Clinical Case Study- Hyperosmolar Hyperglycaemic Syndrome Study

Clinical - Hyperosmolar Hyperglycaemic Syndrome - Case Study Example She was accompanied by her daughter. Mrs. L had a three-day history of confusion, lethargy and drowsiness. She complained of thirst for the last one week, drinking more than eight pints of water a day. Upon registration at the ambulance registration desk of the Emergency Department by administrators, Mrs. L was placed in a separate room, within the department for exceptional care. She was intubated and ventilated because of hypoxemia and poor conscious level, after which her fracture was attended to. Examination showed that the patient had a heart rate of 130, body temperature of 38.2 degrees Celsius, blood pressure of 150/80 and fair chest excursion, with loose wheezes, and serum pH of 7.5. Mrs. L was also dehydrated, as evidenced by her dry mucous membranes. Mrs. L’s spO2 reading was 80%. A blood sample was taken for checking. After the Doctor’s check ups, Mrs. L’s blood glucose was diagnosed with excess of 56. 5mmol. Therefore, her blood glucose was elevated. Tests involving Mrs. L’s urine were positive for glucose; however, she took long to pass urine. She was transferred to the resuscitation room to receive specialised care because she was categorised as having life-threatening conditions and injuries. After investigation from her close family member, the accompanying daughter, it was revealed that Mrs. L had fallen while she at the bathroom. That is why she had a fracture femur. Her family history was also significant for diabetes and hypertension. Clinical Manifestations Dehydration Dehydration is the insufficiency in the amount of water in the human body. It is prudent to identify and treat dehydration early enough to prevent further complications (Konrad, Corrigan, Hamilton, Steiger, & Kirby, 2013). This is because mild dehydration is known to cause tension and fatigue (Ganio & Armstrong, 2011). It can also cause lack of focus, according to (Szalavitz), 2012. It was established from clinical tests that Mrs. L had dry lips an d was dizzy, as well as, confused. Mrs. L also had dry mucous membranes. This was enough evidence that the patient was dehydrated. Most of the patients who are dehydrated are normally confused, dizzy, with dry lips and mucous membranes (Campbell, 2011) and (Heit, 2013). It was found out that the patient had complained of thirst for the previous one week, drinking more than eight pints of water a day, from the history of Mrs. L, provided by her daughter. It is healthy to drink lots of water but excessive thirst, and the frequent urge to drink too much water, exhibited by Mrs. L was a sign of dehydration. Finally, the fact that it took long for the patient to pass urine that was required for urine tests was a sign of dehydration. Hyperosomar Hyperglycaemia Syndrome is characterised by hyperglycaemia, extreme dehydration and hyperosmolar plasma (Balasubramaniyam, Palanis, & Rajamani, 2011). Hyperosomar Hyperglycaemia Syndrome is characterised by severe hyperglycaemia. This is a marked increase in serum osmolality and clinical evidence of dehydration, without the accumulation of acetoacetic ketoacids (Venkatraman & Singhi, 2006). Hyperglycaemia results from either an absolute or relative insulin deficiency. It ca also be a result of decreased tissue responsiveness to insulin, which is an increased insulin resistance. This results into gluconeogenesis and glycogenolysis, leading into a reduced rate of glucose uptake and utilization by peripheral tissues. A rise in

Journal Writing Essay Example for Free

Journal Writing Essay During this class I have made two self- discoveries that will positively impact my career goals. Those self- discoveries has helped to mold, and shape me into a student that I have never thought I would be. Those discoveries were that I am an organized learner, because I made a study plan to help me determine when, and how I would study. Being that I have five children, I had to make sure that I had set a schedule so that my course work including study time would not affect my family time and take away from spending time with my children and fiance`. Since these are the competing priorities in my life right now learning to obtain trust and consistency in the home while I have been attending school has also improved because not only do I see my success so does my children and fiancà ©. Knowing that I had that support also has made it possible to do my best in school, setting the pace for them to do the same in school also, whether it be good grades, sports, etc. I know that they will continue to be good at what they do and have proven to do so time after time. Another self- discovery that I have made that will positively impact my career goals is my willpower. Willpower has become my greatest strength. Being able to control what I do, leaded to personal improvement. I realize that lack of willpower not only causes you to lose focus it also allows you to fail to achieve goals. My ability to resist short-term temptations have helped me to meet some of my long term goals already. There has never been a day that I thought that I could not achieve my goals. I kept a positive mindset just so I could keep going. Negativity takes a lot of willpower from you and I think success is a part of having a positive mindset. Having that determination was not easy at first I can say that, but having that willpower and thinking about my future will positively impact my career goals. Two self-discoveries that I believe will positively impact my personal life, o ne is my happiness. If I am not happy there is nothing good that will come out of being unhappy. In my life I noticed that unhappy people wait for something to make them happy. Happy people make themselves happy without hesitation because they choose to have  positivity surround them in all areas of their lives. I am that happy person, I do not feel like being unhappy because it drains energy, it drains potential, it sucks the life out of you, and it keeps you from becoming successful. I am happy because I am not afraid of change, I am valued, and I attend school knowing that I am a success story. I learned to create positive changes in my life. In doing so this has made a positive impact on my personal life. My character will also have a positive impact on my life. Knowing who I am, my beliefs, values, and morals. The clearer I became about what I value and what I believed in the more effective I became not only for me, but for my family, my friends, and my peers. I have this thirst for knowledge and a thirst to make the best out of any situation and this impacts my personal life in so many positive ways because when I know who I am , my children will learn their true identity because they are my children and they share the same DNA. My grandmother use to tell me that I can be different from everyone else and still be blessed and fabulous, and I believed her.So this has played a part in my self- identity. I also had to explore what my heart wanted, so that I could truly identify who I was, the most beautiful thing that could have happened to me was unfolding that I was an