Chemical engineering distillation column Essay Example | Topics and Well Written Essays - 500 words

Chemical engineering distillation column - Essay Example The required task is therefore to determine if the column has potential to efficiently distillate within economic operation costs. While a five-step procedure is recommended for testing the facility, time is scarce and not all the steps can be implemented. The steps are; calculation of the theoretical capabilities of the distillation column in the lab, preparation of an accurate vapor liquid equilibrium diagram of water and ethanol, accounting for the energy usage of the distillation process, accounting for the final products ethanol concentration, and analysis of the costs and benefits of obtaining higher yields against higher purities. The time scarcity however dictates that only two of the steps are adopted in order to determine the column’s capacity. My team would choose to prepare an accurate vapor liquid equilibrium diagram for water and ethanol, and to account for the final product’s ethanol concentration. The vapor liquid equilibrium would be preferred because of its theoretical basis that can be used in an experiment to test the facility’s efficiency and freedom from errors. This is because for any mixture of two fluids and across varying temperatures or pressures, there is an equation that determines corresponding mole ratios of mixture components in the vapor state given a temperature or pressure. A given volume of water and ethanol can then be used in the column and measurements taken at a given temperature and mole ratio determined. If the experimental values correspond to theoretical values, as determined by Raoult’s theory, then the column is approved to be operationally efficient. It is therefore an accurate measure of efficiency (Theodore, Ricci and Vanvliet, p. 233). Accounting for the final et hanol concentration is another efficient process for determining the operational efficiency of the distillation column. This is because of the

Incentive Plan (paraphrase) for my HR class Essay

Incentive Plan (paraphrase) for my HR class - Essay Example It is the responsibility of the supervisor to conduct a performance appraisal on the employees so as to ensure that the desired performance outcome is achieved in the organization. To do this, different performance appraisal methods can be used. One of the methods is the critical incident method in which the supervisor will write positive or negative performance behavior of a particular employee throughout the performance review period. Another method that can be used is the weighted checklist method where by a large list of descriptive statements of effective and ineffective behavior of the job are rated on each employee. The whole idea of performance appraisal is to ensure that the business retains efficient employees who can collectively perform towards the target goal of the business. Performance appraisal is also used in incentive programs of employees in the business. Incentive plans and acknowledgment programs often overlap to accomplish a common goal by being supervisor that increased motivation to perform. But there are differences. Traditionally, incentives are reserved for salespeople and tied to specific behaviors or outcomes like selling a specific product or line of products.

Course Project Case Study Example | Topics and Well Written Essays - 750 words

Course Project - Case Study Example While trying to identify the reasons associated with the success of the strategies for Apple IPod, focus has to be given on a number of issues. The first reason that needs to be highlighted is that the company Apple provides a lot of focus on introducing innovation in its products (Travlos, 2013). Secondly, the company prefers to promote simplicity in its product offerings. By having a highly simplistic kind of a user interface for the IPod, the company was able to create a favourable point of difference for its music product (Bajarin, 2012). The third factor is that the IPod was launched in the market along with a bundled free service offering. The free service offering which is popularly known as iTunes, helped in a great way in enhancing the customer experience for the product (LePage, 2006). The fourth factor that administered success to the IPod is the unique way of product marketing and branding by Apple. Since marketing is all about generating interest in the minds of the cons umers, the marketing approach of Apple was more focused on generating the buzz for the new product offering of the company at the time of launch. Also, the company focused on positioning the product as a fashion accessory, thereby triggering a further demand for the product (Weisbein, 2008). Finally, the last reason for success of the Apple IPod is the ability of the company to create a captive audience. By designing the highly fashionable lifestyle natured music device in a way, that it will accept only inputs from the company’s music website, helped in a great way in creating a captive audience, which automatically generated a huge amount of revenue for the company (Schulhof, 2006, p. 2). Mini Case 2: Failure The second mini case focuses on discussing the reasons leading to failure for a strategy of a particular company. For the purpose of relevance, the company that has been selected is Nokia, which is a globally present mobile manufacturing and marketing company. Talking more about the company, it needs special highlighting that Nokia in the last couple of years, has lost its market dominance position to various other competitors like Apple, Samsung, etc. On conducting an in-depth analysis, various points of flaws have been revealed. The first factor that has to be considered is that the telecom company lost its product related edge in the market. While its competitors focused on strongly promoting products which are high on innovative features, the company took a laid back approach (ET Bureau, 2013). Secondly, the company failed in a great way to identify the changing and rapidly evolving global mobile market. While the market was to Smartphones with touch features developed by its competitors, Nokia stuck for a considerable amount of time to with promoting Smartphones that lacked uniqueness in its product offering (News, 2012). Thirdly, the factor of brand positioning has to be taken into consideration. The bulky phone presented by Nokia lost its edge in the market when competing with other popular brands which are high on style and product appeal. Over a period of time, due to loss of brand appeal, Nokia’s products looked very old fashioned as compared to the rival’s homogenous and alternative product offerings (Chang, 2012). Cross Case analysis For the purpose of conducting a cross case analysis, it needs to be mentioned that both Apple and Nokia fall in the industry category of electronics.

