Thursday, January 30, 2020
Critique of the paintings by the artist A.E. Backus Essay Example for Free
Critique of the paintings by the artist A.E. Backus Essay Albert Ernest ââ¬Å"Beanieâ⬠Backus is a gifted painter born on January 3, 1906 in Ft. Pierce, Florida. He studied at the Parsons School of Applied Art in New York but his talent in creating wonderful works of art is considered to be only self thought. He devoted his time in creating Florida landscapes after he came from the war and his works became widely popular through his exhibitions in Miami and Palm Beach. (A. E. Backus: A brief biography, 2007) Backus is famous for his creative works that feature picturesque Florida views like sunsets, the vistas of the Everglades, and spectacular beach and river views. One of his artworks, titled the ââ¬Å"Early Taylor Creekâ⬠was in fact a nice example in his set of landscapes. Created in memory of S. N. Baruch, this work of art shows a view of a boat resting on a side of a creek with palm trees and a house looming on its background. The outlines of the shapes and lines are not overly emphasized and are applied in light strokes creating a wispy sort of image to the view. The colors used are mostly in the hues of light green, brown, and blue giving the impression of solemnity and mildness to the artwork. The shading of the colors in the picture is applied subtly while the texture gives a rather unrealistic and semi-solid sense of touch on the surface because of the way the lines are applied in wispy strokes. (Permanent Collection, 2007) When it comes to the application of the principles of design, this work of art can undoubtedly be considered as one having a nice visual balance. The informal type is used in this work wherein unlike objects are placed on either side of the picture to create the illusion of balance. With the boat serving as the central point, Backus created equilibrium by painting a clump of trees on the right side and pairing it with the picture of the house, an expanse of grass, and a withered trunk on the left. (Principles of Design, 2007) Variety is the principle that artists use to make a certain artwork interesting by creating complex relationships in their works to make it appealing and lively. For some painters, however, the concept of variety is out of the question when they want simplicity to rule in their creations. Here in Early Taylorââ¬â¢s Creek, the principle of simplicity is the one used because it displays elegance despite of its plainness in subject. The boat resting on the side of the creek and the house on its background, on the other hand, shows the application of the principle of emphasis since these are the objects that stood out most on the painting. (Principles of Design, 2007) When it comes to contrast, the concept of low contrast is applied in this work since the colors used are mainly in the same hues and the shapes doesnââ¬â¢t give an impression of obvious difference on the whole of the artwork. Repetition is displayed here by the withering trunks on both the left and right side of the picture and it also showed good rhythm by the way Backus painted the trees and the grass swaying in the same direction to emphasize movement. Also, the principle of scale showed here are shown in correct proportions to the standard size references of the actual objects making it look realistic in nature. The spacing of the objects in the picture is done well and the motions as well as depth are also simply well-displayed. (Principles of Design, 2007) Backus has an unrequited passion for wildlife and plants and through his natural talent; he was able to produce captivating paintings of tropical flowers and other flora. One of his particular favorite as his subject is the hibiscus which is a native in Hawaii and Malaysia. One of his paintings featuring this ubiquitous flower is his work called the ââ¬Å"Offering to the godsâ⬠which features a native mask standing amidst a background of several leaves with a red hibiscus lying on its side. (Wikipedia, 2007) Studying the elements and the principles of designs applied to it, this artwork can be well considered as the opposite of Early Taylorââ¬â¢s Creek. The lines and shapes used here are well defined and geometric compared to the earlier landscape giving it a solid and distinct impression. The colors used here are mostly in black and in shades of dark brown, green, and red which gave it a rather gloomy and mysterious kind