A Call to Arms †Style and Tone Essay

â€Å"After a while I went out and left the hospital and walked back to the hotel in the rain† (332). This last line of the novel gives an understanding of Ernest Hemingway’s style and tone. The overall tone of the book is much different than that of The Sun Also Rises. The characters in the book are propelled by outside forces, in this case WWI, where the characters in The Sun Also Rises seemed to have no direction. Frederick’s actions are determined by his position until he deserts the army. Floating down the river with barely a hold on a piece of wood his life, he abandons everything except Catherine and lets the river take him to a new life that becomes increasing difficult to understand. Nevertheless, Hemingway’s style and tone make A Farewell to Arms one of the great American novels. Critics usually describe Hemingway’s style as simple, spare, and journalistic. These are all good words they all apply. Perhaps because of his training as a newspaperman, Hemingway is a master of the declarative, subject-verb-object sentence. See more:  Masters of Satire: John Dryden and Jonathan Swift Essay His writing has been likened to a boxer’s punches-combinations of lefts and rights coming at us without pause. As illustrated on page 145 â€Å"She went down the hall. The porter carried the sack. He knew what was in it,† one can see that Hemingway’s style is to-the-point and easy to understand. The simplicity and the sensory richness flow directly from Hemingway’s and his characters’ beliefs. The punchy, vivid language has the immediacy of a news bulletin: these are facts, Hemingway is telling us, and they can’t be ignored. And just as Frederic Henry comes to distrust abstractions like â€Å"patriotism,† so does Hemingway distrust them. Instead he seeks the concrete and the tangible. A simple â€Å"good† becomes higher praise than another writer’s string of decorative adjectives. Hemingway’s style changes, too, when it reflects his characters’ changing states of mind. Writing from Frederic Henry’s point of view, he sometimes uses a modified stream-of-consciousness technique, a method for spilling out on paper the inner thoughts of a character. Usually Henry’s thoughts are choppy, staccato, but when he becomes drunk the language does too, as in the passage on page 13, â€Å"I had gone to no such place but to the smoke of cafes and nights when the room whirled and you needed to look at the wall to make it stop, nights in bed, drunk, when you knew that that was all there was, and the strange excitement of waking and not knowing who it was with you, and the world all unreal in the dark and so exciting that you must resume again  unknowing and not caring in the night, sure that this was all and all and all and not caring. â€Å" The rhythm, the repetition, have us reeling with Henry. In general, Hemingway’s writing is descriptive yet effective in leaving much to the readers interpretation and allowing a different image to form in each readers mind. The simple sentences and incomplete descriptions frees your imagination and inspires each person to develop their own bitter love story.

Memoirs of a Geisha

I. Title: Memoirs of a Geisha (1997) II. Author: Arthur Golden (1957- ) III. Setting: a. Where: Gion, Kyoto, Japan b. When: Early 1900’s (1930’s, World War II) IV. Character and Characterization: c. Principal Characters i. Sayuri Nitta (Chiyo Sakamoto) Sayuri is the main character of the book. As a child, she always thought well of others. She has determination and does not give up easily. Her gray eyes are what make her stand out the most. ii. Mameha Mameha was a well-known geisha in Gion. She was Sayuri’s older sister (not by blood) and mentor. She taught Sayuri what she needed to do for her to become a successful geisha.She is very determined and would do anything to achieve her goal. iii. Hatsumomo Hatsumomo was a geisha of the Nitta Okiya, the same okiya that Sayuri came from. She boasts of herself and thinks that no one is better than her. She despised Sayuri and saw her as competition, which led to her numerous attempts to destroy Sayuri’s life. iv. Chairman The Chairman was the reason why Sayuri had a purpose to live, which was the result of his act of kindness to Sayuri when she was a child. He is a person who thinks of other’s feelings. As a geisha, Sayuri wanted nothing more than for the Chairman to take notice of her. . Nobu Nobu was the Chairman’s right-hand man, the Chairman owed him a lot. He is patient and kind. Nobu’s appearance is peculiar because of his skin which was damaged by a bomb. He fancies Sayuri and waited most of his life to become Sayuri’s danna. d. Secondary Characters i. Pumpkin Pumpkin was Sayuri’s friend when they were young. Their friendship was destroyed by Hatsumomo, who was Pumpkin’s older sister. She was sweet and very helpful at first, but was influenced by Hatsumomo. Pumpkin also became a geisha from the Nitta Okiya, but she was not as famous as Sayuri. ii. AuntieAuntie was the first person to show kindness to Sayuri when she arrived at the Nitta Okiya . She wanted Sayuri to become successful and to not end up like her. When Sayuri became a geisha, she continuously helped her through what she needed to do. iii. Mr. Tanaka Sayuri, as a child, idolized Mr. Tanaka and thought that no other man is higher than him. Mr. Tanaka was the person who offered Sayuri’s father to sell Sayuri and her sister Setsu. He was the reason why Sayuri ended up in Gion. iv. Mother Mother was the sister of Auntie and the owner of the Nitta Okiya. She was very fond of money and would do anything to become richer.She later adopted Sayuri as her daughter and as the successor of the Nitta Okiya. v. Dr. Crab Dr. Crab was one of the men who were attracted to Sayuri when she became a geisha. Dr. Crab is a kind of person who would let nothing to stand in his way. He is known for spending a lot of money in the pursuit of mizuage. V. Subject Matter: a historical fiction about the life of a geisha in Japan before World War II VI. Thesis/Main Idea: The story re volves around a girl whose life was transformed from rags to riches when her father sold her until she became a well-known geisha in Kyoto.VII. The Part I Like The Best. Why? I was thrilled the most when I was reading the part where the Chairman met Sayuri in the Ichiriki Teahouse after the incident with the Minister on the island of Amami. I was so consumed by the book since I badly wanted to know what the Chairman would say to Sayuri. Shock and disbelief came over me when the Chairman admitted that he knew Sayuri was the child he saw crying near the Shirakawa Stream. VIII. The Part I Like The Least. Why? I did not like the part where the war was going on and Gion closed down.I felt as if the part was not that significant to the main topic of the story and that the story would just have the same effect to the readers without it. As a reader, I thought that this was the dullest part of the story. IX. Vocabulary Improvement: 1. Geisha-(n. ) a Japanese women educated to accompany men as a hostess, performing different skills such as dancing and playing instruments * Most Americans confuse geishas as prostitutes because of the pretend geishas who called themselves geisha girls and sold their bodies to American soldiers in Japan during the World War II. . Okiya-(n. ) the lodging house in which a geisha lives until she has paid all her debts from the okiya for sending her to school * Mameha was a geisha who was allowed to live in her own house since she was able to pay off all her debts from the okiya she was from. 3. Danna-(n. ) a geisha’s patron, a wealthy man who supports the geisha’s needs in exchange for spending time with him privately * Nobu spent almost his entire life waiting to become Sayuri’s danna which unforntunately never happened. 4. Shamisen-(n. a three-string musical instrument that is played using a plectrum * Many geishas, if not all, were taught how to play the Japanese instrument called shamisen, which they used in performa nces. 5. Mizuage-(n. ) the coming of age ceremony of an apprentice geisha, usually associated with the geisha’s loss of virginity; a large sum of money is to be paid to the geisha in return for her mizuage * According to Mineko Iwasaki, the geisha Arthur Golden interviewed for his book, a geisha’s mizuage was never won by means of bidding.X. Brief Summary: Chiyo Sakamoto, a girl from a little fishing village called Yoroido, was 9 years old when her father sold her and her sister Satsu to a man named Mr. Tanaka. They were brought to Kyoto where Chiyo and her sister were separated; Chiyo stayed in Gion in the Nitta Okiya as a maid, whereas her sister was brought to Miyagawa-cho where she worked as a prostitute. Chiyo started going to school to become a geisha, but when she learned about her sister’s location, she went to look for her.When they met, they decided that they would runaway a few days after, Chiyo tried to runaway but failed, which caused her her school ing priviledges. As Chiyo continued to live as a maid, knowing that she won’t see her sister again, she felt as if she has no purpose in life; then he met the Chairman who treated her kindly, which gave her hope for a better future. After this incident, she wanted to become a geisha hoping that she would please the Chairman someday.Mameha, a well-known geisha in the Gion district, became her mentor and trained her to become a successful geisha; she then changed her name to Sayuri Nitta, of the Nitta Okiya. Though she had numerous admirers, she wanted no one but the Chairman to take notice of her; she strived hard to for this and in the end, she eventually learned that the Chairman acknowledged her way back then from the very first time they met. Memoirs of a Geisha â€Å"Memoirs of a Geisha† is a book written by Arthur Golden. The plot takes place in Japan and tells us the story of a young girl; a fisherman’s daughter and her journey through life to become a famous Geisha, a Japanese female entertainer. The book describes the struggles of a young girl, Chiyo, who is abandoned; sold by her father. The story is told in flashback format with reference to the protagonist's present and past. The focal point of the story is constantly on the internal narrator, Chiyo, who later changes her name to Sayuri when she becomes a geisha. Sayuri, who is our protagonist, is eight years old and lives in the small fishing village of Yorido at the beginning of the story. She lived happily with her family until one day her mother becomes sick. Her father who is a fisherman can't afford the medical treatment of her mother. Seeing no other way out, he sells Sayuri and her clumsy older sister Satsu to Mr. Tanaka; the owner of the seafood company which all the villagers work for. Mr. Tanaka brings the girls to the cultural city of Gion. Satsu who is the less beautiful of the two is sold to a brothel while Sayuri is sold to the Nitta Okiya, a geisha house. At the Nitta Okiya she meets a number of different people. There is the owner of the Okiya who is referred to as â€Å"Mother†, a bull-dog looking woman, whose main concern is money as described by Sayuri. The main â€Å"Villain† of the story is Hatsumomo , a famous and successful geisha who lives in the same Okiya as Sayuri. Hatsumomo is the main resource of the Nitta Okiya since all the money she earns goes to support it. From the day Sayuri arrives at the Okiya, Hatsumomo dislikes her, she tries to make Sayuri's life as hard as possible. At first it is hard to understand why she has that kind of behaviour towards Sayuri but as the story continues we understand that it is all about jealousy. Hatsumomo can't stand that Sayuri is beautiful and sees that in a few years she might become a successful geisha unless she gets rid of her. Hatsumomo clearly states that she hates Sayuri and doesn't want her in the Okiya: â€Å"I shall destroy you† (pg. 78)1 Sayuri comes to the Okiya with a debt which she has to pay off. The debt just keeps getting bigger because she has to take geisha ‘lessons. Sayuri is taken out from geisha practice,e after several accidents, and made a slave at the Okiya. She has no hopes for her future when Mameha, a character who becomes very important to the story, comes to convince Mother to let Sayuri continue her geisha practice. She helps Sayuri throughout her career by introducing her to many famous and rich people who can invite her to their parties and by taking her to all important places where the big parties are held. Mameha gives her personal lessons and gives her all help she can and if it weren't for Mameha, Sayuri would never have become a geisha. Throughout the story we see how Sayuri's character changes drastically, from a simple and a naive country girl to a slave with no future to a graceful famous geisha and when the story turns again, a seamstress trying to survive the second World War. Although the story mostly concentrates on Sayuri and we get to know the secrets of a geisha's life, there's a lot more that can be learnt from the story. It tells us about the life in Japan before, during and after the Second World War. The story which is set in Japan wouldn't have existed if we were to set it elsewhere. Geishas are something unique to only Japan and can't be found in any other culture around the world. It tells us about the time before the war when everything was good. Sayuri mentions the war a couple of times, in the beginning but she talks about it as if it were something that was far off and didn't concern her. Then slowly she starts realising that the war is affecting them more and more when they start using ration books. Still, the reality of the war isn't realised fully by either Sayuri or the reader until it hits you in the face when suddenly the heads of different Okiyas are selling fancy kimonos and jewels at the black market for their survival. The book mentions real-life incidents such as the bombing of Tokyo and other big cities. It tells us about the problems that the people of Japan were faced with and how even graceful geishas are forced to become normal seamstresses, making parachutes for the war. The theme of the book in my opinion is first of all, the life of a geisha since it tells us about how geishas lived and what they had to go through. Arthur Golden takes us into an unknown world and reveals the secrets of what seems to us a glamorous life. The book shows that the life of a geisha is far from glamorous. Both in sense of the social problems they have to face such as jealousy from other geisha and the struggle to make a good reputation for themselves in order to survive and also personal problems such as those older geishas, whose skin has rotted and become yellow because of the paints they used, had to face. Another theme of the book may also be; destiny. Sayuri's destiny was to become a geisha no matter what came in her way, no matter how impossible it seemed at times, she finally succeeded in becoming a geisha and not just that, she even became a very successful and famous geisha of her time. When the book starts and we see the village of Yoroido through the eyes of a young innocent girl, you wonder ‘what does this little girl living in a small fishing village have to do with a graceful and glamorous geisha? It's almost as you wonder whether the title of the book is wrong. As the story develops, we see how Sayuri ends up in the cultural city of Gion, but then suddenly when the story turns again and Sayuri is made a servant at the Okiya you start wondering if the story will instead start focusing on Hatsumomo. The book is very slow and boring in the beginning, several times I thought of just putting it down but just then the story takes a new turn. It really tells about a life I knew nothing about before and got really interesting the further I got into the book. The author has tied in historical events into an interesting story reflecting not only the lives of geishas but also the lives of ordinary people of that time. I found the book very interesting and different but a bit slow. Since it is semi-reality based I would recommend it to people both my age but also older people. The story catches your interest whether you are young or old. I would give the book 3 out of 5 points.

