Wednesday, December 11, 2019
The National Rifle Association Essay Category:Social issuesPaper Title:nrsText:The National Rifle AssociationUnion veterans Col. William C. Church and Gen. George Wingate formed theNational Rifle Association (NRA) in 1871. The primary goal of the associationwas to promote and encourage rifle shooting on a scientific basis,according to a magazine editorial written by Church. After being granted a charter by the state of New York on November 17, 1871,the NRA was founded. Civil War Gen. Ambrose Burnside, who was also the formergovernor of Rhode Island and a U.S. Senator, became the NRAs first president. The NRAs interest in promoting the shooting sports among Americas youthbegan in 1903 when NRA Secretary Albert S. Jones urged the establishment ofrifle clubs at all major colleges, universities and military academies. By 1906,NRAs youth program was in full swing with more than 200 boys competing inmatches at Sea Girt that summer. Today, youth programs are still a cornerstoneof the NRA, with more than one million youth participating in NRA shootingsports events and affiliated programs with groups such as 4-H, the Boy Scouts ofAmerica, the American Legion, U.S. Jaycees and others. In 1956, NRA became the only national trainer of law enforcement officerswith the introduction of its NRA Police Firearms instructor certificationprogram in 1960. Today, there are more than 10,000 NRA-certified police andsecurity firearms instructors. Additionally, top law enforcement shooterscompete each year in eight different pistol and shotgun matches at the NationalPolice Shooting Championships held in Jackson, Mississippi. In 1990, the NRA made a dramatic move to ensure that the financial supportfor firearms-related activities would be available now and for futuregenerations. Establishing the NRA Foundation, a 501 (c) (3) tax-exemptorganization, provided a means to raise millions of dollars to fund gun safetyand educational projects of benefit to the general public. Contributions to theFoundation are tax-deductible and benefit a variety of American constituencies,including youths, women, hunters, competitive shooters, gun collectors, lawenforcement agents and persons with physical disabilities. While widely recognized today as a major political force and as Americasforemost defender of Second Amendment rights, the NRA has, since its inception,been the premier firearms education organization in the world. But our successeswould not be possible without the tireless efforts and countless hours ofservice our nearly three million members have given to champion Second Amendmentrights and support NRA programs. Social Issues
Wednesday, December 4, 2019
Moving Toward Preventative Education in the Diabetic Patient Chronic illnesses affect patients in all age groups in all of the ethnical and socioeconomic groups within the United States (Cohen Cesta, 2005). The treatment and management of a chronic illness is a life-long task for the patient, the caregiver, and healthcare provider. The patient and caregiver need to understand the illness, how to manage the disease at home, but most importantly how to prevent further complications of the illness. Nurse case managers influence the disease process through the sharing of their knowledge, providing community based resources, and the relationships that are formed with the patient (Cohen Cesta, 2005). The purpose of this paper is to describe how the nurse and healthcare organizations can provide supportive and preventative patient care to educate the patient with diabetes mellitus. Diabetes mellitus is a chronic illness that affects over 25 million American children and adults (American Diabetes Association [ADA], 2011). We will write a custom essay sample on Preventative Education for the diabetic patient or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page There are many complications that accompany this disease such as, heart disease, stroke, hypertension, kidney failure, hearing loss, blindness, neuropathy, skin conditions, and amputation (ADA, 2011). Diabetes is a chronic illness that has a substantial impact on the cost of healthcare. It is estimated that in 2007, 174 billion dollars was spent on patients with the diagnosis of diabetes (ADA, 2011). Two out of three individuals with diabetes will die from heart disease or a stroke (ADA, 2011). The path that diabetes takes is different in each individual but the education and preventative measures for the disease should be available to all patients in order to prevent the progression and debilitation that it can cause. Nurse case- managers help the chronically ill patient to move along the healthcare system and in the process provide education, quality healthcare, and cost effective healthcare management (Cohen Cesta, 2005). Changes Needed from Supportive Care to Preventative Care and Education Diabetes care has shifted from the hospital setting to the outpatient clinic setting, with the primary care physician leading the plan of care (Greisiner et al. , 2004). This setting often includes the registered nurse, the dietitian, the pharmacist, or a certified diabetes educator (Greisiner et al. , 2004). Preventative healthcare should be initiated with the patientÃ¢â¬â¢s encounter with the primary care physician and support staff. The primary care physician and the nurse have the opportunity to educate, encourage, and perform preventative health screening tests on a regular basis. The Healthcare Effectiveness Data and Information Set (HEDIS) measures are used to improve patient outcomes, lower healthcare costs, and provide education to the consumers of healthcare plans (National Committee for Quality Assurance [NCQA], 2011). Comprehensive diabetes care is a preventative measure that includes hemoglobin A1C monitoring twice a year, an annual lipid panel, urine screening for micro-albumin, podiatry care, an eye exam, and blood pressure monitoring (NCQA, 2011). Many patients are given the diagnosis of diabetes but need guidance and education as to what encompasses the disease process. The nurse case manager has the opportunity to assess the