Rotator Cuff Essays - Shoulder, Synovial Bursae, Free Essays

Rotator Cuff Essays - Shoulder, Synovial Bursae, Free Essays Rotator Cuff It is often difficult to tell where concepts actually begin. It is certainly not obvious who first used the term rotator or musculotendinous cuff. Credit for first describing ruptures of this structure is often given to J. G. Smith, who in 1834 described the occurrence of tendon ruptures after shoulder injury in the London Medical Gazette. (Smith, 1834) In 1924 Meyer published his attrition theory of cuff ruptures. (Meyer, 1924) In his 1934 classic monograph, Codman summarized his 25 years of observations on the musculotendinous cuff and its components and discussed ruptures of the supraspinatus tendon. (Codman, 1934b) Beginning 10 years after the publication of Codman's book and for the next 20 years, McLaughlin wrote on the etiology of cuff tears and their management. (McLaughlin, 1944, McLaughlin and Asherman, 1951) Oberholtzer first carried out arthrography in 1933 using air as the contrast medium. (Oberholtzer, 1933) Lindblom and Palmer (Lindblom and Palmer, 1939) used radio-opa que contrast and described partial-thickness, full-thickness, and massive tears of the cuff. Codman recommended early operative repair for complete cuff tears. He carried out what may have been the first cuff repair in 1909. (Codman, 1934b) Current views of cuff tear pathogenesis, diagnosis, and treatment are quite similar to those that he proposed over 50 years ago. Pettersson has provided an excellent summary of the early history of published observations on subacromial pathology. Because of its completeness, his account is quoted here. (Pettersson, 1942) As already mentioned, the tendon aponeurosis of the shoulder joint and the subacromial bursa are intimately connected with each other. An investigation on the pathological changes in one of these formations will necessarily concern the other one also. A historical review shows that there has been a good deal of confusion regarding the pathological and clinical observations on the two. The first to observe morbid processes in the subacromial bursa was Jarjavay, (Jarjavay, 1867) who on the basis of a few cases gave a general description of subacromial bursitis. His views were modified and elaborated by Heineke (Heineke, 1868) and Vogt. (Vogt, 1881) Duplay (Duplay, 1872) introduced the term periarthritis humeroscapularis to designate a disease picture characterized by stiffness and pain in the shoulder joint following a trauma. Duplay based his observations on cases of trauma to the shoulder joint and on other cases of stiffness in the shoulder following dislocation, which he had studied at autopsy. The pathological foundation for the disease was believed by Duplay to lie in the subacromial and subdeltoid bursa. He thought that the cause was probably destruction or fusion of the bursa. Duplay's views, which were supported by his followers, Tillaux (Tillaux, 1888) and Desch, (Desche, 1892) were hotly disputed. His opponents, Gosselin and his pupil Duronea (Duronea, 1873) and Desplats, (Desplats, 1878) Pingaud a nd Charvot, (Pinguad and Charvot, 1879) tried to prove that the periarthritis should be regarded as a rheumatic affection, neuritis, etc. In Germany, Colley (Colley, 1899) and Kuster (Kuster, 1882) were of practically the same opinion regarding periarthritis humeroscapularis as Duplay. Roentgenography soon began to contribute to the problem of humeroscapular periarthritis. It was not long before calcium shadows began to be observed in the soft parts between the acromion and the greater tuberosity. (Painter, 1907) The same finding was made by Stieda, (Stieda, 1908) who assumed that these calcium masses were situated in the wall and in the lumen of the subacromial bursa. These new findings were indiscriminately termed bursitis calcarea subacromialis or subdeltoidea. The term bursoliths was even used by Haudek (Haudek, 1911) and Holzknecht. (Holzknecht, 1911) Later, however, as the condition showed a strong resemblance to humeroscapular periarthritis, it became entirely identified with the latter. In America, Codman(Codman, 1984) made a very important contribution to the question when he drew attention to the important role played by changes in the supraspinatus in the clinical picture of subacromial bursitis. Codman was the first to point out that many cases of inability to abduct the arm are due to incomplete or complete ruptures of the supraspinatus tendon. With Codman's findings it was proved that humeroscapular periarthritis was not only a disease condition localized in the subacromial bursa, but that pathological changes also occurred in the tendon aponeurosis of the shoulder joint. This

