edmonds, M. (2008). A natural history and framework for managing diabetic foot ulcers. British Journal of Nursing, 17(11), S20, S22, S24, S25-S29. Jarvis, C. (2004). Physical Examination Health Assessment (4th ed.).Philadelphia:Elsevier Khanolkar, M. P., Bain, S. C., Stephens, J. W. (2008). The diabetic foot. Q J Med, 101, 685-695. Prakash, S. (2011). Early Screening to Cure from Type 2 Diabetes. Retrieved March 23, 2011, from http://topnews.us/content/237118-early-screening-cure-type-2 -diabetes Thompson, L., Nester, C., Stuart, L., Wiles, P. (2004). Interclinician variation in diabetes foot assessment- a national lottery?. Diabetic Medicine, 22, 196-199. Wilson, D. J. (2003). Amputation and the diabetic foot: learning from a case study. Wound Care, S18, S20, S22, S24. Worley, C. A. (2006). Neuropathic Ulcers: Diabetes and Wounds, PartI.Etiology and Assessment. Dermatology Nursing, 18(1), 52-53.

Business P6 UNIT 12 Essay Example | Topics and Well Written Essays - 250 words

Business P6 UNIT 12 - Essay Example These types of online marketing operate in a twenty-four-hour time frame, where the target client is, conveniently, placed to get the advertisement (Sheehan, 2010). Online marketing has potential benefits, both to the target client and the advertising company. One of the significant benefits is convenience, where a company is open for business on the world platform with little expenses. It is also convenient to clients in that a person can browse the online stores at any time, and place their orders at a convenient time. Online marketing is also, cost, effective than the usual physical retail. A business entity does not have to incur expenses felt on property rental on retail outlets. Internet marketing enables one to build a personal profile of the client, where client follow up is possible, and the cost is effective. There personalized offers to meet client needs, and invite them to make product reviews, hence retaining them as regular customers (Sheehan, 2010). Another major benefit is accessibility, especially to people who are disabled. Sheehan (2010) observes that physical barriers for accessing products do not exist anymore because the internet can be accessed from various electronic devices that are potable and convenient, even to the disabled. In addition, there are potential benefits to an online organization, making it easy to manage its operation. It is also cost effective, in that one does not have to incur rental property for operation. Furthermore, many businesses are opting to do marketing online, meaning that there is a huge potential for

Arguments Essay Example | Topics and Well Written Essays - 500 words - 2

Arguments - Essay Example San Diego is also considered a well-developed city. Aside from having beautiful beaches, the city has a long chain of fine dining restaurants, shopping malls including telecommunication services like internet cafà © among others. Since most part of the city is composed of a long line of luxurious homes, the standard of living of its residences also increases. On top of the improvements in the social class and status of the people, their personal and home security is also better as compared to a village that is composed of low-income dwellers. According to Kristina Davis – a Union-Tribune staff writer, â€Å"San Diego remains one of the safest large cities in the nation as crime rate continues to fall and the number of officers on the street continues to rise† (Davis). Considering the downturn in the U.S. economic condition and the continuously increasing high unemployment rate, it is expected that criminal activities is present wherever we go. Based on the San Diego Crime Statistics Report, the total violent crime and property crime rate in San Diego is 0.97 and 0.83 times the national average (City Ratings). This figure is still considerably low as compared to other city in California. Because of safety reasons, San Diego is considered a great place to raise a family. Since parents can be more assured of the safety of their children and other family members, individuals who are employed with either small- and medium-scale businesses or large multi-national companies are able to focus on their profession better. Likewise, the city government of San Diego has managed to develop competitive and outstanding educational system for children and young adults. Given that the population of the people living in San Diego has reached a total of more than 4 million individuals throughout the metropolitan area, medical institutions situated in the city has invested a large sum of money on high-quality medical equipments and facilities aside from having