Dawn Kills Animals

Proctor and Gamble tests on animals, they dont want to stop, but they want the public to think they are animal-friendly. Last night, I saw a very disturbing commercial for Dawn dishwashing liquid. The commercial claims that thousands of animals caught in oil spills have been saved by being washed in their dishwashing liquid. The video depicts a penguin, a duckling and an otter, all covered with oil, being bathed with their dishwashing liquid. In the before video, you can see how the duckling stumbles and struggles to walk. In tiny letters at the bottom of the screen, it says, simulated demonstration. This was not footage of an actual rescue. They intentionally covered at least three animals with tempera paint and corn syrup to simulate oil, just so they could wash them on camera. If Dawn really is used to wash oil off of animals, why couldnt they use footage of an actual rescue? The company then has the audacity to put up a website at DawnSavesWildlife.com, extolling their role in wildilfe rescue. Meanwhile, Proctor and Gamble, the parent corporation that owns Dawn, continues to test on animals and defends animal testing: We must conduct research involving animals to ensure materials are safe and effective. Not to be branded monsters, they have joined with The Humane Society of the United States in a partnership committed to the elimination of animal use for consumer product safety evaluation. Im guessing that this guarantees that HSUS will not target PG in any campaigns. PG, if you were really committed to the elimination of animal testing, you would stop it. Today. Now. Stop the lip service. Stop pretending. What you can do: Boycott Proctor Gamble products. Contact Proctor Gamble at 513-983-1100 or via email at comments.impg.com (Update: It appears that PG has now disabled this email address), to tell them you are boycotting all of their products until they stop testing on animals. Its not always easy to tell which brands are owned by PG and the list is always changing, so try to familiarize yourself with this list, from the official PG website. Dozens of brands are part of the PG corporation, including Dawn, Gillette, Cover Girl, Pampers, Tampax, Clairol, Febreeze, Tide, Mr. Clean, ​Crest and others. Iams and Eukanuba are also owned by PG and sponsor the Iditarod, so there are at least two reasons to boycott these two brands. Even better, boycott all companies that test on animals. Two apps available on iTunes make it easy to carry around a list of companies that dont test on animals. Cruelty-Free and BNB (short for Be Nice to Bunnies) are both compatible with the iPhone or the iPod touch. July 21, 2009 Update: I just spoke to Cory, a representative at PG, and told him that Im not swayed by the Dawn Saves Wildlife campaign, and if PG really cared about animals, they would stop animal testing. Cory was very nice and said that he would pass along my comment. He also said that PG is required by law to conduct animal testing. I told him that was not true. Federal law requires drugs to be tested on animals, but no law requires household products to be tested on animals. Cory said that the EPA requires new chemicals to be tested on animals. But thats not the same as requiring all household products to be tested on animals. A dishwashing liquid can be made using known, reliable ingredients, without creating new chemicals. There are lots of cruelty-free companies making the same types of cleaning products that PG makes, without animal testing. Our very civil conversation ended with my accepting Corys offer to send me a pamphlet about PGs animal testing, but turning down his of fer of coupons for PG products. Regardless of the certification from AHA, the animal rights position is that animals should not be used for entertainment or commercials, and should not be covered with paint or corn syrup. Correction, July 22, 2009: The original postincorrectly stated that during the filming of the commercial live animals were covered with oil. However, according to American Humane Association, the animals were covered with a mixture of tempera paint and corn syrup designed to simulate oil. The original post also suggested that animals may have been injured or killed during the filming of the commercial. American Humane Association was on set to supervise the filming of the commercial and certified that No animals were harmed during the taping.

Financial Analysis Of Firstgroup Plc, A Leading Land...

Executive summary This financial analysis report is carried out for the First Group Plc, a leading land transport corporation, so as to determine whether or not the client should invest in the company. For this purpose, some ratios of FirstGroup Plc were reviewed for a 5 year period and compared against its competitors: Stagecoach Group Plc and the Go-ahead Group Plc. In some relevant places, the ratios were also compared with the industry benchmark. However, certain data for 2014 are not available so that up to 2013 statistics were reviewed in that situation. Conclusions are drawn from the above-mentioned financial analysis and assisted the client to make important decision of investing in First Group Plc. Moreover, these financial†¦show more content†¦Moreover, it enables to ascertain value at the start-up stage when a new company may not yielding proceeds in the marketplace. Hence, it appears to be an important financial ratio for the investors in the business environment. However, while c omparing the investment of different companies it is noticed that stocks with higher ROE indicate greater prospects of proceeds derived from each dollar of equity. In other words, higher ROE is a positive sign for the financial condition of the company (Biddle et al., 2009). First Group Plc’s ROE ratio shows drastic decline in the previous year 2014 to 5.30 from 6.02. In 2012, it was recorded 26.76 showing best financial performance in the business environment. Moreover, it means that in this year there were maximum opportunities to maximize the profits from investment and lead to high productivity (For example London 2012 games revenues). It means that previously company was earning higher profits from the investment which declined rapidly indicating poor financial conditions of First group Plc in the business environment. Thus, First group Plc needs to improve its ROE ratio through adopting more effective business strategies and managing other operations efficiently to ensure high profitability. Return on Capital Employed (ROCE) ROCE ratio shows how much profit each dollar of

Migrants to the Coast Free Essays

Migrants to the Coasts Overview and Discussion There are three goals Eder presents in his fieldwork. They were to ; (1) â€Å"understand fishing and the fishing peoples†(Eder 5), how they lived and how their resources affected their day to day lives,(2) The Palawan’s culture had become diverse and he thought it was important he showed appreciation for what it had become. (3) Last, but not least, he wanted to be more involved with research issues such as â€Å"environmental crisis, economic difficulty, and social well-being†(Eder 5). We will write a custom essay sample on Migrants to the Coast or any similar topic only for you Order Now Eder explains these motives throughout the text. In the second chapter Eder explains how the marine wildlife , full of sea grasses and coral reef play a vital role in the food chains for the animals inhabiting it. The author further explains that the â€Å"coastal zone† occupies the coastal plains as well as the water itself. He explains that there is a local distinction between the four types vegetative cover. Eder was able to get both the fishing peoples and the government official’s perspective of the coastal zone, and how they can preserve the area. In San Vicente there are ten communities with a total population of just fewer than 22,000. Here, Eder selects four of the communities in which he studies the people living within them. He provides a clear understanding of his fieldwork in which he works directly with the people of San Vicente. In order to truly understand their culture, Eder listened to their stories in addition to exploring the history of the people and the place itself. To investigate Eder’s motive of engaging in economic research, he looked into many different prominent industries of the region. One of these industries is fishing. As a reader I could easily envision the beautiful coast and its waters used for fishing. The fishing peoples used the resources of the coast in a way to build their economic culture. I think the author could have focused on fewer topics and covered them more in depth, opposed to going over so many. Altogether, the lives of the people and the visuals of their surrounding were enchanting. How Global Forces Impact Local Lives in San Vicente The Philippines is abundant in natural resources, but the people are among the poorest in Southeast Asia. Problems arise when these resources are no longer abundant and taken advantage of. When the logging industry in the 1960s became a top exporter, the license agreements were very corrupt. Instead of using the money to fund programs for the people, the president would distribute the revenue to his own inner circle. The mining industry brought in more money for the wealthy, but at a cost. The businesses were privatized so the profit stayed within. Environmental care was not seen as an issue, and dump mine wastes ruined bays and once plentiful farmlands. The poor essentially became even poorer. Illegal commercial fishing is also a problem among the coastal areas. Fishing for trawler fish is legal at open sea, â€Å"but the national law reserves water within 15 kilometers of the coast†(49). Fish are a major resource and illegal fishing has led the fish population into a downward spiral. Commercial fishing and blast fisherman have severely limited the opportunities to the local people who depend on it. Much of the coastal people make their living by fishing on a small scale. Competition between the people and the market is created due to the vast amount of fishermen in the area. Fishing practices and economic stability differed among the fishing peoples. For example, one man could be struggling to support his family, even by fishing every day, while another is making a considerable living fishing and doesn’t nearly work as often. Because of the privatized companies and the recourses they had, difficulties arose for small time fisherman and led them into poverty. Global forces seemed to restrict the fishing peoples in many ways. They did not open opportunities to the coastal people. The coastal people then had make a living the best way they knew how. With extreme completion, fish prices became inflated, making the people even poorer. The Philippine government needs to intervene, not by shutting down illegal fishing, but by forming programs to help its people. How to cite Migrants to the Coast, Papers

