Sunni vs Shia Essays - Islam, Shia Islam, Hadith, Sunnah, Ali

Sunni vs Shi'a One of the most important periods in Islam is the division between Sunnis and Shi'as. Sunnis and Shi'as are very similar, but some of their practices and beliefs counteract the other. These differences are derived from different interpretations and point of view. The split originated from the death of Prophet Muhammad. Different people had different interpretations of wh o should be the next leader. At first, Sunni and Shi'a was only a matter of who the next leader should be. However, as time went by, Shi'a began to show a preference for Hadith and Sunnah literature. Credited to the Prophet's family and close links. The Sunnis consider any Hadith and Sunnah credited to any of the 12000 companions to be valid. Also, all Muslims must pray 5 times a day, but Shi'a practice permits praying in only 3 intervals. There is also a significant different in the layout of the religious leadership. In Shi'a tradition, the most learned emerge as spiritual leaders. However, there is no such hierarchy in Sunni Islam. But, Sunnis and Shi'as are more similar than it appears to be. They both share the fundamental Islamic beliefs and religious scriptures. Also, they follow the five pillars of Islam.

Using Gustar in Spanish to Say You Like Something

Using Gustar in Spanish to Say You Like Something If you like something, it pleases you. The truth of that statement is obvious, but it nevertheless is important to know when expressing the thought of liking something when speaking Spanish. For in Spanish, the verb usually used when translating to like, gustar, doesnt mean to like at all. It more accurately means to please. Note the construction of the following sentences: English: I like the book. Spanish: Me gusta el libro. Literal word-for-word translation: Me (to me) - gusta (is pleasing) - el (the) - libro (book) Thus we can see that in English the subject of the sentence is the person doing the liking, while in Spanish the subject is the item being liked, and vice versa. Verbs that operate in the same way as gustar are sometimes known as defective verbs, or verbos defectivos, but that term also has other meanings, so it isnt used often. When used in this way, such verbs require an indirect object pronoun. The indirect object pronouns are me (to me), te (to you singular familiar), le (to him or her), nos (to us), os (to you, plural familiar, seldom used) and les (to them). Because the object being liked is the subject of the sentence, the verb must match it in number: Me gusta el libro. I like the book. (The book pleases me.) Me gustan los libros. I like the books. (The books please me.) Les gusta el libro. They like the book. (The book pleases them.) Les gustan los libros. They like the books. (The books please them.) The subject of such sentences does not need to be stated if it is understood: No me gusta. I dont like it. (It doesnt please me.)  ¿No te gusta? Dont you like it? (Doesnt it please you?) A prepositional phrase beginning with a can be added to the sentence for either clarification or emphasis, further indicating who is being pleased. Even when the prepositional phrase is used, gustar still needs the indirect object pronoun: A Kristi le gustà ³ la pelà ­cula. Kristi liked the film. (A Kristi was added for clarification.) Me gustà ³ la pelà ­cula. I liked the film. (No emphasis added.) A mà ­ me gustà ³ la pelà ­cula. I liked the film. (Emphasis added to I.) The subject of such sentences, the object being liked, can be an infinitive: Me gusta nadar. I like to swim. A Pedro le gustaba bailar. Pedro used to like to dance. Note that when there is more than one infinitive, the singular form of gustar is still used. Me gusta beber y comer. I like to eat and drink. You can also use a phrase as the subject, often beginning with que or como. In such cases, a singular form of gustar is used. Me gusta que los chicos respeten y adoren lo que tienen en su paà ­s. I like that the children respect and adore what they have in their country. A à ©l le gusta como bailas. He likes how you dance.

Nurse Practitioners who have had a spanish for health care Research Proposal

Nurse Practitioners who have had a spanish for health care practitioners course will provide better subjective and objective ass - Research Proposal Example Contextually, it has emerged as a vital point of consideration for professionals to obtain differentiated advantages and attain better growth opportunities in the global context. Based on a similar notion, in nursing, language or rather the linguistic skills possessed by the nurses are determined as an important and beneficial attribute when aiming at better patient satisfaction (American College of Physicians, 2009). In today’s society, it is quite essential that what is transmitted by the nurse is effectively comprehended by the patients through effective communication. The role of communication in nursing profession is one of the significant aspects, where recent studies have depicted that many educated nurses face challenge to take care of the patients according to their requirements fundamentally because of linguistic barriers (Allen & Dip, 2007). Stating precisely, language skills play a significant role in the nursing profession which is quite essential in order to faci litate superior treatment to patients belonging from different ethnicity or cultural background. This enables the nurses to understand the needs of the patients more effectively as well as comprehend the information related to the healthcare with minimum chances of misinterpretation from the patients’ end. ... Statement of the Problem Based on the significance of language skills among nurses, the problem to be examined in this study will emphasise that whether nurse practitioners who have obtained the course of Spanish language will facilitate better treatment for the Spanish patients in comparison to those practitioners who do not possess Spanish language skills. The philosophy behind the identified problem or research issue has been based on the belief that communicating in similar language is likely to facilitate effective communication process between the nurse and the patient, confirming better quality healthcare services. In the present scenario of globalization, language has apparently emerged as an essential skill for the nurse practitioners owing to the fact that they need to handle patients belonging to different cultures and linguistic backgrounds. Thus, the research issue in concern denotes that a practitioner who does not have the knowledge of Spanish language will not able to provide necessary care to the Spanish patients. Significance of the Problem for Nursing and Health The problems concerning the communication skills of the nurse practitioners can be observed as quite crucial in the present day context. From a generalized perspective, it can be affirmed that nurses who do not have the knowledge of a particular language will not be able to deliver superior quality care to an individual who belongs to that particular linguistic background. Based on this assumption, this study will attempt to emphasize upon the communication gap resulting because of the linguistic differences existing between nurse practitioners and the patients in the modern day global healthcare sector. Hence, focusing upon the

