50 Incorrect Pronunciations That You Should Avoid

50 Incorrect Pronunciations That You Should Avoid 50 Incorrect Pronunciations That You Should Avoid 50 Incorrect Pronunciations That You Should Avoid By Maeve Maddox Fred Astaire stepped chuckles back in the Thirties with his tune Lets Call the Whole Thing Off in which the darlings cannot concede to the way to express words like either, not one or the other, and tomato. On an individual level, I flinch when I hear somebody sound the t in frequently or articulate walnut with a short a, yet I need to recognize that both these elocutions are broadly acknowledged interchange articulations that can be advocated by the spelling. Exchange elocutions, in any case, are an alternate issue from without a doubt errors. The last mentioned, regardless of how normal, are erroneous, either in light of the spelling that shows another elocution, or on account of what is generally settled upon to be traditional use. Expression of alert: Im composing from an American point of view. Here are 50 as often as possible misspoke words. The rundown is in no way, shape or form comprehensive, yet gives a decent beginning. 1. aegis The ae in this word is articulated/ee/. State EE-JIS/, not/ay-jis/. In folklore the aegis is related particularly with the goddess Athene. It is her shield with the Gorgons head on it. 2. at any rate The issue with this word isn't such a great amount of elocution as the expansion of a superfluous sound. Dont add a s to make it at any rate. The word is ANYWAY. 3. archipelago Because the word is from Greek, the ch is articulated with a/k/sound. State/AR-KI-PEL-A-GO/, not/curve I-pel-a-go/. 4. cold Note the C after the R. State/ARK-TIK/, not/ar-tik/. 5. extra the principal C has a hard solid. State/AK-SESS-OR-Y/, not/ass-ess-or-y/. 6. ask The S precedes the K. State/ASK/not/aks/. 7. mark Notice the subsequent S. State/AS-TER-ISK/, not/as-ter-ik/. 8. competitor The word has two syllables, not three. State/ATH-LETE/, not/ath-uh-lete/. 9. spiked metal Notice the AR in the main syllable. State/BARBD/, not/weave/. 10. store The word is of French beginning, however it doesn't end with an emphasized syllable. A store is a concealing spot or something that is being covered up: a reserve of provisions; a reserve of cash; a store of medications. State/KASH/, not/ka-shay/. 11. competitor Notice the main d. State/KAN-DI-DATE/, not/kan-I-date/. 12. mounted force This word alludes to troops that battle riding a horse. State/KAV-UL-RY/, not/kal-vuh-ry/. NOTE: Calvary alludes where Jesus was killed and IS articulated/kal-vuh-ry/.) 13. bedlam The spelling ch can speak to three distinct sounds in English:/tch/as in chapel,/k/as in Christmas, and/sh/as in culinary specialist. The first stable is heard in quite a while of English birthplace and is the most widely recognized. The second stable of ch,/k/, is heard in expressions of Greek root. The third and least normal of the three ch sounds is heard in words received from present day French. Mayhem is a Greek word. State/KAY-OS/, not/tchay-os/. 14. garments Notice the TH spelling and sound. State/KLOTHZ/, not/kloz/. 15. daã ¯s A daã ¯s is a raised stage. The articulation deficiency is to switch the vowel sounds. The word is regularly incorrectly spelled just as misspoke. State/DAY-IS/not/dä «-is/. 16. expand The word has two syllables, not three. State/DI-LATE/, not/di-a-late/. 17. suffocated This is the past participle type of the action word suffocate. Notice that there is no D on suffocate. Dont include one when utilizing the word in its past structure. State/DROWND/, not/suffocate ded/. 18. and so forth This Latin expression is regularly misspoke and its truncation is every now and again incorrectly spelled. State/ET CET-ER-A/, not/ex cet-er-a/. For the shortening, compose ETC., not ect. 19. February Just about everybody I know drops the principal r in February. The spelling calls for/FEB-ROO-AR-Y/, not/feb-u-ar-y/. 20. foliage The word has three syllables. State/FO-LI-UJ/, not/fol-uj/. 21. strength English has two words spelled along these lines. One originates from Italian and the other from French. The Italian word, a melodic term meaning boisterous, is articulated with two syllables:/FOR-TAY/. The French word, a descriptive word meaning quality or solid point, is articulated with one syllable:/FORT/. 22. Halloween The word for the occasion Americans celebrate with such energy on October 31 gets from Hallowed Evening, which means evening that has been made heavenly. The word bless originates from Old English halig, which means sacred. Notice the an in the principal syllable and state/HAL-O-WEEN/, not/hol-lo-ween/. 23. stature The word closes in a/T/sound, not a/TH/sound. State/HITE/, not/hith/. 24. appalling People new to the TV show Law and Order: S.V.U. may not realize that shocking has two syllables. (The show starts with this sentence: In the criminal equity framework, explicitly based offenses are considered particularly terrible.) Say/HAY-NUS/, not/heen-I-us/. 25. chain of importance The word has four syllables. State/HI - ER-AR-KY,/not/howdy ar-ky/. 26. Illinois As with Arkansas, the last s in Illinois isn't articulated. State/IL-I-NOY/(and/Ar-kan-saw/, not/il-li-noiz/or/ar-kan-sas/). NOTE: Some unknowledgeable people may in any case be attempting to articulate Arkansas as though it had something to do with Kansas. The articulation/ar-kan-zuz/is waaay misguided. 27. decipher The word has three syllables. Dont include one! State/IN-TER-PRET/, not/in-ter-pre-tate/. 28. occurrence Something that happens is an episode. Dont state rate when you mean a particular occasion. There IS a word frequency, however it has an alternate importance. 29. irregardless See the genuine word, in any case. 30. gems The word has three syllables. State/JEW-EL-RY/, not/jew-el-er-y/. The articulation/jewl-ry/is normal yet not right, as it expels one syllable from the word. 31. library Notice where the R comes in the word. State/LI-BRAR-Y/, not/li-ber-ry/. 32. medieval The word has four syllables. The main E might be articulated either short [med] or long [meed]. State/MED-EE-EEVAL/or/MEE-DEE-EEVAL/, not/meed-eval/. 33. smaller than expected The word has four syllables. State/MIN-I-A-TURE/, not/min-a-ture/. 34. Naughty This is the modifier type of wickedness whose significance is catastrophe or mischief. Fiendish is currently connected with innocuous fun so the articulation pernicious insidiousness has been instituted as another term for vandalism. Naughty has three syllables with the highlight on the principal syllable:/MIS-CHI-VUS/. Dont state/mis-chee-vee-us/. 35. specialty The word is from the French and, however numerous expressions of French root have been anglicized in standard utilization, this is one that shouts out to hold a long e sound and a/SH/sound for the che. State/NEESH/, not/nitch/. 36. arrange This word has three syllables. As an action word it intends to put something in its legitimate situation corresponding to something different. It originates from a word meaning east and initially implied situating something according to the east. Presently it is utilized with an increasingly broad significance. State/OR-I-ENT/, not/or-I-en-tate/. 37. antiquated This descriptive word is shaped from a past-participle: molded. Dont leave off the ED. State/OLD-FASHIOND/, not/old-style/. 38. picture Theres a K sound in picture. Dont mistake picture for pitcher. State/PIK-TURE/, not/pitch-er/. Pitcher is an alternate word. A pitcher is a serving vessel with a handle. 39. precipitation This is a thing that alludes to rain or day off, whatever else that ordinarily tumbles from the sky. Similarly as with remedy (underneath), the prefix is PRE-. State/PRE-CIP-I-TA-TION/, not/per-cipi-ta-tion/. 40. remedy Note the prefix PRE-in this word. State/PRE-SCRIP-TION/, not/per-scrip-tion/or/genius scrip-tion/. 41. preventive The word has three syllables. A typical flaw is to include a syllable. State PRE-VEN-TIVE/, not/pre-ven-ta-tive. 42. articulation This word is a thing. It originates from the action word articulate, BUT it isn't articulated like the action word. State/PRO-NUN-CI-A-TION/, not/genius nounce-I-a-tion/. 43. prostate This word for a male organ is frequently misspoke. There is a descriptive word prostrate which intends to be loosened up facedown on the ground. When discussing the organ, be that as it may, state/PROS-TATE/, not/geniuses trate/. 44. Real estate professional The word has three syllables. State/RE-AL-TOR/, not/re-a-la-tor/. 45. in any case The word has three syllables. If you don't mind dont add an IR to make it into the cursed thing irregardless. 46. sherbet The word has just a single r in it. State/SHER-BET/not/sher-bert/. 47. fixed This is a one-syllable word, the past participle type of the action word to fix, which means to expel the ovaries from a creature. Like the action word suffocate (over) the action word fix doesn't have a D in its infinitive structure. Dont add one to the past participle. State/SPADE/, not/neuter ded/. 48. sensitive The word has two syllables. State/TIK-LISH/, not/tik-I-lish/. 49. tract Religious evangelists regularly hand out since quite a while ago printed explanations of conviction called tracts. That is one sort of tract. Houses are based on tracts. At that point theres the word track. Competitors run on tracks. Creatures leave tracks. Dont state/TRAKT/when you mean/TRAK/, and the other way around. 50. vehicle Although there is a H in the word, to articulate it is to sound hicky. State/VEE-IKL/, not/vee-Hikl/. 51. stormy Heres another climate word frequently misspoke, even by the climate individual. The word has two syllables. State/WIN-TRY/, not/win-ter-y/. Got any to add to the rundown? Need to improve your English quickly a day? Get a membership and begin accepting our composing tips and activities every day! Continue learning! Peruse the Spelling classification, check our well known posts, or pick a related post below:How to Punctuate References to Dates and TimesTelling a Good Poem from a Bad OneHow to Send Tactful Emails from a Technical Support Desk

