Analysis and Interpretation of the Research Data Dissertation

Analysis and Interpretation of the Research Data - Dissertation Example 4.2 Respondent’s Profiles Following is the detailed discussion on the profiles of the respondents that participated in the research and supported to collect data through different means i.e., questionnaire, interviews and focus groups. 4.2.1 Profile of Teachers Surveyed The perspective view of the teaching staff at Willowbrook Primary School regarding the issue of student’s behavior and discipline is of prime importance for this study as the teachers have a direct impact on behavior and its management. Thus these views need to be analyzed. In coordination with the school management, in order to to gain valuable teacher and carer knowledge, sentiment and experience associated with behaviour issues, a questionnaire was developed and distributed to 20 in-school teachers responsible for children ranging from five years of age to 11 years. The questionnaires were completed in the free time of the teachers without compromising their primary teaching and classroom management r esponsibilities. The objectives of the research were explained prior to handing over the questionnaire. However, of the 20 questionnaires distributed, 17 were returned and/or deemed valid based on required completeness. Another attempt was made to collected the data from the remaining staff; however, these were not returned. The purpose of the questionnaire was gain information on opinion of the teaching staff on aspects of student’s behaviour and strategies for the behaviour management at primary level. The profile of the respondents is shown below in table 4.1. Total Number of Staff Number of Teachers Surveyed Males Females Percentage of Teaching Staff Surveyed 20 17 7 10 85 Table 1 : Profile of Teaching Staff Surveyed Figure 1 : Percentage of Teaching Staff Surveyed Figure 2 : Gender Distribution of Teaching Staff Surveyed Besides the questionnaire, a total of six teachers were also interviewed, which included three teachers having experience of 10 years or more, one more than 5 years while two having experience less than 1 year. Figure 3 : Experience of Teachers Interviewed 4.2.2 Profile of Students Surveyed Six students of age ranging between six to eleven years, representing equal proportion of both males and females, were interviewed as part of the survey. The students were selected because it was deemed important to get their views on the discipline in schools and its management. The students were selected based on their age and developmental stage enabling them to provide reasonable and clear responses to the interview questions. The students were selected based on the advice of school management. The parental content was sought prior to conducting the interview. The responses of students during the interview have been made part of this study and were handed over to school management to continue with the study. The interview mainly focused in determining the student’s perspective on effectiveness of reward and punishment system and the r ole of teachers in managing the classroom behavior. Age of Students Surveyed Number of Students Surveyed Males Females 6 to 11 6 3 3 Table 2 : Profile of Students Surveyed Figure 4 : Gender Distribution of Students Surveyed 4.2.3 Profile of Parents Surveyed Although parents have no direct role in management of classroom and student’s behavior at school, they do play a major contributory and supportive role. They are involved in

Activity Based Costs Implementation for a Not-for-Profit Essay Example for Free

Activity Based Costs Implementation for a Not-for-Profit Essay The author was tasked with setting up an activity based costing (ABC) system for a not-for-profit organization. The first thing done by the author was to use the internet to research the use of ABC systems for non-profits. The result was the conclusion by the author that QuickBooks’ class feature could be used to track expenses, revenues and balance sheet costs for the implementing ABC. Income, Revenue and Balance Sheet reports are then prepared by class to see the result. Once the decision was made to use the class feature of QuickBooks, the author determined that the ABC system should accumulate costs into activity cost pools designed to correspond to the non-profit organizations major activities or business processes. The author determined that the costs in each pool would be largely caused by a single factor – the cost driver. In activity based costing (ABC), an activity cost driver is something that drives the cost of a particular activity. A factory, for example, may have running machinery as an activity. The activity cost driver associated with running the machinery could be machine operating hours, which would drive the costs of labor, maintenance and power consumption of running the machinery activity. From his research, the author found there are currently no comprehensive manuals to provide off-the-shelf instructions on how to install an ABC system in an organization. Each set of programs and activities, as well as each type of cost, presents different issues and problems. The author anticipated that many of the allocation issues faced by a not-for-profit would be similar to those faced by industry implementing an ABC system. On the other hand, the author determined that flexibility is the essence when implementing an ABC system in a not-for-profit organization. The purpose of ABC should be to provide decision-useful information, not to develop a pure measure of costs. ABC can provide interesting insights into the costs of programs and activities. ABC may highlight changes that have taken place gradually over time of which the manager may not be aware. The rational for using ABC is to allocate indirect costs to goods or services based, not simply on what is convenient, such as direct labor, but on the factors by which they are most influenced. Costs of support services should be allocated on the basis of the factors that most directly affect their magnitude. As demand for increased accountability becomes more intense for an organization, such organization must demonstrate that the benefits of the programs and activities in which they engage are commensurate with their costs. Accordingly, not-for-profit organizations need accounting systems that properly measure and report these costs.

