Friday, January 31, 2020

Functional assessment of an elderly man at home Essay Example for Free

Functional assessment of an elderly man at home Essay According to NHS (2011), elderly people who have attained the age of 65 years and above usually spend an average of 10 hours and above daily sitting or lying down, making them the most sedentary group of people. Due to this apparent inactivity among the elderly, they are more prone to accidental falls, obesity, cardiovascular accidents, heart conditions and sudden death than the general population. In this interview, data was gathered from an elderly man in his early 80s through use of a semi-structured interview schedule that consisted of open-ended questions touching on the instrumental activities of daily living (IADL) and activities of daily living (ADL). The interview schedule provided an opportunity for the interviewer and interviewee to tackle the questions in detail through appropriate probing. Before commencement of the interview, an informed consent was obtained from the respondent where his anonymity and the confidentiality of the information sought from him were assured. The interviewee was asked to sign a consent form if he agreed to take part in the interview. The Rationale To ascertain that a person is able to independently live at home or community, the determination of the daily basic activities performed by the individual is necessary. These activities are referred to as Activities of Daily Living (ADLs). According to PayingForSeniorCare (2007), ADLs only serve as a yardstick of independence of individuals, whether or not they perform these basic activities on their own or get assistance. On the other hand, Instrumental Activities of Daily Living (IADLs) are the actions which are important but not a daily requirement for one to live independently. They usually used to determine what level of assistance is to be accorded to the elderly or disabled people in society. In the interview nschedule, three (3) ADLs and Three (3) IADLs were included. The ADLs included: Bed mobility, Toileting, and Eating. The IADLs were: Responsibility for own medication, Housekeeping, and Ability to use telephone. These activities and actions were included in the interview because they will in the very least point to the functional ability of the respondent given his advanced age. ADLs and IADLs are carried out because ‘ Measuring an individual’s ability to perform the ADLs and IADLs is important not just in determining the level of assistance required but as a metric for a variety of services and programs related to caring for the elderly and for those with disabilities (PayingForSeniorCare (2007, p. 1). Ethical considerations According to Fouka and Mantzorou (2011, p. 3), research ethics involve requirements on daily work, the protection of dignity of subjects and the publication of the information in the research. Research ethics are a set of principles that guide researchers and research organizations on how to conduct themselves when dealing with research participants, other researchers and colleagues, the users of their research and society in general. Among the ethical issues taken into consideration in research include: 1. Informed consent Informed consent is a major ethical issue in carrying out research. According to Armiger (1997), the participant must knowingly, voluntarily and intelligently, and in a clear and manifest way, give his/her consent. Informed consent confers autonomy to the respondent hence they are protected through self-determination. Through informed consent, the participant’s integrity, personal liberties and veracity are protected from violation by researchers. Informed consent enables individuals participate in research voluntarily after they have been provided with information on the potential risks and benefits of the research. Free and informed consent should incorporate an introduction to the study, its purpose, an explanation of the selection of the subjects and the procedures that shall be followed. It is essential to describe any physical harm or discomfort, any invasion of privacy and any threat to dignity as well as how the subjects will be compensated in that case. 2. Beneficence- do not harm This principle ensures that researchers exercise a professional mandate to carry out significant and effective research so as to serve and promote the welfare of the population. A researcher must consider all possible consequences of the research and balance the risks with proportionate benefit. The type, degree, and number of potential risks must be assessed and the risk benefit ratio can only be achieved by identifying these factors. If the risks outweigh the benefits, the study should be revised. It is important that debriefing of the participants is done at the end of the study. Debriefing refers to explaining the exact aim of the study and why certain disclosures were not done. According to Burns and Grove (2005) ‘if the subjects experienced a high level of discomfort, they should be debriefed or referred to appropriate professional intervention as necessary’. 3. Respect of anonymity and confidentiality Confidentiality and anonymity are closely linked with the rights of beneficence. The protection of anonymity is achieved when the researcher does not link a participants personal responses and his/her identity. The management of private information of the respondents must be ensured by the researcher in order to protect the participant’s identity. Confidentiality means that individuals can give and/or withhold as much information as they wish to the person they choose. 4. Respect of privacy Privacy is the freedom exercised by an individual in determining the time, extent, and general circumstances under which private information will be shared with or withheld from others. Therefore, private information shall not be shared with others without the knowledge of the participant. According to Treece and Treece (1982), a researcher must respect a decision by a respondent who considers reporting personal information a violation of privacy. Fauka and Mantzorou (2011, p. 7) state that ‘this may even apply to report of age, income, marital status, and other details that the subject may regard intimate. They also imply that privacy can be invaded when researchers study certain groups without their knowledge and without identifying themselves. 