Earth is my mother Essay

The author’s purpose in writing was to understand for herself and to be able to present Navajo sandpaintings as â€Å"dynamically sacred living entities whose meanings lie in the process of their creation and use† (page xix). Sandpaintings, created from different colored sands and sacred objects, are not art. They are representations of mythical beings and legends created for the purpose of reestablishing someone’s health and harmony. The study of sandpaintings and their various meanings permits the reader considerable insight into Navajo land-tied religious beliefs, world view, creation myths, society, history, and even concepts of time. The author, Trudy Griffin-Pierce, provides little autobiographical information in the book. She mentions her rootless Air Force upbringing and how her early readings were devoted to books about Native American culture, especially the Navajo. Although she is distantly related to the Catawba Indians of South Carolina, she always felt a kinship with the Navajo and lived for a time with a Navajo family, learning their traditions, history, and language. This bond drew her to Arizona after she completed her undergraduate degree in art at Florida State University. N. Scott Momaday, in his â€Å"Forward†, adds that Ms. Griffin-Pierce is a very creative artist, capable of understanding and discussing the artistic dimension of the Navajo world. She makes the inventive and imaginative Navajo system of belief without our understanding. Ms. Griffin-Pierce received her doctorate in anthropology from the University of Arizona in 1987, where she is currently Assistant Professor in the Anthropology Department and teaches three courses. The information on her website at the University of Arizona reveals that this was her first published book. She has written four newer books, The Encyclopedia of Native America (1995), Native Americans: Enduring Cultures and Traditions (1996), Native Peoples of the Southwest (2000), and Paridigms of Power: The Chiricahua Apache Prisoners of War and Naiche’s Hide Paintings (in press); and two articles, â€Å"When I am Lonely the Mountains Call Me: The Impact of Sacred Geography on Navajo Psychological Well Being†, and â€Å"Navajo Religion†. All of her writings center on the history of Indians in the United States’ Southwest. She is currently studying aging and dementia among Arizona’s Native Americans. In Earth is my Mother; Sky is my Father, Ms. Griffin-Pierce details Navajo religious beliefs, world views, historical myths, societal structure, and astronomical concepts before she discusses the use and structure of Navajo sandpaintings. Basic Navajo religious beliefs are still followed by many Navajos who chose not to assimilate the tenets of Christianity presented to them in the 1800’s. There is no word for â€Å"religion† in the Navajo language. Spirituality, health, harmony, and beauty are inseparable. The universe is an all-inclusive whole where everything has a unique place and beneficial relationship to all other living things. God is the â€Å"Unknown Power† worshipped through His Creation. The Navajo also have a close relationship with the Holy People, with whom they interact daily. (page 34) Navajo religious beliefs are closely tied to their intense longing for and their love of their homeland, which they consider the â€Å"point in space from which all conceptions of the cosmos proceed†. (page xv) The land and the earth is their foundation of all belief, wonder, and meaning in human existence, and the four sacred mountains are the center. There are no permanent religious centers. The Native American Church is a local peyote visionary religion.    The Navajo have a circular concept of time that permits their mythic, spiritual world to coexist with their physical world. The author suggests that the Navajo sacred sandpaintings cannot be understood unless we accept the Navajo’s â€Å"mythopoetic context of layered time, space, and meaning†. (page 7) Navajo spirituality affirms humanity’s place in nature as a whole. Their ceremonies restore the interconnectedness of all life. They believe sickness results from failure to maintain reciprocal responsibilities with the environment, infringement of ceremonial rules, and transgressions against one’s own mind and bodies. Her purpose in writing this book is to share a more humane, more connected view of the world and its contributions in reestablishing humanity’s alignment with the universe. (page 9) Navajos still worship gods and goddesses of specific purposes. Their deities include the Sun; Changing Woman, who brings the earthly seasons; and their children, Hero Twins, Monster Slayer, Born-for Water, First Man and First Woman, First Boy and First Girl, the trickster Coyote, and the Speechless Ones, who cannot utter words. (page 34) These are often depicted in the sandpaintings. Navajos have a concept of the â€Å"Holy Wind†, reminiscent of the Christian Holy Spirit, as a being that exists everywhere and is in all living beings. For them this means that all living beings are related and that humanity has a responsibility to care for other living beings. Curiously, in Navajo Creation stories, the Holy People spoke, sang, and prayed the world into existence with their sacred words. Since everyone has an inner form and is part of the Holy Wind, each has a Holy Person located within. Oneness with the universe creates a responsibility to treat one’s fellow creatures with the same respect one has towards oneself. (page 73). The Navajos were among the last American Indians to migrate from Asia to North America and were late in arriving in the Southwest. They settled in the geographical area bounded by the four Sacred Mountains in the Four Corners area of the Southwest. Their geographical isolation protected them from diseases brought by the Spaniards and provided them with access to stealing their horses, sheep, and goats. They learned weaving from the Pueblos. The Navajo societal structure was and is matriarchal, clan, and family based, and they dwell in isolated family groups structured by the nuclear family, the matrilocal extended family, close relatives, and other relatives. Many Navajo live in frame houses today, but some still choose well-constructed hogans. (page 21) Navajo ceremonial healings involving sandpaintings are conducted by highly trained practitioners called â€Å"chanters† who have learned to sing the elaborate Navajo rituals. The Navajo chanter can cure witchcraft, exorcise ghosts, and establish immunity to illness.   A chanter is a priest, not a shaman, and never enters the shaman’s characteristic trance state. Most chanters are men. Women become diagnosticians, or shamans who acquire knowledge in a trance state. (page 39) Navajo ceremonials are rites (rattle is not used) or chants (rattle accompanies singing. The major rites (Blessingway and Enemyway) use drypaintings with pigments made from plants, including corn, pollens, cornmeal, flower petals, and charcoal. The author explains that Enemyway is a form of exorcism against the ghosts of aliens, violence, and ugliness. The chanting ceremonies (Holyway, Evilway, or Lifeway) use sandpaintings of different colors of sand, ocher and charcoal. Other sacred objects, vegetation, and bowls of water are incorporated into both types of ceremonies. (pages 40-41) There are hundreds, if not thousands, of different sandpainting designs. A sandpainting is a place of entry where supernaturals enter and leave, attracted by their likenesses in the painting. The establishment of this pathway lets the evil or illness in the patient be replaced by the good, or healing power of the supernatural being. (page 43) The healing ceremonies last for several days. It takes four to six people three to five hours to complete a sandpainting six feed in diameter. The workers begin in the center and work outwards. (page 45. The Navajos’ basic concept is that the powers of the heavens and earth are drawn into the sandpainting for the purpose of healing. Time is compressed so that powerful mythic events of the past coexist with the present and restore harmony and well being to the person being healed. (page 58) The sandpainted image is intended to let the sick person project his or her mind through time and space, rising above present earthly limitations.   The Navajo layered worldview becomes meaningless during a ceremony as all layers of heavens and underground become one. The Navajos study the constellations and star arrangements primarily for determination of seasons, and they are not part of the ceremonial core of sandpaintings, even though depictions of mythical gods of creation in the form of constellations may be used. (page 103) One of the more interesting myths is how Younger Brother went to the sky country and met an inner circle of hostile beings whom he left to stay with the friendly Star People in the outer dwellings. These friendly Star People, whom the Navajo call â€Å"The People†, and the hostile beings are still incorporated into sandpaintings. The author concentrated on the â€Å"Mother Earth, Father Sky† sandpainting because it is the most familiar to outsiders and presents the most detailed depiction of the Navajo heavens of sandpaintings in use today. (page 175) She describes the intricate, careful, detailed process involved in making a sandpainting. Mother Earth and Father Sky must be identical in shape and size. The act of creating a sandpainting is healing because it focuses everyone’s thoughts on the principles of balance and order. (page 177) The painting becomes â€Å"alive† to serve its transcendent purpose when the chanter strews sacred pollen on it and blesses those attending. (page 183). The sacred and blessed sandpainting forces the patient to reconnect in time and space to past and present sacred forces and reminds the patient of her connectedness to humans present physically or spiritually. (page 194) This book accomplishes the author’s stated purposes and does discuss the themes in detail. However, the information is disorganized and scattered, making the book itself hard to read. The author’s purpose was to teach the reader how to understand and appreciate the making, content, and purpose of Navajo sandpainting, which she accomplishes. Some of the information presented about Navajo religious beliefs is curiously similar to Christianity, and the author does not sufficiently discuss whether or not these were original to the Navajo who migrated to the Americas or picked up and changed a bit from what Christian missionaries tried to teach them. The Navajo ties to the religious symbolism of their land is remarkably similar to early Hebrew thought, but no mention is made of that. The textual sources used by the author are all documented research papers or books that are fairly recent in date. One would wish earlier sources had been consulted on some issues, but their availability is not known. The author combines quite boring detailed information with her myths and more lively text, making the book itself a challenge to complete. BIBLIOGRAPHY Southwest Studies Program. Biography of Trudy Griffin-Pierce. University of Arizona. http://web. arizona. edu/~swst/faculty/tgpierce. htm. Griffin-Pierce, Trudy. Earth is my Mother; Sky is my Father. Albuquerque: University of New Mexico Press, 1992.

