Using Evidence Based Practice for Patient Care - 983 Words

Evidence based practice can be defined as the process of, using the recent evidence base practice to make decision about patients individual care and to make sure that patient is getting most appropriate care by utilising the best practice, judgement clinically, preference for individual patient and systematic review (Nay Fetherstonhaugh, 2007). Hence, when health professional work, they need to consider the characteristics of the context of the practice and the patient’s values and their situation. So, combination of these elements helps to make an assessment in patients care as EBP is involved (Hoffmann, Bennett Del Mar, 2013). Hypothetically, the proper practice of EBP can help to increase consistency in caring patient, supporting the experimental research, which can benefit clinicians to provide quality of care, assessing and justifying patient (Nay Fetherstonhaugh, 2007). For e.g, the act of washing hand prevents from infection. It is consider being the main root of tr ansmission of disease from one person to other. According to the systematic review by So (2011), organism is eradicated from immediate hand washing with liquid soap and water when changing the wound dressing of methicillin-resistant S. aureus (MRSA). According to Hoffmann, Bennett Del Mar, (2013), the rational of the clinical evaluation becomes more obvious when clinical information is integrated on best evidence practice, which is available with knowledge. It also helps to increase confidence inShow MoreRelatedThe Care Of A Patient Using Evidence Based Practice2583 Words   |  11 PagesWithin this assignment it will be exploring the care of a patient using evidence based practice. The patient being explored is one met during a community nursing placement, though all identifying evidence will either be changed or not used to keep the patient’s confidentiality (as with the nmc code). The patient is currently residing in a residential home in Derbyshire. The patient is a man who is in his fifties. He had been put into the residential care following a hospital admission for a brain tumorRead MoreWhat Are Nursing Research?1359 Words   |  6 Pagesquestions about nursing practice† (Houser, 2015, page 5). Nursing research and evidence-based practices are the basis for effective nursing care and helps to ensure that nursing will continue to grow and provide quality nursing care for patients in years to come. Nursing research is vital to the continuation and growth of nursing care. Without research and experimentation, the field of nursing would not advance forward in terms of better and more efficient ways to provide nursing care. Throughout the manyRead MoreBeing A Great Nurse Means To Be In A Mutual Partnership1242 Words   |  5 PagesBeing a great nurse means to be in a mutual partnership with the healthcare professionals and commit to each individual patients condition. It is to collaborate with other health care professionals to provide the best care possible. Becoming an equal partner with a physician, the nurse will become a leader and as such will take part in developing health care plans, tracking improvements, making modifications and participate in important boardroom decision. Interprofessional collaboration and coordinationRead MoreEssay on Evidence Based Practice in Nursing703 Words   |  3 PagesWithin this essay Evidence based Practice will be identified and the signi ficant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice. Individuals need specific care tailored to them, it is vitality important to have the correct professional and appropriate personal care. In order to receive this we need to get the patient involved in the decision process, listen to their views and opinions and receive the relevant, accurate, professionalRead MoreInterventions and Care for Patients808 Words   |  3 PagesEvidence Based Practice Paper Evidence-based practice uses current research and clinical judgment to provide interventions and care for patients (Kelly, 2012). It is important for nurses and all healthcare team members to be up to date on current practices so patients can receive evidence-based interventions that improve clinical outcomes. According to Kelly (2012), almost half of patients that receive care, receive interventions that are not based on evidence which can ultimately compromise theRead MoreThe Research Evidence Based Practice1174 Words   |  5 Pagesrole in research evidence based practice in nursing care. Transplant nurses should practice transplant nursing that is based on evidence. Institute of medicine reported that by 2020, 90% of clinical decisions should be based on evidence, but today 12% to 14% clinical decisions are only based on evidence. Pravikoff and colleagues surveyed 3000 nurses in United States with a 37% response rate .Fifty-eight percent of responding nurses had never used resea rch to support their practice and 46% had neverRead MoreEvidence Based Practice Of Health And Implements High Quality Care Essay1321 Words   |  6 PagesEvidence-based practice benefits all participants of health and implements high quality care. Patients should find comfort in knowing the care they are receiving is the best available. Health facilities provide cost-appropriate care, using resources for effective interventions. Nurses implement practices in-line with the best evidence available. This quality of care involves critically evaluating whether practices are appropriate and applicable to care, and consistently seeking to improve and buildRead MoreEvidence Based Practice : Nursing Implications1399 Words   |  6 Pages Evidence Based Practice: Nursing Implications Misty DelCiampo Submitted to Sarah P. Combs PhD, MPH, RN in partial fulfillment of NR460 Evidence Based Practice in Nursing Regis University August 3rd, 2015 Evidence Based Practice Nursing Implications As the health care environment is becoming more complex, and technology is developing rapidly, the expectations of nurses has increased more than ever before. Times are rapidly changing and to keep up with these changes, nurses areRead MoreCase Study : Georgia College And State University1400 Words   |  6 Pagesprocess of Evidence Based Practice is not truly complete until research translation occurs. Research translation is the transfer of research to the clinical setting where practices can be implemented, evaluated, and communicated. Research is produced and published at high rates while changes in education and practice are slow (Doody, 2011). There are multiple research translation models that attempt to close the gap between research and practice. These models utilize research evidence to improveRead MoreCase Study Management Pl Case Management887 Words   |  4 Pagesâ€Å"Case management is a collaborative process of assessment, planning, facilitation, care coordinatio n, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes† (CMSA. p.6, 2010). Case management plans are an integral part that help to develop and contribute to the care and services that will be needed to provide services to the client to achieve optimal

Associate Degree Nursing as Compared to Baccalaureate...

Since the inception of the Associate Degree in Nursing there has been research and discussion as to whether this degree should continue. This is due to the adversity in the level of competency between the two. Current popular thought is that the entry-level into nursing should be the Bachelor of Science in nursing bringing the increase in the complexity of the medical arena and its every changing makeup to the professional level of the Baccalaureate Degree. It has been shown that a nurse’s level of education can become a major factor to the safety and quality of care of their patients because of this there has been an increase in studies over the years that directly examine patient outcomes in similar situations between Associate†¦show more content†¦The studies have shown that nurses that have gone thru the baccalaureate program have a higher degree in articulation and problem deciphering abilities (Johnson, 1988) and are more proficient in their ability with nursin g diagnosis along with the evaluation of nursing interventions (Geiger Davidhisar, 1990). Research further shows that those registered nurses that have obtained their degrees at the associate degree and diploma levels have an increase in their level of skills when completing a BSN degree. When comparing RN to BSN graduates from the years 1995 to 1998 it was (Rosseter, 2010, para. 24) shown that these students had a higher competency in nursing process, articulation, management, professional integration and analysis/dissemination (Phillips, C.Y., Palmer, C.V., Zimmerman, B.J. Mayfield, M. 2002). All the above studies seem to agree that when a BSN is involved in patient care there is a greater chance the patient outcome will be more positive than when the same patient in the same situation is taken care of by an ADN. The reasoning appears to be that with their higher education the BSN has an enhanced degree of assessment skills. This then allows for better critical thinking abiliti es. These twoShow MoreRelatedBsn vs Adn956 Words   |  4 Pages They will be expected to be more independent, accountable, professional, and highly educated. Baccalaureate programs provide advanced training in critical thinking, leadership, education and patient safety (Cresaia amp; Friberg, 2010). Associate degrees are more focused on the technical aspects of nursing care and teach only the basics of leadership (Moore, 2009). Nurses that obtain a BSN degree are more prepared to face today’s challenges in health care and provide patients with the levelRead MoreStudent Confusion of Different Levels of Nursing Essay928 Words   |  4 PagesMany students who are studying to become a nurse may find the different levels of nursing to be confusing. As mentioned earlier, the definition of RN, LPN, and CNA themselves signify many differences. Additionally, there are different educational requirements for each. One can become a Certified Nursing Assistant or Aides after comp leting just a few weeks of lessons. Federal nurse aide training regularization are mandated in the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987). These stateRead MoreCompetencies Between Nurses Prepared At The Associate Degree Level Versus Baccalaureate Degrees Level Essay1438 Words   |  6 Pagesdifferences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level. 2. Identify a patient care situation in which you describe how nursing care or approaches to decision-making may differ based upon the educational preparation of the nurse (BSN versus a diploma or ADN degree). Introduction Nursing is a combine of science and art. Patient care is the Central focus of the nursing practice . Nursing is a knowledge based discipline. Continuing educationRead MoreDifference Between Nurses with Different Level of Education1104 Words   |  5 PagesDifference between nurses with different level of education As nursing has become a highly competent profession, the educational opportunities for nurses have increased significantly. The hospitals and other organizations that provide health care are also competing with each other and now the demand for nurses with bachelor degree is increasing. For decades the American Nurses association and the National League for nursing have attempted to make the BSN the only educational program for RNsRead MoreAssociate Degree Versus Baccalaureate Nursing1041 Words   |  5 PagesDIFFERENCE BETWEEN NURSES PREPARED AT THE ASSOCIATE DEGREE LEVEL VERSUS BACCALAUREATE DIFFERENCE BETWEEN NURSES PREPARED AT THE ASSOCIATE DEGREE LEVEL VERSUS BACCALAUREATE Different levels at which a nurse is prepared have a strong impact on the nurse`s ability to practice in a health care setting. In the nursing profession, nurses are prepared at different levels. A baccalaureate nurse is a nurse who has completed a four years formal training in a university or senior college and has completedRead MoreLiterature Search Assignment : Bsn Rn Vs. Adn Degree1180 Words   |  5 Pages Literature Search Assignment BSN-RN vs. ADN-RN Degree Diana Dobos Kira Yamada Nevada State College Literature Search Assignment BSN-RN vs. ADN-RN Degree For many years, there have been discussions within the nursing community regarding differences in the career success, performance and patient outcome between nurses who received an AND-RN degree versus a BSN-RN degree. Looking at the articles below data shows that BSN-RN nurses have more advanced leadership skills and improvedRead MoreWho Is Associate Degree Or Bachelor Degree?967 Words   |  4 Pagesmade. You can become a registered nurse in two ways; an associate degree or bachelor degree. These two options are available for one that would want to work as a registered nurse after passing your nursing boards. Some things may play a part in your decision. How much time you have for school may play a big part in your decision. Associate’s degree is a two-year program after you complete a list of pre-required courses while the bachelor degree can range between three to four years after the pre-requiredRead MoreRn to Bsn Essay973 Words   |  4 Pages Nursing is a dynamic profession and life long learning is essential for nurses to stay current with the increased complexity of the healthcare needs of today and into the future. In other words, the needs of our patients are changing, as we must change in order to be prepared to better serve that need. Nursing has a long history of formal education which moved out of hospitals and into colleges and universities early last century. The associate degree level of nursing was developedRead MoreEducational Preparation in Nursing Essay example1097 Words   |  5 PagesPreparation in Nursing Grand Canyon University: NRS 430 11/11/2012 Educational Preparation in Nursing With a consistent change in modernizing medicine, along with the continuing advancement in technology, continuing education in nursing is essential for a variety of reasons. The nurse’s main concern is providing safe, efficient, and effective patient care with positive patient outcomes. This paper will examine the differences in competencies between nurses prepared at an associate-degree level versusRead More Requirements for Entry-Level Nursing Essay1087 Words   |  5 Pagesrequirements must be standardized at the baccalaureate level for several reasons. Spetz and Bates (2013) published that a growing number of hospitals prefer hiring nurses with a Bachelor Science in Nursing (BSN) as this increases the status of the nursing profession (p. 1). Associate Degree in Nursing (ADN), as well as a certificate on-the-job training Diploma are two other educational pathways to become an RN, which can be disadvantageous to the nursing profession in several ways (Tollick 2013;