of feel. The shading applied also added to the factor of the artworkââ¬â¢s shadowy appearance. Due to the smooth application of strokes and the defined lines, the Offering to the gods was able to attain the kind of solidity that lacked in Early Taylorââ¬â¢s creek. (Backusgallery. com, 2007) In examining the principles of design used here, it is noticeable that this creation didnââ¬â¢t use the principle of balance. All the weight is placed on the left side of the picture because of the mask and the clump of leaves behind it. Only the hibiscus flower was placed on the right but its bright red color somehow made up to its lack of size when compared to the dull colors of the objects painted on the left side. Simplicity isnââ¬â¢t also applied here because when you first look at the picture, you will quickly notice the stand out image of the mask looming over the startling red hibiscus lying prone on its side. (Principles of Design, 2007) When it comes to the principle of variety, what lacked in Early Taylorââ¬â¢s Creek was abundant here in this work. Because of this pictureââ¬â¢s mystifying look, it possessed a certain complexity that only the aspects of variety can only give. However, emphasis is hard to distinguish in this artwork because there are only two subjects painted here and both are certainly noticeable. The native mask can be considered as the focal point of the painting because of its appearance and size but the hibiscus can also be taken in as the important subject because its bright red color stands out from the shadowy background of green, brown, and black. On the other hand, the concept of high contrast is used here because of the emphasis of the color of the hibiscus over the shades of the mask, leaves and the background. (Principles of Design, 2007) The concept of repetition is out of the topic since the two subjects here are far different from each other. The principle of scale, however, was quite noticeable in this painting because of the monumental size of the mask over the hibiscus flower. Motion is not applied since the subjects portray a fixed position and the principle of rhythm is also disregarded since it is connected to the concept of repetition. The depth possessed by the artwork is also unfathomable because of the mysterious and gloomy quality brought by its subjects. (Principles of Design, 2007) The Early Taylorââ¬â¢s Creek piece is more appealing to me because of its sheer simplicity and elegance. Its concept is also easy to understand and interpret compared to the dark ââ¬Ëfeelââ¬â¢ that the Offerings to the gods give. I also find that the principles of design are well applied here because the concepts of balance are applied soundly and the lack of variety makes people to easily connect with the message it communicates. Movement and rhythm are also very well handled making this painting more realistic in nature. The Offerings to the godsââ¬â¢ concept may be appealing because of its mystifying aura but Early Taylorââ¬â¢s Creek is still my choice because of the light and placid feel it displays. References: Backusgallery. com. (2007). A. E. Backus: A brief biography. (2007). Permanent Collection. (2007). Principles of Design. (2007). Wikipedia. (2007).
Wednesday, January 22, 2020
Atwoodââ¬â¢s Presentation of her Female Characters Essay -- Alias Grace Ma
Atwoodââ¬â¢s Presentation of her Female Characters Early in the novel Atwood presents us with the division between ladies and women. The example given is Grace compared to the governorââ¬â¢s wife and the ladies who frequently visit her. It seems that grace wishes that she was a lady when she comments ââ¬Å"I have no glovesâ⬠this shows that Grace is conscious of her appearance even if she is in prison. Grace cannot sit on the governorââ¬â¢s wifeââ¬â¢s settee without thinking of the ladies that have sat there before her who have bums ââ¬Å"like wobbly soft boiled eggsâ⬠. These ladies are compared to jellyfish that grace has seen in her childhood, Grace shows admiration for these ladies ass he says ââ¬Å"they were bell shaped and ruffledâ⬠Atwood also makes the point through grace that ladies of this time were restricted. This is achieved by the mentioning of wire crinolines that were ââ¬Å"Like birdcagesâ⬠the ladies were not allowed to touch or brush up against other menââ¬â¢s legs. Grace is now talking about legs in sexual way (also another sign of the times) ââ¬Å"the governorââ¬â¢s wife never says legsâ⬠this commen...
