Healthcare Insurance Essay Example | Topics and Well Written Essays - 500 words

Healthcare Insurance - Essay Example They believe that healthcare insurance would assist them to minimize future health expenses to a great extent. As Cameron and McCallum (1995) point out, ‘income’ is the major potential element determining the demand for health insurance. It seems that low and high income groups are less likely to purchase health insurance. Low income groups may not have potential financial background to purchase health insurance whereas high income groups are reluctant to buy insurance due to increased tariffs. Price of the insurance and tax treatment of insurance are the other important factors affecting demand for health insurance (Avitabile, 2009). When the price of the insurance increases, the demand decreases, and once the price of the insurance drops the demand increases. The same trend is observed in case of tax treatment also. If the government or other competitive organizations adopt a strict approach towards tax treatment, the demand for insurance falls. In contrast, if the hea lthcare insurance is offered at concessional tax rates, more people will be ready to purchase it. This is a clear illustration of law of demand. It is also identified that healthcare expenditure may be a crucial element influencing the demand for insurance. Middle income groups may consider their past health expenditure data before making an insurance purchase decision. Finally, age also affects the demand for healthcare insurance. As compared to old aged people, youngsters are less likely to purchase healthcare insurance as they believe that they are less vulnerable to diseases. In the late XIX century, health insurance began to be available in the form of accident insurance in the United States (Obringer & Jeffries, n.d.). The trend continued until the end of the XIX century, and regulators considered health insurance as disability insurance. Before the US federal

Examine the impact of the US economic crisis on the caribbean nations Essay

Examine the impact of the US economic crisis on the caribbean nations - Essay Example In the Caribbean region which is highly dependent on tourism, the effects of the financial crisis have been most felt on the tourism industry, which has been the key driving force of the region’s economy from the start of 1990s.This later on, caused ripple effects to be felt on the other sectors of the economy such as health. Caribbean countries have been making significant improvements and developments in health outcomes, but due to the US economic crisis, this progress has been threatened, by the reduction of the potential to invest in health by both government and households (World Bank 2009b, p.1).Even though there is a mixture up in empirical results, many studies show that the adverse effects of economic crisis is most likely to be concentrated in countries and households that are poor. (ibid, p.9). Outcomes in health and financing in health are mostly affected by financial crises in more complex manners. Thus in several countries such as those in the Caribbean regions health and disability funding highly deteriorated during the US economic crisis, however the result is quite sensitive to existing policy measures aimed at mitigating the economic effects of the crisis. Thus quick and effective responses are required from the international bodies and respective governments will be very crucial in protecting of the vulnerable sick and disabled people from the adverse effects of US economic crisis. The purpose of this paper is to analyse the impact that the US economic crisis had on the health and disabled fraternity in the Caribbean nations. The paper aims at looking at the impact of the US economic crisis on such social indicators as health and those that are afflicted by disability. It will look at the impact that aggregate fluctuations in income has on indicators of human development, particularly concerning health and the disabled. The results indicate that economic crisis had an adverse

A constructive trust is the formula through which the conscience of Essay

A constructive trust is the formula through which the conscience of equity finds its expression. per Cardozo J, Beatty v Guggenheim Exploration Co. (1919) 225 - Essay Example The simple definition found in a freshman’s law book is a person, whom we shall call the donor, who has complete confidence in another person, (a friend, a relative, or a lawyer), who shall be called the trustee, and gives this person the right to administer his affairs (be it a house, bonds, jewels, an estate, and so on). This is what one usually understands by the word trust. Judge Cardozo gave the following definition: â€Å"when a property has been acquired in such circumstances that the holder of the legal title may not in good conscience retain the beneficial interest, equity converts him into a trustee.†1 This is far from being that categorical, especially when a slew of other factors make it quite confusing, especially when there are differences between the US and the English interpretation of the constructive trust law. â€Å"Lord Wright MR2 deplored the absence of an English work on restitution and noted that the American principles [of constructive trust] stated appear to be consistent with the large and unanalyzed mass of English cases.†¦ [furthermore,] in the Restatement (1937) Lord Wright treats the constructive trust as a remedy,† (Lacy p.1) and assesses the one difference between both countries as to the interpretation and that is one of analysis. If the British judges group the equitable jurisdiction as a restitutionary one, then the remedies must therefore be given by the common law courts. On the other hand, if the English judges take Cardozo’s statement as written then the British judicial system recognizes this US law a universal one regardless of its context. (Lacy p.1) The following cases, Barnes v Addys [1874] LR 9 Ch App 244, Royal Brunei Airlines Sdn Bhd v Tan [1995] 2 AC 378, Belmont Finance Corp v Williams Furniture Ltds [1968] 1 WLR 15555 at 1582, and R v Ghosh [1982] QB 1053, will be used to illustrate the ambiguity of the constructive

Tokugawa Shogunate Regime Essay Example | Topics and Well Written Essays - 1000 words

Tokugawa Shogunate Regime - Essay Example This period was characterized by economic growth and prosperity, very strict social orders, an increase in both environmental protection isolationist foreign policies, popular enjoyment of arts and culture. This form of regime was organized and administered from Edo in Japan in the 1603 by a ruler named Tokugawa Ieyasu. The Tokugawa regime had established a ruling dynasty at the Tokugawa castle, which was based in Edo. Tokugawa regime came into power following a coup that toppled the administration of Oda Nobunaga at a battle known as the battle of Sekigahara at a period known as the Azuchi-Momoyama period. After this battle, Tokugawa Ieyasu who had taken over as the leader of the battle in 1600 took over the administration of Edo area and later on, this administrative power became hereditary to his family. After He later took over the administrative powers, he gained the title shogun, also known as noble military ruler since he was a descendant of the ancient Mina Moto clan. Unlike the previous regimes of the Shogunate, the society in the Tokugawa period was supposedly based on strict, hierarchy which was originally established by Toyotomi Hideyoshi.Unlike other common dictatorial regimes, the Shogun administration was characterized by economic growth and prosperity. The regime had adopted various principles that saw the country prosper both economically and socially. One of the greatest factors t hat saw the prosperity of the Tokugawa regime was the long-standing peace period, which lasted for two hundred and fifty years. Through this long tome peace, the country was able to develop and gain political and economic prosperity. This period of long time peace, also saw the populations of the country largely increase therefore forming a big army known as the Samurais. The large group of Samurais also contributed a lot in protecting the country from future attacks by its enemies. Moreover, the Samurais also engaged in other economic activities such as farming which contributed to the growth of the country’s economy. However, the change from Sengoku meant that they were obliged to work as bureaucrats in the Tokugawa government. The Tokugawa government forced various changes in the different life style of the people of Japan. All the sectors of the society were limited to follow their traditional roles in a stricter manner than it was done in the previous regimes. This form of traditional confinement begun during the administration by Toyotomi Hideyoshi. This harsh imposition saw the regime begin an administration that formed the four-tier class structure, which imposed and enforced rules even regarding small details such as which classes of people could use deluxe silks for their clothing or tortoise shell for hair-pins. In order to enforce their laws, the ruling regime in Japan banned the practice of other religions in the country in 1614 by Tokugawa Hidetada. This move mostly targeted the Christians who were converted by Portuguese traders and missionaries in previous years. In order to make compulsory this law, the Shogunate made it compulsory for all citizens to enlist themselves with their native Buddhist temple. However, those who refused to comply with this orders were considered disloyal from the regime of the Bakufu. This move by the Shogunate saw the eradication of the Shimabara Rebellion, which was comprised mostly of Christian peasant farm ers between 1637 and 1638. The Japanese Christians were later expatriated, executed, or driven underground, and Christianity ceased from existence in the country. Despite this dictatorial regime, the Tokugawa shoguns controlled the country over a long period of peace and relative prosperity in Japan. The long peaceful regime generated the

