The Right Of Assisted Suicide Essay - 1615 Words

The right to assisted suicide is a huge topic that worries humans all around the usa. The debates go from side to side approximately whether or not a death patient has the proper to die with the assistance of a physician. some are in opposition to it due to religious and ethical motives. Others are for it because of their compassion and respect for the dying. Physicians are also divided on the issue. They differ where they area the line that separates alleviation from death--and killing. for many the primary difficulty with assisted suicide lies with the competence of the terminally sick. Many terminally sick patients who re in the final tiers in their lives have requested docs to useful resource them in exercising lively euthanasia. it is sad to comprehend that these human beings are in awesome ache and that to them the handiest desire of bringing that anguish to a halt is thru assisted suicide.whilst humans see the word euthanasia, they see the that means of the word in special li ghting fixtures. Euthanasia for some consists of a terrible connotation; it s miles the same as homicide. For others, but, euthanasia is the act of placing a person to death painlessly, or permitting someone affected by an incurable and painful disorder or situation to die by way of withholding excessive clinical measures. however after analyzing both aspects of the difficulty, a compassionate character should conclude that competent terminal sufferers should accept the right to assistedShow MoreRelatedThe Rights Of Assisted Suicide966 Words   |  4 PagesDying Your Way: The Right to Choose Assisted Suicide Introduction Death has a finality to it that gives even the most cynical person a reason to pause. The possibility of death is always present, the elephant in the room. Prior to the twentieth century, before the leaps and bounds of modern medical care, people worried about the possibility of dying more often. Childhood diseases could strike and take a beloved child away at any moment, affecting two or more homes in the same community. Today childrenRead MoreThe Rights Of Assisted Suicide Essay1584 Words   |  7 PagesThe Right To Die With Dignity Assisted suicide is the act of committing suicide with the help of another person or doctor, most commonly referred to as Physician Assisted Suicide. It is currently legal in Oregon, Washington, Vermont, Montana, California, and Colorado. Considering the increase of people dying from terminal illnesses, assisted suicide should be legalized across the nation. People that suffer from a terminal illness that can’t be cured or treated and will result in death have the rightRead MoreThe Right to Assisted Suicide1548 Words   |  6 Pagescontemplate your options for living out the rest of your life. You wonder if you will be able to cope with losing yourself, your independence, your identity, your dignity. But what choice do you have? Euthanasia, also referred to as assisted suicide or physician assisted suicide or more commonly known as mercy killing is defined by Merriam-Webster dictionary as the act or practice of killing hopelessly sick or injured individuals (as persons or domestic animals) in a relatively painless way for reasonsRead MoreThe Rights Of Assisted Suicide1829 Words   |  8 PagesThe â€Å"right-to-die† has been controversial for a long time and is continuously in debate. Some of the arguments in favor of laws allowing individuals to choose include - Anyone coming into hospital in an emergency has the option of a DNR (do not resuscitate). People who go into comas may leave living wills instructing doctors not to use any extreme life-saving measures (this includes feeding tubes). Perhaps dying with dignity is controversial b/c it seems like a more conscious choice. People can predetermineRead MoreThe Rights Of Physician Assisted Suicide1347 Words   |  6 PagesThe Right to Die By: Antony Makhlouf Antony Makhlouf PHR 102-006 Contemporary Moral Issues Final Paper The Right to Die Physician-assisted suicide, also known as euthanasia, has been a hot topic as of late. If you do not know what this is, physician-assisted suicide is the taking of ones life. This usually occurs when a patient is in a irreversible state, and must live through a tube. With multiple cases occurring in the past, current and the more to occur the in the future, this looksRead MoreAssisted Suicide : Rights And Responsibilities1570 Words   |  7 PagesAssisted Suicide: Rights and Responsibilities A woman suffering from cancer became the first person known to die under the law on physician-assisted suicide in the state of Oregon when she took a lethal dose of drugs in March, 1998. The Oregon Death with Dignity Act passed a referendum in November, 1997, and it has been the United States only law legalizing assisted suicide since then. According to the New England Journal of Medicine, more than 4,000 doctors have approved of the assisted suicideRead MoreThe Right to Assisted Suicide Essay937 Words   |  4 Pagesrespect your elder’s wishes? It is a cruel reality we live in when ability to choose the time of our demise, especially for terminal patients, is not seen as a personal right to be acted upon, but to be shunned as a taboo. This is why assisted-suicide, the contraction of a third-party to provide the materials necessary to commit suicide, should be legalized; it would allow both terminal and permanently disabled patients an escape from the mental, emotional, ph ysical pain of useless treatments, andRead MoreAssisted Suicide : Right Or Wrong?880 Words   |  4 PagesHillard 01/14/15 Nursing Roles I Professor Rodgers Assisted Suicide: Right or Wrong? The article I selected is called Assisted Suicide: Right or Wrong? By: Claire Andre and Manuel Velasquez. This article talked about a researcher named Matthew Donnely. For over 30 years Matthew conducted research on x-rays. Matthew was diagnosed with a terminal skin cancer. During his battle with cancer he had lost his nose, his left hand, two fingers on his right hand and part of his jaw (Andre Velasquez). Matthew’sRead MoreThe Right to Die in Assisted Suicide2517 Words   |  11 PagesInitial Thoughts on Physician Assisted Suicide (February 28th, 2013) The promotion of physician assisted suicide has sparked a debate throughout the world. From my point of view, assisted suicide is doctors assist patients who could not endure the pain of diseases and are voluntarily given lethal amount of substances resulting in death. However, physician assisted suicide might be considered to be deviant in many countries currently due to the religions, laws and the negative image. AlsoRead MoreEssay The Right to Assisted Suicide2100 Words   |  9 PagesThe Right to Assisted Suicide    Recently, a terminally ill British woman lost a high-profile court battle to take her own life in a test case of whether Britain will permit assisted suicide.   Wheelchair-bound Diane Pretty, a 43-year-old mother of two, has waged a lengthy legal fight to allow her husband to kill her without being prosecuted. Pretty, who contracted motor neuron disease two years ago, which is a muscle-wasting disease, lost her bid to have an assisted suicide.   She has had

The Theme Of Romanticism In Mary ShelleysFrankenstein

Throughout the world scientists are making breakthroughs in science; CRISPR, gene therapy, and cloning, these discoveries affect how people perceive the world and what they can do with it. Even so, have people ever stopped to question what this could mean for everyone? Are people breaking and corrupting the natural world to the point of irrevocable damage? One book, Frankenstein by Mary Shelley, is both a great example and warning to readers about such morals. In the book, Mary Shelley uses concepts from Romanticism to help us understand her message. She then asserts her own ideas through use of perspective and tone in her story, which is then accentuated by uses of hyperbole. The message? Nature and natural laws should be left untouched†¦show more content†¦Mary Shelley then introduces the creature, a contrary view created to juxtapose to Doctor Frankenstein’s perspective, something that Frankenstein created. The creature told Frankenstein Cursed, cursed creator!â₠¬  and he then thought why he did â€Å"not extinguish the spark of existence which you [Frankenstein] had so wantonly bestowed?(pg 124) This presents the reader with a tone that is grave and tormented, one that makes it seem that humankinds interference in science is terrible. With the unnatural being, the creature, saying that he wishes that his existence would either end, or be made natural, with the creation of an opposing gender.The creator, Frankenstein, the natural being, reflects, and thinks that his â€Å"career, now serves only to plunge† himself even â€Å"lower in the dust ... like the archangel who aspired to omnipotence† he is â€Å"chained to an eternal hell. (pg 198) Mary Shelley is using these two contrasting opinions on science, to create very different tones, which clarify her message, and when shown that both believe that the unnatural existence of the creature is terrible, and how it would have been better if he didnt exist at all, it clarifies the message she is trying to make. Overall, when paired with the

