Report Essay Example | Topics and Well Written Essays - 2000 words - 20

Report - Essay Example Procurement is fundamental to every project manager in order to advice the company on the right partners to work with, the rights and obligations of every party in a project, and how well the parties can work together. Contracts need strategy in order to succeed and that is why, it paramount to know who will supply what and how the payments of the supplies will be met. A contract to supply raw material, personnel or any other service, should give assurance to the do so for the duration for which the contract runs and under the terms and conditions agreed upon. So that, if the contract is financed on interim basis, the supplier of whichever service or raw material should be able to do so until when payment has been processed (BARNES, 2007). Procurement services should also be subjected to competitive vetting to ensure that the right supplier is awarded the tender to supply raw materials whether all the metallic raw materials or part of that, and that will be the case for all procurements. The project manager will advise the contractor on what elements to look for in tendering a supply of any raw material. Just to highlight, cost of raw material, transport cost; whether it is lumped and gathered for to the site, and the capacity to deliver them in time. The contractor then will have a host of service providers to choose from after which the suitable supplier will commence the supply of the procured materials (MARSH, 2000). Just like any other contract programme, what is binding, has to be backed by evidence and that is the time that has been set out for completion of a project. When a project is completed within the stipulated time, the contractor is entitled to a bonus of the whole cost however, when the project is completed outside this time, the contractor is liable to a penalty. As a matter of fact, the entire project under the watch of a project

Cultural Diversification Essay Example | Topics and Well Written Essays - 750 words

Cultural Diversification - Essay Example For the selection of the class I would observe, I imposed two criteria: a) the class should have a cultural mix of Latino, Asian and African language minority students and b) the academic achievement of these students is profound. Communication between teachers and students and among fellow students was recognizably more than what might be expected in a regular classroom. Individualized activities such as worksheets and large group discussions were very minimal. The teacher employed a "learning center" approach where students are formed into groups not more than eight. Group projects are then given and the teacher travels about the room to assist the groups in their activity and to clarify the student's role in the assignment. This strategy provided a very informal family-like social setting where the teachers serve as the guiding head and each group member a reliable brother/sister to other members of the group. These observations made me appreciate Orkwis (2003) when he wrote that the teacher must adapt a teaching method that would include all students and answer to their differences, limitations and abilities. Culturally distinct students usually struggle when they are on their own and when taught in large groups. With the learning center approach, the teacher can assist them more effectively and the students have their group mates fill their limitations. Day 2 The method employed by the teacher for a controversial Science topic was highly interesting. Instead of the usual discussion to class and the worksheet exercises, the teacher initiated a student-to-student interaction. The students were made to ask other students hard questions and it was observed that done this way, other students were more readily to answer and challenge other answers. The teacher's only role was to make sure that the discussion does not go off the topic and that the students arrive at the right answers. I have observed that this was very effective in terms of increasing student participation and involvement with the subject at hand. Cummins (1991) wrote that effective education of culturally and linguistically diverse students could be enhanced by encouraging student-student talk in a collaborative learning context. As I have observed such measure was indeed very effective not only in increasing student involvement but also in interaction among students. They were more likely to seek assistance from fellow students and were more successful in obtaining it. In other words, this method was eliminating the feeling of alienation usually felt by culturally distinct individual. Day 3 Aside from the two previous observations, it was also observed that teachers were very open to cultural discussions. The teachers would even prod students to form a connection with the topic and their culture. Questions like what equivalent term do they have for a certain word or what they practice in their culture were being asked. The students undergo transition from writing in their native language to the English language without much pressure from the teacher. With regards to their literacy development, one can note that it was very high. This may be due to the increased appreciation of topics by

U.S - European Ties with Obama as President Essay

U.S - European Ties with Obama as President - Essay Example â€Å"The election of Barack Obama as the 44th President of the United States opened a new chapter in transatlantic relations, transforming European assessment of the American president, U.S. standing in Europe, attitudes toward U.S. global leadership, and perceptions on both sides of the Atlantic of the U.S.