excellent mother, a great friend, and a superb student. Knowing these few things lead me to know who I was in the beginning and knowing this has made a positive impact in my personal life. My biggest take way from this course is keeping a growth mindset and knowing that I always have room for improvement. I want to keep ownership over my learning experience. I am in control of my success. I am able to keep this in mind and always grow with it. This is something that I had to develop because when I was younger I had a fixed mindset I did not want to change because I was set in my ways and it felt like everything I was doing had failed me, so I figured that I would quit trying and give up. One day that change I started thinking of other approaches of how to be better and I used trial and error as a way of figuring out what I needed to do. So as I was thinking and applying I realized that I had that growth mindset and I have kept it all through the years. While learning about the fixed mindset and growth mindset I gained a better understanding on what life is really about also and I saw the bigger picture. The way I perceived it to be is to  noticed that if something is not working right the way you are doing it, then try another way and if that works out better than stick with it, but have fun with it and be creative and then you will be successful that way . Life is about trial and error and never giving up no matter what.

Every child has the right to a mainstream education

Every child has the right to a mainstream education Every child has the right to a mainstream education. This is an entitlement for the parents of special needs children, for them to be able to access this, if they believe it to be the correct decision for their child. Many things need to be considered when doing this such as whether the individual child will be able to cope in this type of school environment and whether their ability will allow them to progress along with their peers. This is something which I believe is not the correct decision for every child as I have witnessed pupils who struggle day in day out with issues such as the playground environment, forging relationships with peers and some who are unable to cope with the unpredictability of what can be the normal school day. Inclusion is important, though it is not necessarily the right choice for every pupil. Inclusion is regarded as successful education of all students (whether with or without disabilities, disadvantages) in the same schools and classrooms, celebrating the resulting diversity, including various abilities and cultures (DFES). The era of mixed ability groupings means teachers need to include every child regardless of need and ability through differentiated work, extra support and with a range of activities to suit all needs. The Governments aim is for every child, whatever their background or their circumstances, to have the support they need to be healthy, stay safe, enjoy and achieve, make a positive contribution and achieve economic well-being. Every child matters and they do within the classroom and school environment. (Every Child matters). Education needs to be personalised so every child can learn to the best of their ability and access resources and materials in lessons, and for most cases this happens. There are many occasions in which I have witnessed, however, where special needs pupils fall short of being included all of the time and are given activities which neither stimulate nor challenge them. These are the pupils which perhaps need the most help to progress. They need to be suitably challenged so they may progress in some way, however big or small. Ofsted (2004) suggested that schools should make sure that pupils with SEN in mainstream schools are able to play a full part in school life, and receive a curriculum and teaching relevant to their needs (p.9). Pupils can often get lost in large mixed ability groupings and this is where a child may feel excluded as the teaching is not always relevant to their needs. This paper shall focus upon inclusion and the experiences of pupils on the autistic spectrum in mainstream schools. Significance for my Practice Every school I have been in has at least one child on the autistic spectrum. This is inevitable now in mainstream schools due to inclusion. Each child I have seen has Aspergers syndrome, high functioning autism. These children are clever and generally are placed in good sets. Educationally these pupils can advance and do well. Socially, however, these pupils struggle and they face difficulties on a daily basis. I am involved with some of these pupils at my present school so the significance for my practice will be vast. Understanding the research in this area and carrying out my own research will allow me to draw conclusions which I can then apply in school, to help these pupils and to in turn make other teachers aware, to allow benefit for these pupils across the school as a whole. Historical Background The Education Act (1944) established the grounding that a childs ability should be measured on age, aptitude and what they are capable of. SEN children were categorised by their disabilities. Although the act was groundbreaking for the whole education system, it was the 1970s that the focus of the individuals own need began to be addressed (Parsons, 1999). Research into special educational needs occurred more frequently in the 1970s after the Warnock Report (1978) which found that 20% of children could have SEN but 2% may need support above what mainstream schooling could offer them. Since then a great deal of research and investigation has been done in all areas of special needs. The government has made a number of acts over the years to ensure this happens, the most recent one being the Special Needs and Disabilities Act (2001) which protects students against discrimination. In 2005 however, Baroness Warnock criticised SEN in the UK and has suggested that small specialist provision is needed and that the bullying of SEN children in mainstream schools is inevitable. The claim fails to include that small specialist provision is still available should parents seek this. Specialist provision is now also within some mainstream schools which have specialist units within to cater for more complex needs. Further literature, which is discussed later backs up this claim to some extent. Autistic spectrum disorders (ASD) are a range of related developmental disorders that begin in childhood and persist throughout adult life (NHS, 2010). It causes problems and difficulties with social interaction, impaired language and communication skills and unusual patterns of thought and physical behaviour. There are three main types of ASD; autistic disorder, aspergers syndrome and pervasive developmental disorder. The National Autistic Society (NAS) claim that 1 in 100 pupils have ASD and that all schools should be autism friendly with fully trained teachers. This I believe should be the case but with numerous policies and an extensive range of needs within SEN alone, it is difficult to ensure all teachers are trained in everything. This is perhaps where there should be a number of specialist