Nursing Research Utilization Project: Section C Essay

Several articles have been reviewed as a research base for this project. Identification of appropriate research is critical to the successful implementation of nurse-led evidence-based practice protocols. Each article was carefully selected for what it could contribute to the quality of the project. Using the evidence in this research will help with the development of an implementation plan. Article #1 Adams, D., Bucior, H., & Day, G. (2012, January). HOUDINI: make that urinary catheter disappear-nurse-led protocol. Journal of Infection Prevention, 13, 44-48. This article discusses the use of 7 criteria that must exist in order to keep an indwelling urinary catheter in place. According to Adams (2012), the average daily risk of developing a bacteremia with an indwelling urinary catheter increases by 3%-7% for every additional day the catheter remains indwelling. The study uses the acronym HOUDINI to demonstrate the criteria. The acronym stands for Hematuria, Obstruction, Urologic surgery, Decubitus ulcer, Input and output measurement, Nursing end of life care, and Immobility. In the absence of these aforementioned indications, according to the study, the catheter should be removed to decrease the risk of catheter-associated bacteremia. Article #2 Bernard, M. S., Hunter, K. F., & Moore, K. N. (2012). A Review of Strategies to Decrease the Duration of Indwelling Urethral Catheters and Potentially Reduce the Incidence of Catheter- Associated Urinary Tract Infections. Urologic Nursing, 32(1), 29-37. This article discussed different strategies to decrease the incidence of indwelling urinary  catheter times. It was a retrospective study that analyzed data obtained from hospital databases. The study supports nurse-led or electronic chart reminders every 24 hours to assess the need for indwelling urinary catheters on a daily basis. The conclusion lists timely removal as one of the main factors affecting the incidence of CAUTI. Article #3 Clarke, K., Tong, D., Pan, Y., Easley, K., Norrick, B., Ko, C., & †¦ Stein, J. (2013). Reduction in catheter-associated urinary tract infections by bundling interventions. International Journal For Quality In Health Care: Journal Of The International Society For Quality In Health Care / Isqua,25(1), 43-49. doi:10.1093/intqhc/mzs077 This article reviews the affect on incidence of CAUTI by bundling interventions. Also a retrospective study, this research reviewed the effectiveness of bundling four interventions for patients with indwelling urinary catheters. The bundle consisted of 1) Using a silver alloy impregnated catheter 2) Using a securement device to limit the catheter movement 3) Repositioning of the catheter tubing if it was found to be kinked or on the floor 4) Prompt removal of the catheter on post operative day one or two. Implementing this bundle of care for patients resulted in a significant decrease in CAUTI for these study participants. Pre implementation of the bu ndle the CAUTI incidence rate was 5.2/1000. Seven months post implementation the CAUTI incidence rate was 1.5/1000. The authors have proven with statistical significance that the four-intervention bundle will be successful in reducing the incidence rate of CAUTI in indwelling urinary catheter patients. Article #4 Levers, H. (2014). Switching to an antimicrobial solution for skin cleansing before urinary catheterisation. British Journal Of Community Nursing, 19(2), 66-71. This study suggests that switching to an antimicrobial cleaning solution for the area prior to insertion of a urinary catheter will reduce the incidence of CAUTI. The research recommended using Octenilin solution for cleansing the meatus prior to catheterization. The case studies are ongoing and no results were mentioned in the study except for to say the change was cost neutral and the practice change is promising. This study failed to show a statistically significant decrease in CAUTI post  implementation. Article #5 Meddings, J. A., Reichert, H., Rogers, M. M., Saint, S., Stephansky, J., & McMahon Jr., L. F. (2012). Effect of Nonpayment for Hospital-Acquired, Catheter-Associated Urinary Tract Infection. Annals Of Internal Medicine, 157(5), 305-312. This study reviewed the Centers for Medicare Services (CMS) recent (2008) initiative to hold or eliminate reimbursement for costs associated with hospital acquired CAUTI. This study alluded to the misuse of coding in failing to identify CAUTI when it actually did exist, therefore claiming the financial impact on health care organizations is low for non-payment of hospital acquired CAUTI. Even when the researchers included all urinary tract infections catheter associated and otherwise, the loss of reimbursement to healthcare organizations would have been less than 1% due to improper coding. Conclusion In conclusion, the prevalence and incidence of CAUTI is affected by many factors. First health care workers need to be aware of the significance of CAUTI and be compliant with new practice guidelines to decrease risk. Second, adherence to inclusion criteria for indwelling urinary catheters and their placement using the HOUDINI protocol (Adams, Bucior, & Rimmell, 2012). Lastly, implementation of a bladder bundle to decrease the incidence of hospital acquired CAUTI. Each factor focuses on a unique evidence-based prevention, reduction, or eradication strategy to address the problem of CAUTI. Health care workers, who possess an awareness of the need to decrease this preventable infection, will add to the forward trajectory of solving this problem, and implementing this project. References Adams, D., Bucior, H., & Day, G. (2012, January). HOUDINI: make that urinary catheter disappear-nurse-led protocol. Journal of Infection Prevention, 13, 44-48. Bernard, M. S., Hunter, K. F., & Moore, K. N. (2012). A Review of Strategies to Decrease the Duration of Indwelling Urethral Catheters and Potentially Reduce the Incidence of Catheter- Associated Urinary Tract Infections. Urologic Nursing, 32(1), 29-37. Clarke, K., Tong, D., Pan, Y., Easley, K., Norrick, B., Ko, C., & †¦ Stein, J. (2013). Reduction in catheter-associated urinary tract infections by bundling interventions. International Journal For Quality In Health Care: Journal Of The International Society For Quality In Health Care / Isqua,25(1), 43-49. doi:10.1093/intqhc/mzs077 Levers, H. (2014). Switching to an antimicrobial solution for skin cleansing before urinary catheterisation. British Journal Of Community Nursing, 19(2), 66-71. Meddings, J. A., Reichert, H., Rogers, M. M., Saint, S., Stephansky, J., & McMahon Jr., L. F. (2012). Effect of Nonpayment for Hospital-Acquired, Catheter-Associated Urinary Tract Infection. Annals Of Internal Medicine, 157(5), 305-312.

A Between Soldiers Home by Ernest Hemingway and Speaking of Courage by Tim OBrien

