Task 3 Essay Example | Topics and Well Written Essays - 750 words

Task 3 - Essay Example Foremost, the Mughal Empire had collapsed and regional states had taken centre stage (Page, 2003). As a result, thirst for power by political contestants took center stage as they sought to consolidate power in coastal states through support from the Company administrators. Second, trade rivalries between the British and French prompted each one to build alliances with opponent political groups for purposes of extracting maximum benefits for their respective trade companies (Page, 2003). Furthermore, the personal ambitions of amassing wealth were at play in the company’s political involvement. However, one event proved vital in establishing company rule. It was the British victory over the French in Southeast India and consequent fomenting of their presence in Bengal (Page, 2003). Consequently, the company created Indian Sepoy armies that were used to gradually gain economic control over the expansive Indian territory and dismantling any forms of resistance (Page, 2003). The B ritish vision for India was one whereby the population was unified in speaking one language. Consequently, from 1818 to 1857, the company rule enforced social reforms and government policies based on British values. The company rule faced rebellion from the indigenous Hindus and Indians. It was known as the Sepoy rebellion of 1857. The rebellion was precipitated by several factors that were instigated by the British company. First, the Indians were offended by the apparent efforts by the British to convert them to Christianity. Second, the Indians were angered by the British efforts to instill social change by ending slavery and improving the social status of women in households. However, the boiling point arose when the Sepoy soldiers were forced to bite cartridges that were oiled with animal fat before loading them in their guns (Page, 2003). Apparently, the animal fat used was an affront to Hindu religion since it was derived from pig and cow fat. Consequently, the aggrieved Sepo ys rebelled against the British soldiers and the rebellion spurned across Central and Northern India (Page, 2003). However, the rebellion was defeated by the British army and the aftermath was burnt down villages, loss of innocent Indian lives and a wave of mistrust between the Indians and British. As a result, the British changed tact by removing the company rule and establishing a British Colony in India (Page, 2003). However, a wave of Indian nationalism led by rising middle class nationals started to agitate for Indian independence from Britain. One such movement was the Indian National congress that espoused political unity in the push for independence by 1914. B. Comparison of Tactics The Indian Independence Movement employed a non violent resistance against the British colonial rule. It was led by the revolutionary leader, Mahatma Gandhi. The movement preached a united and non violent Indian resistance against the British rule. Mahatma Gandhi drew his method of non violence f rom the philosophical tactics employed by Baba Ram Singh during the Kuka Movement of 1870s (Page, 2003).The resistance came after a backdrop of issues that the colonial government was perpetrating against the Indians. First, the British had divided the India into regions classified as the Princely states and British India (Page, 2003). The Britons had devised the partitioning as a tool for

Italy Country Profile Assignment Example | Topics and Well Written Essays - 1500 words

