What to Do About Biographical Essay Samples Before You Miss Your Chance

What to Do About Biographical Essay Samples Before You Miss Your Chance Top Biographical Essay Samples Choices The most frequently encountered paper writing service that the majority of our clients require is essay writing. Our customized biography essay writing service is continuously being improved to fulfill your finest expectations. You ought to consider how soon you will introduce the precise subject of your research area, or your customer's name. Tell our experts what kind of homework help on the internet you want to get. Various writers will have varying opinions and data about your favorite person, therefore it's most effective to read a wide array of sources. As you'll have to do research about them, they should be someone who you are able to discover articles and books about. Secondly, it must be simple to acquire the information you need to write regarding the selected individual. Essentially, you should organize all of the info that you've gathered well. Under standing Biographical Essay Samples A biographical research paper, on the flip side, is a brief type of biography about another individual. You aren't writing your entire life story. You may also have quotes that are related to the subject matter that's a personality. Professional aid for suicide prevention needs to be sought on behalf of the man who says they need to kill themselves because what they are telling you is really a cry for support. Biographical Essay Samples You might also get in touch with your writer to supply some excess recommendations or request information regarding the order's progress. These steps outline the specifics for a template which can be employed to aid in writing a memoir. The revisions are unquestionably free! Taking up the job to pen a person's biography is a substantial responsibility. Biography Essays are extremely different from the autobiographical ones where the writer is the topic of discussion or the book. Writers also needs to be careful to keep on topic. Autobiographies fall in the nonfiction category. Third, remember that, though you are writing about true events, the essay still ought to read as a story. An essay with major errors or even consistent minor mistakes will make it hard for readers to concentrate on the story you're trying to inform them about yourself. You'll be advised about including your last thoughts for specific kinds of essays. Also, keep in mind that a topic does not need to be especially thrilling to be unique. Ruthless Biographical Essay Samples Strategies Exploited A biography essay is an essay in which you tell the story of an individual's life. If you're going to compose a biographical essay about yourself, it's going to be called autobiography. A biography can be short in the event of few sentences biography and it may also be long enough to fill a whole book. A biography of a celebrated person is obviously likely to earn a thick book. Three sentences is an excellent length for a bio. Select Stories Crucial to Your Memoir One of the most critical points to keep in mind while writing a memoir is you do not need to document each minute facet of your life. There are a number of ways to commence an essay, and a few are more common than others. On the flip side, an individual having the power may create a profound influence on the growth of the community and entire society based on the power he possesses. There are various people it is possible to be requested to write about. You are able to also interview scholars who focus on the individual about whom you're writing. Life After Biographical Essay Samples Guidelines to writing the autobiographical story include a crystal clear and concise approach to a certain part of your life. As it is not possible to present the whole life story in few paragraphs, thesis may present the important quality of interest. An autobiography essay is a controversial bit of writing as on the 1 hand it may appear to be a simple job to do but on the other hand it has plenty of nuances. You are able to check our top-notch biographical essay example to have a glimpse of the way to organize your work. The Good, the Bad and Biographical Essay Samples It's possible for you to summarize your primary arguments or the key points in your descriptions. There's no fixed number of body paragraphs for an essay and a great paragraph has one central point. Your outline can help you organize the info you gathered during your research while you regard which ideas to include in each individual paragraph. It should be simple and informative. As a result, if you're going to stick to the preceding four step guideline for writing biographical essays then you will certainly wind up with an essay that will fetch great grades for you. When many students may barely compose an essay on a general topic during an academic calendar year, many find it even more difficult to finish an autobiographical essay as part of their application. Nowadays it's very hard to locate a trustworthy essay writing service. Your scholarship essay is a rather important portion of your application. Therefore, it's quite understandable why they have a tendency to obtain biographical essay sample. What's more, our plagiarism checker is one of the very best.

Odysseus’ Search for Purpose in Homers Odyssey Essay

Odysseus’ Search for Purpose in The Odyssey As a wayfarer in life, The Odyssey focuses on life’s greater purpose through the fulfillment of destiny, perseverance, and loyalty. These three themes recur continuously throughout Odysseus’ journey, molding life’s greater vision. Odysseus comes to understand his purpose in life by remaining true to these major themes as he faces and conquers each obstacle in his journey. The overarching theme of The Odyssey is the belief that man cannot escape the destiny which has been preordained for him by the gods. Destiny plays a vital role in the survival of Odysseus throughout his adventures. As Odysseus languishes on the island of Calypso, Hermes commands her to free Odysseus in order for†¦show more content†¦Odysseus’ freedom to make his own decisions is altered my what the gods have preordained for him. Not only do the gods have control over the day-to-day destiny of mankind, but they also decide the circumstances of each mortal’s life. No matter how a mortal struggles, he will die under the conditions that the gods have set out for him. Eurymachus explains to Penelope, Death from the gods can no man shun(161). Eurymachus seeks to comfort Penelope by pointing out that worrying about the fate of her loved ones is useless, since their fate will be decided by the gods and once it has, there is no escaping it. Throughout Odysseus’ journey he is able to persevere against the overwhelming odds he is faced with. The driving force behind Odysseus’ perseverance is his hunger to get home; his crew however does not share this passion and therefore lacks the strength of character to fight on. Odysseus looks back on his life or death struggle as his ship is lost in Poseidon’s storm, out of the ship my comrades fell and then like sea-fowl were borne by the side of the black ship along the waves; god cut them off from coming home. I myself paced the ship until the surge tore her ribs off the keel, which the waves then carried along dismantled. The mast broke at the keel; but to it clung the backstay, made of oxhide. With this I bound the two together keel and mast and getting a seat on these, I drifted before the deadlyShow MoreRelated Disguises in Homers Odyssey Essay954 Words   |  4 PagesDisguises in Homers Odyssey   Ã‚  Ã‚  Ã‚   In Homers Odyssey, disguises help convey a false identity that assist the characters in accomplishing their plans.   Each disguise has its own purpose, such as Athenes image as Mentor to advise Telemachos.   Her purpose was to assist and encourage Telemachos into searching news of his long lost father without revealing her true identity of divinity.   Being old and wise, and especially male, helps put more power behind the words spoken by Mentor because menRead More Essay on Names in The Odyssey and The Bible1634 Words   |  7 PagesImportance of Names in The Odyssey and The Bible      Ã‚   Two of the most widely studied ancient works are Homer’s Odyssey and the book of Genesis from the Bible.   Each of these texts provides a unique viewpoint of an early civilization.   In both of the texts, one can learn not only stories about great heroes, but also about the way that these peoples lived and what they believed.   Many interesting parallels can be drawn between the two developing societies shown in the Odyssey and the book of GenesisRead More A Comparison of Homeric Formalism in The Iliad and The Odyssey1339 Words   |  6 PagesHomeric Formalism in The Iliad and The Odyssey Much that is terrible takes place in the Homeric poems, but it seldom takes place wordlessly... no speech is so filled with anger or scorn that the particles which express logical and grammatical connections are lacking or out of place. (from Odysseus Scar by Erich Auerbach)    In his immaculately detailed study comparing the narrative styles of Homer to those of the Bible, Erich Auerbach hits upon one of the most notable intriguesRead MoreEssay about Use of Disguise in Homers Odyssey1056 Words   |  5 PagesThe Use of Disguise in Odyssey       In Homers Odyssey, the use of disguise to help convey a false identity assists the characters in accomplishing their plans.   Without the use of disguise it would thwart Odyssey’s attempts at arriving back to his homeland. Each disguise has its own individual purpose, for example Athenes image as Mentor to advise Telemachos.   The main intention being to assist and encourage Telemachos into searching for news of his long lost father without revealingRead More Use of Disguises in Homers Odyssey Essay986 Words   |  4 PagesUse of Disguises in Odyssey      Ã‚  Ã‚  Ã‚   The characters use of disguises in Homers Odyssey is a crucial element that helps to catalyze the victory of good over evil.   Each disguise is unique, created for a specific purpose.   Before she talks to Telemachos, Athena disguises herself as a wise old man in order to ensure that her words carry weight and are taken seriously.   She knows that she must assist and encourage Telemachos into searching for his long lost father without revealing her divineRead More Homers Odyssey and Dr. Seuss’ Youre Only Old Once Essay1512 Words   |  7 PagesHomers Odyssey and Dr. Seuss’ Youre Only Old Once      Ã‚  Ã‚  Ã‚   What animal walks on all fours in the morning, on two legs at noon, and on three legs at night? The famous riddle of the sphinx that has been pondered for many years; it is a universal issue that affects all people of every nationality, ethnicity, religion, or geographic area. We, ourselves, are the answer to this puzzle and yet we fight this explanation with every tool possible. We avoid it, refuse to admit it, read about it, jokeRead MoreAnalysis Of The Epic Heroes 1270 Words   |  6 Pagesdivine intervention was a large theme, and this can serve as the backbone of luck for the epic hero. Odysseus from the Odyssey is a prime example as Athena is a constant aid to him in his long journey home. Odysseus truly thrives from divine luck more than his own personal intelligence or bravery. To begin, Odysseus has extreme wit, but much of it is actually luck influenced by the gods. Odysseus is known for his cunning personality, unlike the harsh personality of Achilles. For this, he is seenRead MoreArchetypes In Homers The Odyssey1383 Words   |  6 Pageswere three main archetypes that were used in Homer’s epic ,The Odyssey, which show different aspects of Ancient Greek culture. Those three archetypes were: the hero/father figure archetype, the monster archetypes, and the search for love. The hero archetype explained the Ancient Greeks’ love for thrill and adventure; Odysseus went on many thrilling adventures while on his journey. The monster archetypes represented the Greeks’ love of horror; Odysseus’ men have died due to the monsters and creaturesRead MoreEssay about David Katan’s Translating Cultures1038 Words   |  5 Pagesmeaning. Interpreting and translating a text is not a simple and easy task; it takes time and is also chall enging, because â€Å"the translator cannot merely search for equivalent words in the target language to render the meaning of the source† (Dingwaney and Maier, 3). Up until today there are many translations of ancient works and books, such as the Odyssey; and so, there is a wide range for people to choose from. This choice must be taken with the most care because some may be exceptionally good at communicatingRead MoreGilgamesh And Odysseus Similarities882 Words   |  4 Pagesglory, immortality, and fame, through heroic actions. Odysseus was a Greek king of Ithaca. He was best known for being the greatest eponymous hero of the Odyssey, which described his hardships as he struggles to return home from the Trojan War. Odysseus was the notable leader in the war. He was also the hero of Homer’s Odyssey. Odysseus was under the protection of the goddess Athena. The Odysseus was formed in early Greek. Gilgamesh and Odysseus were both heroes that arose in different time spans

