Use of Honey as Medicine in Wound Healing: Analysis

Use of Honey as Medicine in Wound Healing: Analysis The aim of the assignment is to critique the research article, Standardised antibacterial honey (medihoney) with standard therapy in wound care: randomized clinical trial (2009) by Robson, Dodd Thomas. The tool used for this is Step by Step Guide to Critiquing Research by Ryan, Coughlan; Cronin (2007). Critique is an objective, critical, and balanced appraisal of a research reports various dimensions (Polit and Beck, 2004). The study was on the use of honey as medicine in wound healing. The research was done in the United Kingdom by a group of registered nurses and statistical masters. The study was completed in the year 2007 and was published in the Journal of Advanced Nursing (JAN). The study was based on the use of honey for wound dressing as an antibiotic and wound healing agent. Arguably, the article is well written as it is concise and it does not contain any languages that are characterised to any particular group and are grammatically correct. The layout of the study is good and are given in a good order and kept the academic style of writing. Research reports are like stories, a story should be written in a way which catches the attention of the reader, like as research report should have a readable style. The current researches writing style is good, and is well understandable. No personal views are expressed in the study. The writer had omitted personal pronouns to get an ease in the reading. Credibility variables concentrate on how believable the work appears and focus on the researchers qualification and ability to undertake and accurately present the study (Coughlan et al, 2007). The researchers were well qualified for the current study as their qualifications were stated in the article. Mostly nurses are eligible to do this type of study as they know the effect of dressing a wound. Statisticians also have a role in a research as there are so many calculations which were also included in the study. Methodology of a study is based on the credibility of the qualitative data and its subsequent findings (Polit Hunger, 1999) The title of the article gave an idea of the topic that and what the study is related to. The title is accurate and clear, too long or short titles can make the reader confusing (Coughlan et al, 2007). Too long or short titles can be confusing and misleading to the readers (Coughlan et al, 2007). In the study title is concise and is readable and has its reliability, the title is short too. The title is not more than 10- 15 words. Abstract is a brief description or an outline of the entire article. The abstract should give a clear idea about the research and should include information regarding the purpose of the study, method, sample size and selection which is given clearly in the current article(Coughlan et al, 2007), And from the abstract the reader should able to find out the overall idea about the study. They have also pointed out for further research on this topic with some recommendations. The present study has an agreeable abstract which conveys idea about the study which is simple, clear and interesting for the readers. The abstract is not too long and also explains about the method, sample size and the selection method. The abstract gave an over view of the topic. The abstract also opens an end to further researches. The introduction of the study will always be based on the research problem. Research problem is an enquiry which can be done through a disciplinary way (Polit and Beck, 2004). The purpose of a research highlights the overall sketch of main arguments and theory of the relevant research (Polit Hungler, 1999). In the current research the purpose of the study is stated clearly and an overall idea of the study is been included in the introduction of the research. The research problem is identified and clearly stated in the study. The research was carried out in a step by step process. The article has a flow and a have an ease in reading and all the links are clear. Critical summary of a topic which puts the topic or the research problem into a context is called as the literature review (Polit Beck, 2004). Literature review always points out to the previous studies of the current topic. The review should be logical and its critical analysis should be balanced (Cougllan et al, 2007). In the present study the literature review is clearly illustrated and it is logically presented. The literature review offers a critical analysis. The reviews are mostly facts which were proved by proceeds. A good literature review will always have a good introduction (Cougllan et al, 2007), which is followed in this by the writer. Frame work refers to the overall structure of a report which is based on a theory which was previously proved (Polit Hungler, 1999). Hypotheses are from a primary source and of an empirical nature. Theoretical frame work is what which is found confusing by a researcher. A theoretical frame work is been identified in ethics. The theoretical frame work has been clearly stated step by step clearly. A sound theoretical frame work also identifies the various concepts being studied and relationship between those concepts. The theory is true and the hypothesis is relevant for the study. Theoretical frame work tends to be better developing in experimental and quasi-experimental studies and often poorly developed or nonexistent in descriptive studies (Burns Grove, 1999). The purpose of the aims and objectives is to create a link between the initially stated purposes of the study or research problem (Coughlan et al, 2007). Aims and objectives are the observations or measurement that reflects on the physical reality which is interpreted by the individuals, and can be argued that even such observations may be open to subjectivity (Gerrish Lacey 2006). There is an aim for the study which is clearly stated in the abstract, introduction and also in the study. The hypothesis which is a statement or fact which can be tested or verified (Holloway Wheeler, 2002). The research questions and the hypothesis is clearly identified and stated in the study. The hypothesis and the research questions reflect on the literature review. The samples were chose with a great caution so as to minimise the errors. Samples are the selected units from a population, and sampling is the process of selecting appropriate people from a population for the research (Wood Haber, 1994). The samples were chosen randomly from a group and were informed about the research and the procedures and the effect of the current procedure. The sample which was chose for the study was appropriate as they were patients who were having wounds. The size of the sample was also adequate as a small sample will not help in an appropriate conclusion. The size of the sample is also important in quantitative research as small samples are at risk of being overly representative of small groups within the target population. There was no inclusion or exclusion for the study as they chose an appropriate sample with ethical consideration. The risk of sampling errors decrease as larger sample used (Coughlan et al, 2007). Autonomy infers that an individual has the right to freely decide to participate in a research study without fear of coercion and with the full knowledge of what is being investigated. Ethical committee or institutional review boards have to give approval before the research can be undertaken. There role is to determine the principles and to evaluate the validity of the research (Coughlan et al, 2007). There was ethical consideration for the data collection. All the participants of the study were fully informed about the research. All the participants were protected from all type of in case after effect, and were autonomous. Confidentiality of the subjects was censured by the researcher, and ensured the permission from an ethical committee. In a research study the researcher should ensure that the reader should understand what is meant by the terms and concepts which are used in the research. All the operational terms, theories and concepts in the