Italy Country Profile - Assignment Example . . Italy is a magic. Explore it† (â€Å"Beautiful Italy,† n.d.). With this notion, it can be perceived that Italy must be a paragon of a paradise in the contemporary perspective. The concept of this paper has been created as to depict the PEST-C aspects of the country, including the Hofstede's perspectives of analyzing the culture of Italy as compared to Canada, and depicting the feasible business venture in the country. Lastly, a conclusive remark will be inscribed. 2. PEST-C Aspects Political/Legal. When it comes to dealing with weak pecuniary locus of the country, Italy has announced to cut its budget amounting to â‚ ¬26bn from the period span 2012-14. In accordance with the Transparency International’s Corruption Perception Index 2011, the country is placed at 69th among 183 nations (â€Å"Italy Country Profile,† 2012, p. 4). In the context of European Union, Italy is deemed as having the highest aggregate tax rate. In accordance with Paying Taxes 2 012, the nation’s aggregate tax rate was 68.5%, which is notably above the average of EU of 43.4%. Such taxes may comprise of profit and labor impositions. Dismally, the nation’s aggregate piracy rate is 49% that has eventuated to procure detrimental losses of â‚ ¬1.87bn; such piracy issues are associated to business and entertainment softwares (â€Å"Italy Country Profile,† 2012, p. 5). ... Furthermore, non-performing loans, such as substandard, restructured, bad, and past-due loans. In accordance with the International Monetary Fund, these loans have incremented to 11% in 2011 from about 6% in 2008. The debt turmoil has become the triggering factor for organizations to be exposed to short-term debts, which are dependent to the lending institutions. Otherwise stated, organizations are doomed to fail because of the potential risks of high interest rates and be liquidated. The worst case is that forty percent of these organizations are exposed to interest rates that are payable within a period of less than twelve months (â€Å"Italy Country Profile,† 2012, pp. 4-5). Social/Cultural. It is significant to consider the demographic profile of a country when it comes to depicting the generality of its social aspects. Therein, cultural aspects will be delved as well in the light of fathoming the demographic facets. In accordance with the CIA World Factbook, the average l ife expectancy of Italy last 2012 was at 81.86 years--comprising of men ages 79.24 years and women 84.63 years (â€Å"Italy Country Profile, 2012, p. 5). That record is notably one of the highest in the world. In the light of macroeconomics, the nation’s aggregate workforce is mitigating (â€Å"Country Intelligence: Italy,† 2012, p. 16) and such a situation will deem as detrimental. In fact, Italy’s unemployment rate was about 8.40% in 2011, which was considerably higher than that of the developed countries. This implicates that Italy’s work environment may be the cause of weakening social aspects that will lead to impact the economy of the country. As a matter of fact, Italy’s employment rate of 56.9% was lower compared to that of the EU average of 64.2% (â€Å"Italy

Globalization Essay Example | Topics and Well Written Essays - 750 words - 12

Globalization - Essay Example Speaking about driving forces of globalization, it is essential to mention that, first of all, the globalization is caused by the objective factors of the global development, by the intensification of the international division of labor, scientific and technological progress in the area of transport and communication that reduces the so-called economic distance between countries. Allowing to receive the necessary information from any place on the Earth in real time, modern communication systems facilitate the organization of international capital investment, production and marketing cooperation. In the conditions of the informational integration of the world the transfer of technologies and adoption of foreign experience is greatly accelerated. The preconditions for the globalization of the processes, which are local by nature, for example, receiving higher education distantly, are being formed. The second essential source of globalization is the liberalization of trade and other forms of economic liberalization, which caused the limitation of protectionism politics and made the global trade more independent. As a result the tariffs were lowered, many other barriers set for goods and service trade are removed. Other measures led to the intensification of the movement of capital and other factors of production. The results of the process of globalization can be seen in the fact that the barriers for economic, cultural and even political activity become more transparent. Internet, student exchange, the protection of human rights contribute to the creation of really global society, which consists of networks. The globalization is expressed by the rapid growth of migration and capital, unification of laws, division of labor, the standardization of technology and the union of the cultures in the global scale. It is possible to state that it provides the stimulus for the formation of new international

Building Successful Relationships Essay Example | Topics and Well Written Essays - 1250 words

Building Successful Relationships - Essay Example What could probably be one of the most important relationships in a person’s life would be with a loved one who will reciprocate the love given. However, it should be noted that relationships do not just grow like weeds in the garden but are like flowers that have to be intentionally grown, needing love and care. Personally, I have learned important matters that need to be considered in having a relationship to make it beneficial to the parties involved. I once had a relationship in my earlier years that helped me realize my mistakes and that is helping and guiding me in the relationship that I currently have. Just a few years ago, I struggled in a relationship that I had with a girl that I met in school. She is pretty, cheerful and fun to be with and I liked her for being so loving and caring. She always wanted us to be together, spending time with each other and talking about anything only to pass the time together. However, being the outgoing person that I am, I always found it difficult to find time for her and this made her complain about my attitude. She said that I was to being inconsiderate of her need to be with me and our relationship to be nurtured. She doubted my feelings toward her because I seemed to be more indulged with my friends than with her. Although I tried to explain th at my shortcomings are not the measure of my love for her, I somehow failed to make it appear so to her and, we ended breaking up. The break up was difficult for me. I guess I really loved her so much that I was greatly affected when we had to part ways. I struggled emotionally and psychologically. There were times that I could not sleep well thinking of her. I tried to make things straight with my former girlfriend, asking for another chance for me to become a better partner to her, telling her that I have already learned my lessons. Nevertheless, that is perhaps the extent of understanding that she could give me. She asked me to stop wasting my time going after her. It took me time to finally overcome the grief I felt before I finally bounced back to normalizing my activities and making new friends. I could say that my current relationship is going smoothly because I have learned a lot from my mistakes from my past relationship. It is not that my relationship with my present girlf riend is perfect but at least, we are able to work out our differences and make our relationship work. I found out that truly, a relationship should be nurtured to make it grow. When I first had a relationship, communication was open and regular during the first few months but then, I stopped getting in touch with my former girlfriend on a regular basis because I thought I was already familiar with her and was very sure I knew her very well then. Now, I maintain communicating with my friend to avoid similar problems I had in the past. Whenever we are not able to see each other during the day, I always make it a point to call my girlfriend and ask how she is and how she spent her time. I think this makes our bond stronger because she sees that I am making efforts to show how concerned I am about her. Moreover, whenever I tell her how I spent my day, she stops worrying about me and understands how I spend my time so that whenever I am not able to make it for our dates or other planned activities together, she tries to be considerate and understands