Dirty Work by All Time Low free essay sample

Loving every minute of All Time Low’s former albums, their fourth album, Dirty Work, was something I looked forward to for months. I even preordered it so it would be on my doorstep on the release date. And it was well worth the wait. This album took the four members in an entirely new direction. It’s hard to accept a change in sound when you like a band for their particular sound. So why fix something that isn’t broken? It’s because they’re geniuses. It doesn’t matter what beat the music is to, or how popular they become, everyone who loves All Time Low will still be able to appreciate their extreme sarcasm, and those intense melodies with lyrics that steal your heart and never return it. Alex Gaskarth, the lead singer, released a pre-mature copy of the song ‘Time Bomb’ months before the band even found out when their album would hit shelves. We will write a custom essay sample on Dirty Work by All Time Low or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page It wasn’t meant to be the first single; it was meant to be a bridge between Dirty Work and their previous albums. In my opinion, mission accomplished. The second tasting fans got of Dirty Work was with the release of ‘I Feel Like Dancin’’. The song turned people off because of its similar sound to other popular bands, but those who didn’t appreciate the new sound took it too seriously. The song is purely meant as a joke. And if the fans were discouraged because of the mainstream beat, they obviously didn’t get the joke. The best part about All Time Low is that they take their music seriously; they just don’t take themselves seriously. Dirty Work takes on a thoughtful tone with songs likes ‘Guts’ and ‘Heroes’. The band puts their heart and soul into their music, and it comes through with every note. If you’re looking for pumped up jams with a mix of soulful melodies, Dirty Work is a masterpiece you sh ould check out.

Balthazar Essay Research Paper Balthazars Marvelous Afternoon free essay sample

Balthazar? ? s Fantastic Afternoon Essay, Research Paper Balthazar? ? s Fantastic Afternoon ( Why didn? ? T Balthazar receive the money? ) ? ? Balthazar? ? s Fantastic Afternoon? ? , written by Gabrial Garcia Marquez, is a narrative about a birdcage and a hapless carpenter, Balthazar. In the narrative, Balthazar made a beautiful birdcage that was commissioned by Pepe, the boy of a rich adult male, Jose Montiel. However, when the carpenter took it to the male child, his male parent refused to pay and instead said to sell it other people. Although Balthazar got truly angry, he gave the coop to Pepe as a present. At the terminal of the narrative, he told townpeople that he got much money from the rich adult male and bought everyone cerebratory drinks. Then, why didn? ? T Balthazar receive the money. First, he had no purpose of money when doing beautiful coop. In the narrative, he was accustomed to doing and making coop since childhood. So when Pepe ordered a coop, he could do little coop merely rapidly instead than make large and beautiful coop for two hebdomads ; ( p 381, ll 45~50 ) . Besides, if he was interested in gaining the money, he would non even get down to work on the coop merely by committee of the small male child because he couldn? ? T be certainly whether he can acquire money or non. However, Balthazar was a creative person instead than a common carpenter. What he truly wanted as doing the coop was to do the small male child happier. Second, he felt mean and dirty about rich adult male? ? s money. In this narrative, the coop was glorious and beautiful every bit much as intelligence O f its beauty had spreaded even before he finished the coop. So even though a physician insisted on purchasing that coop, he didn? ? T sell it because he made merely for Pepe. But Pepe? ? s father treated Balthazar like a sly merchandiser but praised its beauty ; ( p 384, ll 45~50 ) . So, Balthazar thought that if he received money for the coop, it was to interchange his originative beautiful coop, in other word his pride, with dirty and average money. Finally, in the narrative, Balthazar was non a realist. Although money is non all in the life, it is really hard to populate in our existent society without money. However the chief character didn? ? T attention about money. Probably, it is because he had no complete household. Even though he had a married woman, he was populating with her without get marrieding and holding babe. That is, he felt less responsible to gain money than common married adult male. Normally, our parents want to gain the money every bit much as possible merely for their kids and household, non for themselves. Throughout their long lives and their existent socity, they have learned that money is necessary to last and that is the world that they can? ? T avoid. However, here Balthazar felt non so much responsible and maintaining his pride and doing graphics was more of import. In decision, at the terminal of the narrative, why Balthazar didn? ? t receive money was because he wanted to give him merely gift and he didn? ? T privation to sell his pride to soil money. Furthermore, in this narrative, because he didn? ? T feel responsible for doing money, he didn? ? t receive money.