Essay about Telecommunication.Docx

Essay about Telecommunication.Docx Essay about Telecommunication.Docx Importance of Telecommunication Networks in Business 1. Customer Service * It enables companies to communicate effectively with customers and deliver high standards of customer service. 2. Collaboration * Telecommunication is also a key element in teamwork, allowing employees to collaborate easily from wherever they are located. 3. Remote * Mobile telecommunication gives companies the opportunity to introduce more flexible working by allowing employees to work efficiently from home. 4. Smartphones * The introduction of Smartphone gives employees new levels of productivity and capability on the move. (Explanations) 1. The telephone remains an important element of a customer service strategy. By using call management techniques, you can handle incoming calls quickly, even when lines are busy, and you can route calls to employees with the right skills to deal with the inquiry. Alternatively, you can offer callers the ability to choose from a range of options, such as "Press '1' for Accounts," or Press '2' for Sales." You can also use the telephone to contact customers proactively, following a service call, for example, or after a purchase. 2. Collaboration between different departments can help your company improve performance in projects such as new product development, customer relationship management and quality initiatives. According to consultancy McKinsey Company, collaborative, complex problem solving is the essence of the work of many employees. Telecommunication helps your project teams maintain momentum and make important decisions, even when all members cannot attend meetings. Abse nt members can join a teleconference or a Web conference if they have a smartphone or computer with Internet connectivity. 3. If your employees in sales, technical and service teams spend a large portion of their working days with colleagues, visiting customers, working at home or traveling, mobile telecommunication can help them maintain essential contact and work productively on the move. The Yankee Group Enterprise Mobility Survey found that 40 percent of respondents regarded more than a third of employees as remote or mobile workers. 4. If your employees in sales, technical and service teams spend a large portion of their working days with colleagues, visiting customers, working at home or traveling, mobile telecommunication can help them maintain essential contact and work productively on the move. The Yankee Group Enterprise Mobility Survey found that 40 percent of respondents regarded more than a third of employees as remote or mobile workers. Disadvantages Separating Work and Home * It's not difficult to fall into the trap of overworking yourself. If you work from home rather than a coffee shop or library, you may find yourself checking emails, working on projects or simply thinking about work well into your "off" time. It may also be difficult to define concrete work hours and avoid distractions at home. Family members or social interruptions may distract you, or you may be tempted to take care of chores and errands around the home, putting off your work until later. Social Isolation * When you telecommute, you get the freedom of less supervision. However, you also may become socially isolated. While some workers thrive on being able to work alone, you may not feel part of a professional community or miss the face to face interaction you get in a traditional office setting. Connect with other telecommuters to avoid isolation. If you're a freelancer, seek out forums, websites and blogs of others in your situation or utilize clients' resources to communicate with others in your industry. Inadequate Work Environment * When you work in an office, most of the setup is done for you because you're already in an office or cubicle. At home, it's up to you to create an efficient environment specifically for work. It needs to be well-equipped and suit your work