Logical fallacies in an editorial (editorial rebuttel) Essay

Logical fallacies in an editorial (editorial rebuttel) - Essay Example Since the authors name is not disclosed, the views expressed therein can be attributed to the Editorial Board of USA Today. In the immediate aftermath of the catastrophic oil spill in the Gulf of Mexico, the Obama Adminstration issued a moratorium banning all drilling activity in the region for the next six months. This meant that all 33 oil rigs in the Gulf will remain idle, along with tens of thousands of oil-rig workers. The moratorium elicited mixed reactions from different sections of society and body politic. The republicans accuse President Obama of pandering to the insecurities and fears of the masses, whereas public opinion is fairly supportive of this decision. The editorials central argument is that the moratorium is too arbitrary a measure; and that the Obama Adminstration could have drawn up more specific set of criteria for the reopening of rigs. The author goes one step ahead and enlists three specific criterions for the eventual reopening of rigs. These are: â€Å"Is it safe to drill?, Is there a credible plan for plugging a blowout?, and Is the industry capable of cleaning up a catastrophic spill?†. He further explains the rationale behind these questions. To this extent there seems to be no editorial bias one way or the other. Major newspapers in the United States are classified as either liberal or conservative; and it appears that the author takes up neither position in the article. Hence it is easy to come to the conclusion that the editorial is not ideologically slanted, and that it espouses neither the right-wing nor the left-wing perspective. But a closer examination reveals more fundamental deficiencies. Beneath the veneer of being objective and critical, one could detect the soft stance toward major oil corporations. Given the sheer scale of the oil-spill catastrophe, one would expect a

How alignment between the values of an organization Essay Example for Free

How alignment between the values of an organization Essay Create a presentation in a common format (PowerPoint or a similar program) with a minimum of twenty (20) slides and corresponding speaker notes in which you: 1. Determine which statistical technique you will employ to measure the quality characteristics of your organization. Provide examples to support the rationale. 2. Analyze the current facility location, and then use the three-step procedure to determine a new location. 3. Analyze the key concepts related to capacity planning and facility location for the new location. 4. Examine the current work system design, and determine your organization’s selected feasibility in the job design (i. e., technical, economic, behavioral). Assess key elements of the rationale in the work design competitive advantage. 5. using the method analysis described in the textbook, defend the new change implementation process and the rationale for the change of method. 6. Develop a diagram showing network planning techniques, in which you use the program evaluation and review technique (PERT) and the critical path method (CPM). 7. Use at least three (3) quality academic resources in this assignment. Note: Wikipedia and other Websites do not quality as academic resources. Your assignment must follow these formatting requirements:

Evidence Based Nursing in Primary Healthcare Team

Evidence Based Nursing in Primary Healthcare Team 189691 Title: Evidence Based Nursing is developing in primary health care . Critically discuss the applications to your practice. (District Nursing) Undergraduate Degree Level Essay 3,250 words Essay The evolution of the nursing profession has witnessed a great many changes of both emphasis and direction in both the delivery and the content of patient care as well as accompanying changes in both the philosophy and the theory of that care. Arguably the nursing profession has historically based its activities and also its philosophies, on tradition and the perpetuation of currently accepted practices which have not been firmly rooted in a general scientifically tested framework.(Roper N 1977). This can be verified by the fact that the nursing literature of the 1970s and 80s has many references from writers and commentators who were arguing for nursing to evolve into a research based profession and highlighting the fact that there was a demonstrable absence of a significant amount of good quality research-based fact which dictated the current practices throughout the profession in general. (Gortner SR 1976). An impartial observer, considering this situation over the intervening years, would probably agree that there has been a clear and marked swing in both the published literature and the actual practice of nursing, towards the underpinning of practice with strong scientific research. Evidence based nursing has emerged as being one of the dominant driving forces in nursing evolution and the advent of evidence based practice has become apparent to the point where it is now and this could be considered to be the â€Å"gold standard† and essential basis for the majority of professional nursing care (Yura H et al 1998) If we look at the issues and considerations that could support this statement, we could point to Hunt’s tour de force on the subject in his seminal paper of 1981 (Hunt J 1981), in which he sums up his belief that each nurse must care enough about her own practice to want to make sure it is based on the best possible information. This plea seemed to strike a chord in the nursing profession to the extent that, over the following few years, there was a noticeable increase in the published papers that both echoed these sentiments and also defined the various barriers to progress in this respect. These were largely quantified as including time constraints, limited access to the literature, a lack of training in critical skills of appraisal and, most fundamentally, a professional ethos and ideology that placed a great emphasis on the practical rather than the intellectual component of knowledge, together with a work environment that did not actively encourage the seeking out, resear ching and recording of new information (after Royle J et al 1996). One could be forgiven for observing that such comments are still relevant to a degree today. In order to present a balanced argument, we can observe that there is not a blind and uniform acceptance of evidence based nursing procedures. There are some who actively criticise evidence base procedures. Haynes (R B et al 1996) points to the fact that a blind following of evidence based practice can promote a concept of a â€Å"cookbook† of procedures that have to be dogmatically followed and it can stifle the holistic consideration of what may be best for each individual patient. We shall return to this point later. White (S 1997) counters this argument with the suggestion that a nurses’ professional training includes both learning the basic pathophysiology and anatomy and acquiring experience. She suggests that it is actually the â€Å"effective application of this experience that requires a sound evidence base.† Research evidence can aid the professional decision making process, but cannot either do the clinical examination or collate the vast amount of sni ppets of information that pass between patient and nurse. White suggests that it is this clinical expertise (derived from learning and experience), that is the crucial element in the application of the evidence based knowledge which separates true evidence based nursing practice from the â€Å"cookbook† approach with Haynes’ vision of the mindless and unquestioning application of â€Å"both guidelines and rules† (White S 1997). Before we leave the general issues relating to evidence based nursing, we shall also cite the analytical work of Pearson (A 2000) who produced an influential treatise on the role of the nurse and nursing in evidence based research. In his paper Pearson makes a fundamental and significant delineation between lay nursing and professional nursing which is defined by the application of research based practices and procedures. He suggests that the evolution of evidence based nursing had its origins in the days of the reforms pushed through by Florence Nightingale, became commonly accepted practice in the 70s and 80s when the â€Å"theoretical constructs of practice began to evolve and be adopted†, and has currently culminated in the advent and emergence of the nurse practitioner and nurse specialist whose professional structure, training and practice