Analysis the Importance of Mobile Robots in Manufacturing Operations

Question: Discuss about the Analysis the Importance of Mobile Robots in Manufacturing Operations. Answer: Introduction The selected topic for this research study is Analysis the importance of mobile robots in manufacturing operations. The research is based on a mobile robot, an automatic machine that has the capability of locomotion. It has the capability to move around, and it is non-fixed to any one physical location (Rogowski, 2013). These types of robots are relying on guidance devices such as Autonomous Guided Vehicle (AGV), which allows the robots to travel pre-defined navigation route in a comparatively controlled space. Objectives The objectives of this particular research study are as discussed: To analyze the importance of mobile robots To become familiar with the use of mobile robots for manufacturing applications To analyze the challenges in the locomotion of mobile robots Area of research project The research project introduces a range of the manufacturing applications that are made possible with the use of the mobile robots. Instead of a requirement of any custom machine tools in order to fabricate large components, it is possible to move smaller and general-purpose tools in order to fabricate it in a new way. Therefore, for this purpose, it will require such a tool that will have highly accurate position measurements and will apply in robotics applications. The advantages of using the mobile robots in manufacturing applications include the capability to offload challenging tasks from people and then automate those tasks (Santolaria Gines, 2013). In order to successfully implement the importance of mobile robots for manufacturing operations, there is a need to focus the research on manufacturing robotics. The mobile robots are such that they can plan their ways, localize themselves accurately, and consists of sufficient sensors as well as manipulators to carry out human tas ks. Conceptual foundation of the topic Robotics has achieved a great success to date within the entire world of the industrial manufacturing. This research topic introduces the foundations as well as the importance of using the autonomous mobile robots for the manufacturing operations. This is a fascinating research topic that is now a day taught in most of the universities (Shin, Kim, Lee, 2015). The sections that are covered under this topic are interaction among human as well as robots, navigation and localization, advanced application of mobile robots system and performance evaluation of the robots in the industry. As our research is based on the manufacturing applications of the mobile robots, therefore this topic is introduced as the mobile industrial robots are the machinery that is specially programmed for industrial settings (Rogowski, 2013). With advancement in robotics, current technology is improved for mobile tasks such as the delivery of products in the industries. These types of additional flexibility with in the manufacturing applications are saving the time of the company as well as money during the process of manufacturing. It results in cheaper end product. Scope of the research The scope of this research study is high as mobility is one of the basic aspects of our lives. The research on the mobile robots is increasing day-by-day as it uses a range of locomotion techniques to do their work. The mobile robots address the demand for flexible material handing within the manufacturing industries (Kang, 2014). This research study will emphasize on new chances for the mobile robots as well as computerization across significant applications. It will also explore the mobile industry trends as well as highlight the potential benefits to incorporate with advanced technologies. The mobile robots require the mechanism of locomotion that enables to move unbounded through its environments (Shin, Kim, Lee, 2015). With this research study, the researcher points out the issues and challenges of locomotion system within mobile robots. The researcher gets familiar with the wide range of applications that lend to use the mobile robots, as there is an improvement in capabilitie s of robots as well as related sensors. Manufacturing or mobile robots hold up production as this type of robots could malfunction anywhere within the industrial facilities. The robots are also prioritizing the safety of the human operators over a programmed task that will complicate the coordination of various autonomous robots (Rogowski, 2013). Even this type of mobile industrial robots are simple. Therefore, this provides the main advantage within the industrial settings due to ease of its use as well as capability to operate via the use of advanced technologies. Finally, the mobile robots can operate for long hours, and the result is that it increases the efficiency within the manufacturing environments so that their manufacturing operations become more efficient and easier. References Kang, S. (2014). Factors influencing intention of mobile application use.International Journal Of Mobile Communications,12(4), 360. Rogowski, A. (2013). Web-based remote voice control of robotized cells.Robotics And Computer-Integrated Manufacturing,29(4), 77-89. Santolaria, J. Gines, M. (2013). Uncertainty estimation in robot kinematic calibration.Robotics And Computer-Integrated Manufacturing,29(2), 370-384. Shin, J., Kim, S., Lee, J. (2015). Production and inventory control of auto parts based on predicted probabilistic distribution of inventory.Digital Communications And Networks,1(4), 292-301.

My Most Memorable Experience free essay sample

So, the two first batch went to Clark for training for three months. During the first three weeks we spent in Clark, we decided for our team to have a team building since some of my team were first timers in Manila. So I suggested to spend it in Enchanted Kingdom since it would also be my first time to go there. It was a sunny day. I woke up in the morning. Our dormitory was noisy because everyone is preparing for our travel to Laguna. â€Å"We are going to Enchanted Kingdom today. † My roommate’s voice interrupted my thought. I could sense happiness in her cheerful voice. The moment we all reached Mall of Asia to get a ride to Enchanted Kingdom, my close friend suggested to take a Van so that we would be much comfortable. So we reached the entrance of EK and we all had taken our own pictures individually and as a group. We will write a custom essay sample on My Most Memorable Experience or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page My supervisor suggested, â€Å"Let’s go for a ride in a roller coaster first. I’ve heard so much about the roller coaster here and I’m dying to try it. † I said: â€Å"No way, I wouldn’t want to be scared to death†. I protested, shaking my head from left to right as hard as I could. And everyone agrees to try that first. I don’t have a choice but to go with them. I don’t know if I have to stay or try it out with my other teammates. I guess, I have no choice but to try and see how I will conquer my fear. â€Å"Hurry up! † urged my Supervisor. I followed him unwillingly. I was even more nervous when I saw the CAUTION. My teammate led me into a small room where the person-in-charge showed us our seats. I sat on my seat reluctantly. â€Å"Relax and enjoy the ride! my Supervisor tried to comfort me but it did not help. I nodded obediently and managed to flash him a smile. After a while, I heard a siren that hurt my ears. The siren warned us that the SCARY trip was about to begin. I shut my eyes tightly. Both my hands seized the seat so tightly that they ached, I guess I was panicky. I tried to calm myself down but in vain. I heard people shouting excitedly. They were so eager to begin the ride. Finally, I felt the roller coaster move. Slowly first, then faster, faster as it began to pick up speed. I felt my stomach turning upside down. It moved so fast that I nearly fell from my seat. I felt streaming down my face from my forehead. My heart was pounding loudly. I regretted taking a rider on this scary thing. I was looking at my seatmate and she was looking very excited with the ride, but I felt like I am going to fell at that moment. It was driving me nuts. The roller coaster swung to the left and then to the right. When the roller coaster slid down from the highest peak, it was the most frightening part of the whole trip. My eyes were wide open, my heart stopped beating. I screamed at the top of my voice and my hair was â€Å"flying wildly in the air†. The fifteen minute ride on the roller coaster was like 15 years to me. My face was as pale as a corpse when I came down from the roller coaster. I buried my face in my hands because I felt the world is spinning. But it was a great feeling that I have conquered my fear and was able to survive the ride. It was scary but an experience that I could never forget.

Write a Summary That Sums It All up

Write a Summary That Sums It All up Write a Summary That â€Å"Sums It All up† When it comes to summarizing a thought or essay for Toronto professors, you must be able to think critically, be concise, and have a certain amount of writing skill. Being a better writer makes you a better reader, because you understand how to find important points. This isn’t a talent developed overnight. Unfortunately, most people don’t know how to summarize effectively. Our tips will help you to recognize what is necessary to do more than explain, restate, or describe something you read. Understand What You Are Reading If you don’t have a thorough understanding of what you are reading, take your time with the text and try to grasp the basic â€Å"gist† of what the writer is conveying. As you read content, try to be more analytical. What argument is the author making? What does an idea presented mean to you? Take Notes If you like, taking notes can be done during a second read-through. Write down answers to any questions you had on the first reading. Write down the main points the author made. Leave out nothing, even if a point seems only vaguely important. Removing certain notes and thoughts is easier than later trying to remember something that wasn’t written. Edit Now is the time to thin out your notes. If anything seems less important to your summary, excise it. Create an Outline Review those notes and structure the paper based on them. Use key details and quotations where appropriate. Edit Again Look for more unnecessary ideas or statements. If an item doesn’t support your argument, remove it. If your text seems too wordy, find ways to say the same thing in fewer words. If your writing seems too short, add by using your thoughts from the reading work. Make sure to save this version under a different title just in case you want to reuse an earlier thought in your final draft. Start Writing Review the outline and beef up the main points. Do this one section at a time. Don’t worry about a first draft being â€Å"perfect;† there’s opportunity to fix things later. Check Your Work Review your writing. Did you make all your points? Are there spelling or grammatical errors? Smooth out the rough edges: Does some writing seem awkward? Read your text out loud and catch more errors. If you need assistance writing a summary for Toronto for school, college, or university, call toll-free: 1-800-573-0840. We can help with this or any other kind of writing assignment.