10 Painful Signs Your Boss is Disrespecting You

10 Painful Signs Your Boss is Disrespecting You There are horrible bosses, cruel bosses, bosses who hate you and are truly out to get you. And great bosses. There are also a million kinds of bosses in between. Some are perfectly decent. Some just plain do not respect you. How can you tell if your boss doesn’t respect you? Rather than relying on your own imperfect intuition, try checking this list of signs that you are being disrespected.1.  Flip FloppingYour boss changes his  mind every day about what you’re meant to be working on. Your top priorities shift constantly. You can’t keep up. He calls you in panic about something that needs to be done ASAP- only to go silent without providing any further instructions- or giving you contradictory instructions later.2. Not Valuing Your TimeYou get asked to do something vague at the beginning of the day, but you can’t seem to get any more clarifying information until- whammo- at the end of the day, a project is dropped into your lap†¦ and needs to be d one an hour ago.3. Ignoring Your NeedsA good boss will check in a couple of times a year to see how you are doing, whether or not you need anything in the way of guidance or feedback, or whether you’re missing any crucial equipment or software to help you get your job done well. This isn’t any fault of yours- it’s just poor management.4. No ExplanationsWhen things change or you’re asked to do things you don’t quite grasp, you ask a question and are met with stiff resistance- the workplace equivalent of â€Å"mind your own beeswax† or â€Å"that’s for me to know and you to find out.† If your boss doesn’t think you need to know things, especially things that might be necessary to you completing your work, that could be a sign that you’re being frozen out. Your concerns and questions should not be uniformly dismissed.5. You Only Get Grunt WorkYou’re constantly getting assigned the mindless tasks that no one el se wants to do- even if you’re just as qualified or more qualified than your coworkers. Or worse, you’re asked to do tedious work that is actually unnecessary for your company or your team.6. MicromanagingEvery piece of work you submit gets over-examined  over by your boss- even if you’ve never made any mistakes and your work is exemplary. This is particularly worrisome if you’re the only one getting micromanaged or over-supervised. Remember, a good boss trusts you to do the job for which you were hired.7. You Feel ReplaceableEven if you have a ton of specialized experience, you’re not consulted. Maybe you know a lot more than your boss does. But you’re never asked. More than that, your boss seems to think that anyone could do your job- despite hiring you and your unique qualifications for that job.8. Bad FeelingsYour boss ignores you, avoids you, laughs at your expense, criticizes you disproportionately or publicly for the slightest mista ke. Her body language suggests she just can’t stand you. She doesn’t make eye contact. She  seems like a totally different and warmer person with everybody else- and a total stern grouchypants with you. A combination of any of these can give you the gut feeling that you’re just not being respected. And you’d probably be right.9. Lack of Face TimeYour boss is always texting or emailing- never inviting you into his office, never stopping by yours. Not even calling. Technology is great, but you can’t forge a real relationship with your boss if you never have any real human interaction.10. Lack of AcknowledgmentDid you just come up with a great idea but your boss can’t seem to admit it was yours? Or worse: did she steal it? Did you make a big contribution, but it’s going utterly unnoticed and unremarked?These are all signs that you’re definitely not being valued. And quite probably being outwardly disrespected. It might be time t o talk to HR or to start looking for another gig.

Medical Negligence and Malpractice Case Study Example | Topics and Well Written Essays - 3000 words

