Acupuncture as a nonconventional treatment for chronic neck pain Essay Example

Acupuncture as a nonconventional treatment for chronic neck pain Essay Acupuncture as a nonconventional intervention for chronic cervix hurting Introduction IntroductionNeck hurting has been classified as one of the commonest jobs among the people. This status arises from assorted upsets or it may arise from tissues located at the cervix ( Hush. et Al. . ( 2009 ) . The cervix is besides known as a cervical spinal column. The cervixs construction is characterized by vertebrae which run from the upper trunk to the skull’s base. The stableness of the spinal column is associated to ligaments and musculuss that run along the vertebrae ( National Institutes of Health. ( 2013 ) . A neck’s chief importance is its mobility and the support it accords to the caput. It is prone to hurts because it is non offered much protection like the remainder of the spinal column. Injuries usually cause less and restricted mobility and triggers NAIP. Unfortunately neck hurting are non accorded earnestness. most people treat the cervix hurting as impermanent. There are alone instances where the symptoms do non travel off and therefore diagnosing and corresponding intervention is required ( American Academy of Orthopaedic Surgeons ( 2013 ) . We will write a custom essay sample on Acupuncture as a nonconventional treatment for chronic neck pain specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Acupuncture as a nonconventional treatment for chronic neck pain specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Acupuncture as a nonconventional treatment for chronic neck pain specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Researchers ( De Loose. V. . Burnotte. F. . Cagnie. B. . Stevens. V. . A ; Van Tiggelen. D. ( 2008 ) . have found out that the strivings are caused by several factors such as wear and tear. sprains and abnormalcies of the cervix tissue. There is grounds of cervix strivings originating from other strivings such as arm or shoulder strivings ( De free. 2008 ) . Normally activities such as utmost decompression sicknesss of the cervix. falls and vehicle accidents can do cervix hurts. In certain state of affairss harm of the cervix can damage the spinal column doing palsy. Research workers have besides found out that Spondylosis which occurs in people above the age of 40. adds strains to make out articulations making a way for chronic cervix hurting. But the status is treatable through both conventional and nonconventional methods. Research workers and physicians have identified stylostixis as a nonconventional intervention method which is a really effectual method for handling chronic cervix strivings. Researcher ( Blosssfeldt. 2004 ) . says that. stylostixis is deriving impulse as a popular nonconventional intervention method for chronic cervix hurting. He besides adds that. the method has been good tolerated and has low hazard of inauspicious effects. ( Liang et al. 2008 ) says that. a combination of both traditional and modern stylostixis technique normally result in a documented and improved cervix hurting forms. ( Blossfeldt. 2004 ) adds that stylostixis is widely accepted and it is utilized as a complementary therapy utile in cervix hurting direction arising from cervical spondylitis. Research workers have carried out surveies associating to acupuncture systematic reappraisal with an purpose to happen out on stylostixis effectivity. The surveies have found effectiveness grounds as inconclusive ( salter et Al. 2004 ) . There are surveies which have produced consequences which are positively favoring stylostixis and there are other consequences which have produced negative findings on the effectual of the method ( salter et Al. 2004 ) . Due to the varying consequences. this research was developed to happen out on the effectivity of stylostixis method as a non-conventional method in intervention of chronic cervix strivings in relation to other research findings. In regard to national wellness statistics and studies. Survey data analysis can be used by medical professionals to mensurate the hurting degrees of patients before and after stylostixis intervention. Gathering consequences from assorted surveies and comparing with the constructions of stylostixis and preventative steps of cervix strivings can assist us find on the effectivity of stylostixis as a intervention method. In this literature reexamine the research worker will reexamine on 1 ) how to set up the viability of stylostixis therapies in the intervention of chronic cervix hurting ; 2 ) apprehension of how assumed. shoal and randomised stylostixis therapies are utilized in the intervention of chronic cervix hurting ; 3 ) supply a conclusive grounds of the success of stylostixis as an ideal method of alleviating hurting ; 4 ) set up the effects of the three stylostixis therapies in the intervention of persons with chronic hurting of the cervix ; 5 ) offer recommendation of the viability of stylostixis as a intervention option that can be used by people with chronic cervix strivings. The research worker will besides compare the continuance of stylostixis intervention with other methods and besides the cost associated and hazard factors thereof. METHODOLOGYTarget PopulationThe research informations collected in this survey focused on patients enduring from chronic cervix hurting. The persons used in the research fell within the age of 21 and 55 old ages old. Although there are many patients who report about cervix hurting complaints in different wellness attention installations across the United States. patients withinthe ages of 21 and 55 old ages old were ideal for this research survey. This was due to the fact that they were easier to track their advancement of mending over a longer period of clip. Aged patients over the age of 55 old ages were non best placed in this research sing the assorted properties in the healing procedures of such people. which was proven to be comparatively lower. Most of the information aboutindividuals with chronic hurting of the cervix was indiscriminately collected in wellness attention installations in the State of California. United States. The bulk of these patients were diagnosed with chr onic cervix hurting and were put under a particular focal point while three stylostixis methods of therapies were performed ( Witt 2004. p. 99 ) . The survey by and large involved a thorough probe of 191 patients in California’s wellness attention. It is of import to admit that the assorted patients were intentionally initiated to acupuncture intervention as their determination to seek the alternate medical pattern after unsuccessful interventions in the mainstream medical processs. There were surely no restriction on the sex of the patients ; hence the research involved both male and female patients. Additionally. there was no specified figure of male or females in the survey. as patients. intervention and advancement of intervention of patients was indiscriminately taken. Further. it was assumed that both male and female patients presented similar responses to the different stylostixis therapies performed in the survey ( Sun et al. 2009. p. 850 ) . The research was non limited by either ethnicity or race. although believed to hold different features in respect to assorted medical processs. Variables of the studyThe dependant variables in this survey included the cervix hurting as an complaint caused by assorted facets such as physical hurt and disease or status among others. The rates of instances affecting chronic cervix strivings during the period of this survey were by and large unprecedented as the causes of such complaints greatly varied. Chronic cervix hurting among the patients varied in respect to the specific causes. which in this instance included degenerative phonograph record disease. neck hurt. cervix strain. herniated phonograph record every bit good as pinched cervix ( Sun et al. 2009. p. 850 ) . The first measure in the intervention process involved a thorough diagnosing of common cervix infections that caused the chronic hurting. The research exploits intervention of such cervix strivings utilizing stylostixis which falls into