In a culturally diverse word, the universality of human rights remains Assignment - 1

In a culturally diverse word, the universality of human rights remains unsettled. Discuss - Assignment Example All people should not be denied their rights unless in a situation that demands legal action against them. For example, the right to liberty can be withdrawn when a person becomes guilty and gets convicted of an offence. International human rights law in the form of treaties, international law, general principles, and other international law sources are factors that determine Human rights. International law seeks to achieve the universality of human rights; however, it faces challenges resulting from the current cultural diversity. Culture is the people’s way of life and contributes much to aspects of their lives. The different cultures that exist in the world are a challenge to trying to implement human rights law. Some cultures would not allow some actions as they differ with them. This work seeks to discuss how the diverse culture in the world contributes to the efforts put towards achieving or settling universality of human rights. It will discuss how the culture relates t o human rights and how it contributes either negatively or positively towards achieving the universality of human rights. It will also focus on different organizations formed to protect and educate the public on understanding their culture and human rights, and how their progress is at present. Background Information Although there have been developments in evolution of human rights, the process is under serious challenge. From 1945, more development of international human rights standards has occurred as compared to previous years (Forsythe, 2009: xviii). However, international issues like Chinese development as a world power, and the United States’ efforts to maintain national security after the September 2001 attack challenge these developments on human rights. As much as the international community talks of human rights and rights laws, there is a violation of the rights as a result of these developments. People did not know about human rights until 1945, but the United S tates and France practiced ‘rights of man’ although no human rights treaties existed until the period of United Nations. The treaties that existed were rights of foreigners. According to Forsythe, it is D. Roosevelt and others who pushed for inclusion of human rights in the United Nations charter. They believed that human rights contributed to international security and peace and that it was human rights’ violation that led to the origin of World War II (Forsythe, 2009: xviii). The quest to adoption of human rights to the UN charter became the origin of their development. Universality of Human Rights Universality is the quality of being dominant or available. Human rights universality is thus the ability to the existence of human rights to every human being. Universality is rather the ability of a society or state to allow its citizens to enjoy the availability of human rights. The diversity in culture, in the present world, affects the universality of human righ ts in various ways. Different cultures affect how their citizens enjoy the provision of human rights. According to Osiatyn?ski, the African take on human rights was not on an individual basis; it focused on the community. This is an indication that culture has a relative impact on human rights universality. In most tribes, in Africa, for example, the decision to marry does not come from a girl, but it is a decision made by the family and clan or the community, depending on the family status (Osiatyn?ski, 2009:128). This practice

The Impact of Welfare on the Country Economics Essay - 157

The Impact of Welfare on the Country Economics - Essay Example The economic conditions that the world was served within the Post First World War were a mere recipe for the disaster, frustration, and anguish within. Pestilence, crippled bodies, handicapped people, unemployment, no pays for the soldiers, empty stocks all were the outlook of the different European societies. The Economic Crunch that hit the World towards the late 1920s decayed the overall structure of social and economic outfit in a further uglier manner (Brassley et.al, 2012, p. 115). The certain clauses and actions taken by the League towards the defeated nations led to the hostile mindset creation within. For example, Germany was left high and dry, which in turn rose the spirit of revenge and vendetta against the European superpowers. Austria and Hungry were segmented within and left underdeveloped. The spoils of the First World War went directly into the hands of the Big Four namely Great Britain, France, Russia, and Italy. Each aimed at maximizing its gains from the war, which in turn led to the imbalance in the distribution. The establishment of Yugoslavia was another area of weakness with regard to the miss calculation in the overall assessment of a situation that was at hand. The other major events that developed towards the post First World War were the jingoism of the Japanese nation. The attacks on Manchuria by Japan were one of the events marked as an act of hostility towards global peace. The weakness of the League on the basis of the fact that major nations stayed away from it, or left it during the midway made it further weaker in its outlook. The absence of the United States of America from the overall environment of hostility did not help the global perspective and European political affairs.