September 11th immigration Essay Example For Students

September 11th immigration Essay Due to the effects of September 11th, panic, xenophobia, and anti-Muslim sentiment has swept the nation. Recent hate crimes have been taking its toll on Muslims mosques, Arabs themselves, and even Sikhs, members of the Indian Sikh religion which have been mistaken for Muslims solely based on the fact that they both grow beards and wear turbans. The Council on American Islamic Relations (CAIR) said it had received reports of harassment of Muslim women and obscenities shouted on the street, bombings and arson attempts at mosques and beatings, death threats and possibly even killings. Public officials throughout the nation, including President George W. Bush, have called on Americans not to blame all people of Arab and Muslim backgrounds for the terrorist activities committed by specific individuals. Television news programs have received calls concerning the formation of more stringent laws concerning the United States immigration policy. If anything is to blame, its not Arab-Americans, its the immigration policy. Right now, the Canadian border poses an even greater threat than the border of Mexico involving terrorism. As of 1998, Canadian intelligence reported as many as 50 terrorist groups operating in Canada, which were engaged in smuggling, providing support for terrorist acts and providing transit to and from the United States. What the INS (Immigration and Naturalization Services) should do is to improve access to databases and info from the FBI and other intelligence agencies. The problem is that the INS has no way of identifying who has entered and who has left the United States. They have somewhat of an idea who enters, but theyre not as observant of the people who leave.