current study has been clearly identified explained and illustrated in the study, and have given proper reference and citations for the rational and the explanations. The organisation, reduction and transformation of the data of a study in order for a review are called as data analysis (Holloway Wheeler, 2002). The methodology or the research design was clearly given to review the study. One of the main instruments in a study is methodology. The data gathering instruments of the methodology is cited in the study. The instrument used is appropriate as they could clearly get many results out of it. In the study 109 subjects participated in the research. The system of analysing the facts with the collected data from the research is called as data analysis (Polit Beck, 2004). Data analysis in quantitative research studies is often seen as a process which loses courage (Coughlan et al, 2007). Most of the data analysis is associated with complex language and statistical notations. The researcher should clearly identify what statistical tests were undertaken why these test was used and what were the results, which have been stated in the current article. In the current study analyse of the data is done in a better way. The strength and limitations of the study is also included in the study to revel the validity and reliability of the study. The discussion of a study should flow logically from the data and should be related to the literature review thus placing the study in context (Russell, 2002). In the discussion part of the research is linked back to the literature review. The discussion part contains the strength and limitations of the study which is referred to the previous study that are made on the same subjects. All the limitations are also generalizability discussed. The research also extends an open end for further research on different aspects of his study; other recommendations are also given to the current study. When doing a research or a research critique it is essential to quote the source of the information obtained, that should be included as in text or end text reference. In a research study the significance of the findings should be stated but these should be conceder within the overall strengths and limitations of the study (Polit Beck, 2006). The reference should help the writer to find the source as quickly as possible (Pears Shields). The copy of others idea is conceder as plagiarism which is serious offence. For the current study the researcher has used the Harvard referring system. The researcher has referred many books and research articles for his study and all the references have been quoted as in text and end text references. All the books referred for the study are appropriate as they are related to the subject or to the research vocabularies. The researcher was very much cautious about the plagiarism. Evaluating the research article with the critiquing tool by Michael Coughlan and team members it was found that the study is arguable with credibility and reliability. The writers have carefully used the strategies in doing a research. The research is readable and understanding by lay men. Holistic Nurse Prescribing: A Case Study Holistic Nurse Prescribing: A Case Study Introduction 1 the patient and their presenting symptoms. Mr Pickles presents an interesting, complex and therapeutically challenging problem. In essence he is a gentleman with multisystem pathology who presents with an almost incidental finding which he was clearly reluctant to discuss. It is a common finding amongst experienced healthcare professionals that in any consultation it is the last 30 seconds which is the most important. As the patient stands up to go, there is the just while Im here moment when they can bring up an issue that really troubles them and may not be the real presented reason for the consultation. In this essay we shall discuss the various aspects of this situation and the measures we can take to try to help him. (Parker and Lawton 2003) 2.a holistic assessment of the pt, including any relevant medical social and psychological issues. If we start with the initial presenting symptom under discussion the impotence it is easier to work backwards from that to discuss the possible pathophysiology that can be relevant. Impotence is said to occur whenever the male fails to get an erection when it is required. This, in itself is neither unusual nor necessarily pathological. It becomes a significant symptom when the male repeatedly fails to get an erection that is sufficient for intercourse. It is quite possible to get full spontaneous erections and yet still be impotent. This is one of the major diagnostic features that distinguishes the psychogenic impotence from the purely physical. (Ackerman MD, Carey MP. 1995) There are a number of obvious physical causes of erectile dysfunction that are relevant to Mr Pickles (see on), but equally there are a number of possible psychogenic causes that may be either primary factors or possibly secondary contributory factors in the aetiology of his problems. The fact that he has recently undergone major cardiac surgery is a very relevant factor. Patients will frequently suffer from a major change in body perception when they have come to a close realisation of their own mortality. If we add to this the fact that, as the major breadwinner in the family, it is likely that Mr Pickles would have felt a major blow to his self-esteem when he was made redundant from a responsible high esteem job and forced to become a taxi driver with long working hours. This is quite apart from the anxiety and fatigue that such a job would engender.(Beck J. 1995) It is possible that the medication that Mr Pickles is taking may have a bearing on his erectile dysfunction as the male erection is dependent on the hydrostatic pressure of the blood for its maintenance. Any medication that reduces the average blood pressure, will effectively reduce the capacity to acquire and maintain an erection. In addition to this the adrenergic beta-blocker group will also selectively block the sympathetic pathways that are vital to the neurovascular control of the mechanisms of erection. Pathophysiology of diabetes and impotence Both of these topics are huge subjects, so in this essay we will restrict out considerations to those aspects which are relevant to Mr Pickles and his problems. We know that Diabetes Mellitus affects about 2% of the UK population with a specifically higher incidence in both the Asian and Afro-Caribbean communities(Nathan 1998). There is also a marked genetic component in the development of Diabetes Mellitus. Mr Pickles has Type II diabetes mellitus which is associated with a number of factors including a high BMI and increasing age. At 56 yrs. old he is currently at the peak incidence age for Type II diabetes mellitus (Gregg et al. 2003). Diabetes Mellitus is known to be associated with a number of complications. The prevalence and incidence of the complications, in general, tends to increase with the length of time that the patient has been diabetic. There is also an independent variable for complications that is directly proportional to the degree of control (as measured by the HbA1 levels). In general terms, the better the control the lower the incidence of complications (Kissebah et al. 1999) As far as Mr Pickles is concerned, there are two major complications of Type II diabetes mellitus that are directly linked with impotence and they are cardio-(macro)vascular disease and neuropathy. (Wagner et al. 1998) We can deduce that Mr Pickles has macrovascular disease by virtue of the fact that he his recovering from a CABG. And this may well be a very relevant factor in his erectile dysfunction but also there is the question of neuropathy which typically occurs in about 2.4% of the general population, but this figure rises to above 8% in the diabetic patient over the age of 60 yrs. ( Hughes 2002) Impotence tends to occur, in varying degrees, in about 10-15% of men under 40 yrs. Its incidence increases with age to the extent that 40% of men at the age of 40 yrs report a degree of impotence and this prevalence rises to 70% at the