Mmse in Nursing Essay

A mini mental state examination (MMSE) also known as the Folstein test is a brief 30-point questionnaire test that is used to screen for cognitive impairment in a patient. It’s use I normally in medicine to screen for the presence of dementia. In this case I used it to estimate the severity of cognitive impairment at a given point in time and to follow the course of cognitive changes in an individual over time. Functions assessed are usually arithmetic, memory and orientation (Changsu Han, 2008). I assessed Mrs. Pandey’s state of cognitive impairment using the mini mental state examination. Mrs. Pandey is a young lady suffering from multiple sclerosis. At this point we assume that she has a normal cognitive state and it was proven correct by the mini mental state examination. After my assessment I found that the MMSE was easy to perform in a way that the type of questions to address where given to me already, concentration was nowon effective communicaion with Mrs. Pandey and developing confidence in her to answer the questions to the best of her ability. To some individuals it is difficult to ask some of the questions , an example was the one question were i had to ask the patient to count backwards from 100 by 7. This was because the patient could find it difficult to understand what is required by the question or interprete in a different way, which can affect the accuracy in determining the patient’s state of cognitive impairment. Some of the questions sounded a bit silly which could possibly annoy the patient especially when they have a normal cognitive state (McMurray, A. 2005). This I thought could cause psychological depression to the patient since they might feel they could be so silly enough not to answer some of the questions correctly. The advantage in this examination could be that no answer is wrong; it is just a way of assessing their state of cognitive assessment. Communication was not much a problem. An issue could be misunderstanding the aim or the purpose of the examination; I did do my best I think to explain the purpose of the exam. I really did not need to rephrase most of the questions because Mrs. Pandey is of an English speaking background therefore I just needed to say it as it is. I do not think, though, that my question could help me draw a definite conclusion because people make mistake even if their cognition is normal due to anxiety and nervousness therefore it is difficult to draw an accurate conclusion (Galea, M. Woodward, M. 2005 ) (McMurray, A. 2005). In terms of the video, i was a little disappointed because i was not speaking loud enough so some of the things i said could not be heard in the video. all in all i think i did a good job in communicating with the patuent, i had a profound open posture to the patient and the patient to examiner positioning was perfect in that it gave the patient a state of superiority

American War of Independence Essay Example | Topics and Well Written Essays - 1250 words

American War of Independence - Essay Example For the measurement of success of any social movement, factors like skilful organisation, optimum use of resources and the identification of opportunities, are vital indicators. Although the United States is usually regarded as a nation-state, supporters of American exceptionalism may prefer to see it as a state bathed in the glory of its own unique light. The country clearly has a sense of national identity and history, Americans refer to an 'American people'. Thus, patriotism is prominent in public life. Nationalism is the appropriate and recognized term for the associated ideology and political movements, within the present United States, and during its history. That does not necessarily correspond with current usage of the term in American politics, or with the views of self-described 'American nationalists'. (Bradford, 1999) In this regard, the British were more corrupt in America during the 19th century than any other colony. They could have established a more urban society and structure in order to lull the Americans into a false sense of rest as a strategy to curb the rebellion. (Smith, 1898) There are no two same theories about when the United States became a nation-state, and developed a sense of national identity. Some historians think that the United States was already a nation-state at independence, others that this occurred during the 19th century, either before or after the American Civil War. The United States was formed from a group of colonies under the authority of the British Crown, each established and governed independently of the others. For most of colonial America's history, a colonist had a duty to the colony and to the Crown, but not to other colonies. (Bradford, 1999) This attitude changed noticeably when the colonies faced a common threat in the French and Indian War. The Albany Plan of Union, although unsuccessful, served as a reference for future discussions. Soon after, the colonies faced another common grievance over taxes enacted by the British Parliament. As the dispute escalated, colonists started to view the British administration as hostile, and sought cooperation with other colonies in response. This cooperation produced the Continental Congress and ultimately independence as a confederation. Ties between the states strengthened with the ratification of the United States Constitution. (Smith, 1898

Censorship an argument for censorship of media on violence against Research Paper

Censorship an argument for censorship of media on violence against women - Research Paper Example While liberalists argue that censorship is an infringement against freedom of expression, the paper takes a stand that unrestricted depiction of violence against women will only fuel the patriarchal superiority of men in a particular society. Hence a certain level of restriction, even if it is an apparent infringement of freedom of expression is deemed necessary. Introduction: Gender equality is a term that one often hears nowadays. The concept has been around for decades, even though its practical relevance even in modern societies is circumspect. Women’s rights group have, over the years, made great strides in empowering women in various activities of human endeavor. Jobs and tasks, once the exclusive prerogative of men are now being opened up to the ‘fairer sex’ as well. ... This embodiment is inflicted on almost every part of the body. Women wear lipstick, curl their eyelashes, do all sorts of things with their hear like dyeing, curling, straightening etc, eyes are shadowed or lined, use high heel or ill fitting shoes, resort to body piercing and even cosmetic surgery and silicon implantation, all in the name of beauty. The author argues that most of these practices are not only physically and mentally harmful, but also degrading to women. These practices are encouraged by the fashion industry, the art world and even women’s and girlie magazines. Moreover, writing against them results mainly in resentment and opposition even from the so called feminists. Jeffrey says that â€Å"Beauty and Misogyny could well fit into precisely those feminist writings which are criticized because I am arguing here that ideologies of beauty and fashion such as those circulated through popular culture do subordinate women, however passionately those women may adher e to then and cut up their bodies in response† (Jeffreys, 15). Violence against women: The above argument was given just to show the element of male superiority and female inferiority in today’s societies. Violence against women is not just passion, but an act of dominance (Riley). The author argues that the aspect is much deeper than pure censorship of media portraying violence against women. The lack of choice in a male dominated society makes women more vulnerable to violence in various forms (Berry. 13). Other arguments over the power of the media to influence males to be influenced by media are also available. The basic argument is that there is no â€Å"simple, direct and casual relationship between the media and

