Need for collaborative projects in business courses Essay Example for Free

Need for collaborative projects in business courses Essay Group projects are integral to the business curriculum and can be useful in developing students skills and abilities as managers. However, faculty encounter several problems with group projects, including assessing students efforts, aiding good communication and coordination among members, and making sure the project is a truly collaborative effort. Technology may aid in addressing these problems; electronic discussion boards and chat rooms, for example, can help faculty and students enhance collaboration and increase the accountability of group members. Keywords: Discussion boards, chat rooms, collaborative learning, student projects INCREASED GLOBAL COMPETITION and other changes in the business environment over the last several years have led organizations to restructure themselves. One aspect of that restructuring is a shifting of responsibility and decision making downward and a movement toward self-directed work teams (Cohen, 1993). To prepare students to thrive in this environment, we obviously need to teach them effective teamwork and communication skills. This article describes two tools that can help accomplish this task, the electronic discussion board and the chat room. These can foster interdependence in group projects and deeper, active learning. First, we discuss the need for and benefits of collaborative projects, the problems of group work, and the role of technology in such projects. We then provide recommendations for incorporating these electronic tools in business communication classes. Need for Collaborative Projects in Business Courses. As many researchers have noted, the structural shift towards teams occurring in many organizations should be reflected in the classroom (Bobbitt, Inks, Kemp, Mayo, 2000). Using groups in class thus prepares students to work collaboratively in the business environment while promoting collaborative learning in the classroom itself. The first benefit of group work in the classroom is that it teaches students how to work collaboratively in the business environment. Business organizations repeatedly indicate that the increased use of teams in the real world has increased students need for exposure and experience with teams (Buckenmyer, 2000). Companies that use teams creatively spend many hours and dollars training individuals to work in teams and training managers to manage teams. Through working in groups, students can enhance their abilities in setting goals, delegating work, and dealing with conflict (Colbeck, Campbell, Bjorklund, 2000). They can also improve their communication, leadership, problem solving, and technical skills. All of these skills are highly rated by recruiters and employers and will help graduates meet the demands and rigors of the workplace (McNally, 1994). The second benefit of group work is that these projects promote collaborative learning. University educators have embraced cooperative learning methods as ways to engage students and to foster cooperation (Ravenscroft, 1997). Researchers have found that the values of Generation X are highly individualistic, visually-oriented, and aligned with information technology, not with the sharing of information (Buckenmyer, 2000). Thus, group course projects, with proper guidance, can help these students learn to deal effectively with others. Group work learning can be an excellent way of encouraging the development of higher cognitive skills in students (Thorley Gregory, 1994) and can be effective even for relatively quiet group members. When groups work well, students consistently fare better in class, on tests, and in attitudes towards the instructor and each other (Jones Brickner, 1996). The quality of learning is improved by peer support, with students gaining experience in communication, negotiation, organization, and task management. Cooperative methods have been recognized as effective ways to motivate students to become actively involved in learning. The collaborative group project creates a forum that allows students to take an active approach towards their own education. The security of working within a group provides an excellent entree into the progression to independent and autonomous learning (Maguire Edmondson, 2001). Problems with Group Projects The many benefits of collaborative projects, however, are often offset by problems. First, a common problem is the failure of the group to work together effectively. Students may exert an individual effort but are unable to coordinate their efforts effectively with their group members to achieve any kind of synergistic benefits (Tullar, Kaiser, Balthazard, 1998). Group members need to be contributing their ideas, questioning and learning from each other, and building on the efforts of the other members. For collaborative learning to occur, students must coordinate the diverse skills and abilities of their group members to address a complex task (Tullar et al. , 1998). A second problem is that often group members simply divide a project so that each individual writes a portion. Then, just before the project is due, the students bring in their disks and combine files without coordinating their efforts or talents effectively. Third, group work often leads to unequal contributions of members, resulting in hitchhikers and workhorses (Cottell Millis, 1993). These hitchhikers, also called free riders and social loafers, can cause problems in the workflow of the group, as they do not do their fair share. Members of the group have difficulty addressing the free-rider problem and documenting the problem and their efforts to solve it (Gremler, Hoffman, Keaveney, Wright, 2000). The issue becomes one students word against anothers as the teacher tries to determine fair individual grades. Finally, group projects are often assigned without the allocation of class time for groups to develop cooperative skills or to become cohesive (Michaelsen, 1992). There is limited time in class to discuss both the needed topics and the mechanics of group management. In many cases, groups meet on evenings and weekends when faculty members are not available for assistance. Additionally, many group members are geographically and temporally dispersed, which makes organizing face-to-face group meetings difficult. The Role of Technology in Enhancing Collaborative Learning Active and cooperative learning approaches will be counterproductive unless they are thoughtfully implemented and well supported. Communication tools like discussion boards and chat rooms can be effective in inter-team collaboration as well as in faculty-student communication. These tools can help ease the problems discussed in the previous section. By solving these problems with technology, faculty can address three learning goals: empowering students, improving their communication skills, and developing their ability to work collaboratively. Finally, these technological communication tools offer teaching opportunities by allowing faculty to be more accessible to students and to track students efforts better. Addressing Group Project Problems Internet-based tools can be a tremendous help in coordinating team efforts, particularly when the team is geographically (whether by a few miles or a few thousand miles) or temporally dispersed (Kaiser, Tullar, McKowen, 2000). With technology, groups can meet either synchronously, using chat rooms, or asynchronously, using threaded discussion boards, in which group members contribute to the group discussion at times convenient to their schedules over a defined time period. These tools enable everyone in the group to talk at the same time or at their convenience by typing their comments into the forum that instantly distributes their comments. Additionally, strong personalities have greater difficulty dominating the group as everyone has equal access to the floor. Students may feel more comfortable presenting ideas this way than in a face-to-face meeting, and the quality and professionalism of their ideas may be higher, knowing that their participation is being monitored. The discussion forum also gives all students ample time for reflection so students responses are often more thoughtful than those in face-to-face situations. Studies have illustrated this level of increased and more evenly distributed participation from students in computer-supported groups (Tullar et al. , 1998). Addressing Learning Goals Projects provide opportunities for