Biography Of Father Serra

An expedition brought Father Sera to San Diego Bay to build his first Mission. His second Mission was in Monterey Bay. It was called Mission Carmela. He built seven more mission and took the Indians In. In 1784 Father Sera was old, tired, and sick. He had a difficult time breathing and his leg was diseased and painful. He went to Mission Carmela which was his favorite and wrote letters to the Padres at the 9 Missions. He died on August 28, 1784 at 70 years old. Building a Mission Adobe was used to make buildings. A hole was dug in the ground by adobe. Adobe is a stiff dirt mixture. Soil is what its made out of. Plaster is important to the Mission. Lime plaster IS made from sea shells and stone. Lime shells where headed in kiln. There were fire proof roofs. The floor tiles were called ladinos. They were made Of a stiffer mixture and cooked in kiln. Livestock Livestock is really important to the Mission. Father Sera and Captain Portola brought with them the livestock during an expedition to California in 1769. The first 5 missions were given 18 cattle, 4 pigs, and some chickens.Cattle was the most important animal at the mission. They had long curved horns and sloping hinds which gave good meat. Cattle was killed a lot for meat, tallow, and hides. The cattle also gave them milk, cheese, and butter. Other animals were really important to the mission. Sheep were used to make wool and meat. Hogs made lard. They used hog and lard for cooking and soap. They ate sausage and ham. They used horses for traveling and riding. Oxen worked hard in fields. They also had chickens that made eggs and meat. The herds increased and the Indians became cowboys.They moved the animals to a rancho miles away. They branded the animals at the rancho. There was good space and water. That was the beginning of Californians livestock industry. Crops Vegetable gardens were in every Mission. They prepared the land the same way. Women, men, and children weeded the garden and hoed the garden. Girls and boys waved sticks and threw stones. Insects and animals build fences. An Indians Life at the Mission The church bells rang then I had to wake up and go say prayers. The second bell rang that called use to breakfast. They had hot corn mush. The third bell rang and called us to our daily jobs. Women stayed inside. They did weaving, sewing, and cooking. The men were outside plowing, planting, and weeding. They ate atoll and add vegetables and chunks of meat. They wrapped it in tortilla. After lunch they would have a siesta and then they would nap. Next they would find a shady place to eat. Grape vines under the tree and after they would go to bed. They would go back to work and a young guy would bring them some cool water. The meals are the same as breakfast.The last ell rings, time to pray. After praying, talking, games, and singing they would sleep again. Mission Santa Barbara Report Mission Santa Barbara was founded by Vermin Lasses on December 4th 1786, the feast day of Santa Barbara, as the 10th mission. This mission is between the Pacific Ocean and the Santa Yens Mountains. Santa Barbara is the only mission to be under the leadership of the Franciscan Friars since the beginning. Mission Santa Barbara was known to have 2 bell towers. They are now the same as the mission bells. It turned into 8 bells in 1833.Which has 8 Mission Bell towers. Operated by Franciscans. It was built with mainly adobe and some bricks. It was covered with plaster/white wash. Mission Santa Barbara is named after Saint Barbara, she was a Christian mater who was beheaded by her dad for following her faith. The inside of Mission Santa Barbara still looks like it did in the sasss. The Mission is not only active in the church, it is also a historical attraction. Mission Santa Barbara was built by Spanish Franciscans to try to get the Chums Indians to become Catholics.

The World's Most Ethical Companies Essay Example | Topics and Well Written Essays - 1250 words - 1

The World's Most Ethical Companies - Essay Example Blue Shield was started in 1939 by the Medical Association of California. It is based at San Francisco, California. It is one of the oldest health insurance companies and has over 3.5 million members and approximately 65,000 physicians (Richards, 2010). The company has developed several health plans. The main ones are individual health plans and family health plans as some of its products, as it offers to the community. The main purpose of the company is to ensure quality provision of health care services and effective costs favorable to the community. These outstanding motives make the company excel in meeting the needs of the consumers, its approach to the environment, and general employee treatment. 2. Determine at least two (2) ways in which the chosen company behaves in a morally responsible way toward each of the following: a. Consumers  b. The environment c. Employees 2.0 Ethical Behaviors practiced by the company towards the Environment The company wants to develop to be a responsible health care institution. This has been defined by its support of the community development and commitment in taking care of its consumers, who are mainly registered members. The effort made in this case is working hard to be socially responsible. This includes reducing the environmental pollution, recycling of material wastes and provision of composite services as explained below. 2.0.1 Reducing environmental pollution This is one of the vital steps taken by the company. It aims at maintaining good health in the surrounding community, as well as the whole environment. Blue Shield believes in a healthy environment as a critical contribution to the well being of the people of California. Pollution has been reduced by curbing air pollutants that come from the Bay Area including treatment of chemical wastes and dumping products in a safe and environment friendly manner (Reece, 2004). These pollutants are presumed to carry substances that make asthma condition of the affected patients worse. It is in the company’s mission not to only see profitable activities but also to strengthen and protect both the community and environment. 2.1.1 Providing Recycling and Compost Services This has been one of the company goals in its intention to maintain a healthy environment. The company recycles several materials that are environmentally unfriendly but reusable. Items such as plastics, bottles, and used cans and paper are recycled. These materials are not just from the company’s outputs, but also those by the community delivered to the company through a third party. In addition, to ensure a clean environment, there is an effort to use recyclable wares by Blue Shield. The materials can decompose, hence contributing as important nutrients to the soil. The company has also employed the services of a vendor, who takes IT materials for recycling (Reece, 2004) 2.1 Ethical Behaviors of the Company towards Customers The company service to customers is explai ned in their goals, which state clear adherence to complete and satisfactory service to its consumers while ensuring quality and affordable health care. High customer retention rate and ability to have repeat clients are the measures through which the company uses to gauge the effectiveness of ethical behavior and Blue Shield has realized the customers are satisfied. Secondly, the employees mandated with the responsibility to serve and take care of customers and attend to

Swatch Marketing Strategy Case Study Example | Topics and Well Written Essays - 2000 words

Swatch Marketing Strategy - Case Study Example It is evidently clear from the discussion that during the last few years, Swiss Watch Industry is holding a prominent position in the economy, by expanding its export operations. The brand name of Swiss, which provides its consumers the best quality goods with appropriate guarantees as well. This report is an overview of the marketing plan for the company to explore the market, and shows what strategies the company should adopt. The company should have clear objectives regarding the way market should be approached because the market is highly competitive in nature. The major objectives of the Swiss industry are that evaluating the customer preferences, provide needful product, and capture the market and a proficient market share. It is necessary to understand the taste and preferences of new customers. Moreover, the company should follow a customer-oriented approach, by understanding the strategy of its competitors. It is necessary to capture the market and maintain profitability thr ough innovative measures and designs. Like any other company, the marketing function of Swatch to has a great contribution to the success of the product in the market. The company was formed after the merger of two largest watch makers ASUAG and SSIG. Swatch dominates the watch market of the world at present. The company actually took over this position after facing a severe crisis in 1970 that is they faced the serious drop in its sales during that period. The peculiarity of Swatch products is that they range from very low priced products to that with the very high price. One of the important factors behind the company's success is that they had very good marketing strategies. Swatch was considered in the market as a fashion accessory or product. This impression was created through the continuous advertisement and publicity portraying this impression. The marketing plan of the company was to make available in the market the cheapest as well as the costlier watch. In order to make c heaper watch the company introduced several technologies. "The bottom end of the market was the subject of a technological revolution, which made watches much cheaper to produce". Â  The company offers products in various designs. Another success factor in its marketing strategy is that it sponsors many sports events the major one being Beach Volley Ball. The marketing aim of the CEO to make Swatch into a fashion accessory took the company to heights. In order to achieve this objective the company focused on reducing the prices of the watch to make it available to every common man. The marketing strategy helped the company to make record sales of one million units after the implementation of the strategy. The major contribution of the company's marketing function is that it helped the company to mark its presence in over 80 countries. The company has therefore sold over 333 million watches all over the world. The other element that contributed to the success of the brand is the inn ovative product design. The company introduced many smart and trendy designs in the market The Company made trendy designs and made that available at every store. Thus the brand gained wide popularity among the teenagers. Swatch made a landmark design in the 80's that posted record sales in the financial data of the company.

Introduction to Human Resource Management Essay - 1

Introduction to Human Resource Management - Essay Example that employee-related laws were followed, and that all staff members were following the company’s policies and procedures (Cafà © Co Case Study, 2009). Also, the company’s hard HRM approach made the HR manager less of a director of HR but more of a policy-maker to make sure employees followed the company rules and regulations. Allen (2007) also describes the soft HRM approach which deals with issues of human behaviour, making sure that people are led rather than managed, are communicated with effectively and are motivated by leadership. The soft HRM approach views staff members are being important to meeting strategic goals and should be treated as valuable assets to achieving what the company wants to accomplish. One aspect of the Harvard model of HR outlines that people should be given rewards for their support to meeting goals (HRM Guide, 2007). After the review of Cafà © Co HR policies, this approach was undertaken with performance management systems and attempts to increase pay. The HR manager role, now as a member of the Board, already has a difficult time trying to improve existing HR policy at the company. Being in such a high position does not give Kim first-hand access to in-store employee behaviours, skills and abilities, therefore the line manager must take on this role in order to provide fair and accurate employee assessments. One HR expert offers that in order to have a good HR policy, line managers should â€Å"interview job applicants, provide training, carry out disciplinary procedures, and provide performance ratings† (Kleiman, 2007). Because there is already such a high turnover rate at Cafà © Co due to HR being unable to perform these tasks, it is both logical and benefitting to the business to have line managers take on these responsibilities since they are the regular point of contact for in-store staff activities, skills and behaviours. Kim simply cannot do this with her busy job role. Ulrich’s first role is being a strategic partner,

Middle Eastern Humanities Essay Example | Topics and Well Written Essays - 1000 words

Middle Eastern Humanities - Essay Example The dancer’s primary task is to embody the different musical rhythms for the people hearing the music (audience). Most Middle Eastern music has an effect known as a â€Å"call and response†. This creates a musical conversation and happens when one instrument plays a certain phrase and one another instruments responds to the lead instrument phrase. This however, changes through the composition and the supporting instruments may at times play the leading phrases. Middle Eastern music is played in scales that are commonly referred to as â€Å"Maqamat†. The main idea of the maqam is that it helps the musician to know the right intervals between scales. It also helps the musician to know the notes that he/she needs to emphasize. Research has shown that about 84% of the population from Middle East listens to music at least once a day (Justice 76). Music plays an important role in entertainment in the Middle East. People listen to music as a form of passing time and entertaining themselves. Middle Eastern music is also educative. Musicians use music as a tool to make the society a better place and also educate people. Sometimes musicians go to the extent of using their personal experiences to educate people. Music is also a source of inspiration. Some types of music encourage people not to give up when they face challenges in life. Music also helps to make work easier or more pleasant. Lastly music is also used for spiritual nourishment. Sacred songs play a role in impressing spiritual truth among people in the Middle

Gap analysis Essay Example | Topics and Well Written Essays - 500 words

Gap analysis - Essay Example Proficiency in communication as an art can be learned depending upon motivations and goals (Littlejohn & Foss, 2008). The advent of information technology with electronic means of communication modernized even its learning process traversing what once were limitations in terms of culture, space and ethics (Littlejohn & Foss, 2008). Sociopsychologist, Cybernetics, and Sociocultural groups may slightly vary in interest, rights, and values in the aspects of communication as well as it motivations, but, bottom-line is the crossover between and among communicators (Littlejohn & Foss, 2008). Being proactive makes an efficient manager bringing about flexibility and the ability to make appropriate responses (Harrell, 2003). Being polite brings about respect, trust and honesty, a mark in trade that can be a lasting legacy (Harrell, 2003). With the advent of Information technology coupled with electronic communication means what is left as the gap facing global communications seems to be the priceless possession which is attitude (Harrell, 2003). It is the individual resolve to prosper as overall attitude determines the quality of life one may live (Harrell, 2003). The gap facing global communication is gradually easing up. Thanks to the contributions of Information technology and its latest electronic communication art.

