Top Argument Essay Samples Ap English Guide!

Top Argument Essay Samples Ap English Guide! All About Argument Essay Samples Ap English The question wasn't merely an invitation to write discursively on the topic of photography. Even if you believe your college essay is ideal, the second pair of expert eyes might be genuine life-saver! Obviously, it is a different story with Nerds. Anyway, your reaction may also make an overall address to the whole documentary without picking parts. Top Argument Essay Samples Ap English Secrets In any case, also make certain that grammar is in order. A good DJ will emphasize certain facets of the music, or bring elements from various tracks into dialog together. AP Language and Composition course is a huge deal, and your primary purpose is to clearly show your capacity to create decent analysis with an ideal structure and grammar indexes. You should have your reasons, and our principal concern is that you find yourself getting a great grade. Some students think about the absolutely f ree response section being the hardest portion of the whole English exam. Demonstrate your confidence this particular problem is resolved and isn't anticipated to reoccur. The act is an entrance exam utilized by the majority of colleges and universities to produce admissions decisions. Even though it might seem that the customer doesn't care about what you've got to say initially, keep in mind that the customer approached you for resolution. Eventually the customer must lower her or his voice to hear what you're saying. He may be angry because he or she made incorrect assumptions that led to improper expectations. He will never be able to navigate the requirements, restrictions or resolution with the same knowledge and experience as you. Reiterate Make sure you are addressing the technical, administrative and emotional facets of the customer concerns. Our customer support will gladly tell you whether there are any special offers at the present time, together with make sure you are getting the very best service our business can deliver. It's not effective to interrupt the customer while he or she's venting combustible sentiments. Tell the customer that you have the issue and will apply your private effort to achieve success. Appropriate preparation proves that you understand how to compose an argumentative essay in AP English. After you are psychologically set to compose the essay and with clear understanding of your audience, conduct research on the subject or essay. There is a particular essay in the prompt that you have to analyze. Lastly, don't neglect to proof read your biology essay before the last submission. You can also see academic essay. You can also see analytical essay. You might also see descriptive essay. It is crucial to be aware an argumentative essay and an expository essay could possibly be similar, but they vary greatly concerning the quantity of pre-writing and research involved. It should encompass your whole essay in only 1 sentence. Reading example essays works precisely the same way! So this very first post is truly the first in a series that intends to lay out a couple of metaphors which may help to convey what DJing is actually about. After all, the subject of the essay ought to be fully disclosed on an expert level. The War Against Argument Essay Samples Ap English There is only one difference within this prompt, and it lies within this synthesis essay you should write. If you cannot determine what the question is, return and reread the prompt. You're predicted to persuade the readers with your arguments, so be certain you include as many supporting academic parts of evidence as you're able to. The ending of your argument should be constructed from the stated thesis statement. A comprehensive argument As mentioned before, an argument does not need to be formal. Attempt to select the best devices to strengthen your argument that you are able to.

Comparing Perfume Advertisements Essays - 608 Words

Comparing Perfume Advertisements For my media coursework I’m going to look at two printed advertisements selling perfumes. One of them is called â€Å"very irresistible by Givenchy† and the other one is â€Å"rush by Dolce Gabbana†. I’m going to compare the slogan, the logos, target audience and the selling techniques used. The target audience refers to who will buy the product. The perfumes are both used by women primarily but the advertisements are aimed at both male and females. The age group, which is aimed at is the younger end of the market up to mid thirties. As they are using young models you know it’s for younger women. The perfumes are priced reasonably so anyone could afford them. I†¦show more content†¦The Givenchy Company doesn’t use a logo in this particular advert because they show the celebrity covering most of the page, which replaces it. The Dolce Gabbana advert also doesn’t use a logo because they’ve written Dolce Gabbana out in full, possibly because Christmas is coming up and they are encouraging people to buy the product as a Christmas gift. By putting only DG, buyers might not recognise the company’s name and not buy its products. The woman in the Dolce Gabbana advert is a tanned model just wearing a bra. With prominent lip-gloss on her lips, she’s laying back. She’s holding the perfume just over her chest showing the name of the brand. Promised land is used to indicate that if you use it you will look as sexy as her. The American actress Liv Tyler presents the new fragrance in a black and white advert. The advertisers have used the colour black and white to make the product seem sophisticated. To make the actual product stand out the only other colour used is pink which is the colour of the bottle. It also highlights the name of the fragrance ‘Irresistible’. Also in pink there is a small sentence saying ‘the new feminine fragrance’. Pink is used possibly because it is a girly colour. The layout is how all the written work and pictures are placed. The Givenchy advertisers have used bordersShow MoreRelatedEssay about Advertising and Ways to Expose New Products1347 Words   |  6 Pageswhat happening and know how to react to that action . Literature review : Nowadays advertisement has many methods to approach their customers’ interest . But, do company which made these advertisements exaggerate things to influence the way people think ? . Do all companies authentic and honest to people ? . And if some advertisements disguise their backwards from the people , how to distinguish which brand is trustful andRead MoreEssay about What are Ads Really Trying to Say?949 Words   |  4 PagesAdvertisements are everywhere in today’s society in the news, radio, on television, pretty much everywhere you go. They are everywhere to try to pull the consumer in to get you to feel, look, or act a certain way. They help consumer narrow their search in what products to buy. The two magazine articles that are being compared are both fragrance ads, Polo and Estee Lauder. I found them both in a cosmopolitan magazine which is a type of upper class magazine for women. Its current content in cludesRead MoreThe Ethnocentric Society of American Culture971 Words   |  4 PagesWhile comparing women and male magazines I noticed some differences in race and social class. â€Å"Social class is a group of people who share a similar economic position in a society, based on their wealth and income† (Newman 321). The majority of the women’s magazine advertisements conveyed white females that were upper class; this could because as women we want to be seen as glamorous, superior, and attractive. 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Underestimating the power of advertisement is illogical and selfish, it does have an immense influence on our consciousness and subconsciousness. It is impossible to deny that we live in the era of consumerism: we earn money to buy things that define our personality. When the creators of Apple understood it they staredRead MoreMaketing Repo rt of Chanel2564 Words   |  11 PagesChanel N °5 is the earliest, the most successful and representative product of Chanel. This is because â€Å"With its links to Andy Warhol and Marilyn Monroe, its Ylang-Ylang from the Comoros and its Grasse Jasmine, N °5 remains the greatest and best known perfume in the world. This timeless classic, both contemporary and unusual, remains the absolute benchmark of feminine fragrances, entrancing, elegant and always modern. 3† N °5 has different smell at different stages: †¢ Top notes: Neroli from Grasse, Ylang-YlangRead MoreChanel Analysis Swot, 6 Ps5076 Words   |  21 Pageslaunched. KARL LAGERFELD In 1983 a new era of Chanel began by employing of Karl Lagerfeld as the art director for haut-couture, prà ªt-à  -porter and accessories, while the fashion label had almost been forgotten, Chanel was at the time only known for the perfumes . Lagerfeld kept the classical line and additionally created more modern clothes, skirts became shorter and new materials were used. Furthermore new products like watches (1987) and cosmetics (1999) were introduced. ART MOBILE CONTAINER The mostRead MorePostmodernism Has Changed The Representation Of Women1721 Words   |  7 Pagesthe way that they are because of their sex, the fact that they have more age determines the lack of representation throughout medium forms when comparing to a younger generation. When referring to images within advertisements, there are younger, beautiful women usually used within the advertisement to promote such skin care products, make up and perfume. Older women are not used anywhere near as much. Lemish and Muhlbauer (2012) argues, â€Å"Older women are framed as an â€Å"other† (i.e., marginal, defectiveRead MoreThe Effects Of Video Advertisements On Society Essay2513 Words   |  11 PagesIntroduction Video advertisements are quick and momentary but their influence is pervasive and prolonged. The power of video advertisements shape norms and common societal expectations on how a person should look and behave. Overtime these gender roles (societal expectations associated with men and women) and behaviors become implicit thus implying normal (or in some instances ideal) men and women should exhibit these qualities and characteristics. Subconsciously, video advertisements impact a personRead MoreEssay on Cacharel Case Study1925 Words   |  8 PagesKapferer, chapter 11, p291) Figure 1 illustrates how components constitute a brand. It consists of brand style (visible components) and intangible elements in which identity is essentially made from the brand kernel. 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Post Natal Care and Management-Free-Samples-Myassignmenthelp