Project Management Essay Example | Topics and Well Written Essays - 750 words - 8

Project Management - Essay Example Some of the cost are administrative, utility bills, etc. this cost are involved in the budget preparation using an agreed rate stating that indirect cost not to exceed a given percentage of the total cost, most project use 15 percent. No, because other costs e.g. taxes and interests that were not involved in execution of the project either directly or indirectly were deducted from the revenue after selling the project. From my point of view the project seems to generate revenue over time as compared to selling it at the completion which will fetch a low price. Average cost of concrete worker per hour (ACW/H) is $ 24.83 (â€Å"Average hourly and weekly earnings of production and nonsupervisory employees on private nonfarm payrolls by industry sector, seasonally adjusted†, n.d.). These overhead charges are the costs that will be incur as the pouring of the reinforced concrete is executed, also referred to as indirect cost. The total estimate cost is $ 67,596. According to (Parker & Isola, 1991) overhead charges charge should not exceed 15% It is very important when a construction project or any other project is being implemented the overhead cost ought to be considered and caution to be taken, so as to prevent budget from being in crisis. Steel is one of the vital components required in reinforcing concrete. When the price of steel increases this has a negative impact to the budget of the project. This normally happens due to inflation or other factors that affect prices in the market. An increase in price will force the project manager to reduce the fund allocated to other activities or to source other funds to overcome the deficit. In budget preparation it is advisable that a 20 percent excess of the actual estimate should be added so as to take care of scenario like this one(Parker & Isola, 1991). Whenever hurricanes occur they cause destruction or

Introdution To Management Case Study Example | Topics and Well Written Essays - 2500 words

Introdution To Management - Case Study Example d with a business opting for operating from another location; more often these include low cost, higher quality, lower risk, lower employee turnover, higher profits, to bring about a change in the way business is done, etc. The parent company’s goals can be varied, and accordingly the goals and objectives of outsourced company are laid (Bangeman, 2005). Exactly for these reasons, Gail Lee, the managing director of Melbourne’s fashion retailer, Leethal Fashion Accessories, offshored some of its business to India; this included creation of ready-to-wear garments based on Australian designs that were sent by Leethal Fashion Accessories and also imported jewelry to be sold in local departmental stores. Besides the reasons for this business offshoring, LFA had to face some issues with respect to receiving the completed products on time due to delay in transport. Other issues were caused due to language and cultural barriers, which sometimes lead to misinterpretations and misunderstanding in the business dealing. These issues lower the confidence of Australian entrepreneurs in Indian business systems; yet, the huge difference in labour costs tends to outweigh losses caused by other issues (Hatch, 2006). Indian economy is diverse, and ranges from traditional village farming to modern manufacturing and services. The contribution of services sector is said to be the maximum to the growth of India’s economy, which indicates availability of surplus labour. Statistics indicate that major portion of the services is provided by the English-speaking educated people in the field of Information Technology in the form of software services export (Rushton & Walker, 2007). Another major contributor to the economy is the small-scale industry segment which plays a pivotal role in employment generation with low capital investment. Estimates indicate that over 18 million people are employed in this industrial segment (John, M.S, 2002). Cottage industries are mostly run by

Team-Working Environment Essay Example for Free

Team-Working Environment Essay Compare the contribution of the different skills described in Task 4a whilst used within a team-working environment. Communication Skills In a sales team, communication skills are vital. They are vital because good communication skills allow someone to make important contributions to a team. In a team, the most important attribution is good clear communications. Good clear communications is important to a team because it helps to avoid mistakes, misunderstandings being made. Clear communication can be a tool used to effect motivation in a positive way. Being tactful this allows you to turn negative into positive. De-motivation occurs because of lack of communication. As a result this will lead to lack of punctuality. Good communication will improve motivation and increase company performance. In addition to that, good communication between team members will enforce standards and show what standards management expects. However, poor communication can lead to low or no motivation on the part of employees. As a result, this can lead to poor punctuality, low motivation, low confidence and low-esteem. In addition to that, poor communication can lead to employees not knowing their targets and this will result in the company stagnating as they are not reaching their targets. Conflicts can happen all the time. Good communication can go a long way to aid conflict management. Communication can help them members dissolve team issues and establish a way forward. Listening and meeting and through face to face communication. When an issue arises it is important to establish the correct method of communication. In the situation, it is better to use face to face contact as this method is very important because people will get to know each other and respect each other. If a team wants to be successful, then this is the way to go. Depending on the situation, for example, when conflict arises, it is better to solve the situation face-to-face rather than through email. In other cases such as a team leader wanting to remind someone of a task, a written memo could be used to remind them. If members within a team are going to work successful then the members will need to be able to understand and recognise each others differences as individuals. Another method is to get to know tea members by making face to face contact and through social encounters. When dealing with criticism, bad criticism can lead to low confidence and self esteem. Bad criticism can result in either two things happening; the person on the end of the criticism can be motivated by it or de-motivated by it. However, it is how the critique gives the4 criticism out is important. If its in a positive way fro example, a teacher is talking to a student and says look Deborah, you have done some fantastic work here but I think you need to add a little bit more detail here and you will defiantly achieve the grading criteria. This kind if criticism would give me the motivation to complete it and make sure I reach the criteria. In this case, it is important that you are open to criticism and do not take as an offensive gesture. if properly communicated then the other person will be open and understand the point you are trying to get across. Adaptability and responsiveness to different situations is important in areas such as the current business climate. Change ban be recognised through communication and implementation can be achieved through communication. Implementation often requires brave discussions taking place and courage to take path. This will be achieved better through face-to-face communication rather than methods such as emailing. In conclusion all the skills I have discussed above are needed to make a successful team are important. Many of the skills highlighted above come back to good effective two way communication skills and as a result will improve team cohesion and improve the way that targets are set and achieved. Now I will list the skills and why they are important. * Articulation of ideas- Important because you need to speak clearly to put your message across. * Tact- important because it involves being respectful for others and their ideas. * Effective listening- important because if you do not listen you will not know what to do. In addition to that listening as well as talking is needed or effective communication. * Sincerity- Important because you have to be sincere and honest when communicating with others as this makes you appear as a better person. * Concern for team members- important because when another person who is doing a task and you show concern, they will be more often than not return the favour and as a result the team will perform at a much higher level. * Building morale/confidence Important because if your team has members who have low morale and low confidence they will not be motivated to complete the tasks that I as the team leader have set. * Questioning- Important because you need to be able to ask appropriate questions. * Defusing and resolving conflict- Important because when conflicts arise it is important that you solve it in an unbiased way that suits both parties. Communication is the most important factor within a team. It is the deciding factor in whether or not a team reaches the targets that have been set.

