Methods of intervention Essay Example for Free

Methods of intervention Essay Any form of restraint, for example leg or wrist restraints, should only be introduced after a multidisciplinary assessment, which includes consultation with service users their families and advocates. If used, they should be selected carefully to impose the least restriction of movement required to prevent harm while attempts should continue to be made to achieve the desired outcomes with less restrictive interventions. Carers who have received specific training in their usage should only use such devices. The rational for using any devices and the circumstances in which they may be used must be clearly recorded within an individuals care plan/ Positive Handling Plan. The Scottish Social Services Council have their own codes of practice for social service workers and employees. A quote from their handbook states; Social Service workers must: Respect the rights of service users, whilst seeking to ensure that their behaviour does not harm themselves or others This is following a pattern from the previous values and standards mentioned, which stated clients can only really go so far, before a method of intervention has to be used. In the mid nineties, a form of intervention was introduced in Scotland, which is now widely practiced in the care industry. C.A.L.M (Crisis and Aggression Limitation Management) Various systems use a prone position in which to restrain. This can be face up, or face down. In this country, the face down position is usually used. In the case of CALM the prone restraint is only one of a hierarchy of responses. There has been growing anxiety about the use of prone restraint. It has been associated with deaths due to positional asphyxia, although other positions also have this risk associated with them. In the US, some states have banned face down prone restraint; others have banned face up prone restraint. It is a method, which can compromise the dignity of both young person and staff. However, there is anxiety in some quarters that the removal of prone restraint may make methods  less effective. CALM Training Services are considering removing the prone restraint from their system. Certain methods of physical restraint include techniques, which include the deliberate use of pain to ensure compliance CALM does not. CALM is a training package which covers the management of difficult behaviour, and which contains, as one of its components, strategies for physical intervention, including physical restraint. In addition, when staff have been trained by CALM Training Services, they are then assessed as to how competently they can carry out the physical elements, and thereafter, if they reach an acceptable standard, they receive accreditation, which has to be updated annually. CALM is now the method of choice of a significant number of employers in Scotland and beyond, and is used in child care services, learning disability services, and mental health services.  ·Physical restraint devicessuch as safety vests and jackets, lap and wheelchair belts, and fabric body holdersmay be beneficial to patients and their caregivers when used properly in settings ranging from nursing homes and hospitals to private homes.  ·Used properly, restraints have many benefits for patients and caregivers in both institutions and homes. Restraints may help protect the elderly from falls, which could result in injury or even death. If absolutely necessary, restraints also can help make medical treatment easier if a patient is temporarily uncooperative or highly agitated. If a patient is dangerous, restraints can protect other patients and staff from possible harm. Some patients feel safer and more secure, and need not worry about falling, if they use physical restraints. The method of restraining can be beneficial for many clients, depending on state of mind/health and situation at present time. A warning though; putting a restraint on certain patients may actually worsen their condition. For example, a chronically agitated patient may become more agitated with a restraint.

Professional Athletes who Cheat in Sports Essay -- steroids, asca, bal

Professional athletes are role models to the American children across the Nation. Professional athletes must follow ethical standards to play fairly in their sport. This means that players must compete without the assistance of performance enhancing drugs such as steroids (Tynes, 2006). Yet, professional athletes choose to cheat by taking illegal substances, which results in the death of some players and a wide variety of health problems. The Federal Government realized that the use of anabolic steroids is a form of cheating and defrauds the players and fans of â€Å"real† competition. As a result, for the concern of the athletes’ health and concern for the ethical standards of the game played, the Anabolic Steroid Act of 1990 (ASCA) was enacted (Tynes, 2006). The ASCA was passed to help the growing concerns of the wide spread of harmful substances that could cause long- term effects (Tynes, 2006). The ASCA made it illegal to take an unapproved substance while playing a professional sport. This research paper will examine professional athletes who participated in the major leagues and Olympic Games who used steroids to defraud the Major Leagues Business and Olympic Associations to gain fame and fortune. The paper will examine the BALCO scandal (CNN.com, 2014), where many professional athletes admitted to taking steroids to improve physical sports performance. The BALCO scandal "outs" players from the American National sports leagues to Olympic competitive sports. A cover up of drug use led to not just a few but many players who chose to use steroids to improve their game. The case went to the courts and left many players to tell the ugly truth about other professional players. In some cases, the players denied responsibility and ... ...BILITY OF THE LEAGUES?. Marquette Sports Law Review, 17(2), 651-678. Thompson, T. (2007) Giambi admits he took steroids. DailyNews. New York. Tynes, J. (2006) Performance Enhancing Substances: Effects, Regulations,and the Pervasive Efforts to Control Doping in Major Leagues. Journal of Legal Medicine. 27:493-509. Unknown Author (2014) Barry Bonds convicted of obstruction of justice in performance-enhancing-drugs case. Los Angeles Times. Los Angeles. USAToday (2007) BALCO Investigation Timeline. USA TODAY SPORTS ONLINE NEWSPAPER. Retrieved from: http://usatoday30.usatoday.com/sports/balco-timeline.htm USAToday (2007) Mitchell Report Timeline. USA TODAY SPORTS ONLINE NEWSPAPER. Retrieved from: http://usatoday30.usatoday.com/sports/baseball/2007-12-13-mitchell-report-timeline_N.htm Wikipedia (2014) BALCO Scandal. Retrieved from Wikipedia.com on March 14, 2014.