Information Systems Today Essay Example for Free

Information Systems Today Essay It is limited to transactions between businesses and consumers. C) Electronic commerce between businesses and their employees is not possible. D) All forms of electronic commerce involve business firms. E) Consumer-to-consumer electronic commerce is a complete reversal of the traditional business-to-consumer electronic commerce. 3) Which of the following is an example of business-to-consumer electronic commerce? A) Brenda files her income tax online. B) A manufacturer conducts business over the Web with its retailers. C) Juan buys Kevins guitar on eBay. com. D) Reuben buys a shoe on Yebhi. om. E) Sandra, an employee, uses the Web to make a change her health benefits. 4) Which of the following is an example of consumer-to-consumer electronic commerce? A) Niobi makes an online deposit of $5,000 into her friend Carlas account because she needs financial help. B) Heath buys a gift for Vannessa from Amazon. com. C) Blanco, a manufacturer, conducts business over the Web with its retailers. D) Ted files his income tax online. E) Marty buys Lobsangs mountaineering equipment from eBay. com 5) Ben buys an Olympus E-PL2 from Sony which starts malfunctioning. When he opts for an exchange, the customer representative says that an exchange or repair is not possible because the damage was of a physical nature and not covered under warranty. Which of the following consequences, if true, would be an example of consumer-to-consumer electronic commerce? A) Ben sells the Olympus E-PL2 to Balvinder Singh in India through eBay. com. B) Ben files an online suit against Sony. C) Ben files a complaint on Sonys Web site asking for an escalation. D) Ben buys a Canon G 12. E) Ben sells the Olympus E-PL2 to the worlds largest used camera dealer KEH. om. 6) Which of the following is a result of global information dissemination? A) Firms link Web sites to corporate databases to provide real-time access to personalized information. B) Firms tailor their products and services to meet a customers particular needs on a large scale. C) Firms market their products and services over vast distances. D) Firms provide immediate communication and feedback to and from customers. E) Firms provide ways for clients and firms to conduct business online without human assistance. 7) Which of the following actions explains mass customization? A) Firms tailor their products and services to meet a customers particular needs on a large scale. B) Firms provide immediate communication and feedback to and from customers. C) Firms provide ways for clients and firms to conduct business online without human assistance. D) Firms market their products and services over vast distances. E) Firms link Web sites to corporate databases to provide real-time access to personalized information. 8) Which of the following is an advantage of using interactive communication via the Web? A) reduced transaction costs B) increased customer loyalty C) enhanced operational efficiency D) reduced brand dilution E) decreased cannibalization 9) The phenomenon of cutting out the middleman and reaching customers more directly and efficiently is known as ________. A) gentrification B) demutualization C) reintermediation D) mutualization E) disintermediation 10) Which of the following is an example disintermediation? A) Land Rover markets most of its four-wheel drives in high altitude regions where vehicles require more power. B) Dunkin Donuts expanded its menu beyond breakfasts by adding hearty snacks that substitute for meals, which consists of items like Dunkin Dawgs, hot dogs wrapped in dough. C) Gatorade Thirst Quencher is a market leader in sports drinks. It is now planning to market its drinks to working women in urban areas. D) OakTeak, a furniture manufacturing firm, started selling directly to its customers after it experienced a dip in sales due to channel conflicts between retailers. E) A luxury car company creates a hybrid line of automobiles for consumers who are concerned about the environment. 11) ________ refers to the design of business models that reintroduce middlemen in order to reduce the challenges brought on by dealing directly with customers. A) Reintermediation B) Demutualization C) Gentrification D) Disintermediation E) Mutualization 12) Which of the following is an example of reintermediation? A) The black Centurian card is issued by invitation only to customers who spend more than $250,000 a year on other American Express cards. B) P;G acquires the list of parents-to-be and showers them with samples of Pampers and other baby products to capture a share of their future purchases. C) Kambo, a fashion apparel company that deals directly with customers to sell its products, added retailers to its supply chain to cater to its target audience in remote geographic locations. D) OakTeak, a furniture manufacturing firm, started selling directly to its customers after it experienced a dip in sales due to channel conflicts between retailers. E) Dunkin Donuts expanded its menu beyond breakfasts by adding hearty snacks that substitute for meals, which consists of items like Dunkin Dawgs, hot dogs wrapped in dough. D) These firms only conduct business electronically in cyberspace. E) These firms do not have physical store locations. 17) Which of the following firms would most likely pursue the brick-and-mortar strategy? A) KEH. com is a used camera dealer that buys and sells cameras across the globe. B) Castros is a watch manufacturing firm known for its effective mass customization. C) SmartInv is a brokerage firm that allows its customers to personalize their portfolios. D) BestBaker is a local bakery store in Bantam, Connecticut and caters exclusively to its residents. E) Nebo, a computer manufacturer, has pursued disintermediation and sells directly to customers. 18) Which of the following statements is true about firms pursuing a click-and-mortar business strategy? A) These firms learn how to fully maximize commercial opportunities in both domains. B) These firms can often compete more effectively on price. C) These firms tend to be highly adept with technology and can innovate very rapidly as new technologies become available. D) Customers of these firms find it difficult to return a product in case of damages. E) These firms can reduce prices to rock-bottom levels, although a relatively small firm may not sell enough products. 19) EZBiz, the brainchild of three college friends, is a startup venture which plans to produce and market sports gear. They are currently trying to decide between a brick-and-click strategy and a click-only strategy. Which of the following, if true, would most undermine the decision to adopt a click-only strategy? A) The company has limited access to funds and is looking to keep its costs low. B) The public is wary of sharing confidential information after a recent spate of credit card scandals. C) A competitor is facing severe backlash after inadvertently releasing sensitive data into the public domain. D) Several companies who have switched from brick-and-mortar strategy to a click-only are experiencing severe channel conflicts. E) Some click-only companies have been unable to achieve economies of scale and subsequently are unable to offer lower prices. 20) EZBiz, the brainchild of three college friends, is a startup venture which plans to produce sports gear. They are currently trying to decide between a brick-and-click strategy and a click-only strategy. Which of the following, if true, would most support the decision to adopt a click-only strategy? A) E-commerce places firms on a global platform, in direct competition with the best in the business. B) Retailers have a preference for established brands that can pay good margins. C) Research suggests that some customers prefer online shopping because of the convenience it offers. D) Product trials and demonstrations are an essential part of the consumer buying process. E) Cyber laws are yet to reach the level of sophistication required to facilitate safe online transactions. 1) Which of the following statements is true about the revenue model? A) It emphasizes the utility that the product/service has to offer to customers. B) It analyzes the existing players in the market and the nature of the competition. C) It describes the promotion plan of the product/service. D) It describes how the firm will produce a superior return on invested capital. E) It analyzes the background and experie nce of the company leadership. 22) Which of the following questions should a manager consider while analyzing the value proposition component of the business model? A) How much are you selling the product for? B) How fierce is the competition? C) How do you plan to let your potential customers know about your product/service? D) Can the leaders of the organization get the job done? E) Why do customers need your product/service? 23) While preparing a business model, a manager considers the question, How do you plan to let your potential customers know about your product/service? Which of the following components of the businessing model is he/she considering? A) Revenue model B) Management team C) Marketing strategy D) Value proposition E) Competitive environment 24) Paying businesses that bring or refer customers to another business is known as ________. A) affiliate marketing B) subscription marketing C) viral marketing D) stealth marketing E) buzz marketing 25) A collection of companies and processes are involved in moving a product from the suppliers of raw materials, to the suppliers of intermediate components, to final production, and ultimately, to the customer; these companies are collectively referred to as ________. A) customer management B) product lifecycle C) enterprise resource management D) supply chain E) market entry 26) Prior to the introduction of the Internet and Web, the secure communication of proprietary information in business-to-business electronic commerce was facilitated using ________. A) enterprise resource planning B) electronic data interchange C) cloud computing D) supply chain management E) executive information system 27) Which of the following statements is true about the extranet? A) It restricts the companys information from going on the Web. B) It can be accessed only by employees within an organization. C) It contains company related information which all the employees of an organization can access. D) It enables two or more firms to use the Internet to do business together. E) It requires large expenditures to train users on the technologies. 