Archives Unique Collections

Archives Unique Collections Introduction Archives contain collections of unique materials, whichare records of value. They may be records of an organization or of private individuals. The materials are not oldin the real sense, but are preserved in a variety of formats in which they appear. The difference between the archival materials and the library materials is that in the archives,the materials are arranged in groups on the basis of their information content.Advertising We will write a custom essay sample on Archives Unique Collections specifically for you for only $16.05 $11/page Learn More This refers to the institution which selects, preserves, and avails to the public those materials of permanent value(Forde,2007).Archives are vital as resources that promote knowledge and efficient operation of the institutions which they serve. They support and nourish teaching and learning at that institutions and within the wider intellectual community (Forde, 2007). The archives may collect and preserve the materials, which are not official records to the public or institutions; but which document the history, development and accomplishments of the institutions (Forde,2007).The records in an archive possess some basic features which distinguishes them from any other form of records. These features include; Inter-relatedness -They come as a result of accomplishments or processes of lifeand therefore, they appear like specific frames of motion picture films, and structures of materials closely knit that they cannot be utilized in absence of each other; if the meaning and integrity is to be preserved.They naturally occur in a contemporary way unlike the personal documents, which are deliberately made for history purposes. Contextual element -The value of the records is drawn from their contexts and therefore, the archive keepers should identify accurately, the context of use and origin of the respective records.They should also ensure maintenance of the records in ways t hat preserve their originality. Evidential -Records are a representation of past occurrences,human experiences and accomplishments and they therefore give objective testimonies ofoccurrences or documented agreements. The importance of archival materials cannot be overemphasized.The institutions select, preserve and make accessible, the records to the public for legal,financial,and administrative purposes (Forde, 2007).The public records administered by the government agencies, for example are able to maintain evidence of the government operations.Advertising Looking for essay on public administration? Let's see if we can help you! Get your first paper with 15% OFF Learn More This ensures accountability to the public, where the citizens are able to closely monitor and evaluate the governments conduct and performance. Privateinstitutions likechurches, businesses and museums also establish archives for keeping their records. Preserving records in archives Preser vation refers to the process of protecting documents,with an aim of minimizing loss of information and slowing down processes that would lead to physical deterioration of the materials;for the sake of the future generations (Proni, 2007). It is done through a variety of measures which must involve everyone handling the materials. The documents have to be placed, displayed and handled in ways that reduce the risk of damage, taking into account their shape, size and physical condition (Proni, 2007). The records preserved in the archives contain sensitive and vital information;thereforethey require proper storage and access strategies. These measures are put in placeto minimize the damages, which may lead to loss of valuable information. Without adequate protection, these materials deteriorate and are rendered useless. The preservation activities provide a range of solutions,under which the materials are made accessible to the public.The extent of preservation dependson the size,maturi ty,needs and resources available to facilitate the program (Banks, 2000).Various strategies may be employed to ensure protection of the records. They include; Holding maintenance program This utilizes a range of preservation procedures, with emphasis on improving the housing and storage surroundings of the records(Banks,2000).The procedures are applied to the entire collection with priorities based on evaluation of the needs of the users(P.56).This offers a great physical protection and enhances chemical stability of the resources(Banks,2000).The procedures include: Proper housing All the permanent and temporary storage areas must be structurally sound and strong enough, to bear severe weather conditions or malicious attacks. Thematerials maintained in the archives should be those that are able to withstand both the internal and the external surrounding conditions of the building.Advertising We will write a custom essay sample on Archives Unique Collections specifically for you for only $16.05 $11/page Learn More The situation of the building has to be secure, i.e.distant from military installations or any chemicalindustries (p.2).There should be no vegetation in close proximity.The area around the building should be a clear perimeter. Shelving The storage areas should utilize shelving, which is a basic methodfor preserving and exhibiting materials in the archive.Wooden shelving is often discouraged since it damages the organic materials and is a brooding site for insects. Metal shelving is therefore preferredsince it provides a standard design and rigidity. A non-toxic paint can be applied, using the powder coating method to prevent rusting and improve the aesthetic value. The shelves must be well paced between the walls to aid ventilation and the bottom shelves should not be too close to the ground to protect them against flooding (p.4). Boxing It’s a recommendation that all the materials be boxed,in high quality material box es, which are not prone to chemical attacks. Boxingprovides a dual advantage for both packaging and protection of the materials from hostile environmental conditions. The materials are free from insects, fire or water damage. Boxing also provides a means of stabilizing the materials, which are fragile or whose reference has been retained as originals, while their copies are in active use. Spacing There should be enough space provided for storage of the archive equipment. They should avoid introducing the physically unhealthy records to the already existing records. Those records are likely to infect the others and as a result damage them. Adequate spacing ensures proper isolation of such materials, which are affected by moisture, fungi or infected by insects. Proper spacing also promotes harmonious working environments under which both the staff and the archive users will not feel under threat or intimidated by overcrowding or interference of their own personal space.Advertising Looking for essay on public administration? Let's see if we can help you! Get your first paper with 15% OFF Learn More The environment Factors like temperature,humidity,light and pollution are conditions that should be put into consideration in the housing program for archival records. Most of the materials in the archives cannot tolerate severe conditions. This accelerates their damage and deterioration. Paper made materials can withstand drier conditions compared to those made of vellum or animal skins, therefore the temperature conditions should be varied appropriately depending on, the type of materials stored therein. The light exposure to the items on exhibit should be measured and controlled. This would also limit the exhibition duration, where the light sensitive materials would stay on exhibition for shorter lengths of time. The materials should also be safeguarded against harmful substances like gases and fumes, which would interfere with quality and originality of the materials like fabrics. Security measures The archives hold vital materials, which include paper records, maps,films,photo graphs and electronic records; which cannot be replaced once lost.There is need to have tight security programs,to protect both the staff and the records from threats of theft, unauthorized disclosure or sabotage (Ritzenthaler, 2003). Appropriate measures should be taken to ensure the security of the archival records listings are done in detail, putting tags and marks where appropriate; for proper identificationof the materialsin case they are lost, stolen or damaged. There should be systems for tracking, issuing and returning items borrowed, in order to minimize unknown disappearances. The storage areas, both permanent and temporary, should be safe and secure to minimize theft risks or other malicious damages. There should be strict and controlled access to the stores, with heavy doors, sufficient locks and regular supervision; where visitors have to pass through a security checkpoint as they get in to the archive. The staff maintaining the area, including the cleaners should be we ll supervised within the established procedures to ensure that security is not compromised in their presence. The rooms should also contain cameras or desks where the staffs are able to monitor the users. Emphasis should also be laid on security measures, which would involve an emergency preparedness component (p.56), like an alarm. Thissystem includes a computerized security control unit,which would monitor intrusion of alarms and the cameras. More to be put into consideration is the structure,construction, location and the surroundings of the facility together with enough fire detection measures and suppression measures (Banks, 2000).The security measures should be applied on daily routines for effectiveness. It’s also vital to constantly train the staff and the users on the importance and rationale of ensuring security in the facility. This would involve teaching factors like emergency preparedness, where each archival participant is made aware of fire associated risks and how to deal with them. Handling of the materials Institutional policies and procedures can also pose a negative contribution to the sound preservation procedures;this occurs especially in the handling of the materials, during transfer and in the storage procedures (Banks, 2000).Proper handling collection procedures should be provided, including: Providing the users with well stipulated guidelines, on using and handling the archival materials; which would prohibit such vices like eating,drinking,smoking or bringing overcoats and bags in the archive (Ellis, 1993). Reduce handling of original archival documents; instead utilize their copies whenever appropriate. Setting up a workspace dedicated for reading and research, which is clean and spacious. Encouraging the staff and users to handle the materials carefully, with clean hands or wear cotton gloves when handling the sensitive materials like photographs, films and electronic records. Supporting the documents that are not strong an d durable e.g. newspaper cuttings, by binding them with cartons or other more durable materials. Isolating the contaminated materials from the public reach, in order to avoid mixing and compromising their health. Open communication and good user relations are a guarantee to proper implementation of the preservation procedures.The staff should be updated on the changes made and be restrained when need arises (p.57).This brings basic understanding and incorporatesthem to be part of the facility. Conservation treatments Conservation treatments are costly but highly effective for safeguarding against damages. The manager should make treatment selections based on an already established criteria that should be uniformly applied (Banks, 2000). If it is an in-house treatment program, then a conservation lab should be established on site or alternatively, a conservator contracted (p.58).The latter is more preferred, since there are fears of limitation ofspace, staff and equipment are charge d with the responsibility making the whole process cost-effective. The priority of applying conservation treatments is to protect the documents for current and long-term provision for access in consultations and research. The strategies applied in conservation treatments include; Mould and pest control The archives traditionally used pesticides and other chemicals to control pestinfestations. There are many hazards however associated with continued use of the pesticides. The chemicals do not control the damage occurring to the materials but deal with the peststhemselves, which may damage the paper based materials. This also poses health hazards to the users; therefore the best mode of pest control has been approved as monitoring of the pests or using an integrated pest management system. Integrated pest management The strategies of the integrated pest management present long term control measures. These measures which provide maintenance and housekeeping environment that ensures tha t pests do not find any hospitable place in the archives (Ellis, 1993).Such activities include inspection,climate control,food restrictions,insect identification,regular cleaning and proper storage conditions (p.28). Managing mould and control The non-chemical means of dealing with mould in the archive like temperature control, relative humidity and air circulation have been proved to be the best effective methods (Ellis, 1993). A relativelyhighhumidity is likely to encourage growth of mould, but controlled air circulation can reduce the risk (p.29). In case the materials are already infected, they should be restored in rooms with a controlled ventilation area, to minimize distortion. Reformatting the materials Preservation of the information is of paramount concern,therefore copying the materials from a paper based medium to a more permanent form, can minimize bulk as it facilitates more access(Banks,2000). Reformatting can serve dual purposes; preservation of the originals, which can be put aside from active utilization, and preservation of the information in a less intrinsic value record which can be destroyed after certification of the film(p.58).Reformatting of the materials involves digitizing the organizations’ records, which have accrued a lot of benefits. These include; Disaster recovery after the occurrence of such disasters, such as fire, floods or earthquakes, it is important to ensure availability. In such a case, scanning the archival important records and storing them in a proper secured and backed up manner might be extremely useful (Podraza, 2012). The sufficient records, which are extremely important to the archive’s existence are protected, avoiding cost and time wastage, as well as considerable efforts required for reconstruction processes of critical information in case the disaster occures (Podraza, 2012). Cost saving and effective -there is no need to acquire and maintain more filling equipment in the archive for storage o f the paper records. Thisminimizes bulk of the paper documents. Real estate savings The Digital initiatives can actually reduce the amount of office space needed, without having to lose access to records (Podraza,2012). With the existing competition for the existing office space, the digitized active records which can be easily accessed online are preferable. it is much more comfortable than filling records in cabinets. This is a way of using the archival space in a more cost-effective manner (Podraza, 2012). Most of archival organizations have shifted to the digital initiatives which minimizes the wide spread accumulation of the records, which makes the facility smarter and economical. Easy retrieval and access -Archival records can be incorporated into an online content management system, providing the staff with a faster and secure and continuous online centralized access, from any location; which allows simultaneous access to information by multiple users from multiple location s(Podraza,2012). Minimal labor costs with improved customer service -Digitizing the archival records will not only minimize the labor costs involved in maintaining large documented records, it will also increases staff productivity (Podraza, 2011). The information is more secure – making the paper records digital and transferring them to a centralized location, with strict access controls and file level permissions, eliminates information insecurity and privacy issues occurring in archival facilities (Podraza, 2012). Archival preservation -When the archive’s historical records are scanned and stored in a web based content management system, they are preserved and easily accessible to members of a working staff and customers (Podraza, 2012). Information sharing -The digitalized mode reduces the paper work, which is labor demanding, therefore facilities’ collaboration and information sharing through work-flow that offers more efficient processing and easy gauging of documents to various units in the archive should be encouraged (Podraza,2012). Preservation measures in the Ireland national archives These are the findings of the measures taken in the preservation of materials in the Ireland national archive: The holding maintenance The archive appreciates the limitations posed on the preservation of resources and thereforethe management is keen on the selection of materials. It avoids duplication and in case of such occurrences, preference is given according to the physical formats, with easy and safe storage.The archive building is well spaced, enough for proper storage of the materials avoiding contamination with already infected materials. The environmental conditions of the archive like temperature and humidity are taken into account; the building is well ventilated with adequate air conditioners and curtains with large curtained windows for light regulation (Ritzenthaler, 2003). Security measures The archive has strong doors with heavy lo cks, which minimizes unwanted intrusion and theft.Materials in the archives are clearly labeled and tagged bearing the institutions’ ownership stamp. The archive building also contains alarms at the corners of each floor, with emergency doors and other escape routes in case of unexpected dangers like fire.The archive has employed several guards for security measures. It alsohas security checkpoints at the entrance and at the exit of the building. Handling of the materials The management has set rules and regulations posted at the entrances, which prohibit the users to eat, smoke or carry clothing and bags into the archive. Most of the materials in use are duplicates of the originals, therefore preserving the original documents.Inside the building, there is a large spacious room specifically dedicated for research and private reading (Mendez, 2007) Conservation treatments The archive has a chemical cabinet in one of the inner rooms which is used for storing chemicals that cont rolling pests. Moreover, the rooms in the building and the storage sections are smartly maintained to minimize pest invasion. Reformatting of the materials All the materials in the paper base medium have been digitalized. This has solved the issue of insecurity and inadequacy of space. Conclusion Preservation is a core function in every collection of records orarchival materials, which helps ensure continuity and availability of information for the present and future generations. References Banks, AK 2000, Principles of archive preservation. Books society publications, Washington. Ellis, J1993, Keeping archives. Thorpe Ltd, Port Melbourne. Forde, H 2007, Preserving archives. Facet-publishing, New York. Mendez, A 2007, The old, the valuable and the future. Oxford University Press, London. Podraza, P 2012, Becoming digital. Winepress publishing, New York. Proni, AJ 2007, Preservation of records. Willey and sons, New York:. Ritzenthaler, G 2003, National archives and records administr ation. Brooks publications, Washington.