three classs including optimized stylostixis. shallow stylostixis and assumed stylostixis. Research LimitationsThe cardinal restrictions were based on cervix hurting due to common infection like virus infection of the cervix and lymph nope swelling. every bit good as other infections such as TB of the cervix. meningitis. and infection of spine castanetss around the cervix. It was hard in the survey since some of patients did non present themselves on the twenty-four hours of the survey. The survey besides used a big figure of patients which was a challenge for the research worker. The different patients involved in this survey had chronic cervix strivings attributed to highly different causes. which included physical hurts. some rare infections. and virus infections among others ( Witt 2004. p. 99 ) . The patients with this job are by and large taken through the three stylostixis therapies. regardless of the cause of their status ( Hush 2004. p. 1533 ) . The fact that all patients are uniformly taken into similar medical processs without being categorized in relation to th eir specific cause of chronic cervix hurting remain as the greatest restricting property of this research. Additionally. clip was a confining factor since the clip allowed for the research was non plenty to expeditiously undertake critically the aims of the survey. Research standards and Database usedIn this survey. the points were collected through seeking equal reviewed journal articles and hence. the research worker exhaustively searched in assorted databases for article that provided information for patients enduring from chronic cervix strivings. specifically those persons between the age of 21 and 55 old ages old. The research worker farther categorized the informations collected to organize two groups of patients of the age bracket of 21 and 34 old ages and those between 35 and 55 old ages old. The creative activity of these two groups was indispensable as taking a wider scope of people of ages 21 to 55 old ages old would show comparatively a higher divergence in the healing processes of the patients. as those above the age of 35 old ages present a much longer period of mending as compared to the vernal 21 to 34 old ages group. The research worker focused the hunt on SPORT Discus. Academic Search Premier. BMJ Research Articles and Gov. . database. Keywords used in the studyThe key footings the research worker normally used while seeking for the relevant articles included: Chronic cervix hurting. cervical hurting types of stylostixis. alternate medical specialty. Sham stylostixis. Shallow stylostixis and Randomized stylostixis. OVERVIEW OF ACUPUNCTURE PRACTICEPracticing stylostixis started many centuries ago as a type of medicine in China. It is the pattern of engrafting acerate leafs at certain points of the human tegument as a signifier of therapy. In stylostixis patterns. there is no engagement of drugs but merely the acerate leafs are adequate to carry through the therapy ( Liang et al. 8 ) . The pattern originated from China and has been noted to distribute all over west of Europe ( Liang et al. 8 ) . As argued by the theoretical account on Chinese medical specialty. the specific topographic points that the stylostixis acerate leafs are placed prevarications on the way named acmes where the dynamic energy goes through. hence leting its entree to command and modulate the flow of energy which is believed to be the cause of force instability ( Willich et Al. 2006. p. 98 ) . Populations and AcupunctureAcupuncture has been practiced in several parts globally. particularly in Europe even though it is in its origin phases in the United States. Harmonizing to NHI study done in the twelvemonth 2007 that besides considered the usage of CAM in America. where 1. 4 % of the respondents were found to be utilizing stylostixis before so. The 3. 1 million of the American population claimed they merely pattern it majorly for terrible megrim and insistent hurting. The survey showed that half of the respondents used stylostixis to handle chronic cervix hurting ( Sun et al. 2009. p. 850 ) . The pattern should evidently be regarded by doctors as an ideal intervention penchant due to the backup it has received from those persons who have used it in the intervention of chronic cervix hurting. Subsequently. the survey did non curtail the grownups establishing on their gender due to limited research. CHRONIC NECK PAINChronic cervix hurting is an complaint that is characterized by hurting in the cervix that lasts for an remarkably long period of clip. normally over a period of three months ( Blossfeldt. 2004 ) . Although different from the common medical conditions of cervix strivings that last for lone yearss. chronic cervix hurting is typically an complaint that takes even old ages without success in its intervention in the mainstream medical patterns ( Irnich. 2002 ) . Chronic cervix hurting is normally associated with a figure of upsets. every bit good as diseases that can affect any of the tissues around the cervix ( Witt 2004. p. 99 ) . For case. the common causes of this status are strains of the cervix. hurt of the cervix like a herniated phonograph record. pinched phonograph record. or whiplash. and degenerative phonograph record disease. In add-on. chronic cervix hurting is besides linked to common infection like virus infection of the cervix and lymph nope swelling. eve ry bit good as other infections such as TB of the cervix. meningitis. and infection of spine castanetss around the cervix. Some patients besides had chronic cervix strivings caused by highly different causes. which include physical hurts. some rare infections. and virus infections among others. Further. chronic cervix hurting is besides caused by certain infections like virus infection of the cervix and lymph nope swelling. every bit good as other infections such as TB of the cervix. meningitis. and infection of spine castanetss around the cervix. RISK FACTORS OF CHRONIC NECK PAINSChronic cervix hurting is by and large caused by legion factors runing from physical hurt to certain infections around the cervix organic structure tissues. Since cervix hurting affects the musculuss around the organic structure countries of the cervix. it becomes painful to travel the cervix ( De Loose. 2008. p. 475 ) . In order to avoid or to forestall cervix strivings for the patients. it is ever indispensable to see remaining off from activities may writhe the cervix and later aggravate the already painful subdivision of the cervix ( Witt 2004. p. 99 ) . Therisk factors for the hurting normally include hurt from engagement in activities like motor vehicle accidents. Equus caballus siting. contact athleticss and bull equitation among others. devolution of cervical phonograph record besides known as Spondylitis. neck dead set and writhing places ( De Loose. 2008. p. 475 ) . In add-on. it is besides advisable to hold activities that will heighten ce rvix beef uping exercising. every bit good as cervix brace. cut down Television watching use of safety belts in motor vehicles and traveling to the gym for exercising. TYPES OF ACUPUNCTURE USED IN CHRONIC NECK PAIN TREATMENTOptimized stylostixis therapyThe pattern of optimized stylostixis therapy involves the use of traditional stylostixis. which is normally followed by intradermic needle therapy. normally referred to as INT ( Hush 2004. p. 1533 ) . The usage of OAT normally consists of the usage of nine stylostixis points typically selected for an optimized stylostixis therapy group on the advice and consensus of the national adept commission of the OAT processs. In this instance. four points are later located by physician meaning to execute the OAT. The points selected are normally the cervical positive reactions planes found in the top and underside of the cervical planes every bit good as horizontally off from the corresponding cervical vertebra ( Witt 2004. p. 99 ) . The survey found that this type of stylostixis pattern is extremely sensitive and therefore the demand to be performed by an person with more than five of pattern experiences Sham stylostixis therapyThe pattern is put into usage merely as a tool for control in the scientific research in order to mensurate the efficiency of existent stylostixis in assorted disease intervention. This type of stylostixis involves the usage of tegument perforating shallow acerate leafs on the specified fake groups’ stamp points. The stamp points that are used in this method of stylostixis therapy are categorized as the cardinal countries recommended for the stylostixis. which are the Ah Shee. besides referred to as oh yes point . The points are important in this therapy and have to be used throughout the intervention process. Typically. the location of fake points is normally defined by 25mm sidelong widening to the standard location used for the OAT group. They include: the assumed point of Dazhui ( GV14 ) 25mm. which is 25 millimeter vertically below the usual criterion GV14. fake points of ( S115 ) Jianzhongshu and Huatuojiaji. which is 25 mm sidelong to standard S1 15 ( Liang et al. 8 ) . After the assumed stylostixis. persons undergoing the procedure or patients are treated through the usage of point pressure ( De Loose. 