patientÃ¢â¬â¢s knowledge on the disease process and also the life style behaviors that affect the progression and path of the disease. The nurse can then set up the educational format to meet the patient and care giver needs (Boehler, Hardesty, Gonzales, Kasnetz, 2009). Patient education should focus on medication knowledge and compliance, dietary modifications, interventions that can be done at home when signs and symptoms of hypo and hyperglycemia are present, the importance of skin monitoring, specifically the feet, why the annual eye exam is recommended, the purpose of testing the urine for micro-albumin, and the annual lipid panel (NCQA, 2011). The nurse case manager can educate the patient on blood pressure management and the importance of not only compliance with diabetes medication, but also with anti-hypertensive medication. Blood pressure control in the diabetic patient is important for decreasing the risk of developing other risk factors such as heart disease and stroke. Providing education on each component of diabetic preventative care is an effective way to treat the patient and keeps the patient involved in the plan of care (Greisinger et al. , 2004). The Benefits to Supportive Care The HEDIS measures are a great starting point for nurses to educate, plan, and develop relationships with patients and families to promote health maintenance and supportive nursing care. The nurse case manager coordinates the plan of care to ensure education, support, the opportunity for community resources, and works to increase outcomes in a resourceful and cost effective manner (Cohen Cesta, 2005). The benefits to care management in the diabetic patient include better glycemic control, goals to achieve aÃ healthy weight status, a decrease in hospital utilization, a decrease in associated illnesses, an increase in diabetic education attendance, and a better understanding of the disease process (Greisinger et al. , 2004). Providing continuity in the care of the diabetic patient with nurse care management provides the patient with a contact to confide in and a resource in the path to managing their disease. The Case Management Theories, Concepts and Strategies. An interdisciplinary system of case management is essential when coordinating the care for a patient with diabetes. Managing the care of a diabetic patient requires the skill and knowledge of various disciplines. The interdisciplinary team can work together to maximize resources that are available to the patient and family (Cohen Cesta, 2005). The clinicians can coordinate their efforts to build a plan of care that unites all necessary resources to support the patient and their journey through the healthcare system (Cohen Cesta, 2005). The Sierra Health Services plan is a care management program that began with the philosophy of encouraging the healthcare providers, the patients, and the insurers to work together to achieve positive patient outcomes (Hillegass, Smith, Phillips, 2002). The philosophy also included that care management is imperative to provide quality healthcare in a cost efficient manner (Hillegass et al. , 2002). The goal of the Sierra Health Services plan consisted of providing continuity of care in a safe and cost effective manner in order to move the patient through the healthcare continuum (Hillegass et al., 2002). This organization was successful in building a care management system for the population with a chronic illness. The organization looked at the population with a chronic illness in regards to their medical needs, their socio-economic status, their functional status, and how they viewed their disease process (Hillegass et al. , 2002). This was needed to determine the type of care management program that was needed with in their organization. The Sierra Health System refined the program and began to assess the chronically ill for home care services. This process included screening the patient for knowledge of their disease, medication knowledge and compliance, physical signs and symptoms of the disease, nutritional status, social support, home safety, functional mobility, and if community resources were involved (Hillegass et al. , 2002). This healthcare system allowed nurses to manage patient care in a collaborative effort that promoted patient independence and compliance with health care prevention as a leading step in providing quality cost effective care. Knowledge and Insights to Provide Diabetic Prevention and Education Providing community care management for the patient with diabetes requires the efforts of many disciplines within the healthcare community. The nurse case manager can provide education and resources but it is a community effort to streamline services for a chronically ill patient with diabetes. The most helpful intervention for the diabetic patient is the establishment of the therapeutic relationship with the nurse case manager. This relationship can serve as the access point in and out of the healthcare environment with the opportunity for the patient to receive education, community services, psychosocial support, nutritional education, and routine medical care. An important aspect of diabetic case management is the ability to engage the patient in their plan of care to promote compliance, improve health status outcomes, and decrease healthcare costs (Cohen Cesta, 2004). Summary Nurse case managers are crucial members of the healthcare team in the assessment, planning, and implementation of a patient education and a preventative health maintenance program. Nurse case managers serve as the gate keepers in the process of teaching, seeking out available resources, and coordinating the interdisciplinary approach to community case management. The patient with diabetes requires multiple community resources to maintain their optimal level of well- being, to decrease the risk of disease related complications and to decrease the incidence of hospitalization. The goals set forth for the diabetic patient and a healthcare organization are to improve quality of life with cost saving processes (MacKinnon-Schifalacqua, OÃ¢â¬â¢Hearn, Schmidt, 2004).
