Balanced Scorecard approach to Technology Assignment

Balanced Scorecard approach to Technology - Assignment Example There might also be disrupting technologies that make the entire range of products or business models haywire.   Along with this, due to lack of proper communication, the problems are not looked into or solved in the right manner by the right people. A company would formulate its strategy in such a way that it enables the business achieve its desired goals and it is the path that would lead the company to its success. This is necessary so that the company can translate its innovative ideas to stories of success in reality.Development of the Balanced Scorecard SystemFirst of all it is important to know and understand the stakeholders that of the company and their individual objectives. Then the strategic components of the business have to be identified and their present position has to be analyzed. These components are the vision, the mission, departmental goals, the core values of the organization and the various dimensions of performance and the forecasting of the probable results .Now for using a Balanced Scorecard approach for Reliant Technologies the health of the company can be measured from both financial and Non Financial perspectives (Kaplan and Norton, 1992). This is the advantage of Balance Scorecards measure that it looks into the business beyond the numerical figures of financial statements and exhibits a better insight into the bigger picture. The main areas of the Balanced Scorecard would be as follows (Figure 1).Accurate Financial data and the proper interpretation and forecasting.... Then the strategic components of the business have to be identified and their present position has to be analyzed. These components are the vision, the mission, departmental goals, the core values of the organization and the various dimensions of performance and the forecasting of the probable results. Now for using a Balanced Scorecard approach for Reliant Technologies the health of the company can be measured from both financial and Non Financial perspectives (Kaplan and Norton, 1992). This is the advantage of Balance Scorecards measure that it looks into the business beyond the numerical figures of financial statements and exhibits a better insight into the bigger picture. The main areas of the Balanced Scorecard would be as follows (Figure 1). Figure 2 Balanced Scorecard Figure 1: Balanced Scorecard (Source: Kaplan & Norton, 1992) Financial Aspect Accurate Financial data and the proper interpretation and forecasting are required for the crucial analysis of the financial position of the organization. This data should be available to each and every segment of the operations of Reliant so that all the persons concerned would know how and which factors are changing the bottom-line of the balance sheet. Rigorous metrics on the profitability like EBIT, EBITDA and Operating Income have to be done to understand the real position of the business. Thus centralization of the system is necessary for the managers. Assessment of the Return on Investment The assessment of financial position is not enough. The situational analyses of risky situations that Reliant might face and the costs and benefits of undertaking different projects should be done instantly. Prior calculations of return on investments have to be undertaken before going for any kind of new project that

Building and Sustaining School culture Research Paper

Building and Sustaining School culture - Research Paper Example Creating awareness of culture within school settings can trigger scholars and tutors to take on tasks that promote growth. A school is an organization that has its own principles, values, and norms. Culture is not a distinguishable aspect of a school setting. A school culture encloses teachers developing their attitudes and impacting their conclusions and deeds. Culture manipulates all facets of a school, as well as such aspects as teacher’s dressing, what the teachers talk about during their breaks, how the teachers decorate their classrooms and the teacher’s stress on definite facets of the program of study. This research paper will focus on the factors that can help in building and sustaining school culture within school settings and institutions and the key players.Sarason (1996) refers culture within a school setting as the set of beliefs and values coherent among the school leaders in steering the school and interpreted by the students into proper conducts and arm ored through the installation of discipline. School cultures are formed and transformed over time. Needless to say, there is a broad correspondence among authors and scholars on how school cultures reacts to and replicates community attributes held by the students. For this reason, school culture can be expressed as the air we breathe. It is hardly noticeable. Moreover, it also typifies the traits and values of its leaders (Sarason, 1996).Culture in school grows as â€Å"teachers associate with each other, students and the community†.... School culture is a dynamic aspect that is continuously â€Å"being constructed and shaped through dealings with other and replications on life and the world in general† (Sarason, 1996, p 27). Culture in school grows as â€Å"teachers associate with each other, students and the community† (Barth, 1990, p. 123).Sarason (1996) argues that it â€Å"becomes the guide for behavior shared among members of the school at large† (p. 32). Kruse and Louis (2008, p. 20) argue that schools â€Å"are shaped by cultural practices and values and reflect the norms of the society for which they have been developed†. Barth (1990) asserts that â€Å"rituals and procedures common to most schools play a vital role in defining school’s culture† (p.124). For instance, ringing bells and having students stand in lines. Sarason (1996, p. 138), asserts â€Å"it is challenging to determine the nature of a school’s culture because our own personal experiences and values put blinders on what we look at, choose to change, and evaluate; because our values and assumptions are usually implicit and second nature we proceed as if the way things are the way things should or could be†. Arguably, people scrutinize the customs, guidelines, curriculum, tasks, pedagogy and practices in institutions from side to side via the sieve of their personal experiences and values. Sarason (1996) points out that people must apprehend and analyze their own cultural impacts before examining a schools’. Before joining the school, teachers and other staff members are attached to other cultures. Their values, experiences, prior education and norms,affect their opinions on pedagogy, curriculum and reforms before stepping into classrooms. For this reason, any proposed cultural reform will be resisted. Effects of