2008. p. 475 ) . The findings show that a patient does non detect whether it is assumed or existent stylostixis being used. The consequences showed that the fluctuation between existent and assumed patterns are caused by addiction or the control effects. If the existent stylostixis is efficient compared to the fake. so the addiction and control effects such as outlooks of the patient. behaviour and beliefs are present. Shallow stylostixis therapyShallow stylostixis group undergoes similar processs as the other OAT groups. However. the doctors are required to infix the acerate leafs in a perpendicular mode in order to make the hypodermic degree at a specified deepness of non more than 3 millimeter ( Salter et al. 2004 ) . Needle use or any other esthesis is prohibited in this peculiar group. Ultimately. after the shallow stylostixis. the patients are to boot treated by INT through the usage of a similar method as in the other OAT groups. It was found that the therapy do non to the full handle the hurting to the full due to its shallow incursion hence the demand for extra intervention that follow the same processs. It consequences to a more efficient intervention in comparing to other therapies though takes much clip ( Salter et al. 2004 ) . ACUPUNCTURE AS AN IDEAL METHOD COMPARED TO PHYSIOTHERAPYZhuang ( 2012 ) ; Robertshawe. ( 2008 ) . compares the usage of stylostixis and physical therapy in the intervention of chronic cervix hurting in a research that took topographic point in China. The research involved showing of a sum of 310 patients. The patients were so indiscriminately split into two equal groups. where one group was treated utilizing stylostixis method. while the other group received intervention through physical therapy. The result of the intervention of the two processs revealed that patients treated under stylostixis processs had better consequences in alleviating cervix hurting. peculiarly after a period of three months. It is indispensable to admit that physical therapy is an alternate medical pattern that can be used in the intervention of chronic cervix hurting. While stylostixis therapies by and large used sterilizes acerate leafs that are normally inserted in the country around the cervix depending o n the type of stylostixis used. physical therapy does non affect the usage of acerate leafs. Physiotherapy utilizes several types of use every bit good as exercising to alleviate hurting. The common illustration of the usage of physical therapy is the stretch. strengthen and unbend up exercising motions of the cervix ( Robertshawe. 2008 ; Willich. 2006 ) . Effects OF ACUPUNCTURE TREATMENTWhite. ( 2001 ) ; Ji-Eun. ( 2010 ) . researched about the inauspicious effects following a usage of stylostixis to handle patients with chronic cervix hurting. In his study. which included a prospective study of 32. 000 audiences with physical therapists and physicians. the research worker. Adrian White aimed at determining the incidence of inauspicious effects that are related to acupuncture intervention. as practiced by British physicians during that clip. The research utilised informations that were collected for the June of 1998 to February of 2000. from a sum of 78 acupuncturists. Altogether the resulting important effects were 43. later giving merely a rate of merely 14 patients of the 10. 000 patients included in the information. The consequences of this survey showed that merely 0. 14 per centum of the patients who used stylostixis in the intervention of chronic hurting experience inauspicious effects ( White. 2001 ) . All the inauspicious effe cts were reported to hold had cleared within the period of one hebdomad after the therapy. Similar decreasing effects were characterized at a longer period. except for merely one incident that lasted for several hebdomads. The consequence derived from the information of stylostixis intervention did non describe any serious inauspicious effects. The rates can merely be classified as minimum sing that it was merely 14 inauspicious effects out of the entire 10. 000 patients who were analyzed with the informations provided ( White. 2001 ; Ji-Eun. 2010 ) . By and large. these consequence rates do non give important hazard per single patient. Recommendation ON ACUPUNCTURE’S VIABILITYThe article by Chen. et Al. . ( 2010 ) . offers sole positions on stylostixis given by assorted doctors. The research by Chen among other writers who contributed to the article. there study marks roll uping information that addresses the function of stylostixis in the direction of hurting in respect to sentiments of doctors who manage such conditions. The research was conducted between 2007 and 2008 utilizing a countrywide electronic mail to 1083 doctors who were in active stylostixis pattern in the United States. Chan et Al. . ( 2010 ) found that the overpoweringly bulk of the respondents of the study had a positive attitude and favourable experience of the usage of stylostixis as an alternate mode in the direction of chronic hurting. The consequences of the study later indicate that stylostixis is considered effectual by doctors in the direction of chronic cervix hurting. CASE STUDIES: Acupuncture for patients with chronic cervix painWitt et Al. . ( 2006 ) undertook the survey in analyzing how effectual stylostixis as an alternate intervention for cervix hurting intervention in comparing to patients who used everyday medical attention. The survey used a random attack of more than 14000 persons aged above 18 enduring from cervix hurting symptoms within a period of 6 months. Besides took a non-acupuncture for 15 Sessionss within a period of 3 months. The stylostixis class were given injections without any other stylostixis intervention. The group which was controlled was non treated utilizing stylostixis but both groups could utilize any other manner of intervention. The survey found out that patients utilizing everyday attention and add on stylostixis intervention showed important betterments in both hurting and quality of their lives in comparing to patients who merely used everyday interventions. Therefore. the consequences concludes that stylostixis can be used aboard everyday interventions to accomplish optimum consequences. Efficacy and safety of acupunctureVas. et Al. ( 2006 ) conducted a survey to set up the effectivity of stylostixis vis a vis placebo. Both methods were to be utilized to handle chronic cervix strivings that were non complicated. ( N=123 ) patients. who were over the ages 17 and who possessed chronic cervix strivings for over 3 months were used. They were indiscriminately selected into 2 groups. the stylostixis group and placebo group. For 3 hebdomads. the stylostixis group was treated with 5 stylostixis interventions. The intervention features were. 30 proceedingss intervention followed by 10 proceedingss manual interventions. While the placebo group was subjected to transdermal nervus stimulation. which was characterized by 30 proceedingss of intervention and the potentiometer was being adjusted after every 10 proceedingss. The findings from this survey were that. stylostixis as a signifier of cervix intervention had minimum side effects. For overall effectivity. stylostixis was found to hold higher effectivity than placebo. Researchers once and for all said that. stylostixis was effectual. DISCUSSIONIn its wide context. this research has dwelled in covering all the related stuff on stylostixis and particularly its effectivity in intervention of stylostixis. Most are the surveies which have found considerable effectivity and a few surveies have found less important betterment in stylostixis usage. The research workers ( salter et al. 2006 ; Liang et Al 2012 ; Chen et al 2010 ; vas et al 2006 ) have favourably recognized stylostixis as an effectual non-conventional intervention method. From the reappraisal above. it is apparent that all the methods of stylostixis are effectual in intervention of chronic cervix strivings. Sham. optimisation and shallow stylostixis all have a capacity of effectivity when administered good. The assorted surveies by salter have provided solid practical grounds and information on patients’ wellness upon utilizing all the three types of stylostixis in intervention of patients and persons ( salter et al 2004 ) . For illustration in 2007. a national wellness interview study in America found that. 1. 