ANALYSIS OF U.S. ECONOMY Essay Example | Topics and Well Written Essays - 500 words

ANALYSIS OF U.S. ECONOMY - Essay Example This may perhaps be the reason for the speculation over the state of the economy considering that during the second quarter the gross domestic product rate fell slightly lower than that which was produced in the first quarter of the year. However, these higher numbers may not necessarily mean that the economy is going to bounce back. There is still concern over the consumer spending as this only rose to 2.4% which was less than the estimation and this may well be a concern as consumer spending constitutes about seventy percent of the gross domestic product . There have been cuts in taxes to coax the consumers from spending more and this may perhaps have helped the situation. By cutting taxes to a degree which would encourage spending there may well be a rise in the gross domestic product and this would certainly be a big boost to the recovering economy. There are some economists who believe that within next year the rate may well rise to 3% and perhaps even more but it would be too e arly to measure the specific rate. Consumers have also gained confidence are now more welcome to the idea of spending. Incomes and spending have risen, which in result have led to a fall in the savings. The Bureau of Economic Analysis has submitted the figures of savings which have dropped from $622.8 to $614.8 from September to October. Figures such as these are a good sign that consumers are becoming more confident about spending money and this is a welcome boost to the industries and especially retailers (US Department of Commerce). The rate of the gross domestic product would not be the only assessment of the economy. Unemployment rates in the United States are at a high and have even increased to a rate of 9.8% (United States Department of Labor). According to one report, the rates are still lower than what the actual situation is at the moment due to the fact that those who have stopped trying to get jobs due to the slow economy are not being

Online Banking Essay Example | Topics and Well Written Essays - 750 words

Online Banking - Essay Example Banks have had to adopt current technology in order to remain competitive, retain their customers and lower operation costs. Online banking was started in the 1980s by a few banks in the United States. Four major banks in New York adopted online banking to allow customers maintain electronic checkbook registers, check account balances, make fund transfers and other banking related activities. Online banking, also known as Internet banking, is part of virtual banking that began with telephone banking and automatic teller machines (ATMs). Virtual banking is a banking system that is non-branch based. Services are provided through various electronic media such as telephones, personal computers, ATMs and the Internet. Virtual banking has existed for quite some time and its transactions costs are quite low as compared to branch transaction costs. Banks are investing in various forms of banking systems to expand their geographical and market coverage with regards to banking systems. However, they are using different forms of banking, for example, some invest in bricks and mortar while others adopt the current ba nking system that uses the Internet (Cronin 42). The Internet is becoming the main channel of communication since its inception in 1969. Internet has recently gained popularity in the U.S. as the main medium for e-commerce. Its potential growth has come with opportunities and threats to businesses. The Internet is on the verge of becoming the main delivery and distribution channel. The growth and rapid diffusion of the Internet has made banking online an alternative banking system at the expense of traditional branch-based banking. Banks in the United States have started providing services via the Internet including Internet banking. Currently, the Internet has revolutionized the banking system and it is considered as an alternative strategic weapon that changes the operation system of banks. Banks are able to deliver services to customers in

