The Conflict and Struggles in Iraq Essay -- Iraq Iraqi Politics Politi

The Conflict and Struggles in Iraq Throughout history, the United States has attempted to overthrow corrupt government in other areas of the world and instating democracies such as ours. What the United States fails to realize is that reforms in a country’s political structure do not occur overnight, but rather to enforce these new changes, money and time is required. Sometimes the money and time seem to be more than we as a country bargain for, but I am a firm believer that you finish what you start. Right now the conflict is in Iraq, where many Americans are angry at the amount of money and time that we are dedicating to installing a democratic government after the overthrow of their dictatorship. As a country, we should be behind our military and our government in supporting their war efforts and attempts to provide freedom and equality for the people of Iraq. The main problem in Iraq is that their culture is centered around religion. Unfortunately, it is not just one main religion, but rather nineteen provinces and three separate forms of religion. The majority of the population is Islamic, and then broken into three sects of Islam: the Kurds, Shiites, and the Sunnis. To have a true democracy, the culture of Iraq must be adapted to separate religious beliefs from governmental policies. Since the melting pot of religions in America do not infiltrate the government, we as a society do not understand the difficulty of diffusing religion out of Iraqi government. To contribute to this setback, each group has different beliefs within their organization which cause continuing difficulty. As Hubert Locke states in his editorial to the Seattle Post Intelligence, â€Å"Yet at some point, we will ha... ...or we cannot think that Iraq will become a truly independent state until we rebuild their economy and get their government standing on its own two feet. We cannot just be a country that invades and then leaves, the remaining citizens becoming lost. If this happens, of course there will be American resentment in the Middle East! We removed their political stability and now it is our job to restore their country with the benefits of freedom and hopefully more opportunity. Works Cited Lewis, Bernard. The Crisis of Islam. New York: Modern Library Education, 2003. â€Å"Rebuilding Iraq.† Editorial. Patriot News 15 July 2003 A15. â€Å"Iraqi War.† Editorial. Chicago Sun-Times 9 November 2003, pg. 32. â€Å"Bush’s Reconstruction.† Editorial. Seattle Post Intelligence 20 October 2003, A8. â€Å"Post-War Efforts.† Editorial. Orlando Sentinel 23 September 2003 pg. 9.

Task Two Cathy Ann Wilson-Bates Western Governors

Task Two Cathy Ann Wilson-Bates Western Governors University EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH EBP 1 Brenda Luther, PhD, RN January 25, 2012 Task Two Introduction: What I have learned about working with children in a chronic healthcare setting like dialysis is that they are resilient beings with the propensity for rapid changes in their medical condition. Children almost always surprise me in their unique description of symptoms and pain. Depending on their age, they may not be able to describe the symptoms they feel or tell me â€Å"where it hurts†.A simple ear ache may be described as a â€Å"drum in my ear† or may be observed with non verbal cues like tugging on the ear. Acute Otitis Media is seen quite often during the cold and flu season. Recent clinical guidelines suggest waiting twenty four to seventy two hours before beginning antibiotic therapy. Parents of children with symptoms of otitis media are accustomed to receiving a prescription for ant ibiotics before they leave the medical office. Adults as well are preconditioned for the little white slip of paper from their physician. You can read also Coronary Artery Disease Nursing Care PlanWaiting twenty four to seventy two hours to evaluate the need for antibiotics will definitely reduce the over-prescription of antibiotics as well as their efficacy. The waiting and watching of several days may seem like an eternity to a parent caring for a sick and crying child. Educating parents during routine visits to the physician office about the risks of over-prescribing antibiotics will help when the physician needs to discuss the possibility of waiting and evaluating before prescribing antibiotics.Providing a list of comfort measures parents can follow may help relieve the anxiety they have in caring for a sick child. Any comfort measure taken to reduce crying is helpful to the parent of a sick child, but mostly to the child. The following table and paragraphs will share the results of how one group of nurses at an outpatient clinic used clinical evidence to manage this situation. Source |Type of Resource |Source appr opriate or |Type of Research | | |general information, |inappropriate |primary research evidence, | | |filtered, or unfiltered | |evidence summary, evidence-based | | | | |guideline, or none of these | |American Academy of Pediatrics and American Academy of|Filtered |Appropriate |Evidence-based guideline | |Family Physicians. Clinical practice guideline: | | | | |Diagnosis and management of acute otitis media. | | | |Causative pathogens, antibiotic resistance and |Unfiltered |Appropriate |Evidence-based guideline | |therapeutic