Research paper of Afro-American Music Example | Topics and Well Written Essays - 750 words

Of Afro-American Music - Research Paper Example He began to sing about his opportunity which was given to him after the declaration of freedom. Blues music rose from this period. During the prior days blues was called society blues. Numerous blues vocalists landed positions in diversion gatherings and troupes and shows. Later on down home music picked up notoriety which brought about blues vocalists coordinating blue grass music into their singing which later on formed into a nation arranged blues style (Ruehl) Jazz music began its movement in New Orleans. Spontaneous creation is the most characterizing highlight of this sort of music. Conceived in the south of America this music perceives the torment of lost love, unfairness, and offers articulation to the triumph of enduring a wrecked heart just as looking down difficulties. It was the extraordinary melodic convention of New Orleans that mixed people, African drumming, church music, jazz, blues and so forth, jazz music was conceived (History of jazz ). Jazz and blues music have bunches of similitudes together. Truth be told both are tangled and it is hard to isolate them. Both of the music has risen up out of the southern piece of America. It was a lot of mainstream with the Afro-American populace of that locale. The melodic types of both jazz and blues are because of the crash of generally African rhythms and with that of European old style and people music. Both jazz and blues are adored and extraordinarily American types of music. The real causes of both jazz and blues can't be found unequivocally. They are very covered. This is on the grounds that these sorts of music were produced out of neediness and the people who created them didn't realize that the music would get famous later on. In any case, both these music structures can be identified with African-American spirituals and with that of melodies sung by slaves at work places. These music contained early mixes of European - African music. .Both jazz and blues music were once viewed as music of the villain. These kinds of

Nursing Reflective Essay Mentorship

Nursing Reflective Essay Mentorship As indicated by the Nursing and Midwifery Council (NMC) (2006) the term coach is utilized to mean the job of an enrolled nurture who encourages learning and administers and evaluates understudies in the training place. They moreover recognize the eight obligatory principles that must be accomplished to turn into a coach, and inside the task I will allude the Standards to Support Learning and Assessment in Practice; NMC norms for guides, practice educators and instructors, and distinguishing the guidelines for tutors required (SM). This task will initially take a gander at the individual and expert reasons why I needed to attempt the mentorship module. It will likewise talk about the significance of a strong learning condition in the working environment, and how basic it is. My job as a tutor to a nursing understudy will be assessed, taking a gander at the manner by which I bolstered her on the ward and how I encouraged this. Taking everything into account, I will recognize my very own improvement in attempted and finishing this module. As an enlisted nurture on a bustling Pediatric ward I generally appreciate supporting understudy attendants while they are on position with us. There is an obvious lack of qualified guides on the ward, and inside my last self-awareness audit with my line supervisor I distinguished a need to achieve the mentorship capability. The Nursing and Midwifery Council (NMC) (2004) states, that as an enlisted nurture, you should keep your insight and abilities modern all through your working life. You likewise have an obligation to encourage nursing understudies and others to build up their skill. As per Hand (2006), educating is viewed as a significant piece of the wellbeing experts job, and sooner or later in their vocation, individuals from most social insurance callings are relied upon to show other staff, understudies, patients and family members. Along these lines, the standard of educators and tutors accessible in the training spot will majorly affect the nature of future specialists, th erefore making an improvement in tolerant consideration. Most understudies and numerous experts note that taking in gained from arrangement experience is considerably more significant and applicable than that procured in the talk room (Quinn 2000). To guarantee any student has a positive learning experience it is basic that the learning condition is for all intents and purposes, expertly, and mentally strong to all who work and learn inside it. Clarke et al. (2003) takes note of that present attendant training places a high incentive on learning in the clinical condition and this places various requests on clinical zones and staff. The nature of these clinical positions affects the learning procedure for nursing understudies. The ward on which I work means to cultivate a decent all-round learning experience to understudies on position as we are lucky to be a well resourced ward with many experienced staff. In spite of the fact that we are a very bustling ward, understudies are decidedly gotten and upheld well, the larger part wishing to work with us once qualified. On beginning of the mentorship module it was discovered that there were no understudies or students accessible to me at first so the time length for my time of coaching with the end goal of the task was restricted to only one month. I was be that as it may, ready to distinguish my own clinical guide on the ward, and after investigation of my own qualities, shortcomings, openings and dangers (SWOT) I settled on my short and long haul objectives and set a learning contract with my tutor in availability for the assignment of an understudy. Jasper (2003) views SWOT investigation as becoming more acquainted with yourself. The comprehension of our aptitudes and capacities and the familiarity with where our cutoff points lie is viewed as vital to having the option to go about as an expert professional. I was at long last assigned a first year kid branch understudy, and was educated by the lady this would be her first clinical position. It was imperative to know where she was in her preparation for me to design sufficiently when supporting her on the ward. An as often as possible utilized scientific categorization in nurture training is the system by Benner (2001) in which there are five levels; amateur, tenderfoot, able, capable, and master. Benner (2001) proposes that medical attendants might be at various levels in various regions reliant on their past encounters. Tragically I couldn't work with her on her first move as I was completing the nightshift as she was beginning with the dayshift. I did anyway invite her to the ward and orientated her to it, guaranteeing she knew who she would be working with on her first since forever clinical move. Davidson (2005) takes note of that understudies can be caused to feel welcome by somebody just knowing their name and being normal. He likewise takes note of that a physical visit is a decent beginning. This takes into account brief acquaintances with other staff that the understudy will be working with. On this underlying gathering I additionally gave her the wards understudy nurture direction/asset pack. This furnished her with essential data about the ward and the various groups and staff inside it, this was to give a decent presentation into the condition that she would learn in during her arrangement. Two days after she started, we had our first clinical move together. I was satisfied to hear that she had discovered different individuals from staff steady during her initial two days on the ward. Cahill (1996) recognizes that the absolute most critical factor in making a positive learning condition is the connection among staff and nursing understudies. She additionally takes note of that a typical issue for understudies is that they can't work consistently with their coach, so I accepted this open door to talk about and plan her off the clock considering any solicitations she had. Kenworthy and Nicklin (2000) comment that the more agreeable and safe an understudy feels inside the earth, the more probable it is that compelling learning will happen and the understudy will get inspired to learn. I was additionally ready to talk about the learning pack which I had recently given her and she recognized that it had all the earmarks of being extremely instructive. Morton-Cooper and Palme r (2000) express that despite the fact that, by and by the guide goes about as a learning asset, it is fundamental for the understudy to get self coordinated in the advancement of their adapting needs. A significant piece of her situation was to set up a learning contract with myself as her clinical guide. A learning contract is an archive used to aid the arranging of a learning venture. It is a composed understanding haggled between the student and the coach wherein adapting needs are recognized (Lowry 1997). So as to do this effectively we expected to distinguish her learning destinations which incorporated the learning results of the modules to be evaluated practically speaking. As this was her first endeavor to set a learning contract it was significant for me to help her through the procedure. Twentyman et al (2006) talk about helped realizing where the coach requests that the understudy distinguish their objectives and intend to make sure about learning openings that help the accomplishment. Jackson and Mannix (2001) note that measure of premium the medical attendant shows in the adapting needs of the understudy and the key job the person plays in their accomplishment are bas ic to the understudies improvement. During the movements that I worked with her we talked about her necessary learning results and during one of our conventional gatherings we concurred her learning contract. Inside this learning contract she had distinguished that she expected to build up her mindfulness in the sheltered utilization of clinical hardware utilized on the ward and the standards with respect to utilizing these. Quinn (2000a) comments that it is imperative to know about the understudies program and the necessary results so as to guarantee compelling learning. After conversation with her it was concluded that an instructing meeting encompassing the protected utilization of blood glucose observing hardware would be good for her, as it was a methodology that was frequently required on the ward. It would cover one of her learning results, and I consented to encourage this. Wallace (2003) takes note of, that it is critical to decrease the chance of uncovering understudy or patient to any hazard, until the understudy has gained adequate ability and information when completing a useful methodology. The significance of appraisal by a tutor is in this manner urgent to guarantee understudies become capable in pragmatic aptitudes. The generally held rule that responsibility originates from preparing and training, is obvious inside the understudy nurture job. As indicated by Pennels (1997) if responsibility accompanies information, understudies are legitimately shielded from full responsibility until prepared. Albeit liable for their activities their insight base might be deficient to permit responsibility. Along these lines, proficient responsibility lies with the enrolled nurture that an understudy nurture works with. It was consoling for me that she and I had immediately built up a viable working relationship where I believed in her capacity to consistently inquire as to whether she got uncertain about a circumstance. She appeared to completely comprehend her job as an understudy nurture as distinguished in the NMC manage for understudies of nursing and birthing assistance (NMC 2006a). Before setting out on any program of encouraging it is critical to perceive that there are diverse learning hypotheses and styles to consider. Reece and Walker (2003) express that there is an incredible arrangement expounded on the manner in which individuals learn and various speculations on the techniques to educate successfully or control individuals in learning. They examine that the principle learning hypotheses are Behaviorism, Cognitivism and Humanism. As indicated by the Behaviorism hypothesis (Skinner 1974), the learning condition is principal to learning, and if this condition is correct, learning happens as associations are made among upgrade and reaction, and reaction and fortification (refered to by Quinn, 2000a). The Cognitive hypothesis (Bruner 1966) considers learning as an inte

GRE, MCAT, LSAT, oh my!