Manti TeO Case Essay Example for Free

Manti TeO Case Essay By having read the comprising articles and the reader comments on the college football player Manti Te’o, this issue has many different meanings to many different readers. And as Gail Collins stated, â€Å"All I can say is, the story tells you a lot†, this open ended story clearly does give off a large amount of information and arouses a series of questions that anyone would hope to have answered for a better understanding. To me, this issue comes off as confusing, disturbing, and at the same time wretched. Even though Te’o had explained that he was hoaxed, I still am confused to what I believe. For some reason, I feel as though he has something to do with the person that has been hoaxing him all this time to make him not look completely foolish. In order for someone to accept to be in an online relationship, they must be absolutely desperate or grasping for a lot of attention. Especially because this is becoming a problem with someone like Manti Te’o is just puzzling. From someone who is a senior at Notre Dame College, and more than likely having dealt with a wide variety of different situations, anyone would think he would have had more common sense to go along with something like this. That is why most individuals, including me, can give a long explanation to why we are confused. After reading these articles, a different question popped up in my head after every sentence and this situation would be a lot more understandable if they were answered. To make a fake profile, and to use it as a way to make another individual feel sorrow for you is just alarming. It is incredible that today’s society has people that stimulate and have to deal with situations like this one. The fact that you can be in an extremely serious relationship over the internet, without ever meeting face to face, and knowing that Manti Te’o is one of the very many makes this society even more provoking. You hear about these types of issues more and more as time progresses. This issue is wretched because it is what today’s society is evolving to and society makes it okay for issues like this to occur. Television shows, social networking sites, magazines, and movies are putting ideas in people’s head and allowing them to think these types of occurrences are okay to perform. It is just absolutely terrible because issues like this are going to continue to occur because no one is attempting to put an end to it and people seem to be just falling into these types of pits more frequently. Consequently, if this situation was to teach anything, it was that our society has a lot ahead of us. Anyone can be a phony, everything in a way can be unreliable, and people need to realize this is become a truly large struggle. Gail Collins statement â€Å"All I can say is, the story tells you a lot† is an understatement. This story tells you much more than a lot and it tells you exa ctly what our future is beginning to become.

Evaluating Two Middle Range Theories Nursing Essay

Evaluating Two Middle Range Theories Nursing Essay The purpose of this paper is to evaluate two middle range theories abilities to test the concept of comfort for the practice question Do neonatal nurses who care for dying infants who attend an end of life care educational training program compared to neonatal nurses who do not attend the program experience a difference in comfort levels (Comfort Level for Caring for Dying Infants (CLCDI)) when caring for a dying infant? A summary of two middle range theories the Comfort Theory (Kolcaba, 1994) and the Theory of Self-Efficacy (Resnick, xxxx) will be summarized and then critiqued using Smith and Liehrs (xxxx) Framework for Evaluating Middle Range Theory. The discussion will conclude with a summary of strengths and weakness of the theories and a research hypothesis to reflect that reflects the most appropriate theories conceptual definitions and propositions. Introduction Background Despite nurses as frontline caregivers for dying patients and their families many nurses have identified that they struggle with the responding adequately to the emotional devastation to parents and siblings when caring for a neonate with an unresolved terminal condition (Frommet, 1991). With the advances in neonatal care and life sustaining treatments, sick and very preterm infants do not often die in utero, at birth, or shortly after birth, but instead they often live much longer in a healthcare paradigm of comfort care and dignified death. This relatively new emersion of the end of life model integrates a more holistic approach which considers a more comprehensive view of the patients needs (emotional, spiritual, and medical) (Mallory, 2002; Mallory, 2003; WHO, 2002). With this paradigm shift, health care professionals are obligated to assess the adequacy of their own knowledge, attitudes, and beliefs about death and dying. Multiple studies regarding nurses preparation for dealing with death and dying have consistently found that nurses that nurses do not feel educationally prepared to care for dying patients and insist that healthcare professionals should receive additional education on end of life care to bridge the deficit gap (Frommet, 1991; Robinson, 2004; White, Coyne, Patel, 2001; Beckstrand, Callister, Kirchhoff, 2006). These findings have led to a further observation that nurses caring for these complex patients regularly experience moral distress from competing principles of their personal, collegial, organizational, and religious/spiritual ethics (Frommet, 1991). Practice Problem To help ease this moral distress an evidence based end-of -life educational training program for NICU nurses has been successfully implemented in several neonatal intensive care units (NICUs) to increase the nurses comfort level of caring for