Pilgrimage of Grace

DBQ Pilgrimage of Grace The Pilgrimage of Grace was to fight Henry VIII’s activities, for example, his Act of Supremacy. This lead to the usage of new polices, for example, burdens, the development of the illustrious force in the North of England, the disintegration of religious communities, and the reallocation of Catholic Church lands. These activities negatively affected the nation, and prompted the Pilgrimage of Grace from October 1536 to February 1537. The Pilgrimage comprised of walks and dissents and equipped shows. The re-formation of a pennant of a marcher delineates God enduring, a furrow and a cows horn.This represents the inspiration for the Pilgrimage of Grace. It can speak to the workers who are enduring similarly as Jesus did (3). Workers, church and men of their word were associated with the Pilgrimage of Grace. Every one of these gatherings of individuals had a particular part in the journey. The individuals who restricted the development executed a large numb er of the radicals, as they dreaded the defiance of power. The members of the Pilgrimage of Grace were worried for their nation and wellbeing from foes, and hence, their objectives were more portrayal, and a rebuilding of the Catholic associations, for example, monasteries.The workers and ministry were the biggest gathering in the Pilgrimage of Grace, and the most influenced by Henry VIII’s activities. Because of the conclusion of the religious communities by the legislature, the workers made an assertion that they should now depend on good cause, confidence, neediness, and that they should be prepared to help each other should criminals or Scots attempt to ransack them (2). This purpose behind dissent repudiates different reasons, for example, the â€Å"Oath of Honorable Men†, which expresses that one ought not enter the Pilgrimage for tedious addition, yet for his affection for God (1).The Catholic ministry, who presently couldn't rehearse their confidence in England , had their property removed and were intensely indicted by the legislature, as appeared in the verses to a ditty a priest composed, â€Å"†¦And held in bonds. Ransacked, ruined and shorn†¦Ã¢â‚¬  (4). The church and workers were worried for their future in northern England, and fought to get back the land and religion, which the administration had taken from them. Men of their word additionally were engaged with the Pilgrimage of Grace.Some who were individuals from Parliament didn't care for Thomas Cromwell’s effect on the King, which took power from the Parliament. In a mysterious flyer, Cromwell is known as a double crosser and that he ought to be expelled from office to reestablish power to Parliament (6). Robert Aske gives the objectives of each one of the individuals who took an interest in the Pilgrimage in his appeal to the individual from the King’s Council, which incorporates having the leader of the congregation be the pope in Rome, to have Thoma s Crowell rebuffed, and to have the religious communities and church lands reestablished (5).Throughout the Pilgrimage, there were riots in which the two normal people and respectable men were included (8). Huge numbers of them were captured and sentenced. The end of the religious community was a drawback to the nation according to the men of honor, as can be found in Robert Aske’s declaration, in which he requests that the ruler come back to the methods of the Catholic Church (11). Albeit numerous everyday citizens, pastorate, and men of their word bolstered the Pilgrimage, it was contradicted by the makers of these laws, King Henry, and high positioning officials.In Richard Madison’s â€Å"A Remedy for Sedition†, Madison contends that the substandard must be content that the more shrewd standard them, which is important in a district. On the off chance that this request isn’t set up, at that point nobody would obey and there would be mayhem (7). Nichola s Leche censures the respectable men who didn't face the resistance in his declaration (8). Henry VII himself gives a discourse absolving the everyday people would have opposed him on the grounds of obliviousness, insofar as they promptly quit dissenting and submit to his government (9).In the preliminaries against those associated with the Pilgrimage of Grace, 67 percent of the men of honor attempted were sentenced, and 62 percent of the laborers that were attempted were indicted. In correlation, 80 percent of the church attempted were indicted. This reflects substantial resistance against the ministry, who in the government’s eyes were the reason for the Pilgrimage. Despite the endeavors of the members of the journey of Grace, none of their objectives were met. Britain was not accommodated to the Catholic Church, nor did the cloisters revive. Cromwell’s pushes toward Protestantism were conclusive.

The Fixer Essay -- Literary Analysis, Bernard Malamud

During the mid 1900’s, the world experienced a racist overthrow that was dealt with diversely all through all nations. Life for Jews in Eastern Europe, during the mid 1900’s, was portrayed by mistreatment, isolation, restricted occupations, and extraordinary bigotry. They were not permitted to wed outside their race and individuals were eager to show their scorn (hostile to Semitism) by means of decals or pins, for example, the two-headed bird of the Black Hundreds on Mr. Maximovitch. In his novel The Fixer, Malamud recounts to the narrative of Yakov Bok, a Jew conceived in Russia during the mid 1900’s. Trying to a decent future, he leaves his home for Kiev to begin another life. While living here he should shroud his social foundation, despite the fact that he doesn't have faith in God any longer, to secure any opportunity of a promising future. It is the point at which he is accused for a homicide that he battles to discover God again and starts to scrutinize h is life decisions. The significant topics of the book are isolation, battle with religion, taking a stab at opportunity, and outrageous bigotry, which are communicated through Yakov Bok’s life. In The Fixer, Malamud reproduces the account of Mendel Belis, a Jew who is living in Keiv and is confined for the homicide of a youthful christian kid. The book is written in a restricted third individual view as it follows the life of Yakov Bok. He is a poor Jew grain getting purchase on his work who leaves his home in would like to make a more up to date and better life in Kiev. Yakov communicates his objective to his farther-in-law when he says â€Å"All I have now in this hopeless town is a poverty stricken presence. Presently, I'll attempt Kiev. On the off chance that I can live there nicely, that is the thing that I’ll do. If not, I’ll make penances, set aside, and head to Amsterdam for a vessel to America. To summarize it, I have pretty much nothing, yet I h... ...cist as he doesn't permit Yakov to do anything and just continues harming him. He fastens him to the bed, endeavors to harm him, and genuinely beats him with strip searches and starvation. In Yakov’s endeavor to leave his him and make progress toward another, increasingly pleasant life, he really made an existence of agony and languishing. Yakov reprimands his religion for what occurred with him, yet reality of him going to prison could had been an indication for him to re discover his religion. His farther-in-law said his religion will support him and despite the fact that he needed to confront the bigotry and isolation for all life, it was his religion that brought into see his opportunity dream. Malamud attempted to make a point through Yakov’s life that even through the most noticeably awful treatment on the planet and the chance of death, having confidence could lead you to this other entryway of opportunity and the genuine life you generally needed. The Fixer Essay - Literary Analysis, Bernard Malamud During the mid 1900’s, the world experienced a xenophobic overthrow that was dealt with distinctively all through all nations. Life for Jews in Eastern Europe, during the mid 1900’s, was described by abuse, isolation, restricted occupations, and extraordinary bigotry. They were not permitted to wed outside their race and individuals were eager to show their scorn (hostile to Semitism) through decals or pins, for example, the two-headed hawk of the Black Hundreds on Mr. Maximovitch. In his novel The Fixer, Malamud recounts to the tale of Yakov Bok, a Jew conceived in Russia during the mid 1900’s. Seeking to a decent future, he leaves his home for Kiev to begin another life. While living here he should shroud his social foundation, despite the fact that he doesn't have confidence in God any longer, to ensure any opportunity of a promising future. It is the point at which he is accused for a homicide that he battles to discover God again and starts to scrutinize his life decisions. The significant subjects of the book are isolation, battle with religion, taking a stab at opportunity, and outrageous prejudice, which are communicated through Yakov Bok’s life. In The Fixer, Malamud reproduces the narrative of Mendel Belis, a Jew who is living in Keiv and is surrounded for the homicide of a youthful christian kid. The book is written in a constrained third individual view as it follows the life of Yakov Bok. He is a poor Jew grain getting purchase on his work who leaves his home in plan to make a more current and better life in Kiev. Yakov communicates his objective to his farther-in-law when he says â€Å"All I have now in this hopeless town is a penniless presence. Presently, I'll attempt Kiev. In the event that I can live there modestly, that is the thing that I’ll do. If not, I’ll make penances, set aside, and head to Amsterdam for a pontoon to America. To summarize it, I have close to nothing, yet I h... ...cist as he doesn't permit Yakov to do anything and just continues harming him. He anchors him to the bed, endeavors to harm him, and sincerely beats him with strip searches and starvation. In Yakov’s endeavor to leave his him and make progress toward another, progressively agreeable life, he really made an existence of agony and languishing. Yakov reprimands his religion for what occurred with him, yet reality of him going to prison could had been an indication for him to re discover his religion. His farther-in-law said his religion will support him and despite the fact that he needed to confront the bigotry and isolation for all life, it was his religion that brought into see his opportunity dream. Malamud attempted to make a point through Yakov’s life that even through the most exceedingly awful treatment on the planet and the chance of death, having confidence could lead you to this other entryway of opportunity and the genuine life you generally needed.