Importance of Learning Asian Languages Essay Example for Free

Importance of Learning Asian Languages Essay If I asked an English speaker, â€Å"Hello, how are you?†, the answer almost invariably will be â€Å"I’m fine, thank you†. This brief dialogue itself establishes a relationship between the two people. It not only stands proof of the two individuals’ ability to speak English but also their collective ability to converse in a common language. From the very beginning a certain level of trust is created as both persons can comprehend what the other is saying and thus, within the limitation of his or her expression, know what the person is thinking. With this also comes fluency in the conversation and in the vocalization of ones thoughts. Not only does this make the interaction faster, it also allows both persons to speak their mind freely and without much hesitation. Now instead, think of a French speaker asking â€Å"Commo à §ava?†, his translator translating, â€Å" How are you?†, the English speaker answering, â€Å"I’m fine, thank you† and the translator translating back, â€Å"Je suis bien, merci†. Quite evidently, the conversation becomes longer and quite tedious. But beyond that, the two individuals also feel a disconnect, as neither of them know for sure what the other is saying. The existence of the middleman disrupts the trust that would otherwise be established in the relationship. Also, both individuals hesitate and think twice before saying anything, pondering its interpretation in the other’s language. The purpose of the above examples is to show the benefit of conversing in a common language. If there is such a radical difference in communicating so briefly, the differences in longer and more complex conversations will be drastic. A common language gives the individual more access, establishes trust and therefore gives the individuals power. Throughout history we have witnessed expansion of various empires and in the process interaction of societies speaking different languages. Examples can be taken from the invasions of Indian kingdoms by the British Empire, British colonization of Australia or from the forceful inhabitation of Native American lands by the European immigrants while USA was being founded. The pattern in all these has been the same. The invaders start from trade. Through this they learn about the native people’s society and culture. Language is an inevitable need of trade and so the foreign traders learn the local language and the natives learn the tradersà ¢â‚¬â„¢. Slowly this gives the invaders access to the local community and gradually colonization takes place. Thus, we see how language gives power. Even in the current scenario, things have not changed a lot. Although the purpose of knowing a foreign language may not be to take over another country, language still gives the individual who speaks it an immense amount of power. It is so in all aspects of the word, the more people you can communicate with, the more are your chances to succeed. This power is exactly what the Australian Prime Minister Julia Gillard wants the citizens of Australia to have. Asia is progressing rapidly, but why would Australians knowing Asian languages â€Å"power Australia into the world’s top 10 wealthiest nations by 2025†? This is because as Asian countries progress and become global leaders, due to their economic and populous advantage, a large part of the world’s business will be conducted with or through them. India and China consist of 5/14th of the world’s population and this population spreads around the globe, knowing Mandarin or Hindi will give the speaker a great tactical advantage in an increasingly competitive world. But you may ask that if a common language is the only thing attracting Australia to have its citizens learn languages like Hindi and Mandarin, what’s wrong with their native English itself? The answer to this has two sides. The first is that English is becoming an increasingly global language and in the coming days, everyone who will do business with the Asians will almost definitely know English. In such cases, having a common language will not be enough. Knowing their native language and establishing an intimate relationship is what will give the language speakers an edge over the others. The other side is that as evidently seen today, a large percent of the Indian population speaks English and in terms of the people who do business, all of them speak English. But in the case of the rest of eastern Asia, few people, even in the corporate world speak fluent English. These aren’t baseless claims. There are various reasons behind this phenomenon such as the British rule over India for over 200 years, the mostly secondary sector development of countries like China and Japan and India’s global dependence for its services export. Since the beginning of British rule in India, many Indians have been learning English to facilitate themselves to get better jobs in the British government. Even after independence, English remained deeply incorporated in the Indian education system. Thus, English was never introduced to Indians as a global language learnt to facilitate communication as is being done now in various countries. It was imposed on on Indians as a necessity to survive in the British common wealth. This is why even the Indian lower middle class knows a moderately good level of English. Also, as India has developed, its tertiary sector has developed tremendously, specifically in the field of Information and Technology. The blooming IT industry far outmatches the demand for IT services in India and therefore there is a need to outsource these services. Thus, interaction of the average Indian with the outside world has increased and so has his need to speak English. As opposed to this, countries like China and Japan have seen the most development in the secondary sector. With the highest population and cheap labour, China has become the manufacturing hub of the world. But this surge in the manufacturing sector has resulted in only the entrepreneurs of these countries being in communication with the rest of the world. Their laborers, with no need to communicate with people outside the country, have found no need to learn English. As these