Where are you going,where have you been Bob Dylan Who is the main Essay

Where are you going,where have you been Bob Dylan Who is the fundamental character ,Connie or Arnold Friend - Essay Example The story spins around Connie who is the fundamental character. She is a wonderful little youngster matured fifteen yet self-consumed. She winds up at chances with her mom and goes out without her parents’ information. Arnold is a companion to Connie and works at a close by café. He is a darker rendition of by one way or another extraordinary figure type. While Connie’s guardians are at a grill supper somewhere else, Arnold heads to her home to take her out for supper. Connie is frail and at last can't challenge Arnold’s impulse. The story occurred in 1960s and portrays a great deal about American life back then. Despite the fact that at a certain point, Connie finds that Arnold is a lot more seasoned than he professes to be, she can't do anything since there was nobody at her salvage. What's more, he unnerves her to surrender to her requests by taking steps to hurt her and her family on the off chance that she does something else (35). This shows nonappearance of law implementing bodies that could ensure all residents of the United States of America. In the story, Carol Oates realizes summoning of Bob Dylan with an important reason. The nearness of lavishness inside the setting of the story makes an improvement towards understanding a settled life. Moreover, Oates brings out riches taking into account delineating a period where Americans were heading off to some place, ‘where are you going?’ towards social insurgency (54). Connie is likewise the primary character since she is speaking to all the ladies in America. It was during this period when the American ladies were at the cutting edge of declaring about their privileges and their hindering need to end their control from men. Oates utilizes Connie as the principle character to depict the status of ladies in America during that period and their purposeful endeavors of asserting their sexuality in a way that was never obvious throughout the entire existence of America. The story is at the focal point of Connie and all what spins around her life. Oates utilized

The Strategic Management

Question : Talk about the Strategic Management ? Answer : Presentation One of the most rumored and eminent organization in the oil and gas division having a place with Australia is Woodside Petroleum. It was established in the year 1954 and the home office of the organization is situated at Woodside Plaza situated in Australia (Woodside.com.au, 2016). The organization is possessed by Royal Dutch Shell and the organization is recorded on the Australian Securities Exchange (Woodside.com.au, 2016). The working benefit of the organization is 26 million US$ in the year 2015. The organization has investigation, activities and advancement of melted gaseous petrol extends in nations, for example, Canada, US, New Zealand, Korea, Ireland and others (Woodside.com.au, 2016). This paper would examine different parts of this association including business techniques, reactions, authoritative culture and business condition investigation. Business Strategies of Woodside Petroleum Woodside Petroleum is an overall mainstream oil and gas association which is considered as one of the biggest administrator of the oil just as gas creation (Woodside.com.au, 2016). The organization has various tasks in remote districts of Western Australia, for example, North West Shelf and Pluto ventures (Woodside.com.au, 2016). These tasks are one of the top notch petroleum gas offices on the planet and have given predominant execution over the most recent 30 years. The vision of Woodside Petroleum incorporate that the organization tries to turn into the world chief in the turn of events and dissemination of oil and gas (Woodside.com.au, 2016). The strategic the organization endeavors to convey the better merchandise exchange than huge number of partners (Woodside.com.au, 2016). The vital bearing of the organization is planned for keeping up its market position in Australia by the advancement of advantages just as commercialization of the top notch openings (Woodside.com.au, 2016). The basic beliefs of Woodside Petroleum incorporate regard, uprightness, discipline, manageability, collaboration and greatness (Woodside.com.au, 2016). There are a few contenders of the association including ROC Oil Co. Ltd, ExxonMobil Australia Pty Ltd and China Petroleum. The business systems of the organization have developed as the years progressed. The business methodologies of the organization have shown a dynamic arrangement of activities that have focussed on the business improvement of the association. During the year 1979, the organization picked up endorsements for beginning the North West Shelf Gas Project (Woodside.com.au, 2016). The association has occupied with the business agreement of Liquefied Natural Gas with eight Japanese firms (Woodside.com.au, 2016). It continually searches for worthwhile firms with which it can make beneficial business openings. Woodside Petroleum is continually searching for new investigation destinations which would be worthwhile choices for the association. This has come about the association to find different condensate fields and oil fields. The organization has confidence in the way that it is critical to find new oil fields to increase upper hand. This drives the organization to continually look and examin e new oil fields (Woodside.com.au, 2016). This excitement of the organization has brought about the revelation of Laverda oil field, Cossack oil field, Hermes oil fields, Laminaria oil field and others. At the present, the organization has embraced an alternate arrangement of business systems. It has received three basic beliefs in their hierarchical strategy, for example, portfolio development, utilizing authoritative ability and boosting the estimation of center resources (Woodside.com.au, 2016). The association has situated itself with growing resource base just as particular capacities that are fundamental for authoritative achievement. This has been finished by the expanded reception of the most recent innovations. The association has received the liquefaction advancements just as LNG advances for more prominent mechanization in their business forms (Woodside.com.au, 2016). The innovation selection has additionally brought about the foundation of the remote activities in the seaward oil ventures (Woodside.com.au, 2016). This has decreased the operational expenses of the organization just as expanded the associations upkeep result. The organization focuses on the Australian area , Sub-Saharan Africa and the Atlantic locales. It endeavors to be the presumed rising oil regions (Woodside.com.au, 2016). Woodside Petroleum endeavors to extend its business activity systems and subsequently it has made a broad system of investigation resources in areas, for example, Spain, Peru, Brazil, Ireland and others (Woodside.com.au, 2016). Analysis of strategic policies The worldwide organizations have consistently confronted numerous difficulties while focusing on business extensions (Kumar et al., 2013). There can be solid obstruction while actualizing new authoritative arrangements. The difficulties can likewise be identified with the everyday working of the association. Similar remains constant for Woodside Petroleum. Before, it was seriously reprimanded for under-execution. The contenders of the organization have not performed well and this has demonstrated profitable to the organization. It has neglected to restore the nature of their operational methodology and henceforth it holds the second situation in the Australian economy. There are two occurrences during which the companys business choices were seriously scrutinized (Woodside.com.au, 2016). The main occasion which end up being problematic for the organization was the point at which the Mauritian head Ely Ould Mohamed Vall declared that the agreements made with Woodside Petroleum. The issue started when Woodside Petroleum consented to pay US$600 million for building up the Chinguetti Offshore Oil Project in Mauritania (Aguilera et al., 2012). The Mauritanian government has asserted that Woodside Petroleum has consented to the arrangement past the lawful structure. The organization was blamed for pay off and debasement when going into the exchange understandings. The association couldn't depict moral strategic policies when managing remote government. The Australian Federal Police blamed Woodside Petroleum for defilement just as pay off, which was accounted for by the Sunday Morning Herald (Woodside.com.au, 2016). The BBC News detailed the organization performed outside the lawful domain which raised incredible ruckus for the association. The second case when Woodside Petroleum confronted serious open analysis was the point at which it offered misleading open remarks (Sridhar and Jone, 2013). The analysis was finished by the business substance Australian Conservation Foundation. The Foundation denounced the organization by expressing that the organization made superfluous misrepresentation in the open which didn't coordinate with the announcements given to the financial specialists and different partners. The various articulations made by the organization in people in general were opposing and this raised gigantic ruckus to the organization. Theprimary point of the organization was to increase free carbon licenses and this was the essential explanations behind the beguiling proclamations, as guaranteed by the Conservation Foundation (Woodside.com.au, 2016). In the year 2009, the Australian Conservation Foundationlodges an authority complaintagainst Woodside Petroleum. The government customer undertakings were likewise included for making reasonable move against the organization. The organization has confronted reactions from the clients, outside partners, lawful foundations, industry specialists and others. This caused negative brand picture of the organization. The lawful procedures and the contention have affected the notoriety of the organization. It has additionally caused major monetary loss of the organization. Business Environment Analysis of Woodside Petroleum The outer just as interior business condition of Woodside Petroleum needsto be broke down for understanding the vital business position in the oil and gas industry. The four diagnostic apparatuses are utilized for this reason, for example, PESTEL examination, SWOT investigation, inside condition examination and explicit condition investigation. Political variables The oil just as gas industry is affected by the distinctive political factors, for example, political shakiness, government guidelines and geopolitical clashes (North et al., 2014). Financial elements There is cozy relationship with the oil costs and estimation of US dollar that influence the evaluating guideline of the organization. The focal worth impacts the dollar esteem which is a significant factor in the evaluating methodology of the oil and gas items (North et al., 2014). The components, for example, shadow banking framework, worldwide monetary emergency and downturn additionally assume a significant job in forming the business strategies of Woodside Petroleum (Azar, 2015). Social components There has been an expansion in the attention to the earth neighborly energizes, expanded familiarity with the petroleum gas items and diminishing reliance on the non-renewable energy sources (Stigka, Paravantis and Mihalakakou, 2014). These components impact the assembling and the dispersion of the oil just as gas associations. Innovative components There are some best in class mechanical components which influence the oil and gas industry, for example, 3D printers, remote review, imaging advancements, information mapping and self-governing vehicles. Natural elements The natural factors, for example, heavier energizes utilization, oil slicks and refined oil spills influence the human just as creature life, as it were, (Doerffer, 2013). The oil and gas pipelines have influenced the common water bodies, for example, waterways, seas and cropland. Legitimate variables The legitimate structure includes the gas guidelines, oil guidelines and the flammable gas guidelines that decide the idea of the business strategies of the organization (North et al., 2014). It is additionally imperative to put accentuation on the licensed innovation rights. The clients have shown an expanded utilization design for the oil just as gas items (Clark, Horner and Harto, 2013). There has been an expansion in the related industr