GRE, MCAT, LSAT, oh my! When I decided I was going to apply for graduate school after my undergrad, there were so many things I had to consider: where I was going to go, what program I would be doing, and what tests I needed to take. I went to a couple info sessions on grad school, and knew for the program I would be applying for I had to take the GRE. But between the GRE, the GMAT, the MCAT, the LSAT, and more, it’s very easy to get confused on who needs to take what test and why. Think of all of these as the grown up versions of the SAT and ACT. While this probably isn’t (and probably shouldn’t) be on your mind during your high school years, it’s important to know what all these acronyms stand for and when they might come in handy. GRE: Graduate Record Examination What it is: It’s a standardized test with three sections: analytical writing, quantitative reasoning, and verbal reasoning. That’s the fancy way to say an essay, math, and reading/vocab. It can be a bit more challenging for students than ACT/SAT simply due to the fact that you might not have taken a math class since high school! Most colleges offer workshops on what the whole process of signing up, studying for, and taking the exam looks like, so you’re not alone. As with all of these exams, everyone prepares in different ways. Dont be afraid to try a few different techniques and see what works for you. What programs: Your typical masters and doctoral programs Score range: 260-340 for quantitative and verbal combined, 0-6 for writing Time: ~3 hours, 45 minutes Cost: ~$205 MCAT: Medical College Admission Test What it is: Exactly what it sounds like. It contains four sections that roughly break down into chemistry and physics, verbal reasoning, biology and biochemistry, and psychology and sociology. The MCAT is required for almost all medical programs. In addition to the MCAT, most medical programs have requirements for courses, so thats something else to keep in mind. If you utilize Pre-Health advising services at Illinois you’ll get all the info you need about the MCAT early on in your college career. Score range: each section: 118-132, full exam: 472-528 Time: ~7 hours, 30 minutes Cost: ~$315 LSAT: Law School Admission Test What it is: The LSAT contains 5 different sections: logical reasoning, reading comprehension, logic games, writing sample, and an “unscored variable section”. This last section is similar to one of the first three, but is only used to test potential new questions. The writing sample is unscored as well, but is sent along with your scores to whatever schools you apply to. Many pre-law/political science classes cover lots of the types of questions that will be asked on the LSAT; however, many pre-law students still spend up to a year studying for the exam. LSAT scores are often looked at as a good indication to your dedication and future success in law school. Pre-law advising at Illinois has a great blog on what students of any year can do to start preparing. What programs: Law schools Score range: 120-180 Time: ~3 hours, 30 minutes Cost: ~$190 GMAT: Graduate Management Admission Test What it is: The GMAT has 4 sections: an analytical writing assessment, integrated reasoning, quantitative, and verbal. Integrated reasoning is about analyzing data in multiple formats. The other three sections are relatively similar to that of the GRE. While not all business schools require the GMAT, it’s often recommended as it shows commitment to the program and is said to be a good indicator of success in business programs. What programs: Business administration, finance, accountancy masters programs Score range: 200-800 Time: ~3 hours, 30 minutes Cost: ~$250 I hope this helps! Applying to graduate school is a time-consuming process, so its good to get an early start. Knowing what type of test your program will require can allow you to start studying early on, and ease the weight of it later on down the road. But for now focus on your undergrad and keep a planner handy! Alex Class of 2020 After switching majors four times, I've finally fallen in love with what I'm studying: communication in the College of Liberal Arts and Sciences. I hope hearing about my experiences can put all your worries at ease, because college really isn't as scary as you might think!

Breathing The Process Of Respiration - 1124 Words

Breathing: The process of respiration, during which air is inhaled into the lungs through the mouth or nose due to muscle contraction and then exhaled due to muscle relaxation (NOAA 2015). I have never done any form of meditation in the past therefore it was kind of difficult to start this exercise, however I was anxious to. I must say it was very easy to separate myself from everything and everyone since it was a customary habit. I was also very excited to be able to carry out this assignment on my peers. Day 1 On the first day I was asked to close my eyes and focus on my breathing while paying attention to the air flowing in and out of my nostril and also to observe the movement of my chest while breathing. At first, it was a bit difficult to concentrate because of all the thoughts that have been flowing through my mind; I tried as much as possible to blank them out. On many attempts I was able to concentrate on my breathing and at the same time ignoring my environment. When I did this, I noticed that I was not able to hear my breathing but felt the rhythmic movement of my chest. It was a calm and peaceful moment that almost sent me to sleep. I felt light and free and wanted to remain in this mode for a long time, however time did not permit me to do so. As I opened my eyes it burned from keeping it closed for so long and also as it had to adjust to the lighting around me. Day 2 On the second day I was more relaxed and open minded to carry out the experiment sinceShow MoreRelatedA Study On Cellular Respiration979 Words   |  4 Pages1. Define the following terms: a. Cellular respiration (aerobic respiration) (2 points) – the process of oxidizing food molecules to carbon dioxide and water. Glucose is an example. b. Fermentation (anaerobic respiration) (2 points)- metabolic process that converts sugar to acids, gas, or alcohol. 2. Summarize what occurs during the three steps of cellular respiration and indicate where each process takes place in the cell. (6 points) a. Glycolysis: occurs in the cytoplasmic fluid of the cell,Read MoreGold Fish Lab Report1135 Words   |  5 Pages152-35 Professor Weller 14 February 2012 Effects of Temperature on Goldfish Respiration Introduction This experiment was designed to identify the effect of cold-water temperatures on the respiration rate of goldfish. The respiration rates helped to identify the goldfish as being ectotherms or endotherms. Organisms exchange gases with their environment through a process called respiration or breathing. Aerobic respiration, also known as aerobic metabolism, occurs when oxygen is taken into the bodyRead MoreThe Effects of Exercise on the Pulmonary Ventilation Rate872 Words   |  3 PagesRespiration is the process that takes place in every living cell to make energy available to the body. Energy is vital for us to carry out many life processes such as movement and so respiration in essential to life. During respiration glucose and oxygen are used in a reaction that produces energy and gives out carbon dioxide and water as waste products. Glucose is obtained by digestion of food and oxygen is taken from the air during a process called breathing or ventilation. Pulmonary Ventilation Read MoreHow Routine Data Collected Throughout Health And Social Care1565 Words   |  7 Pagespatient by listening to the patient’s breathing, look at his or her colour, and see whether the patient is awake. This will immediately tell the patient’s health problems if you see any indicators that the patient is having trouble breathing, is breathing too fast, or his or her colour is unnaturally pale or reddish, or if the patient appears to be in distress. It will suggests the problems to the nurse in duty or the doctor. But, when the patient is breathing, colour, or position in the bed indicatesRead