Tuesday, January 14, 2020
Analysis: Hospital Nurse Staffing and Quality of Case Essay
Hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes such as pneumonia, shock, cardiac arrest, and urinary tract infections, according to research funded by the Agency for Healthcare Research and Quality (AHRQ) and others. Yet increasing staffing levels is not an easy task. Major factors contributing to lower staffing levels include the needs of todayââ¬â¢s higher acuity patients for more care and a nationwide gap between the number of available positions and the number of registered nurses (RNs) qualified and willing to fill them. This is evident from an average vacancy rate of 13 percent. This report summarizes the findings of AHRQ-funded and other research on the relationship of nurse staffing levels to adverse patient outcomes. This valuable information can be used by decisionmakers to make more informed choices in terms of adjusting nurse staffing levels and increasing nurse recruitment while optimizing quality of care and improving nurse satisfaction. continue over the next two decades. A Federal Government study predicts that hospital nursing vacancies will reach 800,000, or 29 percent, by 2020.2 The number of nurses is expected to grow by only 6 percent by 2020, while demand for nursing care is expected to grow by 40 percent. The most recent research shows a jump of 100,000 RNs, or 9 percent, in the hospital RN workforce between 2001 and 2002 because of increased demand, higher pay, and a weakening economy. However, since almost all of the Making a Difference Lower levels of hospital nurse staffing are associated with more adverse outcomesâ⬠¦Page 3 Patients have higher acuity, yet the skill levels of the nursing staff have declinedâ⬠¦Page 5 Higher acuity patients and added responsibilities increase nurse workloadâ⬠¦Page 5 Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000â⬠¦Page 6 Hiring more RNs does not decrease profitsâ⬠¦ Page 6 Higher levels of nurse staffing could have positive impact on both quality of care and nurse satisfactionâ⬠¦ Background Periods of high vacancy rates for RNs in hospitals have come and gone, but the current shortage is different. According to a 2002 report by the workforce commission of the American Hospital Association, the nursing shortage ââ¬Å"reflects fundamental changes in population demographics, career expectations, work attitudes and worker dissatisfaction.â⬠1 In fact, the present situation may well Author: Mark W. Stanton, M.A. Managing Editor: Margaret Rutherford Design and Production: Frances Eisel Suggested citation: Stanton MW, Rutherford MK. Hospital nurse staffing and quality of care. Rockville (MD): Agency for Healthcare Research and Quality; 2004. Research in Action Issue 14. AHRQ Pub. No. 04-0029. increase came from RNs over age 50 who returned to the workforce and a greater influx of foreign-born RNs, this does not alter the structural features in the long term: the aging of the nurse population and the increasing unwillingness of young women to consider nursing as a profession.3 Todayââ¬â¢s difficulties are further complicated by other changes in hospital care, such as new medical technologies and a declining average length of stay, that have led to increases in the amount of care required by patients while they are in the hospital. New medical technologies allow many less seriously ill patients who previously would have received inpatient surgical care to receive care in outpatient settings. Also, patients who in the past would have continued the early stages of their recovery in the hospital, today are discharged to skilled nursing facilities or to home. During the period 1980-2000, the average length of an inpatient hospital stay fell from 7.5 days to 4.9 days.4 An important consequence of these changes is that hospitals have a higher overall concentration of sick people who need more care. Various groups, including the American Hospital Association, the Joint Commission on the Accreditation of Healthcare Organizations, and the Institute of Medicine (IOM), have expressed their concerns about the evolving nursing crisis. The IOM issued a report in 1996 that recognized the importance of determining the appropriate nurse-patient ratios and distribution of skills for ensuring that patients receive quality health care.5 Its report highlighted the fact that research on the relationship between The nurse workforce and nurse staffing levels the level of staffing by nurses in hospitals and patientsââ¬â¢ outcomes has been inconclusive. The IOMââ¬â¢s analysis of staffing and quality of care in hospitals concluded by calling for ââ¬Å"a systematic effort â⬠¦ at the national level to collect and analyze current and relevant data and develop a research and evaluation agenda so that informed policy development, implementation and evaluation are undertaken in a timely manner.