Reaching Reality Essay - 744 Words

It’s amazing, the things that can happen in a second. In one second a bee can flap its wings 200 times, a human can blink their eyes seven, and a sloth can lift its finger 0. In one second 2-4 children are born on some corner of the earth, and 1-2 people will die. In one second light will cover galaxies, traveling 186,000 miles. In one second somewhere on earth 40 lightning bolts will hit the ground, 80, 120, 160. In one second somewhere in the universe 30 super novae happen, and approximately 4000 new stars are born. In this very second somewhere in the world, right now, the sun is setting in one town, and people are going to sleep, into their dreams, escaping from reality. However, at this particular second the sun is also rising†¦show more content†¦No, that would have been boring, and then she might miss it all together. She races on toward the roof top closest to the clock tower, and checks the horizon. Not too late yet. Wind-blown, she reaches the roof top and looks for a way over. The tower is taller than the roof she is on. Torn, she realizes that she can’t make it to the top in time. Sighing, she sits down with her legs hanging over the edge of the building, the soft breeze tickling the bottoms of her feet. There is always tomorrow, she thinks. Inhaling, the crisp morning breeze fills her lungs and spreads through her. The air smells like rain, from the night’s storm. A memory tugs her mind, and she recalls a voice that she can’t place to a specific person any more. The rain doesn’t smell like anything it says ringing through her memory, it just makes everything it touches smell more. So really when you smell rain, your just smelling the whole world around you for the first time. As the breeze whistles around her, she takes another deep breathe. Thoughtfully, she decides that she likes the smell of this part of the world. She looks back over to the horizon waiting, and just then the very tip of the sun peeks over the remaining clouds from last night. It is breathtaking, she concludes to herself. There is just enough clouds to make out the shape of the sun without hurting your eyes. But, they are in just the right place so that the light pouring out from the sun can be seen inShow MoreRelated Comparing the Search in Platos Allegory of the Cave and Anderson’s Winesburg, Ohio1540 Words   |  7 Pagespredict what shadows they will see in the future. Life for the prisoners goes on this way without occurrence until one of them is freed, led up outside the cave, and shown the real world. The freed person will realize that the truth of the shadowed reality is actually a falsehood. After this realization the person who visited the upper world is returned to imprisonment in the cave. Her eyes have to adjust to the darkness of the cave once again. However, this adjustment naturally takes a long time. As Read MoreAllegory Of The Cave By Plato974 Words   |  4 Pagesworld is a reflection of more perfect and ideal forms. As the story begins, Plato’s teacher, Socrates, presents a world of alternate reality to Plato’s brother Glaucon by telling him to imagine a cave full of prisoner’s who have been chained their entire lives. The shadows, voices, and figures given to them by the puppeteers on the wall have constructed the only reality the prisoners have ever known. Those few interpretations lead the prisoners to believe the shadows are real. To the prisoners, theyRead MoreEssay on Descartes Proof For The Existence Of God1543 Words   |  7 Pageswill not be discussed in too much depth in this paper. It is his other goal to prove beyond a doubt God’s existence to all non-believers. Descartes starts by rejecting all his beliefs, so that he would not be misleaded by any misconceptions from reaching the truth. He notices that by doubting all of his previous ideas he is thinking in. Descartes determines that in order for him to think, he must exist. He states that he knows that to be the case beyond any doubt, and that this is the first principleRead MoreConstructivist Theory Of Constructivist Learning Theory1012 Words   |  5 Pagesthe most radical positions concede the presence of a reality, this reality has no inborn structure. Whatever structure we find as a general rule is forced by our experience. What s more, since our encounters are differed, there can be no single right perspective of reality. Reality has no single free significance, just implications forced by differed encountering creatures. This is contrary with the Christian view that God made all of reality and he did as such with a reason, in this manner mixingRead MoreReality Is An Illusion Created By The Brain And Body Essay1399 Words   |  6 PagesReality is Merely an Illusion Created by the Brain and Body Jayson Duffy Victory Charter School Abstract Reality is an illusion. This paper details the different ways that the brain and body integrate