experiential learning, that is, students apply what they have learned to real-world situations and thus develop decision-making skills. But in doing so, projects often produce anxiety as students struggle to determine what answer the instructor wants. However, with these projects, whether it be a case, a report of a business issue, or a business plan, faculty are typically not searching for one right answer, but rather are concerned with the process that students use in solving problems. Teaching students to ask the right questions is thought to be more important than giving students the right answers. In the real world, there is neither one right answer nor is there a sage on a stage that can direct students to the right answer. Students need to learn how to find and to support the answers for themselves. The use of electronic discussion boards and chat rooms can aid student learning in the struggle through the project process. Thus, three learning goals can be addressed through the use of electronic discussion boards and chat rooms with experiential group projects: (1) empowering students to become active participants in their learning, (2) increasing students communication skills in describing and solving problems, and (3) enhancing students abilities to collaborate and work with others in developing their own resources in solving problems. To achieve these goals, education must involve interactivity among instructors, students, and the materials, and electronic discussion boards and chat rooms can enrich that interactivity. Providing Additional Teaching Opportunities Another advantage of these tools is the opportunity for faculty to participate in the discussions and e-mails. Faculty can use these tools to demonstrate concern for students and to provide additional accessibility and feedback. In fact, the transactional distance encourages faculty to maintain a facilitative role rather than an authoritative role (Moore, 1993). Finally, these tools make it easier for faculty and students to keep track of what everyone has said as there is a written record (Kaiser et al. , 2000). Students have the opportunity to reorganize and reshape their understanding of course content. The Web-based tools allow thoughts to be captured for future examination, elaboration, and extension. The end result is usually more robust and thoughtful discussions. In fact, threaded discussions can extend the time that both instructors and students invest in the course (Bruce Hwang, 2001). Recommendations for Using These Tools Many universities are starting to use various computer course tools or platforms to promote online learning. These platforms, such as BlackBoard or WebCT, can be used to design either Web-based or Web-assisted courses. For several years, we have used discussion groups and chat rooms in Web-based classes but have also found that communication can be enhanced in traditional classes through use of these tools. Since more business organizations are using electronic tools, such as Lotus Notes, to facilitate group meetings, using them in the classroom helps students further prepare for their careers. However, the wise faculty member will be advised that these tools should be used judiciously. Therefore, based on our experience, the following suggestions are made to faculty who are considering the use of Web-based tools. Discussion Boards Instructors and students can compose and post messages electronically on electronic discussion boards. Both public and private discussion forums can be implemented. With many computing platforms, such as WebCT, faculty can set up public forums to start threaded discussions for the class to which the students can respond electronically. Students can use these public forums to post questions to which the entire class can respond, such as for help in finding information for the project. A project normally seems easier when the instructor is discussing it in class and few questions arise. However, students questions occasionally occur after class or on weekends. The discussion board allows the opportunity for students to post problems asynchronously and to receive input from the class. The burden is no longer on the instructor to solve every problem as it occurs but is on the students to work with each other as well as with the instructor in solving problems. This is a tremendous lesson for students to learn to deal with problem solving in the real world. When an employer gives an employee a project or task to do, he/she expects the employee to do it on his/her own and not ask for assistance from the employer every step of the way. Students have to learn to be problem solvers on their own, and the use of electronic discussion boards helps develop that skill. The professors role is to help get the conversation started. For example, the instructor can post a question on the public project discussion board asking at which sites people are having success finding information for the project. The students can then respond. Those students who respond in a useful manner will be rewarded, such as with a participation grade. Those students or groups who do not respond can be asked on the discussion board for their input. When students see the progress other students are making, they may be spurred to work harder. Additionally, the faculty need to check the discussion board frequently to see if any misinformation is being spread, to ensure netiquette is being practiced, and to restart the conversation as needed. Finally, faculty can take questions that the students ask individually and request that the students post them on the discussion board. In that way the instructor only has to respond once, and similar inquiries can then be referred to that response. This will eve ntually build a culture in the class where the instructor is not seen as the sole source for information, and the students learn to work with each other in solving problems. Additionally, instructors can create private forums to be used to divide students into groups for class exercises or for the use of asynchronous coordination of group projects in which group members cannot all meet at the same time. The instructor can visit these public and private forums to track group progress, to encourage students to help each other to solve problems, and to provide assistance as needed after the students have tried first on their own. In the private group forums, the students are encouraged to use the board to organize group meetings, to post their research findings, and to post drafts of their work for their group members to see and make comments. The professor can encourage individual group members to post their contributions to the paper to the private forum for the other members to see and post suggestions. This would increase group collaboration in a manner that can be documented. After the group has collaborated on a draft of the project, the instructor can offer suggestions. Finally, instructors should consider requiring the groups to post progress reports on their efforts periodically during the term. These progress reports describe what the group has accomplished, what the groups plans are, if there are any problems, and if there are, how they are being addressed. The instructor should provide guidelines as to what the groups should have accomplished by the progress report dates so the students can determine if they are on track. While these reports could be submitted on paper, doing it through the discussion board makes it easier for group members to be aware of what has been submitted. Chat Rooms. With chat rooms, students can meet electronically at the same time no matter where they are, as long as they have Internet access. Each group can have its own chat room, with the instructor joining in from home or office in one of several ways. The group can meet first and then have a designated time when the instructor logs in to answer questions. The instructor can leave when the questions are answered or give the group time to discuss among themselves and then check back later. For project work, it is important that instructors periodically meet with student groups to answer questions, address problems, and provide guidance. The chat room may be a useful tool in meeting with students out of class. The students can meet with the instructor for a practice chat to get the students comfortable with the technology. The instructor can request that the groups meet with him/her several times during the term to discuss their progress. These meetings can be