Political Science - Politics in Quebec (Canada) Research Paper

Political Science - Politics in Quebec (Canada) - Research Paper Example Cultural globalization refers to the emergence of a combination of values and beliefs even across the world. Globalization is associated with a clash of ideas, lifestyles, and identities, as well as enhanced interdependence within the international community. The amplification of international migration and advancement of technology has led to an increased ethnic and cultural diversification of societies. Canada hosts a constantly increasingly number of immigrants, majority of who originate in cultural1 environments that do not share similar values with the host society (Di Sciulo 2011, p. 28).1 The pressure of globalization on language and culture has triggered a remarkable range of research and analysis. This is certainly true in Canada where scholars and policy makers have long been anxious on the impact of globalization on local culture and language. The problem has aroused keen interest, especially owing to Canada’s geographical and cultural proximity to the U.S., the world’s biggest exporter of cultural products, as well as Canada’s internal division of twin population, French and English. Of recent, issues 2of globalization, ethnicity, and politics of identity have been dominant in Canada, especially in the region of Quebec. Most inhabitants of Quebec have raised concerns on the effects that cultural homogenization could have on Quebec’s distinct culture and language (Fletcher 1998, p. 360). 2 Most Quebeckers are fearful that increased globalization will lead to language loss or language shift together with their cherished cultural heritage. Language shift in this case refers to circumstances in which speech communities witness gradual displacement of a certain language by another. The language question in Quebec has constantly aroused mixed feelings of anxiety and passion enveloping maintenance of cultural and linguistic diversity. Language

Relegion Islamic Essay Example | Topics and Well Written Essays - 1500 words

Relegion Islamic - Essay Example The Ansar, represented by the Khazraj and the Aws tribes, determined that both the future of the nascent religion and the welfare of the community demand the immediate selection of a leader. Abu Bakr and Umar, who, alongside Ali Bin Abi Taleb, are controvertibly regarded as the Prophet's closest companions, were not present at the Saqifa at that time. Upon, however, being informed of the gathering, they rushed to participate. The Muhajirun, however, were not informed of the gathering and, thus, the Meccan Muslim immigrants were not represented at this seminal meeting. Within the context of the Sunni-Shiite division, the identity of the participants, or those present at Saqifat Bani Sa'ida is of critical importance. As noted in the preceding, while the Ansar were represented in their collectivity, the Muhajirun were not and then, later, only by Abu Bakr and Umar. More significantly, Ahl Al Bayt were not present. As Ibn Ishaq (1982, 201-206) quite explicitly notes in his Sira, the Prophet's closet family, those being Ali, Fatima Al Zahra, and Khadija bint Abu Bakr, were not present at Saqifat Bani Sa'ida as they were preparing the Prophet's body for burial. The implication here is not only that their opinion was neither given nor taken but, from the Shiite perspective, that one of those who would have figured as the natural choice for succession was not present: Ali Ibn Abi Taleb. It is within the context of the absence of most of the Muhajirun and the totality of Ahl Al Bayt that Abu Bakr become the Prophet's successor, the umma's first caliph. Yawm al-Saqifa, as reported by Ibn Ishaq (qtd. In Ibn Hashem, 1994, 127-131), was a prolonged and acerbic affair. The Ansar were, from the outset, adamantly opposed to the selection of either a member of Ahl al Bayt or a Muhajir, preferring one of their own. Abu Bakr addressed the Ansar's opposition, arguing that the only a member of Quraysh, Mecca's leading clan, could possibly maintain the Islamic umma and sustain its unity. The reasons, as given by Abu Bakr, were the universal recognition of Quraysh's nobility and its worthiness of leadership. It was, thus, that Abu Bakr suggested that those present select either Umar or him as the Prophet's successor (Ibn Hashem, 1994, 127-131). Needless to say, the Ansar maintain their opposition, with the aforementioned being carried forth by one of their more powerful tribal chiefs, Bashir ibn Sa'd ibn Tha'laba. Indeed, utterly rejected the notion of governance by either Umar or Abu Bakr, the Ansar suggested that they elected their own leader and the Muhajirun their own. At this point, Ibn Ishaq (1982, 209), reports that the meeting went temporarily out of control to the extent that it seemed that the umma had already, only hours after the Prophet's death, divided amongst itself. This was, apparently, Umar's sentiments, whereupon he responded to the said proposal by taking hold of Abu Bakr's hand and swearing an oath of allegiance to him as the leader of the umma. The Ansar, as Ibn Ishaq (1982, 210) continues, however, were not to succumb easily and Sa'd ibn Ubada, the leader of the Khazraj Ansar