considerations in acute otitis media. | | | | |Pediatric Infectious Disease Journal. | | | | |Ear, nose, and Throat, Current pediatric diagnosis and|General |Inappropriate |None of these | |treatment. | | | | |Treatment of acute otitis media in an era of |Filtered |Appropriate |Evidence –based guideline | |increasing microbial resistance.Pediatric Infectious| | | | |Disease Journal | | | | |Results from interviews with parents who have brought |Unfilte red |Appropriate |Primary research evidence | |their children into the clinic for acute otitis media. | | | | | | | | | Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 13 No 5 1451-1465. This article is an evidence-based clinical guideline. It is a systematic review making it a filtered resource which is very appropriate for this situation. The article describes the current, (as of 2004) recommendations for the diagnosis and management of Acute Otitis Media (Subcommittee on Management of Acute Otitis Media, 2004). These guidelines show several different ways to treat acute otitis media depending on the symptoms of the child. It states that sometimes waiting to give antibiotics is good and sometimes waiting to give antibiotics is not good. This article is appropriate and provides clarity on the topic. Block, S. L. (1997).Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. This article discusses antibiotic resistance and describes the bacterial pathogens which are responsible for infections causing acute otitis media. This article is appropriate. It contains a comparison of studies performed based on the different types of bacteria which cause acute otitis media. It stresses the importance of identifying the bacteria causing the infection before giving antibiotics so that number one the bacteria can be eradicated and other bacteria will not become resistant (Block, 1997).PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lang. This textbook source contains general information on the ear, nose and throat. There is much more information here regarding basic anatomy and physiology as well as characteristics of the ear nose and throat. The information regarding otitis media is basic and not an appropriate source of research in this situation for three reasons. Number one, the information is very basic, number two, it does not give any up to date information on how to treat this type of infection, and number three there is too much non-relevant information.McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. This article is a review of the known etiologies that may cause acute otitis media. The article gives up to date information on therapeutic approaches when selecting an appropriate antibiotic therapy. We don’t practice â€Å"cookie cutter† medicine. The same prescription is not always right for all patients or all communities where some bacteria’s may be more prevalent than others (McCracken, 1998). This is appropriate information f or this group of people or community. media, P. o. (n. d. ).Interviews. (C. nurses, Interviewer) This set of interviews is simply raw data. General information can however provide great insight as to what is happening out in the community. For example, this information might shed light on the fact that if the parents are willing to hold off on antibiotics for example, would they be more likely to follow up and come back into the clinic when asked? The reaction of parents is dependent upon other several basic factors like finances, a belief system and possibly the ability to obtain transportation. Knowing how the community is going to respond to their choice may have a great effect on the decisions they make.When evaluating the findings of these sources cumulatively, one must first determine the causative pathogens infecting patients in this given community with acute otitis media. After pathogen determination we can determine which antibiotics may be most useful in eradicating the g iven bacteria. Careful selection of antibiotic therapy will reduce the propensity for antibiotic resistance. Watchful waiting may be a good thing from the perspective of increasing microbial resistance however we must always evaluate patients on their individual needs or on a patient by patient case. One size doesn’t always fit all. Patient education is the key to keeping the public informed of current practice.Physicians and Nurses need to be consistent in the lesson plan shared with patients and remain true to our scope of practice. Communication is essential between the physician, nurse and other multidisciplinary team members in order to provide the best care. There are many considerations in assessing if patients are able to withstand the waiting and evaluation period. Low income families are one example of how the waiting and watching method might not work. Parents may have to take time off work to come to clinic with a sick child. They might struggle finding money for the additional return trip to the clinic and may risk losing their job if they take more time off work.Many low income families may have already waited before seeking help thus creating their own watchful waiting period. They also may not be able to afford antibiotics and as a result may not give the full dose if symptoms have subsided. The perception is that they will save the medication for the next time symptoms