Why do you think you should be considered for this acholarship Scholarship Essay

Why do you think you should be considered for this acholarship - Scholarship Essay Example nd of country I hail from which is now-developing geographically, economically and emotionally, expressing how important this scholarship is to me would be an essential beginning. I am from Haiti, and finished all my schooling here. As the world knows, it is a place where â€Å"just in 35 seconds,† it had to give up many friends, families, schools, churches and hospitals to the devastating earthquake in 2010, a couple of years after it had seen the massive flooding too. Its ever sensitive geographical location is currently in the tight recovering mood which needs assistance from its own people from all corners of the planet, it mainly needs motivation from the within. Being a very part of it, I feel not only responsible to give it back the necessary assistance, I also believe that it is a gift to work where I am needed. Considering my past educational qualifications, my outreach abilities and my experience so far, I am confident I can make a significant difference in many lives as a registered nurse. Although, Haiti is right now in a hopeful shape, where school enrollment increased, vaccination rates and pre-natal coverage increased, and malnutrition among children and mortality rates declined; it still has 0.25 % of physicians and 0.8 % hospital beds for every 1000 people, about 620,000 cholera cases, and several hundred thousands of displaced people still in the camps. More than anything else, through an education program aided by this scholarship, my kind of passionate to-be registered nurses can tremendously contribute to the vulnerable, Haiti. Taking this as the right occasion, I must thank the board of this scholarship to have brought in such an opportunity for students like me to pursue their dream career. I am certain that this scholarship will not only be a key contributor for my financial struggle, it will eventually make me the person who can make a difference in people’s lives. My qualifications, my experiences, my background and not the least, my

ONTOLOGICAL PARADOX Research Paper Example | Topics and Well Written Essays - 2500 words

ONTOLOGICAL PARADOX - Research Paper Example ne has the ability to choose from the multiple patterns of lives with the chance of being embedded in one of the possible past-future pairs (Santas 39). The possibility of breaking out of limitations of only being able to exist in the present has led to many depictions of possible situations where human beings are able to freely move through the past present and future. Obsession with changing the past has not been limited to popular culture but has also featured in academic field such as physics and philosophy. This essay argues against the notion presented by some physicists and philosophers that one can travel back into the past to change based on the inconsistencies of time travelling. In this kind of fantasies, many tend to perceive an instrument such as special machine that will facilitate the backward time travel, think of a special machine which will enable man disappear from one place and time and reappear at a past time in a different or same place. There is a philosophical line of thought based on the existence of what is called a closed timelike curves (CTCs) discovered by philosophers and physicists working on time travel. CTCs are â€Å"curves in space and time† which provide â€Å"possible paths of bodies† to move through various universes. The model containing CTCs was discovered by Kurt GGdel in the 1940s and was believed to be models of the Einstein field equations (Seaman and Ssler 141). Based on model, Godel makes a theoretical assumption that it is possible for one to travel and come back at the exact time and place by making a round trip on a rocket ship in a suitably wide curve. This means that the object will get back to its past to the exact moment when it commenced the journey. The argument presented by Godel is based on the belief by some philosophers and physicists that the past, present and future equally real. These views on past, present and future represent the ideas of externalists group of theorists who argue that there was no

A group II metal hydroxide Essay Example for Free

A group II metal hydroxide Essay To find the identity of X(OH)2 (a group II metal hydroxide) by determining its solubility from a titration with 0.05 mol dm-3 HCL Theory:1. Titrations are the reaction between an acid solution with an alkali. In this reaction (called neutralization), the acid donates a proton (H+) to the alkali (base). When the two solutions are combined, the products made are salt and water. For example: 2HCl(aq) + X(OH)2 (aq) XCl2 (aq) + 2H2O (l) This shows the one of the products i. e. salt being XCl2 and water. So titration therefore helps to find the concentration for a solution of unknown concentration. This involves the controlled addition of a standard solution of known. Indicators are used to determine, at what stage has the solution reached the equivalence point'(inflextion point). This means at which, does the number of moles base added equals the number of moles of acid present. i.e. pH 7 Titration of a strong Acid with a Strong Base: As shown in the graph, the pH goes up slowly from the start of the tiration to near the equivalence point. i.e (the beginning of the graph). At the equivalence point moles of acid equal mole of base, and the solution contains only water and salt from the cation of the base and the anion of the acid. i.e. the vertical part of the curve in the graph. At that point, a tiny amount of alkali casuses a sudden, big change in pH. i.e. neutralised. Also shown in the graph are methyl orange and phenolpthalein. These two are both indicators that are often used for acid-base titrations. They each change colour at different pH ranges. For a strong acid to strong alkali titration, either one of those indicators can be used. However for a strong acid/weak alkali only methyl orange will be used due to pH changing rapidly across the range for methyl orange. That is from low to high pH i.e. red to yellow respectively pH (3.3 to 4.4), but not for phenolpthalein. Weak acid/strong alkali, phenolpthalein is used, the pH changes rapidly in an alkali range. From high to low pH, that is from pink to colourless pH(10-8.3) respectively but not for methyl orange. However for a weak acid/ weak alkali titrations theres no sharp pH change, so neither can work. Therefore in this investigation, the titration will be between a 0.05 mol dm-3 of HCl with X(OH)2, using phenolphthalein. Dependant Variable: Is the volume of HCl to achieve a colour change that is from pink to colourless. The Controlled variables : 1. the same source of HCl 2. same concentration of HCl 3. Same source of X(OH)2 4. Same volume of X(OH)2 5. Same equipment, method, room temperature Controlled Variables How to control How to monitor 1. Same source of HCl Using the same batch of HCl or from the same brand will control this. If the concentration was not to be same throughout, then this will cause different ratios of the components of the solution, that might cause different volume of HCl to be obtained for the neutralization to occur. 2. Same concentration of HCl This will be controlled by using the same batch of HCl and from the same source i.e. the same brand. By using the same batch ensures that the reactant concentration is the same. If another batch were to be used causes the concentration to differ. This causes the HCl obtained to be different. 3.Same source of X(OH)2 Using the same batch of X(OH)2 or from the same brand will control this. If the concentration was not to be same throughout, then this will cause different ratios of the components of the solution that might cause different volume of HCl to be obtained for the neutralization to occur. 4. Same volume of X(OH)2 This will be controlled by using the same batch of X(OH)2 and from the same source i.e. the same brand. By using the same batch ensures that the reactant concentration is the same. If another batch were to be used causes the concentration to differ. This causes the HCl obtained to be different. 5. Same equipment, method, room temperature The method would be kept the same and the same set of equipment and brand will need to be used throughout. The room temperature will be kept throughout at 180C by using a water bath. If different equipment or brands were used then there would be a lot of anomalies in the experiment causing a huge amount of inaccuracy of measurement particularly. Results: Raw data results were collected by using 25.00 cm3 of X(OH)2 with phenolphthalein and the volume of HCl was obtained by the solution going from pink to colourless. The volume of HCl found in 50.0cm3 burette à ¯Ã‚ ¿Ã‚ ½ 0.05 cm3 Trial 1 Trial 2 Trial 3 Trial 4 Average 19.600 19.800 19.600 19.700 19.675 Qualitative results that occurred during the experiment: * Conical flask swirling not even between the trials * Difficult to judge colourless solution change subjective end point * Ability to measure 25cm3 * Filling of burette accurately with HCl 0 point in right spot * Residual distilled water or solutions remain in conical flask i.e. diluted/interfered with subsequent solutions of X(OH)2 Average = trials (1+2+3+4)/4 Therefore: (19.6 + 19.8 + 19.6 + 19.7)/4 = 98.5/4 = 19.675 Due to the equation being 2HCl(aq) + X(OH)2 (aq) XCl2 (aq) + 2H2O (l) Therefore the ratio is 2:1 of 2 HCl : 1 X(OH)2 So using the equations mentioned above: Moles of acid is the number of moles= concentration X volume i.e. the volume will be used from the average Therefore: =0.05mol/dm3 x 19.675 cm3 =19.6 cm3 / 1000 = 0.0196 dm3 =0.05mol/dm3x0.0196 dm3 = 0.00098 moles So Moles of alkali in 25.000 cm3 Moles of HCl / 25.000 cm3 due to the ratio being 2:1, therefore 0.00098/2= 0.00049 moles of HCl So now the ratio is 1:1 so 0.00049 moles of X(OH)2 Moles of alkali in 100 cm3 It is assumed that there are four lots of 25 cm3 = 4 x 0.00049 = 0.00196 moles The next series of results will be used to calculate solubility of each compound by their mass in 100 cm3 The total Mr has been calculated in the table below for each compound. This was done by : Mr of X + ((O + H) X 2). Each element Mr for the following elements (OH)2 Total Mr Be 9.010 (16.00 +1.01) X 2 = 34.020 43.030 Mg 24.310 (16.00 +1.01) X 2 = 34.020 58.330 Ca 40.080 (16.00 +1.01) X 2 = 34.020 74.100 Sr 87.620 (16.00 +1.01) X 2 = 34.020 121.640 Ba 137.340 (16.00 +1.01) X 2 = 34.020 171.360 To obtain the solubilitys of metal II hydroxides is moles X Mr of the compound Therefore this table shows the calculation for the solubilitys for each of the different compounds Each element Total Mr Moles of X(OH)2 Solubiltity given as g/100 cm3 Literature values of the compounds given as g/100 cm3 Be(OH)2 43.03 0.00196 0.0843 0.000 Mg(OH)2 58.33 0.00196 0.114 0.001 Ca(OH)2 74.10 0.00196 0.0145 0.170 Sr(OH)2 121.64 0.00196 0.0238 0.770 Ba(OH)2 171.36 0.00196 0.335 3.700 Uncertainties: The uncertainty in measurement: Uncertainty due to pipette of 25.000 cm3 : Volume of X(OH)2 = à ¯Ã‚ ¿Ã‚ ½ 0.100 cm3 Percentage uncertainty = (0.1/25) X 100 = 0.400% Uncertainty due to Burrette of 50.000 cm3: Assumed due to measured volume of 19.675 cm3 and the uncertainty due to the smallest unit of measurement being 0.1 cm3 Therefore 0.1/2= à ¯Ã‚ ¿Ã‚ ½ 0.050 cm3 Percentage uncertainty = (0.05 /19.675) X 100 = 0.254% Therefore total uncertainty = 0.400% + 0.254% = 0.654% Conclusion and Evaluation: X(OH)2 is most likely to be Ca(OH)2 as the calculated solubility is closest to the literature value given of Ca(OH)2. The solubility for Ca(OH)2 0.145 g/100 cm3 and the literature value is 0.170 g/100 cm3. This shows that the difference is only 0.025 cm3. However the comparison between Be(OH)2 of the calculated solubility is 0.0843 g/100 cm3 and of its literature value 0.000 g/100 cm3 . Shows that there is a greater difference. Showing that it cannot be X(OH)2 solution. This is also shown for Mg(OH)2 as the difference between the calculated solubility and the literature value is 0.113 g/100 cm3, showing that it still has a greater difference than Calcium hydroxide does. The difference between Sr(OH)2 and its literature value is 0.532g/100 cm3. However the difference between the calculated solubility of Barium hydroxide and the literature value is 3.365 g/100 cm3 showing there is a great difference so it cannot be Barium hydroxide. The percentage error of Ca(OH)2 = [(0.170 0.145)/0.170] X 100 = (0.025/0.170) X 100 = 14.705% Throughout the experiment there were systematic errors and random errors that were met. Uncertainties/limitations Error Type of error Quantity of error Explanation for error Improvements Measurement in burette Systematic error +/- 0.05cm3 Equipment limitation, this is because the line where each of the reading might not be precise. Different manufacturer should be used with multiple trials in order to increase the accuracy of the calculated value to the literature value. Measurement in pipette Systematic error +/-0.1cm3 Equipment limitation, this is because due to the pipette only holding 25 cm3 of volume. The line could have been where the actual reading might not be Causing the result to not be precise. Different manufacturer should be used with multiple trials in order to increase the accuracy of the calculated value to the literature value. Point of colour change Random error Not quantifiable Human observation subjective measurement. This is because even though a white tile is used, it is unclear as to what point has the solution gone colourless. Use alternative indicator for several different trials, use pH meter to assess neutralization point. Therefore there will be a more precise point as to when the solution becomes green. Temperature fluctuations Random error Not quantifiable There can be a change of measurements of equipment due to variation in expansion and contraction of materials. Due to the temperatures not being constant from the fan, windows or from the air conditioner. Controlled lab environment of the temperature by using a water bath at 180C with no air conditioner, fans working. To ensure no fluctuations occur. Fluctuations in humidity of room Random error Not quantifiable Change solution concentrations due to differences in evaporation rate in the surrounding air. Controlled lab environment Calibration error in burette Systematic error Not quantifiable 0 line incorrectly marked Divisions on burette inaccurate Use different manufacturers equipment for other trials Calibration error in pipette Systematic error Not quantifiable 25cm3 line incorrectly marked. Because it is unclear as to where the true meniscus lies. Causing the values measured out to be not precise. Also due to there being only one line causes a further decrease in the precision of the results. Use different manufacturers equipment for other trials to ensure that the accuracy increases. Another improvement that will be done, if the experiment were to be repeated is that due to the inaccuracy of the conical flask being swirled. If the conical flask is being swirled unevenly there is a chance of inaccurate results of when the colourless solution occurs. Therefore a stirring rod should be used to increase the accuracy of the swirls of the reaction in the conical flask. Another limitation that arouse in this experiment that would be improved if the experiment were to be done again is that after the neutralization reaction had occurred, there would still be some residue of the distilled water used to rinse out the equipment. This can be improved by increase the number of repeats of rinse. This would ensure that more of the diluted solution would have been removed. Also the trials can also increase, to 10 repeats so that there is more variance so that the accuracy increases. Another improvement might be, to use different indicator, for example methyl orange. Due to the colour change would be from red to yellow would make it easier for the pH 7 to be more easily recognized against a white tile then it was with phenolphthalein. Cited Sources: 1. http://www.vigoschools.org/~mmc3/c1%20lecture/Chemistry%201-2/Lecture%20Notes/Unit%205%20-%20Acids%20and%20Titration/L3%20-%20Acid-Base%20Reactions%20and%20Titration.pdf