Question: Providing a Comprehensive Evaluation of the Post-Operative Postnatal Progress and Care of the Woman. Answer: Introduction: The prenatal and postnatal care or the lack thereof for the women who have had Caesarean section and are pregnant again for the second time or have experiences complications during the surgery is a major public health priority, especially for the single woman. One of the major complications that the pregnant women face in the current times is the preterm labour or premature delivery. Preterm labour can be defined as the phenomenon when the baby is born before the 37 weeks of gestation is completed, there can be various contributing factors leading to preterm labour like recurrent preterm birth, extreme anxiety or stress, excessive smoking, cervical exhaustion, infections, etc. The rate of preterm birth has been increasing rapidly, and just in the past decade the rate has jumped close to 30% (MacIntyre et al., 2012). This case study selected for this assignment explains in detail about the medical history of the Yvette, who have had two previous preterm births and is in preterm labour again with various other complications. The woman under consideration in the case scenario had been a heavy smoker and had been caring for two children singlehandedly. Along with that, she had been suffering with whooping cough, UTI and several other infections while in 32 weeks of gestation and had to be admitted to the hospital where she underwent LSCS (Khan et al., 2010). This assignment will attempt to explore the risk factors associated with such scenarios, design a care plan for the newborn and formulate a midwifery care plan for the woman as well. Risk factors associated: According to the case study, the mother, was 32 weeks in gestation and was admitted to the hospital facility, with symptoms like abdominal pain, dysuria, and mild contractions occurring for two days. The medical history includes Group B streptococcus positive urinary tract infection at 26 weeks of pregnancy as well. Along with that her previous two children were both born prematurely close to two years apart; Yvette is extremely stressed and is a heavy smoker with 20 cigarettes a day, and her premature labour is tensing her further. Based on the finding of this case study the two major risk factors that could have positively contributed to her premature labour are smoking and her past history of recurrent preterm births (MacIntyre et al., 2012). There are a variety of adverse effects of smoking on the health and wellbeing of a normal individual, in case of pregnancy however; the risk factors increase multiple folds. According to a large number of exploratory study, smokers were found to be on an elevated risk of pre term delivery, along with that, the risk for preterm birth increased with the increase in number. For instance, heavy smoker mothers had the greater risk of 24% for very preterm labour, 28% for spontaneous birth, and 28% of medically indicated preterm labour. However, the exact pathway through which smoking escalates the risk for preterm birth is not completely known yet (Khan et al., 2010). Although extensive research has discovered that excessive concentration of nicotine and carbon monoxide in the system, compromising the placental blood flow, which in turn disrupts the vasoconstriction of the placental vessels. Along with that the carbon monoxide present in the tobacco smoke is also known to produce carboxy- hemoglobin interfering with the fetal oxygenation (Tsiartas et al., 2012). The nicotine accumulated in the body system of a smoker is also known to increase the maternal blood pressure and pulse rate, which in turn restricts the blood flow to the fetus. The culmination of all these factors ultimately results in altering the amniotic environment for the fetus and restricts the growth and development of the fetus, leading to the preterm labour; idiopathic preterm labour is also associated with the excessive smoking in pregnant woman and is rightfully considered one of the biggest risk factors to preterm delivery in woman (Olsson, Ahlsn Eriksson, 2016). Another highly impactful risk factors in this case scenario that could have contributed to Yvette having to undergo third preterm birth by the means of lower segment caesarean section is her past history of recurrent preterm labour. Recurrent labour can be defined as the occurrence of two or more births before the 37 weeks of gestation can be completed. Various studies have suggested that the occurrence of previous spontaneous preterm labour increases the risk of the next pregnancy to be preterm as well, however in case of preterm labour associated with preeclampsia, the statistics may vary (Pryhuber et al., 2015). Hence it can be suggested that her previous history of premature birth following preeclampsia followed by second premature delivery due to preterm labour increased the risk factor for her indicated preterm pre labour rupture of membranes or PROM. Authors have discussed the cervical insufficiency resulting from the occurrence of more than one preterm delivery to be the cont ributing factor behind the indicated recurrent preterm labour (Henderson et al., 2012). Cervical insufficiency is the result of early cervical ripening caused by the loss of connective tissue or intrauterine infection which has been present in case of the woman under consideration. Therefore it can be concluded that the post operative cervical ripening due to more than one preterm surgical delivery has been one of the greatest risk factors for Yvette, and coupled with excessive anxiety, smoking, and infections propelled her towards her third PROM (Russell et al., 2014). Care plan for Sam Currently, the newborn baby Sam is undergoing investigation in nursery, as he is a premature baby. He is also undergoing treatment for acute infection. Sam is at increased risk of infection owing to the immunological immaturity and the UTI infection from mother. In addition to infection the preterm babies are at risk of respiratory distress, hypothermia and hyperthermia due to ambient temperature changes. According to Drysdale et al. (2014), respiratory distress is related to lung immaturity and low surfactant produced. The premature babies are also at risk of impaired sensory, auditory functions. Thus, the care plan for Sam include the following To ensure thermal homeostasis the infant will be placed in the warmer and isolette incubator and ensure that the baby has appropriate clothing. The carer may dry Sam thoroughly and discard the wet blanket soon. This process may prevent heat loss from evaporation. The baby must not be positioned on close surface. Sam may have cold stress due to hypothermia and hyperthermia may cause respiratory distress, thus regular monitoring of the temperature is needed. The care provider must provide medication as prescribed to prevent seizures associated with hypethermia (Drysdale et al., 2014). The breast milk can be instilled that is the expressed breast milk (EBM) to maintain body nutrients. It is because Sam may be at risk of imbalanced nutrition as a consequent of low glucose, iron and calcium reserve in the premature baby. As the premature babies have high rate of metabolism and inadequate calorie intake, they have low glycogen stores. Thus, it is mandatory to assess the input and output as well as blood sugar level (risk of hypoglycemia), weight and serum sodium (Green et al., 2015). The baby will be nil by mouth and on IV therapy to restore fluids. As the baby preterm, the careers must insert the nasogastric tube. The rationale for this is the premature babies, who are also prone to fluid and electrolyte imbalances caused by environmental factors and loss through lungs, skin,urine and skin. In case of edema, the fluid volume should be adjusted accordingly. Usually the preterm babies can concentrate urine to ~ 600 mOsm/L (Green et al., 2015). The baby must be regularly assessed for the BP, TPR and ascultate breath sounds to track the spread of infection. Therefore, the baby must be monitored for fever, vomiting, jaundice, urine with blood, cloudy urine or unpleasant-smelling urine. Since the baby already have an acute infection, there is a need of antibiotic therapy (IV antibioticss) as it inhibits the growth of bacteria. The UTI infection is usually treated within two to three days. Until the infection is cured breast, milk should be stopped to void further infections. Further, there is a need of identification and treatment of the voiding dysfunction. Evaluating the condition and based on the childs clinical judgment, the imaging evacuation of the urinary tract can be individualised. The UTI infection from mother can impose the risk of kidney in Sam. Thus, the baby must be assessed for the Kidney function (Vachharajani et al., 2015). It must be ensured in the nursery that all the people coming in contact with the baby maintain hand washing protocol to prevent infection. Sterilised equipments should be used to make necessary assessments (Olsson et al., 2016). Further, the neonate must be monitored for the signs of poor skin turgor, dehydration, ad sunken eyeballs for medical intervention. The babys eyes must be covered with patches while under the phototherapy lights to prevent retinal damage. Regular inspection of eyes is necessary to facilitate treatment for purulent conjunctivitis. The care provider in the intensive care unit must position Sam on side with rolled blanket at his back as this position facilitates breathing. As per Pryhuber et al. (2015), immaturity also leads to fragile skin. To prevent the superficial burns on skin avoid oily applications and repositioning is needed every two hours to avoid pressure areas (Russell et al., 2014). Lastly, the mother should be trained on the implications of the infection and the precautions to be taken to avoid further infections. Proper guideline must be given regarding care, handling of the baby and nutrition and the symptoms that need immediate medical intervention. Postnatal care and management for Yvette: Preterm birth is considered to be one of the most common pregnancy related complication ad a vast majority of the young mothers suffer from this particular complication. Although a preterm delivery is generally highly complicated and there are a number of risk factors associated with the preterm labour (Mercer, 2012). Hence even after the delivery, the preterm birth mothers face dire need of ongoing care and support both medical and psychological from the post natal care providers. Although the nursing acre professions will assist the woman with the pharmacological care needs and requirements the midwives can help the mother deal with other related complications after the preterm birth that will help her recover faster and care for herself and her child much better. One of the greatest challenges that a mother post preterm delivery include the infection, pain, confusion, anxiety, and most of helplessness in controlling her grievances. The midwives can provide immense psychological support along with guiding the mother with the care needs of herself and her baby. He care and management that Yvette will receive from the post natal obstetric staff or midwives in particular, include kangaroo care, postpartum pain management, psychological and social support including anxiety management, successful lactation, family centred care and guidance for planning future pregnancy (Lamont et al., 2011). Kangaroo care can be defined as the skin to skin contact of the mother with her newborn dressed only in a cap and diaper, and for the preterm babies in the neonatal intensive care unit, this technique is highly beneficial facilitating improved breastfeeding rates, stable body temperature for the new born, decreased hospital stays, and improved neurological development of the newborn (Di Renzo et al., 2011). And as the preterm babies lack in body weight and slow growth rates, this technique is even more beneficial for the preterm babies. In this technique the midwife will train Yvette to hold her neonate on her chest providing skin to skin contact which will regulate the babys body temperature decreasing the risk for preterm hypothermia and will train the other in readily accessible breastfeeding when need be. The second support that the woman under consideration for the assignment will receive from the midwives is regarding post partum pain management which is a very common occurrence following a LSCS (Flenady et al., 2013). The immediate relief intervention that the woman can achieve include lateral recumbent position, relaxation techniques like breathing exercises, back rubs, therapeutic touch exercise and administration of mild analgesics as directed by the registered midwife. Successful lactation is one of the most vital parts of the post natal care management and for good health of both the mother and the newborn. According to the American academy of paediatrics, the human milk is absolutely necessary for adequate growth and development of the baby. Although the mothers that give preterm deliveries face the challenge of successful lactation and maintaining adequate milk supply. The midwife can train Yvette the hand pumping technique to increase the milk supply, along with monitoring the breast health and milk production of the mother regularly to avoid mastitis or candidiasis as consequences of excessive pumping. Periodic breast massage is also a caring tactic that midwives take in order to help the preterm mothers increase their milk production rate (Flenady et al., 2013). Post partum depression and anxiety has emerged as one of the major maternal health and wellbeing priorities and Yvette, the woman under consideration for this assignment has already been dealing with excessive stress, anxiety and depression while being a single mother with two infants and a neonatal newborn, psychological support is one of the mandates in this situation. In case of NICE screening for postnatal anxiety and depression is one of the mandatory protocols; though there is not much for the midwives to do in clinical care, therapeutic management can be given to Yvette effectively by midwifery professional. Counselling and relaxation therapies engaging active communication and compassionate support can help the mother overcome her depression and fears and concentrate on keeping herself and her child healthy (Neilson, West Dowswell, 2014). Lastly overall guidance and training for preplanned future pregnancy and social support given by the midwife to the preterm mother, Yvette for this case scenario, has been proven to reduce the risk of post partum depression and anxiety along with the risk of recurrent preterm birth. The midwife will engage Yvette in a proper woman education regarding the risk factors of safe time gap between the next pregnancy and contraceptive techniques ensuring the best health for the mother and her children at large (Wylie et al., 2011). Proper social support of counselling and day care for her children, while she is in the hospital, will also be discussed with Yvette by the midwife. However, there are a few precautionary assessments that the midwife will engage the woman because of the infections that she had been suffering with. As per the case study, there is need for a few blood tests needed for testing the infection status of the whooping cough and the group B streptococcus infection like the CBC or complete blood count test. The temperature of the woman needs to be monitored periodically because of her infections. As Yvette has had whooping cough before the delivery, the midwife will also need to restrict the woman from visiting the newborn until all her infections are reduced. For her C-section, the incision site will be monitored regularly by the midwife for any signs of infection and any irregular bleeding should be monitored diligently as well, along with any impending fever. Conclusion: On a concluding note, it can be stated that the rate of preterm births have been increasing a at a rapid rate over the years and there are a myriad of risk factors that facilitate the preterm labour in women. For instance, in this case scenario where Yvette had suffered through two previous preterm deliveries and different infections and had to suffer through another preterm birth followed by a LSCS surgery. The anxiety and fear that Yvette had been experiencing had been very natural given the circumstances she went through as a single mother without any support, although continuing smoking had been one of the major contributing factors that propelled her towards the complications for the most part. However, it must not escape notice that optimal compassionate care and support has the potential to help her overcome the crisis situation and attain speedy recovery for both herself and her premature child. This assignment has discussed three of the key factors associated with the premature birth in the current age, the risk factors contributing to preterm birth, the postnatal care and management for the neonate and post natal care and management for the mother. It can be hoped that the care techniques and management outlined in the assignment will be beneficial in helping Yvette gain proper health in no time along with her newborn child. References: Di Kenyon, S., Boulvain, M., Neilson, J. P. (2010). Antibiotics for preterm rupture of membranes.Cochrane Database Syst Rev,8(8). Di Renzo, G. C., Roura, L. C., Facchinetti, F., Antsaklis, A., Breborowicz, G., Gratacos, E., ... Radunovic, N. (2011). Guidelines for the management of spontaneous preterm labor: identification of spontaneous preterm labor, diagnosis of preterm premature rupture of membranes, and preventive tools for preterm birth.The Journal of Maternal-Fetal Neonatal Medicine,24(5), 659-667. Drysdale, S. B., Alcazar, M., Wilson, T., Smith, M., Zuckerman, M., Lauinger, I. L., ... Greenough, A. (2014). Respiratory outcome of prematurely born infants following human rhinovirus A and C infections. European journal of pediatrics, 173(7), 913-919. Flenady, V., Hawley, G., Stock, O. M., Kenyon, S., Badawi, N. (2013). Prophylactic antibiotics for inhibiting preterm labour with intact membranes. The Cochrane Library. Green, J., Darbyshire, P., Adams, A., Jackson, D. (2015). Looking like a proper baby: nurses' experiences of caring for extremely premature infants. Journal of clinical nursing, 24(1-2), 81-89. Henderson, J. J., McWilliam, O. A., Newnham, J. P., Pennell, C. E. (2012). Preterm birth aetiology 20042008. Maternal factors associated with three phenotypes: spontaneous preterm labour, preterm pre-labour rupture of membranes and medically indicated preterm birth.The Journal of Maternal-Fetal Neonatal Medicine,25(6), 642-647. Lamont, R. F., Nhan-Chang, C. L., Sobel, J. D., Workowski, K., Conde-Agudelo, A., Romero, R. (2011). Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and metaanalysis.American journal of obstetrics and gynecology,205(3), 177-190. MacIntyre, D. A., Sykes, L., Teoh, T. G., Bennett, P. R. (2012). Prevention of preterm labour via the modulation of inflammatory pathways.The Journal of Maternal-Fetal Neonatal Medicine,25(sup1), 17-20. Mercer, B. (2012). Antibiotics in the management of PROM and preterm labor. Obstetrics and Gynecology Clinics, 39(1), 65-76. Neilson, J. P., West, H. M., Dowswell, T. (2014). Betamimetics for inhibiting preterm labour. The Cochrane Library. Olsson, E., Ahlsn, G., Eriksson, M. (2016). Skin?to?skin contact reduces near?infrared spectroscopy pain responses in premature infants during blood sampling. Acta Paediatrica, 105(4), 376-380. Pryhuber, G. S., Maitre, N. L., Ballard, R. A., Cifelli, D., Davis, S. D., Ellenberg, J. H., ... Ren, C. (2015). Prematurity and respiratory outcomes program (PROP): study protocol of a prospective multicenter study of respiratory outcomes of preterm infants in the United States. BMC pediatrics, 15(1), 37. Reiss, I., Schaible, T., van den Hout, L., Capolupo, I., Allegaert, K., van Heijst, A., ... Tibboel, D. (2010). Standardized postnatal management of infants with congenital diaphragmatic hernia in Europe: the CDH EURO Consortium consensus.Neonatology,98(4), 354-364. Reynolds, L. P., Caton, J. S. (2012). Role of the pre-and post-natal environment in developmental programming of health and productivity.Molecular and cellular endocrinology,354(1), 54-59. Russell, G., Sawyer, A., Rabe, H., Abbott, J., Gyte, G., Duley, L., Ayers, S. (2014). Parents views on care of their very premature babies in neonatal intensive care units: a qualitative study. BMC pediatrics, 14(1), 230. Sweet, D. G., Carnielli, V., Greisen, G., Hallman, M., Ozek, E., Plavka, R., ... Halliday, H. L. (2013). European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2013 update. Neonatology, 103(4), 353-368. Tsiartas, P., Holst, R. M., Wennerholm, U. B., Hagberg, H., Hougaard, D. M., Skogstrand, K., ... Jacobsson, B. (2012). Prediction of spontaneous preterm delivery in women with threatened preterm labour: a prospective cohort study of multiple proteins in maternal serum.BJOG: An International Journal of Obstetrics Gynaecology,119(7), 866-873. Vachharajani, A., Vricella, G. J., Najaf, T., Coplen, D. E. (2015). Prevalence of upper urinary tract anomalies in hospitalized premature infants with urinary tract infection. Journal of Perinatology, 35(5), 362. Van Der Ham, D. P., Vijgen, S. M., Nijhuis, J. G., Van Beek, J. J., Opmeer, B. C., Mulder, A. L., ... Bloemenkamp, K. W. (2012). Induction of labor versus expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks: a randomized controlled trial. PLoS medicine, 9(4), e1001208. Wylie, L., Hollins Martin, C. J., Marland, G., Martin, C. R., Rankin, J. (2011). The enigma of post?natal depression: an update.Journal of psychiatric and mental health nursing,18(1), 48-58