either in the office during office hours or during designated chat office hours, such as on Sunday nights when the instructor is at home. With traditional classes, groups should have the option to meet in person with the professor, particularly early on in the project. For those students who cannot come during office hours, the chat room provides an excellent way to interact, although instructors may want to set clear boundaries or specific hours for when they are willing to meet in the chat room. When the instructor is meeting with groups via chat, patience is needed. It can be confusing when everyone is typing in questions. While the instructor prepares an answer to one question, several more students questions can appear. The instructor needs to make it clear that he/she will discuss questions in the order in which they appear. On the other hand, there may be times when the chat room is silent while the students are preparing their questions. The instructor may want to prompt to see if there are any other questions but should give the students some time if needed. Finally, no one should log off until everyone has finished. Someone may be in the middle of preparing something to post and the silence is seen as the end of the session, or someone may have left the room for a minute and has come back to find an empty chat room. Therefore, a practice chat session may be helpful with these issues. Grading Student Use of Discussion Boards and Chat Rooms Grading student responses in both the discussion forum and chat room can present challenges. Many times there may be a group grade for a project that is then adjusted for the individual students grade base on his/her contribution to the groups project. Additionally, students may be individually graded for their participation in the course. Some students will initially shy away from using the discussion board, as they would prefer to do things the way they always have and do not want to learn a new technology. Other students, particularly those who are too shy to speak up in class, may welcome this new opportunity. It is up to the instructor to provide the incentive to become involved. While a positive attitude may help the instructor in encouraging students, making posts part of their grade, such as a portion of their participation grade, probably ensures the best results. Instructor can grade the posting on several issues: clarity of thought/grammer, quality of comments/critical thinking, and usefulness/participation in responding to other posts. In evaluating the group projects to determine individual grades, instructors often have students submit group evaluations. The information on these evaluations can be substantiated or compared to what has occurred on the groups private discussion forum and what has been documented in the progress posts. If a group member is not contribution, it is the responsibility of the group to communicate this the instructor and to attempt to deal with the problem before the final project is submitted. The use of the discussion board and chat room can be a tremendous help in tracking a groups activities. This puts more responsibility on the students to document and address the issues before it is too late. It also aids instructors in making fairer assessments of individual efforts. To better manage the communication tools, instructors should set up clear guidelines for grading, such as describing how many new posts and response posts are required per week, as well as how often the students are expected to check the discussion board. For example, the professor may want each group to submit a bi-weekly progress report on its project. The instructor may also want to review netiquette as well as set limits as to how many posts students can make on public forums to avoid overwhelming the discussion board. The instructor needs to stress that it is the quality of the posts and not the quantity that counts and provide students with feedback to encourage its proper use. Finally, the instructor can also utilize student management tools that are included in the computing platforms like WebCT to determine when and how many posts the students are making. Additionally, search commands can be used to find all the posts one student has made in order to track an individual students progress. Conclusion Teamwork and group meetings are entrenched elements of an increasingly global environment. As a result, business faculty must prepare their students, as future managers, to collaborate with groups effectively. Electronic meeting tools, such as discussion boards and chat rooms, can play a key role in that training. These tools can enhance and empower student learning and collaboration as well as increase communication and problem solving skills. By collaborating more effectively in school, students will be better prepared to collaborate effectively in the workplace (Kaiser et al. , 2000). These tools also offer additional teaching benefits. They are very useful in documenting student effort and accountability for fair contribution. They also provide a means for faculty to be conveniently accessible and to provide feedback outside of class time. Additionally, electronic tools help students learn to develop their own resources. These tools then can be a tremendous aid for faculty to address group project problems, to help their students achieve learning goals, and to provide additional teaching opportunities to interact with their students. Thus, by using electronic discussion boards and chat rooms, such as with group projects, faculty can effectively enhance their students collaborative learning. References Bobbitt, L. M. , Inks, S. A. , Kemp, K. J. , Mayo, D. T. (2000). Integrating marketing courses to enhance team-based experiential learning. Journal of Marketing Education, 22(1), 15-24. Bruce, S. M. , Hwang, T. T. (2001). Web-based teacher preparation in visual impairment: Course development, teaching, learning and quality assurance. Journal of Visual Impairment Blindness, 95(10), 609-622. Buckenmyer, J. A. (2000). Using teams for class activities: Making course/classroom teams work. Journal of Education for Business, 76(2), 98-107. Cohen, G. (1993). New approaches to teams and teamwork. In J. R. Galbraith E. E. Lawler, III (Eds. ). Organizing for the future (pp. 194-226). San Francisco: Jossey-Bass. Colbeck, C. L. , Campbell, S. E. , Bjorklund, S. A. (2000, January/February). Grouping in the dark: What college students learn from group projects. The Journal of Higher Education, 71(1), 60-83. Cottell, P. G. Millis, B. (1993, Spring). Cooperative learning structures in the instruction of accounting. Issues in Accounting Education, 8, 40-59. Gremler, D. D. , Hoffman, K. D. , Keaveney, S. M. , Wright, L. K. (2000). Experiential learning exercises in services marketing courses. Journal of Marketing Education, 22(1), 35-44. Jones, J. D. , Brickner, D. (1996). Implementation of cooperative learning in a large-enrollment basic mechanics class. ASEE Annual Conference Proceedings [CD-Rom]. Kaiser, P. R. , Tuller, W. L, McKowen, D. (2000). Student team projects by Internet. Business Communication Quarterly, 63(4), 75-82. Maguire, S. , Edmondson, S. (2001). Student evaluation and assessment of group projects. Journal of Geography in Higher Education, 25(2), 209-217. McNally, J. (1994). Working in groups and teams. In L. Thorley R. Gregory (Eds. ). Using group-based learning in higher education (pp. 113-120). London: Kogan Page. Michaelsen, L. K. (1992). Team learning: A comprehensive approach for harnessing the power of small groups in higher education. To Improve the Academy, 11, 107-122. Moore, M. (1993). Theory of transactional distance. In D. Keegan (Ed. ). Theoretical principles of distance education (pp. 22-38). New York: Rutledge. Ravenscroft, S. P. (1997). In support of cooperative learning. Issues in Accounting Education, 12(1), 187-190. Reeves, T. (1996). Relevant readings. Technology in teacher education: From electronic tutor to cognitive tool. Action in Teacher Education, 27(4), 74-78. Thorley, L. , Gregory, R. (Eds. ) (1994). Using Group-based Learning in Higher Education. London: Kogan Page. Tullar, W. L. , Kaiser, P. R. , Balthazard, P. A. (1998). Group work and electronic meeting systems: From boardroom to classroom. Business Communication Quarterly, 61(4), 53-65. Address correspondence to Jacqueline K. Eastman, Department of Marketing/Economics, College of Business Administration, Valdosta State University, Valdosta GA 31698 (e-mail: [emailprotected] edu).