Controversies in ECMO

Controversies in ECMO Parag Gharde, Sandeep Chauhan   Controversy is defined as â€Å"Public debate about a matter which arouses conflicting opinion.† (Oxford English Dictionary) ECMO or ECLS- To start with there is controversy regarding the name itself. There are two abbreviations that we commonly come across in literature ECMO- extracorporeal membrane oxygenation ECLS- extracorporeal life support This support system is used in different clinical settings where the reversible organ dysfunction has affected the lung, the heart or both. When lung rest is needed the veno-venous ECMO system is used and for providing cardiac rest veno-arterial system is used. The term extracorporeal membrane oxygenation (ECMO) came into being when Dr. J. Donald Hill first used it successfully in a road traffic accident victim who developed acute respiratory distress syndrome after multiple blood transfusions. Since lung rest and oxygenation was the main therapeutic requirement, the life support system was named ECMO. But since this support system is now often being used in patients requiring cardiac support where the native lung is functioning well, the term ECMO is not suitable and hence the term ECLS is now in common use in clinical practice. The ECMO society itself is named as â€Å"Extracorporeal Life Support Organization-ELSO†. Therefore the reader should not get confused when they come across the terms- ECMO and ECLS, both meaning the same but to the author the term ECLS appears to be more appropriate as it can be used interchangeably whether support is required for the lung, the heart or for both. The use of the term ECMO is justified only if it is being used to support pulmonary function with the aim of giving rest to the lung. Does ELSO work? After the first successful use of ECLS in an adult, which was reported by Hill etal in 1972 (NEJM 1972; 26: 629-34.), the National Institute of Health sponsored a multicenter randomized study by Zapol etal in 1974, which showed 90% mortality in both ECLS and conventional care group. The anticipated enrolment for the study was 300 patients but the study was stopped after just 92 patients, as the death rates were similar in both the groups. This prospective randomized trial deflated the initial euphoria that was generated by the report of Hill etal. Was this supposed to be a certain miscarriage of a support system devised to deal with patients who are non-responders to conventional medical practice, even before seeing the light of the day? This study was conducted in adults with hypoxic respiratory failure and published in 1979. (JAMA 1979; 242:2193-2196). This first prospective multicenter randomized clinical trial demands a close scrutiny. During the study period a nation wide epidem ic of influenza pneumonia broke out, which might have affected the results. Though the protocol included lung rest but the inflation pressures were high compared to the present recommendation, which may have caused lung injury. VA ECLS was used rather than VV ECLS, which may be responsible for high incidence of pulmonary micro-thrombosis due to decreased pulmonary blood flow. ECMO was instituted after a mean duration of 9 days of mechanical ventilation, which in the present era has been reduced to 7 days. Morrios etal (Am J Respir Crit Care Med-1994;149(3);88) randomized 40 patients with sever ARDS to either pressure controlled inverse ratio ventilation or extracorporeal carbon dioxide removal. Survival at 30 days was not significantly different (42% in mechanical ventilation group and 33% in ECLS group). After these two randomized trials, showing failure of ECLS in the adult setup had put ECLS into disrepute despite many anecdotal mini case series and isolated case reports showing the benefits were published. The much awaited CESAR trial (Efficacy and economic assessment of Conventional ventilator support versus Extracorporeal membrane oxygenation for Severe Adult Respiratory failure), a multicenter randomized controlled trial by Peek etal was published in Lancet 2009. (Lancet. 2009:374:1351-1363.) 180 patients were randomized and 90 patients were managed at the participating tertiary care centers while 90 were referred to Glenfield hospital. Five patients in the ECMO referral group died during transportation and thus the ECMO group consisted of 68 patients of which 43 survived to 6 months (63%). This study showed that survival apart from appropriate time of institution of ECLS also significantly depends on the expertise of the ECLS conducting center. There is no consensus on the optimal time for institution of ECLS. Waiting too long will result in danger of end organ dysfunction and poor outcome, while too early institution without optimizing medical therapy will expose the patient to the inherent risk of ECLS. The success in ECLS has been with neonatal acute hypoxemic respiratory failure with survival to discharge rates reaching 80%. The success story started with Bartlett etal reporting the first successful use of ECLS in a neonate in 1976. Extracorporeal carbon-dioxide removal (ECCO2R) A membrane lung is used to remove carbon dioxide in conditions of acute exacerbation of chronic obstructive pulmonary disease. A low flow is required and is perfused by femoral artery-venous shunt. Low blood flow is not adequate for performing oxygenation. Morris etal conducted a randomized control trial using this device to eliminate CO2. This trial showed no difference between ECCO2R and the conventional treatment and the study was stopped after enrolling 40 patients only. The ECCO2R arm used low flow in a group of patients with severe lung disease, which warranted higher ECMO flows. Before starting the trial, the trial team had limited experience on sheep and one patient.