4 % of respondents have used stylostixis to handle chronic cervix strivings. That per centum reported success. which is a testament to stylostixiss effectiveness ( National Center for Complementary and Alternative Medicine 2012 ) . ( Blossfeldt. 2004 ) in his research notes that. acupuncture optimized technique success rate was a favourable 68 % . Blossfeldt besides noted that. on short term footing. stylostixis was 78 % effectual. while on long term footing it was 49 % effectual. Salter besides found out on effectivity of stylostixis. The cervix hurting questionnaire that he used for a period of 3 months. found out that. of the 34 % of the patients who have cervix strivings. 14 % of these have efficaciously used stylostixis therapy ( salter et al 2004 ) another research worker Liang. who conducted surveies in China in association with other bookmans. they found out that optimized stylostixis as a method of handling chronic cervix strivings was really effectual. Although I extensively performed research on a broad scope of databases. there are some articles that may hold been missed out. Since I was separately carry oning this research entirely. it is possible that the big figure of important articles were later overlooked. In add-on. there are many external factors that could hold influenced the full consequence of the usage of stylostixis as an ideal intervention for chronic cervix hurting. The bulk of surveies somewhat differ in a figure of issues such as informations collected. population. or any of combinations of these factors. White ( 2001 ) exactly researched about the inauspicious events following a usage of stylostixis to handle patients with chronic cervix hurting. with an utmost figure of respondents. Chen. L. et Al. . ( 2010 ) . had a comparatively smaller figure of respondents. and besides had aggregation of informations to be collected merely through electronic mail in his research on the effectivity of stylostixis in the dire ction of chronic hurting in the cervix. These are some of the factors that were out of the range of the research. hence finding the effectivity of stylostixis was hard. since the facet of effectivity could easy be isolated from some external factors. The analysis of the specific information provided by the surveies of the literature reappraisal of this research paper indicates that either of the three methods of stylostixis can efficaciously handle the chronic cervix hurting. The procedural pattern of fake. shoal and optimized stylostixis. though different. they present similar manner of executing the stylostixis therapy. every bit offering effectual intervention for chronic cervix hurting. Liang et Al. ( 2012 ) asserts that the three types of stylostixis to be based on the idea that lessening or disaffection of hurting can be enhanced by let go ofing the chemicals responsible for barricading hurting. Issues of age in the survey have been considered as the research merely focused on persons between 21 old ages old and 55 old ages. as they are likely to hold a faster period of mending as compared to adult aged groups of more than 55 old ages old. By and large. the usage of stylostixis is illustrated every bit effectual as it has a ntecedently been used to handle patients with chronic cervix hurting. The loopholes evident in the research include the possibility of a anterior cognition in finding the differences that may emerge upon consideration for gender in the intervention plan. In the full survey. there is no individual account of the ratio of females against the males in happening out the effectivity of stylostixis intervention processs. The survey focused on a general position of patients with chronic cervix hurting regardless of their several sex or gender. The cognition of the differences that exist between males and females could hold some effects on the understanding the usage of stylostixis. In add-on. the paper did non concentrate on the causes of the assorted cervix hurting. which could besides compromise the consequences of the survey. sing that such programs are typically attributed to a broad assortment of causes. Subjects that can be considered for farther research are set uping the component of gender in finding the effectivity of stylostixis while handling chronic cervix job. The assorted surveies illustrated in the research paper did non indicate out the importance of understanding differences in the healing procedure of male and female patients with chronic cervix hurting. I suggest a survey be conducted with a major accent on the facet of gender differences between patients in order to find the effectivity of stylostixis intervention for cervix hurting in male and female patients. If this survey is conducted. it will be possible to compare the effectivity of stylostixis intervention between male and female patients within the same wellness status of chronic cervix hurting. Mentions Blossfeldt. P. ( 2004 ) . Acupuncture for Chronic cervix hurting: a cohort survey in an NHS hurting Clinic. 22 ( 3 ) : 146-151. Retrieved from hypertext transfer protocol: //www. ncbi. nlm. National Institutes of Health. gov/pubmed/15551941Chen. L. . Houghton. M. . Seefeld. L. . Malarick. C. A ; Mao. Jianren. ( 2010 ) . A Survey of SelectedPhysician Positions on Acupuncture in Pain Management. 11 ( 4 ) . 530-534 Salter. G. C. Roman. M. . Bland. M. J A ; MacPherson. H. ( 2006 ) . Acupuncture for chronic hurting: apilot for randomized controlled test. 7 ( 1 ) : 3-14. Retrieved fromhttp: //www. biomedcentral. com/1471-2474/7/99 Liang. Z. H. . Di. Z. . Jiang. S. . Xu. S. J. . Zhu. X. P. . Fu. W. . A ; Lu. A. P. ( 2012 ) . The optimizedacupuncture intervention for cervix hurting caused by cervical spondylosis: a survey protocol of amulticenter randomized controlled test. 13 ( 1 ) : 2-18. Retrieved fromhttp: //www. ncbi. nlm. National Institutes of Health. gov/pubmed/22776567 American Academy of Orthopaedic Surgeons. ( 2013 ) . cervix hurting. Retrieved fromhttp: //orthoinfo. aaos. org/topic. cfm? topic=a00231Chen. L. . Houghton. M. . Seefeld. L. . Malarick. C. . A ; Mao. J. ( 2010 ) . a study of selected physician positions on stylostixis in hurting direction. Pain Medicine. 11 ( 4 ) . 530-534. Retrieved from SPORTDiscus. De Loose. V. . Burnotte. F. . Cagnie. B. . Stevens. V. . A ; Van Tiggelen. D. ( 2008 ) . Prevalence and hazard factors of cervix hurting in military office workers. Military Medicine. 173 ( 5 ) . 474-479. Retrieved from Academic Search Premier. Hush. J. M. . Michaleff. Z. . Maher. C. G. . A ; Refshauge. K. ( 2009 ) . Individual. physical and psychological hazard factors for cervix hurting in Australian office workers: a 1-year longitudinal survey. European Spine Journal. 18 ( 10 ) . 1532-1540. Retrieved from Academic Search Premier. Irnich. D. . Behrens. N. . Gleditsch. J. M. . Stor. W. . Schreiber. M. A. . Schops. P. . A ; †¦ Beyer. A. ( 2002 ) . Immediate effects of dry needling and stylostixis at distant points in chronic cervix hurting: consequences of a randomized. double-blind.