Stress Reduction Essays - Stress, Aerobic Exercise, Jogging

Stress Reduction Consider how likely you would be to agree if one offers you the opportunity to better your health and your physique while at the same time getting rid of the everyday stresses. I once read that for college students, minor hassles, rather than major life events tend to maintain stress at unhealthy levels. But exercise is one of the essential elements to help lower stress. In an effort to help students, and teachers, to lower stress levels, I analyzed the ambiance found at Miami Dade South track facility. MDCC track offers a 400 meters facility with seating capacity for about 450 people (in permanent concrete bleachers) and additional temporary bleachers suited for 200 more. The track is located behind the pool (building 7000) and between the baseball and soccer fields. The track is made out of red clay, consists of eight lanes clearly separated by white lines, and painted with their respective numbers. The hours of operation of the track are from Monday thru Friday 7:00 to 2:30 PM and 6:30 PM to 9:30 PM; Saturdays from 9:00 am to 4:00 PM and Sundays is closed. Advantages of working out at the MDCC track are that the track is well lit and the students can go right after classes. In the middle of the track there is a well-trimmed grass area that can be utilized while warming up or cooling down. It is favorably recommended for any MDCC student to make use of the campus facilities, especially the track. Not only one will get natural stress reduction while jogging running for walking, but it is also free. In order to enjoy. MDCC track and avoid potential for injury here is a small list to utilize in order to get better results: 1) Start out by wearing comfortable shoes 2) Drink plenty of water throughout the day and try to eat healthy 3) Warm up for at least 10 minutes before starting your exercise (running, jogging or walking); make sure you give your muscles a good stretch without over exhaustion. 4) Start your exercise (run, jog or walk) and continue it for at least 15 minutes. Enjoy the view at MDCC. Look at the people around you and try to get "pepped-up". 5) Finish your exercise by cooling down for at least 5 minutes in the same way you did your warm-up. I am by no means a true expert on fitness and health but I am giving a fist hand account of what turns out to be a very relaxing experience at the track of Miami Dade. I hope you can enjoy it too!

Writing Impressive College Entrance Essays

Writing Impressive College Entrance Essays More and more people are going to college these days right out of high school, so it goes without saying that making a stellar first impression is a necessity in order to stand out from the pack and get that coveted acceptance letter to your chosen university. With that in mind, writing an impressive college entrance essay that makes admissions personnel want to get to know you even better is the ideal way to get the attention you deserve.Write to impressWhether your entrance essay is an open-ended work or directed toward answering specific admissions questions, the key to drawing in the reader and making him or her want to know more is a compelling, honest view into your life and what makes you unique, including your history, accomplishments, strongest traits, interests, extracurricular activities and, of course, grades. Since there is typically a word-count limit to adhere to, the idea here is to give the reader an interesting taste in each of these areas without inundating them wi th information.The best way to do this is to write by example – from an intro that puts the reader right there next to you for one of your proudest or most challenging events in life to little nuggets of interest that demonstrate the positive traits you have and want to let shine. For example, instead of telling the reader all about yourself like so:My proudest moment in life thus far was winning first place in the USAA Gymnastics competition for mens trampoline. I worked for two years training in the event and really wanted to win badly.Showing the reader by taking them with you to the moment is more effective:As I stood in front of a crowded Anaheim stadium full of 30,000 people last July, my name echoed over the loudspeaker and a rush of accomplishment and pride ran through me when I heard, And in first place in mens trampoline, Scott Smith. The words were a culmination of two years of training at the gym – three hours a day on weekdays and five hours a day on weeke nds – for a goal I had set my sights on long before I had even had a drivers license.When a writer uses this second method – showing, not telling – they take the reader to the moment with them, much like a good fiction writer draws in his or her readers. Whether the reader is a gymnastics enthusiast or not, chances are they have experienced the same sort of emotions when accomplishing something, too – pride and the payoff of hard work – and will relate to what they are reading better than simply being told by a writer, Ive worked very hard for things and am proud of myself.The secret to showing, not telling, is to not show too much. No reader (especially busy admissions office personnel) has the desire or time to read two pages of every detail of the above gymnastic event. Therefore, your little tidbits should be just that – three to five sentences that give them a front-row seat at the event you describe. Of course, these all dont have to b e life-altering events like winning a gymnastics championship. Showing the reader by example how you have some positive personality traits is also a sure way to make your college entrance essay stand out. For instance, rather than telling the reader youre involved in volunteerism and church functions like so:I have participated in missions visits to third-world countries each summer since I was 12 with my churchs youth group.Showing the reader this would read something like:My summer vacations since I was 12 have been spent in an exciting variety of Central American countries where I worked on behalf of my churchs youth group at teaching young children in Costa Rican, Guatemalan and Nicaraguan jungle villages some basic reading and writing skills. Not only was this experience fulfilling, seeing the children write their names for the first time in their lives and start to read simple words, but one where I made cherished friendships and realized some vital professional goals for my f uture in a possible career in social work.The maturity, worldliness and ability to think outside of your high schools walls really shine through in this last paragraph. Showing how you have such positive characteristics by the things you have taken part in is a terrific way to demonstrate to a potential college that you have thought about more than just getting finished with your classes in high school. Other excellent, worldly traits to mention would be extensive travel (whether for work or pleasure), having numerous pen pals or connections to other countries (whether you were born in Korea or have extensive family in Greece) or even places you hope to visit one day and compelling reasons why (i.e., not just because they sound cool).Making the best of gradesOf course, a college entrance essay wouldnt be complete without some mention of your high school grades, accomplishments and activities. Since not everyone is valedictorian or has a year of college already finished when they gra duate from high school, it really depends on a writers own grades whether to mention them a lot or not. If you were an A+ student in high school, of course that should be mentioned and touted; if you barely got by with Cs in most of your classes, play up the classes you did do well in or enjoyed most, and make little or no mention of the ones you didnt quite ace.Contrary to popular belief, getting into college is not all about having a 4.8 GPA and being a National Honor Society contender. Of course, if youre trying to get into Harvard or other Ivy League institutions out there with straight Bs, you better have some outstanding stories of your other accomplishments in and out of school to impress them. But an average state university does put significant stock these days in the uniqueness of their students with less than perfect grades.All the more reason to make sure your essay and the parts of your life you use in it to describe yourself make you stand out and get noticed. Your col lege entrance essay does not have to be a boring, form essay listing every trait you think a school wants you to have. Being yourself – and showing a college who that is with intimate, engaging stories – can make the difference between an essay that piques admissions interest or one that gets thrown into the growing pile of mediocre applicants.