Medical Negligence and Malpractice - Case Study Example There were no laws specifying requirements to practice any profession and anyone could practice whatever profession he or she wished to. As a result, there was tremendous competition between physicians and other healers. The only way the public could hold a person responsible for his actions were through tort laws. However, malpractice litigation can exist only with an established practice and a healer cannot be sued for deviating from standards if no standards exist. Since only trained physicians had professional standards, they were sued and quacks were not. There are five fundamental groupings of rationales for medical malpractice. First, a physician "contracts with those who employ him that he has such skill, science, and information as will enable him properly and judiciously to perform the duties of his calling." Second, "the principle is plain of uniform application, that when a person assumes the profession of physician and surgeon, he must, in its exercise, be held to employ a reasonable amount of care and skill. For anything short of that degree of skill in his practice, the law will hold him responsible for any injury which results from its absence (Breen et al, 1997). Third, a physician "undertakes that he will bring to the work a fair, reasonable and competent degree of care and skill in reference to the operation to be performed." Fourth, "freedom from errors of judgement is never a part of a contract with a professional man." And finally, physicians need not guarantee a cure. These principles led to increased malpractice lawsuits against better physicians. Although medical malpractice is founded on the standard principles of tort law, interest groups perceive medical malpractice differently depending on the way malpractice claims affect their financial, social, political, and professional interests. Differences in perception among politically perceptive interest groups have been significant obstacles in resolving malpractice problems. Articles su pporting and opposing the medical malpractice system have appeared in newspapers and magazines. Opponents of malpractice cite malpractice cost as a cause of high health care costs. Opponents argue that the medical malpractice system modifies the doctor and patient relationship and creates an environment in which defensive strategies influence treatment decisions (Fielding and Waitzkin, 1999). Opponents also claim that damage awards are like winnings in a lottery and provide unscrupulous lawyers and patients incentives to sue the providers. The costs of defending malpractice lawsuits and damage awards are increasing the cost of medical treatment. The costs of defensive medicine are increasing medical costs and making medical care unaffordable. Compensation for medical injuries is a paramount goal of medical malpractice actions (Hay, 1992). Compensation should be timely, fair, and paid to all who qualify for it. To be timely, compensation should be paid expeditiously. To be fair, compensation should be proportional to the amount of loss. However, it is important to determine what injuries will be compensated. The system could compensate all injuries regardless of cause, or medically caused injuries only or negligent medical injuries only. Using the concept of quality costs, malpractice costs can be divided into injury costs and

LPN to RN Role Transitions Essay Example | Topics and Well Written Essays - 1250 words

LPN to RN Role Transitions - Essay Example Harrington& Terry(2009) define role transition as â€Å"the passage or shifts from one role to another and involves changing the way one thinks and acts† (p. 54). Role transition from LPN to RN role is a unique experience as it changes and broaden the LPN’s responsibilities, thinking, practice and experience, and the overall view of the nursing world. The decision to become a registered nurse uprooted to the two of the most important goals I have at the moment: one of them is to continue my nursing education and explore a vast array of knowledge, skills, and experiences apart from being an LPN, and the other one is to pursue this long-time dream of being a registered nurse that helps people as well as the increase in income. The road to become a registered is not easy and requires understanding of the differences between the LPN and RN roles, the management of conflicts, application of classroom discussion to role transition and, knowing and understanding the exisiting facts and standards of the state board of nursing. The LPN transitioning to become an RN faces variations in the roles they perform. Often times, distinguishing the differences between the roles they perform becomes difficult as they are bombarded with several role variations. However, there are two specific role changes differences between an LPN and an RN. One of the first specific role changes is the difference in the nature of client care. LPNs focus on the â€Å"how to† of client care.

Critical Response to Article by Karl Hostetler Example | Topics and Well Written Essays - 750 words

