Athens Olympic stadium Case Study Example | Topics and Well Written Essays - 1250 words

Athens Olympic stadium - Case Study Example The immense size of the project and its particular technical complexity were the causes for long delays; the work was finally completed in time and the new captivating stadium was officially reopened on July 30, 2004 (O.A.K.A. 2005). The Athens Olympic stadium roof in the form of a double bowstring tied arch of 80 m high is considered one of the most ingenious modern architectural and engineering projects. This impressive construction of steel and glass is today one of the city's landmarks. Along with its spectacular and pioneering architectural design, the suspended arched roof construction and erection has been a challenge to engineers and an excellent example of integration of construction engineering and hydraulic expertise (Siriani & Di Silverio 2006). The roof structure is in two halves, each comprising a top arch of a diameter of 3.25 m and a lower torsion tube of a diameter of 3.6 m extending for 304 m over the stadium. The wall thicknesses of the tubes are up to 95 mm. All four tubes merge at their ends and are based on four support steel shoes (19 m x 4 m x 4 m) made from 100 mm thick steel plates. The tubes support wire cables that hold polycarbonate panels of a weigh of 17,000 ton in total. 220 girders cantilever out of the torsion tube supporting the panels, thus forming the roof deck. Finally, the panels are covered by a special coating to reflect 60% of the sunlight. Apart from providing shadow, protecting athletes and spectators against the hot Greek summer sun, the roof served as a carrier for telecommunications and security systems during the Games (Siriani & Di Silverio 2006). The layout of Calatrava's roof can be seen in figure 1. Fig.1. The Athens Olympic stadium layout and dimensions of the roof (redrawn from Siriani & Di Silverio 2006). The roof construction project was contracted to the Italian Costruzioni Cimolai Armando Spa of Pordenone. In detail, the stages of the building process were segment fabrication and pre-assembly, segment shipping to construction site, on-site assembly and erection of the two halves of the roof at a distance from the sports arena and finally assembly pulling (sliding) into position. With the exception of the sliding step that was sub-contracted, all remaining stages were undertaken by Cimolai (Siriani & Di Silverio 2006). A number of difficulties arose during the renovations works that were mainly linked to the immense character of the project and the shortage of available time; these issues required technically advanced, ingenious solutions. All steel fabrication works took place at Cimolai's site in Italy, using a 6000 ton press, one of the largest in Europe. The support shoes and pre-assembled tube segments of up to 15 m in length equipped with cable anchorages, diaphragms and girder connections were constructed there and were subsequently shipped by sea to Athens. Shipping has been a gigantic operation due to the excessive size of the segments of the roof (Siriani & Di Silverio 2006). A second particularity of the project was that roof assembly and erection could not take place at its final position, so as to allow other renovation work in the stadium to proceed during the assembly process. Thus each of the arch structures was put together separately on each side of the concrete stadium, at 70 m far from either side. Roof

Education in India Essay Example for Free

Education in India Essay Takshasila was the earliest recorded centre of higher learning in India from at least 5th century BCE and it is debatable whether it could be regarded a university or not. The Nalanda University was the oldest university-system of education in the world in the modern sense of university. [2] Western education became ingrained into Indian society with the establishment of the British Raj. Overall System Education in India is provided by the public sector as well as the private sector, with control and funding coming from three levels: central,state, and local. Education in India falls under the control of both the Union Government and the State Governments, with some responsibilities lying with the Union and the states having autonomy for others. The various articles of the Indian Constitution provide for education as a fundamental right. Most universities in India are controlled by the Union or the State Government. The National Policy on Education (NPE) is a policy formulated by the Government of India to promote education amongst Indias people. The policy covers elementary education to colleges in both rural and urban India. The first NEP was promulgated in 1968 by the government of Prime Minister Indira Gandhi, and the second by Prime Minister Rajiv Gandhi in 1986. It emphasizes three aspects in relation to elementary education: * universal access and enrolment, * universal retention of children up to 14 years of age, and * a substantial improvement in the quality of education to enable all children to achieve * Revival of Sanskrit and other classical languages for contemporary use. Today education system in India can be divided into many stages. * Pre- Primary It consists of children of 3-5 years of age studying in nursery, lower kindergarten and upper kindergarten. At this stage student is given knowledge about school life and is taught to read and write some basic words. * Primary It includes the age group of children of 6-11 years studying in classes from first to fifth. * Middle It consists of children studying in classes from sixth to eighth. * Secondary it includes students studying in classes ninth and tenth. * Higher Secondary Includes students studying in eleventh and twelfth classes. * Undergraduate Here, a student goes through higher education, which is completed in college. This course may vary according to the subject pursued by the student. For medical student this stage is of four and a half years plus one year of compulsory internship, while a simple graduate degree can be attained in three years. * Postgraduate After completing graduation a student may opt for post graduation to further add to his qualifications. 10+2+3 pattern [. * The central and most state boards uniformly follows the 10+2+3 pattern of education. [11]:3 In this pattern, 10 years of primary and secondary education is followed by 2 years of higher secondary (usually in schools having the higher secondary facility, or in colleges),[11]:44 and then 3 years of college education for bachelors degree. [12] Distant Education * National Open University (IGNOU), New Delhi is one of the mega open universities in the world and caters to around 1 million students around the world. Vocational Education. Vocational Education at Certificate level are offered by 1500 vocational institutions in the country in the areas of agriculture, business, commerce, health and para-medical, home science and humanities in addition to engineering trades. Primary Education in India The World Education Forum, held in 2000 set an ambitious goal: universal primary education by the year 2015. Schooling all children until they reach young adulthood is recognized as important because it leads to many substantial positive effects: better family health, lower birth rate, higher productivity, higher earnings, and improved economics of the country as a whole. Globally, however, more than 115 million children of primary school age do not attend school. The Indian government lays emphasis on primary education up to the age of fourteen years, referred to as elementary education in India. [14] The Indian government has also banned child labour in order to ensure that the children do not enter unsafe working conditions. Further, education has been made free[14] for children for 6 to 14 years of age or up to class VIII under the Right of Children to Free and Compulsory Education Act 2009. [18] Current status of primary education in IndiaAbout 20% of Indian children between the ages of six and 14 are not enrolled in school. Even among enrolled children, attendance rates are low and 26% of pupils enrolled in primary school drop out before Grade 5. The situation is worse in certain sectors of the population Despite a vibrant emerging economy and a string of excellent colleges that produce high caliber professionals, India has not made the grade yet