More The Respiratory System Essay1538 Words   |  7 Pagesand the primary purpose of this system is to supply the blood with oxygen in order for the blood vessels to carry the precious gaseous element to all parts of the body to accomplish cell respiration. The respiratory system completes this important function of breathing throughout inspiration. In the breathing proce ss inhaling oxygen is essential for cells to metabolize nutrients and carry out some other tasks, but it must occur simultaneously with exhaling when the carbon dioxide is excreted, this exchangeRead MoreUnit 5 Health and Social Care Essay1298 Words   |  6 Pagesrespiratory system The respiration system is the process of supplying oxygen to the cells so that cells can metabolise energy. The main functions of the respiratory system are to maintain oxygen supply to cells, to remove water from the body, and to remove carbon dioxide from the body. It is divided into four sections, three of which are under the ‘external respiration’. These are breathing, gaseous exchange and blood transport. The respiratory system is the internal of tissue respiration carried out insideRead MoreFunctions of the Upper Respiratory Tract921 Words   |  4 Pagesthese organs do not only contribute to the exchange of gases but also provide separate functions as well. The nose is the organ that projects above the mouth on the face of a person or an animal. The nose contains the nostrils and is used for breathing and smelling. It is the only external portion of the respiratory system. The nose is not comprised of bone but rather of cartilage. The nose has tiny hairs and sticky mucus which traps dust particles. The main role of the nose is to move dustRead MoreThe Effect Of Oxygen On The Heart Rate1735 Words   |  7 PagesThe results obtained for this experiment were somewhat expected as the results had reflected to the theory. While the composition of oxygen in air remains constant only the atmospheric pressure to decrease with altitude. The respiration pattern should have shown a more frequent incidence of trough and crest, but the amplitude decreased with the increasing elevation, as the oxygen molecules contained in each breathe are low. Since less oxygen are presented the oxygen and carbon dioxide should decreaseRead MoreThe Respiratory System And The Effect Of Exercise1376 Words   |  6 Pagesliving organism is composed of cells. Cells consume Oxygen (O2) and produce Carbone dioxide (CO2). The respiratory system has for main function to provide the Oxygen (O2) and dispose of the Carbon dioxide (CO2) produce by the cells through the process of respiration. During exercise the demand of Oxygen (O2) and the production of Carbon dioxide (CO2) raises which affect the respiratory system. This essay will discuss the respiratory system and how it is affected by exercise (Tortora, G., Grabowski, SRead MoreExplain the Physiology of Two Named Body Systems in Relation to Energy Metabolism in the Body1053 Words   |  5 Pagesglucose via the blood stream. Oxygen is need for aerobic respiration to occur. The Cardiovascular System The function of the respiratory system is to remove carbon dioxide and water from the body, also to maintain an oxygen to supply to each of the cells. In the respiratory system there is internal and external respiration. The internal respiration is carried out in the body cells whereas external respiration consists of blood transport, breathing and gaseous exchange. The respiratory system contains

Testing of the Prototype Model of the Proposed End Effector Design - Free Essay Example

Sample details Pages: 15 Words: 4630 Downloads: 5 Date added: 2017/06/26 Category Statistics Essay Did you like this example? Chapter Seven Testing of the Prototype Model of the Proposed End Effector Design 7.1 Introduction The performance of the proposed Dolly Baseboard assembly operation needs to be monitored and analyzed in order to minimize failure. As baseboard and dolly are supplied from different mould cavity in Clipsal, it is important to know the parameters such as the mould cavity number where the parts are made from or inserting speed, that might affect the consistence and cycle time of the assembly process, and to be able to vary or discard them so as to achieve the desired performance of the assembly process. The approach used in this project is an experimental technique known as Design of Experiment (DOE). Don’t waste time! Our writers will create an original "Testing of the Prototype Model of the Proposed End Effector Design" essay for you Create order DeVor, Tsong John (1992) has defined DOE as a statistical tool used in quality design and improvement. The purpose of DOE is to experiment with various combinations of parameters for the purpose of identifying the particular combinations that optimize certain design criteria or performance measures. 7.2 Mathematical representation of DOE In DOE, only the final outcomes obtained by a combination of different variables are of interest. This outcome is usually known as response, which is the performance of the dolly baseboard assembly process in this project. DeVor, Tsong John (1992) states that the response can be represented mathematically by the equation as illustrated in equation 7.1. Assuming that a system involving a mean response that is dependent on input variables x1, x2, . . . , xn. Then could be expressed as This mean that the mean response can be expressed as function with independent variables x1, x2, . . . , xn and a set of parameters 1, 2, . . . , k. The data collected during the experiment are represented by the equation as illustrated in equation 7.2. 7.2.1 Classification of variables by transfer function model The performance of a system can be described by a transfer function model as shown in 7.1. The transfer function illustrates the relationship between the inputs, defined control factors and the output of the process in the presence of noise. According to Taguchis Methods, the factors that can affect the output performance or quality can be classified into mainly four categories which are shown in Table 7.1. Table 7.1 Types of factors in an experiment S/No. Types of Factors Description 1. Signal factors These are factors that may be adjusted by user to attain target performance. 2. Control factors These are the process parameters whose values can be determined during design process. 3. Noise factors They are uncontrollable factors or controllable factors that do not want to control for the purpose of an experiment. 4. Scaling/Leveling factors Special case of control factors that may be easily adjusted to achieve a desired functional relationship between a signal factor and output response. (Source: DeVor, Tsong John, 1992) 7.3 Factors selection in the Dolly Baseboard assembly process One of the most important steps in designing an experiment for Dolly Baseboard assembly process is to select the appropriate factors to study. Basically, there are two groups of factors: The first is the experimental or input factors, those that can be manipulating and are also called the independent variables. The second is the response factors that are measured and are also called the dependent variables. 