28) Web-based technologies are cross platform, meaning that disparate computing systems can communicate with each other provided that ________. A) the computing systems have been manufactured by the same company B) the computing system manufacturing companies are business partners C) they are located in the same country D) standard Web protocols have been implemented E) the computing system manufacturing companies allow it 29) Companies use ________ to secure proprietary information stored within the corporate local area network and/or wide area network so that the information can be viewed only by authorized users. A) firewalls B) phishing C) rootkits D) bots E) pharming 30) Organizations primarily use extranets to ________. A) conduct market research B) manage their supply chains C) identify their target market D) control brand dilution E) manage public relations 1) In the context of B2B supply chain management, ________ can be defined as access points through which a business partner accesses secured, proprietary information from an organization. A) bots B) forums C) portals D) rootkits E) hosts 32) ________ can provide substantial productivity gains and cost savings by creating a single point of access where the company can conduct business with any number of business partners. A) Rootkits B) Ph arming C) Bots D) Phishing E) Portals 33) ________ automate the business processes involved in selling products from a single supplier to multiple buyers. A) Supplier portals B) Reference portals C) Customer portals D) Procurement portals E) Sourcing portals 34) ________ are designed to automate the business processes that occur before, during, and after sales have been transacted between a supplier and multiple customers. A) Sourcing portals B) Reference portals C) Supplier portals D) Customer portals E) Procurement portals 35) ________ are set up as B2B Web sites that provide custom-tailored offers or specific deals based on sales volume. A) Sourcing portals B) Customer portals C) Procurement portals D) Reference portals E) Supplier portals 6) What is the difference between customer and supplier portals and business-to-business (B2B) marketplaces? A) Unlike customer and supplier portals, B2B marketplaces cannot be classified as extranets. B) Unlike customer and supplier portals, B2B marketplaces are secured by firewalls. C) Unlike customer and supplier portals, B2B marketplaces only serve vertical markets. D) Unlike customer and supp lier portals, B2B marketplaces are associated with a particular buyer or supplier who deals with multiple business partners. E) Unlike customer and supplier portals, B2B marketplaces allow many buyers and many sellers to come together. 7) Markets comprised of firms operating within a certain industry sector are known as ________ markets. A) vertical B) parallel C) horizontal D) stipulated E) focused 38) Which of the following statements is true about B2B and B2C payments? A) Most B2B payments are made through credit cards. B) Most B2C payments are made by checks. C) Most B2B payments are made through electronic payment services. D) Most B2B payments are made by cash. E) Most B2B payments are made by checks. 39) Credit cards and electronic payment services are not used for large B2B transactions because of ________. A) the risks associated with these services B) the complications arising out of these transactions C) preset spending limits D) the resulting decrease in working capital E) the expenses associated with these services 40) Organizations implement intranets to support ________ electronic commerce. A) business-to-business B) business-to-consumer C) business-to-government D) business-to-employee E) consumer-to-business 41) Intranets mostly affect the ________ of an organization. A) suppliers B) employees C) customers D) retailers E) advertisers 2) ________ is used to facilitate the secured transmission of proprietary information within an organization. A) Intranet B) Transnet C) Ethernet D) Extranet E) Telnet 43) Which of the following distinguishes an intranet from an extranet? A) An intranet looks and acts just like a publicly accessible Web site. B) An intranet uses the same hardware as a publicly accessible Web site. C) Users access their companys intranet using their Web browser. D) An intranet uses the same networking technologies as a publicly accessible Web site. E) In its simplest form, intranet communications do not travel across the Internet. 44) ________ are temporary work groups with a finite task and life cycle. A) Intensive forces B) Cross functional teams C) Task forces D) Staff committees E) Self directed work teams 45) The term ________ refers to a class of software that enables people to work together more effectively. A) malware B) groupware C) freeware D) webware E) pestware 46) Which of the following is an asynchronous groupware tool? A) shared whiteboard B) online chat C) intranet D) electronic meeting support system E) video communication system 47) One of the benefits of groupware is its parallelism. Which of the following statements best explains this sentence? A) It keeps the group on track and helps avoid costly diversions. B) It can easily incorporate external electronic data and files. C) It enables members to collaborate from different places at different times. D) It automatically records member ideas, comments, and votes. E) It enables many people to speak and listen at the same time. 48) Which of the following is a synchronous groupware tool? A) e-mail B) intranet C) group calendar D) online chat E) automation system 49) Which of the following provides customers with the ability to obtain personalized information by querying corporate databases and other information sources? A) e-filing B) e-integration C) e-information D) e-transaction E) e-tailing 50) The online sales of goods and services is known as ________. A) e-information B) e-integration C) e-tailing D) e-collaboration E) e-filing 51) Which of the following occurs in a reverse pricing system? A) Customers specify the product they are looking for and how much they are willing to pay for it. B) Customers are provided with the product and its price. C) Customers are provided with a product and can decide how much they are willing to pay for it. D) Customers specify the product they are looking for and the company provides the product with a price. E) Customers cannot decide the product but they can decide the price of the products available. 2) How do comparison shopping sites generate revenue? A) by charging a commission on transactions B) by selling their products C) by charging a virtual shelf-space fee to manufacturers D) by increasing the click-count on their site E) by charging distribution fees to consumers 53) The concept of the Long Tail refers to a focus on ________. A) mainstream products B) broad markets C) generic brands D) brand dilution E) niche markets 54) Which of the following is a disadvantage of e-tailing? A) It is limited by physical store and shelf space restrictions. B) It requires additional time for products to be delivered. C) It complicates the process of comparison shopping. D) It restricts companies to effectively compete on price. E) It reduces a companys inventory turnover time. 55) Which of the following explains Web analytics? A) conducting online marketing research to improve product quality B) analyzing Web sites in order to find the best one in its category C) tracking all online purchasers to try and increase their frequency of visit to a particular Web site D) analyzing Web surfers behavior in order to improve Web site performance E) analyzing Web sites in order to find the best online business practices 6) Which of the following is a mechanism for consumer-to-consumer transactions? A) e-tailing B) e-integration C) e-filing D) e-tendering E) e-auctions 57) ________ is a form of e-auction in which the highest bidder wins. A) Reverse auction B) Bartering C) Exchange D) Forward auction E) Request for quote 58) ________ is a form of e-auction where buyers post a request for quote. A) A reverse a uction B) Bartering C) An exchange D) A forward auction E) A request for proposal 59) Which of the following forms of e-auction typically takes place on a business-to-business level? A) reverse auctions B) bartering C) exchanges D) forward auctions E) request for quotes 60) Doug is a frequent visitor of online auction sites. He uses two different accounts to place a low followed by a very high bid on the desired item. This leads other bidders to drop out of the auction. He then retracts the high bid and wins the item at the low bid. This form of e-auction fraud is known as ________. A) shill bidding B) bid luring C) payment fraud D) nonshipment E) bid skimming 61) Which of the following types of e-auction fraud is associated with the sellers failure to ship an item after the payment has been received? A) bid luring B) bid shielding C) nonshipment D) shipping fraud E) payment failure 62) If a companys Web site is listed in the sponsored list of a search engine, the search engine receives revenue on a ________ basis. A) pay-per-click B) pay-per-sale C) click-through