on primary education. Hurdles in primary education (double it as general problems as well) Shortage of resources and lack of political will. High pupil to teacher ratios,(shortage of teachers –one teacher schools) Shortage of infrastructure and poor levels of teacher training. (toilet for girls etc. ) The National Curriculum Framework for Teacher Education of 2009 recommended longer preparation for teachers, but the B. Ed curriculum structure continued to be for a single year. There is also a lack of enough skilled trainers and preparation to develop skills, abilities and attitudes to teach students. Poverty and illiteracy of the parent Gender Issues(girls cannot study). Social Issues like caste system (some castes are not allowed) Several efforts to enhance quality made by the government. (primary education) The District Education Revitalization Programme (DERP) was launched in 1994 with an aim to universalize primary education in India by reforming and vitalizing the existing primary education system. [19] 85% of the DERP was funded by the central government and the remaining 15 percent was funded by the states. [19] The DERP, which had opened 160000 new schools including 84000 alternative education schools delivering alternative education to approximately 3. 5 million children, was also supported by UNICEF and other international programmes. [19] . [19] Significant improvement in staffing and enrollment of girls has also been made as a part of this scheme. [19] The current scheme for universalization of Education for All is the Sarva Shiksha Abhiyan which is one of the largest education initiatives in the world. Enrollment has been enhanced, but the levels of quality HERE first Write to improve all the above negative issues. Sarva Shiksha Abhiyan (SSA)/Right to Education (RTE). Sarva Shiksha Abhiyan (Education for All Movement) is a programme by the Government of India aimed at the universalization of elementary education in a time bound manner, as mandated by the 86th amendment to the Constitution of India making free education to children aged 6–14 (estimated to be 205 million in number in 2001) a fundamental right. The programme was pioneered by Atal Bihari Vajpayee. SSA is being implemented in partnership with State Governments to cover the entire country and address the needs of 192 million children in 1. 1 million habitations. In FY 2009-10,60% of SSA funds came from GOI. This has now been revised to 65%. The programme is looking to open new schools in those habitations without schooling facilities and to strengthen existing school infrastructure through provision of additional class rooms, toilets, drinking water, maintenance grant and school improvement grants. SSA is now the primary vehicle for implementing the Right to Free and Compulsory Education Act (RTE). National Programme for Education of Girls at Elementary Level (NPEGEL) The National Programme for Education of Girls at Elementary Level (NPEGEL), is a focused intervention of Government of India, to reach the â€Å"Hardest to Reach† girls, especially those not in school. Launched in July 2003, it is an important component of SSA, which provides additional support for enhancing girl’s education over and above the investments for girl’s education through normal SSA interventions. The programme provides for development of a â€Å"model school† in every cluster with more intense community mobilization and supervision of girls enrolment in schools. Gender sensitization of teachers, development of gender-sensitive learning materials, and provision of need-based incentives like escorts, stationery, workbooks and uniforms are some of the endeavors under the programme. The future of primary education in India The importance of universal primary education has now been widely recognized by everyone involved. Policies and pledges are easy to make but implementation can be difficult and goals hard to achieve, especially in a vast and populous country such as India. International agencies, the government of India, and the numerous NGOs will have to work together with will, wisdom and tremendous energy to make their desire for universal primary education by 2015 a reality in India. Secondary education. For several decades, it has been argued in the literature that secondary education needs to be expanded both as a response to increased social demand and as a feeder cadre for higher education, giving little emphasis to its other important functions. It is also argued that investment in secondary education yields considerable social and economic returns, making it crucial for national development India is following a service-led growth model and striving hard to survive the global competition, in these conditions it is being increasingly recognised that secondary education, is the most critical segment of the education chain. Apart from the bottom-up pressure (i. e. arising from the growth of primary schooling) and the top-down pressure (as the source of potential intakes for higher education) for its expansion, there is a need to pay greater attention to secondary education as it caters to the needs of the most important segment of the population – adolescents and youth, the source of the future human and social capital of a nation. Secondary education covers children 14–18 which covers 88. 5 million children according to the Census, 2001. Features * A significant feature of Indias secondary school system is the emphasis on inclusion of the disadvantaged sections of the society. * Professionals from established institutes are often called to support in vocational training. * Another feature of Indias secondary school system is its emphasis on profession based vocational training to help students attain skills for finding a vocation of his/her choosing. [27] * A significant new feature has been the extension of SSA to secondary education in the form of the Madhyamik Shiksha Abhiyan[28] Integrated Education for Disabled Children (IEDC) programme was started in 1974 with a focus on primary education. [7] but which was converted into Inclusive Education at Secondary Stage[29] The government started the Kendriya Vidyalaya project in 1965 for the employees of the central government of India to provide uniform education in institutions following the same syllabus at the same pace regardless of the location to which the employees family has been transferred. [7] Policy Initiatives in secondary education After independence, the first step towards improving policy planning for development of secondary education was the setting up of the Secondary Education Commission in 1952(also known as the Mudaliar Commission). The primary objective of the Commission was todiagnose the growth pattern and suggest measures for reorganisation and improvement ofsecondary education. The commission’s major recommendation was to develop a 3-yearnational system of secondary education after 8-years of elementary education (8 + 3 systemof school education) to make it a complete stage. The commission also recommended thereconstruction of the syllabus to provide a wider and more balanced course and adopt mother tongue as the medium of instruction (Kabir, 1955). Nearly one-and-a-half decades after the Mudaliar Commission, the Kothari Commission(1964-66), while articulating goals and objectives at all stages of education in the context ofnational development priorities, recommended for a 4-year secondary education system anddiscontinuing the practice of ‘streaming’ up to Grade X. It may be noted that, ten years afterthe commission submitted its report; education was placed in the Concurrent List States and the centre responsible for its development. This changed the policy context fordevelopment of secondary education. The National Policy on Education (NPE), of 1986 subsequently reiterated the views of the Education Commission to implement a 4-year secondary education system across the states and UTs. 23 The NPE emphasised improving equitable access to secondary education and the enrolment of girls, SCs and STs, particularly in science, commerce and vocational streams (Para 5. 