Political Economy Lectures Essay Example | Topics and Well Written Essays - 750 words

Political Economy Lectures - Essay Example The Council on American Islamic Relations (CAIR) is an association whose principle point is to advocate for the privileges of Muslims in North America. It very well may be said that it speaks to all Muslim who live in North America. Its central command are arranged in Washington D.C, and it has workplaces in any event twenty states and in Canada, and supporting for shared comprehension and equity is its vision. Its crucial to engage every single American Muslim,, secure their privileges, empower discourse and advancing comprehension and equity through structure alliances. The discussion educated us regarding what the Council on American-Islam Relations (CAIR) does in its everyday activities. They incorporate, securing the privileges of American Muslims during addressing by the Federal Bureau of Investigations (FBI) and other law implementation offices, battling for the privileges of Muslims who have been exposed to work segregation and even the individuals who have been ended unfairl y. It additionally halted unlawful seizers of property by law authorization and furthermore advocates for equivalent understudy rights in schools and other learning establishments. The discussions additionally sort to teach us on how individuals generalization Muslims in America. ... The vast majority picked the initial two photos in light of the fact that the individuals in the photos had wearing a way proposing they were Muslims. The speaker demonstrated how individuals weren't right by revealing to them that even the fair woman in one of the photos was for sure a Muslim. The discussion additionally educated us on the demography related with Muslims in America. The speaker called attention to that Democrat acknowledged Muslim Americans more than Republicans. For example the speaker brought up that in the 2008 presidential decisions seventy nine percent of Muslims living in America decided in favor of the applicant from the Democratic Party. It was likewise called attention to that the Republican Party should advocate for the privileges of American Muslim since they hold a huge level of the national vote. The subject of the discussion was by and large resistance towards Muslims in America. The speaker planned for indicating how and why Muslims living in America are exposed to a ton of torment because of the issue of psychological warfare. He indicated this by distinguishing the ascent of Anti-Islam developments and Islam fear in the United States of America. Islamophobia is an extraordinary dread of and scorn of Muslims. After the psychological oppressor assault on the twin towers in September eleventh 2001, disdain and dread of Muslim in America rose. From that point forward, Muslims in America have been put to separation and brutality. ' After the discussion, it was clear how Muslims in America have been abused. The discussion caused me to understand that the assessment I had about Muslims by and large was only a generalization and that it wasn't right. I came to comprehend what Muslims experience and how their privileges are damaged. I would energize the Council on American-Islam Relation (CAIR) to proceed with their great work in campaigning for the privileges of

Sport Injury Prevention Strategies Health And Social Care Essay

Game Injury Prevention Strategies Health And Social Care Essay Crotch torment happens every now and again in wearing exercises, for example, running, kicking, soccer, rugby, and ice hockey which include snappy increasing speeds, decelerations and unexpected quick directional changes (Cowan et al., 2004 and Verrall et al., 2005). Hormon (2007) proposed that, crotch torment might be brought about by a games hernia, osteitis pubis, nerve ensnarement, adductor and Iliopsoas muscle strain or any mix of these elements. The most widely recognized area (>50%) of crotch torment revealed in competitors is the adductor muscle ligament locale (Holmich. 2007). The appraisal and treatment of crotch torment in competitors is troublesome as the life systems of the crotch locale is perplexing and the capacity to envision the life systems of the crotch region is significant for both physical assessment and the differential conclusion (Vincent and Victoria, 2001). Holmich (2007) reports that the reason for constant crotch torment left in banter and orderly clin ical appraisals utilizing dependable assessment strategies were not completed in studies and all around characterized symptomatic elements are not detailed. If you don't mind discover the informative supplement I (a) for a portion of the terms utilized as often as possible. Janda (1992), reports that in any game the initial segment of injury the executives is injury anticipation. Emery (2003) portrays that, to create and assess the game injury counteraction techniques, a great comprehension of injury rates, the member populace in danger and the hazard factors related with injury for the populace should be first distinguished. In athletic populace; crotch strain injury rate definition might be acquired by utilizing a normalized introduction of real player hours isolated between preparing time and game time. The danger of injury is distinctive for various games (Junge et al, 2006). When considering the seriousness of the injury in an English Football Association group that the general hazard to proficient competitors is significantly high around multiple times higher among proficient football players than for high-chance mechanical occupations (Drawer and Fuller2002). The high pace of injury rate among various games may have lead analysts to endeavor to d istinguish chance elements and preventive strategies for various game wounds. Meeuwisse and Bahr (2009), characterizes hazard factors are the ones which makes the athletic injury or adequate enough reason injury. The hazard factors for crotch injury in sport are considered as inborn hazard factors like age, sex and physical wellness, level of play, anatomical arrangement of structures, past injury and body organization. The extraneous hazard factors, for example, defensive hardware, athletic gear, condition factors like climate, surface of play, and human variables like adversary conduct, playing circumstance and furthermore biomechanical portrayal make the competitor helpless to injury. These hazard factors were additionally characterized by Meeuwisse and Bahr (2009), as modifiable or non modifiable. Perseverance, quality, balance and diminished degrees of game explicit preparing are a portion of the modifiable hazard factors. These hazard components can be changed to lessen the crotch injury rates through the execution of injury anticipation procedures. Age, sex, past crotch injury are considered as non modifiable hazard factors for crotch injury. These variables can't be changed to decrease injury rates through the usage of injury avoidance methodologies yet encourage the distinguishing proof of the game populace in danger. See Appendix ii for injury causation model by Meeuwisse (2006) The crotch locale is an exceptionally versatile territory comprises of where guts meets the legs and contains the structures of the perineum (Timothy and Steven, 2008).Therefore, it incorporates the lower rectus stomach muscles, the inguinal district, the symphysis pubis, the upper segments of the adductor muscles of the thigh, and the genitalia, likewise the scrotum in guys. Falvey et al, (2008) portrayed the crotch district by setting out fringes which includes crotch, gluteal and more prominent trochanter of femur called 3G triangle, for sports medication experts to help comprehend the conclusion of crotch torment simpler by the starting point of side effects. (Adjusted from Falvey et al, 2009. The crotch torment: patho-anatomical way to deal with the finding of interminable crotch torment in competitors). The front unrivaled iliac spine (ASIS) and pubic tubercle frames the peak of crotch triangle, as this point alludes to the 3G point. The land characteristics of the unrivaled fringe of the triangle frames by the line between the pubic tubercle and ASIS, while line from the pubic tubercle poorly shapes the average outskirt and line from ASIS superiorly frames the horizontal fringe. See index I (b) for graph for muscles of the crotch locale. The bodys focal point of gravity is situated inside the pelvis, foremost to the second sacral vertebra; hence, the heaps that are created or moved through this zone are significant in essentially every athletic exertion (Anderson, et al 2001).Loads of up to multiple times body weight has been shown in the hip joint during running, with conceivably more noteworthy burdens may introduce during vivacious athletic rivalry (Crowninshield, et al 1978), the structures around the hip are particularly adjusted to move such powers. The most well-known crack is to the femur may brought about by the power transmitted from the hip joint, when subject to a blend of hub pressure, torsion, shear and twisting burdens which can cause break at different locales. Lopsidedness between the heaps applied to the pelvis and the uprightness of the pelvic structures, coming about into abuse issues. Pubic symphysis shows its most prominent portability when it is presented to shear powers. Pizzari et al (2008) r eports that the lopsided characteristics might be happening from lacking pelvic respectability which is natural hazard factor and modifications in the heaps as outward hazard factor or now and then blend of these two can cause osteitis pubis, which thusly adds to crotch pathology. Accordingly, in anticipation of osteitis pubis now and again includes early acknowledgment of hazard factors toward the start of the period might be proper. Having known the multifaceted nature of life structures and biomechanics crotch district, it might be helpful to create complete comprehension of hazard factors causing the crotch torment to create compelling preventive measures among various games. Research Question The initial phase during the time spent any examination study is to frame an exploration question. Four segments ought to be viewed as while shaping an exploration question (Meade and Richardson 1997). These incorporate the customer bunch being explored, intercessions, similar mediations and the results used to gauge the impact. Is distinguishing hazard factors and causes help competitors in forestalling crotch torment? a writing survey. Goal of the investigation This audit inspects the investigations on distinguishing the hazard factors and reasons for the crotch torment and does this aided in forestalling crotch agony, and means to grow new bits of knowledge dependent on current information on the point by exploring the writing. Points of the investigation The point of this examination is to survey the proof to check whether there are certain advantages (diminishing the frequency of wounds) of recognizing hazard factors for causing crotch torment. These positive results may assist wellbeing with caring experts required to forestall competitors crotch torment. Part 1 Preliminary Literature Review In this audit there will be a wide primer writing survey on crotch torment, where occurrence, the study of disease transmission, chance factors and causes corresponding to crotch agony will be examined. Significance and standards of injury counteraction are examined in detail. The study of disease transmission of crotch wounds in competitors Injury was characterized as any occasion that kept a player out of a training or a game or required the consideration of the group doctor (Molsa, et al 1997). In proficient soccer, crotch wounds includes up to 10% of the considerable number of wounds (Hawkins et al, 2001), yet are answerable for an a lot bigger extent of time lost from preparing and play (Muckle, 1982). Creeks et al (2005) have given an account of match wounds related with 546 rugby association players at 12 English Premiership clubs in two seasons. They found that frequency, seriousness of crotch, hip and butt cheek wounds according to each 1000 player hours and seriousness in number of days nonappearance. In first class level soccer, crotch strain wounds have been accounted for to represent 20% of all muscle strain wounds and over 40% in ice hockey and they likewise represent >10% of all wounds in tip top degrees of ice hockey, soccer, and games. In Australian Rules football (AFL), the quantity of games lost was more at all degrees of the game because of hip and crotch wounds. AFL measurements for seasons 2001-2006 saw crotch pathologies representing a normal of 13.0 missed games per club per season including a normal of 3.25 players per group. Over this equivalent period these crotch wounds had a 23% repeat rate. Walden et al (2007) concentrated in elite athletics, and have seen crotch injury as the fourth most basic injury influencing soccer players. Plantation and Seward (2002) consider crotch injury the third most regular injury in Australian Rules football and it likewise has a high pervasiveness in ice hockey and rugby. In any case, in considering time lost from injury, crotch torment plays just close to crack and joint remaking (Brooks et al, 2005). Crotch injury is among the main one to 6th most normal refered to injury in the Olympic games of ice hockey, speed skating, soccer, and games. Crotch wounds represent 3-11% of all wounds in some Olympic games including ice hockey, speed skating, soccer, swimming, and sports. Reasons for crotch wounds Crotch torment in competitors can be arranged into athletic and non athletic causes. (It would be ideal if you locate a table in informative supplement iii for reasons for crotch torment). Adductor muscle strains and osteitis pubis are the most widely recognized musculoskeletal reasons for crotch torment in competitors, wh