Deconstruction of an Advertisement

COMM 10265 DECONSTRUCTING AN ADVERTISEMENT ASSIGNMENT Sexy Subaru Car Wash Sexy Subaru Car Wash Sexy Sumo Car-Wash Video. flv †YouTube Subaru puts another Eastern ironical contort on the convention Western provocative vehicle wash in their promotion for the Forrester which instead of Heidi Klum or Jessica Simpson sumo grapplers insufficiently washing the new vehicle. This ad begins with a grimy Forrester maneuvering into the vehicle wash with enchanting music playing in the background.Most crowds anticipate a gathering of supermodels in swimsuits to come out and wash the vehicle, anyway the older couple and the crowd is amazed to see six sumo grapplers turn out in uniform to wash the vehicle. The sumo grapplers whip their clothes and rub their stomachs facing the vehicle to delineate a scene of what the normal attractive vehicle wash would resemble when sumo grapplers replace swimsuit models. Offer credit to Subaru for adopting this substance of style strategy to publicizing, wi th the cleverness doing their motivation no mischief. What social gatherings is the promotion pointed and what social gatherings are spoken to in the advertisement?This ad by Subaru is focused on vehicle purchasers in Canada, just as an unexpected customer base which consider the to be as an extremist like change to the manner in which vehicle plugs are being created. Its funny and non-traditionalist provocativeness of the advertisement draws in an alternate sort of crowd than the normal vehicle buyer. There is no particular age or sexual orientation that this business is focused on, and by supplanting supermodels with sumo grapplers the vehicle is presently being promoted all the more comprehensively to remember ladies for the objective market.Does the notice disregard or fortify social/social standards? By utilizing sumo grapplers the Japanese vehicle organization Subaru has put an eastern social bend to the ad and this complexity is intended to be humorous in nature. In customary western commercials especially in the car business the utilization of a cliché â€Å"bombshell† would be utilized to advance items. This is to give the feeling that the smooth new item will assist you with achieving these cliché man/ladies of your dreams.This promotion disregards social and social standards by supplanting delightful ladies who ordinarily would publicize vehicles with sumo grapplers, a reference to the root of the vehicles maker. In an article distributed in Motor Authority it was cited that â€Å"Unlike the swimsuit wearing models in different promotions, you're not left pondering where the vehicle is†¦If anything your eyes search out the [car], if just for stylish help. † (Lienert 2011) In this ad Subaru Canada is likewise depicting a feeling of Japanese pride. Sumo grapplers are regarded in Japan and by supplanting a Canadian or American supermodel with an image of Japanese pride, the sumo wrestler.This associates watchers with the pride of a Japanese produced vehicle that the promotion is attempting to sell. What else is the advertisement selling? Subaru Canada is selling another kind of vehicle promotion which demonstrates abnormality to cultural standards by changing the picture of what individuals believe is provocative. Sex sells is a long standing expression that can be utilized to characterize the promoting business and before this business was discharged numerous makers showcased â€Å"sexy† vehicle notices utilizing Sports Illustrated bathing suit models or models of a comparable stature.Subaru in lieu of the provocative swimsuit models has decided to communicate their singularity by picked a social portrayal to make jokes about conventional publicizing. Subaru adopts a hilarious strategy to the business, selling the qualities of the vehicle. The pattern of substance over style is currently progressively evident as purchasers are substantially more taught particularly with respect to the automobile busin ess. Purchasers are currently bound to be worried about mileage, administration capacity/accessibility and resale esteem instead of whether their ride can get them a date for Saturday night.Works Cited Hall, S. (2011, 11 30). Recovered from http://www. adrants. com/2011/11/vehicle brands-despite everything utilizing sex-to-sell. php Lienert, A. (2011, 02 17). Subaru parodies supermodel advertisements with hot sumo grapplers. Recovered from http://www. insideline. com/subaru/forester/2011/subaru-parodies supermodel-advertisements with-attractive sumo-grapplers. html Norm (social) . (2012, 11 10). Recovered from http://en. wikipedia. organization/wiki/Norm_(social) Sexy sumo vehicle wash. (2010, 05). Recovered from

Countering the ISIS /ISIL Threat - Writing Assignment - 2200 Words

Countering the ISIS /ISIL Threat - Writing Assignment (Research Paper Sample) Content: Countering the ISIS/ ISIL ThreatName:Institutional Affiliation:IntroductionCivil conflict within a country always causes tension to the government and the surrounding governments on their securities. There is a fatal tension on security due to the rise of the rebellious terrorist group known as the Islamic State, IS, which is also known as the Islamic State of Iraq and Levant (ISIL/ISIS). This terrorist group has existed now for seven years and as emerged to be a major threat to the government of Syria. A large area in Syria consisting of the north-eastern part and the central Syria is being controlled by the Islamic State. This group crates assault on forces opposed to the Syrian government and forces aligned with the Syrian government. This paper analyses who the ISIS/ ISIL is, how it is a threat to America and possible ways of counteracting the threat posed by this group and recommendations to help counteract the group.ISIS and its threat to America ISIS is an acro nym for Islamic State of Iraq and Levant; it also stands for Islamic State of Iraq and Syria. It is a terrorist group which emerged in Iraq from a radical Sunni Jihadist who fought under the influence of al-Qaeda in Iraq. The group started back in the year 1999 as the Jamaat al Tawhid Wal-Jihad. This group has ties across the world with other radical and extreme terrorist groups. Geographically, ISI is found in Iraq, Algeria, Syria, Libya and Lebanon. Their aim is to achieve Caliphate state in the world. In Arabic, Caliph means successor and an ecclesiastic with such tittle is regarded by Sunni believers as an Iman chosen by Allah from the family of direct descendants of Muhammad the prophet. Thus it is also known as the caliphate. The group has inhabited many parts of Syria and forced many inhabitants of Syrian to be refugees in their country and move to Jordan for sanctuary and safety. The goal of this group is to attain power over the worldwide Muslims and to free their people wh om they term as infidels (Parry , 2014). The impact of this group has been felt in France, Europe and America. Their actions on civil people have been considered a severe abuse of human rights and the civil rights by the Amnesty International and the United Nations. This group conducted their terrorist attack as a retributive for things that they felt America and Europe had done as a show of power over them. United States have tried to employ its security operations towards this terrorist group so as to reduce the threat caused by this group to its personnel in Iraq (Parry , 2014). In August 2016, there was experienced a Syrian airstrike near the U.S proximity where its personnel were operating from. This caused the United Nation to send some more U.S air patrols to that ground to help maintain security for its personnel. To achieve this it has tried much to prevent the Islamic State from using Syria as base for their operation in Iraq. There are members of this group in United Stat es of unknown numbers and also the UK government does not know where exactly they are located (Morell, 2015). United States military is trying to flush members of the group out but because of the nature, it has been a hard task.Intelligence Agencies that can Bring an Impact An intelligence agency is a government institution which is tasked with the responsibility to collect, exploit and analyse valuable information and intelligence to help protect its national interest. Intelligence agencies aid the country to cope and maintain its securities matters and also to protect it from any likely security breach. Within the intelligence agency, there exist other spy agencies that collect secret information to help the country maintain its internal and external security which might interfere with the countrys stability in either political terms or economical terms. Personnel of an intelligence agency must act as the countrys spies, agents or undercover officer and vows his life to work as a secret agent for the state (Laqueur, 1985). In the year 2012, there was a peace negotiation which failed between the Syrian government and the opposition under the guidance of the Geneva Communique. The communique was endorsed by the two governments of United States and Russia and it advocated for a transitional governing in Syria which is endorsed with full executive power to govern the country. The government would include members of the opposition, the present government and other groups and be formed on the root of mutual consent. Other subsequent attempts has also failed which brings in the idea that some other methods can be employed to help attain the peace in the country (Gambhir, 2015). One of the methods that now remain to counteract such evils caused by the ISIS is the use of intelligence agency. For the intelligence agency to work well, some factors must be considered to choose which intelligence agency to use. Some critics on the approach to be used suggest that some w illing effective Syrian partners should also be engaged to help achieve this. Considering the argument, some of the intelligence agency which can be used to help combat the threat by the ISIS must consider covering the most crucial areas. Some of the crucial areas that appear to be part of the problem revolve around politics, social and military areas. The major problem that is being experienced arises from the action from members of a religious group meaning that social aspect must be taken into consideration in this matter. Again this groups actions are being undertaken using the military force, therefore for an equal counteraction, a military intelligence must be involved in this matter. Lastly politics have contributed to a larger perspective in this conflict, most of the attacks are directed towards various governments and also the group is anti-government therefore political intelligence must also be involved in this matter.Capabilities of Each of the Intelligence AgencyPoliti cal IntelligencePolitical intelligence agency is a function group within a country which is tasked with the duty of providing detailed data or information and analysing about the major political happenings unfolding in various countries all over the world. The mandate of this intelligence is to provide briefing for political intelligence in the country and reports on momentous political developments across the international spectrum. The reports are always written on a weekly basis and are expected to offer rich embroidery of an in-depth and dynamic international coverage which is supposed to provide information to the Country-Watch users with complex geopolitical information evolving around the world. Covered in the political intelligence briefing is Featured Country that highlights current key issues trending on the international scale. There is also edition of past political intelligence and past individual articles which also known as political intelligence wire which helps to u nderstand fully what goes around politics of different countries (Coleman, 2016). These duties performed by the political intelligence makes them useful in this fight. Since the problem of ISIS is to have Caliphate state, it all revolves in the political sphere. Therefore understanding the politics involved can help curb the problem. This is one of the areas which the United State had already attempted in advocating for in the communique effort of government that will include both the opposition and those already in government in the Syrian government to help in eliminating the problem, therefore when the political intelligence is employed, it will help in counteracting the force.Military Intelligence AgencyMilitary intelligence agency is a special unit that are tasked with the functions of gathering and analysing information about public relation and foreigners for requisite data and underground operations at the demand of the United States president. Some of the top military intel ligence agencies which can be employed in U.S include Central Intelligence Agency (CIA) which is the most prominent and familiar security agency in the United State among other security agencies like the Federal Bureau of Investigation (FBI) and the Defense Intelligence Agency (DIA). CIA is being considered as the top intelligence agency in the entire world and an independent agency. The chief functions of the agency include gathering and analysing information about public relation and foreigners for requisite data and underground operations at the demand of the United States president. Concerning the capability of military intelligence agency in fighting the ISIS group, it has the potential to do that. Over the years the agency has tried much to fight the ISIS group even though it has never succeeded (Morell, 2015). If it gets more back up force, it can achieve this and silence the ISIS group. Since it has involved itself in the fight for a while, it has gained some useful tricks i n fighting the group. Therefore in any attempt in fighting the ISIS group, military intelligence must be involved. Another useful military intelligence which can be employed is the MI6 which is normally known as the Secret Intelligence Service of the United Kingdom. Due to its nature of secret intelligence, MI6 is at a better position in fighting terror attacks by the ISIS group. According to news of their services, MI6 is among the best agency to employ for such an action. In its territory, MI6 in collaboration with other security agencies in the United Kingdom they managed to stop seven terror attacks which were suspected to have been planned by the ISIS group of Syria. The government of the United Kingdom through the British prime minister also announced that they are ready and willing to put more additional resources to help fight ISIS group by hiring additional 1,900 officers for its three intellige...

