The use of Critical Reflection in Nursing Practice

The use of Critical Reflection in Nursing Practice Nursing practice is a complicated phenomenon, and usually something which has many dimensions. Nurses can develop better understanding of the ways in which they practice, the influences on their practice, and of their responses to challenging situations, through reflection on that practice, and, specifically, reflection on critical incidents. The use of reflection in nursing practice has been established as an important learning and development tool. Not only has it been described as an effective means of engaging in professional and personal development through self-assessment and self-evaluation (Gustafsson and Fagerberg, 2004 p 271), it is also known to be a way of looking at the quality of practice, and questioning how things are done (Bowden, 2003 p 28; Coutts- Jarman, 1993 p 77). Nurses usually use reflective models to guide their practice, as placing a structure on this process makes it more purposeful (Gibbs, 1988, online; Rolfe, 2005 p 78; Jones, 1995 p 783). Price (2004 p 4 6) also argues that reflection is a patient-centered activity, and one that is linked to the development of critical thinking. The NMC (2004 b), the professional body that governs nursing practice and sets the standards for nurses, states that nurses should: Act to ensure the rights of individuals and groups are not compromised; manage risk to provide care which best meet the needs and interests of patients, clients and the public; review and evaluate care with members of the health and social care team, and others; share experiences with colleagues and patients and clients in order to identify the additional knowledge and skills needed to manage unfamiliar or professionally challenging situations; contribute to the learning experiences and development of others by facilitating the mutual sharing of knowledge and experience. This assignment shows how the author has attempted to adhere to these guidelines through this process of reflection. WHAT The author witnessed a member of staff putting medication in the food of a confused and sometimes aggressive patient who regularly refuses their medication. The member of staff was crushing tablets and putting them into the patients food. This patient, an elderly and confused person, is someone dependent upon nursing staff for support with all of their activities of daily living (Farley et al, 2006 p 46). They are difficult to communicate with and it is not possible to get informed consent or true compliance from them. However, the medications were necessary to maintain their state of health, address their mental condition and prevent exacerbations of chronic conditions (such as hypertension). The author was moved to question this practice, and asked the nurse about this, but the reply was rather defensive. It seemed that they believed this was the only way to administer the medications and that it was for the patients own good. SO WHAT To begin with, the author felt that it was important to question this occurrence, because they found it ethically challenging. While the author understood the need to ensure the patient had had their medication, this occurrence challenged previously acquired understanding of informed consent and respecting the rights and dignity of the patient (NMC, 2004a, online). Acting in the best interests of the patient, however, is another requirement of nurses, and in this case, it was easy to see that they did need the medication and that it would help their subjective feelings of wellness to some extent. However, the author would also question how far this would improve their state of being, because with their cognitive impairment, they might not be able to recognize the difference between subjective measures of sense of wellbeing. The main issues in this scenario revolve around the competence of the patient and their ability to give consent (Hedgecoe 2008). The issue of consent is central to nursing practice, particularly in relation to ensuring the patient care is client-centred (DoH, 2001, online; NMC, 2004a, online). The autonomy and dignity of the client is at stake when one considers providing or enforcing care without consent (DoH, 2001, online). Veitch (2002) offers an authoritative overview of the practical issues involved in consent and advises that it is the dividing line between treatment and assault. (Veitch 2002 Pg 11). This is a very important issue to consider, because, as already discussed, the NMC (2008, online) requires nurses to only act in the best interests of their patients. That means being proactive, providing information to the patient, and communicating with them as best they can, even when there are communication difficulties. Veitch (2002) also goes on to comment that Consent is not just the signing of a document prior to undergoing a procedure, it is a hugely complex area with legal, ethical and practical components and all of these are brought into sharp focus when they are compounded by degrees of reduction in cognitive function (Veitch 2002 Pg 22). The problem here is that the patient, who is suffering from vascular dementia, cannot really be considered fully competent to make decisions about their care. They are cognitively impaired, and in need of significant care, surveillance, assistance and input in order to maintain basic levels of health and functioning. As such, this issue highlights the plight of such individuals, because they are occupying a cognitive world which is disconnected from reality, and within which they are unable to reason or understand what is being asked of them (Bowler, 2007). However, in this case, the scenario is taken to be in a residential care home. This means that one could reasonably assume therefore that the patient is not severely cognitively impaired and may suffer from fluctuating degrees of impairment (Bowler 2007). To this extent, the situation may be helped by considering whether they were happy to take the medication when they were less confused. If the patient is normally happy to take their medication when they were cognitively aware, the legal considerations become easier as Lord Donaldson has stated, in legal statute, that if a patient is judged not to be competent then the healthcare professionals who are responsible for their care are also responsible for making a decision that they believe is in the patients best interests and in line with a decision that they believe the patient would have made if they were competent to make it at the time. (Donaldson 1993). It would appear, therefore, that perhaps the actions of the nurse in placing the medication covertly in the patients food is excessive, and may be motivated by expedience and convenience rather than the best interest of the patient. It might be that, as may be the case in many circumstances, preconceptions about patients, and even stereotyping and prejudice, could be affecting actions here, because despite the egalitarian nature of the nursing profession, there appears to be ongoing ageism in clinical practice (DoH, 2001, online). According to the Department of Health in the National Service Framework for Older People (DoH, online), older people are often subject to preconceptions and prejudice because of ageism, and this ageism can be quite subtle, and pervasive in our modern society. Even those who deal extensively in the elderly may be prejudiced towards them, or have some degree of innate ageism (Gunderson et al, 2005 p 167). With the ongoing focus on patient-centeredness (DoH, 2 001, online) and on ensuring patient safety through the highest standards of care (DoH, 2004, online), this author would argue that actions which occur as a result of prejudicial preconceptions are quite likely to place patients at more risk. In this situation, the nurse may possess such preconceptions but be unaware of them, but this action could place the patient at risk. If someone else came along and asked the patient if they had had their medication (obviously in a more lucid moment), the patient would say no, because they would be unaware that this had occurred. Therefore, the patient could be overdosed because a second dose might be given. The ethical