All About the Rise and Fall of the Berlin Wall

All About the Rise and Fall of the Berlin Wall Erected in the dead of night on August 13, 1961, the Berlin Wall (known as Berliner Mauer in German) was a physical division between West Berlin and East Germany. Its purpose was to keep disaffected East Germans from fleeing to the West. When the Berlin Wall fell on November 9, 1989, its destruction was nearly as instantaneous as its creation. For 28 years, the Berlin Wall had been a symbol of the Cold War and the Iron Curtain between Soviet-led Communism and the democracies of the West. When it fell, it was celebrated around the world. A Divided Germany and Berlin At the end of World War II, the Allied powers divided conquered Germany into four zones. As agreed at the  Potsdam Conference, each was occupied by either the United States, Great Britain, France, or the Soviet Union. The same was done in Germanys capital city, Berlin.   The relationship between the Soviet Union and the other three Allied powers quickly disintegrated. As a result, the cooperative atmosphere of the occupation of Germany turned competitive and aggressive. One of the best-known incidents was the Berlin Blockade in June of 1948  during which the Soviet Union stopped all supplies from reaching West Berlin. Although an eventual reunification of Germany had been intended, the new relationship between the Allied powers turned Germany into West versus East and democracy versus Communism. In 1949, this new organization of Germany became official when the three zones occupied by the United States, Great Britain, and France combined to form West Germany (the Federal Republic of Germany, or FRG). The zone occupied by the Soviet Union quickly followed by forming East Germany (the German Democratic Republic, or GDR). This same division into West and East occurred in Berlin.  Since the city of Berlin had been situated entirely within the Soviet Zone of Occupation, West Berlin became an island of democracy within Communist East Germany. The Economic Differences Within a short period of time after the war, living conditions in West Germany and East Germany became distinctly different. With the help and support of its occupying powers, West Germany set up a capitalist society. The economy experienced such a rapid growth that it became known as the economic miracle. With hard work, individuals living in West Germany were able to live well, buy gadgets and appliances, and travel as they wished. Nearly the opposite was true in East Germany. The Soviet Union had viewed their zone as a spoil of war. They had pilfered factory equipment and other valuable assets from their zone and shipped them back to the Soviet Union. When East Germany became its own country in 1949, it was under the direct influence of the Soviet Union and a Communist society was established. The economy of East Germany dragged and individual freedoms were severely restricted. Mass EmigrationFrom the East Outside of Berlin, East Germany had been fortified in 1952. By the late 1950s, many people living in East Germany wanted out. No longer able to stand the repressive living conditions, they would head to West Berlin. Although some of them would be stopped on their way, hundreds of thousands made it across the border. Once across, these refugees were housed in warehouses and then flown to West Germany. Many of those who escaped were young, trained professionals. By the early 1960s, East Germany was rapidly losing both its labor force and its population. Between 1949 and 1961, its estimated that nearly 2.7 million people fled East Germany. The government was desperate to stop this mass exodus. The obvious leak was the easy access East Germans had to West Berlin. With the support of the Soviet Union, there had been several attempts to simply take over West Berlin. Although the Soviet Union even threatened the United States with the use of nuclear weapons over this issue, the United States and other Western countries were committed to defending West Berlin. Desperate to keep its citizens, East Germany knew that something needed to be done. Famously, two months before the Berlin Wall appeared, Walter Ulbricht, Head of the State Council of the GDR (1960–1973) said, Niemand hat die Absicht, eine Mauer zu errichten. These iconic words mean, No one intended to build a wall. After this statement, the exodus of East Germans only increased. Over those next two months of 1961, nearly 20,000 people fled to the West. The Berlin Wall Goes Up Rumors had spread that something might happen to tighten the border of East and West Berlin. No one was expecting the speed nor the absoluteness of the Berlin Wall. Just past midnight on the night of August 12-13, 1961, trucks with soldiers and construction workers rumbled through East Berlin. While most Berliners were sleeping, these crews began tearing up streets that entered into West Berlin. They dug holes to put up concrete posts and strung barbed wire all across the border between East and West Berlin. Telephone wires between East and West Berlin were also cut and railroad lines were blocked. Soldiers closing off East Berlin with barbed wire fences. Keystone / Getty Images Berliners were shocked when they woke up that morning. What had once been a very fluid border was now rigid. No longer could East Berliners cross the border for operas, plays, soccer games, or any other activity. No longer could the approximately 60,000 commuters head to West Berlin for well-paying jobs. No longer could families, friends, and lovers cross the border to meet their loved ones.   Whichever side of the border one went to sleep on during the night of August 12, they were stuck on that side for decades. The Size and Scope of the Berlin Wall The total length of the Berlin Wall was 91 miles (155 kilometers). It can not only through the center of Berlin, but also wrapped around West Berlin, entirely cutting it off from the rest of East Germany. The wall itself went through four major transformations during its 28-year history. It started out as a barbed-wire fence with concrete posts. Just days later, on August 15, it was quickly replaced with a sturdier, more permanent structure. This one was made out of concrete blocks and topped with barbed wire. The first two versions of the wall were replaced by the third version in 1965. This consisted of a concrete wall supported by steel girders. The fourth version of the Berlin Wall, constructed from 1975 to 1980, was the most complicated and thorough. It consisted of concrete slabs reaching nearly 12-feet high (3.6 meters) and 4-feet wide (1.2 meters). It also had a smooth pipe running across the top to hinder people from scaling it. Bettmann Archive / Getty Images By the time the Berlin Wall fell in 1989, there was a 300-foot No Mans Land and  an additional inner wall. Soldiers patrolled with dogs and a raked ground showed footprints. The East Germans also installed anti-vehicle trenches, electric fences, massive light systems, 302 watchtowers, 20 bunkers, and even minefields. Over the years, propaganda from the East German government would say that the people of East Germany welcomed the Wall. In reality, the oppression they suffered and the potential consequences they faced kept many from speaking out to the contrary. The Checkpoints of the Wall Although most of the border between East and West consisted of layers of preventative measures, there were little more than a handful of official openings along the Berlin Wall. These checkpoints were for the infrequent use of officials and others with special permission to cross the border. Checkpoint Charlie. Express / Getty Images The most famous of these was Checkpoint Charlie, located on the border between East and West Berlin at Friedrichstrasse. Checkpoint Charlie was the main access point for Allied personnel and Westerners to cross the border. Soon after the Berlin Wall was built, Checkpoint Charlie became an icon of the Cold War. It has frequently been featured in movies and books set during this time period. Escape Attempts and the Death Line The Berlin Wall did prevent the majority of East Germans from emigrating to the West, but it did not deter everyone. During the history of the Berlin Wall, it is estimated that about 5,000 people made it safely across. Soldiers investigating a tunnel dug beneath the Berlin wall. Michael Ochs Archives / Getty Images Some early successful attempts were simple, like throwing a rope over the Berlin Wall and climbing up. Others were brash, like ramming a truck or bus into the Berlin Wall and making a run for it. Still, others were suicidal as some people jumped from the upper-story windows of apartment buildings that bordered the Berlin Wall.   Soldiers patrolling the Death Strip. KEENPRESS / Getty Images In September 1961, the windows of these buildings were boarded up and the sewers connecting East and West were shut off. Other buildings were torn down to clear space for what would become known as the Todeslinie, the Death Line or Death Strip. This open area allowed a direct line of fire so East German soldiers could carry out  Shiessbefehl, a 1960 order that they were to shoot anyone trying escape. Twenty-nine people were killed within the first year. As the Berlin Wall became stronger and larger, the escape attempts became more elaborately planned. Some people dug tunnels from the basements of buildings in East Berlin, under the Berlin Wall, and into West Berlin. Another group saved scraps of cloth and built a hot air balloon and flew over the Wall. Unfortunately, not all escape attempts were successful. Since the East German guards were allowed to shoot anyone nearing the eastern side without warning, there was always a chance of death in any and all escape plots. It is estimated that somewhere between 192 and 239 people died at the Berlin Wall. The 50th Victim of the Berlin Wall One of the most infamous cases of a failed attempt occurred on August 17, 1962. In the early afternoon, two 18-year-old men ran toward the Wall with the intention of scaling it. The first of the young men to reach it was successful. The second one, Peter Fechter, was not. West Berliners Protesting at Berlin Wall with pictures of Peter Fechters body. Corbis / Getty Images As he was about to scale the Wall, a border guard opened fire. Fechter continued to climb but ran out of energy just as he reached the top. He then tumbled back onto the East German side. To the shock of the world, Fechter was just left there. The East German guards did not shoot him again nor did they go to his aid. Fechter shouted in agony for nearly an hour. Once he had bled to death, East German guards carried off his body. He became the 50th person to die at the Berlin Wall and a permanent symbol of the struggle for freedom. Communism Is Dismantled The fall of the Berlin Wall happened nearly as suddenly as its rise. There had been signs that the Communist bloc was weakening, but the East German Communist leaders insisted that East Germany just needed a moderate change rather than a drastic revolution. East German citizens did not agree. Russian leader Mikhail Gorbachev (1985–1991) was attempting to save his country and decided to break off from many of its satellites. As Communism began to falter in Poland, Hungary, and Czechoslovakia in 1988 and 1989, new exodus points were opened to East Germans who wanted to flee to the West.   In East Germany, protests against the government were countered by threats of violence from its leader, Erich Honecker. In October 1989, Honecker was forced to resign after losing support from Gorbachev. He was replaced by Egon Krenz who decided that violence was not going to solve the countrys problems. Krenz also loosened travel restrictions from East Germany. The Fall of the Berlin Wall Suddenly, on the evening of November 9, 1989, East German government official Gà ¼nter Schabowski blundered by stating in an announcement, Permanent relocations can be done through all border checkpoints between the GDR [East Germany] into the FRG [West Germany] or West Berlin. People were in shock. Were the borders really open? East Germans tentatively approached the border and indeed found that the border guards were letting people cross. Corbis  / Getty Images Very quickly, the Berlin Wall was inundated with people from both sides. Some began chipping at the Berlin Wall with hammers and chisels. There was an impromptu and massive celebration along the Berlin Wall, with people hugging, kissing, singing, cheering, and crying. Corbis  / Getty Images The Berlin Wall was eventually chipped away into smaller pieces (some the size of a coin and others in big slabs). The pieces have become collectibles and are stored in both homes and museums. There is also now a Berlin Wall Memorial at the site on Bernauer Strasse. Luis Davilla / Getty Images After the Berlin Wall came down, East and West Germany reunified into a single German state on October 3, 1990.