13 of the NPE, 1986). The NPE and the Programme of Action (POA), 1992 while recognising secondary education as a critical instrument for social change, called for its planned expansion. The NPE, (as modified in 1992) specifically laid emphasis again on increasing access to secondary education with particular focus on participation of girls, SCs and STs; increased autonomy of Boards ofSecondary Education to enhance their ability to improve quality; introduction of ICT inschool curriculum for coping with globalisation; renewed emphasis on work ethos and valuesof a humane and  composite culture in the curricula; And vocationalisation through specialisedinstitutions or through the refashioning of secondary education to meet the manpower requirements of the growing Indian economy Rashtriya Madhyamik Shiksha Abhiyan (RMSA) This scheme was launched in March, 2009 with the objective to enhance access to secondary education and to improve its quality. The implementation of the scheme started from 2009-10. It is envisaged to achieve an enrolment rate of 75% from 52. 26% in 2005-06 at secondary stage within 5 years of implementation of the scheme by providing a secondary school within a reasonable distance of any habitation. The other objectives include improving quality of education imparted at secondary level through making all secondary schools conform to prescribed norms, removing gender, socio-economic and disability barriers, providing universal access to secondary level education by 2017, i. e. , by the end of 12th Five Year Plan and achieving universal retention by 2020. Inclusive Education for the Disabled at Secondary Stage (IEDSS) The Scheme of Inclusive Education for Disabled at Secondary Stage (IEDSS) has been launched from the year 2009-10. This Scheme replaces the earlier scheme of Integrated Education for Disabled Children (IEDC) and would provide assistance for the inclusive education of the disabled children in classes IX-XIITo enable all students with disabilities, after completing eight years of elementary schooling, to pursue further four years of secondary schooling in an inclusive and enabling environment. Higher education Indias higher education system is the third largest in the world, after China and the United States. [32] The main governing body at the tertiary level is the University Grants Commission (India), which enforces its standards, advises the government, and helps coordinate between the centre and the state. [33] Accreditation for higher learning is overseen by 12 autonomous institutions established by the University Grants Commission. [34] In India, education system is reformed. In future, India will be one of the largest education hub. After passing the Higher Secondary Examination (the grade 12 examination), students may enroll in general degree programmes such as bachelors degreein arts, commerce or science, or professional degree programmes such as engineering, law or medicine. [31] As of 2009, India has 20 central universities, 215 state universities, 100 deemed universities, 5 institutions established and functioning under the State Act, and 33 institutes which are of national importance. [33] Other institutions include 16,000 colleges, including 1,800 exclusive womens colleges, functioning under these universities and institutions. [33] The emphasis in the tertiary level of education lies on science and technology. [35] Indian educational institutions by 2004 consisted of a large number of technology institutes. [36] Distance learning is also a feature of the Indian higher education system. [36] Indian Institutes of Technology (IITs), have been globally acclaimed for their standard of undergraduate education in engineering. [36] The IITs enroll about 10,000 students annually and the alumni have contributed to both the growth of the private sector and the public sectors of India. [37] Several other institutes of fundamental research such as the Indian Association for the Cultivation of Science (IACS), Indian Institute of Science IISC), Tata Institute of Fundamental Research (TIFR), Harishchandra Research Institute (HRI), are acclaimed for their standard of research in basic sciences and mathematics. Government programs on Education Rashtriya Uchattar Shiksha Abhiyan[. The Rashtriya Uchattar Shiksha Abhiyan is a centrally sponsored flagship umbrella scheme aimed at providing strategic funding to State higher and technical institutions. States will develop comprehensive state higher education plans that utilize an interconnected strategy to address issues of expansion, equity and excellence together. Central funding will be linked to academic, administrative and financial reforms of state higher education. The Rashtriya Uchattar Shiksha Abhiyan proposes to put a ceiling of maximum number of colleges to be affiliated to any university at two hundred . [17] Higher Education and Eleventh Plan (2007-2012) With the objectives and proposals of the Plan as the basis, the report mentions that the private sector has played an instrumental role in the growth of the sector. Private institutions now account for 64% of the total number of institutions and 59% of enrollment in the country, as compared to 43% and 33%, respectively, a decade ago. The Government has also given the required thrust to the sector in its Five Year Plans. During the Eleventh Plan period (2007–2012), India achieved a Gross Enrollment Ratio (GER) of 17. 9%, up from 12. 3% at the beginning of the Plan period. India’s higher education system faces challenges on three fronts: Expansion:India’s GER of16% was much below the world average of 27%, as well as that of other emerging countries such as China (26%) and Brazil (36%) in 2010. Excellence:Faculty shortage there is 40% and 35% shortage of faculty in state and central universities, respectively. Accredited institutions 62% of universities and 90% of colleges were average or below average in 2010, on the basis of their NAAC accreditation. Low citation impact India’s relative citation impact is half the world average. Equity There is wide disparity in the GER of higher education across states and the Gross Attendance Ratio (GAR) in urban and rural areas, and gender- and community-wise Drawbacks of Indian Higher Education System * Besides top rated universities which provide highly competitive world class education to their pupils, India is also home to many universities which have been founded with the sole objective of making easy money. * Regulatory authorities like UGC and AICTE have been trying very hard to extirpate the menace of private universities which are running courses without any affiliation or recognition. Indian Government has failed to check on these education shops, which are run by big businessmen politicians. * Many private colleges and universities do not fulfill the required criterion by the Government and central bodies (UGC, AICTE, MCI, BCI etc. ) and take students for a ride. * Quality assurance mechanism has failed to stop misrepresentations and malpractices in higher education. At the same time regulatory bodies have been accused of corruption, specifically in the case of deemed-universities. [39] Road Ahead in Higher Education * Merit-based student financing: This should ensure admissions to meritorious students independent of financial background * Internationalization of education: This would entail aligning different aspects of education (curriculum, faculty, etc) to international standards * Enabling a research environment. This would involve creating adequate means of research funding and practical application of research * High quality faculty: The need of the hour is to create a conducive environment and provide incentives to attract and retain high quality faculty. * Improved technology for education delivery: Leveraging technology for enhancing the teaching-learning experience will ensure better outcomes * Employability: Making education-industry relevant and practical would be the right way to ensure a highly employable talent pool India’s higher education system can be expected to be better aligned to industry and global practices, and be more transparent and inclusive by the end of Twelfth Plan period, provided the Government is able to create an enabling regulatory environment and put in place robust implementation, monitoring and quality assurance mechanisms. * Legislative support. One of the most talked about bill is Foreign Universities Bill, which is supposed to facilitate entry of foreign universities to establish campuses in India. * Private Sector-The private sector can be expected to play an instrumental role in the achievement of these outcomes