neonates and their families at the end of life (Bagbi, Rogers, Gomez, McMahon, 2008). To determine if an evidence based end of life educational program impacts nurses comfort levels in caring for dying infants and their families a question was developed using the population (P) intervention (I) compared to (C) outcome (O) format (Newhouse, Dearhold, 1997). The following discussion will focus on this PICO question Do neonatal nurses who care for dying infants who attend an end of life care educational training program compared to neonatal nurses who do not attend the program experience a difference in comfort levels (Comfort Level for Caring for Dying Infants (CLCDI)) when caring for a dying infant? During the intervention a monthly 1 hour, neo natal end of life education program will be conducted over a 6 month period of time based on research about what nurses would like to know about caring for a dying infant (Robinson, 2004). For the purpose of this problem, comfort is defined as the ability of the NICU nurse(s) to show adequate knowledge and skills in providing neonatal end of life care for dying babies and their families. For this problem comfort will be measured as a score on the ordinal scale of Comfort Level Caring for Dying Infants (CLCDI). The instrument consisting of 15 items, measured on a 5 point Likert type scale equates scores of 1=never; 2=rarely; 3=sometimes; 4=often, 5=always measures the level of comfort a NICU nurse has caring for dying infants as opposed to their perception toward pediatric or neonatal end of life care (Bagbi, Rogers, Gomez, and McMahon, 2008). In evaluating the score, the higher the reported score the greater level of comfort NICU nurses have in caring for dying babies. Testing the Concept of Comfort A portion of Kolbacas (1991) Theory of Comfort and Resnicks (2008) Theory of Self-Efficacy, two middle range theories, will be used to test the concept of comfort for providing an organizing structure. Based on previous studies about nurses comfort when caring for patients, propositions five and six of Kolbacas Theory of Comfort seem to be a promising fit for this problem (Kolbaca, 1991, Kolbaca, XXX). These propositions collectively propose that patients, nurses, and other members of the healthcare team agree upon desirable and realistic health seeking behaviors (HSBs) and if enhanced comfort is achieved, patients, family members, and/or nurses are strengthened to engage in HSBs, comfort is further enhanced (Kolbaca, 1991). However, comfort as defined conceptually in this case as knowledge and skill can alternatively be equated with a sense of competence or self-efficacy of the NICU nurse to care for a dying infant and their family. There are many examples in the nursing literature linking self-efficacy to knowledge and skill (xxxx, xxxxx).) Self-efficacy, knowledge, and skills are also central to Banduras theory, which is the basis for Resnicks (xxxx) Self-Efficacy theory. Self-efficacy as described in Resnicks (xxxx) Theory of Self-Efficacy for this context is described as the judgment about the nurses ability to organize and execute a course of action required to attain designated types of performances. The theory states that perceived self-efficacy, defined as the individuals judgment of his or her capabilities to organize and execute courses of action, is a determinant of performance (Resnick, xxxx). Self-efficacy beliefs provide the foundation for human motivation, well-being, and personal accomplishment (Resnick, xxxx). According to Resnick (XXXX) theory individuals with higher levels of self-efficacy for a specific behavior (caring for a dying infant) are more likely to attempt that behavior. There are many examples in the literature using the Theory o f Self-Efficacy to support nursing education interventions (xxxxx, xxxxx). For these reasons, Resnicks Theory of Self-Efficacy (xxx) will be used to test the concept of nurses comfort or knowledge and skill (self-efficacy) in caring for dying infants and their families. The purpose of the following discussion is to summarize, describe, analyze, and evaluate these theories using the Framework for the Evaluation of Middle Range Theories (Smith, 2008) and conclude with a synthesis and research hypothesis to reflect conceptual definitions and propositions of the theory with the best fit. Theory Summaries: Comfort and Self-Efficacy Kolcabas Comfort Theory The Comfort Theory is a humanistic, holistic, patient need based nursing derived middle range theory (Kolbaca, xxxx). The concept of comfort has had a historic and consistent presence in nursing. In the early 1900s , comfort was considered to be a goal for both nursing and medicine, as it was believed that comfort led to recovery (McIlveen Morse, 1995). Over time comfort has become an increasingly minor focus, at times reserved only for those patients for whom no further medical treatment options are available (McIlveen Morse, 1995). The term comfort is used as a noun (comforter), adjective (comforting), verb (to comfort), or adverb (comfort the patient) (xxx). It is also used as a negative (absence of discomfort), neutral (ease), or positive (hope inspiring). Webster (1990) defines comfort as relief from distress; to soothe in sorrow or distress; a person or thing that comforts; a state of ease and quiet enjoyment free from worry; anything that makes life easy; and the lessening of misery or grief by calming or inspiring with hope. The origin of comfort is confortrare which means to strengthen greatly(Kolcaba, 1992). Based on the diversity of these terms comfort is a complex term. Kolcabas (1991) concept analysis of comfort helped to clarify the role of comfort as a holistic concept for nursing. This review confirmed that comfort is a positive concept and is associated with activities that nurture