Art and gender Assignment Example | Topics and Well Written Essays - 250 words

Art and gender - Assignment Example Men are depicted to be more aggressive and adventurous than women. Conversely, women are portrayed as more affectionate and nurturing (Bar-on et al, 2001). They are also ‘sex objects’; they are shown wearing skimpy clothing most of the times and tend to be pursued sexually more often than men. The message also emphasizes the physical appearance of the women, depicting them as passive and seekers for men attention. These views are consistent with Kalof research findings (Bar-on 191-194). Notably these are not the only images of gender roles young men and women are exposed to while enjoying the visual entertainments. Music video No More Drama by Mary J. Blige tries to depict women in a more empowering manner. The gender stereotypes images shown does not necessarily affect different views by both male and women. Kalof study involved young, educated white college students; thus this result does not apply to other racial groups, social classes or people with less education. In addition Kalof (378-385) study focused to prove if sexual images on videos affected people based on their gender. However, in her article she refers to the participants as women or men, which are terms used to describe one’s biological sex rather than male and female. In light of this indistinctness one’s biological sex can probably be the link to one’s sexual attitudes and not the

Principles of Economics Gross Domestic Product Essay

Principles of Economics Gross Domestic Product - Essay Example During the base year nominal and real GDP are equal. Therefore real GDP reflects both prices and quantities of goods and services produced by an economy, whereas nominal GDP reflects the produced quantities only. GDP does not reflect accurately the nation's productivity. There are products that GDP excludes, because it is difficult to measure them. For one thing, GDP includes all items produced and sold legally in the market. This means that products that are produced and sold illegally cannot be traced and measured by the GDP. Additionally, GDP does not include products and services that are actually produced by households but never enter the market. These are, for example, home grown fruit or vegetables that are used within the households that cultivate them. Also, GDP excludes other immeasurable variables like the quality of the environment or leisure time and does not reflect the distribution of income within an economy.

Observations at Roosevelt middle school Essay Example for Free

Observations at Roosevelt middle school Essay I observe at Roosevelt Middle School, which is in River Forest, in Mrs. Brauns sixth grade English class on Tuesdays in the morning. As I have observed, I have noticed that the classroom is student-centered. During computer time, Mrs. Braun focused more on helping the students get into the computer program to start the assignment than on having enough time to get the assignment done. Several times, Mrs. Braun gave helpful comments on how to do things on the computer or in the program, such as how to install automatic spell check. Mrs. Braun was also very patient as she was being asked questions while she was trying to explain the assignment. From what I saw, some students were getting bored, though, while the assignment was being explained and started whispering to each other. However, the whispering did stop when the students had to get started on the assignment. I have also observed that there seems to be a strong set of rules in place in Mrs. Brauns classroom. This is evident through some of Mrs. Brauns subtle, and not-so-subtle, reminders. For example, she gently made an example of a student by pointing out that his decorated pen (with a silly topper on it) was not allowed in class if it was going to be played and not used. She made a general statement that all pens similar to it are not welcomed is they are going to be played with. Overall, the students follow the rules very well, and there have not been any severe disruptions. There has only been whispering occasionally, but it stopped when Mrs. Braun asked. Disciplinary strategies seem to be in place as well, although I have not seen any discipline used while I have been observing the class. There is even a routine in place in the classroom for each period. During period one, first of all, old assignments are collected by Mrs. Braun, and then vocabulary is covered. Then a vocabulary assignment is given with any other new assignments on what is being cover in class. Next the teacher reads or goes over any assigned readings from the book that is being covered in class. This is the same basic routine for period two. The third period is computer time and the routine seems to vary. There is a quick transition from activity to activity during these routines. The classroom environment is that of a basic classroom setting. There are some decorations and other things hanging on the wall. Among the decorations is a hand-made calendar on the wall by Mrs. Brauns desk. There is a history of each students last name on the wall on the other side of Mrs. Brauns desk. There seems to be a controlled temperature and lighting in the classroom and they are set at an adequate setting. The room is arranged with five groups of desks in a circular type shape. In the middle of the room is a cart where new assignments are put and reading journals are kept. There are different locations throughout the room for different supplies. With the layout of the room, it seems there is adequate space to move around and do in-class activities. The physical space also seems conducive to teaching and learning. The physical space, including seating and grouping arrangements, seems to enhance cooperation and learning because there seems to be fewer distractions around them. There seems to be fewer distractions because the students have less people to talk to than if they were seated in rows, though they may still be tempted to talk. This classroom seems to function well as a total environment through its layout. I have observed many things in my first two observations in Mrs. Brauns class. The students do a lot of in-seat assignments, such as handouts. There seems to be a few good projects being done but they are done mostly outside of class. I feel that some time should be spent in class working on the projects, even if it is 10-15 minutes. The layout seems like both a good idea and a bad idea. It seems like a good idea because if one student gets stuck on something, there are others around to help. It seems to be a bad idea, though, because of what I stated before, there is still the temptation for the students to talk when they are not suppose to and distract each other. The only implication I have is that it seems that some old methods are hard to leave behind, such as busy work (hand outs), for more interactive methods (interaction with each other).

We All Must Take Responsibility :: Argumentative Persuasive Essays

We All Must Take Responsibility "She is a really responsible person." "He doesn't take responsibility for his actions." "She was responsible for the accident." How many times have we heard statements similar to these? A definition of responsible might be accountable, reliable, dependable, or trustworthy. Based on my observations and experiences, I believe many people have a problem translating that into their everyday lives. If something bad happens, it must be someone else's fault, or someone should have to pay. A few months ago, I was involved in my first car accident. I think it's pretty remarkable that this was my first accident, considering that I've been driving for almost thirty years. The accident itself was pretty traumatic. I was at a complete stop behind two cars that were turning left, when a large van traveling at about thirty-five mph rear-ended my car. I was fortunate to escape with only some large bruises and a very sore knee; however, the car didn't fare quite as well. What was more amazing than the accident itself were the actions of the young man who ran into my car. Instead of taking responsibility for his actions, he lied to the police and to his insurance company about the events that took place. His version was that he was driving behind me when I ran into the car in front of me, then bounced back into his van. Perhaps if he'd had more time he might have been able to concoct a more credible story, one that actually made sense. In the end, the police and his insurance company saw through his lies and everything was taken care of. But in the meantime, my car was towed away and I was left with no car. What's amazing to me is that he never got out of his van to see if anyone was injured, and he never apologized for smashing two cars and causing me the inconvenience of being without a car for five weeks while the damage was repaired. Several months ago, there was a tragic fire near the Quad Cities. Unfortunately, two young children lost their lives when one of them started a fire in their apartment.

Artists and Self Portraits

Why would someone take the time to create a work of art that merely resembles themselves? To answer this, one must understand the famous artists of the past, both visual and literary. When analyzing a self- portrait, one notices that it often goes beyond the visual characteristics of the author. Minute details that can be easily overlooked frequently delve into the artist's personality and can sometimes make the viewer look deeper Into themselves. To answer the why of self-portraiture, one must understand the how.By comparing the tertiary elements of Portrait of the Artist as a Young Man, by James Joyce, to the artistic techniques utilized by legendary artists In their self-portraits, one learns the reason of why someone would create a portrait of themselves. When making a self-portrait, It takes much more than simply looking In the mirror and copying what one sees either In text or through art. To make a self-portrait, the artist must look Into themselves and select their most Impor tant qualities that they want to show to the world. Jockey's original version of Portrait of the Artist as a YoungMan, known as Stephen Hero, was comprised of over nine hundred pages and his siblings were major characters. In the revision that made it his portrait, he decided to get rid of a few hundred of those pages and to focus exclusively on the psychological growth of his alter ego, Stephen Deals. While it must have been difficult for Joyce to completely take out a majority of his work from the published product, the more precise version gave readers a true sense of Joyce and what moments in his life affected his process of growth from a young poet to an accomplished writer.The selective process is one of the most important elements of elf-portraiture. Another important aspect of self-portraits is the use of color; in literary portraits, the use of diction. The best way to describe the importance of the two was explained by Vincent van Gogh, â€Å"Instead of trying to reproduc e exactly what I have before my eyes, I use color more arbitrarily, in order to express myself, more forcefully. † Van Gogh understood the importance of colors and how they can affect the overall message off self-portrait.In a portrait that he painted right after being admitted Into a psychiatric hospital (image 1), the background is dark blue and his shirt Is almost the same color. Because the shirt does not have a definite outline, It gives the Illusion that he is fading into the dark abyss of the background. After spending more time In the hospital, he painted another portrait (Image 2). Even though the actual Image of him is almost identical to the previous portrait, It evokes a completely different set of emotions because of the lighter colors he used.The light blue tones make the painting feel relaxed and calm whereas In the previous painting, the dark color makes It feel ominous and depressing. Van Sago's quote can also be applied Joey's writing. In the years after Step hens childhood, he never Just states what Is going on In the world around him; his Dalton and perspective always affect It. The Dalton he uses not only describes his surroundings, but It describes him as well. HIS choice of diction gives the reader Insight Into his personality and his opinion without directly stating it. When talking about prostitutes, he has two very different views.In rebellion, his encounter with the prostitute is very emotional and almost loving. He refers to her as â€Å"a young woman dressed in a long pink gown† and uses phrases like warm and lighthouse,† â€Å"embraced him gaily,† and â€Å"tears of Joy and relief shone in his delighted eyes† to show his happiness and comfort in the presence of the woman. In the third chapter, when Stephen is beginning to close himself off emotionally, he calls prostitutes â€Å"whore's† and describes them using words like â€Å"squalid,† â€Å"yawning lazily,† and â€Å"cluste rs of hair† which accentuates his hardened opinion towards them.Easily overlooked, the use of color and diction changes the overall meaning of self-portraits by conveying feelings that otherwise would have been missed. In addition to color ND diction, small details are another vastly important aspect of portraiture that usually go unnoticed. An artist who understood how small details could express personality and advertise oneself was Judith Leister. She knew how to make people feel as if they knew her when they looked at her portrait.Her self-portrait emphasizes the importance of small details and what they can add to the message of the final product. In her portrait (image 3), her posture alone says many things about her personality. She is leaning back with her elbow on the chair facing towards the ewer which shows that she is confident in what she is doing and takes pride in her work, eager to show it off to any who interrupt her when she is at work. Her facial expression shows that she is happy, outspoken, and has a warm, welcoming attitude towards people.The other miniscule details that she included in her portrait may have been a clever form of self-promotion. The painting she is working on in the picture is of a man playing the violin; she was known for painting lively, happy scenes so by having it in her self-portrait, she is saying that painting these scenes is an important part of her. She is holding eighteen brushes in one hand which shows that she is a talented artist and the clothes that she painted herself in show that she is wealthy and successful.These details could be used to entice potential patrons to hire her because by seeing her portrait, they believe that she is a talented artist who is confident in her work. Like Leister, James Joyce also understood the weight that small details carry. When describing people, Stephen only gives the person's description and actions; he never gives his actual opinions of them. The details that e in cludes shows what stood out to him in the moment and which features of the person were the most important. One character that Joyce gives a personality to through details is Vincent Heron.Heron and Stephen had been competing in school for as long as the two can remember yet Joyce never outright says Stephens opinion of him- it is blatantly stated through the details that are included. The first thing that Heron says is â€Å"Noble Deals' in a high throaty voice. † He then lets out a â€Å"soft peal of mirthless laughter,† and brandishes his cane. Beside him, he has an intimidating yet intelligent friend who agrees with everything Heron says. From these few details, much can be said about what Stephen feels is Heron's personality.From the way laughs and the fact that he carries a cane with him, it is obvious that he is arrogant and believes himself to be better than those around him. It also shows that Heron is a powerful manipulator. His fake laugh, the way he addresse s Stephen and the fact that a more powerful man is his inferior shows that he knows how to interact with people in a way that results in him always having the upper hand in a situation. Small details can have on self-portraits. In addition to these elements of self- portraiture, motifs are significant as well. Might not a painter's choice of lines and colors give an indication of his character, whether it is noble or common? † Paul Gauguin believed that the way in which a person makes their portrait says the most about them. In his Self-portrait from 1889 (image 4), he paints himself among many different symbols. The halo above his head symbolizes him as almost being an angelic figure yet he is holding the snake of temptation between his fingers. He is also within reach of the apples of the Tree of Knowledge which means that when he as painting this, there was a temptation that he had to refrain from.The fact that he only painted his head in the portrait may symbolize that he felt lost in this battle of good and evil and that he felt out of control. The bright red of the background also adds to the chaotic feeling. By painting himself interacting with all of these symbols, it may be his way of conveying his battle between good and evil into a portrait. His painting of the motif showed that he felt there was a hectic struggle going on in his life that affected how he saw himself. Joyce also put emphasis on the power of outfits.In Portrait of the Artist as a Young Man, a major motif that is applied throughout the story is that of temperature. When Stephen was happy and comfortable, Joyce did not have to say it; he made a reference to something that was warm that was a signal of Stephens happiness. When Stephen was depressed and felt lost, something about the situation felt cold. While at Clones, a boarding school that he hated, he always felt cold and uncomfortable and when he thought of being at home to comfort himself, he would feel a wave of warmth wash over him.The motifs that artists use to further their self-portraits often elevate them to a level that takes deep comprehension to understand. So why would one choose to make a self-portrait? Some may say that self-portraiture is a selfish act; merely a way for one to immortality themselves, a way to have a representation on earth long after they are gone. However, James Joyce describes how his self-portrait came to be the best, â€Å"Think you're escaping and run into yourself. † When Joyce first started to write Stephen Hero, he was attempting to distance himself from his embarrassing, poetic sat.Yet as he began to put more into the work, he began to delve deeper into himself, realizing what made him the man he was and what he contributed to the world around him. Self-portraits force the artist to embark on a Journey of self- discovery. They make it possible for the artist to warp the person that the outside world sees into the person that they see themselves as or the pe rson they wish to be. While self-portraiture may have selfish results, the process of creating a self-portrait is the artist's way of understanding themselves, inside and out.