through the creation of knowledge networks, research and innovation centers, corporate-backed institutions, and support for faculty development. Saakshar Bharat (Saakshar Bharat)/Adult Education. The Prime Minister of India launched Saakshar Bharat, a centrally sponsored scheme of Department of School Education and Literacy (DSEL), Ministry of Human Resource Development (MHRD), Government of India (GOI), on the International Literacy Day, 8th September, 2009. It aims to further promote and strengthen Adult Education, specially of women, Education Governing Bodies he Central Board of Secondary Education (CBSE): This is the main governing body of education system in India. It has control over the central education system. It conducts exam and looks after the functioning of schools accredited to central education system. * The Council of Indian School Certificate Examination (CISCE): It is a board for Anglo Indian Studies in India. It conducts two examinations Indian Certificate of Secondary Education and Indian School Certificate. Indian Certificate of secondary education is a k-10 examination for those Indian students who have just completed class 10th and Indian school certificate is a k-12 public examination conducted for those studying in class 12th. * The State Government Boards: Apart from CBSE and CISCE each state in India has its own State Board of education, which looks after the educational issues. * The National Open School: It is also known as National Institute of Open Schooling. It was established by the Government Of India in 1989. It is a ray of hope for those students who cannot attend formal schools. * The International School: It controls the schools, which are accredited to curriculum of international standard. * Classification of Colleges. Colleges in India come under four different categories. This categorization is done on the basis of the kind of courses offered by them (professional/ vocational) / their ownership status( Private/ Government) or their relationship with the university (affiliated/university owned). University Colleges These colleges are managed by the university itself and situated mostly in the university campus. Government Colleges The government colleges are few, only about 15-20 percent of the total. They are managed by state governments. As in case of other colleges, the university to which these colleges are affiliated, conducts their examination, lays down the courses of studies and awards the degrees. Professional Colleges The professional colleges are mostly in the disciplines of medicine, engineering and management. There are few for other disciplines too. They are sponsored and managed either by the government or by private initiative. Privately Managed colleges About 70% of the colleges are founded by the privately owned trusts or societies. But these institutes are also governed by the rules and regulations of the university they are affiliated to. Though initially started up as a private initiative, the state government also funds these college Private Education What is it? What is the need for it ? What are benefits? What are problems with it? What can be done to streamline it? India saw the largest increase in literacy rate in the decadeof 1991–2001 — from about 52 per cent to 65 per cent. From 2001 to 2011, the literacy rate increased by 9 per cent to 74 per cent (Planning Commission 2011). The 13 per cent increase in 1991–2001 has been the largest for any 10-year period in the history of the country. Private investments and the emergence of budget private schools was the main cause for this.! As parents began to earn more in the post-reform era, they began to invest in their children. As better employment opportunities arose, the value of education became more apparent to parents. This increased demand for education was met by a rapid expansion of budget private schools The biggest success story of literacy in India has been written withprivate initiative — parents’ willingness to pay and the edupreneur innovation of an aff ordable school. In post-liberalisation India, the importance of the private sector in economic growth is well understood and appreciated. For economic growth, the state’s role is primarily to enable the private sector as a facilitator, prudent regulator, impartial enforcer of contracts, and at times as a financier Incentives for efficiency are also weak. Government employees have little incentive to minimise costs, fi nd and correct mistakes, innovate, and acquire necessary information about resources and consumer demand. The high teacher absenteeism in government schools is just one indicator of poor incentives. . High prices in terms of tuition fees, donations andlong queues for admissions are signs of the shortage of quality educational institutions. The same paucity of supply existed for consumer goods before the 1991 liberalisation. The license-permit-quota raj still exists in our education system. Schools and colleges need to be made accountable not to education bureaucrats (licensors) but to parents and students (customers). The government policy should be to increase choice and competition in education as it has been done in many areas of the economy — facilitate, not control. The core competency of the private and public sectors should be combined. The private sector should be allowed to produce education — manage schools and colleges — and provide it to all who can aff ord to pay. For those who cannot aff ord to pay, the government should finance their education through scholarships, education vouchers and loans. Instead of focusing on the inputs to education, the government ensures the output — meaningful, high quality learning. This approach combines the efficiency and accountability of the private sector with the equity and independent supervision of the public sector. . Governments and Non-Governmental Organisations (NGOs) should evaluate schools and colleges and publish the results so that parents can make informed decisions. One key goal of global reformers is to increase the accountability of schools towards parents — restructure the system so that schools are at least as much accountable to parents as they are to the education offi cials. There are many ways to achieve this goal: put parents on school boards or district education councils, give powers to parent-teacher associations, create something like our village education committees . One new idea in this bucket is that of school vouchers. Several countries have undertaken pilot projects. The voucher is a tool to change the way governments finance education, particularly of the poor. It is a coupon off ered by the government that covers full or partial cost of education at the school of the student’s choice. The schools collect vouchers from the students, deposit them in their bank accounts and the banks then credit the school accounts with equivalent money while debiting the account of the government. Section 12 of the RTE requires private unaided schools to reserve 25 per cent seats in the entry-level class (nursery or Class I) for socially disadvantaged and economically weaker sections. The government would provide private schools with reimbursements equal to their fees or the per student cost in government schools, whichever is lower. EDUCATION REFORM Just as in economic reforms, the list of education reform ideas could be quite long. This paper suggests that two principles should be the focus of reforms in the education ecosystem — effi cient use of public funds and the promotion of equity and quality through choice and competition. Achieve Efficient Use of Public Funds. (a) Fund students, not schools (school vouchers, charter schools, conditional cash transfers); (b) Convert state funding to per student basis and link it to performance; (d) Give poorly performing state schools to private parties on learning outcome contracts; (e) Hire teachers at the school level, not at the state level; Promote Equity and Quality through Choice and Competition: (i) Apply the same standards to both private as well as government schools; (ii) Annual independent learning outcome assessment across all schools; (iii) Decentralise and depoliticise syllabi and textbooks; (iv) Open Central Board of Secondary Education (CBSE) and state board exams to all students, not only for students who study in CBSE or state board affiliated schools.