Communication Essay Example | Topics and Well Written Essays - 1500 words - 1

Communication - Essay Example The story kept me in suspense. There was no predictability in the plot, which always kept you guessing as to what will happen to the characters. I was half-way through the story and yet I cannot anticipate how the story will end. The main issues in the story remain unresolved even after the story ended. The story keeps running on my mind because I am trying to process the story. There is no clarity and closure even at the end. All throughout the story, I seem to be waiting for a greater surprise as to what will be the ending. The author’s style is to slowly bring the reader to the awareness of the twist in the story. The theme of running away is repeated all throughout and it is presented as an unacceptable option. The story depicts several forms of complicated relationships. The relationship between romantic partners, that of Clark and Carla, the relationship between a parent and a child, that of Carla and her parents and the relationship between friends, that of Carla and Mr s. Jamieson. â€Å"Runaway† also presents the inner struggles of a woman, her weaknesses and her strengths. It shows how sometimes a woman acts differently outside, not letting her inner being reflect her actions. The story is presented in a lucid and vivid manner but I am confused whether I like the characters or not. All the characters in the story starting from Carla, Clark, and Mrs. Jamieson surprise me as to their real persona. They are not predictable. I just cannot anticipate their actions. Munro’s writing style is one wherein she predicts her readers’ thoughts and perceptions and then she disproves the readers’ expectations by writing the opposite of what they expect. This is one quality that I admire in Munro’s literary style. It kept me at the edge of my seat. The characters are described in details which reflect true to life people. It is through this detailed characterization that one can feel an emotional attachment to the characters. I just cannot stop thinking about the characters even after reading the story. I had to analyze each character and explain to myself why they reacted in a certain way when faced with the situations in the story. I also cannot stop wondering what will happen to them in the future. Carla, the main character of â€Å"Runaway† suffered from indecision all throughout the story. Carla depicts a character with an impulsive emotion. She feels lost but she has no roots. I think Carla thought she could run away from her husband but she was actually incapable of doing so. As described in Bruner’s ten features of narrative, I can say that running away from Clark is her intentional state but as we can see from the ending of the story, her intentional state did not determine the ending of story. She wanted to runaway but later on changed her mind. She wanted to change her life abruptly but suddenly while in the bus decides to get-off. There seems to be an onset of a different set of sensations which was exactly the opposite of what she felt when she was conversing with Mrs. Jamieson and planning her escape. Just when you think that Carla is a hero, she unexpectedly shows her flaws. At the beginning of the story, I thought that Mrs. Jamieson was the antagonist in the story because of Carla’s reaction when she saw her driving along the road. She even thought in her mind, â€Å"Let it not be her.† In the end though, I realize that Mrs. Jamieson

Collective bargaining report Assignment Example | Topics and Well Written Essays - 1000 words

Collective bargaining report - Assignment Example It is worthy noting that, collective bargaining is a recognized approach of creating a system of industrial jurisprudence. It acts as a method of introducing civil rights in the industry. It is vital to note that, this procedure enhances management by rules and diminishes management characterized by arbitrary decision-making. More over, collective bargaining is a proven procedure that aid in the establishment of regulations, which define and restrict the traditional authority exercised by the management. There are numerous benefits attributed to collective bargaining process2. They include chances of increasing the strength of the employees consequently their bargaining capacity as a team. On the same note, this study establishes that, collective bargaining increases the self-esteem and productivity of the workforce3. Furthermore, it restrains management’s freedom for arbitrary and unilateral actions against the employees. In addition, collective bargaining has played a fundam ental role in ensuring that, fair settlement of the workers’ grievances is secured. This is possible through the provision of a flexible approach for the adjustment of wages and employment conditions to economic and technological changes in the business. This is owing to the reduced chances for conflicts4. On the side of the employers, collective bargaining aid in easier resolving of issues at the bargaining point rather than taking up complaints of individual employees. In addition, collective bargaining widens the channel of communication amid the employees and thereby reducing the cost of labour turnover to management consequently increases employee involvement in decision-making. Furthermore, collective bargaining is fundamental in resolving industrial disputes. Besides benefits of collective bargaining towards both the employee and the employer, this study examines the gains of collective bargaining attributed to the society. The society gains in terms of industrial peac e stability in the country. More over, it facilitates the establishment of a harmonious industrial climate that aid the country to grow economically and socially. Another significant benefit credited to collective bargaining to the society involves constant check of worker’s exploitation and discrimination. The process of negotiation and substance bargaining is complex since it entails numerous stages, which sometimes remain derailed due to disagreements and conditions. Evaluation and selection strategy A negotiation process starts with evaluation and selection of a strategy, which is intended to guide the problem solving5. This normally involves diverse approaches or procedures of mediation or arbitration. Making contact with other parties The second stage involves making contact with the other party or parties this stage enhances building of personal credibility and promoting commitment tot he procedures set. Collection and analysis of background information The third stage involves the collection and analyzing the background information. The relevant information collected is fundamental in understanding the dynamism exhibited by the participants. In addition, it enhances verification of the data accuracy and minimizes unavailable data. Designing of the negotiation plan The fourth stage involves designing of a detailed plan for negotiation. This