Eating Customs and Traditions in Great Britain Essay

The usual meals in Great Britain are breakfast, lunch, tea and dinner; or in simplier homes, breakfast, dinner, tea and supper. Breakfast is generally a bigger meal than you can have it on the Continent, though some English people like a â€Å"continental† breakfast of rolls and butter and coffee. But the usual breakfast is porridge or â€Å"Corn Flakes† with milk or cream and sugar, becon and eggs, marmalade with butter toast, and tea or coffee. For a change you can have a boiled egg, cold ham, or perhaps fish. Lunch is usually served between twelve and one o’clock. The businessman in London usually finds it impossible to come home for lunch, and so he goes to a cafà © or to a restaurant, but those who are at home generally take a cold meat, e.g., beef, mutton, veal, ham, with boiled or fried potatoes, salad and pickles, with a pudding or fruit to follow. Sometimes you may have a mutton chop, steak and chips, followed by biscuits and cheese and a cup of coffee. Afternoon tea follows between four and five o’clock. You can hardly call it a meal, but it is a sociable sort of thing, as friends often come in for a chat while they have their cup of tea, cake or biscuit. In some houses dinner is the biggest meal of the day. You can have soup, fish, roast chicken, chops, potatoes and vegetables, a sweet, fruit and nuts. The two substantial meals of a day, lunch and dinner, are both more and less the same. But in a great many of English homes the midday meal is the chief one of the day, and in the evening they have the much simplier supper-an omelette, or sausages, sometimes bacon and eggs and sometimes just bread and cheese, a cup of coffee or cocoa and fruit. The two features of life in England that possibly give visitors their worst impressions are the English weather and English cooking. The former is something that nobody can do anything about, but cooking is something that can be learned. English food has often been described as tasteless. Although this criticism has been more than justifies in the past, and in many instances still is, the situation is changing somewhat. One of the reasons that English cooking is improving is that so many people have been spending their holidays abroad and have learned to appreciate unfamiliar dishes. However, there are still many British people who are so unadventurous when they visit other countries that will condemn everywhere that doesn’t provide them tea and either fish and chips or sausages, baked beans and chips or overdone steak and chips. One of the traditional grouses about English food is the way that vegetables are cooked. Firstly the only way that many British housewives know to cook green vegetables is to boil them for far too long in too much salt water and then to throw the water away so that all the vitamins are lost. To make matters worst, they don’t strain the vegetables sufficiently so that they appear as a soggy wet mass on the plate. It would be unfair to say that all English food is bad. Many traditional British dishes are as good as anything you can get anywhere. Nearly everybody knows about roast beef and Yorkshire pudding but this is by no means the only dish that is cooked well. A visitor if invited to an English home might well enjoy steak and kidney pudding or pie, saddle of mutton with red-currant jelly, all sorts of smoked fish, especially kippers, boiled salt beef and carrots to mention but a few. A strange thing about England that the visitor may notice is that most of the good restaurants in England are run and staffed by foreigners-for example, there is a larger number of Chinese, Indian and Italian restaurants and to less extent French and Spanish ones. The food and beverage department has two principal aims. The first- and the more important one- is to provide a standard of food and beverage service consistent with the expectations of the quests. The second aim is to maintain the food and beverage operation within the limits set by the food and beverage department and thus to contribute to the overall profitability of the establishment. It is clearly that beverage sales are not only an important part of the sales mix of hospitality establishments but also more profitable than food sales. Coffee is one of the most popular beverages