How Diversity Affects Roles Of Nurses Nursing Essay

How Diversity Affects Roles Of Nurses Nursing Essay Nursing is an art:   and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painters or sculptors work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of Gods spirit?   It is one of the Fine Arts:   I had almost said, the finest of Fine Arts.   Florence Nightingale Outline Introduction Today, nurses operate in the cultural diverse environment. The contemporary health care setting incorporates both professionals and patients with a diverse cultural background as well as social level. In such a situation, health care professionals have to pay a lot of attention to cultural needs of their patients, while nurses are particularly concerned with issues related to diversity because they spend more time with patients than any other health care professionals. Therefore, professional nurses have to understand the diverse needs of their patients and take into consideration cultural as well as individual peculiarities of each patient to provide them with health care services of the high quality. In such a way, nurses are able to facilitate the recovery of patients and help them to pass through their health problems successfully returning to the normal life. In stark contrast, the ignorance of diversity related issues may lead to the failure of nurses to succeed in their work a nd, what is even more important, the ignorance of diversity put under a threat positive outcomes of the treatment conducted by physicians with the assistance of nurses because patients cannot recover if nursing is inefficient which is the case of nurses unawareness of diverse patients needs and expectations. In such a way, the diversity is an integral concept of the modern nursing and nurses should understand the essence of diversity and be able to find individual approach to each patient respectively to their diverse cultural and individual needs to provide effective health care services to all patients. Diversity in the contemporary health care setting This chapter focuses on the major issues related to diversity in the contemporary health care setting. To put it more precisely, it is necessary to focus on cultural diversity of patients, their diverse cultural background and individual needs and expectations; the diversity within the personnel of health care organizations for nurses have to cooperate effectively with other health care professionals as well as with each other; finally, today, many nurses from different countries get training and nurses with different cultural background have to learn to interact with each other effectively both in the course of the training and in their regular work. Cultural diversity of patients The cultural diversity of patients is a very important issue affecting the work of nurses consistently. In actuality, patients have a diverse cultural background and nurses have to learn to work with patients with diverse cultural background. Patients are not as homogeneous as they used to be in the past. The diverse cultural background leads to the development of diverse sets of values, ethical norms and principles, diverse models of behavior, and so on. Such diversity may raise very serious problems in the course of work of nurses because they have to provide patients with health care services, which may affect patients values or ethical norms and principles. At the same time, the growing immigration and multicultural environment contributes to the long-lasting diversity that makes the adaptation of nurses to cultural diversity in health care setting one of the priorities in their education and professional development. Close interaction between nurses and health care professionals at the international level At the same time, the cultural diversity affects not only relationships of nurses and patients but also the relationship of nurses and other health care professionals working within one and the same health care organization. The personnel of hospitals and medical centers is culturally diverse. Therefore, nurses should be able to interact effectively with their colleagues regardless of cultural differences, which effect is similar to that of the difference in cultural background of nurses and patients. In such a situation, nurses should understand the needs and basic values, ethical norms and principles of their colleagues to develop effective strategies which they can use in their regular work. On the other hand, it is important to take into consideration the growing cooperation between health care organizations at the international level. For instance, Red Cross, Medicins Sans Frontieres, and other international organizations contribute to the closer cooperation between nurses with diverse cultural background. They have to work together and interact effectively to provide patients with essential health care services. In such a situation, diversity can become an unsurpassable barrier preventing nurses from effective professional performance, whereas understanding and development of effective strategies of work in the culturally diverse environment helps nurses to maximize their performance and deliver health care services of the high quality. Training of foreign nurses The emerging cooperation between health care organizations and professionals at the international level stimulates the training of nurses from foreign countries in the national health care organizations. In this respect, the training of foreign nurses raises the problem of diversity of cultural background, traditions, and standards of nurses. The existing national standards and approaches to nursing may come into conflict with standards and approaches to nursing foreign nurses are accustomed to. Therefore, nurses need to adapt their work to some universal standards to avoid conflicts between nurses, as well as between nurses and patients, between nurses and other health care professionals with different cultural background, standards and traditions. Importance of diversity and tolerance among nurses Obviously, the contemporary diverse health care setting stimulates the development of tolerance among nurses to maximize the effectiveness of their work in the diverse environment. Understanding needs and cultural peculiarities of patients with diverse cultural background The education and professional development of nurses operating in the culturally diverse health care setting should focus on the development of tolerance, which is grounded on the understanding of needs and cultural peculiarities of patients with different cultural background. In such a way, nurses learn needs and cultural peculiarities of patients, that means understanding of their cultural norms, traditions and values. As a result, nurses can take into consideration patients needs and to meet their expectations avoiding offensive action or inaction that may occur in case of ignorance of cultural peculiarities of patients. Study and assessment of diversity within the community Nurses cannot work in isolation from the community because the local community affects not only nurses but also patients. Moreover, the community involvement in the treatment of patients, especially with mental health problems or psychological problems, grows more and more popular. Therefore, nurses need to be able to interact with the local community to work effectively and to provide patients with effective health care services. In addition, they may help patients to get integrated into the local community that may facilitate their treatment and recovery. At the same time, the interaction between the local community and health care organizations can not only help to treat patients effectively but also to prevent the development of diseases within the community. However, without understanding of cultural background, needs, norms and traditions of the community nurses, as well as health care organizations, cannot succeed in the development of positive relationships with local communi ty members. Development of tolerance in nurses operating in culturally diverse environment One of the major strategic goals of nursing education and professional development should be the promotion of tolerance in nurses, especially those, who operate in culturally diverse environment. In fact, nurses have to be able to develop effective strategies and approaches to patients with diverse cultural background. The latter is impossible if they do not know cultural norms, standards, ethical principles and values of their patients. This is why, when nurses get started to work with patients, they should learn their cultural background and understand clearly their needs and cultural peculiarities. On the ground of this knowledge, nurses can develop an individual approach to each patient respectively to their needs and expectations. In such a way, nurses can maximize the effectiveness of their work and help patients to recover faster. Conclusion In conclusion, it is important to lay emphasis on the fact that nurses work in culturally diverse environment. They are vulnerable to the impact of diversity in their relationships with patients and their colleagues. In such a situation, nurses need to pay a particular attention to diversity and development of tolerance in the course of their education and professional development. In such a way, understanding of diversity and tolerance can help nurses to provide health care services of the high quality.