The Application Of Clinical Effectiveness In Physiotherapy

The Application Of Clinical Effectiveness In Physiotherapy SCIPS (2006) defined Physiotherapy as a science-based health care profession which emphasises the use of physical approaches in the promotion, maintenance and restoration of an individuals physical, psychological and social well-being through various interventions, supported and influenced by evidence of clinical effectiveness and practitioners may work independently or as members of the health care team. Physiotherapy and rehabilitation services in Oman is still in the young phases where most of our practices follows the traditional method, and evidence based approach involves reading international journals, research papers and attendance to seminars, conferences and postgraduate courses. The services have not been accompanied by a comparable increase in systematic evidence. Few practices have been evaluated either for their efficacy in carefully controlled circumstances or for their effectiveness in typical clinical situations, however to keep abreast with our clinical approach and to attain clinical effectiveness in our services, we need to develop strategies and audits to identify areas of improvement and ways of implementing effective and evidence based care. The essay will demonstrate the action plan by using the quotes of Graham (1996) on clinical effectiveness. The impact of guidelines, auditing and cost- effectiveness will also be discussed within sections of this essay. Clinical Effectiveness NHS Quality Improvement Scotland (NHS QIS 2005) described clinical effectiveness as the extent to which specific clinical interventions do what they are intended to do, i.e. maintain and improve the health of patients securing the greatest possible health gain from the available resources. They further described clinical effectiveness as critical thinking about actions, questioning whether it has the desired result, and about making positive changes to practice. They also continued to describe clinical effectiveness by using the same quotes as Graham 1996. National Health Service (2009) aimed to achieve clinical effectiveness strategy by developing a culture where clinical effectiveness is seen as being integral to the day-to-day provision of clinical care. Furthermore, through the development of an integrated work programme, setting out the structures, priorities, and implementing and monitoring national guidance, standards and policy. Evidence -Based Practice. Evidence-Based Medicine (EBM) is the process of systematically reviewing, appraising and using clinical research findings to aid the delivery of optimum clinical care to patients (Belsey J, Snell T(2009). Hospital management.net (2005) in their review of rehabilitating physiotherapy stated that evidence-based practice is currently becoming a basic ethical stand in physiotherapy and other fields of healthcare. The purpose of evidence-based practice is to make any decision-making on diagnosis and treatment proceeds from proven knowledge in the field concerned. Herbert R et al (2005) in their review of practical evidence-based physiotherapy pointed out that research alone is not enough, it is most effective when patients, health professionals and policy makers bring to their decisions a range of values, preferences, experiences and knowledge. Clinical effectiveness as quoted by Graham (1996) the right persons, doing the right thing, the right way, in the right place, at the right time with the right result The philosophy in this essay involves team members collecting knowledge of the available service, and then using evidence from a wide range of sources to inform the outcome, linked to the priorities facing the profession. Also develop frameworks to guide ongoing development such as competency framework, and an integrated care pathway, through implementation of patient care knowledge. The process for development will be timely and detailed, and will be actively disseminated using strategic planning to promote implementation and later will be evaluated. Success for the development of clinical effectiveness and evidence-based care would be for the team to experience a constructive and enabling process that contributes to their continuing professional development and progression of research knowledge and skills. The following sections will apply the parameters of Grahams quote to the practice of physiotherapy and rehabilitation through clinical effectiveness. The right persons-(competence) Epstein and Hundert (2002) defined professional competence as the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served The therapist has to be fully qualified and competent to be able to make decisions for therapeutic interventions, identify and analyse the patients condition, a particular clinical problem, should be able to identify and define standards relevant to clinical work, and have the knowledge of the subsequent intervention that might improve outcome. The right thing (evidence based practice resources) Graham (1996) quoted that evidence-based practice is about doing the right things right, and Muir Gray (1997) supported the emphasis on the process rather than on the result. Evidence can be gathered from a range of resources including published guidelines, journals articles, conferences, books, peer reviews, client feedbacks and other recourses from libraries. In order to attain the evidence based practice resources the social value must be identified and the impact of provider values on access to services and quality of care should be understood. Rebecca Broughton (2001) stated that clinical guidelines are systematically developed statements designed to help practitioners and patients decide on appropriate healthcare. It stated that guidelines reduce unacceptable or undesirable variations in practice and provide a focus for discussion among health professionals and patients. Furthermore, Van der Wees P and Mead J(2004) in their study on framework for clinical guideline development in physiotherapy concluded that clinical guidelines are a valuable resource for effective clinical practice and are important tools for clinical effectiveness and evidence based practice, and has the potential to improve the quality of patient care. The right way (skills and competence) The team will work collaboratively to deliver a new policy as per the needs through an evidence based approach system and evaluate new policy in the context of local and national priorities and critically review the nature of evidence in the context of the working environment. The right way to develop skills and competence and the necessary step will be observed such as; time to develop the services, required post training for the therapists, duration of training and resources such as current equipment, the evidence based researched journals and the financial implication. Protocols or specification must be developed and updated by ensuring staff development such as participation in Continuing Medical Education (CMEs) and ensuring confidence of current knowledge and skills through evidence based practice. Patients dignity and privacy must be equally maintained in all contexts of intervention. The right place (location of treatment/services) This will involve team work to audit and identify the geographical regions that need developing and observe the clinical practice, thus includes identifying priority areas of work to deliver the strategy, The performance will be audited to measure the quality of care the patient experienced including the effectiveness of implementing the best available evidence and then benchmarked against pre-set standards, changes will then be implemented where needed. The clinical audit process seeks to identify areas for service improvement, develop and carry out action plans to rectify or improve service provision and then to re-audit to ensure that these changes have an effect. (Wikipedia). The right time (provision of treatment/services) The team will determine and assess the clinical needs of care and interventions so as to develop the appropriate delivery of services as per the requirements and assess the cost effectiveness of the service delivery. The status of the current services, the type of patients, clinical intervention, time