Palliative Care Situation Reflection

Palliative Care Situation Reflection Introduction Reflective practice enables nurses to critically review their actions through a process of thoughtful deliberation about past experiences, in order to learn from them (Tickle 1994; Atkins and Murphy 1995; Bailey 1995; Spalding 1998). Reflection is important since it provides opportunities for learning and continuing professional development (Hinchliff et al. 1993; Spalding 1998). Furthermore, it allows the nurse to better handle future situations and deal more ably with challenging events in everyday clinical practice (Jarvis 1992; Smith 1995). A number of models of reflection have been developed. Gibbs cycle considers the process of reflection as six key stages: (1) description of the event, (2) feelings, (3) evaluation, (4) analysis, (5) conclusion and (6) development of an action plan (Gibbs 1988). In this paper, Gibbs cycle will be used to reflect on an clinical incident that I have experienced which focuses on communication in palliative care and specifically, breaking bad news to a patient and his family. Palliative care is the care of any patient with advanced, incurable disease (Urie et al. 2000). Palliative care involves the management of pain and other disease-related symptoms, and aims to improve quality of life using a holistic approach that incorporates physical, psychological, social and spiritual aspects of care (Urie et al. 2000). Effective communication between nurses and other healthcare professionals, patients, and their families and carers forms a key component of palliative care, particularly when breaking bad news. Research has shown that healthcare professionals cite a number of challenges in communicating effectively, including cultural factors, deciding on the best process of communication and information to deliver, and the difficulty of conveying hope to patients and their carers (de Haes and Teunissen 2005). The NHS Cancer Plan published in 2000 states that: â€Å"the care of all dying patients must improve to the level of the best†, with good communication between healthcare professionals and patients as central to achieving this goal (Department of Health 2000). The Gold Standards Framework (GSF) is a framework designed to ensure a gold standard of care is provided for all patients who are nearing the end of their lives (NHS 2005). There are three stages in this framework: (1) identify, (2) assess and (3) plan, with effective communication a key goal underpinning each of these stages. National Institute for Health and Clinical Excellence (NICE) guidelines on improving supportive and palliative care for adults also stresses the value of good face-to-face communication both between healthcare professionals and patients and also inter-professional communication (NICE 2003). This guidance supports the use of the Liverpool Care for the Dying Patient Pathway (2004) which provides a fr amework for improving communication. It is therefore important that nurses develop the required skills to enable them to communicate effectively with patients and carers, and also with other healthcare professionals within the multidisciplinary care team. Reflection using Gibbs cycle (1) Description of the event Mr Smith is a 39 year old father and company director who discovered a testicular swelling. He chose to ignore this, initially because he misinterpreted it as a sports injury, and later because he felt embarrassed about discussing this with a doctor. Nine months later he presented to the emergency admissions unit as he was becoming breathless far more readily than usual, and suffered a constant backache. These symptoms were found to be due to lung metastases and referred pain caused by metastases in the para-aortic lymph nodes. His prognosis was poor and his family were called so that they could be there when he received the diagnosis to help support him. The consultant delivered the news to Mr Smith and his family in a quiet room, with both myself and another staff nurse present. Understandably, both Mr Smith and his family were devastated. (2) Feelings This case has had a huge impact on me. As this was the first time I had attended a case where bad news of this nature had to be broken to the patient and their family, I was naturally apprehensive prior to the event. On seeing the reactions of Mr Smith and his wife to the news, I was unprepared for the strength of my own emotions and found it hard not to cry. Initially, I felt helpless and unable to do anything to help relieve their suffering. I also felt awkward and as if I was intruding at a time when they should be allowed to grieve together privately. However, these feelings quickly passed and were replaced by a desire to do my best to make Mr Smith’s end-of-life care the best possible and provide as much support to both the patient and his family as I could. (3) Evaluation The consultant broke the news to Mr Smith and his family very well and was able to draw on his considerable experience to handle the situation in a professional manner while showing empathy and sensitivity. The choice of a quiet room rather than an open hospital ward provided an ideal environment which afforded Mr Smith privacy to receive the news. The consultant primarily focused on verbal methods to communicate effectively, but also used non-verbal methods, such as sitting down on their level, rather than standing while they sat down; maintaining eye contact with both Mr and Mrs Smith throughout the conversation; using open body language (e.g. not crossing his arms); and using a soft tone of voice. The consultant did not rush in breaking the news and took time to explain Mr Smith’s diagnosis and prognosis, ensuring that what he was saying was understood and providing clarification where necessary. He was also careful not to give unrealistic answers to any difficult questions that were asked and was as optimistic as possible, while still being open and honest. While the consultant was speaking, the other staff nurse observed the reactions of Mr Smith and his family closely to pick up on non-verbal clues to their thoughts and feelings and was quick to step in to place an arm around the shoulders of Mrs Smith when she began to cry which was clearly of great comfort to her. The only negative aspect of the incident was that I felt that having two staff nurses as well as the consultant present was excessive and initially unsettled the family, serving to emphasise the gravity of the situation. (4) Analysis Effective communication As this was the first time I had been involved in a case like this, my role was largely one of observer. Nonetheless, this was still an excellent learning experience and provided me with the opportunity to develop my verbal and non-verbal communication skills through observation. On reflection, I feel that I could have kept my emotions more under control, but I was unprepared for the strength of Mr and Mrs Smith’s response to the news. The consultant played the key role with support from the other staff nurse, both of whom have considerable experience in palliative care. It was clear that hey had already gained the trust of Mr Smith during previous consultations. Trust has been identified as a major factor in establishing successful relationships between healthcare professionals, patients and carers (de Haes and Teunissen 2005), and this enabled more effective, open and honest communication. In palliative care, it is important to relate to the patient on a personal as well as a professional level (Lugton and Kindlen 1999). There should be consistency between verbal and non-verbal communication in order for the healthcare professional to be perceived as genuine (Benjamin 1981). Evidence has shown non-verbal methods of communication to be more powerful than verbal methods (Henley 1973), with listening and eye contact among the most effective forms of non-verbal communication. Touch has also been identified as an important for nurses in certain situations. The consultant relied mainly on verbal communication which may reflect gender-specific differences in communication with men using verbal forms more frequently and women tending to rely more on non-verbal communication methods (Lugton and Kindlen 1999). Observing the other staff nurse readily use touch to comfort Mrs Smith helped the rest of the family to relax and lessened the tension in the room slightly, also breaking down the ‘barrier’ between the healthcare professionals and the patient/family. I observed that the family appeared to view the nurse as a comforter and more approachable than the consultant, a view that continued throughout Mr Smith’s end-of-life care. Although not relevant to this particular case, it is important to acknowledge that effective communication between members of the multidisciplinary palliative care team is also essential. This can be challenging if, for example, team members have differing philosophies of care. One of the key recommendations of the NICE guidelines on palliative care is the implementation of processes to ensure effective inter-personal communication within multidisciplinary teams and other care providers (NICE 2003). During Mr Smith’s end-of-life care, I had to work closely with other members of the care team and there were instances where it was important for me to consider the perspectives of other team members in order to communicate effectively with them. Regular team meetings were beneficial in creating a forum where difficulties could be discussed and solutions to problems found. Reactions to receiving bad news in palliative care After breaking bad news to a patient, healthcare professionals may have to be prepared to deal with a variety of reactions including denial and collusion, and emotional reactions such as anger, guilt and blame. Denial is often a coping mechanism for patients who are unable to face the fact they have a terminal illness but patients will often begin to face reality as their disease progresses over time (Faulkner 1998). Family members and carers may encourage the patient to stay in denial, as this will delay the time when difficult issues have to be faced and discussed. Collusion between healthcare professionals and families/carers to withhold information from the patient is usually viewed as a way to try and protect the patient (Faulkner 1998). However, honest and open discussion with the patient themselves establishes their level of knowledge and understanding and can help to reassure them about their condition and accept reality. Patients and their families and carers often show strong emotional reactions to bad news. Anger may sometimes be misdirected towards the healthcare professional as the bearer of this news, and it is important that the cause of the anger is identified and addressed. Patients may feel guilt, and that they are somehow being punished for something they have done wrong. Alternatively, the patient may serve to blame their condition on other people. While healthcare professionals are unable to take away these feelings of guilt and blame, ensuring the patient has the chance to talk them through and discuss relevant issues can help them come to terms with these feelings. Mr Smith’s reaction to the news was one of self-blame and guilt – he blamed himself for not visiting a doctor earlier and felt guilty that he was putting his family through so much. He appeared to accept his poor prognosis and asked