age of 70 yrs. (Gregoire 1999). If we add to this basic clinical picture the fact that there are other factors such as hypertension, smoking, cardiac neurosis, loss of self-confidence, depression and iatrogenic causes (medication etc.) all of which may well be relevant to Mr Pickles, then it can be seen that there are a plethora of potential causes of his erectile dysfunction. (Barnes, DE. 2004) Both of the first two causes (hypertension and smoking) are independent risk factors for impotence, quite apart for the fact that they are also risk factors for the development of the macrovascular complications of Diabetes Mellitus (Bowering 2001) Mr Pickles diabetic state has been recently well controlled (HbA1 of 6.5%). This is important as the incidence of development of diabetic complications is reduced by between 34-76% (depending on the particular study) for every 10% reduction in the average HbA1 reading. (Bowering 2001). In addition to all of these considerations, atherosclerosis is also a major complication of Type II diabetes mellitus, which, presumably is relevant to Mr Pickles because of his CABG, and this may be a major factor in the development of his erectile dysfunction. Management plan 3.a plan/strategy based on critical understanding of physiological and pharmaceutical issues. Any management plan must firstly be based on an accurate diagnosis. At this point in time we do not have this luxury. As we have discussed, there are anyone of a huge number of possibilities in the aetiology of Mr Pickles erectile dysfunction problem. When confronted with a problem such as this, any experienced healthcare professional may reasonably chose to manage the problem by making a rational judgement of the probabilities of any one particular cause being relevant. Implicit in such a management strategy is the fact that there are some causes that my be correctable (iatrogenic, psychological, and life style related) and there are some that may not (macrovascular damage, neuropathy and atherosclerosis). It is reasonable, in such circumstances, to discuss the situation openly with Mr Pickles and discuss with him the various treatment options. Patient empowerment and education is a vital strategy to adopt in circumstances such as this as Mr Pickles is far more likely to comply and respond if he understands the rationale behind the treatment plan.(Howe and Anderson 2003) We would suggest that an appropriate strategy would be to initially tackle the situation on two fronts. The psychological aspects of the erectile dysfunction are probably best discussed with an experienced psychologist or councillor who has expertise in this particular area. This is important because there is a considerable skill in eliciting the relevant factors from the patient. Many patients are reticent about talking openly about their imitate sexual details and there has to be a careful build up of trust and empathy on both sides. Factors such as good eye contact and a non-judgemental body stance are essential on the part of the healthcare professional if the optimal result is to be obtained Not only can the issues that are relevant be explored, but also any one of a number of psychological treatment techniques can be employed. This is a matter of considerable clinical judgement and skill and therefore probably best done by an experienced healthcare professional in that area. The pharmaceutical area can also be addressed as Atenolol is clearly not the best anti hypertensive to use as, not only will it reduce the blood pressure (which it clearly is important to do) but it also produces a counter productive beta-blockade which will not help the erectile dysfunction problem. The difficulty is that, after the CABG, Atenolol does have a degree of action on the suppression of ectopic electrophysiological foci in the myocardium which is a recognised complication of the procedure. It also is thought to have a cardioprotective effect post-myocardial infarction. It is probably a good idea to change his anti-hypertensive medication, but in the circumstances, it is probably better to seek the advice of the surgical team who performed the CABG. before making the transition. The question of Viagra has been raised by Mr Pickles. This is not as straight forward as it might initially appear. Viagra has been shown to work well in these circumstances. It has the downside that it allows sexual intercourse which is associated with increased peaks of blood pressure. As Mr Pickles is still in the postoperative recovery phase (16 weeks) it would again be sensible to consult with the surgical team as to their advice on the issue. The other problem with Viagra is that if it transpires that the long term aetiology is actually psychological rather than purely physical, then the prescription of Viagra will often breed a feeling of psychological dependence which may firstly be both inappropriate and unnecessary and secondly, very hard to break. It is probably therefore inappropriate to consider such options at this stage in the management. 4.legal and professional accountability should be discussed. The legal and professional issues are largely covered in the making of a management plan. In any area of professional competence, the best defence against criticism or censure, is the fact that a healthcare professional works from a rational evidence-based plan. It is for this reason that we have set out the rational and reasoning for the plan that we have chosen to adopt. It is actually quite permissible (legally) for a healthcare professional to be wrong on any given issue, as long as they have come to a reasoned and rational decision based on the facts that were placed before them. And behaved in a way that the majority of their professional colleagues believe is reasonable in the circumstances. It is, of course, central to these considerations, that all actions are carefully and fully recorded in the patients notes Prescribing decisions 5.a critical discussion of influences on prescribing decisions. The area of prescribing for Mr Pickles is clearly important. To some extent, we have covered the reasoning behind the change of prescription earlier in this essay. There is a common misconception amongst many members of the public (and indeed many of the less experienced healthcare professionals) that the solution to every problem comes in the form of tablets on a prescription. The whole area of patient empowerment and education is often filled with issues of lifestyle change, healthy living, self care and positive thinking which can frequently be more effective that simply giving the patient a prescription. (Boule NG et al. 2001) In the context of the NHS, it is a common observation that sometimes a prescription is given because it is the most expedient short-term measure in a given situation, (Dawes RM et al. 1974), however, time invested in an explanation to a patient as to why other measures might be equally as important is rarely time wasted., (Corrigan B. 1974) Future management 6.consider your future prescribing activity based on experience gained from this case study. In any professional area of activity, the author likes to use the mechanism of reflective practice to allow a critical assessment of a past course of action to modify future actions when faced with a similar situation. (Gibbs, G 1988) On careful reflection of this case, I believe that I may have acted rather rashly in stopping the Atenolol as a first choice. On reflection, I believe that the Atenolol did need to be changed for any one of a number of other anti-hypertensive agents but I feel that, in retrospect, I would have been wiser to take advice from the surgical team before I made that decision. Further reflection and discussion with other healthcare professionals (Marks-Moran Rose 1996), suggested that another appropriate course of action would have been to stop the antihypertensive medication altogether for a short period. This is on the grounds that his hypertension was not severe and was hitherto well controlled. If the erectile dysfunction was simply a reflection of the fact that the medication was holding his blood pressure down to a level where erection could not easily occur, a few days off the medication may allow a transient increase in his blood pressure to the point that erection could occur. As long as one was careful to monitor his blood pressure to ensure that it did not rise too far, I have been advised that this would represent a reasonable therapeutic trial to establish whether the underlying causes were mainly physical or physiological.