The Last Tycoon Essays - Films, The Last Tycoon, Free Essays

The Last Tycoon Essays - Films, The Last Tycoon, Free Essays The Last Tycoon Infatuating Idealism in F. Scott Fitzgerald's The Last Tycoon Idealism Is undoubtably present in F. Scott Fitzgerald's The Last Tycoon. Infatuation may be a better word, for that was exactly what possessed the main character, Monroe Stahr. He was totally engorged with one Kathleen Moore. He idealized Miss Moore as the second coming of his deceased wife Minna Davis. Stahr was a true man of men that had little to do with women since the tragic passing of his wife. He would rather put his feet up with a cigar and shoot the breeze with the boys. Yet once he laid eyes on Kathleen for the first time, all of that changed. It was love at first sight. Kathleen and Stahr meet after an earthquake rocked Los Angles. Stahr was surveying the damage done to the studio, when a prop came floating by with two "dames" clinging to it for their lives. A stage hand rescued and presented them to Stahr for judgement. That was the moment that would change everything. The following excerpt is a narration of what was going through Stahr's mind when he was struck blind by Cupid's golden arrow. "Smiling faintly at him from not four feet away was the face of his dead wife, identical even to the expression. Across the four feet of moonlight, the eyes he knew looked back at him, a curl blew a little on a familiar forehead; the smile lingered, changed a little according to pattern; the lips partedthe same." (Chp II, p.26) She was Minna, but she wasn't. All her features were Minna's, except her voice. "and then he heard another voice speak that was not Minna's voice." (Chp II, p.26) She was obviously British and not glamorous American, as Minna's had been. Nevertheless, she was a replica of his life long love. Stahr determined right then that she would be the next. Before he could get himself together, Kathleen was whisked away by the police for trespassing. Stahr spent the next few days trying to track her down. By this time he had fully succumbed to her rapture. On their third meeting, they happened to stumble upon each other at a posh Hollywood party. Her beauty brought back all the sensations that had trapped him initially. The scene was as follows: "...the white table lengthened and became an altar where the priestess sat alone. Vitality welled up in him, and he could have stood a long time across the table from her, looking and smiling...(while dancing) she was momentarily unreal. Usually a girl's skull made her real, but not this timeStahr continued to be dazzled as they danced out along the floor...." (Chp. V, p.73) Stahr wanted desperately to have her as is own, but she was not to be had. Unbeknownst to him she was engaged to be married. She tried to tell him, but could not. She too was in love. The romance that followed was of a whirl wind pace that ended with a "Dear John" letter. She could not bring herself to tell him in person. Kathleen had fallen in love with Stahr although she resisted it by the fact she was already involved with another man. His ideal was not to be realized. His ideal goddess was the beginning of Stahr's downfall. The simple fact that Stahr was unable to win Kathleen away from her fianc? causes him to become extremely miserable. In F. Scott Fitzgerald's own words: "Stahr is miserable and embittered toward the end." (Author's Notes, p.149) He continued to love her to the end, as he lost his life, he lost it lovelessly. All this fuss over a woman might seem a bit trivial, but in true love, nothing is trivial. Monroe Stahr idealized Kathleen Moore as the true cure to all his ills and loveless nights. To him, she was Minna Davis. In being, but not spirit, she was a replica. This theme of idealism is similar to what Richard Slotkin reflects as "the American dream of perpetual self-improvement and transcendence." (22) Stahr idealized Kathleen as his way of perpetual self-improvement. He believed that Kathleen was the ticket he was waiting for, the ticket to happiness and closure. His life

Coke Star Musical Group Coursework Example | Topics and Well Written Essays - 1250 words

Coke Star Musical Group - Coursework Example Stressing upon the importance of user specific design Lazar (2001) states â€Å"A website is a type of information system and as such needs to be designed to meet the needs of the user. It must offer contents that users want and be designed so that users can easily access it in order for the website to be a success.† Keeping in view this heavy reliance of success on web design and user acceptability three users from major users groups were selected for an interview. These include the online viewer, online customer and future concert or musical show booking. The online viewer wants to have an explicit and systematic listing of all the performances by the group along with thumbnails and details like date of performance, venue, and length etc. The website is required to offer plug-ins required to play the selected performance, all related audio video controls, the fastest streaming and switching between performances. Online customer would like to have preview of what they have ordered and multiple easy payment options. The online customer may be required to select a delivery method or service. The third user has emphasized the need of a calendar of Coke Star future engagements in order to plan and reserve a date with the group. The user would like to receive an email confirmation of the booking along with other details. The exact requirement for the booking should be collect in a carefully designed web form. 3. Wire Frames 4. Target Users The Coke Star Musical Group website will be used by a number of user groups, each of these groups have their specific requirements, interests and goals. Ensuring the fulfillment of users’ expectations is a key to the successful web design and to clearly outline the user requirements following three personas are developed based on direct interview with the users; a) Online Viewer i. May be in any age bracket but mostly between 12-32 ii. The goal of the user is to find and listen his favorite music online iii. The interest of the user in to listen pop music and hit songs iv. The user will visit the site just to listen online free music v. The user may also visit to review the upcoming music albums and to learn about Coke Star upcoming performances. b) Online Customer i. May be in any age bracket but mostly between 12-32 ii. The goal of the user is to purchase CDs and DVDs of his choice iii. The interest of the user in to listen pop music and hit songs iv. The user will visit the site to buy music albums online v. The user may also visit to review the upcoming music albums and to learn about Coke Star upcoming performances. c) Event Manager i. May be in any age bracket but mostly between 22-45 ii. The goal of the user is to contact and confirm availability of Coke Star for a concert or musical show. iii. The user has business motivations and the nature of interaction is serious and straight forward. iv. The user will visit the site to confirm the availability of Coke Star v. To show his interest in a performance and to make a business contract. 5. Evaluation of Wire Frames I have selected the walk through technique to conduct a user centred evaluation of the Coke Star Website. Walkthrough evaluation is a simple and effective technique which can b e carried out with the help of a single user. The user is presented with an interface and is asked to perform a set of instructions on the interface. The same evaluation can be conducted on the wireframe sketches where user gives his feedback on what he can gather from the sketch. This user understanding can be collected