Religious Causes of War Essay

War in the Name of Faith The history of the mankind is not only the one of the development and great inventions; it is also the history of wars. Since prehistoric times, different nations have been fighting with each other and very often the announced reason for it was the religion. We can easily remember the Crusades, which were nothing but a war between Christians and Muslims, civil conflicts between Catholics and Protestants in England and Northern Ireland, wars between the Sunnis and the Shiites in Muslim countries. Observing all this, it is easy to come to the conclusion that religion often causes wars. But personally I strongly disagree with this opinion. There are only two basic reasons for a war. It always starts either because of money or because of power. The Crusades started because the European aristocracy and the Pope wanted to increase their wealth and conquering Palestine seemed an easy solution. Moreover, the Pope wanted to broaden the limits of the power of the Catholic church by converting numerous Jews and Muslims to Christianity. All the other wars with the religious background can be analyzed in a similar way and there would always be found a party, which took the financial or political advantage. However, religion has always been a wonderful pretext, as it makes soldiers, who are supposed to die, feel prouder and fight more enthusiastically, as dying in the name of the god is always more meaningful than in the name of a greedy king, who wants to get another piece of land or a couple of additional jewels to a crown. So, to my mind, religion has nothing to do with wars. The only thing that unites them is the meticulous calculations of those who are interested in improving their financial state and use the pretext of religion to make murders acceptable.

The Main Character And Hero Of This Play By Alexander...

For our final group project we had to pick an ideological lens and apply it to a piece of text we had gone over as a class to create a screenplay. I’ve had the songs from Hamilton stuck in my head since the beginning of the semester when the musical was assigned so I thought it would be of good use to take what is already so prominent in my head and get creative with it. Hamilton is the main character and hero of this play, who is based off of Alexander Hamilton, one of America’s founding fathers. The character displays extreme confidence and enthusiasm, which can come across as arrogant or cocky to some of the other characters, who are also historical figures, such as Aaron Burr. To the audience Hamilton is still admirable and his†¦show more content†¦Most historians would agree that this film is clearly propaganda for fascism, but to the day she died, Riefenstahl claimed that her film was simply a documentary, showing what was happening during that time (Stup p). This is because she wanted to avoid prosecution and affiliation with the Nazi party, but she did end up being deemed a Nazi sympathizer and her career suffered (Leni Riefenstahl.). As I watched her film I took notice of the way she highlighted Hitler in positive lighting and how there would be cuts between him and the excited townspeople. There are many images of children, particularly young boys. I knew I wanted to incorporate these images at some point in my screenplay during a montage as an indicator of fascism. While I knew how to show fascist symbols through film media, I knew that I wanted my screenplay to be more like anti-fascist propaganda, so I realized that it wouldn’t make sense to use Riefenstahl’s techniques alone, so I did more research. I found a Disney short film, Education for Death, which was an American propaganda film shown in theaters throughout the United States during World War II. 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Ispahan Carpet Essay Example For Students

Ispahan Carpet Essay â€Å"Ispahan Carpet† by Elizabeth Burge describes the poets visit in Persia as she examines the carpet makers. Although the poem’s title suggests that the poem is centered on Persian carpets, the poet does not wholly concentrates on its beautiful handicrafts. The poet’s attention is especially drawn to the girls making these rugs in this poem .Through various the use of literacy devices, the readers are able to adopt the poet’s feelings and thoughts as she examines the girls at work. The poem is written in stanzaic form of five stanzas each on one idea. In the first stanza, the poet gives us her first impressions when she say the carpet making â€Å"firm† as the descriptions given as visual. As an example, â€Å"bare† and â€Å"cavernous† is used by the poet to describe the room and using such words Burge makes us understand that they do not live in any luxury. Another instance where first impressions are shown is when she first saw the carpets. The use of strong adjectives, â€Å"sensuous jeweled arabesque’’ is used by the poet to convey her feeling of wonder as she see the carpets. The use of â€Å"jeweled† is indeed an exaggeration, but is still used by Burge to make her readers understand that these carpets â€Å"interwoven pattern† resembles pure beauties, like jewels. Onward, Burges has made the next four stanzas in descending order of number of verses; 8-3-3-2. The idea that the poet may have had behind was to illustrate the hard work behind the carpet making. It may represent the process from start to finish. Furthermore we are given the impression that the carpet making is like a piece of art or â€Å"traditional beauty†. This is one of the ideas that the poet wants us to understand. There are both the feelings of amazement and pity exhibited in this poem as the encounters the girls making the carpets. A tone of disappointment is used by the poet as she introduces the carpet-makers. By writing â€Å"Eight-year-old girls sit sparrowed on a plank†, Burge shows her feeling of shock as she did not expect to see young children working as such. The poet sees the job unfit for these children as they are given the impression to be fragile and weak through the use of a simile, â€Å"bent like old women†. As such we feel that the girls have overworked and are tired like â€Å"old women†. Thus such a negative comparison makes us readers equally feel pity for the weavers. The poet indeed shows that she is worried for these girls. This can be seen in the last stanza, with the metaphor â€Å"my swollen hands are gentle in the greenstick shoulder†. Metaphorically, the swollen hand would refer to the poets being powerless as she is unable to help. The readers could perceive this as a symbolic act of kindness. Literally the poet’s hand could be swollen and in pain she tries to help another person who seems to suffer. The poet’s final verse is strong as it makes us realize the severity of things for these girls. The girl’s call for help is so strong that her â€Å"eye† could â€Å"speak†. The poet makes this clear that the life of these girls is completely wrong, like â€Å"darkness†. Indeed, the poet has not forgotten that the skills of these girls are exceptional. The fourth stanza is quite important as it is directed toward the readers. The importance of carpets is shown through the metaphor â€Å"whole horizon† meaning that carpets are used everywhere. But, the â€Å"traditional beauties† made by this girls is so unique, such that it is made impossible to destroy. The poet makes use of a rhetorical question â€Å"Who can unravel the world’s weaving?†. Even though Burge gives us no detailed description of the â€Å"Ispahan Carpet†, we understand that it is something unique to be admired and valued. .u8dd140d24d95c361a0f59ba7b9fd6aef , .u8dd140d24d95c361a0f59ba7b9fd6aef .postImageUrl , .u8dd140d24d95c361a0f59ba7b9fd6aef .centered-text-area { min-height: 80px; position: relative; } .u8dd140d24d95c361a0f59ba7b9fd6aef , .u8dd140d24d95c361a0f59ba7b9fd6aef:hover , .u8dd140d24d95c361a0f59ba7b9fd6aef:visited , .u8dd140d24d95c361a0f59ba7b9fd6aef:active { border:0!important; } .u8dd140d24d95c361a0f59ba7b9fd6aef .clearfix:after { content: ""; display: table; clear: both; } .u8dd140d24d95c361a0f59ba7b9fd6aef { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u8dd140d24d95c361a0f59ba7b9fd6aef:active , .u8dd140d24d95c361a0f59ba7b9fd6aef:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u8dd140d24d95c361a0f59ba7b9fd6aef .centered-text-area { width: 100%; position: relative ; } .u8dd140d24d95c361a0f59ba7b9fd6aef .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u8dd140d24d95c361a0f59ba7b9fd6aef .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u8dd140d24d95c361a0f59ba7b9fd6aef .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u8dd140d24d95c361a0f59ba7b9fd6aef:hover .ctaButton { background-color: #34495E!important; } .u8dd140d24d95c361a0f59ba7b9fd6aef .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u8dd140d24d95c361a0f59ba7b9fd6aef .u8dd140d24d95c361a0f59ba7b9fd6aef-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u8dd140d24d95c361a0f59ba7b9fd6aef:after { content: ""; display: block; clear: both; } READ: â€Å"Aunt Jennifer’s Tigers† and â€Å"Woodchucks† EssayTo conclude, we see that Burge seems to be against child labour and does this through this poem. In this poem she makes use of numerous techniques, such as structure, imagery, metaphor and tone in such a way to interconnect all of them to make a very pleasing and revealing poem

Michael Coppola Essays - Civil Disobedience, Violence, Activism

Michael Coppola Civil Disobedience Part 2 Civil disobedience is the refusal to comply with certain laws as a peaceful form of political protest. When civil disobedience is practiced when appropriate, it can be beneficial to the development of our society. Many past instances of civil disobedience resulted in positive changes in the structure of our society. In between marches, sit-ins, and demonstrations, found in texts 1, 3 and 4, they cause a huge increase in awareness that diverts the changes in society to a positive path. Civil disobedience brings awareness to both problems in society and solutions to those given issues. Within text 1, "Roughly 1,000 young activists [were] marching through the streets of Washington" with the goal to bring awareness to a "Broken' political system". On line 6, activists "blocked traffic and shut down intersections", causing everyone to pay attention to their invaluable message. People couldn't help but to notice the masses of protesters chanting their message. Many everyday commuters had to pass by this demonstration and had acknowledged their message. Alongside this protest, In text 3, 13 Greenpeace activists had attached harnesses to themselves and dangled themselves off the edge of St. John's Bridge in Portland, Oregon. After this courageous and brave demonstration, blocking boats and attracting hundreds of citizens to watch this awe inspiring act, many of these spectators had also paid attention to their crucial message. Some may say although these people relayed their message, some may argue that it was a great disfavor to society, due to the fact that they had stopped great amounts of traffic and work to bring awareness. In text 4, hundreds of students didn't attend to their classes and instead filled the front of the school, protesting against the unrealistic curriculum, stopping the whole school from achieving any kind of work. When you need to be successful, sometimes you must "Take a small hit for the big heist". Sacrificing a part of a day, making a small dent in society is a cost for being able to spread a message to all, for the greater good. Dante Barry from text 1 claims that, " We are here to take a stand, and to make our mark for a better future for the next generation". They needed to leave a mark, or dent to leave a piece of history to inspire many to change for the better, and to leave a long lasting message. Given the supporting evidence, it is very clear that civil disobedience is a healing factor in society in the long run. In between the marches in texts 1 and the activists in text 3, their message will be a long lasting and meaningful seed in societies developments. Although some people may think that demonstrations may harm society, the evidence shows this is not the case.

