ShantanuT01/DACTYL-Pretraining huggingface dataset:
Results As part of the presented research, secondary analysis was conducted of patient data provided by NIS and HCUP with a range of variables for the purpose of establishing correlations between the perfusion modality applied in cardiopulmonary bypass (pulsatile and non-pulsatile) and patients’ background and recovery information. The data provided by NIS is considered reliable and sufficient for the presented research, as it has been established that the new sampling and data collection methods that have been adopted by NIS since 2012 allowed refining the analysis of hospitalization and reducing the margin of error by approximately 45 percent (see Research Design and Methodology). NIS estimations of access to health care, health care costs, quality, population-wide outcomes, and other rates have been used in health care studies as well as policy making. One of the advantages of using NIS data for the presented research was that it covered all the patients whose health care utilization and outcomes information could have been submitted by hospitals, i.e. patients covered by social health care programs, national social insurance programs, and private insurance, as well as uninsured patients. This scope allowed estimating health care outcomes on a broader scale and with increased reliability because many other sources of healthcare information might have overlooked large patient groups due to insurance issues, which is undesirable in a health care study because the type of insurance itself does not influence health care outcomes for a person. Since the goal of NIS was to collect as much patient information as possible, populations were included that are often missing from other samples (such as Medicare Advantage patients), which is relevant to the results of the presented research because cardiopulmonary surgeries may be given to a patient in any population, and exclusion of any patient groups (except for young people who initially were not planned to be in the sample) would have been deemed undesirable. Two considerations were chosen for this research to estimate health care outcomes and recovery successfulness of patients after a cardiopulmonary bypass: survival rate and length of hospital stay. The two groups of patients compared by these criteria were those who received pulsatile perfusion during their bypass and those who received non-pulsatile perfusion. For sampling, four criteria were chosen for selecting patients for the presented research from the patient data presented by NIS: first, the sample included patients with cardiopulmonary diseases; second, the patients in the sample were older than 65 years old; third, it included patients who were diagnosed with a disease that required a cardiopulmonary bypass surgery; and fourth, it excluded patients with chronic diseases, such as diabetes, renal failure, or hypothyroidism. The exclusion of patients with serious
Introduction Critical thinking is a very wide and important aspect in our society. This is mostly as far as professionalism is concerned. As a matter of fact, it should be known that critical thinking is a disciplined intellectual process that all professionals need to carry out their duties and responsibilities well. In this case, this process should mostly revolve around high-order thinking as time goes by which is good. As far as professionalism is concerned, critical thinking should be able to question various assumptions that might arise. The whole idea should be about a good assessment of various scenarios that a professional will be exposed to. These scenarios can be in form of statements that a given professional is supposed to undertake in relation to his job (Donahue 2010, p. 13). Critical thinking is supposed to evaluate information that has been gathered and this can be by experience or observation which is acceptable. Synthesizing and reflection are also needed to guide the action that a
The interaction between product quality and process quality is a complex one, whereby the quality of output is highly depended on the process quality. Process quality together with other factors such as manpower affects the processing time and the final end product. A process is composed of various stages, which interactively influence each other. In 2005 Harris faced the same problem of retaining the product quality at the same time improving on the production capacity as a result of speculations for demand increment of the chocolate Continuous attempts had been made in reducing the time allocation for each processing step in the Scharffen Berger chocolate maker but this led to great changes in the quality of the America’s best chocolate (Leff, 2005, p. 73). The final decision was to come up with a new ball mill machinery all together. This machine would multiply the production speed at the conching processing stage and at the same time improve on the product’s texture. It would also improve on the flavor of the product by ensuring that less sugar is lost during the long processing times. This big question had finally found an answer but greater challenges lay ahead of the company. This work summarizes the benefits of a quality process line in relation to the Scharffen Berger maker. The case study shows clearly the link between quality of process and quality of products. All processing steps are equally important and slight changes in the time allocated or even some other settings would be very detrimental to the end product. Scharffen Berger Chocolate Maker consists of seven main processing steps among them is the bean cleaner which serves to clean up the beans before production. Poor working conditions of the bean cleaner can lead to chocolate production with poor flavor due to dirt leakages. The other step is the roasting stage, which introduces the caramel flavor to the cocoa beans. Poor