Graduation Speech: We are Prepared for the Challenges that Await Us :: Graduation Speech, Commencement Address

Today completes the chapter of our lives that we have been comfortable with for the past 13 years. High school may be over, but we still have a long exciting way to go in life. From our four-year experience we will take with us the memories, good and bad, and relationships we have made with each other and the County High School staff. From these experiences we have learned and grown and will continue to do so. Growing up and moving on will be a huge part of our lives in the next few months. The decisions we will make come in-part from the choices we have already made. The past four years have been fun and easy for some and a struggle for others. When I reflect on my high school experience, I think of watching football games, playing softball, homecoming weeks, school trips, parties and time with my friends. Others have spent their time in drama, band, community service, part-time jobs and all sorts of other activities. We have all watched Mr. LHS grow along with us until it became a big part of the high school year. I enjoyed laughing with and at the guys as they showed off their talents. This year’s homecoming football game was one of the most exciting ones we have had, with four quarters and three overtimes when we beat Jackson 48 to 42 for a homecoming victory. No matter what types of experiences we have had, I think they are important to remember and grow from. Through these fun and challenging times each one of us has built strong relationships. Whether it was with friends or a teacher, we have developed connections and memories that will be with us forever, even if we lose contact with those individuals. Some students have discovered they have a passion for writing through a creative writing class or want to have a career in business from taking Mr. Ide’s inspirational marketing classes. Others have participated in CLIP or summer school to catch up and make it possible for them to be here today. I went to Heights Elementary and have spent the last 12 years with the same group of people. Attending school with the people I’ve known since elementary and middle school, and making homecoming posters with them for four years in a row, has given me a chance to get to know the people around me better than I ever thought I would.

Critically appraise the education provision available for people with Diabetes. Education on prevention of Foot Ulcers in Diabetes.

Introduction Currently I am working in a nursing home where the elderly residents have various illnesses including the after effects of strokes and dementia. Due to their age and particular care needs the education for health support workers, senior carers and nurses who are at the centre of this care provision is fundamentally important. The aim of this assignment will therefore be the appraisal of this education, meaning their training and ongoing monitored development, with a specific focus on the prevention of foot ulcers in patients who suffer from diabetes mellitus. This is an important area for consideration because at the moment health care support workers have no formal education in the prevention of foot ulcers in diabetes patients and can be ignorant of its symptoms. As with nurses it is reasonable to expect that they should have attained a certain level of knowledge in this area as the consequences of foot ulcers can be very serious and in cases can lead to amputation. This ultimately has a significant impact on the quality of life of the diabetes sufferer and the carer therefore has a duty of care to protect their patient against this preventable outcome. It should be noted that 85% of cases which end in amputation can avoided (Garay- Sevilla et al., 2002, 81-86). In order to carry out this critical appraisal the first step is to consider the causes of diabetic foot ulcers, it signs and symptoms, treatment and prevention. The assessment of these factors is necessary because it deconstructs the knowledge required by health care workers and subsequently allows the provision of education to be accordingly evaluated for its accuracy and comprehensiveness. The next point to discuss is the current state of education on offer. This will be assessed in terms of how far it provides the level of knowledge needed by people who are in the position of diagnose and treat diabetic foot ulcers. Recommendations for best practice will then be make. Causes of diabetic foot ulcer One of the effects of diabetes is decreased immunity and poor wound healing. In the absence of normal blood flow specific lesions of the arteries, particularly in the extremities, can occur. Diabetic foot syndrome is one such complication and occurs in 15% of all patients with diabetes. These changes are a consequence of the existence of diabetic neuropathy. Motor neuropathy in diabetes leads to muscle atrophy and impaired co-flexors and extensors whilst also effecting deformation rate. Sensory neuropathy, sensory disturbance of pain by temperature and touch, increases the risk of injury which in turn contributes to the formation of ulcers. Autonomic neuropathy results in the formation of arterial venous fistulas and impaired blood oxygenation which leads to disorders affecting the trophic ulcers (Rubin & Peyrot, 1998, 81–87). The syndrome occurs in the later stages of the disease and is one of its most severe complications as it can lead to death. It manifests itself in compl ex changes in the joints and foot nerves, limb deformation, and deep tissue damage. It is also associated with damage to blood vessels, nerves, skin and bones. The initial abnormality takes the form of a pressure point which can be caused by, for example, ill-fitting shoes which cause blistering, cuts, and bites caused by foreign bodies. Vascular disease, resulting in decreased blood flow, contributes to poor healing and infections can be caused by numerous microorganisms (Manson & Spelsberg, 2004, 172–184). Patients who experience sensory disturbances find that pain is suppressed and consequently they might not recognize the seriousness of their situation leading to a delay in treatment. The treatment that is required must be prompt and responsible but it can also be protracted (Lustman et al., 2000, 934–943). Foot problems can affect anyone who has Diabetes regardless of whether they are being treated with insulin, non-insulin, tablets, injections, a controlled diet or physical activity. Signs and symptoms of diabetic foot ulcer In order that treatment is successful it is necessary that health care professionals and care workers can recognize the signs and symptoms of diabetic foot ulcers especially when caring for the elderly who are unable to detect the signs and symptoms. The main features of the disease include explicit sores, prolonged healing sores, changes in the shape of limbs, and, in later stages, gangrene. In the early stages symptoms usually coincide with complaints of fatigue which is accelerated by walking and standing, a sense of gravity, and freezing feet due to the deformation problems with wearing familiar footwear. One of the most pressing reasons for a good standard of education in diabetic foot ulcers is the variety of forms it might take. This means that the health care worker must be able to recognize the condition in different scenarios. The neuropathic foot is the most common form with 70% of cases of diabetic foot falling into this category. It takes the form of a hot pink color with a palpable pulse and impaired deep sensation (Wysocki & Buckloh, 2002, 65–99). Another form is known as ischemic. This condition is caused by peripheral vascular occlusive. Diagnosis includes history (hypertension, hypercholesterolemia, smoking) and intermittent claudication. The foot assumes a cold bluish tinge and has no palpable pulse. The sufferer experiences a pain in motion and severe pain at rest (Lustman et al., 2000, 934–943). The final form is neuropatyczno-ischemic. This is characterized by the worst prognosis (Morisaki et al., 2004, 142–145). The main course of action is to preserve the