A Between Soldier's Home by Ernest Hemingway and Speaking of Courage by Tim O'Brien Sometimes the hardest part of going to war is coming home. In the two short stories, â€Å"Soldiers Home† by Ernest Hemingway and â€Å"Speaking of Courage† by Tim O’Brien, each of the characters Krebs and Berlin show the difficulties it has on a soldier returning home from war. Both characters illustrate how hard it can be to adjust to a normal lifestyle compared to the life that they had overseas or the one that they had before they left for war. However, each story differs when looking at how they deal with the aftereffects and who they confide in about the difficulties of war. In a â€Å"Soldier’s Home† when Krebs returns home he has this need to talk to someone but doesn’t know how to approach people about it. Whereas in â€Å"Speaking of Courage† Berlin has the choice to speak of the difficulties and hardships of war honestly, but he chooses not to because he doesn’t want to bother anyone. Each of the characters exhibit fo rms of PTSD and how the war put many hardships in their lives when they returned home. Although, the stories have many differences they also share many similarities about the effects of war. In a â€Å"Soldier’s Home† by Ernest Hemingway before Krebs became a soldier he had a pretty normal life, he was in a fraternity where all the men involved wore the same kind of shirt in the same style. With this, it showed that he had friends who accepted him and a healthy social life. When Krebs was away in war it is discussed that the fellows soldiers â€Å"look too big for their uniforms†. The idea of â€Å"outgrowing† a uniform is a pattern that we consecutively see throughout the short story. Krebs eventually hypothetically speaking outgrew his uniform in the fraternity when he went away to war. Where we see this pattern again is when Krebs is away in war and he eventually begins to outgrow his uniform and returns home from war. In the article â€Å"Where Do We Go From Here? by Trout, Steven he discusses how â€Å"it turned out, many former soldiers, including some of the most decorated of the war, were not up to the challenge of reentering civilia n life without support, economic, or otherwise†. Krebs realized that once he did return to the civilian world that he was on his own, he wouldn’t be able to truly discuss the causality of the war and the experiences that he went through. When Krebs returned home from war this is when we began to see how he was more isolated with those around him, it shows that he was impacted by war and what he saw. When he came home from war it was about late summer, he would sleep late in bed, he would walk to the library, eat lunch at home, he’d walk around town by himself, and then he’d spend the remainder of the night in the pool room. He spends most of his days alone with the exemptions of the times he sees his family. He also is constantly reminding himself of the things that he saw while he was at war. PTSD has the effect of returning military members to disregard their previous social lives to try and narrow the psychological effects of war. We also see this when Krebs wants to be associated with people, but he does not want to have to deal with the stress that comes with it because â€Å"here at home it was all too complicated†(Hemingway 168). After looking into articles based on how Krebs felt when returning home from war it came across the article that further discussed his need to talk about war. Krebs feelings about the war are constantly changing, in the arti cle Soldiers’ Voices in In Our TIme: Hemingway’s Ventriloquism by Milton A. Cohen, it goes into talk about how â€Å"his compulsive need to talk to someone†. Krebs is constantly looking for someone to listen to the stories of war that he encountered, but since it was so late when he returned home everyone thought they had heard it all. As the story continues we see a change in the way that Krebs talks to his sister compared to how he talks to his mother. Krebs has a new view on the world after being in the war for so long he has a hard time adjusting to his life back home and has a hard time controlling what he says because he has a fear of losing those he loves. At the time these scenes take place it is painful to hear how hurt he is to the point he has to tell his own mother that he doesn’t love her. In the article Performative Patterns in Hemingway’s â€Å"Soldier’s Home† by Ruben De Baerdemaeker it goes into discuss how â€Å"Krebs disavows being in God’s Kingdom, and emotionally distances himself from his mother and the world she represents†. When Krebs tells his mother that he does not love her, he quickly realizes that what he said was an accident. Krebs knew that what he has said was wrong, and after saying this, he tries to give reasons for himself but could not se em to come up with an exact answer. He then tries to say that what he said was a mistake and that it came out the wrong way. He couldn’t explain that he didn’t want to lose her, so he was trying to express himself to seek to keep her away from his life because he feels he is damaged. Psychologically Krebs has been changed because of the war, and he tries to get used to his social surroundings, which is now different and complicated to him. We also see these similarities in â€Å"Speaking of Courage† where the main character Norman Bowker has a hard time adjusting to a normal life after returning home from the war too. We can see this when he â€Å"followed the tar road on its seven-mile loop around the lake, then he started all over again, driving slowly† (Tim O’Brien). Norman realizes that he has nowhere to go at this point and turns to driving and reminiscing about his days before war. Bowker wants to talk to someone about what happened to him at war, but he has no one to talk to about anything. He also thinks about conversations that he would have with people about what happened, about the medals that he got awarded to him, but he also wanted to tell those the he was a coward, that he wasn’t brave. In the article Tim O’Brien and the Art of the True War Story by Timmerman, John H. goes into detail about how if people would have listened to Bowker â€Å"people would have heard, if o nly they had listened, was Norman Bowker’s story of he had courage, of how he almost saved his friend Kiowa, except for the terrible sink in the field. His father was the appropriate one to initiate the hearing, for his father also knew the truth of war†. Norman has a hard time accepting what happened to him, about all the changes in the town that happened to him. He can’t accept the fact that what happened to his friend was purely an accident and that if he would have stayed he would have been gone too, that he deserved all of the medals that he received in war. Bowker is clearly in a state of stress that is causing to constantly revisit the incident that happened with his friend, this is otherwise known as PTSD. There was a study produced, published online Sept. 17 in JAMA Psychiatry, that conducted the theory that PTSD can cause listlessness and emotional detachment. Which we see in both of the characters in the two short stories. Krebs and Bowker each have a difficult time adjusting to life outside of war; they have a hard time adjusting to the lifestyle that they knew before which results in them wanting to be alone a lot of the time. Although these characters have a lot of similarities, they also have differences such as the type of war they fought in and how they can talk about it and who they have to talk about it when they return home. The differences of these two short stories were when they soldiers returned home and how the circumstances where. When Krebs returned home from war, it wasn’t right for him to talk about the war and his experiences. He returned home from war so late compared to the other soldiers they thought they had heard everything that had happened and they thought it was weird that Krebs was returning so late after the war was over. Krebs eventually started lying about his experiences to get the attention of those around him, but this resulted in becoming sick whenever he told a lie. In an article posted by the Perelman School of Medicine, it is said that one of the most common side effects of PTSD is changes in mood and cognition, where the person affected by this has exaggerated negative beliefs, and self blame for the traumatic event, detachment from others loss of interest persistent negative emotional state, reduced ability to feel positives emotions. Krebs has a hard accepting what has changed and his inability to find satisfaction in what is around him, especially women whom he finds necessary to get close to because it is far too complicated. As much as Krebs believes in the truth, people around him force him to lie. The story precisely manifests the conflict between Krebs value, which has dramatically changed after his war experience and society expectation toward him to conform to its traditional values. Eventually to maintain his existence Krebs has to choose isolation by detaching himself from social relations, love, religion and ambition. Harold Krebs returned from the war with an inability to love and determined to avoid complications which include lying. But his life is getting complicated already, when he was welcomed by the society people to be listened to at all he had to lie. As the story goes Krebs has to lie again while trying to be attached to his family. Krebs still has some relationship with his family as he is still in touch with his sister, but otherwise he has distanced himself from almost anyone and anything around him. Whereas Bowker has a hard time adjusting to his new lifestyle and talking to those around him, he has started losing those relationships that he once had because he has a hard time adjusting to his new life. Norman Bowker wanted to have conversations with people, but instead of talking he had imaginary conversations with people because he doesn’t know how to actually have them. Bowker had these conversations with people because he doesn’t know how to actually have them. He is afraid of what people might say and do because now that he has returned home from war his life is diverse. He feels as though all the people he wants to have these conversations with are wrapped up in their own lives, and he feels that his issues aren’t important enough to bother them or that they wouldn’t understand them. He has this whole imaginary conversations with his father, whose approval is significant to him, he thinks about how they’d talk about all the medals that he had received in the war. He thinks about how he believes his father would celebrate how courageous and brave that he was in the war, although he feels he was not he thinks of himself as a coward because he à ¢â‚¬Å"almost† won the silver star for valor. He has repeatedly thought about this conversation that h would have because he has thought about how his father would react and what he would say to him.

A chance meeting and exciting news Essay Example | Topics and Well Written Essays - 1250 words

A chance meeting and exciting news - Essay Example A critical assessment of both options is necessary before the declaration of the decision. Primarily, the first question to address is the money issue. Is the new venture more lucrative than the current position? A critical analysis the remuneration offered here shows that for the first year, working with the partners as consultants would be more financially satisfactory. When the $50,000 is shared equally, the annual salary will be $200,000, which is $50,000 more than what Engulf and Devour are offering. However, this is only assured for the first year only. What happens in the second year if there are no clients? Regardless, comparing the $200,000 offer to the $150,000 provided by Engulf and Devour, the former seems more promising since both opportunities have various uncertainties. Taxation is a key consideration as well. With the partnership being a registered entity, the aspect of double taxation is a partner’s financial obligation. With this consideration, the payment promised by the partnership is much lower after taxation as compared what Engulf and Devour are offering. However, the partnership has a more promising financial future as compared to the job and Engulf and Devour. With the possibility of getting bigger clients, as the reputation improves, the promise of better incomes is higher in the case of the partnership as compared to the current job (Lee 109). Financial concerns are the primary concern for any aspiring entrepreneur. After the financial consideration, the next aspect to take into critical account is assessing the uncertainties of the current contract. What would happen if the contract were to be terminated before it was mature? Likewise, considering the terms of payment is equally crucial. Some clients prefer to pay after the completion of the contract, or on a monthly basis. When handling one’s own business, uncertainties are greater as compared to being employed. Assessing the

International Market Entry and Development Essay - 4

International Market Entry and Development - Essay Example International context is frequently grounded in ad hoc decisions and intuition, instead of a systematized market research to match companies with appropriate foreign target markets. The paper seeks to clarify some of the issues surrounding international market entry and development. The process of market research seeks to unravel the market potential of the foreign market. This entails exploring whether the export market of interest possesses the necessary means to purchase imported products, as well as to whether the needs of the market are being adequately satisfied. The analysis of foreign market potential takes into account information regarding aspects such as competition, market size and the country's growth rate, and existing trade barriers. The analysis of market potential also involves competitive intensity analysis by analyzing the number of competitors in the market, as well as the relative size distribution of the market shares (Sakarya, Eckman & Hyllegard, 2007). Market size analysis entails an assessment as to what share of the total market within the country that the firm can reasonably expect to obtain, based on factors such as competition and product pricing. Market growth analysis involves an assessment of current demand and future demand, as well as untapped or unfilled demand (Sakarya, Eckman & Hyllegard, 2007). There are several competitive strategies that might influence the selection of markets such as entering a market in order to forestall the entry of related companies or entering a market in which large competitors are absent. Product adaptation deals with a wide range of issues ranging from quality and appearance of products to other aspects such as materials, production, packaging, style, and modeling. A product may have to be adapted in several ways so as to meet physical, social, or mandatory requirements of a fresh market (Ajami, 2006).

Walt Disney World Speech or Presentation Example | Topics and Well Written Essays - 750 words

Walt Disney World - Speech or Presentation Example Further, it maintains an informal link with England’s Swindon Company as a competitive measure (â€Å"The Walt Disney Company,† n.d.). Walt Disney World’s employees have high morale levels and remain empowered in their undertakings. They work towards providing high quality visitor relations, most notable through smiles. Employees at the resort delight in diversified job arrangements and an all-inclusive workforce nationalities as well as free tickets. They take on consistent self or team tasks and witness ever changing visitor interactions despite the minimal wages and little benefits that they receive. Employees at the resort demonstrate friendliness and learn new skills each day as well as have opportunities for advancement. With regards to strategy formulation, the management utilizes a Customer Relationship Management (CRM) system along with information technology to ease crowding and re-design customer experience. The resort’s corporate, human resourc e and business strategies include modification plans for Downtown Disney’s art concept along with prospects for allowing advertisements application for Hulu initiative. Plans to open Universal’s Cabana Bay Beach Resort in 2014 constitute the resort’s business strategy. Moreover, it aligned with Vera Bradley in generating a new track of bags as well as created a new logo art design for the company (â€Å"The Walt Disney Company,† n.d.). Strategy implementation capacities consist of youth centered initiatives with an annual budget allocation of $500,000 such as ‘A gift for Teaching’ program in addition to obliging to creativity and arts, for instance, summer camps. Social and compassion related services following economic hardships and natural disasters... The paper outlines the value of Walt Disney World. Walt Disney World originally focused on innovation and creativity. Demographic and labor trends for the resort indicate it as the ninth standing leading labor force among all Florida’s markets with increasing percentage of female workforce. The resort’s customer base takes in families, children, government and non-governmental groups, the community and learning institutions. Walt Disney World’s employees have high morale levels and remain empowered in their undertakings. They work towards providing high quality visitor relations, most notable through smiles. Employees at the resort delight in diversified job arrangements and an all-inclusive workforce nationalities as well as free tickets. They take on consistent self or team tasks and witness ever changing visitor interactions despite the minimal wages and little benefits that they receive. Employees at the resort demonstrate friendliness and learn new skills ea ch day as well as have opportunities for advancement. . Walt Disney World invests in local community infrastructures within Florida such as Florida’s children hospital based Walt Disney Pavilion in addition to hospitality and culinary science scholarships for college and university students at the resort. The resort also offers periodic discounts for their visitors on various reservation packages. Human capital as well as human resource metrics became considered with regards to assessment and evaluation. Walt Disney World makes use of less advertising as compared to its rivals in the industry.

