Doctors Without Borders free essay sample

In 1971, a little gathering of specialists in Paris shaped an association. Their objective was to give crisis clinical guide, regardless of where it is required or who needs it. This was the start of Medecins Sans Frontieres, (MSF) or, in English, Doctors Without Borders. The way of thinking of MSF is that all individuals reserve the option to clinical consideration, paying little heed to race, religion, or nationality. Today, as indicated by MSF, the world needs clinical specialists who can give help to any country rapidly, effectively, and without political pressures.MSF started as â€Å"a couple of specialists with a bag and a fantasy. † Now it is the biggest nongovernmental association for crisis clinical alleviation. It has workplaces in twenty nations and has given clinical assistance in eighty-five nations, including Rwanda, Chechnya, Kosovo, Liberia, Afghanistan, and Iraq. MSF sends groups not exclusively to areas that are at the center of attention yet in addition to places where overlooked wars keep on causing languishing. We will compose a custom article test on Specialists Without Borders or on the other hand any comparative point explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page Since such an extensive amount MSF’s work is done in perilous areas, it requires extraordinary courage to be a MSF worker.MSF laborers have been taken shots at, injured, captured, and executed. They have additionally been contaminated with infections that they were attempting to battle. All of MFS’s worldwide specialists are volunteers. Just few volunteers are specialists. Most volunteers fill in as attendants, clinical specialists, sanitation designers, and heads. In spite of the fact that the volunteers are paid just a modest quantity to take care of their expense of living, they are remunerated from multiple points of view. One specialist said that rehearsing medication at an exile camp resembled getting a hands-on exercise throughout the entire existence of medication, far away from his regular encounters in a cutting edge clinical focus. Another volunteer summarized her work along these lines: â€Å"It’s a groundbreaking encounter. † MSF is most popular for its quick reaction in the midst of emergency. At the point when a health related crisis happens, MSF sends in a development group to discover what sort of help is required. This group organizes transportation, frequently to remote areas.Teams may go by jeep, vessel, helicopter, or even by walking. The development group at that point gets in touch with one of its four territorial places, situated in Europe, East Africa, Central America, and East Asia. The middle sorts out groups of volunteers and sends packs of provisions and hardware. The enrollment of the group and the substance of the units rely upon the sort of crisis. For instance, in a war or cataclysmic event, MSF sends in clinical groups with crisis room understanding and completely prepared careful tents, electrical generators, medication, food, and clean water.Another significant capacity of MSF is to instruct individuals in created countries about overall clinical issues. Consistently, the gathering distributes a rundown called the Top Ten Underreported Humanitarian Stories about wars and calamities that get little consideration from the universal media. MSF likewise instructs individuals in creating nations about irresistible ailments, for example, resting affliction, intestinal sickness, and tuberculosis. Also, MSF features the absence of significant medications in helpless countries. MSF calls attention to that fourteen million individuals kick the bucket every year from tropical diseases.However, out of 1,393 new medications created since 1975, just about 1% were focused at these illnesses. In 1999, the Norwegian Nobel Committee granted MSF the Peace Prize for its â€Å"pioneering compassionate work on a few mainlands. † This prize is generally given to people; just four associations have gotten it. James Orbinski, leader of MSF at the time said that clinical guide ought not be attached to wars or governmental issues, yet just to pride of individuals. He proceeded to state, â€Å"An association like this shows what amount can be cultivated with basic and reasonable techniques. †

Bridge paper

The developers couldn't have envisioned that it would be still being used more than 100 years after its opening (ENDEX Engineering 2007). So who were these individuals who manufactured the extension? What gave them the vitality to build one of the world’s most noteworthy wonders? It very well may be securely said that there were just three individuals who put stock in the task all the way. These were the Roeblings’; father, child, and son’s spouse. The account of their accomplishment is the equivalent so while the rest of this paper will harp on child Washington Roebling’s accomplishments it could simply be the tale of the other two.Education and Practical Training Washington Roebling was the child of a great man, conceived May 26th 1837 in Saxonburg, Pennsylvania. Few recollect his dad; which says something regarding Washington’s achievements. His dad claimed a fruitful wire rope business and was a pioneer in the field of iron and steel link. As Wa shington developed more seasoned, he started to assist his with fathering in designing undertakings. Since wire rope is a sublime counterpart for engineered overpass development with adaptability and a high elasticity, the Roeblings’ accomplished a lot of work in this field (Invention Factory 2007).Before entering the military, Washington went to Rensselaer Polytechnic Institute in Troy, New York. Much like structural building majors today, it took him four years to get his degree, however it was considerably more involved than is permitted today. The instruction, harking back to the 1800’s was for the most part hands on preparing, while today PC advancements and getting rid of mavericks through thoughtless schoolwork assume a gigantic job in training. Today present day building understudies, communities and temporary jobs help give sensible situations.During the common war, where Washington Roebling served greatly as a designer official in the sixth New York Calvary, Washington started to become famous. He fabricated a 1200 foot engineered overpass over the Rappahannock River and invested quite a bit of his energy in a sight-seeing balloon, the common war form of air surveillance. Before the development of the Brooklyn Bridge, John sent Washington to Europe to read new strategies for the sinking of the establishments. Later in his life, Washington would offer practically all the credit and information got for the Brooklyn Bridge to his father.Knowledge from the military and from his father were utilized in his completing of the two monster rock brick work towers that climbed 276 feet above high water over which to suspend wire links to help a street 135 feet at its most noteworthy point over the water. This stature was required for boats to go under. The scaffold would be wide, at 85 feet, and the links that would bolster the range would be bound to tremendous harbors of 60,000 tons each (ENDEX Engineering 2007). The Brooklyn Bridge was an imagi native undertaking. Table 2 shows all the achievements and advancements that are identified with the Brooklyn Bridge.Socioeconomic and Political Environments After the Civil War, Washington came back to the privately-owned company, helping with finishing two more engineered overpasses over the Ohio River (Invention Factory 2007). During this time Washington’s father, John, got keen on building a scaffold over the East River. New York administrators at long last understood the requirement for a course over the East River and passed a bill for a type of development. The biggest limitation that the designs for the structure needed to submit to was its tallness over the waterway, which was set to dodge contact with poles of boats that goes under it.This thought of a scaffold was the same old thing. For a long time, various methods of connecting Brooklyn and New York had been thought of (Trachtenberg 1965). Before long, the city of New York set up the principal ships from Manhatta n to Brooklyn in 1812 yet progressively adaptable travel was required. The Brooklyn Bridge was raised out of monetary need and never-ending suburbia (Brooke and Davidson 2006). New York City was an immense migration center point. In the mid-1800’s, people started to emigrate from Europe and many settled in Brooklyn. Therefore, many lived in loading up houses.Brooklyn as of now comprised essentially of Irish settlers. Settlers were paid inadequately considered the work they proceeded as it was consistently the most requesting and unsafe. From 1860 to 1870, Brooklyn’s populace development was 50 percent; the quickest developing city at that point (Trachtenberg 1965). Manhattan was something contrary to Brooklyn, in that it was basically a business locale in the mid 1800’s. Roughly 40 percent of bet workers in Brooklyn had employments in Manhattan. The northeastern coast was a significant center point for imports and assembling merchandise after the Erie Canal was built.At the time the best way to get from Manhattan to Brooklyn was by pixie which was regularly moderate and hampered by storms. Taking the ships would in general be perilous. Plans for an either an extension or a passage over the East River were hindered by the Civil War. Scaffolds were believed to be unimaginable as no materials where known to be sufficiently able to help the required range. Some portion of the issue was that the scaffold should have been high over the channel to permit masted boats to go underneath it, even at elevated tide. These subtleties had demonstrated outlandish until then.A armada of ships carried individuals and merchandise over the waterway consistently. John Roebling, with his wire rope business and history of effective engineered overpasses, had a feasible arrangement (Invention Factory 2007). The Brooklyn Bridge would utilize steel in its links. Great created iron breaks at 30 tons where great steel of a similar size breaks at 75 tons (2. multiple times more grounded) (Hart 1967). While it was not trusted at the time in light of its novelty, the Roeblings’ had confidence in its quality. At that point, engineered overpasses were seen with suspicion.Many had bombed in storms or under live loads; nonetheless, none of the scaffolds John had assembled had ever fizzled. One reason he had succeeded was that he made them exceptionally firm, forestalling flexing from wind that would torment other engineered overpass manufacturers into the following century and most broadly in the Tacoma Narrows Bridge in 1940, over 70 years after John. After due discussion, the Brooklyn Bridge Company was shaped with John Roebling as boss specialist (Invention Factory 2007). One thing that the occasions loaned to the task was a decent wellspring of modest labor.Poor outsiders, principally Irish, were the ones who worked the most on the scaffold. They additionally took the brunt of the setbacks. Roughly 20-30 individuals kicked the bucket during development and organization saw it as important and unavoidable. Work was exceptionally manual and at the time laborers had almost no force in governmental issues. The Irish laborers didn't appreciate the decision of date, as it corresponded with the Queen’s birthday. Mechanical Context and Construction Details In December 1849, a mishap ruined Roebling’s father’s left hand while experiencing testing on the imaginative wire rope machinery.This new innovation would set this extension a long ways comparatively radical, using a braded design permitting adaptability and simpler dealing with (Trachtenberg 1965). The Brooklyn Bridge would utilize steel in its links. Great created iron breaks at 30 tons where great steel of a similar size breaks at 75 tons (2. multiple times more grounded) (Hart 1967). While steel was not trusted at the time due to its originality, the Roeblings’ had confidence in its quality. At that point, steel or no steel, engineered overp asses were seen with doubt. Many had bombed in storms or under live loads; notwithstanding, none of the extensions John had fabricated had ever failed.One of the reasons he had succeeded was that he made them extremely firm, forestalling flexing from wind that would torment other engineered overpass manufacturers into the following century and most broadly in the Tacoma Narrows Bridge in 1940, over 70 years after John’s lifetime. Development was extremely dangerous around then, in any event, for boss architects. Toward the beginning of the undertaking, the Brooklyn Bridge Company lost an essential part. A ferryboat squashed John Roebling’s foot when he was nearby. In the wake of having his toes severed, during which he declined sedative, a disease set in and murdered him (ENDEX Engineering 2007).Surprisingly there was little discussion over who ought to succeed him. Washington Roebling was at that point profoundly engaged with the venture so he was designated replaceme nt (Invention Factory 2007). In 1872 catastrophe struck once more. Washington himself was down in the caissons more than any one else. He was abruptly hit with what was called caisson ailment, and is what is currently called the twists (Invention Factory 2007). This ailment was not comprehended at that point and results from delayed presentation to high weights and afterward unexpected decompression, permitting nitrogen air pockets to shape in blood and conceivably obstruct them.Washington was not the first to become sick from the twists, actually, individuals had as of now kicked its bucket however work continued on. In the wake of returning despite the fact that unmistakably wiped out, Washington was out of commission, injured for the rest of the undertaking. He was just ready to represent 10 minutes when the scaffold opened in 1883 (Smithsonian Associates 2004). Washington remained head engineer providing orders from his bed however the individual generally obvious to guests at t he undertaking was his significant other, Emily. She knew the same amount of about the venture as Washington.When a leading group of enquiry was assembled to attempt to expel the incapacitated head engineer she expelled adequate uncertainty from its individuals for Roebling to remain (Smithsonian Associates 2004). To state she was the head architect would just be a slight distortion. The towers that upheld the range were made out of limestone, stone and cement. Recently discovered methods for making steel made it a modest, solid metal for the suspension links (Hart 1967). The primary thing to take care of was to sink the two goliath caissons into the riverbed to help the towers (Figure 1).These were made of 12 x