English Importance in the Next Few Years Free Essays

The topic under discussion is that â€Å"compare the importance of English to the other major languages of the world and then tell whether it will be able to sustain its superiority in the next hundred years†. I am for the topic. A language is a systematic means of communication by the use of sounds or conventional symbols. We will write a custom essay sample on English Importance in the Next Few Years or any similar topic only for you Order Now It is the code we all use to express ourselves and communicate to others. It is a communication by word of mouth. It is the mental faculty or power of vocal communication. It is a system for communicating ideas and feelings using sounds, gestures, signs or marks. Language therefore remains potentially a communicative medium capable of expressing ideas and concepts as well as moods, feelings and attitudes and thus makes humans different from other living beings. The latest and the most advanced discoveries and inventions in science and technology are being made in the universities located in the United States of America where English language is the means of scientific discourse. The importance of English as a spoken language began as a result of the colonial era, when European powers took to the seas in order to find new lands and natural resources. The effects of that time can still be felt in the number of English speakers in India, select parts of Asia and Africa, and North America. The influence of English grew stronger in the 20th century, with the increased mobility of populations, the growth of the United States as an economic power, and the presence of international media in everyday life. As of 2010 there are fewer native speakers of English than Chinese, though English is spoken in more places, and more people speak English as a second language. The importance of English in business comes from its use as a lingua franca, or a means of communication between speakers of two different languages. Many of the world’s top languages function this way, including French, Russian and Arabic, but English still has the widest reach. A South Korean businessman traveling to meet the head of an Argentinean conglomerate in Germany will expect the common language for all to be English. Aside from the United Nations, many other international organizations operate in English. After World War II, key financial institutions were created in English, including the International Monetary Fund and the World Bank. The World Trade Organization and a variety of other UN affiliates such the World Food Program and the World Health Organization use English in spoken and written communication. Five of the largest broadcasting companies (CBS, NBC, ABC, BBC and CBC) transmit in English, reaching across the world through satellite television and local holdings. Estimates for the number of people using the Internet in English lie only slightly ahead of users in Chinese, but well ahead of Spanish and other major languages. In the publishing industry, English is also well ahead: 28 percent of books published annually are in English, and the market for books in English for second language speakers is growing. English currently dominates in science and technology, a position that it took over from German after World War I. Scientific journals publish in English, and many researchers, especially in physics, chemistry and biology, use English as their working language. The historical circumstances of India (having been ruled by the British for over two centuries) have given the Indians an easy access to mastering English language, and innumerable opportunities for advancement in the field of science and technology. Many Indians have become so skilled in English language and have won many international awards for creative and comparative literatures during the last few years. Sometime ago, an Indian author, Arundhati Roy, won the prestigious booker prize for her book â€Å"The God of Small Things†. Her book sold lakhs of copies all over the globe. According to the 2004 World Factbook, 49 countries list English as their official language, not counting the United States and the United Kingdom, which do not list any official language but use predominantly English. In 2001, a poll of the 189 member countries in the United Nations showed that 120 of them preferred to use English to communicate with other Over the years, English language has become one of our principal assets in getting a global leadership for books written by Indian authors and for films made by Indians in English language. A famous Indian movie maker Shekhar Kapoor’s film â€Å"Elizabeth† has got several nominations for Oscar Awards. It does not require any further argument to establish the advantage English language has brought to us at the international level. English language comes to our aid in our commercial transactions throughout the globe. English is the language of the latest business management in the world and Indian proficiency in English has brought laurels to many Indian business managers. English is a means not only for international commerce; it has become increasingly essential for inter-state commerce and communication. English language comes to our aid in our commercial transactions throughout the globe. English is the language of the latest business management in the world and Indian proficiency in English has brought laurels to many Indian business managers. English is a means not only for international commerce; it has become increasingly essential for inter-state commerce and communication. Some of the states of India are witnessing popular increase in public demand for teaching of English language from the primary classes. Realizing the importance, recently, the Minister of Indian Railways, Laloo Prasad Yadav, demands teaching of English language in schools. The great demand for admission in English medium schools throughout the country is a testimony to the attraction of English to the people of India. Many of the leaders, who denounce English, send their own children to English medium schools. Many of the schools in the country have English as the sole or additional medium of instruction. A language attracts people because of the wealth of literature and knowledge enshrined in it. English poses no danger to Indian languages. The Indian languages are vibrant and are developing by the contributions of great minds using them as their vehicle of expression. English is available to us as a historical heritage in addition to our own language. We must make the best use of English to develop ourselves culturally and materially so that we can compete with the best in the world of mind and matter. English language is our window to the world. English language is one tool to establish our viewpoint. We can learn from others experience. We can check the theories of foreigners against our experience. We can reject the untenable and accept the tenable. We can also propagate our theories among the international audience and readers. We can make use of English to promote our worldview and spiritual heritage throughout the globe. Swami Vivekananda established the greatness of Indian view of religion at the world conference of religions in Chicago in 1893. He addressed the gathering in impressive English. Many spiritual gurus have since converted thousands of English people to our spirituality by expressing their thought and ideas in masterful English. English has thus become an effective means of promoting Indian view of life, and strengthening our cultural identity in the world. CONCLUSION: Generally, Standard English today does not depend on accent but rather on shared educational experience, mainly of the printed language. Present-day English is an immensely varied language, having absorbed material from many other tongues. It is spoken by more than 300 million native speakers, and between 400 and 800 million foreign users. It is the official language of air transport and shipping; the leading language of science, technology, computers, and commerce; and a major medium of education, publishing, and international negotiation. For this reason, scholars frequently refer to its latest phase as World English. Thus English is evitable. Thus English will never loose its superiority even in the next hundred years, How to cite English Importance in the Next Few Years, Papers