Thursday, November 28, 2019
// Maxim's Config (aka BananaGaming) // When you type "//" the game ignores whatever is written after con_enable "1" //Enables Console cl_clanid 7238336 //Use Steam Group Tag "Go Bananas" echo Config Loaded! (1/2) //This confirms that the config has been loaded // Crosshair - Single Yellow Dot Instead of Crosshair (2017-05-04) // Made with Crashz Crosshair Generator cl_crosshair_drawoutline "1" cl_crosshair_dynamic_maxdist_splitratio "0.35" cl_crosshair_dynamic_splitalpha_innermod "1" cl_crosshair_dynamic_splitalpha_outermod "0.5" cl_crosshair_dynamic_splitdist "7" cl_crosshair_outlinethickness "1.000000" cl_crosshair_sniper_show_normal_inaccuracy "0" cl_crosshair_sniper_width "2" cl_crosshairalpha "100.000000" cl_crosshaircolor "5" cl_crosshaircolor_b "0" cl_crosshaircolor_g "255" cl_crosshaircolor_r "255" cl_crosshairdot "1" cl_crosshairgap "-4.000000" cl_crosshairgap_useweaponvalue "0" cl_crosshairscale "0" cl_crosshairsize "0.500000" cl_crosshairstyle "4" cl_crosshairthickness "1.000000" cl_crosshairusealpha "1" cl_fixedcrosshairgap "3" // Viewmodels - Viewmodel Settings viewmodel_offset_x "1" //Changes viewmodel view in X scale viewmodel_offset_y "2" //Changes viewmodel view in Y scale viewmodel_offset_z "-2" //Changes viewmodel view in Z scale viewmodel_fov "68" //Highest viewmodel FOV // Bob - How much you move around with weapons cl_bob_lower_amt "5" //How much the viewmodel lowers when running, set to lowest for less distraction cl_bobamt_lat "0.1" //How much the viewmodel moves side to side when running, set to lowest for less distraction cl_bobamt_vert "0.1" //How much the viewmodel moves up and down when running, set to lowest for less distraction cl_bobcycle "0.98" //The frequency at which the viewmodel bobs, set to default cl_viewmodel_shift_left_amt "0" //Removes shifting of arms cl_viewmodel_shift_right_amt "0" //Removes shifting of arms // Bindings - These bindings bind "v" "+voicerecord" //You can communicate with the V key instead of K bind "f1" "autobuy" //Autobuy weapons if you have lots of money with F1 bind f3 "buy flashbang; buy smokegrenade; buy molotov; buy hegrenade" //Buy flash & smoke with F3 bind "f4" "ignoremsg" //Ignore chat by turning off enemies, teams and both bind "f" "+lookatweapon" //Inspect your weapon with F bind "k" "say !r" //Used together with CKSurf plugin for Bhop, Surf & Kz bind "leftarrow" "+left" //Turn left with arrow key bind "rightarrow" "+right" //Turn right with arrow key unbind "i" //So you don't accidentally enable hud fade, which is very annoying // No Tutorial or Info Messages - Can give FPS BOOST and is also very annoying gameinstructor_enable "0" //Removes in game lessons cl_showhelp "0" //Removes on-screen help cl_autohelp "0" //Removes automatic help cl_disablefreezecam "1" //Disables Freezecam, very important to have off cl_disablehtmlmotd "1" //Removes "Message of the day" page when joining a server // Rates - These network settings are optimized for high speed internet rate "786432" //Max rates. Only use if you can get 8 Megabits per second (Mbps) download speed or more. //rate "250000" //Only use this if you can get 3.5 Megabits per second (Mbps) download speed or more. //rate "500000" //Only use this if you can get 5.5 Megabits per second (Mbps) download speed or more. cl_cmdrate "128" //Max number of command packets sent to server per second cl_updaterate "128" //Number of packets per second you are requesting from the server cl_interp_ratio "1" //Sets the interpolation amount (final amount is cl_interp_ratio / cl_updaterate) cl_interp "0" //Sets the interpolation amount, always set this to 0 cl_lagcompensation "1" //Lag compensation helps by eliminating combat latency from client side view cl_predict "1" //Skip waiting for server feedback and simulate client side movement in real-time cl_predictweapons "1" //Skip waiting for server