Jim Morrison Essay -- Biography

Hopkins and Sugerman (2006) and Stone (1991) built up the picture of Morrison as a shaman and as Lizard King dependent on the turn of events, by Morrison, of his job as a shaman and the picture of the Lizard King. This picture was the â€Å"existing esteem structure† of Morrison at the hour of his demise, in spite of endeavors made by Morrison to change this picture. As the â€Å"the manner by which the all out picture develops decides or possibly restricts the bearing of future growth,† Hopkins and Sugerman (2006) and Stone (1991) were working inside the parameters of Morrison's picture. In this manner, the picture of Morrison as a shaman and Lizard King turned out to be inside rational and predictable through redundancy and served to sort out both recorded and after death thoughts regarding Morrison, overriding reality. Diminish Jan Margry (2008, 145), in â€Å"The Pilgrimage to Jim Morrison's Grave at Pã ¨re Lachaise Cemetery: the Social Construction of Sacred Space,† composes of Stone (1991) â€Å"[giving] an entirely different force to this mythologizing [of Morrison].† â€Å"The film† composes Margry (2008, 145), â€Å"partly affirmed the current picture however included new, ground-breaking iconographies and narratives.† Well known life stories of Morrison, distributed since Hopkins and Sugerman (2006), have stressed the mythic ramifications of Morrison's biography, for example, the advancement of mythos encompassing Morrison during his life, his secretive demise and the improvement of a clique following, including journey to his grave in Paris (see Davis 2005; Densmore 1990; Henke 2007; Hopkins 2010; Mazerak 1999; Riordan and Prochnicky 2006). The hugeness of understanding Morrison as a shaman identifies with the roots of attribution. Morrison, through self-portrayal as a shaman, impelled the task of a strict air sur... ...onal independence and model hero debauchery. As Morrison has not been dependent upon an investigation of commodification, as has Presley, at that point the investigation of Morrison as a product, and its religion to thought of him as a â€Å"religious figure,† warrants future examination. At last, to comprehend the advancement of a strict emanation, encompassing Morrison, and Morrison as a â€Å"religious figure,† all parts of his life and picture must be represented. Truly, his life, self-engendered fantasy, picture, demise and potential as a ware. After death, his common misconception, journey to his gravesite and commodification of his picture. Morrison as a shaman and Lizard King is just one explanation behind his strict emanation; its commitment to the improvement of the prevalent misconception, alongside the focal qualities contained in his picture, added to the possibility of Morrison as a â€Å"religious figure.†

Electrical & electronic principles ( lap report ) in transistor Assignment

Electrical and electronic standards ( lap report ) in transistor - Assignment Example At whatever point they are, utilized a little BJTs’ number is coordinated inside a high-thickness chip complimentary. This coordination is alluded to as the BICMOS particularly when BJT is incorporated with CMOS. This report investigates the bipolar transistors and the qualities of its DC gain transistor. The word bipolar is utilized to clarify the possibility that all gaps and electrons participate in the BJT activity. This suggests the minor dissemination transporter assumes a key job along these lines to the PN diode intersection. The term intersection infers that the PN intersection is significant to the BJTs activity. The BJT could be alluded to as the bipolar transistors. It is ordinarily made of producers that are intensely doped, N-type authority, and P-type base. This suggests the gadget would be a NPN BJT (Harame, et al. 2005). The transistors with NPN show high transconductance and speed contrasted with the transistors that are PNP. This is so on the grounds that the versatility of electrons is expanded contrasted with the portability of the gap. The intersection of a base producer is an intersection where the electrons are sent towards the more base that is softly dropped. The electrons diffuse over the base towards the base authority intersection that was opposite one-sided and washed away to the gatherer. This prompts the creation of current alluded to as the gatherer current (IC). IC is typically VCB autonomous except if VCB is a turned around inclination. Then again, IC could be found by distinguishing the pace of infused electrons to the base from the producer. This is set up by the infusion electron rate into the base from the injector. Producers are typically connected to the ground. The bend of IC is constantly plotted versus VCE. In situations where by VCE is more than o.3v, its worth would be equivalent to VCE= VCB+ VBE. When VCE is under 0.3V the intersection of the base gatherer is emphatically one-sided forward creation the IC to lessen. The IR Parasitic drops are difficult to

International Management Decision Making Assignment - 1

Universal Management Decision Making - Assignment Example To do showcase division appropriately, Tesco gathers segment and psychographic information. Both these kinds of information are vital for the accomplishment of an association. Segment information is the sort of information which can be placed into classes and named measurably. Segment information incorporates age, race, pay, religion, sexual orientation and so on. It contains essential realities. For example, Tesco discovers what age section visits their store normally, which age section doesn't, what sort of items do they like, would could it be that they don’t like, when do deals rise and when do deals plunge. It at that point gets down to business its limited time offers in like manner. Then again psychographic information cannot be evaluated it is utilized to comprehend shopper conduct, how target advertise feels, what they need and how they approach getting what they need in their every day lives. It encourages them in their buying choices. Tesco uses this information, at that point breaks down it and concocts reports to help it in anticipating request and making limited time offers. J Sainsbury Plc was built up in 1860. It is home to in excess of 872 stores and 537 general stores all over UK and has somewhere in the range of 335 accommodation stores. It at present possesses Sainsbury’s Bank and LIoyd’s Banking Group. It has two joint endeavors to be specific the Land Securities Group PLC and the British Land Company PLC. Sainsbury’s brand was worked to offer a specific legacy to clients. They convey solid , protected, new and delectable food. The nature of their food is kept in class and goes connected at the hip with a sensible way to deal with business. Their food is especially known for new food and they ceaselessly endeavor to improve items so they are in accordance with client needs. Sainsbury’s is right now serving 19 million clients for each week and has a piece of the overall industry which is over 16%. They have in excess of 30,000 item s to

Most Universities Will Charge £9000 Tuition Fees

Most Universities Will Charge £9000 Tuition Fees The OE Blog National Student Union president Aaron Porter has revealed that his “behind the scenes conversations” with university executive committees across the country indicate that the majority will choose to charge the maximum £9000 tuition fees in 2012. The controversial coalition government’s policy to raise tuition fees is to replace withdrawn government funding due to enormous cuts to the education budget. Throughout the debate, Prime Minister David Cameron, Deputy PM Nick Clegg and Universities Minister David Willetts have insisted that the upper limit of £9000 would only be charged by a few universities under “exceptional circumstances”, and would be subject to extremely strict measures to ensure that such universities were offsetting the higher fees with a broad and effective access program to support underprivileged applicants. This new information from Porter suggests that these assurances may have been no more than a smokescreen blown by the government in an attempt to reconcile angry voters and protesters to the scheme, which has attracted a huge amount of controversy and opposition from across all sectors of society. Education institutions, campaign groups and protesters have all warned that the decision of the government to allow university tuition fees to be almost trebled could have devastating consequences for fair access to education, with a huge number of children from more underprivileged backgrounds no longer being able to make the move to university. If Porter is right, their doom and gloom prophecies may well come true. These reports are especially worrying given the failure of the government to follow through on its planned rigorous access procedures, with the promising initial scheme of a year’s free state-funded tuition for the poorest students being scrapped in favour of allowing universities free reign to choose from a number of cushier, less-targeted access options. Allowing universities to choose their own access schemes is likely to result in the same problems we see at the moment, where elite universities like Oxford and Cambridge who claim to spend thousands of pounds on access programs nonetheless yield unimpressive results, with only a tiny percentage of such pupils going on to take up Oxbridge places. Not only will such a large proportion of universities charging the maximum fees be catastrophic for access to education, it could also ironically render the government’s entire money-saving scheme defunct, as higher fees will mean higher loans being taken out by students, with longer repayment periods, putting a much greater financial strain on the public purse. A top UK think-tank has also proved that should future graduate earnings waver by only a few percentage points from the government’s predictions, the scheme would be “as likely to lose as to make money” overall. Porter’s “behind the scenes” revelations suggest that universities will be reluctant to charge lower tuition fees, seeing the prices they set as an indication of the quality of education they provide, and with enormous public spending cuts to recoup, who can blame them? Whilst the government have tried frantically to quash Porter’s suggestions as scaremongering and guesswork, one cannot help but look at the facts. Universities will now rely almost entirely on fees after the enormous government cuts â€" a strong incentive to charge the highest tuition fees they possibly can to retain financial stability. Figures out this week showed that an overwhelming 210,000 students missed out on university places this year â€" suggesting an enormous demand for places that must make most institutions feel fairly confident about filling their quotas regardless of how high they set their prices. And access measures wielded by the government as some sort of magic wand to restrict prices from getting too high have proved to be pathetically wishy-washy in development. The temptation to rush out and join the protesters grows stronger by the day…