arise. Confidentiality might be an issue in smaller communities. People tend to be concerned about neighbors and co-workers and some may not care to share their experience with others. This may be an issue for parents who don’t share custody as in the case of divorce. It is a greater issue when parents or partners don’t share the same fundamental values, especially those related to healthcare. Conclusion:Watchful waiting like the nurses in this clinic are looking at may be useful for some of the patients, but not all. Again, a one size fits all philosophy is not always appropriate in healthcare. Tools like algorithms may be helpful in determining the appropriateness for watching and waiting versus immediate action as determined by physical findings and social circumstances like parental adherence for follow up and ability to afford treatment. Whatever course you choose, watchful waiting or immediate antibiotics the best practice remains a plan of care based on the individual needs of our patients. References Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media.The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. media, P. o. (n. d. ). Interviews. (C. nurses, Interviewer) PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lan g. Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 113 No 5 1451-1465.

Task Two Cathy Ann Wilson-Bates Western Governors

Task Two Cathy Ann Wilson-Bates Western Governors University EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH EBP 1 Brenda Luther, PhD, RN January 25, 2012 Task Two Introduction: What I have learned about working with children in a chronic healthcare setting like dialysis is that they are resilient beings with the propensity for rapid changes in their medical condition. Children almost always surprise me in their unique description of symptoms and pain. Depending on their age, they may not be able to describe the symptoms they feel or tell me â€Å"where it hurts†.A simple ear ache may be described as a â€Å"drum in my ear† or may be observed with non verbal cues like tugging on the ear. Acute Otitis Media is seen quite often during the cold and flu season. Recent clinical guidelines suggest waiting twenty four to seventy two hours before beginning antibiotic therapy. Parents of children with symptoms of otitis media are accustomed to receiving a prescription for ant ibiotics before they leave the medical office. Adults as well are preconditioned for the little white slip of paper from their physician. You can read also Coronary Artery Disease Nursing Care PlanWaiting twenty four to seventy two hours to evaluate the need for antibiotics will definitely reduce the over-prescription of antibiotics as well as their efficacy. The waiting and watching of several days may seem like an eternity to a parent caring for a sick and crying child. Educating parents during routine visits to the physician office about the risks of over-prescribing antibiotics will help when the physician needs to discuss the possibility of waiting and evaluating before prescribing antibiotics.Providing a list of comfort measures parents can follow may help relieve the anxiety they have in caring for a sick child. Any comfort measure taken to reduce crying is helpful to the parent of a sick child, but mostly to the child. The following table and paragraphs will share the results of how one group of nurses at an outpatient clinic used clinical evidence to manage this situation. Source |Type of Resource |Source appr opriate or |Type of Research | | |general information, |inappropriate |primary research evidence, | | |filtered, or unfiltered | |evidence summary, evidence-based | | | | |guideline, or none of these | |American Academy of Pediatrics and American Academy of|Filtered |Appropriate |Evidence-based guideline | |Family Physicians. Clinical practice guideline: | | | | |Diagnosis and management of acute otitis media. | | | |Causative pathogens, antibiotic resistance and |Unfiltered |Appropriate |Evidence-based guideline | |therapeutic considerations in acute otitis media. | | | | |Pediatric Infectious Disease Journal. | | | | |Ear, nose, and Throat, Current pediatric diagnosis and|General |Inappropriate |None of these | |treatment. | | | | |Treatment of acute otitis media in an era of |Filtered |Appropriate |Evidence –based guideline | |increasing microbial resistance.Pediatric Infectious| | | | |Disease Journal | | | | |Results from interviews with parents who have brought |Unfilte red |Appropriate |Primary research evidence | |their children into the clinic for acute otitis media. | | | | | | | | | Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 13 No 5 1451-1465. This article is an evidence-based clinical guideline. It is a systematic review making it a filtered resource which is very appropriate for this situation. The article describes the current, (as of 2004) recommendations for the diagnosis and management of Acute Otitis Media (Subcommittee on Management of Acute Otitis Media, 2004). These guidelines show several different ways to treat acute otitis media depending on the symptoms of the child. It states that sometimes waiting to give antibiotics is good and sometimes waiting to give antibiotics is not good. This article is appropriate and provides clarity on the topic. Block, S. L. (1997).Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. This article discusses antibiotic resistance and describes the bacterial pathogens which are responsible for infections causing acute otitis media. This article is appropriate. It contains a comparison of studies performed based on the different types of bacteria which cause acute otitis media. It stresses the importance of identifying the bacteria causing the infection before giving antibiotics so that number one the bacteria can be eradicated and other bacteria will not become resistant (Block, 1997).PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lang. This textbook source contains general information on the ear, nose and throat. There is much more information here regarding basic anatomy and physiology as well as characteristics of the ear nose and throat. The information regarding otitis media is basic and not an appropriate source of research in this situation for three reasons. Number one, the information is very basic, number two, it does not give any up to date information on how to treat this type of infection, and number three there is too much non-relevant information.McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. This article is a review of the known etiologies that may cause acute otitis media. The article gives up to date information on therapeutic approaches when selecting an appropriate antibiotic therapy. We don’t practice â€Å"cookie cutter† medicine. The same prescription is not always right for all patients or all communities where some bacteria’s may be more prevalent than others (McCracken, 1998). This is appropriate information f or this group of people or community. media, P. o. (n. d. ).Interviews. (C. nurses, Interviewer) This set of interviews is simply raw data. General information can however provide great insight as to what is happening out in the community. For example, this information might shed light on the fact that if the parents are willing to hold off on antibiotics for example, would they be more likely to follow up and come back into the clinic when asked? The reaction of parents is dependent upon other several basic factors like finances, a belief system and possibly the ability to obtain transportation. Knowing how the community is going to respond to their choice may have a great effect on the decisions they make.When evaluating the findings of these sources cumulatively, one must first determine the causative pathogens infecting patients in this given community with acute otitis media. After pathogen determination we can determine which antibiotics may be most useful in eradicating the g iven bacteria. Careful selection of antibiotic therapy will reduce the propensity for antibiotic resistance. Watchful waiting may be a good thing from the perspective of increasing microbial resistance however we must always evaluate patients on their individual needs or on a patient by patient case. One size doesn’t always fit all. Patient education is the key to keeping the public informed of current practice.Physicians and Nurses need to be consistent in the lesson plan shared with patients and remain true to our scope of practice. Communication is essential between the physician, nurse and other multidisciplinary team members in order to provide the best care. There are many considerations in assessing if patients are able to withstand the waiting and evaluation period. Low income families are one example of how the waiting and watching method might not work. Parents may have to take time off work to come to clinic with a sick child. They might struggle finding money for the additional return trip to the clinic and may risk losing their job if they take more time off work.Many low income families may have already waited before seeking help thus creating their own watchful waiting period. They also may not be able to afford antibiotics and as a result may not give the full dose if symptoms have subsided. The perception is that they will save the medication for the next time symptoms arise. Confidentiality might be an issue in smaller communities. People tend to be concerned about neighbors and co-workers and some may not care to share their experience with others. This may be an issue for parents who don’t share custody as in the case of divorce. It is a greater issue when parents or partners don’t share the same fundamental values, especially those related to healthcare. Conclusion:Watchful waiting like the nurses in this clinic are looking at may be useful for some of the patients, but not all. Again, a one size fits all philosophy is not always appropriate in healthcare. Tools like algorithms may be helpful in determining the appropriateness for watching and waiting versus immediate action as determined by physical findings and social circumstances like parental adherence for follow up and ability to afford treatment. Whatever course you choose, watchful waiting or immediate antibiotics the best practice remains a plan of care based on the individual needs of our patients. References Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media.The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. media, P. o. (n. d. ). Interviews. (C. nurses, Interviewer) PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lan g. Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 113 No 5 1451-1465.