considerations that arise from this particular scenario are not the same as the legal ones, although there are large areas of both overlap and concordance of views (Lo, 2005). Hippocrates has been cited as stating that one should first do no harm. (viz Carrick 2000). This is the basis of the Hippocratic Oath which is taken by all doctors in the UK, and also the basis of fundamental principles of healthcare and professional practice. This is effectively translated into the Principle of Non-maleficence which means that the healthcare professionals must ensure that the patient is not harmed. An aggressive and confused patient may well be in danger of harming themselves and suitable treatment can be considered as justified in this context (van Uffelen, Chinapaw, van Mechelen et al. 2008), but it is questionable how much harm would occur due to this refusal to take the medication. The author would question whether it would not be more appropriate to allow the patient time to return to a more lucid state and then give consent for the medication, complying with their care themselves. This would respect their autonomy, and would also mean that the care given was not entirely bound by routines within the residential home, and would mean a patient-centred approach (DoH, 2001, online). The Principle of Beneficence can also be considered here, and it should be noted that this Principle is coloured by the circumstances of the event being considered. One could argue that the use of medication to ease the patients apparent distress is doing good under the terms of this Principle. If the overall aim of nursing practice is to act in the best interests of the patient, then it may be necessary to take such action, and to take responsibility for making such a decision, if it can be fully established that these actions are only done because it is better for the patient. This author would argue that in this situation, if the decision to put the medication in the food is just about expedience, about it being more convenient and manageable for the staff, then this would not be acting within the principle of beneficence. It is important to not just continue with standard or routine practice just because everyone does it. The balance in this situation is between beneficence and m aleficence, and is therefore relating to the motivation of the individual. Is the nurse doing this to avoid having to spend time and energy persuading the patient to take their medication? Or is this simply the best solution because otherwise the patient will not take the medication and will become ill as a result? More details about this would be required to fully understand the ethical challenge here. It would seem that the major problem with hiding medication in food is deception. Although it may be considered a practical expedient, It would not be an appropriate course of action if the patient was rational and competent, so consideration is required as to why it would be considered appropriate just because they are not competent and rational at this time (Wong, Poon, Hui 2007). Therefore, it is appropriate for the author to have questioned this practice, at this time, and to explore the parameters and dimensions of this action (Hargreaves, 2004 p 196). This area of intervention is fraught with difficulty and should not be entered into lightly. If a decision is made by the healthcare professionals to give the medication, it should be recorded in the notes together with the reasons for that decision and it should be given. If the patient will not take tablets then alternative routes of administration should be considered (Welsh and Deah 2007). It is not appropriate to overtly deceive or mislead the patient as doing so contravenes any concept of personal autonomy and dignity (NMC, 2004a, online; NMC, 2008, online). ). However, it may be that this course of action has been agreed with relatives or next of kin who have responsibility for the patient, which clouds the debate somewhat. There appears to be a fine line here between ethical and unethical practice, and therefore, it is important to clearly understand and justify why this course of action was taken. It would also help if nurses could address their own prejudices and potential bias about certain patients, through critical self examination and reflection (Daly, 1998 p 323). This would also help develop critical thinking skills (Daly, 1998 p 323). Nurses could then reflect critically on these kinds of actions to explore if there are not perhaps alternative approaches which could be used, such as providing the medication in a different form, one that is more palatable to the patient. It is not possible to easily define what the right course of action is in these circumstances, but if the nurse adheres to the principles of client centred practice (DoH, 2001, online), it should be easier to evaluate the motivations for these actions and therefore understand the ethical impact of this situation. However, it wo uld also be important to consider the theoretical basis for this, and for nurses in this particular care environment to discuss this practice and come to some consensus relating to the ethical issues and the ethical principles which arise from this kind of situation. NOW WHAT As part of this reflection the author will now try to draw together conclusions about the scenario described and discussed above, evaluating it as a whole. Having reflected on this scenario, it is apparent to the author that there is a lot to be learned from the situation. To begin with, it highlights how complex even simple nursing actions can be, particularly when they address ethical issues. The primary ethical issue in this scenario relates to the autonomy and capacity of the patient, and the motivation for the actions of the nurse involved. Autonomy is a key ethical principle, and respecting the rights and the individuality of the patient is central to professional nursing practice. Patient-centered practice is an ideal, but it should be a fundamental principle and in such a scenario, using patient-centeredness as a benchmark for evaluating care could be a useful way of analyzing whether nursing actions are ethical or not. In this scenario, the author would argue that the nurse should have taken more time with this particular patient, and should perhaps have considered how to provide the medication safely without challenging her autonomy quite so much. It is obvious that deception is a concept and practice that is incompatible with the fundamental principles of nursing and health care. This author has learned from this that covert actions are inacceptable, and if this situation were to arise again, they would feel empowered to challenge it, and to take action, to turn the focus back onto the rights of the patient. It is also important to consider the balance between the factors surrounding what constitutes the best interests of the patient. There will always be an ongoing negotiation, in situations when the patient is not fully competent, but if the nurse adheres to ethical principles, they will provide patient-centered care and this must, ultimately, meet the individual needs of the patient. This process of reflection has been a significant learning journey for the author, because it has broadened and deepened their understanding and insight into ethical challenges they face in their daily work and practice. Reflection, guided by a constructive model, has helped the author to analyze and evaluate this situation, and to explore the parameters of the ethics and philosophies which apply to it. The author has found that carrying out this reflection has not only enhanced their understanding of this situation, and of the complexities of the ethical questions raised by it, but also enhanced their critical thinking skills. Ethical decision making in nursing appears to be something that is hard to pin down, as ethical questions often leave a degree of confusion about the right and the wrong thing to do. Such is the case here, but the author has learned that there is literature to inform the nurse about the rights and wrongs of the more ambiguous ethical dilemmas, and that using such information can aid understanding and improve future practice.