Mobile and Wireless Communication Essay - 550 Words

Mobile and Wireless Communication (Essay Sample) Content: Mobile and Wireless CommunicationStudent NameLearning InstitutionQuestion 1The diagram shown is a representation of protocols to send uni-cast packets. It uses the basics of Distributed Foundation Wireless Media Access Control (DFWMAC). The mechanisms used here are Request to Send (RTS) and Clear to Send (CTS). From the diagram, data transmission by other nodes has to seek authentication with RTS (request to send). It is then relayed to CTS (clear to send). When the transmission is successful, the terminal frame node confirms with the ACK (Acknowledgement) frame to tell the sender that the message relay has been a success. The NAV (Network Allocation Vector), acts like a guard to other nodes by informing them the amount of time that other channels would wish to spend. Short Inter-Frame Spacing (SIFS) is utilized as a small time waiting period for other frames like CTS, RTS, ACK and DATA. DIFS (Distributed Inter-Frame Space) allows transmission from CTS and RTS if the data destination system is idle, otherwise it is postponed until a DIFS period when the current data is transmitted.Question 2A wireless networking involves the use of computer networks for wireless network connection. The most basic features of wireless networking can be described as;High capacity load balancing to reduce congestion in usersScalable, that is expansion as demand increases without necessarily overhauling the whole systemRole based access control to assign role the wireless based devices depending its authentication.Web content filteringMobile device management A wireless networking can be compared to wire networking in that wireless devices require power source to operate. Wireless networkings suffer from signal loss and fading in dead spots, in this case on areas without reception. On the other hand, wireless networking has from multipath distortion because of wave reflection to other antennas. This is common with radio waves which get reflected in case they come ac ross an obstacle. More over there is the problem of shared airwaves due to limited spectrum.A wireless network loses privacy whenever it enters the air and so it is prone to errors and data loss. The argument behind this is that this type of networking uses waves to transmit data from source to destination; hence the waves can be reflected to some other receivers once they are reflected by an obstacle. This means that data does not get to the desired destination (loss) and gets to the wrong hands (privacy). This is unlike wired networking which requires coupling very close to the wire to intercept the signals.Question 3Basestations are sometimes described as fixed hosts which are used to connect several mobile hosts or systems. Basestations cover some fixed and specific distances known as cell which can communicate to the mobile host if is within some specific fixed distances. The basics under which a base station works on mobile/cellular or fixed networking is the same; the signals pass between the base station and the subscriber because both of them emit radio frequency waves which are used for communication.Question 5The relationship between time domain, frequency domain and phase domainAny electromagnetic signal can be represented in frequency, phase and time domain. The frequency of a signal is the number of cycles per second (number of periods per second). Time domain is a representation of how amplitude of a signal varies on a given time, while phase domain is described as the difference between where the signal starts and its initial point. Two signals S1 (t) and S2 (t) can be represented by the equation;S1 (t) - 5sin (2pi106 t -pi/4)S2 (t) 4sin (2pi 104 t + pi/4)The time domain can be represented as
The frequency domain is a representation of how amplitude varies with frequency. Under this domain the variable parameter are frequency and amplitude. Phase domain is a representation of how amplitude varies with phase. Under this domain the variables ar e time and frequency.Question 6For B to get a route to J a Route Request (RREQ) packet for transmission has to be created. In this case, every packet from B to J will contain addresses; Js IP address, SEQ#, Bs address, SEQ#, hopcount=0. A RREQ message will be send from node B to its neighboring nodes; Q, C, D, F) with broadcast id .Question 9Multipath propagation of signals takes place all directions and angles. Since the signals do not take place in a specific path when they leave or enter the trans...

A Comparison of Feminism in Trifles and A Jury of Her...

Feminism in Trifles and A Jury of Her Peers As a strong feminist, Susan Glaspell wrote â€Å"Trifles† and then translated it to a story called â€Å"A Jury of Her Peers.† These works express Glaspell’s view of the way women were treated at the turn of the century. Even though Glaspell is an acclaimed feminist, her story does not contain the traditional feminist views of equal rights for both sexes. The short story and the play written by Susan Glaspell are very much alike. The story takes place in an old country town in the early 1900’s. Mr. Hale has found his neighbor, John Wright, strangled upstairs in the Wrights’ house with Minnie Wright, John’s wife, sitting calmly downstairs. With John Wright dead and his wife in jail,†¦show more content†¦Ã¢â‚¬Å"A Jury of Her Peers† is refers to the people who are judging Minnie Wright for her crime. In the story, Mrs. Hale and the sheriff’s wife, Mrs. Peters, are the peers whom the author is referring to and who are judging Minnie Wright. These women know Mrs. Wright and their views of her are altered by the fact that she is their neighbor and also a woman. The women feel sorry for Mrs. Wright because her husband was emotionally abusive to her. They do not pay attention to the fact that she did indeed kill someone. If Susan Glaspell had really wanted women to be treated just like men, she would have written the story so that Minnie Wright had a normal trial. Minnie Wright should have gotten a trial with a jury consisting of people who did not know her or anything about her past. To a true feminist, equal rights are very important. A woman should be treated like a man regardless of the crimes committed. When Minnie Wright killed her husband, the women thought that she had a right to because she had been emotionally abused while she was married to her husband. That does not mean that John Wright did not have a right to live. If the roles had been reversed, and it was John Wright who kill ed Minnie Wright, then there would be no question that John Wright would have been accused, prosecuted, and convicted. People would have said that there were no excuses for what he did. Even the men wouldShow MoreRelatedFeminism : Women s Rights On The Grounds Of Political, Social, And Economic Equality1529 Words   |  7 PagesFeminism is a term defined as the advocacy of women s rights on the grounds of political, social, and economic equality to men. This theory is centered on women living in patriarchal society. During the 1900s life for women differed greatly from the lives of men. Patriarch communities were very prevalent during this time. As a result Susan Glaspell dedicated many, if not all of her works as dramas describing the restricting view of women living in the early twentieth century. Feminism shows how

Ian McEwan’s novel ‘On Chesil Beach’ set in July 1962 is a...

Ian McEwan’s novel ‘On Chesil Beach’ set in July 1962 is a story of a few crucial hours in the lives of a newly-wed couple on their wedding night that horribly goes out of kilter. It is a story of a day in the life of a young couple- Edward Mayhew and Florence Ponting, who have just been married and are spending their honeymoon in a small hotel on the Dorset seashore at Chesil Beach on English Channel. There is a significant difference in the couple’s family status, with Edward- the son of a schoolmaster and Florence- the musically gifted daughter of a wealthy industrialist and an Oxford philosophy lecturer. However, both are smart, well-read young people with promising futures. The story unfolds the course of events of a fateful evening†¦show more content†¦Thus, the newly-wed couple were about to start their lives in the critical time of 1960s, an era beset with complexities and challenges that has unpleasant effect on their social life. The book predominantly deals with the issue of sexual autonomy and dives into the consciousness of the characters bringing forth the minutia of the event. Edward, an earnest history student with little experience of women, is sexually motivated and though intelligent has a taste for rash behaviour, while Florence, daughter of an Oxford academic and a successful businessman, is bound by the social code of another era (and having been sexually abused by her father) is terrified of sexual intimacy. The author skilfully develops on the character’s inadequacy when it comes to their sexuality. McEwan presents Florence as the one with puzzling and obscure intentions and reactions. She is quite a bossy lead violinist in a string quartet; which gives the impression of her being someone who would confidently express her interest in sex. â€Å"The Florence who led her quartet, who coolly imposed her will, would never meekly submit to conventional expectations. She was no lamb to be uncomplainingly knifed. Or penetrated. She would demand of herself what it was exactly she wanted and did not want from her marriage, and she would say so out loud to Edward, and expect to discover some form of compromise with him.† But