Description of Composition Essay Example for Free

Description of Composition Essay I have many wonderful moment in my life, in my home country with my family and my friends. we lived in a beautiful areaand Were pleased with our neighbors. during Have the holidays left all the campaign. However, I remember a good experience that i still can not forget. During this spring break I made a visit to my cousin Matthew who live in Dallas, tough spending years without seeing I was very pleased to be able to spend this time with him. Dallas is a great city and wonderful buildings are very large in the city center. During my stay Mathieu showed me around the zoo of the city of dallas a place where we encounter several species of animals that are found throughout the world, among other gorillas, snakes, parrots. That day was the first time in my life I saw a gorilla who was nearly two meters long, this animal was really impressive both for its size and its weight. At the end of the visit to the zoo I wanted to eat some things. We went to Matthew and me in a fancy restaurant in the city. This restaurant is located near the city center in a large building with a beautiful cadre. ur map for this restaurant we could see dishes from different origins Africa, Europe and America. We took each European dishes and we talked about our childhood. When we finished eating we took several photographs in the restaurant throughout the city of Dallas to keep in memory of this moment of reunion between my cousin and me. I really enjoyed the spring break this year because i had a lot of fun. i there fore look foward to the summer break and i hope i twill be even more beautiful than i will to live.

Literature Review: Treatment and Management of Pain

Literature Review: Treatment and Management of Pain INTRODUCTION The aim of the wise is not to secure pleasure  but to avoid pain -Aristotle The word pain is derived from the Greek word poine, which means penalty or punishment. Pain is a sensory experience associated with actual or potential damage of tissue,with physiological and psychological responses. Pain is a personal experience and varies from person to person. It is manifested in verbal and nonverbal behaviours, physiological responses like pulse rate, respiratory rate, blood pressure, emotional and spiritual reactions(Nursing clinics of America,2002). Inadequate treatment of both acute and chronic pain is widespread throughout medical surgical wards, intensive care units, emergency departments and in general practice. This neglect is extended to all age groups, from neonates to the elderly. In September 2008, the World Health Organization estimated that nearly eighty percentage of the population in the world has either insufficient or no access to treatment for severe and moderate pain. Every year millions of people around the world, suffer from pain without treatment. Reasons for proper pain management failure include cultural, religious, societal, and political attitudes, including acceptance of torture(Taylor et al.,2008). When surveyed 21% to 90% of adults expressed some about the pain associated with the needle based procedures. Up to 90% of young children shows serious distress during vaccination. This general level of anxiety can be severe, and is termed as injection phobia. This phobia can result in syncopal attacks with significant clinical impact (Yael et al.,2003). In hospital practice intravascular lines are used for various purposes like recording pressure and to administer drugs, fluids and to draw out blood. Pain inflicted by the insertion of cannula into the skin is a significant concern. Effort should be made to assess and manage acute pain. As, by doing so, nurses can reduce pain, increase patient comfort , satisfaction and improve patient outcomes (Jacobson, 1999). Research evidence shows that cutaneous stimulation is an independent nursing intervention to minimize patients pain. Gate control theory clearly explains the effect of cutaneous stimulation. Cutaneous stimulation modalities can be clubbed with acupressure to increase its effectiveness in pain management. Research studies have highlighted the fact that cryotherapy is equally effective and important in alleviating or minimizing pain as a cutaneous stimulation technique (Sabitha P.B, et al.,2008). The analgesic effects of cutaneous stimulation (pressure, massage, vibration, heat, cold) are thought to be caused by activation of large A-beta fibers and inhibition of smaller A-delta and C fibers, thus closing the gate to pain impulses. The exact mechanism by which this gating occurs has not been established, but it may be through endorphin release (Ruth,2009). NEED FOR THE STUDY Research Studies reveals that, among nursing diagnosis pain constantly ranks the highest position. Nurses often have the closest contact with patients on a daily basis. They are the health care providers most directly responsible for the overall management of pain. Nurses play a pivotal role in pain assessment, pain intervention, monitoring the effects of treatment and communication of information about pain management (Keela A.Herr, et al.,1992). The complementary therapies are used to relieve the symptoms of pain. These include relaxation technique, visual imagery, cryotherapy, massage, aromatherapy etc. Increasingly complementary therapies are attracting attention in contemporary nursing practice. These interventions are suitable for procedures like injections, venepuncture, that cause acute transitory pain (Barbara, 2000). Cold application relaxes muscle and muscle contractility, vasoconstriction decreases capillary permeability, decreases blood flow, slows cellular metabolism, decreases pain by slowing nerve conduction rate and blocking nerve impulses, decreases edema by reducing capillary permeability (Barbara kozier, 2006). The pain related to minor invasive nursing procedures can be dealt with non-pharmacological measures than pharmacological measure. The pharmacologic measures like local anesthetic spray, eutectic mixture of local anesthetic (EMLA) have long term effects, which is undesirable. Also its cost effect should be kept in mind, as these simple but essential procedures are repeated for the same person for many times. Hence non-pharmacological measures can be the choice for relieving or preventing such minor invasive pain, like venepuncture pain (Saju T.P,2009). A study conducted to find out the effects of two non-pharmacological pain management measures for IM injection pain recommended to use cold therapy and distraction