D) pay-per-conversion E) click-per-visit 63) Under the ________ pricing model, the firm running the advertisement pays only when a Web surfer actually clicks on the advertisement. A) pay-per-refresh B) pay-per-sale C) pay-per-click D) pay-per-conversion E) click-per-visit 64) Click-through rate reflects ________. A) the ratio of surfers who visited the Web site divided by the number of surfers who clicked on the ad B) the ratio of surfers who click on an ad divided by the number of times it was displayed C) the percentage of visitors who actually perform the marketers desired action D) the ratio of surfers who clicked on the ad divided by the number of people who made the purchase E) the ratio of surfers who visited the Web site divided by the number of people who made a purchase 65) ________ allows individual Web site owners to post companies ads on their pages. A) Bum marketing B) Stealth marketing C) Viral marketing D) Buzz marketing E) Affiliate marketing 66) In a ________, a site hosting an advertisement creates fake clicks in order to get money from the advertiser. A) competitive click fraud B) irate click fraud C) network click fraud D) shill click fraud E) dedicated click fraud 67) MakeYourClick is an online ad agency that is known for its ability to create ads which lure customers to purchase. Brenda, an ex-employee of the firm, was fired from the agency on baseless grounds. An angry Brenda inflates MakeYourClicks online advertising cost by repeatedly clicking on the advertisers link. Brenda has committed ________. A) competitive click fraud B) irate click fraud C) network click fraud D) shill click fraud E) dedicated click fraud 68) ________ is used in order to have small, well-defined tasks performed by a scalable ad hoc workforce of everyday people. A) Nearshoring B) Insourcing C) Offshoring D) Crowdsourcing E) Homesourcing 69) ________ is an example of m-commerce. A) e-auctions B) e-tailing C) e911 D) e-filing E) e-integrating 70) Which of the following is an argument against digital rights management? A) It encourages unauthorized duplication. B) It enables publishers to infringe on existing consumer rights. C) It discourages publishers to control their digital media. D) It inhibits online transactions in the industry. E) It restricts copyright holders to minimize sales losses. 71) E-filing is an example of a ________ tool. A) government-to-citizen B) consumer-to-consumer C) government-to-government D) consumer-to-business E) business-to-business Chapter 5: Enhancing Collaboration Using Web 2. 0 1) Which of the following is a basic concept associated with Web 2. 0? A) shift in users preference from online sites to encyclopedias as sources of unbiased information B) shift in users role from the passive consumer of content to its creator C) shift in users interest from sharing information o finding information D) shift in users lifestyle due to increased purchasing power E) shift in users preference to environment-oriented products 2) Which of the following is a consequence of the use of social software? A) People are using encyclopedias as sources of unbiased information. B) People are using environmentally-friendly products. C) People have increas ed purchasing power. D) People are sharing more personal information. E) People have become passive consumers of content. 3) The use of ________ within a companys boundaries or between a company and its customers or stakeholders is referred to as Enterprise 2. . A) Web 1. 0 techniques and intranet B) extranet and intranet C) Web 2. 0 techniques and social software D) extranet and Web 1. 0 techniques E) social software and extranet 4) Which of the following statements is true about Web 1. 0? A) It helps users share information. B) It helps users find information. C) Users rule these applications. D) Users receive and give recommendations to friends. E) It helps connect ideas and people. 5) A major benefit of social software is the ability to harness the wisdom of crowds, which is also referred to as ________. A) collaborative filtering B) preference elicitation C) creative commons D) consensus democracy E) collective intelligence 6) The concept of ________ is based on the notion that distributed groups of people with a divergent range of information and expertise will be able to outperform the capabilities of individual experts. A) cognitive dissonance B) creative commons C) collective intelligence D) consensus democracy E) preference elicitation 7) Which of the following statements is true about a discussion forum? A) It started out as a novices way of expressing themselves using very simple Web pages. B) It is the process of creating an online text diary made up of chronological entries that comment on everything. C) Rather than trying to produce physical books to sell or use as gifts, users merely want to share stories about their lives or voice their opinions. D) It is dedicated to a specific topic, and users can start new threads. E) It enables a person to voice his/her thoughts through short status updates. 8) Which of the following statements is true about blogs? A) They emulate traditional bulletin boards and allow for threaded discussions between participants. B) They allow individuals to express their thoughts in a one-to-many fashion. C) They are dedicated to specific topics, and users can start new threads. D) They are moderated so that new postings appear only after they have been vetted by a moderator. E) They enable people to voice their thoughts through short status updates. 9) Which of the following Web 2. 0 applications has been classified as the amateurization of journalism? A) blogs B) discussion forums C) social presence tools D) instant messaging E) online chats 10) Keith Norat, the Chief Technology Officer of Kender Internationals, relies on blogs while making decisions. In his words, Blogs are an important part of our purchase decisions. In todays environment, blogs provide diverse information that help us to make good decisions. Which of the following is an underlying assumption? A) Information in blogs is accurate. B) Some of the blogs are not written well. C) Blogs are company sponsored. D) Professional bloggers rely heavily on advertisements to sustain their operations. E) Blogs lead to the amateurization of journalism. 11) Which of the following explains the term blogosphere? A) the movement against blogs B) the amateurization of blogs C) the revolution against microblogging D) the community of all blogs E) the movement against discussion forums 12) Social presence tools are also known as ________ tools. A) social bookmarking B) instant chatting C) microblogging D) videoconferencing E) geotagging 13) Which of the following facilitates real-time written conversations? A) instant messaging B) discussion forums C) status updates D) blogs E) tagging 14) ________ take the concept of real-time communication a step further by allowing people to communicate using avatars. A) Blogging B) Microblogging C) Instant messaging D) Discussion forums E) Virtual worlds 15) Which of the following statements is true about virtual worlds? A) It allows people to communicate using avatars. B) Small firms have not been successful in consumer-oriented virtual worlds. C) It is designed for short status updates. D) It is the process of creating an online text diary made up of chronological entries that comment on everything. E) Large companies have been able to realize the potential of consumer-oriented virtual worlds. 16) The network effect refers to the notion that the value of a network is dependent on ________. A) the speed of the network B) the number of other users C) the knowledge of the users D) the commitment of the users E) the technical expertise of the moderators 17) ________ is a cooperative Web 2. 0 application making use of the network effect. A) Media sharing B) RSS C) Tagging D) Instant messaging E) A discussion forum 18) ________ is the distribution of digital media, such as audio or video files via syndication feeds for playback on digital media players. A) Narrowcasting B) Crowdsourcing C) Blogging D) Netcasting E) Phishing 19) Podcasting is a misnomer because podcasts ________. A) are concerned with the dissemination of information to a narrow audience B) cannot be played on Apples iPods C) are not related to distribution of digital media for digital devices D) are concerned with outsourcing tasks to a large group of people or community E) can be played on a variety of devices in addition to Apples iPods 20) Social bookmarking allows users to share Internet bookmarks and to create categorization systems. These categorization systems are referred to as ________. A) tag clouds B) podcasts C) folksonomies D) geospatial metadata E) microblogs 21) Which of the following statements is true about social bookmarking? A) It is the distribution of digital media. B) It allows netcasters to publish and push current shows to the watchers/listeners. C) It allows people to communicate using avatars. D) It allows users to create folksonomies. E) It allows users to post short status updates. 22) ________ is the creation of a categorization system by users. A) Social cataloging B) Podcasting C) Social blogging D) Netcasting E) Crowdsourcing 23) ________ refers to manually adding metadata to media or other content. A) Phishing B) Tagging C) Crowdsourcing D) Podcasting E) Netcasting 24) Which of the following statements is true about tagging? A) It is the rocess of creating a categorization systems by users. B) It is the process of distributing digital media for playback on digital media players. C) It is the process of adding metadata to pieces of information. D) It is the process of of creating avatars and syndication feeds. E) It is the process of creating an online text diary. 