The Bakun Dam Project in Sarawak Essay Example

The Bakun Dam Project in Sarawak Paper For more than 30 years, there have been discussions concerning the development of the Baku Dam in the East Malaysian state of Karakas. If built, the dam would be the largest in South-East Asia. The Baku Dam: A Case Study indicates that generating 2400 megawatts of power, it would provide electricity for all of Karakas, and for industries and cities in mainland Malaysia, through a cable under the South China Sea. At 650 kilometers, this would be by far the longest cable in the world. The Baku Dam has been a highly controversial issue spanning over three decades as its validity and use to the people of Malaysia have been questioned. For the cost that involves producing this dam, at seven billion dollars and rising, is there a need for so much power at all? The main environmental issue here is whether Karakas should sacrifice forests in order to promote the economic growth of its country or cease construction to preserve the traditional environment and standards of living. It is essential to the people of Malaysia that the construction of the dam continues, as it will benefit them in the future through industrialization. This dam can be seen as a source of employment for the nation, the creation of international interest, and increased economic growth. There are also many negatives to the completion of the dam; which include the displacement of natives, increased foreign debt, and the gradual deterioration of the dam after many years. There are many other factors that contribute to this issue, however, the above three positive components are fundamental to the further growth of Malaysia. We will write a custom essay sample on The Bakun Dam Project in Sarawak specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on The Bakun Dam Project in Sarawak specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on The Bakun Dam Project in Sarawak specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The main stakeholders involved in this area of interest include Malaysian non- governmental organizations opposed to the project, indigenous peoples affected, non-governmental organizations outside Malaysia opposed the reject, Malaysian State and Federal governments, Koran Bernhard (the developer), and international corporations contributing to the project. The Baku Dam has had an uncertain, highly controversial history. The project is of importance to Malaysian political and business leaders as there is a promise of abundant electricity and a lever by which Karakas could be lifted out of its backward state. It has been said that for environmentalists and the native people, the project would flood tropical forests and force the resettlement of approximately 10 000 people in order to generate high cost electricity, for which no market might exist (Dams Initiative). These contrasting perspectives on the Baku Dam make it valuable as a case study to identify the best power solution for a nations economic problem. There have been many complications regarding the Baku Dam since its introduction. Bevies (1 995, p. 65) stated that after initial surveys in the early asses, in 1 986, a decision by the national government was made to construct the dam. In 1 990, official postponement of the project was made due to protests and doubts about the dams economic viability. In 1 993 however, he project was renewed with the catalyst being Malaysias desperate need for power. It was said that in 1 994, the awarding of the project contract to Koran Bernhard cemented the importance the dam was for the Malaysian government to address its financial issues (Bevies, 1995, up. 101-102). But nevertheless, further problems mounted and in 1 997, the project was deferred in the face of the Asian economic crisis. In recent years, the project has been rehabilitated with last year being the set date for the completion of the project. Clearly however, the completion of the Baku Dam will not take lace for a further few years. There are many advantages to the completion Of the Baku Dam for Malaysia. Proponents of the project argue that the dam has several benefits, and minimal impacts. For the native residents of the region, it would be a source of employment during construction, and would indirectly stimulate creation of other employment opportunities. It has been stated that increased cash income for these residents was advocated as the only means to change the backward status of this region, and to address poverty (Chocolates, 1993, p. 163). These are the initial steps to consolidating Malaysias economic and environmental future. Even after the project had been shelved in 1990, lobbying by its proponents continued, particularly by the Karakas government, which urged the federal government to revive the project. Finally, in September 1993, the Malaysian cabinet approved construction of the Baku Dam. In reviving the project, Malaysias need for power was most often invoked as justification. By 1993 the Malaysian economy was growing by more than 8 percent per year, with electricity demand expanding even faster. The Borneo Bulletin affirms that lockouts in 1992 and 1993, and a predicted doubling of demand by 2000, were indications of a power crisis, justifying extraordinary efforts to expand supply. Project proponents also believed the Baku Dam could help reduce dependence on fossil fuels, especially oil. Most evident however, was that this project was consistent with an energy policy relying almost entirely on supply. In Hardens argument, he referred to the quote from environmentalist Grit Sings (1995) to prove his theory: The concept of energy conservation and certainly its implementation is virtually absent in Malaysia. This is why Malaysia needs to complete the dam, to enhance its economic and environmental status on the worldwide scale. Furthermore, the Baku Dam has attracted the attention of numerous international engineering and construction companies, with experience building dams elsewhere. The IRON Baku Campaign specifies that this is a means of attracting investment to Karakas, of fostering its industrialization, so that it could develop to the same extent as, or even beyond, mainland Malaysia. Originally, Germany, Mexico and Brazil were major participants in a consortium to bid to have privileges to build the dam. The dam was used as a connection to develop close ties between Malaysia and associated countries. Spires (1 995 p. 135) reported that recent contract an announcements have included Europe, Latin America and certain parts of Asia to add to the increasing number of foreign firms constructing the dam. This is beneficiary for the Malaysian economy as there is more money coming into the nation. Beyond the economic viability of the project itself, the Baku Dam has been justified in terms of the overall economic development of Malaysia. In 1991 Malaysia established Vision 2020, a plan that envisages Malaysia becoming fully developed and industrialized nation by 2020. Within this context, the IRON Baku Campaign informs that the Baku Dam could contribute in several ways to Vision 2020 through the supply of electricity, needed by manufacturing. In recent years, demand for power has increased by up to 13%/year. In addition, the project would be a model of close partnership between the state and federal governments, and the private sector. Furthermore, Vision 2020 can be achieved through gaining access to advanced power technology, such as turbines and transmission lines, provided by foreign engineering firms. The role the dam plays on Vision 2020 can progressively contribute to Malaysia becoming industrialized in the future. However, the Baku Dam has been the focus of intense controversy as well. Human implications included the displacement of approximately 10 000 native people to the Karakas region. The displacement and resettlement of these people in effect involved the loss of their way of life, and the acceptance of a modern lifestyle. Most people are now subsistence farmers, supplementing their income through cash crops or jobs in timber companies. These native people once valued their autonomy, as one indigenous person dated in a Friends of the Earth press release (1995): We are poor only insofar as we have little money. In fact, we are rich, because we have all we need to feed ourselves and house ourselves. Rice is free, fish and meat are free, vegetables are free, water is free, and lumber is free. After the relocation these natives no longer have their own land, and have to seek work instead on large plantations to survive. Malaysia: the progress bought by the Baku Dam in Karakas states that the project had long been criticized for the possibilities of a dam collapse, earth remorse, new waterborne diseases, deterioration of the reservoir, disruption of downstream water quality, salt water intrusion, loss of fish habitat, and sediment accumulation behind the dam that would render it useless within fifty years. Construction of the dam would also result in loss of approximately 23 000 ha fertile agricultural land. These were some of the many environmental effects cited that would one day harm Karakas. There were also questions about the economic costs of the project. The Lira Monthly (1 995, p. 71) assumed that in the asses, much of the necessary UAPITA would be raised through loans from international agencies such as the World Bank and the Asian Development Bank. These loans would substantially increase Malaysias foreign debt. It was even unclear whether the nation, then in recession, needed so much electricity. However in todays society, research shows that the need for electricity would aid in the industrialization of the nation. There have been many alternating perceptions on the Baku Dam issue. Many people believe that the Baku Dam is just the start of the transformation of Malaysia. Private investors from all around the world live that their investments will bring them great financial returns. One investor from Belgium stated: There has been so much controversy over this dam. I chose to invest in it because I believe it has great potential. The Baku Dam will be the means Of a new and improved Malaysia, all it needs is some financial assistance. Is there any controversy in financial assistance? As part of an international lobbying effort, Friends of the Earth along sent letters to hundreds institutional investors and fund managers in February 1997 warning them of the financial, environmental and social risks involved in he Baku project. Sarah Tack of Friends of the Earth said: It is clear that major institutional investors and financial analysts are beginning to realizes that an investment in this Baku Hydroelectric project is not only unethical but carries a high financial risk due to overly optimistic performance forecasts. Koran must take this Luke warm response from potential foreign investors as a reflection Of the lack Of confidence in this project There is a great need for private intervention on the project to assist in its completion. In the projects incarnation in the asses, funding for the dam was to discussed in any detail publicly. It was the assumption that Malaysia would seek loans from international sources. However, in the 1 sass, there were strong intentions from the federal government to avoid funding from multilateral sources. In a recent newspaper article published by the Borneo Bulletin (2001 a statement by Prime Minister Mathis helps explain his governments effort to avoid involvement of the World Bank: We in the poor countries would like to have some cheap hydroelectric power. But all manner of campaigns are mounted against our proposals the World Bank will be used to deprive poor countries of cheap hydroelectric power. And all this after the rich have developed most of their hydro potentials. Instead, funding is being sought through domestic private and government sources, as well as international private investors. While domestic sources are envisaged as the dominant sources of funding, funding from foreign private sources is also clearly a priority for project proponents, perhaps because of the credibility such funding would provide. However, the effort devoted to obtaining private funding illustrates the obstacles encountered in financing such a project without subsidies. It has often been argued by dam opponents that such projects could not survive without large subsidies from governments or multilateral development banks. Difficulties that Koran has encountered in soliciting interest from foreign private investors suggest that this is also the case in this project. Malaysia: the progress bought by the Baku Dam in Karakas reports that in July 1 996, Delphi International, a British consulting firm, warned its clients and potential investors in the project that the Baku Dam promised far greater kiss than is typical of power projects, and lower returns. This has presented an additional obstacle to Sarans efforts to attract foreign investment. The extent to which the Baku Dam represents prevarication of power generation is ambiguous; while Koran Bertha currently holds the largest stake in the project and is actively seeking private investment, the Karakas state government and Cosec are also major shareholders. (Spires, 1995, p. 139-140). Evidently, although there are firms that are currently investing in the Baku Dam, more needs to be done to attract further investors. Koran has also agreed to sell much of the power to the national public utility, at rates that may involve considerable subsidy of the project by Malaysian electricity consumers. This is an important process towards providing for a more advanced and Industrialized Malaysia. There is certainly a way the Baku Dam can be built with minimum impact on the environment and the Malaysian economy. Initially, there are uncertainties concerning the technical details of project. These include variations in rainfall and stream flow at the dam site, and the design and stability of the dam itself. One of the most significant technical worries relates to the cables that will deliver power to the Malaysian mainland. They are, in effect, an unprecedented experiment. Dams Initiative studies show that at 650 km, they are far longer than the longest existing undersea power cables, beneath the calmer waters between Denmark and Sweden. No reliable estimates of how much these cables will cost, how long they will last, or how much power will be lost as it travels through the cable, are available yet. The Baku Dam project is definitely manageable, and a positive step to consolidating Malaysias economic and environmental future. The design of the Baku Dam has evolved since the initial studies carried out in the early asses, taking into account developments worldwide. The design of the dam has incorporated features that will ensure the highest degree of safety and economics. The project certainly yields more positive outcomes with respect to the use of local resources and employment, promotion of regional development and industrialization, savings of fossil fuel, and river regulation. Negative ecological effects include the deterioration of the water quality (although temporary), displacement of natives, and high foreign debt. However, with proper planning of precautionary measures, these negative outcomes can be kept under control. The main recommendations in consideration are to constantly monitor water quality, provide to the natives essential needs, and maintain appropriate foreign debts. Ultimately, the negative outcomes are only temporary. Although environmental conditions may not be positive and debt will mount during construction of the dam, these situations will diminish over a period of time and these impacts will lessen. Malaysia will benefit greatly from the Baku Dam in the not too distant future.

Prescription Mix-ups essays

Prescription Mix-ups essays When a person goes to the doctor and receives a prescription for medicine, the patient assumes the pharmacy will provide the right drug. That is usually the case, but sometimes the pharmacist cant read the doctors handwriting and may misinterpret what medicine is being prescribed. Also, it is the pharmacists job to ask the person if he is taking any other drugs, including over-the-counter products. The pharmacist has to do this to make sure the person is not mistakenly mixing drugs that can be harmful. Mix-ups are not common, but they do happen in the $103-billion-a-year prescription business. One major reason is that there are so many drugs that look or sound alike. Studies have shown that one to three percent of prescriptions dispensed have some kind of error. About 15,000 mistakes by pharmacists happened in 1998, according to estimates by Tony Grasha, a psychology professor at the University of Cincinnati who studied mistakes by pharmacists. About 2.8 billion prescriptions were filled in that year. If a person gets the wrong drug, it can be deadly. That is why the United States Pharmacopeia (USP), which sets standards for drugs, is running a voluntary hot line for health workers to report mix-ups. The USP has been able to find out which drugs are the easiest to confuse. Here are a couple: Accupril (taken for high blood pressure) and Accutane (for acne). Also, Zyrtec (an antihistamine) and Zyprexa (an antipsychotic). One of the problems, according to the Vice President of USP, Diane Cousins, is that drug companies have already worked their way through the alphabet, trademarking thousands of catchy names. She goes on to say in a Consumer Reports interview, How many combinations of five to seven letters starting with a Z are there that are easily pronounceable? The Journal of the American Medical Association reported that an older woman in a hospital emergency r...