Multimicronutrient Supplementation and Asymptomatic

Question: Discuss about the Multimicronutrient Supplementation and Asymptomatic. Answer: Introduction: Urinary tract infection is one of the most common infections that worsen the heath status of patients in long-term hospital stay, especially for older people in ager care facilities. UTI is often associated with the catheter-related infections. In this essay, the preventable measures for the catheter related UTI would be analyzed with the help of evidences in the recently published journal resources. Based on the findings, recommendations would also be provided. Its relevance relies upon the promotion of safe catheter usage in hospitals through the implementation of new and effective measures of preventing catheter associated urinary tract infection (CAUTI) in elderly. In order to carry out the research, a series of search were applied and authentic databases were searched to access high quality research papers. The search terms were: urinary catheter, catheter related infections, hospital-acquired infection, aged population and catheter infection. The databases were PubMed, EbescoHost and Science Direct. To make the search more precise, exclusion and inclusion criteria have been applied. Research papers published in English language, within last 6years, peer-reviewed and full text articles were accessed. Boolean operators like OR, AND, NOT were applied to make the literature search more specific. Literature search generated almost 30 papers and application of Boolean operators narrowed down the search to 15 most relevant papers. Lee et al., (2015) conducted an RCT for evaluating effects of nurse-family partnership model on the occurrence of the catheter-associated UTI in 61 patients, in which the author revealed significant improved patient outcomes through nurse-family partnership (level IIa). Whereas, an implementation of the national initiative for CAUTI prevention On the CUSP: STOP CAUTI in 500 nursing homes in 50 states was done by Mody et al., (2015); the study revealed involvement of technical and socio-adaptive principles and improved leadership in nursing can be helpful in ensuring the efficacy of future initiatives for reducing other infections (level I). The effectiveness of novel silver-impregnated Foley catheter system was evaluated by Leuck et al., (2015) in a single-centre RCT trial (level IIa), revealing that the system can protect against asymptomatic bcteriuria due to gram negative bacilli infection associated with catheter usage for longer time. Schwenger, Tejani and Loewen (2015) selected 9 RCT studies to review 735 susceptible patients through medical records, however, the study did not receive any significant action of probiotics along with placebo to reduce CAUTI rate on patients (level Ia). The first initiative of no preventable harms campaign: creating the safest health care system in the world was studied by Saint et al., (2015), where a quantitative and qualitative trial of 1000 patients was done. The evaluation revealed some major areas of improvement for preventing CAUTI rate, including consideration of local policies, procedures, individualized initiatives, providing time between initiatives and involving all stakeholders along with the need for partnership with national centre for patient safety on a CAUTI collaborative initiative. Juthani-Mehta et al., (2016) reviewed an innovative intervention through a double blind RCT trial for preventing CAUTI prevalence, by administering cranberry capsules among 185 65-years old women (level IIa), but the study did not reveal a significant effect. Commission for Hospital Hygiene and Infection Prevention (KRINKO) provided recommendation for CAUTI preventive measures in hospitals. Heudorf et al., (2016) investigated the effec tiveness of the recommendations (level IV). The author investigated operations in 40 nursing homes and revealed that following the recommendations, the rate of UTI has been lowered along with lowered usage of antibiotic therapy for users of urinary tract catheter. The author reveled resistance-based antibiotic stewardship is an efficient strategy. Mulcare et al., (2015) analyzed the perceptions of care providers regarding the use of indwelling urinary catheters in older adults, by conducting a qualitative focused group study (level VI) with 38 participants and reported the overutilization of indwelling urinary catheters in emergency departments for older adults for which an evidence-based clinical protocol for IUC management can reduce CAUTI rate. Freeman-Jobson, Rogers and Ward-Smith (2016) conducted an evidence based education program to assess the effectiveness of education sessions enhancing awareness of health care staffs regarding UTI prevention by involving 42 participants and revealed improved patient outcomes with enhanced care providers knowledge (level VI). Christ-Libertin et al., (2015) conducted a pilot study for evaluating the effectiveness of evidence-based guidelines for preventing CAUTI rate in burn-injured patient population. The evidence-based guidelines helped the nurses to reduce CAUTI rate and reduced cat heter days along with significant reduction of infection incident within 248 days (level IV). Trautner et al., (2015) evaluated the effectiveness of a multifaceted guideline implementation intervention to reduce the antibiotic overtreatment to the catheter-associated ASB. The researcher emphasized on the fact that most professionals face difficulties in distinguishing between CAUTI and ASB and providing a clinical guidelines regarding diagnosis showed reduced overtreatment and unnecessary screening and improved patient outcomes compared to the standard protocol (level IIa). Mody et al., (2015) conducted a RCT study (level IIa) evaluating the effectiveness of multimodal targeted infection program (TIP) including active surveillance for MDROs, CAI, preemptive barrier precautions and staff training and the intervention reduced overall CAUTI and MDRO rates in NH residents (level IIa). In addition to the previous articles, Boekitwetan et al., (2016) evaluated the effectiveness of a significant measure, multimicronutrient supplement to reduce UTI incident in older patients, especia lly in residency care homes, by conducting a double blind RCT (level IIa), which revealed significant reduction of UTI incident caused by predominant organism E. coli in test group patients compared to the control group. Carter, Nina M., et al. (2014) reviewed existing literatures related CAUTI prevention and implemented those interventions in a 28 bed unit showing a significant reduction of catheter-associated UTI, supporting the findings of Mulcare et al., (2015) and Christ-Libertin et al., (2015) (level IV). The final article that has been reviewed represented the review of clinical cases for identifying the effective interventions to reduce CAUTI rates in patients. The article revealed the use of fixation devices can enhance patient satisfaction rate along with reduction of care cost (Holroyd, 2016). From the above fifteen articles, several unique and effective interventions has been found which can be recommended for reducing the rate of CAUTI in the health care settings. Boekitwetan et al., (2016) recommended the multimicronutrient supplement as a prevention measure of CAUTI in older adults, as it has been seen that opportunistic pathogens are predominant in CAUTI incidents, which are raised due to reduced immunity of older patients, thus, multinutrient supplement would help older patients to improve immunity reduce the opportunity for infection. On the other hand, several articles revealed the importance of care providers knowledge and skills for using catheter, which reduces the replacement of catheter and reduces the recurrence of infection due to infrequent replacement of catheter tube (Christ-Libertin et al., 2015). The importance of staffs training and knowledge is always important for enhancing the quality of health care services provided to the catheter users. All the articles indicated the high rate of CAUTI rate in older patients and represented different strategies for controlling or preventing the incident of CAUTI rate in patients, who are in long term care. One study presented the use of fixation devices in catheterization. It showed improved patient outcomes with enhanced patient and health care staffs satisfaction. Thus, this strategy can be recommended to be used in the hospitals or residential care homes for patients with catheters. The author presented one innovative device known as Ugo Fix gentle, which is a purpose-designed medical device that is used for fixing and supporting patient catheters at the catheter bifurcation. It can be recommended in the hospitals to be used in the case of long-term patients, as its use has shown reduced risk of CAUTI, trauma and reduced discomfort due to catheter pulling or rubbing the urethra. It is evident that catheterization is significantly discomfortable for patients, as it increases pain and difficulties in moving; thus using this fixative device would enhance patients comfort and improve the overall health status (Holroyd, 2016). Moreover, the articles also highlighted the importance of following proper guidelines in handling, inserting and removing catheter from the patient. It has been revealed that inefficient handling of catheter increase pain, discomfort and incident of CAUTI in older and long-term patients. Reviewing the above literature, another recommendation for the nursing staffs was revealed that is, the nurses or other medical staffs should be able to distinguish between the ASB and CAUTI, as the screening period is responsible for worsening the CAUTI symptoms in patients. All the articles showed the scope of implementation in new Zealand nursing care, as in most cases, the primary data were revealed along with the review of evidence based practices. However, in one article by Schwenger, Tejani and Loewen (2015) did not revealed relevant results that can be applicable in New Zealand nursing setting. From the above literature review, it has been revealed that there are several significant strategies for preventing CAUTI incident in the older patients in long term care, but further research regarding the best fixative device and the details of multimicronutrient required for preventing the CAUTI incident is required. Reference List Boekitwetan, P., Surjawidjaja, J. E., Aidilfit, M., Lesmana, M. (2016). Multimicronutrient supplementation and asymptomatic urinary tract infections in the elderly. Universa Medicina, 28(1), 25-33. Carter, Nina M., et al. (2014) "An evidence-based approach to the prevention of catheter-associated urinary tract infections." Urologic Nursing, p. 238+. Academic OneFile, Christ-Libertin, C., Black, S., Latacki, T., Bair, T. (2015). Evidence-based prevent catheter-associated urinary tract infections guidelines and burn-injured patients: a pilot study. Journal of Burn Care Research, 36(1), e1-e6. Freeman-Jobson, J. H., Rogers, J. L., Ward-Smith, P. (2016). Effect of an education presentation on the knowledge and awareness of urinary tract infection among non-licensed and licensed health care workers in long-term care facilities. Urologic nursing, 36(2), 67-72. Heudorf, U., Gasteyer, S., Mller, M., Samoiski, Y., Serra, N., Westphal, T. (2016). Prevention and control of catheter-associated urinary tract infectionsimplementation of the recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) in nursing homes for the elderly in Frankfurt am Main, Germany. GMS Hygiene and Infection Control, 11. Holroyd, S. (2016). Innovation in catheter securement devices: minimising risk of infection, trauma and pain. British journal of community nursing, 21(5). Juthani-Mehta, M., Van Ness, P. H., Bianco, L., Rink, A., Rubeck, S., Ginter, S., ... Quagliarello, V. (2016). Effect of Cranberry Capsules on Bacteriuria Plus Pyuria Among Older Women in Nursing Homes: A Randomized Clinical Trial. JAMA. Lee, K. C., Chao, Y. F. C., Wang, Y. M., Lin, P. C. (2015). A nursefamily partnership intervention to increase the self?efficacy of family caregivers and reduce catheter?associated urinary tract infection in catheterized patients. International journal of nursing practice, 21(6), 771-779. Leuck, A. M., Johnson, J. R., Hunt, M. A., Dhody, K., Kazempour, K., Ferrieri, P., Kline, S. (2015). Safety and efficacy of a novel silver-impregnated urinary catheter system for preventing catheter-associated bacteriuria: A pilot randomized clinical trial. American journal of infection control, 43(3), 260-265. Mody, L., Krein, S. L., Saint, S., Min, L. C., Montoya, A., Lansing, B., ... Rye, R. A. (2015). A targeted infection prevention intervention in nursing home residents with indwelling devices: a randomized clinical trial. JAMA internal medicine, 175(5), 714-723. Mody, L., Meddings, J., Edson, B. S., McNamara, S. E., Trautner, B. W., Stone, N. D., ... Saint, S. (2015). Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes. Clinical Infectious Diseases, 61(1), 86-94. Mulcare, M. R., Rosen, T., Clark, S., Scherban, B. A., Stern, M. E., Flomenbaum, N. E. (2015). Provider perspectives on the use of indwelling urinary catheters in older adults in emergency department settings: Developing a novel clinical protocol. American journal of infection control, 43(4), 341-347. Saint, S., Fowler, K. E., Sermak, K., Gaies, E., Harrod, M., Holland, P., ... Krein, S. L. (2015). Introducing the No Preventable Harms campaign: Creating the safest health care system in the world, starting with catheter-associated urinary tract infection prevention. American journal of infection control, 43(3), 254-259. Schwenger, E. M., Tejani, A. M., Loewen, P. S. (2015). Probiotics for preventing urinary tract infections in adults and children. The Cochrane Library. Trautner, B. W., Grigoryan, L., Petersen, N. J., Hysong, S., Cadena, J., Patterson, J. E., Naik, A. D. (2015). Effectiveness of an antimicrobial stewardship approach for urinary catheterassociated asymptomatic bacteriuria. JAMA internal medicine, 175(7), 1120-1127.