sensory information into our perception of reality. Each sense contributes to our personal realities and add to the illusion of what is and is not real. Each sense gathers and begins integration of sensory information to be sent to the brain. The brain contains specialized areas designed for the integrationRead MoreWhy Does Plato Considers Ordinary Human Existence to Thatos Chained Prisoners in a Cave1618 Words   |  7 PagesPLATO COMPARE ORDINARY HUMAN EXISTENCE TO THAT OF CHAINED PRISONERS IN A CAVE? Plato in his famous Allegory of Cave compared the ordinary human existence to that of chained prisoners in a cave. According to Plato, we are all stuck in a false reality in this world like prisoners in a cave. His cave theory still applies today in the sense that the people are influenced and controlled by the world around them. They do not want to realize or seek the truth; instead they wish to live in the comfortRead MoreIdentity : Socially Constructed Or Innate?1348 Words   |  6 PagesWill† projected a view that identity was innate and considered the Jews as inferior and incapable of reaching their potential. However, Anthony Marx’s concepts on the trap of essentialism and the artificiality of categories lay a solid case for the social construction of identity. Many people believe that their identities are biologically determined and as a result permanent and unchangeable. In reality, however, all these groups are socially constructed and largely a product of the social surroundingsRead More Socrates Essay1596 Words   |  7 Pages Socrates believes that the everyday world is an illusion compared to the world of knowledge. People are often too distracted by money and materialistic things to appreciate truth and reality. Socrates says, â€Å"the capacity for knowledge is innate in each man’s mind.† This exemplifies the point that man has the ability to look into the world of truth, but when one is caught up in superficiality then truth does not receive the attention and glory that it should. This is why Socrates feels that the artsRead MoreDescartes Proof for the Existence of God Essay example1562 Words   |  7 Pagesnot be discussed in too much depth in this paper. It is his other goal to prove beyond a doubt Gods existence to all non-believers. Descartes starts by rejecting all his beliefs, so that he would not be misleaded by any misconceptions from reaching the truth. He notices that by doubting all of his previous ideas he is thinking in. Descartes determines that in order for him to think, he must exist. He states that he knows that to be the case beyond any doubt, and that this is the first principleRead MoreThe Physics Of Mathematics And Mathematics Essay1236 Words   |  5 Pages Introduction There are reasons to doubt the physical nature of reality, tenets taught by society through heredity and ones’ own consciousness, simply because of the fallacies and imperfections of the human condition. Thus, it is reasonable that any human thought can be questionable. However, Mathematics is not to be doubted. Although, limitations, paradoxes and problems exist in mathematics and is a product of human intelligence, Nevertheless, Mathematics is a continuum of understanding of the universe

Nucleophilic Acyl Substitution the Synthesis of Esters

Nucleophilic Acyl Substitution: The Synthesis of Esters Razon, Valjean Paulo Mella Rico, Fatima Sarah Rogel Institute of Chemistry, University of the Philippines, Diliman, Quezon City 1101 Philippines Department of Food and Nutrition, College of Home Economics, University of the Philippines, Diliman, Quezon City 1101 Philippines Abstract ------------------------------------------------- ------------------------------------------------- The purpose of this experiment is to observe the synthesis of esters (also known as esterification), to understand the chemical processes that ester synthesis undergoes, and to know the optimum conditions needed for high yields. Esterification is a Nucleophilic Acyl Substitution Reaction†¦show more content†¦However, the proton that left replenishes that acid catalyst to help repeat the mechanism for other molecules. The general mechanism of Nucleophilic Acyl Substitution could be simplified and shown by Figure 3 and the specific mechanism of the Fischer Esterification reaction that ensues in the experiment is portrayed by figure 4. (John McMurry, 2007) Figure 3 Nucleophylic Acyl Substitution Reaction Mechanism Figure 4 Fischer Esterification Mechanism (Gunawardena, 2009) Practically, the procedure involves the heating a mixture of an alcohol and a carboxylic acid in the presence of an acid catalyst to yield an ester and water as end product. The reaction is reversible and the position of equilibrium depends on the reaction conditions. An excess of the alcohol favor the formation of the ester. While the presence of water drives the reaction backwards. (John McMurry, 2007) This concept of driving thereaction forward makes use of Le Chatelier’s principle states that â€Å"When an equilibrium system is subjected to change in temperature, pressure, or concentration of reacting species, the system responds by attaining a new equilibrium that partially offsets the impact of change.