(Wagner G et al 1998). On the face of it, this does seem reasonable but I believe that I would have to take further advice before I was fully comfortable with that decision. It follows from what has already been discussed, that I also feel that I may have been too quick to consider the pharmacological interventions before making a complete holistic assessment of the patient. There are clearly a number of lifestyle adjustments that may be relevant here such as weight loss and increasing exercise and looking for a new focus in life (to minimise any element of depression) which would be comparatively easy to achieve with appropriate empowerment and education of the patient. (Funnell R et al 2004) All in all, this is not a straight forward case. There are many elements which require careful and considered assessment. I believe that it is one of those cases that helps to point out that although there is a huge emphasis to be placed on modern scientific understanding and application of medical principles, there is also a very large element of human understanding and caring that is so very important to the successful management of patients such as Mr Pickles (Waterlow J. 1998) References Ackerman MD, Carey MP. 1995 Psychologys role in the assessment of erectile dysfunction: historical precedents, current knowledge and methods. J Consult Clin Psychol 1995; 63: 862-87 Barnes, Darryl E. 2004 Action Plan for Diabetes Copyright 2004 ISBN: 0736054596 Pub. Human Kinetics Illinois USA Beck J. 1995 Hypoactive sexual desire disorder: an overview. J Consult Clin Psychol 1995; 63: 915-927. Boule NG, Haddad E, Kenny GP, et al. 2001 Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. JAMA 2001;286:1218-27 Bowering (2001) Diabetic foot ulcers. Pathophysiology, assessment, and therapy. Can Fam Physician. 2001 May;47:1007-16. Dawes RM, Corrigan B. 1974 Linear models in decision making. Psychol Bull 1974;81:95-106. Funnell, and Robert M. Anderson, (2004) Empowerment and Self-Management of Diabetes Clinical Diabetes 22:123-127, 2004 Gibbs, G (1988) Learning by doing: A guide to Teaching and Learning methods EMU Oxford Brookes University, Oxford. 1988 Gregg, R. B. Gerzoff, C. J. Caspersen, D. F. Williamson, and K. M. V. Narayan (2003) Relationship of Walking to Mortality Among US Adults With Diabetes Archives of Internal Medicine, June 23, 2003; 163(12): 1440 1447. Gregoire 1999 ABC of sexual health: Assessing and managing male sexual problems BMJ, January 30, 1999; 318(7179): 315 317. Howe and Anderson 2003 Involving patients in medical education BMJ, Aug 2003; 327: 326 328. Hughes RAC. 2002 Regular review: Peripheral neuropathy BMJ, Feb 2002; 324: 466 469. Kissebah AH, Freedman DS, Peiris AN. 1999 Health risks of obesity. Med Clin North Am 1999; 73: 111-138 Marks-Moran Rose 1996 Reconstructing Nursing: Beyond Art and Science London: Balliere Tindall October, 1996 Nathan D. (1998) Some answers, more controversy, from UKPDS. Lancet 1998; 352: 832-833. Parker and Lawton 2003 Psychological contribution to the understanding of adverse events in health care Qual. Saf. Health Care, Dec 2003; 12: 453 457. Wagner G, Seanz de Tejada I. 1998 Update on male erectile dysfunction. BMJ 1998; 316: 678-682 Waterlow J. (1998) Prevention is better than cure. Nurs Times 1988; 84: 69-70 Appendix

Deforestation In The Amazon Rainforest

In this coursework I will be investigating deforestation and stating my opinion on whether I think it should continue or not in the Amazon Rainforest In doing so I will identify the various different values and attitudes. In this assignment I will include maps as well as diagrams, graphs, charts. The Earth is a constant changing system; a serious type of change that is being contributed by man, is deforestation. Deforestation is the clearing out of forests so that they can cultivated and used for other purposes. Due to this particular method of cultivating land it has resulted with vast areas of the Amazon rainforest being totally destroyed far beyond repair. Because of this scientists fear that many natural medicinal plants and vegetation may be lost permanently. Deforestation In The Amazon Rainforest Deforestation robs the world of countless species, destroying crucial Biodiversity and losing species with potential uses in medicine, agriculture and industry. Biodiversity is important because it contributes to resiliency in my opinion and should take precedence. The main worry for environmentalists such as my self is that many species are being lost as their habitats are being destroyed. In a rainforest, certain small areas are individual, specific habitats themselves. This means that if one small area of the rainforest is cleared, it could mean that a whole series of species are wiped out. The clearing of trees causes the roots anchoring the soil in the land to be destroyed, the removal of leaves and branches that intercept eight out of every ten raindrops lead to soil erosion. These devastating effects cause the land to become inhospitable and lead to the further cutting down of trees to provide new agricultural land. Nearly 40 percent of all the tropical rainforest left in the world is in the Brazilian Amazon. Brazil, the largest country in South America, has perhaps the best opportunity remaining to save large tracks of tropical rainforest. Although Brazil has lost approximately 58 percent of its frontier forests (large tracks of relatively undisturbed old growth forest), the country still has are over 772,200 square miles of frontier forest, among the largest amount of any country worldwide. Brazil is also home to a second, less famous rainforest, the Atlantic Rainforest. This strip of rainforest extends from the northeast coast down to the southern state of Parana. Formerly covering more than 386, 100 square miles, only 5 percent of the original Atlantic Rainforest remains. Many species that live here, including river otters, jaguars, and armadillos, are at high risk of extinction due to habitat loss caused by logging and agricultural clearing. The Amazon is one of the world's great rainforests and its river, is longer than any river but the Nile. The vast Amazon basin covers more than two and a half million square miles, more than any other rainforest but for how long will this be the case? The Amazon rainforest is located in South America, where its area takes up a quarter of the content. The forest is so large it spans nine countries French Guyana, Brazil, Suriname, Guyana, Venezuela, Columbia, Ecuador, Peru, and Bolivia. It has an extremely humid climate as do most rainforests due its equatorial location which means it rains frequently â€Å"The rain becomes trapped in canopy causing heat† Warm air caring water vapor will rise Warm air that falls here will become trapped in the canopy this will raise the temperature. The Amazon rainforest has many different species of plants and animals. For plant species there are between 5,000,000 and 30,000,000 (estimated). Only a little more than 30,000 have been classified and this represents 10% of all plants around the world. As for animal species there are about 324 mammals, and there are 2,500 to 3,000 species of fresh water fishes in the Amazon River. â€Å"Statistics in this paragraph were taken from: http://oz. plymouth. du/~lts/conservation/Ecosystems/amazon. html† Deforestation In The Amazon Rainforest The Correlation between Deforestation And Soil Erosion: Once trees are felled there are no leaves to protect the soil beneath, from heavy rainfall also there are no roots to hold the saturated soil in place. When this occurs it makes it extremely easy for soil to be washed or blown away. Then the area of land becomes useless because you can't build on it because foundations won't be stable enough and