of the world. It is made from berries grown in tropical climates and shipped to the country green that is unroasted. The berries produced vary in composition and the treatment after picking. For this reason, Mocha, Java, Arabica and South American coffees are quite distinct from each other. There are three main methods of preparing coffee- boiling, percolating and drip method. The coffee should not stand long before serving. Tea is made from the leaves of tea bush which is indigenous to the Orient. Black tea is made from leaves which are fermented before drying. Green tea is not fermented; the leaves are steamed and dried. There are two main ways of serving tea: â€Å"English† tea is served in cups and with milk or cream; â€Å"Russian† tea is served in glasses with a slice of lemon. Cocoa and chocolate. As beverages made from them are generally made with milk, they are much more nutritious than the other beverages. Cocoa and chocolate are made from beans or seeds of trees which grow in tropical countries. Also drinks can be classified into soft drinks which contain no spirits (such as lemonades, Pepsi, Coke, etc.) and strong ones, they contain some part of alcohol (such as whisky, gin, wine, liquor, beer). Tea in English is a suitable occasion for social intercourse, when people often come in for a chat over their cup of tea. There are two kinds of tea, â€Å"afternoon tea† and â€Å"high tea†. â€Å"Afternoon tea† takes place between three-thirty and four-thirty and consists of tea, bread, butter and jam, followed by cakes and biscuits. â€Å"High tea† is a substantial meal and is eaten between five-thirty and six-thirty by families which don’t usually have a late dinner. In a well-to-do family it will consist of ham or tongue and tomatoes and salad, or a kipper, or tinned salmon, with a strong tea, bread and butter, followed by stewed fruit, or tinned pears, apricots or pineapple with cream or custard and cake. Tea-making in England is an art. The hostess first of all rinses the teapot with boiling water (this is called â€Å"warming the pot†) before adding four or five teaspoons of tea. The amount of tea varies, of course, according to the number of people present. The pot is then filled with boiling water and covered by a tea-cosy to allow the tea to infuse for five minutes. English people seldom put lemon juice or rum into their tea, usually they have it with milk. The English custom of afternoon tea, as it is said, goes back to the late 18th century, when Anne, wife of the 7th Duke of Bedford, decided that she suffered from â€Å"a sinking feeling† at around 5 p.m. and needed tea and cakes to bring back her strength. Before long, complaints were heard that â€Å"the labourers lose time to come and go to the tea-table and farmers’ servants even demand tea for their breakfast†. Tea had arrived. Fashionable Tea Rooms were opened for high society, and soon tea be came the national drink of all classes. Today the British drink more tea than any other nation – an average of 4 kilos a head per annum, or 1650 cups of tea a year. They drink it in bed in the morning, round the fire on winter afternoons and out in the garden on sunny summer days. In times of trouble the kettle is quickly put on, the tea is made and comforting cups of the warm brown liquid are passes round. Tea has even played its part in wars. When George III of England tried to make the American colonists pay import duty on tea, a group of Americans disguised as Red Indians dumped 342 chests of tea into the sea in Boston Harbour – the Boston Tea Party which led to the War of Independence. In another war the Duke of Wellington sensibly had a cup of tea before starting the Battle of Waterloo, â€Å"to clear my head†. In peace time official approval of the national drink came from the Victorian Prime Minister, Gladstone, who remarked: â€Å"If you are cold, tea will warm you; if you are heated, it will cool you; if you are depressed, it will cheer you; if you are excited, it will calm you.