process, duration of treatment and location should be reviewed. Hurley et al (2009) in their study on effectiveness and clinical applicability of integrated rehabilitation programs for knee osteoarthritis showed that correct integrated rehabilitation programmes involving exercise and self-management are more clinically and cost effective and may be the best way of managing the large and increasing number of people suffering chronic knee pain. Another example from Santos et al (2004) in their project implementing clinical evidence in the management of coronary care provided a foundation for the development of a management strategy by using a multidisciplinary team approach, involving updating guidelines and resources. A positive outcome of the project was a reduction in hospital admission. An example in our local services was seen in a study of rehabilitation and management of elderly individuals following stroke which required an integrated approach from a multidisciplinary team. This minimised readmission of chronic cases and proved cost effective. Cost-effectiveness analysis should be done to address and ensure the efficient use of recourses and compare the financial costs of therapies whose outcomes can be measured purely in terms of health effect. (Alan Haycox 2009). Ceri. P. (2001) stated that one such method for measuring the extent of health gains is the quantity adjustment life year (QALY). The right result (clinical effectiveness/ maximising health gain) The results should be identified and reported to assess the benefits and patients satisfaction. The appraised research has to have valid and relevant information in the overall results that could be of clinical benefit safe, effective, cost beneficial and when used on the general population will make a difference. Hence health care authorities should develop appropriate use of evidence-based, standardized processes and centers of excellence to support easy reach of health care through a multidisciplinary care team of physiotherapy and rehabilitation. CONCLUSION This essay has discussed the mechanism of clinical effectiveness and evidence based practice in the context of physiotherapy and rehabilitation service. The essay has reflected on the needs and future expectations in the provision of a safe and effective care on a national scale. It has been found that in the context of providing effective rehabilitation, the implementation of up-to-date guidelines, auditing and cost evaluation are all paramount for the assessment of clinical effectiveness. In conclusion, clinical effectiveness in physiotherapy and rehabilitation services uses an integrated approach and can be thought of as the sum of the right person; as being the competent skilled therapist, backed with the right evidence, protocols and guidelines (the right way). In addition, an efficient well equipped environment. An ongoing review of such intervention and approach is required to evaluate and further improve the results of the provided service.

Essay --

Edouard Manet was a French painter whose work inspired the impressionist style. His art was due to his portrayal of everyday subject matter. Manet’s principal influences of his art were that of Frans Hals and Diego Velazquez. Manet began painting everyday subjects. He used bold brush techniques while painting his subjects. His painting Le dejeuner sur l’herbe in 1863 drew a lot of attention. Manet did not gain recognition until late in life, when his portraits became much sought after. http://www.renoirinc.com/biography/artists/manet.htm Manet preferred to paint the people and places he knew best. His first and second wife frequently served as models. Manet preferred to paint from life. He wanted his model in front of him. He had to achieve this by painting rather quickly so he chose to use the right colors the first time. Manet painted in patches of color to make sharper contrasts. He used a technique called â€Å"Tachism† (Tache means â€Å"spot† or â€Å"blot† in French). Claude Monet was born in Paris France and then moved to Le Havre. Monet developed a reputation as a charcoal impressionist. The whole French Impressionist movement is names after a painting by Monet called â€Å"Impression, Sunrise.† Monet had served in the army for two years when he had to leave, so he pursued his career in art. Monet was also an impressionist artist. He became increasingly more popular as an artist. Monet painted a series of weeping willows to commemorate the many Frenchman who died in World War I. http://www.biographyonline.net/artists/claude-monet.html Monet was also a very wealthy man, he was obsessed with money and spending money. Monet was introduced to outdoor painting by Boudin which became the touchstone for his life’s work. Impre... ...if the people where alive. Manet chose to use people in his painting and Monet chose landscape for his paintings. Edouard Manet was not the very first Modern artist. Claude Monet is said to be the "Father of Modern Art" since he was the first to officially launch the Impressionist movement in 1872. Edouard Manet started off as a Realist, and did convert to Impressionism later on. In my opinion the revolutionized art because of their style of painting. They chose to use a different style of brushstroke and colors. The impact of both painters was big, but Monet had more of an impact. His Impression, Sunrise was the first painting to develop impressionism. Manet’s work became what was later to be known as modernism. Manet’s work shocked the world with some of his scandals paintings. So to me they are both equally important and had a huge impact on art today.

Colonialism in Jackie Chan Films Essay -- Movie Film Essays

Colonialism in Jackie Chan Films    For over 20 years Jackie Chan has been the biggest action star in most of the world. First becoming popular in his native Hong Kong in the early 80s, his popularity slowly spread across the globe, and finally hit the U.S. with the 1996 release of Rumble In The Bronx (1994.) Since then Chan has made three highly successful films with American studois and several more with the Hong Kong studio Golden Harvest. He is easily one of the most recognizable Asian movie stars or all-time. Jackie Chan’s movies are famous for their over-the-top stunts and hilarious-but-amazing fight scenes, so much so that the actual plots of the films are sometimes forgotten. However, if one looks past the all the fights and laughs present in almost all of Jackie Chan’s films and just examines the stories behind them, an odd set of recurring themes soon make themselves present. Many of Chan’s best and most well-known works are attacks on colonialism and racism, not just in Hong Kong, but al so across the world. At the same time Chan is making these rather blatant anti-colonial films, other films of his seem to be defending colonialism while reinforcing negative stereotypes about the Chinese people and even other races. Some of his films even seem to do both, attack and defend colonialism, at the same time. It is my goal to show that the majority of Jackie’s films, especially his more recent work, all deal heavily with themes of colonialism and racism, whether it is good or bad, and that this has to do greatly with Hong Kong’s relationship with Europe and America. I will also attempt to show, that while Jackie has begun to make films in America, his anti-colonialism, and to some extent his anti-European and anti-American vi... ..., the most obvious being that Britain no longer has control of Hong Kong, China does. Whether this will translate into more anti-Chinese films to be made is unknown, but it is likely that Jackie Chan will continue to find complex message about race and colonialism in his films, regardless of where they are made, even if they may not be as strong as they were in the past.    Works Cited Logan, Bey. Hong Kong Action Cinema. New York: Overlook, 1996. Hsiao-peng Lu, Sheldon, ed. Transnational Chinese Cinemas. Hawaii: University Of Hawaii Press, 1997. Chan, Jack and Jeffy Yang. I Am Jackie Chan. New York: Ballantine Books, 1999. Fore, Steve"Life Imitates Entertainment: Home and Dislocation in the Films of Jackie Chan." In Esther Yau, ed., At Full Speed: Hong Kong Cinema in a Borderless World. Minneapolis: University of Minnesota Press, 2001, 115-42.      