Away by Michael Gow - 857 Words

Michael Gow’s play Away is the story of three different Australian families who go on holiday for Christmas in the sixties. By going away each family is hoping to resolve their issues. Although Away is set some time ago the themes and issues explored in the play are still relevant to a modern day audience, even one of a non-Australian background. Shakespearean plays that were written many hundreds of years ago and are still understandable and relevant to people all over the world today. Away is the story of three Australian families who go on holiday during the Christmas of 1968. Roy and Coral (the headmaster and his wife) are becoming increasingly close to breaking up. Their son was killed in the Vietnam War and Coral is still†¦show more content†¦Meg replies that she couldn’t help herself. I know how she feels. You don’t mean to hurt the person or upset them but you just have to have your say, no matter what the consequences of that may be. I also feel that I can relate to Gwen, Meg’s mother as she reminds me of my own mum. The near constant stressing about everything, and wanting the very best for her daughter is very familiar. The issue of death is also covered in Away. Roy and Coral lost a son in the Vietnam was and Coral is still grieving for him. While Harry and Vic know that there son Tom is going to die from leukaemia. People all over the world, no matter what language they speak, what culture they come from, or which country they live in can understand and empathise with what these families may be feeling. The sense of loss and grief that comes with death is a universal feeling that can make the play relevant to so manyShow MoreRelatedAnalysis Of Away By Michael Gow925 Words   |  4 PagesIn Michael Gow’s play ‘Away’, a story of families in the 1960’s and how they come to embrace each other’s differences through gaining self-knowledge. Through identifying the context of act 3 scene 2, as well as the relationships between characters and the reasons behind them, as well as the stylistic devices used by Gow to share a message with his audiences that, even today, an au dience can relate too. By analysing quotes from the scene to support conclusions, the purpose of this scene will be identifiedRead MoreAnalysis Of Away By Michael Gow751 Words   |  4 PagesAWAY Michael Gow â€Å"Away† is a play written in 1988 by Michael Gow. Away refers to the central ideas of Australia in 1967-68. The central ideas embrace the outsiders, family conflicts and grief and loss which affected families in the play. Gow uses three main families to convey the message of the play. The use of language and stylistic devices influence the way Gow has been able to speak to the modern Australian audience. In the play â€Å"Away† Gow is able to speak to the modern Australian audience withRead MoreAway Michael Gow Analysis808 Words   |  4 PagesSelf-discoveries can affirm or challenge an individual’s previously held attitude through acceptance contributing to a change in perception of self and the world. This notion is explored in Michael Gow’s play â€Å"Away† where three fractured families go on transformative holiday as they experience discoveries about themselves and others. Self-discovery of a certain individual can stimulate modification f or others’ perception and lead them to a more prominent discovery. Similarly, the poem: â€Å"the core†Read MoreAnalysis Of Away By Michael Gow883 Words   |  4 PagesAway is a play written by Michael Gow in 1986. It took him three weeks to write and it had little editing, as there was no complex writing involved. Gow admired Shakespeare’s refusal to be literal and so this was adapted into his play. ‘Despite its historical setting, Away is still able to speak to modern Australian audiences.’ This statement holds a lot of truth, as the play shows family conflict in three separate families, grief and loss in two different stages and people who are seen as differentRead MoreEssay about Away by Michael Gow1387 Words   |  6 PagesAway Set in the Australian summer of 1967, Michael Gow’s Away is an elaborate play which explores the ideas of self- discovery and change. Through the war affected nation, three families, each from different social classes, depart on an iconic Australian holiday to the beach. In the play, Gow utilises the characters to demonstrate that going away physically is intrinsically linked to their mental developments. With the help of references to Shakespeare’s A Midsummer night’s Dream, Away uses GwenRead MoreDiscovery Essay on Away Michael Gow923 Words   |  4 Pagesâ€Å"To discover is to gain sight or knowledge of something.† How have ideas about discovery been shown in Away and The Book Thief Discovery allows main characters to gain sight or knowledge into themselves and others. This is evident in Michael Gow’s Away, as seen through the characters of Gwen, Coral and Tom. The three gain sight and knowledge into theirRead MoreAway by Michael Gow Character Analysis Essay2386 Words   |  10 Pagesis supported by her husband Roy, but Roy is not the best supporter at times. Coral is quiet and hasn’t built many strong relationships with others as others are trying to with her ‘Did you enjoy the play? [Coral stares at her for a moment then looks away’.] Roy: Roy is the principal at Meg and Tom’s school. He is a very well-spoken man who seems to be quite successful. â€Å"So what do you think of our little Chips Rafferties, eh? Proud mums and dads?† He’s married to his wife Coral who is a very mysteriousRead MoreAway by Michael Gow: Character Analysis Essay examples684 Words   |  3 Pagesattitude and this causes Coral to lower herself to the behavior of a naà ¯ve child â€Å"I’ll be good! I’ll improve!† When Coral does begin to speak, it is presented as very expressive and mournful. Her tone is filled with emotion as she is constantly â€Å"wiping away tears†. Coral finally begins to socialize, with a woman named Leonie. She seems instigated by the fact that Leonie (the woman) appeared to be hiding something. Leonie (like Roy) attempts to conceal her distress with a social disguise. Whilst dismissingRead Moreessay on preliminary topic journey847 Words   |  4 Pagesfound. Through Michael Gow’s ‘Away’ and ‘The Blind Side’ produced by John Lee Hancock, applications of both dramatic and film techniques allow the responder to see the direct impacts a journey puts on the traveller, either physically, emotionally or spiritually. We see this through bald transformations in the characters of both texts when they part take on a physical travel that takes them on an internal journey to discover a renewed inner purpose. In Michael Gow’s play â€Å"Away† Coral’s, physicalRead MoreBelonging Essay1446 Words   |  6 Pagesare clear divisions in him not belonging. The related texts reviewed include ‘The Arrival’ (Shaun Tan, 2006) graphic novel which illustrates a visual story of an immigrant who leaves home to create a better life for his family and the play ‘Away’ (Michael Gow, 1993). Thus it may be ascertained, that belonging defines who we are. In the poem of ‘Feliks Skrzyneckis’ Peter Skrzynecki explores filial relationships. This issue is highlighted between Feliks and Peter Skrzynecki, a cultural barrier

Causes of World War II - 784 Words

The great global conflict of the Second World War was started because of the inexistent actions taken to prevent the war. The Second World War did not happen directly, but there was a series of events that led up to the horrific war. The deadly World War II had begun by the inability to enforce the Treaty of Versailles, the corrupted League of Nations, and the failed policy of appeasement. These three points are long term causes which express thee reasoning for the outbreak of war. The inability to enforce the Treaty of Versailles played an important role in the starting of World War II. The weight of enforcing the rules of the Treaty was put all on the shoulders of Britain and France. It was hard to impose because some major powers did not sign the Treaty like the United States and the Soviet Union. The loss of the support from major powers had affected the Treaty of Versailles, because it made it harder to know what Germany was doing, and how to take action to prevent it. Many politicians also felt that the Treaty was too harsh on Germany, and that some rules on the Treaty should be overturned. Germany in World War I was blamed for everything, lost a lot of land and was restricted from doing many things. When the Treaty was created, the terms were not fair, and Hitler realized this and wanted to get back what was `rightfully` his. When Hitler began obtaining territories everyone was fine with it, because it was understandable since Germany`s restrictions in the TreatyShow MoreRelatedThe Cause Of World War II1259 Words   |  6 PagesThere is a fact that the causes of World War II are from the end of World War I, which a consequences of ending the frist World War affect to cause World War II. For ending of World War I, The final Allied push towards the German border began on October 17, 1918. As the British, French and American armies advanced, the alliance between the Central Powers began to collapse. Turkey signed an armistice at the end of October, Austria-Hungary followed on November 3.Germany began to crumble from withinRead MoreThe Causes Of World War II1134 Words   |  5 PagesThe Causes of World War II: The seeds of world war II lies in the instability created by world war I. particularly the instability in Germany in the economic and political conditions due to the harshness of the Versailles treaty and as a result the rise of Adolf Hitler and his Nazi party The effects of the treaty of Versailles: The treaty of Versailles harshness was one of the main causes for the outbreak of World War II. It began in 1919 when Lloyd George of England, Orlando of Italy, ClemenceauRead MoreThe Causes of World War II772 Words   |  3 Pages World War II was one of the biggest wars known. The things people have done, the things that have happened in that war were so graphic that it has ruined the thoughts of people forever. There were so many causes of WWII; even just one would’ve been enough to make it happen. It has affected the lives of so many people, not only people that experienced it, but individuals who have looked upon it. It was such a powerful event with things to be learned. But, it all starts and ends somewhere; andRead MoreCauses And Consequences Of World War II908 Words   |  4 PagesOf all the wars that the world has seen happen, none have been more catastrophic than the terrible world war II. But what were the causes of this war? There were many causes to World War II, although there were four true causes: anger over the Versailles Treaty, Fascism and its increase in the European countries, and the nitrous goals of Adolf Hitler combined with the isolationism of America and Britain from war. Wi th all of these main causes combined together, the will create the most devastatingRead MoreCauses and Consequences of World War II777 Words   |  3 Pages World War II: Causes and Consequences On September 1, 1939 World War II started after Adolf Hitler signs the Treaty of Versailles. Hitler shortly attacks Poland, not keeping his promise. Shortly after the attack France and Britain declare war on Germany. Hitler was the cause of World War II since he broke the treaty causing other countries like Britain and France to declare war. Hitler kept all the Jews in concentration camps because he thoughtRead MoreCauses And Effects Of World War II1370 Words   |  6 PagesCauses and Effects of World War II World War II has been considered one of the worst things to ever occur in history. Violence, death and aggression took place in the 1930s and 1940s in certain European nations. German leader, Hitler played an important, yet a very big role during this time. With the rise and domination of fascism in Germany and Italy, the goal was to maintain peace, established by the Treaty of Versailles ended up in major disaster. World War II began with the poor economic conditionsRead MoreCauses of World War II Essay907 Words   |  4 PagesCauses of World War II When Hitler came to power in 1933 he made several of actions that some years later lead to war. These actions were re-armament, leaving the league of nations, re-militarism of the Rhineland, the spanish civil war, the lightning war and the alliances with Italy and Japan. Hitlers aims were clear, he wanted lebensraum (living space) in order to gain self-sufficiency, wanted to abolish the treaty of Versailles and revenge for those who signed itRead MoreEssay on The Causes of World War II1106 Words   |  5 Pagesthere were many causes that lead up to World War II. World War I left Germany with many shortfalls, thus leaving them in the hands of the Treaty of Versailles. Rather unfair of a Treaty, this left Germany once again looking for another way out. A country resented by many had no other choice but to feel optimistic toward Adolph Hitlers empty promises†¦ making it substantially simple for him to gain power so quick. Throw in the Great Depression, and you have a vastly unstable world, which the GermansRead MoreThe Cause And Effects Of The World War II1291 Words   |  6 PagesAn Pham Mr. Grosse World History Research Paper February 10, 2017 The Cause and Effects of the World War II The world has changed since that day, September 1, 1939, with the invasion of Poland by Nazi Germany, the start of World War 2. There were many fluctuations in economic terms as well as the politics of some powerful countries in the world also started from there. This is a catastrophic world war between the Allied forces and the Axis under fascism. Although this war just lasted in 6 years,Read More Causes of World War II Essay2009 Words   |  9 PagesCauses of World War II Many historians have traced the causes of World War II to problems left unsolved by World War I (1914-1918). World War I and the treaties that ended it also created new political and economic problems. Forceful leaders in several countries took advantage of these problems to seize power. The desire of dictators in Germany, Italy, and Japan to conquer additional territory brought them into conflict with the democratic nations. After World War I ended, representatives