Any company of the ones in the Quesation paper Case Study

Any company of the ones in the Quesation paper - Case Study Example Key elements of IBM's web strength are listed below: 1) IBM has highly reliable web infrastructure used to host its website and is available 24X7. 2) It has adopted its own web services platform known as Websphere for hosting its web services. 3) Back-end is hosted on its robust server infrastructure consisting of IBM mainframes. 4) The website is intuitive and easy to use, without complicated English or too much of technical words - IBM's site is one of the simplest to read and understand. 5) The web services are country-specific covering all services for a given country. This is a huge competitive advantage because IBM operates out of more than 170 countries! 6) The 'support and services' part of its website is designed very well - it is simple and easy to use. 7) It's e-commerce facilities are built on its own CommercePOINT platform - The platform details are shown below: Picture 2 - Source: wolrath.com 8) It has solid partner services in the form of 'IBM Partnerworld' - All partner business facilities are available as part of this website. 9) It has a very robust data warehouse and business intelligence back-end to interpret web requests and serve the relevant information. Competitive Advantages of web services The key elements that make IBM stand out apart from its competitors such as HP, Accenture and others are as follows: a) The Websphere web services platform has become very popular and it is even used by competitors today for packaging and use web application services. b) Its back-end mainframes are very robust and are built with the longest duration of research and development within the market. c) Its country-specific services are completely localized to individual countries and this has proven very useful for marketing and sales targeted at...It is therefore chosen as the subject of this business analysis. The analysis is divided into three parts as follows: d) IBM is a big supporter of open source development. It has built a separate web facility called 'DeveloperWorks' to help software and IT professionals. This is hugely popular and is seen as an advantage over competitors. e) The PartnerWorld web portal for its developers is used very well by its several partners. IBM has been a strong partnering company right from the beginning and this strength has come over to its web services for the partners as well. IBM has been a company of radical change all through its decades of existence. The Organization is traditionally known to be very conservative and formal in its management style - but surprisingly, it has made very strong and firm moves repeatedly to meet changing market conditions and demands. Major changes are discussed below: i. The turning point in IBM's history was when the company decided to enter the field of digital computers (manufacturing) in the early 1950's.

The Rise of a Successful Turkish National Movement Essay

The Rise of a Successful Turkish National Movement - Essay Example According to Shaw, during that period, the Empire gained first control over one of its conquered land known as the Anatolian peninsula. The Ottoman Empire was recognized as one of the successful and powerful states in the world due to a chain of reasons including military tactic and the collapse of the Byzantium Empire. Nevertheless, during the 19th century, the Ottoman Empire succumbed to war. This strong nation was overpowered and reduced to be the land of Turkey. The Empire signed Armistice of Mudros on October 30, 1918, to call off the war, due to the fear of losing everything. Their decision had repercussions since the empire lost control over its Middle Eastern territories to France and Britain under the Sevres treaty. After the downfall of the empire, the Turks began the Turkish national movement, led by Mustafa Kemal since other countries came up with their new territories. This was a result of the occupations of Izmir and Istanbul along with the invading Greek, French, and British. They declined to acknowledge the government in Istanbul and the invading forces. The movement also came up with a people’s army, defending the empire from intruders like the Greeks, French, and Italian. Atatà ¼rk led the Turkish national movement in the Turkish War of Independence. He tactically defeated the forces sent by the allies since he had established a strong provisional government in Ankara, which was loyal to him. His planned military campaigns liberated his country to emerge as an independent state. As an aficionado of the age of Enlightenment, he transformed the former Ottoman Empire into a democratic, modern, and secular state. The principles of Ataturk’s reforms that led to the establishment of Turkey are known as Kemalism.  

Communicating With Confidence Essay Example | Topics and Well Written Essays - 1500 words

Communicating With Confidence - Essay Example A writer’s ability to quickly attract attention and create interest in the target audience gives them an edge towards communicating confidently. Generation of new ideas through creative and critical thinking leads to a better understanding of the topic and makes the writer to clearly understand the research problem. Communicating credible information obtained by the use of the proper research methodology creates confidence. Multiple measuring instruments such as interviews and questionnaires can be used to avoid biasness in the information. Writers should also be able to use relevant and intellectually stimulating examples with other supporting details to give evidence of deep thinking. In today’s world where there is an overload of information due to high technology, effective and clear communication is essential in order to create a good impression. For a person to communicate confidently, a combination of technical knowhow and appropriate formatting of information to fit the target audience is necessary. Effective communication skills are beneficial because they foster healthy relationships between individuals and organizations and enhance the chances of people building on a successful career. Therefore, a person with the ability to communicate confidently in a world where information is constantly changing and a great deal of time is spent on writing stands a better chance of being successful. According to Mati (2009), many business people lack the ability to communicate effectively in writing therefore businesses must be committed to rewarding the best writing practices. A number of factors have to be considered for a person to improve writing skills and communicate concisely. The initial step involves deciding on the audience or readers that the message is being conveyed to and the format of communication which defines whether the tone will be formal or otherwise. For example, a written letter

Managing Employment Relations Essay Example | Topics and Well Written Essays - 1500 words

Managing Employment Relations - Essay Example This paper will discuss the objectives of pay, the factors that influence the determination of the pay and the various forms that pay can take place. A company has a certain objective when deciding the pay scale on which all the employees have to be paid. First the objective is determined and then the pay scales are formulated accordingly so that the pay is following and fulfilling the objective in mind. Companies can have various objectives. The first and the foremost one is that companies are trying to recruit, retain and then motivate their employees through the pay scale. Recruitment becomes easy if the company is paying more than the industry average. All prospective employees searching for jobs will consider the company as one of the most lucrative places to work if it is paying more than the industry average. Moreover, it also contributes to a very positive and appealing employer branding of the company in the eyes of the prospective employees. Once a person has been hired as an employee, a good pay scale will help in recruiting him for a long period of time, even if he gets offers from other companies to join them. moreov er, motivation to perform better and to give increased levels of productivity are also one of the major objectives that can be linked with the pay. (Brown, pg 17, 2003) The second type of objectives that a company can have are that which are part of broader organizational objectives, for instance if the company has decreasing the amount of pay it is giving to its employees, then it is using this action as a contribution to the broader organizational objectives of controlling costs and cutting down on the expenses of the company. if the company wants to be competitive in nature, then its objectives as far as pay is concerned, will be to increase the pay so that it can get that edge over competitors. Other objectives can be that the company keeps a certain purchasing power position for its employees and gives them pays accordingly. (Locke, p234, 1995) It will help the company to see exactly how much purchasing power does its employees have in relation to the present economy. Objectives of fairness and equity can also be achieved through paying well. For instance, the motivation and productivity of the company's employees are also directly linked with how much fair the pay system is. If one person is giving less input than another person, is he getting less output than the other person Is there any sort of inclination towards certain employees when it comes to the pay systems This is linked to the concept of "a fair days pay for a fair days work" since everyone wants to get that share of the pay which they deserve and they do not want to see others getting more pay with less work. Thus, equity has to be maintained and the right balance between work and pay should be tried to achieve by the employers so that pay can be performance related, rather than time related. Time related pay leads to the employee getting too complacent about his work responsibilities and he might not be as productive as he can be in actuality. Lastly, the objectives of pay can also be linked to regularity, security, improvement and development. (Wright, p192, 2004) A company wants to