7.3.1 Input factors and their levels According to Pareto principle, there should be hundreds of factors to choose from, but only a vital few that really make significant changes to the response. It is crucial to identify these input variables and decide on their importance on the quality of output. The input factors and their levels that will have real effects on the performance of the assembly process are presented in Table 7.2. Table 7.2 Type of the input factors used in DOE S/No. Input Factors Description A Baseboard geometry with (Four Levels) Baseboard and dolly are made from different type of injection moulding machines in Clipsal, any geometrical variation might affect the performance of the assembly process, for example; if the geometry of dolly tends to be smaller and baseboard tends to be bigger, the assembly process will become harder. The dolly and baseboard can be selected from four different type of mould cavity to be used in DOE B Dolly geometry with (Four Levels) C Assembling speed with (Three Levels) This is the speed where dolly and baseboard are assembled together. The selection of this speed affects not only the performance of the assembly process, but also the assembly cycle time The setting of these three different speeds can be achieved using teach pendent of jointed-armed robot 7.3.2 Response factor It is also known as output factor, in this case, is to measure the performance of the assembly process. Taguchi mentioned that when selecting the response factors for their practicality, they should be hard, variable-scale factors (1-10) where possible. Thus, factors such as volts, shrinkage, size, and defect count make good response factors. The percent yield is an example of a poor response variable as it does not tell the quality of the rejected material. In this DOE, the performance of the assembly process is measured on a (0 to 2 variable-scale) factor which is explained as below: 0 It indicates poor assembly process; no dollies are assembled to baseboard. 1 It indicates fair assembly process; only one dolly is assembled to baseboard. 2 It indicates excellent assembly process; two dollies are assembled to baseboard 7.4 Design of three factors full factorial experiments The experimental design required is a fixed effect model of three factor full factorial designs. DeVor, Tsong John (1992) defined fixed effect model of factorial design as the levels specifically chosen by the experimenter. In hypothesis testing about level means, the conclusions will apply only to the factor level considered in the analysis. The three variables used in the experiment are assembling speed, baseboard and dolly geometry. The level condition of these variables is listed in Table 7.3 and it is noted that the levels of the assembling speed is in ascending order but not for the dolly and baseboard geometry which cannot be controlled that they might be the same or randomly different throughout the experiment. However, this is not important as it will not affect the final conclusion of the experiment. In order to adopt a standard notation, the variables are coded as A, B, and C with level coded as a, b and c and the possible test conditions will be 4 x 4 x 3 = 48. These are illustrated in Table 7.4. Table 7.3 Variable setting to determine the performance of assembly process Variables Unit Level 1 Level 2 Level 3 Level 4 Baseboard geometry (A) Cavity no.7 Cavity no.8 Cavity no.9 Cavity no.10 Dolly geometry (B) Cavity no.2 Cavity no.3 Cavity no.4 Cavity no.5 Assembling speed (C) mm/s 5 (Slow) 10 (Medium) 15 (Fast) Table 7.4 Coded and actual test conditions in standard order Coded Test Conditions Actual Test Conditions Test no. A B C Baseboard Geometry Dolly Geometry Assembling Speed (mm/s) 1 a1 b1 c1 Cavity no. 7 Cavity no. 2 5 2 a2 b1 c1 Cavity no. 8 Cavity no. 2 5 3 a3 b1 c1 Cavity no. 9 Cavity no. 2 5 4 a4 b1 c1 Cavity no. 10 Cavity no. 2 5 5 a1 b2 c1 Cavity no. 7 Cavity no. 3 5 6 a2 b2 c1 Cavity no. 8 Cavity no. 3 5 7 a3 b2 c1 Cavity no. 9 Cavity no. 3 5 8 a4 b2 c1 Cavity no. 10 Cavity no. 3 5 9 a1 b3 c1 Cavity no. 7 Cavity no. 4 5 10 a2 b3 c1 Cavity no. 8 Cavity no. 4 5 11 a3 b3 c1 Cavity no. 9 Cavity no. 4 5 12 a4 b3 c1 Cavity no. 10 Cavity no. 4 5 13 a1 b4 c1 Cavity no. 7 Cavity no. 5 5 14 a2 b4 c1 Cavity no. 8 Cavity no. 5 5 15 a3 b4 c1 Cavity no. 9 Cavity no. 5 5 16 a4 b4 c1 Cavity no. 10 Cavity no. 5 5 17 a1 b1 c2 Cavity no. 7 Cavity no. 2 10 18 a2 b1 c2 Cavity no. 8 Cavity no. 2 10 19 a3 b1 c2 Cavity no. 9 Cavity no. 2 10 20 a4 b1 c2 Cavity no. 10 Cavity no. 2 10 21 a1 b2 c2 Cavity no. 7 Cavity no. 3 10 22 a2 b2 c2 Cavity no. 8 Cavity no. 3 10 23 a3 b2 c2 Cavity no. 9 Cavity no. 3 10 24 a4 b2 c2 Cavity no. 10 Cavity no. 3 10 25 a1 b3 c2 Cavity no. 7 Cavity no. 4 10 26 a2 b3 c2 Cavity no. 8 Cavity no. 4 10 27 a3 b3 c2 Cavity no. 9 Cavity no. 4 10 28 a4 b3 c2 Cavity no. 10 Cavity no. 4 10 29 a1 b4 c2 Cavity no. 7 Cavity no. 5 10 30 a2 b4 c2 Cavity no. 8 Cavity no. 5 10 31 a3 b4 c2 Cavity no. 9 Cavity no. 5 10 32 a4 b4 c2 Cavity no. 10 Cavity no. 5 10 33 a1 b1 c3 Cavity no. 7 Cavity no. 2 15 34 a2 b1 c3 Cavity no. 8 Cavity no. 2 15 35 a3 b1 c3 Cavity no. 9 Cavity no. 2 15 36 a4 b1 c3 Cavity no. 10 Cavity no. 2 15 37 a1 b2 c3 Cavity no. 7 Cavity no. 3 15 38 a2 b2 c3 Cavity no. 8 Cavity no. 3 15 39 a3 b2 c3 Cavity no. 9 Cavity no. 3 15 40 a4 b2 c3 Cavity no. 10 Cavity no. 3 15 41 a1 b3 c3 Cavity no. 7 Cavity no. 4 15 42 a2 b3 c3 Cavity no. 8 Cavity no. 4 15 43 a3 b3 c3 Cavity no. 9 Cavity no. 4 15 44 a4 b3 c3 Cavity no. 10 Cavity no. 4 15 45 a1 b4 c3 Cavity no. 7 Cavity no. 5 15 46 a2 b4 c3 Cavity no. 8 Cavity no. 5 15 47 a3 b4 c3 Cavity no. 9 Cavity no. 5 15 48 a4 b4 c3 Cavity no. 10 Cavity no. 5 15 7.5 Method of data collection The data collection process begins by randomly selecting the test condition to be conducted. Each of the test condition is replicated 10 times and the mean average yijk is calculated. The total expected number of replicate is 48 x 10 = 480 and the estimated hours required is about 12 hours. In order to maximize the accuracy of the experiment, the test was accomplished in one full day and the same program was used throughout the entire testing, except for the three different assembling speeds mentioned earlier. Due to the insufficient parts supplied from Clipsal, dolly and baseboard must be used repeatedly. Finally, after counting all the available number of parts for the experiment, it was found that dolly and baseboard, which are made of plastics material, could be replaced with a new one in every 5 replications to avoid any inaccuracy to the final conclusion due to excessive bending. 7.2 shows the arranged baseboards and dollies that are ready for the test and a sample of the exper imental result is illustrated in 7.3. The experimental data for test 1 to 48 can be found in Appendix G. Before proceeding to the tests, it is important to make some assumptions to the experiment and they are discussed as below: a. The baseboard and fixture are secure enough to withstand the force exerted by the end effector during the assembly process. It means that their positions are fixed throughout the experiment. b. The area where baseboard is placed in the fixture, and dolly is attached to the end effector are dimensional controlled and should be constant throughout the experiment. It means that if baseboard and dolly geometry do not vary, they should be always at the same assembling position. c. The repeatability and accuracy of the motor in jointed-arm robot are kept to the minimum influence in this experiment d. During the assembly process, the areas where baseboard must be bended in order for dolly to be assembled will always resume to its original position within at least 5 replicate number of test. This means that their dimension will remain constant within 5 repetition of use. e. The geometry of baseboard and dolly made by the same mould cavity number is identical. If there is any geometrical variation, it should be small enough to have little effect in the final result. However, different mould cavity number might produce different part and this geometrical variation is allowed. Test No. Test Date Test venue Equipment used : 1 : 10 Sept 2004 : M-15a (UNISA) : Joint-arm robot Parameters settings Baseboard geometry Dolly geometry Assembling Speed : Cavity no. 7 : Cavity no. 2 : 5 mm/s Replicate no. Response Scale Factor(0-2) Replicate no. Response Scale Factor(0-2) 1 2.0 6 2.0 2 2.0 7 2.0 3 2.0 8 2.0 4 2.0 9 2.0 5 2.0 10 2.0 Mean Average, yijk = 2.0 7.6 Experimental results The graphs in 7.5 shows the results obtained from the 48 sets of experiment conducted. The graph for each test shows the average score for the 10 replicates of the assembly operation and it also indicates the consistency of the assembly process for each combination of the input factor. It can be seen that all test have a full score, except for test 2, 8, 10, 14, 20, 24, 34, 38 and 42 which score 1.9, and test 4 and 6 which score 1.8 for the consistence of the assembly process. The total number of test failed in the assembly