Abi Abdulkalam Essay

Political views In his book India 2020, Abdul Kalam strongly advocates an action plan to develop India into a knowledge superpower and a developed nation by the year 2020. He regards his work on India’snuclear weapons program as a way to assert India’s place as a future superpower. It has been reported that there is a considerable demand in South Korea for translated versions of books authored by him.[8] Kalam continues to take an active interest in other developments in the field of science and technology. He has proposed a research program for developing bio-implants. He is a supporter of Open source software over proprietary solutions and believes that the use of open source software on a large scale will bring the benefits of information technology to more people. Aerospace engineer After graduating in Physics from St. Joseph’s College, Tiruchirapalli, Abdul Kalam graduated with a diploma in Aeronautical Engineering in the mid-1950s from the Madras Institute of Technology.[10] As the Project Director, he was heavily involved in the development of India’s first indigenous Satellite Launch Vehicle (SLV-III). As Chief Executive of the Integrated Guided Missile Development Program (I.G.M.D.P), he played a major part in developing many missiles in India including Agni and Prithvi although the entire project has been criticised for being overrun and mismanaged.[11]. He was the Chief Scientific Adviser to the Prime Minister and the Secretary of Defence Research and Development Organisation from July 1992 to December 1999. Pokhran-II nuclear tests were conducted during this period and have been associated with Kalam although he was not directly involved with the nuclear program at the time. See more: Distinguish between problem-focused coping and emotion-focused coping Essay Awards and honors On April 29, 2009, he became the first Asian to be bestowed with the Hoover Medal, America’s top engineering prize, for his outstanding contribution to public service. The citation said that he was being recognised for: * making state-of-the-art healthcare available to the common man at affordable prices; * bringing quality medical care to rural areas by establishing a link between doctors and technocrats; * using spin-offs of defense technology to create state-of-the-art medical equipment; and * launching tele-medicine projects connecting remote rural-based hospitals to the super-specialty hospitals. It added that he was an eminent scientist, a gifted engineer, a visionary, and a humanitarian.[12] On 13 September 2009, he was awarded the International von Kà ¡rmà ¡n Wings Award.[13] The Government of India has honored him with some of the country’s highest civilian awards: * Padma Bhushan in 1981 * Padma Vibhushan in 1990 * Bharat Ratna in 1997 for his work with the ISRO and DRDO and his role as a scientific advisor to the Indian government. Kalam was the third President of India to be honored with a Bharat Ratna before being elected to the highest office, the other two beingSarvepalli Radhakrishnan and Zakir Hussain. He is also the first scientist and first bachelor to occupy the Rashtrapati Bhavan. After his tenure as the President he is now a visiting professor at J.S.S. University, Mysore. He has agreed to deliver a minimum of four lectures every year. Books and documentaries Kalam’s writings * Wings of Fire: An Autobiography of APJ Abdul Kalam by A.P.J Abdul Kalam, Arun Tiwari; by K. Bhushan, G. Katyal; A.P.j. Pub. Corp, 2002. * Scientist to President by Abdul A.P.J. Kalam; Gyan Publishing House, 2003. * Ignited Minds: Unleashing the Power Within India by A.P.J. Abdul Kalam; Penguin Books, 2003. * India 2020: A Vision for the New Millennium by A.P.J. Abdul Kalam, Y.S. Rajan; Penguin Books India, 2003. * India-my-dream by A.P.J. Abdul Kalam; Excel Books, 2004. * Envisioning an Empowered Nation: Technology for Societal Transformation by A.P.J. Abdul Kalam; TATA McGraw-Hill Publishing Company Ltd, 2004. * Guiding Souls: Dialogues on the Purpose of Life by A.P.J. Abdul Kalam, Arun K Tiwari; Ocean Books, 2005. * Children Ask Kalam by A.P.J. Abdul Kalam; Pearson Education, ISBN 81-7758-245-3 * Indomitable Spirit by A.P.J. Abdul Kalam, 2006 * The Scientific Indian: A Twenty-first Century Guide to the World around Us by APJ Abdul Kalam and YS Rajan Biographies * Eternal Quest: Life and Times of Dr. Avul Pakir Jainulabdeen Abdul Kalam by S. Chandra; Pentagon Publishers, 2002. * President A.P.J. Abdul Kalam by R. K. Pruthi; Anmol Publications, 2002. * A. P. J. Abdul Kalam: The Visionary of India by K. Bhushan, G. Katyal; A.P.H. Pub. Corp, 2002. * A Little Dream (documentary film) by P. Dhanapal; Minveli Media Works Private Limited, 2008.[14] * The Kalam Effect: My Years with the President by P.M. Nair; Harper Collins, 2008. * My Days With Mahatma Abdul Kalam by Fr.A.K. George; ISBN No:978-8190452953; Publisher: Novel Corporation, 2009. References 1. ^ A Brief Biography of Dr. A. P. J. Abdul Kalam 2. ^ â€Å"Former presidents†. Government of India. 3. ^ Bidwai, Praful (23 June 2002). â€Å"‘Missile Man’ as India’s President†. http://original.antiwar.com. Retrieved 27 September 2009. 4. ^ â€Å"Kalam was real people’s President: President’s bodyguards†. Hindustan Times. 2007-07-24. Retrieved 2009-03-27. 5. ^ Perappadan, Bindu Shajan (2007-04-14). â€Å"The people’s President does it again†. The Hindu. Retrieved 2009-03-27. 6. ^ Pruthi, R. K. (2005). â€Å"Ch. 4. Missile Man of India†. President A.P.J. Abdul Kalam. Anmol Publication. pp. 61–76. ISBN 978-8126113446. 7. ^ Sen, Amartya (2003). â€Å"India and the Bomb†. In M. V. Ramana and C. Rammanohar Reddy. Prisoners of the Nuclear Dream. Sangam Book. pp. 167–188. ISBN 978-8125024774. 8. ^ â€Å"Kalam, the author catching on in South Korea†. 9. ^ â€Å"India leader advocates open source†. 10. ^ Missile History 11. ^ â€Å"Missile plan: Some hits, misses†. 12. ^ â€Å"Former President Kalam chosen for Hoover Medal†. Indiatimes (New York). 27 March 2009. Retrieved 30 October 2010. 