How New York Times vs Sullivan changed political thinking Essay Example for Free

How New York Times vs Sullivan changed political thinking Essay The history of the American nation has been evidently marked with many landmarks legal interpretations of its constitution. The case of New York Times vs. Sullivan is one good example of landmark cases which greatly changed the political thinking of the American population. It is clear from the underlying proceedings of the Supreme Court on the case that the legal understanding of the first and fourth amendments of the civil right bill is not to allow any recovery for media reports unless the complainant can sufficiently prove acts of malice when making the defamatory report (FindLaw, 2010). This is what marked the many historical appreciations of the media freedom in our legal justice system. It is indeed a direct result of this 1964 ruling that the media gain freedom to sufficient cover the proceedings of civil rights movement thus aiding in the realization of the ultimate inclusion of the black American’s right to the civil rights in the American constitution. This essay is written as a critical analysis of the New York Times vs. Sullivan and how it evidently changed political thinking in America. The author first gives an analytical discussion on the underlying facts presented in the case. A discussion on how the case set a precedent for public officials and how that is just another thing to consider for public figures getting into politics is also given Summary of the New York Times vs. Sullivan case 1. The trial courts judgment The case of New York Times vs. Sullivan involved a claim by New York Times in an advertisement that the arrest of Martin Luther king junior was a campaign to compromise his efforts in encouraging the blacks to vote (FindLaw, 2010). The advert claimed that the Montgomery police had been allegedly directed their acts against students who were involved in the civil rights demonstrations. The led to the filing of defamation case against New York Times by Sullivan, a commissioner in the police department at Montgomery (Shah Anderson, 2007). It is however here to be made clear that the advert was not directly mentioning Sullivan but Sullivan claimed that it was targeting him since he was the chief supervision of the police department in Montgomery. he low court trial judge in Alabaman found the New York Times guilty of committing an actual malice defamatory statements against a public officer and ordered them to pay Sullivan damage worthy half a million US dollars. 2. The Supreme Court’s judgment and its reflection on the first and fourteenth amendment It is however to be realized that the New York Times did not accept the lower court jury’s judgment thus forcing to file an appeal with the supreme cour t in the quest realizing a fair and just judgment (Tysoe, 2008). At the Supreme Court, the judges clearly confirmed that the provisions of the first amendment of the civil rights bill did not allow a public officer to be granted damages for defamation unless he or she clearly proves that such statements were made will actual malice against them. Still citing the fourteenth amendment to the constitution, the court ruled out that the states is not obliged to award damages for defamation to a public offices based on falsified claims unless the officers sufficiently proves actual malice in the statements (Shah Anderson, 2007). It is also clear from the proceedings at the Supreme Court that an individual statement can never its protection under the American constitution even if it appears in the form of a paid advert. The judges claimed that it is not the purpose of the government to judge the truth and that a public officer must live to take critics from the public unless they can sufficiently proof malicious acts in the statements (Write Lidsky, 2004). It was evidently claimed that any act of allowing Sullivan to be paid damages for insufficiently qualified claims of malice could act as a loophole for compromising any future critics to public officers. Still to be noted here is the fact that such any act could greatly compromise genuine critics for fear of intimidation, a move which could evidently compromise the just and fair provision of services by public officers to the general public. It is based on this reasons that the Supreme Court ruled against the lower courts ruling thus favoring New York Times. How New York Times vs. Sullivan set a precedent for public officials The first lesson is that it became evidently clear that a public official is subject to public criticism. It is quite clear from existing historical information that the realization of just and fair rules and regulations in the American nation has never been without social movements. Still clear is the fact that such realizations were heavily compromised with public office power interferences (Wright Lidsky, 2004). The civil right movement of the twentieth century is no exception to this. It is based on this reasoning and by applying the principles of conclusion by sufficient reasoning that the 1964 interpretation of the American constitution served to protect the political elite and/or public officials from imposing force to the public. Another change that was brought by the impact of the New York Times vs. Sullivan case ruling is that the political elite in the community must be role models (Tysoe, 2008). It is found in the proceedings of the Supreme Court ruling that public officials should be open to critics from the public domain. This was made to emphasis the fact that such are the leaders who should lead the American nation to the next level of fairness and justice for all in the society. It was only by instilling the fact that the general public has a constitutional right to critique their leaders that political comments made by leaders are subject to self liability. This is what has made the political elite of the American nation respectful of the constitutional provisions thus sufficiently realizing greater levels of justice and fairness in the society (Melbourne University Law Review, 2001). Still proved by the case is the fact that sufficiently prove of defamation by actual malice is the ultimate reason for claiming legal awarding of damages (Melbourne University Law Review, 2001). The proceedings at the Supreme Court clearly established that the constitutional protection of claimed statement can not be negated due to the fact that such have been expressed in the context of a paid advertisement. This clear makes public officials subject to proving of actual malice in their damage claim suits. It is to be clearly noted that most true expression which go to the media can be easily disputed by the source (FindLaw, 2010). However, the question of whether or not to get defamatory damages remains subject to the provision of substantial evidence proving actual malice in the presentation of the expressions. How New York Times vs. Sullivan is just another thing to consider for public figures getting into politics The ruling in the case of the New York Times vs. Sullivan also instilled the lesson that no one in the American land is above the rule of law as provided in the constitution. Clear from the ruling of the lower court, it can be claimed that the jury sort less evidence to make the judgment in favor of Sullivan (Wright Lidsky, 2004). This could be closely attributed to the fact that the government was out to control the progression of the Martin Luther King led civil rights movement. It is however clear from the Supreme Court judgment that despite such previous rulings on the case the constitutional provisions must be respected and applied equally to all in the society (Melbourne University Law Review, 2001). The provision for proving actual malice for compensation of defamation of an individual’s reputation should equally respect all even the politically advantaged in the society. It is this that made political influence on justice provisions mitigated thus respecting the rule of rule as reflected in the constitutional provision for independence of the judiciary. Another lesson from the case is that of limiting claim for awarding damage due to purported defamatory speech (Tysoe, 2008). From the advertisement that led to the defamation claims by Sullivan, it is quite clear that it claimed to be the onset of a new pattern of modern freedom. According to the ruling of the Supreme Court, it is quite clear that the constitution sufficiently protects the human right to speech. It is due to this that it found no sufficient claim of defamation in Sullivan’s claims due to the fact that the students involve were being deprived of their constitutional right to speech (Shah Anderson, 2007). It is based on this reasoning that the ruling changing our political approaches to reflective our constitutional right to speech. The last lesson from the case ruling is that it made it clear that freedom of the press must be respected. It is to be noted here that the sole duties of the media is to provide news to the general public on occurrences around them. It is due to this reason that any act of compromise quality and accuracy of such news must be mitigated. Still to be understood here is the fact that the advertisement published by the New York Times was made for overseeing the fair and just execution of the underlying demands of the civil rights movement (Melbourne University Law Review, 2001). This is what made the ruling a greatly political influence blow in civil matters. Still realized from the ruling is the ultimate realizing of freedom of press. Indeed the New York Times vs. Sullivan led to the protection of the media against intimidation in covering the civil rights movement.  It is thus clear that the ruling changed the perception the political and public officials had with regard to the media in the society. Conclusion In conclusion, it has been clearly established that the Supreme Court ruling in the case of the New York Times vs. Sullivan marked the dawn of respect for freedom to speech and the press by public officials. It is thus clear that such a case qualifies to be a landmark case in the history of the American nation. It is this court ruling which mitigated misuse of public office and/or political power to impose legal awards for damages without sufficiently prove of actual malice.

Why Democracy Fail in Pakistan Essay Example for Free

Why Democracy Fail in Pakistan Essay Executive Summary – Pakistan has been in quest for stable democratic system from its very inception. The process of its democratization has been slow and passive. Its nature has remained fragile. It has been showing high vulnerability towards non democratic interventions. Besides, it has been easily falling prey to non civilian forces. As a result, Pakistan has been continuously failing to offer what a democracy promises. Such pathetic scenario has various reasons behind it at all three levels: State, government and society. This Essay attempts to pin point and analyze the reasons behind such fragile and weak nature of democracy in Pakistan and extends recommendations along with identifying various means and players especially youth for strengthening democratic process in Pakistan to make it promising and delivering. Introduction. – From very its start, Pakistan has choiced democratic form of government for itself. Its founders had ardently supported and emphasized for democratic system that could ideally permeate the governance structure and body politic of Pakistan; Quaid Azam Muhammd Ali Jinnah’s speech at the Staff College on June 14, 1948 is the witness of his staunch support for democracy as corresponding structure for the polity of Pakistan to make it people friendly and welfare state. However, it is an other fact that Quaid Azam Muhammd Ali Jinnah himself laid the foundation of non-democratic trends through centralizing structure of Muslim Leauge, dissolving non democratically Sindh Assembly and Ministry of Khan Sahab in NWFP in 1948 . Despite all this, what he choiced and dreamt for Pakistan about system is undoubtedly democracy. But unfortunately being constitutionally a democratic country, Pakistan entirely fails to offer what constitutional democracies offer viz, sovereign parliament, free, fair and regular elections, supremacy of constitution, independent Judiciary, rule of law, civilian control over the armed forces, political life free from military involvement, safety to minority rights, provision of basic human needs and guarantee of freedoms of movement, expression, association and assembly. Contrary to dreams ,hopes and promises ,What Pakistan offers is the chequered history of democracy and unstable democratic process. Ironically, the country’s constitution has been abrogated twice (1958 and 1969) and suspended thrice (1977, 1999 and 2007) . More than half of its political life has been encroached by military generals. Five elected governments have been removed by army. Zulfiqar Ali Bhutto, the founder of political vibrancy, mass based politics and giver of Atomic power to Pakistan was ruthlessly executed through judicial murder. Ex-prime ministers, and Nawaz Sharif and Benazir Bhutto were exiled. Causes: Nothing exists without any reason in universe; creation of everything carries reason with itself. More ever, According to principle of â€Å"Cause and Effect† unless the root causes of any problem are not accurately identified and thoroughly diagnosed, problem can’t be solved on sustainable basis. Therefore, let’s find and discuss the causes behind such weak, vulnerable and dented face and status of democracy in Pakistan and try to reach at workable solutions. Colonial Inheritances and Institutional Imbalance. From time of its very creation, Pakistan has been experiencing institutional imbalance. Its roots go back to British period. Pakistan inherited administrative, political and legal legacies of British period . From political and adminstrative legacies point of view, Pakistan inherited high institutional imbalance characterized with strong and organized civil and military bureaucracies, weak1 Political institutions and non-democratic political parties. As a result, it lacked strong, dynamic and sustainable political institutions which could hold regular elections based on universal franchise, could build trust of masses into democracy, could protect democratic process against constitutional transgression and could provide a conducive environment for democracy to flourish and could correspond to desires and aspirations of masses. Muslim Leauge which is credited to creation of Pakistan was a movement not a well-structured and deeply rooted political entity2 that could offer post partition program, could counter the power of army and bureaucracy and could offer corresponding structure to desires and needs of masses after the partition. Besides, League was non democratic in its nature led by elitists3. Consequently, It could not produce first line aswell second line leadership embedded with love for democratic norms and values in particular and overall democratic culture in general . In this backdrop, administrative supremacy coupled with absence of elections based on universal franchise4 in particular and lack of democratic culture and process in general facilitated bureaucrats to rein the country from 1947 to 1958. Their periods is characterized with dummy and rubber stamped parliaments, abrupt and non democratic dissolutions of assemblies, political intrigues, bickering and quarrelling, inefficiency, abrupt and fast changes of regimes.