Gp3 performance management and employee services Research Paper

Gp3 performance management and employee services - Research Paper Example It will allow them cooperating in a professional manner towards the accomplishment of their goals and objectives. Apple Inc is a real life example that has the following pattern and model in practice. Google inc. is another example of the same kind where free hand and communication means are provided to the employees and they make use of their efforts in a completely cordial manner. The two of them have uniform system of operations where the appraisal systems are intact and the employees get regular and timely feed back with regard to their contributions and efforts in the overall projects at hand. The performance management program which is based on effective communication and equal opportunity imparting to the different domains will allow for the clear goals determination and easy accomplishment of the tasks. Talent management and communication build up models were the two performance management and overall productivity enhancement models and programs suggested and initiated for the purpose of improvement in the organization. Out of the two short listed programs (talent management and communication enabling means), the latter was chosen. This was chosen so based on the realization of the need for an effective communication channel presence in the modern times where enterprises are connected by the virtual means of communication (Lesikar, 2005, p 3). The new program will be communicated to the employees through formal and informal methods. In the informal methods the daily routine activities will encompass the guidance and details sharing. The formal methods of transferring the idea and knowledge would include the seminars, training sessions, visits and other practical demonstrations which will enable them working in a more amicable environment based on effective production and desired outputs at the end of the undertaken objective and plan. The possible consequences of inadequate performance reviews will include failure

Analysis of Mills Utilitarian Theory Essay Example | Topics and Well Written Essays - 500 words

Analysis of Mills Utilitarian Theory - Essay Example If all persons yearn for happiness, then morality will be first rated in the society.Of essence, Mill brings out the view that utilitarianism is based on happiness, and happiness comes from justice and existence of rights in the society. In summary, Mill argues that though controversies on wrong or right overtake the theory, especially in terms of morality, the theory hold a lot of significance. A discovery of the basics of wrong and right would create a situation whereby they would be applied with a lot of ease. The ends of the actions by persons also determine what is good and what is wrong. Drawing a line between wrong and right creates a society which has some sense, since all actions are directed towards the good of the society. Of essence, Mill’s utilitarian theory is out to bring systems into place that will allow the society function not only in a just manner, but also in the fairness that it deserves. If these rules and foundations are adhered to, it is possible that the society function in an orderly manner. The views brought forward by Mill can be justified, as he bases foundations of morals throughout the work. This interprets that all actions, according to Arthur, must be analyzed in terms of their good and evil. This means the moral nature of actions determine reasoning of right or wrong. Culture and stability of the society has also been analyzed. Mill is of the opinion that morality is special in the society since it shapes the actions portrayed by individuals. This has been termed as the concept of utility