Ministry of Manpower, Singapore Free Essays

Brief Description of Ministry of Manpower EE4041 E-learning week assignment by LIU TIANCHI Group Y15 As one of the Tripartite Partners in Singapore, Ministry of Manpower (MOM) plays the government role and aspires to develop a great workplace together with the other two partners, the National Trades Union Congress (NTUC) and the Singapore National Employers Federation (SNEF) which represent the employees and employers separately. The mission of MOM is to achieve a globally competitive workforce and great workplace, for a cohesive society and a secure economic future for all Singaporeans. To break it down into two parts: MOM aims to empower Singaporeans so that they can realize their potential; MOM also deals with and regulates the workplace so as to achieve a cohesive society. We will write a custom essay sample on Ministry of Manpower, Singapore or any similar topic only for you Order Now In order to achieve the mission, MOM is structured with divisions and statutory boards, both of which have certain specific responsibility. For example, Labor Relations and Workplaces Division (LRWD) plays a crucial role in dispute settlement. Most of the time, the parties, unions and companies, can settle disputes between themselves, as they know the issues well and would be in a good position to find solutions. If this fails, then conciliation by LRWD would kick in at the request of either party. LRWD or MOM receive and settle an average of about 300 disputes from the unionized sector for conciliation every year. This is an important pillar in maintaining industrial stability in Singapore. One example of the statutory board is Central Provident Fund (CPF) Board, which administers the CPF well known as a compulsory and comprehensive social security savings plan. Besides the regulation and administration responsibilities, MOM also provides services. For example The Work Pass Division facilitates the employment of foreign nationals in Singapore with a convenient application process. The foreign employees can find all information that they need to know before coming to work in Singapore from MOM website. Most of the application processes also take place online, which is very efficient. MOM has won many awards because of its great contribution to the healthy tripartite relationship, which is the envy of many countries. It’s worth mentioning that MOM once won United Nations Public Service Awards, which is the most prestigious international recognition of excellence in public service. As can be seen, MOM has its unique and important role in maintaining the healthy and striving workplace in Singapore. How to cite Ministry of Manpower, Singapore, Essay examples

First day of high school free essay sample

My first day of high school was at Riverside secondary and it was a breeze I assume kids would be anxious on the first day of high school. There are bigger kids it’s a new school new teachers that sort of thing. This didnt bother me though I had a good set of my middle school buddies and the best part was that I lived 3 minutes away so I could sleep in. My day started with me waking up energized without an annoying alarm clock buzzing in my ear. After a filling breakfast my buddy Ryan was at my door waiting to head out. He was transferring from my old school and this was like icing on the cake I didn’t get to see him as much. Since we were going to different schools, but now that had all changed. When we got to school it was pretty hectic the front lobby was full with boards carrying our schedules and kids cramming between each other trying to find theirs. We will write a custom essay sample on First day of high school or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page So I went off with Ryan to look for some of my friends until it calmed down. Once we meet up with my friends and I introduced Ryan to them we got our schedules, and headed to our classes. Ryan had a class with one of my good friend, but unfortunately for me I didn’t have classes with any of my close friends. This didn’t bother me though you win some you lose some and my day was looking pretty good so far. Everything was going well. I got through first, second period, which was pretty boring the teachers just talked about the class outline, and what they expected from us but I did see some familiar faces. Then I met up with my friends for lunch and we had a good laugh and boastfully reported on which cute girls we had in our classes. The bell rang we headed to third period which blew by, and then came fourth. I don’t know why but fourth period has always felt the longest to me maybe because it was the last class of the day. Once the bell rang freeing me from boredom, I count up with my friends we hanged out for a bit before heading home. Ryan stayed at my place until he got picked up and we talked about school. My first day of high school was a breeze.

Killing Without Emotions free essay sample

This human nature of ours makes us think or stops us in order to kill without emotions. When humans are hardwired to be empathetic and compassionate not to kill, it is hard to understand why there is so much killing in the world? How, with empathy and compassion, can people kill? They must override their emotions with stronger emotions of hate and notions of purpose based on their beliefs. In the following paragraphs will present few examples that will indicate why and how some people override their emotions with stronger emotions based on their purpose. A common example of this is of a suicide bomber. So how these suicide bombers are formed or what is the psychology involved behind suicide bombing. . Often the suicide bombers arrested in Pakistan are usually teenagers and are from a poor background. They are usually kidnapped on their way to school or madraassa (religious school) and then brainwashed. We will write a custom essay sample on Killing Without Emotions or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Research and Today’s media reveals that suicide bombers using their religion as a shield justifies what they are doing are right. During brainwashing they are kept isolated and given misleading information on the name of the religion. They are told by the corrupt religious leaders that killing of the non Muslims are justified according to their religion. In addition to this they are also told that dying in the name of their religion will earn them the rank of a martyred. They are also brainwashed that they will earn a high rank in the heavens and rivers of milk and honey and beautiful virgins await. (Yusufzai and Jamal). They are offered high price to get the job done. They are assured that their family will live wealthy life after their job is done. Almost 90% of the suicide bombers are normal humans but, after knowing the position they can earn by dying in the name of their religion, change their emotions to kill hundreds of innocent humans. From this above example it can be concluded that they simple overcome their emotions with stronger emotions of earning high rank in Heavens by dying in the name of the religion, securing the lives of their family and obeying the orders of God. Another type of the people who override their emotions to kill are the soldiers. Soldiers override their emotions for certain reasons that they learn during the training. During the training there are told that they are the protectors of the land. The lives of their families and their countrymen depend on them. Moreover, they are trained with the fact that what they are doing is right and justified and God is with them. The training for the soldiers keeps on the changing with time to time. The soldiers are given complete training/ practicing area. The soldiers are desensitized by making them shoot at human shaped paper targets, drill and then to moving targets and pop up targets look kind of human shape making their response automatic and focused†. (Dwyer). The training areas includes all kinds of difficult pathways, underground tunnels and sudden appearance of the human shaped targets which they have shoot at and take them down. They are also congratulated on their first kill which increases their confidence to override their emotions more easily â€Å"In addition to this there are addressed directly making them believe that they actually have to kill. (Robinson). â€Å"Often a times the present the enemies in way that does not even feel like a human; for instance they will call their enemies by those names that even don’t look familiar. Names like â€Å"gook† who knows what is gook? It does not sound like a human or a person. Half of the desensitizing and dehumanizing is made easier in presenting a person that does not even to our class or kind. In addition, saying that God is with us, we are fighting for the sake of our country and the people and God is proud of us. A lot of killing is made easier in this for the soldiers presenting these as a reason. † (Pomerantz) So, with this kind of training and lessons of patriotism being given to the soldiers makes it easier to override to their emotions. In the conclusion I would restate again that killing without emotions is really hard unless you have you don’t overcome your emotions. It takes a lot of nerve and heart to kill without emotions. Works cited Dwyer, Gwynne. Soldiers trained to kill and post-traumatic psycho-babble. Thuppahis blog, 29 April 2011. Web. Web. 18 Feb. 2013. Yusufzai, Asfaq, and Amna Nasir Jamal. Teenagers recruited, trained as suicide bombers.   Central online Asia. N. p. , 11 04 2011. Web. 18 Feb 2013. Robinson, Steve. The impact of killing and how to prepare the soldiers .   Frontline. Frontline, 01 Mar 2001. Web. 18 Feb 2013. Pomerantz, Andrew. The impact of killing and how to prepare the soldiers .   Frontline. Frontline, 01 Mar 2001. Web. 18 Feb 2013.

Rene Descartes The Proof for the Obvious. The Existence of the Truth Is Questioned

Rene Descartes The Proof for the Obvious. The Existence of the Truth Is Questioned Believing fully, regardless of any scientific or logical means of proving the idea wrong is pretty much the basis of any faith. In a slight departure from arguing whether the Creator actually exists or is merely a figment of people’s imagination, Rene Descartes preferred touching upon the reasonability of faith, i.e., believing in God.Advertising We will write a custom essay sample on Rene Descartes: The Proof for the Obvious. The Existence of the Truth Is Questioned specifically for you for only $16.05 $11/page Learn More Taking a closer look at the arguments that the philosopher offered, one can possibly figure out whether they make a completely coherent and logical string of ideas or if there are certain issues that slipped their attention. However, there is an even more interesting idea in Descartes’ Mediator’s train of thoughts, namely, the rejection of the ultimate truth. Descartes claims the following: Nevertheless, the belief tha t there is a God who is all powerful, and who created me, such as I am, has, for a long time, obtained steady possession of my mind. How, then, do I know that he has not arranged that there should be neither earth, nor sky, nor any extended thing, nor figure, nor magnitude, nor place, providing at the same time, however, for [the rise in me of the perceptions of all these objects, and] the persuasion that these do not exist otherwise than as I perceive them ? (Descartes) Hence, the fact that people perceive the everyday reality the only possible right way is questioned. To put it in a more simple language, one can no longer be one hundred percent sure that what people call a red color is truly red. Thus, not only the qualities, but also the existence of the elements of the everyday world is questioned. If stretched to its logical maximum, the given idea leads to the suggestion that the entire world is merely a figment of someone’s imagination. Even though Descartes argues the absurdity of the given idea by saying â€Å"I think, therefore, I exist† (â€Å"Cogito ergo sum† (Descartes)), it can be still argued that one’s thoughts are the exact proof of the existence of reality. According to Descartes, a single idea produced by a human being proves the fact of the existence. However, if pushing the question of reality as it is even further, one can suggest that the thought itself can actually be an element of a dream, like one of those fantastic dream sequences that people have. To put it simple, the thoughts and ideas that people have can actually be the part of someone else’s well-planned reality, like the elements of a strategy game. Therefore, it is clear that the arguments which Descartes offers are rather provocative. Even though they drive to the commonly known â€Å"I think; therefore, I exist† (Descartes), they still leave a lot of food for thoughts. Raising the question of whether the world is a reality or merely a part of someone’s consciousness triggers a range of the most intriguing issues to discuss, such as what happens when the supposed dreamer wakes up or starts dreaming about another universe.Advertising Looking for essay on philosophy? Let's see if we can help you! Get your first paper with 15% OFF Learn More Intense and thought-provoking, the idea that the world might be not actually what people see it, but something quite different might seem absurdly plausible, may actually turn true. Vast and truly immense, a world is filled with riddles, and mistaking while tying to understand it is the only way to approach the truth. Descartes, Rene, n.d., Meditations on First Philosophy. 28 Sept. 2012. https://oregonstate.edu/.