Task Two Cathy Ann Wilson-Bates Western Governors

Task Two Cathy Ann Wilson-Bates Western Governors University EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH EBP 1 Brenda Luther, PhD, RN January 25, 2012 Task Two Introduction: What I have learned about working with children in a chronic healthcare setting like dialysis is that they are resilient beings with the propensity for rapid changes in their medical condition. Children almost always surprise me in their unique description of symptoms and pain. Depending on their age, they may not be able to describe the symptoms they feel or tell me â€Å"where it hurts†.A simple ear ache may be described as a â€Å"drum in my ear† or may be observed with non verbal cues like tugging on the ear. Acute Otitis Media is seen quite often during the cold and flu season. Recent clinical guidelines suggest waiting twenty four to seventy two hours before beginning antibiotic therapy. Parents of children with symptoms of otitis media are accustomed to receiving a prescription for ant ibiotics before they leave the medical office. Adults as well are preconditioned for the little white slip of paper from their physician. You can read also Coronary Artery Disease Nursing Care PlanWaiting twenty four to seventy two hours to evaluate the need for antibiotics will definitely reduce the over-prescription of antibiotics as well as their efficacy. The waiting and watching of several days may seem like an eternity to a parent caring for a sick and crying child. Educating parents during routine visits to the physician office about the risks of over-prescribing antibiotics will help when the physician needs to discuss the possibility of waiting and evaluating before prescribing antibiotics.Providing a list of comfort measures parents can follow may help relieve the anxiety they have in caring for a sick child. Any comfort measure taken to reduce crying is helpful to the parent of a sick child, but mostly to the child. The following table and paragraphs will share the results of how one group of nurses at an outpatient clinic used clinical evidence to manage this situation. Source |Type of Resource |Source appr opriate or |Type of Research | | |general information, |inappropriate |primary research evidence, | | |filtered, or unfiltered | |evidence summary, evidence-based | | | | |guideline, or none of these | |American Academy of Pediatrics and American Academy of|Filtered |Appropriate |Evidence-based guideline | |Family Physicians. Clinical practice guideline: | | | | |Diagnosis and management of acute otitis media. | | | |Causative pathogens, antibiotic resistance and |Unfiltered |Appropriate |Evidence-based guideline | |therapeutic considerations in acute otitis media. | | | | |Pediatric Infectious Disease Journal. | | | | |Ear, nose, and Throat, Current pediatric diagnosis and|General |Inappropriate |None of these | |treatment. | | | | |Treatment of acute otitis media in an era of |Filtered |Appropriate |Evidence –based guideline | |increasing microbial resistance.Pediatric Infectious| | | | |Disease Journal | | | | |Results from interviews with parents who have brought |Unfilte red |Appropriate |Primary research evidence | |their children into the clinic for acute otitis media. | | | | | | | | | Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 13 No 5 1451-1465. This article is an evidence-based clinical guideline. It is a systematic review making it a filtered resource which is very appropriate for this situation. The article describes the current, (as of 2004) recommendations for the diagnosis and management of Acute Otitis Media (Subcommittee on Management of Acute Otitis Media, 2004). These guidelines show several different ways to treat acute otitis media depending on the symptoms of the child. It states that sometimes waiting to give antibiotics is good and sometimes waiting to give antibiotics is not good. This article is appropriate and provides clarity on the topic. Block, S. L. (1997).Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. This article discusses antibiotic resistance and describes the bacterial pathogens which are responsible for infections causing acute otitis media. This article is appropriate. It contains a comparison of studies performed based on the different types of bacteria which cause acute otitis media. It stresses the importance of identifying the bacteria causing the infection before giving antibiotics so that number one the bacteria can be eradicated and other bacteria will not become resistant (Block, 1997).PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lang. This textbook source contains general information on the ear, nose and throat. There is much more information here regarding basic anatomy and physiology as well as characteristics of the ear nose and throat. The information regarding otitis media is basic and not an appropriate source of research in this situation for three reasons. Number one, the information is very basic, number two, it does not give any up to date information on how to treat this type of infection, and number three there is too much non-relevant information.McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. This article is a review of the known etiologies that may cause acute otitis media. The article gives up to date information on therapeutic approaches when selecting an appropriate antibiotic therapy. We don’t practice â€Å"cookie cutter† medicine. The same prescription is not always right for all patients or all communities where some bacteria’s may be more prevalent than others (McCracken, 1998). This is appropriate information f or this group of people or community. media, P. o. (n. d. ).Interviews. (C. nurses, Interviewer) This set of interviews is simply raw data. General information can however provide great insight as to what is happening out in the community. For example, this information might shed light on the fact that if the parents are willing to hold off on antibiotics for example, would they be more likely to follow up and come back into the clinic when asked? The reaction of parents is dependent upon other several basic factors like finances, a belief system and possibly the ability to obtain transportation. Knowing how the community is going to respond to their choice may have a great effect on the decisions they make.When evaluating the findings of these sources cumulatively, one must first determine the causative pathogens infecting patients in this given community with acute otitis media. After pathogen determination we can determine which antibiotics may be most useful in eradicating the g iven bacteria. Careful selection of antibiotic therapy will reduce the propensity for antibiotic resistance. Watchful waiting may be a good thing from the perspective of increasing microbial resistance however we must always evaluate patients on their individual needs or on a patient by patient case. One size doesn’t always fit all. Patient education is the key to keeping the public informed of current practice.Physicians and Nurses need to be consistent in the lesson plan shared with patients and remain true to our scope of practice. Communication is essential between the physician, nurse and other multidisciplinary team members in order to provide the best care. There are many considerations in assessing if patients are able to withstand the waiting and evaluation period. Low income families are one example of how the waiting and watching method might not work. Parents may have to take time off work to come to clinic with a sick child. They might struggle finding money for the additional return trip to the clinic and may risk losing their job if they take more time off work.Many low income families may have already waited before seeking help thus creating their own watchful waiting period. They also may not be able to afford antibiotics and as a result may not give the full dose if symptoms have subsided. The perception is that they will save the medication for the next time symptoms arise. Confidentiality might be an issue in smaller communities. People tend to be concerned about neighbors and co-workers and some may not care to share their experience with others. This may be an issue for parents who don’t share custody as in the case of divorce. It is a greater issue when parents or partners don’t share the same fundamental values, especially those related to healthcare. Conclusion:Watchful waiting like the nurses in this clinic are looking at may be useful for some of the patients, but not all. Again, a one size fits all philosophy is not always appropriate in healthcare. Tools like algorithms may be helpful in determining the appropriateness for watching and waiting versus immediate action as determined by physical findings and social circumstances like parental adherence for follow up and ability to afford treatment. Whatever course you choose, watchful waiting or immediate antibiotics the best practice remains a plan of care based on the individual needs of our patients. References Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media.The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. media, P. o. (n. d. ). Interviews. (C. nurses, Interviewer) PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lan g. Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 113 No 5 1451-1465.