13 Essential Editing Tips to Use in Your Essay Writing

It can be a challenge to find ways to keep improving, but one way of making your essays instantly better is effective editing. Editing your essay before you submit it could mean the difference between a good grade and a brilliant one, so it’s worth taking fifteen minutes or so before you send it off just checking through it to make sure that the structure and wording is as good as it can be. In this article, we give you some tips to think about when you’re editing your own writing. Keep these tips alongside you to use as a checklist and you can’t go far wrong! 1. Start by getting the structure right Unlike a house, an essay can be rearranged even after you’ve put it together. If you have time, try to leave a bit of time between finishing your essay and starting the editing process. This gives you time to approach it feeling reasonably fresh; if you edit immediately after spending a long time on something, you might find that you’re so close to it that you’re unable to spot errors. When you do sit down to look through it, start by looking at its structure. Think about the overarching shape of the argument you’re developing and check that the points you’ve made help build your essay towards a logical conclusion. You may have written an essay with the points in order of when they occurred to you, but is this really the most sensible order? Does one point follow logically on from the other? Would it make the essay more interesting to include a certain point near the beginning to tease the reader, or are you revealing too much in the opening, meaning it would be better to move some points nearer the end? These are just a few of the ways in which it might be possible to improve the structure, so it helps to keep in mind your overall argument and ensure your structure puts it across as effectively as possible. With word processors now the primary means of writing essays, it couldn’t be easier to rearrange paragraphs into a more logical structure by dragging and dropping or cutting and pasting paragraphs. If you do this, don’t forget to reread the essay to ensure that the wording works with this new order, otherwise you may end up with a sentence leading into the wrong paragraph. 2. Prune long sentences and paragraphs The perfect essay is like a bonsai tree – trimmed down to just the right size. Whether you’ve exceeded your word count or not, long sentences and paragraphs should be edited because they can be trickier to read, and risk being boring or hard to follow. Try, therefore, to keep sentences to a maximum of two or three clauses (or segments). Avoid long paragraphs by starting a new one if you find one getting longer than three or four sentences: a wall of text can be off-putting to the reader. Leave a space between paragraphs if you’re typing your essay, as we’re doing in this article. Another way of keeping sentences to a reasonable length is to go through what you’ve written and tighten up the wording. If you find yourself writing long sentences, try to look for ways in which you can reword them to express what you’re trying to say more concisely. You’ll probably find numerous instances of phrases that take many words to say what could be said in two or three. 3. Keep overly complicated language in check It’s going to look obvious if you’ve had a thesaurus next to you while writing, just so that you can replace all the simple words with more complicated ones. The thing is, it doesn’t always make you look intelligent; you may, for instance, inadvertently choose the wrong synonym, not realising that even close synonyms can have subtly different meanings or connotations. Sometimes using big words where simple ones would suffice can seem contrived and pompous; aim for clear, concise language to avoid being verbose or pretentious. That’s not to say you shouldn’t use more complex words at all – just choose the situation carefully and don’t overdo it. 4. Watch for repetition of ideas and words Avoid repeating yourself. It’s easy to repeat yourself without realising it when you’re writing, but the editing process is there to enable you to spot this before your teacher or lecturer sees it. As you read through your essay, keep a look out for ideas you’ve repeated and delete whichever repetitions add nothing to your essay (don’t forget that the first instance of the idea may not be the most appropriate place for it, so consider which is the best moment to introduce it and delete the other mentions). On a related note, look out for instances in which you’ve laboured the point. Going on about a particular point for too long can actually undermine the strength of your argument, because it makes you look as though you’re desperately grappling to find supporting facts; sometimes a simple, clear statement with a brief piece of evidence to back it up is all that’s needed. You should be equally wary of repetition of words within the same sentence or paragraph. It’s fine to repeat common words such as â€Å"the†, obviously, but it’s best to avoid using the same connecting words, such as â€Å"also†, more than once in the same paragraph. Rephrase using alternative expressions, such as â€Å"what’s more†. More unusual words should be used just once per paragraph – words such as â€Å"unavoidable†, for example – unless it’s for emphasis. 5. Don’t rely on the spellcheck It’s a tip we’ve told you before, but it’s worth repeating because it’s very important! The spellcheck will not pick up every single error in your essay. It may highlight some typos and misspellings, but it won’t tell you if you’ve inadvertently used the wrong word altogether. For example, you may have meant to write the word â€Å"from†, but accidentally mistyped it as â€Å"form† – which is still a word, so the spellchecker won’t register it. But it’s not the word you meant to write. 6. Spotting typos Printing something out in order to edit it can help you spot mistakes. It’s said that if you read through your work backwards, you’re more likely to spot typos. This is probably because it’s giving you a new perspective on what you’ve written, making it easier to spot glaring errors than if you read through it in the order in which you wrote it and in which you know what to expect. So, start with the last sentence and keep going in reverse order until you get to the beginning of your essay. Another tip is to print out your essay and take a red pen to it, circling or underlining all the errors and then correcting them on the computer later. It’s often easier to read a document from a printed version, and it also means that you can follow what you’re doing by touching each word with the end of your pencil to make sure you’re not skimming over any errors. 7. Omit unnecessary words and eradicate weasel words Without even realising it, you’ve probably used plenty of unnecessary words in your writing – words that add to the word count without adding to the meaning – and you’ll find that your writing works just as well without them. An example is the word â€Å"very†, which almost always adds nothing to what you’re trying to say. As Mark Twain said, â€Å"Substitute ‘damn’ every time you’re inclined to write ‘very’; your editor will delete it and the writing will be just as it should be†. Weasel words are worse, as they are used to hide weak or objectionable arguments. A study of Wikipedia found that these tend to fall into three different categories: numerical vagueness (such as â€Å"many people say† without specifying who these people are), the use of the passive voice to distance the writer from what they’re saying (â€Å"it is often said†, for example, without saying by whom it is often said), and the use of adverbs designed to soften a point (such as â€Å"probably†). Look out for these in your own writing and rephrase to remove them; they are disingenuous and your essay will be stronger without them. 8. Remove tautologies Also, ‘big’ is quite an unimpressive adjective. A tautology is a stylistic error involving redundant words, in this case the use of two consecutive words that mean the same thing, such as â€Å"the big giant† (referring simply to a â€Å"giant† would have been sufficient to convey the meaning). Students often use them when they’re trying to make their writing wordier, not realising that they simply make their writing worse. 9. Watch the commas People tend either to put too many commas into a sentence, or too few. Too many, and the sentence sounds broken and odd; too few, and the reader has to read the sentence several times to figure out what you’re trying to say, because it comes out in a long, jumbled mess. The secret is to put commas in where you would naturally pause when speaking aloud. If it helps, try reading your writing aloud to see if it flows. Where you would pause for slightly longer, a semi-colon might be more appropriate than a comma. Use a semi-colon to connect two independent clauses that would work as two separate sentences. 10. Consistent spelling Some words have more than one correct spelling, and the important thing is to be consistent with which one you use. You could, if you wanted to make your life a little easier, delve into the settings on your word processor and manipulate the spellcheck so that it highlights the version you decided against – or even autocorrects to the right version. If you’re writing in the UK, ensure that your word processor’s default language is set to UK English so that you don’t end up inadvertently correcting English spellings to US ones (â€Å"colour† to â€Å"color†, for example). 11. Get rid of exclamation marks and ellipses If you use lots of exclamation marks, be aware that this is how your readers will picture you. In virtually every case, you don’t need to use an exclamation mark, and – at least in academic writing – your use of one may result in your writing not being taken quite so seriously. Only use them in exceptional circumstances when you really want to convey a feeling of surprise or outrage. Ellipses (â€Å"†¦Ã¢â‚¬ ) should also be avoided except when you’re indicating the truncation of a quote from another writer (that is, where you left a bit out). 12. Attribute quotations Quotations from authors or academic writers should be attributed to them. As you read through your essay, keep a look out for any quotations you’ve mentioned and make sure that you say where they’re from. If you’re writing an essay for university, a footnote would be an appropriate way of citing another writer. If you are using footnotes, this gives an extra area on which to focus your editing skills; ensure that all footnotes are consistently formatted, and don’t forget to put a bibliography containing all the books you’ve used at the end. 13. Consistent formatting There’s no reason to have bad formatting when you’re using a computer. The appearance of your essay matters, too – and the formatting should not be neglected when you’re in editing mode. This means being consistent with your use of fonts, using italics or underline for emphasis rather than using them interchangeably, ensuring that the spacing between lines is consistent throughout, and other such minor aesthetic points. This may not sound very important, but consistent formatting helps your essay look professional; if you’ve used different fonts or line spacing or anything like that, your essay will look a mess even if what you’ve said in it is good. You could make use of the pre-populated formatting options in your word processor to ensure consistency throughout, with header 1 for the title, header 2 for subheadings and ‘normal text’ for the body of the document. If you find that there are too many things on this list to think about in one go when you’re reading through your essay, you could read through it several times looking out for different things each time. All this may seem a lot to think about when you’ve already put in so much effort to write the essay in the first place, but trust us: it will pay off with a sleek and polished piece.

The MBA Thesis for Graduate Students Essay Example

The MBA Thesis for Graduate Students Essay Example The MBA Thesis for Graduate Students Essay The MBA Thesis for Graduate Students Essay Essay Topic: Thesis MBA treatise And Communication Activity a MBA treatise sometimes takes the attribute of communication, disagreeable to persuade others that you change a dianoetic stand on the issue you are perusal. In MBA theses, action assignments oftentimes enquire you to achieve a coaxing casing graphic. You are questionable to sway the MBA theses clergyman of what your characteristic is which you deprivation to compose. This attribute of affect, oftentimes titled educational argumentation, follows a accepted activity in MBA treatise activity. MBA Explore Treatise Activity Activity MBA treatise starts with Debut. Aft a instrument debut of your case, you attribute your stand on the case direct and unremarkably in ace condemn. This condemn is the treatise evidence, and it gives a abstract of the argumentation you’ll achieve in the breathe of your MBA treatise. 1. Debut This is a broad activity to what the MBA treatise is each active; it is not conscionable a statement of the list of apiece component. 2. Backcloth Collection (elective) A abbreviated component gift backcloth collection hawthorn be needful, especially if your chore spans cardinal or often accepted fields. 3. Explore Ask or Difficulty Evidence It states a instrument evidence of the ask that your MBA theses tackles 4. Lit Accounting This location of the MBA explore treatise is oftentimes many accessible benign. It hawthorn acquire ace or various sections and subsections. 5. Epistemology This component includes the methods of inquiry old in the MBA theses. E.g., interviews, surveys, reports etc. 6. Findings or Results This is component of MBA theses where we investigate the results base in Lit examination component. 7. Conclusions The MBA explore Essay editing treatise unremarkably covers 4 things in the conclusions area, and apiece of these unremarkably merits a abstracted section: Conclusions Unofficial Approaching Explore Deduction 8. References The database of references in MBA Research papers theses is nearly bound to the lit examination. About examiners have your database of references looking the big activity in the country, so our MBA treatise group takes bound they are catalogued.

ICT's & strategic change-master level Essay Example | Topics and Well Written Essays - 2250 words

ICT's & strategic change-master level - Essay Example The original intention use of social media networking is to socializing but it is has exploited by organizations as a mean of information communication technology ICT’s for strategic change. This exploitation of social media networking is consequence of unintended use of IS application. ICT’s & the Strategic Change Drivers: Organization Perspective Jansen et al (2010) investigated the relationship between information sharing on social media and user’s behaviors, they found that the more users involved in social media application the more is their ability to act on these opinion sharing and knowledge they received. The Drivers of Organization behind Employing Social Media Application In theory, any organization is part of external environments, interconnected to other organizations and external environment which is known as ‘the organization as a system’ (Senior &Fleming, pp.6, 2006). The Organization, as a system theory, is not in isolation but a pla ce in the external environment where it receives its input from the external environment and produces their output to the environment. This implies the interrelation and influence of an organization on each other’s and the influence of the external environment in border context. ... The Game theory helps us to understand our organization and our competitors, the theory has been derived from the art of war based on ‘thus, it is said that one who knows the enemy and knows himself will not be endangered in a hundred engagements. One who does not know the enemy but knows himself will sometime be victorious, some time meet with defeat. One who knows neither the enemy nor himself will invariably be defeated in every engagement’ (Day & Reibstein , 2004). By understanding the different theories related to the organization and the dynamic external environment that will help us to understand the need for strategic change. Many sounds theory emphasized that any organization is not island of isolation but further more is placed in dynamic environments with many other organizations. Therefore the need to understand this environment is matter along with understanding other organization in another word the ‘competitors’. In the case of UK government, employing some framework would be good to analyze and understand the dynamic environment in which the organization placed. I will apply two framework here which are SWOT analysis and Porter framework. SWOT The basic strength of the UK government is its resiliency and the government structure in itself. The vast resources that have been accumulated in the past several hundred years is a testament to the resiliency of the UK government. The ICT of the UK in general gives an edge over all the other European countries. The weakness from my point of view of the UK government is the red tape that abounds the government offices. This weakness is borne from the different controls needed to safe guard the interest of the public. The opportunity that is