teachers, rather than have all teachers specialise in everything. This however, suggests that in a typical secondary school there could be more than ten children with this disposition. Aspe rgers (high-functioning autism) is common in most secondary schools and the experiences of some pupils are difficult ones. ASD was first identified by Kanner (1943) as a specific pattern of abnormal behaviour. He identified this as being rare but made no attempt to define the amount of people who may have had this. Though the study is very dated, it is still highly influential today and has been a steeping stone for all future research. It is still also relevant to society today as people show the same symptoms as identified and therefore is still of huge importance. Other studies have shown differing prevalence rates of this, including Lotter (1966) who identified a frequency of 4.5 per 10,000 children with autism in an empirical study that was carried out which was epidemiological in nature. This developed the findings from Kanners research, nevertheless further research by Wing and Gould (1979) identified a rate of 15 per 10,000 of children who had social interaction, communication and imagination difficulties. This was the triad of impairments. Patterns of a repetitive nature were also identified whi ch is common today in most children was ASD. The children in the study were not that of the autism Kanner had described. Wing and Gould identified these being part of a broader spectrum of needs. These needs together were identified in 20 per 10,000 children. The prevalence rate is difficult to trust as many people portray elements of ASD yet are not defined as such. Experience has shown this. With prevalence rates, not all of the population can be tested and therefore the rate should be taken as an estimate. Asperger (1944) focused on a group of children who had similar behaviours to what Kanner (1943) had described as autism, but whom had enhanced abilities.   Asperger presented four case studies of children.   In these children he identified some patterns of behaviour and abilities and consequently named these autistic psychopathy.   These behaviours resulted in a lack of empathy, little ability to form friendships, one-sided conversation, intense absorption in a special interest and clumsy movements.   Asperger went on further to explain how these children displayed a great understanding and depth of knowledge on their favourite subject.   These claims are great and wholly unjustified on merely a study on only four boys.   Further research is hinted at within the text but as the paper only identified four case studies it should be regarded as a small scale study. It is common now also for girls also to be associated with being diagnosed with Asperger syndrome, which is a s ignificant point that Asperger missed. The behaviours identified are some which I have witnessed and which are consistent with my experience. Children with Aspergers syndrome can talk in depth on their favourite topic and can completely change the course of a conversation they are in to talk about this. They can often have one sided conversations on this and are not necessarily talking to anyone in particular on their specialist subject. The limitations of this research lie with the time, these were studies that were done during World War II and therefore behaviour due to trauma from the war could have indeed impended the true behaviour that matched the child.   It could be argued though that there were indeed many other children who presented with these behaviours and abilities, but an in-depth study of just four ensured significant detail and strengths in assessing a range of behaviours over a period of time, which consequently could be later relayed onto other children with a similar disposition.   The considerable delay in the translation of this paper led to Western understanding decades later; his finding are now regarded and accepted worldwide.   Aspergers syndrome is indeed a social construction and the paper should be taken as such but noteworthy research which will be discussed later now backs up the claims made in this paper. What could be regarded as another influential study is done by Wollf (1995). Having studied Asperger syndrome for over 30 years the findings are most definitely worthy to a great degree. The studied children were of average or high ability who were impaired in their social interaction but who do not have the full picture of the triad of impairments. However, these children represent the most subtle and most able end of the autism spectrum; are higher functioning. The majority become independent as adults, many marry and some display exceptional gifts, though retaining the unusual quality of their social interactions. There is great debate on why to even include these children in the autistic spectrum. Wolff suggests that these children often have a difficult time at school and they need acknowledgment, understanding and acceptance from school staff as well as parents. Is this the best option for these children though? To identify them as different and therefore facilitate them to a l ife of indifference as they live with this brand upon them. This makes the research lose some credibility as there should be more justification than they have a difficult time at school. Other children have difficult times at school, for many other reasons. Research Theories and Findings A good proportion of studies have been completed on including pupils in a mainstream school with autistic spectrum disorders. These studies differ in terms of their methodologies and findings. With a huge proportion of pupils in the UK facing difficulties with communication, social interaction and imagination, studies for mainstream schools focus upon high functioning autism in the form of Aspergers syndrome. It is more common to find pupils with Aspergers syndrome in mainstream schools as their intellectual level is greater than those with pure autism. Inclusion and Autism; Pupil Experience Humphrey and Lewis (2008) looked into the views and experiences of a pupil with ASD in a mainstream school. Through a small scale study it found that the inclusion of pupils with Aspergers syndrome in mainstream schools presents challenges and opportunities for the various stakeholders (e.g. teachers, pupils, parents and peers) in this process. The study was purely the views of pupils and their experiences though it is often witnessed by teachers that issues at home equate to problems at school. As a result, it may have been appropriate to include teachers views to ensure the participants were portraying behaviour that was usual. Inclusion is fraught with difficulties, with the whole range of needs that exist in mainstream schools at present. A report shows 1000 examples of inclusion in education from members of NAS, Barnard et al (2000). The findings claim that parents with a child in an autism specific provision were twice more likely to be very satisfied than those who had a child in a mainstream school. It shows that views decline through the later school years, the older the child becomes. The survey was completed by over eight hundred