† (Petrucci, 2010) The structure of the reagents greatly affects the rate of Esterification. Presence of bulk groups on the alpha carbon or the site of the reaction causes esterification to slowShow MoreR elatedClassification Tests for Carboxylic Acid and Derivatives1580 Words   |  7 Pagesacid halides,acid anhydrides, esters and amides.Carboxylic acids and their derivatives areusually seen in industrial processes and mostbiological pathways. Esters can be seen as fatsand within the cell membrane. Esters are alsopresent in pleasant smelling liquids that areresponsible with the fragrant odor of fruits andflowers. Amides are also present in animalprotein and also in industrial products such asnylon. Acid chlorides and acid anhydrides areused in the synthesis of carboxylic derivatives.TheseRead MoreEsters And The Process Of Esterification709 Words   |  3 PagesEsterification Esters are the carboxylic acid derivatives most commonly produced by the reactions esterification. The most famous esterification is also called Fischer esterification, which is actually an acid-catalyzed reaction of alcohol and carboxylic acid. In addition to acid, alcohols can react with acyl chlorides, anhydrides, and esters are also formed. U with the reaction of alcohol and acyl chloride, with the ester there is HCl, so in such esterification reactions should be added to the baseRead MoreSynthesis of Salicylic Acid and Potentiometric Determination of Its Purity and Dissociation Constant4209 Words   |  17 PagesSynthesis of Salicylic Acid and Potentiometric Determination of its Purity and Dissociation Constant ------------------------------------------------- Abstract The purpose of the study is to synthesize salicylic acid from the ester, methyl salicylate, and determine the acid’s dissociation constant and purity. The ester was converted to salicylic acid by base hydrolysis. The products were refluxed and recrystallized, to ensure maximum purity, and filtered, dried, and weighed. The melting pointRead MoreGrignard Synthesis of Triphenylmethanol Lab Report Essay5146 Words   |  21 PagesThe Grignard Synthesis of Triphenylmethanol Organic Chemistry Lab II March 19, 2012 Abstract The purpose of this experiment was to synthesize the Grignard reagent, phenyl magnesium bromide, and then use the manufactured Grignard reagent to synthesize the alcohol, triphenylmethanol, by reacting with benzophenone and protonation by H3O+. The triphenylmethanol was purified by recrystallization. The melting point, Infrared Spectroscopy, 13C NMR, and 1H NMR were used to characterize and confirmRead MoreOrganic 2 Lab Report6389 Words   |  26 Pagessolvent used is a 3:1 mixture of toluene and petroleum. After the developing chamber is prepared, it is essential to begin preparation of the unknown DNPH derivative[6]. The preparation of the 1,2 DNPH derivative of a ketone is in fact a small organic synthesis which produces a fraction of a gram of product. The second part of the lab makes use of NMR Spectrometry. NMR takes advantage of the magnetic properties of the 1H amp; 13C nuclei. We are only concerned with 13C because 12C does not have a magnetic

Alcohol Use during Pregnancy Linked to Hyperactivity in Children Free Essays

Most women understand that drinking alcohol during pregnancy can cause physical and mental birth defects. Multiple studies indicate women who drink three or more glasses of alcohol at any one occasion in early pregnancy increase the child’s risk of developing alcohol disorders by 21 years of age (JAMA and Archives Journal, 2006; British Medical Journal, 2005) and is also linked to higher incidents of hyperactivity I children (British Medical Journal, 2005). Conversely, the National Institute of Alcohol Abuse and Alcoholism (NIAAA) reveals that â€Å"data on the relationship between FAS and hyperactivity are inconsistent† (Jacobson Jacobson, 2003). We will write a custom essay sample on Alcohol Use during Pregnancy Linked to Hyperactivity in Children or any similar topic only for you Order Now Studies conducted by the NIAAA, indicate hyperactivity of clinic–referred patients â€Å"may have been caused by social and environmental factors, such as co–occurring attachment disorders, anxiety, and post–traumatic stress disorder† (2003, Hyperactivity and Attention, para 3). Fetal Alcohol Syndrome (FAS) was first identified in 1973 has reached new levels in terms of research and relevance to other birth defects (Locke-Wellman et al, 2000), including the hypothesis that â€Å"alcohol consumption in doses not generally associated with alcohol problems can produce a