Heres What You Need to Know About Lesson Plans

Heres What You Need to Know About Lesson Plans A lesson plan is a detailed step-by-step guide that outlines the teachers objectives for what the students will accomplish during the course of the lesson and how they will learn it. Creating a lesson plan involves setting goals, developing activities, and determining the materials that you will use. All good lesson plans contain specific  components  or steps, and all essentially derive from the seven-step method developed by Madeline Hunter, a UCLA professor and education author. The Hunter Method, as it came to be called, includes these elements: objective/purpose, anticipatory set, input modeling/modeled practice, check for understanding, guided practice, independent practice, and closure. Regardless of the grade level you teach, Hunters model has been adopted and used in various forms for decades by teachers across the nation and at every grade level. Follow the steps in this method, and youll have a classic lesson plan that will be effective at any grade level. It doesnt have to be a rigid formula; consider it a general guideline that will help any teacher cover the necessary parts of a successful lesson. Objective/Purpose Students learn best when they know what they are expected learn and why, says the  U.S. Department of Education. The agency uses an eight-step version of Hunters lesson plan, and its detailed explanations are well worth reading. The agency notes: The purpose or objective of the lesson includes why students need to learn the objective, what they will be able to do once they have met the criterion, (and) how they will demonstrate learning....The formula for the behavioral objective is: The learner will do what with what how well.   For example, a high school history lesson might focus on  first-century Rome, so the teacher would explain to students that they are expected to learn the salient facts about the empires government, its population, daily life, and culture. Anticipatory Set The anticipatory set involves the teacher working to get students excited about the upcoming lesson. For that reason, some lesson plan formats actually put this step first. Creating an anticipatory set means doing something that creates a sense of anticipation and expectancy in the students, says Leslie Owen Wilson, Ed.D. in The Second Principle. This can include an activity, a game, a focused discussion, viewing a film or video clip, a field trip, or reflective exercise. For example, for a second-grade lesson on animals, the class might take a field trip to a local zoo or watch a nature video. By contrast, in a high school class getting ready to study  William Shakespeares play,  Romeo  and Juliet, students might write a short, reflective essay on a love they lost, such as a former boyfriend or girlfriend. Input Modeling/Modeled Practice This step- sometimes called  direct instruction- takes place when the educator actually teaches the lesson. In a high school algebra class, for example, you might write an appropriate math problem on the board, and then show how to solve the problem in a relaxed, leisurely pace. If its a first-grade lesson on important sight words to know, you might write the words on the board and explain what each word means. This step should be very visual, as the DOE explains: It is important for the students to see what they are learning. It helps them when the teacher demonstrates what is to be learned. Modeled practice, which some lesson plan templates list as a separate step, involves walking the students through a math problem or two as a class. You might write a problem on the board and then call on students to help you solve it, as they also write the problem, the steps to solve it, and then the answer. Similarly, you might have first-grade students copy the sight words as you spell each out verbally as a class. Check for Understanding You need to make sure students understand what you have taught. One easy way to do this is to ask questions. If youre teaching a lesson on simple geometry to seventh-graders,  have students practice with the information you just taught, says the  ASCD (formerly the Association for Supervision and Curriculum Development). And, be sure to guide the learning. If students dont seem to grasp the concepts youve just taught, stop and review. For the seventh-graders learning geometry, you may need  to repeat the previous step by showing more geometry problems- and how to solve them- on the board. Guided and  Independent Practice   If youre feeling like the lesson plan involves a lot of guidance, youre right. At the heart, thats what teachers do. Guided practice provides  each student a chance to demonstrate her  grasp of new learning by working through an activity or exercise under the teacher’s direct supervision. During this step, you might move around the room to determine your students level of mastery and provide individual help as needed. You may need to pause to show students how to successfully work through problems if they are still struggling. Independent practice, by contrast,  can include homework or seatwork assignments, which you give to the students to complete successfully without the need for supervision or intervention. Closure In this important step, the teacher wraps things up. Think of this phase as a concluding section in an essay. Just as a writer wouldnt leave her readers dangling without a conclusion, so too, the teacher should review all key points of the lesson. Go over any areas where students might still be struggling. And, always, asked focused questions: If students can answer specific questions about the lesson, they likely have learned the material. If not, you may need to revisit the lesson tomorrow. Tips and Hints Always gather all needed supplies ahead of time, and have them ready and available at the front of the room. If youll be conducting a high school math lesson and all students will need are their textbooks, lined paper, and calculators, that makes your job easier. Do have extra pencils, textbooks, calculators, and paper available, though, in case any students have forgotten these items. If youre conducting a science experiment lesson, make sure you have all of the ingredients needed so that all students can complete the experiment. You dont want to give a science lesson on  creating a volcano  and find out once students are gathered and ready that youve forgotten a key ingredient like baking soda. To ease your job in creating a lesson plan, use a  template. The basic lesson plan format has been around for decades, so theres no need to start from scratch. Once you figure out what kind of  lesson plan  you will be writing, then you can determine the best way to use the format to fit your needs.

Banking on a Beard Award Assignment Example | Topics and Well Written Essays - 1000 words

Banking on a Beard Award - Assignment Example Decision making process I have used a decision tree as a support tool to show possible consequences and also chance outcomes, resources costs and losses. I have used the decision identify a most likely strategy to reach a goal (Goetz T 2011). In addition, it is used to calculate the conditional probabilities. Before making any conclusion, I have looked at the scenario at hand and have realized that there are different points that my friend has not synthesized. It is also noticeable that the starting of the restaurant may be due to vague opinions. This is so because research has to be carried out before undertaking any business venture. It emerges that Jennifer, enjoys her current career and her drive are to manage her own business. She is also inclined towards entrepreneur ventures and adds that it is a way of improving her personal value. Her justification and judgment depends on her desire to manage her business. During my analysis, I have realized that sixty percent of business ve ntures into restaurants fail within their first three birthdays. It is also noticeable that if Jennifer starts the restaurant business she will use her saving worth 250 dollars. If Jennifer remains in her current job, she will be eligible for a promotion whereby she will be entitled to fifty percent increase in price. Conclusion According to the decision tree the probability of Jennifer retaining her current job as a banker is 0.333. The probability also of getting a promotion and termination is also 0.333. If Jennifer get a promotion after a year, the amount of money she will get, will be greater than any other option. It is also likely that if she retains her job, she may also retain her current position as a banker. This means, she will not get promotion but, this is not a dreadful thing since she will earn slightly lower, than the restaurant business. She will also retain her savings unlike when she starts the business since she will top up the bank loan. There is a 0.333 chance that Jennifer may also loose her job meaning that she will have no earnings. The other option with Jennifer is to start her restaurant business; this may be risk taking since more than half businesses fail before their 3rd birthday. The probability that the restaurant business will flourish with a huge success is 0.1 or ten percent chance. It is a pretty low chance to act on but if the business succeeds Jennifer will earn a large profit. The profit is greater than her current career job even if she does not get a promotion. The moderate success probability is 0.3; this is thirty in percentage scale. The probability is below the average or half. There is a large probability that the business will close. This accounts to sixty percent. Jennifer should take caution when analyzing or rather making a decision whether or not to start the restaurant business. In order to break even, the restaurant should be big enough to produce sales exceeding $ 200,000 so that she manages to pay the ban k loan, and return the money lent to the business and also get a substantial profit. Recommendations The recommendation that I would give Jennifer regarding her desire to quit her job, and start her restaurant is to remain in her job, and not to start her restaurant. This is because in the banking job, the money she would get annually when promoted much greater than what she would get from the

How far does the British state conform to, or depart from, the ideal Essay

How far does the British state conform to, or depart from, the ideal of an enterprise association, as opposed to a civil association - Essay Example The Marxist interpretation of Colonialism will be our point of departure, due to its scientific validity in our estimation. Thereafter, the Marxist stand point losses its relevance for our paper as it tends to adhere to a meta-analytical perspective and tends to be clichà ©d, lacking a predictive quality, whereas the paper requires to focus on British Colonialism and its reverse influence on the state structure of Britain. To fascilitate our argument we have appropriated and borrowed David Easton’s Systems’ Approach to comprehend the complexity of the reverse interaction in focus. Thereafter we will further our argument by referring to the useful categorization of Hanrieder to demonstrate that how colonial interests ultimately shaped the British state at the institutional level. Great Britain was a relatively late entrant on the world stage as a colonial power. The Spanish and Portuguese seaborne empires preceded Britain. These colonial empires were built on the linchpin of maritime power and subsequent colonial acquisitions. The dominance of Iberian Peninsula lasted roughly till late 16th century (Brewer.1989). This was what the Marxist call ‘Mercantile Period’. Britain as a mercantile state par-excellence began to dominate world colonial matrix by the end of 16th Century. One reason for emergence of Britain’s dominance was that the ‘industrial revolution had centered on Britain, thereby necessitating an â€Å"organization of production and accumulation†, designed to fascilitate a merchant capitalist economy, looking for raw material, cheap labour and markets for finished products’ ( Luxemberg.1951). Britain’s colonial expansion was propelled by the emerging needs of a nascent political economy which needed co lonies. Thus at the outset of this epoch, British State geared itself to colonize and acquire territories to safeguard the interests of a mercantile state, thereby as a corollary almost canonizing principle of free trade and