respondents, with half of the children being in a mainstream setting. A majority proportion of these children had statements. Findings are primarily based on opinions of parents but the views could be contested as they do not attend school with their child. The parental opinion on what they think their child should have may exceed the needs that their child actually holds. In a mainstream school I am working in children with ASD are supported in a variety of ways and are making good progress. There are issues that these children struggle with but they are guided through these with help from staff in school and through external agencies support. Humphrey is a leading researcher in the field, with a number of studies looking into the effects of inclusion for pupils. Humphrey (2008) identifies that the number of students with ASD being educated in mainstream schools is growing, though educational experiences of these students are unfounded. Whats more, the article found that pupils with ASD are more than twenty times more likely to be excluded from school than those without special educational needs. This implies that pupils are unable to cope suitably in this setting yet reasons for the exclusions are not explored. The paper identifies strong strategies for behaviour and such, yet without the reasons of why these people are excluded the suggestions on improving behaviour are speculative. Literature also draws upon the debate of whether inclusion in mainstream education is the best route for all special needs children. Wang (2009) identified through a critical analysis that certain difficulties may occur by allowing ASD childr en into mainstream education. It also notes on how inclusion is worth striving for and how disadvantages can be resolved by training educators appropriately. Much research in this area pertains that it is teachers who need to understand more and in turn need to implement different strategies. This shall be discussed further later. Tobias (2009) found that by providing students with a mentor figure and by meeting the needs of the individual rather than applying blanket policies to groups of students with ASD, that these were strategies to support and aid in inclusion which worked well and were consequently perceived as such. This on the other hand, is one isolated example and was a small scale study of just fifteen participants and research in this respect is limited. Most studies seem to take the view that experiences could be improved; bullying was found to be a major issue within literature. Peer Understanding and Bullying A significant number of researchers have identified the need to ensure peer understanding to allow ASD students to be included in the activities associated with school life. Many reports account for many students with ASD being bullied by peers, either because they know they are different and have ASD or because they are seen as different and cannot handle social situations as well as others may. Humphrey and Lewis (2008) identified the fact that much research had suggested these pupils make easy targets for bullies. The symptoms associated with ASD make these pupils stand out from their other peers so this statement could be suggested from observations, the research needs to identify why this is as it found almost all pupils reported being bullied at different levels of severity and frequency. This also seemed to occur regularly. Research on this suggests that it is boys in particular who suffer in school settings. Granzio et al (2006) confirm that the oddness of pupils with Asperge rs syndrome led to verbal abuse and social exclusion on a daily basis from peers. From this it may be reasonable to suggest that social exclusion could lead to other problems in a child such as the child becoming depressed due to social rejection as around one-third of school time is spent outside the classroom (Nelson, 2004). This therefore is an area where more research needs to be done; in particular in that of social integration. Norwich and Kelly (2004) recognise that those with special educational needs are more likely to be bullied than other pupils. When thinking of the difficulties faced by children with ASD; particularly that of social and communication difficulties it is not surprising the rate and frequency that bullying occurs. The World Health Organisation (2007) suggests that social difficulties are exacerbated if dyspraxia or developmental clumsiness is present, which is often the case. Students therefore need to develop an understanding of ASD pupils to allow them to develop some compassion to how they must feel on a day to day basis. Humphrey (2008) established from previous research that students need to understand a little about why students with Asperger syndrome have such quirky behaviours. A little understanding and knowledge can go a long way to show other students how to assist easily, rather than ignore or taunt this student. Most research in this area suggests that more knowledge is nee ded, whether it is for the pupils or school staff. A further study looks into the relationships with peers and the use of the school environment. Wainscoat et al (2008) found through a case control study that Aspergers pupils, in comparison with controls engaged in fewer social interactions, spent breaks and lunch times in adult supervised areas of the school, reported having fewer friends and therefore likely to be the targets of bullying. This once more shows recognition in the fact that experiences of these pupils within mainstream education are not all good. This is one of the few quantitative studies yet provides little understanding into reasons behind the findings compared with the qualitative studies. It provides strong evidence to support these claims through statistics but the structured interview could have included some open questions to allow participants to elaborate. The literature discussed shows pupils are isolated, often bullied and somewhat unhappy. This suggests mainstream education is perhaps not the best place f or all students. There also seems to be a social stigma attached to these pupils as research suggests quirky or odd behaviour. With up to 1 in 270 students at secondary mainstream schools having SEN related to an ASD, Barnard et al (2002) this accounts for a huge proportion of pupils who may be having the same difficulties. This calls out for a greater need for more research in this field to ensure ASD pupils are getting the support they need to deal with these issues and how these issues are dealt with in mainstream schools. Teachers Perceptions Ashburner et al (2010) compare teachers perceptions of students with ASD to their perceptions of typically developing students with regard to their capacity to perform academically and to regulate emotions and behaviour in mainstream classrooms. This was a case control research design and participant bias, in respects to the participating teachers is highly prominent in this research. It was based on teachers ratings from teachers whom already possessed views and opinions on the childrens aptitudes, abilities and more importantly temperament. This, on the other hand, means they had a