Discuss the ways in which women’s domestic role

Beginning in the home, a woman's role is socially constructed from an early age. A woman's role models are traditionally her parents and many women naturally follow in their mothers footsteps. However, this can often work In reverse and women of whose mothers stayed at home In a domestic care role then go on to carve careers for themselves. Although these days women do have careers they are still socially seen as the homemaker regardless of this.A woman's domestic role is often run alongside other work and a great number of women choose careers which are care eased. The sexual division of labor is at the heart of gender inequality, which is underpinned by the patriarchal family structure where the man Is the highest authority and sole provider and there Is a rolled dolls of tasks and responsibilities, all of which have been regulated by social norms that have become constructed and ingrained over time. Florence Nightingale was a great influence in creating the nursing/caring role.She acknowledged that a great number of women naturally progressed into care roles and so she introduced the role of a nurse yet it was not a consider profession at this point Medical stations in the Crimean war were poorly staffed with awful medical and sanitary conditions. This was reported by the media In Britain. Florence Nightingale, one of 38 voluntary nurses traveled to Turkey to help relieve the situation. Nightingale worked towards improvements in sanitation, nutrition, and activity for the patients of the hospitals.Death rates were reduced dramatically with the introduction of such measures. Nightingale kept meticulous records of the number of deaths, and the causes of deaths, so that on her return to Great Britain she could Justify the need for Improving conditions In hospitals. Criticisms of Florence Nightingale have been that she created a female occupation, excluding males based around her view that women were naturally caring and naturally gifted at looking after people. This only emphasized ‘female virtues' especially in the media as they made this her main point even though there was much more to her than Just this point. As a result of what she did the beliefs of the male professionals were further supported. Those beliefs being that women are innate males in the workforce and the nursing role was stereotyped as a role which only women performed bringing with It the stereotype which we still hold today. Even now, with many more men taking on the role of the nurse we seem to find this unusual and sometimes quite a surprise.During this time the education system excluded women from the ability to gain scientific knowledge and the medical profession denied access to women who actually had managed to gain education. After Florence Nightingale, Ethel Bedford Fenwick (who is she) said that by 1901 , although we had moved on from the workhouses there was still no professional nurses in Britain and campaigned for a nationally recognized training sys tem to create an actual nursing ‘profession' This era was such named the era of the ministering angel' She worked to elevate nursing from the time of Florence Nightingale.During much of the 20th Century there was little progress with the imbalance of male to female care professions, even with the introduction of the INS women still made up the majority of the workforce in the INS with the male professions making up the majority of top rank Jobs, such as surgeons and insulates, much higher paid, recognized and respected professions. Domestic service of all kinds was the single largest employer of women (40 per cent of female occupations stated in the census of 1851 in provincial cities and 50 per cent in London).The textile and clothing sectors came a close second (http:// www. BBC. Co. UK/history/British/Victorians/women's_work_OLL . SHTML) A greater number of women than men choose Job roles in the care industry. Ann Oakley refers to this as being the influence of gender oscil lation and the women's domestic role in the home throughout history. This fact adds to the divide between men and women in the health and social care sector with statistics showing that in 2010 for an example, women made up 74% of the workforce in the INS and men only 26%.Even the most educated women earn less than men, women generally receive a lower return on their education and workplace discrimination against women is reflected in pay irrespective of educational level. In 2009 the BAM report was released, highlighting the inequality in male and female salaries within the health care industry. An average gap of El 5,245 between men and women in the same reversions. â€Å"Our results show that men and women with identical experience and expertise are paid differently – which suggests evidence of discrimination† (BAM 2009) It seems women are discriminated against due to her weakness in her ability to move.

Juvenile Justice in Australiaa essays

Juvenile Justice in Australiaa essays The Juvenile Justice Act 1992 (QLD) defines a juvenile as a young person under the age of 17 years. It maintains that a child under the age of 10 years is not considered criminally responsible, and is incapable of forming 'criminal intent'. Similarly, a child under the age of 14 years is not considered criminally responsible, unless it is proven that the child understood the offence was morally wrong. The extent of Police Powers over juveniles, the efficiency of the juvenile justice system, and possible solutions to the problems arising from these systems, need to be addressed in order to reduce the high rate of youth crime. Queensland police have insufficient powers over juveniles, due to the introduction of the Police Powers and Responsibilities Act, which commenced on 6th April 1998. Police have the authority to stop a juvenile, search, question and detain them for questioning without arrest if the officer reasonably believes that juvenile was or will be involved in criminal activity. Cautions can be issued to juveniles as an informal means of addressing a matter, as arrests are only encouraged in exceptional cases. Police can question, fingerprint, photograph and take bodily samples from a juvenile, on the condition that a parent or guardian is present. All other police procedures involving juveniles are uniform to those of adults. The current juvenile justice system is ineffective in dealing with young offenders. For a simple offence such as stealing, the most a child can expect as a means of punishment is a caution, which is not revealed in a further court action concerning the child, or a good behaviour order. It is thought that punishments such as these do little in preventing juveniles from reoffending. The Queensland Police Service Statistical Review for 1996-7 revels that 25% of all offences, 66% of break and enters, 61% of motor vehicle thefts, 44% of robberies and 41% of stealing offences ...

Avoid these Overused Resume Phrases

Avoid these Overused Resume Phrases Avoid these Overused Resume Phrases The goal of every resume is to provide a brief and comprehensive summary of your job history and skills while leaving a lasting impression on the recruiter. Since companies receive dozens of resumes per hiring season, employers who are assigned to sort through these documents encounter repetitive phrases which render the submission clichà ©. Several online resources provide a list of key phrases to avoid when writing a resume. While helpful, sometimes these phrases provide the opportunity to share something valuable. Instead of deleting these phrases altogether, rewrite them in a way that makes your resume stand out, and provide concrete examples of your work experience. Here are some commonly used phrases from resumes and suggestions to rewrite them: â€Å"Works well independently† Most of the time, this phrase is used as a crutch (and is usually part of a bullet list). Instead of focusing on the trait alone, provide an example that showcases your independent nature. Example: â€Å"In 2010, I launched my own website focusing on providing young adult readers with tips and tricks to save money.† This statement showcases your skill, experience, and knowledge while providing a concrete example to the reader. â€Å"A great team player† Teamwork is important is crucial in any workplace to meet company goals, but this phrase does not impress. Instead, share events that showcase you and your former team’s participation or achievement.Example: â€Å"Volunteered with colleagues and organized a 2011 fundraiser.† â€Å"Results driven† Results usually require quantitative data. To avoid this ambiguous claim, write about strategies you implemented which resulted in a percentage of change.Example: â€Å"Reduced the percentage of tardy employees by 10% by implementing an incentive and penalty policy to encourage them to be on time.† â€Å"Good communication skills† Communication skills are important, but this is another example of a broad statement. In this case, provide an example showing how your skills were put to good use.Example: â€Å"Prepared and presented a slideshow to job applicants attending the 2010 job fair in Springfield.† â€Å"Strong attention to detail† It pays to be meticulous with details but it’s even better when other examples are provided.Example: â€Å"I have considerable experience editing articles for an SEO company.† If you rewrite overused phrases and provide concrete examples of your success, potential employers are more likely to schedule an interview with you. Your new resume offers a concise summary of your knowledge, skills, and experience while helping you stand out from the rest of the applicants. hires a team of talented writers who have considerable experience in writing, editing, and/or proofreading resumes while providing key phrases that impress employers.