to decrease pain intensity. The first group received local cold therapy, the second group received distraction and the control group received only routine care. The results shows that average pain intensity in local cold therapy, distraction and control groups was 26.3, 34.3 and 83.3 respectively. The findings indicate that pain intensity was significantly higher in the non-interventional group than the interventional groups. This study supports the efficacy of non-pharmacologic pain management methods (Hasanpour M et.al.,2005). The large intestine energy meridian is an acupressure point located on the backside of the hand between index finger and the thumb. Largeintestine energy meridian point can be used for relieving pain in the scapula, arm and shoulder, rigidity of the neck, eye diseases and also in the treatment of other disorders like constipation. The large intestine energy meridian pathway is bilateral. Considering the anxiety due to painful procedures such as venepuncture, as well as the unpleasant feelings, the investigator felt that application of cryotherapy to the skin would decrease the pain-related responses associated with venepuncture. This study was therefore undertaken to asses the effect of cryotherapy on the large intestine energy meridian point (li4), during intracath insertion to reduce the perception of pain and variation in physiological responses like pulse rate, respiratory rate and blood pressure. CHAPTER II REVIEW OF LITERATURE Review of literature is a key step in research process. It refers to an extensive, exhaustive and systematic examination of publications relevant to the research project. Nursing research may be considered as a continuing process in which knowledge gained from earlier studies is an integral part of research in general. Literature review refers to the activities involved in searching for information on a topic and developing a comprehensive picture of the state as knowledge on that topic (Polit and Hungler,1993 ). Therefore the investigator studied and reviewed the related literature to broaden the understandings about the topic to gain insight into the selected problem under study. The literature has been reviewed under the following headings: SECTION A: Literature regarding pain and changes in physiological parameters during venepuncture. SECTION B: Literature regarding large intestine energy meridian point and pain. SECTION C: Literature regarding effectiveness of cryotherapy on pain and physiological parameters. A quasi experimental pre test post test control group study was conducted to assess the effectiveness of vibratory audio visual stimulation to reduce acute evoked procedural pain experienced by the individuals, during invasive procedures in a selected health centre. Convenient sampling technique was used to select 80 persons who were receiving IM injection. Among the participants 95% expressed a reduction in pain due to vibratory audio visual stimulation,15% said that they had not experienced any reduction in pain. Results of the study suggested that vibratory audio visual stimulation was effective in reducing acute evoked procedural pain (Saju T.P,2009). A randomized, controlled study, in a convenience sample of 92 patients in the emergency department who required peripheral cannulation as part of their evaluation were enrolled in the study. All the subjects answered questionnaires pre and post IV placement and rated pain intensity during procedure on a 100 millimeter visual analogue scale. Participants in the study included 47(51.1%)of patients received the anesthetic spray and 45(48.9%) were randomly assigned to control group and had their IV line placed in a standard method. The mean pain score in the study group was 27 millimeter and 28 millimeter in the control group (p=0.934). Results revealed that anesthetic spray was an effective intervention in reducing pain during intravenous insertion (Hartstein B.H,et al.,2007). A crossover single blind experimental study conducted on  effectiveness of acupressure to reduce pain in IM injection. Each  subject received an injection with acupressure applied to one buttock and an injection without acupressure to the other buttock or vice versa. The perception of pain was measured on a visual analog scale. Among 64 patients, 32(50%) were female. The mean score for perceived pain intensity for acupressure injection was 3+-2 and the mean score for the injection without acupressure was 5+-2. Results revealed that acupressure was effective in reducing IM injection pain (Alavi N.M,2006). A prospective randomized clinical trial to evaluate the effect of a Valsalva manoeuver, which stimulates the vagus nerve, on perception of pain during peripheral venous cannulation in adult patients. Among 110 patients scheduled for elective surgery, half of them underwent venepuncture during a Valsalva manoeuvre and the other half underwent venepuncture without performing a Valsalva manoeuvre. The numerical rating scale score was 1.5+/-1.2 for Group A and 3.1+/-1.9 for Group B, the difference being statistically significant (P Pain management is in the purview of all health professionals, specially nurses and is an important component of comprehensive nursing care, since it is the patient and nurse who faces the pain alone. Although most of the nurses have a commitment in pain reduction, far fewer work for alleviation. Ignoring patients pain may be causing harm. Unrelieved Pain can cause cell, tissue damage and even death. Health education on pain management for health professionals at all department levels have been noticed as an important measure towards changing ineffective pain management practices (Holleran R.S,2006). Needle phobia is a term used to describe an anticipatory fear of needle insertion. If pain and anxiety are poorly managed, there can be significant negative consequences. The memory of traumatic venepuncture experiences can lead to extreme anxiety and physiological responses such as venous constriction . Some children and young people may have been conditioned by the fears of relatives or friends concerning needle procedures(Thurgate C. Heppell S, 2005). A quasi experimental design was adopted to obtain data from 86 younger (between the age group of 25-55) and 89 older (between the age group of 65-94) volunteer samples. Subjects responses to experimentally induced thermal stimuli were measured with following pain scales: vertical visual analog scale,21-point numerical rating scale, verbal descriptor scale,11- point verbal rating scale and faces pain scale. For