truer perception of the child that a researcher would not have had and therefore results are plausible. Ashburner et al propose the research findings were concurrent with prior research which suggests that students with ASD exhibit significantly higher levels of behavioural and emotional difficulties at school than their typically developing peers. Jordan (2008) claims that teaching pupils with ASD is hard. It is hard for just the same reason that students with ASD find it difficult to learn in our current school system. Just as these children have no natural intuitive ways to understand their teachers, teachers, in turn, have no natural intuitive ways of understanding students with ASD. Teaching is made more difficult by the fact that no child with ASD is the same and strategies that work on occasions, may not do on every occasion. This is what I have found in my practice. This is where Every Child Matters comes into play and is particularly important, where each child needs support to enjoy and achieve. Jones et al (2007) conducted a review of needs and services for young people with Aspergers syndrome. It identified that within education many children, parents and carers will meet people in their school lives whom have no knowledge of Aspergers syndrome, teachers included. Thirty five children took part in the review and the majority (68%) would have liked their school to be different. Although this is based on ASD children, it goes without saying that most children would like school to be different and therefore more specifics need to be recognised. Within the survey bullying was also identified, yet this was something which school staff failed to mention. Research in regards to teacher understanding comes across not only in research that is based solely on the teacher, but also from research on peers and pupils themselves with ASD. This shows there is a greater need for teachers to be more aware of the whole range of need associated with ASD, not just Aspergers syndrome which is commonly found in mainstream setting. Conclusions from the research The general consensus from the research identified is that inclusion and autism is improving, but improvements still need to be made. There is limited research into social integration of pupils into mainstream schools, which considering the estimated prevalence rate is quite alarming. A significant number of researchers have also identified the need to ensure peer understanding, as well as a greater awareness of ASD for teachers. The majority of the research identified bullying as an experience within school. The percentages of this are soaring and it is something which I believe schools needs to research promptly. Bullying is identified in the research from accounts by the pupils, yet teachers perceptions on this seem somewhat different. Research falls short of statistical evidence and a lot of it is qualitative, but this provides in depth explanations and good quality accounts of experiences within mainstream schools. Part B In analysing the different research studies it seems appropriate to start from near the beginning and look at where new and relevant research stems from. In this respect there will be a focus on Aspergers syndrome (Asperger, 1944). The paper by Asperger (1944) is highly pertinent in understanding a range of autism that may occur in a person. It continues on from the work done by Kanner (1943). A great deal of evidence is collected, including that of family history. The research methods, however, are somewhat lacking. The testing that Asperger conducted on these children often failed in providing any useful analysis and was therefore disregarded. Intelligence tests were conducted where these included construction tests where the child would copy from memory, rhythm imitation, memory for digits (repetition for six digits was expected at the age of ten, one boy who was six thus proved to be above average), memory for sentences (this could not be evaluated) and similarities between different things were tested. Analysis focused on memory for digits, along with observation and parental examples of abilities. The latter is a difficult one to reprehend as parents often believe their child to be above average of other children of a similar age and this for that reason is only their opinion. It is essentially qualitative data in the respect that most of the research is carried out through observations and opinions. The data is essentially more rich with lots of detail and therefore of good quality. The justifications for the intelligence tests were on the basis that the child carrying out these tests were observed and therefore judged on communication and ability. This fundamentally enhances the reliability of the tests as there was a plausible reason behind carrying them out, rather than just purely to measure intelligence. The tests however were adapted to the personality of the child so conclusions from these as a whole need to be somewhat justified more. This was essential in terms of ethical issues to put the child at ease but each of the data sets collected are detached from each other, as each case study had a different method. The research is highly subjective and researcher bias is great due to the nature of the observations. The case studies, however, provide enough detail through comprehensive descriptions to justify the claims made. Overall, this paper has provided a good grounding for all research conducted today in this field and is highly important. The research methods conducted are limited but further research and advancements in technology since 1944 have allowed a greater picture of Aspergers syndrome to be developed over time. In contrast, a recent paper on the views and experiences of Aspergers children in a mainstream school moves away from looking at how these children behave to focusing on how they feel and what their experiences are like. This links to the last paper discussed on what Aspergers is but looks at their perceptions of what Aspergers is, so is not purely from the side of the researcher. Humphrey and Lewis (2010) provide an in-depth analytical paper on how these children cope in school. This is a small scale qualitative study on twenty pupils in North West England. It looks at four mainstream high schools. The research is phenomenological where interpretive phenomenological analysis was used to explore how pupils made sense of their educational experiences. The research was qualitative in its methods; the study incorporated semi-structured interviews and pupil diaries. The diaries were used for a month which made possible vast amounts and quantities of detail from each participant in the st udy. This is difficult to analyse and researcher bias will occur to decide which points are valid and are worth mentioning above others. The diaries were also conceived via different methods; either written, orally or electronically. This could yield different results. The participants had a choice but this may not have necessarily been the correct method to enable them to explain in the greatest amount of detail. All participants did not fill in the diary for a whole month period but a number of participants