â⬠To begin to meet that need, AHRQ-funded research and other research have pursued a number of different paths. Hospital nurse staffing and nursing-sensitive outcomes Hospital nurse staffing is a matter of major concern because of the effects it can have on patient safety and quality of care. Nursing-sensitive outcomes are one indicator of quality of care and may be defined as ââ¬Å"variable patient or family caregiver state, condition, or perception responsive to nursing intervention.â⬠6 Some adverse patient outcomes potentially sensitive to nursing care are urinary tract infections (UTIs), pneumonia, shock, upper gastrointestinal bleeding, longer hospital stays, failure to rescue, and 30-day mortality.a Most research has focused on adverse rather than positive patient outcomes for the simple reason that adverse outcomes are much more likely to be documented in the medical record. a ââ¬Å"Failure to rescueâ⬠is defined as the death of a patient with a lifethreatening complication for which early identification by nurses and medical and nursing interventions can influence the risk of death. The nurse workforce consists of licensed nursesââ¬âregistered nurses (RNs) and licensed practical nurses (LPNs)ââ¬âand nursesââ¬â¢ aides (NAs). Both RNs and LPNs are licensed by the State in which they are employed. RNs assess patient needs, develop patient care plans, and administer medications and treatments; LPNs carry out specified nursing duties under the direction of RNs. Nursesââ¬â¢ aides typically carry out nonspecialized duties and personal care activities. RNs, LPNs, and nursesââ¬â¢ aides all provide direct patient care. RNs have obtained their education through three different routes: 3-year diploma programs, 2-year associate degree programs, and 4year baccalaureate degree programs. Almost a third of all RNs have a baccalaureate degree, and 7.6 percent of hospital nurses have advanced practice credentials (either a masterââ¬â¢s or doctoral degree). LPNs receive 12-18-month training programs that emphasize technical nursing tasks. Nursesââ¬â¢ aides are not licensed but many acquire certified nurse aide or nursing assistant (CNA) status after proving they have certain skills related to the requirements of particular positions. Nurse staffing is measured in one of two basic ways: â⬠¢ Nursing hours per patient per day. â⬠¢ The nurse to patient ratio. ââ¬Å"Nursing hoursâ⬠may refer to RNs only; to RNs and LPNs; or to RNs, LPNs, and nursesââ¬â¢ aides. 2 www.ahrq.gov A broad array of research on this topic has found an association between lower nurse staffing levels and higher rates of some adverse patient outcomes. A new evidence report entitled The Effect of Health Care Working Conditions on Patient Safety, produced by an AHRQfunded Evidence-based Practice Center (EPC), reviewed 26 studies on the relationship between nurse staffing levels and measures of patient safety.b Most of the studies examined nurse staffing levels and adverse occurrences in the hospital setting, including in-hospital deaths and nonfatal adverse outcomes such as nosocomial infections, pressure ulcers, or falls. The EPCââ¬â¢s researchers found that lower nurse-topatient ratios were associated with higher rates of nonfatal adverse outcomes.7 This was true at both the hospital level and the nursing unit level. With regard to in-hospital deaths, however, the evidence does not consistently show that lower nurse staffing levels are associated with higher mortality. The largest of these studies on nurse staffing (jointly funded by AHRQ, the Health Resources and Services Administration, the Centers for Medicare & Medicaid Services, and the National Institute of Nursing Research) examined the records of 5 million medical patients and 1.1 million surgical patients who had been treated at 799 hospitals during 1993.6,8 Among the studyââ¬â¢s principal findings: â⬠¢ In hospitals with high RN staffing, medical patients had lower rates of five adverse patient outcomes (UTIs, pneumonia, shock, upper gastrointestinal bleeding, and longer hospital stay) than patients in hospitals with low RN staffing. c â⬠¢ Major surgery patients in hospitals with high RN staffing had lower rates of two patient outcomes (UTIs and failure to rescue). â⬠¢ Higher rates of RN staffing were associated with a 3- to 12-percent reduction in adverse outcomes, depending on the outcome. â⬠¢ Higher staffing at all levels of nursing was associated with a 2- to 25-percent reduction in adverse outcomes, depending on the outcome. Table 1 illustrates some of the major findings. For example, the researchers found that medical patients in hospitals with high RN staffing were 4-12 percent less likely to develop UTIs than