feedback and perform client side prediction of weapon effects // Video - Brightness & Disabling TV Mode mat_monitorgamma "1.6" //Sets the Brightness to it's highest value, highly recommended mat_monitorgamma_tv_enabled "0" //Turn off TV Mode for less off-set light // Sound - Sound settings, doesn't affect volume in-game, adjust that yourself. voice_scale "0.4" //Turns down the volume of other players voice to 40% snd_musicvolume "0" //Turns off all music, easier to focus snd_use_hrtf 1 //Turn ON Head-Related Transfer Function // Net - How much frames you have and solid graph fps_max "300" //Map loads fast and allows high frames net_graph "1" //Shows my network usage data net_graphheight "0" //Changes height net_graphmsecs "400" //The latency graph represents this many milliseconds net_graphpos "2" //Positioning of Net Graph net_graphproportionalfont "0" //Makes font smaller net_graphshowinterp "1" //Shows interpolation value net_graphshowlatency "1" //Shows latency value net_graphsolid "1" //Solid Net Graph net_graphtext "1" //Shows text fields net_maxroutable "1200" //Requested max packet size before packets are 'split' net_scale "5" //Makes font smaller // Other r_drawtracers_firstperson "0" //Hides bullet tracers in first person view lobby_voice_chat_enabled "0" //Turns microphone off in lobby, really useful cl_use_opens_buy_menu "0" //Disables E from opening buy-menu, really useful mm_dedicated_search_maxping "50" //Maxping Search in Matchmaking cl_autowepswitch 0 //Don't auto-pick weapons func_break_max_pieces 0 //Less clutter from breaking vents (especially in Mirage) // Make sure mouse is using "Raw Input" & "No Acceleration" m_rawinput "1" //Enable Raw Input for perfect precision (Raw input is unavailable on OSX) m_mouseaccel2 "0" //Disables windows mouse acceleration initial threshold, safety precaution m_mouseaccel1 "0" //Disables windows mouse acceleration initial threshold, safety precaution m_customaccel "0" //Custom mouse acceleration disabled m_mousespeed "0"
Sunday, November 24, 2019
Oedipus Rex1 essays Knowledge is a great weapon used by society for help, comfort, and most importantly advancement of the human race. Unfortunately, knowledge is often accompanied by sorrow and grief. In the Greek tragedy Oedipus Rex Sophocles shows how Oedipuss thirst for the knowledge of his past leads to his own demise. Knowledge is not just given to the characters in the tragedy. Oedipus, sincerely and seriously, "must know it all, [and] see the truth at last"(1169). He also most know the percise truth, "what exactly"(1130) happened in his past. Oedipus feels that "The time has come to reveal this once for all"(1153) knowing completely the sorrow the truth may bring. He accepts that there may be grief following the truth shouting "Let it burst! Whatever will, whatever must!"(1183) knowing that the truth may be "something monstrus"(1181). Once Oedipus has been fed a morsel of truth he questions his wife, "What - give up now?, with a clue like this? Fail to solve the mystery of my birth? Not for the world!"(1162). Oedipus seals his own fate when he ask the chorus "Even if god had never urged you on to act, how could you leave the crime uncleansed for so long?"(293). Oedipus is not the only one to quest for knowledge. In the beginning the chorus wants to know "Whose ruthless bloody hands hav e done the work?"(530) and "Who is the man the voice of god denounces resounding out of the rocky gorge of Delphi?"(522). Jocasta, Oedipuss wife and mother, is also inquisitive before her moment of recognition. When a messenger from Oedipus's birth land comes to Thebes she ask, "What have you come for? Have you brought news?"(1021). We, like the characters of Oedipus Rex, are inquisitive even knowing that the truth sometimes can only bring sorrow to us and the ones we love. Almost every piece of information learned in Oedpius Rex leads t ...