5. Concerns of vulnerable group of people Vulnerable group of people are the individuals who are unable to protect their own rights and welfare. Opinion is still divided as to whether they should be included in research studies or not due to their inability to give informed consent. They include prisoners, mentally ill people, the aged and children among others. They need further protection for they are vulnerable to being deceived, threatened or forced to participate in research studies they have no idea about. According to Burns and Grove (2005), the vulnerability of these individuals increases the need for justification for the use of such subjects in research studies. 6. Honesty, objectivity, integrity, legality and competence It is important to maintain honesty in research undertakings. Honestly report data, results, methods and procedures, and publication status. Avoid any fabrication, falsification, or misrepresentation of data. Do not deceive colleagues, granting agencies, or the public. To maintain objectivity, the researcher must avoid bias in study designs, data analysis, data interpretation, peer review, personnel decisions, grant writing, expert testimony, and other aspects of research where objectivity is expected or required. Avoid or minimize bias or self-deception. Disclose personal or financial interests that may affect research. Integrity should be ensured through keeping of promises and agreements. The researcher must act with sincerity, and maintain consistency of thought and action. Every researcher must ensure and improve his/her own professional competence and expertise through lifelong education and learning and steps must be taken towards the promotion of competence in science as a whole. Research studies are guided by the relevant rules and regulations that must be adhered to at all times, whether institutional or governmental. Research ethics play important roles in research studies as they; 1. Bring about respect for and cause no harm to the participants 2. They are a professional requirement in research studies 3. They are a requirement in obtaining funding for research undertaking 4. They ensure that research studies are conducted within the ethical guidelines provided by the Ethics Committee 5. Ensures that the research findings are acceptable to the research community and the public Interviewee current IADL/ADL practices According to Quinn et al. (2011), elderly individuals usually present with acute and chronic problems that adversely affect function, often defined by functional decline and loss of independence. This might eventually lead to institutional care for such individuals. The decreased function may be a pointer to occult pathologies which lead to increased mortalities (Schumacher, 2005). From the interview, it was found out that the respondent had limited capacity in carrying out daily activities. For instance, in determining the ADLs, in bed mobility, he needed other than two persons physical assist, had a limited physical assistance in toileting and limited assistance when eating. His actions too were limited as he scored lowly in IADLs. For instance, in responsibility for own medication, he only takes medication when it is prepared in advance and in right dosages, he answers the telephone only and cannot dial by himself, and finally he does not participate in any form of housekeeping. The respondents attributed all this to poor memory, fast failing eyesight, affliction by arthritis and advanced age. Conclusion Elderly individuals are afflicted by many ailments that lead to poor health, and as a consequence they are usually unable to undertake simple tasks that are geared towards maintaining good health. It is therefore imperative that functional assessment are done on such persons in order to put in place appropriate strategies that can help them lead at least ‘normal’ lives. Therefore, ADLs and IADLs are important towards this end and can help determine the kind of care to be provided to elderly individuals. This can be in the form of institutional care, family and friends care giving. References Armiger, B. (1997). Ethics in Nursing Research: Profile, Principles, Perspective. Nursing Research, vol. 26, no. 5, pp. 330-333. Burns, N Grove, S. (2005). The practice of nursing research: Conduct, critique, and utilization (5th ed.), St. Louis, Mo: Elsevier/ Saunders. Fauka, G   Mantzorou, M. (2011). What are the major ethical issues in conducting research? Is there a conflict between the research ethics and the nature of nursing? Health Science Journal, 5(1), pp. 3-14. NHS (2011). The importance of exercise as you get older. Retrieved from: http://www.nhs.uk. Quinn, J, McArthur, Ellis, G Stott, J. (2011). Functional assessment of older people. BMJ. doi: doi: http://dx.doi.org/10.1136/bmj.d4681 Schumacher, J. (2005). Emergency medicine and older adults: continuing challenges and opportunities. Am J Emerg Med, 23: pp. 556-60. Treece, E Treece, J. (1982). Elements of research in Nursing. St-Louis: Mosby. Appendix Appendix A Informed consent letter My name is †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦., an undergraduate student at †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. University carrying out a study on ‘the importance of ADLs and IADLs’. All information provided in this study will be treated with confidentiality and your identity shall not be disclosed. All information provided in this study will be treated with confidentiality and your identity shall not be disclosed. The participation in this study is on voluntary basis, and therefore you are free to accept or decline to take part in the study. Your cooperation shall be of great importance in achieving this goal. If you agree to take part in this study, please append only your signature below ____________________________________ ______________________ Respondent Signature Date Interviewer signature Date Appendix B Interview schedule Part 1: ADLs 1. How will you describe your ability to move in bed while you lie on it? Any difficulties? 2. Please describe your ability to use the washrooms. Any important information worthy noting? 3. Can you please describe to me your eating habits? Are you able to cut chew and swallow food independently or with supervision? Part 2: IADLs 1. Are you responsible for taking your medications? Yes [ ] No [ ] If NO in the above question, please explain. 2. Do you perform housekeeping chores? 3. How will you describe your use of the telephone? any reasons for that?