and strengthen patients (David, 2002). Over a period of years and revisions Kolcaba (1994) developed the comfort the ory which continues to evolve and change with changes as recent as 2007 (Figure 2). Kolcaba (1994, 2001, 2003) has defined comfort as the immediate state of being strengthened through having the human needs for relief, ease, and transcendence addressed in four contexts of experience (physical, psychospiritual, sociocultural, and environmental). The terms relief, ease, and transcendence are types of comfort that occur physically and mentally (Figure 2). The terms are defined based on definitions from medicine, theology, ergonomics, psychology, and nursing (Kolcaba Kolcaba, 1991). Relief is the state of having a discomfort mitigated or alleviated. Ease is the absence of specific discomforts. Transcendence is the ability to rise above discomforts when they cannot be eradicated or avoided (e.g., the child feels confident about ambulation although (s)he knows it will exacerbate pain). Transcendence, as a type of comfort, accounts for its strengthening property and reminds nurses to never give up helping their children and family members feel comforted. Interventions for increasing transcendence can be targeted to improving the environment, increasing social support, or providing reassurance. The three types of comfort occur in four contexts of experience: physical, psychospiritual, sociocultural, and environmental. These contexts were derived from an extensive review of the nursing literature on holism (Kolcaba, 1992). When the three types of comfort are juxtaposed with the four contexts of experience, a 12-cell grid is created, which is called a taxonomic structure (TS) (Figure 1) . Taken together, these cells represent all relevant aspects (defining attributes) of comfort for nursing and demonstrate the holistic nature of comfort as an important goal of care. All comfort needs can be placed somewhere on the taxonomic structure, and the cells are not mutually exclusive. A sample pediatric case study using the TS as a guide for a holistic comfort assessment is demonstrated below (see Figure 1). The concepts for the middle range for Comfort Theory include comfort needs, comfort interventions, intervening variables, enhanced comfort, health-seeking behaviors, and institutional integrity (Kolcaba, 1994). All of these concepts are relative to patients, families, and nurses (Kolcaba, 2003; Kolcaba, Tilton, Drouin, 2006). There are eight propositions which link the above concepts together. All or parts of the Comfort Theory can be tested for research (Peterson Bredow, 2010). In the comfort theory, Kolcaba asserts that when healthcare needs of a patient are appropriately assessed and proper nursing interventions carried out to address those needs, taking into account variables intervening in the situation, the outcome is enhanced patient comfort over time (Kolcaba, 2007). Once comfort is enhanced, the patient is likely to increase health-seeking behaviors. These behaviors may be internal to the patient (eg, wound healing or improved oxygenation), external to the patient (eg, active participation in rehabilitation exercises), or a peaceful death. Furthermore, Kolcaba asserted that when a patient experiences health-seeking behaviors, the integrity of the institution is subsequently increased because the increase in health-seeking behaviors will result in improved outcomes. Increased institutional integrity lends itself to the development and implementation of best practices and best policies secondary to the positive outcomes experienced by patients (Kolcab a, 2007). To translate the concepts to practice the effectiveness of a holistic intervention can be targeted to the taxonomic structure for enhancing comfort in a specific patient, family, or nurse population over time. Holistic comfort is defined as the immediate experience of being strengthened through having the needs for relief, ease, and transcendence met in four contexts of experience (physical, psychospiritual, social, and environmental).The comfort theory has been operationalized in many research settings with a variety of patient and target populations ranging from end of life care to the comfort of nurses (xxxx). Resnick Theory of Self-Efficacy Self efficacy is described as a way to organize an individuals judgment of his or her capability to execute a course of action. The Theory of Self-efficacy states that self-efficacy expectations and outcome expectations are not only influenced by behavior, but also verbal encouragement, reflective thinking, physiological sensations and role or self-modeling (Bandura, 1995).. Through self evaluation an individual judges their capability to perform and established self expectations which is visually depicted in the conceptual model (Appendix 2) (Resnick, 2008). Resnicks Theory of Self Efficacy is based on Banduras social cognitive theory and conceptualizes person-behavior-environment as triadic reciprocity the foundation for reciprocal determinism (Bandura, 1977, 1986). Most of the research into self-efficacy beliefs among older adults has been quantitative and has consistently supported the influence of those beliefs on behavior. However, it has not been established how efficacy beliefs actually influence motivation in older adults, or what sources of efficacy-enhancing information help strengthen those beliefs. Kolcabas Comfort Theory: Description, Analysis, and Evaluation Theory Description Historical context. The Comfort Theory is a humanistic, holistic, patient need based nursing derived middle range theory (Kolbaca, xxxx). The concept of comfort has had a historic and consistent presence in nursing. In the early 1900s , comfort was considered to be a goal for both nursing and medicine, as it was believed that comfort led to