a number of questions which demonstrated a full understanding of his situation. Spiritual and cultural beliefs can influence an individual’s experience of illness and the concerns of both patients and their families or carers may need to be addressed either at the time bad news is broken or at a later stage during end-of-life care when individuals are facing death (Matzo et al. 2005). Incorporating spiritual care into nursing is therefore particularly important in palliative care; however, since neither Mr Smith or his family were particularly religious, this was not a key issue in this incident or in his subsequent care. Control of cancer-related symptoms in palliative care Patients with advanced cancer are typically polysymptomatic (Grond et al 1994). Common symptoms include pain, fatigue, weakness, anorexia, weight loss, constipation, breathlessness and depression. Effective control of these symptoms is essential for optimal quality of life during end-of-life care. As previously discussed, one of the main processes in the GSF framework involves assessing patients symptoms and planning care centred around these, to ensure that these symptoms are controlled as much as possible (NHS 2005). Three symptoms that required effective management as part of Mr Smith’s care plan were pain, breathlessness and depression. One of Mr Smith’s greatest concerns was that he would suffer considerable pain during the advanced stages of his cancer. This is a common fear held by many cancer patients. Pain is a symptom experienced by up to 70% of cancer patients (Donnelly and Walsh 1995; Vainio and Auvunen 1996). Pain may result from the cancer itself, treatment, debility or unrelated pathologies, and accurate diagnosis of the cause(s) of pain is therefore important. The World Health Organisation (WHO) ‘analgesic ladder’ (WHO 1996) provides a system for managing cancer pain and has been shown to achieve pain relief in almost 90% of patients (Zech et al. 1995; WHO 1996). Pharmacological interventions for pain management include the use of non-opioids such as paracetamol, aspirin, and non-steroidal anti-inflammatory drugs (NSAIDS) for the control of mild pain. In Europe, oral morphine is the dug of choice for the control of moderate to severe cancer pain, but weak or strong opioids may also be used, either with or without non-opioids. Correct dosing of opioids and effective management of common side effects (e.g. constipation) are essential (Walsh 2000), and adjuvant treatment for specific pain may also be required. Non-pharmacological interventions include the provision of emotional and spiritual support, helping the patient to develop coping strategies, use of relaxation techniques, acupuncture or the use of a transcutaneous electrical nerve stimulator (TENS). Evidence from a meta-analysis of randomised controlled trials assessing nursing non-pharmacological interventions demonstrated these interventions to be effective for pain management but some trials showed minimal differences between the treatment and control groups (Sindhu 1996). Breathlessness is a common symptom among cancer patients which can be difficult to control and may cause considerable distress to both patients and their carers (Davis 1997; Vora 2004). Appropriate management frequently requires both pharmacological and non-pharmacological interventions (Bausewein et al. 2008). Pharmacological interventions include the use of bronchodilators, benzodiazepines, opioids, corticosteroids and oxygen therapy (Vora 2004). Non-pharmacological interventions which have been shown to be effective include counselling and support, either alone or in combination with relaxation-breathing training, relaxation and psychotherapy (Bausewein et al. 2008). There is limited evidence that acupuncture or acupressure are effective. Both anxiety and depression are common among patients with advanced cancer but both of these conditions are frequently under diagnosed (Barraclough 1997). Furthermore, these conditions are sometimes viewed as simply natural reactions to the patient’s illness. Pharmacological interventions such as antidepressants should be used if the patient show symptoms of a definite depressive disorder. Non-pharmacological interventions include relaxation, psychosocial therapies and massage (Lander et al. 2000). Optimal management of depression in patients with advanced cancer typically involves a combination of both pharmacological and non-pharmacological approaches (Lander et al. 2000). Ethical and legal considerations in palliative care There are a number of ethical and legal considerations in palliative care such as euthanasia and the right to withhold or withdraw life sustaining treatment. Those aspects which were of importance in this account address the patient’s right to know their diagnosis (i.e. autonomy). Evidence shows that the majority of cancer patients wish to know their diagnosis and the likely progression of their disease (Faulkner 1998). This may present a challenge for clinicians and nurses who may wish to try to protect the patient and convey an optimistic outlook even when the prognosis is poor. In the case of Mr Smith, he wanted to know as much information as possible about his diagnosis and treatment and the consultant and nurse answered his questions as openly and honestly as possible. (5) Conclusion Reflective practice is important both as a learning process and for the continuing professional development of nurses. The use of a model such as Gibbs’s cycle enables the nurse to move logically through the reflective process and provides a structured approach. Effective communication is essential in palliative care. Nurses and other healthcare professionals must be able to communicate effectively both with patients and their families/carers but also with other members of the multidisciplinary care team. The nurse plays a key role in the provision of supportive and palliative care and must develop excellent verbal and non-verbal communication skills. Breaking bad news such as that given to Mr Smith is one of the hardest tasks for healthcare professionals, regardless of their level of experience, and it is essential that the situation is handled professionally, but also with empathy and sensitivity, taking full account of the ethical and legal aspects of the situation. The use of non-verbal communication by the nurse is as important as verbal methods of communication. (6) Action plan This incident provided me with a valuable learning opportunity and were I to encounter a similar situation in the future, I would feel much better prepared to deal with this. I have learnt that preparation is important, for example, selecting a suitable environment in which to break the news, and ensuring that chairs are placed correctly within the room. Rather than relying primarily on verbal communication, I would be more aware of the effectiveness of non-verbal methods, particularly touch, if this was appropriate. I have also developed a greater awareness of the ethical issues surrounding breaking bad news in palliative care, and the need to be open and honest with the patient and their family where possible. References Atkins, S. and Murphy, K. 1995, ‘Reflective practice’, Nursing Standard, vol. 9, no. 45, pp. 3135. Bailey, J. 1995, ‘Clinical reflective practice; reflective practice: implementing theory’, Nursing Standard, vol. 9, no. 46, pp. 2931. Barraclough, J. 1997, ‘ABC of palliative care: depression, anxiety and confusion’, British Medical Journal, vol. 315, pp. 1365–8. Bausewein, C., Booth, S., Gysels, M., Higginson, I. J. 2008, ‘Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases’, The Cochrane Database of Systematic Reviews, no. 3. Benjamin 1981, The helping interview, 2nd ed. Houghton Mifflin, Boston. Davis, C. L. 1997, ‘ABC of palliative care. Breathlessness, cough and other respiratory problems’, British Medical Journal, vol. 315, pp. 931–4. de Haes, H. Teunissen, S. 2005, ‘Communication in palliative care: a review of recent literature’, Current Opinion in Oncology, vol. 17, no. 4, pp. 345–50. Department of Health 2000, The NHS cancer Plan: a plan for investment, a plan for reform. Retrieved 1st September 2008 from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4009609 Donnelly, S. Walsh, D. 1995, ‘The symptoms of advanced cancer’, Seminars in Oncology, vol. 22, pp. 67–72. Faulkner, A. 1998, ‘Communication with patients, families, and other professionals’, British Medical Journal, vol. 316, pp. 130–2. Gibbs, G. 1988, Learning by doing: a guide to teaching and learning methods. Oxford Further Education Unit, Oxford Polytechnic. Grond, S., Zech, D., Diefenbach, C., Bischoff, A. 1994, ‘Prevalence and pattern of symptoms in paients with cancer pain: a prospective evaluation of 1,635 cancer patients referred to a pain clinic’, Journal of Pain Symptom Management, vol. 9, p. 372–82. Henley, N. 1973, ‘Power, Sex, and Nonverbal Communication’, Berkeley Journal of Sociology, vol. 18, pp. 1–26. Hinchliff, S. M., Norman, S. E., Schober, J. E. 1993, Nursing practice and health care, 2nd ed, Edward Arnold, London. Jarvis, P. 1992, ‘Reflective practice and nursing’, Nurse Education Today, vol. 12, pp. 174–81. Lander, M., Wilson, K., Chochinov, H. M. 2000, ‘Depression and the dying older patient’, Clinics in Geriatric Medicine, vol. 16, no. 2, pp. 335–56. Liverpool Care Pathway 2004, Liverpool Care of the Dying Patient Pathway. Retrieved 1st September 2008 from: http://www.endoflifecareforadults.nhs.uk/eolc/files/F2091-LCP_pathway_for_dying_patient_Sep2007.pdf Lugton, J. Kindlen, M. 1999, Palliative care: the nursing role. Churchill Livingstone, London. Matzo, M., Matzo, M. L., Witt Sherman, D. 2005, Palliative Care Nursing: Quality Care to the End of Life, 2nd edn. Springer Publishing Company, New York. NHS 2005, The Gold Standards Framework. Retrieved 1st September 2008 from: http://www.goldstandardsframework.nhs.uk/ NICE 2003, Improving supportive and palliative care for adults. Retrieved 1st September 2008 from: http://www.nice.org.uk/guidance/index.jsp?action=downloado=28800 Sindhu, F. 1996, ‘Are non-pharmacological nursing interventions for the management of pain effective? – a meta-analysis’, Journal of Advanced Nursing, vol. 24, pp. 1152–9. Smith, C. 1995, ‘Evaluating nursing care; reflection in practice’, Professional Nurse, vol. 10, no. 9, pp. 593–6. Spalding, N. J. 1998, ‘Reflection in professional development: a personal experience’, British Journal of Therapy and Rehabilitation, vol. 5, no. 7, pp. 379–82. Tickle, L. 1994, ‘The induction of new teachers’, Castell, London. Urie, J., Fielding, H., McArthur, D., Kinnear, M., Hudson, S., Fallon, M. 2000, ‘Palliative care’, The Pharmaceutical Journal, vol. 265, no. 7119, pp. 603–14. Vora, V. 2004, ‘Breathlessness: a palliative care perspective’, Indian Journal of Palliative Care, vol. 10, no. 1, pp. 12–18. Walsh, D. 2000, ‘Pharmacological management of cancer pain’, Seminars in Oncology, vol. 27, no. 1, pp. 45–63. WHO 1996, WHO guidelines: cancer pain relief, 2nd ed. World Health Organization, Geneva. Zech, D., Grond, S., Lynch, J., Hertel, D., Lehmann, K. A. 1995, ‘Validation of World Health Organization guidelines for cancer pain relief: a 10 year prospective study’, Pain, vol. 63, pp. 65–76. Vainio, A. Auvunen, A. 1996, ‘Prevalence of symptoms among patients with advanced cancer; an international collaborative group study’, Journal of Pain Symptom Management, vol. 12, pp. 3–10.