Prozac for Anxiety Disorders

Prozac for Anxiety Disorders Social Anxiety Disorder Treatment and Therapy Print Prozac for Anxiety Disorders Side Effects, Interactions, and Risks By Arlin Cuncic Arlin Cuncic, MA, is the author of Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder and 7 Weeks to Reduce Anxiety. Learn about our editorial policy Arlin Cuncic Reviewed by Reviewed by Amy Morin, LCSW on July 01, 2019 facebook twitter instagram Amy Morin, LCSW, is a psychotherapist, author of the bestselling book 13 Things Mentally Strong People Dont Do, and a highly sought-after speaker. Learn about our Wellness Board Amy Morin, LCSW Updated on December 10, 2019 Social Anxiety Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Verywell / Cindy Chung In This Article Table of Contents Expand Overview Prozac for Anxiety Safety Other Treatments View All Prozac (Fluoxetine) is an antidepressant that was first introduced in the United States to treat depression in the 1980s. It is part of a class of medications known as selective serotonin reuptake inhibitors (SSRIs). Prozac is mainly used to treat major depression, obsessive-compulsive disorder, and panic disorder (approved uses by the U.S. Food and Drug Administration) but is also sometimes used off-label to treat other anxiety disorders.?? How Prozac Helps With Anxiety As an SSRI, Prozac works by preventing the brain from reabsorbing naturally occurring serotonin. Serotonin is involved in mood regulation. In this way, Prozac helps the brain to maintain enough serotonin so that you have a feeling of well-being, resulting from improved communication between brain cells. Research also highlights how medications such as Prozac may help in combination with psychotherapy. In a 2008 mice study published in Science, it was shown that Prozac helped the brain to enter a more immature and plastic state, possibly making it easier for therapy to have an effect. Studies like this have provided insight into the fact that combining medication such as Prozac with talk therapy is effective for anxiety. What It Feels Like to Take Prozac If you experience a positive response to Prozac, you might notice a decrease in your anxiety symptoms and feel more like yourself again:More relaxedLess anxiousImproved sleep and appetiteGreater interest in lifeIncreased energyImproved focusRemember that it may take time for these improvements to become noticeableâ€"even up to 12 weeks in some cases. You may also experience side effects at first, so it may be hard to notice the improvements until the side effects lessen. Using Prozac for Anxiety Prozac is often considered a first-line treatment for anxiety disorders. However, there are a number of steps involved in obtaining a prescription. Generally, a diagnosis of a mental health disorder must be given before you would be prescribed Prozac. While a family doctor is capable of writing a prescription, the process is better handled by a mental health professional, such as a psychiatrist, who can prescribe medication. Dosage and Administration Prozac is usually prescribed at a low dose to start, and then gradually increased to 20 mg per day. The maximum dose is 80 mg a day. It is taken as a liquid or capsule, and should be used as prescribed. It can take several weeks for effects to show, so it is important not to stop taking Prozac abruptly if you think it is not working. Only take the medication as prescribed by your doctor or psychiatrist. Stopping cold turkey could be dangerous and cause withdrawal symptoms. What to Do If Your Antidepressant Stops Working Safety of Prozac There has been some controversy as to the safety of Prozac, due to the issuing of a safety warning by the U.S. Food and Drug Administration in 2007 about the risk for suicidal thoughts among certain groups. Despite this warning, Prozac continues to be prescribed and can be used safely (or discontinued if adverse effects develop) when under the guidance of a physician. If you have concerns about the safety of taking Prozac, bring these up to your doctor. Medication Interactions Prozac should not be combined with monoamine oxidase inhibitors (MAOIs) or taken within 14 days of discontinuing an MAOI. Allow at least five weeks after stopping Prozac before starting an MAOI. Use of pimozide and thioridazine also increases the risk involved in taking Prozac. The result of medication interactions can be serious and potentially fatal, so you should discuss all medications you are taking with your doctor or psychiatrist to determine whether potential interactions exist. How MAOIs Work and Common Side Effects Side Effects   Some side effects of Prozac are more likely than others. Some people notice that side effects lessen over time, or become less bothersome. Common side effects: Sleep problemsHeadachesFatigueDizzinessNauseaLoss of appetiteAnxietyLightheadednessYawningSweatingSexual problemsDry mouthHeart burnDiarrheaBlurred vision Does Prozac Cause Weight Gain? Rare side effects: VomitingSeizuresRash/hivesFeverSwellingFeeling confusedExtreme anxietyTrouble breathing or swallowingBleeding or bruisingSuicidal thoughts or behavior If you experience any of these severe side effects, be sure to notify your doctor or psychiatrist. Who Should Not Take Prozac Prozac can be passed to babies during pregnancy and through breast milk. Consult with your doctor if you are pregnant or nursing before taking Prozac, to determine whether the benefits outweigh the risks. There are also some potential risks for individuals age 65 or older that should be discussed with your doctor.  The safety and effectiveness of Prozac for use with children younger than 18 years of age has also not been established.   What Are Prozacs Potential Side Effects in Children? Drug Interactions Prozac should not be combined with alcohol,  certain over-the-counter (e.g., aspirin, due to the risk of bleeding)  and prescription medications, and nutritional supplements or herbs (e.g., St. Johns Wort). Be sure to tell your doctor about everything that you are taking. Prozac should not be taken at the same time as  monoamine oxidase inhibitors (MAOIs) (pimozide and thioridazine), tricyclic antidepressants (TCAs), or drugs metabolized by CYP2D6. Care should also be taken if using drugs that affect the central nervous system (CNS), such as benzodiazepines. Warnings Use of Prozac can carry risks, including the potential for clinical worsening and in rare cases, increased thoughts of suicide.  Serotonin syndrome  can also occur, particularly if used in conjunction with certain other medications. Close monitoring by your psychiatrist or doctor is important. How Serotonin Syndrome Is Diagnosed and Treated Prozac also comes with a black box warning that it may increase the risk of suicide in people younger than 25 years old. In these individuals, it may lead to suicidal thoughts, or worsening of these types of thoughts. If you belong to this group, your doctor should monitor you, particularly in the early stages, for these serious issues. Prozac may also activate mania in people who are prone. Withdrawal If you stop taking Prozac all of a sudden, you may notice withdrawal symptoms, including DizzinessConfusionNightmaresInsomniaIrritabilityCrying spells For this reason, never stop a medication without consulting your doctor. Prozac should always be tapered off to avoid withdrawal effects. Tips to Reduce Antidepressant Discontinuation Symptoms Other Options If Prozac is not well tolerated, other SSRIs that are sometimes prescribed for anxiety include  Paxil  (paroxetine),  Lexapro  (escitalopram),  Luvox CR  (fluvoxamine) and  Zoloft  (sertraline).  Effexor XR  (venlafaxine) is another antidepressant called a serotonin-norepinephrine reuptake inhibitor (SNRI) that also may be effective in treating your anxiety. Finally, benzodiazepines are another class of medication often used for anxiety, but they are generally a short-term solution because of their risk of dependence. Typical medications in this category include    Valium  (diazepam),  Xanax  (alprazolam),  Klonopin  (clonazepam) and  Ativan  (lorazepam). The 5 Most Used Antidepressants A Word From Verywell If youve been prescribed Prozac for anxiety, you may feel worried about side effects and whether the medication will be helpful. Share your concerns with your doctor and stay in contact about how you are doing once you begin the medication. Communication is key to ensuring that this medication is used in an appropriate way for maximum effectiveness.