variety of neurocognitive deficits in the absence of effects on growth and morphology† and â€Å"appear to have a continuum of neurobehavioral morphological and developmental effects† (e.g. hyperactivity), (Locke-Wellman et al.,2000,p. 661). Understanding Hyperactivity The National Institute of Neurological Disorders and Stroke (NINDS) defines hyperactivity –as applies to this report- as Attention deficit-hyperactivity disorder (ADHD), which is a neurobehavioral disorder affecting 3-5 percent of all American children (Attention Deficit-Hyperactivity Disorder Association, 2007). ADHD interferes with an individual’s ability to focus (stay on a task) and to exercise age-appropriate inhibition (cognitive alone or both cognitive and behavioral) (NINDS, 2007). Warning signs include what may appear as ignoring verbal instructions, lack of organization (personal and school work), fidgetiness, excessive talking, inability to finish chores and homework, and problems paying attention to and responding to details (NINDS, 2007;Attention Deficit Disorder Association, n.d.). While hyperactivity at any level is most common in the younger years up to the early teens, there are many whose condition continued into the adult years (Ibid). Research Supports Alcohol’s Link to Hyperactivity More than 20 years ago, studies first revealed alcohol use during pregnancy as a valid link to hyperactivity. In effect, children who were administered the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (KSADS) who showed signs of hyperactivity were born to mothers who admit to drinking during pregnancy (Coles et al., 1997; Chambers et al., 1985). In 1989, Archer et al. indicated a need to study specific factors (e.g. dietary sensitivities and fetal alcohol damage) that may be important for subgroups of hyperactive children. However, the authors add that this findings are â€Å"unlikely to account for the syndrome as a whole† (Archer et al.,1989, p. 18). When covering substance use and abuse, Archer et al. (1986, 1989) reported on an earlier study by Weiss et al (1979), explaining that follow-up findings on substance use and abuse (both alcohol and other compounds) have not been consistent, of which Jacobson’s theory (2003) supports citing that potential reasons for these inconsistencies includes differences in geographic study locations, the birth years of subjects, attrition rates, data collection procedures, definitions of use and abuse, and varying degrees of co-morbidity (e.g., ADHD symptoms and conduct problems) across studies (Archer et al, 1986, 1989). Conduct problems in the early adolescence of hyperactive children have been consistent in most studies, of which Weiss et al (1979) reported that â€Å"at [the] follow-up mean age 13 years, 25 percent of formerly hyperactive subjects showed a history of antisocial behavior, 16 percent were referred to juvenile court, and 3 percent (2 of 64 subjects) were placed in a reform school†¦teachers reported that hyperactives exhibited more conduct problems than controls† (p. 1350). Ackerman et al (1986) acknowledges the findings of Weiss et al. (1979) citing that when comparing hyperactive, hypoactive, and normoactive learning-disabled boys and controls in a 4-year follow-up (mean age 14 years) the results indicated a three to sixteen fold increase in comparatively serious behavioral problems (e.g. breaking and entering, aggressive acts in school, and serious incorrigibility) in the hyperactive group (Ackerman et al., 1986; Weiss et al, 1986). However, all studies reveal that the outcome in late adolescence and young adulthood is less clear. How to cite Alcohol Use during Pregnancy Linked to Hyperactivity in Children, Papers

System Sciences in Healthcare-Free-Samples-Myassignementhelp.com

Question: Analyse the Case Study provided - Evacuate or Stay? Northshore LIJ and Hurricane Sandy and write a report using the attached Writing a case study response as a guide. Answer: Introduction Emergency situations can be at the operation theatre or a patient admitted with medical case that needs to be treated urgently. Whereas, there are other emergencies also that arise due to natural calamity. Natural calamities like severe storms, hurricanes often devastate places that lay on their path. Hence, an important question looms over the hospital Authorities whether to evacuate or to stay. Staying is not always the best option while evacuating needs a whole lot of cooperation and coordination of the hospital staffs, nurses and the doctors. If the evacuation procedure is not done correctly, then it can jeopardize several valuable lives, which includes not only the patients but also the hospital staff, nurses and the doctors. The case study is based on emergency responses arising due to natural calamity like hurricane and how the hospital authority must tackle the emergency situation. The problems that arise due to natural calamities