13. ^ Caltech GALCIT International von Kà ¡rmà ¡n Wings Award 14. ^ â€Å"Documentary on Kalam released†. The Hindu. 2008-01-12. Retrieved 2009-03-27. 15. ^ My Days With Mahatma Abdul Kalam, ISBN 978-8190452953 Retrieved 2010-07-01 Gandhian Missile Man Dr. A.P.J. Abdul Kalam * Achievements Dr. Avul Pakir Jainulabhudin Adbul Kalam, was born on the 15th October, 1931, at Rameshwaram in TamilNadu. He did his B.Sc. at the St. Joseph’s College, Tiruchi, and DMIT in Aeronautical Engineering at the MIT, Madras, during 1954-57. He joined the DRDO in 1958. During 1963-82, he served the ISRO in various capacities. As Project Director, SLV-3, he was responsible for carrying out design, development, qualification and flight testing of 44 major sub systems. In 1982, as Director, DRDO, was entrusted with the Integrated Guided Missile Development Programme. He conceived the programme cnstituting 5 major projects for meeting the requirements of the defence services and for establishing re-entry technology. The development and successful flight test of Prithvi, Trishul, Akash, Nag, and Agni established the indigeneous capability towards self reliance in defence preparedness. The successful launching of ‘Agni’ surface-to-surface missile is a unique achievement which made India a member of an exclusive club of highly developed countries. Thus, through SLV and Guided Missile Programme a solid foundation has been created in the indigeneous testing and development of high technology Aerospace Projects. An Advanced Technology Research Centre, called Research Centre Imarat has also been established by Dr. A.P.J. Abdul Kalam as an extension of DRDL to undertake development in futuristic missile technology areas. He has also established a unique 3 tier management structure to integrate and commit technologists, academic institutions, Industries etc. As a crowing glory to all his achievements, he was appointed Scientific Advisor to Raksha Manthri and Secretary, Dept. of Defence Research and Development. He is a member of Indian National Academy of Sciences, Astronautical Society of India and many other professional bodies. He has published two books. Awards * He has been Awarded with the India’s Highest civilian Award â€Å"The Bharat Ratna† in 1997. * Starting with Anna University’s first D.Sc., Honoris Causa, he has received many such including the one given by IIT, Bombay, BHU and others. * Other prestigious awards include Dr.Biren Roy Space Award, Om Prakash Basin Award for Science and Technology, National Nehru Award, Arya Bhatta Award. * Dr. Abdul kalam, is praised as a welder of people and a Gandhian Missile Man by R.K. Laxman, in his cartoon in â€Å"Times of India.† * As a humanitarian and with his extreme simplicity, easy access, he has become a National Hero. He loves Tamil poetry and is interested in carnatic music. He has himself written poems in Tamil. He adores his Gurus of MIT and cherishes his education and training at MIT.| Return to Home Page Dreams To Ignite Young Minds India has to have vision to become a developed nation. A good dream for our young people is the vision. Can we ignite our young minds? These are the thoughts that frequently ‘fire’ the mind of India’s missile man– this year (1998) Bharat Ratna awardee Dr. A.P.J. Abdul Kalam. In an interview to Science Express, the man who built biting molars and awesome muscles into India’s missile programme outlined the vision he has of India of tomorrow. â€Å"Whenever there is a goal, the dynamics of performance changes, Technology is the economical strength of the nation†, says soft-spoken Kalam. â€Å"India has people of high calibre and intelligence. The only thing required is more facilities in our labs, government funding and good leadership in scientific areas.† After a pause, he fires another missile: â€Å"Most importantly, determined youngsters.† No wonder he advices the youth of the country to â€Å"dream, dream and dream and conver t these into thoughts and later into actions.† Kalam’s advice to the youngsters of the nation is to â€Å"think big† . â€Å"We are a nation of a billion people and we must think like a nation of a billion people. Only then can we become big.† Dr. Kalam’s, Scientific Advisor to the Defence Minister and Secretary, Defence Research and Development is the second scientist to receive the Bharat Ratna, the highest civilian award, after the late Dr. Homi Jehangir Baba. This genius attributes his success to his parents and the team which worked relentlessly to achieve the goal. Science, according to him, is a global phenomenon. He feels there are a few areas where India can develop its core competence. These areas are software engineering, computer products and design, agriculture and food, aviation, defence research and space technology and chemical engineering. â€Å"This will lead to a highly beneficial economic and social progress for the nation,† says Kalam. The man who said, â€Å"Friends, you now have the fire to torch the Agni† turns out to be extremely shy. His love for the Bhagavad Geetha and the long mane almost gives the missile man the halo of a saint. In fact, his views on technology and life make him the copy book saint of science armed with Brahmastras and the power to heal wounds. That is another passion of Kalam-using missiles that maime and kill to give a fresh hope to the disabled. In a U turn, Kalam has not shied in using the technology behind fire-spewing missiles to build artificial limbs and spring-like coils called stents to keep the heart vessels open. He is one of those scientists who aims at putting technology created by him to multiple use. He used the light weight carbon-carbon material designed for Agni to make calipers for the polio affected. This carbon-carbon composite material reduced the weigh t of the calipers to 400 grams (from its original weight of 4kgs.) Nizam’s Institute of Medical Sciences (NIMS, Hyderabad) was the birthplace for the defence technology spin offs from Kalam’s