integrity of the skin. This is because the main danger lies in the wounds and fractures where if infection takes hold the result will be purulent inflammation and necrosis. Severe pain or numbness, sores, blisters, and peeling require the most urgent medical intervention because these can lead to gangrene and ultimately amputation of the affected limb. As the only quantifiable sign of inflammation, which indicates tissue lesions, is skin temperature it is necessary to used infrared thermometers. These can be used to determine the temperature of the skin in different areas of the foot. Dermal thermometers are also useful in the interpretation of the different phases of Charcot foot and in determining the most appropriate orthopodologic treatment in each phase. However, these are specialised tools and are unsuitable for carers to use nursing homes. Methods There is very particular method which should be implemented for assessing the health of a diabetes suffer’s feet. It is this type of information which should be included in an educative strategy used to train health care workers. Before measuring the temperature of the skin in the feet, the patient should be barefoot for at least five minutes before the examination to avoid a rise in temperature due to footwear or hosiery. The result should then be recorded. The next step is to repeat the measurement in the same area of the contralateral foot and compare the results obtained. This should be done for all the high risk areas. A difference in temperature of less than 2? c can be considered normal. Once infection has been ruled out, differences greaterthan2? C in diabetic patients are highly suggestive of Charcot activity. When the examination is done in a patient with Charcot foot and the difference is less than 2? C it shows that the acute period has come to an end. If the patie nt observes a difference in temperature greater than 2?C in self-examination on two consecutive days, he or she should contact a healthcare professional to determine the cause of the difference (www.diabeticfootjornal.net). Unfortunately there is no effective treatment for diabetic ulcers but reducing the load on the feet does offer hope of saving the affected limb. Alternative treatments can involve the use of hydrotherapy and ulcer surgery to remove necrotic tissue. Algorithm for the treatment of infected feet includes glycemic control (insulin), strain rates (shoe inserts, crutches, plaster casts), antibiotics and surgical procedures (drainage, incision, removal of dead tissue). Prevention of diabetic foot ulcer One of the most effective treatments is preventative. All patients with Diabetes Mellitus should be screened when there is a sensation of numbness or pain exists even if there are no visible lesions or ulcers (Morisaki et al., 2004, 142–145). The education of health care workers in foot ulcers therefore needs also to take into account prevention. Inspection of the stop should be performed as often as possible. If the skin of the foot shows sign of a scratch or crack you cannot use adhesive, alcohol or fat-containing ointments as these tools lead to further irritation. Redness or paleness, the presence of edema, blunting of the sensitivity, fungal lesions, and the overall deformation of the foot should be examined for deviations from the norm. If identified treatment should start immediately. In addition, from time to time, it is desirable to perform a neurological examination to determine the tactile, thermal, and vibration sensation of the foot. Angiographic diagnosis of vasc ular leg reveals the presence of thrombus. Basic steps can also be taken to prevent the occurrence of gangrene. These include the maintenance of desired blood sugar levels, the monitoring of the hygiene of the feet, making regular visits to an endocrinologist and follow their recommendations. (Clement, 1995, 1204–1214). Good foot care Education is important because good foot care has lots of pitfalls. Using the wrong cream, overcutting toe nails, walking barefoot, wearing the wrong shoes or socks can increase the chances of foot ulcers. It is necessary that the carer should be able to advise diabetes sufferers in all the dos and don’ts when it comes to looking after their feet in the proper manner to decrease the chances of contracting a foot ulcer in the first place (www.patient.co.uk). Some of these dos and don’ts are as follows; In contrast to what might seem like common sense it is vital to avoid using items such as moisturising oils or cream designed for dry skin and the prevention of cracking. Look out for athletes foot (common minor skin infection) as it can cause flaky and cracked skin The space between toes can become sore and can become infected. It is essential to monitor this. Cut your nails by following the shape of the end of the nail. Do not cut down the sides of the nails as this may cause damage or lead the nails to develop an ingrown nail. It is important to wash feet regularly and dry them carefully, especially between toes. Do not walk barefoot even at home You right treads Always wear sole or shoes or other footwear however don’t wear too tight socks around the ankle as they may affect circulation Shoes, trainers and other foot wear should; Fit well to make into accounts any awkward shapes or deformities Have broad front and plenty of room for toes Heels to avoid pressure on toes. Have good laces, buckles to prevent movement and rubbing of feet in the toes When you buy shoes, wear the type of socks that you usually wear Avoid slip on shoes, shoes with pointed toes, sandals, or flip flops. Always feel inside foot wear before you put footwear on to check for stores, rough edges etc. Tips include avoiding food burns and water burns – checking the bath temperature with your hand before stepping in to it It important to avoid using items such as hot water bottles, electric blankets or foot spas. Do not sit too close to fires. Further measures include looking very carefully at the feet each day including between the toes. This involves examining the area for reduced sensation in order to not miss any vital signs of the inset of a foot ulcer. It is also necessary to look for any cuts, abrasions, bruises, blisters, redness or bleeding. If any of these symptoms are spotted carers should immediately inform the nurse who is in charge who should in turn carry contact a podiatrist or similar specialist. Existing education provision To date education in diabetic foot ulcers takes several forms. NICE recommends that all people with diabetes should be offered structured education as an integral part of their diabetes management (www.nice.co.uk). The purpose of this is to raise awareness of the side-effects and complications of diabetes in those who suffer with it. This increases the chance for early identification of foot ulcer symptoms. The XPERT Programme was launched in 2007 to provide education to all health care professionals across Wales so they are able to give structured advice to patients with type2 diabetes. In addition the National Service Framework (NSF) (2001) for diabetes set out a ten year programme for change. It outlined evidence-based standards for the planning, organising, and delivery of diabetes services. This programme represents the Welsh Assembly’s strategy for improving diabetes and through the progressive implementation of the NSF the quality of care and treatment for those living with diabetes (www.wales.gov.uk). However within this long-term plan there is little direct reference to patients in residential or nursing homes. This is also the case with the Desmond, Dafne and Bertie programmes which have little relevance for the care of the elderly. Clearly there is a significant gap within the education of health care professionals. This gap is apparent in the nursing home where I work as none of the staff have received any particular training specifically related to diabetes mellitus. This clearly puts the residents of the home in an at risk category because the chances of their carers recognising the early symptoms of foot ulcers are substantially reduced. Within the nursing home