Medieval armor Research Paper Example | Topics and Well Written Essays - 1500 words

Medieval armor - Research Paper Example However, armor was associated with rank within the military and served the purposes of the cultural event of war as much as it served the functionality of battle. As well, it often designated the role of the individual within society, the type of armor worn having relevance to class and social status. Armor served a great number of purposes within the medieval social environment and was not strictly a resource for functionality. Armor began to appear in the fourth century in Europe, often made from what was left behind by the Roman soldiers who had tried to conquer the lands. Barbarians began to construct protection from what was left behind and setting up the culture to eventually improves upon those designs. As metallurgy began to grow technologically, armor began to reflect a higher sophistication in its manufacture (DeVries and Smith 38). The many types of armor during the Middle ages are numerous and vary from one country to the next. However, the basic European styles of armor were divided by head armor and body armor, with differences in each section. Head armor was a vital form of armor in that it protected the most vulnerable and essential part of the fighter. The head was vulnerable to cutting, thrusting, and bludgeoning moves that would immediately take down or kill an offender. A common configuration of armor was a chain mail hood, called the camail or the coif de mailles, with a metal helmet placed over the chain mail (Cosman and Jones 2

Software Usability Case Study Example | Topics and Well Written Essays - 500 words

Software Usability - Case Study Example Building on these concepts basic criteria for the evaluation of usability can be formed. A critical point in this assessment is to know that it is central on the reactions and the actions of the users for who the interface is designed. That being said, the first criteria would be the ease with which a first time user can perform basic tasks on the site. This would judge the complexity of the site design, how user friendly it is and is pivotal to the learnability aspect. Second, we look at the speed with which the regular user’s, who are more familiar with the design, perform tasks. This forms a building block in the efficiency component of usability by reflecting how successful the basic interface design is at facilitating usability. Next we assess usability by looking at the rate of recall of user’s who return to the design after a prolonged period. How easily these users’s can go back to efficiently using the interface to perform tasks and the number of errors they make while they’re at it will be used to evaluate the memorability and errors aspect of usability. Another key determinant of usability is the overall satisfaction level of the user’s. If their experience with the usage of the design is positive and pleasant it will denote a higher level of usability.

A Secret Gift Essay Example | Topics and Well Written Essays - 750 words

A Secret Gift - Essay Example Interested people were required to write and submit reports telling the benefactor about their economic problems. According to Gup, the primary aim of the gift was to reduce the pain and suffering of poor Cantonians who were bracing themselves for the harshest festive season which most of them had never experienced (34). Eventually, 150 families benefitted from $5 each instead of the earlier planned $10 for 75 families due to the overwhelming response from the needy audience. According to Chambers, Gup was touched by the narrations of suffering amid undying hope of the Cantonians as captured in the letters, which he came across in suitcase that belonged to his grandfather almost eight decades earlier (85). At first, the investigative journalist was keen on uncovering the experiences behind the letters; this led him to scan through the documents and piece up the information by interviewing the authors’ descendants across the country. From the interviews involving hundreds of respondents, Gup has reestablished the role played by Mr B. Virdot’s when the country was reeling in economic meltdown. A substantial number of people could not afford to put bread on the table, while others had run out of coal and clothing among other vital necessities. Gup’s investigations show that his grandfather’s role had substantial impacts on the beneficiaries’ lives when life was practically unbearable. Taylor argues that as a journalist, Gup releases an expose of the sorrows and happiness of the tens of families who were strange to Sam Stone, but whose fortunes were basically the result of Mr Stone’s very complicated life of secrecy, philanthropy and equity (18). Gup reveals deeply hidden facts about Stone’s life; from his humble, abusive childhood experiences to his rather criminal life of evading capture by American authorities for lacking the required immigration documents. Mr Stone’s life in the alien country may have played an

Consensus and Conflict Theory in Society

Consensus and Conflict Theory in Society Marxism and Functionalism can certainly be defined as classical sociology and both have had a significant impact upon contemporary understanding of culture. Neither perspective is the preserve of a sole theorist. They are multifaceted and extensive in scope. Thus, due to the limits of this study, this essay shall concentrate on but a few of the theoretical points, namely consensus and conflict because, as I hope to prove, these provide and incredibly useful framework for the analysis of contemporary culture In Leviathan Thomas Hobbes notes that man in the state of nature is inexorably engaged in a war of all against all. Reason dictates that one’s life is, â€Å"Solitary, poor, nasty brutish and short,† (Hobbes in Parsons p90) where man’s interests conflict so greatly. How humanity solved this problem of conflict of interest, the creation of society, was the study of Emile Durkheim, the French sociologist who first developed the Functionalist perspective. â€Å"In his (Durkheim’s) criticism of the utilitarian (Hobbes) conception of contractual relations†¦Ã¢â‚¬ ¦he insists that a vital part is played by a system of binding rules embodied in the institution of a contract.† (Parsons p376) The functionalist perspective was further advanced by Talcott Parsons. â€Å"The concept of order is located predominantly at the level of the social system itself and the cultural system becomes a mechanism of the functioning of the social system.† (Savage p146) The normative order, for Parsons, is the key ingredient that retains social order in society. Norms, which can be regarded as moral standards, regulate action and interaction. Norms are coercive, to break them invites sanctions from social estrangement to capital correction and punishment. Individuals are forced to cooperate and act in predictable ways, or face the consequences. Norms are external to individuals, laws and the like, but also internalised through socialisation, children’s schooling being a very important normative learning area. The normative order, that produces acquiescence in individuals to the order, Is the staple of Parson’s consensus theory. â€Å"Society therefore is a self equilib rating system: order is always maintained without major changes in society. In the end, the system functions.† (Jorgenson p285) A perfect example of how the system functions is Durkheim’s concept of Anomie in his study of suicide. Anomie is, â€Å"precisely the state of disorganisation where the holds of norms over individual conduct has broken down.† (Parsons p377) A possible outcome of this kind of break down is suicide. Norms so permeate society that personal equilibrium, individual’s thoughts and actions, is permeated too, as governed by norms as social interaction and law. â€Å"A persons will is constrained by the application of sanctions.† (Parsons p379) If an individual breaks one of the norms of society, then society will sanction them to discourage other such deviant behaviour through the threat of punishment. In the case of Durkheim’s suicide study, the sanction imposed when an individual commits suicide is the social stigma that then attaches itself to their family accompanied by the threat, in Christian countries for instance, of religious punishment burning in hell. In Erving Goffman‘s view of society, â€Å"The key factor is the maintenance of a single definition of the situation, this definition having to be expressed, and this expression sustained in the face of a multitude of potential disruption.† (Goffman p246) For Goffman actors meet on the field of interaction under a metaphorical flag of truce, working together to attempt the smoothest possible interaction with the best possible outcome for both sides. â€Å"The maintenance of this surface of agreement, this veneer of consensus, is facilitated by each participant concealing his own wants behind statements which assert values to which everyone present feels obliged to give lip service.† (Goffman p20-21) The definition of a given situation may well only be a veneer, a pretence, lies may be suspected even known but, as long as they are not revealed, then definition of the situation is maintained. Goffman’s language, the use of the word consensus, shows his theoretical links to the Functionalist perspective, in particular Parson’s consensus theory. The reason that lies may not be exposed is because it would be against a societal norm to do so. Thus norms regulate interaction providing a consensus. For Goffman the individual acts in different roles that are governed by norms, suppressing and sacrificing certain drives, needs or wants in order to maintain the definition of the situation, to maintain the consensus. As the definition of the situation allows individual acts of interaction to maintain cohesion and momentum, so the normative order governs those definitions, allowing the juggernaut of society to roll ever on. This classical thread, from Durkheim to Goffman via Parsons is incredibly important for the understanding of contemporary culture. That there is a normative order and how it regulates human action is critical for any understanding of society. The minitatude of Goffman’s analysis, explaining the exigencies of social interaction, the tiny details, has proved both popular and crucial in contemporary sociology. The Marxist tradition, starting with Karl Marx and Frederich Engels, has many issues with the functionalist consensus view of society. â€Å"The state is by no means a power imposed on society from without; just as little is it ‘the reality of the moral idea,’ ‘the image and the reality of reason.’† (Engels in Hechter p180) The Marxist tradition has many issues with what it considers a utopian explanation of power in social order. The state, the embodiment and, in many cases producer, of societal norms is felt to be the inevitable consequence of a society ripe with irreconcilable antagonisms largely manifesting in class conflict. â€Å"A power, apparently standing above society, has become necessary to moderate the conflict and keep it within the bounds of ‘order’.† (Engels in Hechter p180) This power, this normative order of the state is alienating and another tool for the ruling class to maintain its position of dominance over th e working classes. As with most Marxist theory, the power that maintains social order is not fostering cooperation but coercion. We have already seen that punitive punishment is meted out to norm breakers. Where Parsons sees this as a tool for society to remain cohesive and function relatively smoothly, Engels sees a repressive state apparatus designed to keep the proletariat in its place through sanctions. Where Functionalism describes consensus, Marxism defines conflict, class conflict. The normative order is ideology in all the very worst senses of the word. â€Å"A dominant power may legitimate itself by promoting beliefs and values congenial to it; naturalising and universalising such beliefs so as to render them self-evident and apparently inevitable.† (Easthope p5-6) Appearing as truth, immovable, certain, ideology controls the class conflict always in favour of the ruling class, the bourgeoisie. The most pertinent criticism of Functionalist theory by Marxism is that it explains the inequalities of the system as functional. That the proletariat are poor is for the good of the system, the society. Marxism refuses to accept this. The system is unfair and unequal because those in charge, through ideology, keep in that way, protecting their interests. â€Å"Children also learn the rules of good behaviour, i.e. the attitude that should be observed by every agent in the divisio n of labour, according to the job he is ‘destined for’: rules of morality, civic and professional conscience, which actually means rules of respect for the socio-technical division of labour and ultimately the rules of order established by class domination.† (Althusser p127) The Marxist tradition, and in particular the concepts of ideology, are hugely important to contemporary Feminist understandings of society. â€Å"The univocity of sex, the internal coherence of gender, and the binary framework for both sex and gender are considered throughout as regulatory fictions that consolidate and naturalise convergent power regimes of masculine and heterosexual oppression.† (Butler p44) The pervasive and domineering regimes in Marxism and Feminism are, essentially, controlled by the same rich and powerful men. The importance of feminist sociology in contemporary society is its understanding of, and explanation for, the universality of female subjugation. It is considered not enough that women are dominated by men because it is functional, for the best of the system. It is illogical to conclude, as the functionalist tradition can be accused, of assuming that it is functional to effectively marginalise the contribution of one half of the population of man kind. Just as it is illogical to assume that it is functional to marginalise the proletariat, who constitute a majority of humanity. The Marxist tradition, and the feminist, emphasise the conflict in society, along gender and class lines, and demand sociological attention be paid. Moreover they identify the place where much of this conflict occurs, the ideological order, the self same normative order that the functionalist tradition regards so highly. No sociological study of contemporary society would be worth attempting without some attempt to explain gender, class and other inequalities beyond the assumption that they are ‘for the best,’ of the system. In conclusion society continues. Always has and always will till humanity is extinguished. In no way could society continue without some form of consensus, some shared values or norms. To be without such rules we would exist in the state of nature, in anarchy and thus we would not exist for very long. Yet within those rules there is great scope for conflict. Functionalism, in its more ‘pure’ form of Durkheim and Parsons, and in the more unique observations of Goffman, help explain that consensus that is so essential to avoid anarchy. Marxism, the pure of Marx and Engels, the adaptation of Feminism, show how that consensus becomes corrupted and a tool for one section of society to dominate another. Society continues. With conflict and consensus. Contemporary society can not be understood without appreciating why and how conflict and consensus occur. Functionalism and Marxism both illuminate those aspects, both show how society continues. Bibliography Althusser, Louis, 1971. For Lenin Western printing services Ltd. Butler, Judith, 1999. Gender trouble. Routledge Easthope, Antony, 1991. Literary into cultural studies. Routledge Goffman, E, 1990. The presentation of the self in everyday life. Penguin Michael Hechter Theories of social order published by Stanford University press 2003 Nik Jorgenson Sociology an interactive approach Harper Collins 1997 Parsons, Talcott, 1937 The structure of social action. Free press. Stephen Savage The theories of Talcott parsons pub by Macmillan 1981