control of the roasting temperatures could lead to burning of the cocoa beans leading to poor quality products or even worse complete lose of the product. From here the product goes to the melangeur stage, which is necessary for a smooth paste of cocoa (Perry & Ruffenach, 2008, p. 191). This stage highly defines the texture of the finished product a major quality parameter in chocolate production. Conching is another processing step involved in Scharffen Berger chocolate making process. It involves further refining of the chocolate mass at the same time incorporating air into the mixture for better taste. This greatly influences the quality of the end product. Tempering is the stage involved with the hardening of the chocolate mass and ensuring that the gloss is well maintained. For a chocolate to have viscosity the tempering stage has to be fully controlled. The final stage in the chocolate manufacturing is the packaging stage, this serves to hold the final product and for display purposes. Quality packaging serves to attract more customers and sell the product in greater volumes. In Scharffen Berger chocolate maker, quality of packaging is ensured by outsourcing 65% of the packaging and the other 35% is done from the company’s premises (Ax
A great number of prosperous and developing companies can face difficulties in the future in case they would not take measures of the work quality improvements. According to Chris Argyris, the author of the article Good Communication that Blocks Learning, the work improvement is not connected with the hard work but with the analysis of the employees’ behavior in the process of work, the level of their responsibility for it, and abilities to solute fundamental problems. The aspect of the communication skills analysis covers and unites the process of effective learning, great commitment, and broad empowerment. The key element of the company’s prosperity and work improvement is considered to be communication. As it was stated by the author, business leaders have always tried to bring new communicational tools such as different organizational surveys or focus groups in order to provide some rapid changes to the process of business running and reach necessary results from the work of employees. The author stated that leaders are to take measures having an impact on the workers’ results. Different employee surveys should be carried out in order to inform about business routine issues; nevertheless, they do not influence the behavior of the employees and their quality of work. According to the article, most companies are merely concentrated on the process of organizational learning. The author stated that managers working at the company cannot react to stressful situations in an adequate way. Organizational learning makes them stick to some particular rules in the solutions of the problems though the cases may be unpredictable. The article highlighted the most important aspects of the problems faced by the employees in some situations:   * Managers are unable to defend their interests because of the lack of skills and professional automatism;   * It is difficult for the employees to interact with others because of the lack of communication skills. It should be noted that these obstacles providing threatening conditions for the workers draw a line between communication and the process of learning. The author managed to identify the major rules for the company workers one of which is to be forthcoming and truthful about the conditions, norms, and procedures of the world one work in. Communication is the only way to success. The author managed to prove this fact by stating that superior staff should truly inform the employees about any changes in the organizational process. It is leaders who can control and modify the successful work of the company. Employees are to be provided with the tru
Definitions of marketing Since marketing is always evolving, its definition changes from time to time. My definition of marketing is that it is the process by which goods and services are advertised to the customers through various ways including the media and by word of mouth. This is done with the aim of creating awareness for the products or services of a company to the current and potential customers. Through marketing, consumers of certain goods and services can choose from a variety of producers and select the most suitable. The American Marketing Association (AMA) provided a definition of the term marketing. The American Marketing Association [APA] (2012) defined it as “the activity, set of instructions, and processes required for creating, communicating, delivering and exchanging offerings that have value for customers, clients, partners and society at large” (p. 3). It is a process by which organizations provide value for the consumers of their products. AMA’s previous definition of the same term was that it is “an organizational function and a set of processes for creating, communicating and delivering value to customers and for managing customer relations in ways that benefit the organization and its stakeholders” (American Marketing Association [APA], 2012, p. 7). It is through this process that strategies involving sales techniques, business development and business communication are generated. Another definition of the term marketing was provided by Kotler. Kotler (1991) defined it as “the management process responsible for identifying, anticipating and satisfying customer requirements profitability” (p. 91). Importance of marketing in organizational success Any organization seeking to become successful must incorporate the concept of marketing in its businesses. This is because most aspects of its businesses would be dependent on the success of marketing. This would involve the incorporation of advertisement, public relations, conducting promotions and sales. Before products and services can be sold successfully to the consumers, they must first be introduced and promoted to them. An organization may offer the best goods and services as compared to other similar organizations but without marketing, none of the potential customers would be aware of the goods and products. This is where marketing plays a big role since without it, s