Asian superpowers rise, the existing world leaders relatively decline in their economic and political status. With this in mind and considering that the whole of Europe barely amounts to half the population of China, learning learning Asian languages will be much more advantageous that learning European languages except for specific purposes. One could argue that some European languages like Spanish and French could be used in communication in earlier Spanish and French territories like South America and Quebec but this wouldn’t provide any advantage considering the economic and populous strength of Asian countries. Although all the pros favor learning Asian languages, it isn’t such an easy task, especially for a country that has been under British rule and speaks English that has a completely different script than any of the Asian languages. In this aspect it would be easier for students in Australia to learn European languages, as the script is the same as English. Another factor affecting the foreign language Australians would prefer to learn is their ancestry. Most of the Australian population consists of European immigrants who moved to Australia during the British rule. Many of these immigrants now in the 4th or 5th generation after the migration see a loss of culture in the generation following them and therefore would prefer that their children learn their mother tongue and be well rooted in their origins. Although a valid argument, people need to make a conscious choice between the past and the future. Learning their original European languages may give them a better taste of their own culture but by doing that, they are possibly depriving themselves the chance of a better future. Even the aspect of education is quite debatable. It is a well-known scientific fact that as you grow older, your ability to learn different languages decreases. The language learning agility during childhood allows children to master various languages irrespective of the differences between them. I myself have learnt English, French and Spanish, all having the same script while also knowing Hindi and Gujarati, both of which follow a different script than that of European languages. There are people out there who know various languages from many scripts and you don’t need to be a linguist to learn them, you just need to be a kid! This unconventional tactic to teach Australian citizens Asian languages could prove to be a great advantage to learners in this Asian century and could facilitate Australia to make it one of the ‘top 10 most wealthiest countries by 2025’ which, as stated by Julia Gillard, the Australian Prime Minister, is the primary goal of this initiative. To materialize this goal will take a lot of effort and will put a great toll on Australia’s education budget. If achieved though, Australia won’t be far behind the Asian giants in the coming global race.

High Risk Pregnancy and Women with Complex Health

High Risk Pregnancy and Women with Complex Health For this assignment I have been asked to look at the care I have seen and been involved in giving to a woman with a high risk pregnancy. I intend to identify how my practice could be developed to meet the similar needs of women in the future. To do this I am going to use a reflective approach. I am going to look at the normal anatomy and physiology and analyse the patho-physiology in relation to high risk pregnancy and birth. For most women, their midwife is their first point of contact so they have a crucial role to play in identifying any risks. Included in their extensive role is facilitating pregnancy and childbirth as a positive and fulfilling experience. This is most fundamental for those women whose childbearing experience has been categorised as high risk (Page, 2006). A pregnancy is classed as high risk if there are any factors that may adversely affect the fetal or maternal outcome. Risk factors must be identified as early as possible to increase the chances of an improved outcome (Queenan et al, 2007). When a woman is booked for her maternity care, her medical and obstetric history is taken to ascertain whether she would be suitable for midwifery led care (low risk) or consultant or obstetric led care (high risk). A woman can change from either group during her pregnancy. For example, she may start her care as low risk but then something may happen or a condition may develop so she may therefore require consultant input into her care. Factors which could mean a woman has a high risk pregnancy include epilepsy, diabetes, cardiac problems, multiple pregnancy, hypertension, obesity and previous obstetric complications, i.e. caesarean section, previous haemorrhage (whether that be antepartum, intrapartum or postpartum), recurrent miscarriages or previous intra-uterine death. Using Gibbs (1988) reflective cycle, I am going to discuss a woman I recently cared for whilst working on Central Delivery Suite, whose pregnancy had been assessed as high risk. This was due to her having had a previous emergency caesarean section and a previous ventouse delivery. In accordance with The Code (NMC, 2008) I have changed all names mentioned to respect their confidentiality. Description: Laura, aged 39 years old, was 39+1 weeks pregnant, gravida three, para two. As just mentioned, her obstetric history meant she would see an obstetric consultant during her pregnancy. As Laura was planning on having a vaginal birth after caesarean section (VBAC) this increased her risk. It was also apparent she had tested positive for Group B Streptococcus (GBS) in both her previous pregnancies. Laura had gone into spontaneous labour. Laura and her partner had both requested antibiotics to be started as soon as possible due to the previous GBS. This was not something my mentor could agree to as Laura had not tested positive for it at any point during this pregnancy. However, due to Lauras admission temperature reading being 38.1 °C and in view of the previous two pregnancies testing positive for GBS, it was decided by the obstetric consultant on duty that she would receive antibiotics during labour. We confirmed she was in established labour by performing a vaginal examination, with consent, and finding the cervix was 4-5 cms dilated, partially effaced and membranes were felt intact. After Laura was cannulated, the antibiotic Benzylpenicillin (Penicillin G) 3g was administered intravenously. Then at four-hourly intervals she was given 1.5g until delivery. Due to Lauras high risk status a cardiotocograph (CTG) was