-EU relationship† (Transatlantic Trends Key Findings, p.6). It is a fact that Obama enjoys heavy support from the European countries compared to his predecessor. Obama’s handling of international affairs has already attracted many Europeans. The handling of Afghan crisis, economic crisis and climate change has helped Obama to acquire support even from the traditional anti- American publics in Turkey and Central and Eastern Europe. On the other hand, Western Europe is almost unique in supporting Obama’s policies. In fact Obama enjoys more support from the European publics than from the Americans at present. In America at least the Republicans are strongly oppo sing Obama’s economic and foreign policies whereas in Europe, irrespective of the political difference, Obama enjoys strong support at present. The recently concluded G20 summit and the winning of Nobel Prize for peace have helped Obama to polish his face among the Europeans. â€Å"People in the European Union and Turkey have fallen under the Obama spell..In 2008, their assessment of Bush was 18 percentage points lower than Bush’s approval in the United States. In 2009, the situation was reversed. Their positive judgment of Obama (77%) was 20 percentage points higher than in the United States (57%)† (Transatlantic Trends Key Findings, p.6). The leadership of America in global matters is more acceptable to the Europeans at present compared to the Bush regime. But it is a fact that the former socialist countries like Bulgaria, Slovaks, etc are still keeping reservations about the American leadership in global matters. Europeans are more

- ISLAMIC BANKING AND FINANCE Research Paper Example | Topics and Well Written Essays - 2000 words

- ISLAMIC BANKING AND FINANCE - Research Paper Example Sukuk have gained popularity in Islamic finance as one of the best strategies to raise funds over the last few decades. Sukuk can be termed as legally acceptable certificates or securities issued in the Islamic economy with the intention to raise capital. These certificates serve the same purpose as bonds in the western economies. Bonds are not accepted in the Islamic finance structure since they carry an interest rate. Charging interest on securities is not acceptable under the Islamic sharia laws since it violates the principle of contractual certainty and mutual benefit between the financier and the debtor. According to the Islamic faith, wealth is God given, and mankind was created to guard and make good use of wealth and resources. In this regard, charging interest on bonds is against God’s will on equality and brotherhood. The Islamic sharia law is the foundation on which the Islamic finance is built. For any financial decision to be acceptable in the Islamic economies, it must fulfill all the requirements enshrined in the sharia law. Sukuk is an Arabic word used to refer to securities that are structured in accordance with the provisions of the Islamic law and intended to raise capital (Ariff, Iqbar, and Mohamed 13)Sukuk are used to stand in place of undivided shares in the ownership of real/visible assets concerning a specific investment undertaking. For Sukuk to be issued, there must be a clear record of the existing tangible assets on the balance sheet of the entity intending to raise capital. The process of issuing Sukuk starts by identifying the assets of the entity to assess their validity. The next step involves arrangement of an effective organizational structure that respects the Sharia law. Once an effective organizational structure has been established, the adjacent step involves the application of a suitable Sariah structure. Once that has been accomplished, a lead manager is

Prisons As Industry Essay Example for Free

Prisons As Industry Essay What is the most profitable industry in America? Weapons, oil and computer technology all offer high rates of return, but there is probably no sector of the economy as abloom with money as the privately run prison industry. Prison industry in recent years has become a high-profit business and it competes with industries such as the oil and gas industry. The aim of this paper therefore is to examine the industry as a whole. In examining the industry therefore, there shall be a cursory analysis of some salient point vis-à  -vis the prison industry.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A very important fact is that the prison industry came about because of the congestion in the various government-owned prisons in throughout the country. The demand for prisons seems to be ever increasing and the public prisons scattered all around the country are incapable of providing adequately for this. Nearly every prison in America is overcrowded and will continue to be so if new prisons do not spring up. So therefore, the aim of the prison industry is to make provisions for more space to keep dissidents at a lower cost than federal prisons can.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In other words, privately owned prisons are unique because demand for prisons is high, while supply of prisons is low.   That is what makes this industry so appealing. Thus, privately owned prisons are good substitutes for federally run services. Therefore, this brings us to the issue of prison privatization. This involves the transfer of running state-owned prisons to private industries to manage. Thus, by using the private sector to build or manage prisons, many states believe that they can reduce costs. Privatization of prisons can take various forms. This includes: Contracting out services: This is the most common form of prison privatization. Currently, 39 states in the US hire private firms to provide such services as medical and mental health treatment, drug treatment, education, staff training, and vocational training and counseling. Contracting out prison labor This also is another means of privatizing prisons. By putting prisoners to work and paying inmates competitive wages, many private companies are reducing prison costs for the government by withholding earnings for taxes, room and board, family support, and victims compensation. Such employment also gives prisoners the skills and work experience that will prepare them for the job market when they are released from prison. Construction and lease/purchasing Many states see private construction as a promising solution to the prison over crowding crisis. States normally finance construction by cash appropriations (a pay-as-you-go approach) or by issuing general obligation bonds The points above are some of the ways by which prisons by various states in the US. In another vein, privatization of prisons can also occur at the federal level. For instance, the Federal Government of the United States recently proposed contracting with a private firm for a new 500 bed minimum-secure facility for illegal aliens. In addition, the Bureau has considered contracting for