Immoral or Unconstitutional Government Decrees :: Politics Political Essays

Immoral or Unconstitutional Government Decrees Imagine this scenario and let's do a thought experiment. I'm ordered by the Department of Health and Human Services (DHHS) to perform, without compensation, cleaning services at a local senior citizen retirement home. I've not been found guilty in a court of law of a crime for which I'm being punished. I've simply been ordered by DHHS to work at the senior citizen home in the name of promoting the public welfare. Failure to comply means going to jail. I might seek a court injunction against DHHS's edit. But suppose the court ruled that DHHS had the authority to order me to perform cleaning services at senior citizen homes. I might take my complaint all the way to the U.S. Supreme Court only for the Court to rule: yes, under the U.S. Constitution's welfare clause, and the authority it gives Congress, I'm compelled as ordered by DHHS to perform cleaning services. My question to you is now that the courts have ruled, should I simply comply? You might rejoin by suggesting that the question cannot be answered unless additional information is supplied such as: Did Congress properly vote to authorize DHHS to order me to clean senior citizen homes? Did DHHS single me out or are other Americans assigned similar tasks? In other words, was there invidious discrimination? My response to your first set of questions is what does a vote have to do with the rightness or wrongness of the DHHS mandate? Would one determine the rightness or wrongness of rape, murder, theft and slavery by whether there was majority vote? To the second question, I would also ask does the rightness or wrongness of an act depend upon the number of people, a hundred people or millions of people, forcibly used to serve the purposes of another? Was slavery in our country okay because 4 million blacks were enslaved instead of just one? Does equality in servitude make servitude just? One might rejoin by saying, "All those arguments are neither here nor there; the law is the law and people should obey." I say balderdash! South Africa used to have apartheid laws that strictly controlled where blacks could live, work, and eat. Nazi Germany had anti-Semitic laws. In United States there was the Fugitive Slave Act of 1850. Would you have obeyed those laws? Would you have approved of and sought prosecution of white employers who hired black workers in contravention of job reservation laws that were a part of South Africa's Civilized Labour Policy?

Brain & nervous system

Brain is the part of the nervous system that is enclosed in the skull. All vertebrates have well-developed brains; most invertebrates do not have true brains. Instead, they have groups of nerve cells called nerve nets, nerve cords, or ganglia. The human brain is an extension of the spinal cord, and with it makes up the central nervous system. It contains billions of neurons, or nerve cells, each with more than 10, 000 synapses, or connections to other neurons. No two brain cells are alike. The brain cannot regenerate new brain cells but it can bypass dead or damaged cells to form new synapses between existing cells.The brain receives information from all parts of the body and sends out instructions to the body’s various organs and systems. The information and instructions travel through the brain in the form of nerve impulses, electrical signals that elicit chemical changes. The impulses travel along the neurons and move from one neuron to the next across the synapses by means of chemicals called neurotransmitters. It is through nerve impulses that the brain controls such activities as voluntary and involuntary movement (Zoeller, 2003).The brain is connected with the sense organs, muscles of the head, and internal organs of the body by 12 pairs of cranial nerves. Some of the cranial nerves, called motor nerves, carry impulses from the brain to various parts of the body. Others, called sensory nerves, carry impulses from the body back to the brain. Most pairs of cranial nerves contain one motor and one sensory nerve; a few pairs contain sensory nerves only. The brain consists of two types of tissue: (1) nerve cells, or gray matter; and (2) sheathed nerve fibers, or white matter. The sheath is composed of myelin, a fatty protein that protects and insulates the fibers.A large number of blood vessels carry nourishment to the brain. The brain extracts certain substances from the blood and metabolizes them (that is, produces chemical changes in them) to produc e energy. Glucose, its main source of energy, is metabolized by a chemical reaction with oxygen carried in the blood. The human brain is more complex and has more functions than the brain of any other animal. It is the seat of consciousness and the coordinator of the nervous system. Thought, memory, imagination, and other mental processes are functions of the brain.Specific areas in the brain are responsible for language and emotions. The brain is the seat of sensations. All voluntary and some reflex muscular movements are initiated and regulated by the brain (Colzie, 2006). In addition, various parts of the brain control such automatic functions as heartbeat, temperature regulation, digestion, and breathing. The brain of the average human male weighs about 3 pounds (1. 4 kg); the human female, 2. 7 pounds (1. 2 kg). At birth, a baby’s brain weighs only 11 to 13 ounces (310 to 370 g), but it grows rapidly during the first years of life.By the age of seven, a child’s br ain has reached nearly its full weight and volume, after which its growth is slow. The brain of a human male is fully grown by the 20th year, that of a female somewhat earlier. After the age of 20, the brain loses about one gram (0. 04 ounce) of weight per year (Spear, 1995). This study discusses the brain development and how it functions. II. Discussion Brain tissue is very soft and easily injured. It is well protected, however, by the skull and by three membranes of connective tissue, collectively called the meninges, between the skull and brain.The outermost membrane is thick and tough, and fits closely to the inner surface of the skull. This membrane is called the dura mater, which is Latin for â€Å"hard mother. † The innermost membrane is the pia mater, Latin for â€Å"tender mother. † This thin membrane contains a network of blood vessels. These blood vessels supply nourishment to the brain, and carry blood from its interior back to the heart. The pia mater conf orms exactly to the outer surface of the brain itself (Cynader, 1994). Between the dura mater and the pia mater is the arachnoid, or â€Å"spider-like,† membrane.It is a soft, delicate, transparent tissue. The subarachnoid space, between the arachnoid membrane and the dura mater, is filled with cerebrospinal fluid, a clear, colorless liquid composed of protein, glucose, urea, and salts. It moistens the tissues of the brain and protects them from injury. The brain is also protected by the blood-brain barrier, a network of tightly meshed capillaries (tiny blood vessels) that selectively filter out harmful chemicals and waste products while permitting other substances, such as nutrients, to