include relocation of the patients, the huge burden of relocation the patients rely on the hospital authorities and the proper coordination and cooperation of the hospital staffs, nurses and the doctors. Hence, another problem is that if the hospital staffs, nurses and the doctors do not coordinate and cooperate properly then it might lead to escalation of health issues and even the valuable lives of the patients can be at jeopardy. Description Low lying areas or the coastal areas are the major vulnerable regions that get affected badly due to natural calamities or hazards like hurricanes. Along with such vulnerabilities, the presence of hospitals and health care centers in such areas even worsens the situation. Several issues like the patient safety, timely relocation of all the patients and even minimizing assets loses are the major issues which make the hospital authorities to contemplate. similarly, same kind of issue arose on August 2011, hurricane named Irene wreak havoc on the East coast of New York City. Forecaster even predicted the path of the hurricane Irene, and accordingly the New York city Authorities evacuated the low lying areas and the coastal communities. North shore long Island Jewish Hospitals (North shore LIJ) had 15 hospitals in the long island and According to the predictions of the forecasters the hospitals were located in the low lying areas and thus were at risk of flooding and severe storm. Likewi se, the North Shore LIJ hospital authorities on 24th august 2011 relocated all the 947 patients to other hospitals further inland. However, the hurricane Irene lost its strength and the greater New York was left unscathed. It is needless to say, the relocation of the 947 patients was an unnecessary step (1). Although there were no negative consequences, the experience gained from the exercise made the north Shore LIJ vice president of the protective services and the chief operating officer to take in to account the pros and the cons of relocation of patients during such extreme weather events. After around 14 months, an almost same event occurred, the North Shore LIJ was again under the radar of another hurricane named Sandy. The hurricane Sandy already devastated a big portion of the Caribbean islands, thus risk looms over the North Shore LIJ, whether the hospital Authority should evacuate the hospital or stay. Discussion Issues and its implication on different stakeholders Previously, the hurricane Irene did not affect and wreaked any damage to the hospital because Irene lost its strength, but before the hurricane Irene lost its strength, the hospital authorities made an important decision of relocating all the 947 patients from the hospital to further inland. Hence, the hospital authorities contemplating that the decision of relocating the patient was not right (1). The main issue that now looms over the North Shore LIJ is the another incidence hurricane named Sandy which can wreak havoc upon the coastal areas of New York City. The prime stake holders according to the present situation are the North Shore LIJ hospital, the patients, the hospital staffs and the doctors, James Romagnoli (vice president of protective services), Mark Solazzo (Chief operating officer) (1). Thus, the major question that is looming over both James Romagnoli and Mark Solazzo is should they relocate the patients again considering the hurricane Sandy or should they stay back. The major implications on the different stakeholder can be assessed as follows: The patients- leaving the patients in to the hands of the devastating Hurricane Sandy can be fatal, whereas the shifting the patients far into the inner parts of the city will be uncomfortable for the majority of the patients (2). The North Shore LIJ hospital- relocating the patients is a costly affair, the hospital authorities have done it before, but doing the same again can put a strain on to finances of the hospital. James Romagnoli Mark Solazzo- the vice president of protective services and the chief operating officer respectively are the have got the experiences of relocating the patients previously. Thus the responsibility of patients safety and the procedures to be followed are on both these officials. Whatever decision they will take will directly affect the patients and the hospital staffs and doctors. The hospital staffs and the doctors- relocating 947 patients from one location to another is a cumbersome job. It needs good coordination of the staff, nurses and the doctors. Hence, it will test their abilities again (2). Issues and linkage with academic researches The first major issue is relocation of the patients- the relocation of the patients to a different hospital due to an emergency of natural calamity is a laborious and cumbersome job both affecting the patients mental and physical state. A hospital has several kinds of patients ranging from disabled to