facilities to house special needs prisoners, such as juveniles, women, protective custody cases, and for prisoners needing medical services. However, the federal government is wary in contracting out the more mainstream prisoners such as those imprisoned in the Federal Correctional Institutions and the U.S. Penitentiary System. Nevertheless, the prison industry has raises certain questions. These questions must be answered before a deeper understanding and full grasp of the objectives of the industry can be achieved. The first question is that has the federal government abrogated its responsibility by privatizing prisons. In other words, Should the private sector be responsible for a function traditionally performed by the government sector? Evidence has shown that that prison privatization does not mean that the government relinquishes its responsibility. The government still would select the inmates to be placed in private prisons, choose the type of facility to be contracted out, oversee the contractors disciplinary practices and, most important, evaluate the contractors performance. Furthermore, another good question to be asked is whether service quality and flexibility is maintained or not? This is because some policy makers maintain that the quality of management in private prisons will tend to be high at first, because of competition and the desire to win contracts. However, they question the private sectors ability to sustain high-quality standards. This is not true of the prison industry because contracting standards are likely to improve over time as more firms enter the market and competition increases. Periodic bidding creates incentives for firms to improve constantly the quality and cost-efficiency of their performance. These above questions, among others, are some of the questions to ask in order to have an enlightened grasp of the prison industry. Now, it is of necessity to look at the history of prison industry. Historically, prison population started to grow in the United States in the 70s. Statistically, one out of every hundred adults is now imprisoned. In order to curtail the unwanted rise in the number of inmates, larger sentences are being imposed on to act as deterrent and other policies, which are known as the ‘broken window’. They have introduced the ’three strike’ policy which means that if you are convicted of any 3 offences you will receive life which is a very good deterrent. The state of Virginia applies this always, and has managed to slow the growth of the population (Bratton 2002).   Ã‚  Ã‚  Ã‚  Ã‚   In addition, the government has tried to seek alternative modes of punishing offenders instead of retaining them in the prison yards. Undauntedly however, the rate of offenders soars. This has gone a long way in boosting the prison industry. The industry is now much bigger than ever before worth around 40 billion dollars a year. Due to the overcrowding in state prisons and federal prisons, which are on average 34% over designed capacity according to the BJS report, the prison industry has to rely on private prisons. Many states enjoy the companies taking on the task of building the prisons and covering the costs and just charging the state per inmate, as the state tends to be a lot more lenient to a convicted felon in order to save money. So therefore, prison industry continues to soar high. Investors are now having good times because of their net profits from prison business. For example, the leading company in prison business, Corrections Corporation of America, has made a tremendous success in the business. The revenue of this company rose by 81% in 1995 alone. Again, Investors in Wackenhut Corrections Corporation, another leading prison industry,   have enjoyed an average return of 18 percent during the past five years and the company is rated by Forbes as one of the top 200 small businesses in the country as of today. The list goes on an on. Ten years ago, there were just five privately run prisons in the country, housing a population of 2.000. Nearly, a score of private firms run more than 100 prisons with about 62,000 beds today. Thats still less than five percent of the total market, but the industry is expanding fast, with the number of private prison beds expected to grow to 360,000 during the next decade. This could be said to be the reason why a recent headline in USA Today which says that; Everybodys Doin the Jailhouse Stock In view of this, the prison industry is now a lucrative business. In fact, almost 30 states in the US have 28 states have passed legislation making it legal for private contractors to run correctional facilities and many more states are expected to follow suit. God knows maybe one day, the prison industry will take over as the most lucrative and cost-effective business. To summarize it all, there are many reasons why America has incarcerated more of its population than any other country including China, which has a much greater population. The main reason is still the fact that the prison industry is being portrayed as a business and companies are making money from crime. Therefore, toughening of laws by both the federal and state governments does not help matter. Therefore, one can safely conclude that prison industry has come to stay. What is to be done now is for the government to tighten laws on the establishment of privately owned correction centers across the States. This would go a long way in ensuring that the privately owned prisons function effectively as their public counterparts.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   REFERENCES Tonry M., 2004. Prisons and Imprisonment, International Encyclopedia of the Social and Behavioral Sciences, Pages 12062-1206. Walker, S., Spohn, C., Dolone, M., 2004. The Color of Justice, Race Ethnicity, and Crime in America, 3rd Ed, Wadsworth Publishing. Scalia, J., August 2001. Federal Drug Offenders, 1999 with trends 1984-99, Bureau of Justice Statistics Special Report, U.S. Department of justice. Samaha, j., 2001. Criminal justice, 5th ed. Wadsworth publishing. Renshaw, B., December 1982. Prisoners 1925-1981, Bureau of Justice Statistics Special Report, U.S. Department of justice. Harrison, P., November 2004. Prisoners 2003, Bureau of Justice Statistics Special Report, U.S. Department of justice.