Teachings of Islam Research Paper Example | Topics and Well Written Essays - 1500 words

Teachings of Islam - Research Paper Example Islam is just another monotheistic religion like Judaism and Christianity and like them preaches the oneness of God whom the Muslims call Allah. There are differences present in the practices but Islam in originality is a peaceful religion and it is the practice of the few which has gotten it labeled as a terrorist, violent or extremist religion. The basic beliefs and tenets of Islam The main belief of Islam lies in monotheism. Islam's fundamental belief is that God is one and Mohammad is His messenger. This belief can be elaborated by believing that God is one and supreme, unique, all encompassing and powerful. The second belief lies in the prophet hood of prophet Mohammad who initiated the religion in 610 A.D. Their belief relative to prophets is that prophets are human being sent for the guidance and showing the right path. Also that out of many prophets sent by God Mohammad is the last prophet. Thus Islam acknowledges the presence and the prophet hood of Jew and Christian prophet s like Jesus, Moses etc and their names are mentioned in the holy book of Muslims, the Quran. The third belief of Islam states that God sent Holy books of which Quran is meant to be for eternal guidance and all other books are negated by the revelation of Quran. The fourth belief lies in angels who are pure non-human beings performing divine jobs and the last belief lies in resurrection and the day of judgment. This day of judgment, according to Muslim beliefs will be the day when all actions will be weighed and decision regarding heavens or hell will be made. (Alhoda, 2001) There are five basic tenets of Islam of which the first and the foremost is belief in God with all his attributes and attributing no other partners with him. The second is saying prayers five times a day and men gathering in the mosque for Friday afternoon prayers. The third is fasting from dawn to duck in the Holy month of Ramadan (Muslims follow the lunar calendar) and the fourth is giving a fixed percentage o f wealth in the path of God to the poor and the needy. The last is performing pilgrimage to Mecca once in the lifetime for all those who can afford to do so. (Devera) Islam and Muslims in the U.S Muslims entered the United States as Moriscoes who accompanied Columbus when the continent was first discovered. These were followed by slaves who were brought to work in the US and the waves of migrations increased the number of Muslims (Kabourra). In the U.S. today there are between 6-8 million Muslims in the United States out of which African-Americans are predominant. It is the fastest growing faith in the United States (A brief history of islam in the United states) and mosques, Islamic centers and Islamic schools are found in every Muslim community. Regional and national conferences of Muslims are held and issues of common concern are streamlined. Muslims in the USA are allowed to freely practice their religion and MSA's (Muslim Students Association) are present and active in all coll eges and universities. A survey reports that there are 1000 mosques, 400 Islamic schools, 400 associations and over 80 Islamic publications in the US. (A brief history of islam in the United states). Thus Muslims in the United States can practice their religion more freely than a few Islamic countries for example like Turkey where the headscarf is banned or like Egypt or Morocco where being extremely devout is often

C.S.I. Movie Analysis and Review of Episode 321 FOREVER Essay

C.S.I. Movie Analysis and Review of Episode 321 FOREVER - Essay Example The episode is about a horse that stomps her trainer to death aboard a luxurious personal jet. This horse is then quarantined by a vetenary officer after the jet landed. Things become suspicious when the horse suddenly dies and the vetenary officer disappears (CSI Ep 21.). Conversely, another incident happens where two teenagers have been alleged to commit suicide and their bodies found in the middle of the desert. Detectives from CSI look at this cases separately to determine the truth behind them. The trampling death of the horse trainer is investigated by Grissom, Nick and Catherine. Warrick and Sara look into the two teenagers (Romeo and Juliet) scenario in the desert. Crime Scene Investigation (CSI) is an American crime and drama television series that premiered in 2000. This series follows The Las Vegas Criminalists in which the analysts use the physical evidence to solve murder cases in this unusual graphic drama. CSI has been acknowledged as the most popular dramatic series a nd has been awarded International Television Audience by CBS. It has also been awarded the Best Television Drama Series for the last three years. Most of the episodes in this television series deal with a team of forensic investigators who are trained to solve crimes based on the evidence that has been collected. They are specialized in collecting irrefutable evidence and find the missing pieces of the puzzle to unravel the mystery behind every case. A murder aboard in a deluxe 747 personal jet and the discovery of two formally attired teens found in the desert confound the chief analyst Grissom and his crew in this absorbing episode of CSI. First, a horse trainer is found dead inside the cargo bay of a privately own jet that is carrying 12 well –heeled passengers and a horse worth millions (CSI Ep 21.). At first, it appears that the victim was trampled to death; however Grissom and Catherine uncover evidence that suggest foul play. In a separate incidence, In Hell’s G ate section of Death Valley, CSI analysts Warrick and Sara probe the alleged suicide of a 15 year old boy whose body is found under a bed spread. This investigation becomes more intensified when a girl’s body is discovered half a mile away. This is one of the most memorable episodes in this series; it is not only well written but cleverly plotted. In the first case, Grissom and Catherine are in the quest to determine the cause of death of the horse trainer and the horse itself. Both of them go to the airport to gather pieces of evidence. They found some abnormalities inside the plane that insight them to carry out further investigations (CSI Ep 21.). When the horse dies, after it contracts uterine infection, they take it to the lab to determine the cause. After they perform an autopsy on the horse, they find diamonds inside the uterus. The crew on the plane orchestrated the death of the horse trainer to smuggle the diamonds inside the horse. Grissom says â€Å"uncut diamonds ? The horse is a â€Å"mule†. The horse trainer discovered the abnormalities in the horse and when he tried to help the horse, it stamped on him causing his demise. But, this was not the real story, the vet that was waiting for the horse at the airport knew about the diamonds. The killed the horse trainer because he was going to blow their cover and the diamonds could have been discovered. In the second scenario, a boy is found dead at the dead valley. It is a strange scenario to find a boy dressed in a suit who

Knowledge Management and the Competitive Strategy of the Firm Article

Knowledge Management and the Competitive Strategy of the Firm - Article Example The study reviews literature that tackles knowledge management in relation to the competitive advantage of an organization. The literature includes Porter ‘5 forces model’, and ‘Wernerfelt’s’ resource base view of a firm. The relationship between KM and strategy formulation by use of resource-based perception of the organization is established. The applicable literature that links KM with strategies is examined. The paper culminates with research findings, implications, and conclusions. Porter based his argument on SWOT analysis concept. Porter views that the five force model depends heavily on the competition level in the industry. The five forces include; the threats presented by new entrants in the market; suppliers bargaining power; threats offered by the substituting goods, and the jockeying among the existing contestants. When an organization has perfect information pertaining to the existence of the above factors they tend to conquer the market . This is because the organization will devise a strategic plan that counteracts the actions of the competitors. The strategy focuses on external factors that analyzing the opportunities and threats evident in the industry. Barney views that organizations that utilize their internal strengths to act on the opportunities at the same time weakening threats and avoiding internal weakness attain a significant value on the competitive competition. The theory argues that a firms’ success lies in its ability to incorporate its ability and resources. A firm’s resources must never be easily imitated by the competitors. Various researchers supporting the theory including Penrose, Barney, and Mahoney and Pandian asserts that; competitive advantage resources must be valuable, with no substitute and inimitable.