recovery (McIlveen Morse, 1995). Over time comfort has become an increasingly minor focus, at times reserved only for those patients for whom no further medical treatment options are available (McIlveen Morse, 1995). The term comfort is used as a noun (comforter), adjective (comforting), verb (to comfort), or adverb (comfort the patient) (xxx). It is also used as a negative (absence of discomfort), neutral (ease), or positive (hope inspiring). Webster (1990) defines comfort as relief from distress; to soothe in sorrow or distress; a person or thing that comforts; a state of ease and quiet enjoyment free from worry; anything that makes life easy; and the lessening of misery or grief by calming or inspiring with hope. The origin of comfort is confortrare which means to strengthen greatly(Kolcaba, 1992). Based on the diversity of these terms comfort is a complex term. Kolcabas (1991) concept analysis of comfort helped to clarify the role of comfort as a holistic concept for nursing. This review confirmed that comfort is a positive concept and is associated with activities that nurture and strengthen patients (David, 2002). Over a period of years and revisions Kolcaba (1994) developed the comfort the ory which continues to evolve and change with changes as recent as 2007 (Figure 2). Structural Components. Assumptions. Kolcabas Theory of Comfort (1994) makes four basic assumptions about reality. She assumes that humans beings have holistic responses to complex stimuli; comfort is a desirable holistic state that is germane to the discipline of nursing; human beings actively strive to meet, or to have met, their basic comfort needs, and that comfort is more than the absence of pain, anxiety, and other physical discomforts (Kolcaba , 2009). Concepts. Kolcaba defines six concepts of comfort which are relative to patients, families, and nurses (Table 1) . The term family, as defined by Kolcaba (2003) encompasses significant others as determined by the patient (Kolcaba, 2003; Kolcaba, Tilton Drouin, 2006). The first concept is of comfort needs which is the relief/ease/transcendence in physical, psychospiritual, sociocultural and environmental contexts of human experience. Comfort interventions in the model are defined as interventions of the health care team specifically targeting comfort of the patient, family and nurses. Intervening variables are positive or negative factors over which the health care team has little control, including physical limitations of the hospital or patients home, cultural influences, socioeconomic factors, prognosis, concurrent medical or psychological conditions. Health-seeking behaviors are those behaviors of patient, family or nurses (conscious or unconscious) which promote well-being; may b e internal, external or towards promoting a peaceful death. The final concept, institutional integrity, added in most recently, are values, financial stability and wholeness of health care facilities at the local state or national levels. Propositions. To help test the concept of nurses comfort caring for dying infants, propositions five and six of Kolcabas comfort theory are examined. These propositions state that patients, nurses, and other members of the healthcare team agree upon desirable and realistic health seeking behaviors (HSBs) (five) and if enhanced comfort is achieved, patients, family members, and/or nurses are strengthened to engage in HSBs, which further enhances comfort (six). These propositions provide rationale for why nurses and other health care professionals should focus on the patient, family, or in this case the nurses comfort beyond altruistic reasons. Because health seeking behaviors include internal and external behaviors almost any health-related outcome important in a healthcare setting can be classified as a health seeking behavior (Peterson Bredow, 2010). The desirable and realistic health seeking behavior (HSB) for this study is nurses comfort (knowledge and skills) to relieve moral di stress in caring for a dying infant and their family. Several studies support that moral and other types of distress are frequently observed in nurses who care for dying infants (Frommet, 1991) and most importantly indicate that nurses are seeking education regarding patient end of life issues (XXXXX). It is believed that reducing this distress and frustration can be affected through an effective end of life educational programs and is likely to improve the knowledge and skills nurses need to help increase their comfort level in caring for dying infants (xxxxx). Functional Components. Visualizing the concepts in the conceptual model, the Theory Analysis and Evaluation To analyze and evaluate Kolcabas Comfort Theory (1994) the substantive foundation, structural integrity, and functional adequacy of the theory using Smith and Liehrs (2008) Framework for the Evaluation of Middle Range Theories is discussed below (Appendix 1). Substantive foundations. Assessing the substantive foundation of a middle range theory is based on four criteria (Smith, 2003). The first criterion evaluates whether the theory is within the focus of the discipline of nursing. Kolcabas comfort theory successfully addresses four concepts comprising the metaparadigm of nursing, defining the concepts as they correspond to the theory (Dowd, 2002; Kolbaca, 2007) as well as presents a diagram of how the Comfort Theory relates theoretically to other nursing concepts (Figure 2) (Kolcaba, 1994) . Nursing is described as the process of assessing the patients comfort needs, developing and implementing appropriate nursing interventions, and evaluating patient comfort following nursing interventions. Person is described as the recipient of nursing care; the patient may be an individual, family, institution, or community. Environment is considered to be the external