Household Waste! :: essays research papers

Household Waste! One morning my mom said "Andy, get up and clean the bathroom!" It was always an essential and important labor to the family. I got up and gathered all the normal cleaning agents we used; Ajax, ammonia, and this liquid bleach that my mom said worked wonders. The toilet I cleaned using the Ajax the sink I cleaned using the Ajax there seemed to be no need for the other two. Then I saw it- the bath tub, AH! There was a ring around the bath tub that I knew would be difficult to clean off. I decided to add the ammonia I scrubbed at the ring but it was not coming off. I then looked around thinking what to do†¦ "The Bleach!" I shouted aloud. And then -- it hit me, my mom's hand. "Never, Never, Never, use Bleach with ammonia. Infact don't mix any chemicals with one another." This is an excellent example of common mistakes people make when dealing with household chemicals/cleaners. In this assignment I will examine different cleaners commonly used in my house. I Ajax I go to the cupboard and find a can of the powder, Ajax. The can use to have a piece of tape to cover the top but now it has been lost; a potential problem. The can has an expiration date on it, 9/98. This expiration date may be incorrect because that piece of tape to cover it has been lost for some time now. II Windex In the cupboard in the upstairs bathroom is where we keep the Windex. The Windex is blue and clearly labeled, with no chance of any person mistaking it for something else. The top part is tightly screwed on with Windex filled to  ¾ of the original volume. I cannot find any expiration date, nor can I find any hint there ever was one. I should contact the product vender to see if the Windex is immortal or what. III Vinegar I go to the kitchen cupboard and find vinegar. Vinegar is what we use to mop our tile floor with. The vinegar has an "Easy flip-off cap!" and is about half of what it originally was. This too, has no evidence of an expiration date. I don't think I need to contact the item vendor because it's only vinegar. IV Formula 409 Next to the Ajax in our "Cleaner-Cupboard" we carry Formula 409, the ideal for kitchen clean-up. It is clearly labeled with no chance for