Learning in the EYFS Essay Example for Free

Learning in the EYFS Essay Knowledge and understanding of the world Knowledge and Understanding of the World relates to children’s everyday lives, their homes, families, other people, the local environment and community and the wider world. Personal, social and emotional development The social and emotional development of a child helps practitioners/parents understand the behaviors they exhibit. Though children develop and mature at different rates, social and emotional development generally occurs in predictable stages. Communication language and literacy Childrens learning and competence in communicating, speaking and listening, being read to and beginning to read and write must be supported and extended. They must be provided with opportunity and encouragement to use their skills in a range of situations and for a range of purposes, and be supported in developing the confidence and dispositions to do so. Problem solving reasoning and numeracy This area mostly focuses on a child’s ability to solve simple problems and builds an awareness of shapes space and measures. Practitioners do this by looking at shapes, numbers, building bricks etc. Physical Development Children are encouraged to take part in a variety of physical activities. Children develop physically at different stages and times. This area helps practitioners to keep track of each individual child’s development. Creative development Being creative covers a multitude of ideas including how children express and communicate ideas. They can explore all sorts of media (eg ICT, music) and materials. They will also develop their imagination through play. Although they are all different a good planned activity will cover more than one area of development. For example, playing a snakes and ladders board game will help a child with their Problem solving, reasoning and numeracy mainly but it will also help them with their Communication, language and literacy development as they are being encouraged to communicate with other children playing the game. Also the areas are interdependent if the child is struggling with one area it can affect how they develop in other areas. For example, if a child is disabled and cannot join in physical activities this can affect their physical development but it can then also affect their communication, language and literacy and Personal, social and emotional development because they aren’t joining in with the same activities as their peers. This can be avoided or at least limited by good planning and inclusive practice. 1.2 Outcomes are given to the different areas of learning within the EYFS to ensure that practitioners have something to focus on. These outcomes are outlined within the EYFS as â€Å"overarching principles† these are: Every child is a unique child, who is constantly learning and can be resilient, capable, confident and self-assured Children learn to be strong and independent through positive relationships Children learn and develop well in enabling environments, in which their experiences respond to their individual needs and there is a strong partnership between practitioners and parents and/or carers Children develop and learn in different ways and at different rates. The framework covers the education and care of all children in early years provision, including children with special educational needs and disabilities. And three main areas of development which are; Physical Development – This is the development of a childs physical skills. It includes the Gross motor skills, such as walking, jumping, running, catching and the fine motor skills such as the pincer grip, hand-eye-coordination, doing up laces or zips. Personal Social and Emotional Development The social and emotional development of a child helps practitioners/parents understand the behaviors they exhibit. Though children develop and mature at different rates, social and emotional development generally occurs in predictable stages. Communication and Language Development Language development is the process by which children come to understand and communicate language during early childhood. 1.3 The documented outcomes are assessed by practitioners in different ways. On-going assessments are carried out in settings frequently. Practitioners plan an activity, observe the child/children, record information and evaluate the outcome. If needed they then plan another activity and repeat the process until they get the information they need. These are also known as â€Å"formative assessments† and they are an integral part of the EYFS framework. It helps parents, carers and practitioners to constantly monitor a child’s progress and pick up on and solve problems if there are any. At the age of two a child has a progress check. This is when practitioners review their progress and produce a short written summary of a child’s development in the main areas of development. This helps to make sure a child is on track with their development and helps to identify any areas that a child may be developing at a slower rate than is expected. This can also pick up on any dis abilities or learning difficulties. If a practitioner does pick up on a learning difficulty they should put together a plan to support the child’s future learning and development. Practitioners must discuss with parents how the outcome of the assessments can be used to support the child’s development at home, and parents are encouraged to share the outcome with any relevant professionals i.e. a teacher or a health visitor. In the final term of the year in which the child turns five practitioners must complete the EYFS profile for each child. This profile must reflect on-going observation, all relevant records held by the setting, discussions with parents and carers, and any other adults whom the teacher, parent or carer judges can offer a useful contribution. The profile lets parents, carers and other professionals have an overview of a child’s knowledge, understanding and abilities, their progress against expected levels, and their readiness for year one. Year one teachers are given a copy of this profile and it will outline whether the child is meeting, exceeding or not yet reaching the expected levels of the early learning goals. I think assessments are important to Practitioners and other professionals like teachers because it helps them to work together to identify any problems that may arise with a child’s development and address the problems quickly and effectively also if the child is very quick at development it can be spotted and they can be given extra planned work to stop them from getting bored. I think it is also good for parents because they have guidance on how to help their child’s development at home.