Nurse Intervention in Cervical Screening Programmes

Nurse Intervention in Cervical Screening Programmes Nurses deliver care to patients in an ever-changing environment that revolves around changes in local and governmental policies as well as technology and pharmaceutical advancement for effective practice, (Ellis, 2016). According to Nursing and Midwifery Council (NMC) Code of Conduct (2015), nurses assess patients’ needs and deliver timely, efficient and effective patient care based on the best available evidence. Evidence Based Practice is the integration of best research evidence with nursing practice and patient needs and values to facilitate effective care, it also promotes quality, safe and cost-effective treatment for patients, families, healthcare providers and health care system, (Brown, 2014; Craig and Smyth 2012). This assignment aims to explore an area in nursing, identifying gaps between theory and practice. Using research and discussing strength of the literature and overcoming related issues in the specified area. The assignment will focus on barriers to cervical screening and nurses’ intervention to improve screening programmes. Cervical cancer screening can be detected early and treatment of precancerous cells and cervical cancer, (White et al., 2015) continues to exist. Cervical cancer starts from a pre-invasive stage known as cervical intraepithelial neoplasia (CIN) however, it can be detected through cervical screening, (Foran et al., 2015). Cervical cancer is the second most common cancer among women globally after breast cancer, (World Health Organization, 2016). According to the Department of Health (DH) (2012a) detecting cervical cancer at an early stage can prevent around 75% from developing. World Health Organization (WHO) (2015a) asserts that prevention and early detection of cervical cancer is cost –effective and a long-term strategy.   Hoppenot et al (2012) points out that screening can reduce incidence and death rates. Research shows cervical screening is associa ted with improved treatment for invasive cervical cancer, (Andrea et al., 2012). This highlights the importance of cervical screening programmes. Cervical screening reduces the occurrence of cervical cancer and research shows it prevents approximately 4500 deaths annually in Britain, (Bryant, 2012). In England, there is an invitation for screening for women aged 25-64.   Women aged 25-49 should attend screening appointment every three years and women aged 50-64 every five years, (Health and Social Care Information, 2012).   However, the last fifteen years has seen a gradual increase in more women being left unscreened for   five years or above, from 16% in 1999 to 22% in 2013 (Health and Social Care Information Centre, 2013). Research shows differences in screening is among women who are younger, lower income earners, less educated or women from minority ethnic background and sexually abused women, (Waller et al., 2012; Cadman et al.,2012; Marlow et al., 2015; Albrow et al., 2014). A comprehensive search of databases for literature review namely, Medline, Science Direct, CINAHL, National Institute for Health and Care Excellence (NICE) and Cochrane. An advance search strategy including ‘Cervical Screening, Barriers to Cervical Screening, Early Detection Cervical Cancer and Cervical Screening Adherence’. The search was refined to literature in the past five years and incorporated international literatures from United Kingdom, Australia, Sweden and Korea to give an insight of those barriers from a global perspective. Firstly, as regards discussion of non-attendance among women from minority ethnic background. Marlow et al (2015) conducted both qualitative and quantitative study titled ‘Understanding cervical screening non-attendance among ethnic minority women in England’. The study investigated and compared differences in attendance among 720 women from minority ethnic background and White British women. For clarification purpose, ethnic minority are black, Asian and minority ethnicity (BAME). The study found that BAME women were less likely to attend cervical screening with 44-71% non-attenders compared to 12% white British women. This highlights the need for more intervention by nurses to improve practice. Reducing inequality in cancer pathway particularly among minority ethnic groups is a policy priority (Dept. of Health 2011). Marlow et al (2015) found that women from ethnic minority viewed that they were not sexually active so they did not have to do the test. This is an important aspect for nurses to educate in order to improve practice and to promote attendance with educational materials in various languages for better interpretation. The study also found 65% women from minority ethnic background believed they do not need to attend smear test in the absence of any symptoms compared to 6% white British women. These barriers are primarily associated with lower education and lower socio- economic status, (Fang and Baker, 2013).   