Advanced Practice Nurses are vital players in the contemporary healthcare environment. Their scope of practice enables them to provide a wide range of care services to patients and be an integral part of healthcare teams. The nature of nursing practice means that it is impacted by various personal values, attitudes, and beliefs that shape nurses’ views of practice issues and help them navigate their roles successfully. Formulating a personal philosophy of care can be helpful to nurses because it aids in identifying the core principles that the nurse will apply in their work and aligning them with those of prospective employers to fit in with the organizational culture of care. The present paper will seek to describe my personal philosophy of practice with respect to medical care, communication with patients, reimbursement, and billing. The essay will also discuss how I intend to align my philosophy with that of prospective employers. Finally, because reimbursement is an important topic to consider in preparing for employment, the paper will describe a plan for negotiating salary and benefits that I will apply in my first job. Philosophy of Practice Medical Care In describing my philosophy of practice, it is essential to outline the aim of each process and the guiding principles behind it. Firstly, I believe that medical care should be aimed at prolonging people’s healthy lives while improving their quality of life. The prevalence of chronic diseases and conditions in the contemporary world is rather high, and many of them have a negative impact on people’s quality of life. Here, care providers have a duty to help individuals live better lives, even if their condition cannot be fully treated. In acute and life-threatening conditions, the focus is typically on preserving an individual’s life. Still, it is essential to understand that some treatments could do so while reducing their quality of life dramatically, which might not be in the patient’s best interests. Aligning medical care with the principles of independence, autonomy, and respect is essential to make treatment choices and support ethical practice. The principle of independence is integral to the quality of life since people need independence to remain healthy and happy. In patients whose chronic conditions do not allow for full independence, care providers should seek to help patients achieve the highest possible level of independence appropriate for their health. The principle of patient autonomy is crucial to decision-making because it helps to ensure that the medical care benefits the patient by supporting their health and life goals. In addition, respect for patients is crucial to medical care because it facilitates ethical practice and contributes to the relationship between patients and providers while also protecting patients. Finally, it is also essential to note the importance of
Introduction Obesity poses a major problem to the population since it comes with a raft of life-threatening problems. To date, there isn’t a universally accepted definition of obesity (MacDonald, 2003); several definitions exist, including absolute weight, body mass index and proportion of fat in the body. Obesity results from several factors acting alone or in combination; these include genetic predisposition, individual habits, social and economic environment and psychological issues. Some of the conditions that can easily be preceded by obesity include dysfunctions of the vertebral column, pseudotumor cerebri, hypertension, type II diabetes mellitus, among others. Additionally, there are several malignant cancers whose incidence is increased by obesity, including colonic and breast cancers (MacDonald, 2003). Obesity has been acknowledged as one of the leading health issues in the country, and the mortality and morbidity associated with the condition are expected to surpass that of tobacco as the leading cause of preventable death in the United States. Among the bigger concerns is the ability of the healthcare sector to support the management of this condition; this stems from the estimation of the cost of management of a single co-morbidity of obesity, diabetes mellitus, as USD100 billion per year. The total cost of the effects and the management of obesity is estimated to amount to about 10% of the healthcare expenditures in the united states (Koplan and Dietz, 1999). Additionally, in combination with the effects of a sedentary lifestyle, obesity is estimated to cause about 400,000 deaths every year (CDC, 2000). The Epidemiology of Obesity The problem of obesity has been on the increase in recent years, raising concerns about the ability to handle a large scale problem in the country. Obesity has been the subject of study and debate both from the scientific and lay sectors, and many conclusions have been made regarding the cause, effect and management of the condition. One study put the proportion of adults in the United States with obesity at 64.5%, totalling over 120 million people (Hellmich, 2000). This is an increase from 45% in 1960. However, a more alarming increase has been that of obesity which has just about doubled in the last two decades affecting approximately 15% of kids aged between six and nine years old (Smolowe, 2002). Although the outcomes of various studies vary regarding the prevalence of obesity in the United States, the general consensus is that the trend is generally that of increase over the last 20 to 30 years; additionally, the recognition of the fact that obesity in children is the new frontier for the disease. In 1999, a study carried out by the National Center for Health Statistics estimated that the proportion of people in the United States that had a body mass index (BMI) greater than 25 was 61% and thus classified as being overweight; additionally, those with a BMI>=30 thus classified as being obese made up 26% of the