you can't cultivate it â€Å"grow crops† because nutrients such as silt etc have been washed/blown away. Nobody benefits. Soil Loss In Tones Per Hectare Per Year. : Bare Soil : Pasture : Crop Land : Rain/Forest As you can see when a area of land is bare the soil erosion is at its highest and when it's left alone as Rain/Forest it's at its lowest the activity of deforestation obviously affects the rain forest but soil erosion is a perfect example of a more subtle affect, it not only damages the rainforest directly but also damages cultivating potential for the area and any future plans you may have for the site e. g. building etc Deforestation occurs in many forms most of the clearing is done for agricultural purposes grazing, planting crops, cattle ranches etc. Poor farmers place pressure on the Brazilian government and local authorities to allow them to cut down small areas of Rainforest (typically a few acres) and burn the tree trunks in a process called slash and burn. Slash and burn is the traditional method used by the American Indianans of the rainforest and they all ways replace the areas they damage. Although this method is the most sustainaiable it's the most dangerous and one of the most abused. Desperate farmers will request an area of land to be cultivated and purposely let the fire grow beyond control so they will be able to claim a few acres extra, due to the fact the slash and burn method is never exact and the method is so finial. â€Å"Once it's done its done† the government feels they are powerless. Intensive or modern agriculture occurs on a far greater scale, sometimes deforesting several square miles at a time. Large cattle pastures often replace rainforest to grow beef and such like for the world market, mostly for fast the food industry. McDonald's etc. Commercial logging is another common form of deforestation, cutting trees for sale as timber or pulp. Logging can occur selectively-where only the economically valuable species of tree are cut, or by clearcutting, where all the trees are cut. Commercial logging uses heavy machinery, such as bulldozers, road graders, and log skidders, to remove cut trees and build roads, which is just as damaging to the rainforest overall as the chainsaws are to the individual trees. Deforestation In The Amazon Rainforest Deforestation by peasant farmers is often done to raise crops for self-subsistence, and is driven by the basic human need for food. Most tropical countries are very poor by U. S. standards, and farming is a basic way of life for a large part of the population. In Brazil, for example, the average annual earnings per person is U. S. $5400, compared to $26,980 per person in the United State The causes of deforestation are very complex. A competitive global economy drives the need for money in economically challenged tropical countries such as Brazil. Governments sell logging concessions to raise money for other vitial projects such as hospitials and schooling, to pay international debt, or to develop a more advanced industry infer structure. For example, Brazil had an international debt of $159 billion in 1995, on which it must make regular payments each year. The logging companies seek to exploit the rainforest and make a profit from the sales of pulp and valuable hardwoods such as mahogany. Brazil hasn't got much to offer the world in material goods other than what resources it has in its Rainforest so their government feels that if they don't continue to allow this clear and obvious exploitation of the rainforest they will fall behind in their payments and be unable to support their expanding population. I would describe Brazil as a middle income developing country I would place it in the same bracket as Mexico and Malaysia Its â€Å"GNP US $ PER CAPITA† is 3020 and it has a high infant mortality rate 57. One can only assume that a government would want to change these statistics and the easiest and quickest way for the brazilin government to get there hands on the money to do this is through the rainforest. Some other effects of deforestation are less rainfall so the cleared land becomes much drier possibly even a desert. More CO2 in the air this increases the greenhouse gasses causing global warming and climate change. Industry and power stations that have been built give off more C02 fewer trees to produce oxygen and absorb CO2. Fewer trees means less transpiration and this mean less water vapor in the air less water vapor in the air means less condensation overall. Many birds, insects, and animals rely upon the rainforest as a food source and for shelter. After deforestation they will either die or be forced to move away from there natural habitat when animals move some where else it will put a strain on other food chains and may even cause a mass extension. When the Rainforest is cleared peoples that lived there before are forced to leave and mix with the mainstream population this has had dire effects on them because when they mix with people outside the rainforest they develop illnesses that they had no immunity from there immune systems can't cope with western illnesses â€Å"measles, influenza† Those who are brave enough to stick out and stay are soon driven out from their homes by the construction of roads mines and reservoirs. Many people who tri to resist developers are killed by developers. Trees absorb a tremendous amount of water if there are no trees the water will sink into the soil and change it to mud If it continues to rain many surrounding crops will be ruined because of flooding Humus Cycle In Area of Tropical Rainforest Rich Tree Growth Numerous Fallen Leaves Leaves Decay To for Humus Nutrients Added To Soil Humus Cycle In Area of Forest That's Been Cleared Poor Quality Vegetation Fewer Trees And Leaves Less Humus Fewer Nutrients Added To Soil Less fertile Deforestation In The Amazon Rainforest People Living In Urban Areas In Brazil % In This Graph you can see that the number of people choosing to live in urban areas is increasing dramatically this is one of the reasons the Brazilian government continues to clear vast areas of rainforest. The cleared areas can be turned into residential areas to house more and more people. Statistics for this graph were taken from the Key Geography book Cleared Natural Forest In Order To Build Roads For Mining Access In This graph you can see that Brazil has by far the highest clearance for mining access. This is because the Brazilian government export masses of mined goods found in and around the rainforest such as gold, sliver, and iron ore. Statistics for this graph were taken fromWWW. GREENPEACE. COM Deforestation in the Amazon Rainforest Groups of people that support deforestation in the Amazon rainforest are the Logging and mining companies as well as the various governments. Multinational companies support deforestation because they are supplying for demand and a huge market, if people want mahogany furniture and rare gems/metals then they'll go and clear entire forests in order to give it to them and make a huge profit in the process. These companies see developing countries as an easy target they can clear huge areas of forest and pay them a fraction of what they should do the ironic thing is they no they'll be grateful for the money because they can barley support there expanding populations. As an outsider you would see these actions as inhuman and immoral but they do help the countries where deforestation is taking place a great deal. Many of these countries have nothing to offer other that holiday destinations so the only thing they can sell sad as it may seem is there heritage and Rainforest. When land has been cultivated through logging and mining the money will go to the government who will spend the money on its population in the form of a better education or hospitals and roads so the peoples of these countries are benefiting slightly but some people may say that its not worth it in the long term if they keep on then sooner or later there will no rainforests at all then the big companies will leave them with nothing. Places where there is a growing population in urban areas such as Brazil find them selves allowing