Prozac for Anxiety Disorders

Prozac for Anxiety Disorders Social Anxiety Disorder Treatment and Therapy Print Prozac for Anxiety Disorders Side Effects, Interactions, and Risks By Arlin Cuncic Arlin Cuncic, MA, is the author of Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder and 7 Weeks to Reduce Anxiety. Learn about our editorial policy Arlin Cuncic Reviewed by Reviewed by Amy Morin, LCSW on July 01, 2019 facebook twitter instagram Amy Morin, LCSW, is a psychotherapist, author of the bestselling book 13 Things Mentally Strong People Dont Do, and a highly sought-after speaker. Learn about our Wellness Board Amy Morin, LCSW Updated on December 10, 2019 Social Anxiety Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Verywell / Cindy Chung In This Article Table of Contents Expand Overview Prozac for Anxiety Safety Other Treatments View All Prozac (Fluoxetine) is an antidepressant that was first introduced in the United States to treat depression in the 1980s. It is part of a class of medications known as selective serotonin reuptake inhibitors (SSRIs). Prozac is mainly used to treat major depression, obsessive-compulsive disorder, and panic disorder (approved uses by the U.S. Food and Drug Administration) but is also sometimes used off-label to treat other anxiety disorders.?? How Prozac Helps With Anxiety As an SSRI, Prozac works by preventing the brain from reabsorbing naturally occurring serotonin. Serotonin is involved in mood regulation. In this way, Prozac helps the brain to maintain enough serotonin so that you have a feeling of well-being, resulting from improved communication between brain cells. Research also highlights how medications such as Prozac may help in combination with psychotherapy. In a 2008 mice study published in Science, it was shown that Prozac helped the brain to enter a more immature and plastic state, possibly making it easier for therapy to have an effect. Studies like this have provided insight into the fact that combining medication such as Prozac with talk therapy is effective for anxiety. What It Feels Like to Take Prozac If you experience a positive response to Prozac, you might notice a decrease in your anxiety symptoms and feel more like yourself again:More relaxedLess anxiousImproved sleep and appetiteGreater interest in lifeIncreased energyImproved focusRemember that it may take time for these improvements to become noticeableâ€"even up to 12 weeks in some cases. You may also experience side effects at first, so it may be hard to notice the improvements until the side effects lessen. Using Prozac for Anxiety Prozac is often considered a first-line treatment for anxiety disorders. However, there are a number of steps involved in obtaining a prescription. Generally, a diagnosis of a mental health disorder must be given before you would be prescribed Prozac. While a family doctor is capable of writing a prescription, the process is better handled by a mental health professional, such as a psychiatrist, who can prescribe medication. Dosage and Administration Prozac is usually prescribed at a low dose to start, and then gradually increased to 20 mg per day. The maximum dose is 80 mg a day. It is taken as a liquid or capsule, and should be used as prescribed. It can take several weeks for effects to show, so it is important not to stop taking Prozac abruptly if you think it is not working. Only take the medication as prescribed by your doctor or psychiatrist. Stopping cold turkey could be dangerous and cause withdrawal symptoms. What to Do If Your Antidepressant Stops Working Safety of Prozac There has been some controversy as to the safety of Prozac, due to the issuing of a safety warning by the U.S. Food and Drug Administration in 2007 about the risk for suicidal thoughts among certain groups. Despite this warning, Prozac continues to be prescribed and can be used safely (or discontinued if adverse effects develop) when under the guidance of a physician. If you have concerns about the safety of taking Prozac, bring these up to your doctor. Medication Interactions Prozac should not be combined with monoamine oxidase inhibitors (MAOIs) or taken within 14 days of discontinuing an MAOI. Allow at least five weeks after stopping Prozac before starting an MAOI. Use of pimozide and thioridazine also increases the risk involved in taking Prozac. The result of medication interactions can be serious and potentially fatal, so you should discuss all medications you are taking with your doctor or psychiatrist to determine whether potential interactions exist. How MAOIs Work and Common Side Effects Side Effects   Some side effects of Prozac are more likely than others. Some people notice that side effects lessen over time, or become less bothersome. Common side effects: Sleep problemsHeadachesFatigueDizzinessNauseaLoss of appetiteAnxietyLightheadednessYawningSweatingSexual problemsDry mouthHeart burnDiarrheaBlurred vision Does Prozac Cause Weight Gain? Rare side effects: VomitingSeizuresRash/hivesFeverSwellingFeeling confusedExtreme anxietyTrouble breathing or swallowingBleeding or bruisingSuicidal thoughts or behavior If you experience any of these severe side effects, be sure to notify your doctor or psychiatrist. Who Should Not Take Prozac Prozac can be passed to babies during pregnancy and through breast milk. Consult with your doctor if you are pregnant or nursing before taking Prozac, to determine whether the benefits outweigh the risks. There are also some potential risks for individuals age 65 or older that should be discussed with your doctor.  The safety and effectiveness of Prozac for use with children younger than 18 years of age has also not been established.   What Are Prozacs Potential Side Effects in Children? Drug Interactions Prozac should not be combined with alcohol,  certain over-the-counter (e.g., aspirin, due to the risk of bleeding)  and prescription medications, and nutritional supplements or herbs (e.g., St. Johns Wort). Be sure to tell your doctor about everything that you are taking. Prozac should not be taken at the same time as  monoamine oxidase inhibitors (MAOIs) (pimozide and thioridazine), tricyclic antidepressants (TCAs), or drugs metabolized by CYP2D6. Care should also be taken if using drugs that affect the central nervous system (CNS), such as benzodiazepines. Warnings Use of Prozac can carry risks, including the potential for clinical worsening and in rare cases, increased thoughts of suicide.  Serotonin syndrome  can also occur, particularly if used in conjunction with certain other medications. Close monitoring by your psychiatrist or doctor is important. How Serotonin Syndrome Is Diagnosed and Treated Prozac also comes with a black box warning that it may increase the risk of suicide in people younger than 25 years old. In these individuals, it may lead to suicidal thoughts, or worsening of these types of thoughts. If you belong to this group, your doctor should monitor you, particularly in the early stages, for these serious issues. Prozac may also activate mania in people who are prone. Withdrawal If you stop taking Prozac all of a sudden, you may notice withdrawal symptoms, including DizzinessConfusionNightmaresInsomniaIrritabilityCrying spells For this reason, never stop a medication without consulting your doctor. Prozac should always be tapered off to avoid withdrawal effects. Tips to Reduce Antidepressant Discontinuation Symptoms Other Options If Prozac is not well tolerated, other SSRIs that are sometimes prescribed for anxiety include  Paxil  (paroxetine),  Lexapro  (escitalopram),  Luvox CR  (fluvoxamine) and  Zoloft  (sertraline).  Effexor XR  (venlafaxine) is another antidepressant called a serotonin-norepinephrine reuptake inhibitor (SNRI) that also may be effective in treating your anxiety. Finally, benzodiazepines are another class of medication often used for anxiety, but they are generally a short-term solution because of their risk of dependence. Typical medications in this category include    Valium  (diazepam),  Xanax  (alprazolam),  Klonopin  (clonazepam) and  Ativan  (lorazepam). The 5 Most Used Antidepressants A Word From Verywell If youve been prescribed Prozac for anxiety, you may feel worried about side effects and whether the medication will be helpful. Share your concerns with your doctor and stay in contact about how you are doing once you begin the medication. Communication is key to ensuring that this medication is used in an appropriate way for maximum effectiveness.

Health of Democracy

Democracy is a form of government system in which the government is chosen from the common man and it works for that common man and the representative are also selected among themselves . so it is rightly said it’s a form of government for that people , by the people from the people .. India being one of the oldest democratic country of the world has seen many changes in its democratic system but lately it has been there is an influence of certain section of society and people over the working of the government which has led to a widening gap between number of rich and poor in the country . the common man is not getting his shares of value in a democratic country which he must get . in present days it has been seen that many people such as social as social activities , reformers and political reformers are rising there voice for this in correct from of democracy in which the common man is suffering although he abites all rules and regulation . . A new party has been recently set up and also warm in one of the leading states was advocating a fact that there must be a participation of government and common people to remove this corruption and would try to change the present democratic system into a more open and transparent system in which the common man could be benefited with such a approach this is making a great impact in today political environment as people belive them to do parties are also compiled to change there way of governance . so I think that this is a good step to change the health of the democratic and increase public participation .