operation is 13 and the input factor combination of these 13 tests are labelled and separated from the rest so that the root to their failure can be verified in future, and this is illustrated in 7.4 below. The assembly efficiency for the selected end effector design can then be calculated as below: Assembly Efficiency = = = 0.9729 or 97.29 % 130 Testing of the Prototype Model of the Proposed End Effector Design 7.7 Random order of test The run order of the 48 testing has been randomised as shown in Table 7.5. Randomisation of test order was exercised because it helps to lessen the effects of other factors that are not included in the study, particularly for effects that are time-dependent. Column 2 of Table 7.5 shows the test numbers which were randomly selected to be tested in order and column 6 is known as the response obtained from experiments, which is actually the mean average performance of the assembly process. The variable response scale factor is 0 to 2. Table 7.5 Test order and result obtained from each test 1 2 3 4 5 6 1 2 3 4 5 6 Test Order Test No. A B C (mm/s) Response (0-2) Test Order Test No. A B C (mm/s) Response (0-2) 1 6 a2 b2 c1 1.8 25 44 a4 b3 c3 2.0 2 2 a2 b1 c1 1.9 26 3 a3 b1 c1 2.0 3 30 a2 b4 c2 2.0 27 8 a4 b2 c1 1.9 4 42 a2 b3 c3 1.9 28 7 a3 b2 c1 2.0 5 9 a1 b3 c1 2.0 29 10 a2 b3 c1 1.9 6 12 a4 b3 c1 2.0 30 4 a4 b1 c1 1.8 7 1 a1 b1 c1 2.0 31 13 a1 b4 c1 2.0 8 16 a4 b4 c1 2.0 32 23 a3 b2 c2 2.0 9 25 a1 b3 c2 2.0 33 18 a2 b1 c2 2.0 10 15 a3 b4 c1 2.0 34 21 a1 b2 c2 2.0 11 11 a3 b3 c1 2.0 35 17 a1 b1 c2 2.0 12 19 a3 b1 c2 2.0 36 33 a1 b1 c3 2.0 13 32 a4 b4 c2 2.0 37 27 a3 b3 c2 2.0 14 37 a1 b2 c3 2.0 38 20 a4 b1 c2 1.9 15 28 a4 b3 c2 2.0 39 31 a3 b4 c2 2.0 16 40 a4 b2 c3 2.0 40 26 a2 b3 c2 2.0 17 48 a4 b4 c3 2.0 41 36 a4 b1 c3 2.0 18 22 a2 b2 c2 2.0 42 41 a1 b3 c3 2.0 19 45 a1 b4 c3 2.0 43 43 a3 b3 c3 2.0 20 24 a4 b2 c2 1.9 44 46 a2 b4 c3 2.0 21 34 a2 b1 c3 1.9 45 38 a2 b2 c3 1.9 22 47 a3 b4 c3 2.0 46 35 a3 b1 c3 2.0 23 39 a3 b2 c3 2.0 47 29 a1 b4 c2 2.0 24 14 a2 b4 c1 1.9 48 5 a1 b2 c1 2.0 Note * A = Baseboard geometry a1 = Cavity no. 7 a2 = Cavity no. 8 a3 = Cavity no. 9 a4 = Cavity no. 10 B = Dolly geometry b1 = Cavity no. 2 b2 = Cavity no. 3 b3 = Cavity no. 4 b4 = Cavity no. 5 C = Assembling speed c1 = 5 mm/s c2 = 10 mm/s c3 = 15 mm/s 130 Testing of the Prototype Model of the Proposed End Effector Design 7.8 Use of statistical software to analyze the experimental results Assembly efficiency of 97.29 % was calculated in the previous session and this shows that there will be 1 failure for the assembly operation in every 37 cycles in the actual situation. This is obviously undesirable and must be improved. Therefore, it is necessary to know what factors that actually causes the 2.71 % to affect the consistency of the assembly operation. Generally, the use of statistical software to analyse the results of a designed experiment has been a common practice in the industries where the engineer only requires a fair knowledge of basic statistics and considerable time required for the manually statistic calculation can be reduced. In the case of this project, the software use for the analysis is known as Minitab version 13, which is available in the campus computer pool. The main objective of this software is to analyse the collected data so as to improved assembly efficiency of the selected end effector design by: a. Randomising the run order of the test. b. Generating Analysis of Variance (ANOVA) table to see which factor will affect the assembly operation significantly; this is illustrated in 7.6. c. Generating main and interaction effects plot for response to see which level of the factor will affect the assembly operation significantly. 7.8.1 Analysis of variance for the consistence of the assembly process The aim of Analysis of Variance (ANOVA) is to identify the source of variance that is likely to have influence in the experimental result by comparing the P-value of the input variable to some defined confidence level such as 1 %, 5 % and 10 %. According to the interpretation of ANOVA, the source of variance will become significant if its P-value is less than the defined confidence level. Table 7.6 as shown below tabulates the result of the ANOVA generated from Minitab for the three-factor fixed effect model. From the P-value in the last column of the table, it is observed that the baseboard (A) and assembling speed (C) will significantly affect the response since their P-values are far less than 0.05, which is in fact the standard and common confidence level that is set to be 5 % in this study. Dolly (B) has the P-value that is very close to the 5 % confidence level and this shows that it might have slight effect in the assembly operation. The P-value for baseboard (A) is 0.000 and this shows that it mainly affects the consistency of the assembly process no matter what confidence level is being defined. The (A C) interaction F-ratio has the P-value of 0.005, indicating that there is interaction between baseboards and the assembling speed. Table 7.6 The ANOVA table for the consistence of the assembly process Source of variance Sum of Square (SS) Degree of Freedom (DF) Mean Square (MS) F-ratio (F) P-value (P) Baseboard (A) 0.038958 3 0.012986 11.94 0.000 Dolly (B) 0.010625 3 0.003542 3.26 0.046 Assembling Speed (C) 0.012917 2 0.006458 5.94 0.010 AB (interaction) 0.018542 9 0.002060 1.89 0.119 AC (interaction) 0.030417 6 0.005069 4.66 0.005 BC (interaction) 0.003750 6 0.000625 0.57 0.746 Error 0.019583 18 0.001088 Total 0.134792 47 * Confidence level at 5 % (for general cases) 7.8.2 Interpretation of the level of main and interaction effect Once the source of variance which will affect the assembly operation was identified, it is to focus on what are the levels of that variable input that really causes the assembly process to fail. The relative importance of the level of the three main and interaction effects of the input variables on the assembly operation are shown graphically in 7.7 and 7.8. Both the magnitude and sign of the effects mean something: a. The sign tells the direction of the effects, that is, if the response increases or decreases. b. The magnitude indicates the strength of the effect. From the graph in 7.7 above, it is observed that the sign of the baseboard level changes significantly and that is why it has the 0.000 P-value in the ANOVA table. The best combination of the variable input was found to be (c2, b4 and a1 or a3), and the worst combination of the variable input is (c1, b1 or b2 and a2) which must be discarded in the assembly operation. Moreover, all the level of the variables that fall below the dotted-line, which is the position of the 5 % confidence level used in the study, should be discarded. These levels are a2, a4, b1, b2, c1 and c3. As refer to the graph in 7.8 above, the significant interaction between baseboard and assembling speed is indicated by the lack of parallelism of the average response at each level of the variables and this is obviously why it has the P-value that is less than the 5 % confidence level in the ANOVA table. It can be seen that a2 and c1 are the main causes to this significant interaction and they must be discarded in the assembly operation. In addition, (a4 c1), (a4 c2) and (a2 c3) will also have some effect in the assembly process. The results from the main effect and interaction plot are needed to combine to identify which levels of the variable that must be discarded in order to improve the assembly efficiency. This is illustrated in Table 7.7. It can be easily concluded that a2, a4 and c1 must be discarded as their duplicated existence in the table had mainly caused the inconsistency of the assembly operation during the experiment. The generated statistical data from Minitab version 13 can be found in Appendix H. Table 7.7 Summary of the result of the main effect and interaction plot Severity of the Significance (in the assembly process) Main Effect Plot (Level of the variable input) Interaction Plot (Level of the variable input) 1 a2 a2 c1 2 c1 a2 c3 3 b1, b2 a4 c1 4 a4 a4 c2 7.9 Analysis of the root to the discarded input variable It had been found that mould cavity 8 and 10 which manufactures baseboard, and assembling speed of 5 mm/s must be discarded in order for the assembly operation to be consistent. However, it is important to understand what actually causes these two variables to be discarded so that further recommendations can be used to improve the assembly operation. 