big companies to destroy their rainforest in order for them to afford to destroy it them selves in processing large rainforest areas into residents for people to live in. Any one would love to earn something for nothing and that's exactly how these companies view it they get these valuable materials for next too nothing and sell them on for extortionate prices. They see them selves as aiding the developing countries and in a way they are but what they are actually doing is feeding them with one hand and killing them with the other. There are many groups of people that do not support deforestation in the Amazon rainforest such as the natives that lived in the rainforest; they see developers not as savors and job makers but as ruthless exploiters that kill vast amounts of animals and wild life with no remorse. Other reasons both the natives and local people are so against the clearing of the rainforest are they don't actually see any benefits in return the government often waste money on city expansion, national defense ,and economic aid which comes as a surprise since they can hardly feed them selves let alone any one else. When forest clearing was first introduced the main reason was to help them get out of debt but people who don't agree with deforestation will say they never been in so much debt they were better of living in small villages before at least then they could feed themselves and lived a less complicated life. The amount of land with trees on it shrinks each year. It gets harder and harder to meet local and global demands for wood and is extremely stressful and for what? Some people have proposed that the solution to tropical deforestation is to set aside vast areas as parks and reserves. This may buy enough time to give local governments a chance to address the underlying causes of deforestation-poverty, growing populations, and misguided policies. And many people feel that setting aside tropical reserves will ensure that unused areas will continue to exist. They point out that many species can't survive in managed (human-used) forests. Local people may say that the rainforest is one of the main reasons people come to visit them without that then they will lose a lot of revenue gained through tourists. People have not dwelt in large numbers throughout the tropical rain forests, but small groups of people live throughout the region. They constantly move around and clear small areas and plant crops. When they reach an area they want to use, they chop down trees and burn them in order to create a clear area. They then plant seeds in the ashes–but after a few years the soil nutrients become used up and it is no longer good for gardening, so they move somewhere else and start the process all over again. This process is called slash-and-burn cultivation, which can support a small population but will not work with larger ones. Deforestation in the Amazon rainforest In this assignment I will be investigating Deforestation in the Amazon rainforest. I have been given a hypothesis, which I have to agree or disagree with the statement by using the sources and from my own research. The hypothesis I have been given is ‘Deforestation of the Amazon rainforest is a major global environmental issue that only the Brazilian government can solve'. The whole issue is about deforestation, Deforestation is the felling and clearance of the forest land. It began in the Mediterranean lands many centuries ago. Today is mainly taking place in the less economically developed countries that have the tropical rainforests as their natural vegetation. The Amazon rainforest in Brazil is one of the largest rainforest in the world, it contains 50% of the world's animal population and it produces one third of the world's oxygen. Pharmatical Company's across the world use plants from the forest to produce life saving medicines for the people of the world. How and why is the rainforest being cleared ? There are many reasons to why the rainforest is being cleared. One of them is that the Brazilian government has allowed deforestation to take place in the Amazon rainforest is because they are in debt. They have let the Multinational companies deforest the rainforest so that they can raise money to pay off their debt owed to the banks in the MEDC countries. These developments are taking place now in the Amazon rainforest e.g. Commercial logging, cattle ranches, raw materials, mining and e.t.c. when these development takes place large areas of the rainforest has to be cleared out. From my research I found out that only 5% of the forest trees are actually wanted by the loggers but to get those trees they have to damage or destroy 65% of the remaining ones. What groups benefit from deforestation in the Amazon rainforest ? They are many people and groups that benefit from deforestation in the Amazon rainforest. Mostly the MNC's, they have cleared large areas for cattle ranching. They have burnt down trees and replaced it with grass. Then the beef which is produced from the cattle ranches is gone to Europe and US to be made into burgers. The MNC's are also involved in logging, which has been permitted only in 13 designated areas. Source E supports my point, it says that â€Å"The USA is the main importer of Brazilian mahogany†. The multinational companies pay tax for every area they felled but they benefit from it because the money goes back to the banks in MEDC countries to pay off their debts. The external debt of Brazil's is getting lower by letting people and companies fell the trees in the rainforest as you can see in Source G shows a graph of the external debt of Brazil, which shows at the beginning the debt was low and then in the middle it got higher and now its getting lower. This source is consistent with Source J because it tells how the external debt got higher. In the Amazon rainforest large areas are being cleared to make hydro electric PowerStation because it rains a lot in the rainforest so there is unlimited water supply. The HEP stations provide cheap and plentiful energy for transport, domestic use and industry. The mining companies also benefit from it because there are huge deposits of iron ore, copper, gold, bauxite and other minerals in the rainforests. So these companies have felled the trees to build roads through the forest to reach these deposits. What are the negative consequences of deforestation ? Deforestation has many negative consequences globally and locally. The Amazon rainforest in Brazil is responsible for producing one third of the world's oxygen. Many trees have been felled, which has increased global warming because carbon dioxide is getting higher. Because of the increase of carbon dioxide it has started to destroy the ozone layer, which then lets the harmful rays from the sun reach earth. As you can see source O States how carbon dioxide goes into air and also source P which also shows that America is the largest polluter. Source R also shows us that if there were no trees there won't be any oxygen, it also shows in the picture the clouds representing pollution. The other consequences are loss of wildlife where birds and insects rely on trees for food and shelter. There is a loss in medicine. It has also killed 96% of the Indians living in the rainforest because of the arrival of the Europeans. Those remaining have been driven from their homes by the constructions of roads, mines, reservoirs, cattle ranches and also forced to live in reservations. Source A talks about the Indians who are dying as development takes place. Their life styles are changing. The felling of the trees has also led to soil erosion by the rain in the rainforest. It rains every half and hour and is led to frequent flooding because there are no trees. All the rich soil which has the humus in it is flowed away by the flooding. After the rain there is a lot of heat given by the sun which bakes the poor soil, which then the areas of the forest which don't have trees turn into deserts. As it is also stated in source F in the second paragraph that the â€Å"Scientific studies have repeatedly shown that the Amazon soil is not suitable for agriculture and cattle ranching†. The