pass directly into the brain (Zoeller, 2003).This barrier prevents harmful compounds in the blood from being absorbed by brain tissue. A. Parts of the Brain The brain itself consists of three main parts: a large forward part called the forebrain; a narrow middle portion called the midbrain; a nd a rear part, called the hindbrain. It contains four cavities (hollow spaces called ventricles). The Forebrain, which is made up mainly a mass of neurons called the cerebrum, occupies most of the skull cavity and accounts for 90 percent of the weight of the entire brain. The surface of the cerebrum is a layer of gray matter called the cerebral cortex.It has many folds, or convolutions, which greatly increase its area. The longitudinal fissure, a deep cleft running from front to back, partially divides the cerebrum into right and left hemispheres. A central band of nerve fibers called the corpus collosum connects the two hemispheres. It contains bundles of nerve fibers called nerve tracts that carry information between the two hemispheres. The corticospinal tract carries impulses from the cerebral cortex to the spinal cord. Its fibers cross each other at the region where medulla oblongata (an area in the hindbrain) meets the spinal cord (Sousa, 2006).Thus, the left interprets the s ensations of the right side of the body and vice versa. Each hemisphere performs unique tasks. The left hemisphere is responsible for logical thought, writing, and mathematical skills. The centers of language are also located here. Broca’s area, situated in the frontal lobe (the forward section of the hemisphere), is responsible for the production of language. Wernicke’s area, situated in the temporal lobe, a section above the ears, is responsible for the comprehension of language. The two areas are connected by a bundle of fibers called the arcuata fasciculus.Damage to these fibers will cause speech impairment. The right hemisphere is responsible for intuition, musical and artistic ability, and analysis of visual patterns. Although each hemisphere is responsible for different functions, one can take over for the other in the event of localized brain damage (Puckett, 1999). The cerebral cortex contains two specialized areas: the somatic sensory cortex and the motor cor tex. They are separated by the central fissure, a deep cleft perpendicular to the longitudinal fissure and extending across the roof of the brain.The somatic sensory cortex receives sensory signals from the skin, bones, joints, and muscles. The motor cortex controls the voluntary movement of muscles. Almost every part of the human body has a specific region controlling it in both the somatic sensory cortex and the motor cortex. Body parts that perform intricate movements, such as lips, hands, and legs, are controlled by large parts of the cortex. Body parts that perform gross movements, such as the shoulders and trunk, are controlled by smaller areas. Adjacent regions in the brain control adjacent body parts (Spear, 1995).The cortex of each cerebral hemisphere is divided into four sections, called lobes: 1. The Frontal Lobe, the forward, upper part of the cerebrum, includes the areas concerned with intelligence, judgment, emotional reaction, and the movement of skeletal muscles. 2. The Parietal Lobe, in the upper, back area of the cerebrum, receives and interprets the sensations of pressure, temperature, and position. 3. The Temporal Lobe, above ears, is concerned with hearing, memory, and understanding of speech. 4. The Occipital Lobe, in the back part of the cerebrum, is concerned with vision and the interpretation of objects that are seen.Each hemisphere contains a mass of nuclei called the thalamus (plural: thalami). It consists of gray matter that integrates a wide range of sensations from the visual and motor cortexes. It also plays a role in emotions. Above each thalamus are two basal ganglia, clusters of neurons that help regulate body movements (Cynader, 1994). Beneath the thalami is the hypothalamus, a mass of nerve cells and fibers that controls the reaction of the body of stress and to strong emotion. It also regulates the body’s water balance, temperature, appetite, sleepiness, and heart rate.Below and in front of the hypothalamus is the pi tuitary gland, which is partially controlled by the hypothalamus (Colzie, 2006). The pineal gland, or epiphysis, is a coneshaped organ located beneath the corpus callosum. It is connected by nerves to the eyes and is extremely sensitive to light. In response to darkness, it secretes melatonin, a hormone that is believed to induce sleep (Sousa, 2006). The olfactory bulbs, which govern the sense of smell, are located on the undersurface of the hemispheres. Nerves run from the nose through these bulbs to the cerebrum (Sousa, 2006).The Midbrain contains tracts (bundles) of nerve fibers that connect with other parts of the brain and with the spinal cord. The midbrain also has centers for auditory and visual reflexes, such as the contracting of the pupils (Sousa, 2006). The Hindbrain consists of three parts: (1) the cerebellum, behind and beneath the cerebrum; (2) the pons, beneath the midbrain and opposite the cerebellum; and (3) the medulla oblongata, attached at its base to the spinal cord (Sousa, 2006). The cerebellum, like the cerebrum, has a convoluted surface. The chief function of the cerebellum is to coordinate and regulate movements of the skeletal muscles.(The movements, however, are initiated and controlled by the cerebrum). When the cerebellum is damaged, ordinary movements directed by the cerebrum cannot be carried out. Limb movements become slow and jerky, and speech may become slurred. The pons is a smooth-surfaced bulge between the midbrain and the medulla oblongata. It contains tracts that connect the two sides of the cerebellum, and tracts that connect other parts of the brain with each other and with the spinal cord. Many of the cranial nerves pass through here. The pons controls the motor and sensory nerves to the eyes, jaw, face, and muscles.Together with the cerebellum, it regulates posture and balance (Puckett, 1999). The medulla oblongata is smooth, without convolutions. It contains three important nerve centers: one affects the rate of hear tbeat; one controls breathing; and one produces the constriction of blood vessels to control the volume of blood supply to the tissues. It is also the site where the nerves from the left hemisphere cross over to control the right side of the body and vice versa. Reflex centers of vomiting and swallowing also lie in the medulla. The midbrain, pons, and medulla, oblongata together form a structure called the brain stem.Deep within the brains tem, extending from the medulla to the midbrain is a network of nerve cells and fibers called the reticular formation (Cynader, 1994). The reticular formation regulates the amount and speed of electrical activity in the cerebral cortex. Many sensory nerves feed into it. It is believed to be the seat of consciousness. Ventricles. There are four ventricles within the brain. These cavities are connected to each other and to the hollow core of the spinal cord. The largest cavities are the two lateral ventricles, located in each