(Am J Respir Crit Care Med,1994:149; 295-305.) Effective CO2 clearance is achieved with blood flow as little as 10-15ml/kg/min, while oxygenation requires at least 50-60 ml/kg/min of blood flow. Nova lung (Germany) produces a membrane lung, which can be perfused using femoral arterio-venous shunt, enough blood flow for CO2 removal. ECLS Vs Ventricular assist device (VAD) Patients with failing heart and waiting for heart transplant need a bridge to transplant till the time a donor heart is available. If these patients develop acute exacerbation of cardiac dysfunction, which route should be chosen- ECLS or VAD? There are no guidelines regarding this situation. The main advantage ECLS holds over VAD is in patients with bi-ventricular dysfunction, which will require a bi-VAD. VA-ECLS on other hand can support both the ventricles along with respiratory failure and refractory pulmonary artery hypertension. The only limitation is the duration of support, which at most is 4-6 weeks. Cardiac ECLS The controversy is regarding patient selection. Though ECLS guideline clearly defines presence of a reversible condition before institution of ECLS, there are situation when it’s difficult to predict if the condition is reversible and most often the decision is surgeon dependent who may have a biased opinion regarding the true indication for instituting ECLS. This usually results in financial burden, resource and manpower wastage, bad outcome, lowers the moral of the team and loss of faith in the support system (ECLS). When is the ideal time to institute ECLS in cardiac surgical patient? Is it ideal to institute ECLS directly from CPB or to initiate it later in the intensive care unit after giving a trial? It has been shown that survival benefits were more in patients who went on ECLS directly from CPB thus avoiding the ill effects of prolonged low cardiac output state or subsequent to cardiopulmonary resuscitation (CPR) in the intensive care unit. Antegarde or retrograde ECLS Retrograde ECLS via femoral artery cannulation especially for cardiac support in a failing left ventricle is not a good option. The failing heart with this form of support has to compete with retrograde ECLS flow from the femoral artery cannula. This causes increase in LV wall stress and may even result in mitral regurgitation both of which increase left atrial (LA) pressure, thus affecting gas exchange due to pulmonary congestion. This may impair oxygenation and delivery of inadequately oxygenated blood to coronary and cerebral artery circulation will further worsen cardiac function and delay recovery. Therefore central ECLS with aortic cannulation has some advantage over peripheral ECLS, especially in case of cardiac support. But central ECLS takes time to initiate and is ideal in post cardiac surgery setup. In an emergency situation peripheral ECLS is easy to institute. Serial echocardiography needs to be done to rule out LA distention. If LA distention is present then placement o f an LA vent is necessary via percutaneous atrial septostomy. Some prefer retrograde ECLS because of the fact that 10-15% patients suffer from stroke when carotid artery was used for arterial cannulation in profound hypotension or arrest. Neck vessels are used in children up to 5-6 years and femoral access in older patients. Limb ischemia is common with femoral artery cannulation and may require additional distal limb perfusion. Is axillary artery cannulation a better option? This can provide sufficiently oxygenated blood to the upper body, which is lacking with retrograde flow. The issue of limb ischemia is also addressed. The decreased pulmonary blood flow in full support VA ECLS may increase the risk of thrombus formation, in the pulmonary circulation, because of lower levels of anticoagulation. Does the type of oxygenator influence outcome? In vitro studies reported problems with Biomedicus (Medtronic, USA) pump heads. Thiara etal demonstrated improved circuit durability and reduced hemolysis when changing from Biomedicus (Minimax oxygenator) circuit to a Rotaflow (Lilliput 2 oxygenator), but failed to demonstrate survival improvement. (Perfusion, 2007;22:323-26). The earlier oxygenators were spiral wound silicone membrane oxygenator (Affinity, Avecor Cardiovascular Inc, USA), and the recent multiple hollow fibers