25) ________ refer(s) to a way of visualizing user generated tags or c ontent on a site. A) Crowdsourcing B) Tag clouds C) Phishing D) Podcasting E) Pharming 26) Which of the following is one of the uses of geotagging? A) to use avatars while chatting online B) to create categorization systems for social cataloging C) to know the location of a person sending out a breaking news update D) to create folksonomies for social bookmarking E) to use syndicate feeds while sharing media 27) Which of the following is an example of synchronous communication? A) online reviews B) work flow automation systems C) intranets D) videoconferencing E) collaborative writing tools 28) Which of the following is an example of asynchronous communication? A) group calendars B) videoconferencing C) online chatting D) shared whiteboards E) electronic meeting support system 29) Which of following factors differentiates asynchronous communication from ynchronous communication? A) language B) network speed C) coordination in time D) expertise E) distance 30) In todays business environment, project teams comprise highly specialized members, many of whom are not colocated. ________ are comprised of members from different geographic areas. A) Work groups B) Virtual teams C) Work teams D) Task forces E) Command groups 31) Which of the following is an electronic communication tool that allows users to files, documents, and pictures to each other and share information? A) e-mail B) instant messaging C) application sharing D) electronic calendars E) knowledge management systems 2) Which of the following is an electronic conferencing tool that facilitates information sharing and rich interactions between users? A) e-mail B) wikis C) blogs D) instant messaging E) online document systems 33) Which of the following is a collaboration management tool that is used to facilitate virtual or colocated meetings ? A) Internet forums B) videoconferencing C) wikis D) fax E) intranets 34) Web-based collaboration tools ________. A) allow for easy transferability from one person to another B) have well-documented procedures for system complexities C) reduce the risk of exposing sensitive corporate data D) require users to frequently upgrade their software E) are complex and time-consuming to learn 35) Which of the following statements is true about Gmail? A) It is an enterprise-level collaboration tool that allows users to create group Web sites and share team information. B) It allows users to select a custom domain name for an additional fee. C) It allows users to share events and subscribe to public calendars for new events. D) It is an instant messaging client. E) It is an online office suite comprised of a spreadsheet application, a word processor, and a presentation application. 6) Which of the following Google Apps is an instant messaging client? A) Gmail B) Google Calendar C) Google Talk D) Google Sites E) Google Docs 37) ________ is an online office suite comprised of a spreadsheet application, a word processor, and a presentation application. A) Gmail B) Google Talk C) Google Sites D) Google Calendar E) Google Docs 38) Which of the following statements is true about Googl e Sites? A) It is an enterprise-level collaboration tool that allows users to create group Web sites and share team information. B) It allows users to select a custom domain name for an additional fee. C) It allows users to share events and subscribe to public calendars for new events. D) It is an instant messaging client. E) It is an online office suite comprised of a spreadsheet application, a word processor, and a presentation application. 39) A(n) ________ system allows users to publish, edit, version track, and retrieve digital information. A) social presence B) collective intelligence C) application sharing D) content management E) peer production 40) Which of the following statements is true about content management systems? A) It is the creation of goods or services by self-organizing communities. B) The creation of the goods or services is dependent on the incremental contributions of the participants. C) It allows the assignment of different roles for different users. D) Anyone can help in producing or improving the final outcome. E) It is a family of syndication feeds used to publish the most current blogs, podcasts, videos, and news stories. 41) Which of the following is the responsibility of an administrator in a content management system? A) editing the content into a final form B) managing account access levels to the digital information C) sharing team information D) publishing new information E) creating database applications 42) ________ is the creation of goods or services by self-organizing communities. A) Peer production B) A folksonomy C) Creative commons D) Groupware E) Social software 43) Which of the following statements is true about peer production? A) The creator is responsible for publishing new information. B) Only editors have the right to develop new content. C) It is also known as enterprise content systems. D) Anyone can help in producing or improving the final outcome. E) The guest is a person who can only view the digital information. 44) Which of the following occurs during wiki wars? A) editors do not agree with the creators of the content B) participants debate on a particular topic before creation C) administrators refuse to publish a creators content D) guests edit the creators content without permission E) contributors continuously edit or delete each others posts 45) ________ is a phenomenon where companies use everyday people as a cheap labor force. A) Nearshoring B) Phishing C) Crowdsourcing D) Narrowcasting E) Pharming 46) ________ enables people to work in more flexible ways on a variety of Internet-related projects. A) E-filing B) E-auction C) E-tailing D) E-lancing E) E-timing 47) ________ sites create social online communities where individuals with a broad and diverse set of interests meet and collaborate. A) Crowdsourcing B) Social cataloging C) Social networking D) Social bookmarking E) Media sharing 48) Which of the following statements is true about viral marketing? A) It uses the network effect to increase brand awareness. B) It uses everyday people as a cheap labor force. C) It is the dissemination of information to a narrow audience. D) It enables people to work in more flexible ways on a variety of Internet-related projects. E) It is used to market a product without the audience realizing it. 49) Which of the following is a critical factor in the success of a viral marketing campaign? A) restricting access to viral content B) doing what the audience expects C) making sequels D) restricting easy distribution E) distributing products for free 50) ________ attempts to provide relevant search results by including content from blogs and microblogging services. A) Social search B) OpenSearch C) Enterprise search D) Metasearch E) Netsearch 51) Which of the following statements is true about Real Simple Syndication (RSS)? A) It is used to increase brand awareness through the network effect. B) It is used to disseminate information to a narrow audience. C) It is used to market the product without the audience realizing it. D) It is used to enable people to work in more flexible ways on a variety of Internet-related projects. E) It is used to publish the most current blogs, podcasts, videos, and news stories. 52) For companies operating in the digital world, online collaboration with suppliers, business partners, and customers is crucial to being successful. ________ allow(s) data to be accessed without intimate knowledge of other rganizations systems, enabling machine-to-machine interaction over the Internet. A) Web services B) Widgets C) RSS feeds D) Social search E) Peer production 53) Android is a Web service hosted by Google to ________. A) create customized search features B) build mobile phone applications C) manage personal calendars D) integrate Googles mapping system into Web sites E) allow us ers to build applications that work with multiple social communities 54) Which of the following statements is true about widgets? A) They can be placed on a desktop, but cannot be integrated into a Web page. B) They can integrate two or more Web services. C) They are created by the integration of Web services and mashups. D) They are small interactive tools used for a single purpose. E) They can be integrated into a Web page, but cannot be placed on a desktop. 55) Together, Web services and widgets enable the creation of ________. A) protocols B) mashups C) codecs D) folksonomies E) tag clouds 56) Which of the following statements is true about a mashup? A) It is a small interactive tool used for a single purpose. B) It is used to increase brand awareness through the network effect. C) It is the process of allowing companies to use everyday people as a cheap labor force. D) It is used to disseminate information to a narrow audience. E) It is an application or a Web site that integrates one or more Web services. 57) Which of the following is a reason for the development of semantic Web? A) Web pages can be understood by people but not by computers. B) Users should be able to use any device in any network for any service. C) Users give a lot of unnecessary personal information to social networking sites. D) Widgets cannot be integrated into Web pages. E) Users are skeptical while making purchases online due to the fear of getting cheated. 58) Which of the followings is NOT true about an Enterprise 2. strategy? A) Web 2. 0 sites base their success on user-driven self-expression. B) Enterprise 2. 0 applications are not suited to traditional top-down organizational structures. C) Enterprise 2. 0 applications should be driven by a specific usage context. D) Organization-wide Enterprise 2. 0 implementations typically need changes in terms of organizational culture. E) Within organizations, the critical mass needed for an Enterprise 2. 0 application is often easily achieved. 59) Enterprise 2. 