Quality Of Life Among The Elderly

Quality Of Life Among The Elderly Loneliness is a geriatric giant leading to impaired quality of life, greater need for institutional care and increased mortality. Routasalo, Pitkala, 2003 The phenomenon of loneliness occurs in people of all ages it may be a particular problem in the elderly according to a study carried out at Edinburg University in the nursing science department. It is acknowledged that loneliness is not necessary accompaniment to ageing and that ageing is not solely responsible for the development of loneliness in the elderly people; however there is a relationship between ageing and loneliness. There is a need to understand the casual relationship between life-events and loneliness, how to predict it and whether negative consequences maybe alleviated.(Routasalo, Pitkala, 2003). This study is about loneliness among the elderly people. I was interested in this topic because the fact that many old people are still experiencing loneliness at different levels cannot be overlooked. Loneliness and social isolation have often been used to characterise the social world of older people and as an indicator of their quality of life (Victor, scamber and Bond, 2009) but loneliness among the elderly has been under addressed.Like many other social science concepts,loneliness is often a taken-for-granted idea from every day life.Loneliness is a common problem among the elderly that lead to widespread unhappiness and social exclusion. The purpose of this study is therefore to portray loneliness among the elderly ,the main influencing factors and strategies to address it. This study is entirely based on Qualitative Research methodology by probing into different academic disciplines so as to gather a deeper understanding of this particular topic. WHAT IS LONELINESS? Loneliness is a situation experienced by the individual as one where there is unpleasant or inadmissible lack of (quality of) certain relationships. This includes situations in which a number of existing relationships is smaller than is considered desirable or admissible as well as situations where the intimacy one wishes for has not been realised. (De jong gierveld, 1987, p.120 quoted in vangelisti and pelman 2006, p. 585-500) (Peplau, 1981 quoted in vangelisti and pelman 2006, p. 585-500) defines loneliness as the unpleasant experience that occurs when a persons network of social relations is deficient in some important way either qualitatively (Quality related) or quantatively (size related). Loneliness categories (Weiss, 1973 in vangelisti and pelman 2006, p. 585-500) categorise loneliness as: Emotional loneliness This is as a result of absence of an intimate figure or a close emotional attachment (a partner, best friend) e.g. in divorce or widowhood. We can further subgroup it as: Developmental Experienced when there is a need for intimacy balanced by a pursuit for personal happiness and independence (goals). Internal Often includes feelings of low-esteem and vulnerability. Social loneliness This kind of loneliness arises with the absence of a broader group of contacts or an engaging social network like friends, collegues and people in the neighbourhood. It can also be termed as Situational/Circumstantial which can be explained by situations like loosing a relationship or moving to a new city. Measurements of loneliness among the elderly Loneliness is subjective(It is based on somebodys opinions or feelings rather than on facts or evidence) and is measured using questions that seek perceptions of relationships,social activity and feelings about social activity(British Columbia ministry of health ,2004) Loneliness is very cultural and temporally specific(jylhà ¤ 2004).It is and has been difficult to compare levels of loneliness accross cuntries because the meaning of loneliness is highly cultural(and possibly temporary)specific. Variations in measures used to measure loneliness by researchers in different countries has made it difficult to make a comparison across different countries. Findings of the study Main factors influencing loneliness among the elderly Health resources Chronic poor physical or mental health, Sensory impairments, Falls and Self-rated health and Health expectations (Tijhuis et al 1999) found that increase in loneliness was attributed to poorer subjective health but not on activity limitation or cognative function.Lonely and isolated peoples health may deteriorate becausethey lack the environmental support,social ties and assistance by others that become critical factors in the maintainance of their independence later in life.(Bosworth and schaie 1997 p.197) Mental health issues such as depression can impact self-rated score in an indirect way as those who are depressed may evaluate their social relationships negatively and therefore create apparent associations with other risk factors when infact it is depression that is the issue.(Russel et al,1997) Social resources E.g. Availability of family, friends and Social contacts Recognition of the importance of the importance of the relationship between social engagements and quality of life is not new (Victor, scamber and Bond, 2009). Social relationships and social engagements are a very important part of quality of life in old age according to (Victor, camber and Bond 2009).Rowe and Kahn (1997) suggest that a high level of social engagement is a key factor in achieving the goal of successful ageing. This same observation has been made in ideas of healthy ageing and active ageing. Demographic factors E.g. Age, gender, household composition, neigbourhood and Marital status Age and gender Being widowed and living alone are more common among women because of their tendancy to outlive male partners. Neigbourhood Favorable neighborhood is associated with feeling safe and secure. Immediate neighborhood is of particular importance to the well-being and quality of life of older people(bowling 2006,Victor,Scamber and Bond 2009)Whilst there has been much focus on the importance of maintaining older people at home this has been often interpreted as the narrow confines of the built dwelling or house rather than the wider environment of neighborhood or locality. Yet place is clearly important in providing the spatial context within old age (Berkman et al., 2000; berkman and Glass, 2000, Victor, Scamber and Bond 2009) Household composition Most people who live alone are lonely but not all people who live alone are lonely.Living alone also interacts with many other variables to create varying pictures of loneliness.Living together with someone and living in ones own apartment(as opposed to an institition) showed a positive influence on feelings of loneliness for this population(Holmen et al 2000 as cited in gierveld,Tilburg and Dykstra in Vangelisti and perlmans 2006) Material resources E.g. Home ownership, access to car and education Qualifications Economic status and self-esteem have been found to have a relationship with loneliness. Loneliness was expressed by those older persons with less adequate self-rated economic conditions and those living in actual poverty.(Mullins,Elston and Gutkoiski,1996) agrees that the less financially adequate individuals perceive their situation to be the more lonely they were. Access to Transport/car Driving status and transportation have an effect on the loneliness and social isolation of the elderly because of their role in facilitating access to the social network.(Kivett 1979) categorized older rural adults with transportation problems as a high risk of loneliness. Many seniors are restricted to pre-arranged van trips with community or volunteers drivers. Dependence on others for transportation related socializing may change the nature of social interaction for those people (Hall Havens,1999). Programs for seniors will be ineffective if they cannot access them. Life Events E.g. Bereavement ,widowhood and onset of illness Death of a spouse and living alone is a major additive risk factor for loneliness and isolation. Events like widowhood emphasize that bereaved persons are especially vulnerable for emotional isolation(loneliness)rather than social isolation (Van baarsen et al,1999) Discussions of findings Given the potential harmful effects of social isolation and loneliness in seniors,it is important to persue this issue in order to reduce emotional damage to seniors and inappropriate health and social service usage.However,caution should be observed when again interventions without knowing the target population and assessing the possible negative consequences of the planned intervention.( British Columbia Ministry of Health.March 2004) Strategies to address loneliness and isolation for older people. A survey done in campaign launced by leeds metropolitan university on behalf of the british gas to combat isolation and lonelness developed recommendations with the older people to address the issue of isolation and loneliness.Through interviewing older people and trying to identify what they want,the following suggestions were arrived at. Involving older people in planning,developing and deliverly of activities that target social isolation and loneliness. Practical,flexible and low level assistance that could help older people to remain indipendent,gain confidence to identifytheir own solutions and support them in retaining their own social networks. Individually tairoled solutions to meet specific needs,within a variety of activities available within their local neighborhood and within the reasonable travelling distance. Transport that takes the mobility of the elderly into account. Availability of Services that cater for specific groups such as carers,ethnic minorities,older men and those with hearing impairments or mobility problems and those who have been isolated for a long time. Support and encouragement for the elderly to learn new skills as well as the opportunity to share their skills with other older people.

Harper Lees To Kill a Mockingbird Essay -- Kill Mockingbird Harper Le

Harper Lee's To Kill a Mockingbird Courage is the quality of mind that enables one to face danger with confidence, resolution, and gain a firm control of oneself. Many of the characters in To Kill a Mockingbird showed courage in their own way. Courage can come in many different forms: physical, mental, emotional and moral. Courage is not the only main theme displayed in To Kill a Mockingbird; prejudice and education are also very important themes exhibited throughout the progression of the novel. Through the eyes of Scout Finch, a bright, sensitive and intelligent little girl, these themes of the novel are explored in great depth. The many forms of courage are shown throughout the novel by the characters of Jem, Boo (Arthur), Mrs. Dubose, and Atticus. Jem showed one of the greatest acts of physical courage as he protected his little sister Scout from the attack of Bob Ewell on the night of Halloween. Boo was also very courageous, he lived many years without human contact. That is a lonely thing to do, and it took mental courage for him to try and reach out to Jem and Scout when his father kept him imprisoned. Emotional courage is shown through Mrs. Dubose; she was a morphine addict and it took great courage for her to quit before her death to  ¡Ã‚ °die beholden to nothing and nobody ¡Ã‚ ±. Atticus is one of the most courageous characters in the novel. He showed moral courage when he defended a black man who was falsely charged with the rape of a white woman. He stood up for ...

Freshwater Mussels Essay -- Marine Life Mollusks Conservation Essays

Freshwater Mussels Mussels are a species of marine life that inhabits many of the bodies of water in the United States. They serve as an important aspect of the ecological system of the water in which they occupy. However, the number of mussels have been declining such that many are now considered as endangered species. There are a few reasons for the decline in population, including domination by a single species of mussels called the zebra mussel. Conservation has begun on mussels because of their strong environmental influence. The two groups interested in mussels involve parties that use the lakes for recreation and consider mussels as a threat to their gaming as well as ecologists that understand the domination of zebra mussels and attempt to protect the native mussels from the zebra mussels. Mussels are in a group of invertebrate animals called mollusks. Freshwater mussels are also referred to as clams, naiads, and unionids. Mussels spend its life anchored in rivers or lake bottom sediments. The vast majority of them are found in streams. Their movement is through either muscular feet or powerful flood currents. A mussel captures oxygen and microscopic food particles in flowing water through filtration (Vermont's Freshwater WWW). Mussels continuously pump water through their bodies. Water enters through the incurrent or branchial siphon and exits via the excurrent or anal siphon (Mussel Biology WWW). This pumping process allows the mussel to filter food from the water. The food consists of detritus, organic matter found on the stream, and plankton which are microscopic plants and animals suspended in water (Mussel Biology WWW). Mussels are long lived species with some living more than 10 years. Others have been record... ...reissena polymorpha. NAS. Prepared by the Florida Caribbean Science Center of the Biological Resources Division: http://www.nfrcg.gov/zebra.mussel/docs/sp_account.html#HDR2. Mussel Biology. http://www.inhs.uiuc.edu/cwe/wwwtest/mussel/Pages/introduction.html Vermont's Freshwater Mussels Uniqueness and Diversity, Now Under Siege. The Nature Conservancy of Vermont. http://tnc.org/searchtnc.html (second listing under search for mollusk). West Coast Mollusc Culture: A present and future perspective proceedings of a California Sea Grant Workshop in cooperation with the Pacific Sea Grant College Program. edited by Rosemary Amidei. La Jolla, CA California Sea Grant College Program, Institute of Maine Resources, University of California 1988: 87 pages. Zebra Mussel: Dreissena polymorpha. http://tnc.org/searchtnc.html (first listing under search for mollusk).

Loss of Vioxx Leads to Increased Pain For Arthritis Sufferers :: Interviews Prescription Drugs Papers

Loss of Vioxx Leads to Increased Pain For Arthritis Sufferers The consequences of Kevin Swearingen’s two-story fall in 1988 were more diverse and long term than expected. The 41-year-old construction worker sustained a spinal injury that left him with arthritis on the inside of his spinal column causing him pain, frustration, and depression. â€Å"After I recovered [from the fall] I had to keep working, but at a much lower pay scale since going back to construction work was impossible,† Swearingen said. Dealing with the pain, inability to work and play with his kids, he fell into a depression. â€Å"I was an emotional mess. I was drinking to kill the pain and I was contemplating suicide,† he said. It wasn’t until Swearingen began taking Vioxx that things began to look up. â€Å"It gave me much of my life back. I could play with the kids on better pain days and it greatly reduced the pain on the bad days.† Vioxx is a Cox-2 nonsteroidal anti-inflammatory drug (NSAID) that cuts down on pain, stiffness and swelling by reducing the production of prostaglandins which help the brain read messages of pain from the body. Other popular cox-2 inhibitors include Celebrex and Bextra. â€Å"Vioxx and Celebrex were developed for those who had stomach problems like ulcers and bleeding,† Dr. Bukowski from Boston’s Brigham and Women’s hospital said. Swearingen having suffered an ulcer at age twelve was put on Vioxx after being diagnosed with Osteoarthritis at age 26. Merck, the drug manufacturer, took Vioxx off the market last September after studies revealed the drug caused complications of heart problems in users. When taken off the market, some 80 million patients who have used it were affected. According to the New England Journal of Medicine, it was the â€Å"largest prescription-drug withdrawal in history.† Many arthritis sufferers such as Swearingen were distressed with Merck’s decision. The trial revealing heart risks associated with Vioxx was conducted by an independent data safety monitoring board (DSMB). The Adenomatous Polyp Prevention on Vioxx (APPROV) trial revealed that Vioxx did in fact pose heart risks. 3.5 percent of the 2600 patients using the Vioxx had suffered myocardial infractions or strokes compared to the 1.9 percent who took a placebo pill. The trial’s goal was not to test Vioxx’s safety, but rather to test it’s effectiveness in preventing colorectal polyps in patients with a history of colorectal adenomas. The trial was stopped prematurely once these statistics were discovered.