The Growth of Nora in A Dolls House :: A Dolls House Essays

The Growth of Nora in A Doll's House In the play " A Doll's House", written by Henrik Ibsen, Nora, the main character of the play, decides to abandon her husband, her home and her children in order to find herself. She finally realizes she has to leave when confronted with a problem in her relationship with her husband, who keeps treating her like a doll, reflecting the childish treatment she always received from her father before. She finds the strength to leave with her childhood friend Kristine, who has led a hard life, and has the wisdom to guide and support her. Nora leaves the role of the doll child and doll wife she played her whole life, and becomes an independent self-thinking adult, when she realizes that the world is different than she always thought it was, and that she herself is not who she thinks she is. Nora lives in a dream world, a child fantasy, where everything is perfect, and everything makes sense. She thinks that the world would never condemn a woman who tries to save her husband's life or protect a dying father. When confronted by Krogstad, who tells her it is against the law to sign someone else's signature, she responds: " This I refuse to believe. A daughter hasn't a right to protect her dying father from anxiety and care? A wife hasn't a right to save her husband's life? I don't know much about laws, but I'm sure that somewhere in the books these things are allowed." Nora simply does not understand the ways of the world, and the final realization that she is in real danger of risking hers and her husband's reputation, and worse, makes her snap out of the childish dream she had been living. Kristine, Nora's childhood friend, is the wisdom and support Nora needs to grow up. Kristine is a woman who has been in the real world, unlike other wives of Torvald's friends. At the same time, Kristine is a friend from Nora's childhood, a person who she can tell her problems to and relate to in some way. Also, unlike everyone else who surrounds Nora, Kristine tells her the truth, she does not pamper her.

Reconstructed Portrait of Juan Dela Cruz Essay

Reflection: This kind of article is somewhat made to be funny upon criticism although some of his statements are true but need adequate citation of example. The author’s points are thoughts of a typical charlatan English 101 passer that wants to show off his talent in composition of proses like this one. Nevertheless, I will give my comments on the statement given by him. First, the author’s claim of Filipinos’ uniqueness when it comes to humor didn’t work. The statement â€Å"†¦people making fun of their own mistakes†¦Ã¢â‚¬  makes me think of humorous videos of other races laughing at their own mistake, the statement doesn’t prove the uniqueness of the subject. And the part of the said article where â€Å"sense of humor† is talked about comes with a complicated context that it blends the positive and negative statement in one part of the text. He could’ve written it in a flow which either of the two statements comes first. Second, the issue of the Filipinos speaking foreign languages for them (foreigners) to appreciate the hospitality of the natives; it doesn’t seem to make a sense. For all I know, it’s a part of tourism. This statement proves that we only please the foreigners by speaking their language in our country and they do not speak our language in their country when we visit as tourist is baseless, the foreigners teach us their language and vice versa it serves as a souvenir, a token of knowledge. Maybe the author doesn’t know that we learn â€Å"konichiwa, aloha, que tal?† and they learn â€Å"mabuhay, kumusta ka† and â€Å"mahal kita† through this mean, it is hospitality Mr. author. Third, describing the creativity of Filipinos by mentioning â€Å"when there is a big flood, they take it to their advantage to go up on the roofs of their houses to fish tilapia for their dinner.† this has nothing to do with creativity and inventiveness, climbing up the roof on a big flood is not creative, it is matter of life and death, they are not there to go fishing, they are trying to save their lives Mr. author. Fourth, the claim of us Filipinos being great violators is a mere blind  judgment and an exposition of colonial mentality; violating street signs, eating medically prohibited food, buying pirated goods, â€Å"walang ganyan sa states†? I don’t think so. American people do these things worse than we do. Fifth, cramming is compared to the story of Juan Tamad, I don’t really think it’s related at all.