hardwood is also becoming endangered. Source E also shows that the MNC's buy raw material like mahogany which they know come in illegal areas which they turn the blind eye on purpose. This source also talks about slavery which existed in the rainforest, which was abolished in 1888. People went to complain to the police about this but the police were corrupt and bribed and were useless. Government Actions The government is facing great problems now like the debts its facing which is getting higher everyday because of its interests. Brazil is trapped in the cycle of poverty. The government is also involved in causing more global warming and itself has done some deforestation in the rainforest. The other actions the government took was when the cities in the south east were very overcrowded and they reduce this problem by giving these people land in the middle of the rainforest where there wasn't a good infrastructure. The government has protected National Parks as it says in source C that the government has protected the rare areas of outstanding natural beauty to preserve and protect the future as these cannot be produced again. There are many companies who take advantage of Brazil's cheap resources. The Brazilian government has employed people from the favelas to work for these companies so the profit does not go straight out of the companies. Evaluation of the sources used ! Source A is against development and it's quite recent. It says it's a Brazilian newspaper but we don't know which one, we don't know how many Amerindians there were in the beginning. It's incomplete and it also tells us that the Multinational Companies (MNC's) and the government are working together to move the people to the Amazon. Source C is about what is the government doing? This source is sustainable but it is inconsistence and has exaggerated the facts like when it says in the third paragraph â€Å"From 2001 to April 2002, it transferred 20 million hectares.† When the source was adapted from a Brazilian newspaper which we don't know in March 2002. This shows that the dates were exaggerated because April 2002 had not come yet. Source E is against development and is reliable because it's a broad sheet which is more reliable than tabloid. There are other reasons why is reliable that is it there has been an interview with the MNC's, it's got facts, its quite recent, it has got dates and it tells us the true corruption. Source F is against development. Although the first paragraph is reliable because of the via satellite which does not lie but the second paragraph we don't know which scientific studies. Although this source is from the charity which most of the time charities exaggerate so that they get money and get known. But this source is reliable because they have done space research. Source G is for development because it's showing that by letting the MNC's deforest the rainforest their debt is getting lower. It is also reliable because it's consistent with source J and we also know the newspaper. Source J is for development. The headline is exaggerated. It is very reliable because it's consistent with source G but only the date is old. Source O is against development and it's reliable because the source is adapted from the UN. This source is 5 years old. Source P is against development and it's reliable because the source is from the UN. This source tells us that America is the largest polluter. This source is also 5 years old. Source R is against development. This source could be bias. This source shows us that the trees which provide oxygen are not there now, the clouds shows pollution and the person is getting bigger. Conclusion In my conclusion I agree with the hypothesis that only the Brazilian government can solve deforestation in the Amazon rainforest because they have started it and they are the one who can end it. One way they can make money without damaging or destroying the rainforest is by increasing their export so that their trade becomes surplus, that means that they export more than they import and by doing this they will get more money. There are two conflicts of interest in the rainforest. One is the groups that want to use the rainforest to make money. The other group of people wants to protect the rainforest and leave it as it is. In the middle are the people who live there. These people living in the forest want to preserve and use the resources from the forest to improve their standard of living. The solution to this is to manage the rainforest sustainable which is using the resources carefully like when cutting down the trees needed you shouldn't destroy the surroundings with it. The Brazilian government can also charge more tax for every area the MNC's deforest and also make them plant 3 more trees in that area.

Guest Loyalty Programs

Implementing a Guest Loyalty Program is a form of building a loyal client base, and also enticing new guests to patronize a particular business establishment. The inclusion of Guest Loyalty Programs is part of managing a business establishment that aims to develop   sound and desirable relationships with its clients and take advantage of their worth for the business, such as added revenue. Primarily, Guest Loyalty Programs attract guests and encourages them to return for more offers and services. (Otwell & Davis, 2005) Moreover, guests who frequent business establishments are awarded benefits and advantages in order to show appreciation for their loyalty and patronage through the Loyalty Program Guest Loyalty Programs come in different forms. For instance, businesses allow guests who frequent their establishments to earn advantage points for their every visit in the establishment. These points allow them to redeem added services and offers that fit their most pressing needs. These benefits include for example health and relaxation services such as spa treatment services and a day at the gym programs for luxury hotels, food discounts, freebies and gift certificates for restaurants, etc. while others include complimentary full course meals of breakfast, lunch, or dinner buffets, etc. In order to gain a better understanding of Guest Loyalty Programs, several examples that are widely used at present in business establishments shall be compared and contrasted in the following paragraphs. Visible Results Limited has launched an innovation for the purpose of Loyalty Programs, called the Graphicardâ„ ¢. The Graphicardâ„ ¢ is a form of a loyalty card the exceeds the standards of ordinary membership cards that we know of. The Graphicardâ„ ¢ is digitized and it incorporates elements of technology that make it easier to use and track down accumulated points as well as the corresponding benefits that shall be granted to the client. For every transaction in the particular establishment that a client makes, it is reflected on the face of the card. Moreover, as the client accumulates more points, the benefits and advantages granted to him are also reflected on the face of the card. (Visible Results, 2006) The good thing about it is that it updates itself for every transaction, it shows value for every transaction that the client makes, it utilizes a pointing system that is needed to establishing the particular Loyalty Program, it is much more enticing than other Loyalty Programs because it employs high technology, which represents the current trend, and it also accumulates all the benefits and services that are incurred during a specific period of time, with the client’s continuous patronage. Another example of a Guest Loyalty Program is one that is employed by the Carnival Cruise Lines. It also implements subscriptions for a membership card called the â€Å"Platinum† card wherein a client gets to be a member of the â€Å"Carnival Concierge Club.