Independent Prescribing | Supplementary Prescribing

Independent Prescribing | Supplementary Prescribing Introduction This portfolio has been compiled in order to complete the non-medical prescribing qualification through the University of Central Lancashire. Throughout the portfolio, the author has analysed situations encountered whilst working along a designated medical practitioner (DMP). The author is a mental health nurse and is employed in a community mental health team, offering support to individuals who suffer with severe and enduring mental health problems. In the practice area, new ways of working (Department of Health (DH), 2007) is beginning to take effect which has enabled expansion of current roles, including non medical prescribing. The portfolio is organised into sections, with an index page for navigation. Two consultations are presented; the first involving an individual with a neurotic illness, where independent prescribing was deemed appropriate in the absence of co-morbid illness or significant risk. The second consultation pertains to an individual with severe and enduring mental health problems who has suffered adverse reactions to medication previously and for whom supplementary prescribing appeared to be the safest prescribing option. The consultations are followed by an evidence section and appendices. Completion of the portfolio has facilitated extensive development of knowledge in terms of pharmacology, including physiological variance (evidence 15). Knowledge of psychotropic medicines has also greatly improved and the importance of physical health monitoring for service users has since become a priority. The author believes that becoming a non-medical prescriber will provide an ideal opportunity to have a direct effect on public health targets such as reducing avoidable death from suicide and offering quicker, more appropriate treatment options to people with mental illness. The author also feels confident that non-medical prescribing in mental health will lead to increased concordance and better service user satisfaction. The required practice hours of the course have been achieved (evidence 1) through working with members of the prescribing team (evidence 2a, 2b, 2c, 2d, 2e). Throughout the portfolio, the author has ensured protection of confidential information, as directed by the Nursing and Midwifery Council (NMC) (2008) by referring to the service users by pseudonyms i.e. Alexander and by anonymising information related to the Trust for which the author works. Furthermore, consent forms have been obtained for named professionals and user perspectives Independent Prescribing Independent prescribing is defined as prescribing by a practitioner (e.g. doctor, dentist, nurse, pharmacist) responsible and accountable for the assessment of patients with undiagnosed and diagnosed conditions and for decisions about the clinical management required, including prescribing (DH, 2006 p2). The author will critically analyse an independent prescribing situation, addressing learning outcomes 1,2,3,4 and 5 in doing so. Reference to the stages of the prescribing pyramid will be made as this is a useful model to ensure appropriate prescribing (National Prescribing Centre (NPC), 1999). The patient will be referred to as Anne Knowles. Anne was a 28-year-old woman with a history of depression, referred by her General Practitioner who suspected a relapse. In order to confirm this, a full assessment was undertaken. Fortunately in mental health, adequate time is allocated for practitioners to gather information. Prescribers are encouraged to approach consultations in a structured way (NPC, 2003) therefore the Calgary-Cambridge model (Silverman, Kurtz and Draper 1998) was used alongside a structured tool in support of this approach. Health authorities have formulated unique Care Programme Approach (CPA) assessment tools based on the original guidance in Caring for People (DH, 1990) to accomplish a holistic assessment and this is what is advocated by the NPC (1999), as the first element of good prescribing practice. The author used the tool designed by the local health authority in the assessment of Anne (evidence 3). While the CPA assessment is comprehensive, the author elected to enhance it with additional tools to better inform prescribing practice. Incorporating Mortons (1992) symptom analysis tool a thorough assessment of Annes presenting symptom was facilitated. Furthermore, an individualised report obtained using a solution-focused approach (de Shazer, 1988), gave the author an appreciation of what was currently happening and how improvement would be detected (evidence 3, page 13). The author also utilised Becks Depression Inventory-II (BDI-II) (Beck, Steer and Brown, 1996) (evidence 4). Although routinely used in the practice environment due to its ease and speed of completion, it has been criticised due to the gender and cultural bias (female, Caucasian), which it represents (Hagen, 2007). This is something with which the author would agree and plans to use the Montgomery-Asberg Depression rating scale (Montgomery and Asperg, 1979) in the future as this has a broader reflection than the BDI-II. The remainder of the assessment, including a full medical, social and medication history, allergy status and exploration of Annes beliefs about her illness and future treatment were also included in the assessment. It is commonplace in clinical practice for staff to present assessments to the medical team where discussion of differential diagnosis occurs. Such discussion facilitates accurate diagnosis and debate of treatment options; however it is reliant on a precise initial assessment and effective presentation of the case. Following this a diagnosis of moderate depression was agreed under section F32.1 of the International Classification of Disease (World Health Organization (WHO), 1992). Considering the prescribing pyramid, the second step requires deliberation of the appropriate strategy to use. As the diagnosis of moderate depression was established, the author knew that a prescription was needed. Guidance from the National Institute of Clinical Excellence (NICE) (2004) suggests that individuals diagnosed with moderate to severe depression should routinely be offered a pharmacological intervention before psychological interventions. When considering choice of products, the third step of the prescribing pyramid, prescribers have available various antidepressants from diverse groups, namely Monoamine-oxidase Inhibitors (MAOIs), Tricyclic Antidepressants (TCAs), and Selective Serotonin Reuptake Inhibitors (SSRIs). There are also listings in the British National Formulary (Royal Pharmaceutical Society (RPS) British Medical Association (BMA), 2007) for other antidepressant drugs that cannot be classified into specific groups due to their unique pharmacology i.e. Mirtazapine and Reboxetine. In choosing between the agents, the author consulted national guidelines (NICE, 2004) which examine the effectiveness, appropriateness, safety and cost-effectiveness of drugs. NICE (2004) favours use of SSRIs to other antidepressant groups. This is because they are as effective as TCAs but concordance is higher because of the better side effect profile (NICE, 2004). Barbui and Hotopf (2001) reported that Amitriptyline, a TCA was more effective than SSRIs however conceded that use of SSRIs was higher because of their enhanced tolerability. SSRIs are less likely to cause sedation and cause much fewer anti-muscarinic effects than TCAs (RPS BMA, 2007). The other major distinction is that should they be used in overdose, SSRIs are considered less toxic than TCAs. Use of an MAOI was not considered as first-line treatment for Anne. Although once viewed as less effective than other antidepressants, when used in adequate doses, MAOIs are as efficacious (Riederer, Lachenmayer and Laux, 2004). However MAOIs are generally better in treating atypical depression (Riederer et al, 2004) and are associated with dangerous dietary and drug interactions (Nash and Nutt, 2007). SSRIs are the agents of choice in the practice area (evidence 5), in line with national guidelines. The common pharmacology of SSRIs is the prevention of reuptake of the neurotransmitter serotonin into the pre-synaptic cell, leaving increased amounts of serotonin available to bind to post-synaptic receptors (Carrasco and Sandner, 2005). Although the central nervous system is the desired site of action, SSRIs also exert their effect throughout the body, which explains their side effects. Aside from the primary pharmacology of the SSRIs, each has diverse properties, knowledge of which assists prescribers to choose the most appropriate agent. NICE (2004) directs prescribers to opt for Fluoxetine or Citalopram due to their ease of discontinuation as with other SSRIs, users have reported distressing discontinuation symptoms. A review by Haddad (2001) found as many as fifty different discontinuation symptoms, ranging in severity from mild to severely disabling. These included dizziness, nausea, lethargy, headache, electric shock like sensations, insomnia and nightmares. An understanding of the physiological mechanisms underlying the syndrome has yet to be realised. Theorists such as Tamam and Ozpoyraz (2003) and Blier and Tremblay (2006) speculate that the readaptation of the neurotransmitter systems, which rapidly increase reuptake of serotonin and subsequently decrease the amount of serotonin able to bind to post-synaptic receptors, are the likely triggers. Drugs with shorter half lives i.e. Paroxetine are the most problematic and those with longer half-lives and active metabolites i.e. Citalopram and Fluoxetine appear to fair better (Taylor, Paton and Kerwin, 2007). In terms of appropriateness, all SSRIs share identical cautions and contraindications and research has shown that Citalopram is just as effective as Fluoxetine in treating depressive symptoms (Patris, Bouchard, Bougerol, Charbonnier, Chevalier, Clerc, Cyran, Van Amerongen, Lemming and Hopfner Petersen, 1996). Consideration of patient-specific factors during the history taking identified that Anne found previous success with Citalopram. The medical history had not highlighted any conditions where cautions apply such as epilepsy, cardiac disease, diabetes mellitus, allergies etc and the author was aware that use of all antidepressants was contra-indicated in mania (RPS BMA, 2007). The choice of product was made in discussion with Anne. She had a preference for Citalopram and after reviewing the available evidence, the author concurred with this choice and prescribed Citalopram (evidence 6). See evidence 7 for a profile of Citalopram. Next, it was necessary to negotiate a contract with Anne, stage four of the prescribing pyramid. Anne understood Citalopram from previous use, however education regarding what the prescription was for and how long it would take to work (evidence 7) was given. Anne did not have a preference in terms of formulation and therefore tablets were prescribed, as this was the cheapest option. The side effects and red flag concerns of the medication were then identified to Anne (evidence 1, section 6). All antidepressants have been linked with a possible increased risk of suicidality. Research into SSRIs and suicidality demonstrates conflicting findings in that Healey (2003) found increased risk in early treatment and Isacsson, Holmgren and Ahlner (2005) reported a reduction. The Medicines and Healthcare products Regulatory Agency maintain that prescribers of SSRIs should monitor and assess for this regularly. Due to the possibility of suicidality occurring as a red flag, a prescription for treatment to last seven days was given and the rationale explained to Anne and her partner. In the practice area, service users are given information from the United Kingdom Psychiatric Pharmacy Group (UKPPG), available via the Trust intranet; the data regarding Citalopram was given to Anne (Appendix 1). Furthermore, Anne was encouraged to refer to the patient information leaflet, dispensed with the product from the chemist. Annes partner expressed concerns about media reports questioning the efficacy of antidepressant medication; this was addressed by giving him a copy of the Trusts response to the information (Appendix 2). This information was successful in reassuring him (evidence 8), along with the arrangements for reviewing Anne on a regular basis. In terms of reviewing Anne, stage five of the prescribing pyramid, a further appointment was made for seven days, in line with NICE (2004) guidance due to her higher background risk of suicide as an individual under the age of thirty years. Based on the evidence that SSRIs can increase risk of suicide, planning to see any patient commenced on antidepressants within a week would better ensure safety and professional accountability, in addition to addressing the public health target to reducing suicide. Although increased energy and motivation is apparent a week into treatment, the antidepressant effect is not, therefore the individual may continue to experience depressive symptoms and have the impetus to act on suicidal thoughts (NICE, 2004). Frequent monitoring thereafter is recommended by NICE (2004) who suggest professionals look for signs of akathisia, suicidal ideas and increased anxiety and agitation, which can occur with all antidepressants, including Citalopram. The author elected to give Anne and her partner the contact details for the Crisis Team in the local area, should support be needed out of working hours, explaining that they could be contacted if her mental health further deteriorated or she began to suffer with suicidal thoughts. It was indicated to Anne that she would be unlikely to feel the full benefit from the treatment for approximately two weeks due to the pharmacology of the drug (evidence 7) and that once the depression had lifted; guidelines suggest treatment should continue for at least six months after this marker. Geddes, Carney, Davies, Furukawa, Kupfer, Frank and Goodwin (2003) found that treatment continued for this time frame reduces the risk of relapse. In terms of keeping records, stage six of the prescribing pyramid, Annes progress was recorded using the electronic Care Programme Approach (eCPA) system. Use of eCPA in the practice area is a new development, intended to replace the paper-record system, allowing immediate access to relevant mental health staff. It is currently inaccessible to other health professionals; therefore duplication of work is necessary in order to ensure effective communication. Currently, professionals involved in the care of an individual seen by psychiatric services are identified as part of the initial assessment (evidence 1, section 19) and are advised of their treatment plan and progress via separate letters (Appendix 3). Working in this manner ensures safe, ethical practice by good communication with members of the multi-disciplinary team (NMC, 2008). In line with the NMC