Employment and Trade Unions Essay Example for Free

Employment and Trade Unions Essay Throughout the study I have tried with the best of my capacity to accommodate as much information and relevant issues as possible and tried to follow the instructions as you have suggested. I tried my best to make this report as much informative as possible. I sincerely believe that it will satisfy your requirements. I however sincerely believe that this report will serve the purpose of my course (Industrial Relation). I am grateful to you for your guidance and kind co-operation at every step of my endeavor on this report. My effort will be reworded only if it adds value to the research literature. Introduction One of the major functions of human resource management is to maintain smooth industrial relations (IR). It is also treated as one of the oldest functions of HRM. It is basically allied with the relations between the employer and the workers in the industry (Singh Kumar, 2011: 3). According to Weeratunga (2003:5) Industrial Relations or Labor Relations, the terms used interchangeably, can be viewed as the interaction between the various interested parties involved in employment. The employer and the employee are obvious parties. The state, in ensuring a level playing field for both sides, provides the legal framework within which such relations may take place. In industrial relations, workers are generally represented by their trade unions formed under chapter 13 of Bangladesh Labor Act2006 whereas employers are represented by their associations such as Bangladesh Employers Federation. HR managers mediate the relationships between workers and employers though they are appointed by the representatives of employers. Another related term is Employee Relations. Though both the terms industrial relations and employee relations are structurally similar (Decenzo Robbins, 1999: 18), employee relations includes, in addition to industrial relations, such aspects as participative management, employee wellbeing, employee development, employee compensation, employee protection and health, and the like (Aswathappa, 2008:534). Generally industrial relations cover the areas such as trade unions, collective bargaining, settlement of industrial disputes, grievance handling procedure, role of government, labor laws, courts and tribunals and role of employers. In the context of developing countries, industrial relations has been influenced by features such as high exploitation of workers, low level of worker participation in decision making, government and political interferences, high rate of illiteracy of workers, low level of employment, low level of awareness among the laborers regarding rights, laws, and trade unionism, and low labor productivity (Khan Taher, 2008: 222-23). Industrial relations plays an important role in establishing and maintaining industrial democracy (Monappa, 2004: 9) and it is the key to improve productivity in industrial enterprises (Aswathappa, 2004: 534). Human resource management can play vital roles in enhancing cooperative and friendly industrial relations. In Bangladesh, collective bargaining on pay between employer and workmen is prohibited in the public sector enterprises as the government designs uniform pay and benefits for the employees of all public sector enterprises (Mahmood, 2008). The limited scope of collective bargaining in the public sector of Bangladesh influences the trade unions to develop network with government, political parties and other powerful bodies in organizing their activities. It hinders effective interactions between the representatives of employers and workers at enterprise level. Though performance based pay is considered to have significant impact on employee performance (DesslerVarkkey, 2010: 15), it is not at all practiced by the public sector enterprises in Bangladesh. As a result, public sector enterprises in Bangladesh have been incurring huge losses. On the other hand, all types of collective bargaining takes place at enterprise level in case of private sector enterprises (Khan, 1996). Mahmood (2008) mentioned that the industrial relations process in the private sector was often disturbed by links between private and public sector unions. Objectives: a) To explore the differences between public and private sector industrial enterprises of Bangladesh with respect to overall status of IR. b) To put forward policy implications of overall improvement in IR of Bangladesh. Industrial Relations Studies in Bangladesh Khan (1986) studied industrial relations in Bangladesh with special emphasis on trade unionism. †¦ Trade Unions Trade Union is an organization of workers who have banded together to achieve common goals such as protecting the integrity of its trade, achieving higher pay, increasing the number of employees an employer hires, and better working conditions. An organized association of workers in a trade, group of trades, or profession, formed to protect and further their rights and interests. A group of employees in a particular sector, whose aim is to negotiate with employees over pay, job security, working hours, etc. using the collective power of the members. The most common purpose of these associations or unions is maintaining or improving the conditions of their employment. Causes of organizing trade unions Provision of benefits to members: professional training, legal advice and representation for members is still an important benefit of trade union membership. Industrial action: Trade unions may enforce strikes or resistance to lockouts in furtherance of particular goals. Political activity: Trade unions may promote legislation favourable to the interests of their members or workers as a whole. To this end they may pursue campaigns, undertake lobbying, or financially support individual candidates or parties. Conditions of employment and any grievances — are settled through trade unions. Bargaining rights: Trade unions bargain and ensure the status, rights, wages and demands of workers of the modern world of industry. Contribution in economical growth: Trade unions are growing rapidly in an economy because of the expansion of business and economical growth. Objectives Trade unions are the only way to manage, compliant, and control the labour force. Lots of objectives are there to organize trade unions. . To defend or improve the wages and working conditions of workers and to bring about a change in the economic order. 2. To strengthen their (labour) bargaining power collectively to establish and achieve all their rights. 3. To dully protect all other interest of the workers . And from the managements point of view the objectives as written: a) To reduce the number of negotiation. b) To specify work rules, disagreements and grievances to give the better solution to workers claim. c) To establish the efficient communication between the employers and management to enforce the predictable standards. ) To enhance the overall organizational effectiveness workers can also be sometimes inspired to form and organize trade union. In fact, objectives of a trade union are not defined; rather these are changing according to the need of the economy and overall industry. When these objectives are not settled then the rivals are started History of Trade Unions The Pakistan Period (1947-71) -The East Pakistan Trade Unions Act, 1965 was enacted repealing the Trade Unions Act, 1926. -The Labor Disputes Act, 1965 was enacted. -Industrial Relations Ordinance, 1969 was enacted integrating the above two Acts. Bangladesh Period (1971-onwards) -Government of Bangladesh declared a labor policy in 1972. The right to strike and collective bargaining in the nationalized industries was prohibited for six months by Presidential order no. 55 in May 1972. -In 1973, the right to strike and lockout, as granted by IRO, 1969 was withdrawn. -In 1974 Act completely suspended the democratic rights of workers by prohibiting trade union activities such as strikes, lock-outs, collective bargaining. -The military regime of 1975 imposed restrictions on the rights of collective bargaining. The Industrial Relations (Amendment) Ordinance, 1977 liberalized the Rights of Freedom of Association -The Labor Policy of 1980 restored the right to freedom of association to a considerable extent -In 1982 the military regime banned trade union activities, strikes, and right of freedom of association. Limitations In Bangladesh Trade Unions have a lot of unavoidable problems: 1. Lack of consciousness: Trade union are not actu ally completely aware about employees legal rights and duties. 2. Lack of Unity: In Bangladesh trade unions are separated for political influence. 3. Lack of knowledge: The workers of Bangladesh dont have enough knowledge about their rights and duties. 4. Political influence: In Bangladesh, trade unions work a part of political parties not as a free right saving association. 5. Division of trade union: Bangladesh is a country where every organization has more trade unions in name only. The overall productivity got down. Suggestions Strengthening bilateral collective bargaining for solving problems quickly and effectively. Multiplicity of trade union creates the rivals in a union. So it must be reduced. Political involvement must be reduced. Organization must support financially as trade unions support the worker. Training programs under trade union should be helpful to develop the skills of the workers. Trade unions function should be increased and widened throughout the organization. Union leader must be given importance and encourage the members. If trust between workers and management increases, productivity increases. Management must help and guide trade unions to settle industrial clashes and crisis. Trade unions always should demand reasonable thing to the management. . What is a dispute? Academically speaking, industrial dispute refers to any conflict between employees and employers, between employers and employers and between employers and employees. †¢ But in reality, dispute is understood as the conflict between employees and employers. There are three types of Disputes : †¢ Disciplinary disputes †¢ Grievance disputes †¢ Industrial disputes †¢ According to Industrial Dispute Act, 1947, Industrial dispute means any dispute or difference between employers and employers, or between employers and workmen, or between workmen and workmen, which is connected with the mployment or non-employment or terms of employment or with the conditions of labour of any person. Causes of Industrial Disputes: Some of the prominent causes of industrial disputes may be listed thus: Employment: The list here includes disputes over wages, allowances, bonus, benefits, working, condition, unjust dismissals, retrenchment of workers, methods of job evaluation, changes in methods of production, non-implement of awards of tribunals, etc. The National Commission on Labor remarked â€Å"though on majority of occasions industrial disputes were based on claims pertaining to the terms and condition of employment, sometimes economic issues of a general character dominated and, on occasion, purely motives†. The causes of industrial disputes can be broadly classified into two categories: economic and non-economic causes. The economic causes will include issues relating to compensation like wages, bonus, allowances, and conditions for work, working hours, leave and holidays without pay, unjust layoffs and retrenchments. The non economic factors will include victimization of workers, ill treatment by staff members, sympathetic strikes, political factors, indiscipline etc. Wages and allowances:  Since the cost of living index is increasing, workers generally bargain for higher wages to meet the rising cost of living index and to increase their standards of living. In 2002, 21. 4% of disputes were caused by demand of higher wages and allowances. This percentage was 20. 4% during 2003 and during 2004 increased up to 26. 2%. In 2005, wages and allowances accounted for 21. % of disputes. Personnel and retrenchment:  The personnel and retrenchment have also been an important factor which accounted for disputes. During the year 2002, disputes caused by personnel were 14. 1% while those caused by retrenchment and layoffs were 2. 2% and 0. 4% respectively. In 2003, a similar trend could be seen, wherein 11. 2% of the disputes were caused by personnel, while 2. 4% and 0. 6% of disputes were caused by retrenchment and layoffs. In year 2005, only 9. 6% of the disputes were caused by personnel, and only 0. 4% were caused by retrenchment. Indiscipline and violence:  From the given table, it is evident that the number of disputes caused by indiscipline has shown an increasing trend. In 2002, 29. 9% of disputes were caused because of indiscipline, which rose up to 36. 9% in 2003. Similarly in 2004 and 2005, 40. 4% and 41. 6% of disputes were caused due to indiscipline respectively. During the year 2003, indiscipline accounted for the highest percentage (36. 9%) of the total time-loss of all disputes, followed by cause-groups wage and allowance and personnel with 20. 4% and11. % respectively. A similar trend was observed in 2004 where indiscipline accounted for 40. 4% of disputes. Bonus:  Bonus has always been an important factor in industrial disputes. 6. 7% of the disputes were because of bonus in 2002 and 2003 as compared to 3. 5% and 3. 6% in 2004 and 2005 respectively. Leave and working hours: Leaves and working hours have not been so important causes of industrial disputes. During 2002, 0. 5% of the disputes were because of leave and hours of work while this percentage increased to 1% in 2003. During 2004, only 0. % of the disputes were because of leaves and working hours. ? Miscellaneous:  The miscellaneous factors include   Ã‚   Inter/Intra Union Rivalry   Ã‚   Charter of Demands   Ã‚   Work Load   Ã‚   Standing orders/rules/service conditions/safety measures   Ã‚  Ã‚  Ã‚   Non-implementation of agreements and awards etc. Collective Bargaining Collective bargaining includes not only negotiations between the employers and unions but also includes the process of resolving labor-management conflicts. Thus, collective bargaining is, essentially, a recognized way of creating a system of industrial jurisprudence. It acts as a method of introducing civil rights in the industry, that is, the management should be conducted by rules rather than arbitrary decision making. It establishes rules which define and restrict the traditional authority exercised by the management. Importance to employees ? Collective bar aining develops a sense of self respect and responsibility among the employees. It increases the strength of the workforce, thereby, increasing their bargaining capacity as a group. Collective bargaining increases the morale and productivity of employees. It restricts management’s freedom for arbitrary action against the employees. Moreover, unilateral actions by the employer are also discouraged. Effective collective bargaining machinery strengthens the trade unions movement. The workers feel motivated as they can approach the management on various matters and bargain for higher benefits. It helps in securing a prompt and fair settlement of grievances. It provides a flexible means for the adjustment of wages and employment conditions to economic and technological changes in the industry, as a result of which the chances for conflicts are reduced. Importance to employers 1. It becomes easier for the management to resolve issues at the bargaining level rather than taking up complaints of individual workers. 2. Collective bargaining tends to promote a sense of job security among employees and thereby tends to reduce the cost of labor turnover to management. 3. Collective bargaining opens up the channel of communication between the workers and the management and increases worker participation in decision making. 4. Collective bargaining plays a vital role in settling and preventing industrial disputes. Importance to society: 1. Collective bargaining leads to industrial peace in the country 2. It results in establishment of a harmonious industrial climate which supports which helps the pace of a nation’s efforts towards economic and social development since the obstacles to such a development can be reduced considerably. 3. The discrimination and exploitation of workers is constantly being checked. 4. It provides a method or the regulation of the conditions of employment of those who are directly concerned about them.

Legal Issues Case Study For Nursing Essay -- essays research papers

Legal Issues Case Study for Nursing Case 2 Nursing Situation: Cindy Black (fictitious name), a four-year-old child with wheezing, was brought into the emergency room by her mother for treatment at XYZ (fictitious name) hospital at 9:12 p.m. on Friday, May 13. Initial triage assessment revealed that Cindy was suffering from a sore throat, wheezing bilaterally throughout all lung fields, seal-like cough, shortness of breath (SOB), bilateral ear pain. Vital signs on admission were pulse rate 160, respiratory rate 28, and a temperature of 101.6 Â °Fahrenheit (F) (rectal). Cindy Black was admitted to the emergency department for treatment. Notes written by the emergency department physician on initial examination read, "Croupy female; course breath sounds with wheezing; mild bilateral tympanic membrane hyperemia. Chest X-ray reveals bilateral infiltrates." Medication prescribed included Tylenol (acetaminophen) 325 mg orally for elevated temperature, Bronkephrine (ethylnorepinephrine hydrochloride) 0.1 millimeter subcutaneous, and monitor results. Nurse Slighta Hand, RN (fictitious name) administered the medication as ordered and the child was observed for thirty minutes. Miss Hand's charting was brief, almost illegible, and read, "Medicines given as prescribed. Cindy observed without positive results. Physician notified." The physician examined the child; notes read that the child had "minimal clearing" in response to the bronchodilator. The following medications were then prescribed: Elixir of turpenhydrate with codeine one milliliter by mouth, Gantrinsin (sulfisoxazole) 10 Case 3 milliliters, and Quibron (theophylline-glycerol guaiacolate) 10 milliliters. Nurse Slighta Hand, RN charted the medications were given as prescribed. Her note at 11:08 p.m. read, "Vomiting; unable to retain medicine. Respiration increased (54), temperature 101.4Â °F (rectal); wheezing with increased difficulty breathing." No further notes were made regarding Cindy's condition on the emergency department record by the nurse, except to state that at 12:04 am, "child released from emergency department." Thirty minutes after discharge from the emergency department, Cindy Black was brought back to the hospital. This time her vital signs were absent, her skin was warm without mottling, and the pupils of the eye were dilated but reacted slowl... ...30 minutes) Â · Pulse rate, rhythm, quality (every 15 minutes) Â · Respiratory rate, rhythm, character (every 15 minutes) Â · Patency of the airway (at least every 15 minutes, more if in distress) Â · Blood pressure (every 30 to 60 minutes) Â · Skin color and temperature (every 15 minutes) Â · Level of consciousness (every 15 minutes) Â · Emesis amount, character, and frequency Summary: Communication throughout the nursing process is crucial for the provision of safe patient care consistent with the prevailing professional standard. Spoken communication among all members of the health-care team, and especially between nurse and physician for clarifying orders, planning patient care, and reporting significant patient observations is vital to the nursing process. Equally important is written communication by the nurse in the form of prompt and accurate entries in the medical record. References Bernzweig, E. (1996). The nurse's liability for malpractice. (6th ed.). St. Louis: Mosby Creasia, J. and Parker, B. (1991). Conceptual foundations of professional nursing practice. St. Louis: Mosby Earnest, V. (1993). Clinical skills in nursing practice. (2nd ed.). Philadelphia: J. B. Lippincott