Behavioval Science and Human Relations Term Paper

Behavioval Science and Human Relations - Term Paper Example It is considered that each of these internal systems possess specific control behaviors. It is assumed that the probabilities of transition between these internal states predict human behaviors in varying social contexts. The trends in these interstate transitions are calibrated and hierarchically organized by behavioral scientists to understand long term and short term human behaviors. It is these two ranges of behaviors which makes the foundation for human behavior and human relations. Such a modeling of human behavior can be helpful in many ways. These models can be used to develop human-machine systems which can assess and recognize human behavior. This could even be used to predict human behavior. Here the requirement is to have inputs for this system on the internal human states. However, the challenge here is that these human states are not readily observable. These internal states are to be estimated through an indirect estimation process. There are several researches on beha vioral science which has led to the designing of models which can estimate these internal human states. For instance, Pentland & Liu (199) has used a model termed Hidden Markov Model (HDD) to undertake this assessment and were able to recognize human driving behaviors and predict the pattern of human control states. It has been claimed that they were able to do accurate predictions and anticipate human behavior even up to few seconds in future. Behavioral science uses several human systems to analyze human behavior and relations. It has been recorded that human behaviors like speech, handwriting and hand gestures can be precisely recognized through some of the assessment models(Pentland & Liu, 1999). However, very detailed properties like smoothness and continuity are required to go up to the level of accurate simulation and prediction. Sharper models are required to capture the additional properties of smoothness and continuity. The application of these behavioral models in managem ent is based on the basic theory that every employee moves within his own unique system of human behavior. These are further influenced by the cultural, environmental and the experience based conditioning of each individual. It is important to understand these factors as it is these factors which make an individual to react in a particular when it comes to human relations. Thus it is important in management to understand these factors. It is these factors which constitutes that particular individual’s behavioral system. Thus if one could identify the factors within the behavioral system of an individual, the management will be in a position to predict that individual’s response in a given situation. The Human Relations approach The consideration of human behavior and elementary drivers of human behaviors in management has evolved as different school of thought in management, which is termed to be the human relations approach (Likert, 1961). This school of thought is ho wever, contradictory to the conventional management concepts. While the conventional management theories rely on rationalizing of management processes, the human relations approach leaves ample space for human behavior and emotions within in management. In simpler words, classical theories of management quantify work and work routines through tangible markers whereas the human relations approach accommodates emotional and relational needs of individuals

Assignment Example | Topics and Well Written Essays - 1750 words - 1

Assignment Example In cyanobacteria, strains with a clock period length that matched the environmental photoperiod outgrow strains with no clock or with an out of phase period length in competitive culture conditions (Woefle et al., 2004). This does gesture to the probability of the clock being an important evolutionary step that allowed survival of early organisms. Circadian rhythms can influence sleep-wake cycles, hormone release, body temperature and other important intrinsic functions. Organization and function Function: The main principle of circadian clocks is oscillatory gene activation. The initial gene activation is regulated by the last one in the sequence, making up an auto-regulatory feedback loop that lasts about 24 hours. That is, feedback loops of transcription and translation, whereby the protein product of a clock gene will indirectly shut off its own expression. Such feedback loops are controlled and probably lengthened by post-translational modifications of most proteins involved (Ha rms et al., 2004) Organization: They have three major components: 1) A central oscillating mechanism with a period of about 24 hours. 2) Several output pathways associated with distinct phases of the oscillator. These control the activities of the organism. 3) Several input pathways to this central oscillator to allow programming of the circadian clock. Metazoans possess circadian clocks in most cells of the body. Each of these clocks is autonomous (Welsh et al., 1995). This means that each of the cells has to be entrained autonomously as well. But, since the oscillations of the clocks are roughly 24 hours in length, there has to be a form of synchronization. In the case of direct light entrained organisms, such as the drosophila, this entrainment occurs in cells independently (Plautz et al.,1997) (Whitmore et al., 2000). In drosophila, the Drosophila ring gland and Malpighian tubules show some sort of rhythms. This autonomous cell entrainment may also be seen in higher organisms wh ere the parasympathetic system is responsible for entrainment (Ishida et al., 2005). It is itself entrained by the central master clock. In higher organisms, the process is more complex and requires what is known as hierarchical entrainment. This is discussed below. In higher organisms such as man, the entrainment of the clock is hierarchical. This is similar to most other vertebrates. In mammals, the suprachiasmic nucleus acts as the main/master clock. It is a paired neuronal structure located at the base of the hypothalamus. It is just above the optic chiasm/bifurcation (Klein et al.1991). It facilitates entrainment and synchrony of all other tissues by direct and indirect methods. These include use of hormones, temperature regulation, feeding regulation and metabolism. The suprachiasmic nucleus undergoes entrainment by relation with the optic apparatus via optic tract. This is the retionohypothalamic tract (Ben-Schlomo and Kyriacou, 2002). The SCN consists of a mixed population o f neuronal and glial cells, but which types of cells might be capable of acting as circadian oscillators is presently unknown . Since they are autonomous in function, several theories have been proposed as to their synchronization. One is the synchrony of circadian rhythm due to production of melatonin by the pineal gland. It