Wound care essentials summative assignment The WritePass Journal

Wound care essentials summative assignment Reference List Wound care essentials summative assignment IntroductionSection 1. Search strategySection 2. Wound aetiologySection 3. Wound AssessmentSection 4. Wound ManagementSection 5.Reference ListRelated Introduction Section 1. Search strategy Describe the strategy you used to retrieve the right resources to help you write your assignment. You must include the key words you used, the databases used and other sources of your literature such as websites, the years searched and the type of literature you were looking for. Approximate word count: 150-200 Your answer here: Keywords used in the search engine are: diabetic, foot, ulceration, risk, prospective, aetiology, prevalence, cost, infection, dressing, treatment, amputation, wound, management, policy, guidelines, UK, Philippines, South Asia, Europe, which were consecutively joined together, using the Boolean Operation of adding AND and an asterisk to each terms. The main databases used were CINAHL plus and PubMed.   Another source of evidence that the researcher used is the official website of the National Institute for Health and Clinical Excellence in which a clinical guideline was used deemed necessary for the said topic. The World Health Organization and the National Health Services websites were also used in collecting data for statistics as well as the Department of Health website in the Philippines. Peer reviewed articles have been searched using the said databases and have been sources of information. Limitations in this search have been identified. These are as follows: The search has been limited for ten years only to make the search more manageable and clinically up to date while capturing key information. The search is only applicable for humans aged 65 and up, regardless of gender.   This bracket has been chosen because according to the World Health Organization (2006) diabetic foot ulceration is rampant in this age group. The search is limited for peer reviewed journals only. The search is not confined to the United Kingdom only; hence, statistics from Asia were also gathered. Section 2. Wound aetiology Select a common wound type (e.g. diabetic foot ulceration, pressure ulcer, leg ulcer, fungating wound, dehisced surgical wound. Now explain and discuss: What your chosen wound type is How this type of wound develops (including contributory factors) How this type of wound is recognised (common characteristics) Who it affects Prevalence in UK and home country (if known) Approximate word count:   800-1000 Your answer here: The type of wound that the author chose is diabetic foot ulceration. This was chosen because this type of wound is prevalent in the nursing home that the author is currently working at and Diabetes itself is a serious health issue worldwide.   Consequently, diabetic foot ulceration is considered to be one of the most significant complications of diabetes, representing a worldwide issue of medical, social, and economic problem greatly affecting the patient’s quality of life. (World Health Organization, 2004)   Earlier definitions of diabetic foot ulceration dated back to 1985 by the World Health Organization stating that it is an infection, ulceration, and/or destruction of deep tissue related with neurological abnormalities and various degrees of peripheral vascular disease in the lower extremities. This has been argued by Brownlee (2005) that the term ‘diabetic’ foot signifies that there are specific qualities about the feet of the individual with diabetes th at sets this disease apart from other conditions that affect the lower extremities. However they added that anything which affects the foot in those with diabetes can also affect the foot in those without the disease. Thus the definition by De Heus-van Putten (1994) best neutralise those views, stating that diabetic foot ulcers is the many different lesions of the skin, nails, bone, and connective tissue in the foot which occur more often in diabetic patients than non-diabetic patients, such conditions like ulcers, neuropathic fractures, infections, gangrene, and amputation. This is supported by the contemporary study of Vileikyte (2001), presenting that the diabetic patients are statistically more likely to develop foot ulcer that usually leads to disablement and leg amputation. The aetiology of diabetic foot ulceration comprises many components. A multicentre study by Rathur and Boulton (2007) attributed 63% of diabetic foot ulcers to diabetic neuropathy and peripheral vascular di sease to be the main causative factors of diabetic foot ulceration. Peripheral neuropathy is a complication of diabetes that is the result of overtime damage of the nerve due to high blood sugar levels (Jerosch-Herold, 2005). This complication consequently contribute to the cause of diabetic foot ulcer for the nerves that relay messages of pain and sensation to the lower limb are generally affected, leading to numbness or even complete loss of sensation in the legs and feet. Losing sensation would also mean not knowing if the feet are hurt or damage. This explains why diabetic patients are usually prone to problems like minor cuts, bruises and blisters without them feeling it.   Ã‚  Furthermore, another risk factor is the peripheral vascular disease wherein there is narrowing of the arteries caused by fatty deposits that accumulate in the lining of the arteries resulting to poor blood circulation to the feet (Medina, Scott-Paul, Ghahary Tredget-Edward, 2005). Inadequate blood sup ply to the wound means decrease healing and is likely to be damaged. This explains why even a mild injury like stepping in small object or a small scratch in bare foot can eventually become ulcer for a diabetic patient. Moreover, according to Veves, Giurini, and LoGerfo (2006), predisposing factors that may act in combination to the two main risk factors are the unrecognised trauma, the biomechanical abnormalities or deformity, the limited joint mobility, and the increased susceptibility to infection. Demographic factors also play an effect on diabetic foot ulceration, such as age, gender, ethnicity and lifestyle (Medina, Scott-Paul, Ghahary Tredget-Edward, 2003).   According to the World Health Organization (2004) Diabetic foot ulcerations are common on individuals who have Type 1 and Type 2 Diabetes and who are in the age bracket of 65 years old and above. This statistics is not only relevant here in the UK but also worldwide. People who have diabetes for a longer period or man age their diabetes less effectively are more likely to develop foot ulcers.  Smoking, not taking  exercise, being  overweight and having  high cholesterol  or blood pressure can all increase diabetes foot ulcer risk (Diabetes UK, 2004). Previous foot ulcers and diabetes complications can increase foot ulcer likelihood, as can ill-fitting shoes or previous foot problems such as bunions, etc. Diabetic foot ulceration usually located in increased pressure points on the bottom of the feet. However, ulcers related to trauma can occur anywhere on the foot (Diabetes UK, 2004)   Anatomical distribution of diabetic foot ulceration comprises 50% of ulcers are on the toes; 30-40% are on the plantar metatarsal head; 10-15% are on the dorsum (sole) of the foot; 5-10% are on the ankle; and up to 10% are multiple ulcers (Department of Health, 2002). According to the National Diabetes Support Team (2006), the appearance of a diabetic foot ulcer generally has a base with pink/red or brown/black, depending on the patient’s blood circulations, and with a border of ‘punched-out’ like appearance while surrounded by callous skin. It has a bed with necrotic cap or ulcer (underlying tissues are exposed). Ulcers  with a mainly neuropathic aetiology will have a healthy granulating bed whilst those with a significant arterial component will have a necrotic bed (Reiber, 200 1). The International Diabetes Federation (2005) accounts that there are 170 million cases of diabetics reported worldwide. By 2025, this figure is expected to rise to 300 million. These diabetics patient have a 12-25% risk of suffering a foot ulcer at some time in their life. According to Reed (2004), elderly people with diabetics have twice the risk of developing foot ulcer, three times the risk of developing foot abscess and four times the risk of developing osteomyelitis. Similarly, diabetics were at greater risk of either local amputations or higher amputations (Hall DeFrances, 2003). Since different regions of the world have populations that at variance in body builds, footwear, habits and lifestyles, the differences in the prevalence of diabetic foot ulceration is expected. Such differences are likely to be found in Asia, Africa and America for developing countries will experience the greatest rise in the prevalence of Type 2 diabetes in the next twenty years (Stanley Colli er, 2009). Thus, people living in these countries will be expected to have greater risks of ulceration in the later years. However, Abbott et al (2005) focused on Type 2 diabetics among migrant populations of South Asia and African-Carribean populations, compared with data from Europeans living in the UK, and revealed a three to four times higher incidence of ulceration in the Europeans. The lower risk of South Asians was attributed to the lower rates of foot deformity, peripheral vascular disease and neuropathy. In the Philippines on the other hand, the author was not able to find statistics regarding the prevalence of diabetic foot ulcerations on individuals with either Type 1 or Type 2 Diabetes. Apparently, the Department of Health Philippines website does not have relevant statistics regarding the above matter however, according to the World Health Organization (2004), the prevalence of people having diabetes in Asia is fast rising and it may comprise to 75% of all diabetics in 2025 worldwide. Section 3. Wound Assessment Identify one feature of your chosen wound type that is commonly identified during the assessment process and critically discuss different ways of assessing this problem. Your discussion must make clear which aspect of wound assessment you have chosen e.g. exudate, odour, infection, and include an exploration of the different options available for measuring, describing and documenting it. You must link your discussion to the contemporary wound care literature. Approximate word count: 800-1000 Your answer here: When a diabetic patient develops an ulcer, it is very essential to know that the ulcer presents in the perspective of the diabetic. However, in the case of a diabetic patient, the skin usually in the feet does not heal efficiently and is prone to develop an ulcer as discussed on the previous section. This is what the writer believes to be the foremost feature of the diabetic foot ulceration that needs major consideration for it can eventually result to infection. Assessing the delay wound healing of a diabetic foot and its relation to the aspect of infection involves thorough evaluation, thus, a general assessment by the multidisciplinary care approach of the patient with diabetic foot ulcer is fundamental. This includes evaluating for evidence of retinal and cerebro-vascular pathology that could relate to foot and ankle problem (Pham et al, 2000). The said evidence can play a part to falls, traumatic injury and poor foot hygiene of the patient and can aid in appropriate treatment of the wound. The renal and cardiac disease evaluation is another pathological assessment that can contribute to the evaluation of poor healing potential (Stanley Collier, 2009). The standard observations of blood pressure, heart rate and temperature are also requisite assessment for these can reveal overriding features of sepsis such as pyrexia, tachycardia and general malaise (Costigan, Thordarson Debnath, 2007).   Stanley and Collier (2009) also added that in spection of the diabetic foot such as the characteristics of the skin, nails, and web spaces, is important for it can reveal pathology of the nails (Paronychia) or the cause of the spread of infection. Generally, limb-threatening infections can be defined by cellulitis extending 2cm from the ulcer perimeter, as well as deep abscess, osteomyelitis   or critical ischemia (Frykberg et al, 2002). The existence of odor and exudates, and extent of cellulitis should be properly noted for these are indicative of osteomylitis which could indicate infection (Frykberg et al, 2002). In the case of neurological assessment, Jerosch-Herold ‘s (2005) assessment review stated that Semmes-Weinstein monofilament is considered to be the most reliable test for evaluating any loss of protective sensation done in the sole of the feet. The test is not only relevant in assessing loss of sensation; it also evaluates foot deformity, risk for ulceration and signs of infection. Moreover, a vital part in this assessment is the classification of diabetic foot ulcer itself. This is supported by Frykberg et al (2002) stating that classifying ulcer is important in order to facilitate a logical approach to treatment and aid in the prediction of outcome. In line with that, there are several wound classification guidelines used universally to assess the diabetic foot ulcer. One of this is the Wagner ulcer classification system (1987) is the most widely accepted descriptive classification of diabetic foot ulcerations. It categorises wound depth according to 6 wound grades. These include: grade 0 (intact skin), grade 1 (superficial ulcer), grade 2 (deep ulcer that includes tendon, bone, or joint), grade 3 (deep ulcer with abscess or osteomyelitis), grade 4 (forefoot gangrene) and lastly grade 5 (whole foot gangrene). However, the downside of the Wagner classification system is that it does not specifically address the aspect of infection and circulation problem, which are actually the important parameters of diabetic foot ulceration.   