The Power of Mission and Vision … What’s Yours

The Power of Mission and Vision †¦ What’s Yours Why Have a Mission and Vision Anyway? And What Does It All Mean? Creating a mission and vision statement can be a formidable task. Large companies spend weeks and months on the process. When used to full advantage, a mission and vision truly underlie a company’s business model and become what employees and clients/customers align to. If someone is not excited about the company’s mission and vision, that person is not a good fit for the organization. ActionCOACH, my business coaching company, defines vision as strategic intent- why the entity exists; it is a statement against which all decisions can be measured. Mission, by comparison, is a practical description of how the ultimate vision will be achieved. Of course you can have a mission and vision whether you are a job seeker or a business owner. As you read the story of The Essay Expert’s mission and vision, I invite you to consider what your mission and vision would be. If you create one you like, please share it in the comments. The Essay Expert’s Mission and Vision Journey The Essay Expert did not have a mission statement for probably its first year. When I created one, it sounded right and it stuck (it also was a relatively easy process given that I was the only person who had to approve of it!). Here it is: The Essay Expert works intensively and personally with job seekers, college applicants and companies, to create powerfully written job search and marketing content. Our clients achieve unprecedented success in moving their careers, education and businesses to the next level. That mission statement does state how my company will achieve its ultimate goal. But without a vision statement, that ultimate goal was not defined. Then, last year in a business coaching meeting, Susan Thomson encouraged me to craft a vision statement to complement the mission. The vision I created was this: To empower people and companies to be confident and unstoppable in reaching their goals. This seemed like a statement with a higher purpose and goal that I believe in. And I have been using it. Each time I have considered bringing in a new writer, I have read this mission to them and ask for their thoughts on it, introducing them to the culture of my company. Inevitably, the writers I have chosen for my team have been very committed to contributing to the success of The Essay Expert’s clients. They have been truly aligned with my mission and vision, and I have never had a problem with a writer not being fully committed to The Essay Expert’s clients. Be Careful What You Vision For†¦ However, I have also encountered some issues when I have demanded more time and corrections from my writers than some other resume writing companies they have worked with. Why was this happening? Why were my writers feeling frustrated with my commitment to excellence? Two weeks ago, I discovered through a brief coaching session with Dr. Bob Wright that my company’s mission and vision were part of the problem. They were all about our company’s clients, and not about our team! This was a blind spot for me up until Bob pointed it out, and it was quite a revelation. I now realize that my company’s mission and vision must be not just about the work we do, but about who we are as a company and as human beings working together. To that end, my new vision and mission are â€Å"in progress† and will include something like this: We bring out the best in our clients and each other as a team of writers. We are committed to excellence. We strive to write more effectively, communicate more effectively, and showcase the brilliance in ourselves and in everyone we touch. Can you imagine a company where everyone is aligned with this philosophy? Where we are all working together toward excellence, becoming our best selves while supporting our clients to do the same? That’s a company I would want to work for! What is your mission and vision for yourself or your company? Please share below.

Amenorrhea in Adolescent Girls Essay Example | Topics and Well Written Essays - 500 words

Amenorrhea in Adolescent Girls - Essay Example It has been gathered that 75% girls begin breast development by age 11.5 years. By age 12 more than 95% girls begin breast development. So it is perfectly fine to evaluate no menstruation state after age of 13 years. Eating disorders is considered one of the causes of primary amenorrhea. Appropriate evaluation and referral becomes necessary in such cases. Around 0.3% to 0.5% of young women are found to have the condition of Anorexia Nervosa and majority of the cases are in age group of 15 to 19 years. While diagnosing anorexia nervosa, amenorrhea is found as one of necessary features. Other contributing factors are excessive exercise, low body weight, and stress -induced activation of the hypothalamic function. Low body weight and amenorrhea has some kind of relationship; however, it is not always the case. It has been found that around 20% of the women with anorexia nervosa have been found to develop amenorrhea before they lose significant body weight. It is important to notice that young women with bulimia nervosa are of normal weight even then they are found to suffer from irregular menses, perhaps due to dietary restriction. At times, many women do have some kind of eating disorders that cannot be classified as anorexia nervosa or bulimia nervosa adolescents but they are part of an eating disorder not otherwise specified (EDNOS) and some of them are also found to have amenorrhea. Usually, weight restoration and nutritional food resumes menses. Amenorrhea may also occur due to prolong use of antipsychotic medication. Antipsychotic drugs have been found to block dopamine D2 receptors increasing prolactin secretion by 5-10 times from the pituitary gland. Antidepressants too have been found to increase prolactin levels. Contraceptives in injectable form also cause amenorrhea. The use of medroxyprogesterone acetate (DMPA) causes amenorrhea in 50% of cases and that number increases to 75%, if its use continues for two years. Stress, physical or

Controlling Bureaucracy Article Example | Topics and Well Written Essays - 250 words

Controlling Bureaucracy - Article Example At times one unit is seen superior when it implements its functions effectively. This makes its functions seen; thus people referring it superior than the others. As you put, none is more superior to the other, except only on the fact that which unit is carrying out its duties effectively. Otherwise, I totally agree that all have equal control powers. Your analysis is very exhaustive. It is true that a particular control unit may be ineffective to serve the people. Basing on the life examples you have given, it is true that people can impact a control system of a particular unit. This only is applicable when ordinary citizens vote wisely when electing their political leaders. In that case, your vote counts. This will limit the ineffectiveness of the popular control of elected officials. Each control unit has specific roles over bureaucracy. For instance, legislature may not have powers to overrule the president nor the elected officials. It carries its control duties as per the constitution. Likewise, the judiciary is superior by its own in executing its functions. Although the president is the commander in chief of the armed forces, he has to rule within his control limits. This shows that each control unit is superior in its side. However, one may be seen less effective, depending on the measure of power assigned to implement p articular duty. For your case you are right to say that this is more effective than the other, but with reference to executing particular