Diabetic Clinic For Ethnic Minority Health And Social Care Essay

This papers sets out the Isleworth wellness Centre for cultural minority nurse led diabetic clinic an ambitious docket for transmutation within the diabetic community wellness and present the most informed information and engineering system that will offer them choice service and authorise the manner of intervention, direction and diagnostic of Diabetes in the London borough of Hounslow. Harmonizing to intervention record of outpatient in Edward junior, Isleworth wellness Centre[ I ]indicates that 2.3 % ( www.gpcontract.co.uk ) of its current patients are diabetics. It ‘s on this respect that the undertaking was based to put apace with of all time demanding challenges of its patient ‘s multi-ethnic and multiracial human ecology of the British populace in partnership with Hounslow primary attention trust and the NHS to prolong and accomplish wellness for all challenges in the[ two ]twenty-first century. ( Hounslow primary attention trust ) In order to accomplish these challenges, the pattern come up with a program to spread out its current service of beside offering general patterns, besides offers specialist signifier of diabetic clinic that will cut down in its current signifier of extremely dependent onto infirmary referrals and long waiting line of exigency and accident Centres to acquire a speedy aid by the patients. The recent partnership formation by Isleworth wellness Centre with five other hot spot countries GPs of extremely vulnerable diabetes inhabited parts of Hounslow borough will do the Centre the most alone in its approached in ego readiness in undertaking this undetected threat within the society ‘s wellness and enrich this groups and all other suffers with chance to acquire information online, advice and aid required that will do them self pull off their diabetic state of affairs under control. The South Asiatic people of Indian beginning feel that they have been neglected and left out with small aid and that make them the disregarded category of people that live in countries societal deprived with no much societal comfortss and diversion Centre and less enriched public outdoor activities. The undertaking intends to counter these redresss in order to promote patient ‘s self instruction and direction system and set mechanism in topographic point to debar the degree of endemic of diabetes in the borough with a position of preparation, upgrading and heightening the service available over the intended services which will run into the needed marks and run into the people outlooks and aspirations with all the self-respect it deserves from our portion and that of our extremely qualified proficient adviser that will assist us accomplish this aspiration. The local population of[ three ]Hounslow borough is going older age and ethnically diverse with higher proportion of being black minority cultural ( BME ) group. There is demand of complexness of healthcare demand within the population and the pressing demand for better wellness attention service as the prevalence of Diabetic and high blood pressure is one that is of all time increasing in the recent old ages. ( Hounslow PCT ) 3.1 Project Title: Specialist nurse led Diabetic clinic in London borough of Hounslow Primary Care Trust ( PCT ) for Cultural minority at Isleworth Health Centre.3.3 BackgroundThe Isleworth Health Centre pattern support director has the aspiration us plan to incorporate four independently running patterns into one umbrella groups of GP who are presently called green creek wellness Centre. As the consequence of that amalgamation success, the pattern directors and the executive managers have besides thought of thought to spread out one of the chief patterns Centres, which is the Centre core operational countries for the four others to incorporate a specializer nurse led intervention for diabetic patient of Cultural minority who are extremely diagnosed group of people with diabetes. They have thought of dead set fount and three other countries where the freshly constituted group each wanted their single thoughts considered has triggered the pattern proprietors to bespeak our input in, transporting out a feasibleness surveies and countries assessment to give a determination support and suitableness of the locale and location within the range of the broad patients and local communities.4.1 IntroductionDiagnostic of diabetic disease can be of a major impact if non dictated before plenty to salvage life and the wretchedness of its complications including amputations and going for good disable.Sign and Symptoms of diabetesFrequent micturition particularly at dark Excessive thirst and dry lips Excessive hungriness Weight loss Blurred vision Fatigue Confused thought Recuring infections Slow healing of lesion[ four ]( Robert H. Phillips )4.2 PurposesWe need to increase consciousness of the hazards of been diabetic without cognizing yourself To give them a walk in clinic of their ain and build their capacity and assurance to portion each other ‘s experiences, tips and fast ones that made some to get the better of the disease more than the others. To advance s consciousness of the symptom in order to enable those who are non cognizant of their predicament of been diabetic could seek immediate medical attending. Making consciousness and publicity of healthy life styles by giving them the counsel on the best manner to self manage and avoid farther complicating of their life. Better on what methods could be used to circulate information in order to authorise patients and their households.4.3 ObjectiveThe aims of the undertaking was To acquire speedy and mensurable measure of people to be seen as their life improving and understand the complexness of the disease and familiarize themselves easy. To better self-management attention system among the people with diabetes and better entree to incorporate diabetes care services. To convey about sweeping in lifestyle alterations of this peculiar groups in modifying their wont of dieting and eating without impacting their cultural value and belief. To give them a engineering that they can utilize at their ain clip and infinite to acquire advice, latest intelligence on research about diabetes and newer medical specialties available to them on their finger tips. The diabetic clinic is puting self internal mark for patient attention and intervention of up to 30 a twenty-four hours where a sum of 7,800 patients diagnosed and cared for in the new clinic proposed in six months period. Supporting people with diabetes by giving them the best therapy available in the market by Management and control of blood glucose degrees. To cut down the Numberss of diabetic patients by bettering and advice the measure and the methods of avoiding the root causes, which is been obesity, fortune of exercising and feeding of excessively much sugary greasy and drug addict nutrient. In malice of the great paces that have been made in the intervention of diabetes in recent old ages, many patients do non accomplish optimum results and still experienced lay waste toing complication that consequence in a reduced quality of their life and such ruinous phenomenon could be avoided at every cost The wellness attention suppliers besides struggle to give the recommended degree of Nutritional information as of import stairss of effectual direction of diabetes and to protect those at hazard.5.1 Project range and demandsThe system to be developed is meant for Diabetic patients and other stakeholders to position and portion the resource. They can register online, book an assignments and acquire advice information linked to YouTube like picture advice and what other patient feel and state about the disease. They should besides login and question some of the pressing issue by station some inquiry online and acquire answer every bit shortly as it is applicable to the staff. Due to complexness of the disease it ‘s non possible at this phase to state how many users are meant to user it but it should suit as many people as it can defy.5.2 PremisesThe Centre has already some grade of installations that can be utilised for the intent of handling, reding and caring for the patients. There is one audience room available to the clinic and portion of the response to suit the new receptionist of diabetic clinic. There is besides adequate infinite to suit the GP outpatients and the diabetic patients to sit and interchange each other ‘s position in relaxed and friendly environments.5.3 Project JustificationHarmonizing to[ V ]Dr Rashmi Kaushal, adviser Endocrinologist who is specializer in diabetes at the West Middlesex Hospital estimates that 1 in 5 of the local people of Hounslow borough may be enduring from diabetes. This means that every bit many as 20 % of the population are most likely have some signifier of diabetes. In UK entirely there are over 2.4 million people harmonizing to the diabetes UK. ( NHS trust ) The research besides province that about 750,000 have the status of diabetes but do non cognize themselves and harmonizing to Hounslow primary attention trust at that place up to 10,000 people, are diabetes and farther 5,000 remain undiagnosed from the disease. ( NHS trust ) Hounslow is the largest place to Asian of Indian beginning and histories for 24.7 % of the population harmonizing to national norm of 4.6 % in UK. ( NHS trust ) joint reappraisal by the Diabetes UK and South Asian Health Foundation conclude that the south Asian who live in UK is about up to six times more likely to hold type 2 diabetes than the white European population and by 2025 diabetes prevalence predicted to be 47 % , will hold a greater impact to this group, if non averted at present phase where the warning is earlier adequate for us to move to avoid such contingencies ‘ . ( Diabetes org.Uk ) The undertaking will besides turn to those who could non make the service by puting an on-line web service that will convey to the bow most urgent issue of diabetic symptom so that the patients will do self opinion conditions to corroborate with a physician or non. The production of high criterion service to diabetic patients would be a really ambitious issue to undertake. Other grounds is for the diabetic community to hold an entree to free information on a web site, an online physicians advice and an online look intoing their current position whether one is enduring or non is rather ambitious undertaking to bring forth within the lifetime of this undertaking. The GPs will besides salvage some clip and money to better other general patients without the diabetic patients in attending of their services. Presently there are three staggering Centres in Hounslow borough those traffics with diabetic patients, which is run and managed by the diabetic charitable administration in Hounslow. Beside the three Centres that are making simple screen and referrals system. Newly proposed undertaking will further cut down force per unit area from the Centres by taking on board more of their patients in the waiting list. The Asian and the minority communities are the highest suffers of this slayer disease. As consequence many people in UK are deceasing at an earlier age due to type two diabetic complications. This has a batch of impact on the local communities and the NHS who should hold used its budget to be allocated to other signifier diseases intervention beside the diabetes.Hazard factored groups in UKThe most vulnerable and diabetes prone communities are people of South Asian, African, African- Caribbean, Polynesian, Middle eastern and American Indian decent are the most people who are at hazard of type 2 diabetes compared with the white population. They are vulnerable due to their household history, inactive, corpulent and conditions that triggers non merely type1, but besides type 2 diabetes which is known for undetected complication within those who have non seek treated earlier adequate. ( www.patient.co.uk/doctor/Diabetes )The Diabetic prevalence in Hounslow Borough in comparing to other m ajor diseasesTable 2Prevalence of chronic Disease in London Borough of Hounslow 2005Local countries commissionDiabetessACHDAHigh blood pressureAAsthmaAAfigureratefigureratefigureratefigurerateChiswick 1,0052.00 %804 1.60 % 3,510 7.10 % 1,806 3.70 % Isleworth & A ; Brentford 11322.80 %846 2.10 % 3668 9.10 % 1913 4.80 % Central Hounslow 30834.80 %1972 3.10 % 7867 12.20 % 3190 5.00 % Heston & A ; Cranford 18304.60 %1076 2.70 % 4061 10.20 % 1836 4.60 % west countries 21503.80 %1408 2.50 % 6118 10.70 % 2759 4.80 % Hounslow PCT 9,2003.70 %6,106 2.40 % 25,224 10.00 % 11,504 4.60 % Beginning: Hounslow percentage ( choice direction and analysis system. Blue is the lowest rate and ruddy is the highest rate ) ( hypertext transfer protocol: //www.hounslow.gov.uk/part_2 )6.1 Research studyThe undertaking research was conducted by a signifier of email contacts, by calling some of the stakeholders, the pattern through appoints and one to one interviews. Other on-line research was besides conducted through the university larning resource Centre and by go toing the faculties talks and workshops to derive more theoretical and practical facet of the undertaking viability, feasibleness survey and other signifier of executions.7.2 Undertaking Organisations and StakeholdersDR Edward JuniorPractice Executive DirectorDR Mohammad Rashidy Md MRCPDR Sowmya SreeharanBSc MRCP MRCPDr Pamela RaiMB CHBDr Asif MalikMRCGP MRCPNew Specialist NursePractice Manager:Michele LooslyNurse: Shirley SingingLead Receptionist:Christine PalmerNurse: Edle maskellReceptionist:Adelaide JohnsonReceptio nist:Kayleigh HarveyThe hierarchy above shows the Doctors and staff of the Isleworth wellness Centre who will be responsible of the patient ‘s interventions and undertaking long clip sustainability and success. The undertaking administration squad will be lead by the undertaking co-ordinator Cam faculty leader Mike forest, undertaking director is Dr Janet Cole Cam supervisor and undertaking Field leader is Mr Adan Ahmed Cam pupil.Stakeholders to this clinicThe GP practician Dr Edward junior The Hounslow Primary attention trust The Diabetic patients in Hounslow countries The Specialist nurse Mr Mohamed Osman Other Staff of Isleworth wellness Centre where the clinic is based The authorities Local council The Middlesex University Hospital The local Pharmacy Local stores, household members, friends and relations of the diabetic patients.7.3 Academic aimsThe academic aim is to acquire penetration of the undertaking direction and execution cognition as a hereafter undertaking director. The procedure of analyzing, planing and implementing of this undertaking will enable me as 3rd twelvemonth pupil, the ability to construction and develop project specification of the concern demands and demands of the client aim by accomplishing ends like, Ability to use undertaking aim Ability to analysis, design and construe informations as per the undertaking demand and specification The ability to understand the impact of the success and failure of the undertaking execution in existent life. Ability to run into coveted demands and restraints such as the undertaking execution in relation to, political, economic societal, technological, environmental, legal and ethical deduction that it may hold to the implementing squad and the undertaking lifetime and to that of the benefiting clients and patients at big.8.1 Client aimsThe current construction of the pattern does non suit much of diabetic patients as there were less resources and less trained work force to manage the state of affairs. The clients to accomplish the