International Finance in USA Assignment Example | Topics and Well Written Essays - 1750 words

International Finance in USA - Assignment Example Last March 9, 2006, the US Census Bureau/US Bureau of Economic Analysis issued a press release outlining the state of the country’s economy. It announces that total January exports of $114.4Billion and imports of 182.9 billion resulted in a goods and services deficit of $68.5 billion, which is $ 3.4 billion, more than the 65.1 billion in December. January exports were 2.8 billion more than December exports of 111.6 billion. January imports were 62.2 billion more than December imports of 176.6 billion. (U.S. Department of Commerce, March 9, 2006). The balance of payments (or BOP) is a measure upon which a country traces how much money flows into or out of a given country or countries1. Factors involved in the determination of balance of payment is the country’s export2 and import3 of goods, services and financial capital4, including financial transfers. The need for some balance of payments statistics can be traced back to the Fourteenth century when the Bullionist Doctrine5 was developed in England which led to the prohibition of export of bullion. This is the early form of Mercantilism which seeks to achieve an equilibrium between the value of exports and imports (Soderstien 1980). The latter part of the Mercantilist period observed that there are also transactions which stem from trade relations outside of the country and should be taken into considerations in order to establish a state of economic equilibrium. The principle of balance of payment gives us an idea of how much money or wealth is flowing and how much is flowing out of the county. If the amount of wealth flowing out of the country is more than the amount flowing into such a country, we have a negative balance of payment or a deficit. In the same manner, where more wealth enters into the country than that which flows out, then we have a positive balance which we refer to as surplus.  

Modern World History - Assimilation & Exclusion in Societies Research Paper

Modern World History - Assimilation & Exclusion in Societies - Research Paper Example Burchardt et al defined social exclusion as â€Å"†¦the attempt of one group to secure for itself a privileged position at the expense of some other group through a process of subordination..† (p.2). Social exclusion has existed in so many ways and forms in societies. South East Asia generally refers to the nations east of the Indian sub-continent and west of China and the Indian Ocean islands south of these nations. It includes Burma, Vietnam, Philippines, Indonesia, Malaysia and Singapore. Most of the people living in these areas speak dialects of the Austronesian family of languages and they share similar cultural practices and animist religious traits (McKay, p.429). In the 13th Century, Jewish, Christian and Muslim influences were felt in the region by traders. After the 1300s the Muslims established the Malacca which became a trading entry point and flourished in trade (McKay, 430) In 1511, the Portuguese captured Malacca and the Spanish occupied Manilla in 1571. Th is marked the beginning of world-class social exclusion in this region. The Europeans sent missionaries to convert the Southeast Asians with a view of training them to integrate into their Europeanized colonies. Mendelssohn & Marika report that the Europeans used the support of these Europeanized natives to suppress ‘inferior’ tribes. ... They were granted second grade status. (Bauer, p79) In 1599, a Dutch fleet containing large quantities of spices returned to Amsterdam and this prospect caused them to establish the Dutch East Indies Company with the intention of taking over the spice trade from the Portuguese (Kagan et al p.77). The Dutch East Indies Company became the national tool for the colonization of several islands in South East Asia by the 1700s. Britain followed with the colonization of Malaysia and some other lands in the region whilst the French took over the territory now known as Vietnam. The next thing that followed was widespread social exclusion, where white Europeans were living privileged lives on the socio-economic plane whilst the natives toiled on the farms. â€Å"In Southeast Asia, economic profit was the immediate and primary aim of the colonial enterprise. For that purpose, colonial powers tried wherever possible to work with local elites to facilitate the exploitation of natural resources. Indirect rule reduced the cost of training European administrators and had a less severe impact on the social group.† (Duiker, p36). The colonial powers forced the natives to work hard on plantations in very harsh conditions. The Europeans exported all the products, mainly palm oil and spices to Europe, which they sold for very high profit margins. Duiker reports that the South East Asian barely had enough to feed himself and his family. However, the Europeans and their ‘priyayi’ (native collaborators) enjoyed luxurious lives in Southeast Asia whilst the locals were denied rights to basic necessities like education, healthcare and justice. The main advantage of colonialism is that it set the stage for the modernization of these nations.