Thursday, November 21, 2019
English - Essay Example This included food chemical flavoring, working conditions of beef industry and production of chicken and cattle. This section also takes a look on the dangers of meat consumption and the global interest of fast food in America as a cultural export (Schlosser 12). The assignment requires selection of one topic in the book explained above and its examination. In addition to that, the paper will craft an argument that will convince the readers to change the way they think, do things, or behavior as explained in the selected topic. In order to accomplish the requirements of the assignment, the paper is based on one topic Ã¢â¬Å"what we eatÃ¢â¬ . Fast food in America has become one of the most factors that drive the economy. At least over the last three decades, the American has been infiltrated by fast food. The fast food industry first began with the small quantity of fast food in the State of California. The influence of the industry has spread to every part of America and to a bigger extent all over the world. The industry is fulfilling the wants of its customers by processing a wide range of food stuffs with a purpose of reaching its market. The industry has taken a good distributing strategy where the food is being distributed in cafeterias, in school, bus stages and restaurants. The nation is known to spend more on fast food than what is spent in a combination of magazines, videos, newspapers, books and movies. According to Schlosser (2001), the fast food industry has a hygiene issue. One may find a person in the construction work just taking the packet of fast food without even washing their hands. People take the exercise of buying fast food as routine without any issue. However, fast food has a revolutionary force in the United States. The food is booth metaphor and a commodity to drive the economy of America. The influence of what people eat or do not is due to
Wednesday, November 20, 2019
Management - employee compensation and organization - Essay Example 232). A manager has to create a balance between these two types of rewards so that it recognizes the employee's motivation. The manager shall not choose it for them. Qn.2 What is the relationship between an employee's salary and his or her feeling of worth Explain your rationale from the viewpoints of an employee and a manager. How can managers create a balance between the two Total words: 250 An employee feels that salary fulfills his basic need and also gives him a feeling of higher esteem (Buelens et al., 2006, Pg. 177-179). An employee views salary as compensation to his skill sets, experience etc. Whereas, a manager, if he is responsible for the cost location, feels that salary is a cost on the organisation. A manager has to set out a balance in providing a salary structure which would mirror the worthiness in the minds of the employee, without jeopardizing the interest of the organisation. In reality, compensation is the one which satisfies the needs of an employee, and it is within its boundaries develops the employee's worthiness. Qn.3 What type of compensation component would you like to have through your employer that is not currently offered Explain your rationale.
Sunday, November 17, 2019
Quality improvement program - Essay Example Normally, not all outpatient clinics are required to pass the Joint Commission Requirements for quality; nevertheless, VSA is necessitated to. Since the time of its launch where it first developed its quality control program until today, the Virginia Surgical Associates remains serious about meeting all Joint Commission Requirements such as the Environment of Care, which pertains to how safe, functional and efficient the environment for patients, staff, and other individuals is in the organization; Infection Prevention and Control: how well the clinic is able to lower down the risk of surgical patients acquiring infection; Rights of Individual, which evaluates the establishment of informed consent, participation in decision-making of patients, and services to respect patientÃ¢â¬â¢s rights, etc. (Joint Commission, 2014). But despite VSAÃ¢â¬â¢s strong commitment to maximize the quality of its services, it is still bending more attention to quality improvement that includes examinin g rates and complications and lab equipments such as ACT machine that s a point-of-care, blood clotting test used to monitor anticoagulation (Philip et al., 2008). The Virginia Surgical Associates is constantly developing its Quality Improvement Program to address these requisites. While healthcare quality measurement is developing, there are more things to take care of. The complicated environment of the healthcare industry makes quality program monitoring and implementation a lot more difficult. It is important that in revising and monitoring quality program implementation, new quality measures are developed in order to address rising issues within the healthcare industry. 1. Type of Care and Patient Engagement. The quality of the healthcare services can be monitored by the patient engagement with respect to the types of care being administered (Mainz,