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Response Memo - Case Study Example nly receive the various biometric systems that we manufacture, but also ensure that we carry out follow up procedures and installations to ensure the effective working of these systems. It is critical to go through the responsibilities of my subordinates for it allows for the understanding of their operations, review their character and abilities and also advise on the best manners through which they can improve in their roles. The first assistant operating officer is one of the major characters that work with me in the organization. As a chief operating officer, I have the task of reporting to the board the various activities that the company engages in. In addition, I ought to gauge and report on the performance of the junior staff. This information is gathered from carrying out various rounds in the organization and seeing their performance. The first assistant operating officer has the responsibility of reporting to me in the case of employee negligence or any other form of hiccup that may hinder full functioning of the organization. The first assistant officer also reports to me on the various market trends that take place in the technology environment and through this I have the ability to make recommendations to the board regarding the functioning of the organization and the changes required. The second assistant operations manager handles the research part of an organization (Stair 26). By going through magazines and mobilizing personnel that receive payments through commission, these officer reports to me on changes that other competing firms incorporate in their functioning. Such information is very important for an organization and this is because competitors are very innovative and have the ability to incorporate new strategies that may deem my organization slow in development. Understanding the changes brought about by these organizations is effective for it allows ID Security Inc to carry out appropriate measures and offer new inventions in the

Marketing research Essay Example | Topics and Well Written Essays - 2000 words

Marketing research - Essay Example Moreover on its growing popularity Skitka and Sargis (2006) stated that in 2003-2004 American Psychological Association Journals had at least one article published that used web based data collection. Web based survey gained popularity at accelerated pace. Lyons, Cude, Lawrence, and Gutter (2005) mentioned that web based surveys provide greater benefits as compare to traditional methods of paper –pencil or telephonic surveys. Most frequents benefits associated with online survey are efficacy, specific to time and money, huge data availability, less response bias etc while biggest demerits associated with this kind of survey are reliability and validity of the research (Vereecken, 2001). This ease of conducting survey is being witnessed in two domains; first, reduced cost as it is relatively less expensive and cheaper to get the required data through online survey. Second, the ease provided by the online survey, in getting one’s customers’ feedback has provided sm all companies an opportunity to conduct survey which was earlier confined with companies having large marketing and research budgets. Companies now use this option on constant on-going basis to keep customers intact with their websites; hence, it has become an important tool to keep bringing traffic to the websites that on one side brings in revenue from advertisers as well as constantly upgrades data-bank regarding changing customers’ thought patterns. On most prominent feature of the web based survey is characteristics of population it uses to get responses. At an instance, where internet based population provides access to virtual groups and communities this feature can also turn as disadvantage (Wright, 2005). With lack of control on environment it gets difficult to verify participants. For instance, verification of age, status etc is not possible. Similarly, one cannot verify if the participants are actually eligible for the response e.g. minors responding to surveys des igned for adults etc or people are participating frivolously or maliciously in a way that could undermine the integrity of the study (Garrick, 2009). RESEARCH PROBLEM: Web based survey has taken an extensive importance in business research as well as business enhancing tools. With the growing popularity of web based research there has arisen many problems with it more specifically with the main component of research .i.e. population (Litvin and Kar, 2001). For every product there is certain group of customers who do not participate in online surveys and hence, their liking, disliking or in general their opinions are left unattended. Therefore, there arises a problem to cater the suggestions of that particular group of people (Yun and Trumbo, 2000). Hence, the research problem this study is aimed to address is finding if any difference exist in response of people in online surveys and other surveying techniques. Internet usage has grown in multiples in past years and the pace is stil l growing, however there is still certain percentage of population that do not use internet. The objective of this research is to explore the fact that how much similarity exists in the responses of customers through online surveys and through other survey techniques. This study will explore an entirely new domain for researchers as well as businesses. Similarity in results would benefit the research organizations to divert their resources (expertise) more towards web based resources. On contrary to this, if

Globalized Homogeneous Society And Culture In Nepal Cultural Studies Essay

Globalized Homogeneous Society And Culture In Nepal Cultural Studies Essay The dictionary of sociology defined the term, homogeneous as the same in structure, quality etc.; similar or identical or composed of similar or identical elements or parts; uniform. Theobald (1994) suggested that etymologically, the word tour is derived from the Latin tornare and the Greek tornos, meaning a lathe or circle; the movement around a central point or axis. This meaning changed in modern English to represent ones turn. The suffix -ism is defined as an action or process; typical behavior or quality whereas the suffix -ist denotes one that performs a given action. When the word tour and the suffixes -ism and -ist are combined, they suggest the action of movement around a circle. One can argue that a circle represents a starting point, which ultimately returns to its beginning. Therefore, like a circle, a tour represents a journey that is a round trip, i.e., the act of leaving and then returning to the original starting point, and therefore, one who takes such a journey can be called a tourist and whole process known as tourism. In a simple word, globalization is a process by which product and capital markets, economies and cultures are getting progressively integrated on global scale. There are many ways of globalization around the world and no doubt; tourism is a means of globalization. Tourism is an important transmitter of globalization in Nepal. It has significant impacts on societies and cultures in the destinations. It seems a process of acculturation or westernization or Americanization and leads globalized homogenous society and culture. It has been a major source of intercultural contact. Globalization leads to socio-economic and cultural changes in Nepal. Regarding tourism, the impact is differentiated culturally, socially and economically on globalization. According to Robinson, there has been little evidence that tourism brings the world together. Further, he states, tourism is one globalization influence that can initiate dramatic and irreversible changes within the cultures of host communities (Robinson, 1999, p.22). While there is agreement that culture has become increasingly global (Hannerz, 1987; Lechner, 1989; Featherstone, 1990; Robertson 1992), few scholars defend the thesis of a global culture (McLuhan, 1964; Schiller, 1976; Levitt, 1983; Sklair, 1991). Most sociologists (Guillà ©n, 2001) reject the idea that a homogenizing global culture is in the making (Mazlish, 1993; Friedman, 1994; Appadurai, 1996; Geertz, 1998; Held et al., 1999; Inglehart and Baker, 2000). It is clear that a globalization of culture does not necessarily lead to global cultural homogeneity. Micro-phenomenological and conventional cultural models stress the tradition-based resistance of local life to the exogenous pressures of modernization (Meyeret al., 1997). Others point towards diversification in the form of hybridization (Nederveen Pieterse, 1995) or glocalization (Robertson, 1992) of world culture. However, they miss the extent to which, in the contemporary world, the local is itself cosmopolitan (Hannerz, 1987). Again, some scholars strongly argue that