Technique to Facilitate Treatment of Urethral Strictures

Technique to Facilitate Treatment of Urethral Strictures Title:  A simple technique to facilitate treatment of urethral strictures with optical internal urethrotomy Konstantinos Stamatiou MD,PhD,Consultant Urologist, Urology Dpt, General Hospital Tzanio, Piraeus, Greece Aggeliki Papadatou MD, Radiology Resident, Radiology Interventional Radiology Dpt, General Hospital Tzanio, Piraeus, Greece Hippocrates Moschouris MD, Consultant Radiologist, Radiology Interventional Radiology Dpt, General Hospital Tzanio, Piraeus, Greece Corresponding author: Aggeliki Papadatou, General Hospital Tzanio, Zanni Afentouli 1 str, 18536, Piraeus, Greece Key words: urethral stricture, optical internal urethrotomy Introduction An urethral stricture is a narrowing of a section of the urethra. It causes a blocked or reduced flow of urine which can result in a range of manifestations, from asymptomatic to severe discomfort. Moreover, it can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Blunt perineal trauma, urological instrumentation, chronic inflammatory disorders such as lichen sclerosus et atrophicus and sexually transmitted diseases are the most frequent causes of strictures; a large proportion are iatrogenic . Currently, three different interventions are used to treat urethral strictures: dilations, optical internal urethrotomy and open urethroplasty(1). Dilations are easy to perform in every day clinical practice, however they show the highest recurrence rates while their outcomes are the less satisfying to the patients. On the other hand, open urethroplasty shows the lowest recurrence rates and its outcomes are the most satisfying to the patients (2). Although it is the current gold standard against which the traditional treatments are compared, this technique requires skills, expertise and equipment, often not available in the resource limited settings. For the above reasons, most patients with urethral stricture are offered optical internal urethrotomy . This procedure is preferred as the first treatment option by many urologists, as it is performed within short operative times, under either spinal, or local anaesthesia. It can be also done as an outpatient procedure for the treatment of short urethral strictures . Optical internal urethrotomy is performed by a rigid urethrotome or a flexible cystoscope/urethrotome combination. The instrument is inserted and guided to the face of the stricture and a small blade at the tip of the instrument is deployed using a trigger mechanism to cut the stricture at locations determined by the surgeon. Upon completion of the internal incision(s), the instrument is withdrawn and an appropriately sized Foley catheter is inserted through the repair and into the urinary bladder. Hospitalization lasts 2 days and the patient keeps the catheter a few days . However, technical difficulties associated with poor visualization of the stenosis or of the urethral lumen may increase procedural time and substantially increase the failure rates of internal urethrotomy. In this report we describe a technique for urethral catheterization via a suprapubic, percutaneous approach through the urinary bladder. Case Report A 35-year-old male patient, presented to our urology department with a severe (> 5 cm), tortuous stricture of the penile urethra, previously diagnosed by descending cystourethrogram (Figure 1). A suprapubic catheter was in place. Technique The urinary bladder was filled with 300 millilitres of diluted iodinated contrast (contrast/normal saline: 1/3) via the suprapubic catheter. A 0035†, J-tip standard angiographic guidewire was inserted into the urinary bladder through the suprapubic catheter. The latter was removed and exchanged with a short (11 cm), 5-French angiographic sheath. The angiographic guidewire was subsequently withdrawn and a Cobra-1 angiographic catheter (5 Fr, 65 cm) loaded with a 0035, hydrophilic, J-tip guide-wire was inserted into the bladder. Under fluoroscopy, the catheter-guidewire combination was guided towards the internal urethral orifice and urethra was catheterized. The hydrophilic guidewire was used to negotiate the stricture and was finally advanced through the external urethral orifice (Figure 2). The angiographic catheter was subsequently advanced through the stenosis, over the guidewire (Figure 3). The hub of the catheter was cut off and the vascular sheath was removed. The posteri or part of the catheter is stabilized on the abdominal wall with a suture. The patient was then taken to the operating room and placed in lithotomy position, under spinal anaesthesia. By keeping the angiographic catheter stretched, the rigid urethrotome was inserted in the urethra (Figure 4) and directed to the face of the stricture. The blade at the tip of the instrument was deployed using a trigger mechanism to cut the stricture at the 12 o clock location along the entire length of the stenosis. Upon completion of the internal incision, the instrument was withdrawn and a Foley catheter was inserted through the repaired stricture and into the urinary bladder. Results Antegrade catheterization of the urethral stricture and subsequent treatment of the stricture by using the angiographic catheter as a guide for the urethrotome proved feasible. No urethral injury, false passage or development of fistula were observed. The fluoroscopically guided antegrade catheterization of the stricture lasted 11 minutes. The patient remains free of recurrence 7 months post-operation. Discussion Internal urethrotomy has advantages of ease, simplicity, speed and short convalescence. However, success rates vary and long term results are generally low. In the short-term (less than 6 months), success rates are 70 to 80 percent. After one year, however, recurrence rates approach 50 to 60 percent and by five years, recurrence falls in the range of 74 to 86 percent(4). Although different studies have proposed different etiologies as poor responders to optical internal urethrotomy, technical and anatomical factors such as reduced visibility during the operation and stricture length are uniformly recognised as predictors of recurrence . Other factors associated with treatment failure are the perioperative urinary infection, the presence of periurethral fibrosis (spongiofibrosis) and stricture etiology(5). In cases of severe urethral stenosis or excessive urethral tortuosity the actual site of the stricture may not be visible at all4. Intraprocedural bleeding, presence of blood clots, inflammatory or injured tissues add extra difficulty in localization of the stenosis and in safe advancement of the urethrotome. Retrograde instillation of methylene blue through the suprapubic catheter and/or antegrade advancement forwarding of an ureteral stent are usually used in order to visualise narrowed urethral lumen, or to guide the urethrotome through a tortuous urethra respectively. However both manoeuvres are of questionable effectiveness. In several cases the procedure is concluded in two sessions; in other cases a scar appears after urethrotomy (probably as a result of a false route of the urethrotome) and this causes a new stricture. The above may explain surgical success rates as low as 20% . To overcome these problems, we devised a technique which is based on percutaneous, trans-cystic catheterization of the urethra. The technique requires low-cost, widely available materials of interventional radiology and a fluoroscopy unit. The procedure is brief, well-tolerated and requires no anesthesia. Our initial experience showed that even a long and severe stenosis could be negotiated with rotational and gentle probing movements of the hydrophilic guidewire. Of note, we preferred to utilize the angiographic catheter instead of the guidewire as a guide for the urethrotome; compared to the guidewire, the angiographic catheter proved more stable, more efficient for straightening of the urethra and more easily visible endoscopically. References 1. Tritschler S, Roosen A, Fà ¼llhase C, Stief CG, Rà ¼bben H. Urethral stricture: etiology, investigation and treatments. Dtsch Arztebl Int. 2013;110:220-6 2. Wani BN, Jajoo SN, Bhole AM. Outcome of urethral strictures managed by general surgeons in a rural setting of India. Indian J Surg. 2011;73:336-40. 3. Kreder KJ, Stack R, Thrasher JB, Donatucci CF. Direct vision internal urethrotomy using topical anesthesia. Urology. 1993;42:548-50. 4. Jordan GH, Schlossberg SM, Devine CJ. Surgery of the penis and urethra. In: Walsh PC, Vaughan ED, Retik AB, Wein AJ, editors. Campbells Urology. Philadelphia: Saunders; 1998. pp. 3316–3394. 5. Wong SS, Aboumarzouk OM, Narahari R, ORiordan A, Pickard R. Simple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men. Cochrane Database Syst Rev. 2012;12:CD006934. Legends Figure 1 Descending cystourethrogram showing severe stenosis of the penile urethra (arrow). Figure 2 Demonstration of the technique after the replacement of the suprapubic catheter with the angiographic sheath (arrow). The angiographic catheter (dotted arrow) and the guidewire (arrowhead) have been inserted through the angiographic sheath into the bladder. The guidewire has negotiated the stenosis and has been externalized through the external urethral orifice. Figure 3 The angiographic catheter (dotted arrow) has been advanced across the stenosis over the guidewire. Figure 4 Endoscopic view of the angiographic catheter which served as a guide for the urethrotome.