surroundings of the patient and can be manipulated to increase patient comfort. Fi nally, health is viewed as the optimum functioning of the patient as they define it. The ability of the framework to suggest interventions that help guide nursing interventions to increase comfort supports the discipline of nursing, and in doing so meeting the first criteria. The second criterion evaluates whether the assumptions are specified and congruent with the focus. The four assumptions in the Comfort Theory are explicitly stated and so meet the second criteria. Comfort theory (xxxx) assumes that humans beings have holistic responses to complex stimuli; comfort is a desirable holistic state that is germane to the discipline of nursing; human beings actively strive to meet, or to have met, their basic comfort needs, and that comfort is more than the absence of pain, anxiety, and other physical discomforts (Kolcaba , 2009). Because the Comfort Theory (XXXX) substantially describes the concept of comfort at the middle range level of discourse, the third criterion of the substantive foundation is met. Kolcabas (1991) concept analysis of comfort helped to clarify the role of comfort as a holistic concept for nursing. This review confirmed that comfort is a positive concept and is associated with activities that nurture and strengthen patients (David, 2002). The Comfort Theory provides an excellent description, explanation, and interpretation of the comfort concept in multiple domains and practice settings. Comfort theory is at the middle range level in that is defined in a measurable way and can be operationalized in both research and practice settings. The final criterion for this category evaluates if the origins are rooted in practice and research experience. The Comfort Theory has been used in numerous practice and research settings to provide a framework where patients have comfort needs and enhancing their comfort is valued. It has also been used to enhance working environments, especially for nurses, and most recently as a framework for working toward national institutional recognitions. More specifically parts are all of the theory have been used to test the effectiveness of holistic interventions for increasing comfort (xxxxxxx), to demonstrate the correlation between comfort and subsequent HSBs (xxxxx) and to relate HSBs to desirable institutional outcomes. It has also been used as a framework for helping families make difficult decisions about end of life (xxxxx). International and national healthcare institutions have also used Comfort Theory to enhance the work environment for nurses (xxxx). In these cases, nurses comfo rt is of interest and is theoretically related to the integrity of the institution. Summarize specific studies and tools used here. Structural integrity. There are four criterion for evaluating structural integrity. The first criterion is that the concepts are well defined. The concepts (defined above) of comfort needs, comfort interventions, intervening variables, enhanced comfort, health-seeking behaviors, and institutional integrity are clearly defined and easy to understand. There are numerous examples of applying the concepts in the literature for further clarification (xxxxx). The second criterion of structural integrity is that concepts within the theory are at the middle range level of abstraction. The concepts of the Comfort Theory-comfort needs, comfort interventions, intervening variables, enhanced comfort, health seeking behaviors, and institutional integrity are near the same level on the ladder of abstraction at the middle range level. They are more concrete because they can and have been operationalized and measured (xxxxx). The third criterion of structural integrity is that there are no more concepts than needed to explain the phenomena. Overall, the concepts adequately explain the phenomena of comfort. The theory is synthesized and organized in a simple manner. Lastly, the fourth criterion evaluates whether the concepts and relationships among the concepts are logically presented with a model. In the Comfort Theory (1994) model the ideas are integrated to create an understanding of the whole phenomenon of comfort in a model. The Comfort Theory (1994) model is a great example of presenting the concepts and statements in a linear logical order so the appreciation of the theory can be recognized (Smith, 2003). Functional adequacy. Because the criterion for functional adequacy overlap somewhat the five criterion will be discussed collectively. The five criterion include: theory can be applied to a variety of practice environments and clients; empirical indicators have been identified; published examples exist of research and theory in practice; and that the theory has evolved through scholarly inquiry. The Comfort Theory easily meets all of these criterions. For example, the Comfort Theory has been used widely in a variety of research in practice settings and patient and family populations. Even though the Comfort Theory has been used most widely with patients and families at the end of life and surrounding holistic palliative care nursing interventions, there has been a broad application of the theory in other populations as well including mothers in labor (xxxx), Alzheimer patients (xxxx), pediatric intensive care unit patients and families (xxxx), patients on bedrest (xxxx), those underg oing radiation therapy (xxxx) and for infants comfort and pain (xxxx). Most recently research of using the theory in practice has expanded to support institutional nursing recognition and comfort in the nursing working environment. In each of the populations mentioned above a psychometric comfort instrument has been developed as empirical indicators of concepts in the theory. However, the empirical indicators extend beyond