Employment Law Issue Essay Example | Topics and Well Written Essays - 500 words

Employment Law Issue - Essay Example Sexual harassment usually involves males who are at higher positions and they harass their subordinate women in order to get sexual favors by threatening them of getting fired from the job. It is not only a form of unlawful employment discrimination that is based on sex but also it violates title VII of the civil rights act 1964. If we talk about harasser, we can say that at any specific workplace, the harasser and the victim can be an employee, an employer, supervisor, a person from the management staff, and even the boss. Some cases of sexual harassment may involve such homosexual men who are at higher positions and they harass their subordinate heterosexual men in order to get sexual favors. Conte (2000) found that in some cases, the victims of sexual harassment make complaint to the higher officials regarding offenses and in some cases they don’t want to expose the situation because of the society and the relatives. In such cases, sexual harassment gets increased and the victim sometimes gets in more trouble instead of coming out of the unwanted situation. The strategy which our company’s manager has implemented regarding the prevention of sexual harassment involves privacy of the victim. If a case of sexual harassment occurs in our company, the victim writes the incident on a paper and submits it to the manager instead of telling him by words. Then the manager calls the offender and the victim in a separate room in order to settle down the issue and take the required action against the offender. â€Å"It is the organizations responsibility to encourage staff to report incidents of sexual harassment by making the process accessible to all and by being approachable and dealing allegations in a sensitive and confidential manner† (Dawkins, 2007). At present, the management of the companies focuses on the privacy of the victim in order to

Britain and Ethnic Divisions Essay Example | Topics and Well Written Essays - 1250 words

Britain and Ethnic Divisions - Essay Example While on one side, it is the cultural conquest, most often referred to as the internal colonialism, the colonies of the Celtic fringe continued to exist from Middle Ages. Whereas, these areas showed a renewed frenzy of nationalism every now and then, English had hardly any nationalism or nationalistic movement. In case of the other ethnic minority, since there was a subjugation of rights, there was a spirit of nationalism among them too. While colonisation of other parts of the world by the English have been history, the settlement and colonisation of the Celtic fringe has been subtle. The first empire of the English was to establish the British. This is possibly the reason why nationalism and ethnicity were not referred to in the context of the British. The Celtic Fringe in British National Development 1536 - 1966. The colonisation started in the sixteenth century and in many cases was very subtle. 'They had been sleep walking towards their extinction. Not knowing what internal colonialism has done to them'. (Ken Saro Wiwa 1 Jan 1996). Internal colonialism is not easily recognised either by the settler or by the conquered. A similar colony was created in the Celtic Fringe by the English. This was to be an integrating effort resulting in the English becoming the British. The English culture became overpowering. ... Though the entire event started as a migration of the English from the lowlands to the rest of the regions, the regions soon become colonies of England. This trend was continued by the English when they colonised many other nation states across the world. English did not thrust their culture or practices on to the people whom they colonised. This also happened in the Celtic fringe (Ellis, Summer 2003) where the original culture of the Irish, the Scottish and that of the Welsh continue to exist in addition to the imperial culture of the English. Ethnic Migration The Ethnic migration, on the other end, resembles more for a want of better living conditions and of course, financial gain. Migration of the people in other countries was towards greener pastures. Large number of ethnic migrants came into the UK. Larger groups are the Caribbean, Black African, Indian, Pakistani, Bangladeshi, Chinese and others apart from white migrants settled elsewhere. All these people contribute to the large scale migration into the country. Nature of work they get themselves into after getting into the country, indicates the type of life they lead and their capability to work. Most of the people end up doing routine and manual work while a few do get into professional work. Figure: 1 Data on nature of work ethnic migrants get into. (National Statistics 2001) Figure 2: Social Class of the ethnic migrants (National Statistics 2001) Similarly the migrants mostly end up in the working class which amounts to almost 73.1% of the total ethnic migrants from 1971 to 1981. The nature of people who come into the country are from either the poor or the low level