globalization leads to a homogenization of culture for example, Giddens (1997:64), who sees it in terms of growing economic and cultural interdependence. In General, it is very difficult to find out what process is there (in Nepalese culture and society), acculturation or Westernization or homogeneous or globalised homogeneous? Respondents opinions were different according to geographic regions, villages and cities. People from cities like Kathmandu, Chitwan, Janakpur and Lumbini have different experiences than Khumbu, Annapurna and Pokhara. A respondent nearby Bouddhanath in Kathmandu said: Everything has changed; you will not get any typical local cultures in this area. People are directly connected to tourist and have to fulfill the demand of tourist. Therefore, they has been using foreign languages, fast food and drinks (pointing to the Coca Cola in shop) but now it turned to habits and not easy to leave these things at present. I totally do not believe, tourism is only one factor for this phenomenon, the actors of globalization are more responsible for it. For example, I use English more than Nepali, in one hand tourism is responsible because my profession is related to this field, but, in other, I listen English songs, watch English movies and many more because without English we ( specially Nepali people) will not grab any better opportunities. A respondent in Themal Kathmandu Actually, the Thamel and Lakesied lifestyle has always attracted western travelers, because they have been getting any things like in western societies, like disco hall, music and movies, food, dress, drinks etc. Even local people are happy to use English language than Nepali. For us it is normal, to celebrate western festivals like Christmas, New Year, concerts, valentines day etc, because we are in touristic area and we must do these things. Again, we are learning some new culture. A respondent in Lakeside Pokhara In the tourist regions and groups most affected by tourism, aspects of a globalized culture are evolving and a special reconstruction of Nepalese culture for tourists is performed. Other groups react against this by re-inventing Nepalese traditions. Tourists themselves enjoy a combination of globalized and reconstructed Nepalese culture, though not willingly and able to understand negative Nepalese reactions and reinvented traditions. This section will describe the impact of tourism based on globalization, on Nepalese society, culture and economy; and how it creates globalised homogeneous society and culture in Nepal. Based on primary data, socio-cultural structures have changed considerably under the influence of tourism in Nepal. Those changes, both positive and negative, have varied from place to place. Tourism has contributed to social and cultural changes in host societies, including changes in value systems norms, traditional lifestyles, cultures, family relationships, language, models, individual behaviour or community structure in Nepal. The responses of the hosts in the face of these modifications have been quite diverse and complex, ranging from an active confrontation to a complete acceptance of Western culture. The choice of strategies to cope with changes wrought by tourism depends on the socio-cultural characteristics of the host community and the level of change affected by tourism. It is suggested that earlier homogeneous community characterized by a specific response to tourism becomes varied and groups exhibiting different responses to tourism emerge within the community because of touristic developments. Tourism makes connection between local to global people. It affects the change in societal norms and values in favor of Western or American norms and values. It is destructing the indigenous culture, system, tradition, social norms, value system, daily life, language, food, drinks, dress and many more through the process of homogenization under state patronages and later creates globalized homogenized society and culture. When local Nepalese, meet with the Western or American norms and values through tourist and globalization have begun to look down upon their own traditional norms and values due to the influences of Western and American norms and values. This situation is not only seen in tourists areas but also into remote villages as well. Needless consumer production of Multinational Companies such as disposable diapers, baby and canned foods, blue jeans, two-wheelers and four-wheelers, fast/junk foods, imported liquors, soft beverages, soft drinks ( like Coca-Cola, Beer), electr onic products are consumed/used by urban Nepalese. The very complex impacts of tourism on Nepalese are discovering new types of culture, society, values, norms and traditions, which contains their own traditional and Western or Americans. This looks like new but combination of local traditional and foreign cultures, values, societies, living style, food and drinks, language and many more. Here are some facts found by researcher during his study time; majority of Nepalese in tourists hubs are intending that that individualism is good, but communication is bad, that Christianity is good but Animism, Lamaism, Hinduism, and Buddhism are bad. Similarly, drinking local beer ( Chyang and tongba), Mohi, Lassi (A kind drink made by Yoghurt) and milk are bad but drinking Western Beer, Wine, Whisky Coca-Cola and imported dust milk are good, that riding car is good but walking/ trekking is bad. Similarly, CNN and BBC are the reliable news sources but not National channels are not, English or foreign movies are best but not owns, again best educa tion is available in USA, U.K., Germany, Australia, and Canada but not inside country. On the basis on data, the researched concluded that, it is interesting that due to impact of tourism by the process of globalization, two things are happening in Nepalese society and culture: a globalized homogeneous are developing and at the same time Nepalese cultures are reconstructing on local levels ( for tourist but also as identity building and national politics). The researcher has analyzed various variables to prove, tourism has created globalized homogeneous society and culture in Nepal. The researcher has collected data on family structure of local respondents. The traditional family structure of local people was joint family headed by father or mother. After introduction of tourism, people knew that single family is good and easy to manage than extend family. After that, the structure of joint family has been changing in to the nuclear family. The history and literatures says; the nuclear family has started from Europe and America after industrial revolution. Most of the natives especially new generation who are working in tourism are interested to stay in nuclear family instead of joint or extend family. The research has found, tourism is one cause of the cause of single (nuclear) family; because they are busy than others profession and cannot give time for their family members. This types of data proved that Nepalese family structure is not different form European and American. Gambling, prostitution and drug abuse were not found in the history of Nepalese civilization. Somehow, it was exist unknowingly in high-level family like Rana and Royal, because these are socially prohibited activities and still these are socially prohibited. After introduction of tourism, such activities were found in touristic areas. At the beginning, the Government and local societies ignored those activities due to tourism industry and gradually these activities were increased dramatically. Now it is big problem for Nepalese society. Gambling, prostitution and drug abuse are directly related to tourism in Nepal because tourism is the key factor of those activities. Such activities are more in touristic hubs of Nepal and slowly expanding to the all-major cities. The answer given by tourist from USA in Thamel: I was surprised when I was walking in Thamel, Kathmandu, I feel I was walking in some street of Las Vegas of USA and walking street in Thailand. Nepal is not so for from sex tourism. Similarly, in the case of gambling, some countries found to manage gambling for the foreigners in their countries. In this aspect, Los Vegas of America is a famous gambling center in the World. Such types of facilities are mostly found in Hotel in Nepal. But, Nepal government do not have any rules against local people to involve in such activities. Major touristic areas of Nepal like Kathmandu, Pokhara and Chitwan such activities has been increasing especially Young locals. Which prove that tourists places of Nepal is not different from American and European touristic places. This could be an example of globalised homogeneous society and culture created by tourism in Nepal. The next variable of globalised homogeneous society and culture in Nepal is language. Nepalese society is ethnically varied and