† Upon membership, the client is automatically granted specific and identified benefits and services that he may enjoy while aboard the ship. Benefits and services include personalized club items such as stationeries, priority laundry services and dinner reservations, etc. (Carnival Cruise Lines, 2006) The similarity between the Graphicardâ„ ¢ and the loyalty program implemented by Carnival Cruise Lines is that they both grant benefits and services to their clients. However, the difference lies on how clients are included in the program and what benefits and services shall be granted to them. For instance, the Graphicardâ„ ¢ shall be given to clients and the benefits and services that they receive shall depend on how often they use the card. On the other hand, the loyalty program of Carnival Cruise Lines shall only be awarded to clients who have sailed with their ships for over ten times and the benefits and services that shall be granted to them is fixed and applies for all. Some industry best practices that businesses employ include personalized loyalty programs that allows clients to get involved with how they become members of loyalty programs (such as personalizing membership card themes and mode of payments, etc.), partnership marketing or an business establishment’s links to other establishments and organization in order to provide benefits and services for clients wherever they are, â€Å"green† marketing or a business establishment’s involvement with nature that allows him to establish a socially responsibly image and reputation,   and digitized types of membership. (Pearson, 2007) Business establishments are able to implement different types of guest loyalty programs. Rewards Loyalty Programs allow customers to earn points for their every transaction. Accumulated points are redeemed through rewards that the business establishment shall grant to their clients. Rebate Loyalty Programs provide for gift checks or cards that the client is able to redeem during the next transaction. Usually rebate checks and cards are granted to clients if they reach a certain amount throughout their course of spending within the business establishment. Loyalty Programs that show appreciation to the continued patronage of their clients are not granted in monetary form. They are usually non-monetary benefits and services such as complimentary meals in restaurants, room upgrades in hotels, etc. Partnership Loyalty Programs are benefits or services awarded to clients that are provided for by the business’ partner establishment. For valued guests who have proved their loyalty to the business establishment, the loyalty program by affinity is implemented, such that benefits and services are additions to preview rewards and bonuses. (Summers) Guest Loyalty Programs are successful if it encourages clients to purchase or patronize services and offers provided by a business establishment. After the client’s primary experience, he is convinced to return to the particular business establishment. Basically, loyalty programs are successful for the obvious facts that they attract many clients, not only to the point of attracting them but also in making them stay. Moreover, successful loyalty programs are those, which encourage clients to spend more, thus, increasing the revenue of the business establishment. (Customer Service Point) The advantages of employing different approaches in Guest Loyalty Programs is that it motivates clients who have already been a member long before, to learn more and explore about the new offerings of the business establishment. Moreover, innovations are appreciated by clients because of the efforts that business establishments do to satisfy their clients. Generally, people are always encourage to try things that are new to them, so introducing innovative loyalty programs shall motivate them to continue patronizing the services that business establishments provide. The disadvantage is that, perhaps, new members who have been part of the previous loyalty program might get discouraged if the system of gaining points and earning rewards, without having them to accumulate points in order to gain rewards, is changed ever so often. In addition, membership cards that are needed to be renewed for the changes in loyalty programs might become costly for clients who have to pay for the membership again. (De Weaver, 2002) References Carnival Cruise Lines. (2006). â€Å"Carnival Cruise Lines Rolls Out New Past Guest Loyalty Program.† Retrieved April 17, 2008, from Carnival Cruise Lines. Customer Service Point. (2008). â€Å"Loyalty Programs Characteristics.† Retrieved April 17, 2008, from Customer Service Point. Website: http://www.customerservicepoint.com/loyalty-programs-characteristics.html De Weaver, G. (2002). â€Å"The Good, Bad, and Ugly of Loyalty Programs.† Retrieved April 17, 2008, from B&T Today. Website:   http://www.bandt.com.au/news/6a/0c010f6a.asp Otwell, K. & Davis, D. (2005). â€Å"Guest Loyalty Programs for the Vacation Rental Industry.† Retrieved April 17, 2008, from Visual Data Systems. Website: http://www.vdsys.com/presentations/garezfest.pdf Pearson, B. â€Å"The Global Loyalty Infusion: Best Practices and Innovations Around the World.† Retrieved April 17, 2008, from Penton Media, Inc. Website: http://chiefmarketer.com/cm_report/global_loyalty_0211/index.html Summers, J. (2008). â€Å"Five Types of Loyalty Programs: Which is Right For You?† Retrieved April 17, 2008, from Restaurant Coaching Solutions. Website: http://restaurantcoachingsolutions.com/five-types-of-loyalty-programs-which-is-right-for-you/ Visible Results. (2006). â€Å"Graphicardâ„ ¢.† Retrieved April 17, 2008, from Visible Results Limited. Website: http://www.visibleresults.com/loyalty/graphicard.htm                  

EMR Vendors Essay example - 1010 Words

1. EMR vendors are being stretched to the limits by requirements to support multiple standards across the country is this good or bad, why so? EMR vendors are being stretched to the limits by requirements to support multiple standards across the country. One of the functions of EMR is to make possible to transfer data into information and to support the knowledge; other indicator of quality is its interoperability (De.ryerson.ca, 2013 CHIT 100), in order to meet these requirements EMR system has to support multiple standards. This is required not only to be able to be used across the facilities and/or networks, but also to make it highly functional and interoperable with EHR. Vendors are required to make EMR system maximum functional†¦show more content†¦In addition, use of provincial standards developed by CIHI, Infoway, will make easy vendors’ job and help standardization process. I do think that meeting requirement of supporting multiple standards is good idea; however vendors should try to keep the system as simple as possible to use, to not discourage and raise resistance among health care providers. EM R systems have to meet requirement to support multiple standards across the country in order to be able: †¢ To understand, translate, code, accumulate, analyze different indicators, both in terms of administrative, statistical and medical use; †¢ To be used across the medical and diagnostic facilities, all over the province, †¢ To be adjustable, interoperable and multifunctional. 2. Reusing standards the article discusses issues from the authors perspective, what is your opinion in this regards? In my opinion ‘reusing of standards’ is a good idea. Off cause with about twenty years of history of EMR, this is not a case when everything new is well forgotten old; however the other proverb - why reinvent the wheel is a good fit for it. Existed standards can be utilized, if there is no technical problem. If the new system is not compatible and its’ use will require much more job to be done to integrate the standards, then vendor should decide how to meet client’s requirement. Use of existing standards is beneficial not only in terms of having ready the part of the job, but also in terms ofShow MoreRelatedUniversity Emr Implementation : Case Analysis1282 Words   |  6 PagesStanford EMR Implementation: Case Analysis This case analysis of Stanford’s Hospital and Clinics (SHC) electronic medical record (EMR) system implementation will focus on how the healthcare organization focused on resolving a problem to meet regulatory pressures and responded to an opportunity to create operational efficiency, by capitalizing on the use of information technology to help reduce costs. 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