hemisphere of the cereb rum.Beneath the lateral ventricles is the third ventricle and under it is the fourth. Cerebrospinal fluid is formed and stored in the ventricles (Cynader, 1994). Within the lateral ventricles is the limbic system, a group of structures that controls emotions and behavior, stores memories, and is involved in learning. It contains two masses if gray matter: the amygdale and the hippocampus. B. Chemistry of the Brain Since the early 1970’s, researchers have discovered that the brain contains more than 50 neurotransmitters, chemical substances that facilitate the transmission of nerve impulses between neurons.They interact with specific receptor sites in the brain to elicit chemical changes. Some circulate throughout the body (Spear, 1995). All neurotransmitters have chemical precursors. These are substances, composed of glucose and amino acids, which are produced elsewhere in the body and are carried in the bloodstream. The precursors are able to cross the blood-brain barrier in to the brain, where they are eventually converted into neurotransmitters (Spear, 1995). The quantities of neurotransmitters in the brain are affected by the consumption of certain foods and also by strenuous exercise.Endorphins make up a family of neurotransmitters that act as natural painkillers. They moderate the amount of pain an individual feels. They are composed of chains of amino acids called peptides. Narcotic analgesic drugs, such as heroin or morphine, effectively reduce pain by occupying the same receptor sites and producing the same interactions as endorphins. These drugs are often prescribed for severe pain or when there is a delay or malfunction in the release of the natural painkillers (Zoeller, 2003). Acetylcholine is a neurotransmitter that functions in storing memories, regulating moods, and controlling body movements.Consumption of such foods as eggs, soybeans, and liver increases its production. All of these contain lecithin, which is converted into choline in th e liver. Choline is a chemical precursor that is converted into acetylcholine in the brain. Serotonin, a neurotransmitter found only in the hypothalamus and midbrain, relieves depression, reduces sensitivity to pain, and induces sleep. Its chemical precursor is tryptophan, which is found in the protein in meat, fowl, and fish. Norepinephrine is another neurotransmitter that helps relieved depression (Zoeller, 2003).Its precursor is tyrosine, which is also found in protein. Strenuous exercise increases the production of endorphins and norepinephrine. It is this increased production that causes â€Å"runner’s high—an increased tolerance to pain and a state of euphoria experienced by many long-distance runners. III. Conclusion In conclusion, as I study this subject I have discovered one thing and that is— brain is like your computer’s body. It receives information from the internal organs such as the heart, intestines and from the sense organs—the ey es, the ears, the tongue, the skin and the nose.It makes me think that the brain is the control center of the body. It receives all messages from different parts of the body, interpret them, and tell the parts what to do. Moreover, as what I have understood from the research I conducted, it gives me an idea that the brain is not completely developed even in full-term newborn infants. A great deal of brain development takes place in the first few months of postnatal life; and, in fact, brain growth continues at least until adolescence, and perhaps in adulthood. Some nerve fibers in the brain develop myelin sheaths.Many of these nerve fibers have not become myelinated by the time of birth. The process of myelination continues for years, especially in the reticular formation and parts of the forebrain. Reference: 1. Colzie, Lakesha (2006). The First Three Years and Beyond: Brain Development and Social Policy. Childhood Education, Vol. 82. 2. Cynader, Max S. (1994). Mechanisms of Brain Development and Their Role in Health and Well-Being . Daedalus, Vol. 123. 3. Meltzoff, Andrew N. (2002). The Imitative Mind: Development, Evolution, and Brain Bases. Cambridge University Press. Cambridge, England. 4.Puckett, Margaret (1999). Examining the Emergence of Brain Development Research. Childhood Education, Vol. 76. 5. Sousa, David A. (2006). How the Arts Develop the Young Brain: Neuroscience Research Is Revealing the Impressive Impact of Arts Instruction on Students' Cognitive, Social and Emotional Development. School Administrator, Vol. 63. 6. Spear, Norman E. (1995). Neurobehavioral Plasticity: Learning, Development, and Response to Brain Insults. Lawrence Erlbaum Associates. Hillsdale, NJ. 7. Zoeller, R. Thomas (2003). Thyroid Toxicology and Brain Development: Should We Think Differently? Envir

Egyptian Art vs Renaissance Art Essay

The ancient Egyptians have had a huge impact on the world today. From Cleopatra, to The Mummy movies, the theme that is Egyptian is something that is very easily recognized. Egyptian art is very flat with exaggerated body parts. These figures have very long arms and legs with pointy eyes. Pointy eyes are a vanity thing that is still sought after and many women achieve this look with liquid eyeliner. Another factor that makes Egyptian art special is their color pallet. The Egyptians used many warm colors such as various shades of brown, red, yellow, and orange. The frescos done by the Egyptians were done with egg and vinegar. One thing I found that was very interesting is that the Egyptians painted males with a dark reddish skin tone, and they painted the women a lighter yellow color. This shows that men were very active outdoors and they women were mainly indoors. This shows how important detail was to Egyptians and that their paintings were very accurate to how they were living. Renaissance style art is classical and most known for their religious pieces. A characteristic Renaissance art had that Egyptian did not was mannerism. Mannerism in Renaissance art included unusual poses of figures and the body language. Compared to the Egyptian’s stiff style, Renaissance art contained much movement and was very soft to look at. Below is a mannerist painting. As you can see the poses seem strange to few, but regardless the painting contains bold colors with the focal point being the woman and her pale skin. One of the things that differentiate Egyptian art to Renaissance art is that Renaissance art uses realism. Their paintings include drawing of people in a realistic way. The people in Egyptian art do not exactly look how a real person would look today. Below, is a renaissance style portrait of Raphael Sanzio compared to an Egyptian painting of the pharaoh. What they both have in common is that they are both of males, they are both wearing head pieces, and both seem to be inspired by the human body. Their differences include color, dimensions perspective, makeup, props, and clothing to name a few. Comparing Egyptian art to Renaissance art is like comparing pizza to sushi. Both very different but amazing in their own way. Both types of art had a huge impact on art today and are considered timeless. As an artist in my spare time, I look up to both styles as my inspiration.