Graphic Novels Are They `` Real `` Literature - 916 Words

Graphic Novels: Are they â€Å"Real† Literature? Graphic novels are an up and coming new genre of literature. In any aspect, new concepts and ideas that are introduced are always put into question of how capable they are. Many people believe that graphic novels are not a type of literature that can be used in a classroom because they are not â€Å"real books† (Crawford Weiner, n.d). I believe that graphic novels should be offered and encouraged in classrooms. According to Julia Rick, many educators are hesitant to use graphic novels in the classroom. She also states that the reason behind their actions is because they are not educated in graphic novels (Rick, 2011). They do not want to teach something to their students that they are not completely familiar with. Educators also believe that, when they incorporate graphic novels into the curriculum, they are taking away the importance of traditional text. I believe there are many benefits to using Graphic novels in the classroom. Graphic novels have many different elements of literature all in one format. For instance, in Romeo and Juliet The Graphic Novel: Original Text, there are pictures, dialogue, and narratives all within the book. They allow students to make the connections needed to understand the plot. When dealing with a difficult literature such as Romeo and Juliet having those other elements helps readers understand what is happening in the scene, while trying to interpret the text. In a study conducted byShow MoreRelatedGraphic Novels : Literature? Yes, But Not All Them Can Be Classified As Literature995 Words   |  4 PagesAre graphic novels literature? Yes, but not all them can be classified as literature. Some people think that graphic novels are literature, while others disagree. A few teachers even prefer to use graphic novels as their main source. On the other hand, other teachers consider graphic novels as lack ing knowledge. Thus, the answer to this question varies from person to person depending on how they see things. Not all graphic novels are literature, but they can be. What is literature? Literature isRead MoreThe Dark Knight Returns, By Jorge Luis Borges Essay1082 Words   |  5 PagesWriter, Jorge Luis Borges says, â€Å"The things that are said in literature are always the same. What is important is the way they are said.† Literature is such a broad, all encompassing term that much is lost in translation. This is part of the reason behind the ongoing brawl: what qualifies as literature? In the case of graphic novels, they are often cast aside by critics, deemed definitively inferior and lacking intellectual merit. However, this assumption does not hold up in today’s world of literaryRead MoreGothic Realism And The Vampire Sub Cultures1512 Words   |  7 Pagesromantic and young adult literature and in celluloid. Vampire graphic narratives are finding increased popularity and have since developed into an â€Å"Iconic popular culture phenomenon drawing an obsession and fascination globally†. (Jacqueline, Ng, 2014) So what inspired this new genre of graphic narrative? Ghouls, ghosts and terrifying monsters have been around since the days of old, but the roots of horror graphic narrative begins in the late 18th century with Gothic Literature. To many the word GothicRead More Personal, Social, and Cultural Contexts Established by the Frame Story in MAUS1635 Words   |  7 PagesEstablished by the Frame Story in MAUS  Ã‚      The use of the frame story, an overarching narrative used to connect a series of loosely related stories, pervades literature. An example of a frame story on a large scale - tying together a whole book-length work, not a simple short story - can be found in Art Spiegelmans graphic novel MAUS. Each of the narratives six sections is framed with snatches of the interaction between Vladek and Art during the interview that supposedly occurred to createRead MoreAnalysis Of `` No Matter What Their Genre `` Essay1675 Words   |  7 PagesPeople have always enjoyed graphic novels for as long as they have been around. They have been used to spread around an important message, politic viewpoints, explore new ideas in literature, and expose different styles of art to people around the world. There are many genres, graphic novels can fall into, but a large majority of them will always be fiction because then the authors can expand more into their stories than they can with non-fiction. â€Å"Today, images still have the power to elicit aRead MoreThe Ideology of War Essay836 Words   |  4 Pagesenvelope for our behavior. We create ideology. We stop simply killing each other because we want to. We kill each other because of religion, patriotism, democracy, nationalism and other reasons which now justify our behavior. Marjane Satrapi in her graphic novel â€Å"Persepolis† illustrates for us how war and ideology work hand by hand on her own life example of growing in Iran during Iran-Iraq war. Her book illustrates how war and ideology can switch all value in our life when death becomes a great pleasureRead MoreUnderstanding Art Spiegelmans Maus1204 Words   |  5 PagesWhen beginning to understand Art Spiegelmans 1991 Maus, one must also remember that no literary work exists within or around a vacuous context, and that each piece of literature is ultimately influenced by the social and cultural contexts of both the author and the reader. This graphic novel is no exception. Each of the six sections within the book is framed with bits of the interactions between Vladek and Art during the interview that seemingly occurred to form the book. This framing acts as aRead MoreThe Comic Book MAUS1288 Words   |  5 PagesHolocaust but within the Jewish community pertaining to the appropriateness and representational meaning of the Holocaust in the modern literature. Many people who participate in the discussions or read the book have perceived the comic fashioning of the book as trivial, hence making the book appear as mocking, derogatory and comedic. Nevertheless, this is not the real purpose for the format employed by Art Spiegelman. The comic representation plays a critical role in ensuring that the message is atRead MoreThe Melting Pot By Harriet Jacobs874 Words   |  4 Pagesthis; we can enjoy a bounty of American Ethnic Literature. What does this mean? American Ethnic Literature are the poems, novels, and histories written by the minor ity peoples of this new world. They were the outsiders of a predominately white world and therefore had an experience like no other. 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Questions On Electronic Fiscal Devices Essay - 830 Words

2.0 Introductions This chapter summarized the studies from other researchers who have carried out their research in the same field of study. The specific areas covered are the background Electronic Fiscal devices and its challenges faced by user of EFD machines in Tanzania by drawing inference from all over the world. 2.1 Definitions of Electronic Fiscal devices Electronic fiscal device involve wide variety of technological devices that tax authorities use to monitor transactions (IMF, 2013). It is further defined as tool for efficient management controls in areas of sales analysis and stock monitoring and control (TRA, 2012). It is also defined as small machines that are used to determine the amount of Value Added Tax remitted to the government (Mapira, et al., 2000). The commonly used types of EFDs are Electronic Cash Registers, Electronic Tax Registers, Electronic Signature Devices and Electronic fiscal printers (EFPs). 2.2 Theoretical literature reviews 2.2.1 Background of electronic fiscal devices EFD was initially used by Italian authority then followed by Greek Tax Agency before spreading to other countries (Casey Castro, 2011) and the machine became popular in 2000s where a number of efforts had been done by international organizations such as IMF to promote uses of EFD machines. (IMF, 2013) The EFD purposes do not differ between the countries implementing EFD for instance Dominican Republic adopted EFD with aim of controlling local sales intended for intermediateShow MoreRelatedThe Challenges Faced By Taxpayers1026 Words   |  5 PagesZULU STUDENT NUMBER: R 154659 V ACADEMIC FACULTY: FACULTY OF COMMERCE DEPARTMENT OF ACCOUNTING MODE OF ENTRY: VISITING PROJECT PROPOSAL A qualitative case study on the challenges faced by Taxpayers in using Electronic Fiscal Devises in calculating Value Added Tax in Zimbabwe. A Case study of some selected taxpayers in KweKwe. CHAPTER ONE INTRODUCTION 1.0 Background of Study Tax evasion and avoidanceRead MoreSony Corporation Case Study1210 Words   |  5 Pagesof their business that is causing losses. Thus in summary Sony wants to narrow its focus and sell the PC to a Japanese firm who will target Japan in particular. 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The Mexican Mafia And Organized Crime - 3946 Words

The Mexican Mafia, or â€Å"La Eme†, as they refer to themselves, is one of the most powerful and influential organized crime gangs in the United States. The organization has risen through the decades of mass gang wars and violence to become the power it is today. Their control is limitless and they have ventured far beyond the expectations of what was thought that gangs were capable of. They have infiltrated governments and manipulated politics. They have taken over neighborhoods and attempted to ethnically cleanse them. Innocent people have become caught up in the affairs of La Eme throughout its history and many have faced violence and death at their hands. This paper is a continual of the case analysis of the Mexican Mafia and will attempt to provide explanations for some of the crimes committed by this organization. Researching gangs and organized crime is important because of their large influence and control over many aspects of daily life. The significance of attempti ng to provide causations of their crimes can better provide the criminal justice system a clearer understanding of problems that lead to gang members committing crimes on behalf of the organization. A clearer understanding of problems can help the system to provide solutions to combat situations that inhibit crimes. *. Theories *. Social Disorganization Theory Before we provide theories in depth on the micro level, we must establish the broader concept on the macro level of the location where many of theShow MoreRelatedOrganized Crime Group Analysis1527 Words   |  7 PagesOrganized Crime Group Analysis Team A CJA 384 Organized Crime Group Analysis In this paper it was asked of us as a team to give an in-depth historical analysis of an organized crime group. With this class being about organized crime one would think to write about mobsters, but we decided to think outside the box. 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The Media Of The Oil Spill Of 2010 From China, The United...

Modern culture thrives on news media as our primary source of information, but this creates an information overload from all of the various perspectives in coverage. Media coverage is essential is our development and understanding of international affairs. Therefore, the biases in coverage can have drastic effects in our interpretation of world’s news. Countries tend to present their news in a way that favors them and their governmental responses, but coverage of other nations can be telling of their relations. The use of word choice, tone, and even selective use of quotes can have drastic effects on people’s perceptions of the information from the media. This can be observed in the media analysis of the Xingang Port oil spill of 2010 through news sources from China, the United States, and Ireland. 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Acute Care Care Implementation and Evaluation. Free Essays