Recovery Programme For Patients Undergoing An Anterior Resection

Recovery Programme For Patients Undergoing An Anterior Resection The topic I have chosen for my project is the Enhanced Recovery Programme (ERP) for patients undergoing elective colorectal surgery, and whether this aids with early discharge from hospital. I shall discuss traditional pre and post operative assessments alongside the one used for ERP. I will also discuss each of the seventeen modals used within ERP and how when it is used collaboratively can aid with early discharge. I will also discuss any complications that arise from ERP and traditional surgery and if there is any difference to the patient. Within the conclusion, I will discuss the findings and any way of gaining additional knowledge and skills. I will undertake a comprehensive search of literature using the cinhal, pubmed databases and reading literature that is available within the university library. I will use quantitative research to analyse my data and incorporate this and any further learning into my conclusion. During the last four years of my training, I have developed a keen interest in colorectal surgery and this is something I would like to expand on when I become a qualified nurse. I have nursed a lot of patients on the Enhanced Recovery Programme, but I have never looked into this at any great length and I wanted to see if this had any benefit to the patient or even whether it truly did mean early discharge from hospital. In the early part of the 1990s, surgery underwent a drastic change it went from using long lasting anaesthetics to shorter fast acting ones. Combining the new anaesthetics and analgesic methods together with new surgical techniques, a new surgical pathway was created and this seems to have shortened the post operative recovery period. This means that patients could be taken out of main operating theatres as they didnt need as much recovery time. Minor surgical cases were moved to smaller day stay units (Apfelbaum 2002). The term for this new pathway was called fast tracking. Recovery times for patients on the fast track programme were considerably shorter in comparison to those patients that were not. Arguments were bought up to justify the use of fast track surgery such as reduce the nurses workload, reduce hospital costs and improve patient care by getting them back to their preoperative condition more quickly (Watkins 2001). The expansion of fast track meant that more surgical pro cedures were being performed as day cases. The expansion of the fast track concept to colonic surgery was pioneered by Henrik Kehlet, a surgeon of the Hvidovre University Hospital in Denmark. He stated that of 60 patients who underwent a colostomy on the fast track programme, 59 required a hospital stay of two days. In 2001 Enhanced Recovery after surgery (ERAS) group was formed, it was their job to look into the case mix, clinical management and clinical out comes of colorectal patients. What they found was that in Denmark, the length of stay was considerably shorter than Edinburgh, Sweden and Norway who were practicing care that is more traditional. The length of stay within Denmark was 2 days and the other 4 had an average stay of between 7-9 days (Nygren 2005). With the experiences of Denmark in mind, ERAS group developed a new evidence based concept that was holistic in its approach. There are 17 key elements to the Enhanced Recovery Programme (ERP) (appendix1). The 17 elements can be divided into 3 facets Preoperative, Intraoperative and Post operative. Each one of these facets is evidence based and only when they are used collaboratively in elective surgery do they produce a paradigm shift on how we manage our patients. The concept of ERP is to increase patient satisfaction and decrease patient complications. A patient preparing for traditional open bowel surgery used to be prepared in pre-operative assessment for a stay in hospital of around 14 days (Rickard et al 2004); Enhanced recovery patients are being prepared for a stay in hospital of 5 days (Elwood 2008). What ERAS did was to discover that there is a gap between evidence and practice, one of the consistent findings in health service research was what should be done according to scientific evidence and best clinical practice (Bodenheimer 1999). Improving the quality of care increases the amount of patients that are seen each year. This is because the right things are being done in a timely and organised fashion. Preoperative The effectiveness of the Enhanced Recovery Programme (ERP) depends on changing the patients outlook on their hospital stay. Encourage patients to believe that a shorter stay in hospital is a viable option. Department of Health (2009) states that the enhanced recovery uses evidence based interventions both pre and post operative. It is well established that stress levels rise when faced with the prospect of surgery but this concept has recently been challenged by Fearon K (2005a) in which he suggests that elements of the stress response can be reduced or even eliminated with the application of modern anaesthetic, analgesic and metabolic support. The ERP relies heavily on a multi professional approach involving all members equally. Tradition was that doctors gave the pre assessment teaching. But due to time constraints on the consultants, this was often rushed due to the amount of other patients that needed to be seen and not all patients questions were answered. The introduction of nurse specialist pre assessment clinics helped alleviate some of the pressure, and the atmosphere was more relaxed and the nurses understanding of the programme made it easier for patients to follow (Crenshaw, Winslow 2002). It is essential that all patients are well prepared for the operation, not just for a check on their physical condition but also their psychological needs. Looking after the patients psychological needs is an important part of the enhanced recovery programme as it helps reduce the stress of surgery. Patients are counselled on the important parts of the enhanced recovery programme such as early mobilisation and diet resumption. Screening for malnutrition will also take place at this appointment it should include weight, height and the body mass index should be calculated and any unintentional weight loss should be calculated use of the malnutrition universal screening tool (MUST) should be used (appendix 2). It is also reasonable to discuss discharge at this point. A patient being diagnosed with any disease is hard enough to deal with but then to be told you need an operation. Obtaining consent is a vital component to the success of the programme. Gaining consent is more than signing a bit of paper (Department of health 2009). Consent must be given freely and without coercion. All the facts must be given about the treatment and any risks should be discussed. The core ethical principle according to royal college of nursing (2004) is respect for the individuals rights. Gaining consent is a legal requirement. As a nurse the NMC (2008) states that, we are accountable for our own actions so we must ensure consent is obtained before any procedure is carried out. Some patients may not wish to know all the facts if this is the case the consultant in charge of the patients care should document this in the patients medical records, and all healthcare professionals should adhere to this. Patients are encouraged to bring in their own clothes so they are not sitting around in bed all day. Patients with disabilities or who may require more help are also identified at this visit. It is explained in the pre assessment what is expected of the patient after surgery. Clarke (2005) suggest that only forty two per cent of day surgery patients in the UK are currently offered a pre-assessment visit, within my own personal experience a pre assessment appointment is well advised, as this gives the patient time to ask any questions and alleviate any last minute fears. This part of the ERP has not changed from the preoperative counselling for traditional surgery. The preoperative assessment is a critical component of ERP as it gives patients autonomy over their own care. One of the main principles of the enhanced recovery care is that bowel preparation is avoided as this can cause dehydration and electrolyte imbalance particularly in the older patient (Burch, J.2009) a point that is also raised by Holte (2004a) he also goes on to state that bowel prep can also be very stressful. The trust that I am placed only one of the consultants uses bowel preparation usually in the form of an enema as these help prevent post operative constipation and contamination of the surgical area by faeces and is only ever used if a stoma formation is not required. Bowel preparation is still used for traditional surgery with oral sodium phosphate being the most convenient method. However concerns were raised that by not giving bowel preparation this could cause problems post operatively, but these fears have not surfaced (Holte et al 2004b). A recent study by Guenaga (2005) suggested that giving oral bowel preparation can cause anastomotic leaks, and may cause wound infect ions and possibly death. Nil by mouth after midnight originated in 1946 when reports suggested that a higher risk of pulmonary aspiration existed among patients that had general anaesthesia that had not fasted. Reassessment of this tradition began in the 1980s where numerous studies failed to demonstrate that fasting ensured that the stomach would be empty (Crenshaw, Winslow 2002). Also noted was patients that had prolonged fasting would complain of headaches, dehydration, hypovalemia and hypoglycaemia. As a result, in 1999 American Society of Anaesthesiology developed guidelines that support a more liberal preoperative fasting protocol. The original belief of nil by mouth (NBM) from midnight before surgery is still widely adopted for some surgical procedures and is still applied to some elective cases (Maltby 2006).Consumption of oral fluids up to 2 hours prior to surgery is known to reduce post operative vomiting without any adverse effects, contrasting with patients that are starved normally prior to surgery (Khoyratty, Bhavik, Ravichandran 2010).There are several elements of the programme that are important, one element is the careful use of fluids, traditional surgery uses too much (Burch 2009). It is documented that hyperglycaemia increases diabetic complications, in a study by Nygren et al (1999) also found that patients that werent Diabetic had the same amount of glucose within their blood work as patients with type2 diabetes. Patients on the enhanced recovery programme are given two clear carbohydrate drinks to take: 800mls is taken the night before surgery, 400mls is to take with breakfast (Grover 2010) this reduces the preoperative thirst and hunger but it also reduces post operative insulin resistance, therefore patients are in a better anabolic state to benefit from post operative nutrition, The Carbohydrate drink consists of 12.6g of complex carbohydrate in the form of Maltodextrin Nygren et-al (2006). Having these carbohydrate drinks is the equivalent of having 2 roast dinners. A patient on a morning list must not eat after midnight but can have clear fluids until 3am. In contrast, consumption of an appropriate mixture composed of water, minerals and carbohydrates offers some protection against surgical trauma in terms of metabolic status, cardiac function and psychosomatic status. Oral intake shortly before surgery does not increase gastric residual volume and was not associated with any risk of as piration. For normally nourished patients restoration of gastrointestinal (GI) function is one of the primary goals of post operative care. A recent study by Khoyratty, Bhavik, Ravichandran (2010) found that many of their patients voluntarily fasted longer than was given in the written instructions this is not advisable as this can cause post operative complications and can delay the healing process. This was also noted by others (Baril Portman 2007). Food and drink is a basic need and is needed to sustain life and aid with the healing process. A patient will routinely have a catheter inserted on the operating table and close monitoring of Urine output is vital, minimum output per hour is usually 35mls if it reduces then the team should be called because understanding fluid management is vital for the ERP to work. Intravenous fluid will have been prescribed avoiding normal saline and ideally stopping after 24hours (Billyard et al 2007). Fluid balance charts are vital as 60% of a males body weight and 55% of a females body weight is made up of water and electrolytes; one third of this fluid is extracellular (ECF) and two thirds intracellular (ICF). A reduction of 5% in total will result in thirst and thus considered to be mild dehydration (Welch 2010). Inadequate fluid intake or fluid loss can also cause dehydration. Patients who have had major abdominal surgery will have some fluid loss. With reference to preoperative and post operative patients Intravenous fluid on traditional surgical patients were given 3.5 to 5l of intravenous fluid on the day of surgery (Tambyraja et al 2004) however recent studies have found that providing no more fluid than is necessary to maintain fluid balance (for example a patients body weight), as this reduces post operative complications thus reducing a patients stay in hospital (Brandstrup et al 2006).For more traditional surgery the patient would normally be on restricted oral intake but this is not the case with ERP so monitoring intake is vitally important. Poor urine production can lead to renal failure and electrolyte imbalance. Monitoring fluid balance is important because as nurses we need to carefully monitor a patients input and output, as poor monitoring can lead to poor outcomes. The hourly catheter bag is changed to a leg bag on day 1 after the operation to make it easier for the patient to mobilise but strict fluid balance must be maintained (Burch J 2009). This should include stoma output if a patient has had a stoma. The catheter is usually removed on day 2 post operatively as long as there are no post operative complications and strict out put is still monitored. While fluid balance charts are a good and useful tool for monitoring fluid balance they are only as accurate as the data recorded on them, another good way of monitoring fluid loss or gain is to weigh a patient, as 1000mls is equivalent of 1kg any rapid weight gain can be directly related to a change in fluid status. The detrimental effects of fluid imbalance can be life threatening, therefore the importance of strict monitoring and accurate recording can not be stressed enough. Nursing staff of all levels should strive to complete fluid balance charts as fully and as accurately as possible. Traditional surgery required starving a patient the day before surgery. When a patient returned from theatre they were not allowed to eat until the Surgeon could hear normal bowel sounds and sometimes this may not happen for 4-5 days post operatively. So a patient could be starved of anything to eat and drink for as long as a week. A patient undergoing colorectal surgery may already be malnourished and the complications following surgery are greatly increased. Malnutrition can affect every tissue, muscle and organ within our bodies it can also have an affect on our psycho-social welfare (Todorovik 2003). National Institute for Clinical Excellence (2006) state in their nutritional support in adults that malnutrition is usually caused by physical factors. A recent study into nil by mouth versus early feeding found that of 837 patients that met with inclusion criteria found that early feeding reduced the risk of any type of infection although the risk of vomiting was increased (Lewis, e t al 2001). Patients on the programme are