Deities and Lesser Spirits Essay Example for Free

Deities and Lesser Spirits Essay Deities and Lesser SpiritsGods represented in mythology possess different characteristics. Lesser gods or deities may have ultimate power, finitude, good, or evil tied to the stories that tell about their lives and existence. The purpose of this paper is to define the terms ultimate power, finitude, good and evil and identify four mythological deities that personify these terms. Apollo, who is also referred to as Apollon, was a Greek Olympian god. His mother was Leto, a bride of Zeus. Apollo was a god of prophecy, healing, disease and plague, music, song and poetry, archery and he protected young life. He had ultimate power as a god. Ultimate power is defined as Gods are considered immortal and in control of lesser life forms (Theoi Greek Mythology, 2000-2007). Apollo had invented the flute and the lyre. Suprisingly, he had built the walls of Troy while simply playing the lyre. The Theoi Greek Mythology (2000-2007) stated, Apollo guarded the cattle of Laomedon in the valleys of Ida. In these two examples, it appears he in fact was the god of music, song and protection of young life. Finitude means being finite. Therefore, a god that personifies finitude is one whom only existed for a limited time (Language of Light Glossary, n.d.). The god that was chosen that represents finitude is Christ. Christ represented God during his tenure on earth and all the finite limitations that humans, created by God, face. Life with its choices puts a black or white finish on an individuals moral standing. Death representing the end of the opportunity to make those choices was experienced by Christ himself. Christ while interacting with both the Jews and Gentiles admonished individuals for a variety of sins and life styles that were uncharacteristic of a godly life. Measures were not applied to actions (i.e. tithing) but standards were applied to acts (the act of giving). The life Christ lived provided an example of finiteness people live with during their short lives but the reward as seen through Christs resurrection is infinite life in the realm of heaven. The definition of good as it relates to the gods is sometimes hard to define. Good is defined as having sought-after qualities, kind, merciful, high  morale values, religious, successful, fair to mention a few. With regard to the gods, a good god represented the positive, non-evil powers. Having a bountiful harvest, producing many children, finding love, and being successful in business could be tied to a god protecting the people. Although when researching good gods there seemed to be a shortage as compared to the gods associated with power or evil. A god that represented good was the Aztec god Quetzalcoatl, who was one of many gods in the Aztec belief system. Quetzalcoatl is reported to have given man the science of agriculture and writing as well as being the god of the morning and evening star and the wind. Quetzalcoatl was considered a hero among those who worshiped him and he fought with other gods for what he thought was right. Evil is defined by one source as morally bad or wrong (WordNet Search, n.d.). An evil deity is therefore, one whose actions are morally wrong. An example of a deity that personifies evil is the Devil. The Devil is a deity in Christianity that is described as a fallen angel who rebelled against God. The Devil best represents the term evil because of his hatred for humanity and all things created by God. According to Bible stories, throughout the history of mankind, the Devil has tempted humans to rebel against God and follow him. To achieve that end, the Devil is said to tell to tell lies and intentionally deceive people. The Devil promotes of deceit, sin, and other morally wrong behaviors. In fact, the devil is said to be the cause of original sin, which is the reason for the Apocalypse, or the second coming of Christ. The Devil rewards those who turn against God with eternity in Hell. In conclusion, the gods of mythology possess different characteristics. The story of Apollo is example of a god with ultimate power as he had healing power and could protect young life. Quetzalcoatl shows us good as he was considered a hero and worshiped for