Thursday, January 23, 2020

The Role of Scholars in the Era of Digital Texts Essay -- Education Me

In her introduction to Electronic Text: Investigations in Method and Theory, Kathryn Sutherland asks if there is "a real danger that the scholar-worker, toiling for years in the remote regions of the library stacks in the hope of becoming expert in one small field, will be transformed by the computer into the technician, the nerdy navigator able to locate, transfer, and appropriate at an ever faster rate expert entries from a larger set of information that he/she no longer needs or desires to understand" (Sutherland 10). Her inquiry is based on an issue that still plagues many scholars: with quick access to so much digitized information, how do we evaluate what we still need and desire to understand? Of course, her question implies that evaluating printed information is an evaluation based on less access and therefore a smaller set of information, and evaluating printed information is not an uncomplicated issue; it is one which scholars reconsider constantly. One such group—li terary scholar-workers—may spend years "toiling" over similar versions of a printed text in order to produce a singe representative edition. In the case of Christopher Marlowe's The Tragedie of Doctor Faustus, for example, there is no extant manuscript, nine versions were printed between 1604 and 1631, and the first appeared almost nine years after Marlowe's death. Those that appeared in 1604, 1609, and 1611 are similar and are collectively known as the A-text. The 1616, 1619, 1620, 1624, 1628, and 1631 versions are also similar and known as the B-text. Which one should a reader or scholar consult? Remarkably different, the A- and B- texts have inspired an extensive amount of critical commentary and scholarly editors since W.W. Greg appear to agree on one ... ... 2. Binda, Hillary. "An Overview of this Electronic Doctor Faustus." Accessed October 2004.. 3. Greg, W.W., ed. Marlowe's Doctor Faustus' 1604-1616: Parallel Texts. Oxford: Clarendon Press, 1950. 4. Lavagnino, John. "Completeness and adequacy in text encoding." The Literary Text in the Digital Age. Finneran, Richard J. (Ed.), Ann Arbor: The University of Michigan Press, 1996. 5. Schreibman, Susan. "Computer-mediated Texts and Textuality: Theory and Practice." In Siemens (Ed.). A New Computer-Assisted Literary Criticism? Special edition of Computers and the Humanities, 36:283-293, (2002). 6. --"The Versioning Machine." Literary and Linguistic Computing, 18:1 (2003). 7. Sutherland, Kathryn (Ed.). "Introduction." Electronic Text: Investigations in Method and Theory. Clarendon Press: Oxford, 1997.