Impact of obesity on womens health during pregnancy

Impact of obesity on womens health during pregnancy Obesity is a clinical term used to describe excess body fat. The most common method of measuring obesity is the Body Mass Index (BMI). BMI is used because, for most people, it correlates with their amount of body fat. It is calculated by dividing a persons weight measurement (in kilograms) by the square of their height (in metres). a BMI of 30 or above means that person is considered to be obese (DoH, 2010). Rising rates Obesity is an increasing phenomenon worldwide. In 2008, the Health Survey for England (HSE) data showed that 61.4% of adults (aged 16 or above) in England were overweight and of these 24.5% were obese. They found this was an increase since 1993. In pregnancy- In pregnancy the incidence is around 18-19% in the United Kingdom (Kanagalingam et al, 2005). Between 2004 and 2007, 15% of all UK maternal deaths occurred in women with a BMI of more than 35, half of which had a BMI of over 40. Fifty-two per cent of deaths occurred in women with a BMI of over 25, which is classed as over-weight (Lewis, 2007) Dangers and complications- Obesity is a common risk factor in many conditions, especially metabolic (e.g. type 2 diabetes), circulatory (e.g. cardiovascular disease) and degenerative (e.g. osteoarthritis). For women, the risk of gynaecological complications, like endometrial cancer, infertility, menstrual disturbances and ovulation disorders, increase if the woman is obese. There are many significant risk factors during pregnancy that are affected by obesity. These include early miscarriage, gestational diabetes and pregnancy hypertension/pre-eclampsia (Andreasen et al, 2004/Duckitt et all, 2005/Erez-Weiss et al, 2005/Shaw et al, 2000), venous thromo-embolism and anaesthetic problems, e.g. tracheal intubation or epidural/spinal insertion (Irvine et al, 2006). If maternal complications develop the fetus/neonate is also at risk of neural tube defects (Shaw et al, 2000), late still birth (Irvine et al, 2006) and neonatal death (Kristensen et al, 2005), fetal macrosomia (Yogev et al, 2005), fetal trauma and neonatal unit admissions (Irvine et al, 2006). Obesity also causes issues pertaining to the value and reliability of certain aspects of care during the antenatal period. These include difficulties in performing amniocentesis (Irvine et al, 2006), difficulties in achieving venous access, difficulties in performing abdominal palpation (Farrell et al, 2002) and difficulties obtaining ultrasound data for fetal anomalies and growth (Martinez-Frais et al, 2005). There are significant risk factors due to obesity during the intrapartum period. These comprise increased rates of prolonged labour (Vahratian et al, 2004), risks associated with macrosomia e.g. shoulder dystocia (Irvine et al, 2006/Andreasen et al, 2004), increased rates of operative birth (Irvine et al, 2006/Fraser, 2006), especially for primigravida (Dempsey et al, 2005), difficulties in undertaking instrumental and operative procedures (Irvine et al, 2006/Andreasen et al, 2004) and difficulty siting an epidural or spinal for labour or caesarean section (Irvine et al, 2006). Postpartum related obesity issues consist of longer post-operative recovery times and increased rates of post-operative complications, e.g. infections of wounds and urinary tract (Irvine et al, 2006). Women who are obese during pregnancy exhibit a tendency to retain fat centrally on their abdomens postnatally, which may results in increased morbidity and mortality later in life (Soltani et al, 2002). Contraception choices will also be influenced by the presence of complications. Whilst out on my community placement, I was involved in the care of a woman who had a BMI of 52. We were caring for her postnatally after an elective caesarean section. Most likely due to her weight, the surgeon chose to use metal skin clips on her wound, rather than a suture (Irvine et al, 2006). On day five postnatally we were due to remove alternate staples. However, we could see the wound was still gapping and not fused closed so we left them for one more day. On day six we returned and removed the alternate clips with no problem. Irvine et al (2006) recommend an interrupted suture or skin clips on the basis that if a small haematoma or a localised area of infection develops, a few clips/sutures can be removed to aid resolution. When we revisited the woman on day eight, we found the wound to be very red, oozing puss and giving off a very offensive smell. The woman simply could not get any air to the wound, due to the over-hang of her stomach on to the wound. Even whilst lying down, the stomach still covered the area if it was not held up and supported. I feel this was an important factor to her getting a wound infection. Due to the over hanging of the pannus, women are significantly at increased risk of wound infection even if given postoperative prophylactic antibiotics (Irvine et al, 2006). Discuss differing health promotion strategies according to context of the case study Obesity levels in England have currently reached epidemic levels and Suffolk is consistent with this. Suffolk is below the average obesity level, but this varies across the county (Transforming Suffolk, 2008). A new project has been launched, called Healthy Ambition Suffolk to make Suffolk the healthiest county in the UK by 2028. Part of this includes tackling obesity. Governments 5 a day scheme In January 2009, the Government began a campaign in response to the rising rates of obesity. Change4Life is Englands first ever national social marketing campaign to promote healthy weight and supports the overall Healthy Weight, Healthy Lives strategy. One of Change4Lifes recommendations is to eat 5 A DAY as part of a healthy balanced diet (DoH, 2010). Eating at least five portions of fruit and vegetables everyday seems valuable, however it is hard to see exactly how this will help with the fight against obesity, unless it is thought that consuming more fruits and vegetables will transfer calories from other sources. Healthy start vouchers The Government has also introduced another health promotion strategy called Healthy Start. This consists of vouchers with a monetary value which can be used against fresh fruit and vegetables, fresh milk and also infant formula. Not every woman will be able to claim these, they are income assessed and women need to fit certain criteria (DoH, 2006). Dietian/nutritionalist referrals In accordance with the National Institute for Health and Clinical Excellence (NICE, 2010), pregnant women with a body mass index of more than 30 will be under consultant led care and receive any additional care they require. Midwives should refer women to a dietician for assessment and advice on healthy eating and exercise. However, they should not recommend weight-loss during pregnancy (NICE, 2008). In 2003, a report on obesity by the House of Commons demanded six other government departments joined forces. These departments were: Department of health: Main responsibility as obesity is a public health issue. Department of culture, media and sport: For promoting sports and physical activity. Department for education and skills: To ensure that children get adequate physical education at schools and have access to food at schools. Department for transport: For making healthy transport policies to encourage cycling and walking. Department of environment, food and rural affairs: For farming and produce of healthy food. Department of trade and industry: For food manufacturing and retail industry Analyse concepts of poverty, disadvantage and inequality and the impact on childbearing women, babies and their families. There is evidence that maternal obesity is related to health inequalities, particularly socioeconomic deprivation, inequalities within ethnic groups and poor access to maternity services (Heslehurst et al 2007). Healthy food is often more expensive and gyms facilities and fitness classes are not readily available for low income families. Analyse and reflect upon the role of the midwife and other professionals in their contribution to the public health agenda The Faculty of Public Health define public health as the science and art of preventing disease, prolonging life and promoting health through organised efforts of society (Acheson, 1988). Public health is about promoting physical, mental or emotional well-being by inspiring, educating and empowering the public to stay healthy (CSP, 2010). Midwives play a very important role in achieving this. When initially booking women for their pregnancy care, if there are any health concerns the midwife should advise and refer to other health professionals if necessary. The role of the midwife has evolved in recent years with more emphasis on a public health role (DoH, 1993). It is reasonable to expect that midwives should have a working knowledge of the effects obesity, as well as other common public health issues, including teenage pregnancy, drug and alcohol abuse and smoking. They should have an understanding of the common risks associated with obesity and what they should be able to offer by way of support (English National Board, 2001). The Saving Mothers Lives report (2003-2005) carried out by the Confidential Enquiry into Maternal and Child Health (CEMACH) recommends that obese women should receive help to lose weight prior to conception. However, this is not always possible. I believe the Government are currently taking the correct steps to combat obesity. Whilst working on community and undertaking booking appointments, I have not actually seen women being referred for high BMIs. This is due to my Trust not taking a womans height and weight at the booking appointment so their BMI is unknown. These details are recorded when the women go for their 12 week dating scan. Therefore, referrals for high BMIs are carried out from the antenatal clinic. As midwives, we are used to managing women with complex needs in partnership with other agencies. I believe it is working within the multi-disciplinary team which gives the best care to women. The Royal College of Midwives (RCM) surveyed midwives and new mothers, which were published during Midwifery Week 2008. They showed that due to the shortage of midwives women are being short-changed on essential public health services and advice and are not getting the level and quality of service needed in areas such as obesity, smoking cessation, breast feeding and alcohol intake. The level of help that obese pregnant women are receiving is a cause for concern. Only 8% of women were offered help and advice, while the amount of women who said they would have liked to have had the service was 30%. The midwives surveys supported these findings, with only a fifth (22.5%) stating that they are able to offer or run obesity clinics, and 71% saying their Trust do not run them (RCM, 2008).

james madison Essay -- essays research papers

James Madison begins his famous federalist paper by explaining that the purpose of this essay is to help the readers understand how the structure of the proposed government makes liberty possible. Each branch should be, for the most part, in Madison's opinion, independent. To assure such independence, no one branch should have too much power in selecting members of the other two branches. If this principle were strictly followed, it would mean that the citizens should select the president, the legislators, and the judges. But, the framers recognized certain practical difficulties in making every office elective. In particular, the judicial branch would suffer because the average person is not aware of the qualifications judges should possess. Judges should have great ability, but also be free of political pressures. Since federal judges are appointed for life, their thinking will not be influenced by the president who appoints them, or the senators whose consent the president will s eek. Madison furthers, the members of each branch should not be too dependent on the members of the other two branches in the determination of their salaries. The best security against a gradual concentration of power in any one branch is to provide constitutional safeguards that would make such concentration difficult. The constitutional rights of all must check one man's personal interests and ambitions. We may not like to admit that men abuse power, but the very need for government itself proves they do, "if men were angels, no government would be necessary." Unfortunately, all men are imperfect, the rulers and the ruled. Consequently, the great problem in framing a government is that the government must be able to control the people, but equally important, must be forced to control itself. The dependence of the government on the will of the people is undoubtedly the best control, but experience teaches that other controls are necessary. Dividing power helps to check its growth in any one direction, but power cannot be divided absolutely equally. In the republican form of government, the legislative branch tends to be the most powerful. That is why the framers divided the Congress into two branches, the House of Representatives and the Senate, and provided for a different method of election in each branch. Further safeguards against legislative tyranny may be neces... ...ports: Partition of powers Each Department  · Should have a will of its own  · Thus members of each should have little to do with appointments of members of the other  · Member of each should be as little dependent as possible of the others for the emoluments annexed to their offices. In framing a government 1. government needs to control the governed 2. government needs to control itself Each department should have different amounts of self-defense because some departments need it more than others. Ex. Repersentative government legislative huge – divided into subgroups. Two considerations:  · Single - All the power surrendered by the people is submitted to the administration of a single government. Compound – power first divided by two distinct governments and then each portion subdivided among separate departments.  · Guard society not only of oppression of its rulers, but also injustice of the other part. Need to guard minorities. Keeps people from just electing someone on a whim. james madison Essay -- essays research papers James Madison begins his famous federalist paper by explaining that the purpose of this essay is to help the readers understand how the structure of the proposed government makes liberty possible. Each branch should be, for the most part, in Madison's opinion, independent. To assure such independence, no one branch should have too much power in selecting members of the other two branches. If this principle were strictly followed, it would mean that the citizens should select the president, the legislators, and the judges. But, the framers recognized certain practical difficulties in making every office elective. In particular, the judicial branch would suffer because the average person is not aware of the qualifications judges should possess. Judges should have great ability, but also be free of political pressures. Since federal judges are appointed for life, their thinking will not be influenced by the president who appoints them, or the senators whose consent the president will s eek. Madison furthers, the members of each branch should not be too dependent on the members of the other two branches in the determination of their salaries. The best security against a gradual concentration of power in any one branch is to provide constitutional safeguards that would make such concentration difficult. The constitutional rights of all must check one man's personal interests and ambitions. We may not like to admit that men abuse power, but the very need for government itself proves they do, "if men were angels, no government would be necessary." Unfortunately, all men are imperfect, the rulers and the ruled. Consequently, the great problem in framing a government is that the government must be able to control the people, but equally important, must be forced to control itself. The dependence of the government on the will of the people is undoubtedly the best control, but experience teaches that other controls are necessary. Dividing power helps to check its growth in any one direction, but power cannot be divided absolutely equally. In the republican form of government, the legislative branch tends to be the most powerful. That is why the framers divided the Congress into two branches, the House of Representatives and the Senate, and provided for a different method of election in each branch. Further safeguards against legislative tyranny may be neces... ...ports: Partition of powers Each Department  · Should have a will of its own  · Thus members of each should have little to do with appointments of members of the other  · Member of each should be as little dependent as possible of the others for the emoluments annexed to their offices. In framing a government 1. government needs to control the governed 2. government needs to control itself Each department should have different amounts of self-defense because some departments need it more than others. Ex. Repersentative government legislative huge – divided into subgroups. Two considerations:  · Single - All the power surrendered by the people is submitted to the administration of a single government. Compound – power first divided by two distinct governments and then each portion subdivided among separate departments.  · Guard society not only of oppression of its rulers, but also injustice of the other part. Need to guard minorities. Keeps people from just electing someone on a whim.