multifaceted (complex). In Nepal, there are 61 ethnic cast group and they speak different languages. Languages, cast religion, and dress are different according to geographic regains. Formally, most of people in different geographical regions communicate each other in their own language. After introduction of tourism in communities, all indigenous people, who have opened hotels, restaurants, souvenir shops, travel and trekking agencies are, have to speak foreign languages for their business. Similarly, the local guide and all workers related to tourism should speak English and other foreign language. Therefore, there are huge demand of such persons able to speak English and foreign language. To get better opportunities people started to learn foreign language. Most of the people had started to learn foreign languages with tourists because they did not have language center in their society, for this work, different International and national organization has been helping them. I have been working in tourism more than 30 years, I do not have any schooling education in foreign languages, me and my family members can speak English very fluently, not only in business we use English at home also. Even my son can speak German, French and Japanese except English, we learnt it from tourist. A father with his family members in Thamel Kathmandu Furthermore, majority of the indigenous people involved in tourism can understand communication easily with the tourist in different foreign languages. Nowadays the youngsters are gradually adopting to speak English and foreign languages in their daily activities too. These changes in people are because of the involvement in tourism and enable to speak English and other languages in their daily activities. However, nowadays people are happy to use English rather than their own language. Most of the people are using mixed Nepali language: Nepali plus English. The researcher has found most of local people are using broken language; English plus Nepali in the study areas. It is proved that, people are using neither their own language correctly nor foreign. They introduced new types of mixed language for their daily life. Therefore, westernization in language is seen clearly in Nepal. It will be certainly happen that in future large number of the Nepalese will use English language in the ir daily life. This could be the best example of globalized homogeneous society and culture, because English is spoken all over the World as international language. Similarly; Food, drinks, dress, marriage and lifestyles are other important variables to discuss on globalized homogenous society and culture in Nepal. The food of Nepal is as diverse as the country itself, it is easy to cook and good to eat and famous for its nutrition level and tempting taste. Dal Bhat (Pulses and rice), Roti (flat bread), Gundrook- Dheedo (wheat, maize porridge and dried green vegetables) are common food. In addition, milk, Rakshi, Tomba, Mohi, Lassi (A kind drink made by Yoghurt) are common drinks in Nepal. After introduction of tourism, local people were forced to make varieties of foreign food to fulfill tourists demand. Gradually, local peoples food items were changing in to foreign food. Nepalese neither changed their local food totally nor accepted foreign food. Some new types of food were introduced, having both qualities form local and foreign food. However, majority of local people were happy to consume modern foreign food and drinks, like Biscuits, Noodles, sweets, Pizza, Pasta, Burger, Cake, Coca-Cola, Pepsi, Western Beer, Wine, Whisky and many more food and drinks. Even people prefer to go to the hote ls and restaurants rather than at home. Our children are growing their hair out, and the evening, when they leave the Patan, each carries a bottle of Coca-Cola and fast food in their hand. Nowadays, there is a rebellion against family values. I grew up with a different lifestyle than my son. When I talk to him: look my son; he is Badmasi (a bad people in Nepalese sense); you have to respect our traditions, cultureà ¢Ã¢â€š ¬Ã‚ ¦, he said; do not worry. But, they never care on it. I am afraid that they are importing some bad values and customs, thats why I moved away from here. A respondent in Patan Durbar square, Lalitpur Regarding to Nepalese dress, Daura-Suruwal and Topi (Nepali Cap) for men and Sari (Gunyo), Choli for women in general but men use Shirt, Pant, and women use Kurtha-suruwal also. People who have connection with tourist are using different types of western fashion like jeans, metallic clothes, t-shirt of Bob Marley, Michael Jackson, WWE superstar and some junky dresses. Such condition is worst in women; they are happy with modern boutiques, tight jeans and with two pieces of clothes seem undressed, which is not acceptable in Nepalese society, such things are found more in tourist areas. Similarly, arrange marriage has been considering as the best marriage system in Nepal in the past even today. However, the idea of romantic love has seeped into the mentality of youngsters. This is a result of external influences, among them tourism and movies. They prefer love marriages, where they can choose their own mates. Sometimes their own choosing results in inter-caste and inter-community marriages. Except for one reported case, cross-cultural marriages are rare in Ghandruk, Khumbu, Chitwan, Kathmandu and Jankpur as compared to the Armapuma region and Lumbini, where such marriages are more frequent. Overall, tourists remain a fascination for youngsters, along with their material wealth and ideas about conjugal matters. In other cases, the tourist ends up marrying native people in Khumbu, Annapuran, Kathamndu, Pokhara, and Chitwan etc. The new generation of such couple has both mixed culture; foreign and local, which is one of the key factor to introduce a new type of globali sed homogenized society and culture in Nepal. The influxes of tourists have had major effect on the local communities, particularly on the indigenous people like Sherpas Rai, Gurung, Tamang, Tharu (a Nepalese ethnic group), who live around the trekking routes of Khumbu, Annapurna region and Chitwan. The culture of those indigenous people has been changed as well as the structure of the local economies. Here is a comparative chart between traditional and globalised Nepalese culture before and after tourism. Before tourism (Traditional) After tourism (Globalised) Family structure ( Joint or extend family) Gambling, prostitution and drug abuse were not found. Traditional Nepali and other Languages according to Region and cast. Traditional food and drinks; Dal Bhat, Roti, Gundrook- Dheedoand milk, Rakshi, Tomba, Mohi, Lassietc. Dress; Daura-Suruwal, Topi, Shirt, pant for men and Sari (Gunyo), Choli and Kurtha-suruwal for women. Nuclear family Gambling, prostitution and drug abuse can be found everywhere especially more in tourist places. Mixed (Nepali and other foreign) languages, and majority of people speak English in their daily life. Globalised food and drinks; Biscuits, Noodles, Chocolates, Pizza, Pasta, Burger, Cake, Coca-Cola, Pepsi, Western Beer, Wine, Whisky and many more. Dress; western fashion like jeans, metallic clothes, t-shirt of Bob Marley, Michael Jackson, WWE superstar. Tourism still has impact on local society and culture in Nepal. Participants report that tourism has more contradicted religion and traditions, while some of them expressed the fear of potential impact on younger generations. Such sentiments were centered near Khumbu and Annapurna, where the impact on society and culture are more present than in the other sites. Among the negative impacts reported in study, areas are; the consumption of alcohol, the imitation of tourist behaviour and sexual relations with tourists, increasing foreign food, dress, drug, language, gambling and unwanted lifestyle change. Yet, as we have already seen, if anything characterizes developments such as those mentions above, it is their particularism. In my opinion, it would be a mistake to read this particular case as an example of global cultural heterogeneity. As representing some more authentic cultural voice, that has its roots somewhere outside global culture. A number of theories of the global condition are eager to point out that the current phase of cultural globalization neither implies that we are merely witnessing a new kind of cultural imperialism not means that world cultural is becoming more homogeneous. If anything, the current phase of globalization is characterized as much by cultural differentiation as it is by homogenizing process. Therefore, I can say by looking answers given by respondents, tourism is an important transmitter of globalization in Nepal, due to tourism two things happened in Nepalese society and culture: a globalized homogeneous culture develops but the same time Nepales e cultures are reconstructed on local levels.