commenced to keep a trace on the fetal heart rate and the uterine contractions. Laura laboured for approximately 6 hours in total, and went on to have a normal vaginal delivery of a healthy baby boy. Postnatally, Lauras observations were taken and baby observations were also taken six hourly and observed for a minimum of twelve hours in accordance with Local Trust Guidelines (Local Trust, 2005). Feelings: This event particularly sticks in my mind due to my own curiosity about Group B Streptococcus. When Laura was showing a temperature of 38.1 °C, I recognised this was out of the normal range so I informed my mentor. I knew a high temperature could indicate a sign of infection so it was important I made my mentor aware. I felt calm at the time and knew my mentor and the obstetric consultant had the matter under control. My mentor made me feel included in the situation and explained fully what she was doing and when. She went through the process of preparing the drugs and the IV line with me. I was very happy with the outcome of the situation. At the end of the day, we all wanted a normal, natural delivery of a healthy baby and that was achieved. Evaluation: The ultimate goal of this situation was a healthy mother and baby, which was successfully achieved. I am glad the consultant made the decision that Laura would be started on antibiotics as I was aware of how anxious she was. Analysis: The final outcome was Laura had a healthy baby with no signs of GBS disease. Contributing factors to this were how I relayed important information to my mentor and how the obstetric consultant made the right choice offering Laura antibiotics, even though she had not tested positive for GBS in this pregnancy. I believe Laura should have been offered a test for GBS to confirm if it was present in this pregnancy or not. She was very anxious about the situation so I feel this would have at least helped put her mind at rest knowing either way. Her and her partner had come to CDS demanding antibiotics as a precaution anyway, and luckily for her, her high temperature meant she received them. Had she not had the high temperature that decision would have been down to the consultant. Conclusion: I learnt from this experience the correct drugs to be given in labour, and the quantities and times stages they should be given. I also learnt the drug to be given if the woman is allergic to the primary choice drug. Plus, from using this topic as my high risk assignment, the further reading I have undertaken has also taught me a lot. Action Plan: If the situation happened again, I would feel more confident in my knowledge of explaining to the woman and her family why we would advise her to have the antibiotics. In this particular situation, Laura knew a lot about GBS due to her previous pregnancies being tested for it and she was then subsequently treated during the labours. However, if a woman I was caring for had little knowledge of GBS, I feel I could explain it. Laura was classified as high risk due to her previous obstetric history. However, I am going to concentrate on the Group B streptococcus (GBS) she was concerned she had, after having it in both previous pregnancies. I also have a personal interest around GBS as this was something I tested positive for during my pregnancy and I did not really understand what it was or the complications of it. I was screened routinely as I was living in Spain at the time. Laura was only aware of her GBS, in her previous pregnancies, due to routine screening in Germany. She had not been screened here in the UK for GBS in this pregnancy, due to the uncertainty of clinical evidence and cost effectiveness of the routine screening (NICE, 2003). As mentioned in my reflection, this was something Laura was concerned about and requested she receive antibiotics during her labour as a precaution. Group B streptococcus is a common type of streptococcus bacterium. Approximately a third of men and women are carriers of GBS in their intestines and a quarter of women carry it in their vagina. Most people are unaware they are carriers as it can be difficult to detect and does not cause any symptoms. Carrying it is perfectly normal as it is one of many different bacterias that live within our bodies. Problems can arise when GBS is transmitted to the fetus. This could happen if the membranes rupture, during labour or the delivery. The fetus could come into contact with GBS if the bacterium travels upwards from the womans vagina and into the uterus due to the membranes not being there to protect the fetus. If there are prolonged rupture of membranes there is increased risk of transmission due to more time for the micro-organisms to be transported from the vagina into the cervix, and then to the uterus. According to the Group B Strep Association there is also evidence that GBS may cross intact membranes to expose the fetus whilst it is still in the womb. This could therefore cause preterm births, stillbirths or miscarriages. The fetus could also be exposed while passing through the birth canal. A preterm infant would be more susceptible as their lesser-developed bodies and immune systems are more vulnerable to GBS infection than older infants. The fetus could become infected if they swallow or inhale the bacteria (GBSA, 2011). If the fetus acquires GBS in utero this is known as early onset (Chapman, 2003). GBS can also be found on the hands and in the respiratory tract of a colonised person. So once a baby is born, GBS could be passed on to it from the hands. This is why, especially within the first 3 months of a babys life, it is so important for anyone who comes into contact with a baby, washes and dries their hands thoroughly. If the baby was to develop the disease from repeated exposure, this is called late onset (Chapman, 2003). In Lauras case, we were concerned about in utero transmission which could cause early onset GBS disease. This gave us the option for the administration of prophylactic antibiotics during labour, and at least two hours before delivery, which has been shown to reduce the frequency of neonatal GBS infection (Local Trust Guideline, 2009). Antibiotics given during labour can be very effective at preventing this transmission. A guideline written by The Royal College of Obstetricians and Gynaecologists (RCOG, 2003) state a woman should be offered intrapartum antibiotic prophylaxis if they have the following risk factors: à ¢-  previous baby affected by GBS à ¢-  GBS bacteriuria detected during the current pregnancy à ¢-  preterm labour (less than 37 completed weeks of pregnancy) à ¢-  prolonged rupture of the membranes (more than 18 hours before delivery) à ¢-  fever in labour (a temperature of more than 37.8 °C) Although Laura only had one of the above risk factors, she was offered the antibiotics at the discretion of the consultant. Women must also be reminded of the risks with taking antibiotics and be given all the information so they can make an informed choice. The antibiotics a woman receives will also depend if she has any allergies to medication. The recommended antibiotic for those allergic to penicillin is clindamycin, 900mg administered intravenously, from onset of labour and every 8 hours until delivery (GBSS, 2007, Local Trust Guideline, 2005). During my placement on the Neonatal Unit, I also cared for a baby that had to be admitted for antibiotics as its mother had tested positive for GBS during her pregnancy. She was unable to receive antibiotics as the the delivery was so fast and there was not enough time. Therefore the baby was admitted to the Neonatal Unit so he could receive antibiotics. Blood cultures from the baby were obtained and he was treated with penicillin until the culture results were available. This enhanced the importance of the woman receiving the prophylactic antibiotics during labour. In any high risk situation it is vital that maternal and fetal well being is monitored. As Laura was high risk she was placed on continuous cardiotocograph (CTG) monitoring. This gave us a recording and trace of the fetal heart rate so we could indentify any deviation from the norm, in comparison with the baseline for that baby. The primary aim of the CTG is to identify a fetus that may be hypoxic so additional assessments of fetal well-being can be used (i.e. fetal blood sampling) or the fetus being delivered by an instrumental vaginal birth or caesarean section. The use of this kind of technology is justified in being able to save the life a fetus that is shown to be in distress. The CTG detects the fetal heart rate (FHR) and the uterine activity (toco) simultaneously and displays it in the form of graph. It is important to check the maternal pulse at the same time as applying the CTG, to ensure the machine is recording the fetal heart rate, and not the mothers. The modern machines we use at my Trust have a maternal pulse sensor which the mother applies to her finger, which then records the maternal pulse rate on the graph that is printed out. The continuous electronic monitoring using the CTG is vital to get a contemporaneous recording of the fetal heart rate. It will give us the baseline heart rate (usually between 110-160 beats per minute), accelerations (momentary increases in the fetal heart rate) and decelerations (momentary decreases in the fetal heart rate). Some aspects of labour will cause natural alterations in the FHR patterns. For example, the pattern will be different when the fetus is asleep or awake. External factors, like uterine contractions and maternal movement can cause the FHR to change. The FHR can also be affected by opiate based painkillers, like pethidine. Some of these changes are quite subtle and can only be detected by continuous CTG e.g. baseline variability, temporal shape of decelerations. To be a competent midwife, it is imperative I have knowledge on how to interpret the recorded traces of a CTG. I have seen many CTG traces whilst on my hospital placement due to the high number of high risk women my Trust cares for. However, I still feel I am learning new things every time I see one, as everyone is different. I can distinguish between baseline tachycardia (where the fetal heart rate baseline rises above 160 beats per minute) and baseline bradycardia (the opposite, where the fetal heart rate baseline goes below 110 beats per minute) (Mukherjee, 2007). Baseline tachycardia could be physiological if the trace is from a preterm fetus due to immaturity or secondary to maternal pyrexia or dehydration. It could also be a sign of fetal hypoxia. The fetus would try to increase the cardiac output mainly by increasing the heart rate to supply vital organs with oxygen and nutrients. Baseline bradycardia could be physiological if the trace is from a post-term fetus or possibly a large fetus, provided there are also accelerations present and there baseline variability is above the normal range (>5 beats per minute). If it is just baseline bradycardia with no other normal or reassuring factors, this would need immediate action. Another form of technology used within Lauras pregnancy was screening. When she was initially booked for her antenatal care, her blood and urine would have be sent for screening, after she consented to this. She would also have attended ultrasound scans which are also a form of screening. This is something that is offered to all pregnant women and regardless of their risk status, it is used in both low and high risk pregnancies. It is a process which has been developed, which was not done previously due to lack of knowledge and technology. The standard screening during the antenatal period is urine; to check for any sign of infection, and blood; to check the womans blood group, her rhesus status, her iron levels, if she is immune to rubella, and to check for hepatitis B, syphilis and HIV (NHS Choices, 2011). In line with the National Institute for Clinical Excellence (2003) pregnant women should be offered evidence based information and support to enable them to make informed decisions regarding their care. This means women should be informed of all screening tests available to them. I believe this should include information about screening which is not necessarily available within the NHS but could be carried out privately, for example, GBS screening. There are arguments for and against introducing routine screening for GBS in the UK. Plumb, Holwell and Clayton (2007) argue that in the UK, GBS prevention is inadequate. They believe the NHS should offer testing for GBS in late pregnancy, thus giving women the opportunity to establish whether their baby is at higher risk of developing the GBS infection. My current Trust guideline (2005) state there is not enough evidence for it at this time. GBS awareness campaigners, Group B Strep Support, are pushing for routine testing to be introduced in the UK (Prince, 2011). According to GBSS, Western countries that routinely test, have a lower incidence of infection in new born babies, where as cases in the UK are on the rise. Even since the introduction of the Royal