fighting for what was right. Christ represented God during his tenure on earth and all the finite limitations that humans face, such as death. The Devil is the ultimate example of evil as he intentionally deceives and promotes deceit, sin, and other morally  wrong behaviors. Stories tell about the existence and lives of deities and lesser gods and from those stories, one must decide which powers they possessed. References Davies, N. (1973). The Aztecs. Norman, Oklahoma, University ofOklahoma PressLanguage of Light Glossary. (N.D.). Retrieved November 4, 2007 from http://www.goddirect.org/glossary/f.htmTheoi Greek Mythology. (2000-2007). Apollon. Retrieved November 2, 2007, from http://www.theoi.com/WordNet Search. (n.d.). WordNet Search. Retrieved November 1, 2007, from http://wordnet.princeton.edu/perl/webwn?s=evilsub=Search+WordNeto2=o0=1o7=o5=o1=1o6=o4=o3=h

Integrated Occupational Therapy Practice Case Study

Integrated Occupational Therapy Practice Case Study Introduction This report will focus on the occupational therapy (OT) process for Meera (Appendix A), a 56-year-old woman with a left cerebral vascular accident (CVA). Stroke is the death of brain cells due to the lack of oxygen (Bartels et al. 2016).It can either present as haemorrhagic or ischaemic in nature. Risk factors of CVA include hypertension and hypercholesterolemia which Meera has. Stroke may lead to neurological, psychological, speech and musculoskeletal complications. Meeras symptoms of right hemiplegia, right sided neglect and speech difficulties can be attributed to the occlusion of her left middle cerebral artery (Mtui et al. 2016). A multidisciplinary inpatient stroke rehabilitation unit was involved with Meeras post-stroke rehabilitation. Stroke patients who underwent treatment inpatient stroke care were found to have improved independence (Stroke Unit Trialists Collaboration 2013). Treatment was aimed at managing vital problems through restorative and compensatory approaches in order to prepare her for discharge (Edmans 2010). Thus, this service was most appropriate for Meera due to her recent onset of stroke. The OT process was guided by recommendations from the College of Occupational Therapist, National Institute for Health and Care Excellence (NICE)(2013) and Intercollegiate Stroke Working Party (ISWP)(2016)(Edmans 2010). Assessments and Problems Identified An initial assessment was gathered through an interview using the Kawa Model. It portrays a persons life as a river and various objects such as rocks, river banks and driftwood depict circumstances experienced by a person (Teoh and Iwama 2015). Younger stroke patients such as Meera may require services which cater particularly to their needs which most stroke units were found not to do so (ISWP 2016). As Kawa focuses on the view of the client, it allows the therapist to know what is important to Meera in order to formulate priorities for intervention. The assessment is shown below: Life flow and priorities (river) Past Medical History: Hypertension Hypercholesterolemia Roles and Occupations: Independent in self-care Proud Stay at home mother Took charge of matters at home such as: Cleaning Shopping Gardening Laundry Enjoys cooking for family Present Medical History: Stroke Roles and Occupations: Patient Needs assistance in most self-care tasks Loss of previous role and not engaging in occupations meaningful to her Future Meera felt afraid and pointless to talk about the future, worrying that she may have another stroke if she engaged in activity. Obstacle and Challenges (rocks) Occupational performance challenges: Right hemiplegia with increased spasticity in right arm and leg, causing difficulty in: Sitting Coordination of movement Tasks that require her hands due to being right handed Unable to feel sensations on right hand Feels she cannot remember things as easily and may not know the time and place she is at Right sided neglect with visual agnosia, resulting in difficulty : washing right side awareness of people approaching from affected side interacting with others Expressive dysphagia hinders communication with others. Feeling low mostly Feels useless Embarrassed that people are taking care of her Fatigues easily Concerns Family unable to function as she is unable to manage the household A burden to family, especially her husband who needs to manage the household together with the pressure at work now that she is in hospital Childrens studies and social life may be affected as they may be concerned about Meera and visiting her in hospital may affect their daily life Physical and Social Environment (river banks) Physical (Home) 3 room semi-detached Bathroom, toilet