However, this method is not really very reliable in assessing ischemia and infection because only useful guidance in the management of each class of ulcer is provided. Nonetheless, a more comprehensive scale has been developed at the University of Texas, which includes risk stratification and expresses tissue breakdown, infection and gangrene separately. According to Abbott et al (2005),   this system is generally predictive of the outcome for it uses four grades of ulcer depth (0 to 3) and then stages them into four stages (A to D) basing on the presence or absence of ischemia and   infection. The classification system assesses the depth of ulcer penetration, the presence of wound infection, and the presence of clinical signs of lower-extremity ischemia. Similarly, the International Working Group on the Diabetic Foot (2004) has proposed the PEDIS classification which grades the wound on a 5-feature basis: Perfusion (arterial supply), Extent (area), Depth, Infection, and Sensation. Finally, according to the Infectious Diseases Society of America guidelines (2004), the infected diabetic foot is sub-classified into the categories of mild (restricted involvement of only skin and subcutaneous tissues), moderate (more extensive or affecting deeper tissues), and severe (accompanied by systemic signs of infection or metabolic instability). In addition to that, another form of assessment for infection is the surface swab. But according to Bowker and Pfiefer (2001), it is inadequate for identifying the type of bacteria causing limb-threatening deep infection. The most accurate and reliable technique involves removing exudates from the ulcer, getting a little tissue biopsy from the base of the ulcer and sending the sample to the laboratory in appropriate aerobic and anaerobic culture material. Plain film radiographs should also be obtained to look for tissue, gas and foreign bodies and to evaluate the infected ulcer for bone involvement. (Sutter Shelton, 2006) Probing to bone using aseptic technique is also done to find out if osteomyelitis is present. Section 4. Wound Management Using the same wound feature that you identified in Section 3; critically discuss the different ways there are of managing this problem. Your discussion must include: The different types of wound care dressings, products and treatments that could be used to manage this problem Other appropriate/related aspects of patient care such as nutrition and positioning How the patient experience can be improved Approximate word count: 800-1000 Your answer here: After a comprehensive assessment, an ulcer management plan must be developed to direct treatment goals. In the treatment of diabetic foot ulceration, the primary goal is to attain wound closure and to control infection (Frykberg et al, 2002). In order to achieve this goal good wound care techniques are required. Part of this wound technique are dressings. Wound dressings represent a part of the management of diabetic foot ulceration. Ideally, dressings should alleviate symptoms, provide protection for the wound and promote healing. (Hilton, Williams, Beuker, Miller Harding, 2002) In line with that, the NHS (2002) released a guide for useful dressings which included dressings for infected diabetic wound. Dressings that are low or non-adhering must be used on infected diabetic wounds with daily dressing changes. According to Foster, Greenhill, and Edmonds (2007), the ideal dressing for infected diabetic foot ulcers are those that fit in the shoes and does not take up too much room, it could withstand shear forces and carry out properly in an enclosed environment, does not increase the risk of infection, absorbs exudates suitably as well as allow drainage and it can be changed frequently and can be removed easily. Hydrocolloids are the best example of such dressings. They contain gel-forming agents, such as gelatin, so when the dressing comes into contact with wound exudate it absorbs ï ¬â€šuid and forms a gel which creates a moist healing environment (Heenan, 2008).   According to Pudner (2001), it is advisable to use hydrocolloids in a diabetic foot ulcer as they absorb exudates and can give a visual indication of the need to change dressing. This kind of dressing can be easily removed by gently lifting an edge of the dressing and pulling carefully upwards to reduce the seal of the dressing on the skin and thus minimise trauma to the wound bed and surrounding skin. (Pudner, 2001) Regular dressing changes are done to monitor deterioration of the ulcer. Dressi ngs with Inadine, Iodoflex or Iodosorb are also used to reduce bacterial inhabitation in the ulceration. Daily Flamazine dressings are also recommended for the treatment of Pseudomonas infection. (Sibbald et al, 2003) When the infected diabetic wound become heavily exudated, foams and alginate may be used because they are highly absorbent.   Hydrogels facilitate autolysis and may be beneficial in managing ulcers containing necrotic tissue. Dressings containing Inadine and Silver may aid in managing wound infection. Occlusive dressings should be avoided for infected wounds. All dressings require frequent change for wound inspection. (Armstrong, Lavery Harkless, 2003) Another management is debridement. The purpose of this is to remove dead or devitalised tissue. (Bowker Pfeifer, 2004) It is also recognised as one of the most important methods of wound bed preparation because it promotes the release of growth factors which contribute to progressive wound healing. (Leaper, 2002) Ulcer debridement is performed to remove unhealthy tissues such as necrotic, callus and fibrous tissue and recondition them back to bleeding tissues in order to facilitate full image of the extent of the ulcer and its underlying problems like abscesses or osteomyelitis (National Diabetes Support Team, 2006).   Offloading must also be part of the management plan for the infected diabetic foot ulcers to relieve pressure from the wound to allow healing to take place. (Doupis Vevies, 2008) However, offloading devices might be impractical for diabetic individuals who are frail or susceptible to falls, and a disadvantage of devices that cannot be removed is interference with b athing and showering. (Caravaggi, Faglia, De Giglio, 2000) In addition to the management stated above, antibiotic treatment is also necessary. The antibiotic regimen should be based on the anticipated spectrum of infecting organisms. (Chantelau, Tanudjaja Altenhofer, 2006) The combination of an aminopenicillin and a penicillinase inhibitor has the required activity but other options include a quinolone plus either metronidazole or clindamycin. (Tentolouris, Jude Smirnoff, 2003)   In addition to antibiotic therapy, It may also be necessary to promote non weight bearing strategies such as bed rest and or use of wheelchair, crutches, walker, or cane. Diabetic individuals may also be advised to replace or modify their footwear. The lack of sensation associated with neuropathy can result in the tendency to buy shoes that are too small or too tight. It is necessary to accommodate any foot changes or deformities. Orthoses or custom-made shoe inserts may be required for pressure reduction. (Armstrong, Lavery, Harkless, 2003) In selecting devices , the ability of a device to remove or redistribute pressure, the ease of application, cost-effectiveness, and ability to gain compliance must be taken into consideration. Proper footcare and general skincare must also be implemented. Feet should be checked daily for further cuts, sores, blisters, bruises or dry skin to prevent further ulcer formation. Bringing blood glucose levels within normal range is essential. (International Diabetes Federation, 2009) Strictly managing diabetes is the first stage in treating all the other complications and even the condition itself. Diet and exercise will almost certainly play a role in preventing as well as treating diabetes. (Embil, 2003) Section 5. Identify a contemporary source of evidence based guidance (i.e. a clinical guideline) which could be used as a basis for providing a high standard of care to patients with this type of wound. Critically discuss how the guidance given in this document might influence your nursing practice including whether you believe there are any omissions or recommendations made that would be difficult to manage in your own placement. Please also comment on whether the Guideline recommendations could be implemented in your home country e.g. Philippines, Sri Lanka, Malaysia, China. You must clearly state the title your chosen guideline document and link your work to other healthcare literature where appropriate. Approximate word count: 400-500 Please start this section by stating the name of your chosen Clinical Guideline. Name of Guideline: Clinical Guidelines for Type 2 Diabetes Prevention and management of foot problems A very crucial statement in the guideline states that diabetic individuals should have their feet and legs examined for specific problems at least once a year. This is highly recommended and should be implemented. Diabetic individuals need help to detect problems when they develop neuropathy and lack of protective pain sensation. If this is carried out, prevalence of infection and other diabetic complications will surely go down. With regards to the whole healthcare setting, the NICE guideline recommends that health care professionals who carry out examinations must be properly trained but specific details of the training are not given. Nurses as well as other members of the healthcare team would need specific trainings most especially on handling equipments as well as imparting management to the affected individuals. It was also mentioned that diabetic individuals with active problems will be seen by the multidisciplinary foot care team that consists of highly trained podiatrists and orthotists, nurses with training in dressing diabetic foot wounds and diabetes specialists with expertise in lower limb complications. However, there is currently a shortage of podiatrists, nurses and other specialised members of the healthcare team. Lack of clarity about the membership of the multidisciplinary team may affect in the implementation of the guideline. Regarding ulcer management, there is a further problem with the section in the NICE guidelines on how ulcers should be managed. One or more interventions are suggested, including dressings, antibiotics to treat infection, and pressure relief by the use of special shoes or total contact casts. However, there is little guidance as to which intervention should be chosen and in which circumstance. Unfortunately, this could lead to a reinforcement of current practice where many patients with diabetic foot ulcers have dressings applied to their ulcers with no further interventions until the ulcer deteriorates. (Rathur Boulton, 2007) Nurses caring for patients with diabetic foot ulcers should understand that, in addition to dressings, patients need effective pressure relief and management of infection. As with regards to the author’s workplace which is a nursing home, although the guideline is flawed, as all guidelines are, the author believes that it will be really helpful in the management of diabetic foot problems since almost all of the residents who have diabetes are experiencing foot problems already. However, it will be better if the guideline made recommendations regarding services exclusive to nursing homes to address to the specific needs of the diabetic residents. The author believes that this guideline is not achievable to the Philippines. In view of the current health care setting of the country, it will be very had to implement the guideline due mainly to lack of funding and a huge shortage of specialist health care professionals. The Philippines is one of the countries in South East Asia that prevalence rate of diabetic foot ulcerations and infections are fast rising (WHO,2004) but unfortunately, the country is also understaffed and underfunded. The author believes that for the NICE guidelines to be implemented whether in the placement or for the whole healthcare setting, it will be necessary to recruit and train a lot of diabetic foot professionals or better yet, educate existing health care professionals. Careful monitoring of the diabetic individuals will be essential as well as imparting proper lifestyle change and management. Reference List Abbot, C.A, Carrington, A.L., Ash, H., Bath, S., Every, L.C., Griffiths, J., et al. (2002). The Northwest diabetes foot care study: incidence of and risk factors for new diabetic foot ulceration in a community based cohort. Wiley.19(5). 377-384. Abbott, C.A., Garrow, A.P., Carrington, A.L., Morris, J., Van Ross, E.R. Boulton, A.J. (2005). Foot ulcer risk is lower in South-Asian and African-Caribbean compared with European diabetic patients in the UK. The North-West Diabetes Foot Care Study,  Diabetes Care, 28(8), 1869–1875. Armstrong, P.G., Lavery, L.A., Harkless, L.B. (2003). Validation of a wound classification system. Diabetes Care. 21 (5). 855-859. Brownlee, M. (2005). The pathology of diabetic complications. Diabetes. 54. 1615-1625. Bowker, J.H., Pfeifer, M.A. (2001). The Diabetic Foot. 6th edition. St. Louis: Mosby Caravaggi, C., Faglia, E., De Giglio, R., Mantero, M., Quarantello, A., Sommaria, E., et al. (2000). Effectiveness and safety of non removable fibreglass off-bearing cast versus a thereapeutic shoe in the treatment of neuropathic foot ulcers: a randomized study. Diabetes Care. (12). 1746-1751. Chantelau, E., Tanudjaja, T. Altenhofer, F. (2006). Antibiotic treatment for uncomplicated neuropathic foot ulcers in diabetes: a controlled trial. Diabetic Medicine. 13. 156-159. Costigan, W., Thordarson, D.B., Debnath, U.K. (2007). Operative management of  ankle fractures  in patients with  diabetes mellitus,  Foot  and Ankle  International, 28(1), 32–37. De Heus-van Putten,  M.A. (1994). The role of the Dutch podiatrist m the treatment of diabetic feet. Journal of British Podiatric Medicine,49(42), 161-164. Department of Health. (2002). National service framework for  diabetes. London: HSMO. Diabetes UK. (2004). Epedimiology and Statistics. London: HSMO Doupies, J., Vevis, A. (2008). Classification, diagnosis, and treatment of diabetic foot ulcers. Retrieved March 30, 2009, from woundresearch.com/article/8706. Embil, J. (2003). Getting to the bottom of the diabetic foot. The Canadian Journal of CME. 3:76-86. Foster, A.V.M., Greenhill, M.T., Edmonds, M.E. (2004). Comparing two dressings in the treatment of diabetic foot ulcers. J Wound Care. 3: 224-228. Frykberg, R.G., Armstrong, D.G., Gurini, J., Edwards, H., Kraviette, M., Kavitz, S., et al. (2002). Diabetic foot disorders: a clinical practice guideline. The Journal of Foot and Ankle Surgery. 39(5). Hall, M.J. DeFrances, C.J. (2001).  National Hospital Discharge Survey. Advance data from vital and health statistics; No: 332, National Center for Health Statistics:Hyattsville. Heenan, A. (2008). Frequently asked questions: hydrocolloid dressings.   Retrieved February 2007 from www.worldwidewounds.com/1998/april/Hydrocolloid-FAQ/hydrocolloid-questions.html Hilton, J.R., Williams, B.T., Beuker, B.M., Harding, K.G. (2004). Wound dressings in diabetic foot disease. Medline. 1:39, 100-103. International Diabetes Federation. Diabetes. (2009). atlas 2nd edition. Brussels. Leaper, D. (2002). Sharp technique for wound debridement. Retrieved December 15, 2005 from www.worldwidewounds.com/2002/december/leaper/sharp-debridement.html Medina, A,, Scott Paul, G., Ghahary, A. Tredget Edward, E. (2005).   Pathophysiology of chronic nonhealing wounds,  Burn Care Rehabilitation,  26(4), 306–319. .National Diabetes Support Team. (2006). Diabetic foot  guide, NHS Clinical Governance Support Team. London: NHS. National Health Service . (2002). Diabetic Foot Ulcer Dressings Guidance and Referral Advice. Leicester. National Institute for Clinical Excellence. (2004). Prevention and Management of foot problems in people with type 2 diabetes. Retrived January 2002 from nice.org.uk/nicemedia/live/10934/29246/29246.pdf Pham, H., Armstrong, D.G, Harvey,   C., Harkless, L.B., Giurini, J.M. Veves, A. (2000). Screening techniques to identify people at high risk for  diabetic foot  ulceration: a prospective multicenter trial,  Diabetes  Care, 23(5), 606–611. Pudner, R. (2001). Hydrocolloid dressings in wound management. Retrieved February 2007 from www.jcn.co.uk/journal.asp?MonthNum=048 Rathur, H.M Boulton, A.J. (2007). The diabetic foot. Clinics in Dermatology, 25(1),109-201. Reed, J.F. (2004). An audit of lower extremity complications in octogenarian patients with diabetes mellitus,  International Journal of Lower Extremity Wounds, 3  (3), 161–164. Reiber, G.E., Smith, D.G.,    Wallace., C.,(2002). Effect of therapeutic footwear on ulceration in patients with diabetes. Journal of the American Medicine Association. 287: 2552-2558. Sibbald, R.G., Williams, D., Orstead, H.R., Campbell, K., Keart, D., Krasner, D. et al. (2003). Preparing the wound bed: Focus on infection and inflammation. Ostomy/Wound Management. 49 (11). 24-51. Sutter, J.H., Shelton, D.K. (2006). Three phase bone scan in osteomyelitis and other musculoskeletal disorders. Diabetes Medicine. 24 (12). 93-98. Tentolouris, N., Jude, E.B., Smirnoff, I. (2003). Methicillin resistant Staphylococcus Aureus, an increasing problem in the diabetic foot clinic: a worsening problem. Diabetic Medicine. 20 (2). 159-161. Veves, A., Giurini, J. LoGerfo, F. (2006).  The Diabetic Foot: Medical and Surgical Management.  Totowa, NJ: Humana Press. Vileikyte, L. (2001).   Diabetic foot ulcers: a quality of life issue.  Diabetes Metabolism Research and   Review,17(4), 46–249. Wagner, F.W. (1987). The diabetic foot.   Orthopedics, 10, 163–72. World Health Organization.   (2004). Adherence to Long term Therapies in Diabetes. Geneva.