† What exactly is tea? Basically, it is a drink from the dried leaves of a plant that only grows in hot countries. The British first heard of tea in 1598, and first tasted it in about 1650. For nearly two centuries all the tea was imported from China, until, in 1823, a tea plant was found growing naturally in Assan in India. Sixteen years later the first eight chests of Indian tea were sold in London, and today, London’s tea markets deal in tea from India, Sri Lanka (Ceylon), and from Africa more than from China. Plum pudding is sure of its place of honour on Christmas dinner table. Some English people could even dispense with mincepies, but a Christmas dinner in Britain without the traditional pudding would be strange indeed. The Christmas pudding is a direct descendant of the old time â€Å"hackin†, or plum porridge, beloved by English people in the middle ages. In those days it was made of beef or mutton broth thickened with brown bread, with prunes, raisins, currants, ginger and maize being added to the boiling mixture. This was served as a thick soup and eaten at the beginning of the meal. In the 18th century, plum porridge began to change its character with the addition of flour. The porridge thus turned into plum pudding and it became the custom to eat it at the end of the meal. Nowadays, in addition to the basic mixture of flour, bread-crumbs, suet and eggs, the ingredients of Christmas pudding include raising, currants, candied peel, chopped almonds and walnuts, grated carrot and a good measure of brandy, whisky or old ale on place of the described mutton broth. In many households the mixing of the pudding is quite a ceremony with all the members of the family taking turns to stir and make a wish. After being boiled for several hours, the pudding is stored until the time comes for heating it on Christmas Day when it is brought to the table on a large dish, big, round, dark-brown, with a flag or a place of holly stuck in at the top of it, and flames licking round its sides. The Christmas pudding is covered with white sauce and burning in brandy. Receiving each a slice, the guests are warned to eat carefully because sixpenny bits, shillings, a tiny silver bell and a silver horse-shoe have been put in it. Those who find the â€Å"treasure† are supposed to have money in the coming year, whoever gets the bell is to be married, and the horse-shoe is the traditional sign of good luck.

Contributions of Tun Dr Mahathir Essay

Dr Mahathir was Malaysia’s fourth Prime Minister and he worked very hard to develope our country since the day he was appointed as the Prime Minister. Dr M served as the prime minister of Malaysia for 22 years. He created a concept called VISION 2020, where by the year 2020 Malaysia is expected to be a fully developed country. He called upon the entire citizens of Malaysia to work harder and to prepare themselves to really achieve that vision. Dr M transformed Malaysia from a country that completely depended on self-subsistant agriculture, cultivation of rubber and tin mining, into a vibrant economic country based on trading and industrialisation. Malaysia now has heavy and high technology industries that have become more developed and competitive with other developed countries in the world. Besides that, Dr Mahathir took steps to enable Malaysia to face the future by establishing the Multimedia Super Corridor, which emphasizes ‘Information Technology’ as a very i mportant asset for the country in the new millennium. Dr Mahathir also announced the National Car Project (Proton), which is one of the many important developments of Malaysia in achieving Vision 2020. In the field of literature, Dr Mahathir has contributed greatly since his schooling days. Due to his great interest in writing, Dr Mahathir was an editor of a magazine called Darulaman. Other than that, Dr Mahathir successfully handled the financial crisis 1997 and stabilized the Malaysian economy. All schools were equipped with computers with the help of Dr Mahathir. Dr Mahathir helped Malaysia to not depend too much on neighbouring country ports by constructing Malaysia’s own major ports. This helped Malaysia to reduce foreign currency outflow until now. Dr Mahathir beginned various large scale national projects, such as the North-South Highway, The Multimedia Super Corridor, Malaysia’s new administrative capital Putrajaya, Port of Tanjung Pelepas, KLIA in Sepang, and an adjacent Formula One Circuit, Olympic-class stadium in Bukit Jalil and the Petronas Twin Towers, the tallest twin towers in the world, the world’s tallest building from 1997-2003, that has become the symbol of modern Malaysia.