Acute Care: Care Implementation and Evaluation. This assignment will be based around the care that is implemented and evaluated, within a National Health Service (NHS) Foundation Trust (FT). The focus of the assignment will be to discuss two health problems that a selected patient has and has been admitted to the FT with. We will write a custom essay sample on Acute Care: Care Implementation and Evaluation. or any similar topic only for you Order Now The selected patient had been admitted into FT with breathing difficulties and also suffering from dehydration. The assignment will focus upon the goals that are set for the patient whilst in FT and the reasons why the goals are set. The patho-physiology of the two problems will also be discussed and also the care that had been implemented to achieve the goals. Throughout the assignment, the patient will be known as Terry with the permission from the patients parents, according to the Nursing and Midwifery Council (NMC, 2008) confidentiality guidelines. The assignment will also aim to discuss the role of the Health Care Professional (HCP) in planning appropriate care for the patient, in particular, using the assessment technique of goal setting by using Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T) target planning technique (Roper et al, 1996). The reasons for planning care can involve the HCP assisting in preventing potential health problems, for example, breathing difficulties for the patient becoming worse and to also assist in solving problems where possible. Care planning can also assist in alleviating possible health problems that cannot be solved by HCP’ s and so will need the assistance of Multi Disciplinary Team (MDT) , for example, consultant, physiotherapists to further improve an develop the care plan. Terry is a 42 year old single man, who lives with his parents, and has suffered from a number of illnesses throughout his life, for example, optical glyoma, Deep Vein Thrombosis (DVT), epilepsy, and also learning difficulties. Terry has difficulty with breathing, and this appears to have been caused by respiratory rhythmicity centre in the medulla and the pons (areas of the brain which can control breathing) and these appeared to not be working in the correct way (MacKenzie, 1996; Waugh et al 2006). Terry’s reduced neurological status was due to trauma that had been suffered in the motor pathways, and the peripheral nerves, in the brain (Iggulden, 2006). Terry was admitted to the Intensive Care Unit (ICU), within the NHS FT, suffering from numerous problems that were mainly neurological. Terry’s admission to ICU was due to the increased breathing difficulties that he was experiencing. Due to the breathing difficulties, the nursing team, and Terry’s consultant, agreed that it would be best for Terry to have a percutaneous tracheostomy inserted. Due to Terry suffering from a probable cerebellar lesion, severe learning difficulties and poor communication skills; it did appear that Terry could not understand what the nursing team were informing him of, the medication that he needed and the care that was being delivered (NMC, 2008). Due to the fact that Terry appeared not to be able to understand or communicate with the nursing team, and that his parents and family members were with him, the nursing team, and myself, ensured that the parents, and family members, were informed of what was happening regarding the care that had given to Terry. The fact that Terry could not understand the instructions given to him, due to learning difficulties, consent to insert a percutaneous tracheostomy had to be given from Terry’s parents, to the Consultant (NMC, 2008). The tracheostomy that had been inserted into Terry helped the nursing team in the ICU and on the ward, to oxygenate Terry to the optimum level of 98%. The tracheostomy, also ensured that Terry was able to maintain a breathing rate of between 35 and 50 breathes per minute (Bailey, 2008). Although Terry was able to maintain a respiration rate, the normal respiration rate for an adult is normally between 14 and 18 breathes per minute (Bailey, 2008). The nursing care that had been implemented included ensuring that oxygen was flowing through the tracheostomy and this ensured that Terry had enough oxygen in his body for his heart and lungs to function, and that the heart pumped the oxygenated blood around the body (Machin et al 1996; Roper et al, 1996; Bailey et al 2008). Due to Terry’s respiration centre not working properly, and suffering from breathing problems, this meant that gaseous exchange was impaired, and led to a risk of respiratory acidosis. Gaseous exchange is where the oxygen goes into the alveoli capillaries, and the carbon dioxide is moved out of these capillaries (Bailey, 2008). The respiration centre is made up of a group of nerve cells, which are in the reticular endothelial system of the medulla oblongata. These cells send impulses to the motor neurones, via the spinal cord, and are then sent to the intercostal muscles (Bailey, 2008). The trauma that Terry had suffered with, was a possible cerebella lesion when he was a child. When Terry was admitted, his oxygen level was 82% (Bailey, 2008). The goal for this problem was to keep Terry’s respiration and oxygenation at a level that was suitable. A suitable level of respiration for an adult is between 14 and 18 breaths per minute, and an oxygen level of around 97 to 98% (Bailey, 2008). The patho-physiology of breathing difficulties includes a lack of oxygen to the tissues of the body, including the brain, and even death (MacKenzie, 1996; Waugh et al 2006). Due to Terry haiving an oxygen saturation level of 82%, we set the goal that we would aim for and set this goal with his parents. The goal that the nurses had set with Terry’s parents, due to the fact that Terry had learning difficulties and could not set the goal with the nurses. The goal was set as the nurses aimed to have his oxygen saturation level between 95% and 98% within two hours. The goal had to fit in with the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T) target planning technique (Roper et al, 1996; Faulkner, 2000). Terry’s sitting and lying position had to be carefully planned around him, this ensured that we as a nursing team where able to ensure that his lungs would expand to their optimum and to maintain a satisfactory oxygen saturation levels within his body (Roper et al 1996; Machin et al 1996; Hackman, 2008). The normal oxygen saturation level is between 95% and 98% (Woodrow, 1999). The fact that Terry had an oxygen saturation level of just 82%, the Consultant had to prescribe oxygen for Terry. The oxygen that had been prescribed for Terry, had been increased from 24% to 40% (NMC, 2002). The consultant advised us to ensure that the oxygen was to be humidified. Due to Terry having the tracheostomy, we were able to deliver the oxygen with the use of a tracheostomy mask and what is called a T-piece circuit (Machin et al 1996; Dolan, 2008; Soady, 2008). The consultant also advised the nursing team to ensure that neurological observation’s were undertaken, especially the oxygen saturation levels, every 15 minutes until Terry’s oxygen saturation levels had risen to 96% (Machin et al 1996; Dolan, 2008; Soady, 2008) The neurological observations with regards to the goal, meant that the nurses were able to deliver oxygen, which would enable the oxygen saturation level to be maintained (Machin et al 1996; Dolan, 2008; Soady, 2008). Once the nursing team had ensured that the oxygen had been delivered to Terry at 40% and was humidified, they then ensured that 15 minute observations were maintained. The Consultant had to ensure that the 40% oxygen that he had verbally prescribed, was documented and written clearly in Terry’s medical notes and on his prescription sheet (NMC, 2002; NMC, 2004). The fact that Terry had been prescribed the higher rate of oxygen, this needed to be clearly documented within Terry’s nursing notes (NMC, 2004). The documentation was needed, so that the other nurses were aware of the change. Although the observations had been maintained every 15 minutes, with regards to Terry’s oxygen saturation levels, this ensured that the nursing team maintained Terry’s neurological observation’s (Machin et al 1996; Dolan, 2008; Soady, 2008). The goal that had been set by the nursing team and Terry’s parent’s, for his oxygenation levels did fit into the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T) target planning technique. The goal was specific, measurable and realistic for Terry and the nursing team caring for him, as well as being achievable in the time frame that had been set by Terry’s Consultant (Faulkner, 2000). Due to the fact that the nursing team had achieved this goal for Terry, proved that the nursing care and interventions made by the nursing team, were effective. The nursing care and interventions were effective enough, for this goal to have been met (Roper et al 1996). The goal that had been set for Terry with regards to his oxygen saturation level, had to be documented. The goal had to be documented within the nursing notes, which the nursing team had to document clearly. The nursing team were able to hand over the information about Terry, to the nursing staff that would have been caring for him on the next shift. (NMC, 2004) The second of Terry’s problem’s is that he was at risk of dehydration, this was due to the fact that Terry could not swallow as he had a reduced neurological status. The fact that Terry could not swallow was due to the motor area of cerebral cortex of his brain, did not work in the way that it should (Waugh et al 2006). The motor area of the cerebral cortex of Terry’s brain, was damaged due to the increase in epileptic seizures. Dehydration can cause the cells to deplete, due to not having enough fluids for them to replenish. The cells replenish in the sense that the fluids help the cells to regenerate, regulate the body temperature, to dilute the waste products within the body, and to maintain the level of fluids within the tissue fluid and blood (Waugh et al 2006). The patho-physiology of dehydration includes thirst, the mouth being dry, the tongue would look leathery, and fluid from within the tissues and skin would be withdrawn (Roper et al 1996; Brown, 1997; Day, 1997). Due to Terry not being able to drink fluids, he was not able to regulate his own body temperature, nor was his body able to dilute the poisonous substances in his body (Waugh et al 2006). Due to fluid being withdrawn from the body, this would mean that the body would not be able to maintain its own volume in blood (Roper et al 1996). The patho-physiology of not having enough fluids also includes the kidneys would excrete less than they normally would; a person would be lethargic; the skin would lose its elasticity and would appear to be more wrinkled (Roper et al 1996; Brown, 1997; Day, 1997). If Terry had been suffering from dehydration, his would have looked sunken and his urine output would be reduced as well as being more concentrated. If Terry had been suffering from a severe case of dehydration, his blood volume would be reduced. If the blood volume was to cause a circulation deficiency, this would cause his kidneys to fail to excrete the waste products that they normally excrete (Roper et al 1996; Brown, 1997; Day, 1997). Due to Terry not drinking the recommended two litres of fluids per day, we had to set a goal. The goal that had to be set, had to be set with Terry’s parents (Roper et al 1996). The goal for the second problem, was to prevent dehydration during Terry’s stay in hospital, through ensuring that Intravenous Saline was delivered through venous access (Dougherty et al 2008). The Intravenous Saline had to be delivered through venous access, due to the fact that this was the most effective way in which to infuse fluids. The fluids had to be infused over a period of 24 hours, due to the volume of the fluids. The Consultant prescribed two litres of Intravenous Saline, and the nursing team ensured that it was delivered (NMC, 2002; NMC, 2004; Dougherty et al 2008). Due to the fact that the fluids needed to be infused, the nursing team ensured that the fluids were delivered through the venous access, by using an infusion pump. The pump that was used by the nursing team, was the volumetric pump. The volumetric pumps allow health care professionals to