The Invisible Hand

The Invisible Hand Introduction Economics is a social science, which is concerned with the distribution of scarce resources amongst limited, competing and insatiable wants of consumers. The invisible hand principle was coined by Adam Smith; a classical economist, to elucidate how the market regulates itself in a capitalistic setting (McConnell and Brue 1).Advertising We will write a custom research paper sample on The Invisible Hand specifically for you for only $16.05 $11/page Learn More The aforementioned resources are usually employed in the production of goods, and provision of services to the myriad types of markets; where producers and consumers interact. Incidentally, due to competition in these markets; there is always friction between producers and consumers which is occasioned by the need of producers to exercise their desire of profit maximization, and the consumer’s need to attain maximum utility per commodity purchased. This is tantamount to the consumer, b eing on the highest possible indifference curve; as indicted by a rational consumer yearning to be on indifference curve I1 in the graph below. Graph One In the preference map above, a consumer operating on indifference curve I1 is a utility maximizing agent; choosing to be where there is optimum combination of commodity X and Y.Advertising Looking for research paper on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Producers on the flipside, gravitate towards maximizing their profits by minimizing their production costs. The invisible hand therefore, is natural equilibrating component of the market, which provides a middle ground between producers and consumers with regard to their welfare. The Circular Flow of Income Seemingly, the primary constituents of the economy in a macroeconomic perspective are the household and the firm. In a circular flow of income mechanism, there is always exchange of services, pr oducts and income between these two agents. The invisible hand principle assumes that; there is no government intervention in the market where these agents interact, to counter market imperfections. Diagram: Showing Economic Exchange between Households and Firms. The Price Mechanism Ordinarily, the basic microeconomic principle with regard to equilibrium between demand and supply, is the price mechanism; where demand and supply automatically self- correct to attain a price and quantity that is ideal to both producers and consumers. In situations where demand exceeds supply, there is shortage and where supply exceeds demand there is a surplus. The invisible hand is mandated with the task of equilibrating demand and supply in the market. Advertising We will write a custom research paper sample on The Invisible Hand specifically for you for only $16.05 $11/page Learn More Graph Two The Free Market, Command and Mixed Economies Much as we may acknowledge the ex istence of free market economies, in reality there is no way that an economy can function smoothly with the reliance on the invisible hand exclusively; without the government’s input (Suntum 10). In practice most economies that purport to be free market economies, are typically mixed economies where both the invisible hand and the state play dual roles; in ensuring that, consumers are cushioned from high prices set by producers. Additionally, producers are able to produce in a fair and conducive environment. Therefore, a mixed economy is an amalgamation of the command economy’s government intervention, and the free market economy’s invisible hand. Conclusion The invisible hand plays a very pivotal role in the free market economy, in the regulation of demand, supply and price in the market. Much as we would love the market to regulate itself, there always seems to be some market imperfections that are usually not anticipated. The invisible hand cannot address all the market imperfections; therefore, some intervention by the state in the economy, ensures that there is a level playing field for all producers, and that the consumer is cushioned from exorbitant prices, that might be charged by unscrupulous producers. McConnell, R., Campbell, and Brue, L., Stanley. Economics: Principles, Problems and Policies. New York: McGraw-Hill, 2007. Print.Advertising Looking for research paper on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Suntum, V., Ulrich. The Invisible Hand: Economic Thought Yesterday and Today. New York: Springer, 2005. Print.