Subjects to Citizens: Locke, the Enlightenment

The idea of people as citizens rather than as subjects originates in 16th century Europe, during the Early Modern Period. During this period, European social order was in a state of flux as the rule of kings was confronted with a persistent and determined challenges defined by social forces that were pushing for more secular and democratic governments. There were both individuals and events that today may be seen as powerful drivers of those forces, and among them are John Locke, the Enlightenment, and the French Revolution.As such a force, the Enlightenment, which began during the mid-17th century and remained a major political and philosophical phenomenon until approximately 1800, had tremendous impact in the rise and triumph of democracy over monarchy. The Enlightenment was catalyzed by the persistent discourse of a number of philosophers and historians, one of the foremost of which was John Locke.The magnitude of change introduced by the Enlightenment is rendered more clearly whe n viewing that period in context of the preceding era—the Medieval Period, during which the rule of kings prevailed, sustained by an embedded religious institutions that qualified the lineages of kings for ruler ship through divine ordainment. The Church enjoyed considerable reciprocity from the crowns by doing so, because rulers recognized the equity that religion held in the minds of their â€Å"subjects†, and found value in making mutually beneficial agreements with the church to preserve this closed loop cycle of maintaining and preserving a rigid social order.The losers of course were the â€Å"subjects† of those kingdoms, who ultimately had little say in who ruled them, and who were indoctrinated into a life of mute slavery and poverty, deprived of both education as well as the right to imagine upward social mobility, much less the access to opportunities to actually pursue such improved quality of life.It was the endpoint of these social dynamics, and the progressive deterioration of social responsibility throughout the dual leadership trees of church and crown, that catalyzed the French Revolution during the last decade of the 18th century. The French Revolution, in a nutshell, was the revolt of the long repressed peasantry against what they rightfully recognized as a corrupt governmental power cartel defined by the closed loop relationships between the crown and the Church.The French Revolution really punctuates the spirit of the Enlightenment, because the Enlightenment was all about waking people up to the notion that they had a right to select their leaders and that anybody was capable of exercising reason and logic in doing so, and most importantly that exercising those capacities was a much better answer to society’s problems than continuing to rely on superstitious belief in the right of a lineage of kings to continue ruling despite worsening social conditions.It was not until the French Revolution however that the Enl ightenment really manifested full force. John Locke died nearly a century before the French Revolution, but he played a key role in developing the philosophies that activated and drove the Enlightenment, particularly through his composition of the Two Treatises. In these documents, he makes an effort to refute the notion that people do not have the capacity or knowledge or political understanding to select their own rulers.Locke’s philosophical arguments here really took those of opposing contemporaries like Sir Robert Filmer, whose viewpoints closely reflect the social order maintained by pre-Enlightenment establishment. Filmer’s Patriarcha: The Natural Power of Kings Defended Against the Unnatural Liberty of the People, a composition that presented arguments supporting the pre-existing social order of monarchic rule. The prevailing establishment justified monarchic rule through a number of arguments, both sociological and religious.Among these, they did so by arguing that a nation is like a family, with the population as the children as the king as the parent. Another argument was that to share the power of leadership in a democratic manner would be to invite and embrace the breakdown of social ethics, presumably because the natural disposition of a populace is to chafe under rules and laws and to desire more freedom, and that the endpoint of this would be excessive liberties, the deterioration of morality and ultimately the rise of an era where selfish and unjust rulers would take power.Rulers believed that the population simply could not, nor would they ever in a sustainable manner be capable of, responsibly selecting its own leaders. Locke challenged these ideas by introducing the concept of the Commonwealth, which would be defined by a social contract whereby the members of the Commonwealth participate in surrendering a certain level of liberty in order to ensure the stability of society and the preservation of the community.This surrender would only be the minimum required to preserve the peace, safety and security of the commonwealth, and part of this would involve the implementation of a democratic or republican system by which citizens would have at least a representative body in the government to ensure their needs were addressed. Notably, this was a key factor that activated in the French peasantry a desire to overthrow the First and Second estates, which they felt were taxing them without caring for their needs or interests.

Health Care Utilization Essay

Health care reform is not a recently devised concept. The government and health professionals have studied and tried to establish legislation that would assist the general population with a means of accessing adequate health care for decades. The task has proven itself as a daunting one although studied the world over. Individuals struggle with disease and illness that they cannot afford medical attention and treatment. Insurance companies price gouge or drop individuals from their insurance coverage. Reform has to be implemented to protect the public and provide across the board health care for every situation. Ronald Andersen wrote in the Journal of Health and Social Behavior there is a model of behavior that determines the seeking out of health services (Anderson, 1995). Anderson collaborated with Odin Anderson and wrote The Initial Behavioral Model in 1968 to assist in the analysis of national survey data collected by the Center for Health Administration Studies and the National Opinion Research Center at the University of Chicago (Andersen & Anderson, 1967). The model explains that there are elements that may determine if an individual will access health services. Anderson explained, â€Å"I want to stress that the model was initially designed to explain the use of formal personal health services rather than to focus on the important interactions that take place as people receive care, or on health outcomes†(Andersen, 1968, p. 1). The Initial Behavioral Model (1960s) PREDISPOSING ENABLING USE OF CHARACTERISTICS RESOURCES NEED HEALTH SERVICES Demographic Personal/Family Perceived Social Structure Community  (Evaluated) Health Beliefs (Revisiting The Behavioral Model and Access to Medical Care: Does it Matter?, 1995) The president had legislation passed in 2010 to implement the Affordable Care Act. Today, more than 45 million Americans lack access to affordable health insurance. Additionally, many individuals who do have health insurance have incomplete coverage that may include exclusions for pre-existing conditions, or they may be one-step away from losing coverage because of a change in employment. Individuals with health insurance face increasingly high premiums and medical costs that drive some to bankruptcy or force choices between maintaining health insurance coverage and paying for other household essentials (HHS, 2013). These new regulations will provide consumer protections and the developing of a competitive market. Insurance companies will be required to spend a specific percentage on health care and not excessive administrative costs. There have been major changes to the accessibility of insurance coverage for individuals which have been diagnosed with a pre-existing medical condition. Insurance companies will no longer be allowed to deny insurance coverage for individuals, such as children born with life-threatening illnesses. This will also address lifetime limits on medical care. There has been a health insurance exchange in an effort to pool millions of people and allow them to examine various insurance coverage policies to determine the best policy for them and their families. Health and Human Services has implemented a website for the comparison of the insurance coverage options (HHS, 2013). There have been conversations for decades about the implementation of universal health coverage. The World Health Organization defines it as a goal to ensure that people obtain the health services they need without suffering financial hardship when paying for them. It goes on explaining, access to health services enables people to be more productive and active contributors to their families and communities†¦.financial risk protection prevents people from being pushed into poverty when they have to pay for health services out of their own pockets (WHO, 2012). There is a definite similarity with the concepts of universal health care and the Affordable  Care Act now in place in this country. Attempts are being made to ensure that all citizens can access health care and increase their wellbeing in the process. The expansion of Medicaid will benefit multiple low-income citizens who, through no fault of their own, are working at a minimum wage job. They are barely earning too much money to be eligible for assistance and are not making enough of a salary to afford health insurance coverage. It turns into a viscous cycle. The individual has to decide whether it is better to quit work and get assistance for medical care or to continue struggling and still not make the grade. There have been no major issues personally with the implementation of the health care expansion. The insurances that I carry are both the Medicare and Medicaid. Medicaid has changed in that they are requiring that there is a primary care physician (PCP) established to oversee medical services provided. The initial visit would be to the PCP where any examination and testing would be performed for the determination of the necessity of a referral. The PCP’s office would organize all medical records and coordinate with the specialist’s staff to establish a consultation. I consider myself an extremely fortunate individual because I have been able to have multiple medical issues addressed and corrected because of the medical coverage. The Medicare coverage is not as restrictive as Medicaid. Medicare allows the individual to access any physician or facility that the patient desires for treatment as long as their insurance is accepted. There has not been any specific positive or negative effect with this coverage. Medicare has provided successfully for preventive measures in my health services such as yearly mammograms, colonoscopy testing every two years (if deemed necessary through findings during prior examination), and comprehensive yearly physical examinations. Unfortunately, there is minimal dental coverage and no eye examinations available. There has been major skepticism with the Affordable Care Act being voted on and implemented in the governmental realm. It is exhibiting a number of positive actions implemented with the creation of this act. It is time that this country gives thought to the individuals which are suffering because of no fault of their own other than being on the lower end of the income scale. Also citizens are pleased with the inclusion of the poor souls battling daily with an affliction that requires more attention and treatment than they could ever afford. It is in this new light that people are viewing the creation of the Affordable Care Act and see that this should prove to be beneficial to every citizen within the national borders. Reference Andersen, R. M. (1995). Revisiting The Behavioral Model and Access to Medical Care: Does it Matter? Journal of Health and Social Behavior, 36, 1-10, retrieved from: http://www.jstor.org/stable/2137284 Andersen, R.M., Anderson, O.W. (1967), A Decade of Health Services, retrieved from: http://www.jstor.org/stable/1815595 Health and Human Services (2013), Strengthen Health Care, retrieved from: http://www.hhs.gov/secretary/about/goal1.html World Health Organization (2012), What is Universal Health Coverage, retrieved from: http://www.who.int/features/qa/universal_health_coverage/en/index.html