My Hero-Muhammad Ali David Ramsey 10A Essay

My hero is Muhammad Ali who first came into the public eye as Cassius Clay when he won a gold medal at the Olympic Games in Rome in 1960. In 1964 he stunned the boxing community with his defeat of Sonny Liston, the heavyweight champion, and shocked the world yet again when he changed his name to Muhammad Ali after the fight. During the Vietnam war he was ordered to go and fight but he refused on religious grounds, but his decision was not met with ease, he was branded a draft-dodger and threatened with prison. He was stripped of his title and was effectively banned from boxing. Despite this, he never gave in to the American Government and stuck to his principles and during the years of exile from boxing he spent time studying his religion and public speaking. It was evident that he was sincere in his beliefs and he started to reclaim the respect of the American public, especially as the horrors of what was happening in Vietnam began to be shared more widely.When he was 28 and after 3 years band from the sport he loved, he was able to resume his boxing career. He eventually regained his title and went on to fight in some of the most breathtaking fights the world has ever seen. During his career, his influence on the world of boxing changed the sport forever. He took the world heavyweight championship away from it’s traditional New York City venue and took it to Canada, Britain, Germany, Zaire, Malaysia and Manila, as well as the United States. He used his position to speak out against inequality and always helped people who were less fortunate than himself. He is still an ambassador of his religion and continues to try to give people hope. After he came back from suspension, he started with a mission to reclaim his title, he was granted a title shot against Joe Frasier in 1971, he underestimated Joe’s ability however, and lost the fight, it would now be even harder to become champion again. The world said that he was too old and past his peak when he was beat again by Ken Norton in 1972. Joe Frasier was beaten by George Foreman so Ali knew that if he was once again to become the Greatest he would have to beat Ken Norton, which he did and then he made an amazing comeback against Joe Frasier in the rematch in 1974. Ali had earned his title shot, the stage was set for Zaire (the Rumble in the Jungle) Ali vs Foreman. Muhammad Ali was very old and although he had made amazing comebacks against Frasier and Norton, neither of these were the fighter that George Foreman was, even Ali’s own trainer asked Foreman to take it easy on Ali because he was an `old man`. But yet again Muhammad Ali proved the world wrong yet again by knocking out George Foreman out in 8 rounds to regain his title. He reigned as champion for 4 years until he was beaten by Leon Spinks, now Leon was thought to be the greatest and the world expected him to become the next Muhammad Ali, he repeatidly taunted Ali until the rematch when Ali taught him what it meant to be the greatest! He was the first man to win the title 3 times. His flamboyant style has made him a legend, and his slogans `I am the greatest` and `float like a butterfly, sting like a bee` became catch phrases. Ali’s lifestyle was plagued with divorces and failed relationships but stayed loyal to his religion and his fans. Ali was president Carter’s special envoy to Africa in 1980 (attempting to persuade nations to boycott the Olympics). Muhammad Ali has lots of personal qualities and values. He spoke for civil civil rights against discrimination of black people in America on numerous occasions and refused to go to Vietnam for 2 reasons: he remained loyal to Islam and he refused to murder innocent people. This shows dignity and independence because he wouldn†t get drafted into the army when he didn’t want to. I admire Ali’s determination and strengh of character in this act even when he was sentenced to 5 years imprisonment and had his boxing license revoked he would not submit to the American Government. Ali has got to be the most entertaining sportsman ever, his humour, charisma and skill in the ring earned him the sportsperson of the century award. I admired his boxing skills when I first learnt about Muhammad Ali but as I progressed in learning about his life I was amazed to find out how much money he donated towards charity, he held many fundraisers for under priveliged children on the streets of America and Africa. Ali was very endurant because he has always been the only boxer to dance around the ring for a whole 15 rounds during a fight. He was always confident in his ability’s and always optimistic. Ali has great ambition, ever since he started boxing he said he would be the greatest and went in the right direction to do so because he is widely known as the greatest boxer ever. Ali has the courage to stand up and fight for what he believed in because he became a muslim whilst getting alot of criticism off muslims themselves, and changed his name to Muhammad Ali to suit his religion even when his own family disapproved of it. Now, Muhammad Ali is suffering from Parkinson’s disease, which attacks the nervous system, there is no cure for this disease and Ali has suffered immensly as a result of it. Despite this he still finds the energy to fund the Black Muslim campaign and other charities. Muhammad Ali has certainly influenced my life for the better because he has taught me to never give up on my dreams. Muhammad Ali is a perfect example of that if you work hard enough and never give up you can achieve just about anything, just as he did. The world might never have known Muhammad Ali if his bike hadn’t been stolen when he was 12. He set out an aim to be the greatest ever and worked extremely hard but never gave up, even when he was deemed too old to fight again, he beat George Foreman, against all odds, in Zaire. In conclusion, Muhammad Ali is my hero because he has proved the world wrong again by defeating other boxers against all odds (and still leave room for his witty humour). I will remember Muhammad Ali as someone who stood up for his beliefs always and was indeed the greatest.