Stock Prices Change And Earnings Changes Essay Example | Topics and Well Written Essays - 1500 words

Stock Prices Change And Earnings Changes - Essay Example Forecasted free cash flows (operating profit + depreciation + amortization of goodwill - capital expenditures - cash taxes - change in working capital) are discounted to a present value using the company's weighted average costs of capital. DCF analysis shows that changes in long-term growth rates have the greatest impact on share valuation. Investors can also use the DCF model as a reality check. Instead of trying to come up with a target share price, they can plug in the current share price and, be working backward, calculate how fast the company would need to grow to justify the valuation. The lower the implied growth rate, the better - less growth has therefore already been "priced into" the stock The dividend discount model is a more conservative variation of discounted cash flows, that says a share of stock is worth the present value of its future dividends, rather than its earnings. The dividend discount model can be applied effectively only when a company is already distributing a significant amount of earnings as dividends. But in theory, it applies to all cases since even retained earnings should eventually turn into dividends. That's because once a company reaches its "mature" stage it won't need to reinvest in its growth, so management can begin distributing cash to the shareholders. (Plan "B" would be for the CEO to pursue some insane acquisition, just to gratify his bloated ego.) As Williams puts it, If earnings not paid out in dividends are all successfully reinvested... then these earnings should produce dividends later; if not, then they are money lost... In short, a stock is worth only what you can get out of it. We generally find earnings developed in three Anglo-Saxon countries—where capital is traditionally raised in public markets and reporting rules are unencumbered by taxation requirements—to have greater explanatory power for stock returns than cash flow metrics.

Economics Essay Example | Topics and Well Written Essays - 1000 words - 33

Economics - Essay Example Macroeconomics focuses on the international and national economic trends. Neoclassical economics pursues economics through means of demand and supply models, which determine prices on the basis of subjective preferences of consumers and producers. Neoclassical economics depends on subjective preferences in determining prices. Sustainability is associated to the quality of life in a society. It determines whether the environmental, social and economic systems, which make up the society, are offering a productive, meaningful and healthy life for the current and future generations. Sustainable development is the growth, which satisfies the requirements of existing generations without compromising the capability of upcoming generations to satisfy their requirements. There are three features of sustainable development; economic sustainability, environmental sustainability and social sustainability. Environmental sustainability is described as sustenance of life supporting systems. Economic sustainability is described as sustenance of economic capital. It refers to the maximum amount of revenue, which may be spent without diminishing future consumption. Social sustainability is described as sustenance of social resources. Sustainable growth should integrate these categories of sustainability and employ them in ensuring that development is sustainable. There are developments of the new economic ideas in the modern economy. The world economy has experienced various economic conditions and new ideas are evolving, complementing the traditional economic ideas. The following are the alternative economic ideas in the modern economy. First, modern economies are considering shifting from outsourcing to in-sourcing. Economies are encouraging local production to enhance domestic employment. Another idea includes the accessing of wealth of the locals; information and communication technologies are changing