Box Analysis Using the box analysis, this situation would be divided into four main parts namely, medical suggestions, quality of the patient’s life, his/her preferences, as well as the contextual features. According to box analysis method, this condition is best understood when divided into the four groups. The case under study is that of a young child, Ashley, who is six years old and suffers from severe disability that does not allow her to talk, walk, or even move from her position, when she lies down. She also suffers from low cognitive ability, which is likened to that of a three year old. Diagnosis shows a condition of static encephalopathy, which is thought to have hampered her physical and intellectual capacity. Apart from that, according to her parents, she is jovial and enjoys watching lights and audio from music or TV, she is said to embrace the family, enjoy being cuddled and company. For this reason, the parents are opting to stay with her at home and request for medical intervention, which could inhibit her growth to maturity. They feel that when she grows, it may deprive her, the joy and flexibility to be moved from one place to another, which she now enjoys. In this context, we shall consider Ashley’s condition and organize it as shown below. Medical Condition                                                                                                                                                 * Severely disabled                                                   Patient Preferences                                                                       * Static encephalopathy; severe physical and intellectual disability    * Enjoy lights and sounds from music or TV                                              * Cannot walk                                                           * Enjoys company                                                                        * Cannot Talk                                                           * Embraces her family                                                                   * Cognitive ability low (like a three year old)                                                                                                                 * Cannot move from her lying position                                                                                                                         Quality of life                                                         Contextual Features                                                                       * Good                                                                  * Parents request for hysterectomy and other interventions t
Alfred J. Prufrock At the turn of twentieth century, more and more educated White people were finding themselves being deprived of psychological qualities that allowed their ancestors to build and to maintain civilization – they were becoming increasingly incapable to pursue with the collective mode of existence, while being slowly turned into egoistic individuals, for whom seeking the emotional comfort became a solemn purpose of their existence. These intellectuals would often indulge in utterly decadent practices, such as drinking small amounts of poison to make their skin look paler (this was considered fashionable in early 20 th century Europe), while suffering from the fact that they were no longer able to feel themselves being an integral element of society – they experienced an utter metaphysical loneliness. The reading of Thomas Eliot’s poem “The Love Song of J. Alfred Prufrock” comes in especially handy, within a context of getting an insight of the main issue of existentialist philosophy of early 20 th – one’s inability to take an active stance in life. In his poem, Eliot pinpoints exactly to the cause of Prufrock’s unhappiness: “And indeed there will be time To wonder, “Do I dare?” and, “Do I dare?” Time to turn back and descend the stair, With a bald spot in the middle of my hair” (Eliot, 1919) It appears that Prufrock is not content with surrounding reality because his lack of willpower does not allow him to affect it. He does not consider “daring” but only wonders as to how does it feel “daring”. At the same time, he possesses enough intellectual honesty to admit his own existential worthlessness: “Time for you and time for me, And time yet for a hundred indecisions, And for a hundred visions and revisions, Before the taking of a toast and tea” (Eliot, 1919) “Indecisions”, “revisions” – these are the words from vocabulary of 20th century. It requires certain strength to name things for what they are. Prufrock prefers to withdraw from rearranging the world, according to his own wishes, and to simply indulge into the dubious pleasure of savoring different aspects of his own sensuality. Nowadays, this Eliot’s work is being often referred to as “romantic novel”, but it is doubtful of whether author could feel love towards anybody but himself. In order to know how to love, one must know how to sacrifice. While living in England, Eliot did not volunteer to become a soldier, during World War One, while acting as a true coward. He considered himself as being too sophisticated to join the ranks. Therefore, the seemingly “deep” philosophical allusions, found in “Love Song of Alfred Prufrock”, are utterly artificial. Eliot’s poem did not have any greater purpose other than to socially establish the author as credible poet. Although in his poem Eliot never gets tired of whining about his loneliness and abou