Non-Verbal Behaviour and Gestures in “A Streetcar Names Desire” Essay

Task: Tennessee Williams uses very specific and detailed stage directions to indicate the emotions, thoughts and actions of his characters. Select a character from the play and discuss how his/her gestures and non-verbal behaviour serves to further reveal his/her personality traits. You might also add how his/her behaviour relates to the surroundings and cultural setting. The essay is based on Scenes 1 and 2. Word limit: 800 Tennessee Williams uses very specific and detailed stage directions to indicate the emotions, thoughts and actions of his characters in his famous play â€Å"A Streetcar Named Desire†. We communicate with much more than words. Most of the messages we send other people are nonverbal, these include our facial expressions, gestures, eye contact, posture, and tone of voice. The ability to portrait nonverbal communication in a play, or body language, is a powerful tool which can be utilized by any author to enhance the reading experience and give the play, even though it is just on paper in words and not enacted a deeper setting and a more natural interaction with the character. It acts like an unconscious language that broadcasts the character’s true feelings and intentions at any given moment. Blanche DuBois is no different in this respect to the extent that her actions speak more for her than she does verbally, considering her being a very talkative person. In the first Scene Blanche arrives at Elysian Fields to visit her Sister Stella, here the first sign of non-verbal behaviour can be observed. Blanche gives Eunice, the co-owner of Stella’s house and up-stair neighbour, a peculiar look as she enters the house, which she first doubted to believe was in fact her Sister’s due to its weathered grey and raffish appearance. This immediately causes a reaction on Eunice’ part resulting in a defensive tone of voice. â€Å"EUNICE [defensively, noticing BLANCHE’S look]: It’s sort of messed up right now but when it’s clean it’s real sweet.† – pg. 4 The defensive tone and the knowledge of Blanche’s â€Å"look† reveals that Blanche is used to living in a clean home, perhaps a bigger one with no neighbour on the second floor. It gives the reader the impression that she feels she has entered a house not up to her standards. This awareness directly influences the way the reader reads the next line, Blanche’s reply. â€Å"BLANCHE: Is it?† – pg. 4 Even though the author has not indicated a particular tone, the reader automatically may jump to a sarcastic one, developing the reader’s first impression of Blanche further solely due to the non-verbal message sent by Eunice through her tone of voice. The next instance is fully described by Tennessee Williams in one of his many stage directions right after Eunice leaves to hustle up Stella and tell her that her Sister Blanche has arrived. Alone in the house now, â€Å"Blanche sits in a chair very stiffly and her shoulders slightly hunched and her legs pressed close together and her hands tightly clutching her purse as if she were quite cold.† – pg. 5 Her posture exposes her inner feeling towards the situation and new environment she currently is in. She feels awkward in this estranged, messy house; her hunched shoulders and pressed legs expression anxiety and uneasy adaptation to the location. Her clutching her purse, valuable belongings, may also display intimidation or mistrust to a certain extent, but this is not directly hinted by the author. Perhaps it is her next action that plays a crucial part in understanding Blanche or having a better idea of the kind of person she really is. â€Å"†¦she begins to slowly look around. (†¦) Suddenly she notices something in a half-opened closet. She springs up and crosses to it, and removes a whisky bottle. She pours a half tumbler of whisky and tosses it down. She carefully replaces the bottle and washes the tumbler at the sink. Then she resumes her seat in front of the table.† – pg. 5 This short action tells us a number of different things about Blanche; she is a secretive and cautious person, she washes the glass and replaces the bottle to its original place as if nothing had happened. She does not feel guilty of using the situation to her advantage, she enjoys it. And last but not least, the reader is hinted at that she is not the person she may seem to be from the perspectives of the other characters; she is the secret alcoholic, addict without a strong se nse of self control. Later on in Scene two Blanche reveals another facet to her character – she flirts with Stella’s husband Stanley Kowalski and later even tells her about it. But that is verbal; the non-verbal component to this is in the stage directions: â€Å"[She sprays herself with her atomizer; then playfully sprays him (Stanley) with it. He seizes the atomizer and slams it down on the dresser. She throws back her head and laughs.]† I am not sure whether one would describe â€Å"playfully spraying† as a gesture, but either way it is non-verbal and leads to the direct assumption that Blanch is in fact flirting with her Sister’s husband, quite openly. It is something that usually people simply don’t do; it tells the reader that she is a character with a weak moral stem and an interest for men which outweighs her social values and family relationships. Her body language as she â€Å"throws back her head† also points towards feeling comfortable and not intimidated under Stanley’s presence and insinuates a further relation with him that may come out later on in the play. The significance of this is not yet known at the end of Scene 2, but it leads the reader to believe she may have an eye out for her Sister’s husband. The non-verbal behaviour and gestures throughout the first two Scenes of this play are more important than one may imagine. They give depth to every characters personality traits and have a direct impact on the way the reader categorizes them and in turns the tone the reader then reads their lines in.