A Framework for Sustainable Port Security Essay

This research was conducted to determine the best ways in which United States can protect its ports which are the main source of economic connection with the world from terrorist attacks. The research question that implies here is; How important ports are for the U. S economy? And what measures can be taken to protect ports from terrorist attacks without affecting the economic activities? Is there a hypothesis or thesis or central argument that is clearly stated or implied? If so, what is it? The central argument was clearly portrayed and it depicted that even though a port may be viewed as a collection of assets but the port actually is a complex system consisting of loosely coupled sub systems, Secondly importance of organizational interrelationships that must exist in order to avoid the acts of terrorism and difficulties in bringing together the private and public entities that have a stake in port security system and finally the negative impact on economy that might occur due to port security interventions must be understood and curtailed. Does the Author answer the â€Å"So what? † Were you convinced that the study was worth doing? The research provided a brief sketch of how terrorist threats should be dealt with and it demonstrated how set of security interventions can be classified in respect of how they will affect the economy. It also identified that the primary aim of terrorist is to hurt our economic viability of ports and maritime systems. So security measures should be designed in a way that they do not harm the economy. Is the study unique in any way? The study was unique in a way that it defined the weakness; differ in threat, type of attack and potential consequences of each subsection separately implying that risk reduction intervention should be different for each sub system. The system was divided into four sub systems which are as follows: †¢ Containerized cargo †¢ Petrochemical cargo †¢ Bulk cargo †¢ Ferry passengers The owners and operators of containers are reliable as they are established companies and follow a fix route and schedule; the threat comes from the lack of ability to identify what is inside the container as these containers are sealed. System interventions should be designed in a way that they identify, track and secure the contents of container. The threat to petrochemical subsystem is that fire/explosion can be caused by any attack on the vessel containing dangerous material or the hijacking and use of vessel as a weapon. The management should ensure that the vessels are operated by trusted operators and it should increase the marine and terminal fire fighting capabilities in order to deal with any hazardous consequences. Bulk cargos are not owned by reliable operators so measures should be taken to make the system of ownership more transparent the cargos should be inspected before arriving to the port and a trusted shipper program should be shaped in an attempt to deal with these uncertainties. Ferries are locally owned and operated by government authorities, the terrorist attacks on these ferries can cause mass destruction so the passengers and vehicles should be inspected properly and they require a mass casualty response which is not available in most ports. What are the main points of the article? Following are the main points of article †¢ The large part of US trade is dependent upon shipping (Ports and maritime systems) and it is the main source of economic connection with the world. †¢ The aim of terrorist attacks on US ports is to destroy the US economy †¢ Emphasis should be given to organizational interrelationships in order to avoid acts of terrorism †¢ The port security should involve a step by step procedure and the terrorist attacks should be looked as a chain starting from threat factors and ending at the delayed consequences that the attack will have. †¢ The current scenario of defense is poor because the accountable authorities are less likely to be informed about report of immediate threats, secondly the weaknesses associated with the complex economic system are not properly understood and the risks are not easier to anticipate accurately. †¢ A port consists of different sub systems and each sub system requires different security measures. †¢ Each port has different sub system, an important step in determining the vulnerability of a particular port is the information of which sub system is operating in that port. This information is also essential to design a consequence management strategy for each port. What kind of literature review is provided and/or what sources are cited? How well does it fulfill that purpose? Following are the major sources of information for the study †¢ Barriers to port security †¢ Perspectives on the use of risk assessment to address terrorism †¢ Terrorism as hazard; a new species of trouble †¢ Crisis and emergency management †¢ Organizing for homeland securities. The sources were perfectly in line with the purpose of study and were quite helpful in finding out the essential information which was needed for the study. The literature review provided was of both qualitative and quantitative nature which made the arguments more strong How well does the Author explain their method of collecting and analyzing data? Could you replicate the study based upon the article before you? The method of collecting and analyzing the data was not clearly mentioned in the study and it could have been better and much easier for the readers to make judgments if the author would have defined the methods of collecting and analyzing the data. Is there any discussion of variables? Is so, how? Does the Author look at alternative points of view? The author did not look at the alternative points of view which could have made the study more interesting and commendable; there was ambiguity regarding the discussion of variables, still the study was worth doing and appreciable. Do the studies findings support the authors Goals or Thesis? How valid are they? The study was in line with the thesis and it found out that how significant US ports are for the economy and how important it is to devise a separate security strategy for each port. The importance of organizational interrelationship was defined; and the author discussed the responsibilities of each state in order to strengthen the organizational interrelationships. The study supported the thesis by answering the negative impact that US economy will have if security interventions are not planned adequately. The figures that were given regarding the risk management approach, organizational interventions and responsibilities were also helpful in tracking the threats and tactics to deal with those threats. However, the main emphasis of the study was on the physical attributes of the port and the differentiation between each port. The study found out that different security models can be prepared by comparing the cost associated for applying the model versus its effectiveness, but the purpose is not to prepare a list of models but to find out the most cost effective model. Does the conclusion follow from the evidence provided? Are you persuaded by it? Why or Why Not? The conclusion followed the findings of the study and described the danger of terrorist threats to US ports and the reason behind these threats is to hurt the US economy. So the security measures should be taken in away that they don’t dent the economy. Does the Author address the implications of these results? If so, how comprehensively is this done? The author looked at the broader perspectives and pointed out the areas which are needed to be work upon but in depth analysis of each aspect was not done the author touched different issues which were necessary and essential to curtail the possibility of dangerous consequences and the adverse effects that terrorism might have on the economy. Do you notice other strengths and limitations of this study? The study was done in an organized manner and numerical figures and solid sources were used to make the article stronger; the usage of diagrams also made it unique and substantial. However, more up to date sources could have made the research more effective and worthy.

The Many Uses of Swipe

The Many Uses of Swipe The Many Uses of â€Å"Swipe† The Many Uses of â€Å"Swipe† By Maeve Maddox Ben writes: I have noticed the changing in usage of words. When I was growing up â€Å"to swipe a card† (credit cards were not around then) meant to steal it and now you see the term â€Å"swipe the customers card.† No one’s quite sure where this word swipe originated. It’s kin to sweep and swoop. All three words suggest a wide sweeping motion. They can be used as nouns or as verbs. A batter takes a swipe at the ball. (noun) A waiter swipes a table with a towel. (verb) A hawk swoops down on a chicken. (verb) Macduff, learning of the murder of his family, cries: All? What, All my pretty Chickens, and their Damme, At one fell swoope?† (noun) A housewife sweeps the steps. (verb) An opera diva sweeps onto the stage in a long gown. (verb) A card player makes a clean sweep of all the stakes. (noun) The compound noun sweepstakes, meaning â€Å"prize won in a race or contest† entered the language in 1773. An earlier form of the word, swepestake existed in Middle English with the meaning â€Å"one who sweeps or wins all the stakes in a game.† King Henry VII of England had a ship with that name. The verb sideswipe, â€Å"to strike with a glancing blow,† dates from 1917. Its most common use is in speaking of vehicles: His mother was sideswiped by a driver in a green pickup truck. Swipe with the meaning of â€Å"to steal† is a latecomer, dating from 1889. This meaning is said to have originated as theatrical slang used of actors stealing jokes or stage routines from one another. Like Ben, I would have thought, growing up, that â€Å"to swipe a card† meant to steal it. That sense of swipe is still current. Swipe meaning â€Å"to run a credit card† came into use in the 1990s. In practice there’s probably not much chance of confusing the two meanings because context will make the difference clear: I swiped my credit card. The clerk swiped my credit card. Somebody swiped my credit card. Another popular use of swipe in the expression â€Å"to take a swipe at† with the meaning â€Å"to criticize† or â€Å"to make a verbal attack on† or even, perhaps, as in the Google quotation below, â€Å"to threaten†: Lindsey Graham Takes Another Swipe At Glenn Beck Google Takes Another Swipe at Newspapers And Magazines With Fast Flip The Vampire Diaries takes a swipe at Stephenie Meyers Twilight The New Yorker takes a swipe at  everyone Clearly swipe is a word we like to use in a variety of contexts. My only suggestion is that I’d avoid using swipe as a synonym for â€Å"to steal† in a serious context. It’s acceptable enough when used in a non-larcenous context among friends: Who swiped the last donut? He was drinking, so I swiped his car keys. Used of real crimes of theft, it becomes a euphemism to soften a vicious act. For example, this headline about the two juveniles who stole weapons from a gun cabinet and went on to murder five people and wound ten others: School shooters swiped guns from unlocked rack and these: Criminals swipe cables to cash in on soaring value of scrap metal the victim left his building, which is near 75th Street, the night before only to return at 10 am to discover his vintage basketball cards, valued at $2,000, had been swiped. I see no reason to avoid the stronger and more precise word steal in such contexts. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:Punctuating â€Å"So† at the Beginning of a Sentence"Have" vs "Having" in Certain Expressions50 Synonyms for "Song"

Canadian workers essays

Canadian workers essays . How did McLachlan attempt to bring women into the wage campaign in 1917, and how did this strategy reflect ideas about masculinity? Women became the focus of J.B. McLachlans campaign for higher wages during 1917 in which there would have been, roughly, a 30 percent pay increase. After discussing it with the AMW, McLachlan set out to include women as part of the struggle so there could be a better understanding of the needs of workers and their families. Women were asked to write to McLachlan to provide information regarding an imaginary family budget. This budget had to include living expenses such as food and rent. At the time, workers were only receiving $3.50 a day which, as one woman points out, was not even enough to cover the food bill and the rent alone. This was McLachlans attempt to bring women into the wage campaign and it also changed the miners perception of womens role in the home. Within the mining community, women became more recognised as an important asset to their well-being within the community. The reason women were picked for McLachlans contest was because of their knowledge of money with respect to household expenses. Men were occupied working in the mines for ten hours a day while women took responsibility for managing the money. Asking them for the financial needs of mining families seemed like an obvious option to McLachlan and the AMW. The masculinity that existed during this time is something that should not be overlooked. It stemmed from the notion that men where the only ones who were supposed to work and earn a living, not women. The main purpose of keeping women in the home was for them to take care of the children as well as tending to the house. McLachlan also believed in this patriarchal norm that was part of society at the time. It was not typical for a man of this time period to stay at home and not be the breadwinner of the family. This way of thi ...