0 is likely to fail if ________. A) an organizations workforce is dominated by baby boomers B) an organization has a flat organizational hierarchy C) an organization emphasizes open communication D) an organizations workforce is dominated by millennials E) it is integrated well with an organizations existing information systems infrastructure Technology Briefing: Foundations of Information Systems Infrastructure Networks, the Internet, and Databases 68) ________ is a computer networking model in which multiple types of computers are networked together to share data and services. A) Centralized computing B) Mainframe computing C) Task computing D) Distributed computing E) Serial computing 9) A(n) ________ is a computer network that spans a relatively small area, allowing all computer users to connect with each other to share data and peripheral devices, such as printers. A) enterprise network B) wide area network C) campus area network D) local area network E) value-added network 70) A(n) ________ is a wide area network connecting disparate networks of a single organization into a single network. A) value-added network B) global network C) enterprise network D) local area network E) personal area network 71) ________ are private, third-party-managed medium-speed WANs that are shared by multiple organizations. A) Value-added networks B) Enterprise networks C) Global networks D) Local area networks E) Personal area networks 72) A(n) ________ is an emerging technology that uses wireless communication to exchange data between computing devices using short-range radio communication, typically within an area of 10 meters. A) value-added network B) local area network C) personal area network D) enterprise network E) campus area network 73) ________ are network services that include the storing, accessing, and delivering of text, binary, graphic, and digitized video and audio data across a network. A) Print services B) File services C) Message services D) Application services E) Software services 74) The high-speed central networks to which many smaller networks can be connected are known as ________. A) last-mile networks B) ISPs C) Internet exchange points D) private branch exchanges E) backbones 75) Which of the following wireless communication technologies uses high-frequency light waves to transmit data on an unobstructed path between nodes—computers or some other device such as a printer—on a network at a distance of up to 24. 4 meters? A) Bluetooth B) wireless LAN C) high-frequency radio D) infrared line of sight E) microwaves WLANs based on a family of standards called 802. 11 are also referred to as ________. A) Bluetooth B) wireless fidelity C) ethernet D) personal area networks E) infrared line of sight 77) Which of the following is a characteristic of terrestrial microwave communication? A) high attenuation B) speeds up to 16 Mbps C) low expense D) high susceptibility to eavesdropping E) low electromagnetic interference 78) ________ is the set of rules that governs how a given node or workstation gains access to the network to send or receive data. A) Media access control B) Logical link control C) Hypertext transfer protocol D) File transfer protocol E) Internet control message protocol 79) ________ is a commonly used method of random access control, in which each workstation listens to traffic on the transmission medium (either wired or wireless) to determine whether a message is being transmitted. A) Code division multiple access B) Carrier sense multiple access C) Hybrid coordination function D) Group packet radio service E) Point coordination function 80) In a(n) ________ network all nodes or workstations are connected to a central hub, or concentrator, through which all messages pass. A) ring B) bus C) star D) mesh E) tree 81) Which of the following network topologies is capable of covering the largest distance? A) star network B) bus network C) ring network D) mesh network E) tree network 82) Which of the following statements is true of a bus network topology? A) A bus network has the most complex wiring layout. B) Extending a bus network is more difficult to achieve than it is for other topologies. C) A bus network topology enables all network nodes to receive the same message through the network cable at the same time. D) The configuration of bus networks facilitates easy diagnosis and isolation of network faults. E) In a bus network, every computer and device is connected to every other computer and device. 83) As per the Open Systems Interconnection (OSI) model, which of the following layers defines the way data is formatted, converted, and encoded? A) application layer B) transport layer C) presentation layer D) data link layer E) session layer 84) According to the OSI model, the ________ layer defines the protocols for structuring messages. A) physical B) session C) transport D) data link E) network 5) According tot he OSI model, the physical layer defines ________. A) the protocols for data routing to ensure that data arrives at the correct destination B) the way data is formatted, converted, and encoded C) the mechanism for communicating with the transmission media and interface hardware D) the way that application programs such as electronic mail interact with the network E) the protocols fo r structuring messages 86) A ________ is a device that converts digital signals from a computer into analog signals so that telephone lines may be used as a transmission medium to send and receive electronic data. A) modem B) LAN card C) network adapter D) PCI connector E) USB port 87) A ________ is a PC expansion board that plugs into a computer so that it can be connected to a network. A) transceiver B) multiport repeater C) cable router D) network interface card E) modular connector 88) A(n) ________ is a piece of networking hardware that manages multiple access points and can be used to manage transmission power and channel allocation to establish desired coverage throughout a building and minimize interference between individual access points. A) router B) wireless controller C) network switch D) modem E) network interface card 89) Which of the following entities is responsible for managing global and country code top-level domains, as well as global IP number space assignments? A) American Registry for Internet Numbers (ARIN) B) World Wide Web Consortium (W3C) C) Internet Assigned Numbers Authority (IANA) D) Internet Governance Forum (IGF) E) European Organization for Nuclear Research (CERN) 90) Which of the following Internet connectivity technologies enables data to be sent over existing copper telephone lines by sending digital pulses in the high-frequency area of telephone wires? A) integrated services digital network technology B) digital subscriber line technology C) dial-up service technology D) cable modem technology E) fiber to the home technology 91) Computers working as servers on the Internet are known as ________. A) network adapters B) modems C) network switches D) Ethernet hubs E) Internet hosts 92) A(n) ________ is a unique identifier that should be created and used when designing a database for each type of entity, in order to store and retrieve data accurately. A) foreign key B) surrogate key C) primary key D) superkey E) candidate key 93) In which of the following database models does the DBMS view and present entities as two-dimensional tables, with records as rows, and attributes as columns? A) relational database model B) hierarchical database model C) network database model D) object-oriented database model E) semantic database model 94) ________ is a technique to make complex databases more efficient and more easily handled by the DBMS. A) Assertion B) Exception handling C) Normalization D) Model elimination E) Structural induction

Patients With Post Stroke Dysphagia Health And Social Care Essay

Patients With Post Stroke Dysphagia Health And Social Care Essay This chapter deals with discussion, summary and conclusions drawn. It clarifies the limitations of the study, the implications and recommendations given for different areas in Nursing practice, Education, administration and research. DISCUSSION The present study was designed to assess the effectiveness of Selected Nursing Interventions among patients with Post Stroke Dysphagia at KMCH, Coimbatore-14. The researcher carried out the study among 30 patients and adopted pre-experimental research design with single group pre test post test design. The researcher used non probability purposive sampling technique to select the 30 subjects. The researcher conducted this study to assess the effectiveness of Shaker Exercise and Hyoid Lift Maneuver on Swallowing and Feeding Performance among patients with Post Stroke Dysphagia. DEMOGRAPHIC DESCRIPTION OF SUBJECTS The demographic variables included in the study were Age, Sex, Education and Habits. The mean Age of the subjects was 60. Half of the subjects were in the Age group 50-70 years. Almost equal numbers of subjects were in the 30-50 and above 70 years Age groups and it was about 23 and 27 percent respectively. Regarding the Sex, nearly equal numbers of subjects were in the male and female Sex group and it showed 53 and 47 percent respectively. On the basis of their Educational Status, 67 percent of the subjects were studied up to secondary Education. About 33.33 percent of the subjects completed any one of the graduate degree course. In accordance with their Personal Habits, 53.33 percent had no bad Habits like Smoking and Alcoholism. Ten percent of subjects had the habit of Tobacco use. Seven percent of subjects were consuming Alcohol. Thirty percent of the subjects had the habit of both Tobacco and Alcohol consumption. CLINICAL DESCRIPTION OF SUBJECTS The clinical variables include Type of Stroke and Co-morbid Illness. In consistent with the Type of Stroke, 10 percent of the subjects had Stroke due to the problem in anterior circulation, 40 percent of the subjects had Stroke due to problem in middle circulation and 50 percent of the subjects had Stroke due