Wednesday, January 15, 2020

Of Mice and Men – Misc Questions

OMAM Essays a) How does Steinbeck use details in this passage to present the bunkhouse and its inhabitants? Steinbeck uses many different ideas to present to present the bunkhouse and its inhabitants. Steinbeck emphasises that the inhabitants have little possessions by commenting about the â€Å"apple box† forming â€Å"two shelves for the personal belongings of the occupant of the bunk†. As all the occupants would be itinerant workers, which meant that they had a nomadic lifestyle, this also highlights that the occupants couldn’t afford possessions and probably didn’t have a lot of room for them anyway.This indicates that they had little home comfort and it was probably quite an uncomfortable, stark and hostile environment they lived in. This lack of familiarity or care is also further portrayed by the description of the bunkhouse itself. The walls are described as â€Å"whitewashed† and the floor is â€Å"unpainted†. This could indicate tha t the owners of the bunkhouse really don’t care about the inhabitants. However, this may not be because the owners dislike the inhabitants, more probably because the itinerant workers don’t stay around for long enough for the workers and the boss to have a proper relationship.This reiterates the point that â€Å"maybe everyone in the whole damn world is scared of each other† and the society they live in is truly a backstabbing and hostile environment. We even know that Crooks, who is a long time inhabitant of the bunkhouse, isn’t treated fairly and much more like an animal because he lives in the barn and he has little possessions. This also shows how cruel their environment is. Despite all of this – at least the inhabitants still have pride.This is demonstrated by George’s disgust when he finds a yellow can of pest killer next to his bed, indicating that the bed may be infested. Clearly, George was not expecting there to be pests in his bed which could indicate that he is a cynical man and has been hardened by his surroundings. This could also emphasise how out of place Lennie is. His docile approach just doesn’t fit in with his life. b) In the rest of the novel, how does Steinbeck present the lives of ranch workers at that time? Steinbeck has intentionally designed each character to represent a segregated group of society.Together, all the characters are presented in a microcosm and they all represent something much larger. For example, Crooks represents the prejudice that black people had to put up with and Crooks’ opinion of this treatment is evident throughout the book in an unbiased way, allowing the reader to digest the ideas of Steinbeck. George is one of the most pivotal characters in the book, as he represents the typical itinerant worker, trying to get money wherever they can after the backlash of the wall street crash.Unfortunately, like most workers at the time, they were all very lonely beca use of their nomadic lifestyle. Although George doesn’t appear to be lonely because of his friendship with Lennie, there are subtle indicators that being lonely is George’s fate. For example, George often plays Solitaire which is a game for one person. Steinbeck is highlighting how lonely it would be for the workers to always be working with no stable home. George also says that he â€Å"ain’t got no people† and that people like him who are alone â€Å"get wantin’ to fight all the time. This indicates that life for the workers was hard because all the workers were exactly like George – they were alone and they were a product of an inimical environment. Through George, Steinbeck is also describing how angry and nasty everyone becomes when they are alone. This is demonstrated by Crooks – who was cynical and nasty to Lennie when he showed weakness. Crooks has often proven to be an angry and bitter man, however this is only because of th e way he is treated. As he is black, people don’t talk to him or accept him for what he is.They even go as far as to not let him in the bunkhouse. Early on in the book, when Candy is describing Christmas on the ranch he says â€Å"they even let the nigger in† as if that was an unusual event – which of course for them it was. Through this, Steinbeck is addressing the segregation that blacks lived with in 1930s America. a) How do the details in this passage add to your understanding of George and his relationship with Lennie? In this passage it is clear that Lennie looks up to George

Monday, January 6, 2020

Journal of Sofonisba Anguissola Essay example - 1150 Words

Journal of Sofonisba Anguissola From the Journal of Sofonisba Anguissola: June 1, 1581 I have painted many self-portraits in my life, but the one that sticks out the most to me is the one in which I painted myself holding a book. I was born in a time, when women typically were not encouraged to obtain an education. My family, however, went against the grain, and actively supported my sisters and I in our education. Even today, as I write this, my society celebrates women for our â€Å"virtue and beauty,† (Niyazi, 2011) with our sole purpose being solely the â€Å"ambition to marry and bear children† (Niyazi, 2011). Nowadays, women in Italy are â€Å"consigned to sit in their palazzos and pursue needle work† (Burke, 1995) when not occupied with†¦show more content†¦I avoided these â€Å"female signifiers† (Niyazi, 2011) so that the audience would not connect my image with beauty, which is something that is traditionally connected to women in my society. I created this image to look masculine in order to show that I am mature, indepen dent, and self-possessed (Niyazi, 2011). Even the background behind me has nothing that would detract from this; the background is a rich green color that only makes my figure stand out to the viewer. I can only hope that the women that have looked at this portrait of me are inspired to pursue their goals and dreams, no matter how foolish they may seem to be by society. I have been fortunate enough to be allowed to break away from my expected norms and go after the arts. I hear that I am the â€Å"first known woman artists to achieve international fame,† (Clara, 2012) which means that my efforts and my talents have not gone in vain. It is my humble wish that decades from now, women can look at this painting and see that their efforts to be more equal to men are worth and so important. Amongst the paintings that I have created, there are several others that I think are an important contribution to the study of art. The first one is The Family Group, which I painted in 1558. In this painting, the central figures are my father, Amilcare, my sister Minerva, and my only brother, Asrudbale. In the painting, my fathers attention is focused on my brother, while my sister stands behind them. This painting representsShow MoreRelatedArt History Study Guide3003 Words   |  13 PagesMeadow; Galatea; Alba Madonna; Pope Leo with Nephews; Baldassare Castiglione * Titian –Assumption of the Virgin; Pesaro Madonna, Venice; Venus of Urbino; Isabella d’Este; Portrait of a Man * Mannerism (1520-1560) * Anguissola, Sofonisba –Artist’s Sisters and Brothers * Bologna –Abduction of the Sabine Woman; Astronomy * Bronzino –Venus, Cupid, Folly and Time (aka Exposure of Luxury); Portrait of a Young Man * Cellini –Saltcellar of Francis I;