Critical Response to by Karl Hostetler - Article Example This preamble marks the paper out as something a little different from the usual mainstream literature, and the impression of novelty is further enhanced by statements to the effect that researchers need to be playful and irreverent about serious subjects, and need to offend some people and annoy others. Hofstetler certainly practices what he preaches, since the article is full of provocative statements that could be taken as undermining the most fundamental values of academic research activity in most contemporary universities. The key problem that Hostetler identifies is a tendency for education researchers to focus on how their work is done, rather than undertaking a deep analysis of what they are doing and why they are doing it. Analogies such as debating which way to investigate the effectiveness of thumbscrews (Hostetler, 2005, 16-17) or herding lemmings toward the cliff (Hostetler, 2005, 17) or even sticking students with cattle prods (Hostetler, 2005, 19) are somewhat ludicro us, but the point important: too many researchers do not reflect enough about the fundamental aim of education and how far their work helps of hinders people who might be affected at some later date by the outcomes of this research. This line of argument flies in the face of standard notions of research which involve concepts such as objectivity and scientific rigor. Without the use of statistics and analytical methods, there would be very little beyond anecdotal evidence to inform policy making and practice. Hofstetler makes a valid point, but he overstates it with his deliberately â€Å"naughty† (Hofstetler, 2005, p. 17) examples, and he risks not being taken seriously by the vast majority of interested readers who are quite capable of combining scientific methods with careful ethical reflection, and see no necessary conflict between the two. A second problem that Hostetler describes is that of definitions, for example the very different ways that the conception of â€Å"c haracter† in school programs is constituted. Clearly there are quite fundamental variations in the ideologies that can underpin such notions, and Hostetler argues that this complexity is something that needs to be more fully taken into account by researchers. On this point the article is convincing, and certainly there is a case for more clarity in the way that abstract educational terminology is used, especially in government slogans and initiative titles. Hofstetler speaks up for the particular student experiences that are hidden within the data of randomized trial procedures, for example, suggesting that some of the generalizing theories that researchers produce may contain within them actual harm to individual students, since minority results tend to be lost in the bigger picture. Hofstetler questions whether the trade-off is justified, and this is a commendable observation because it highlights the dilemma of that section of the school population with behavioural or learn ing disorders who are so often lost in the drive for overall quality improvements. This article raises a number of valuable questions, and provides much material for reflection, but it is rather short on concrete answers to these questions. The conclusion which is reached is little more than a platitude expressing approval of the likes of Mahatma Gandhi, Mother Teresa and other moral giants of history and calling for a more

Challenging Behavior Essay Example | Topics and Well Written Essays - 3500 words

Challenging Behavior - Essay Example Special Educational Needs (SEN) Policy: The Special Educational Needs Policy is the backbone of the policy framework of Hampshire County Council. It serves as a key element for supporting and catering to the needs of children and adolescents between the ages of 0-19 (Hampshire County Council, 2009, p.1-9.). Main Priorities: The main priorities indicated by the policy are the formation of a safer and securer environment of Hampshire for all citizens, the enhancement of the quality of services being provided, responding effectively to the improvements the community wants, meeting the demands of the local people, and maximising well-being and prosperity in the community. SEN provisions of the Special Educational Needs and Disability Act takes account for the appeal of rights of children with special educational needs to study in mainstream schools, a right for nursery education providers, educational institutes to request a statutory evaluation, and assessment of a child and achievement of substantial acts, to ensure the arrangements to provide the parents of children with SEN with services offering advice and necessary information as a means to resolve and refute disputes by enforcing LEA duties. It is a sign of popularity of the policy amongst the community that it has been revised for the period of 2009-2012. This revised policy is responsive to certain changes whilst ensuring that the local authorities fulfil the duties and responsibilities required by the SEN and Disability Act 2001, and improve its standards of quality service provided (Department of Health, 2005, p.2-24). The revised policy focuses upon the progress made by children and young people from their birth to adulthood, in pre-school settings and in schools, and the promotion of their well-being, learning, and achievements. Aims and Objectives: The policy aims to improve and maintain the quality of provision for children with special educational needs wherever it is delivered. It is also striving to recognise further that schools and supporting services collectively provide for the needs of all children in the community. Operating effective assessment systems as early as possible in conjunction and collaboration with other agencies is another objective which has to be reached. Other important aims of the policy include allocation and usage of resources effectively and equitably in an efficient manner, and to assure that partnerships and associations with children, parents/carers and other stakeholders, work effectively (Hampshire County Council, 2009, p.1-9). Mentioned above is the rationale and achievements of SEN, but the following conclusions are obtained on the critical analysis of SEN: Methods: The methodology used involves a review of the related previous literature, a thorough study of the old and revised policies of SEN, Interviews with experts on field and conduction of case studies and surveys. Findings and Recommendations: SEN System lacks in addressing the inacce ssibility of the services to the parents of children with behaviour issues. The parents have to face many challenges in getting the right support for their children. The conflict amongst the local authorities and delay in services has resulted in the undermining of confidence of people. The revised policy is concentrated on the children in the Hampshire County only; the children from other areas are not receiving these privileges and the emphasis on the collaboration of