and bedroom on the upper storey Kitchen, combined living and dining room on ground floor Nearest bus stop and convenience store 10 minutes walk away Social Close knit family Meera usually supports family members as they will confide her during difficulties Looks forward to dinner every day where family will gather together Family is most vital source of support for Meera Frequent interaction with neighbours and will help each other with chores if needed Occasionally communicates with extended family overseas on phone Personal resources (driftwood) Personality Hardworking Afraid of trying new things Kind and caring Responsible With information from the initial assessment, the problem list was formulated in a client-centred manner (ISWP 2016). Stroke survivors felt more engaged in the therapeutic process when their perspectives were taken into account (Peoples et al. 2011). Interventions were based on Meeras perceived problems in order to increase her motivation in therapy which she lacked. However the Kawa model only shows the problems perceived by Meera but not the therapists views. In order to gather a clinical and therapeutic point of view, standardized assessments were conducted as well. The table below depicts the various assessment conducted, reasons for use, limitations and results. Assessment Reasons for use and limitations Results Assessment of Motor and Process Skills (AMPS) (Fisher and Jones 2010) AMPS evaluates motor and processing skills of clients through observation of appropriate tasks (Fisher and Jones 2010). Self-care, specifically showering, dressing and cooking tasks which was important to Meera, were used to assess. This allowed the OT to break the tasks down and acknowledge the challenges Meera faced in order to formulate an appropriate intervention. AMPS was found to be valid, reliable and standardized among cultures but results has to be computer generated in order to be valid which may make the process tedious (Fisher and Jones 2010). Less than 1 for both motor (Moderate increase in physical effort) and process (Moderate inefficiency and disorganization) skills. Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) (Itzkovich et al. 2000) LOTCA evaluates the orientation, visual and spatial perception, visual-motor organization and thinking operations through the use of various activities included in the kit (Itzkovich et al. 2000). This allowed the OT to assess Meeras right sided neglect and to discover any underlying cognitive deficits. The LOTCA is reliable and valid for use in people with stroke but needed to be conducted in more than one sitting as assessments were long and tedious for Meera who experience fatigue (Katz et al. 2000). Meera was able to sequence tasks but was unable to complete tasks involving her right field of vision. She needed prompts to complete orientation tasks. Activities involving memory were also a challenge for her. Rivermead Motor Assessment (RMA) (Lincoln and Leadbitter 1979) The RMA consists of tests evaluating the gross, leg, trunk and arm function of a stroke patient (Lincoln and Leadbitter 1979). This was conducted together with the physiotherapist. The RMA allowed the team to know which movements Meera had difficulties in order to formulate appropriate interventions. This assessment was found to be reliable and valid but due to being strenuous and long, it had to be conducted in a few sessions due to Meera showing signs of fatigue (Kurtais 2009) Meera was not independent in transfers and mobility, she required assistance of one for transfers and used a wheelchair for mobility. She also had minimum trunk and leg control at her affected side and require assistance for movement. However, she is able to hold objects using her affected arm but cannot reach for an object far away due to scapular instability. Â  From these assessments, 3 problems Meera faced, in order of significance was developed: 1. Loss of independence in self-care affected Meera the most. From the assessments conducted, it was found that challenges in motor, cognition and perception affected her performance in self-care. Managing self-care would focus on these domains as well (NICE 2013). It was hoped that Meera would be more engaged in therapy by focusing on an issue she perceived as critical. This was evidenced by a study where patients were more motivated and engaged more in interventions when treatment was catered to their perceived needs (Combs et al. 2010). This would also help Meera to elevate her mood as low involvement in self-care was found to be a factor for post-stroke depression (Jiang et al. 2014). The psychologist in the team would be managing Meeras low mood as well (ISWP 2016). By working with Meera on her self-care would also remove some burden from Sanjay, who was assumed to be her main carer when she is discharged from hospital. 