patients receiving the intensive care. Even to turn the bed or using a toilet makes relocation task a very delicate and complex issue. Shifting a disabled patient requires manually to handle the patient and shifting the patient to a wheelchair while a bedridden patient can be shifted only by shifting the patient to a stretcher (3). While shifting a patient who is receiving intensive care needs to be done with outmost caution and care, while several complications include changing site of the vascular catheters, sedation management, carefully scheduling the procedures (4). The 3-5% of patients are the high risk patients and the rising risk patient includes 20-30% while the majority are th e low risk patients which include a whopping 70%. Hence, to deal with the care of the high risk patients, each of these patient must have one assigned doctor to monitor the patient continuously or can be monitored remotely through artificial intelligence, hence moving such patient requires the most attention (5). Secondly, the rising risk patients do not need to be assessed by individual doctors but care must be taken so that such rising risk patient do not escalate to high risk. Rising to high risk can again spell problems for both the patient and the doctors that increase the complexity of the case (6). Lastly, the low risk patient forms the majority of the patients, thus managing these patients requires planning and proper cooperation and execution of the same between the staffs and the nurses (7). Suggestions Regarding the issue of evacuation or stay. It can be suggested that evacuation can be done on a priority basis. Strong hurricanes can disrupt the power supply, hampering the patients that are under the intensive care. Hence, such patients must be relocated first and the patients that can be categorized as low risk patients (7), such patients can be kept in the hospital to minimize the complications. Because a large number of patients fall under this low risk category and relocating such patients both includes huge finances and larger staff cooperation. The location of hospitals is vital for both the communities that are getting benefitted, however hospitals should not be built near the coastal areas that are prone to strong hurricanes (8). Such step will minimize asset loses that arise due to devastating storms and hurricanes. The hospitals staffs, doctors and the nurses must be trained to deal with emergencies arising due to storms and hurricanes. Storm and hurricanes arrive before several days. Hence the hospital staffs can stay prepared to handle such situations. Hospitals within the vicinity of storms and hurricanes can set up mock drills that can help the staffs to prepare for the emergencies (9). Also workshops and seminars can be organized that will emphasize on the emergency preparedness and adaptability of the hospital staffs with regard to emergencies. Providing effective training to the staffs is not enough unless the same is given to the patients as well. Research shows that relocating patients affect them mentally, hence, mentally preparing the patients by training them to understand that the relocation is for their own benefit can yield fruitful results (10). Evaluation of the suggestion based upon the selected case According to this case, all the solutions suggested above is applicable. The previous attempt of relocating patient went well with negative outcomes and even the hurricane Irene lost its strength. Hence, the attempt although successful, was needless and unnecessary. Whereas, this argument is only put forward after the storm got weakened, but before the storm was predicted by the National Weather Services, the outcome was uncertain. Likewise, the present question is whether to evacuate or stay because of another hurricane named Sandy. The patients health condition is one of the major concerns of any hospital. Whether it is high risk patient or a low risk patient, the safety concerns remains the prime motive of every hospital. Hence, relocating patient based on the priority of health condition can help a lot to reduce confusion and complexity (11). Training the patients and making them mentally prepared before relocation is helpful to reduce escalations of health risks. Management of t he staffs, nurses, doctors and providing them with the necessary training will help a great deal in increasing cooperation during the patient relocations (12). Conclusions Therefore, from the above disclosure, it can be concluded that during crisis situations like the severe storms and hurricanes. It is often necessary to relocate patients to a safer location, to minimize the escalations of health conditions. Often the hospital authorities stay in dilemma whether to evacuate or stay during a storm and hurricane warning. Evacuations as a whole mean to relocate the patients which include both the high risk and low risk patients. Relocating