medical patients in the comparison group. Lower staffing levels are linked to higher adverse outcome rates The EPC report included five studies funded by AHRQ that examined the relationship between adverse patient outcomes and hospital nurse staffing. All five studies found at least some association between lower nurse staffing levels and one or more types of adverse patient outcomes. How often do such adverse ââ¬Å"nursing-sensitiveâ⬠patient outcomes occur in hospital care? Different studies report varying adverse event rates, which vary by the type of patient (medical or surgical) as well as other factors. For example, UTIs occur in from 1.9 percent to 6.3 percent of surgical patients and pneumonia in 1.2 percent to 2.6 percent of surgical patients.8-10 b Table 1. Percent reduction in rates of outcomes among medical patients in hospitals with high nurse staffing (75th percentile) compared to the rates in hospitals with low nurse staffing (25th percentile) Amount by which rates are lower for: In order to improve the quality and delivery of health care services, AHRQ has sponsored a series of evidence reports that are based on rigorous, comprehensive reviews of relevant scientific literature. These reports are developed and written by outside research and academic organizations designated as Evidence-based Practice Centers (EPCs). The reportsââ¬â¢ emphasis is on explicit and detailed documentation of methods, rationale, and assumptions. The goal of these reports is to provide the scientific foundation that public and private organizations can use to develop their own clinical practice guidelines, quality measures, review criteria, and other tools to improve the quality and delivery of health care services study measured RN staffing as hours per day and as the RN proportion of nursing hours. Hospitals with higher hours of RN staffing (75th percentile) had an average of 9.1 hours of inpatient RN nursing per patient day, while those with lower RN staffing (25th percentile) had an average 6.4 hours of inpatient RN nursing per patient day. Hospitals with a higher proportion of RN staffing (75th percentile) had an average of 75 percent of inpatient nursing hours provided by RNs, while those with lower RN staffing (25th percentile) had an average of 62 percent of nursing hours provided by RNs. Outcome in medical patients Urinary tract infection Upper gastrointestinal bleeding Hospital-acquired pneumonia Shock or cardiac arrest High RN staffing 4-12% 5-7% 6-8% 6-10% High staffing, all levels (RNs, LPNs, aides) 4-25% 3-17% 6-17% 7-13% c This Note: Difference is expressed as a range of values (e.g., 4-12 percent) because several statistical models were used in evaluating the relationship between nurse staffing levels and each adverse event. Source: Needleman J, Buerhaus P, Mattke S, et al. Nurse-staffing levels and patient outcomes in hospitals. Final report for Health Resources and Services Administration. Contract No. 230-99-0021. 2001. Harvard School of Public Health, Boston, MA. www.ahrq.gov 3 Medical patients in hospitals with high levels of total nurse staffing (RNs, LPNs, and aides) were 4-25 percent less likely to develop UTIs than patients in the comparison group. A similar analysis was performed for the smaller group of surgical patients (Table 2). Surgical patients in hospitals with high RN staffing had a 5-6 percent lower rate of UTIs and a 4-6 percent lower rate of failure to rescue than surgical patients in the comparison group.d Pneumonia rates are especially sensitive to staffing levels Three AHRQ-funded studies found a significant correlation between lower nurse staffing levels and higher rates of pneumonia. â⬠¢ The first study found that adding half an hour of RN staffing per patient day could reduce pneumonia in surgical patients by over 4 percent.12 This study covered 589 hospitals in 10 States during 1993. â⬠¢ A second study by the same researchers also found that fewer RN hours per patient day were significantly correlated with a higher incidence of pneumonia.13 The study examined administrative data on post-surgical patients in 11 States during 1990-96. â⬠¢ A study of nurse staffing levels and adverse outcomes in California found that an increase of 1 hour worked by RNs per patient day was associated with an 8.9-percent decrease in the odds of a surgical patientââ¬â¢s contracting pneumonia. 