Studying Two Alan Bennett Monologues Essay Example

Studying Two Alan Bennett Monologues Essay Example Studying Two Alan Bennett Monologues Paper Studying Two Alan Bennett Monologues Paper Essay Topic: Literature A monologue is a play with a single performer. The word monologue is of Greek origin and comes from mono-logos. Mono means word of one person and logos means voice hence monologue, one voice. Alan Bennetts work is impressive and his understanding of characterization is second to none. He has an ability to capture the life- styles and backgrounds of the characters he creates. The language of each character brings forward clichi s that can be humorous although in my view this might not have been always intentional. In carrying out my research I found an article in The Times Newspaper where Alan Bennett recognized that although he calls this work a series of monologues they could be plays. In fact, two of his monologues have been lengthened to enable them to be performed in the theatre. The article also stated that they could, equally well, be called short stories, for although none has a conventional short story construction, each has a plot, of sorts. It is a measure of Bennetts skill with language, that all of the scripts establish detail, plot and development of character. A Lady of Letters Patricia Routledge was cast in the BBC production to play Irene Ruddock, a middle aged woman who writes letters. We soon discover that what she regards as her public responsibility has in the past turned into libel. As a result legal action has been taken against her and she has been bound over to keep the peace by a court for writing invasive and offensive letters to her neighbours. Irene Ruddock is a lonely and sad woman. The death of her mother had a deep effect on her life and writing letters is in a way her escape route for loneliness and a lack of friends/family. Her letters include writing replies to circulars and even a letter to the Queen about dog droppings! It starts to become really serious when she writes to her neighbours believing that they were abusing and neglecting their child. This is based on her prejudice towards the parents, for example she is disgusted by the fact that he has a tattoo and the kiddy looks filthy. Although Irene realizes that she may need help and visits the doctor she neglects to take the medication. Her local vicar also has little influence on her. Eventually Irene is cautioned by the police and informed that the child has died of leukemia. She is prosecuted and given a suspended sentence and assigned two social workers, who try to encourage her to join the community. Her response is to write another series of letters about the local community policeman and the lady at No. 56, which land her in prison. Prison life dramatically changes Irene because she has now found the friends and companionship she had longed for in the outside world. Irene making friends in prison is surprising because she is now mixing with people who were the victims of the letters she used to write. The strength of the monologue comes from a malicious trouble maker who finally becomes a liberated woman. It is ironic that for Irene prison is for her freedom. A Cream Cracker under the Sofa Thora Hird in the original BBC production plays Doris, a fiercely independent woman. While carrying out housework she severely injures herself. She tries to attract attention and when a policeman knocks on the door she decides to turn him away. Doris refuses to consider moving to an old peoples home where everyone smells of pee. Although one should feel sorry for Doris it is difficult to do so given her obsessions with hygiene. This monologue and the revelations about Doris and Wilfred the baby which wasnt fit to be called anything and which was wrapped up in newspaper as if it was dirty is much more shocking than A Lady of Letters. Doris has a very old fashioned outlook on life, she remembers the world when people were clean and the streets were clean. Doris is a very strong-willed woman. It is ironic therefore that to be saved she must admit that she is unable to look after herself, because she does not realise this she would rather die on the floor of her home than go to aold folks home. Talking Heads My research established that Alan Bennett believes forms. dictate themselves and that material demands to be written in a particular way and no other. Each of his characters, according to the author has a single point of view and none is telling the whole story. He says that his characters are artless and dont quite know what they are saying. This is in my view very much about the conventions he establishes. It seems to me that Alan Bennett writes very realistically. The actors speak directly to camera and alone. It is as if the audience is not watching as far as the speaker is concerned. In some ways this is like a catholic confession. The characters reveal themselves to be what they are. The writer assumes that you understand the characters emotions and you can relate to them in some way or another. The writer also assumes that you care about what happens to the characters. The BBCs approach to televising Alan Bennetts plays for television was in many ways to keep their theatrical presence although they were recorded in a television studio. The BBC broadcast them in the late 1980s; they received great public and critical acclaim because of their portrayal of human endeavour. Thora Hird won a BAFTA in 1988 for her performance as Doris in A Cream Cracker Under the Sofa and won three more awards for performances in