It is surprising that women are still not aware of cervical cancer screening when people should have received letters and leaflets as part of the NHS programme, this highlights that women who have never attended screening had not read any information, (Kobayashi, 2016). Furthermore Benito et al. (2014) argued that nursing activities were mainly in areas namely health education and promotion, clinical, research, training, and program evaluation. Nurses’ intervention to educate thereby improving knowledge and understanding of cervical cancer and the benefits of screening is essential. In addition, participants had deep-seated personal opinions including fear and embarrassment. Ethnic minority women were more likely to be fearful and preferred female health practitioner. To improve practice support groups in the community may be a good avenue to discuss about screening. These interventions should lay emphasis on the efficacy of cervical screening and address concerns regarding shame and embarrassment. The main strength of this study is information from a large population that makes it a relevant and reliable study to improve cervical cancer screening programme. A qualitative study conducted by Cadman et al (2012) titled ‘Barriers to cervical screening in women who have experienced sexual abuse; an exploratory study.   Women from the age of twenty and above who visit the Website of the National Association for People Abused in Childhood (NAPAC), a United Kingdom Charity who provide support and information for people from abusive background were invited to complete a web-based survey of their opinions and experiences of cervical screening. This survey included closed questions assessing social class, screening history and past records of abuse. Participants indicated the type of abuse they had experienced either physical, sexual, emotional, neglect, spiritual or any other form of abuse. Study shows women who have a history of sexual abuse are at risk of gynaecological problems and cervical neoplasia compared to women who have not. Women who have been sexually abused are more likely to smoke, take drugs and consume alcohol. The study revealed that a number of barriers impeded their attendance and adherence to cervical screening including embarrassment, lack of trust on meeting someone for the first time, gender of smear taker, pain, tension, fear and anxiety. The findings indicated that some study participants made remarks about the intrusive nature of the test. Some participants mentioned they were not comfortable with interventions performed while on their backs.   The argument suggest that women who have history of sexual abuse may be fearful and anxious because of triggering memories of the trauma so they may avoid such responses which is true therefore this study is valid and reliable. In relation to evaluation and analysis of the study, the findings also revealed that further training should be provided to increase nurses’ knowledge and sensitivity.   NMC Code (2015) points out that health care providers respect individual choices and deliver care without delay.   In an event of a sensitive discussion, nurses are required to ask patient preference and should remain professional not expressing any sign of shock. Fujimori et al. (2014) argues that to attain effective communication, nurses should inquire patients’ preferences and expectations at the start of the screening process. To improve this skill can be taught in communications skills training which has proven to be an effective approach. Nurses could show empathy by explicitly asking women about their expectations of the screening encounter and whether they have any concerns. This may help to surface issues that the nurse and patient could tackle together to minimise anxiety and fear. For example, it could be to provide the option of a female practitioner for the cervical screening appointment, maintain dignity and sensitivity. Effective communication between nurses and patients is essential. To achieve this, however, nurses must be sensitive to their specific needs and demonstrate empathy. Having nurses who are adequately trained with special knowledge of abuse is essential. There should be interventions such as counselling and support activities as part of ways of ensuring that they attend screening. This is particularly important at cervical screening appointments for sexually abused patients to deliver safe and sensitive practice. The Waller et al (2012) conducted a qualitative study evaluating differences to barriers among women from different ages. The study   interviewed practitioners working in the screening programme and other related charities as well as women who never attended screening focusing on their views on how age can influence non- attendance and non-adherence in cervical screening. The study found that women were classified into two distinct groups, which were those who wanted to go for screening but did not attend which consisted younger women and others who had decided not to attend were mainly older women. Wardle (2016) argues that nurses’ intervention at improving uptake could be beneficial by considering different approaches for various age groups to improve practice. The findings of the following analysis identified barriers that included many described in other studies namely fear of discomfort, pain, embarrassment and lack of education. There is a reliable argument that providing support with when, where and booking an appointment is effective. Additionally one of the key themes emerging from the study is that older women are more conscious about their bodies as they age. For example, one participant discussed about changes in her self-image as she grew older and how it has affected her self-esteem and how she feels reluctant to undergo invasive procedures.   