Ta gueule Essay examples

Ta gueule Essay examples Ta gueule Essay examples f. In statements of comparison, mentally finish the comparative by adding the implied missing words: Next year I hope to earn as much as she. (The verb earns is implied here: . . . as much as she earns.) g. Pronouns must be in the same case as the words they replace or rename. When pronouns are used with appositives, ignore the appositive: A new contract was signed by us (not we) employees. (Temporarily ignore the appositive employees in selecting the pronoun.) We (not us) citizens have formed our own organization. (Temporarily ignore the appositive citizens in selecting the pronoun.) h. Pronouns ending in self should be used only when they refer to previously mentioned nouns or pronouns: The CEO himself answered the telephone. Robert and I (not myself) are in charge of the campaign. i. Use objective-case pronouns as objects of the prepositions between, but, like and except: Everyone but John and him (not he) qualified for the bonus. Employees like Miss Gillis and her (not she) are hard to replace. j. Use who or whoever for nominative-case constructions and whom or whom- ever for objective-case constructions. In making the correct choice, it’s sometimes helpful to substitute he for who or whoever and him for whom or whomever: For whom was this book ordered? (This book was ordered for him/ whom?) Who did you say would drop by? (Who/He ... would drop by?) Deliver the package to whoever opens the door. (In this sentence the clause whoever opens the door functions as the object of the preposition to. Within the clause itself, whoever is the subject of the verb opens. Again, substitu- tion of he might be helpful: He/Whoever opens the door.) 1.09 Guidelines for Making Pronouns Agree With Their Antecedents. Pronouns must agree with the words to which they refer (their antecedents) in gender and in number. a. Use masculine pronouns to refer to masculine antecedents, feminine pronouns to refer to feminine antecedents, and neuter pronouns to refer to antecedents without gender: The man opened his office door. (Masculine gender applies.) A woman sat at her desk. (Feminine gender applies.) This computer and its programs fit our needs. (Neuter gender applies.) b. Use singular pronouns to refer to singular antecedents: Common-gender pronouns (such as him or his) traditionally have been used when the gender of the antecedent is unknown. Sensitive writers today, how- ever, prefer to recast such constructions to avoid gender-biased pronouns. Study these examples for bias-free pronouns. See Chapter 2 for additional discussion of bias-free language. Grammar/Mechanics Handbook GM-9 ï ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼CHE-GUFFEY9E-11-0315-Grammar.indd 9 05/01/12 7:40 PM ï ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼ ï ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Ã¯ ¿ ¼Each student must submit a report on Monday. All students must submit their reports on Monday. Each student must submit his or her report on Monday. (This alternative is least acceptable since it is wordy and calls attention to itself.) c. Use singular pronouns to refer to singular indefinite subjects and plural pro- nouns for plural indefinite subjects. Words such as anyone, something, and anybody are considered indefinite because they refer to no specific person or object. Some indefinite pronouns are always singular; others are always plural. anybody anyone anything each either nobody both everyone no one few everything somebody many neither someone several always singular always Plural Somebody in the group of touring women left her (not their) purse in the museum. Either of the companies has the right to exercise its (not their) option to sell stock. d. Use singular pronouns to refer to collective nouns and organization names: The engineering staff is moving its (not their) facilities on Friday. (The singular pronoun its agrees with the collective noun staff because the mem- bers of staff function as a single unit.) Jones, Cohen,

Recipes for Crystal Growing Solutions

Recipes for Crystal Growing Solutions Find a crystal growing recipe. This table includes recipes for preparing solutions of common crystal grown in aqueous or water solutions. Crystal Growing Solution Tips In most cases, prepare a crystal growing solution by dissolving a powdered or granular solid in boiling water. You want a saturated solution, so dissolve as much of your chemical, called the solute, as possible in the water, which is your solvent. Usually, its fine to add too much solute to the water, so that you get some undissolved material at the bottom of your container. Filter this liquid through filter paper, a coffee filter or a paper towel and use the filtered solution to grow your crystals. Crystal Growing Recipes Crystal Growing Solution sugar crystals or rock candyclear or dyed with food coloring 3 cups sugar1 cup boiling water alum crystalsclear, cubic 2-1/2 tablespoons alum1/2 cup very hot tap water borax crystalsclear 3 tablespoons borax1 cup very hot tap water Epsom salt crystalscolorless 1/2 cup Epsom salt1/2 cup very hot waterfood coloring (optional) Rochelle salt crystalsclear, orthorhombic 650 grams Rochelle salt500 ml boiling water table salt crystals(sodium chloride) 6 tablespoons salt1 cup very hot tap water copper acetate monohydrateblue-green, monoclinic 20 g copper acetate monohydrate200 ml hot distilled water calcium copper acetate hexahydrate 22.5 g calcium oxide in 200 ml wateradd 48 ml glacial acetic acid20 g copper acetate monohydrate in 150 ml hot watermix the two solutions together monoammonium phosphatecolorless or easily dyed 6 tablespoons monoammonium phosphate1/2 cup hot tap waterfood coloring sodium chloratecolorless, cubic 113.4 g NaClO3100 ml hot water sodium nitratecolorless, trigonal 110 g NaNO3100 ml hot water potassium ferricyanidered, monoclinic 46.5 g potassium ferricyanide100 ml boiling water nickel sulfate hexahydrateblue-green, tetragonal 115 g nickel sulfate hexahydrate100 ml hot water

BHS 328 B.S. Health Sciences Team Building (Mod 4 SLP) Essay

BHS 328 B.S. Health Sciences Team Building (Mod 4 SLP) - Essay Example When there is no effective communication then conflicts arises between people and we have to manage conflicts. Conflict resolution is the process by which an organization handles and resolves conflicts within the organization and within the organization and the community (Bill Warters 2000). There are various methods to manage conflicts: In health care delivery, team working is very important because you have to coordinate each and every thing. If your work is not coordinated, then their will be less coherence amongst the employees and therefore everyone will be working with their own interest and with their own feasibility. For example in a hospital, when a doctor is doing an operation, he has to work with his colleagues as a team so that a successful operation is done. If for example if the doctor is not communicating with the nurses for example during the operation, then they might do some mistake in understanding the doctors orders and could lead to problems. For resolution of conflicts, first of all you should have the skill to solve problems for example active listening, formulate the desired outcomes, identify the underlying interests and develop and analyze options. Your attitude should be such that it demonstrates knowledge of ethics of collaborative conflict resolution. You should be having the appropriate knowledge to solve conflicts. For example you should be having knowledge of cross cultural considerations when dealing with conflicts because a manager might have to deal differently with a western worker as compared to the south eastern (Bill Warters 2000). Conflicts are handled differently with different types of people but responses to conflicts fall generally under four broad categories including attack, avoid, soften and resolve. It depends on the situation in which you are handling the conflict and you take decision according to that. For example if there is a conflict between the government and the masses and the masses are violently reacting, then the government will also have to take violent reaction in response to it to solve the conflict. Suppose that I am the administrator in charge of oversight for an emergency unit at a hospital. A nurse administers the wrong medication dose to a patient. A second nurse wants to write-up the first nurse immediately. But I don't think so that writing up to her at this stage is a good option to resolve the conflict. In this case it is an emergency situation and writing to her and then getting the reply will take a lot of time and during this time the patient's life can be in danger. The second nurse should directly go to the first nurse and talk to her face to face and tell her that the dose which she gave to the patient

Islam gave preference to men over women Research Paper

Islam gave preference to men over women - Research Paper Example In that case a burqa is a pagan invention, the pre-Islamic, preserved in some Muslim countries due to practical needs: protecting from the desert wind, carrying sand, protecting from the looks of men-strangers. By the way, the Arabs adhere increasingly the fourth verses of the Koran, which says to be married only on one woman, if the man has no possibility to satisfy her needs. Here we are talking about equality in property. In marriage, woman has the right to choose her husband. She can require the signing of a pre-nuptial agreement with her husband-to-be (Bakhtiar Web). The possibility of polygamy is provided in exceptional cases. For example, if a woman can`t have children, if there is a psychological or sexual incompatibility with her husband. The man is allowed to continue living with the first family and marries a second time. However the percentage of such marriages is extremely low in the Muslim countries, and on those territories, where women are more emancipated, like Syria, Jordan, Iraq, polygamy is practically absent, with rare exceptions. If we talk about the different rooms during praying in the mosques, it is arranged for the purpose that man must not see her in the position of committing Sujud (prostration during prayer). By the way, in many mosques women`s half of territory is carpeted or has heated floors. We have also another interesting fact. When a woman from a Muslim family goes to work, then all her salary arrives into her pocket, bypassing the so-called â€Å"family† budget. This point shows us that a Muslim woman can have even more rights in some cases than Christian one (â€Å"Women Laws† 40). Religion of Islam claims that a woman - as well as man - has a will, freedom of action and spirituality, and it considers her ability to achieve true perfection and happiness. Quran puts woman on a par with a man and refers to both at the same level (Roald 213). With this statement Islam destroys the ideology of the allegations

Mara Guevarra Personal Statement Example | Topics and Well Written Essays - 2000 words

Mara Guevarra - Personal Statement Example I never heard her judge anybody nor heard her complain about any problem. I never saw her cry. I guess that was her strength- the ability to hide her feelings. After two years, Mara got to be separated from her friends. She had to transfer to another school because of financial problems. All the times that we were together, she was not mentioning any problem. I could see in her eyes the sadness, but still, no tears dropped from her eyes and instead she said, "I will miss you guys, I will surely miss my pets." Still cracking joke despite of loneliness and still, trying to cover her emotion. The communication with her friends was constant but it was not like before wherein, she could saw them regularly and talk to them physically anytime she wanted to. She gained new friends on her new school but her friendship to her old friends remained the same. She chose to celebrate with us, her old friends, right after the graduation ceremony. I told her that I was so proud of her. I was not expecting her reply: "No problem can hinder me from achieving my goals. I need to fight and survive because in the end, I know I will always win. "That is such an optimistic and strong remark coming from a person that I once perceived as happy-go-lucky. Mara attended a party where he met Robert. He got Mara's cellular phone number from her friend and he started courting her. At first, Mara did not like him because he is under-graduate. But because of Robert perseverance and everyday sending of flowers, she fell in love with him and decided to accept the love that Robert was offering her. The relationship, at first, was fine. They are getting along and having fun just by doing simple things like watching movies together and spending time talking "anything under the sun." After three months, she discovered Robert's weakness. He loves hanging out with friends just to drink alcohol. Such weakness of him became their problem. They fought every now and then. One night, they had a big fight .She got out of control and she slapped him on his face. Robert being drunk and so angry hit her on her stomach. That was when she finally decided to break up with him. The first round of their story lasted for four years. HER DARKEST MOMENT Mara was so depressed with what happened to their relationship. She tried to forget Robert by having relationship with different guys. Robert on the other hand, was doing his best to win Mara back. Mara resigned from her work and in her new company, she met James. They had a relationship but he was not serious with herand she knew that. They were having premarital sex and unfortunately, Mara got pregnant. James denied being the father of her baby. She was terminated due to immoral act. She did not know where to get money for her needs. Robert was still there waiting for Mara's acceptance. When he found out her condition, he asked Mara to marry him and he will shoulder all the responsibility as his husband and as a father to her