is essentially evidence based. This essay is primarily about how evidence based nursing is developing in primary healthcare team with specific reference to personal practice. This is a potentially a vast topic and therefore we will use illustrative examples of specific areas of development. A great deal of a primary healthcare team’s time (particularly that of the nurse) is taken up with the treatment of pressure sores and ulcers. It is instructive to consider the evolution of the evidence base for the treatment of this condition and then to extrapolate the process to other conditions frequently seen in primary care. We can cite the work of Sir James Paget who made the observation in 1862:- Elderly patients with femoral neck fractures and other high risk groups develop them (pressure sores) early, chiefly in the first week, and then made the observation â€Å"They often appear on the day of operation. It is not just the patient, but every part of his or her body, that must survive the operation†. (Bliss MR 1992). The rationale for citing this statement is that it illustrates a comment and observation that may be factually correct, but has no evidence based weight whatsoever other than being a reflection of the author’s opinion. It has no foundation in statistically verifiable fact and may be subject to all forms of objective bias. It obviously was never produced as a result of a randomised controlled trial but, like many other â€Å"pronouncements† by prominent practitioners, it has both influenced and been accepted by generations of healthcare professionals over the years. This exemplifies Roper’s point, cited earlier, relating to the tradition of previous practice being perpetuated by successive generations. The point can be tracked further still by considering a more recent paper by Vohra (Vohra R K et al. 1986). On the face of it, this paper gives a comprehensive overview of the (then) current practices in the treatment of ulceration and pressure sores. It goes into great detail relating to the aetiology, pathophysiology and trends in management of the ulcer patient and has an extensive and current reference section in the paper. The problem form the perspective of this essay is that, although the paper is undoubtedly comprehensive in its approach, virtually the entire paper together with virtually all of the cited references, is opinion based with not a single reference to a good quality randomised controlled trial. (MacLean DS 2003). The paper does make use of comparative studies where one treatment is compared with another, but this in turn exemplifies yet another shortcoming and that is that such trials are good if a healthcare professional has only these two options at their dispo sal for treatment, (which is seldom the case). Modern philosophy would dictate that in good evidence based practice, the nurse would need to be able to cite evidence that one treatment is demonstrably superior to all others for a given set of clinical circumstances and that this evidence is from a repeatable and unbiased source. To give an illustration of this point, MacLean makes the comment:- It is clearly of minimal value to a patient to be able to say to them that a comparison of rubbing a pressure sore with honey has been found more beneficial than rubbing it with butter when the use of a ripple mattress is clearly superior to both of them. If we contrast this paper with another, more recent paper (Bliss et al. 1999), there are a number of very significant differences. This paper is also an overview of the current trends in treatment of ulcers and pressure sores. Firstly the author is a nurse. Secondly, it only cites 12 references (as opposed to over 70 in the Vohra paper) but each is a randomised controlled trial selected to support the various statements made in the paper. This represents a major and fundamental change in presentation, philosophy and practice. It could be suggested by the cynic that such observations are a chance finding in two randomly selected papers. We would suggest that an examination of the literature of the periods involved would support the view that they represent a true reflection of the genuine change in both style and expectation that now pervades the nursing professions and more fundamentally, it also reflects the criteria by which papers are now judged and accepted for publication in the major peer reviewed journals. It is not appropriate to discuss the content of the paper in detail other than to observe the fact that the paper concludes with a description of the classic Gebhardt trial (Gebhardt KS et al 1994) which compared the results of bed rest with intermittent chair nursing on the development of ulceration and in the words of Morris (A 2002):- In many respects, the Gebhardt trial is a reflection of both the calls noted in the previous paper for proper scientific scrutiny to be brought to bear on the subject and the evolution of the expectation of the healthcare professions into the requirement for a firm evidence base for their continued work. In terms of direct impingement on the practical aspects of primary healthcare nursing, the move towards evidence based procedures can be illustrated in the development of scales such as