Nurses could encourage action by   reassuring older women and   to remind them of the importance and benefits of cervical screening. Sabatino et al (2012) argued that effective communication improves cervical screening. This systematic review by Albrow et al (2014) found similar findings with Waller et al (2012) further evaluated the influence of intervention in cervical screening evidence uptake amongst women less than 35 years. The findings from the study increased validity and reliability from the argument that younger women are less likely to attend cervical screening. Ninety-two records were screened and four studies investigated. One of the studies evaluated the use of invitation letters and reported no significant increase compared to standard invitation. Three studies investigated the effect of reminder letters. Study participants described how screening was yet another demand on their time and often competed with work and childcare, which are of higher priority. For others, they could not attend due to inconvenient location, fear, discomfort and embarrassment, (Waller et al., 2012). There was a widely view among 30 year old women as sickness was associated with old age and felt they had no reason to attend screening (Blomberg, 2011). Analysis of the findings   indicate an increase in the number of women attending cervical screening after receiving reminder letters compared to those that were not given, however the increase was relatively small. For this reason, cervical screening programmes need to look beyond the use of invitation and reminder letters among younger women and to develop other interventions to overcome as many barriers. Another study reported no increase amongst women aged 20-24, although in some places these women are below the age threshold. However, the same study reported an increase among 25-29 (95%) and 30-34 that also reported (95%) increase. It could be argued that there is some evidence to suggest that reminder letters had positive effects on adherence to cervical screening programmes. The results also showed that telephone reminder from a female nurse, which had 6.3% and 21.7% increase. The study also reported 2.4% increase after a physician reminder. In evaluation of how nurses can improve practice among these, age group there is a need to remove practical barriers and provide other incentive methods that includes mass media campaigns and educational intervention. There are so many users of social media especially within this age group and if used properly it will play a significant role in creating awareness and educating patients (Merolli et al., 2013). Concerning low perceived risk, this may relate to misperceptions of the purpose of the screening programmes with patients focusing on detection rather than prevention of cervical cancer.   Again, patients should be empowered through social support in the community.   In addition, nurses can educate, giving information regarding importance and benefits of cervical screening. Lastly, the review of GP incentive such as nurses providing flexibility in appointment times and out of clinic days will improve practice. In conclusion, cervical cancer is preventable and relatively easy to diagnose. Several barriers upon women’s decision to attend cervical screening programme have been identified. Given this, there is a need for how women view cervical cancer and make screening decision. This assignment collates available evidence in order to investigate potential psychosocial influences on women from different perspectives. It is essential that patients adhere to nurses’ advice and educational interventions. In order to improve cervical cancer patient experience, there is a need that nurses receive adequate training and develop skills that can improve practice. One possible strategy is being sensitive to the screening process as a result of its intimate nature combined with effective communication. Nurses can play an important role in treating patients with dignity, respect and showing empathy. This can make a difference to all women most especially women who have experienced sexual abuse. Another contributing factor is to respect patients’ choice; an example is providing preferred gender of the sample taker. This could encourage more attendance and adherence to the cervical screening programme. PART 2 Reflective practice is essential to nursing profession. My search for the best evidence for cervical cancer screening interventions began by doing literature search. Designing a research study is an advanced and complex skill that requires clinical experience as well as analysing and evaluating the research design. While doing my research I focused on the needs of patients and effectiveness of nursing interventions. The result of my search enabled me acquire knowledge and skills in patient care by extensive literature search using electronic databases and advanced search with combined words. Discovering how to refine my search using full text and finding up to date evidence in the last five years.   