2. Problems with visual perception, specifically right side neglect and agnosia, were targeted as it was found to have an influence on self-care (Barker-Collo et. al 2010). This would help Meera in performing self-care tasks. Her visual deficits also affected her social life and transfers. Managing her perceptual problems would allow her to interact more with other patients in the ward which could provide her with social support. 3. Meeras motor challenges, specifically right side weakness and spasticity were addressed as it was one of the major challenges faced during self-care. It was hoped that through the management of motor deficits, Meera would increase her engagement in occupations. This would also have a positive effect for Meera in future as it was shown that physical function affected quality of life in stroke patients (Ellis et al. 2013). Motor challenges faced by Meera would be managed in conjunction with the physiotherapist (ISWP 2016). Skills in managing motor challenges can also be transferred to other aspects such as cooking and reinstating her role as a homemaker. Treatment Plan Client Aims: Meera wants to be more engaged in her personal care. Therapist Aims: To increase Meeras engagement in her self-care tasks. To manage Meeras right sided neglect and agnosia. To manage Meeras weakness and spasticity in her right arm, leg and trunk. Objectives: Meera should be able take charge of her own shower and dressing every morning for an hour, with assistance of one, in 4 weeks. Meera should be able to independently identify items required on her right field of vision for washing and dressing every morning in 4 weeks. Meera should be able to go from lying to sitting, and pivot transfer from bed to wheelchair as well as from wheelchair to shower chair, every morning with assistance of one in 4 weeks. Intervention Washing and dressing assessment was conducted through the use of AMPS. This allowed the OT to formulate an appropriate wash and dress plan for multi-disciplinary use through identified difficulties in motor and processing skills (Fisher and Jones 2010). Using a meaningful occupation as a basis for intervention was beneficial for Meera. This can be supported by a study where occupation based intervention was shown to be critical in improving occupational performance (Wolf et al. 2015). The intensity of the intervention would be higher than the recommended minimum frequency of 45 minutes, 5 days a week as it was included in Meeras daily routine (NICE 2013). The washing and dressing plan was adapted from Salisbury District Hospitals (2013) assessment form. The OT conducted the first session in order to teach Meera the relevant compensatory and visual scanning skills. Other sessions could be conducted by other staff with guidance from the plan. A further review after every few days would also be required in accordance to recommendations (ISWP 2016). Washing and dressing plan for Meera Transfers Bed Mobility: Meera is able to roll to her right side independently. She requires assistance from lying to sitting. Bed to wheelchair: Require assistance of one for pivot transfer Standing: Require assistance of one and grab rail in the bathroom Wheelchair to shower chair: Require assistance of one for pivot transfer Allow Meera to navigate to bathroom Washing Notes: Require the use of a shower chair in the shower Allow Meera to initiate and sequence task independently Only give Meera assistance when she asks for it Place items necessary for shower on Meeras right side If Meera seems to be searching for something, prompt her to look for it by turning her head Encourage use of right hand to wash herself Meera may require assistance to release her grip on objects Provide assistance if Meera feel fatigue Upper body: Meera is able to wash her right side independently Meera require assistance to wash above her elbows on her left side Assistance may be needed to wash hair and back thoroughly Lower Body: Meera should be able to wash her genitals and front upper thighs independently Assist Meera in standing with the grab rail with one person supporting at all times Another person will assist Meera in cleaning her bottom and her rear upper thigh Encourage Meera to wash her lower thighs but prevent her from falling from the shower chair Assist in cleaning the rest of the lower thighs Dressing Upper Body: Encourage Meera to put on the bra independently using the one arm method. Allow Meera to use the one hand method to wear her t-shirt. Prompt her