College of Obstetrics and Gynaecologists guideline for preventing GBS infection in newborns, in 2003, there has not been a decrease in either the number or the incidence of GBS infections in babies (GBSS, 2007). The table below shows the how the GBS infection in babies has increased throughout England, Wales and Northern Ireland. Year report published Number All cases (babies 0-90 days old Incidence per 1000 live births Number Early onset (babies 0-6 days old) Incidence per 1000 live births Number Late onset (babies 7-90 days old) Incidence per 1000 live births Number 2003/3004 311 0.48 207 0.32 104 0.16 0.48 2006/2007 409 0.61 248 0.37 161 0.24 0.61 2007/2008 421 0.61 258 0.37 163 0.24 0.61 2008/2009 470 0.66 279 0.39 191 0.27 0.66 (data published by the Health Protection Agency taken from www.gbss.org.uk/filepool/GBS_Infections_on_the_Increase.doc) Table 1 Number and rate (per 1000 live births) of group B streptococcal bacteraemia reports in infants 0à ¢Ã¢â€š ¬Ã‚ 90 days old in England, Wales and Northern Ireland: 2003-2009. The overall number of GBS infections within adults is also reported to have increased by more than 72% from 2001 to 2008: (data published by the Health Protection Agency taken from www.gbss.org.uk/filepool/GBS_Infections_on_the_Increase.doc) Table 2 Number of GBS infections in both males and females within England, Wales and Northern Ireland: 2001-2008. A better indication of the rise in GBS infections would be taken from women only, who are 35-37 weeks pregnant. I believe this would give more of an insight into pregnancy GBS infection rates. While the evidence states the increase in rates, I could not find any reasons for the increases. Some factors I believe may contribute to the rise include the lack of personal hygiene, modern living or even due to lifestyle. For example, many years ago clothing and underwear used to be boiled when washing but now people may be washing their clothes on a 40 °C wash and this may not be enough to kill all the bacteria. It may not be due to any of these factors; it may just be we have a better awareness of GBS now then what we did years ago. With the constant improvement of technology, we will also be finding out new things. Although the internet is not a form of technology we use within midwifery, it is certainly a form of technology we definitely need to be aware of. Within the last ten years or so, the internet has become increasingly popular. This means the general public can find about anything, more importantly medical information they may not have been able to access before. Therefore, we need to be aware of those women that we care for, that may have either some basic knowledge or an in-depth knowledge of a medical issue, for instance GBS. The NHS even has a website called NHS Choices (www.nhs.uk) which people can access to check symptoms and research illnesses and also pregnancy. I think this is mainly a good thing, although women may read so much into something they find online and it may make them more anxious or worried. It should not replace the direct contact with their midwife. The Nursing and Midwifery Council (NMC, 2008), state we should be delivering care based on the best available evidence. By reading the research I have found to write this assignment I am adhering to The Code by giving women evidence based advice. I may not be able to radically change my operational practice but I will definitely be more aware of what to look for and how to manage the situation. I will also ensure I am aware of those women who may have a more in-depth knowledge about GBS and understand their anxieties. From writing this assignment I have identified the risks of GBS, who the risks affect and to what degree it could affect them. I feel I would be able to recognise the signs and be aware of the treatment and management. I have acknowledged the main technology used is for the screening of GBS within the laboratory investigation systems and believe this should be carried out routinely within the UK. Final Word Count: 3,361

Scarlett Letter :: essays research papers

Pearl and the Spice of Life Really good salsa has lots of zesty vegetables and spices to make it good. But what if the spiciness of the salsa was taken away? It would just be tomato sauce. Pearl is the spice of The Scarlet Letter by Nathaniel Hawthorne. If her character was not present, the book would have a completely different flavor. In his essay entitled â€Å"The Genius of The Scarlet Letter,† Anthony Trollope states, â€Å"Pearl is miraculous,-speaking, acting, thinking like an elf,-and is therefore, I think, a drawback rather than an aid. The desolation of the woman, too, would have been more perfect without the child† (Trollope 243). Trollope’s point is well made, however the absence of Pearl would have made The Scarlet Letter an entirely different story. Without Pearl there would have been no proof of Hester’s adultery, and she might have become more depressed, even sinned more. However, if Pearl had been a more normal and obedient child, she would have been more well liked by readers. The most drastic change that would have been made in the book in the absence of Pearl would be that it would no longer have been called The Scarlet Letter. The reason for this being that without Pearl, there would have been no proof that Hester had committed adultery. Therefore, no one would have known and there would have been no punishment. Instead, Hester would have gone through the same guilt and internal battle as the minister, Reverend Dimmesdale. The reason that Dimmesdale is so tortured inside is because of the incredible feeling of guilt that he has because of having never taken blame or punishment for his sin. If Hester took no punishment, she would feel that same torture inside. But Pearl is present, so she is proof of Hester’s adultery. Hawthorne says it best when he states, â€Å"God, as a direct consequence of sin which man thus punished, had given her a lovely child† (82). Hester’s punishment was the consequence of having a child. Pearl is not only the proof of Hester’s adultery, she is also the thing that keeps Hester going. Hester may have fallen into a depression and eventually died, but Hester has to keep sewing, keep getting out of bed in the morning, and keep taking care of herself because she has someone else to take care of too. Hester’s feelings about Pearl are revealed when Hawthorne states, â€Å"But she named the infant ‘Pearl,’ as being of great price,-purchased with all she had,-her mother’s only treasure!† (82).