to problem in the posterior circulation. With reference to the Co-morbid Illness, 13.33 percent of the subjects had No Co-morbid Illness. About 10 and 40 percent of the subjects had the complaints of Diabetes Mellitus and Hypertension respectively. Remaining 36.67 percent of the subjects had both Hypertension and Diabetes Mellitus. The major findings of the study were discussed according to the objectives: The first objective was to assess the Swallowing and Feeding Performance of patients with Post Stroke Dysphagia. In the pre test assessment of the Swallowing Performance using GUSS Score indicates 23.33% of the subjects had Mild Dysphagia, 40% of the subjects had Moderate Dysphagia and 36.67% of the subjects had Severe Dysphagia. The post-test assessment of Swallowing Performance explains that 16.67% of the subjects were improved to the No Dysphagia stage with good Swallowing and Feeding Performance. About 26.67% of the subjects had Mild Dysphagia and 23.33% of the subjects had Moderate Dysphagia. Remaining 33.33% of the subjects had severe Dysphagia with various improvements in the Swallowing Performance. The pre test and post test Feeding Performance Score using FOIS describes equal number of subjects in the Tube Dependent (36.67%) and Total Oral Intake category (63.33%). Despite the result revealed an equal number of subjects in the pre and post test assessment, the subjects had an improvement in the Feeding Performance during the post test assessment from no oral intake level to tube supplement with consistent oral intake level in the Tube Dependent category. Likewise, subjects showed an improvement from the intake of single consistency to the total intake with no restriction in the Total Oral Intake category. The present study was supported by Trapl et al., who conducted study in 2002 and described that out of 30 patients, 30 to 50% had Severe Dysphagia and showed significantly higher risk of aspiration with liquids compared with semisolid textures (p=0.001). Therefore they confirmed the subsequent sequence of GUSS. The second objective was to determine the effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance in patients with Post Stroke Dysphagia. With reference to the Swallowing Performance based on the GUSS Score, the mean pre-test SwallowingS among subjects was 12.50 and the mean post-test Swallowing Score was 13.87 based on the GUSS tool. Paired t test was used to compute the mean difference. The t value for this mean difference between pre and post test Swallowing Score was 6.150. The t value obtained at .001 level of significance and at 29 degrees of freedom. Hence there is a significant difference exist between the mean pre and post test Swallowing Scores. It further implies that the Swallowing Score in the post test was higher than the pre test Swallowing Score. This improvement was due to the Selected Nursing Interventions such as Swallowing Exercises and Positioning while Swallowing. So the Swallowing Exercises such as Shaker Exercise and Hyoid Lift Maneuver found to be effective in improving the Swallowing Performance in Stroke patients. The final result concluded that 22 subjects (73.3%) expressed improvement after the treatment. Remaining 8 subjects (26.7%) had no changes in their Swallowing Performance after the therapy. The median of pre-test Feeding Score among subjects was 5 and the median of post-test Feeding Score was 6.5. Sign test was computed to find out the difference between the pre and post test median Scores of Feeding. The sign test Score showed the p value 0.000 which was significant at .001 level. It showed that, a significant difference present between the pre and post test Feeding Scores. It further implies that the Feeding Score in post test was higher than the pre test Feeding Score. This improvement in the Feeding Performance was due to the Selected Nursing Interventions. So the Swallowing Exercises were effective in improving the Feeding Performance in Stroke patients having Dysphagia. Median test was used to compare the effect between the pre test and post test group instead of mean as because the FOIS was a 7 point likert scale. As the variables did not follow the normality and the highest Score was 7, parametric test was not applicable. Hence non parametric sign test was adopt ed which is equivalent to paired t test to find out the effectiveness. The result of the present study was substantiated with a study conducted by Mepani et al., in 2005 on augmentation of deglutitive thyrohyoid muscle shortening by the Shaker Exercise. The study involved the effect of 6 weeks shaker exercise in 11 dysphagic patients; six patients were randomized to control group and 5 patients to the Shaker Exercise group. After the therapy the change in thyrohyoid distance among Shaker Exercise group was significantly greater compared to the control group (p=0.034), this subsequently improve the swallowing function of the patients. Association of the Swallowing and Feeding Performance with selected Demographic and Clinical variables among patients with Post Stroke Dysphagia The Fisher exact test was used to associate the selected Demographic and Clinical variables with the Swallowing and Feeding Performance of the patients with Post Stroke Dysphagia. The calculated p values for the association between the Swallowing Performance of Post Stroke patients with the selected Demographic and Clinical variables such as Sex, Habits, Type of Stroke and Co-morbid Illness were not significant and hence there exist no association between them. The calculated p values for the association between the Feeding Performance of Post Stroke patients with selected Demographic and Clinical variables such as Sex, Habits, Type of Stroke and history of Co-morbid Illness were not significant and hence there is no association between them. SUMMARY The aim of the present study was to assess the effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance among patients with Post Stroke Dysphagia, for which the following objectives were formulated; To assess the Swallowing and Feeding Performance of patients with Post Stroke Dysphagia. To determine the effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance in patients with Post Stroke Dysphagia. To associate the Swallowing and Feeding Performance with selected Demographic and Clinical variables. The study was based on Ernesteine Wiedenbachs helping art of clinical nursing theory (1970). The research design applied for the study was pre experimental single group pre test-post test design. Study was conducted in KMCH. 30 samples were selected by non probability purposive sampling technique. The tool used for data collection consists of Demographic and Clinical variables, Gugging Swallowing Screen (GUSS) and Functional Oral Intake Scale (FOIS) to assess the Swallowing and Feeding Performance in Post Stroke Dysphagic patients. The data were collected for a period of 6 weeks. Descriptive and inferential statistics were used in statistical analysis, to assess the effectiveness of Selected Nursing Interventions among patients with Post Stroke Dysphagia. Fisher exact test was used to find out the association between the selected Demographic and Clinical variables with the Swallowing and Feeding Performance in patients with Post Stroke Dysphagia. Major findings of the study On the basis of Gugging Swallowing Screening (GUSS), the investigator observed the degrees of improvement in Swallowing difficulty after the therapy among patients with Post Stroke Dysphagia. About 16.67% of the subjects had No Dysphagia, 26.67% had Mild Dysphagia, 23.33% had Moderate Dysphagia, and 33.33% had Severe Dysphagia. In accordance with the Functional Oral Intake Scale (FOIS), 36.67% of the subjects were in Tube Dependent category and 63.33% were in Total Oral Intake category with sustained improvement in the Feeding Performance. The mean pre test score of the Swallowing Performance using Gugging Swallowing Screening (GUSS) tool was 12.50. The mean post test Score of the Swallowing Performance using GUSS evaluation tool was 13.87. There was a significant difference between the mean pre-test and post-test Swallowing Performance Score. The t value obtained was 6.150 which is significant at 0.001 level and at 29 degrees of freedom. The final result explained that, 22 subjects (73.3%) expressed Swallowing improvement after the treatment. Remaining eight subjects (26.7%) had no changes in their Swallowing Performance after the therapy. Median test was used to compare the Feeding Performance Score of the pre and post test groups. The median pre test Feeding Performance of the patients with Post Stroke Dysphagia was 5 with a range of 1 to 6 and that of post median test was 6.5 with a range of 1 to 7. The non parametric sign test was used to find out the effectiveness of the therapy on Feeding Performance. The obtained p value was 0.000 at 0.01 level of significance. This revealed a significant improvement in the Feeding Performance of Post Stroke Dysphagic patients. The final result revealed that 24 respondents (80%) showed an improvement in their Feeding Performance after the therapy and was assessed by FOIS scoring. But remaining six respondents (20%) showed no changes in the Feeding Performance when assessed by FOIS. There was no significant association exist between the Swallowing and Feeding Performance of the Post Stroke Dysphagic patients with the selected Demographic and Clinical variables. CONCLUSION The study was tested and accepted the hypothesis that there is a significant difference in Swallowing and Feeding Performance before and after the implementation of Selected Nursing Interventions in Post Stroke patients with Dysphagia. The result concluded that the study group had better outcome than the others. There was a significant improvement in the Swallowing and Feeding Performance of the Post Stroke Dysphagic patients after the Exercise and Positioning therapy. The