by reminding her of the steps if she is struggling Lower Body: Meera requires assistance to put on her trousers while assisted in standing. Both the restorative and adaptive approach was used to guide the intervention. Restorative approach is grounded upon neuroplasticity where relearning takes place when new neural connections form in the brain during constant exposure to various stimulus (Gillen 2016). By practising various movements of her affected side during self-care, Meera should have a reduction in her impairments. This is supported by a study where patients who went through functional motor relearning therapy were found to have improved balance and performance in self-care (Chan et al. 2006). The compensatory approach is where tasks are modified to be easier for the clients to achieve (Edmans 2010). Even though this approach has been criticized for hindering motor recovery in people with stroke, it is still appropriate for Meera (Jones 2017). The compensatory method of using the one hand dressing method served as a feedback mechanism which could improve motivation as supported by Popovic et al. (2014). This would thus encourage Meera to engage in therapy. Risk Management Plan Meera might be fatigue and may not be able to do some of the tasks required. The staff in charge will assist when required and allow Meera to rest when needed. Due to the intimate nature of a wash and dress, Meera might feel embarrassed and down during the process. In order to preserve her dignity, sensitive areas would be covered whenever necessary and observation would be subtle. Environmental hazards would be checked before commencing any transfers or wash and dress in order to prevent falls. Relapse prevention In the hospital setting, encouragement for frequent engagement in occupation and usage of relevant motor and cognitive skills would prevent Meeras occupational performance from deteriorating (Brainin et al. 2015; Ullberg et al. 2015). According to NICE (2013), long-term health and social support should include education on symptoms and dysfunction relating to stroke, services available and participation in meaningful occupation. As such, Meera and her family would be briefed on these strategies. Outcome Measures Evaluation of treatment outcomes is important to conclude if the intervention was successful and used to change the treatment plan according (Mew and Ivey 2010). The outcomes were evaluated by using goals and comparing standardized assessment at baseline and outcome. Firstly, intervention was evaluated through the achievement of goals. Goal achievement was linked to client satisfaction and a significant client-centred outcome (Custer et al. 2013). Meera was able to achieve the objectives as expected. Secondly, the AMPS was conducted again, using the task of showering and dressing (Fisher and Jones 2010). Meera scored higher in these tasks but still required some assistance in achieving them. Thirdly, Meera improved on the LOTCA tasks which involved visual scanning, little to no improvement was seen on the orientation and memory tasks (Itzkovich et al. 2000). Lastly, the RMA was conducted again (Lincoln and Leadbitter 1979). Meera improved in the trunk, leg and upper limb function but there were still signs of weakness and instability involved. Further plans Other domains of concern would be managed as according to initial assessment and outcome measures. Further interventions would include management of cognitive function such as memory and orientation through cooking. Including Meera in a social group such as breakfast club in the ward would be beneficial to her as well (Venna et al. 2014). To prepare for discharge, Meera would be referred to the Early Supported Discharge team. The team would help Meera and her family by introducing appropriate adaptations at home and relevant education on stroke (ISWP 2016). A smooth transition from hospital to home was found to improve patients function in activities of daily living and service satisfaction (Fearon et al. 2012). This would thus be beneficial for both Meera and her family. References Bartels MN, Duffy CA and Beland HE (2016) Pathophysiology, Medical Management, and Acute Rehabilitation of Stroke Survivors IN: Gillen G (ed) Stroke Rehabilitation: A Function-Based Approach (4th Edition). Missouri: Elsevier 2-45 Brainin M, Tuomilehto J, Heiss WD, Bornstein NM, Bath PMW, Teuschi Y, Richard E, Guekht A and Quinn T (2015) Post-stroke cognitive decline: an update and perspectives for clinical research. European Journal of Neurology 22(2):299-e16 Chan DYL, Chan CCH and Au DKS (2006) Motor relearning programme for stroke patients: A randomized controlled trial. Clinical