Machu Picchu Essay -- essays research papers

Machu Picchu is a physical symbol of the culture that created it. It is located in the Andes Mountains in Peru, South America, high above the Urubamba River Canyon Cloud Forest. The Incan capital, Cuzco, the closest major city, is forty three miles northwest of this landmark. Machu Picchu is five square miles and eighteen square kilometers in size. This ancient civilization has an altitude of eight thousand feet and is surrounded by towering green mountains. Although covered in dense bush, it had many agricultural terraces that were sufficient enough to feed the population. Due to water from the natural springs as well as the agricultural terraces, it had the ability to be self-contained. Machu Picchu was created by the Inca culture for the purpose of religious observance. In order to build this city, the Incans used stone tools, bronze tools, and chisels. The materials they used were mud, clay, adobe, and granite blocks. Each block weighed fifty tons! They would thatch the roofs with tree trunks and straw. After the buildings were constructed, the Incan people would smooth the stones with sand, mud, and clay to make the structures look polished. The people who inhabited this ancient site considered it to be magical because of the Andes Mountains and the Amazon River. The Temple of the Condor was a place of worship where the head of the condor was used as an altar for sacrifices. The Intihuatana is a column of stone that is rising from a block of stone. As winter approached, a priest held a ceremony to prevent the sun from disappearing. Intihuatana means ‘for tying the sun’ and ‘hitching post of the sun.’ Intihuatanas in other Incan civilizations were destroyed by the Spanish. However, the Spanish never found Machu Picchu, th... ... was discovered by Hiram Bingham, an American, who lived from 1875-1956. He went to Princeton, Yale, and got a PhD from Harvard. Bingham was a military officer, governor of Connecticut and a US senator. He mistook it for the long lost Inca capital of Vilcabamba. Machu Picchu was discovered on July 24th, 1911. When discovered Hiram Bingham said, â€Å"I was left speechless.† Scientists can surmise about who built it, who lived there, and why it was abandoned and forgotten, but they still are not one hundred percent sure. Machu Picchu was used for religious observance, astronomical observation, a royal retreat, and a secret ceremonial city. Therefore, I have partially proved my thesis. I said that Machu Picchu was created by the Inca culture for religious observance. Machu Picchu was used for that and many other things and that is why it is such an amazing civilization. Machu Picchu Essay -- essays research papers Machu Picchu is a physical symbol of the culture that created it. It is located in the Andes Mountains in Peru, South America, high above the Urubamba River Canyon Cloud Forest. The Incan capital, Cuzco, the closest major city, is forty three miles northwest of this landmark. Machu Picchu is five square miles and eighteen square kilometers in size. This ancient civilization has an altitude of eight thousand feet and is surrounded by towering green mountains. Although covered in dense bush, it had many agricultural terraces that were sufficient enough to feed the population. Due to water from the natural springs as well as the agricultural terraces, it had the ability to be self-contained. Machu Picchu was created by the Inca culture for the purpose of religious observance. In order to build this city, the Incans used stone tools, bronze tools, and chisels. The materials they used were mud, clay, adobe, and granite blocks. Each block weighed fifty tons! They would thatch the roofs with tree trunks and straw. After the buildings were constructed, the Incan people would smooth the stones with sand, mud, and clay to make the structures look polished. The people who inhabited this ancient site considered it to be magical because of the Andes Mountains and the Amazon River. The Temple of the Condor was a place of worship where the head of the condor was used as an altar for sacrifices. The Intihuatana is a column of stone that is rising from a block of stone. As winter approached, a priest held a ceremony to prevent the sun from disappearing. Intihuatana means ‘for tying the sun’ and ‘hitching post of the sun.’ Intihuatanas in other Incan civilizations were destroyed by the Spanish. However, the Spanish never found Machu Picchu, th... ... was discovered by Hiram Bingham, an American, who lived from 1875-1956. He went to Princeton, Yale, and got a PhD from Harvard. Bingham was a military officer, governor of Connecticut and a US senator. He mistook it for the long lost Inca capital of Vilcabamba. Machu Picchu was discovered on July 24th, 1911. When discovered Hiram Bingham said, â€Å"I was left speechless.† Scientists can surmise about who built it, who lived there, and why it was abandoned and forgotten, but they still are not one hundred percent sure. Machu Picchu was used for religious observance, astronomical observation, a royal retreat, and a secret ceremonial city. Therefore, I have partially proved my thesis. I said that Machu Picchu was created by the Inca culture for religious observance. Machu Picchu was used for that and many other things and that is why it is such an amazing civilization.