A Comparison of My Last Duchess and Porphyrias Lover Essays -- Robert

"My Last Duchess" is a poem about an arrogant and extremely powerful Duke who is describing his deceased Duchess. From the word "last" in the title it is implied that the duke has had more than one duchess. In this poem, the Duke is extremely egotistic. He says, "I choose never to stoop." The duchess would look at everyone in the world as being equal no matter what class they are. The duke however cannot do this. He is too worried about his appearance. "Porphyria's Lover" is a poem in which a man describes an evening in which his lover, Porphyria, visits him and he unexpectedly murders her. In this it is unlike "My Last Duchess" because Porphyria 'worships' her lover unlike the Duke From the title "My Last Duchess", we immediately learn that this is a personal poem to the duke. It is a love and murder poem. It is a dramatic monologue and is written as a single stanza. Both poems also have a silent listener. In 'My Last Duchess' the silent listener is the Ambassador for the Count, who is the father of the Duke's next bride whereas in 'Porphyria's Lover' the silent listener could be a number of people it could be a police officer, or he could just be telling the story to a friend. There is no evidence in the poem, which tells the reader who he is talking to. The tone in these poems is important as it acts as a contrast to the content of the poem. In "My Last Duchess", Browning uses a soft tone and describes the Duke having the Duchess killed subtly, " This grew; I gave commands;/ Then all smiles stopped together." Browning describes this without changing the tone. However in "Porphyria's Lover" the tone is normal and soft throughout the poem until the point in which the Lover murders Porphyria, "I... ...both of the characters kill their lovers. "She was mine, mine, fair,/ Perfectly pure and good". This is what the lover said before he killed Porphyria. He kills her because at that precise moment in time he has complete power and control over Porphyria and wants to preserve this. Browning uses a simile extremely effectively in "Porphyria's Lover" to describe the body of Porphyria. He says "As a shut bud that holds a bee". This gives the reader the image that her soul is still alive but her body is dead. The bud is shut and the bee is still alive inside of it. Overall, I found these poems both quite enjoyable to read. I enjoyed "My Last Duchess" less than I enjoyed "Porphyria's Lover". This is because the murder in "Porphyria's Lover" was so unexpected and a shock whereas in "My Last Duchess", it was written more subtly giving it less excitement.

Baccalaureate Nurses vs. Associate Nurses Essay

Is having a Baccalaureate Degree in Nursing (BSN) better than an Associate Degree in Nursing (ADN)? Why should nurses get a BSN? Many nurses ask themselves these questions. Hospitals are pushing for nurses to advance their education. If there is an ADN nurse and BSN nurse applying for the same position most likely the BSN nurse will receive the job before the ADN nurse because â€Å" the additional course work enhances the student’s professional development, prepares the new nurse for a broader scope of practice, and provides the nurse with a better understanding of the cultural, political, economic, and social issues that affect patients and influence health care delivery† (â€Å"American Association of Colleges of Nursing,† p.1). Different Education Routes for Nurses Diploma graduates, Associate graduates, and Baccalaureate graduates are the three education routes for licensures of Nurses. Even though all three programs sit for the same National Council Licensure Examination for Registered Nurses (NCLEX-RN), this exam verifies only â€Å"minimal competency to provide safe, basic care† (Haverkamp & Ball, 2013, p. 144). ADN vs. BSN Competencies Many say that Associate nurses are trained strictly on clinical skills, whereas Baccalaureate programs â€Å"emphasize evidence-based clinical practice and leadership through course work that includes research, statistics, population-based care, nursing management, and the humanities† (Haverkamp & Ball, 2013, p. 144). This meaning that, Baccalaureate nurses receive training that allows them to look at the whole picture, like why and how things happen and what they can do to prevent them. Associate nurses as a Member of the Health Care Team, â€Å"refer patients and their families to resources that facilitate continuity of care; health promotion, maintenance,  and restoration; and ensure confidentiality† (Texas Board of Nursing). Whereas a Baccalaureate nurse as a Member of Health Care Team, â€Å"use multiple referral resources for patients, families, populations, and communities, considering cost; confidentiality; effectiveness and efficiency of care; continuity and continuum of care; and health promotion, maintenance, and restoration† (Texas Board of Nursing). Patient Care Situation An example in the difference of education between Baccalaureate nurses and Associate nurses is shown here. The patient was admitted for Diabetic Ketoacidosis, not taking home medication because he was homeless and lacked health insurance. Nurse A, admitted this patient and cared for the patient for three days. On the third day the patient was to be discharged, keep in mind this patient came to the hospital because he is a Type 1 diabetic and was admitted for Diabetic Ketoacidosis and was not taking any of his insulin because he could not afford them. Upon Nurse A telling the patient he was going to be discharge the patient became irritated and started to become angry and stated â€Å"I am homeless, how am I suppose to pay for my medications that I need, and I will just come right back to the hospital because I won’t be able to take any of my medications.† Nurse A, being an Associate nurse thought to herself what am I suppose to do? Nurse A then stated to the patient â€Å"The doctor has discharged you so you are medically stable to leave.† Nurse A explained to the patient that the doctor wrote prescriptions for him to take and fill so that way the patient would have his medication. Again the patient stated â€Å"How am I suppose to pay for my medication if I am homeless and have no money.† Nurse A was stuck in what she needed to do. So during morning rounds with Case Management Nurses which carry a BSN, Nurse A expressed the patients concerns and their response was well let us take a look at every resource that we have and maybe we can voucher his medication for one month and possible sign him up for some type of health care that will help him with his insulin and other medications that he needed. The next thing the Baccalaureate nurse did was go into the patient’s room asked a variety of questions and came back out of the room and told Nurse A, that the patient qualifies for state health insurance and that she will work on the vouchers for his medication for a month. The Baccalaureate nurse explained to the Associate nurse that she would have to  go further up in the chain of command to get the medications vouchered. The Baccalaureate nurse also gave the patient resources that would help him with his troubles in life, examples were housing for the homeless, churches that donate clothes and food to the homeless. What if the Nurse had a BSN? If the nurse taking care of this patient had a BSN they would have started to collaborate with the Case Manager about vouchering his medications and helping him find health insurance upon admission. Examples of what the Baccalaureate nurse would do are: find resources for the patient for food, shelter and health insurance on the day the patient was admitted, or have made a case management referral. Whereas the Associate nurse was focused on treating the patients and the illness and verifying and following the doctors orders. This is an example of how a Baccalaureate nurse was able to apply leadership and critical thinking skills while the Associate nurse was unable to. The Associate nurse struggled with the situation that arisen on the day of discharge. For the three days the Associate nurse had the knowledge base to treat the patient illness; taking blood sugars, administering insulin and bringing the patient back to holistic level of wellness. Conclusion In conclusion, it is important for all nurses to further their education. Baccalaureate nurses can provide better care for their patients and educate their patients about their disease process in depth and use the resources available to all nurses. They are also able to provide better patient outcomes through their advanced knowledge. Baccalaureate nurses also have opportunities for career advancement in all sorts of different positions whereas the Associate nurses are most likely staying in patient care areas. Baccalaureate nurses can move up and work as Nurse Managers, Case Managers, Quality Management and Infection Control. The encouragement for all nurses to advance their education is a quality step in the right direction for delivering excellent and safe patient care. References American Association of Colleges of Nursing. The Impact of Education on Nursing Practice. (n.d). Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/impact-of-education Haverkamp, J. J., & Ball, K. (2013, August). BSN 10: What is Your Opinion? AORN Journal, 98(2), 144-152. http://dx.doi.org/10.1016/j.aorn.2013.06.006 Texas Board of Nursing. (December 2011). Differentiated Essential Competencies of Graduates of Texas Nursing Programs. Retrieved from http://www.bon.texas.gov/about/pdfs/delc-2010.pdf