President James Madison Essay -- Presidents American History Essays

President James Madison James Madison, (1751-1836), 4th President of the United States of America. Although he served eight years each as a member of the U.S. House of Representatives, as secretary of state, and as president, Madison's principal contribution to the founding of the United States was as "Father of the Constitution." Madison's place among the Founding Fathers reveals the essential qualities of his public career. Jefferson had a superior vision of the potential for life under republican government, a greater capacity for leadership, and a special gift for the memorable phrase, but Madison had a more subtle and incisive political sense. Madison's ancestors, probably all from England, settled in Virginia along the Rappahannock and Mattaponi rivers in the mid-17th century. James Madison himself, however, lived all his life in Orange county on a 5,000-acre plantation that produced tobacco and grains and was worked by 100 slaves. Madison was born at the home of his maternal grandparents in Port Conway, Va., on March 16, 1751. Madison also read John Locke, Isaac Newton, Jonathan Swift, David Hume, Voltaire, and others who fashioned the Enlightenment world view, which became his own. Madison's understanding of public affairs developed during the decade of colonial resistance to British measures, 1765-1775. Madison's skill led to his election in 1780 to the Continental Congress, where he served for nearly four years. In 1783, after ratification of the peace treaty and demobilization of the army, Madison ranked as a leading promoter of a stronger national government. For three years in the Virginia legislature, Madison worked to enact Jefferson's bill for religious freedom and other reform measures. He also continued to strengthen the national government by securing Virginia's support of it. Madison offered the Virginia plan giving taxing and law-enforcement powers to the national government, and he worked with James Wilson and other nationalists to support a strengthened executive, a broadly based House of Representatives, long terms in the Senate, an independent federal judiciary, and other devices to enhance national power. Madison argued that an enlarged, strengthened national government, far from being the path to despotism its opponents feared, was in fact the surest way to protect freedom and expand the principle of self-govern... ...th sides tired of war, a peace treaty was signed restoring the pre-war boundaries and ensuring American national independence. The French minister, who had been close to Madison throughout the war, observed that three years of warfare have been a trial of the capacity of American institutions to sustain a state of war. With threats of disunion ended, the path opened for westward expansion, the nation confident of its security in the world and its institutions vindicated, Madison's last two years as president were triumphant. Though in urging a variety of measures, Madison cast aside republican dogma about weak government, he still opposed internal improvement schemes except under a constitutional amendment. Happily retired to his Virginia farm, Madison practiced scientific agriculture, helped Jefferson found the University of Virginia, advised Monroe on foreign policy, arranged his papers for publication, and maintained a wide correspondence. Nationally, Madison wrote in support of a mildly protective tariff, the National Bank, and, most importantly, the power of the union against nullification. Madison's health slowly declined, forcing him more and more to be a silent observer. President James Madison Essay -- Presidents American History Essays President James Madison James Madison, (1751-1836), 4th President of the United States of America. Although he served eight years each as a member of the U.S. House of Representatives, as secretary of state, and as president, Madison's principal contribution to the founding of the United States was as "Father of the Constitution." Madison's place among the Founding Fathers reveals the essential qualities of his public career. Jefferson had a superior vision of the potential for life under republican government, a greater capacity for leadership, and a special gift for the memorable phrase, but Madison had a more subtle and incisive political sense. Madison's ancestors, probably all from England, settled in Virginia along the Rappahannock and Mattaponi rivers in the mid-17th century. James Madison himself, however, lived all his life in Orange county on a 5,000-acre plantation that produced tobacco and grains and was worked by 100 slaves. Madison was born at the home of his maternal grandparents in Port Conway, Va., on March 16, 1751. Madison also read John Locke, Isaac Newton, Jonathan Swift, David Hume, Voltaire, and others who fashioned the Enlightenment world view, which became his own. Madison's understanding of public affairs developed during the decade of colonial resistance to British measures, 1765-1775. Madison's skill led to his election in 1780 to the Continental Congress, where he served for nearly four years. In 1783, after ratification of the peace treaty and demobilization of the army, Madison ranked as a leading promoter of a stronger national government. For three years in the Virginia legislature, Madison worked to enact Jefferson's bill for religious freedom and other reform measures. He also continued to strengthen the national government by securing Virginia's support of it. Madison offered the Virginia plan giving taxing and law-enforcement powers to the national government, and he worked with James Wilson and other nationalists to support a strengthened executive, a broadly based House of Representatives, long terms in the Senate, an independent federal judiciary, and other devices to enhance national power. Madison argued that an enlarged, strengthened national government, far from being the path to despotism its opponents feared, was in fact the surest way to protect freedom and expand the principle of self-govern... ...th sides tired of war, a peace treaty was signed restoring the pre-war boundaries and ensuring American national independence. The French minister, who had been close to Madison throughout the war, observed that three years of warfare have been a trial of the capacity of American institutions to sustain a state of war. With threats of disunion ended, the path opened for westward expansion, the nation confident of its security in the world and its institutions vindicated, Madison's last two years as president were triumphant. Though in urging a variety of measures, Madison cast aside republican dogma about weak government, he still opposed internal improvement schemes except under a constitutional amendment. Happily retired to his Virginia farm, Madison practiced scientific agriculture, helped Jefferson found the University of Virginia, advised Monroe on foreign policy, arranged his papers for publication, and maintained a wide correspondence. Nationally, Madison wrote in support of a mildly protective tariff, the National Bank, and, most importantly, the power of the union against nullification. Madison's health slowly declined, forcing him more and more to be a silent observer.

5 Paragragh Essay: The Catcher In The Rye :: essays research papers

From the novel, The Catcher in the Rye, the youthful protagonist Holden Caufield, employs the word â€Å"phony† to describe the behavior of a number of characters including Mr. Spencer and Ossenburger, however it is not them who areâ€Å"phony†, it is the young main character. First, Mr. Spencer, Holden’s ex- history teacher, is not described as phony, but according to the adolescent, his choice of words are. Secondly, according to our main character, Ossenburger is not the generous philanthropist he portrays himself to be, but rather a greedy undertaker. Lastly, the protagonist could quite possibly be the authentic phony. All in all, the main character’s use to describe many other characters in the book is with the single word phony, when in fact the word phony would be the most probable word to describe the lead character. Illustrating Mr. Spencer as phony because of his vocabulary, is when Holden leaves Pencey Prep permanently, and goes to say good-bye to the ex-history teacher. The depicted fake tells the ex-Pencey student â€Å"I had the privilege of meeting your mother and dad when they had their little chat with Dr. Thurmer some weeks ago. They’re grand people†. The ex-Pencey student immediately impugns Mr. Spencer’s use of the word â€Å"grand†, and tells the reader: â€Å"Grand. There’s a word I hate. It’s a phony. I could puke every time I heard it.† To sum up, Holden disgusts Mr. Spencer’s utilization of the word â€Å"grand† and thinks it is fraudulent. Also, Caufield, describes Ossenbuger as phony because of what Holden perceived he did for a living. The wing where the central character lived at Pencey was called the â€Å"Ossenbuger Memorial Wing† named after a men who went to Pencey and later donated a substantial amount of money to the school. Ossenburger makes this income by the â€Å"business of undertaking†. Next, according to our youthful character, Ossenburger is phony because â€Å"he probably just shoves the dead bodies in a bag and throws them in the river†. As a result, Caufield feels that Ossenburger is phony because of his profession in undertaking. While observing the discription of many other characters in the novel as phony, it is safe to say that the phony character is indeed the protagonist. For example, the false character when lying to Mr. Spencer about going to the gym to clear everything out before leaving, is Holden. Once again we see this falsehood, when he tries to hit on some women in a bar, despite thinking the girls are not particularly extraordinary women.

Evaluation Of The New Deal Essay -- essays research papers

Franklin D. Roosevelt brought the new deal into American life in the early thirties. Its purpose was to overcome the depression. Following the depression there were many programs and acts to help the nation recover from the depression. The "forgotten Americans" were the citizens who needed the new deal to benefit their poverty-stricken way of life. These people were the blacks, women, immigrants, and the many people who suffered from the lack of monetary supplement. Unemployment was one of the biggest issues to strike the "forgotten Americans." The new deal provided helping programs such as the Social securities act, WPA, and the federal Emergency Relief Act to lower unemployment and to help those who couldn't work. Checks could be received by those who were poor because of the Social Securities Act. The WPA, led by Harry Hopkins, was built to help artists and musicians obtain a steady form of employment that would help lift the nations’ spirit. The federal Emergency Relief Act provided relief money for a limited time to those workers who had been laid off. For the black workers, the NAACP was created; it was one of the most important groups fighting for the rights of blacks and is still involved in the black community today. Minorities were still unchanged in the labors. Even under the new deal, blacks were treated unfair. Women were also treated very poorly when it came to the labor situation. They were given the so-called women's jobs, such as teac...

Internal factors for HR planning Essay

Organisational needs: A demand for goods and services in an organisation needs to be considered. If there is a high demand of good/services, the organisations’ staffs have to cope with the demand or they need to employ more staff. The organisation can use sales trends to help in planning. Technological changes: Where there is technology available, organisations can increase production without necessarily increasing in staff. Staff can be re-trained to use the technology but not all employees welcome technology and could be resistant to change. A skills audit can help to identify suitable staff for training. Skills requirements: In Newham General Limited the abilities of the present workforce is a crucial piece of HR arranging as it empowers a business to develop a profile of the preparation, experience and capabilities that representatives as of now have. This is critical whether the business is capital escalated or work serious. As the nature and kind of work changes inside of an association, so do the abilities basics. Location of production: Some organisations may look for areas where labour is cheap and move their businesses there. The final decision will be based on whether there are sufficient qualified staffs available to do the task. Workforce profile: A workforce profile is a description and analysis of the current staff. They could be questions in the profile such as the skills they have and how well they are performing. Also one of the questions could be what the age of the staff is. Teleworking: Teleworking is very important in HR planning and can save an expensive office cost. With Teleworking one desk is enough for a number of workers since they are all not in the office at the same time. External factors of HR planning: Supply of Labour: This enables the organization to know where labour is coming from. In the event that their arrangement shows labour is originating from outside of the organization then demand job/unemployment patterns and pay rate. Labour cost: In order to attract employees, an employer must provide pay and conditions to match those in comparable jobs elsewhere. If an organisation finds it labour cost expensive it might relocate to areas where labour is cheap. Government policy: With the presentation of new working environment agreeability benchmarks your HR office is always underweight to stay inside of the law. These sorts of regulations impact each procedure of the HR office, including employing, preparing, pay, end, and considerably more. Changing nature of business: A job for life used to be a standard thought in the working environment, yet now representatives require a more extensive scope of abilities and be willing to change head honcho and employment part to stay in work. Overnight meeting expectations, adaptable working hours and telecommuting are currently typical in the work environment. Level hierarchical structures mean workers may need to move to get advancement. Unit 16 P2 What are your skills? Carrying out a skills audit will help you to analyse the skills which you have developed during your research career and develop a skills profile. The profile created by the skills audit is a key instrument for CV building and confirming abilities at an interview. An abilities review will help you recognize gaps in your abilities set and organize any preparation needs you may have. When you know your preparation need you can arrange for how to meet them viably.