7.9.1 Cause of the discarded assembling speed Among the three assembling speeds mentioned previously, medium speed of 10 mm/s is found to be the best while slow speed of 5 mm/s is found to be the worst. It shows that the initial guess of slow assembling speed will be the best is absolutely wrong. As dolly is not really secured by the suction cup of the end effector during assembly operation, there will be a higher chance that it will move around inside the end effector and cause the assembly operation to fail if the assembling speed is too slow. However, if the assembling speed is too fast, the shaft of dolly might not have sufficient time to insert properly into the hole of baseboard and this cause the failure of the assembly operation. As a result, medium assembling speed of 10 mm/s becomes the best choice. 7.9 as shown below illustrates the failure of the assembly operation due to the inappropriate setting of the assembling speed. 7.9.2 Cause of the discarded baseboard Although mould cavity 7 and 9, which manufactures baseboard, produce excellent result during the experiment of assembly operation, it is impossible to discard all baseboard from the other two mould cavities as this will cause the number of baseboard to be insufficient for the assembly operation. In contrast, it is more important to distinguish the geometric difference of baseboard from all the mould cavities. 7.9.2.1 Inspection of the baseboard geometry All the baseboards involved in the failures of the assembly operation are deeply inspected. Since mould cavity 7 and cavity 9 have no influence in the assembly operation, one of them is also inspected to compare with the inspection result of the failed part so that any geometric difference between the measured parts can be identified. Simultaneously, it is necessary to establish some useful dimension to be measured and this is illustrated in 7.10. Basically, the reason to obtain these three dimensions of A, B and C can be briefly explained as below: A. This dimension is important as its variation will directly affect the success of the assembly process, especially when it is too large. B. This dimension will affect the position of the baseboard to be assembled. C. This dimension sits inside the fixture and any variation of it will also affect the position of baseboard to be assembled. From the graph, it can be seen that dimension B and C have the two lines that are very close to each other, while dimension A has the two lines that is quite apart from each other. Moreover, the entire dimension A values of the failed baseboard are higher than the good baseboard. Therefore, it shows that this increased dimension A values of the failed baseboard had significantly caused the assembly operation to fail. Furthermore, out of the three dimensions value, only dimension A value has increased and it indicates that the problem did not come from the shrinkage problem of the mould cavity, otherwise all the three dimension value should have together increased. It is believed that the initial assumption that baseboard will resume to its original position within 5 replicates during the experiment is not valid, and thus causes dimension A value of the baseboard to increase. This is probably due to the different setting of the temperature in the injection moulding machine which event ually affects the material property of the baseboard and causes the assembly operation to fail. 7.9.2.2 Repetitive use of baseboards in the experiment As mentioned before, each of the baseboards was used 5 times before they were replaced with a new piece in the experiment due to the limited supply of the part from Clipsal. This means that each of the new part of baseboard and dolly was used only in the first and sixth replicate of the test number, while the fifth and tenth replicate of the test number are the part that were repeatedly used for five times during the experiment. In this case, the replicate number which failed in each of the test during the experiment of the assembly operation was observed. Table 7.8 as shown below summarize this observation. It can be seen that all the test number of the failed baseboard fall between the forth and last replicate number. It shows that the poor material property of the baseboards had made baseboards sustain excessive bending and that is why they could not resume to its initial position after 4 or 5 repeatedly use, and thus caused the assembly operation to fail. As a matter of fact, baseboard will be required to be bended for only one time in the actual assembly operation in Clipsal and this shows that the actual assembly efficiency should be more than 97.29 % if baseboard or dolly was not used repeatedly during the experiment. However, it is impossible to verify this value by conducting another set of experiments due to the limited time and resource in the project. Therefore, it can be concluded that the repetitive use of baseboard from mould cavity 8 and 10 had significantly increased the baseboard geometry but this will not affect the performance of the actual assembly operation in Clipsal. Table 7.8 Summary of the replication used of the failed baseboard during experiment Failed Baseboard Test No. 2 4 4 6 6 8 10 14 20 24 34 38 42 Replicate No. in Each Test No. 10 5 9 4 10 5 5 9 5 9 5 4 10 No. of Repetition of Use 5 5 4 4 5 5 5 4 5 4 5 4 5 7.9.2.3 Observing of the assembly operation during the experiment During the experiment, not only the results of the 480 replicates of the assembly process were recorded, but their behaviours were also observed very carefully. It was found that the two shafts of dolly did not really insert into baseboard together, but they rather inserted one side and then followed by the other side into baseboard, even when dolly was pushed from its centre. This two-motion insertion situation had made dolly to be shifted very close to one side of baseboard after assembly operation and this eventually might force the inserted dolly to pounce back from baseboard, especially when the geometry of baseboard is somehow increased. This observation is illustrated in 7.12 as shown below. It can be seen that this observation is actually similar to the one that had obtained during the force analysis in chapter 4. Therefore, it can be concluded that either dolly geometry needs to be increased or baseboard geometry needs to be decreased in order to maintain the high consistenc y of the assembly operation. 7.10 Conclusion Since the response of the proposed assembly operation is either pass or fail, which is much different from those situations where specific tolerance is given. As a result, three factors full factorial experiment, which requires tremendous number of trial of 480, was conducted to analyze the performance of the assembly operation. The assembly efficiency was found to be 97.29 %, which is quite far away from the manual one of 99.69 %. The result obtained from the statistical software of Minitab shows that the optimal assembling speed is 10 mm/s and dolly geometry had very little or negligible effect in the assembly process. Baseboard mould cavity number 8 and 10 were initially found to have significant influence on the inconsistency of the assembly operation. However, it was later clarified that the repetitive use of baseboards in the experiment are then the main cause to it The automatic assembly efficiency is then believed to be much higher but this is impossible to be verified by conducting set of experiment due to the limited resource in the project. Finally, observations obtained in DOE and force analysis are used to conclude that either dolly geometry needs to be increased or baseboard geometry needs to be decreased. This is important as it will help to further increase the assembly efficiency.