patients is a logistical and labor intensive job which needs proper coordination and continuous monitoring of high risk patients and cooperation between the hospital staffs, nurses and the doctors. The main reason due to which the hospital authorities often perform the relocation task is because, for them the health conditions of the patients is the major concern. The health conditions of the high risk patients like the patients that are under the intensive care require uninterrupted power supply to continue the proper functioning of the life supporting services. Such patients require to be relocated to safety on priority basis. While the low risk patients can be relocated later depending upon the urgency and need to minimize the chances of health condition escalation. According to several researches, it is found that 70% of the patients fall into the category of low risk patients which often do not require active monitoring and doctor watch. Hence, such low risk patients can be relocated depending on the degree of health condition (13). The hospitals no doubt are the important for every community, but their location near the coastal areas often make them vulnerable to storms and hurricanes. Such hospitals need to constructed after assessing their geographical positon and such hospitals must have the emergency power supply to support the electrical equipment needed to drive the life supporting devices and equipment (14). During an emergency situation arising due to natural calamity, the hospital staffs and the nurses are first to respond to such situations. Hence, the hospital staffs and the nurses need to be properly trained to deal with emergency situations (15). Workshops, seminars can be organized by the hospital authorities aimed at delivering quality training to the hospital staffs and the nurses (16). References Powell T, Hanfling D, Gostin LO. Emergency preparedness and public health: the lessons of Hurricane Sandy. JAMA. 2012 Dec 26;308(24):2569-70. Yeo HJ, Bak WS, Yoo MC, Park SC, Lee SC. Evaluation of patients' queue environment on medical service using queueing theory. Journal of the Korean Society for Quality Management. 2014;42(1):71-9. Knibbe JJ, Knibbe NE, Waaijer E. Flying through the hospital: efficiency and safety of an ergonomic solution. Work. 2012 Jan 1;41(Supplement 1):5642-3. Leditschke IA, Green M, Irvine J, Bissett B, Mitchell IA. What are the barriers to mobilizing intensive care patients?. Cardiopulmonary physical therapy journal. 2012 Mar;23(1):26. Langen PA, Katz JS, Dempsey G, Pompano J, inventors; Digital Equipment Corporation, assignee. Remote monitoring of high-risk patients using artificial intelligence. United States patent US 5,357,427. 1994 Oct 18. Cooper S, Cant R, Porter J, Missen K, Sparkes L, McConnell-Henry T, Endacott R. Managing patient deterioration: assessing teamwork and individual performance. Emerg Med J. 2012 Jan 1:emermed-2012. Ammenwerth E, Schnell-Inderst P, Hoerbst A. The impact of electronic patient portals on patient care: a systematic review of controlled trials. Journal of medical Internet research. 2012 Nov;14(6). Burkey ML, Bhadury J, Eiselt HA. A location-based comparison of health care services in four US states with efficiency and equity. Socio-Economic Planning Sciences. 2012 Jun 30;46(2):157-63. Wheeler DS, Geis G, Mack EH, LeMaster T, Patterson MD. High-reliability emergency response teams in the hospital: improving quality and safety using in situ simulation training. BMJ Qual Saf. 2013 Feb 1:bmjqs-2012. Flynn D, Knoedler MA, Hess EP, Murad MH, Erwin PJ, Montori VM, Thomson RG. Engaging patients in health care decisions in the emergency department through shared decision?making: a systematic review. Academic Emergency Medicine. 2012 Aug 1;19(8):959-67. Elliott RA. Reducing medication regimen complexity for older patients prior to discharge from hospital: feasibility and barriers. Journal of clinical pharmacy and therapeutics. 2012 Dec 1;37(6):637-42. Macphee M, Suryaprakash N. First?line nurse leaders health?care change management initiatives. Journal of nursing management. 2012 Mar 1;20(2):249-59. Grol R, Wensing M, Eccles M, Davis D, editors. Improving patient care: the implementation of change in health care. John Wiley Sons; 2013 Mar 18. Powell T, Hanfling D, Gostin LO. Emergency preparedness and public health: the lessons of Hurricane Sandy. JAMA. 2012 Dec 26;308(24):2569-70. Curtis JR, Back AL, Ford DW, Downey L, Shannon SE, Doorenbos AZ, Kross EK, Reinke LF, Feemster LC, Edlund B, Arnold RW. Effect of communication skills training for residents and nurse practitioners on quality of communication with patients with serious illness: a randomized trial. Jama. 2013 Dec 4;310(21):2271-81. Ross K, Barr J, Stevens J. Mandatory continuing professional development requirements: what does this mean for Australian nurses. BMC nursing. 2013 Mar 27;12(1):9.