Organisational dialouge Essay Example for Free

Organisational dialouge Essay Question 2: A range of authors (e.g. Gerard and Ellinor 2001; Isaacs 1993, 1999; Schein 1993; Senge 1995) suggest that dialogue can positively transform organizational cultures. Do you agree with this assessment? Why? Why not? Engage with relevant academic literature in developing your argument. Student Name: Nguyen Vu Hoang Dung Student Number: 11477445 In organization people spend 80 percent of their time to communicate (The British Psychological Society 2012). Communication is a key tool to share information, foster different opinions and build alignment and trust. According to Gerard Teurfs (1995), the process of dialogue is an invitation to create organization cultures through conversations. It acts as a learning environment that shifting individuals to â€Å"a deeper understanding of collaboration in groups, and a new way of sensing their connections to others throughout the organization† (Querubin 2011, p.19). It brings all the ideas together and suspends judgment so people will have a greater chance to understand each other (Brayman, Grey Stearns 2010). This essay will analyze the role of dialogue in transforming organizational cultures positively and all the benefits it brings. However, it will also examine the challenges of implementing dialogue. Organizational culture includes shared values and beliefs that guide behaviors of all members and determine the way things should be done in the organization (Sergiovanni 1984). Company has its own culture usually indicates higher performance. The role of dialogue is not only to spread the common values and meanings that company wants its employees to follow but also allow everyone to express their own interest. According to Gerard and  Ellinor (2001), the main purpose of dialogue is to produce collective understanding. Firstly, they compared the differences between dialogue and discussion. In discussion, people tend to protect their own thoughts and do not truly concern about other’s opinions and needs. They play as a speaker’s role rather than as a listener. It might leave the remainder out of discussion with frustration, isolation and disrespect. Decisions could be made by the person who has the most power and influence in the group (Gerard and Ellinor 2001). Hence it weakens the aim of enhancing organizational cultures. In contrast, when employees participate in a dialogue, their role as a listener is more important than as a speaker. They desire to hear what others want to say. They try to fit all different perspectives into a common value. Therefore, if issues occur, they listen to deeply understand other’s thoughts and opinions (Gerard and Ellinor 2001). By doing that, employees are getting closer to each other and conflicts are minimized. They help their team or their department to build shared culture. Secondly, Gerard and Ellinor (2001) stated five skills of dialogue including suspension of judgment, listening, reflection, assumption identification and inquiry. They defined the meaning of suspension in dialogue is not to stop one’s judgment about a problem. Instead, they have to aware what their judgments are and â€Å"then holding them lightly so they can still hear what others are saying† (Gerard and Ellinor 2001, p. 7). After listening carefully to other’s ideas, they need to reflect their own assumptions. Therefore, to revising whether those assumptions are linked to the organization or not. If they cannot understand the differences, they must inquire for more information. Hence, this process of dialogue enables each employee to foster different views and converge them together to become one unique aim. Organizational culture is enhanced. In agreement with Gerard and Ellinor, Isaacs (1999) analyzed four principles of dialogue based on Bohm’s research in 1996. They are listening, respecting, suspending and voicing. Firstly, Isaacs had compared listening skill in dialogue to listening to music. He stated a single note of music could not deliver the meaning of the whole song. It is similar to one’s role in a conversation. A single idea is not sufficient to set purposes and  cultures for the whole organization. Hence, dialogue is an excellent practice to give people a chance to listen deeply and get into the nature of the conversation. Secondly, he defined respecting as getting to know more about one person and figure out what sources or circumstances has created their particular thinking. Based on this understanding, people in an organization will pay more respect to each other. The main goal of respecting in dialogue is not to seek decision but to tolerate difference, gap and conflict (Isaacs 1999). The third principle of dialogue, suspending, is determined similar to Gerard and Ellinor (2001). And the last principle Isaacs mentioned is voicing. He suggested people should listen internally so as to select what should say and what should not say in a circumstance. Sometimes keeping silence and listen can achieve the best result. Therefore, the purpose of voicing means people contribute their speech, not only for themselves, but to the whole idea. Overall, these principles are considered having positive effects on organizational learning. They emphasize group and organization achievements rather than an individual accomplishment. In Schein’s study (1993), he described dialogue as â€Å"talking around the campfire† (p. 391). He used â€Å"campfire† as a metaphor to explain how decision is made through dialogue. In the past, people sat around campfire during meeting and shared their own opinions. Arguments would never come up as people just simply expressed their thoughts without any discussion or debate. Through that, they were aware themselves which idea was acceptable and were unacceptable (Schein 1993). This process allowed enough time for each person to listen to a deeper layer of other’s opinions then reflect on their own assumptions. Moreover, Schein introduced the check-in concept. At the beginning of the meeting, each person will respectively contribute his or her ideas, views and feelings to the group as a whole, and therefore, â€Å"has helped to create the group† (Schein 1993, p. 392). Lastly, Schein stressed the limitation of eye contact. This makes people feel ea sier to suspend disagreements and concentrate on listening. Senge (1995) determined dialogue as a facilitator for team learning. Based on his research, team is the key unit to build culture in an organization. By applying dialogue into team learning process, it develops shared vision and  brings result every member truly desires. It also creates teamwork and shares equal leadership to each member in the group. Through sharing a common pool of meaning, culture is positively transforming from individual to group values and beliefs. Although dialogue is proved to have a great effect on organizational culture, there are challenges in implementing it into organization learning system. The first challenge is due to hierarchy level in an organization (Raelin 2012). Dialogue requires equal say and sharing from each member of the organization. However, employees tend to afraid of expressing their true views in front of their managers. They leave decision making to people at higher position. In top-down companies, upper levels of management have full knowledge of desired targets, goals and norms. They have the right and ability to create and change organizational culture. They enforce rules and duties on their employee. They usually do not spend time to listen to individual’s opinion and feeling. Hence, it is very challenging to apply dialogue into this type of business. Furthermore, if the organization involves a cross-culture, that employee come from different culture backgrounds, there is a need for a more lengthy and complicated process of dialogue (Schein 1993). In this type of organization, people use different languages and operate from different mental models. Organization needs to design a dialogue that enables all these people to communicate effectively. Thornhill, Lewis Saunders (2000) also emphasized there is may be a need to â€Å"re-designing of performance appraisal systems and reward systems† and â€Å"the re-definition of job roles to induce employees into accept the new behavior expected from them† (p. 27). Hence it is costly and time consuming. Finally, dialogue may not be suitable to apply to all organizations cultures in the world. For example, Western culture is different from Eastern culture. As dialogue encourage the limitation of eye contact (Schein 1993), people from the West will consider this as impolite or even disrespectful (Spindler 1990). In addition, in Western countries people prefer confrontation whereas Eastern people prefer to say what they feel most  appropriate in this circumstance or least hurtful to the others (Schein 1993). Therefore, dialogue must be selective so it is suitable for each particular organization. In conclusion, dialogue has played a key role in positively transforming organizational culture. It acts as a learning environment that shifts individual to group thinking. It leads each employee to recognize the essential of collaborating in a group. Querubin (2011) demonstrated that dialogue enables members to â€Å"become open to diversity and lose an â€Å"us vs. them† paradigm so prevalent in task-oriented cultures† (p. 19). Hence, group achievement is more important than individual accomplishment. Moreover, dialogue includes suspending of judgment, listening, respect, reflection, assumption and voicing. Through all these principles, dialogue creates collective understanding and leads all members of the organization to higher commitment. However, the implementation of dialogue still faces several challenges, including hierarchy levels, time consuming and different cultural backgrounds. Therefore, selective approach of dialogue must be considered to apply to specifi c organization. REFERENCES Bohm, D. 1996, On Dialogue. Ed. Lee Nichol, Routledge, London New York. Brayman, J., Grey, M. Stearns, M. 2010, Taking Flight to Literacy and Leadership, Rowman Littlefield, viewed 16 December 2010, Ellinor, L. Gerard, G. 2001, Dialogue at Work: Skills at Leveraging Collective Understanding, Pegasus Communications, Waltham, MA. Ellinor, L. Gerard, G. 2001, Dialogue at Work: Skills at Leveraging Collective Understanding, Pegasus Communications, Waltham, MA, pp. 7. Gerard, G. Teurfs, L. 1995, Dialogue and Organizational Transformation, 1st edn, Sterling Stone, Inc., San Francisco. Isaacs, W. 1999, Dialogue and the Art of Thinking Together: A Pioneering Approach to Communicating in Business and in Live, Currency, New York. Querubin, C. 2011, ‘The effect on the organization’, Dialogue: Creating Shared Meaning and Other Benefits for Business, pp. 19, Raelin, J. 2012, ‘Dialogue and deliberation as expressions of democratic leadership in participatory organizational change’, Journal of Organizational Change Management, Vol. 25. Schein , E. H. 1993, On dialogue, culture, and organizational learning . Organizational Dynamics, pp 391-392. Senge, P. M. 1995, The spirit of personal mastery, MN: Charthouse International Learning Corporation, Burnsville. Sergiovanni, T. 1984, ‘Leadership and excellence in schooling’, Educational Leadership Journal, vol. 4. Spindler, G. 1993, The American Cultural Dialogue and Its Transmission, Psychology Press, The British Psychological Society 2012, Dialogue: How to create change in organizations through conversation, viewed 14 May 2012, http://www.bps.org.uk/events/dialogue-how-create-change-organisations-through-conversation-1 Thornhill, A., Lewis, M. Saunders, M. 2000, Managing Change: A Human Resource Strategy Approach, Prentice Hall, London.

An Organizational Study of The United States Air Force :: Business Organization Research

The United States Air Force faced a leadership vacuum with the resignation of Air Force secretary James Roche and his Undersecretary Peter Teets. The Pentagon decided to take over of the buying decisions for the Air Force since they believed that there was no one who was in the position to take on the responsibility. The Department of Defense is now taking in charge to support and to assist the Air Force Command by overseeing and providing advice on important Air Force programs during a time of transition. It was clarified however that within the next six months, a new Air Force Secretary will be appointed. At present though, the Air Force is under the temporary command of Lt. Col. Michael Rodriguez (http://money.cnn.com/2005/03/28/news/fortune500/pentagon/). All organizations whether it be in the business industry, socio-civic, private or government-regulated face the challenge of running the whole system according to the principles as well as the goals and objectives of the system. The organization normally is confronted with how it will operate accordingly to meet the expectations and put up with the responsibilities and duties of the members as well as the departments that make up the whole system. The changes in the surroundings of the workplace in the internal as well as in the external environment and affairs make influence the overall operations of the structure. The military is not an exemption in this regard even for the fact that the defense team of a country undergo regulations that are very systemic and defined. There are internal as well as external affairs, issues and problems that should be attended to in order for the whole organization to function fully and provide the necessary outputs being demanded. That i s why it is interesting to look at a certain military arm experience a challenge of change in the system to be able to fit in the constantly changing global and wide social context on which it operates. Air Force Organizational Structure Just like other organizations, the United States Air Force is composed of complicated and systematic divisions. The people in this particular service are classified not just according to ranks. Since the recruits in this defense arm came from different state with varying cultural orientation, it is but expected that the people in this service are also diverse.