My skills have greatly improved using electronic databases. This was done in order to obtain relevant up to date search. NMC (2015) requires nurses use up to date evidence and competent to practice. Such insight in itself is relevant to nursing competency and can help to improve patient care.   I read and understood articles relevant to nursing practice, clinical expertise and understanding patient values. Reading the research articles and reflecting on each one, identifying assumptions, key concepts and methods and determined whether the conclusions were based on their findings. Appraising the steps of the research process in order to critically analyse and use it to inform practice. This developed my assessment skills and I was able to identify valid and reliable studies. Reviews and ratings of the evidence resulted in recommendations for practice. According to National Institute of Nursing Research (NINR) 2013, nursing research is defined as research that involves and develops nursing care in order to promote patient healthcare. Nurses play an important role in the National Health Service (NHS) they provide front line services, support patients and contribute to health research. Furthermore, research generates knowledge for nurses and contribute towards health care (Parahoo, 2014). I am more enlightened about the importance of analysing and evaluating research studies, which helps nurses to acquire more knowledge and be up to date with evidence thereby promoting patient care. It is evident that evidence base practice will continue to have great impact on the professional practice of nursing. Evidence based practice is important in nursing because it improves patient outcomes, care is delivered more effectively and efficiently and it minimises error, (Houser,   2016). I have acquired more knowledge, skills during the duration of this evidence based practice assignment and recognised my strengths, and areas that I needed to improve on. REFERENCES Albrow, R., Blomberg, K., Kitchener, H., Brabin, L., Patnick, J.and Tishelman, C. (2014) Interventions to improve cervical cancer screening uptake amongst young women; A systematic review. Acta Oncologia, Vol. 53, no. 4, pp.445-451. Andrea, B., Andersson, T.M. and Lambert, P.C. (2012) Screening and cervical cure; population based cohort study. British Medical Journal, Vol. 1344, pp.900. Bang, J.Y., Yadegarfar, G., Soljak, M. and Majeed, A. (2012) Primary care factors associated with cervical screening coverage in England. Journal of Public Health, Vol. 34, no. 4, pp. 532-538. Brown, S.J. (2014) Evidence- based nursing. The research practice connection. 3rd ed., Sudbury MA; Jones & Barlett. Bryant, E. (2012) the impact of policy and screening on cervical cancer in England. British Journal of Nursing, Vol.4, pp. 6-10. Cadman, L., Waller, J., Ashdown-Barr, L. and Szarewski, A. (2012) Barriers to cervical screening in women who have experienced sexual abuse; an exploratory study. British Medical Journals, Vol. 38, no. 4, pp. 1-19. Craig, J. and Smyth, R. (2012) the evidence based practice manual for nurses. 3rd ed., Edinburg Scotland; Church Livingstone Elsevier Ltd. Department of Health. (2012a) cervical screening. {Online} {Accessed on 12 September 2017} http;//www.tinyurl.com/7gvxef9 Ellis, P. (2016) Evidence – based Practice in Nursing. 3rd ed., London; Sage Publications. Fang, D.M. and Baker, D.L. (2013) Barriers and facilitators of cervical cancer screening among women of Hmong origin. Journal of Health Care Poor Undeserved, Vol. 24, no. 2, pp. 540-555. Ferlay, J., Soerjomataram, I., Ervik, M., Dikshit, R., Eser, S. and Mathers, C. (2013) Cancer incidence and Mortality Worldwide. IARC Cancer Base NO.11 Lyon; International Agency for Research on Cancer. Foran, C. and Brennan, A. (2015) Prevention and early detection of cervical cancer in the UK. British Journal of Nursing, Vol. 24, no.10, pp.2. Fujimori, M., Shirai, Y. and Asai, M. (2014) Effect of communication skills training program for oncologist based on patients preferences for communication when receiving bad news. Journal of Clinical Oncology, Vol. 32, no.20, pp. 2172-3266. Hope, K.A., Moss, E., Redman, C.and Sherman, S.M. (2017) psychosocial influences upon older women’s decision to attend cervical screening; a review of current evidence. Preventive Medicine, Vol. 101, pp. 60-66. Hoppenot, C., Stampler, K. and Dunton, C. (2012) cervical cancer screening in high- and low resource countries; implications and new developments. Obstetrician Gynaecology Survey, Vol. 67, no. 10, pp. 658-667. Houser, J. (2016) Nursing Research; Reading, Using and Creating Evidence. 