empiricism and some include perceptions, self reports, observable behaviors and biological indicators (Ford-Gibloe, Campbell, Berman, 1995; Reed, 1995). The Comfort Theory (1994) has also been revised with the latest revision in 2007. The empirical adequacy of the Comfort Theory is evidence of the maturity of this theory (Smith, 2003). Summary The Comfort Theory (1994) is a well defined and well tested theory. Its strength lies in the versatility, adaptability, and testability of the concepts. The comfort theory clearly defines the concepts in the theory and the relationship between them. Because the comfort theory meets most of the substantitive foundations, structural integrity, and functional adequacy criteria the Comfort Theory (1994) is a strong middle range theory. An area that could increase the generalizability especially for nursing institutions is a change in the term in the model of nursing interventions to comfort interventions (xxxxx). Resnicks Self-Efficacy Theory: Description, Analysis, and Evaluation Theory Description Historical context. Resnicks Theory of Self Efficacy is based on Banduras social cognitive theory and conceptualizes person-behavior-environment as triadic reciprocity the foundation for reciprocal determinism (Bandura, 1977, 1986). The cognitive appraisal of these factors results in a perception of a level of confidence in the individuals ability to perform a certain behavior. The positive performance of this behavior reinforces self-efficacy expectations (Bandura, 1995). Structural Components. Although it is not explicitly stated, the core of this theory assumes that people can consciously change and develop or control their behavior. This is important to the proposition that self-efficacy also can be changed or enhanced through reflective thought, general knowledge, skills to perform a specific behavior, and self influence. This perspective is rooted in the model of triadic reciprocality (foundation for reciprocal determinism) in which personal determinants (self-efficacy), environmental conditions (treatment conditions) and action (practice) are mutually interactive influences. Therefore, improving performance depends on changing some of these influences (Bandura, 1977). In order to determine self-efficacy an individual must have the opportunity for self evaluation to evaluate how likely it is he or she can achieve a given level of performance. Concepts. The two major components of self efficacy include self-efficacy expectations and outcome expectations (Table 2). Self-efficacy expectations are judgments about the personal ability to accomplish a given task. Outcome expectations are judgments about what will happen if a given task is accomplished. These two components are differentiated because individuals can believe a certain behavior will result in a specific outcome, however, they may not believe they are capable of performing the behavior required for the outcome to occur (Bandura 1977, 1986). For example, a NICU nurse may believe attending an end of life education series will increase his/her knowledge and skill and ease moral distress, but may not believe that they could provide sensitive care for some ethical, religious, or moral reason. It is generally anticipated, but not always realistic that self-efficacy will have a positive impact on behavior. There are times when self-efficacy will have no or a negative impa ct on performance (Vancouver, Thomspon, Williams, 2001). Bandura (1977, 1986, 1997) suggests that outcome expectations are based largely on the individuals self-efficacy expectations, which generally depend on their judgment about how well they can perform the behavior; can be disassociated with self-efficacy expectations; and are partially separable from self-efficacy judgments when extrinsic outcomes are fixed. Because the outcomes an individual expects are the results of the judgments about what he or she can accomplish, they are unlikely to contribute to predictions of behavior (Bandura, 1977). Judgments about ones self-efficacy is based on four informational sources including enactive attainment, vicarious experience, verbal persuasion and physiological state. The first source, enactive attainment, or the actual performance of a behavior has been described as the most influential source of self-efficacy information (Bandura, 1986,; Bandura Adams, 1977). There has been repeated empirical evidence that actually performing an activity strengthens self-efficacy beliefs due to informational sources (Bandura, 1995). The second source, vicarious experience or visualizing other similar people perform a behavior, also influence self-efficacy (Bandura, Adams, Hardy, Howells, 1980). Conditions that impact vicarious experience include amount of exposure or experience to the behavior (least experience causes greater impact) and amount of instruction given (influence of others is greater with unclear guidelines) (Resnick Galik, 2006). Another source verbal persuasion or exhortation i nvolves telling an individual he or she has the capabilities to master the given behavior. Verbal encouragement from a trusted, credible source in counseling or education form has been used alone to strengthen efficacy expectations (Castro, King, Brassington, 2001; Hitunen et al. 2005; Moore et al., 2006; Resnick, Simpson, et al., 2006). The final information source physiological feedback or state during a behavior can be important in relation to coping with stressors, health functioning, and physical accomplishments. Interventions can be used to alter the interpretation of physiological feedback and help individuals cope with physical sensations, enhancing self efficacy and resulting in improved performance (Bandura Adams, 1977). Propositions. To help test the concept of nurses comfort caring for dying infants,