8 â⬠¢ This study also found that a 10-percent increase in RN proportion was associated with a 9.5-percent decrease in the odds of pneumonia. The researchers in the California study believe that the strong relationship between RN staffing and pneumonia can be attributed to the heavy responsibility RNs have for respiratory care in surgical patients. This study examined the effects of nurse staffing on adverse outcomes in 232 acute care hospitals from 1996 to 1999.f Unlike many earlier studies, the California study included only adverse outcomes that were not present at admission.7 Table 2. Percent reduction in rates of outcomes among surgical patients in hospitals with high nurse staffing (75th percentile) compared to the rates in hospitals with low nurse staffing (25th percentile) Amount by which rates re lower for: High staffing, all levels (RNs, LPNs, aides) 3-14% 2-12% 19% Outcome in surgical patients Urinary tract infection Failure to rescue Hospital-acquired pneumonia High RN staffing 5-6% 4-6% 11% Note: Difference is expressed as a range of values (e.g., 2-12 percent) because several statistical models were used in evaluating the relationship between nurse staffing levels and each adverse event. Source: Needleman J, Buerhaus P, Mattke S, et al. Nurse-staffing levels and patient outcomes in hospitals. Final report for Health Resources and Services Administration. Contract No. 230-99-0021. 2001. Harvard School of Public Health, Boston, MA. A second study, funded jointly by AHRQ and the National Science Foundation, examined licensed nurse staffing (RNs and LPNs) and adverse outcomes among both medical and surgical patients in Pennsylvania acute-care hospitals.11 It found a lower incidence of nearly all adverse outcomes it studied in hospitals with more licensed nurses. For example, a 10-percent increase in the number of licensed nurses is estimated to decrease lung collapse by 1.5 percent, pressure ulcers by 2 percent, falls by 3 percent, and UTIs by less than 1 percent. Also, with a 10-percent higher proportion of licensed nurses, there was a 2-percent lower incidence of pressure ulcers.e,11 d Surgical patients overall had lower rates of adverse outcomes than medical patients, perhaps because they are healthier. Also, the smaller number of surgical patients in the study may have made it more difficult to detect associations. Nurse staffing was measured in two ways: (1) the ratio of licensed nurses (RNs + LPNs) to the patient load (with and without adjustments for patient acuity) and (2) the proportion of licensed nurses to the total nursing staff (RNs, LPNs, NAs). The adverse outcomes selected for study were ââ¬Å"either caused by or not prevented by medical managementâ⬠based on criteria used by the Harvard Medical Practice Study. Nurse staffing was measured in three ways: all hours (the total number of productive hours worked by all nursing personnel per patient day), RN hours (the total number of productive hours worked by registered nurses per patient day), and RN proportion (RN hours divided by all hours).
Monday, January 6, 2020
What Violates The Fourth Amendment - 1194 Words
What Violates the Fourth Amendment? ââ¬Å"Unreasonable search and seizures shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.â⬠ââ¬â Amendment IV The most controversial aspect of the fourth amendment is the debate over what constitutes as a legitimate search. Since the amendmentââ¬â¢s addition to the constitution on December 15, 1791, citizens have questioned police action. The case of United States vs. Jacobsen states that ââ¬Å"A seizure of property occurs when the government meaningfully interferes with a personââ¬â¢s possessory interest.â⬠With this great debate in effect, a theory was introduced calledâ⬠¦show more contentâ⬠¦However, before this case, the case of Terry vs. Ohio also helped set the investigatory bar. Terry vs. Ohio involved the Supreme Courtââ¬â¢s decision in deciding whether it w as of reason for a police officer to stop a person and search him, when less than probable cause for an arrest was present. The consequences presented in Terry vs. Ohio were put forth but examination of the ââ¬Å"reasonable balancing test.â⬠By doing so, a balancing test that has a wider variety of causes is now in effect. In this landmark case, it was held that policemen are permitted to perform a ââ¬Å"stop and friskâ⬠pat down, if there is reasonable suspicion that the person is presently dangerous and carrying a deadly weapon. This ââ¬Å"stop and friskâ⬠method was later extended to vehicle arrests as well. After the case of Terry vs Ohio, this wider variety of the balancing test came into effect the case of Louisiana vs. Morgan. In this case, Johnny Morgan was observed walking at a rather quick pace, late at night, at a poorly lit area, by a policeman named Sergeant Brown. After realizing that it was a deputy watching him, Morgan fled and was apprehended by Br own. After noticing the man sweating and seeming to grow nervous, Brown found what looked to be a crack pipe. Crack cocaine was also discovered in the defendantââ¬â¢s pockets. Morgan was arrested a hauled off to jail where he was charged with possession of
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