Ow Does the Author Present Human Nature in Lord of the Flies? Essay

Lord of the Flies is a novel written by William Golding, it was published in 1954. It is an allegorical novel in which Golding uses many powerful symbols to present his ideology about human nature. In this novel human nature is seen as a theme which runs through the entire novel. In this essay I will give examples of how Golding presents Human Nature in Lord of the Flies. The quote â€Å"where’s the man with the megaphone? † connotes Human Nature. When the boys land on the island after greeting one anther they ask for others. This shows Human Nature because naturally they are curious about their surroundings; this is developed in each human from a very young age. Looking for other people when you are lost is a common thing to do. Human Nature is presented through the pronoun â€Å"where† because as most humans would do when they are lost, they are questioning things. â€Å"We’ve got to have rules and obey them. † When Ralph starts to desire rules it is the beginning of civilization on the island. Rules are a way of keeping everything under control so that everyone behaves and all rights are equal. The noun â€Å"rules† represents Human Nature. It connects with the principle of Human Nature where naturally rules are desired to keep everything in line. Rules have been made dating back to biblical times to restore law and order. Without rules there is chaos, the fact that this boy has recognized that rules are needed to be made and obeyed shows the impact not only human nature but society has on all of us. The conch is a strong symbol of rules and rules relate to civilization. The conch was one of the first set of rules made on the island. No boy may speak unless he is holding the conch and once he is holding it, he cannot be interrupted. The boys have imposed this â€Å"rule of the conch† on themselves, and thus the conch represents society’s rules. We have rules so that we act civilized, desiring to be civilized is simply part of our Human Nature. Human Nature is presented through the event of Jack killing the pig. â€Å"His mind was crowded with memories; memories of the knowledge†¦.. taken away its life like a long satisfying drink† this quotation gives the reader chance to explore the mental state of Jack in the aftermath of killing his First Pig. Jack is overjoyed by kill and is unable to think straight as his mind is â€Å"crowded with memories†. A flaw of Human Nature is the feeling of power it’s something all humans desire unfortunately the lengths some people will go for power can be extreme. Golding explicitly connects Jack’s exhilaration with the feelings of power and superiority he experienced in killing the pig even If it is not a good thing. Jack’s excitement stems not from pride at having found food and helped the group but from having â€Å"outwitted† another creature and â€Å"imposed† his will upon it. â€Å"Ralph Wept for the end of innocence, the darkness of man’s heart† this is at the end of the novel when Ralph realizes that although he is saved from death on the island. He will never be the same again. He as well has lost his innocence and learned about the evil that lurks within all human beings. The phrase â€Å"darkness of man’s heart,† talks about the presence of evil instincts lurking within all human beings, no matter how civilized you may be. This connotes Human Nature as it talks about something that is within all humans naturally just that some people are able to suppress the evilness. The question that rises in this novel is whether these boys where evil all along or whether it was the effect the environment had on their nature. Human Nature is presented in the novel as the protagonist Ralph and the antagonist Jack. It is clear that when they both land on the island they both appear as immature kids who wanted to get back home. It is part of their Human Nature to return back to where they came from, which is what they try to do. â€Å"You’ll get back to where you came from† here Simon talks and acts almost as if he was a prophet, as if he knows truly that they were going to go home. It is in their nature to go somewhere knowingly that eventually they will go back to where they came from. Golding’s use of words in the novel and the way he presents Human Nature through different techniques makes us question Human Nature. The novel mostly focuses on Humans Nature being the cause of Society’s Flaws. The novel makes you think about Human Nature as a whole and whether these boys were capable of killing each other from the beginning or whether it was due to their surroundings. It also makes you think about yourself; someone who is affected by human nature; if you were left on an island at a young age to tend for yourself what would become of you. In this novel Jack the antagonist has his first experience of killing a pig at first he couldn’t do it, but eventfully he did. This urge then took over his innocence and turned him into a murdering savage. It is clear in Lord of the Flies that Golding believes Human Nature to be evil.