aspiration of its of all time spread outing demand for service bringing by the wider Hounslow population and the social-demographical alteration across Europe due human mass supplanting in seeking for green grazing land has forced the desire for enlargement and convey on board some signifier of specializer intervention for diabetic community in Isleworth Health Centre through the support of Hounslow primary attention trust..8.2 Personal aimsMy personal aim about the undertaking is to derive farther accomplishments to foreground in footings of undertaking research, undertaking direction, planning and executions as a hereafter undertaking director. To travel and make research in a new countries of medical field without holding a background of medical survey is a large challenge for me and to convey to the visible radiation the importance of the topic affairs for the public good. To stretch my ability in understand the complexness of the underlay facts that has non been brought to the bow for the improvement of this socially deprived group in footings of their diabetic prevalence within the cultural minorities in Hounslow primary attention trust. To believe further into complex and more critical issue in footings of peoples wellness and do research on them without have a medical grade, as an informatician is an accomplishment I am taking to develop farther so what this undertaking could offer to its clients in footings of reconstructing hope and success within their day-to-day life.8.3 Project ApproachAcademic aims The academic aim of the undertaking is to prosecute with the demands of the local community and pattern within the boundary of fit period to accomplish a certain standardized signifier of battle and present undertaking that will be good to the local society and to sharpen my academic making to that degree of undertaking adviser. The undertaking will expose a idea of a 3rd twelvemonth pupil thesis to turn out the degree of apprehension, the counsel accorded to the me in order to turn out that apprehension, certain criterion and process has to be follow and present the undertaking on that line of survey like prince2, DSDM Agile and XP procedure of package development and undertaking direction. What has been taught at the university has to be put into pattern and do it a world in order to profit the said community and highlight their immediate job and how best signifier of action can be developed from my accomplishments.8.4 Work Breakdown Structure ( WBS ) Activity programCalendar monthActivitiesMilestonesDate deliverables29 September Project feasibleness survey Meeting clients 17 November 2009 7 October Interviews with clients Interviewing client same 14 October Planing analysis study Meeting undertaking squad same 18 October PID progress degree coverage Desktop researching sameProduct Breakdown Structure ( PBS ) – Prince 2Documents & A ; merchandisesDeliverablesday of the monthsPelvic inflammatory disease First client meeting Interviews of staff and clients Feasibility survey Project team board meeting PID progress degree coverage Submission of Biding undertaking 29/9/2009 5/10/2009 16/10/2009 19/10/2009 12/11/2009 19/11/2009 Analysis Case survey of the undertaking Software usage analysis Earlier user instance diagram Design Earlier paradigm design Uml and database User instance Class diagram ERD diagram Sequence diagram Execution Execution model Agile procedure DSDM Prince 2 Testing Black box proving EVALUATING Quality Assurance Impact analysis9.1 Project BudgetItemDescriptionCostInitials Budget allocatedGrant from Diabetes UK, Hounslow PCT & A ; GP?10,000Nurse Training disbursalsSpecialist fee upfront and allowances?2,750Consultant feeCoding, proving and execution of package?750Staff engagingReceptionist and excess per clip nurse?2,500operating expensesRents, measures and others?1,500Equipments and toolTherapies, beds, Glucometer and drug?1,500Software and HardwareWeb development and other signifiers of tool?1,000Entire10,0009.2 SWOT & A ; PESTLE factors to see:FactorCould include:Swot analysis & A ;PoliticalThe authorities may present new system to do the populace to pay for their ain medicine. The populace may defy the new undertaking through tribunal action to exclude Cultural minorities given any penchant over the autochthonal people. If BNP won the election of following, they plan to take all none autochthonal people from Britain and this will do the undertaking relevant and useless Internal: The clinic has four other spouses where patients can be seen and treated at that place. The GP has other funders like Diabetes UK and many none governmental organic structures support. External: the rivals may besides dispute their competencies of Nurse led diabetic clinic They may open similar service and private patients intervention cut down their figure of patients hence cut down supportEconomicThe current economical clime of recession may do the NHS to prostration and hence undertaking fails as it depends on NHS for fund. New and inexpensive signifier of therapy development may render the clinic irrelevant. Internal: may non be feasible to run Cost of running is really high against the income from the givers like NHS External: the authorities alteration of program to provide for the cost of intervention The therapies monetary value hiking and patient could non afford to pay for itSocialThe Ethnic minority may non come out and seek intervention for fright of reprisal while others may non even both to seek intervention Making the GP to abandon the undertaking earlier at proving and rating period. Internal: the patient may became shy from male Nurse handling them due to their cultural barriers The patient may still hold troubles go toing the clinic to avoid going with coach, alternatively travel to their local GP External: the GP has no socializing installations like eating house where they could come and eat and imbibe and avoid all together Patients find boring to go to and from the clinic and avoid perturbations.TechnologicalThe find of new medical specialty by research workers for Diabetic patients may turn the undertaking irrelevant in its entireness and ends lifetime of the undertaking. Internal: utilizing on-line system may be excessively complex for staff and avoid looking at on-line engagement, doing patients frustrated The staff became excessively busy to read and answer electronic mails and make unneeded holds for the patients External: Most of the patients due to endorse land may non read and compose doing system relevant for usage. Due to habit of merely booking assignment through phoning of the GP, patient may non even use system often.EthicalEthically many Indians celebrate Diwali with really sweet nutrient and hence taking the advice of the specializer nurse for altering their wellness life style of eating healthy nutrient agencies giving up of their cultural belief. This may damage the credibleness of the nurse, in reding the them to cut down or halt all together any inordinate sugary nutrient, without exasperating them. Internal: stating the patient halt eating sweet nutrient may damage the relationship as it ‘s their cultural belief to eat sweet nutrient on Diwali twenty-four hours. Cultural barrier may render the service un of import to patients External: the preparation of staff and registry with GMC and NHSLegalHealth and safety has to be adhered to at all clip and former informations in the system should be destroyed and deleted from the system. Internal: cheque and develop the staff of the legal deductions of running merely cultural minority clinic. Complains like racial maltreatment claim against the clinic will be unsafe External: all staff should be registered with the concerned organic structures of professional making to fulfill the criterion of intervention offered.EnvironmentalWrongly utilizing their therapies like needle to pierce the finger may be thrown manner in the street and do environmentally risky for others. Internal: the usage of therapy preparation and disposal method should underscore . Patient may through it anyplace, this may ensue clinic to be fined by the council garbage section External: patients ignorance of disposal of waste stuffs may be accused of environmentally unfriendly The council could salvage a tribunal order for that ground as risky11.1 Investigation techniquesThe fact-finding techniques used this undertaking is based on field appraisal, interviews, run intoing the GP staff and the stakeholders, presentation of the demand of the undertaking and11.2 InterviewingThe complete portion one and portion two of the suitableness and convenience of the undertaking and the GP from the point of the pattern director, patient and adviser position will be included in the concluding undertaking as portion two will be conducted subsequently January to supervise advancement and all inclusions of all the concerned parties.11.3 Feasibility survey techniquesThe feasibleness survey techniques used was by carry oning interviews with patients and the proactive directors and executive managers, directing out questionnaires to the concerned parties like the Hounslow PCT, Middlesex Hospital and the local communities that will impact as consequence of this undertaking or b e a donees on the hereafters of this undertaking. A brief study was besides conducted by the undertaking adviser before many any decision to transport out the undertaking initial paperss to be presented to the clients who in this instance is my personal coach Dr Janet Cole and Mike Woodland as the executive undertaking co-ordinator in order for the undertaking to be approved and accepted as standardized binding application for the undertaking project and its viability to the concern demand and the donees and other stakeholders like external testers has to be put into consideration.11.4 TechniquesThe techniques that will be used are the web development linguistic communication like hypertext markup language, xml and PHP and Dreamweaver package for the web developments and MYSQL and Apaches as the database and waiter severally. There new readymade engineering of web development presently used in E-commerce faculty that has ready waiter and some basic input that does non necessitate to construct from abrasions at this twenty-four hours and age of engineering there will be no more utilizing of hypertext markup language and edifice web site with database from the abrasion any more. Two of this illustrations are shopify and magento amalgamation with Xampp package which is a free beginning. The undertaking direction and development manner used are Prince 2 UML and Agile. Other methods to be included are Swot analysis, Pestle, Rich image, and user instances requirement catalogue interviews and HCI11.5 Functional and non-functionalThis will done subsequently on the concluding stage of the undertaking, at this clip is non a precedence but, subsequently on as the undertaking advancement to its concluding execution and rating so this will became an of import portion of the procedure and will be to the full included on the finals study.12.1 Description of the current systemThe present system in topographic point is a rather boring one where 1 has to name for an assignment in order to see even their local GP. The patient so is been referred to hospital depending to the state of affairs and status of the patient. Then the infirmary will book an assignment for him or her to see a specializer in minimal period of six to thirteen hebdomads clip. Soon the diabetic patients queue in the same line with any other patients waiting to be attended to and this make the affair really complex for them when the patient glucose is flat is really high and that needed immediate attending and that you can non leap the queuing system and the patients can non shout to explicate to every that he or she is in a really awkward state of affairs and needed aid. The GP is presently holding merely one telephone line and when the one line is engaged than you have to wait for a long clip to speak to human and this made affair farther really complex to cover with in a day-to-day footing of the operation of the GP and forced patients travel to Emergency & A ; Accident unit of the Middlesex Hospital to acquire assist if their ain GP could non be contacted12.2 Design – possibilitiesThe design of the undertaking will follow Agile package system analysis and proving method to implement the undertaking as it ‘s easy to manage and follow up with upfront bringing and of PID, paradigm presentation and posting presentation followed by concluding study. As you design and review with traveling to a later revisable phases. Agile manner undertaking development life rhythm will be used. The undertaking will besides follow the Prince 2 direction and control manner of undertaking development lifecycle DSDM12.3 Proposal of alternate solutions recommendationsTo develop a web page that has all the nexus from Nurse to specialist Doctor to assist patient seek ego intervention with the support of available information and support provided by this site in a user friendly mode. The site should hold a full entree database that will separate the diabetic patient entered information from assortment of disease symptoms that will cut down the premise that the patient is non a diabetic but has related diseases. The queuing and calling the pattern to see a physician should discontinue forthwith as all the primary beginning of concerned is addressed at the web page where all the needed information and intervention is available at this site 24/7 and needed no physician to explicate the facts. The current Glucometer should be improved to read around seven major disease than its current province of merely ready digital numeral Numberss runing from 0-100 without lucubrating what precisely it is approximately and alternatively advice patient to seek immediate attending of a physician if his last known reading degree has exceeded the 24 hours reading in the memory. The Glucometer should besides provide for those who have blurred vision and added some characteristics that is of helpful to deaf and blind to assist understand their reading alternatively of seeking aid every clip.12.4 TimescalesThe undertaking will take to implement between six to seven month depending on the blessing of the interest holders and the undertaking direction squad. Presently the pattern could non do determination as to where it should establish the pattern of specialise diabetic clinic as there were new amalgamation of patterns that are scattered in five different but strategically place place and this consequence the urgency and desire for the input of a undertaking adviser to assist decide the undertaking location and justification while utilizing other patterns as back up Centres to run the undertaking efficaciously.DocumentsSTART DATEEnd DatePelvic inflammatory disease 05/10/2009 16/11/2009 Analysis 16/11/2009 18/12/2009 Design 18/12/2009 18/01/2010 Execution 18/01/2010 04/02/2010 Testing 04/02/2010 04/03/2010 EVALUATING 08/03/2009 05/05/201013.1 Gantt chartPlease look into the Gantt in the Appendix A on page 1713.2 RISK ANALYSIS TABLESNameEventuality programExtenuationBadnessInternalExternalProbabilityMeeting the mark Time constrains Patient acceptableness about Nurse handling them as specializer medium yes yes 65 % Nurse reluctant to take occupation Give nurse some clip off to develop Make certain other GP nurse do n't do confusion for the patient high yes yes 50 % Fiscal constrains due to recession Negotiate with stakeholders Fund may be reduced treating patients high yes yes Other rivals ‘ Private GPs may set about