Critical Thinking Master Case Study Example | Topics and Well Written Essays - 4000 words

Critical Thinking Master - Case Study Example The commitments by his team members or his Boss regarding iScanner are not valid because they do not know the bigger picture. Pat is trying to put her weight on him because she holds a senior designation in the company. Marketing personnel have the habit to jump to conclusions in the spurt of their aggression without trying to understand the product capabilities and positioning in a market segment. Pat hasn't done her homework in estimating the sales performance of the proposed product. Chris hasn't done his homework in concluding the budgetary figures The Organization hasn't developed any new product for more than a decade and hence lacks expertise in the same. Chris said yes to the plan under pressure from Pat and Cliff. He has not given due diligence from his side as well. Assumptions by Pat Lambert: Pat has a sound retail background and hence feels that her thoughts about the market are more powerful than survey reports and data analysis. She is more than convinced about the success of her idea. Getting into an innovation will ensure ample time to Pat thus taking her away from immediate revenue target pressures After reading the high level specifications of the iScanner software, Pat assumed that slight modifications in the product will make it suitable to be used in the application of her thought. Pat got a positive response from Kelly in a discussion that, in the perspective of Pat was a serious discussion while Kelly assumed that it is a casual discussion out of curiosity. Pat took his positive reply as "Technical Approval". An approval from Chris is good enough for her to build a proposal to Cliff. Kelly is too junior to be involved in the bigger picture at this... Kelly is proud to be the key architect of the iScanner Software and hence assumes that no plans in the company pertaining to this product can be successful without his approvals. He got mad when he came across a number of features defined by Pat that were discussed with his Boss and the CEO but not with him. He is not worried about the safety of his job in the company. Whatever might happen to others in the organization, he is convinced that his job cannot be taken because he is indispensable for the organization. Pat got a positive response from Kelly in a discussion that, in the perspective of Pat was a serious discussion while Kelly assumed that it is a casual discussion out of curiosity. Pat took his positive reply as "Technical Approval". An approval from Chris is good enough for her to build a proposal to Cliff. Kelly is too junior to be involved in the bigger picture at this stage and specifically when he has already given his so called "Technical Approval". Pat thought that after seeing the approvals from Cliff and Chris, Kelly will immediately get to work (given his level in the company, he is not supposed to question her decision and their approvals).

Social learning theory and style of learning Essay

Social learning theory and style of learning - Essay Example It is based on the supposition that people use several channels of perceiving information. Visual, auditory and kinaesthetic are the major sensory modalities used by humans. All the small children use kinaesthetic channel to explore the world. Later we develop the visual modality and finally master the auditory one. One should strive for developing all three modalities. However, most of people use one of the systems as the major to check the information. Visuals prefer to see information (they need to see a text, or charts and diagrams). Visual learners may be linguistic and spatial. Linguistic learners would remember a lecture if they watch slides with text, while spatial learners do better with charts, videos, demonstrations, and other visual materials. Those with dominant kinaesthetic modality need to touch and perform to master new skills. People with dominant auditory channel prefer to listen to information. Most of people are visuals. There are also many people with leading kin aesthetic modality. Dominant auditory modality is the less spread one (Adler 1997, Clark 2000). As Don Clark (2000) explains, the three learning styles are forced upon us through life like this: up to the third grade new information is mostly presented kinaesthetically, in grades 4-8 visual presentation prevails, while starting with the high school information is usually presented auditory by lectures. My dominant modality is visual spatial. I prefer to get information through pictures, maps, charts, movies and videos. It is easier for me to retain information in mental images than in audio and kinaesthetic format. To remember things I need to make schematic notes. However, I’ve got also a well developed kinaesthetic modality, so that in many cases I learn well through hands-on approach. Another useful instrument to be remembered is social learning theory, which provides glimpses at how most of us acquire our knowledge and

What function does religion play in human society Why is religion Essay

What function does religion play in human society Why is religion Universal Is there an evolutionary explanation or a social phenomenon - Essay Example It also explores the reasons why human society appears to be so fond of religious expressions, looking at both evolutionary and social explanations for its popularity. There are many religions in the world, and they can appear very different to observers, but they share three main features in common: there is faith in something supernatural; there is a system of beliefs that adherents sign up to, and there is a set of ritual behaviors which believers follow as a way of expressing their religion (Palomar College, 2011). These things work together to help people formulate a world view, in which there is meaning and purpose. Human beings have a high intelligence compared to other animals, and religion appears to be both a result of the ability to reason with an advanced brain, and of the need to have explanations for things so that future actions can be properly planned. It could be, then, that religion serves an evolutionary purpose, in helping people to understand the environment and adapt to its changes. Its universality is due to the way that the human mind works, seeking out answers to things. This curiosity and search for understanding lies behind human progress through different stages of technology and is a fundamental feature of the homo sapiens species. This evolutionary explanation shows that the first function that religion plays in human society is therefore â€Å"to provide a sense of order in what might otherwise be seen as a chaotic existence.† (Palomar College, 2011) Religion provides a collective framework which people use to interpret inexplicable events like natural disasters or the changing seasons. The supernatural dimension arises because human beings know that their own power and understanding is limited, and that there are forces far bigger and stronger than they are. Religion is needed to explain how human beings fit into the universe around them. This has a dual function, first in providing a connection between humans and these gr eater forces, and secondly in allowing people to harness these powers and let them affect their daily lives: â€Å"religion tunes human actions to an envisaged cosmic order and projects images of cosmic order onto the plane of human experience† (Geertz, p. 90) This binds human beings to their environment more closely and explains why so many religions have connections with the sky, the sun and weather phenomena. By developing a set of beliefs around these phenomena, people make them more comprehensible, and less frightening. This is a psychological need which minimizes stress, and provides some security for people who could otherwise feel afraid and lost in a world that can bring unexpected events at any moment. The first and most important reason for the universal existence of religion in human societies is therefore the evolutionary advantage that it gives, but the second reason has more to do with the way that human beings live in social groups. Forming groups appears to b e a common behavior in many different animal types, and these groups create safety in numbers against predators and a hostile environment. One of the ways that groups determine the boundaries between one another is to have different cultures, or ways of doing things. Religions are an important way of forming groups. Many of the rituals that religions have are initiation rituals, such as circumcision, baptism, trials of faith, etc. which demonstrate who has become a member of the group and who has not. Following the rituals of religion binds the

Feet by Seamus Deane Essay Example for Free

Feet by Seamus Deane Essay The following extract is taken from the book- Reading in the Dark by Seamus Deane written in 1996. The extract focuses on one of the chapters in the book titled as Feet. The extract is based on a young boy hiding under the table viewing the death of his sister and how she is taken to the hospital. Through the style, setting and characterization, the reader is able to understand the thoughts and feelings portrayed by Deane. The extract is written in an autobiographical style, from the point of view of a young boy who narrates the story. The repetition of I gives the extract a personal touch. Using the boy as the narrator allows the writer to acquire greater intimacy and sympathy for the character. In addition, it makes the extract comic and light hearted, even though it talks about death and loss. This fusion of comedy and tragedy reflects the idea that life is a series of sorrows and joys. The extract is set under the table. Throughout the extract, the boys name is not revealed which allows the reader to explore other characters in the extract through his perceptions. The reader gets the impression that the boy is young and naà ¯Ã‚ ¿Ã‚ ½ve. He is not aware of the seriousness of the situation as he loved the names of the diseases. He finds the names peculiar and compares them with Italian football players, racing drivers and opera singers. The dog is symbolic of what the boy feels. The whimpering and quivering of the dog reflects the boys inner feelings. I became deaf to their words and alert to their noise presents the idea that the boy has become like the dog, behaving in the same way. Deane mentions feet in the first line of the extract which reinforces the importance of the title. Also, the repetition of feet suggests the importance and significance of the title since the young boy sees everyone from under the table judging them only on what shoes theyre wearing. Deane uses visual and aural imagery to captivate the readers attention in line 1 and 2- I could only see their feet. But I could hear the noise and some of the talk Deane uses heavy sensory imagery to emphasize the importance of feet as the title. He describes the characters and their social status through the shoes theyre wearing. For instance, in lines 30-34, I recognized Uncle Manuss brown shoes: the heels were worn down Uncle Dan and Uncle Tom had identical shoes, heavy and rimed with mud and cement Dans were dirtier but they werent good shoes. The detailed description of the shoes allows the reader to make judgments about the characters. The description is used for characterization- mud and cement, give the reader the impression that theyre working men at a construction site. Heavy suggests that theyre strong, muscular men and develops their personality in the readers mind. But they werent good shoes suggests that theyre not very rich people. The predicament of the extract is presented through specific and short sentences. Una. My younger sister, Una. This sentence clearly brings the focus on Una, to highlight the importance of her character. The writer tells the readers that she is going to die and goes into great details describing her illness and pain. That morning, Una had been so hot, pale and sweatyshe had made me think of sunken fires her eyes shone with pain and pleasure, inflated from the inside. The coupling of pain and pleasure reinforces the idea that joy and sorrow go hand in hand. With his style, use of imagery, setting and characterization, Deane creates an intriguing story which reflects harsh ideas of death and reality through the innocent, happy world of a young, naà ¯Ã‚ ¿Ã‚ ½ve boy.