administer large amounts of infusions, and this is why were used this type of pump to deliver the fluids that Terry needed over a 24 hour period (Sarpal, 2008). Due to the fact that the nursing team were delivering Intravenous Saline to Terry, it was important that this was documented by the nursing team within his nursing notes. The fact that this was documented in Terry’s notes, ensured that the information was handed over to the nursing team on the next shift (NMC, 2004). It was important hat a fluid balance chart was also documented, as this would help the nursing team to ensure that the amount of input from fluids, was similar to Terry’s urine output. The fact that the nursing team were able to monitor Terry’s fluid input and output, ensured that his body was not retaining any of those fluids within a 24 hour period (Hunt et al 2008). The goal for dehydration by providing two litres of Intravenous Saline over a 24 hour period, did fit into the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T) target planning technique. This was due to the fact that the goal was specific, measurable and time set. The goal was achievable and realistic, but only while Terry’s venous access was as good as it was. When Terry’s venous access for the Intravenous Saline to be delivered was poor, this meant that the nursing team had to find another route to deliver these fluids. The nursing team had to re-set the goal for delivering the Intravenous Saline. (Faulkner, 2000) Due to the fact that the nursing team could not deliver the Intravenous Saline through the venous route, had to be documented. The nursing team had to document the fact that Terry had poor venous access, and that they had asked his Consultant to review Terry (NMC, 2004). When Terry’s Consultant had been to review him, the Consultant advised the nursing team to deliver the Saline through Terry’s PEG tube. Terry’s Consultant had to document the fact, that he had advised the nursing team to deliver the Saline through Terry’s PEG tube. The Consultant also had to document that his advice was due to Terry’s poor venous access in Terry’s medical notes, and he had to document this on the prescription chart (NMC, 2004). Due to Terry having a Percutaneous Endoscopic Gastrostomy (PEG), the nursing team and Terry’s parents re-set the goal to deliver the fluids that Terry needed (Faulkner, 2000). The new goal that had been set, was to deliver one litre of Intravenous Saline through Terry’s PEG tube. The litre of Saline was delivered to Terry through his PEG tube, over an 8 hour period rather than a 24 hour period. Even though the nursing team had to deliver the fluids through the PEG tube, they had to ensure that the goal did fit into the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T. ) target planning technique. This goal was specific, measurable, achievable, realistic and time set for Terry and the nursing team (Faulkner, 2000). Before the nursing team could deliver the Saline through Terry’s Percutaneous Endoscopic Gastrostomy, the Saline had to be prescribed by his Consultant. The Consultant had to document the Saline on Terry’s prescription chart, and also had to document the route that the nursing team were to deliver the Saline (NMC, 2004). The Saline that had been prescribed by Terry’s Consultant, also had to document in Terry’s medical notes, that he had prescribed this and also document the route that he had advised to the nursing team (NMC, 2002; NMC, 2004). When the nursing staff had commenced the delivery of the Saline through the Percutaneous Endoscopic Gastrostomy (PEG) tube, they themselves had to document this. The nursing team had to document the Saline running through the PEG tube, to enable the nursing notes for Terry to be up-to-date. The nursing team to document the amount of Saline that was to run through Terry’s PEG tube, and what time the Saline infusion began. The nursing team also had to document how much of the Saline was to be infused in any one hour, when the Saline was due to finish, as well as document the lot number and expiry date that were on the bag of Saline. NMC, 2002; NMC, 2004) The documentation of the infusion of the Saline running through Terry’s Percutaneous Endoscopic Gastrostomy (PEG) tube, ensured that the nursing team could hand over the information to the nursing team that were due to care for Terry on the next shift (NMC, 2004). The goal that had been re-set by the nursing team, and Ter ry’s parents, fitted in with the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T. ) target planning technique (Faulkner, 2000). The fact that the goal had to be re-set, ensured that the nursing team had been able to deliver the Saline through the Percutaneous Endoscopic Grastrostomy (PEG) tube. The goal to deliver the Saline through the PEG tube, had been specific, measurable, realistic and time set for Terry and the nursing team. This goal had been achieved, due to the fact that the care that the nursing team had been able to deliver the Saline in the time that they had set with Terry’s parents (Faulkner, 2000). Due to the goal being achieved in the time frame that had been set by the nursing team, and Terry’s parents, meant that the nursing team had been able to deliver the care that had been needed to achieve this goal (Faulkner, 2000). I am now at the point in this assignment when I can reflect. For my reflection, I will be using the Gibb’s Reflective Cycle to reflect upon this assignment, which is documented within his book that was published in 1988 and entitled Learning by Doing: A Guide To Teaching and Learning Methods (Gibb’s, 1998). Due to the fact that Terry ad a number of health problems, I had a hard task of choosing which two that I would use. I did have to think long and hard about which two health problems that I would use, but I was given permission from his parents to enable me to write this assignment (NMC, 2008). The two health problems that I had chosen, were breathing difficulties and dehydration. Due to the breathing difficulties that Terry suffered with, meant that his oxygen saturation levels were low. Due to Terry’s breathing difficulties, this is why the nursing team, and his Consultant, had to gain consent from Terry’s parents, to insert a percutaneous tracheostomy. The fact that the tracheostomy was inserted soon after Terry’s admission, enabled the nursing staff within the ITU and the ward of the NHS FT, to ensure that Terry’s oxygen saturation levels were maintained. Therefore, this is the reason why a goal was set. Due to a goal being set for Terry’s oxygen saturation levels to be maintained, provides evidence to show that the nursing interventions were effective. The effectiveness of these nursing interventions, proves that goals that are set for an individual patient can also be met. The second goal that had been set for Terry by the nursing team, and his parents, had fitted in with the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T. ) target planning technique. Due to the fact that this goal was only partially met, did not necessarily mean that the care that had been delivered to Terry, had been ineffective. The care that had been delivered to Terry had been effective, but the goal could no longer be achieved through the venous route, due to the fact that Terry’s venous access was poor. Due to Terry’s poor venous access, this is why the nursing team had to re-set the goal with his parents. The goal that had to be re-set, fitted in with the Specific, Measurable, Achievable, Realistic and Time Set (S. M. A. R. T. ) target planning technique. The goal had been re-set, and had also been achieved in the time frame that had been set with Terry’s parents. The goal that had been re-set, had been achieved in the time frame that had been set. The goal had been achieved due to the fact that, the nursing team were able to deliver the Intravenous Saline through the Percutaneous Endoscopic Gastrostomy (PEG) that Terry had in place. The fact that the nursing team could not achieve this goal when it had first been set, was not an issue that could have been anticipated. Even though nursing teams can not anticipate why the goals are not met, they can re-set the goal and in time, meet the new goal. Therefore, the nursing care and interventions that are delivered, do make nursing care effective. Documentation of all care from the nursing team was important, due to the fact that the nursing team on one shift, were able to inform the nursing team of the next shift. Documentation also ensures that if the nursing team were unsure of any test results, that they were able to look over the nursing notes to ensure they knew where we were up to with the patient. The Consultants documentation in the patients medical notes, ensured that other doctors or Consultants were also aware of the patients condition and any tests that may have been ordered. Bibliography. Bailey, M. , Crossen, S. , Holland, J. , Hollis, V. (2008) Observation’s in Dougherty, L Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 25, Pages 496-544. Oxford: Wiley-Blackwell Publishing. Brown, A. (1997) Caring for the Patient Undergoing Surgery in Walsh, M. (ed) (1997) Watson’s Clinical Nursing and Related Sciences. 5th ed. Chapter 10, Pages 232-259. Edinburgh, Bailliere Tindall. Day, S. (1997) Caring for the Patient with a Nutritional Disorder in Walsh, M. (ed) (1997) Watson’s Clinical Nursing and Related Sciences. 5th ed. Chapter 16, Pages 552-570. Edinburgh, Bailliere Tindall. Dolan, S. (2008) Respiratory Therapy in Dougherty, L Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 38, Pages 749-765. Oxford: Wiley-Blackwell Publishing. Dougherty, L. , Farley, A. , Hopwood, L. Sarpal, N. (2008) Drug Administration: General Principles in Dougherty, L Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 11, Pages 202-251. Oxford: Wiley-Blackwell Publishing. Faulkner, A. (2000) Nursing: The Reflective Approach to Adult Nursing Practice. 2nd ed. Gloucestershire: Stanley Thornes Publishers Limited. Gibb’s, G (1988) Learning by Doing: A Guide To Teaching and Learning Methods. Oxford: Further Education Unit, Oxford Polytechnic. Hackman, D. 2008) Positioning in Dougherty, L Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 34, Pages 668-689. Oxford: Wiley-Blackwell Publishing. Hunt, P. , Kelynack, J. Stevens, A. M. (2008) The Unconscious Patient in Dougherty, L Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 44, Pages 849-853. Oxford : Wiley-Blackwell Publishing. Iggulden, H. (2006) Care Of The Neurological Patient. Oxford: Blackwell Publishing Limited. Local NHS Trust (2004) NHS Trust – Recommended Protocol for Care of the Patient with a PEG. Liverpool: Local NHS Trust. Machin, J. , Rhys-Evans, F. (1996) Tracheostomy Care and Laryngectomy Voice Rehabilitation in Mallet, J. , Bailey, C. (eds) (1996) The Royal Marsden NHS Trust – Manual of Clinical Nursing Procedures. Chapter 41, Pages 550-565. London: Blackwell Science Limited. MacKenzie, E. (1996) Respiratory Therapy in Mallet, J. , Bailey, C. (eds) (1996) The Royal Marsden NHS Trust – Manual of Clinical Nursing Procedures. Chapter 35, Pages 474-480. London: Blackwell Science Limited. Nursing and Midwifery Council (2002) Guidelines for the Administration of Medicines. London: NMC. Nursing and Midwifery Council (2004) Guidelines for Records and Record Keeping. London: NMC. Nursing and Midwifery Council (2008) The Code – Standards of Conduct, Performance and Ethics for Nurses and Midwives. London: Nursing and Midwifery Council. Roper, N. , Logan, W. W. , Tierney, A. J. (1996) The Elements of Nursing. 4th ed. America: Churchill Livingstone. Sarpal, N. (2008) Drug Administration: Delivery (Infusion Devices) in Dougherty, L Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 13, Pages 290-309. Oxford: Wiley-Blackwell Publishing. Soady, C. (2008) Tracheostomy Care and Laryngectomy Care in Dougherty, L Lister, S. (eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 7th ed. Chapter 42, Pages 809-829. Oxford: Wiley-Blackwell Publishing. Waugh, A. , Grant, A. (2006) Ross and Wilson Anatomy and Physiology in Health and Illness. 10th ed. Philadelphia: Churchill Livingstone. Woodrow, P. (1999) Pulse Oximetry. Nursing Standard. Volume 13, Number 42. Pages 42-46. Woodrow, P. (2006) Intensive Care Nursing – A Framework for Practice. 2nd ed. Oxon: Rouledge. How to cite Acute Care: Care Implementation and Evaluation., Papers