Analysis Of Robert Frost s Poem A Late Walk - 971 Words

The last days of each earthly season makes an impression on the conscious that has been pondered since the beginning of human evolution. Each season that passes represents change, new beginnings, and a better understanding of what was and will be. The poetry of Robert Frost particularly uses themes of nature, seasons, nostalgia and remembrance as means to reflect on the past and their implications on the future. â€Å"A Late Walk,† a poem inspired by his time on his farm during the turn of the 19th century, is one of many that show his melancholy affection for change. In this poem, Frost uses simple natural imaginary, written in quatrains and 3/4 beat line alterations, to take the reader on a stroll with a farmer as he returns home from the final days in the crop fields in the last days of fall and the associated nostalgia of every step. In the opening stanza, frost describes the narrator, a farmer, walking through the mowing fields back home. The phrase â€Å"The headless aftermath† produces imagery that connotes warfare, however, frost is portraying a field that has been recently harvested and the straw has been bailed (2). It is as if the farmer is a warrior that has battled the field all fall and now stands triumphant over his defeated enemies, now headless and still. Many have argued that Frost is supporting violence with this phrasing, however it is simply an observation the Narrator is making. Frost uses first person perspective to bring the reader along through the field thatShow MoreRelatedRobert Frost : A New England Poet3698 Words   |  15 PagesRobert Lee Frost Known for being a New England poet Robert Frost was born in San Francisco, California on March 26th, 1874. Born to a New England father William Prescott Frost Jr. and a Scottish mother Isabelle Moodie who moved to the west coast from Pennsylvania after marriage (Bailey). Both his parents were teachers and poets themselves, but his father later became a journalist with the San Francisco Evening Bulletin (Bailey). Frost spent 12 years of his life growing up in San Francisco, untilRead MoreLiterature and South Africa6682 Words   |  27 Pagesan autonomously functioning semiotic system. In this essay, the poem Mending Wall by Robert Frost is going to be used to describe how meaning are produced by codes, by recoding and overcoding according to Lotman’s semiotic theory. It is necessary to define codes and the process of interpretation before one delves in the semiotic analysis of the poem Mending Wall. As defined by Structuralist, literary codes that matter in our analysis per se are the literary signs, their overdetermination that amountRead MoreLiterature and South Africa6676 Words   |  27 Pagesan autonomously functioning semiotic system. In this essay, the poem Mending Wall by Robert Frost is going to be used to describe how meaning are produced by codes, by recoding and overcoding according to Lotman’s semiotic theory. It is necessary to define codes and the process of interpretation before one delves in the semiotic analysis of the poem Mending Wall. As defined by Structuralist, literary codes that matter in our analysis per se are the literary signs, their overdetermination that amountRead MoreLanguage of Advertising20371 Words   |  82 Pagesstylistic features. The eighth chapter introduces the role of parentheses insertion as additional information. Very important advertising text in sociolinguistic coverage and phonetic expressive means and stylistic devices in the ninth chapter (Galperin`s stylistic devices, the definitions of stylistic devices with examples). In the chapter of tenth we consider classification of language styles (Belles-Letters Style, Pablicist Style, Newspaper Style, Scientific Prose Style). And finally in the chapterRead MoreOrganisational Theory230255 Words   |  922 Pagesmanaging, organizing and reflecting on both formal and informal structures, and in this respect y ou will find this book timely, interesting and valuable. Peter Holdt Christensen, Associate Professor, Copenhagen Business School, Denmark McAuley et al.’s book is thought-provoking, witty and highly relevant for understanding contemporary organizational dilemmas. The book engages in an imaginative way with a wealth of organizational concepts and theories as well as provides insightful examples from theRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pagesand permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. To obtain permission(s) to use material from this work, please submit a written request to Pearson Education, Inc., Permissions Department, One Lake Street, Upper Saddle River, New Jersey 07458, or you may fa x your request to 201-236-3290. Many of the designations by manufacturersRead MoreLogical Reasoning189930 Words   |  760 PagesNorman Swartz, Simon Fraser University v Acknowledgments For the 1993 edition: The following friends and colleagues deserve thanks for their help and encouragement with this project: Clifford Anderson, Hellan Roth Dowden, Louise Dowden, Robert Foreman, Richard Gould, Kenneth King, Marjorie Lee, Elizabeth Perry, Heidi Wackerli, Perry Weddle, Tiffany Whetstone, and the following reviewers: David Adams, California State Polytechnic University; Stanley Baronett, Jr., University of Nevada-Las