Clinical Risk Management Health And Social Care Essay

Clinical Risk Management Health And Social Care Essay The aim of this essay to provide the reader with insight to the term clinical risk management and how this is implemented within NHS trusts focusing particularly on the role of Pharmacists in doing this. Objectives: Defining clinical risk management and discussing its importance Discussing ways in which trusts implement clinical risk management Defining what is a medication error and identifying the role of the pharmacist to reduce these Discussing systems or processes in place in my base hospital to reduce medication errors 1.0 Importance of clinical risk management Clinical governance was first mentioned in British Health policy in 1997 as a term used to describe the accountability processes for clinical quality of care. It evolved as a system to address and respond to a series of high profile media cases highlighting poor quality patient care as revealed in the Nottingham IT vincristine disaster, Bristol Heart surgery, Shimpan and Alder Hey organ retention. During I997 in England, the Department of Health published the white paper the New NHS; modern, dependable which introduced Clinical governance as a method of accounting for clinical quality in health care but really came to prominence in 1998 when Scally and Donaldson appraised Clinical governance and the drive for quality improvement in the NHS   in the British Medical Journal. The paper highlighted four components of quality as initially identified by the World Health Organisation: Professional performance (technical quality) Resource use (efficiency) Risk management (risk of injury or illness associated with the service provided) Patient satisfaction with the service provided. Majority of NHS care is of a very high standard and in comparison to the high volume of care provided on a daily basis in hospital and community, incidence of serious failures are uncommon.1 However when they do occur, they have devastating consequences for individual patients and families.1 Greater patient expectations, knowledge and media exposure of high profile cases have resulted in the NHS being scrutinized focusing on its policies of operation, facilities and operating culture. It is estimated that an average of 850,000 adverse events may occur in the NHS hospital sector each year resulting in a  £2billion direct cost in additional hospital days alone.1 Poor clinical performance results in patient harm and loss of patients confidence in the NHS services as well as an increase in litigation costs.4 In 2009/10, 6,652 claims of clinical negligence and 4,074 claims of non-clinical negligence against NHS bodies were received by the NHS Litigation Authority, up from 6,088 claims of clinical negligence and 3,743 claims of non-clinical negligence in 2008/09.4  £787 million was paid in connection with clinical negligence claims during 2009/10, up from  £769 million in 2008/09.4 Errors are discussed as either human or systematic in the Department of Health document An organisation with a memory. As an NHS organisation the focus is systematic, a more holistic approach when dealing with errors. This approach recognises the importance of resilience within organisations and that errors result as a number of interacting factors and failures within the system.1 NHS Quality Improvement Scotland (NHS QIS) clinical governance and risk management standards define risk management as the: Systematic identification and treatment of risk Continuous process of reducing risk to organisations and individuals alike Culture, processes and structures that are directed towards realising potential opportunities whilst managing adverse events In the past, clinical risk management was poorly managed in the NHS. There were no individuals designated to manage risk management, incident reporting in primary care was largely ignored, there was no standard approach to incident investigation, and existing systems did not facilitate learning across the NHS.1 In the 1990s there was a concerted drive to develop risk management and risk management within NHS organisations.1 Following on from this there has been an increased awareness of the cause of medication errors in NHS trusts and how these can be prevented.1 In 2000, the government made a commitment to reduce the rate of serious errors by 40%. The advances in technology and knowledge in recent decades has resulted in a more complex healthcare system.2 This complexity carries risks and evidence indicates that things do and will go wrong in the NHS sometimes resulting in patient harm.2 The NHS quality improvement strategy1 encompasses; Clear national quality standards; NICE, NSF Dependable local delivery; systems of clinical governance in NHS organisations Strong monitoring mechanisms; a new statutory commission for health improvement, an NHS performance assessment framework, and a national survey of NHS patient and user experience. It is hoped adaptation of these approaches in individual NHS organisations should have a positive impact on the development to detect, prevent and learn from system failures at a local level.1 The introduction of clinical governance provides NHS organisations with a powerful imperative to focus on tackling adverse health care events1. The time is right for a fundamental re-thinking of the way that the NHS approaches the challenges of learning from an adverse health care event.1 2.0 Implementing Risk Management within NHS trusts The Department of Health publication An organisation with a memory facilitated the patient safety movement in the NHS.2 It proposed solutions to risk management incidences through a culture of openness, reporting and safety consciousness within NHS organisations.2 Four Key areas highlighted from this report were:2 Unified mechanisms for reporting and analysis when things go wrong; A more open culture in which incidents or service failures can be reported and discussed; Systems and monitoring processes to ensure that where lessons are identified the necessary changes are put into practice; A much wider appreciation of the value of the systems approach in preventing, analyzing and learning from patient safety incidents. In response to an organisation with a memory, the Government report Building a safer NHS for patients focuses on how to implement these recommendations2. It outlined a blueprint for a national Incident reporting system and discussed the role of the National Patient Safety Agency (NPSA).2 The NPSA was set up by the Department of Health in 2001 with the aim of preventing harm from high risk medicines. The NPSA produced the National Incident reporting and Learning system (NRLS) to set priorities, develop and disseminate actionable learning following reports of patient safety incidents. Following this guidance all NHS trusts should have a risk management strategy in place. This includes systems for the identification of all risks which may compromise delivery of patient care. To aid with this trusts are obliged to deliver patient services in compliance with statutory regulations according to national and local requirements highlighting the level and quality of services required. The implementation of risk management policies within NHS trusts will be overseen by Clinical Governance managers and Risk managers4. Trust Risk management strategies will need to be regularly reviewed and audited; individual trusts will have Risk Managers within each department to oversee this4. The Trust Board will ensure that risk management, quality and safety receive priority and the necessary resources within budgets. Pharmacy departments will have a medicines management team comprising of a risk management pharmacist to implement risk management at a local level. The Risk management pharmacist will ensure staff are aware of risk management issues both locally and nationally and will update staff on actions to be taken to minimise risk thereby promoting compliance with external risk management standards. The risk management pharmacist will also need to ensure local risk management policies are kept up to date. In order to deliver the risk management agenda, individual trusts must meet the requirements of the NHS Litigation Authority Risk Management standards and the Care Quality Commission standards (CQC) from the Health and Social Act 2008. From April 2010, NHS providers will need to register with the CQC and provide proof of adherence to standards set by the CQC5. 2.1 National Patient safety agency and National Reporting Learning System In 2001, following the publication of the Department of Health document and Organisation with a Memory1 the National Patient safety agency (NPSA) was set up. The introduction of the NPSA has for the first time provided a systematic focus on medication safety6. The aim of the NPSA is to lead and contribute to improved, safe patient care by informing, supporting and influencing organisations and people working in the health sector with one core purpose to improve patient safety by reducing the risk of harm through error7. The NPSAs initiative was to identify patterns and trends in avoidable adverse events so that the NHS could implement changes to prevent these incidents from reoccurring. The NPSA will 2, 8: Collect and analyze information an adverse events in the NHS Assimilate other safety-related information from a variety of existing reporting systems Learn lessons and ensure that they are fed back into practice Where risks are identified, produce solutions to prevent harm, specify national goal and establish mechanisms to track progress The NPSA then went onto produce the National Incident Reporting and Learning system (NRLS) which aims to identify and reduce the risks to patients receiving NHS care and leads on national initiatives to improve patient safety. There are NHSLA risk management standards for each type of NHS health care organisation. The standards will address clinical and non-clinical health and safety risks.4 Individual trusts will be examined regularly and measured against standards to ensure a risk management strategy has been devised, it is in place throughout the trust, it is workable.4 This will minimise litigation costs resulting in more funds available to trusts to improve patient care; providing an incentive for better clinical and non-clinical risk management. The NRLS collects confidential data on medication errors from all NHS trusts in England and Wales and improves patient safety by enabling the NHS to learn from patient safety incidents8. This builds on incident reporting systems that were previously used on an adhoc basis in individual trusts. The NRLS reporting system has been designed to be compatible with local risk management systems that are used in majority of NHS organisations.2 NRLS reports are analyzed by clinicians and safety experts8 and key themes and trends contributing to patient safety incidents are identified.2 Steps are then taken to minimize these risks through the development and prioritisation of national solutions. Trusts reporting incidents regularly suggest a stronger organisational culture of safety.8 Encouraging staff to report clinical incidents affecting patient safety can help implement risk management strategies within NHS trusts. The more incident reports submitted the more data available to rapidly identify and act upon patient safety incidents. The NRLS suggests trusts should be submitting incident reports monthly.8 In pharmacy these will mostly involve incidents relating to medication errors. The development and promotion of the NHS fair blame culture encouraged error reporting reassuring staff the root causes of errors will be looked into. However, lack of awareness and fear of disciplinary action remain as some of the main barriers to incident reporting.8 To overcome this staff need to be adequately trained on when and how to report clinical incidents. At my base hospital, incident-reporting training is included in the trust induction and at a local pharmacy level as an in-house induction. Each trust incident is graded in accordance to standardised NPSA scoring systems; 1 being minor with no harm to patient ranging to catastrophic level 5 i.e. patient death. Following the completion of an online incident form, the risk lead for that particular area will receive a copy of the report. These reports will be analysed and appropriately graded and any serious incidents will then be reported to the Trust Board via the risk management committee. A report by the NPSA stated the most commonly reported medicine related incidents to be:8 Wrong dose, strength and frequency of medicines Wrong medicine Delayed and omitted doses Medicine related incidents will be reported to the Risk Management pharmacist who will provide feedback to the pharmacy team. All category 4 and 5 incidents have a full root-cause analysis performed and are submitted to the NRLS. These reports are then analysed by the NPSA, and if necessary rapid response alerts are produced.1, 8 Rapid response alerts act as a crucial means to focus the efforts of trust clinical risk managers into proven high risk areas.8 Delayed and omitted doses of medication led to the production of a recent rapid response alert. This alert was delivered to trusts by the NPSA via the NHSs Central Alerting system.8 On receipt of this alert, trusts were expected to respond and act upon requests contained within it within the specified deadline provided. Each alert contains instructions for regular audits in order to review the action taken. 3.0 Medication Errors Most medication are not without adverse effects and most side effects and adverse events are predictable, thus exposure to these adverse events can be minimised or avoided through careful prescribing and usage. Nevertheless some adverse effects are unpredictable and therefore unavoidable.6 However medication errors occurring as a result of mistakes or lapses when medications are prescribed dispensed or used are avoidable. These can be related to practice, procedures, products or systems. 6 Medication errors as defined by the NPSA are any preventable event(s) that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or consumer. Such events may be related to professional practice, health care products, procedures and systems, including prescribing; order communication; product labeling, packaging and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use. 10 Numerous studies have been conducted to investigate the incidence and outcomes of medication-related harm. A 2008 study conducted in an emergency department in Scotland found 2.7% of admissions were related to adverse drug reactions. 