participants had reduced the risk of aspiration and aspiration related complications after the therapy. Hence, Selected Nursing Interventions such as Swallowing Exercises like Shaker exercise and Hyoid Lift Maneuver and positioning during Swallowing can be recommended for the patients with Post Stroke Dysphagia. IMPLICATIONS The present study has its own implications in nursing practice, nursing education, nursing administration and nursing research. Nursing practice: Dysphagia is one of the major complications among Post Stroke patients. This study implies the effectiveness of Selected Nursing Interventions in the improvement of Swallowing and Feeding Performance among the Post Stroke Dysphagic patients. This study creates awareness among the nursing personnel about the importance of the various complications after the Stroke and its various evidence based management. The present study shows that the exercise intervention for the Post Stroke Dysphagic patients can prevent the risk of aspiration and aspiration pneumonia. The result shows that, Selected Nursing Intervention for the Post Stroke patients can reduce the risk of malnourishment. Nurses can gain skill for providing Swallowing Exercises in the Post Stroke Dysphagic patients to improve their quality of life. Nursing Education: The nurse educator can create awareness among the health care professionals about the complicated effects of Stroke and its various evidence based management. The nurse educator can arrange in-service Education programs to update their knowledge regarding the new techniques and modalities to manage the Post Stroke Dysphagia. The nurse educator can teach the students about the present study findings and its implication in patients with Post Stroke Dysphagia. This will help to improve the knowledge of the students on Swallowing Exercises. The nurse educator can motivate the nursing personnel and students to use this Swallowing Exercises and positioning in the improvement of Swallowing and Feeding Performance and in the reduction of aspiration risk in Post Stroke Dysphagic patients. Nursing administration: Nurse administrator should aware of the problem experienced by the clients after the Stroke. Nurse administrator can provide continuing education or short term courses in the clinical area for preparing the nurses with competence in managing the after effects of Stroke especially Dysphagia. Nurse administrator can plan and organize seminars, workshops and conferences about Selected Nursing Interventions for the improvements of Swallowing and Feeding Performance among patients with Post Stroke Dysphagia. Nurse administrator can formulate protocol to incorporate the study findings in nursing intervention. Nursing research: This study provides a basis for further studies. The findings of the study can be a foundation for conducting the study on large sample to strongly support the efficacy. The implications of the study can be used as a motivation for nurses to conduct research in India, where the health care system is advancing. This study helps to update the knowledge and proper utilization of resources in the field of nursing practice. LIMITATIONS OF THE STUDY The study was limited to small sample size of 30 subjects. The study was limited to a single setting. The study was conducted using a single group. RECOMMENDATIONS A similar study can be conducted with large number of subjects to generalize the research findings. A study can be conducted at different settings. Similar study can be undertaken using different Swallowing and lingual exercises. This study can be conducted with experimental and quasi experimental design. A comparative study can be conducted between different types of Swallowing Exercises in Post Stroke Dysphagic patients. A similar study can be done to assess the effectiveness of Swallowing Exercises among patients with Dysphagia who are receiving head and neck radiation for cancer. ABSTRACT The present study entitled Effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance among patients with Post Stroke Dysphagia at KMCH, Coimbatore-14. This study was undertaken during the year 2012-2013, in partial fulfillment of requirement for the degree of Master of Science in Nursing at KMCH College of Nursing, Coimbatore, which is affiliated to the Tamilnadu Dr. M.G.R. Medical University, Chennai. Objectives: 1.To assess the Swallowing and Feeding Performance of patients with Post Stroke Dysphagia. 2. To determine the effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance in patients with Post Stroke Dysphagia. 3. To associate the Swallowing and Feeding Performance with selected Demographic and Clinical variables. Research Design: Pre experimental design with single group pre test-post test design. Setting: Neuro inpatient and outpatient department of Kovai Medical Center and Hospital, Coimbatore. Samples: All Post Stroke Dysphagic patients. Sample Size: The sample size was 30. Sampling Technique: Non probability purposive sampling. Conceptual framework: Ernestine Widenbachs Helping Art of Clinical Nursing Theory (1970) was adopted. Intervention: Selected Nursing Interventions such as Swallowing Exercises and Positioning during the swallowing were incorporated. The clients were instructed to do the Shaker Exercise and Hyoid Lift Manoeuvre 3 to 6 times a day for a period of 6 weeks. The subjects were instructed to elevate or down the chin and tilt the head towards stronger side while Swallowing. Outcome Measures: Swallowing and Feeding Performance was assessed by Gugging Swallowing Screen (GUSS) and Functional Oral Intake Scale (FOIS) respectively. Results: The mean difference between pre and post test Swallowing Score was 6.150 and which was significant at 0.001 level. The p value obtained for Feeding Score was 0.000 at 0.001 level of significance. The result showed a significant improvement in the Swallowing and Feeding Performance. Conclusion: This study proved that the implementation of Selected Nursing Interventions rather than the other conventional treatment will improve Swallowing and Feeding Performance among Post Stroke patients with Dysphagia. Hence the Swallowing Exercises and Positioning can be recommended in clinical practice to improve the Swallowing and Feeding Performance in Post Stroke Dysphagic patients.

Sleeping With The Enemy Essay -- essays research papers

Sleeping With the Enemy Summary Oppression of women in our patriarchal society is seen daily. Men dominate women in so many ways it becomes hard to distinguish one form of oppression from another. In the movie Sleeping With the Enemy, a young woman battles daily with an abusive, domineering husband. Although the outside world may view Laura's life as perfect, the viewer sees the whole truth. Laura's perfect life consists of an attractive, wealthy husband who would do anything for her-even kill. They live in a beautiful mansion on the coast, and Laura does not have to work if she so chooses. Every day Laura is tortured and ridiculed and criticized by her husband. Her husband, Martin Burns, is obsessed about keeping the household in perfect condition. If one towel is out of line, one can out of order in the cupboard, or if dinner is slightly late, Laura receives a severe beating. The only way for Laura to escape from her tyrannical husband is by staging her own death. Laura takes her husband and neighbor out on a sailboat one stormy evening to execute her plan of escape. She "falls" off the boat and swims to shore. Her husband believes that Laura dies at sea because she could not swim. Secretly, though, Laura had been taking swimming lessons at the YWCA in order to facilitate her plan. After packing a small bag with some personal items and money, Laura Burns abandons her abusive husband and leaves her miserable life behind. Thus begins Laura Burns' new life as Sara Waters. She changes her name, location, situation, and is reborn. In Laura's new life, she works at a library and starts to date again. As Sara, she is able to enjoy life and be free. Sara rebuilds her self-esteem, is able to spend more time with her mother, and can relax without being afraid of whether the shelves in the kitchen will meet her husband's standards. The escape seemed foolproof, until Martin found a piece of evidence that proves Laura is still alive. (Laura had thrown her wedding ring in the toilet and Martin finally sees it.) After weeks of searching, Martin is able to hunt down his wife. He feels that if he cannot have her, then no one will. Sara does not want to return to the terrible oppressive lifestyle she was trapped in before. Instead of giving up her new life, she shoots the "intruder" in her house and puts an end to her husband's reign of terror over her.... ...common and rarely reported. Memories of these experiences often become suppressed because of the personal humiliation and shame women feel about the situation. Notice that, in the movie, Laura never seeks legal retribution for Martin's abuse, all she wants to do is escape. Sexual abuse and spousal abuse are psychologically devastating for women because these are acts that inflict feelings of guilt upon the victim. It is too often that a female rape victim will do nothing because she feels responsible. In the beginning of the movie, when Laura was subjected to daily abuse from her husband, she probably started to feel like she deserved the treatment because her husband constantly beat her down emotionally and made her feel like nothing. When someone is beaten down for long enough they start to believe that they are worthless. Finally, Laura escapes her oppressor forever when she kills him. Not all women are so fortunate to be able to start their lives over, though. Many women die from domestic violence, and most men do not suffer consequences for their actions. This movie shows the triumph of a woman over her oppressor because she goes to any length to gain her freedom and respect.