discriminating different levels of pain sensation all the five scales were effective. The most preferred scale to represent pain intensity in both cohorts was the numerical rating scale, followed by verbal descriptor scale (Frana Benini,M.D,2004). Pain is a phenomenon that we experience to a greater or lesser extent, and the associations between blood pressure and pain are potentially of great interest . It is well recognized that pain can raise blood pressure acutely. Acute pain leads to generalized arousal and increased sympathetic nerve activity. Blood pressure increase during the application of physical pressure to the nail beds or the skin of the cheek, or during electrical stimulation of a digital nerve. Various studies found that inflated cuff leads to forearm ischemia and increases the degree of pain, which correlates with the increase in blood pressure (Pickering G.Thomas,2003). SECTION B:Literatures regarding large intestine energy meridian point and pain. The large intestine energy meridian point is referred to as LI4 or Hoku. The energy meridian pathway is bilateral and begins in the surface of the skin at the root of the index fingernail. It courses through the arm and hand , and the outward end of the shoulder blade is crossed. Then the meridian leaves the skin surface to connect with the lower part of the lung and transverse colon. It then returns to the skin surface at a point under the chin. From that point, the meridian is again buried deep within the area referred to as the double chin. It follows the lower row of dental roots, passing then to the upper line of teeth roots, crossing the front of the mouth to emerge on the skin surface and the facial point next to the nostrils (Chandramita Bora,2009). A randomized controlled trial was conducted on 60 primiparous women who were randomly assigned in two groups (n = 30): ice massage (treatment) and sand bag group (control). The severity of the basal pain was measured at the beginning of active phase (4 cm cervical dilation) based on Visual Analogue Scale (VAS). Then, after two groups received intervention, the severity of the labor pain in 4, 6, 8 and 10 cm cervical dilation was measured. In the case group, the crushed ice twisted in a terry bag was rocked on the web of skin between thumb and forefinger. The massage was carried out in large intestine energy meridian point throughout three contractions. The sand bag tactile massage in large intestine energy meridian point was served in the control group. The data were analyzed using SPSS software and descriptive analysis using Mann- Whitney, à Ã¢â‚¬ ¡ 2, paired and independent t tests and P A one-group, pre test, post test study conducted to evaluate the the use of ice massage on acupressure energy meridian point large intestine 4 (LI4) to reduce the labor pain. The pain was measured using McGill Pain Questionnaire (MPQ) and 100-mm Visual Analog Scales (VAS). Participants noted a pain reduction mean on the VAS of 28.22 mm on the left hand and 11.93 mm on the right hand. The post delivery ranked McGill Pain Questionnaire dropped from distressing to discomforting. The study results suggest that ice massage is a safe, noninvasive, nonpharmacological method of reducing labor pain (Waters L.Bette, et al.,2003). A study using ice massage for reducing labor pain was carried out by a researcher among twenty women on their admission to the labor and delivery unit at Florida. Ice massage of the energy meridian LI4 was performed during each contraction and was carried out over a 30-minute period. Data from the Visual Analog Scale (VAS) showed a mean reduction in pain of 25.15. The reduction of pain was statistically significant despite the small number of participants. The study results suggest that ice massage is a safe method of reducing labor pain (Naomi lester, et al., 2003). A one group repeated measurement post test study was aimed at identifying the effect of cutaneous stimulation in large intestine energy meridian point on reduction of arteriovenous fistula puncture pain among forty five hemodialysis patient. First the arteriovenous fistula puncture pain of control group was measured, and then the arteriovenous fistula puncture pain of experimental group (with cutaneous stimulation) was measured using visual analogue scale and objective pain behaviour checklist. Analysis of data was done by use of paired t-test, t-test, ANOVA and Pearson correlation coefficient. The results concluded that the subjective pain score of arterial line (paired t = -0.28, p = 0.77) and the subjective pain score of venous line (paired t = 2.61, p = 0.01). The cardiopulmonary signs of arteriovenous fistula puncture pain in experimental period was (pulse paired t = -0.8, p = 0.42; systolic BP paired t = 0.98, p = 0.33; diastolic BP paired t = 0.43, p = 0.66).Results revealed t hat cutaneous stimulation in large intestine energy meridian point was effective in reducing arteriovenous fistula puncture pain(Kanho Taehan,2001). A study in which patients having acute dental pain were treated with ice application on largeintestine energy meridian point of the hand on the same side of the painful region. Ice massage was administered by inserting ice cubes into wet gauze pad and gently massaging the skin around the large intestine energy meridian point. When the patient stated that the area is felt numb or after a period of 7 minutes whichever, occurred first, the massage was stopped. Control group received tactile massage alone. McGill pain questionnaire was used to measure the pain intensity of the patients.. Ice massage reduced the intensity of dental pain by fifty percentage or more in most of the patients, and reduction in pain were significantly greater than those produced by tactile massage alone (Melzack Ronald, et al.,2000). SECTION C : Literatures regarding effectiveness of cryotherapy on pain and physiological parameters. A study was conducted to determine the effectiveness of cryotherapy on arteriovenous fistula puncture pain in hemodialysis patients. A convenient sample of 60 patients (30 in experimental and 30 in control group) who had undergone hemodialysis through AVF, was assessed using randomized control trial. Both the objective and subjective pain scoring was performed on two consecutive days of hemodialysis. The tools used were a questionnaire assessing demographic data, an observation checklist for monitoring objective pain behaviour, and a numerical pain intensity scale for subjective pain assessment. The objective and subjective pain scores were significantly (p=0.001) reduced within the treatment group than the control group. Results revealed that cryotherapy was effective in reducing arterivenous fistula puncture pain in hemodialysis patients (Mahajan S, et al.,2008). A quasi experimental study to assess the effectiveness of hot fomentation versus cold compress for decreasing intravenous infiltration in patients admitted in a selected hospital in Pune . The sample size was 60 and data collected with an observational checklist and behavioral pain scale. The pre treatment mean score of degree of infiltration was decreased from 7.1667 to 0.7071 in hot fomentation and from 6.9333 to 0.7571 in cold fomentation. The findings indicate that the hot fomentation and cold compress both are effective in treatment of intravenous therapy related infiltration (Anjum shabana,2007). A quasi-experimental study to determine the effect of local refrigeration applied to skin prior to venepuncture on pain-related responses in 80 school-age children who got admitted in the emergency ward in the pediatrics center in Iran. Subjects were selected by purposive sampling and were divided into two equal groups: test and control. In the test group the physiological responses were measured prior to venepuncture. Then the skin on the area of venepuncture was refrigerated by an ice bag for 3 minutes and the procedure is performed immediately. After five minutes of the procedure the physiological responses, behavioural responses and subjective responses were measured. In terms of the physiological responses before and after the procedure in the experimental and control group, there was no significant difference (p=0.07) between the two groups. There was a significant difference (p=0.0011) between the test and control groups with regard to the behavioural responses to the painful procedure.There was also a significant difference (p=0.0097) in the subjective data in the two groups after venepuncture.Results revealed that the local refrigeration was effective in reducing venepuncture pain (Movahedi Fakhar Ali,et al.,2006). An experimental study to assess the effectiveness of ice application on the treatment zone prior to type -A botulinum toxin treatment on the pain during injections . Totally, twenty four patients who underwent botulinum type-A toxin in upper face for esthetic purposes were undertaken in the study. Ice application was done five minutes prior the injections on the right lateral orbital zones of the patients, and on their left sides, toxin were injected without applying ice. The average visual analog scale values indicating the pain that the subjects felt in their right and left sides were found as 1.1 and 5.9, respectively. Results revealed that ice application is effective in reducing pain during injections (Sarifakioglu N,2004). A study was conducted to evaluate the effect of the application of cold or hot on the pricking pain sensation based on autonomic responses. Electrical stimulations were applied to subjects arms as an artificial pricking pain, the skin blood flow and skin conductance level at the tip of the finger were measured. Pain was assessed using visual analog scale. Pain stimulation produced a significant rise in skin conductance level and a significant decrease in blood flow. Cold application to the stimulation site using an ice-water pack decreased blood flow and skin conductance responses and sensation of pain. Application of heat, by hot water bottle resulted in a significant rise in pain sensation . The results suggested that cold application promotes relief of pricking pain sensation and suppress the autonomic responses, and the application of heat has no such effect (Saeki Y,2002). A one group pre test post test experimental study to evaluate the effect of cutaneous stimulation (cryotherapy) on pain reduction in Emergency Department patients . Second objective was to identify the effect of cutaneous stimulation on blood pressure and heart rate. Potential factors that could influence the dependent variables such as age, gender, educational level, location of pain, and site of cutaneous stimulation were tested. All 50 samples were treated with cutaneous stimulation to relieve pain. After cutaneous stimulation, subjects reported significant reduction in pain, and demonstrated decrease in heart rate, and blood pressure readings. The most effective site of cutaneous stimulation was contralateral to the pain. Age, gender and educational level had no significant effect. The results of this study provide empirical evidence that cutaneous stimulation effectively reduces pain, heart rate, and blood pressure (Sylvia M. Kubsch,2002). A study was conducted to evaluate the effectiveness of local dry cold application on the bruising, haematoma and pain at the subcutaneous low molecular weight heparin injections site. The researcher selected sixty three patients who had received 2 x 20 milligram enoxaparine and divided the samples into four groups. In the first group, cold therapy was not given. Cold was applied to the injection site for five minutes before the injection in the second group, and in the third group five minutes after the injection. In the fourth group, it was applied to the injection site for five minutes pre and post injection.After each injection, the patients pain intensity and duration were measured, and the occurance of bruise and haematoma were monitered at 48 and 72 hours after the injection. Results showed that haematoma was absent at the injection site of all subjects. The subjects pain perception was significantly reduced with the application of ice (Kuzu N, et al.,2001). In a paired clinical trial, the effectiveness of ice in reducing the pain of intravenous catheter placement was assessed in 28 adult volunteers. An ice pack was placed over one arm for 10 minutes, followed by insertion of an 18-gauge angio catheter in both arms. Patients recorded their pain assessment after each venepuncture on a previously validated 100-mm visual analog scale and identified their preferred method for the procedure (pretreatment with ice or no pretreatment). The mean pain score for catheter placement on arms pretreated with ice was 27.5  ± 15.9 mm; the mean pain score for the control arms was 34.2  ± 21.6 mm (P = 0.17).Results revealed that application of icepack was an effective method in reducing pain of intravenous catheter placement. Future studies should examine whether ice is effective at reducing pain from other more painful procedures and whether the response to ice is gender-related (Richman P B, et al.,2000).