11 In 56.7% of cases the adverse drug reaction was the documented reason for admission but only 13.3% were considered to be unavoidable.11 Another study carried out by Charles Vincent reviewed more than 1000 records and found that 10.8% of patients experienced an adverse event and that half of these were preventable.12 It was found that a third of these adverse events led to either serious consequences or death.12 Medication errors also occur in other health care systems, and is estimated harmful errors occur in 1.8% of hospital admissions in the United States, leading to about 7,000 deaths each year.6 Similarly, an Australian study showed that 0.8% of inpatients suffered a harmful medication error.6 3.1 Why do medication errors occur? To be able to reduce the risk of medication errors, the cause of medication errors need to be understood.6 Previously medication errors were thought to be the sole responsibility of the individuals considered to be the cause of the error. However, now a more holistic approach is taken and it is acknowledged errors occur when both human and system factors interact in a chain of events often complex- resulting in an undesirable outcome.6 Not only the individual at fault but latent conditions within an organisation and triggering factors in clinical practice should also be considered as important causes of error as well.6 As Lucian Leape, the Physician and Professor at Harvan school of Public Health said: Human beings make mistakes because the systems, tasks and processes they work in are poorly designed. 6 Human factors result from the individual and may occur due to lack of training and education and lapses in concentration. System errors result from the running of the organisation and the lack of policies and procedures in place to reduce clinical risk. Recent experience shows in certain situations those safeguards have not been adequate and have failed to prevent serious error and harm to the patient.6 Active failures and latent conditions cause holes in the defence system to open up.6 The active failures occur as a result of unsafe practices of the people working with a system, examples include the prescriber failing to double check a prescription, or the pharmacist failing to identify an incorrect dose on a prescription.6 Latent conditions occur due to the structure of the organisation and its resources, management and processes in place.6 These either alone or in combination with an active failure, can lead to error. Examples include the lack of a computerised prescribing system with inbuilt systems to highlight an erroneous prescription or the lack of an effective communication system between primary and secondary care.6 3.2 The role of the pharmacist in managing medication errors Pharmacists as experts in medicines have an invaluable role in reducing medication errors. As a profession and specialists in the careful use of medicines we are best placed to minimise the risks associated with medication usage.12 The government safety of doses report recommended seven action points to improve medication safety. These are:13 Increase reporting and learning from medication incident. Implementation and audit of NPSA medication alerts guidance. Improve staff training and competence. Minimising dose errors. Ensure medicines not omitted. Ensure correct medicine correctly labeled gets to the patient. Document patient allergy status. The three areas of focus in medication error reduction for Pharmacists to detect and prevent are:12 Risk in the medicine itself. Risk in the manufacture, storage, and distribution of medicines. Risk in use of medicines. Pharmacy departments as a whole are similar to high quality manufacturing units and test each stage in the production, storage and distribution of medicines.12 Pharmacists are involved in almost all stages of the medication cycle from clinically checking of the prescription to the accuracy checking and final release of the medication dispensed. Within the pharmacy culture there is the expectation for errors to occur and consequently systems have been developed and put in place to minimise these.12 Examples of pharmacy services to reduce medication related errors in hospitals are:12 Checking of prescriptions and supplying of drugs. Ward drug charts. Use of our knowledge and pharmacokinetics to assess toxic and sub-therapeutic doses. Quality control and assurance measures. 3.2.1 Ward based Pharmacy services Pharmacy services at ward level were first proposed as a health policy in 1970 and have proven to detect and prevent prescribing errors.12 The role of the pharmacist is ever evolving and pharmacists are becoming recognised as an integral part of the multi-disciplinary team. The pharmacists role has moved on from the traditional supply role to a more clinical role allowing pharmacists to use their specialist knowledge surrounding medication use to reduce medication errors at ward level. Pharmacists are a lot more active at ward level and as such are now the first port of call for advice on medication by patients and other health care professionals. The pharmacists role also extends to medicines management and formulary development, medicines information and involvement in various dispensing stages. Throughout these different roles the pharmacists remain active in promoting safer practice and reduction of medication errors. 3.2.2 Medicines Reconciliation Medicines reconciliation is a process designed to ensure that all medication a patient is currently taking is correctly documented on admission and at each transfer of care. It encompasses: Collection Checking Communicating The National Institute for Health and Clinical Excellence (NICE) in collaboration with the NPSA issued guidance to ensure appropriate processes are in place to assure any medication patients are taking prior to admission is properly documented on admission to hospital.8 The NPSA reported the number of incidents of medication errors involving admission and discharge as 7070 with 2 fatalities and 30 that caused severe harm (figures from November 2003 and March 2007).8 An accurate medication history is necessary to aid safe prescribing. To improve medicines reconciliation at hospital admission NICE/NPSA has recommended that:8 pharmacists are involved in medicines reconciliation as soon as possible after admission the responsibilities of pharmacists and other staff in the medicines reconciliation process are clearly defined; these responsibilities may differ between clinical areas strategies are incorporated to obtain information about medications for people with communication difficulties. At my base hospital, medicines reconciliation involves doctors, nurses, pharmacists and pharmacy technicians. Systems and policies are in place to deliver medicines reconciliation in different areas of care and to ensure all staff involved in the medicines reconciliation process are accredited and adequately trained. 3.2.3 Education and Training At my base hospital information regarding clinical risk management is widely accessible to all staff through a variety of sources; alongside co-operate clinical mandatory training sessions and in-house local training sessions, a wide variety of information is available on the local trust intranet. These include a governance newsletter entitled Lessons Learned detailing adverse events which have occurred and steps taken to prevent reoccurrence of such events, risk management manuals available on-line and the NPSA patient safety literature. At a local pharmacy level, the monthly medicines management bulletin includes medication safety updates and is distributed to all pharmacy staff. As well as these measures education and training to other health care professionals and patients on medication is paramount. Pharmacists are the professionals best placed to do this. The Central Manchester Foundation Trust took part in a prescribing error audit known as the EQUIP study. This showed pharmacists as experts in medicines held invaluable knowledge and through organised education programmes can help reduce medication errors.14 The main cause of prescribing errors amongst newly qualified medical staff was simply due to lack of knowledge regarding medicines.14 Results demonstrated the need for pharmacists at ward based level and the prevention of potentially serious medication errors through their presence on the ward.14 Pharmacists on wards gave medical staff immediate access to advice regarding dosing, interactions and therapeutic monitoring of drugs.14 Pharmacists are also more likely to complete incident reports involving medicines and should encourage other staff to do the same. Ensuring staff are aware the only way to improve the systems in place is to learn what we are doing wrong. Pharmacists are also involved in developing and delivering teaching sessions for various groups of staff. Examples included at my base hospital are VTE prophylaxis, IV drug calculations and monitoring for unfractionated heparin. All Pharmacists are encouraged to deliver and attend teaching sessions early on in their career. As well as educating medical staff, pharmacists counselling of patients in outpatients and at discharge will also aid reduction in medication errors. As well as delivering information and teaching packages, pharmacists need to ensure information provided is sufficient, easily accessible and up to date. Medicine information pharmacists will review how best to provide information for safe prescribing and drug administration.6 The formulation and dissemination of medicine policies and clinical guidelines by pharmacists contributes to risk management. Pharmacists also advice clinicians on risk issues arising from quality assurance reports e.g. NPSA, national and local clinical audit.4 3.3 Reduction in medication errors Medication errors occur due to a number of failures. Pharmacists clinically reviewing a prescription can detect and prevent prescribing errors, but prescribing is only one aspect of the medication cycle.7 Failures in the processes of reviewing, dispensing, administering and monitoring of medicines also occur.7 To overcome these adequate systems and checks to prevent medication errors need to be in place. Examples of such systems include:13 Effective communication Education of all health care professionals Integrated electronic care records Systems and policies in place for ordering, dispensing, administering and transporting in medicines Providing 24 hours medicines information services and support to medical staff Increase specialists staff, more training for junior staff from an undergraduate level and improved discharge procedures Development of information technology services and standardised electronic incident reporting systems 3.3.1 Information Technology The developments of technological systems have helped in the running of medicine based services and include automated dispensing systems and electronic prescribing. Similar packagings of medications by the same manufacture lead to frequent dispensing errors. The implementation of an automated dispensing robot in my trust has significantly reduced error rates through the incorrect selection of medication. It also minimises administration errors through the production of standard warning labels such as Methotrexate weekly dosing warnings, and reminders to attach penicillin containing stickers to relevant antibiotics. However, the system is not fool proof and as such errors still occur mainly due to over reliance causing staff to become deskilled. Near miss audits to identify potential errors are conducted regularly within my trust to highlight areas of concern and systems put in place to prevent these errors reoccurring. Implementation of electronic prescribing systems (medisec) for discharge and electronic dose calculator on our neonatal unit has also proven to reduce medication errors. Medication errors due to illegible handwriting no longer occur minimising risk of dispensing errors. The availability of drug name, dose, formulation and dosing schedule have also reduced the risk of medication errors.7 3.3.2 Medication safety at discharge Poor communication between different health care professionals can lead to medication errors at discharge. Medicines reconciliation on admission has proven to be useful in linking patients care at primary care and secondary care. However, more focus needs to be placed on ensuring community pharmacists and GPs are aware of changes to medication at the point of discharge. Improved communication will prevent GPs from prescribing drugs that are no longer indicated, contra-indicated or even duplicate drugs.7 The implementation of the electronic discharge system medisec and the automated electronic copy of the discharge summary detailing information regarding medication changes has proven to be a useful tool in improving communication to GPs, and maintaining the link between primary care and secondary care. In addition to this, patients receiving a copy of their discharge summary and being counseled on their medication at the point of discharge will contribute to reducing medication errors . 4.0 Conclusion The need to manage risks is particularly important in the NHS because of: Finite resource the NHS has a limited amount of money and staff to provide a service Complexity the service we provide is extremely complex because of both the size and nature of the task Expectation we strive to meet the expectations of an increasingly aware public Clinical Risk Management is an integral part of clinical governance and thus everyones business. Managers in all areas are responsible for ensuring that risks in the area are identified, monitored and controlled in line with the Trusts Risk Management Strategy. This will contribute to improved delivery of services by providing a structured approach to decision-making. . All staff working in the NHS have a responsibility to be aware of and implement risk management within their individual job roles. The development of technology, systems and processes and education of all staff will be the key to implement clinical risk management at local and national levels in individual trusts. Word count: 4,338