As Planes Get Bigger, the Marketplace Gets More Competitive Free Essays

Q1: Have you, or anyone you know, experienced a situation similar to those described, where the marketing organization exceeded your service expectations? If so, what do you think of the company now? Yes, I have a experienced a situation that a marketing organization exceeded my service expectation. There was a catering firm in my hometown. Both the service and the taste of food were the best because of some good waiters and the top chefs, Whereas the price was relatively lower than other catering firms. We will write a custom essay sample on As Planes Get Bigger, the Marketplace Gets More Competitive or any similar topic only for you Order Now As a result, it exceeded my expectation. I think that the catering firm has attracted more new customers because of its opprobrium now. Regular customer can come again because of good service and fine food. Q2. Do you think that any and every employee can be trained to want to give good service? If so, what form might that training take? If not, what should a company do if it encounters major resistance? Not every employee can be trained to want to give good service. To overcome major resistance, the marketing organization may change its strategy to raise the job satisfaction of the employee and increase the productivity. Organization should employ some people who like this job. In addition, employees who are not eligibility should be trained again. Q3. Do you believe that customers are becoming more demanding? If they are too demanding, what might be the outcome for marketing organization? Yes, I believe that customers are become more demanding because some consumers who are high-income earners and better educated are indulged in good service. Marketing organizations need to offer the better service for their consumers Therefore, employees should receive the best training to improve their service quality. Q4. Might marketing organizations be taking risks by raising customer expectations too high? Yes, marketing organizations may take risks when raising customer expectations. High expectations mean that marketing organizations would rise to the challenge to achieve the customer satisfaction. When marketing organizations cannot satisfy customers expect, the relationship between company and customer would break. As a result, marketing organizations may take risks. How to cite As Planes Get Bigger, the Marketplace Gets More Competitive, Essay examples

Nursing concept map for mental health free essay sample

Presenting Problem: This is a 28 year-old Caucasian female who was admitted to Doctors Hospital Psychiatric Unit 4 South due to an overdose on multiple medications. The patient was found by the police on January 13th picking through garbage near the hospital. Patient overdosed on approximately 30 Alprazolam, Venlafaxine, Trazadone, Benadryl, and Nyquil. She stated she remembered taking the all of the drugs, but does not remember anything after that. Patient believes that the stressors in her life are what caused to overdose on medication. Patient also states that the main reason she overdosed was because she was raped three days prior. Patients Perception of Stressors/Illness: Patient states that she is aware of her diagnosis. Patient believes that the stressors in her life are what caused to her overdose on medication. These stressors included financial issues, overwhelmed by school, and her job at a plastic factory where she has conflict with her boss. We will write a custom essay sample on Nursing concept map for mental health or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page MENTAL STATUS EXAM Behavior: Patient was dress appropriately for the weather. The patient appears her stated age of 28. Patient’s weight was appropriate to height. She was not well groomed and did not practice proper hygiene. Patient sat stiff in the chair, often drifted during the conversation, and did not give consistent eye contact throughout the interview or at group therapy. Facial expressions were flat and she showed no emotion. Patient did not participate in group activities unless she was called upon by the social worker, and she would vaguely share her insight. Speech: Patient’s speech was organized and clear. She spoke at an extremely slow rate with a very soft volume. Attitude: Patient’s attitude was positive about getting treatment. She stated that she wants to â€Å"go home and get better so that I can care for my three children†. She comes to group activity, which shows cooperation and progress towards her treatment. Mood: Patient’s mood is anhedonic. She shows no interest in activities or in other patients. Affect: Patient’s affect was flat and she did not show much emotion throughout interview or in group activities. Thought Content: Patient did not speak unless spoken to. However, while conversing with the patient I noticed that her thoughts were appropriate to the conversation. Orientation: Patient is alert and oriented to person, place, time, event, and oriented to the significance of the circumstances of being in the hospital. Insight/Judgment: Patient exhibits fair insight and unstable judgment decisions. Although she understands that she has a mental illness, she is led to believe that suicide is the only option for her. Patient needs to improve on judgment skills. PSYCHIATRIC HISTORY Patient was first hospitalized in 2000 due to her first suicide attempt of overdose on vitamins. She was hospitalized again in 2011 when she overdosed on Tylenol. Patient has a history of anxiety attacks and depression that she has battled her whole life, with multiple outpatient treatments. PSYCHOSOCIAL ADAPTATIONS Ideas of Harm to Self/Others: Patient denies suicide or homicidal ideations at the present time. However, a history of multiple suicide attempts ultimately puts the patient at a danger to herself and possibly others. Ego Defense Mechanisms (describe how used by the patient): One defense mechanism noted from the patient was dissociation. Patient stated that she had a bad childhood, and finds it hard to trust people. I notice that now she is dissociating herself from the world and feels disconnected from reality. Another defense mechanism used by the patient was rationalization. Patient states that she has trouble at work because her boss does not like her. Lastly, patient uses suppression when dealing with stressors. She feels that if she ignores them, they will go away (Varcarolis, Hlater, 2011, p. 216-217) Level of Self Esteem: Patient shows signs of chronic low self-esteem. Patient stated that â€Å"I have always been self conscious, I always feel like I am not good looking enough, especially the fat on my legs†. According to Maslow’s hierarchy of needs, when self-esteem is compromised, we feel inferior, worthless, and helpless (Varcarolis, Halter, 2011, p. 39) Communication/Interaction Patterns (nonverbal communication): Patient did not exhibit many body movements when communicating with health care staff, other patients, or myself. Patient sat still in her chair and did not show any emotion with her thought process. Patient did not make eye contact with anyone she communicated with. Sexual Patterns (consider roles, identity, lifestyle): Patient states that she is heterosexual. Patient is not currently in a relationship nor is she sexually active. She used to have multiple sex partners in the past. Psychosomatic Responses (describe somatic complaints that may be stress related): Patient states that she has a lot of trouble sleeping. Other than insomnia, patient did not complain of any other somatic responses that could be stress related. Use of Alcohol or other Drugs: Patient denies the use of drugs and alcohol. Degree of Participation in Care/Groups: Patient was part of the Blue Group (Lower functioning). Patient did not exhibit interest in any group activities or care from the staff members. Patient would only answer a question if she was called on, but she never was the first to initiate a response during group activities. However, she is aware that group therapy, activities, and adhering to the medication regimen are all part of the program to be released from the psychiatric unit. Adjustment to Illness/Disorder: Patient has been battling mental illness from as long as she can remember. She has never formally â€Å"adjusted† to her illness. She is aware that she has a problem, however she is unable to see results in any treatment she received in the past. Previous Patterns of Coping with Stress: Patient uses suppression when coping with stress. She states that she â€Å"pushes things to the side and ignores them instead of dealing with them†. Patient states that she does not know how to properly cope with stress. CULTURAL, SOCIAL AND ECONOMIC INFLUENCES Environmental Factors: Patient’s financial situation is one of the greatest stressors in her life. She is a single mother with three small children. The father is not in the picture, so she has to care for her children alone without help from anyone. Patient also does not have health care insurance,  making it difficult for her to get access to healthcare. Religious Beliefs/Practices: Patient does not obtain a specific religion. Patient states that she is an atheist. Education: Patient currently attends Oakland Community College for Landscaping. She is only four credits away from earning an associates degree. Peer/Social Relationships: Throughout the shift, I noticed that the patient did not interact with peers. When asked, she stated that she does not have friends. One patient took a liking to H.C., however she did not seem to show much interest in him. Support System: Patient mentioned that she does not have much of a support system. Her children are