Social, Economic and Political Factors Involved in the Spanish Civil Wa

Social, Economic and Political Factors Involved in the Spanish Civil War With reference to any civil war in the 20th century examine the social, economic and political background to the divisions in the society involved. To what extent were the problems which caused the war resolved in the post-war period? The state of Spain during the early years of the 20th century can be said to have been a state of great "unease". Spain was one of the first powers to loose her imperial influence, the state was politically unstable, industrially weak and had suffered some humiliating defeats. It can be said that these were the main causes that lead to the great instability of Spain during the Civil war and post civil war periods. Left-winged radicalism and nationalistic movements, such as the Catalan movement frequently came into conflict with the central government, which lead the government to use corruption more and more frequently as a form of control. The result was a military coup in 1923 lead by Miguel Primo de Rivera. Rivera preferred a more direct way of governing, with a strong Christian base and a very anti-communist attitude. He did not like party politics, preferring to govern pragmatically, at first with a military cabinet, but later on (1926) he decided a systematic government would be more efficient. So he introduced the `National Assembly' intended to represent different classes and groups, probably to soften the opposition; as well as the Union Patriotica, created to mobilize popular support for his regime. Rivera also managed to strengthen the Spanish infra-structure, but the funding had to come from loans from other nations, because the upper classes would not a... ...d. A great success was the 1953 Madrid Pact between Spain and the U.S.A, which provided Spain with quite a substantial amount of military and monetary aid in return for access to its military bases. This pact, as well as the better relations between Spain and the other powers and the great stability brought about because of the enormous repression that came with his regime, led Spain to booming years during the 1960's. The Spanish people saw a better Spain, economically, but it was still in a very primitive state politically and socially compared to other european nations, who were not under military rule (with a few exceptions, of course). The end of the Franco regime left many scars in the social and political side of Spain. People had been submitted to a suppressive state, where very little regard for any basic human right was given.

The Effects of Dota Game Among the Players

There are many students and even some young professionals that are addicted to DotA. This is one of the computer games that can be played by many players and is one of the most popular games to young students. Many students get addicted to this game and they even spend long hours inside the computer shop just to play the game. There are studies that getting addicted in playing computer games affects their studies and this is the cause why they are lying to their parents that they need extra money for their school project but the truth is they are just using the money to rent a computer where they can play DotA with their classmates. Sometimes, in order to make the game exciting, they have a deal to pay those who won the game, so it already becomes a form of gambling. When time spent on the computer playing DotA games or cruising the Internet reaches to the point when it harms a child’s or adult’s family and social relationships, or disrupts school or work life, that person may be caught in a cycle of addiction. Like other addictions, DotA game has replaced friends and family as the source of a person’s emotional life. Increasingly, to feel good, the addicted person spends more time playing video games or searching the Internet. Time away from the computer or game causes moodiness or withdrawal. When a person spends up to ten hours a day or more rearranging or sending files, playing games, surfing the net, visiting chat rooms, instant messaging, and reading emails, that easily can reach up to seventy to eighty hours a week on-line with the computer and will result to major disruptions from work, school, and in social life.

Research Proposal Thesis, Major Points, and Plan essayEssay Writing Service

Research Proposal Thesis, Major Points, and Plan essayEssay Writing Service Research Proposal Thesis, Major Points, and Plan essay Research Proposal Thesis, Major Points, and Plan essayChild welfare regulations are essential for the maintenance of the high standards of living for all children, regardless of their social background.Thesis statement: the existing child welfare regulations need changes because they have to be enhanced to provide all children with equal opportunities to have normal standards of living that meet the national average standards of living.Major points:The child welfare is essential for the maintenance of the healthy social environment, where children could grow and have access to basic public goods, including education and health care services.Today, many children are sill deprived of basic welfare benefits and cannot maintain the standards of living that mean the nation average.Existing child welfare programs still cannot close persisting gaps between children living in low income families and in the middle- and upper-class families.Literature reviewExisting studies reveal the fact tha t the current situation in the child welfare is quite challenging for children living in low income families. In this regard, the major problem existing child welfare program face is the shortage of financial resources to fund the programs and to provide either financial support for children and related programs.At the same time, many researchers (Solomon George, 1999) insist that the existing child welfare programs need consistent improvements to create equal opportunities for all children. Some researchers (Gauthier, 1996) point out that children in immigrant families have particularly significant difficulties because they may fail to enroll in the child welfare programs but they suffer from the lack of financial resources in their families. In addition, they have difficulties with the low language competence and cultural gaps.MethodsThe proposed study will involve social workers, policy makers and parents of children enrolled or counting on the child welfare programs. In such a way, the study will involve key stakeholders that will help to find out the effectiveness of the existing child welfare programs and possible ways to improve those programs. Subjects of the study will be selected randomly, regardless of their age, gender, social status, cultural and ethnic background. However, parents of children enrolled in welfare programs are likely to represent minority communities because children living in those communities are in the most difficult position and often they are either enrolled or count on the enrollment into the child welfare programs.Questionnaires and interviews will comprise the core of the methodology used in the course of the current study, interviews and questionnaires will developed for three groups of participants, including social workers, policy makers and parents of children enrolled or counting on the enrolment into the child welfare programs.FindingsFindings of the study are likely to prove findings of other researchers (), who rev eal the low effectiveness of the existing child welfare programs. At the same time, the study is likely to uncover possible ways to improve the existing child welfare programs due to the involvement of key stakeholders, who know the problem of the contemporary child welfare programs from within.DiscussionThe discussion part will include the detailed analysis of findings of the study with the revelation of possible ways for the improvement of the child welfare program along with the revelation of implications for further studies.ConclusionThe conclusion part will sum up key findings of the study and its implications.

A comparison between cardiac CT scanning and cardiac digital subtraction angiography (DSA) The WritePass Journal