Alan Bennett monologues, Two BAFTAs and one EMMY. These monologues were among Alan Bennetts first to be produced and broadcast. One of the challenges in televising a monologue is keeping the audiences attention as monologues are not always visually entertaining. In the programmes the directors use a close-up camera shot when the character is talking about something important. For example, in The Lady of Letters when she talks about the visit from the police when Irene states the line: No. Leukaemia The technique of mid-shot and close-up is used throughout. The music in the monologues is very fitting and allows the audience to appreciate the different moods of the play. The music is in the minor key throughout most of the monologues, demonstrating how depressed and miserable the characters sometimes are. The music is introduced to create atmosphere when something particularly emotionally stirring or dramatic is occurring. The music is also used to link the end of scenes and the fades to black. However, silence also is used to highlight different parts of the play. When the actors say important lines there is a silence for a few seconds before music is brought back. This allows the audience time to assess the dramatic effect of the play. There are several set changes in both monologues. The Lady of Letters starts off in Irenes house, in a dull plain room with just a desk and a window. The walls are plain and white with no form of decoration. The lack of decoration might suggest her lack of interest in the inside of her house; she is more interested in what is outside. After a short period of time she moves to an armchair to read the paper, yet she is still in view of the window. In the middle of the monologue there is an end of scene in which Irene is leaving her house and putting her coat on. The only other set change in A lady of Letters is when she is sent to prison. The prison walls have a plain industrial pattern and a reinforced window to prevent the inmates escaping. The sets in A Cream Cracker under the Sofa do not change very often. At the beginning of the monologue Doris is sitting in an armchair in her main room. In the room is a fireplace. When Doris tries to go and make a cup of tea she is unable to do so and ends up on the floor by the fireplace sitting next to the wedding photo she cracked. Doris attempts to make it to the door to get help. This is when the next scene change occurs. Doris ends up seated on the floor in front of the door. Later on as the monologue draws to a close Doris manages to drag herself back into the living room in which she started the monologue. The main setting of a Cream Cracker under the Sofa is Doriss main room. This room is full of furniture and is very out of date. I think this is linked with the fact that she is trapped in the past by her views of people and her obsession with hygiene. In a monologue, normally you do not see the plot happening directly. It happens, then the character tells you about it. The only exception of this in the two monologues is at the end of A Cream Cracker under the Sofa. When the police officer approaches the window you actually see Doris turn down the officers help. Fading to black is used to differentiate between two different time periods and to change the set, for example in A Lady of Letters after Irene says the line: He needs reporting (when referring to the police officer who is having an affair with the woman down the street) It fades to black and comes back with Irene in prison, this shows it is used as both a change of time and place. In the monologues the character is always talking to the camera and almost always looking straight into the camera. This makes it seem as if the character is talking directly to the viewer and I think this helps the viewer to understand their choices and opinions better than if they were not talking to the camera. One becomes almost like the characters diary. I think this because they tell you everything, yet you play no part in the plot or their life. The two monologues vary in the use of humour. A Lady of Letters subject matter uses humour effectively whilst A Cream Cracker under the Sofa has little humour. The situation of an old woman alone and in pain, condemning herself to death leaves little to laugh about. However a few moments for example are when Doris is lying distressed on the floor and a young boy enters her garden and she sees him spending a penny she says: The cheeky monkey. Hes spending a penny. Hey. Hey. Get out. Go on. You little Demon. Would you credit it? Inside our gate. Broad day light. The placell stink. Also Doris states: They ought to get their priorities right. They want learning that on their instruction course. Shouting about Jesus and leaving gates open. Its hypocrisy is that. It is in my book anyway. Love God and close all gates. Most of the comedy in the two monologues is ironic humour. Irony is when the character says something then something happens that completely contradicts what they said for example, when Irene says: Prison, they have it easy, television, table tennis, art. Its just a holiday camp, do you wonder theres crime? Then when she is sent to prison she enjoys it, this is ironic. The settings in both monologues are similar yet subtly different. For example they both start off in rooms that are old fashioned, but they are old fashioned in different ways because they are from different generations. Both the rooms have a focal point that is involved in the plot and the character concentrates on it. In A Lady of Letters it is the window. Irene is near a