Job - Character Analysis :: essays research papers

Job was a man who was perfect (not sinless) and upright, one that feared God and turned away from evil. Job is a perfect example of universal suffering, why those are good suffer along with the individuals who are called bad. Job was a man who God had allowed to obtain riches and fame. He had all of the finer things in life. Satan knew this, and wanted to bring sorrow and pain into Job’s life for the main purpose of showing God that these were the reasons Job was so faithful. Satan was wrong as always. Job understood that it is the Lord that gives and takes away, for Job said, â€Å"blessed be the Lord.† The book of Job was written to instruct us, to rebuke and correct us, and perhaps to prepare us to handle the hardships of life, the experiences of bereavement, loss, and grief at a level that man could never hope to achieve. Job is a book about a man who believed in God, a believer who was badly advised by three friends who were ill equipped to counsel, and had no grasp of the spiritual realities that God teaches. God permits suffering in the life of the believer in order to strengthen his faith. It is precisely when the hedges are moved from around us that we find ourselves depending upon God. The more we are deprived of the temporal supports for our earthly happiness, the more we are driven to the Lord for our comfort. This is why Job was chosen. Because of his completely undeserved suffering, his steadfastness in faith, and his complete submission to God, Job received the honor of becoming a chief figure in the Bible (Psalm 23, Hebrews 12:11, James 5:11). God’s ways are often beyond our understanding because we view the issues of life from a limited earthly perspective. God’s viewpoint is from above, he sees all things from the standpoint of