A comparison between cardiac CT scanning and cardiac digital subtraction angiography (DSA) Abstract A comparison between cardiac CT scanning and cardiac digital subtraction angiography (DSA) ). This review aims to review the literature on coronary CT scanning and digital subtraction angiography, their clinical applications, techniques and comparative value in coronary artery assessment and diagnosis. Cardiac Digital subtraction angiography Coronary angiography is the conventional diagnostic procedure used in coronary artery disease. It is a minimally invasive technique, whereby a catheter is placed into the radial or femoral artery and is advanced through the arterial system to the coronary arteries. A contrast agent is then injected at the aortic root and allows visualization of the arteries using x-ray in real time at up to 30 frames per second. This allows a view of the extent, location and severity of coronary obstructive lesions such as atherosclerosis and enables prognostic indication (Miller et al., 2008). Coronary angiography also enables catheter placement either side of the lesion to assess pressure changes and determines the degree of flow obstruction (Miller et al., 2008). . Digital subtraction angiography (DSA) again works by introducing a contrast agent into the coronary arteries and taking x-rays in real time, however a pre image is taken by x-ray. This allows for the post images to be subtracted from the original mask image, eliminating bone and soft tissue images, which would otherwise overlie the artery under study (Hasegawa, 1987). Unlike conventional angiography, it is possible to conduct DSA via the venous system, through accessing the superior vena cava via the basillic vein (Myerowitz, 1982). This removes the risks associated with arterial cannulation (Mancini Higgins, 1985). The procedure can also be performed with a lower dose of contrast agent and be done more quickly therefore eliminating constraints of using too much contrast during a procedure (Myerowitz, 1982). Whilst DSA is the gold standard in arterial imaging of carotid artery stenosis (Herzig et al., 2004), the application of DSA to the coronary arteries is limited due to motion artefacts associated with each heartbeat and respiration (Yamamoto et al., 2009). There are numerous cardiac clinical applications of DSA, it can be used to assess coronary blood flow (Molloi et al., 1996), valvular regurgitation (Booth, Nissen DeMaria, 1985), cardiac phase (Katritsis et al., 1988), congenital heart shunts (Myerowitz, Swanson, Turnipseed, 1985), coronary bypass grafts and percutaneous coronary intervention outcomes (Katritsis et al, 1988; Guthaner, Wexler Bradley, 1985). However, others have suggested that the coronary arteries are not visualized well due to their small size, movement, their position overlying the opacified aorta and left ventricle, and confusion with other structures such as the pulmonary veins (Myerowitz, 1982). Cardiac CT Scanning Development of CT scanning in the 1990s enabled an increase in temporal resolution that was sufficient to view the beating heart, and they now provide a non-invasive technique for diagnostic and prognostic purposes. Cardiac CT scans have clinical applications that go beyond perfusion investigation, and can be used to assess structure and function of the heart (for example in electrophysiology disorders or congenital heart disease) due to its ability to provide anatomical detail (Achenbach Raggi, 2010). CT scans can be used to assess coronary artery disease with and without injection of contrast agent (Achenbach Raggi, 2010) by calcium scan or CT angiography. Coronary calcium CT scanning uses the evidence base that coronary artery calcium is a correlate of atherosclerosis (Burke et al., 2003) and is a strong prognostic predictor of the future development of coronary artery disease and cardiac events (Arad et al., 2000; Budoff et al., 2009; Achenbach Raggi, 2010). Calcium is easily depicted on CT scan due to its high CT attenuation, and is classified according to the Agatson score, which considers the density and area of the calcification (Hoffman, Brady Muller, 2003). Coronary CT angiography (CTA) allows visualization of the coronary artery lumen to identify any atherosclerosis or stenosis within the vessels. Patients are injected intravenously with a contrast agent and then undergo a CT scan. There are limitations regarding the suitability of patients for coronary CTA due to prerequisites of sinus rhythm, low heart rate and ability to follow breath-holding commands. Additionally, obesity presents a problem for patients that cannot fit into the scanner and affects the accuracy of the procedure. (Achenbach Raggi, 2010). Comparison of cardiac DSA and cardiac CT scanning The technical differences between cardiac DSA and cardiac CT scanning give rise to differences in the clinical indications for the procedures, their diagnostic efficacy and also different risks or relative benefits to the patients. Due to the nature of the images produced by coronary CTA and DSA, each lends itself to different indications for use. Whilst coronary DSA provides imaging of all aspects of perfusion, CTA used with contrast agent also provides this however has the additional advantage of being able to assess structure and function of the heart. Coronary CTA has been shown to have a high accuracy at detection and exclusion of coronary artery stenoses (Achenbach Raggi, 2010). In a multicentre trial conducted by Miller et al. (2008), patients underwent coronary calcium scoring and CT angiography prior to conventional invasive coronary angiography. The diagnostic accuracy of coronary CTA at ruling out or detecting coronary stenoses of 50% was shown to have a sensitivity of 85% and a specificity of 90%. This showed that coronary CTA was particularly effective at ruling out non-significant stenoses. Additionally, coronary CTA was shown to be of equal efficacy as conventional coronary angiography at identifying the patients that subsequently went on to have revascularisation via percutaneous intervention. This was shown by an area under the curve (AUC), a measure of accuracy of 0.84 for coronary CTA and 0.82 for coronary angiography. Miller et al.’s (2008) study included a large number of patients at different study sites, and additionally represented a large variety of clinical patient characteristics. The author’s claim that these factors contribute to the strength and validity of the study findings, and suggest that in addition to using patients with clinical indications for anatomical coronary imaging, should be used as evidence that coronary CTA is accurate at identifying disease severity in coronary artery disease. Miller et al. (2008) did however,, find that positive predictive and negative predictive values of coronary CTA were 91% and 83% respectively and therefore suggested that coronary CTA should not be used in place of the more accurate conventional coronary angiography. A low positive predictive value (in relation to the prevalence of disease) was proposed to be due to a tendency to overestimate stenosis degree as well as the presence of artefacts leading to false positive interpretation (Achenbach Raggi, 2010). Other research providing comparison between coronary CTA and conventional coronary angiogram has highlighted variability in results. A meta-analysis conducted by Gorenoi, Schonermark and Hagen (2012) investigated the diagnostic capabilities of coronary CTA and invasive coronary angiography using intracoronary pressure measurement as the reference standard. The authors found that CT coronary angiography had a greater sensitivity than invasive coronary angiography (80% vs 67%), meaning that coronary CTA was more likely to identify functionally relevant coronary artery stenoses in patients. Despite this,, specificity of coronary CTA was 67%, compared to 75% in invasive coronary angiography, meaning that the technique was less effective at correctly excluding non-diagnoses than invasive coronary angiogram. This research appears to contradict the power of cardiac CTA at excluding diagnoses of coronary artery stenosis as suggested by Miller et al. (2008), he study did combine evidence from over 44 studies to provide their results and therefore had a large statistical power. The authors interpret the results in light of the clinical relevance of cardiac imaging, suggesting that patients with a higher pretest possibility of coronary heart disease will likely require invasive coronary angiography for revascularisation indicating that coronary CTA may be a helpful technique in those patients with an intermediate pre-test probability of coronary heart disease that will therefore not require invasive angiography. Goldberg et al. (1986) investigated the efficacy of DSA in comparison to conventional coronary angiography in 77 patients. They found that the two angiograms agreed within one grade of severity in 84% of single cases and 90% of multiple cases, identifying both patent and lesioned arteries. The results led the authors to conclude that there was no significant difference between the two methods and that DSA could be used in selective coronary angiography to find results comparable to that of conventional angiography. In addition to being a small study into the efficacy of DSA, the study also had several sources of inherent variability that should be considered when interpreting the results. These included differing sizes of digital imaging screen and non-use of calipers, meaning that the interpretation of the images could vary throughout the study. The authors also suggest that whilst showing strong support for the use of DSA in coronary artery disease, the technique may not actually p ermit better prognostic determinations or clinical judgements that are better than conventional angiography, and therefore the further implementation of the techniques may not be founded or necessitated. More recently, there has been further research looking at the effectiveness of DSA as a way of measuring coronary blood flow. Whilst motion artefacts have proven a problem in lots of past research (Marinus, Buis Benthem, 1990; Hangiandreou, 1990), recent research has developed methods to minimise these. Moilloi and colleaues (1996) showed that using a motion-immune dual-energy digital subtraction angiography, absolute volumetric coronary blood flow could be measured accurately and thus provide an indication of the severity of any arterial stenosis.This may provide further suggestion for clinical implementation of DSA. Although these studies provide evidence for the efficacy of cardiac DSA and CTA, they often make comparisons to conventional angiography. This is useful as a baseline comparison, however it is difficult to make comparisons between the two procedures directly due to less available evidence making direct comparisons. Lupon-Roses et al. (1985) conducted a study investigating both coronary CTA and venous DSA. The study looked at the efficacy of both techniques at diagnosing patency of coronary artery grafts compared to the control conventional angiography. CT was shown to diagnose 93% of the patent grafts and 67% of the occluded grafts whereas DSA correctly diagnosed 98% and 100% of patent and occluded grafts respectively. Interestingly, the DSA picked up the 11 grafts that were misdiagnosed by CTA and the CTA picked up the 2 grafts misdiagnosed by the DSA. This data may suggest that individually, DSA has a better profile for diagnosis of coronary artery occlusion, however if the two procedures are used in combination exclusion of patent arteries and diagnosis of occluded arteries would be effective (Lupon-Roses et al., 1985). Coronary DSA and CTA are both non-invasive procedures (unlike the conventional coronary angiography where a wire is placed in the coronary vasculature). With the only invasive part of the procedure being the injection of the contrast material into a vein. This presents a significant advantage to both procedures over that of conventional angiography, and may even permit investigation on an outpatient basis (Meaney et al., 1980). Similarly, both DSA and coronary CTA are favoured because of their intravenous