labs via the DRDL (Defence Research and Development Laboratory), DMRL (Defence Metallurgical Research Lab) and the RCI (Research Centre Imarat). â€Å"It was a great experience to see, in the orthopaedic Department of NIMS, how the light weight caliper could bring happiness to the polio affected†, remembers Kalam. Another important event that took place in Hyderabad is the development of the Cardiac stent. Cardiac stents are used during a Balloon Angioplasty. The clogged arteries are opened up using a balloon and stents are inserted to prevent the vessels from collapse. â€Å"The stent developed by us costed much less (he is modest not to say that the cost is less than half) than the ones imported,† explains Kalam. Kalam says there are many more avenues wherein defence technology can be used for a social cause. The technology used for defence imaging systems can be used for medical imagery which is yet another value product, he says. â€Å"We are also working on a cost-effective lighter substitute for the Jaipur foot,† he adds. He is of the opinion that a mission oriented programme should be chalked out where in medical equipments and their maintenance should grow out of indigenous technology, thus making us self reliant. But personally, given a chance would he rather opt to use technology solely for social purposes or continue with his missile programmes? â€Å"If India has to become a developed nation it has to have overall development. That includes the field of medicine, defence technology and everything else,† says Kalam in a matter-of-fact tone. Having rolled out sophisticated missiles at regular intervals, Kalam is now striving to make the reusable missiles dream a reality. Like the space shuttles, the reusable missiles can carry war-heads to a pre-determined target, de liver the fire power and return for another run. The reusable missile’s close ‘cousin’ is Nishant – the Remotely Piloted Vehicle (RPV) or a one-time-use missile that can thumb its nose at even sophisticated radars. Many of Kalam’s pet projects like the Integrated Guided Missile Development Programme (IGMDP) and several other defence ventures under his command, are poised for a quantum leap next year. According to a status report of major ongoing projects of the Defence Research and Development Organisation (DRDO) headed by Kalam, the development of the five indigenous missiles under the IGMDP is progressing as per schedule. â€Å"Agni† missile, the crown of the IGMDP, is being given top priority and DRDO scientists have been able to indigenously produce carbon-carbon composite material which could withstand temperatures upto 3500 degrees celsius during the flight of the missile. UNI quoting Defence Minisry sources said production of 150-Km range â€Å"Prithvi† missile for the Army had already commenced and two flight trials of the 250-Km range, Indian Air Force (IAF) version, â€Å"Prithvi† had also been completed. User trials of the other three missiles under the IG MDP – the 9 Km short range low level quick reaction Trishul for the three services, the 25Km medium range surface to air missile â€Å"Akash† with multiple target handling capability, the third generation 4Km range anti-tank â€Å"Nag† missile – were slated to commence next year. In many ways, the â€Å"Akash† missile is emerging as a key weapon which is being developed by the DRDO as it employs ram rocket propulsion to facilitate carrying of bigger pay loads. ‘Akash’ is the key in the sense that ram rocket technology is also to be employed by India for the futuristic reusable missile systems. As far as the current status of India’s ambitious Light Combat Aircraft (LCA) was concerned, the second LCA was under integration along with the simultaneous development of technology demonstrator TD-1. Several new technologies had been established with regard to the LCA. They included carbon fibre composite structure, control law for unstable aircraft, digital fly-by-wire control system and advanced computing system. The Kaveri engine had been developed and was undergoing evaluation. Its integration with LCA was expected in early 1999. No country can throttle India’s missile programme despite technology denial regimes, believes Kalam. An important aspect of â€Å"the integrated guided missile development programme was identification of critical technologies and their indigenisation as the missile technology control regime was primarily directed at India.† Elaborating on his future plans, the senior most serving defence scientist referred to the Technology Mission 2020 which proposes to change the national status from a developing one to a developed one and involve 500 people from academia, industry and government. He also spoke about working on a 10 year self-reliance programme in defence technologies. Kalam was born into a family of modest means in Rameshwaram, a small town in TamilNadu. It was his father who wanted him to take up science in the college. After graduating from St.Joseph College, Tiruchirapalli, he joined the Madras Institute of Technology (MIT) to specialise in Aeronautical Engg. This was indeed his launching pad for this promising young man who was destined to become the father of Indian missile programme. After a brief stint in the Defence Research and Development Organisation (DRDO), he joined the Indian Space Research organisation (ISRO) in 1963. While at the Vikram Sarabhai Space Centre, he developed the Satellite Launch Vehicle (SLV-3) which put the Rohini Satellite into orbit. He later re-entered DRDO at the Defence Research and Development Laboratory (DRDL), Hyderabad, as the director and this is where most of the research and development of his missile programmes were conceived and created. In his hour of glory, the missile man remembered his parents, co-workers especially at the Vikram Sarabhai Space Centre, Thiruvananthapuram and a Hyderabad-based defence research laboratory, besides teachers who collectively contributed in various ways towards this achievement.