stopped at differing intervals. This led to varying amounts and different quantities of data sets from each participant. The research should have perhaps been carried out on a smaller time scale to allow for full participation. The diaries, on the other hand do provide good detailed responses as opposed to purely using interviews. For example, a participant proceeded to draw images and diagrams depicting his school life which gave a more rounded picture on his feelings and emot ions. This level of detail allows for greater understanding of their experiences and therefore enables the research to be reliable due to the high quality that it portrays. The semi-structured interviews then back up thoughts and feelings from the participant which also enables prompts from the researcher, to allow greater explanation on why they think or feel this particular way. The paper is high in terms of validity and there is a small chance the participant may be lying as issues were recorded in the diary and discussed further via this route. The study also adds to input from its participants by allowing them to provide commentary on the findings, which were then incorporated into the paper. This ensures the theme on their views is completely adhered to, again adding to the consistency of the methodology. The visual representation of results both allowed for the pupil understanding when they were providing commentary on the paper but it also identifies strong categories and th emes in an area where research is wholly limited. Furthermore, this will provide a strong grounding for further and future research in this particular area. Another study, Wainscot et al (2008), looks at experiences in a mainstream school of participants with Aspergers syndrome, but this focuses more specifically on the relationship with peers and the use of the school environment. Research methods included a case control design where pupils undertook a structured interview on their social interactions that day, at the end of school. This method was justified entirely by suggesting the alternative approach of using a cohort study could result in an unbalanced sample based on the kind of prevalence observed. By justifying the method the paper gains credibility and warrants why the method it chose was to all intents and purposes best for this particular research. Structured interviews provide limited scope for the participant to respond and as a result there was a lack in the depth and quality of answers. For example, a question posed was did you have a good day at school today? This is a yes or no question and reasons behind this answer c ould be vast. A pupil may not have slept well or simply was not in a good mood, but in terms of the research conducted it could be interpreted as the participant not liking school or anything the researcher interprets it as. This is a quantitative study and as such responses were entered into SPSS database and analysed. A snowball sampling strategy was used which was again justified as the characteristics required of participants are rare. The control participants were chosen with dyslexia to further investigate SEN as a risk factor for social isolation. The overall number of dyslexic pupils in the study however, turned out to be just three. The research therefore focused primarily on those with Aspergers syndrome and those without. The case-control dyad matched a whole range of variables; age, gender, academic ability, physical size, lessons attended, socio-economic background and ethnicity. The variables were matched where they could be but not all of the case control dyads were. This implies the amount of variables was perhaps too complex to allow for all true matches. The data was collected at different times, in different years to be specific. This implies a lack of reliability as data was collected over a year apart and therefore the researcher did not allow the research to be consistent; this may well have influenced the second data collection period more notably than the first. The study provides a number of limitations but in essence provides good substantial evidence, with a clear comparison between two groups. The researcher could have had more control over the study as opposed to allowing case-control matches by the schools. Again, as with the previous study discussed a need for more research in this field has been acknowledged and suggestions of peer bullying are further recommended. Barnard et al (2000) carried out a large scale study focusing on examples of inclusion in education from the National Autistic Societys members. Although this is slightly dated, it is one of a few large scale studies on inclusion and autism that has been conduc

Calle Ocho Walk of Fame :: Miami Latin Culture

Calle Ocho Walk of Fame The Hollywood Walk of Fame is known worldwide and is a major tourist attraction. Javier Soto wanted Miami to have a similar Walk of Fame in which Latin stars would be recognized. His dream came true on March 2, 1989, when Gloria Estefan and the Miami Sound Machine received the first star on the Latin Star Walk. However, this did not happen overnight. Forming a company, developing the idea, and getting the support and permission of local government organizations took time and became a long and drawn out process. It all started when Soto, a publicist, and his wife, Sara, an operator with ITT, formed the company called Latin Stars, Inc., in 1988. The purpose was to obtain the sidewalks in Little Havana between 12th and 17th avenue on Calle Ocho, the main street in Little Havana, to be reserved for the stars. The idea came about when Celia Cruz, the Cuban salsa queen, received a star in 1987 on the Hollywood Walk of Fame. The Sotos were proud of her accomplishment, but they realized that many Latin celebrities would never be recognized in Hollywood. The Miami Commission gave their approval for Soto's project on December 17, 1988. The Little Havana Development Authority and the Latin Chamber of Commerce began their nominations. A seven-member committee chose the stars. Christina Saralegui, a member of the committee and editor of Cosmopolitan en Espaà ±ol, referred to the project as being a "Hispanic Hollywood". The downfall of Latin Stars Inc., this nonprofit organization run by Soto and volunteers, came in 1991, when the company went broke. An audit was performed, but their financial information was incomplete. Further problems arose when sponsors did not pay on time. These sponsors were needed to help cover the $6,800 necessary to pay for a star. This price is how much it cost in the early 90's to actually build the pink marble star, receive permits that were needed, and cover the price of the event that occurs the day a celebrity gets his/her star. From the money spent on the limousine to the security to printing up the invitations, the dollar amounts added up. In addition, Miami commissioners started to screen the celebrities being picked due to local controversy over the issue and their own concerns. On March 12, the city completely severed all relations with Soto's company. Adding to these problems, Soto was accused of hiring a hit man to kill Miami Commissioner Miriam Alonso.