approach, eliminating the risks of bleeding or arterial injury from an intra-arterial catheterization and being able to be used in those with limited arterial access. However, although the intravenous approach used in cardiac DSA makes it favourable, it does lead to difficulty with visualisation of the coronary arteries due to the overlying iodinated pulmonary and cardiac structures (Mancini Higgins, 1985). Therefore,, intra-arterial DSA is also sometimes used (Yamamoto et al., 200 9). As with all CT scanning, coronary CTA carries with it a dose of ionizing radiation (Brenner Hall, 2007). Studies have estimated that for diagnostic CT scanning, patients are on average exposed to 12mSv of radiation during the procedure, the equivalent of 600 x-rays (Hausleiter et al., 2009). Estimates of radiation doses associated with conventional coronary angiography are lower than that of coronary CTA at 7mSv (Einstein et al., 2007). Additionally, DSA technique reduces the radiation dose from that of conventional coronary angiography as the vessels are visualised more clearly (Yamamoto et al., 2008). The dangers of radiation exposure are increased risk of developing cancer, skin injuries and cateracts (Einstein et al., 2007). It is therefore important that the benefits of conducting the procedure greatly outweigh the risk of radiation exposure. CT calcium scanning provides a low radiation dose at around 1mSv (Hunold et al., 2003). Cardiac CT calcium scanning does not require administration of a contrast agent, unlike in coronary CTA and DSA that use iodine based contrast agents. The risks associated with contrast agent include nephrotoxicity and risks of hives, allergic reactions and anaphylaxis (Maddox, 2002). The amount of contrast agent used is partly dependent on the length of the procedure and how clearly the arteries can be visualised. For this reason, both cardiac CTA and DSA use less contrast agent that conventional coronary angiography (Brant-Zawadzki, et al., 1983). CT calcium scanning of the coronary arteries is therefore recommended in those with less likelihood of coronary artery disease (NICE, 2010). Both coronary CTA and DSA require interpretation by trained physicians, and the importance of training and achieving intra-rater reliability should not be underestimated (Pugliese et al., 2009). Conclusion Overall, both coronary CT and DSA have been demonstrated as effective procedures for the imaging of the coronary arteries in CAD (Achenbach Raggi, 2010; Miller et al., 2008; Moilloi et al., 1996; Goldberg et al., 1986). Whilst cardiac CT scanning does provide a wider range of clinical applications, allowing assessment of perfusion as well as cardiac structure and function (Achenbach Raggi, 2010), coronary DSA has many applications that allow assessment of coronary blood flow (Molloi et al., 1996; Katritsis et al, 1988; Booth, Nissen DeMaria, 1985; Guthaner, Wexler Bradley, 1985; Myerowitz, Swanson, Turnipseed, 198). Both cardiac DSA and CTA procedures have their advantages. As non-invasive procedures, these techniques pose less risk to patients, and enable the possibility of outpatient investigation, to be used to rule out diagnoses and to avoid inappropriate invasive coronary angiogram (Gorenori et al., 2012). Additionally, intravenous access is preferential to arterial cannulation for the contrast infusion, removing the risks associated with bleeding or intra-arterial injury. Cardiac DSA exposes the patient to a lower dose of radiation that coronary CTA (Hausleiter et al., 2009; Yamamoto et al., 2008; Einstein et al., 2007), which is beneficial at reducing the risk of genetic mutations and cancer. Cardiac CTA and DSA also have their common disadvantages. The use of contrast agent may present side effects for the patient including kidney damage and risk of allergic reactions and anaphylaxis (Maddox, 2002). For this reason, calcium CT scanning can be useful in patients that are not at high likelihood of coronary artery disease (NICE, 2010b). Additionally, both cardiac DSA and CTA are subject to motion artefacts from respiration and heart beats, which can cause difficulties with interpretation (Achenbach Raggi, 2010; Yamamoto et al., 2009). In the case of cardiac CTA, this excludes a subset of patients that are unable to follow commands and those who have high heart rates. Overall, cardiac CTA and cardiac DSA are effective, non-invasive imaging techniques for assessment of coronary artery disease. Whilst they are not the gold standards in cardiac monitoring, they can provide important diagnostic information without exposing patients to the risks of invasive angiography. Due to this, their use should be weighted against clinical need, the risks of the procedures, and the suitability of the patient. Interpretation of cardiac CTA and DSA imaging should be by trained individuals. References Achenbach, S., Raggi, P. (2010) Imaging of coronary atherosclerosis by computed tomography. European Heart Journal. 31:1442 Arad, Y., Spadaro, L. A., Goodman, K., Newstein, D., Guerci, A. D. (2000). Prediction of coronary events with electron beam computed tomography.Journal of the American College of Cardiology,  36(4), 1253-1260. Booth, D. C., Nissen, S., DeMaria, A. N. (1985). Assessment of the severity of valvular regurgitation by digital subtraction angiography compared to cineangiography.  American heart journal,  110(2), 409-416. Brenner  D. J., Hall  EJ.  Computed tomography: an increasing source of radiation exposure.  Ã‚  N Engl J Med.  2007;357(22):2277-2284 Budoff, M. J., McClelland, R. L., Nasir, K., Greenland, P., Kronmal, R. A., Kondos, G. T., Blumenthal, R. S. (2009). Cardiovascular events with absent or minimal coronary calcification: the Multi-Ethnic Study of Atherosclerosis (MESA).  American heart journal,  158(4), 554-561. Bugiardini, R., Manfrini, O., Pizzi, C., Fontana, F., Morgagni, G. (2004). Endothelial function predicts future development of coronary artery disease a study of women with chest pain and normal coronary angiograms.Circulation,  109(21), 2518-2523. Burke, A. P., Virmani, R., Galis, Z., Haudenschild, C. C., Muller, J. E. (2003). Task force# 2- what is the pathologic basis for new atherosclerosis imaging techniques?.  Journal of the American College of Cardiology,41(11), 1874-1886. Einstein, A. J., Moser, K. W., Thompson, R. C., Cerqueira, M. D., Henzlova, M. J. (2007). Radiation dose to patients from cardiac diagnostic imaging.Circulation,  116(11), 1290-1305. Goldberg HL, Moses JW, Fisher J, Tamari I, Borer JS (1986). Diagnostic accuracy of coronary angiography utilizing computer-based digital subtraction methods; Comparison to conventional cineangiography. Chest 90, 793–797, Gorenoi, V., Schà ¶nermark, M. P., Hagen, A. (2012). CT coronary angiography vs. invasive coronary angiography in CHD.  GMS health technology assessment,  8,  Doc02-Doc02.. Guthaner, D. F., Wexler, L., Bradley, B. (1985). Digital subtraction angiography of coronary grafts: optimization of technique.  American journal of roentgenology,  145(6), 1185-1190. Hacker, M., Jakobs, T., Hack, N., Nikolaou, K., Becker, C., von Ziegler, F., Tiling, R. (2007). Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina.  European journal of nuclear medicine and molecular imaging,34(1), 4-10. Hangiandreou N. J.  (1990) Coronary Blood Flow Measurement Using Digital Subtraction Angiography and First Pass Distribution Analysis. Madison, Wis: University of Wisconsin-Madison; Thesis. Hasegawa, B. (1987). Physics of Medical X-Ray Imaging 2nd Edition. Medical Physics Publishing Corporation. Hausleiter, J., Meyer, T., Hermann, F., Hadamitzky, M., Krebs, M., Gerber, T. C., Achenbach, S. (2009). Estimated radiation dose associated with cardiac CT angiography.  Jama,  301(5), 500-507. Herzig, R., BuÃ…â„¢val, S., KÃ…â„¢upka, B., Vlachov, I., Urbnek, K., MareÃ… ¡, J. (2004). Comparison of ultrasonography, CT angiography, and digital subtraction angiography in severe carotid stenoses.  European Journal of Neurology,  11(11), 774-781. Brant-Zawadzki, M., Gould, R., Norman, D., Newton, T. H., Lane, B. (1983). Digital subtraction cerebral angiography by intraarterial injection: comparison with conventional angiography.  American Journal of Roentgenology,  140(2), 347-353. Hoffmann, U., Brady, T.J., Muller, J. (2003). Cardiology patient page. Use of new imaging techniques to screen for coronary artery disease. Circulation 108 (8): e50–3. Hunold, P., Vogt, F. M., Schmermund, A., Debatin, J. F., Kerkhoff, G., Budde, T., Barkhausen, J. (2003). Radiation Exposure during Cardiac CT: Effective Doses at Multi–Detector Row CT and Electron-Beam CT 1.Radiology,  226(1), 145-152. Katritsis, D., Lythall, D.A., Cooper, I.C., Crowther, A., Webb-Peploe, M.M. (1988) Assessment, of coronary angioplasty: Comparison of visual assessment, hand†held caliper measurement and automated digital quantitation.  Catheterization and cardiovascular diagnosis,  15(4), 237-242. Kaufmann, P. A., Gnecchi-Ruscone, T., Schfers, K. P., Là ¼scher, T. F., Camici, P. G. (2000). Low density lipoprotein cholesterol and coronary microvascular dysfunction in hypercholesterolemia.  Journal of the American College of Cardiology,  36(1), 103-109. Liu, J. L. Y., Maniadakis, N., Gray, A., Rayner, M. (2002). The economic burden of coronary heart disease in the UK.  Heart,  88(6), 597-603. Lupà ³n-Rosà ©s, J., Domingo, E., Marinez-Vzquez, J. M., Là ³pez-Moreno, J. L., Montaà ±, J., Permanyer-Miralda, G., Soler-Soler, J. (1985). Direct non-invasive techniques for assessing coronary bypass graft patency.  The International Journal of Cardiac Imaging,  1(3), 181-188. Maddox, T. G. (2002). Adverse reactions to contrast material: recognition, prevention, and treatment.  American family physician,  66(7), 1229. Mancini, J. G. B., Higgins, C. B. (1985). Digital subtraction angiography: a review of cardiac applications.  Progress in cardiovascular diseases,  28(2), 111-141. Marinus, H., Buis, B., Van Benthem, A. (1990) Pulsatile coronary flow determination by digital angiography.  International Journal of Cardiac Imaging, 5, 173-182 McClure, K. H., McGivern, J. P., Stultz, M. R., Whitehurst, T. K. (2009).  U.S. Patent No. 7,481,759. Washington, DC: U.S. Patent and Trademark Office. Meaney, T. F., Weinstein, M. A., Buonocore, E., Pavlicek, W., Borkowski, G. P., Gallagher, J. H., Maclntyre, W. J. (1980, August). Digital subtraction angiography of the human cardiovascular system. In  Application of Optical Instrumentation in Medicine VIII  (pp. 272-278). International Society for Optics and Photonics. Miller, J. M., Rochitte, C. E., Dewey, M., Arbab-Zadeh, A., Niinuma, H., Gottlieb, I., Lima, J. A. (2008). Diagnostic performance of coronary angiography by 64-row CT.  New England Journal of Medicine,  359(22), 2324-2336. Molloi, S., Ersahin, A., Tang, J., Hicks, J., Leung, C. Y. (1996). Quantification of volumetric coronary blood flow with dual-energy digital subtraction angiography.  Circulation,  93(10), 1919-1927. Myerowitz, P. D. (1982). Digital subtraction angiography: present and future uses in cardiovascular diagnosis.  Clinical cardiology,  5(12), 623-629. Myerowitz, P. D., Swanson, D. K., Turnipseed, W. D. (1985). Applications of digital subtraction angiography in cardiovascular diagnosis.  The Surgical clinics of North America,  65(3), 423-437. National Institute for Health and Care Excellence. (2010a). Unstable angina and NSTEMI: The early management of unstable angina and non-ST-segment-elevation myocardial infarction. CG94. London: National Institute for Health and Care Excellence. National Institute for Health and Care Excellence. (2010b). Unstable angina and NSTEMI: Chest pain of recent onset: assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin. CG95. London: National Institute for Health and Care Excellence. Pugliese, F., Hunink, M. M., Gruszczynska, K., Alberghina, F., Malagà ³, R., van Pelt, N., Krestin, G. P. (2009). Learning curve for coronary CT angiography: what constitutes sufficient training?.  Radiology,  251(2), 359. Yamamoto, M., Okura, Y., Ishihara, M., Kagemoto, M., Harada, K., Ishida, T. (2009). Development of digital subtraction angiography for coronary artery.  Journal of digital imaging,  22(3), 319-325.