Waves On Pregnant Women Health And Social Care Essay

Waves have been applied to many of import processs presents. In this article I am traveling to look into the application of moving ridges on pregnant adult females. One of the really of import subjects is the application of echography in antenatal medical examination ; therefore I would concentrate on this subject and discourse its rule and advantages among other different methods of antenatal medical examination. However moving ridges do non merely conveying benefits to pregnant adult females, but besides injury. There are some electromagnetic moving ridges ( or EM moving ridges ) which may be harmful to both the female parents and the foetuss, such as X ray. Yet, will pregnant adult females truly have an increased hazard of abortion after holding an X-ray? Recently there are besides concerns about the consequence of wireless moving ridges and microwaves on gestation. In this article I am traveling to look into them one by one. Obstetric Ultrasonography Ultrasonography refers to the usage of ultrasound. Ultrasound is longitudinal moving ridge, it has the same velocity as hearable sound moving ridge in air, which is 340ms-1. The chief difference between hearable sound moving ridge and ultrasound is that ultrasound has a frequence beyond hearable scope of homo, which is around 20 Hertz ( 20 Hz ) to 20 kHzs ( 20 kilohertz or 20,000 Hz ) . Normally the frequence of ultrasound used in antenatal medical examination is ranged from 1.6 to 10 MHz ( MHz ) , depending on what constructions of the foetuss are being examined. Ultrasound with lower frequence can perforate deeper into organic structure tissues, because the higher the frequence, the more supersonic moving ridges are being absorbed alternatively of reflected, therefore while analyzing deeper tissues like the liver and kidney, ultrasound with lower frequence ( around 1.6-6MHz ) is used. In the echography, ultrasound moving ridges are emitted by a device called transducer. Actually the term transducer refers to a device which converts one signifier of energy into another, so there are tonss of types of transducer. In the echography, an electroacoustic transducer is used to change over electricity to breathe and have ultrasound ; therefore to be more exact, the device used is besides called an ultrasound transceiver. The transducer is placed on the venters of the pregnant adult female, the ultrasound emitted penetrates the tegument and so reaches the fetus and other internal variety meats of the female parent. The moving ridges are so reflected back to the transceiver, the transceiver senses the moving ridges and converts them into images. An ultrasound transceiver: hypertext transfer protocol: //l.b5z.net/i/u/6062479/i/transducer_tn.jpg beginning: hypertext transfer protocol: //www.chesapeakeultrasound.com/ultrasound_products An echography: hypertext transfer protocol: //gulfcoastmri.files.wordpress.com/2010/06/sonogram-human-foetal-fetal-ultrasound-scan-at-22-weeks-mono-1-anon.jpg Beginning: hypertext transfer protocol: //gulfcoastmri.wordpress.com/2010/06/07/obstetric-ultrasonography/ In instance that the pregnant adult female is in early gestation or corpulent, she can undergo transvaginal echography, which a investigation is placed in the adult female ‘s vagina. Sometimes the trial is besides carried out if the pregnant adult female has got unnatural vaginal hemorrhage or pelvic hurting. This type of echography has the similar rule as the echography mentioned above. Some female parents may desire to see the pulse of their babes, they can transport out the Doppler echography. It has fundamentally the same rule as the echography except the ultrasound is farther enhanced by Doppler Effect. Generally the foetus ‘s pulse can be detected after 7 hebdomads of gestation, therefore the blood flow of the foetus can be detected every bit good. The blood flows in a circulation in the organic structure of the foetus, the Doppler echography can therefore observe the alteration in waies of blood flow by Doppler consequence and see if the circulation is normal or no n. This can be done by mensurating the alteration in the frequence received in the transceiver. In fact there are a few more types of prenatal medical examination, such as amniocentesis and chronic villus trying. However, the echography is the safest manner for diagnosing. The echography merely involves a transducer puting outside the female parent ‘s venters, while amniocentesis and chronic villus trying necessitate mechanical incursion and trying inside the female parent ‘s womb or venters, this increases the hazard of abortion during the trials. Despite this fact, echography can merely give an early diagnosing of the female parents and foetuss, it can non handle anomalousnesss or familial diseases. Harmonizing to the trial conducted by RADIUS survey group in 1993, research workers found that obtaining echography has no significantly negative consequence on cut downing perinatal morbidity or mortality among the foetuss or the female parents. Furthermore, the sensing of anomalousnesss really did non change the result of newborn babes. Therefore it is of import to a dmit that echography is merely a trial whether