4th ed., Jones& Bartlett Kobayashi, L.C., Waller, W.C. and Wardle, J. (2016) A lack of information engagement among colorectal cancer screening non-attenders; cross sectional study. British Medical Colorectal Public Health, Vol. 16, pp. 659. Marlow, L.A., Wardle, J. and Waller, J. (2015) Understanding cervical screening non-attendance among ethnic minority women in England. British Journal of Cancer, Vol. 113, pp. 833-839. Merolli, M., Gray, K. and Martin Sanchez, F. (2013) Health outcomes and related effects of using social media in chronic disease management; a literature review and analysis of affordances. Journal of Biomedical Information. Nursing and Midwifery Council. (2015) the Code; Professional Standards of Practice and Behaviour for Nurses and Midwives. NMC, London. The Health and Social Care Information Centre annual report- 2012 to 2013 www.gov.uk/†¦/thehealth-and-social-care-information-centre-annual-report-an Wardle, J., Wanger, C.N., Kralji-Hans, I., Halloran, S.P., Smith, S.G. and McGregor, L.M. (2016) Effects of evidence-based strategies to reduce the socioeconomic gradient of uptake in the English NHS Bowel Cancer Screening Programme (ASCEND) ;four cluster- randomised controlled trials. Lancet, pp.751-759. White, A., Thompson, T.D. and White, M.C. (2015) cancer screening test- use- United States. MM WR Morb Mortal Weekly Rep, Vol. 66, pp. 201-206. World Health Organisation (2015a) Cancer. {Online} {Accessed on September 12 2017}

SUVs: Not Just Practical Essay -- miscellaneous

SUVs: Not Just Practical Car technology is advancing quickly and unstoppably. Along with that, the concepts of some vehicles have also changed, creating new uses that consequently make them attractive for other clients. Following this tendency for more multifunctional machines, one kind of vehicle has increased its popularity as it combines the best of work vehicles and regular automobiles. Therefore, a new market has been opened for the Sport Utility Vehicles (SUVs). SUVs creators have developed such a comfortable and practical interior by placing accessories, small gadgets, devices, pleasure add-ons, and many other things we could want or need. Because of that, now it is easier than ever, for a person who owns a SUV to do activities that were not considered appropriate for these vehicles not very long ago. Examples of this are how these SUVs respond to demands regarding road trips, field trips, every day usage, usage as entertainment centers, and even in family vehicle usage. For the purpose of understanding the uses presented above it is helpful to know its definition. A SUV can be described basically as a high-performance four-wheel car built on a truck chassis, an element that gives a big part of its strength and durability. Even though, according to WordIQ.com, a SUV is a type of vehicle that combines the load-hauling and passenger-carrying capacity of a station wagon or minivan with features designed for off-road driving. In more recent years, though, the term has also grown to include vehicles with similar size and style marketed as sport utility vehicles, but do not incorporate many off-road features. The SUVs is considered to be descendent of commercial and military vehicles such as Jeep and Land Rover, starters of the genre. In the last 25 years, though, and even more in the last decade, they have become popular with urban buyers. Therefore, it has to fit the demands of urban buyers, who may use the SUVs to travel long distances. One very noticeable characteristic of today’s SUVs is that they have changed in order to be more suitable for long trips in them, keeping up with the competition for that market. Since a few years ago these cars were used almost exclusively for work, the purpose for what they were created, the manufacturers were not paying too much attention on how comfortable they would be for spending a big amount of time in ... ...umerous utilities. The SUVs can provide that, and they will continue to improve in order to fulfill the need of the buyers in the next decades, which will probably search for products with even broader uses. This appears to indicate that the SUVs are slowly becoming the vehicle of the future, for they are the most likely candidates to win in one market, that, along with many others, seems to be destined to become every time more simple. Finally, what was only a type of vehicle with work purposes is now also popular in cities and with people that would not think they needed it a few years ago. Statistics are moving towards the SUVs’ taking over the automobile market: Every year a bigger number of them being bought. Still, the exterior of the SUVs has barely changed during the last few years. This lead us to the conclusion that it is the redesign of the concept and interior of this type of car, not of the exterior, what has led to this major change of the use of it, which has been reflected on its current customers. They now not only give usefulness, but also comfort. This has led to the fact that we can do more things than ever with the every time more functional â€Å"house vehicle†.