the Waterlow scale (PN 1991). This was developed as a direct recognition of the need for an evidence based tool which would both directly help the nurse assess and quantify the degree of risk together with helping them predict just which was the most effective treatment modality for any individual patient. This was accomplished by allowing a reproducible measurement of ulceration and thereby rendering this area of clinical practice amenable to proper scientific scrutiny and testing. The result of this scale development is that the nurse can identify a treatment that has not only been suggested by previous practice or experience, but one that can be shown to be the most appropriate for a given set of clinical circumstances with the most likely clinical benefit (NT 1996). It is a logical step from this position to the situation where new scales are developed based on evidence based assessments and treatments, to predict the likelihood of healing of ulcers. Such a situation has resulted in the development of tools such as the PUSH scale (Gardener S et al 2005). This represents the currently accepted end-point of a logical progression that we have traced and quantified from the type of opinion based pronouncements of Sir James Paget, past the experience based observations and comparative trials such as those of Vohra, through to the completely evidence based practices of today where a clinically defined situation is identified, a solution is hypothesised and then subjected to validation by appropriate double blinded and unbiased scientific techniques in a randomly controlled clinical setting. It allows the authors (Gardener S et al 2005) to conclude their paper with the comment The PUSH tool provides a valid measure of pressure ulcer healing over time and accurately differentiates a healing from a non-healing ulcer. It is a clinically practical, evidence-based tool for tracking changes in pressure ulcer status when applied at weekly intervals. Such a comment is virtually unchallengeable because of the weight of valid recorded evidence behind it. If we consider new and current moves to examine the evidence base of activities in the primary healthcare team, we can also consider the advent of screening clinics which are commonly nurse-led. (Califf R M et al. 2002). We could consider the current trend for hypertension screening. It is commonly accepted that treating hypertension is of value in preventing both morbidity and mortality, (Cooper R et al. 2000), but a less frequently asked question is â€Å"What is the rationale and the evidence base for providing a screening programme for patients?â€Å" (HTT 2005). Curiously, the evidence base for the screening programmes that have been run has been rather insecure. The main reason for this has been the comparative paucity of definitive information relating to the levels of effective treatment and, as the treatment can realistically only be assessed as effective over a long time span, such studies take many years to yield substantive information. It therefore follows that the evi dence base for screening can only realistically be determined once a rational an proven evidence base for treatment has been established. (Brotons C et al. 2003). This is the position set out in the comprehensive paper by The National Heart, Lung, and Blood Institute Working Group (HTT 2005). A pragmatic view would also have to observe that the position is further complicated by the constant evolution of new drugs and methods of measuring blood pressure which render previous data on the subject out of date by the time that it is assimilated. (Appel L J et al. 2003). This paper is very detailed in its assessment of the situation and it is not practical to consider all of its findings in any depth, but it provides a comprehensive overview of the evidence base for the promotion of hypertensive screening together with the evidence to support the use of different levels of hypertension as the endpoint of the screening process. Perhaps we can conclude this essay about the relevance of evidence base nursing practice to primary health care with the excellent and though-provoking article by Frances Griffiths. (Griffiths F et al. 2005). Although we have been arguing for the use of evidence based practice in modern nursing care, there is one commonly overlooked aspect of this practice which is the subject of the Griffiths paper. As the wealth of good quality information relating to the effectiveness of many clinical interventions and practices increases, this fact alone presents healthcare professionals in general with the increasing dilemma of how to apply the information obtained to the individual patient. The evidence base for a procedure will generally inform clinicians of the likelihood of it being successful in the general population. It will not give any indication, other than a probability, of its chance of success in the individual patient. This is a problem for the nurse (and other healthcare professio nals), as the bulk of current medical practice is on a face-to-face basis with individual patients, rather than dealing with populations. (Fox R C 2002) To illustrate this point, Griffiths points to the fact that it is commonly accepted that