the foetuss are healthy, but non a intervention to anomalousnesss. Harmful consequence of X ray X ray is an electromagnetic moving ridge with a wavelength ranged from 0.01 to 10 nanometres ( 0.01-10 x10-9m ) . It has a velocity of 3Ãâ€"108 ms-1 in vacuity. In fact, X ray is normally used in medical interventions, such as radiation therapy of malignant neoplastic disease and medical imagination engineering. X ray is produced in an X-ray tubing. In the X-ray tubing, negatrons are accelerated by using a high electromotive force. Electrons so collide with a metal, and the sudden slowing of negatrons consequences in the emanation of X ray. An X-ray tubing: hypertext transfer protocol: //hyperphysics.phy-astr.gsu.edu/hbase/quantum/imgqua/xtube.gif Beginning: hypertext transfer protocol: //hyperphysics.phy-astr.gsu.edu/hbase/quantum/xtube.html X ray has high ionising power, therefore there are many people worrying about the harmful effects of holding an X-ray diagnosing, particularly pregnant adult females. It is true that a really high dosage of radiation from X ray may ensue in radiation illness. Prolonged and uninterrupted exposure to X-ray besides increases the hazard of malignant neoplastic disease development, and in pregnant adult females, there may besides be a hazard for the foetus to develop childhood malignant neoplastic disease or even abortion. However, it seems that the harmful effects of exposing to X ray are exaggerated. The serious harmful effects mentioned above are merely the consequences of high dose in a short period of clip. There are different sorts of X raies, one type is used in scanning or diagnosing, one type is used in handling malignant neoplastic disease. The energy stored in different types of X raies is different. For normal X-ray scanning, the dose is highly little. The captive dosage of X ray is measured in rad, which 1 rad = 10Ãâ€"10-3 J kg-1 = 10-2 J kg-1. If a pregnant adult female is holding a chest X ray, the estimated fetal dosage is about 60 millirads, the dosage is about 290 millirads for an abdominal X ray. This is rather a low value, as the dosage from the radiation from outer infinite is around 90-100 millirads. In fact, the hazard of the foetus holding oculus abnormalcies or mental deceleration additions merely when the dose exceeds 10 rads, therefore it is really rare that pregnant adult females suffer from harmful effects by the X-ray radiation. Harmonizing to the American Academy of Family Physicians, by and large X raies are safe even for pregnant adult females, and harmonizi ng to radiotherapists, no individual diagnostic X ray has a radiation dosage important plenty to do inauspicious effects in a underdeveloped embryo or foetus. Normally physicians will non inquire pregnant adult females to undergo an X-ray scanning, unless when it is pressing and necessary. It is besides suggested that pregnant adult females should state the radiotherapists about the gestation, so that radiotherapists can set the radiation degree to better protect the female parents and the foetuss. To reason, many people are afraid of holding X-ray scanning when they are pregnant, but in fact the hazard is non that high if we compare the dose to the exposure to outer infinite radiation. An X-ray movie demoing gestation: hypertext transfer protocol: //www.neurobodyfit.com/wp-content/uploads/2012/03/xray-pregnancy.jpg Beginning: hypertext transfer protocol: //www.neurobodyfit.com/x-rays-are-safe-during-pregnancy/ Concerns of wireless moving ridges and microwaves Besides X-ray, some people are refering about the consequence of wireless moving ridges and microwaves on gestation. In fact the consequence of these two types of EM moving ridges is even less than X ray. There has been a survey look intoing the relationship between exposure of wireless moving ridges and microwaves of female physical therapists, and the ratio of abortion. Due to occupational usage, physical therapists are really frequently exposed to medical equipment breathing microwaves diathermy and wireless moving ridges. Harmonizing to the survey, research workers compared the uneven ratios between those pregnant physical therapists and other pregnant adult females. The consequences showed that the hazard of abortion was non associated with reported usage of diathermy equipment, therefore people need non worry excessively much about this issue. A microwave diathermy: hypertext transfer protocol: //image.ec21.com/image/medicm/oimg_GC04993002_CA04993086/Microwave_Diathermy_HM-801C.jpg Beginning: hypertext transfer protocol: //medicm.en.ec21.com/Microwave_Diathermy_HM_801C — 4993002_4993086.html Decision Waves have been widely used in medical equipment, and there are several applications of moving ridges on gestation. Ultrasonography is the most common and the safest method of antenatal medical examination. Though it can be used in diagnosing, it is unable to handle diseases in foetus. Many people concern about the side effects of utilizing X-ray, microwaves and wireless moving ridges, nevertheless it is in fact really safe because the dose of radiation is highly little. Therefore people need non worry excessively much about the hazard of abortion caused by exposure to these moving ridges.