Case Study of Managing patient suffering Opoid constipation

Case Study of Managing patient suffering Opoid constipation This case study outlines the clinical management of a client with a problem with Opioid induced constipation. Opioid analgesics (narcotics) cause constipation in most people. Opioids slow down the stool as it passes along the intestinal tract. This causes the stool to become hard. If you have hard stools, have difficulty passing bowel movements and the movements become infrequent, then you have constipation. Constipation can be very bothersome and last as long as you are taking narcotics on a regular basis. Therefore, it is important that we learn to manage our bowels effectively. Throughout the analysis the anonymity and confidentiality of this patient will be protected as outlined by the Nursing and Midwifery Council (2008) and therefore the patient will be referred to as Mark Scott. Additionally consent was gained by Mark to allow the author to use his case for my assessment. History of present illness Mark Scott is a 64 year old gentleman who is 2 days post op following a Right Total Hip Replacement (RTHR). Total hip replacement involves removal of a diseased hip joint and replacement with a prosthetic joint. Whilst doing the medications Mark confided in the nurse that he may have a problem with his bowels and that he may be constipated. To enable the nurse to assess Mark she would have to understand constipation, it helps to know how the colon, or large intestine, works. As food moves through the colon, the colon absorbs water from the food while it forms waste products, or stool. Muscle contractions in the colon then push the stool toward the rectum. By the time stool reaches the rectum it is solid, because most of the water has been absorbed. Constipation occurs when the colon absorbs too much water or if the colons muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly. As a result, stools can become hard and dry. Mark asked the nurse if there was anything she could give him to ease the discomfort he was experiencing, However as Mark has presented with a new problem with the possibility of him needing medication, the nurse would first need to undertake a holistic assessment of Mark. The purpose of assessment is to allow the nurse to examine all relevant factors of the problem and allow her to make the decision of whether prescribing a patient group directive (PGD) is an appropriate intervention (Humphries, 2002). Consider the patient When Mark stated he thought he was constipated, it was important to ascertain his own interpretation of what this meant. For example, Wondergerm (2005) states that for some, constipation may mean opening their bowels less than three times a day. On the other hand, constipation may mean opening of the bowels less than three times a week. There appears to be a general consensus that the range for normal bowel activity lies somewhere between three bowel motions daily to one bowel motion every three days. However, it is important to remember that a change from three bowel motions a day to one every three days may represent a significant change for the patient, despite remaining within the normal limits (Peate, 2003). Mark felt he was constipated because he hadnt had a bowel movement in the last five days. On further questioning it emerged that these symptoms had been going on approximately 4 days before his surgery and when he did have a bowel movement he had difficulty passing the stools and often had to strain. Mark also stated that the stools were very hard and painful to pass, the symptoms that Mark presented with were consistent with the side effects of constipation, However the cause of constipation is multifactoriol with many influencing factors that need to be investigated and eliminated wherever possible (Banks,1998). In Marks case it was the analgesia he was taking to control his pain post operatively. During Marks assessment, enquiries were made as to whether he was experiencing any other symptoms with his constipation, such as blood in the stools, rectal bleeding and/or mucus discharge, recent weight loss, abdominal pain or alternating constipation/diarrhoea. Edwards and Bentley (2001) state that this is important during history taking as all of these symptoms are common of colon and rectal cancer and the possibility of this disease should be in the mind of the nurse looking after Mark. Mark assured the nurse that he hadnt experienced any of the symptoms mentioned although he did have a little discomfort in the area of his abdomen, lots of wind but no pain. If Mark had any of these symptoms the nurse would have to liase with the patients consultant. No medication would have been given by the nurse at this stage. This is because as a nurse, she is accountable for her actions and omissions (NMC, 2008). For example, if Mark was to have a bowel obstruction such as a tumour which is c ontra-indicated for most laxatives, and the nurse had prescribed such medication then Mark may believe he has been harmed by her careless prescribing. Additionally failure to refer a patient for more senior opinion is considered to fall below an acceptable standard of care (Griffith and Tengnah, 2004). It is important to ascertain how much dietary fibre and fluids are being taken by the patient as high fibre content is effective in increasing stool weight and bowel movement frequency, ultimately preventing constipation. Additionally, low fluid intake has been associated with constipation, slowing colonic transit time or reducing stool output (Walker, 1997). Current medication regimes, whether prescribed or purchased over the counter is essential information and can assist in identifying any drugs that may be responsible for causing constipation (Annells and Koch, 2002). Additionally, a history of medicine taking should include noting whether a patient has any allergies. For example, arachis oil enemas have a nut basis and may cause allergic reactions (Edwards and Bentley, 2001). Pre and post operatively Mark had been prescribed analgesics in the form of Paracetamol, codiene and ibuprofen for his pain. He had been taking these regularly daily. Mark wasnt taking any other medication, wasnt allergic to anything he knew of and hadnt purchased anything over the counter for his constipation. Opioids are a common cause of constipation and act by increasing intestinal smooth muscle tone, by suppressing forward peristalsis and reducing sensitivity to rectal distension. This results in delayed passage of faeces through the gut (Fallon and ONeil, 1998). Through assessment together with eliminating possible causes and sinister abnormalities, the nurse diagnosed Mark with constipation secondary to opioid use. Which Strategy/Product Where the patient complains of feeling constipated and is experiencing discomfort, a rectal examination (DRE) is indicated in order to detect a loaded rectum and to determine which choice of product to administer, and this will depend on the consistency of the stool found on examination (Edwards and Bentley 2001). Digital rectal examination (DRE) is an invasive procedure and should only be performed after completion of a full assessment of constipation. The Royal College of nursing guidelines (2006) recommend that nurses undertaking digital examination are appropriately trained. Furthermore consent to this procedure needs to be gained as outlined by the Nursing and Midwifery Council (NMC) (2008) Further to examination, it emerged that no stools could be felt within the rectum. However, Edwards and Bently (2001) suggest that it is anatomically impossible to conclude that the rectum is empty through simple digital examination, as the length of the rectum is approximately 15cm and is th erefore beyond the reach of the longest index finger. Therefore due to Marks history, the preferred medical route will therefore guide the need to administer a laxative. Amongst the stimulant laxatives are senna and bisacodyl. These laxatives stimulate the intestinal mucosa, promoting the secretion of water and electrolytes, enourging peristalsis (Duncan, 2004). Timby et al (1999) recommend that stimulant laxatives be used only for short periods of time to allow normal bowel function to return as soon as possible as long term use may result in diarrhoea and hypokalaemia. However Marks constipation may remain for as long as he is using opioids or could re-occur. Therefore this type of laxative may not be sufficient. Osmotic laxatives act by retaining fluid within the bowel that they are administered to or by drawing fluid from the body. They include lactulose, macragols, magnesium salts, rectal phosphates and rectal sodium citrate (Peate, 2003). A phosphate enema would not be used in this case because this is usually used prior to radiology, endoscope and surgery for rapid bowel clearance. Additionally Mark stated he didnt want to go through having an enema, and would prefer something he could take orally. Lactulose is non-absorbable and acts by softening and increasing water absorption. This laxative may take up to 72 hours to act and bloating, flatulence, cramping and an unpleasant taste have all been reported side effects, (Banks, 1998). Additionally, lactulose may not be suitable in constipation where gut motility is impaired such as opioid use in Marks case, unless accompanied by a stimulant such as Senna. However, choosing a senna/lactulose combination, means that taken together they will act at different times (Edwards and Bently, 2001). However, evidence comparing different types of laxative is very limited. Nonetheless, a study was found comparing a low dose macragol with lactulose for the treatment of constipation. The treatment was 1-3 sachets of compound oral powder (movicol) versus 10-30g of lactulose daily. After 4 weeks patients in the movicol group had a mean number of stools and a lower median daily score for straining than the lactulose group (Attar et al, 1999).This concluded that movicol was more effective and better tolerated than lactulose in the treatment of constipation. This would then justify prescribing movicol for Mark, therefore increasing the frequency of bowel movements and reducing straining. However the Nurse had to get Marks doctor to prescribe Movicol as it is not listed in Patient group directive, so the nurse gave Mark 10mls of lactulose and 2 senna until this was prescribed. Negotiate contract In implementing the strategy the consent and agreement of the patient is paramount, and may be viewed as a shared contract between patient and nurse. This is known as concordance. It is important for nurses to adopt this approach to administering medication, as this directly involves patients in decision making about their treatment. It must be remembered that nurses owe a duty of care to their patients. Duty of care is a legal requirement owed by one person to another to take reasonable care not to cause harm. The courts have held that the nurse-patient relationship gives rise to such a duty (Kent v Griffiths, 2001). Additionally, common law decided from cases requires that nurses take care when prescribing, otherwise, a patient harmed by careless medicine administration can sue for damages by claiming negligence (Griffith and Tengnah, 2004). It is essential therefore that duty of care extends to quality of prescribing, including, assessment, advice and information giving, record ke eping, decision making along with medication selection and calculation, as well as communication with the patient and other professionals. The patient needs to know what is expected of them in carrying out the treatment plan and when the nurse needs to reassess the situation. Additionally the patient needs to know what the medication is for, how long it takes to work and how to take the product (Edwards and Bentley, 2001). In Marks case it was explained to him that he would be prescribed a product by the name of movicol for his constipation and evidence found on its appropriateness along with possible side effects for his condition was explained. He would receive 20 sachets with a view to taking 1-3 sachets a day. It was explained he would have to mix 1 sachet with 125ml of water (British National Formulary, BNF 2009) and the importance of drinking 2lts of fluid was explained along with the effects that movicol will have within his bowel. Mark was alerted to any know side effects of movicol as these could be alarming to the patient if that information is not given, for example, abdominal distension, pain and nausea. However this does not mean that Mark will experience any of these. Nonetheless, this information is essential and Mark was told to report any adverse effects to the nurse. Record keeping The NMC (2005) guidelines for records and record keeping, state that good record keeping is integral to our role as records are sometimes called in evidence in order to investigate a complaint. In light of this all details, including full assessment details, along with care plans which were both planned and executed, plans for review, and medications and prescriptions given, were all entered into Marks patient held records immediately. Additionally this was also recorded within notes in Nursing Notes. Marks own consultant was also informed of this information in order to assist with prescribing and also to avoid polypharmacy and adverse events from drug interactions. The nurse also ensured the drug card was signed as per NMC guidelines. Complementary Therapies Complementary therapies are treatments used to support regular or orthodox treatments such as medication. These treatments may be used to reduce stress and anxiety or may be used to help with problems such as pain, nausea and constipation. Abdominal massage has been shown to be effective as a marginally effective laxative regimen in one trial. However, massage is extremely demanding on staff time, and consequently is unlikely to be of widespread benefit to the patient. Acupuncture, One small within subject trial of sham versus true acupuncture showed some benefit in chronically constipated children, but acupuncture has never been tested for opioid-induced constipation. Herbal preparations such as Senna, a laxative, may be used as pods or a tea. Rhubarb stems (not the leaf, which contains poisonous oxalic acid), chrysanthemum stems, and peach leaves have laxative properties. Many preparations promoted as herbal or natural laxatives are in fact bulk forming preparations which should be avoided in opioid-induced constipation. However, if possible medication can be avoided as bowel movements may be facilitated if done at the same time every day, by mobility and physical activity, and increased dietary fibre and fluid intake. However, these approaches alone may not benefit all patients, especially those with severe constipation. Nevertheless, deficiencies in physical activity, and fluid and fibre intake should be addressed. Physical constraints and barriers should also be rectified, and commonsense toilet practices should be reinforced, such as not suppressing the urge to defecate, and using public washrooms if out of the house rather than waiting to return home. Summary The above account highlights that in the clinical management of medicine administration, it is vital that this is undertaken in an informed and systematic manner. This can be achieved through the selection and application of an assessment tool and by having clarity about the decision-making framework used to underpin Evidence Based Practice. The NMC emphasises that the administration of medicines is an integral and essential entry criteria for the Councils Professional Register (NMC, 2008). Furthermore, the Code of Professional Conduct clearly states that medication administration must not be seen solely as a mechanistic task but as a task that requires thought and the exercise of professional judgement (NMC, 2008). For nurses to practice competently, they must ensure that they possess the knowledge, skills and abilities required for lawful, safe and effective practice. They must acknowledge their professional competence and only undertake practice and accept responsibilities for those activities in which they are competent (NMC, 2008). The NMC guidelines of professional conduct (2008) require that nurses must maintain knowledge and competence. This can partly be achieved by the use of reflection on prescribing and administrating decisions. Word Count 3012 References Annells M Koch T (2002) Faecal impaction: Older peoples experiences and nursing practice. British Journal of Community Nursing. 7 (3)118-126 Banks A (1998) An overview of constipation: causes and treatment. International Journal of Palliative Nursing 4 (6) 271-275. Duncan J (2004) The management of constipation by nurse prescribers. Nurse prescribing 2 (2) 66-69. Edwards M Bentley A (2001) Nursing management of constipation in housebound older people. British Journal of Community Nursing, 6 (5) 245-252. Fallon M, ONeil (1998) ABC of Palliative Care. London, BMJ books. Griffith R, Tengnah C (2004) A question of negligence: the law and the standard of prescribing. Nurse Prescribing 2 (2) 90-92. Hardy, D., Smith, B. (2008) Decision Making in Clinical Practice. British Journal of Anaesthetic Recovery Nursing. Vol. 9 (1), pp. 19-21 Humphries J (2002) Assessment and evaluation in nurse prescribing, 2nd ed Palgrave, Hampshire. Kent v Griffiths (2001) QB 36 IN Griffith R, Tengnah C (2004) A question of negligence: the law and the standard of prescribing. Nurse Prescribing 2 (2) 90-92. Kyle, G. (2007) Bowel care, part 5 a practical guide to digital rectal examination. Nursing Times; 103: 45, 28-29. Nursing and Midwifery council (2008) Guidelines for records and record keeping. London. Nursing and Midwifery Council. (2008) The Code: Standards of Conduct, performance and ethics for nurses and midwives. London, NMC. Wondergerm F (2005) Relieving constipation. Journal of community nursing, 5 12-16 Peate I (2003) Nursing role in the management of constipation: use of laxatives. British Journal of Nursing. 12 (19) 1130-1136. RCN (2006) Digital Rectal Examination and Manual Removal of Faeces: Guidance for Nurses. London: RCN Timby B, Schere J, Smith N (1999) Introductory Medical-Surgical Nursing. 7th edn. , Philadelphia, Lippincott. Walker R (1997) Diagnosis and treatment of constipation. Practice Nursing 8 (4) 20-22