window for almost the whole of the monologue this is because she is observing the social life of her community rather than taking part in it. In A Cream Cracker under the Sofa the focal point is the fireplace. Doris injures herself while trying to dust it, she ends up next to it when she tries to go and make a cup of tea. Windows are also key in A Cream Cracker under the Sofa. Through the windows Doris sees the little boy spending a penny and the police officer coming to help her. There is a wide variety of connection between the two monologues. They both are about women who are trapped in some way. Irene is trapped by her anti-social letter writing and her lack of friends. You know that Irene has a lack of friends because she calls her pen a real friend. Doris is trapped by her obsession with hygiene and her old fashioned views. You can tell that Doris is obsessed with hygiene because she talks about how she had an argument with her deceased husband Wilfred about having a tree in the garden she says: Given the choice Wilfred Id rather have concrete. He said concrete has no character. I said, Never mind character, Wilfred, Where does hygiene come on the agenda? With concrete you can feel easy in your mind This extract shows just how obsessed with hygiene Doris is and how it rules her decisions and her life. Another extract that demonstrates how obsessed with hygiene she is, is when she and Wilfred have a discussion about getting a dog: Hairs all up and down, then having to take it outside every five minutes. Wilfred said he would be prepared to undertake that responsibility. The dog would be his department. I said, Yes, and whose province would all the little hairs be? What they both need is friends and family, to distract Irene from the goings on of her neighbours and to stop her from sending letters and to give Doris companionship. Both monologues are about two women who are living by themselves and they both have lost a loved one, Doris her husband and Irene her mother. Each monologue makes you feel sympathetic towards the characters involved because of the ordeal they have been through. At the end of A Lady of Letters you feel happy for Irene because of her new found friends. At the end of A Cream Cracker under the Sofa you are not sure if you should be happy for Doris because she avoids being sent to the old peoples home (Stafford House), or if you should feel sad for her because she dies. The monologues have quite similar structures. Both the monologues start off in mid conversation leaving the audience confused as to what is happening and what the character is talking about. They also both finish with a summing up line. For A Lady of Letters the finishing line is: and Im so happy The last line in A Cream Cracker under the Sofa is: Never mind. Its done with now, anyway. Both these lines give the audience a look at how the character views her decisions and their outcome. The language used by the characters and written by Alan Bennett is quite varied and it is like a real conversation. It is not like someone is reading from a script. It is as though they are really making it up as they go along, because Alan Bennett has written in thinking time and pauses for contemplation. The language that is used is the kind of language that women of those ages would be using. I noticed that the two characters speak quite similarly and have a similar vocabulary of words; for example, they both refer to children as Kiddies.

Body fluid and salt metamoblism

Body fluid and salt metamoblism There are several causes underlying dysnatremia. Most significantly are both the management of dysnatremia and parenteral hydration. In normal status, the normal range of blood sodium concentrations are of 135-145 mmol/L. Sodium and its accompanying anions, which are mainly chloride and bicarbonate, represent for 90% of the extracellular effective osmolality. The plasma water content is a main determinant of the sodium concentration. Dysnatremias may have result in central nervous system dysfunction whereas hyponatremia may lead to brain swelling and hypernatremia may lead to brain shrinkage. According to the extracellular fluid volume status the hyoponatremia is classified as either hypovolemic or normo-hypervolemic. In children, vasopressin release is triggered by the low effective arterial blood volume in case of hypovolemic hyponatremia this is called syndrome of appropriate anti-diuresis. The primary defect in dilutional hyponatremia is euvolemic also there is inappropriate increase in circulating vasopressin levels this is called syndrome of inappropriate anti-diuresis. To determine presence of hyponatremia may shows obvious cause such as vomiting or diarrhea. In some status, to discriminate hypovolemic from normo- hypervolemic hyponatremia may not be obvious. Some patients have difficult to assess their status volume but there is helpful way to assess their status by detect urine spot sodium and the fractional sodium clearance. In state of normovolemic, the major defense against developing hyponatremia is the ability to dilute urine and excrete free-water. There are special causes lead to hypotonic hyponatremia which are hospital-acquired hyponatremia, desmopressin, endurance athlete and diuretics. Hypernatremia is a net water Loss or a hypertonic sodium gain, with Inevitable hypertonicity reflects hypernatremia. If sodium concentrations above 160 Mmol/ L are usually sever symptoms evident only with presence of acute and large increases in concentrations. Almost the cause of hypernatremia is always obvious from the history. If