The effect of biological principles on the architectural design Toward Essay

The effect of biological principles on the architectural design Toward sustainable approach - Essay Example Sponges can be examined in order to create more efficient buildings. Nature also optimizes energy consumptions and the elasticity of biomaterial. It introduces an era where expectations are not what to extract from nature, but rather what can be learn from it (Benyus, 2002) and (Pawlyn, 2011). This new era (Benyus, 1997) defines biomimicry as a new science that uses nature’s models as an inspiration to study the design, in order to find a solution to solve human problems. The concept of using nature as a model for manufactured products is not a new. Although Biomimicry has created a radical change, the architectural community and peoples’ perception of the contemporary building has not been positive. Like most new trends, some criticism has been raised against this approach. Biomimicry should be incorporated into inspirational architectural designs. The aim of this essay is to investigate how to create a natural design by exploring the link between the biological principles on the architectural design. The first part of this essay will discuss the background of biomimicry. The second part of the paper will focus on the principles of biometry and the relative approaches. The third part of the essay will discuss the effectiveness of the levels of biomimicry. In the last part the paper will illustrate some drawbacks against biomimicry In the English language, the creation of the term bionic (also known as biomimetic, biomimicry, bio-inspiration, biogenesis, biologically inspired design) probably originated from the Greek word bion (Iouguina, 2013). This word means life. Mimicry is to imitate or copy. Thus biomimicry is the imitating of life or living things. â€Å"Biomimicry from bios, meaning life, and mimesis, meaning to imitate is a new discipline that studies natures best ideas and then imitates these designs and processes to solve human problems. Studying a leaf to invent a better solar cell is an example, it

'it's not enough to condemn crime, we need to understand its causes' Essay

'it's not enough to condemn crime, we need to understand its causes'. Critically analyse this statement from the perspective of right wing criminologists and on - Essay Example This has worked to turn the legal system quite mechanical and the concept of crime that is seen with fear and disdain and not a social disease that has to be attacked from the roots. This paper examines the view that criminology should adopt a studious stance on the fact that the events of crime should not be considered as those that need just a structured meting out of justice to the perpetrator but that each crime event should be proactively viewed as an event that is caused by underlying social forces and equations that have given rise to root factors for its perpetration. Only when such a view is taken will the present criminal justice system emerge towards effective elimination or reduction of the crime from our society. There has been tremendous interest of late into the political, social and commercial realities of the victims of crime. This is encompassed within a broad ranging view concerning the changing role of victims within the criminal justice process, their needs and rights, as well as victimological theories which help to explain and understand the process of victimization. In tandem to this there has been a parallel interest in the political, social and commercial realities of the perpetrators of the crime which lead to a set of factors that spurred the happening of the crime events. These augmenting factors if tackled and resolved effectively would help reduce crime. This, in fact is the preventive approach to crime. Different criminal justice systems the world over have different core orientations. For instance, the US criminal justice system views itself as following a â€Å"systems" approach to criminal justice, with improved coordination among law enforcement, courts, and correctio nal agencies.(Walker,1992) The 1967 Presidents Commission on Law Enforcement and Administration of Justice termed the criminal justice system as the means for society to "enforce

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Genders at work - Essay Example Griffith & Goodwin (2012) observe that the childhood behavioral patterns are carried onto the workplace culture. Segregation between the male and female groups is also a characteristic that is evident in the workplace. Men form more cohesive groups that are greatly concerned with competition and turf protection (Griffith & Goodwin, 2012). Women groups on the other hand are less cohesive but demonstrate high levels of democracy and avoidance of confrontation (Griffith & Goodwin, 2012). These characteristics are very applicable in solution development and conflict management within the organization. From the above discussion, male employees are less likely to resort to democracy compared to female employees. In the occurrence of a problem that requires a solution; male employees are more likely to resort to fast solution development choices that will not require extensive consultancy techniques. However, the female trait in avoiding confrontations would lead to the development of the fairest and most democratic choice of solution, with the aim of providing the most satisfactory solution (Griffith & Goodwin, 2012). Indeed the gender role in the workplace influences decision making processes and most especially in problem solving situations. The discussion concludes that male employees are less likely to go for an extensive problem inquiry compared to their female

Development Assistance Essay Example for Free

Development Assistance Essay The best way for international donors to quicken development in poor Asian countries is to maximize overseas developmental assistance. ODA should be provided both to governments directly and to international and local NGOs. † Development can be considered as one of the most omnipresent concepts today. This term had been a commonplace in governments and non-governmental organizations alike (Nault, 2008). Overseas developmental assistance also referred to as official overseas assistance (ODA), had been a vital part of world economies especially to those who belong to the third world. As early as 1960s, underdeveloped and developing countries have seen the importance of receiving grants in forms of ODA from more developed countries (Berlage and Stokke, 1992) It is now given that most of the countries, which are underdeveloped, or those who are still in the process of developing are indeed in great need of ODAs coming from their more developed counterparts. The lack of resources on the part of the poor countries makes them suffer the opportunity cost of not attending to other pressing issues in within their territories. This paper will present arguments in two fold. First, it will make a point on how international donors can quicken development in poor Asian countries by maximizing the amount it gives through ODAs. Second, it will argue on why is there a necessity to give funds directly to international and local NGOs rather than just giving it to the government; it having the sole discretion on the funds’ disbursement. Similar to the case in developed countries, rising and relentless budget deficits had become one of the major causes for concern in developing countries. Asian countries have been suffering from massive budget deficits for the past recent years (Gupta, 1992). Given that most of the developing and underdeveloped countries are suffering from budget deficit, there really is a need that ODAs should be intensified in order to address other social concerns that are being neglected by the governments due to lack of budget. These social concerns, which deals with welfare and other public issues are often taken for granted by governments despite their noble ideas because they lack resources in financing these programs. If resources will be provided through ODA, the local government will be better equipped of bringing service to their people. Aside from mere economic progress, development must also entail improvements with regard to life expectancy, education levels, literacy, and access to resources (Nault, 2008). With more funds, which are easily available to finance social programs of the government, people may easily reap the benefits of ODAs coming from developed countries. The funds coming from the ODA can be allocated to programs aimed at empowering the grassroots and improving the living conditions of the people. With regard to economic progress, there is also a great need for the funds, which are given by more developed countries. Given the lack of resources of underdeveloped countries, they have no enough assets to stimulate their respective economies. Nowadays, government-initiated economic policies are necessary to save the worsening condition of the global economy. The world economy is being threatened by massive recessions. Hence, there is a necessity for state intervention in stimulating the economy. ODAs can be used by the government to back up state-initiated economic programs aimed at ameliorating the country’s economy. ODAs may be used as capital by the government and also as investment so that it would yield to higher profits in the future. ODAs can also be used by the government in coming up with schemes that will help protect the economy from the global trend of economic downturns by implementing regulations, which will somehow put safety nets to the national economy. ODAs may be used in employment training and job creation in order to assure that the citizens of the country are equipped with appropriate knowledge, which they may use in finding employment. Having established the necessity of increasing the amount of ODAs being transferred by developed countries to their poorer and less fortunate counterparts of Asia, the argumentation will shift towards the necessity of diverting funds not only to state governments but to non-governmental organizations as well. First, the author of this paper acknowledges the vital role being played by the government with regard to managing ODAs. Much substance have been given earlier in this paper and it is beyond argumentation that state-government acceptance of ODAs is indeed necessary. However, a new concept is being realized and offered which relates to the offering of ODAs from developed nations directly to international and local NGOs in the country. Perhaps one of the reasons to such proposition is the lessening trust of developed nations to their underdeveloped counterparts in Asia when it comes with governance. Many Asian countries, especially those who are financially-burdened, are often described in the international arena as engaging in the process of corruption. Documented evidence is being studied to support such claim (Lindsey and Dick, 2002). Good governance within the public sphere is indeed crucial in creating an environment, which will help mobilize resources, both domestically and internationally as well (Organization for Economic Co-operation and Development, 2002). Grantors of ODAs take into consideration the political climate within the country, which will receive their grant. They give premium to those who are practicing good governance. However, most countries in Asia had been involved in cases related to corruption. Hence, they do not appear as flawless to those who are sending them their ODAs. On the other hand, NGOs send a message of altruism to the international community. These NGOs project an image that they are indeed concerned in bringing progress to the countries where they have offices in. They appear as the good guys, whose business is to promote the welfare of the oppressed. NGOs are also offering programs that are aimed at bringing progress and development to their host countries. Sometimes, such programs from the NGOs are not being offered by state-governments. Another point is the fact that since grantors of aids are losing trust to corrupt governments, they are finding alternative channels to send their ODAs to residents of the receiving countries. Most NGOs in the international levels have earned themselves of the reputation to help others due to their noble causes. In spite of the manner as to how developed countries will be sending in their grants, what matters most is the fact that these grants are indeed helpful in bring progress and development to underdeveloped countries. References Berlage L. and Stokke, O. (1992). Evaluating Development Assistance: Approaches and Method. London: Routledge Publishing. Gupta, K. L. (1992). Budget Deficits and Economic Activity in Asia. London, Routledge Publishing. Lindsey, T. and Dick, H. W. (2002). Corruption in Asia: rethinking the governance paradigm. Annandale: NSW Federation Press. Nault D. M. (2008). Development in Asia: Interdisciplinary, Post-Neoliberal, and Transnational Perspectives. Boca Raton: Brown Walker Press. Organization for Economic Co-operation and Development (2002). Official development assistance and private finance: attracting finance and investment to developing countries. Paris: OECD Publishing.