standards for recordkeeping (NMC, 2005) the author recorded and disseminated the information in a timely manner, using the same format as her DMP. In the future, the author plans to work with the non-medical prescribing lead to develop an appropriate format for her practice, which should enhance professional accountability. The seventh and final principle of the prescribing pyramid encourages reflection on prescribing practice. The author was confident that a prescription was necessary and therefore did not feel pressured by the patient to issue treatment against better judgement as can be the case (Britten, Ukoumunne and Boulton, 2002). Neither did the advertising activities of the relevant drug company influence the choice of product. Reliance on independent research was used to inform prescribing practice. Supplementary Prescribing Supplementary prescribing is described as a voluntary partnership between an independent prescriber (a doctor or a dentist) and a supplementary prescriber to implement an agreed patient-specific Clinical Management Plan with the patients agreement (DH, 2005a paragraph 8). A critical analysis of a supplementary prescribing scenario will follow, addressing learning outcomes 1, 2, 3, 4 and 5. As in the IP scenario, reference will be made to the prescribing pyramid (NPC, 1999). The patient will be referred to as Alexander Stewart. Alexanders General Practitioner (GP) had been managing his care; however he had been referred to the service following discontinuation of antipsychotic medication Risperidone, due to sexual dysfunction. Alexander was under the care of a consultant psychiatrist who had diagnosed Schizophrenia of the paranoid type, under Section F20.0 of the International Classification of Disease 10 (WHO, 1992). At the time of meeting Alexander, early warning signs of relapse were evident in that he believed others were against him and were sending messages via media sources. Alexander had sufficient insight to be able to recognise that his mental health was declining and had attended the appointment in the hope that an alternative treatment could be prescribed. The independent prescriber (IP), Dr Gater, felt that Alexander was a suitable candidate for a supplementary prescribing arrangement as there were no issues of substance misuse, no co-morbid illnesses and he had a good history of engagement. It is recommended that these factors be considered before contemplating supplementary prescribing in mental health care (DH, 2005b). New Ways of Working in Mental Health (DH, 2005c) dictate that individuals with highly complex needs, including those with dual diagnosis, history of poor engagement, co-morbid physical illness and assessed high risk of harm to self or others are seen by more advanced, highly trained professionals such as consultants. Dr Gater discussed with Alexander the possibility of supplementary prescribing and he agreed to work in this way, with the author as the supplementary prescriber (SP), who also took on the role of care co-ordinator. The IP set the parameters of the Clinical Management Plan (CMP) and this was then drawn up and signed, (evidence 9) indicating agreement by the IP, SP and Alexander as is mandatory for supplementary prescribing situations (DH, 2005a). The IP and SP had shared access to the patient record. The CMP in this instance was broad and permitted prescription of antipsychotic medication from a wide choice of agents, however CMPs can be specific, for example, only allowing the SP to make dose or frequency of dose changes to an identified medicine (DH 2005b). In such cases, if a patient were to develop adverse side-effects from the medicine, a new CMP would have to be developed, leading to increased workload and time delays for treatment. In this instance, because of the knowledge and experience of the SP, the close working relationship of the IP and SP and the accessibility of comprehensive guidance regarding the management of Schizophrenia (NICE, 2002b) a broad CMP was considered appropriate. The author used the prescribing pyramid to aid practice (NPC, 1999) and adhering to the first principle, considered a holistic assessment. The IP had already taken a thorough history and made a diagnosis, however the history taking was repeated by the SP to ensure that Alexanders presentation had not changed. Difficulties can arise if this occurs (evidence 2d). A CPA assessment was carried out (evidence 10), supplemented by a symptom analysis tool, namely Morton (1992). The assessment confirmed the original diagnosis. The National Service Framework for Mental Health (DH 1999a) reported that individuals suffering with this illness are nine times more likely than the general population to commit suicide and that the risk of death from other violent incidents is over twice as high. Government policy since this time has aimed to ensure that people with mental health problems are better able to access services and appropriate treatments in a timely manner, to prevent the aforementioned likelihoods. The author was keen to uphold these principles and treat accordingly. Theorists such as Wyatt (1991) and McGlashan and Hoffman (2000) have speculated that prolonged non-treatment of Schizophrenia can result in brain-damaging neurotoxicity and synaptic plasticity, respectively; however there is limited research into these theories (McGlashan, 2006). Findings from duration of untreated psychosis studies have lead to the recent development of Early Intervention Services which aim to ensure that people with mental illness receive timely treatment in order to prevent biological, psychological and social decline (Whitwell, 2001). Personal experience has further demonstrated that non-treatment of the illness results in further loss of insight, increased distortions of judgement and the possibility that the active phase will last indefinitely. This knowledge meant that the second principle of the prescribing pyramid was satisfied since the appropriate strategy was to issue a prescription. Alongside this, the author, working as care co-ordinator for Alexander highlighted interventions to address issues relevant to his quality of life and well-being including housing, finance and employment support etc as suggested by government policy (DH 1999a, DH 1999b). The third principle, consideration of product choice, was initially agreed via the CMP. This indicated use of antipsychotic medication; however the selection of agents was open for discussion between Alexander and myself. To aid the decision, referral was made to the NICE guidance for treatments in Schizophrenia (NICE 2002a). The guidance recommends use of atypical antipsychotics in the treatment of Schizophrenia. Evidence 12 explains typical versus atypical antipsychotics in further detail. Alexander previously had a good response to an atypical drug, namely Risperidone, however stopped it due to the adverse drug reaction (ADR) he suffered. Alexander developed retrograde ejaculation, a reasonably high reported adverse effect of this drug (Taylor et al, 2007). Alexanders G.P had been satisfied that the symptom was not caused by other conditions such as diabetes mellitus or multiple sclerosis; and as the symptom ceased following discontinuation of Risperidone, was satisfied that it was an ADR. Although evidence suggests that this effect is dose related (Raja 1999, Loh, Leckband, Meyer and Turner 2004), Alexander did not wish to recommence this treatment. In choosing the most appropriate treatment, the criteria was therefore further simplified to an atypical agent, where possible, with a low affinity for alpha1 adrenergic antagonism since this is thought to be the cause of retrograde ejaculation with Risperidone (Loh at al, 2004). From the atypical agents listed in the current British National Formulary (RPS BMA, 2007), the two with the lowest affinity for alpha1 adrenergic antagonism are Aripiprazole and Quetiapine (Loh et al, 2004). Alexander was also presented with information comparing antipsychotics in terms of other commonly experienced side effects (Appendix 4) and then given the opportunity to ask questions. Finally, Alexander and I agreed on Aripiprazole and a prescription was issued (evidence 11). In addition to the importance of the positive side effect profile, Aripiprazole also rated as less expensive than comparable treatment with Quetiapine (Taylor et al, 2007) and this is a factor which prescribers are directed to pay attention to (NPC 1999, NICE 2002). In terms of preparations, Aripiprazole is manufactured in tablet form, orodispersible tablets and as an oral solution. As Alexander was happy to take tablets, this was the preparation prescribed. Aripiprazole is described as having a uniquely robust pharmacology (Davies, Sheffler and Roth 2004), centred on it being a partial agonist at Dopamine D2 receptors. Evidence 12 provides a profile for Aripiprazole, which explains this in further detail. It is distinctive from the other atypical agents as it stabilises the spread of dopamine in two of the four major pathways (mesolimbic and mescortical) where the neurotransmitter Dopamine is found, as opposed to purely blocking dopamine receptors or working as an antagonist at D2 receptors. Despite this difference, a recent systematic review of Aripiprazole actually found that it did not have significant advantages over other atypical medicines, neither did it demonstrate increased efficacy over typical drugs (El-Sayeh and Morganti, 2004). Coupled with this, Aripiprazole was shown to instigate similar adverse effects as treatment with typical agents, with the exception of akathisia, which lead to improved compliance (El-Sayeh and Morganti, 2004). Aripiprazole has not been shown to cause elevation of prolactin levels, nor is it associated with the development of impaired glucose tolerance or weight gain, therefore in theory, monitoring of these factors is not required (Travis, Burns, Dursun, Fahy, Frangou, Gray, Haddad, Hunter, Taylor and Young, 2005). In fact, Travis et al (2005) purport that no specific monitoring is required outside of the basic screening advocated in NICE (2002b) i.e. monitoring for endocrine disorders and cardiovascular risk factors etc. Despite this, the NHS Trust for which the author works recommends extensive monitoring (Appendix 5). The author would therefore be compelled to work within the guidance of the employing authority. In negotiating a contract (stage four), because Alexander and I shared the decision to try Aripiprazole, it was hoped that concordance would be achieved. Evidence 14 highlights the implications of excluding service users from the decision making process. Delivering the choice agenda in mental health is considered key to an effective prescribing value base for nurses (Jones and Jones, 2007), however it must be identified that issues of capacity for individuals with mental health problems can jeopardise this. For individuals lacking capacity during an acute Schizophrenic episode, guidance recommends the use of oral atypical medications, prescribed after consultation with the individuals carer or advocate (NICE, 2002a). Government policy has stated that service users should be encouraged to compile an Advanced Directive (AD) as part of their care plan, highlighting their treatment choices (NICE 2002b), although in practice, the author has limited experience of this happening (evidence 13) and does not feel it is something that the Trust encourages. Concerns have been expressed that service users might draw up unrealistic and illogical plans, refusing all forms of treatment, however a recent study found evidence to the contrary of this (Papageorgiou, Mohamed, King, Davidson and Dawson, 2004). It is the opinion of the author that where possible ADs should be formulated, allowing the patient to be autonomous, however the author also acknowledges that there may come a point where decision-making is replaced by that of the prescriber. At present ADs can be over-ridden if the patient is subject to compulsory treatment under the Mental Health Act (1983). In Alexanders case, an AD was offered but refused. Alexander was considered capable of providing informed consent and therefore, following the principles of good practice (United Kingdom Central Council for Nursing, Midwifery and Health Visiting, 1996), the author communicated to Alexander, various details about the prescription. These included information on what the prescription was for, how long the drug would take to work, how long to take it for, what dose to take and the possible side effects. The UKPPG data regarding Aripiprazole was given to Alexander (Appendix 6). The fifth principle of the prescribing pyramid, review of the patient was dictated by the CMP. Weekly review was carried out in order to ensure that the treatment was effective, safe and acceptable. Had it not been, the broad CMP permitted use of alternative agents. The IP and SP reassessed Alexander as planned three months later. In this time however the IP and SP met frequently to discuss the progress of Alexander and record keeping was kept up-to-date using the eCPA system. At present, GPs are advised of supplementary prescribing arrangements and changes in these via Trust devised letters (see Appendices 7 and 8). In this instance the letters were compiled and sent within 24-48 hours in line with local policy. The author reflected on her prescribing decision as recommended by the final stage of the pyramid and is confident that neither patient pressure nor the action of pharmaceutical companies affected decision-making. In practice, the author has experience of nursing individuals on a range of antipsychotics and is aware that this may affect choice of drug in the future Conclusion The author has described and analysed an independent and supplementary prescribing experience and has attempted to meet the module learning outcomes in doing so. The author is confident that her rationale for prescribing decisions is based on sound comprehensive guidelines and practice experience. The author plans to base future decisions on the prescribing pyramid model, making a conscious effort to see outside of the prescriptive toolkit so as to remember the importance of other nursing interventions. It is the intention of the author to utilise the support and clinical supervision available in the practice area, including discussion about differential diagnosis and treatment options with the medical team following assessments. This will ensure safe practice, professional development and recognition of the contribution of non-medical prescribers within the team. Evidence 16 details the authors plans for continuing professional development in prescribing practice, both as an independent and a supplementary prescriber. These goals are important to ensure competency in prescribing practice is maintained. By ensuring that practice is updated, monitored and evaluated, service user experience is hopefully improved leading to increased concordance and better health outcomes