the cause is not evident, determine of urine osmolality in relation to the effective blood osmolality and the urine sodium concentration. There are two mechanisms prevent developing hypernatremia which are: release vasopressin and a powerful thirst mechanism. When the effective blood osmolality exceeds 275-280 mosmol/ kg H2o, release of vasopressin occurs and when the effective blood osmolality exceeds 290-295 mosmol/kg H2o that results in maximally concentrated urine. There are two causes of hypernatremia in outpatient which are breastfeeding and diarrhea or vomiting . In breastfeeding the major problem is water deficiency that cause sodium concentration raises as a result of low volume intake and a loss of water. Diarrhea or vomiting comparison to the past is less because of presumably to the advent of low solute infant formulas and the increased use and availability of oral rehydration solutions. In management of hyponatremia, used either V2 antidiuretic hormone receptor antagonists or urea. In fasting patients, Intravenous maintenance fluids done by Holliday are used to provide water and electrolyte requirements. used administer intravenous isotonic (or near isotonic) crystalloid solutions in children who resistant to initial oral rehydration therapy. Traditionally, mange chronic normovolemic (or hypervolemic) hyponatremia either by restricting water intake or by giving salt. May be the use of nonpeptide vasopressin receptor antagonists as alternative. There are several receptors for vasopressin which are v1a, V1b and v2receptors. In patients who have nephrogenic syndrome of inappropriate childhood anti-diuresis the vaptans do not correct hyponatremia. In these cases, use oral administration of urea. All in all, pediatricians must aware of the changing epidemiology of dysnatremia . Also, the hydrated parenterally with the hypotonic solutions which recommended by Holliday.

Employee Satisfaction Surveys Research Paper Example | Topics and Well Written Essays - 1500 words

Employee Satisfaction Surveys - Research Paper Example Their relevance to the organization will also be proffered. The first type of employee satisfaction survey is the employee engagement surveys. In an employee engagement survey, the passion and commitment of the employee with regards to their work, company and co-workers are analyzed (NBRI, 2012). This type of survey aims to determine whether the employees feel empowered and whether they have a good relationship with their supervisors and managers (Sheahan, n.d.). Through this survey, management will know what the employees think about the company’s goals and values and if they are willing to support them (NBRI, 2012). The second type of employee satisfaction survey is the employee attitude survey. This survey â€Å"assesses the feelings or emotions of employees within the workplace† (NBRI, 2012). This survey will give management an idea on how it can boost the morale of their employees by understanding their views and perceptions and identifying the root causes of their attitudes in the workplace (NBRI, 2012). The employee opinion survey is another type of employee satisfaction survey. This type of survey reveals the employees’ behaviors, beliefs, feelings, thoughts and conclusions on matters such as commitment, management style and productivity (NBRI, 2012). The data gathered from this survey entails a precise analysis. The factors that motivate and discourage employees will be exposed in this survey. The fourth type of employee satisfaction survey is the employee development survey. This survey will prevent high turnover rates within an organization because it will determine whether employees perceive the company as a place where they can develop professionally (Sheahan, n.d.). If employees believe that the company offers opportunities for growth, this survey will be able to show it. Another kind of survey is the straightforward satisfaction survey which goes directly to the point of questioning employees how happy they are with their job s (Sheahan, n.d.). Sheahan goes on further to say that this type of survey usually has a scoring system which rates the satisfaction levels on a scale of 1 to 15 (n.d.). Moreover, the questions on the survey will give management an idea if there are any problems on morale and compensation. The sixth type of employee satisfaction survey is the improvement survey. This survey is conducted when an organization is contemplating on changing some policies or job conditions (Sheahan, n.d.). It will assist management in determining whether such changes will be acceptable to the employees. They will be able to gauge how the employees will react or feel if such changes were imposed. The 360 degree survey is another kind of employee satisfaction survey which is conducted by companies to evaluate the employees from the points of view of the supervisors, peers, subordinates, customers, vendors, and other external stakeholders (NBRI, 2012). One of the more important type of survey is the exit sur vey. This is administered to an employee who will leave the company. This survey is an excellent indication of employees’ attitudes and is known to elicit very honest responses (Ipathia, Inc., 2005). All the surveys mentioned above may either be conducted online or paper-based. A primary consideration though for online surveys is that not all the employees may have computer and internet access and there may be employees who lack computer skills to complete the survey (Lock Media Services, Inc., n.d.). An online survey however is less costly than a paper-based survey.