and home care system however there does exist a health care specialist with the expertise to assist in raising awareness about the causes and prevention of foot ulcers; the podiatrist. The work of a podiatrist is overseen by the Chiropody Code Of Conduct which states that chiropodists and podiatrists must be able to work, where appropriate, in partnership with other professional support staff, service users and their relatives and carers. They should also ‘be able to demonstrate effective and appropriate skills in communicating information, advice, instruction and professional opinion to colleagues, service users, their relative s and carers’ (Standards of proficiency, Health Professions Council, 2009). However, in practice this is frequently not the case. The health support workers are not currently included in visits and are not given the opportunity to learn or ask questions when the podiatrists are called to review residents. Neither do they pass on information about their findings to staff on duty. Evidently there is an issue of communication. The podiatrist is not the only person with a professional duty to assist health care workers with their treatment of foot ulcers. The NMC code of conduct states that nurses should work with others to protect and promote the health and wellbeing of those in their care, their families and carers and the wider community. Therefore, the nurse in charge should ensure that learning opportunities are facilitated and that staff have feedback from these specialist visits which help to inform and improve the care delivered to residents. Education – best practice The current provision of education demonstrates that the education of health workers is largely at the discretion of their employers. If individual employers do decide to provide their staff with training there is little in the way of advice to follow and this can result in poorly informed, ill-conceived or simply inadequate education. At the same time it creates a situation whereby health care workers have to rely on experience gained on the job to identify the symptoms of foot ulcers or their own inclination to acquire further knowledge. For new members of the staff who lack experience there might exist a worrying amount of ignorance on the subject. There is however much potential to improve this situation. In best practice education takes a variety of forms. This may include formal study sessions, workplace booklets or posters and online education programmes. Therefore there is potential for foot ulcer education to be flexible and made to suit the particular needs of a workplace. At my workplace none of these options have been made available. Ideally the best situation would be a formal study session where the expert knowledge of a specialist can be imparted and where full training can be given. The information gained should then be reinforced at the workplace through posters or leaflets. Conclusion Conclusively it is very important that diabetic foot ulcers are prevented at all times while treating patients with diabetes, especially in the elderly who might for other reasons associated with dementia and impaired movement find it harder to care for themselves. Education of health care professionals is key in achieving this. They should have the necessary knowledge to help prevent foot ulcers, to recognise the first symptoms of one, and to provide effective treatment. They must also be able to advise the diabetes sufferer on how to care for their feet and how to avoid the contraction of a foot ulcer in the first instance. Despite this clear need for knowledgeable clinicians the situation as it currently stands fails to provide health care workers who look after the elderly with the training they require to the provide the best standard of service possible. Whilst measures are in place for the education of both diabetic sufferers and nurses, more work needs to be done on identifyi ng the educational requirements of those who care for elderly patients. Best practice in education should be drawn upon and formal training sessions organised alongside the better provision of information within the workplace. The expertise of specialists such as podiatrists should also utilised more effectively so that staff within the nursing home are well informed and understand the treatment their patients are undergoing and their specific needs. Communication is at the heart of this.

Describe An Issue Of Personal Concern Essays - Renaissance Painting

Describe An Issue Of Personal Concern Essays - Renaissance Painting Describe An Issue of Personal Concern Harvard I am violently warring for peace. I know this is a paradox, and I'm rather proud because it is true. Passivity has been a lifelong threat, laziness a constant lure in my search for identity. This world begs me to succumb to existing in the image of someone else, it asks only that I slip silently and blindly into the niche it provides instead of carving my own. I required a long time to work up courage to fight for the serenity I had glimpsed in hot summer woods and in lovingly handled books read late until the early morning. Doubt had established itself in my mind at some early age, when or why I do not know, and I could trust any person or group more than myself. Doubt begat fear, and fear gave birth to obscuring myself from the eyes of the world while I was a child. Now, I am dedicated to the fight, after over five years of fear and immobility. I rejected the easiest way out of life, and demanded truth. I strengthened my body as I strengthened my mind against the attacks I faced. When I was fifteen I started Tae Kwon Do, the martial arts class that was offered through my school. I learned more about blocking, kicking, and punching in the first two weeks of that class than I had known my entire life. My once powerless body, petite and thin, could knock the wind out of someone with a well placed punch, and I could kick people taller than me in the head. So what I could do, I did, and now my friends instinctively block when they see me grin mischievously in their direction. I am content to know I have taught them something useful. Last spring for the third time in a row, I shakily accepted my teacher's hand as he congratulated me on second place in women's division sparring. It was a bittersweet triumph, three times now I have lost to the same girl. She has become an icon for everything I wish to triumph over in this world. She is beautiful, hair like black silk, impeccable taste in clothing,makeup like a Renaissance painting, and average when it comes to everything else. I watch her silently stride into art class on three inch heels, skirt above her knee, no runs in her stockings, and manicured nails smoothing invisible wrinkles from he shirt. I look down at myself, one of my shirt buttons missing, securely replaced with a safety pin, my comfortable green pants provide freedom of movement if little style, and my sturdy black shoes have been with me for three years. I hear my voice laughing almost too loudly, physics notes are sticking out of my sketchbook, and I am well aware of that I am not average. I fight this opponent I have created and what she represents not because she chooses to live her life by the beauty standard, and not because I feel inferior. We are at war because no one outside of Tae Kwon Do class ever sees what she is capable of. They don?t know that those perfectly moisturized hands can break through boards or leave your head spinning. No one knows that those feet captured in three inch heeled prisons can leave you hurting for days, bruised where you blocked, bruised and bleeding where you failed to. I fight her because she is a symbol of how I tried to hide myself and my potential. I?m tired of being afraid of how the world will respond to me, and I war against the part of myself that would rather just please fashion magazines and popular concepts. Peace comes from accepting my identity, not from hiding it. I will laugh loudly at outside ideas of who I am supposed to be, kick down the opposition to my goals, and I will continue to fight until I have my peace.