Managing & Enhancing Care in Rapidly Changing & Complex Situations Leadership Essay

Introduction to the folder of Evidence This assignment is an analysis of my leadership development though my training, and to assist me to adapt from a student nurse to a staff nurse confidently. This, along with an action plan (appendix 1) is completed though out my module 8 placement in accident and emergency. My leadership skills are developed by shadowing my mentor whilst she is in charge of shifts for 3 weeks, as well as accurately and confidently handing over patients to other members of the multi-disciplinary team. In this setting, skills such as communication, decision making, prioritising care and time management are necessary, therefore this placement has assisted me in developing those skills. This assignment relates to learning outcome 2-Utilise a range of therapeutic approaches and problem solving skills when planning, implementing and evaluating care to enhance quality of life for patients and carers, 3- Utilise effective coaching skills in the support of patients, carers and less experienced colleagues, and 4- Analyse and develop professional care, management and leadership roles within the context of multidisciplinary and collaborative care delivery in meeting health and social care needs for patients with increasing levels of dependency. (MSG, 2011) I will develop my leadership skills by shadowing her whilst she is triaging patients, in charge of shifts, and when she is handing over, along with accurate communication skills. Though out the placement, I will gain feedback from my mentor on my progress in order to help me to achieve sufficient leadership skills. Introduction The aim of this reflective account is to analyse leadership skills that have been developed throughout my module 8 placement in Accident and Emergency. I will debate the motives for my choice of actions, and evaluate the extent which it has enabled me to improve my leadership skills. I will discuss what I have discovered about my leadership skills, how I’ve developed as a leader, and what effect this has on the care given to my patients. This assignment, in collaboration with the practise assessment document, will assist me in identifying skills developed, with significance to learning outcomes 2, 3, and 4. The identified skills along with leadership literature will be evaluated using the Gibbs Reflective Cycle (1988) which comprises of description, feelings, evaluation, analysis, conclusion, and action plan. There are many definitions of leadership, such as being a ‘’function of knowing yourself, having a vision that is well communicated, building trust among colleagues, and taking effective action to realize your own leadership potential ‘’. (Bennis, 1959), ‘Leadership involves the use of interpersonal skills to influence others to accomplish a specific goal.’ (Sullivan and Garland, 2010). All of these definitions gave me a great idea of leadership, and allowed me to choose an aspect of leadership skills within my placement. This allowed me to focus on my leadership skills whilst making decisions in the clinical setting. Clinical decision-making is a process that nurses undertake on a daily basis when they make judgements about the care that they provide to patients and management issues. (Banning, 2007). NMC 2008 states that you must ‘‘Provide a high standard of practice and care at all times’’. This reflective account is also based on my leadership skills whilst leading handover. Clinical handover refers to the transfer of information from one health care provider to another when a patient has a change of location or venue of care, and/or when the care of/responsibility for that patient shifts from one provider to another (ACSQHC, 2005). The NMC (2008) states that ‘’you should be aware of, and develop, your ability to communicate effectively within teams. The way you record information and communicate is crucial. Other people will rely on your records at key communication points, especially during handover, referral and in shared care.’’ Stage 1: Description of the event Decision making plays an important role in the A&E department. This determines the care each patient receives. My mentor asked me to triage a patient in the minors department. No names are mentioned in this piece in order to respect dignity and privacy as stated by the NMC (2008). I began to triage a 29 year old female who presented with abdominal pain and vaginal bleeding. This patient was 7 weeks pregnant. As I was assessing the patient I noticed that she was hypotensive at a blood pressure of 95/65. Following this, I informed my mentor of my patient and my findings. Following a discussion with my mentor, we decided that this patient was high priority. Whilst my mentor inserted a cannula and took bloods, I was given the responsibility of allocating the patient to a bed. Following the discussion with my mentor, I felt that it was necessary to place the patient in majors, and on a monitor bed. As this was being put into action, my mentor and I noticed that all monitored beds were tak en up. I then had to liaise with the nurse in charge to decide if all patients on the monitored beds were required to stay on monitors. After organising a monitor bed for the patient, I then bleeped the gynecologist on call for further advice. After the patient was assessed by other members of the multi-disciplinary team, it was decided that the patient was to be admitted for further tests, as the gynecologist was querying an ectopic pregnancy. My mentor then allowed me to liaise with the bed manager to organise a bed on a suitable ward for the patient. After a bed was arranged, I then escorted the patient to the ward and gave a full handover to the nurses under my mentors supervision. Handover is another very important aspect of communication in the clinical setting, as it ensures the correct information is given to the nurse, and therefore, care for the patient will be organized accurately. Stage 2: Feelings When my mentor allocated me to triage patients, I felt that I was given a lot of responsibility. Porterfield (1999) states that empowering employees is an important part of employee development and can in turn produce a higher level of employee satisfaction. I questioned my ability to assess to as I was not used to this level of responsibility. I mentioned this to my mentor and she reassured me by discussing what assessment tools to use, and  mentioning that she and the rest of the nursing team were there for any guidance throughout the assessment. Once the patient was assessed and allocated to majors, I felt quite confident in my decision making skills. My mentor mentioned that I had triaged the patient successfully and competently and this was very reassuring. As I continued care for the patient, I became to feel more confident in the care I was providing. After a clinical decision was made and the patient was to be handed over to the nursing staff on the ward, I felt slightly nervous in regards to ensuring the correct and accurate information is being given to the staff, as well as the essential information in regards to the patient. As I proceeded to begin handover, I became more confident as I had been with this patient since the beginning, and had a good insight to the care that was given and the care that was to be given. I gave the nurses a full handover in regards to the patient, including what examinations were carried out and the results of the examinations, and what the patient is required in order to keep comfortable. I also mentioned that this was the patient’s first pregnancy and reassurance is vital. Following handover, my mentor gave me feedback on how I handed over the patient. We discussed my communication skills, and my mentor mentioned that I gave an accurate and well-spoken handover, and mentioned all relevan t information in regards to the patient. After receiving that feedback, I felt that my style of leadership tailed was transformational. Stage 3: Evaluation Leaders are often described as being visionary, equipped with strategies, a plan and desire to direct their teams and services to a future goal (Mahoney, 2001). Decision making is a fundamental element of nursing, and is essential to understand. (Reilly, 2003). By my mentor allowing me to make clinical decisions on patient care, leadership skills whilst making decisions were put into practice. With the support of my mentor and all the staff, I was able to analyze clinical situations and make a decision based on best practice, as well as evidence based practice. By gaining feedback from peers, it allowed me to evaluate how effective my decision making and communication skills were. Communication can be identified as a vast field with the nursing setting. (Donnelly and Neville, 2008). Throughout handover, my delivery of information was accurate and precise, and the level  of communication between the nursing staff receiving handover from I was approached to in a professional manner. I feel that, throughout the experience, my confidence levels were low and adverse. Dao (2008) states that self-confidence is the fundamental basis from which leadership grows. Although, I received positive feedback from peers, being given such important tasks made me doubt my competency as a nurse. Stage 4: Analysis The Gibbs et al (1988) reflective model encourages the analysis stage to break down the event into its components so they can be explored separately. In order to analyze, becoming aware of the variety of learning theories and styles will assist in evaluating. Timmins (2006) states that critical analysis should analyse current practice along with examining the research base of practice and exploring theories that update nursing. I feel by exploring various leadership styles, I achieved this throughout my placement. An effective leader should be able to adopt, either consciously or unconsciously, various leadership styles in various situations (Bennett et al. 2010). By approaching the range of leadership theories, I feel that I have obtained the transformational leadership technique. Transformational leadership style is made up of 4 elements, Idealized influence, Inspirational motivation, Intellectual stimulation, and Individual consideration. In comparison, Transactional leadership style is made up of 2 elements, Contingent Reward and management by exception. Aarons (2006) states transformational leadership inspires and motivates followers, whereas transactional leadership is based more on reinforcement and exchanges. I feel that I built a professional relationship with not only my mentor, but with other colleagues in the department, and had the support necessary to assist me in making decisions and handing over. In terms of patient’s safety, accurate decision making and hand over is an essential. The NMC (2008) states that you must ‘’provide a high standard of practice and care at all times’’. By obtaining a transformational leadership style, this ensures that whilst decision making, that all decisions are made with rationale and in the best interest of the patient. When handing information of care of patients over to colleagues, effective co-ordination and communication is essential. Clinical decision-making is a complex activity that requires practitioners to be knowledgeable in relevant aspects of  nursing, To have access to reliable sources of information and appropriate patient care networks and to work in a supportive environment. (O’Neill, Dluhy & Chin, 2005). However, although being supervised whilst making decisions and handing over, I was expected to do these tasks independently and professionally, and based on the best interest of the patient. This allowed me to gain further insight to the transition of student nurse to staff nurse. Stage 5: Conclusion In conclusion I feel the time I spent working within the Accident and Emergency team facilitated greatly in assisting me to develop my leadership skills. The stated event reflected best shows how I incorporated two aspects of my new leadership skills. I feel by studying the styles and skills involved in leadership I gained a good knowledge of leadership styles which I presented during my time here. I received feedback from my mentors and colleagues in regards to the skills, which have given me confidence to practice these skills in the future as a staff nurse. I have come to realise that a variety of leadership styles of leading best work in a hospital setting. In the future I will strive to further develop my leadership skills. Stage 6- Action Plan I plan to continue developing my leadership skills by observing and taking part in handover throughout the rest of my placements. I also hope to continue developing my decision making skills by shadowing my mentor and other colleagues throughout triaging and deciding patient care. As a self-regulated learner, I plan to gain feedback from both mentors and colleagues and focus on areas of further development. REFERENCES Aarons, G. (2006). Transformational and Transactional Leadership: Association With Attitudes Toward Evidence-Based Practice. . 57 (8), 1162-1169. ACSQHC- Passing the baton of care – a patient relay – May 2005. Available. http://www.sswahs.nsw.gov.au/pdf/policy/gl2007002.pdf. Last accessed 17 May 2012. Banning, M. (2007). A review of clinical decision making: models and current research. J. Clinical Nursing. Available at http://bura.brunel.ac.uk/bitstream/2438/1395/1/2005-0319%20R2.pdf. Accessed 26 May 2012. Bennett, C., Perry, J., Lapworth, T. (2010) Leadership skills for nurses working in the criminal justice system. Nursing Standard. 24 (40), p.35-40. Bennis WG (1959) Leadership Theory and Administrative Behavior: The Problem of Authority. Admin Sci Q 4(2): 259–301 Bennis W. (1999). The Leadership Advantage. Available: http://www.hr-newcorp.com/articles/bennis_Leaders.pdf. Last accessed 26th May 2012 Dao, F. (2008). Without Confidence, There is No Leadership. Available: http://www.inc.com/resources/leadership/articles/20080301/dao.html. Last accessed 29 May 2012. Donnelly, E, Neville, L. (2008) Communication and Interpersonal Skills, p4 Reflect Press Ltd Publishing. Gibbs, G. (1998) Learning by doing: a guide to teaching and learning methods. Oxford centre for staff and learning development. London Further Education Unit. Polytechnic, Oxford Mahoney, J. 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