currently with her aunt, and that is one of the only people she can count on for help if needed. Patient states that she is independent and would rather do things herself rather than rely on others as most people have disappointed her in the past. Occupational History: Patient states that she has had many different jobs in the past. Her most recent job was at a Plastic Factory working on the line. She believes that the job will not be available to her when she gets discharged from the hospital as she did not call the facility to let them know she is unable to come to work. Avenues of Productivity/Contribution (current job status, role contributions, and responsibility for others): Patient is employed at a Plastic Factory and is responsible for herself as well as her three young kids. Patient does not receive aid from the government, nor does she receive help from the father of her children. Health Beliefs and Practices: Patient believes that most health conditions (including mental illness) can be partially treated with proper nutrition. Healthy eating and exercise are important to the patient. Other Lifestyle Factors Contributing to Present Adaptation: None other than stated above. PHYSICAL HEALTH STATUS Co-existing Medical Conditions (need for medical management): None. Vital Signs: Blood pressure: 99/69, Heart rate: 133, Temperature: 98.2 F, Respirations: 16, No pain. Lab Results: Sodium: 141 mmol/L Potassium: 4.1 mmol/L Chloride: 110 mmo/L CO2: 28 mmol/L Anion Gap: 3 Glucose: 98 mg/dL BUN: 11 mg/dL Creatinine: 0.80 mg/dL NON-AA GFR: 91 APR AMER GFR: 110 Calcium: 8.2 mg/dL WBC: 4.10 K/ uL RBC: 3.00 M/ uL Hematocrit: 32.1% Hemoglobin: 12 g/dL Platelets: 162 k/uL Urine Specific Gravity: 1.02 Results of other Diagnostic Tests: None. Client Strengths: Patient states that she is a good mother. She stated that â€Å"Even after everything, I still try my hardest to give my kids a great life†. She also states that she is very artistic. Current Medications including Dosage and Frequency. Use the MAR form, Appendix D (Include what these medications are for and why ordered for this client. Use multiple pages, as necessary. Refer to MAR. DIAGNOSIS, PLANNING, INTERVENTIONS, EVALUATION DSM IV-TR Axis (List from patient record): Axis IBipolar Disorder Type 2, Acute Psychosis, Major Depression Axis IINone. Axis IIINone. Axis IVSupport group, occupational problems, economic problems, access to health care. Axis V 10-20. Nursing Diagnosis #1 (highest priority): Risk For Suicide RT: History of Prior Suicide Attempts (2000, 2011, 2013) AEB: Suicidal Ideations Short-term Goals/Objective (in measurable terms, with timeframe stated) 1. Patient will remain safe while in the hospital, with the aid of nursing intervention and support (Varcarolis, 2011, p. 483). 2. Patient will name two people she can call if thoughts of suicide recur before discharge (Varcarolis, 2011, p. 483). 3. State one positive thought everyday and why that positive thought makes her want to continue to live (Varcarolis, 2011, p. 483). 4. Make a no-suicide contract with the nurse covering the next 24 hours, then renegotiate the terms at that time (Varcarolis, 2011, p. 483). Nursing Interventions with scientific rationales: Identify one scholarly research reference for at least one nursing intervention from the priority diagnosis (provide copy.) 1. During the crisis period, health care workers will continue to emphasize the following four points: the crisis is temporary, unbearable pain can be survived, help is available, and you are not alone. Rationale: Because of â€Å"tunnel vision,† patients do not have perspective on their lives. These statements give perspective to the patient and help offer hope for the future (Varcarolis, 2011, p. 483). 2. Follow unit protocol for suicide regarding creating a safe environment. Rationale: Provide safe environment during time patient is actively suicidal and impulsive; self destructive acts are perceived as the only way out of an intolerable situation (Varcarolis, 2011, p. 484). 3. Keep accurate records of patient’s verbal and physical behaviors and all nursing/physician actions. Rationale: These might become court documents. If patient checks and attention to patient’s need or request are not documented, they do not exist in the court of law (Varcarolis, 2011, p. 484). 4. Put on either suicide precautions or suicide observation. Rationale: Protection of all patient’s life at all costs during crisis is part of medical and nursing staff responsibility. Follow hospital protocol (Varcarolis, 2011, p. 484). 5. Keep accurate and timely records, document patient’s activity, usually every 15 minutes (follow hospital protocol. Rationale: Accurate documentation is vital. The chart is a legal document as to patient’s ongoing status, interventions taken, and by whom (Varcarolis, 2011, p. 484). 6. Construct a no-suicide contract between the suicidal patient and nurse. Use clear, simple launguage. When contract is up, it is renegotiated. Rationale: The no-suicide contract helps patients know what to do when they begin to feel overwhelmed by pain (Varcarolis, 2011, p. 484). Patient Outcome/Evaluation Criteria (Evaluate the patient’s progress toward their goals). 1. MET: Patient stayed safe while in the hospital and was recently discharged. 2. PARTIALLY MET: Patient states that she will call her aunt if she has thoughts of suicide. 3. MET: Patient states she wants to live because she has three young children at home. 4. NOT MET: Patient did not make a no-suicide contract with the nurse. Nursing Diagnosis #2: Rape Trauma Syndrome RT: Sexual Assault AEB: Suicide Attempt Short-term Goals/Objective (in measurable terms, with timeframe stated) 1. Patient will express reactions and feelings about the assault before discharge (Varcarolis, 2011, p. 472). 2. Patient will have a short-term plan for handling immediate situational needs before discharge (Varcarolis, 2011, p. 472). 3. List common physical, social, and emotional reactions that often follow a sexual assault by the end of the day (Varcarolis, 2011, p. 472). 4. Patient will have access to information on obtaining competent legal council (Varcarolis, 2011, p. 472). Nursing Interventions with scientific rationales: 1. Approach victim in a nonjudgmental manner. Rationale: Nurses’ attitudes can have an important therapeutic impact. Displays of shock, horror, disgust, or disbelief are not appropriate (Varcarolis, 2011, p. 473). 2. Confidentiality is crucial. Rationale: The client’s situation is not to be discussed with anyone other than medical personnel involved unless victim gives consent (Varcarolis, 2011, p. 473). 3. Explain to victim the signs and symptoms many people experience during the long-term phase, like nightmares, anxiety, depression, and insomnia. Rationale: Many individuals think they are going crazy as time goes on and are not aware that this is a process that many people in their situation have experienced (Varcarolis, 2011, p. 473). 4. Listen and let the victim talk. Do not press the patient to talk. Rationale: When people feel understood, they feel more in control  of their situation (Varcarolis, 2011, p. 473). 5. Stress that they did the right thing to save their life. Rationale: Rape victims might feel guilt or shame. Reinforcing that they did what they had to do to stay alive can reduce guilt and maintain self-esteem (Varcarolis, 2011, p. 473). 6. Do not use judgmental language. Rationale: Use the words: reported not alleged, declined not refused, and penetration not intercourse (Varcarolis, 2011, p. 473). Patient Outcome/Evaluation Criteria (Evaluate the patient’s progress toward their goals). 1. PARTIALLY MET: Patient expressed a few feelings about the incident, but nothing in depth. 2. NOT MET: Patient does not have a short-term plan for handling immediate situational needs. 3. NOT MET: Patient did not list common physical, social, or emotional factors following a sexual assault. 4. MET: Patient will have access to information on obtaining competent legal council. Additional Data Needed: I would like to receive more information on her past psychiatric history, as well as the details regarding the recent sexual assault. Patient did not answer questions in detail when asked. Learning Needs of Client to be addressed through Teaching: Patient needs more information regarding coping skills. Patient seems to be making the same mistakes (suicide attempt) over and over again. Client’s Perception of Progress: Patient believes that she is starting to feel better, and believes that she is on her way to recovery. She understands that she will need an intense outpatient therapy once she is discharged. Student Reflection: It is always interesting to talk to different patient’s and to understand the reasoning behind their mental illness. From my experience, I notice that stress is usually the cause of exacerbated symptoms of a latent mental illness. As with H.C., multiple life stressors are what caused her to feel the need to attempt suicide for the third time. As always, speaking with H.C. has helped me with my communication techniques. Although she was not as verbal as other patient’s that I have had in the past, it was a nice change that ultimately challenged me to take charge and ask open-ended questions to be able to fully understand her more in detail. It will be a long road to recovery, but I see hope in the future for H.C. if she receives extensive outpatient treatment. References Varcarolis, E.M. (2011). Manual of psychiatric nursing care planning: assessment guides, diagnoses, psychopharmacology (fourth edition). St. Louis, MO: Saunders. Varcarolis, E.M., Halter, M.J. (2011). Foundations of psychiatric mental health nursing, a clinical approach. (sixth edition). St. Louis, MO: Saunders.a