the occupation Patient may wish the service offered for wage but quality medium yes 50 % The monetary value of therapies may be expensive Reduce monetary value and even give free New Glucometer may be expensive for NHS to buy medium yes 55 % Technology Development of new appliances New Glucometer that can state when take therapy to patients is the market high yes 35 % New find of medical specialty Follow up and see All patient may travel for new therapy and leave the clinic medium yes 80 % Unanticipated failures Its unpredictable and unanticipated Any issue unpredictable should be all cheques and fixed as it go high both both 70 % Government alteration of policy May do intervention money for all Those who could non afford should be seek aid from charities medium both both 50 %14.1 Internal factors project hazardRanksNameDurationImpactBudgetInternal HazardExternal Hazard1 Meeting the marks 6 months medium medium both both 2 The figure of people overwhelm the GP Long term high high both both 3 Unanticipated failures immediate medium low Both both The undertaking has several hazard attached to, like the viability in long clip puting in it, where if a new medical specialty is discovered to handle the diabetic patients and drug becomes available at the high street counters than the undertaking lifetime will came to an terminal. The scientist discover cistron that is attached to human variety meats that can be treated with certain simple beltway operations and the diabetic patient get cured by this simple mechanism than the undertaking viability will besides be affected in a long clip venture earnestly. The current economical state of affairs of the state acquire worsens and that NHS became belly-up than the lifetime of this undertaking will decidedly came to an terminal.14.2 ControlThe method used to command the undertaking will establish on the Prince2 and nimble manner of direction where the undertaking feasibleness survey will be delivered and followed by the first stage of the paradigm design presentation and followed by the posting presentation to the clients and the concluding bringing of the whole procedure of the undertaking execution and rating in finishing the procedure by updating hazard log and papers readying good in progress for concluding bringing of the undertaking in guaranting smooth return over by the client.14.3 Project Report Weightings Marks.ItemsMarks weightEntire MarkssAnalysis25 %120Design45 %Execution25 %Evaluation25 %14.3 DecisionThe undertaking is non that complex and large plenty to make some kind of confusion to implement. The range of the research is excessively boring and complex as I have to research through 1000 of papers of information to analysis in order to come up with filtered informations that is precise, easy to understand and readable adequate to do the determination shapers to move and do decisive opinion for the undertaking to travel caput as agenda in this undertaking initial papers. I have try really venue to do it clear and associate the resource if farther elucidation are required with easy and flow of information both from the beginning and the demand to convey them on board to this papers as manner of legalizing the importance of the service bringing to this extremely vulnerable group of people to type 1 and 2 diabetes to accomplish the line of life of their life clip.14.1 Appendix Angstrom14.2 Appendix BHandiness of resourceNumber of sites has really utile resource of information for both the staff and the patients. The staff of the clinic can entree database of the quality result model administration that sporadically roll uping informations from GPs across UK and analysis to update the prevalence and diagnostic and other signifier of betterments done or received by the patients. Diabetess UK, patients, UK NHS and Hounslow percentage are few of the sites that carry rather good advice for both patients and staffs Access cyberspace web sites for advice, on-line information of diabetes, interventions available, statistical figures, cognition on diabetes related wellness jobs, petition for a free Glucometer and replacing therapies available every bit good as drugs available on prescription. Electronic mails can be sent in add-on to posting short message on the web site in order to achieve a speedy response from the clinic and other staff that are working in concurrence with the specializer nurse. Telephone conversations can besides be arranged to acquire responses. This may be ideal for those who are busy and can non give a speedy response by missive or electronic mail. Questionnaires can be placed in surgeries, dental patterns, and pharmaceuticss to obtain diabetics patients sentiments. Consequences from questionnaires obtained from pharmaceuticss can be retrieved from Hounslow PCT to see what services need bettering and what services are missing. Posters, cusps, media coverage, exposure of diabetes related diseases to do tobacco users cognizant of the wellness hazards.QualityUse latest information from the cyberspace ( e.g. NHS, Cancer Research UK, Net Doctor, ASF, Diabete.org, the database of quality result model ( QOF ) ) , medical and pharmaceutical books, medical diaries ( e.g. British Medical Diaries ( BMJ ) who are trusted medical publishing houses supplying information on medicine that can help the determinations physicians and patients make every twenty-four hours ) and the DH. Quality confidence cheques can be made to see how consequences are summarised to guarantee they are recorded in the best possible manner and in manner as to reflect true responses. The authorities can supply up-to-date information on diabetes, including the figure of diabetic patients in a peculiar part of the UK, and can besides supply information on what future programs are to set about the turning issue of diabetic diseases.DependabilityThe facts and figures from Hounslow PCT will be accurate as it ‘s besides a authorities service, so it will hold up-to-date information on local diabetes consultative services and diabetic disease within the local country. The PCT will look into with pharmaceuticss and surgeries on the figure of diabetes within the country and the information needed can be obtained from the PCT. BMJ have a web site, and to entree the medical diaries in deepness there are subscription charges, monetary values depend on whether user would wish diaries sent in the station and to see on the web site. British National Formulary site is updated by Royal Pharmaceutical Society of Great Britain and Medicines and Healthcare merchandises Regulatory Agency who are responsible for the criterions of safety, quality and public presentation of drugs and medical contraptions issued in the UK markets14.3 Appendix C.The diabetic graphs harmonizing Hounslow percentageThe degree of patient positions and contacts and interventions done by the GP and why the pattern is sing the enlargement sing diabetes clinic is due the fact that it ‘s based in a strategically of import point of contact. The Isleworth wellness Centre is on the London route thatResidentialThe GP is within the scope of the most patient ‘s residential countries like Syon Park, ivy span estate, Brentford, greater Isleworth community, Hounslow cardinal trade Ford and Heston.Transport links- BussThe GP can be entree by coachs from Hounslow is H20 which frequent right in forepart of the GP and link the remainder of Isleworth , Tesco Twickenham and Hounslow cardinal to civic Centre while 267 coachs connects to shepherd shrub green, Hammersmith, Brentford and Twickenham town Centre to full good bus garage.TrainsThe nearest train station are Isleworth and Twickenham both walking distance and besides connectable via coachs 267, H20,418,281 and 237 respective in really root all this coachs are connectable from Isleworth, Brentford, Hounslow high street and Twickenham train station to southern trains that connect to the remainder of London via Waterloo. There is walking distance of 6, 10, 15 minute from Isleworth station, Twickenham station and Syon park station severally. Advantage The advantage of Isleworth wellness Centre over its rivals is that, the pattern is the most favorable for the undertaking to NHS and Hounslow primary attention trust in footings of its strategically place within the residential habitation of the diabetic patients and approachable localities via public conveyance, train and by walking in clinic makes it more convenient. Isleworth wellness Centre has late formed partnership with five other General patterns within Hounslow borough and can outsource some of its patients harmonizing to their ZIP codes to avoid overcrowding of one peculiar Centre and easy pull off the flow of patients attention and intervention with less force per unit area and this is a immense advantage over its concern rivals. The umbrella name of the new amalgamation is named as green creek health care group of GPs and their patient registered prevalence of diabetes. They are: Isleworth wellness Centre ( diabetes prevalence 2.6 % ( hypertext transfer protocol: //www.gpcontract.co.uk/surgery.php ) Ashford wellness Centre ( diabetes prevalence new no statistic found ) Bed fount clinic ( diabetes prevalence 5.9 % ( hypertext transfer protocol: //www.gpcontract.co.uk/surgery.php ) Chinchilla Centre for wellness ( diabetes prevalence 4.1 % Heston pattern ( diabetes prevalence 4.7 % Manor pattern ( diabetes prevalence 2.9 % ( hypertext transfer protocol: //www.gpcontract.co.uk/surgery.php ) The current diabetic patient intervention and care given in an overall per centum compared to other Hounslow pattern and the national norm of the diabetes patients study is represented this graph tabular array below. Patient study conducted in 2009 and this graph of the several countries of response the patient gave their positions on the attention and service they received from the pattern. Satisfaction study of patient assurance to acquire aid and care support offered by the clinic in general in this twelvemonth ( hypertext transfer protocol: //www.nhs.uk/ServiceDirectories/Pages/GP The reply to the inquiry is in the signifier of per centum as per the general feedback given by the overall patients presently registered in the GP. ( hypertext transfer protocol: //www.nhs.uk/ServiceDirectories/Pages/GP ) Rich Picture1: The rich image for the users, stakeholders, moneymans, the regulators and direction proprietors.18.1 Appendix DRich Picture 2: for the diabetic patient and its stakeholders connected to the service suppliers and carersBeginning of GP incomeThe GP in UK are contracted by the NHS in return for service to the populace by a formalization and wage bundle signed agreed in a charter in 1965 by the section of Health. The dossier which was called the ruddy book contains the expression to cipher the payment and intervention of patient per visit. The method was classified in to six classs: Service dependent income The basic pattern allowance The standard capitation fee The want payment Rural pattern payment Seniority paymentsAverage GP income for the last 15 old ages.Although this information was old informations that in 2008/09 reappraisal of wage bundle for GPs are non included and hence merely added this information for income of GP presentations which is derived from assorted factors lake age, demographic population and child vaccinations and immunizations are non included in this computations.Item199520002005Income including patterns cost63,991106,652230,097Practice cost21,70036,167129,927Income excepting pattern cost42,29170,485100,170hypertext transfer protocol: //www.ncbi.nlm.nih.gov/pmc/articles/PMC2670288/19.1 Reference and BibliographyPull offing cognition and accessing demand of Hounslow people Hounslow pct study of 2007/08 page 6 of 52 and pdf file For more in for QOF database hypertext transfer protocol: //www.nhs.uk/ServiceDirectories/Pages/GP. hypertext transfer protocol: //www.hounslowpct.co.uk/documents/annualreport07-08_000.pdf entree on the 12/10/2009 at 13.25pm Income development of General Practitioners in eight European states from 1975 to 2005 Madelon W Kroneman, Jouke Van der Zee, and Wim Groot hypertext transfer protocol: //www.ncbi.nlm.nih.gov/pmc/articles/PMC2670288/accesed on 3/11/2009 at 20.15 autopsyPull offing clinical jobs in diabetic and Edited by Trish dunning and Glenn ward First published in 2008 by Blackwell Publishing company ltd e-book in e-resource of larning resource Centre at Kingston university, Page 5, 165, 177 hypertext transfer protocol: //www.dawsonera.com/depp/reader/protected/direct/SearchResults, buttons.eBookView.sdirect? sp=S9780470698099 Date entree on 27/10/2009 at 22.10pm Diabetic prevalence in Hounslow the borough countries. The tabular array of statistic is extracted from this web site. hypertext transfer protocol: //democraticservices.hounslow.gov.uk/HounslowHeathPopulationProfileCentralHounslowAreaCommittee.docA.ps.pdf the site was visited on the 17th October 2009 at 20.51 autopsy Diabetes a theoretical account of wellness attention direction p10 and p11, the paper was researched and written by William Laing and Rhys Williams and forwarded by Lord Butterfield. Published at Office of wellness economic sciences on October 1989, 12 Whitehall London sw1a 2dy World blind tendency for diabetes and signifier of practical damage hypertext transfer protocol: //www.fims.uwo.ca/NewMedia2007/blindstats.aspx Diabetess Dr Diabetess hypertext transfer protocol: //www.youtube.com/watch? Gestational diabetes and diabetic in gestation adult femaleshypertext transfer protocol: //www.walsallhospitals.nhs.uk/Services/Diabetes/GestationalDiabetes.aspHealthcare for LondonReport – Diabetes attentionHounslow Primary Care TrustReport on the PCT ‘s public presentation on attention for people with diabetes July 2008 hypertext transfer protocol: //www.lho.org.uk/Download/Public Accessed on the 18/10/2009 at 15.17pmFigure 2.2.6 Prevalence of Chronic Diseases by Committee Area, 2005The study on Hounslow primary attention trust on public wellness page 106hypertext transfer protocol: //www.hounslow.gov.uk/part_2_sec2.2_health_1.pdfAccessed on 11/10/2009 at 12.25 autopsyFor more in for QOF database hypertext transfer protocol: //www.nhs.uk/ServiceDirectories/Pages/GP Diabetess UK desk at Middlesex infirmaryDiabetess UK and south Asiatic foundationhypertext transfer protocol: //www.diabetes.org.uk/Professionals/Publications-reports-and-resources/Reports-statistics-and-case-studies/Reports/Diabetes-UK-and-South-Asian-Health-Foundation-recommendations-on-diabetes-research-priorities-for-British-South-Asians/ Diabetess and south Asiatic foundation recommendation to reexamine the impact hypertext transfer protocol: //www.diabetes.org.uk/Professionals/Publications-reports-and-resources/Reports-statistics-and-case-studies/Reports/Diabetes-UK-and-South-Asian-Health-Foundation-recommendations-on-diabetes-research-priorities-for-British-South-Asians/Diabetess Mellitus, hazard factored group of diabetes people in ukPatients UK web sitehypertext transfer protocol: //www.patient.co.uk/doctor/Diabetes-Mellitus.htmaccessed on 31/10/2009 at 16.01pmRashmi Kaushalhypertext transfer protocol: //www.west-middlesex-hospital.nhs.uk/media-centre/press-releases/diabetes/The followers are the contacts about the diabetes clinic and diabetes direction in Middlesex university infirmaryMrs Parminder Diabetic specializer NurseTel: 02083216468MR Rashmi KaushalConsultant Endocrinologist who specialises in diabetes at the West Middlesex University HospitalOther contacts by electronic mail to acquire more of the undertaking importance to patientsdavidcahill @ onetel.com.