Photography History in the News Essay

Over two centuries, civilizations have used print media to spread news and information to the masses. During a period of time around 59 B.C the Roman Acta Diurna, is the earliest recorded â€Å"newspaper†. Julius Caesar, wanting to inform the public about important social and political happenings, ordered upcoming events posted in major cities. Written on large white boards and displayed in popular places like the Baths, the Acta kept citizens informed about government scandals, military campaigns, trials and executions. In 8th century China, the first newspapers appeared as hand-written newssheets in Beijing. In the year 1969 extraordinary activity in the exhibition field vied with the introduction of new products and it called as photographic year. The year’s largest display both of products and pictures was held at the nine-day Photo Expo 69, which filled all four exhibition floors of the New York Coliseum and drew a total of nearly 100,000 visitors. More than 3,000 black-and-white and color photographs by amateurs and professionals were displayed, and individual exhibits covered space photography and other specialized fields. Supplementing the print shows were a number of temporary theaters for slides and movies which reflected the newest ideas in the presentation of these media. Among other shows that attracted attention and drew visitors was ‘600 Faces by Beaton, 1928-1969,’ originally exhibited at the National Portrait Gallery in London and shown in the United States at the Museum of the City of New York. It was the largest one-man show (and the only one-man show of British photographer and designer Cecil Beaton) ever held in New York, and it contained portraits of many of the outstanding personalities of the past four decades. Later on, photojournalism was introduced to accompany the written information, because photojournalism has unique power to fix events, places and human in our collective history. But before we move on further, let us try to determine first what is photograph? A photograph is a picture produce through the chemical action of light on sensitive film. It is a medium of recording reality that is iconic as well as indexical. Although a photograph resembles or imitates something, making it iconic, it achieves this through the use of light from the subject, therefore making it less arbitrary. However, a photograph is a representation of a particular moment and situation in time. Barthes expressed his view that a newspaper photograph is, ‘an object that has been worked on, chosen, composed, constructed, treated according to professional, aesthetic or ideological norms which are so many factors of connotation.’(cited in Bagnell, 1977: p.98). Traveling photographic exhibits visited many cities in the United States, Canada, and Latin America during the year. Among the exhibits sponsored by the George Eastman House, the museum of photography at Rochester, N.Y., were ‘Contemporary Photographers,’ a multipart exhibition; a retrospective of the work of Eugà ¨ne Atget, a French photographer active in the early part of the century; and ‘Photography in the Twentieth Century.’ The Smithsonian Institution, in Washington, D.C., sent out several traveling shows, which included ‘Australia—The Sunburnt Country,’ ‘The Color of Man,’ ‘The Concerned Photographer,’ and ‘Laos.’ The technological revolution of today is creating new challenges and opportunities for traditional media. Today books, newspapers, magazines and any other forms of media is really using photograph to illustrate or to picture out the of   they mean in their written information. Literature Cited Newspaper the History. http://en.wikipedia.org/wiki/Newspaper#History

Meeting Learning Needs Case Study

Meeting Learning Needs: Case Study In this rationale I intend to discuss â€Å"Why we do what we do† when it comes to Inclusion and Special Educational Needs (SEN). This will be a case study of a pupil with SEN attending the school in which I work. It will first outline the nature of the pupils Special Educational Needs and then critically examine how these needs are being met. The role of multi-agency approaches in providing support to the pupil and parental involvement will also be analysed. All children, wherever they are educated, need to be able to learn, play and develop alongside each other within their local community of schools† (Dfes 2004 p5), going further to state that â€Å"inclusion is about much more than the type of school that children attend: it is about the quality of their experience; how they are helped to learn, achieve and participate fully in the life of the school† (p25). http://sen. ttrb. ac. uk/ViewArticle2. aspx? ContentId=15915 (Access ed on 20/01/11) The case study I carried out was on Billy who is 9 years old, Billy was diagnosed with Autism at the aged 4 shortly after he started mainstream school in reception. Autism is a type of disability. There are many people with autism in England, Scotland, Wales and Northern Ireland. 1 out of every 100 people has autism. You cannot always tell that someone has autism just by looking at them. Autism lasts for all of a person's life. But they can still do a lot of things and learn a lot of skills. The three main areas of difficulty which all people with autism share are sometimes known as the ‘triad of impairments' which are Social Communication, Social Interaction and Social Imagination. The triad of impairments is the term that describes the difficulties that people with autism experience in differing degrees. Because all people are different, the way autism affects them is also different. To enable the setting to remove Billy’s barriers to learning we firstly arranged a meeting at his home with him and his parents and the Special Needs Coordinator (SENCo). At the meeting we discussed Billy’s learning and personal needs, at first we concentrated on Billy’s routine at home enabling us to see how he dealt with everyday issues. It is vital that we alleviate confusion and give Billy a sense of security. This will be done by preparing Billy whenever possible if his routine is going to be broken, someone will talk him through what is going to happen. We also intend to invite Billy into the setting to meet his new teacher, and will be providing him with photographs of the settings and his support workers to facilitate him in familiarise himself with his new setting. We have taken photographs to allow us to personalise the learning spaces with pictorial sequences, rule reminders, schedules and labels. A space in the classroom will be made available for Billy to work with his one-to-one support and peers where possible. By using these strategies Billy’s learning can be structured to support his need for routine. ‘Being clear and consistent is supportive to all learners in the classroom but will be essential for the child with an autistic spectrum disorder’ G, Knowles, Supporting Inclusive Practice (p. 16) I feel that it is very important that all children have the right to be included in mainstream school and where possible they should be able to meet there learning needs and the targets set in the National Curriculum. One of the fundamental principles of the Special Education Needs Code of Practice is ‘the needs of children and young people with Special Educational Needs are identified and assessed quickly and matched by appropriate provision’ (Department for Education and Skills, 2001 p. 9). I believe that it should be a collaboration between the teachers, the parents of the child and the child themselves who decides whether they would benefit from being in mainstream school or not. Extensive research studies have been undertaken to determine the effectiveness of integrating and including students with severe disabilities. Tornillo (1994) feels that, ‘teachers are required to direct inordinate attention to a few, thereby decreasing the amount of time and energy directed toward the rest of the class. Indeed, the range of abilities is just too great for one teacher to adequately teach. Consequently, the mandates for greater academic accountability and achievement are unable to be met’. http://www. sedl. org/change/issues/issues43/concerns. html (accessed on 30/01/11) During my research into Inclusion in mainstream school I found that, some parents of students with more severe disabilities are concerned about the opportunities their children will have to develop basic life skills in a regular classroom setting. They are also cautious about inclusion because of fears that their children will be ridiculed by other students. Its at this point I feel it necessary to state that Inclusion is not about making sure all children are taught the curriculum in the classroom, it is making sure that all individuals be they disabled or non disabled have access to the curriculum, and that learning is facilitated to suit their learning needs. The next step to facilitate Billy’s learning needs is to draw up an Individual Education Plan (IEP). An IEP describes the educational program that has been designed to meet that child's unique needs. ‘An Individual Education Plan is an assessment, planning, teaching and reviewing tool which records specific learning goals, teaching requirements and review arrangements to help a pupil with SEN which are ‘additional to and different from’ those of most pupils, to make progress in key areas of learning’ (Dovestone, Cullingford-Agnew, 2006, p. 23). Each child who receives special education and related services must have an IEP. Each IEP must be designed for one student and must be a truly individualized document. The IEP creates an opportunity for teachers, parents, school administrators, related services personnel, and students (when age appropriate) to work together to improve educational results for children with disabilities. The IEP is the cornerstone of a quality education for each child with a disability. As stated in the SEN Code of Practise (2001) where possible, children and young people with SEN should participate in all the decision-making processes that occur in education including the setting of learning targets and contributing to IEPs, discussions about choice of schools, contributing to the assessment of their needs and to the annual review and transition processes. Following the initial meeting we arranged for Billy and his parents to visit the setting for a day allowing them the opportunity to assess the setting. All areas of the school were made accessible to them so they could see how Inclusion of all students is important too us as a setting. It is essential that Billy’s parents are involved in every stage of Billy’s integration into the setting as stated in the SEN Code of Practice(2001) ‘It is vitally important that schools welcome and encourage parents to participate from the outset and throughout their child’s educational career at the school’. In my setting we encourage parents to come to us with any questions or concerns they may have about there child/children and we persevere to accommodate their needs. It is vitally important for parents to be involved with every stage of their child’s education as Parents are the most important people after the child. ‘They know there child best and know what they want out of the staff and the school. ’ (As stated in my settings Inclusion Policy) It is our responsibility as a setting to ensure that parents are aware of the Partnership with Parents (PwP). PwP aims to ensure that parents are able to play an informed part in any decisions about the educational provision made to meet their child SEN and to build partnerships between parents, the Local Education Authority (LEA) and schools. WORD COUNT 1343 Reference List and Bibliography Department for Education and Skills. (2001). Special Educational Needs Code of Practice. London: DfES. Dovestone, M, Cullingford-Agnew, S. (2006) Becoming a Primary Higher Level Teaching Assistant: Primary Special Educational Needs. Exeter: Learning Matters Ltd. http://www. sedl. org/change/issues/issues43/concerns. html (accessed on 30/01/11) http://sen. ttrb. ac. uk/ViewArticle2. aspx? ContentId=15915 (accessed on 20/01/11) Knowles, G. (2006) Supporting Inclusive Practise. David Fulton Publishers Ltd. London