Workaholics Essay -- essays research papers

INTRODUCTION Why did I choose to write about workaholics? The main reason is that the general picture about these people is bad, but there are a lot of them around us and very often we admire them. They are doing exactly what they love – work – and they can never have enough of it. Although they spend most of their time working, surprisingly they are happy. They show so good results in what they do. But the consequences are great. Family life is disrupted, intellectual horizons narrow and the consequences to the workaholic's health are severe: fat, lack of exercise and stress. Why do people become workaholics? When a person becomes workaholic is there a way back? How should people around him act in order to keep both him and themselves happy? Lets start explaining what workaholics are, how they act and then we'll get answers to this questions. WHAT AND WHO ARE WORKAHOLICS?   Ã‚  Ã‚  Ã‚  Ã‚  The definition of workaholism from a dictionary would be someone who has a compulsion to work all time and a workaholic is someone who loves to work or who is addicted to work. How can this people work throughout the whole day and be happy and never tired knowing that they sleep only for 4-5 hours a day. Perhaps the main reason for this is that people evaluate themselves more on measurable things such as personal achievements and financial worth – not emotional wellness. People often tend to feel guilty if they are not constantly being productive, as they tend to consider relaxation a waste of precious time. They need work to feel good. Workaholics are people who put the work on first place. Usually they need to prove themselves to the their colleagues or their bosses so they would praise them. Sometimes workaholism occurs because the person works to avoid the pain. Workaholism is addiction and all addictions are in a way avoidance of pain. They work just t o cover the pain and not deal with it. Some of the workaholics became what they are because of greed. They can never have enough so they want to work as much as possible. Sometimes the hard workers are being referred as workaholics. While hard workers are ready to work some extra time to finish a project or to meet a deadline, the workaholic uses all his extra time to work. Workaholics don’t have hobbies except if they are related to the job such as golf games with business partners. Everybody thinks tha... ...usiness phone calls the workaholic will make [none can not be at the beginning, but after certain period of time if the whole procedure goes over and over again that can be established]. HOW CAN WORKAHOLIC TURN BACK TO NORMAL? All the methods offered for overwhelming workaholism are either group therapy or self-improvement courses. Both are based on describing what workaholism is, and how dangerous it can be for the entities. Also differentiating the hard working from workaholism. The two courses also tend to make the workaholics reasonable answers to questions like: How much is really enough for me? How long do I usually rest and is this enough? Is what I’m exchanging my life worth it? What summer vacations are for? And maybe the most important: What am I trying to prove and to whom I want to prove myself? Making the workaholic aware of what he has become and what is he actually doing is the first step to turn the person away from his addictiveness and make him get back to track and work normally. Reference: â€Å"Workaholics† – Marilyn Machlowitz *** â€Å"Journal of Applied Psychology† Nr.60 *** â€Å"The truth about burnouts† – Christina Maslach, Michael P. Leiter