Rehabilitation 30(3):191-200 Combs SA, Kelly SP, Barton R, Ivaska M and Nowak K (2010) Effects of an intensive, task-specific rehabilitation program for individuals with chronic stroke: A case series. Disability and Rehabilitation 32(8):669-678 Custer MG, Huebner RA, Freudenberger L, Nichols LR (2013) Client-chosen goals in occupational therapy: Strategy and instrument pilot. Occupational Therapy in Health Care 27(1):58-70 Edmans J (ed) (2010) Occupational Therapy and Stroke (2nd Edition). Chichester: Wiley-Blackwell Ellis C, Grubaugh AL and Egede LE (2013) Factors associated with SF-12 physical and mental health quality of life scores in adults with stroke. Journal of Stroke and Cerebrovascular Diseases 22(4):309-317 Fearon P, Langhorne P and Early Supported Discharge Trailists (2012) Services for reducing duration of hospital care for acute stroke patients. Cochrane Database of Systematic Reviews 7: CD000443 Fisher AG and Jones KB (2010) Assessment of Motor and Process Skills Vol. 1: Development, Standardization and Administration Manual (7th Edition). Fort Collins: Three Star Press Gillen G (2016) Stroke Rehabilitation: A Functional-Based Approach (4th Edition). Missouri: Elsevier Intercollegiate Stroke Working Party (2016) National Clinical Guideline for Stroke. Royal College of Physicians. Available from: https://www.strokeaudit.org/SupportFiles/Documents/Guidelines/2016-National-Clinical-Guideline-for-Stroke-5t-(1).aspx [Accessed 28 March 2016] Itzkovich M, Averbuch S, Elazar B and Katz N (2000) Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) Battery (2nd Edition). New Jersey: Maddak Inc. 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Stroke 46(2):389-394 Venna VR, Xu Y, Doran SJ, Patrizz A and McCullough LD (2014) Social interaction plays a critical role in neurogenesis and recovery after stroke. Translational Psychiatry 4(1):e351 Appendix A Meera CVA Meera is a 56-year-old woman who was recently admitted with a left Cerebral Vascular Accident affecting the middle cerebral artery. She has a history of hypertension and hypercholesterolemia. She was admitted via A E after being found by her husband. Her husband reports that she felt unwell and made her way upstairs to have a lie down. He went out to walk the dog and on his return found her on the floor in the bathroom. Meera presents with a right hemiplegia with increased spasticity in her right arm and leg. As a result, she has difficult with sitting balance and co-ordinating her movements in order to engage in activities such as washing and dressing. Meera also presents with right sided neglect, which results in her failing to identify objects on her right side, difficulty washing her right side and responding to others who approach her from her right. She has difficulty in articulating in a meaningful way to get her needs met and is very tearful. The Occupational Therapist under took an initial assessment with Meera, the report is detailed below. Initial assessment summary Meera appears low in mood and is reluctant to talk about the future. She is worried that she may have another stroke and consequently is reluctant to engage in activity. Meera is embarrassed that she needs help in personal activities of daily living and is reluctant to talk about activities that she finds difficult. Family Meera is married to Sanjay, a 58-year-old man who works as a plumber. They have two children, Anni aged 18 years who has just completed her A levels and will be attending a local university in one months time, and Sam aged 17 who is at secondary school. Social situation The family live in a privately owned three bedroomed semi-detached property in a small town. Sanjay describes Meera as a stay at home mum who prides herself on her family and her cookery skills. Posture Meera has a right- sided hemiplegia; her scapular is unstable and she finds it difficult to flex her arm above 90 degrees. Elbow extension is uncontrolled and there is stiffness in her forearm making supination difficult. She is able to grasp objects but finds release very difficult. Sensory assessment Meera has poor deep and light sensation in her right hand, which has a profound effect on a range of performance areas. Cognition and perception Meera has a right sided neglect which interfers with washing and dressing, and transfers. She also has difficulty socialising with other patients on the ward due to to this. Meera has some cognitive impairment which presents as poor memory and disorientation. These features are more prominent at the end of the day when Meera is tired. Mobility Meera currently uses a wheelchair but can manage a controlled transfer with one person assisting.