encouraged to drink and eat straightaway if they feel like it. Usually sips of water are offered and if tolerated they are offered nutritional supplements to drink, usually one about an hour after surgery, if this is tolerated then another will be given and left for the patient to drink at leisure (Fearon 2005b), Billyard (2007) contradicts this and states: the patient should drink at least 2L including three nutrition drinks on returning to the ward. Once a patient can tolerate fluids without vomiting or feeling nauseous, they can progress on to solid foods usually something light. A concern for surgeons was post operative ileus (POI). POI is a well recognised consequence of any abdominal surgery and is frequently experienced by patients, Leir (2007) states that it is not a life threatening complication but is a costly post operative complication. POI is defined as a transient impairment of intestinal motility after abdominal surgery (Han-Geurtz et al, 2007).There are many factors that have shown to increase its progression such as Local intestinal inflammation Anaesthetic Agents Over hydration Post operative analgesia(opiates) Reduced mobility. POI along with nausea and vomiting are the most common complication. POI can be minimised with the use of epidurals. Scoop et al (2006) stated: that mid-thoracic epidural is considered the pinnacle of the enhanced recovery programme. Although it is possible to use Patient Controlled Analgesia (PCA), Morphine can increase the risk of vomiting it can also cause the bowels normal peristaltic movement to temporarily paralyse. Recent research in to POI and the different approaches to treatment found by giving a patient chewing as a form of Sham feeding (making the body think it was eating) helped with gut motility. Schuster et al (2006) found that gum was an inexpensive and of some benefit after colostomy formation. Five randomised trials of chewing gum to restore the natural gut motility found that patients who were chewing gum passed flatus 24% earlier and had bowel movement 33% earlier, which shows a significant and positive conclusion of early discharge which on average 17.6% earlier than those that did not have the chewing gum (Chan and Law 2007). POI is usually diagnosed with symptoms of nausea and vomiting along with abdominal distension, pain and the failure to pass flatus or faeces. Parnaby et al (2009) found although flatus and faeces were passed earlier in patients who chewed gum it did not have any bearing on early discharge or post operative complications. If tachycardia is present then other causes should be excluded. The treatment for POI is inserting a nasogastric tube (NG) although one is inserted during the intubation process during surgery it is removed as soon as the surgeon has finished operating because there is good evidence to suggest that leaving a NGT in place can cause pneumonia (Cheatham et al 1995). Once a diagnosis of POI has been made, all oral intake should discontinue, and the patient should be removed from the programme and the traditional approach should commence. Patients are encouraged to take regular anti emetics to aid the patient with early return of oral intake the trust that I work cyclizine is the anti emetic of choice. Post operative pain is always a concern this is why Professor Kehlet designed the ERP because he believed every patient deserved to have a pain free recovery. For patients to understand pain nurses need to be able to educate the patient. Biggs (2009) states that less than 1% of university education is spent on pain and the effects of pain. It is vital that nurses have an understanding of pain physiology in order to educate our patients and in turn increase patients knowledge and reduce anxiety, increasing patient satisfaction. Regular pain assessments should be maintained at rest and on movement by a competent nurse (DH2009). It is stated by Vickers et al (2009) that pain should be classed as the Fifth Vital sign. In postoperative patients on ERP, it is vital that nurses monitor pain because pain can reduce a patients motivation for all the other parts of ERP. Concerns have arisen about the use of thoracic epidurals as the analgesia of choice due to immobility and urinary retention, but if inserted high enough in a thoracic position it is possible to mobilise safely and with fewer side effects such as constipation, this means that opiates which have an adverse effect on the bowel can be avoided and again this can facilitate to an earlier discharge. 1 gram of paracetamol is given 4 times a day and is given in conjunction with PCA or epidural, this is also part of multimodal approach. Also, the afferent nerves are blocked resulting in less stress response less gut paralysis and a decreased risk of pulmonary complications (Jorgenson et al 2000). The epidural dose is reduced 48 hours after surgery, and once epidural is running at 2mls per hour then a trial without epidural should commence and pain reassessed after 1 hour if minimal or no pain then commence co codomol 30/500 every 6 hours and oral Non Steroidal Anti Inflammatory Drug (NSAID) diclofenac 50mg every 8 hours (British National Formulary, 2009) with this in mind the consultant can prescribe a mild laxative for patents as this will avoid constipation although this is not the case where stoma formation occurs. Alternatively, at the anaesthetists request oral paracetamol 1g 6 hourly may be given also diclofenac 50mgs 8 hourly and 10-20 mgs of Oxynorm every 2-4 hourly. As a nurse I am aware of the importance of pain management within the ERP because psychologically a patient in pain will not feel like eating, or mobilising so keeping on top of pain by using trust pain charts and ensuring that pain relief is delivered on time helps reduce anxiety. In theory, there is not hing stopping nurses from giving paracetamol or co-codamol every 4 hours during the day as making the patient comfortable will aid sleep meaning that paracetamol or co-codamol will not be needed between midnight and six in the morning, it also means that extra pain relief may not be needed thus reducing post operative complications. On saying all of this post operative pain is believed to be at its worst directly after surgery and the intensity is expected to diminish over time (Buyukilmaz et-al 2010), the World Health Organisation analgesic ladder (2007) is used in reverse for surgical patients. on return from surgery patients, initial observations should be taken by the trained nurse so she has a baseline to work with. All further observations should be meticulously maintained as per any hospital policy. The use of Bair huggers during surgery has reduced the incidence if hypothermia during the operation it is important to maintain a constant core temperature as it was found that all of the anaesthetics used during operations caused hypothermia also there are several non pharmacological reasons that warrant the use of Bair huggers for example shaving the surgical site (Sessler and Akca 2002). Wound infection is a serious and costly complication. During colorectal surgery, the incidence of wound infections increases to 10%. Ikeda et al state that all incidences of wound infections occur during the first two hours of any surgical procedure. The primary connection between hypothermia and surgical site infection (SSI) is vasoconstriction because of a decrease in tissue oxygenation and if a patient is immunosuppressed which most colorectal patients are this can also cause SSI. Blood loss during surgery can increase the risk of SSI due to blood transfusions during surgery. On return to the ward from recovery the nurse in charge of the patient must ensure that the wound site is checked for bleeding and check the dressing for any sign of strike through the nurse would expect to see some excess on the dressing but it should be regularly monitored so any problems can be found early. Port sites where a patient has had laparoscopic surgery should be checked. When a stoma has been formed, the nurse should look at the site making sure it is pink/red in colour and it is warm and there is no excessive bleeding. Wound infections can delay discharge so any problems should be found early reported to the patients team and the correct antibiotics can be prescribed early and may only delay discharge by 2-3 days. Anti thrombotic prophylaxis is a must within colorectal surgery; treatment is usually commenced the evening following surgery and continued on a small maintenance dose of 40mg of enoxaprim (Dylan 2010) until the patient has regained full mobility. There are no further advantages in general surgery for extended use of enoxaprim but there are advantages for patients undergoing orthopaedic surgery. Associated use of low dose heparin and continuous use of epidural analgesia is open for discussion as there have been reported cases mainly in the United States of epidural haematomas (Tryba 1998). A patient undergoing stoma formation under ERP pathway can have their discharge delayed due to teaching, on how to care for the stoma. Although pre-operative teaching does occur, the reality often does not sink in until after the operation. The stoma nurse specialist will see the patient on the day after the operation. The patient returns with a clear see through bag so nursing staff can see when t he stoma becomes active. Teaching begins at the bedside where the patient may only want to observe the proceedings, but all of the time the stoma nurse actively encourages the patient to take note of the proceedings. Psychologically the patient may need lots of reassurance as to them this is not natural (Rust 2007). A patient with a stoma should plan for a stay in hospital between 5 -10 days and it usually takes this long for a patient to be able to manage their stoma. To become self caring with a stoma is the patients biggest psychological battle (Bekkers et-al1996). So on my understanding of the research available stoma formation does infact delay discharge by four days depending on the patient and his/her ability to manage. Patients are not always proactive recipients of care (Ellwood 2008). Early Mobilisation is important to reduce complications such as chest infections. Chest infection rates have dropped from 4% to less than 2% this is because patients are not laying in bed for days. Bed rest not only increases insulin resistance it also decreases muscle tone and in addition, there is an increased risk of thromboembolism. On the ward, the physiotherapist has a book which nurses can refer patients and patients should be seen on day 1 following surgery. Patients are encouraged to sit in the chair for two hours on the day of surgery to encourage deep breathing (Francis 2008). A care plan should be formulated with a specific mobilisation plan incorporated. It is essential that a patient should be nursed in an environment that encourages early mobilisation. Anti embolic stockings are also prescribed. The stockings facilitate venous return from the lower extremities. They also provide venous thrombosis. As nurses, we should make sure the patient is lying down as this allows the veins to relax. The stockings should be removed at least once a shift, so that the nurse can inspect the patients legs and feet for any signs of redness as the skin around the heel can break down very quickly. Encourage leg exercises every hour during the day. Muscle contractions compress the veins, preventing a clot. Contractions also promote arterial blood flow. The introduction of the enhanced recovery nurse has been invaluable not only for the patients but also for staff. The role of the ERP nurse (ERPN) is fundamental to the programme as she/he co-ordinates patient care from the beginning. The ERPN works freely within the colorectal team seeing patients in clinics. He/She helps the patient through their hospital admission reinforcing the goals and liaising with hospital ward staff. ERPN works closely within the surgical team, colorectal cancer team and stoma nurses. The biggest challenge for the ERPN was changing the practice of nursing staff on the wards repeated teaching sessions with all new nurses and doctors with regular feedback and all new updates to the programme (Elwood 2008). Unfortunately, within the trust I am placed the already busy colorectal cancer team initiate all of the teaching, ERP has become a large part of the daily schedule within the trust that a need for an ERP nurse is deemed necessary and funding for the post has become available. Although regular care pathways and protocols are in place, an integrated care pathway was drafted but due to increased pressure from our consultants the document was abandoned, and deemed unworkable but after reviewing the evidence it seems to be used within most other trusts that incorporate the ERP as part of their surgical planning. Nursing interventions within the ERP can influence the out come so it is important that the nurse looking after the patient has the most up to date knowledge and skills and able to detect when a patients condition deteriorates. Another useful tool is a patient diary so that the patient can keep a record of when they got up so the patient is aware of when they can get back into bed. On the first day of surgery, the Patient should aim for 2 hours and then 6 hours until discharge (Fearon et al 2005). Patients are encouraged to walk 60 meters from day one post operatively. To enable continuity of care nurses need to consider the clients needs for assistance within the home. Discharge planning begins even before the patient comes into hospital; the process is usually started at pre admission clinic. The nurse will take a full social history; this is obtained so nursing staff on the ward are aware of any social problems. Fearon et al (2005c) stated that patients are fit for discharge after the following criteria has been met Have good pain control with oral analgesia Are eating solid food and no Intravenous Fluids Are independent with all ADLs And willing to go home All patients should be discharged with an information leaflet including a telephone number of the ward in case they have any problems. In some of the trusts, an enhanced recovery nurse specialist post has been created and on discharge, the ERPN will telephone the patients on the programme at home to allay any fears and to check that there are no post operative complications. a telephone helpline has been set up at one London hospital so that patients can have direct contact with someone during out of hours and they are hoping that this will reduce the amount of AE admissions. The ward I worked on would refer all patients on the ERP to the district nurse with first visit being on the day of discharge, making sure that the referral form states that the patient is currently on ERP. Patients can telephone the ward if problems occur within the first 24 hours. Because patients on ERP are discharged earlier, this means that potentially serious complications can occur at home for example ana stomotic leaks (King et al 2006). Therefore, it is important that patients have a port of call once they are home and within the community setting. The need for support at discharge is also unlikely, compared to a patient who has traditional open surgery Readmission rates for patients on ERP shows that from 1998-2008 334 patients of which 99 (30%) were on ERP and 235 were not (Larsson et-al 2010). The 99 on ERP tolerated soft diet approximately 2.5 days earlier than those not on ERP and were discharged at least 2 days earlier from hospital. Recent research done by 2 Doctors searching the colorectal cancer data base for the trust found; ERP has reduced the length of stay by 3 to 5 with no change in mortality or readmission, the best results came from a gynaecology ward where the nursing staff followed the ERP care pathway in its entirety. Conclusion Traditional Perioperative procedures and prac