Amy Tans novel The Joy Luck Club - Free Essay Example

Sample details Pages: 5 Words: 1550 Downloads: 5 Date added: 2019/07/03 Category Literature Essay Level High school Tags: Joy Luck Club Essay Did you like this example? Amy Tans novel The Joy Luck Club follows the lives of four pairs of Chinese-American mothers and daughters, and how they are trying to mend their broken and relationships, which are full of misunderstanding. The mothers attempt to pass down their experiences, wisdom and Chinese culture to their daughters, but the daughters do not want to understand their heritage and are more influenced by the American circumstances they grew up in. However, when some of the daughters are faced with marital and relationship issues, they draw wisdom from their mothers to help deal with the hardships in their lives.. Don’t waste time! Our writers will create an original "Amy Tans novel The Joy Luck Club" essay for you Create order The daughters unstable romantic relationships help them fix and strengthen their relationships with their mothers by allowing them to understand their mothers, as well as their guidance and/or who they really are. Waverly and Lindo Jong have an extremely unbalanced relationship because they both misinterpret each other. Waverly thought of her mother as oppressive and almost manipulative and believes that she and Lindo are enemies in a figurative chess battle which she thinks up whereas Lindo believes Waverly is too American and that she does not appreciate her. Waverly believes that her mother disapproves of her fiance, Rich, and thinks he is uncultured. When Waverly sees that Lindo accepts her and Richs engagement, Waverly begins to understand her mothers true self and intentions, because she is able to see past the controlling and harsh image of her mother that she created. When Waverly goes to confront her mother and tell her about her marriage, she mentions a time when Lindo judged Richs looks, she says: I saw what I had been fighting for: It was for me, a scared child, who had run away a long time ago to what I had imagined was a safer place. And hiding in this place, behind my invisible barriers, I knew what lay on the other side: Her side attacks. Her secret weapons. Her uncanny ability to find my weakest spots. But in the brief instant that I had peered over the barriers I could finally see what was really there: an old woman, a wok for her armor, a knitting needle for her sword, getting a little crabby as she waited patiently for her daughter to invite her in. (183-184) From confronting her mother, Waverly sees through her own assumptions and misconceptions about her mother and discovers who Lindo truly is rather than the distorted image of the monster that Waverly presumed her to be. Realizing who her mother really is leads to Waverlys newfound comprehension that her mother is Chinese, but also American and that she doesnt have any ill intentions. Waverly had only seen her mothers Chinese ways and flaws rather than Lindos love for her, and, with this realization, she finally sees how similar they both are, and that L indo had always wanted the best for her. By realizing that their relationship is full of misunderstanding, they can begin to accept each other and put aside their differences, allowing them to use these understandings while interacting with each other as well as other people. When Ying-Ying St. Clair was a little girl, she was carefree and curious, but a traumatic experience that left her lost and helpless caused her to begin to forever lose who she was and change her personality. Because of this, Ying-Ying becomes unassertive and yielding, and after a miscarriage, she becomes depressed and can be metaphorically likened to a living ghost. When raising her daughter, Lena, Ying-Ying tries to encourage her to be the opposite of herself. However, Lena still ends up similar to her mother in the ways that matter. Lena is caught in a flawed and impractical marriage that is now only based off of a balance sheet and does not believe that she can do anything about it. However, Ying-Ying wants her to act upon her marriage, rather than standing still and letting it fall apart. Ying-Ying cannot let Lena stand by and watch her marriage fall apart, and as a result, she is finally able to pass on her spirit and wisdom in order to help Lena because she finally realizes how passive Lena has become, allowing Lena to understand her mother. When Ying-Ying hears Lena and Harold arguing, she narrates, I will gather together my past and look I will hold that sharp pain to penetrate my daughters tough skin and cut her tiger spirit loose. She will fight me, because this is the nature of two tigers. But I will win and give her my spirit, because this is the way a mother loves her daughter (252). By trying to cut her tiger spirit loose(252), Ying-Ying is trying to pass on her advice and former spirit to Lena so that she can realize that she has always had power and an ability to change things. Ying-Ying is only able to do this now because this is where she ultimately realizes how passive, yielding and spineless Lena has become. Lena can now also recognize aspects of her mother that she never saw before and can use her mothers spirit to help herself and her marriage. By understanding this piece of her mother, and therefore understanding her mother better, she has the possibility to change her ways and her life. When An-Mei Hsu was a child, she couldnt make decisions and was taught not to attract attention or show her unhappiness. However, after her mother committed suicide to ensure that An-mei would live a better, happier life in her stepfather Wu Tsings household, she discovered that she could be strong and stand up for herself. An-mei tells her daughter Rose that she should grow like a straight and strong tree, rather than a crooked and weak tree that bends to listen to too many people. However, Rose was still extremely indecisive, like An-mei was as a young girl, due to the loss of Roses brother, Bing, who died in a tragic and random incident at a very young age. Now, Roses husband Ted is fed up with how unassertive Rose is and wants a divorce so that he can marry another woman. Roses divorce helps her understand how to follow her mothers advice to be strong, similar to a tree by standing her ground, and as a result, bring them closer. When Rose confronts Ted in front of his garden, she says, And then I saw the weeds: Some had sprouted in and out of the cracks in the patio. Others had anchored on the side of the house. No way to pull them out once theyve buried themselves in the masonry; youd end up pulling the whole building down(195). Rose and Teds garden symbolizes their marriage, as at first in their relationship, Ted obsessively tended it but as their relationship goes through a crisis, leading to their divorce, the garden becomes neglected and full of weeds, as does their marriage in a metaphorical way. Ted is trying to uproot Rose from his life, but he does not realize that he cannot get rid of her without hurting himself. In their marriage, Ted is stifling Roses spirit and refusing to let it grow wild and free. When Rose sees the weeds, she is reminded of her mothers advice to never bend to listen to any other people (191) and to not be like weeds. However, when she is talking to Ted she sees the strength in weeds they spread out, and no matter how often you try to trim them, they always come back which allows her to find her own strength and discover her spirit. As a result, she and her mother can now connect to each other on a deeper level and Rose can implement her mothers wisdom and her own spirit into her actions and stand up to Ted. By the end of The Joy Luck Club, each daughter can use their mothers guidance to help with their romantic relationships as well as their relationships with their mothers. When Waverly confronts her mother Lindo about her fiance Rich, they both can begin to understand why their lacking relationship is the way it is. They both can use this newfound knowledge to see each other clearer and develop the connections that they have not ever had. As Lena lets her marriage fall because she believes that she cannot stop it, Ying-Ying realizes that she has to pass on her spirit and her strength so that Lena can realize her capability and can understand her mother better. Lastly, Roses failing marriage allows her to use the advice her mother gave her as a child and find her spirit. This also lets her apply her newfound identity to her mothers advice, and connect to her mother more because she can understand An-mei better. The mothers have all passed down a piece of advice or part of themselves so that the daughters can understand the mothers better and learn to deal with struggles in their lives. Now, each mother-daughter pair can now keep mending their relationships, put their differences aside, and build a better understanding of each others cultures. The daughters can now apply the mothers wisdom and experiences to difficulties in their own lives, such as their marriages and relationships, and do things that the mothers did not have the opportunities to do.