Arthur Harris - World War II Arthur Bomber Harris Biography

Arthur Harris - World War II Arthur Bomber Harris Biography Early Life: The son a British Indian Service administrator, Arthur Travers Harris was born at Cheltenham, England on April 13, 1892. Educated at Allhallows School in Dorset, he was not a stellar student and was encouraged by his parents to seek his fortune in the military or colonies. Electing for the latter, he traveled to Rhodesia in 1908, and became a successful farmer and gold miner. With the outbreak of World War I, he enlisted as a bugler in the 1st Rhodesian Regiment. Briefly seeing service in South Africa and German South-West Africa, Harris departed for England in 1915, and joined the Royal Flying Corps. Flying with the Royal Flying Corps: After completing training, he served on the home front before being transferred to France in 1917. A skilled pilot, Harris quickly became a flight commander and later commander of No. 45 and No. 44 Squadrons. Flying Sopwith 1 1/2 Strutters, and later Sopwith Camels, Harris downed five German aircraft before the end of the war making him an ace. For his accomplishments during the war, he earned the Air Force Cross. At wars end, Harris elected to remain in the newly formed Royal Air Force. Sent abroad, he was posted to various colonial garrisons in India, Mesopotamia, and Persia. Interwar Years: Intrigued by aerial bombing, which he saw as a better alternative to the slaughter of trench warfare, Harris began adapting aircraft and developing tactics while serving abroad. Returning to England in 1924, he was given command of the RAFs first dedicated, postwar, heavy bomber squadron. Working with Sir John Salmond, Harris began training his squadron in night flying and bombing. In 1927, Harris was sent to the Army Staff College. While there he developed a dislike for the Army, though he did become friends with future Field Marshal Bernard Montgomery. After graduating in 1929, Harris returned the Middle East as Senior Air Officer in the Middle East Command. Based in Egypt, he further refined his bombing tactics and became increasingly convinced in aerial bombardments ability to win wars. Promoted to Air Commodore in 1937, he was given command of No. 4 (Bomber) Group the following year. Recognized as a gifted officer, Harris was promoted again to Air Vice Marshal and sent to Palestine and Trans-Jordan to command RAF units in the region. With World War II beginning, Harris was brought home to command No. 5 Group in September 1939. World War II: In February 1942, Harris, now an Air Marshal, was placed in command of the RAFs Bomber Command. During the first two years of the war, the RAFs bombers had suffered heavy casualties while being forced to abandon daylight bombing due to German resistance. Flying at night, the effectiveness of their raids was minimal as targets proved difficult, if not impossible, to find. As a result, studies showed that less than one bomb in ten fell within five miles of its intended target. To combat this, Professor Frederick Lindemann, a confidant of Prime Minister Winston Churchill, began advocating area bombing. Approved by Churchill in 1942, the doctrine of area bombing called for raids against urban areas with the goal of destroying housing and displacing German industrial workers. Though controversial, it was approved by the Cabinet as it provided a way to directly attack Germany. The task of implementing of this policy was given to Harris and Bomber Command. Moving forward, Harris was initially hampered by a lack of aircraft and electronic navigation equipment. As a result, early area raids often were inaccurate and ineffective. On May 30/31, Harris launched Operation Millennium against the city of Cologne. To mount this 1,000-bomber raid, Harris was forced scavenge aircraft and crews from training units. Utilizing a new tactic known as the bomber stream, Bomber Command was able to overwhelm the German night air defense system known as the Kammhuber Line. The attack was also facilitated by the use of a new radio navigation system known as GEE. Striking Cologne, the raid started 2,500 fires in the city and established area bombing as a viable concept. A huge propaganda success, it would be some time until Harris was able to mount another 1,000-bomber raid. As Bomber Commands strength grew and new aircraft, such as the Avro Lancaster and the Handley Page Halifax, appeared in large numbers, Harris raids became larger and larger. In July 1943, Bomber Command, working in conjunction with the US Army Air Force, commenced Operation Gomorrah against Hamburg. Bombing around the clock, the Allies leveled over ten square miles of the city. Heartened by the success of his crews, Harris planned a massive assault on Berlin for that fall. Believing that the reduction of Berlin would end the war, Harris opened the Battle of Berlin on the night of November 18, 1943. Over the next four months, Harris launched sixteen mass raids on the German capital. Though large areas of the city were destroyed, Bomber Command lost 1,047 aircraft during the battle and it was generally viewed as a British defeat. With the impending Allied invasion of Normandy, Harris was ordered to switch away from area raids on German cities to more precision strikes on the French railroad network. Angered by what he perceived as a waste of effort, Harris complied though he openly stated that Bomber Command was not designed or equipped for these types of strikes. His complaints proved moot as Bomber Commands raids proved highly effective. With the Allied success in France, Harris was permitted to return to area bombing. Reaching peak efficiency in the winter/spring of 1945, Bomber Command pounded German cities on a routine basis. The most controversial of these raids occurred early in the campaign when aircraft struck Dresden on February 13/14, igniting a firestorm that killed tens of thousands of civilians. With the war winding down, the final Bomber Command raid came on April 25/26, when aircraft destroyed an oil refinery in southern Norway. Postwar In the months after the war, there was some concern in the British government about the amount of destruction and civilian casualties caused by Bomber Command in the conflicts last stages. Despite this, Harris was promoted to Marshal of the Royal Air Force before he retired on September 15, 1945. In the years after the war, Harris stalwartly defended Bomber Commands actions stating that their operations conformed to the rules of the total war started by Germany. The following year, Harris became the first British commander-in-chief to not be made a peer after he refused the honor due to the governments refusal to create a separate campaign medal for his air crews. Always popular with his men, Harris act further cemented the bond. Angered by criticism of Bomber Commands wartime actions, Harris moved to South Africa in 1948, and served as a manager for the South African Marine Corporation until 1953. Returning home, he was forced to accept a baronetcy by Churchill and became the 1st Baronet of Chipping Wycombe. Harris lived in retirement until his death on April 5, 1984. Selected Sources BBC: Sir Arthur Bomber HarrisRAF: Arthur Bomber Harris

Executive Research Report Paper Example | Topics and Well Written Essays - 1250 words

Executive Report - Research Paper Example So it has become necessary to look into the connections between tourism development and environment. Also, it has become necessary to identify various models of sustainable tourism. Blue Lagoon Cruises, the newly acquired client company, is facing certain problems which are to be solved at the earliest in order to ensure continuous growth of the company as it has experienced in the last 10 years. One of the problems is related to meeting the environmental demands while ensuring tourism development. This executive report illustrates the relation between tourism development and sustainable environmental preservation and suggests various ways to achieve profit while protecting environment. This research project intends to investigate the impact of tourism development on environment and suggests various ways to introduce sustainable tourism development which ensures both profit and environmental protection. This report will be highly helpful for the special stakeholder committee which consists of Blue Lagoon executives, investors, Kona government officials, various special interest groups like World Watch Group, and village groups. This report will give all these people a comprehensive understanding of the different models of tourism development, which ensure profit while addressing environmental concerns. This report will conduct the research by answering three queries. First of all, it will identify the impacts of tourism on environment by analyzing works like that of the United Nations. Secondly, by analyzing cases like Bonaire National Parks Foundation and the Blue Flag, this work will identify various successful environmentally sustainable practices adopted by various agencies around the world. Thirdly, it looks into cases like Green Globe, International Tourism Partnership to prove that it is in fact more profitable in the long term

SPSS Assignment only Lab Report Example | Topics and Well Written Essays - 500 words

SPSS Assignment only - Lab Report Example None of the relationships is significant because they have a p value that is greater than 0.01. There is a weak positive correlation between math achievement in 8th grade and socio-Economic Status. This is because the data points are highly scattered and the trend of the data points seems not to be linear. Based on the scatter plot for math achievement in 8th grade and math achievement in 12th grade, what direction is the relationship? How strong is the relationship? Be sure to explain you answer. (2 points) There is a strong positive relationship between math achievement in 8th grade and math achievement in 12th grade. The trend of the scatter plot clearly shows it’s linear whereby the variables are directly proportional How does whether the State has a waiting period for handgun purchase influence the handgun homicide rate for that State? Remember to describe this relationship in terms of existence, strength, and direction. How does having a waiting period, unemployment rate, and number of executions influence the handgun homicide rate of a State? Remember to describe these relationships in terms of existence, strength, and direction. Number of execution has a negative influence while the unemployment has a positive influence on the handgun homicide rate of a state. Both have a weak relationship with the handgun homicide rate of a