Fair Value Accounting Essay

Topic: To what extent is â€Å"Fair Value Accounting† an effective method in measuring the values of financial instruments in financial statement? In recent years, the breakout of global financial crisis has raised controversial debates about whether or not fair value accounting (FVA) is an effective method in measuring the values of financial instruments (Laux & Leuz, 2009). As two main accounting standards around the world, both International Financial Reporting Standards (IFRS) and US Financial Accounting Standards (FAS) have adopted FVA as an accounting method to judge the values of some financial instruments (Mala and Chand, 2011). This essay will argue that although FVA can provide timely and transparent price information to the users of accounting information in some cases, there are potential problems of FVA in measuring the values of financial instruments on account of unreliable evaluation models, biased prices in inefficient markets and a negative price contagion effect. There are three main parts in this essay. Firstly, it will give the definition of FVA and then it will analyze why the effectiveness of FVA may be limited from three aspects, namely unreliable evaluation models, biased prices in inefficient markets and a negative price contagion effect. At last, it will consider the pros of FVA regarding the timely and transparent information it provides in some cases and analyze the pros. According to Financial Accounting Standards 157, fair value accounting can be defined as â€Å"an accounting method to measure the values of assets and liabilities based on the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date†. That is to say, FVA relies on the actual market prices of the financial instruments and records the exact market prices on the financial statements. In fact, FVA replaces historical cost accounting (HCA) with the development of accounting standards (Boyer, 2007). Compared with FVA, historical cost accounting can be described as an accounting measurement of values based on the original or historical cost when the company got the assets or liabilities. For example, a company bought a stock for 50 pounds last year. In this year, the price of the stock increases to 100 pounds. Under FVA, the company should record the value of  the stock at 100 pounds this year while 50 pounds will be recognized under HCA. As the replaced FVA has been regarding as accelerating the global financial crisis, it draws a lot of attention in respect of its potential weaknesses in the accounting field. Firstly, the model to estimate fair values of financial instruments in illiquid markets seems to have insufficient reliability (Laux & Leuz 2009 and Mala Chand 2011). If the markets for the identical or similar financial instruments whose values need to be evaluated are active, the available prices can be used to evaluate the fair values of them (Laux & Leuz 2009). However, if the markets do not exist, which means the the markets are inactive or illiquid, the fair evaluation model is needed to estimate the fair value of the financial instruments (Ball 2006). Specifically speaking, the model to evaluate fair values of financial instruments rely on the future cash flow of the financial instruments and borrowing rate of the company. The future cash flow can be described as the future cash inflow (income) and outflow (expense) brought by the financial instruments whilst the borrowing rate of a company can be considered as the cost of capital which can be invested in other investments rather than the financial instruments. The users of the evaluation model should firstly predict the future cash flow of the financial instruments and then use the borrowing rate of the company to calculate the present fair values. Ljiri (2005) states that using model to estimate the values of financial instruments provides significant discretionary power to the users and gives uncertainty, which may influence the objectivity of the valuation of financial instruments. Indeed, the same financial instrument could be evaluated differently on account of different estimation of future cash flows and distinct borrowing rate. Because the users of the evaluation model have the power to forecast the future cash flow, different users may have distinct estimations of the same financial instrument based on their perspectives of its future profitability. In addition, different companies may have different borrowing rates due to distinct industries involved. Thus, the above two uncertain factors affects the objectivity of the fair evaluation of the financial instruments, which limits the reliability of the evaluation model. Secondly, the inefficient markets could distort prices, which has a negative effect on the basis of FVA (Laux & Leuz 2009). An inefficient market can be defined as a market in which the prices of financial instruments can not be measured accurately due to the inefficient information it provides (Aboody et. al 2002). Additionally, Lim and Brooks (2010) review the empirical literature about the evolution of market efficiency over time and find that the market cannot be always efficient and market inefficiency can be easily caused by investor irrationality and liquidity problems. That is to say, the market prices of financial instruments could be distorted by biased behaviors of investors, such as overconfidence or overreaction to a stock, and liquidity problems, such as illiquid market for a long-term bond. What’s more, the distorted prices can not reflect the real values of financial instruments, which makes FVA lose the reliable basis to measure the fair value of financial instruments. Therefore, the biased prices in the inefficient markets tend to the appropriateness of fair evaluation of financial instruments. Thirdly, Laux and Leuz (2009) argues that FVA could enforce negative price contagion in the financial markets, which has been considered as the main cause of rapid