epidemiology tells us that smoking is an independent risk factor in the population for myocardial infarction, yet there is no evidence base to tell us which particular individuals will be affected. Similarly there are a multitude of good quality trials which show that there is an increased risk of breast cancer that is linked with hormone replacement therapy but there is nothing that will tell us which individuals are at specific risk. (Willis J 1995) This dilemma is central to the proper understanding of the place of evidence based practice as the balance between good practice based on proper evidence and individual patient care is central to the history of nursing and will not disappear however good the evidence base for a particular treatment becomes. In the words of Haynes (R B et al. 2002):- Diseases always manifest themselves in patients bodies and minds, and in seeking to understand, treat, and predict the outcome of disease, clinicians need to move their focus from the individual to more generalised research. To this end, the nurse would do well to reflect on the fact that assimilation of evidence is central to her practice, but communicating that evidence to patients is a key part of clinical consultations, with a growing evidence base of how it is best achieved. References Appel L J, Champagne C M, Harsha D W, Cooper L S, Obarzanek E, Elmer P J, Stevens V J, Vollmer W M, Lin P H, Svetkey L P, Stedman S W, Young D R; for the Writing Group of the PREMIER Collaborative Research Group. 2003 Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. J Am Med Assoc. 2003 ; 289 : 2083–2093. Bliss M and Bruno Simini 1999 When are the seeds of postoperative pressure sores sown? BMJ, Oct 1999 ; 319 : 863 864 Brotons C, Godycki-Cwirko M, Sammut M R. 2003 New European guidelines on cardiovascular disease prevention in clinical practice. Eur J Gen Pract. 2003 ; 9 : 124–125 Califf R M, DeMets D L. 2002 Principles from clinical trials relevant to clinical practice: part I. Circulation. 2002 ; 106 : 1015–1021 Cooper R, Cutler J, Desvigne-Nickens P, Fortmann S P, Friedman L, Havlik R, Hogelin G, Marler J, McGovern P, Morosco G, Mosca L, Pearson T, Stamler J, Stryer D, Thom T. 2000 Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention. Circulation. 2000 ; 102 : 3137–3147. Fox R C. 2002 Medical uncertainty revisited. In: Bendelow G, Carpenter M, Vautier C, Williams S, eds. Gender, health and healing: the public/private divide. London : Routledge, 2002 : 236-53. Gardner S, Rita A. Frantz, Sandra Bergquist, and Chingwei D. Shin 2005 A Prospective Study of the Pressure Ulcer Scale for Healing (PUSH) J. Gerontol. A Biol. Sci. Med. Sci., Jan 2005 ; 60 : 93 97. Gebhardt KS, Bliss MR. 1994 Preventing pressure sores in orthopaedic patients. Is prolonged chair nursing detrimental? J Tissue Viability 1994 ; 4 : 51-54. Gortner S R, Bloch D, Phillips T P. 1976 Contributions of nursing research to patient care. J Adv Nurs 1976 ; 1 : 507–18. Griffiths F, Eileen Green, and Maria Tsouroufli 2005 The nature of medical evidence and its inherent uncertainty for the clinical consultation: qualitative study BMJ, Mar 2005 ; 330 : 511 ; Haynes R B, Sackett D L, Gray J A M, et al. 1996 Transferring evidence from research into practice.-The role of clinical care research evidence in clinical decisions ACP Journal Club 1996 Nov-Dec ; 125 : A14–6. Haynes R B, Devereaux P J, Guyatt G H. 2002 Physicians and patients choices in evidence based practice. BMJ 2002 ; 324 : 1350 HTT 2005 The National Heart, Lung, and Blood Institute Working Group on Future Directions in Hypertension Treatment Trials Major Clinical Trials of Hypertension: What Should Be Done Next? Hypertension, Jul 2005 ; 46 : 1 6. Hunt J. 1981 Indicators for nursing practice: the use of research findings. J Adv Nurs 1981 ; 6 : 189–94 MacLean D S 2003 Preventing Managing Pressure Sores Caring for the Aged March 2003 Morris A H 2002 Decision support and safety of clinical environments Qual. Saf. Health Care, March 1, 2002 ; 11 (1) : 69 75. NT 1996 Pressure sore assessments Uses and limitations of standard pressure sore classification and risk assessment systems. Nursing Times July 17 1996 Vol 92 No.29 Pearson A 2000 Nursing Practice and Nursing Science: Building on the Past and Looking to the Future Joan Durdin Oration Paper Series Number 6 2000 PN 1991 A policy that protects The Waterlow pressure sore prevention/treatment policy. Professional Nurse February 1991 Roper N. 1977 Justification and use of research in nursing. J Adv Nurs 1977 ; 2 : 365–71. Royle J A, Blythe J, Ingram C, et al. 1996 The research utilisation process: the use of guided imagery to reduce anxiety. Canadian Oncology Nursing Journal 1996 ; 6 : 20–5. Vohra R K and C N McCollum 1986 Fortnightly Review: Pressure sores BMJ, Oct 1986 ; 309 : 853 – 857 White S. 1997 Evidence-based practice and nursing: the new panacea? British Journal of Nursing 1997 ; 6 :175–7 Willis J. 1995 The paradox of progress. Oxford: Radcliffe Medical Press, 1995. Yura H, Walsh M. 1998 The nursing process. Assessing, planning, implementing, evaluating. 5th edition. Norwalk, CT : Appleton Lange, 1998. ################################################################ 11.9.06 PDG Word count 3,454