In this assignment you will draw two primary sources and two secondary Research Paper

In this assignment you will draw two primary sources and two secondary sources written after 1990 to explore a topic addressed i - Research Paper Example There are several factors that played a key role in the collapse of one of the greatest empires in the world. According to Bauer (84), several factors that occurred within a span of approximately 500 years were instrumental in the collapse of a strong empire, the Roman Empire. Expansion of the Rome Empire can be referred to as one of the major causes of its collapse. Rome kept conquering many nations and therefore there was rapid growth in the land they owned. Consequently, there was great need to defend the borders and the territories of Rome. As they struggle to keep this under their control, emperors increased taxes on non-Romans and these created more enmity where frequent rebellions arose. Lack of enough solders to safeguard their territories forced them to employ foreigners who were against them resulting in the collapse of the empire. Since the empire was growing at a rapid rate, it needed more soldiers for it to remain a great conqueror. As such, militarism was adopted as a m ean of the emperor and his compatriots remaining in full control. In this case, constant fighting needed heavy military spending. This demand for the military was high since the Roman Empire became over stretched, and the need for more solders was proportional to its needs for expansion and protection of their overstretched territories. Due to this, there was overspending in the military body, hence other fundamental activities were left with few resources. Vital issues such as provision of houses to the public, quality roads and channel were left untouched. This also resulted in emperors raising taxes repeatedly resulting in increased levels of inflation. Roman Empire faced a failing economy and increased levels of inflation. Inflation is a state where prices increase and the purchasing power of currency declines. The Rome Empire was in this situation and the government was threatened of impoverishment as it did not have sufficient cash to cater for its needs. Overexpansion and eff orts to protect their territories resulted in this. For instance, the increased population required more militaries and the demand forced them to recruit and train more people. This process was demanding and more money was used in paying the large numbers of military personnel .The other factor is that after they diminished new lands conquering, the flow of gold to their economy decreased. This resulted to less use of coins and the coin become less valuable. Due to over-expansion of the territories, there were more merchants from the conquered places who raised the prices of the goods that they sold. Several persons changed their way of trading and butter trade erupted eventually. People stopped using coins and they began to undertake barter trade in order to get what they wanted from others. This went to as far as paying salaries in the form of food and clothing while tax collection also changed and vegetables and fruits were used to pay taxes. In this case, the expansion of territ ories shows how the economy was affected resulting to its decline. According to Goldsworthy(72) Over expanded Roman Empire territory had people from different ethnic groups and was over populated. As a result, the labor force was composed of slavery resulting in unemployment. Plebs in

Earthquakes in the Xi Chuan Province Research Paper

Earthquakes in the Xi Chuan Province - Research Paper Example Being near an active fault, the area regularly experiences light tremors due to the constant movement of the plates. However, there are instances where big, catastrophic earthquakes hit the region. An example of which happened on May 12, 2008, 06:28:04 (UTC) which according to official reports, seventy thousand people were killed, three hundred seventy four thousand people were injured, and about seventeen thousand more were reported missing. (Chen, Qiao, and Liu 809) To make a good equivalence, the Xi Chuan province is like Charleston of the United States. These places when they were established were not really plagued by catastrophe but, throughout the years, they became known to be the â€Å"center of calamity† for their respective countries. (Steinberg 5) For most people, inside and especially outside China, we only hear about these great catastrophes through the reports given by media. Although those in the media are sworn to present news in the most accurate way possible , it is hard for get such an accurate representation. There will always be bias and only snippets of the catastrophe can be recorded at one time. The perspective from which the report was derived is important in determining how a catastrophe will be seen by viewers inside and outside the immediate areas affected. Responses from these reports will ultimately determine how people will act with regard to the needs and situation of those struck with the calamity. There are several perspectives that a disaster report might come from. A disaster can be seen through the eyes on a local who has experienced the tragedy first hand, or through the eyes of an outsider, a foreign journalist perhaps that was tasked to report on the case. Another and more prevalent perspective, especially in a socialist country like China, is the perspective given by the government. These perspectives are the key that determines how locals as well as the policy makers will prepare their disaster management and pre paredness plan in for future catastrophes. Loopholes in the presentation of facts or exaggerations in the number of lives lost or damage to property can adversely affect these efforts to reduce damage and mortality for earthquakes. Aside from the perspectives, there are also a lot of ways wherein the reports on the disaster can be expressed. Newspapers and Blogs carry text and images regarding the aftermath of the disaster. Television and radio broadcasts also carry video and audio information about the activities and current situation of those affected. Incorporation different types of media and harnessing different modes of getting information disseminated can create a big effect on how a disaster is perceived and might well be the key determinants to the immediacy as well as the appropriateness of the actions instigated in response to the catastrophe. In this regard, the study intends to analyze how the Xi Chuan earthquakes are represented in media through text, videos, photo doc umentaries, and press releases. The study tries to connect how these reports affect the views of the locals, and even the rest of the world regarding earthquakes in the Xi Chuan province and will also try to determine the implications of these reports on the disaster management and preparedness plans for the area, the conduct of the rescue and relief operations as well as its effect on other relevant sectors. Literature Review A brief history of the study of seismic activity in the Xi Chuan basic region was detailed in the study of Han and Jiang (231). The Xi Chuan –