spread of global financial crisis. It is argued that FVA has stimulated the financial crisis in a vicious spiral and leading to the spread and depth of the financial crisis (Begtsoon 2011, Allen and Carletti 2007, Appelbaum 2009 and Jones 2009). To be specific, after financial crisis broke out, the liquidity of financial instruments’ markets dried up, which means very few trades of the financial instruments existed in the markets (Begtsoon 2011). As a result, the market pricing mechanism became dysfunctional because the prices should be evaluated from very few trades, which resulted in low prices of financial instruments (ibid). In turn, the low prices put pressure on the financial statements of some financial institutions in terms of assets depreciation under FVA (Allen & Carletti 2008). In order to keep capital requirements, the financial institutions had no choice but to sell assets at low prices, which led to lower prices of financial instruments in the markets and stimulated further assets depreciation on other financial instruments’ financial statements under FVA  (Plantin et al. 2008a). To sum up, the prices in the market could negatively influence the evaluation of financial instruments under FVA and at the same time, the evaluation of financial instruments under FVA could have a further negative effect on the market prices, which forms a vicious circle that can speed up the price contagion and fluctuations. Nevertheless, supporters of FVA believe that FVA can provide transparent and timely information for the users of accounting information (Brown 2008). As Hughes (2009) says, the function of FVA is â€Å"like that of the thermometer-it mirrors reality, it does not create it†. Since FVA can reflect what is happening in the market on the financial statements immediately, it allows the information users to get easy access to the most timely and transparent market information. In addition, Hinks (2009) argues that the useful information provided by FVA allows the investors and regulators to approach to the up-to-date position of financial institutions and encourage them to make corrective decisions. Indeed, it cannot be denied that FVA can provide prompt and transparent price information in some cases. However, it is not always the case which contributes FVA to an effective measurement to value financial instruments. First of all, in an illiquid or inefficient market for some financial instruments, even if FVA could provide timely price information of the financial instruments, the timely information provided is unreliable, which leads to the uselessness of the timely and transparent information provided by FVA. Secondly, even though the financial instruments have an active or efficient market, FVA cannot result in increased transparency of information in financial statements as expected (Krumwiede 2008). Thirdly, under FVA, timely price information would lead to volatility of financial statements (Barth 2004). The continuous volatility of financial statements causes confusion for the users of accounting information and raises the company’s cost to keep accounts. Hence, although FVA could offer some timely and transparent information to the users, these information limits to some extent because of unreliable information, limited transparency and volatility of financial statements. In conclusion, this essay has discussed three aspects limiting the effectiveness of FVA to measure the values of financial instruments, including evaluation model, inefficient markets and price contagion effect. In addition, it also considers the pros of FVA in terms of timely and transparent information provided in some cases. It can be concluded that even though up-to-date and transparent information could be provided by FVA occasionally, the effectiveness of FVA to measure the values of financial instruments has been limited due to the unreliable evaluation model, distorted prices in inefficient markets and a negative price contagion effect. Because of word limit, this essay cannot cover the detailed application of FVA to specific kind of financial instrument. However, the above discussion can clearly show that FVA has some general problems in measuring the values of financial instruments. Based on above analysis, it can be suggested that the problematic aspects of FVA could be improved or revised by providing more clear explanation and more specific regulations by the constitutors of accounting standards and for some specific financial instruments with illiquid or inefficient markets, it is better to use some other methods to measure their values.

Adam Sandler essays

Adam Sandler essays Adam is truly what is means to be comedian he has done it all. When Adam was seventeen, he did his first stand up at a nightclub that he was frequenting. With some coaxing from his brother, Adam took the stage at the Boston comedy club and found that his talent for making people laugh could be more than just something to do, it could be a career From TV shows to movies to Cds to Concerts. He first appeared on SNL as most comedians do, but that was the least of his accomplishments. His first album Theyre all gonna laugh at you blew up the billboard charts staying on the chart for nearly 100 weeks. It also earned him his first Grammy award nomination. He had minor roles in Airheads, Cone heads, and Mixed Nuts His first lead role was in Billy Madison. Which still today most anyone will remember? After a slew of Cds and movies; Little Nicky, Happy Gilmore, The Wedding Singer, and the WaterBoy. After all of that work he has achieved 20 million dollar status meaning that is how much you gotta shell out for him to star in your movie. Not bad from Manchester who was practically forced onstage by his brother the first time. At dinner I want to ask him what is felt like to take that first plunge in comedy. How did you feel when you finally got your leading role in Billy Madison? Are you going to go on tour again? ...