Tradition v.s Common Sense

Traditions are a very Important aspect of human life. They are seen as another way of life. Many traditions teach things of value to children, things which parents hope will be passed on to future generations. In many societies however, traditions have taken over the common sense of the people.Nowadays, humans blindly follow traditions, not knowing or even acknowledging what they are really doing. Whether It Is a celebratory tradition or a tradition that has been followed since ancient times, unmans will not question the motives behind it; they will just continue to follow it. In the short story â€Å"The Lottery† by Shirley Jackson, villagers blindly follow their annual tradition, one that claims a life every year.All the villagers take part in this event knowing that there will be death yet no one dares to stop and question It, Even when some people do stop and question the reasons that began the tradition, they will not do anything about it because it is a tradition that ha s been followed countless and they do not want to be the only ones to question it or even worse, not follow it. This shows that human beings will tolerate acts of evil and Injustices In traditions, making them unable to step out of that circle and see what is really going on because of their preference of tradition over common sense.It does not matter if the tradition FIFO Traditions have been around for thousands of years, even before civilized human life began. They have been performed all over the world, in all points of time. In the overview by Joyce Moss and George Wilson, it is explained that ancient cultures believed sacrifices were necessary to benefit the community. In fact, during ancient times a tradition similar to â€Å"The Lottery' was such â€Å"a highly regarded mean of decision-making that eventually most civic matters were resolved by. † Joyce Moss & George Wilson) This is because traditions were among the main parts or sections of ancient human life.Even n ow, traditions are still a big part of human life. Many traditions around the world are a huge thing for humans. They will make special foods, decorations, and even rituals. However, many of these traditions are performed without thought. Many traditions are followed because it has been done before, no one has questioned it before, and so there is no reason to stop it now. In â€Å"The Lottery' one can analyze that the original meaning and aspects of the tradition have indeed been lost and that the tradition is followed Just because.The analysis made on study mode suggests that â€Å"Substituting slips of paper for chips of wood, a recital prior to the lottery, and a salute to address each person† are some of the aspects that have changed prior to the original lottery, the first one that began everything. (Analysis of the Tradition in Shirley Jackson's â€Å"The Lottery') It also mentions that the actual tradition has remained a routine. This leads to the conclusion that th e lottery is no longer continued because of the tradition, but because it has been done for so long it Just feels right to continue to follow it.In many societies, rituals are part of the traditions. Many believe these rituals are performed because of religion or a similar idea. What people do not know is that not all rituals are needed or performed because of religion. Many rituals are Just performed because of tradition. It does not matter if the ritual is harmful and has a active impact on society; many societies will still perform them Just to keep the tradition going. The short story, â€Å"The Lottery' by Shirley Jackson, shows a perfect example of this.The people of the town still perform the ritual because of the tradition held every year. They do not care if someone they love or care for dies; they just want to follow the tradition. Even the own family members participate in the ritual, which is stoning one of their own family members to death. These types of rituals are i ncredible acts of evil but humans still participate in them. In the last section of the overview by Jennifer Hicks, she explains very thoroughly the tradition of stoning. In it she explains that it was a standing ritual.She does mention that the â€Å"original paraphernalia for the lottery has been lost long ago. † (Hicks) There is a part in the story where old man Warner stated, â€Å"Lottery in June, corn be heavy soon. † This refers to human sacrifices benefiting the community with food, which is something that by the time the story takes place, which is around the 1700 to sass, should be known that it is not real. So why do they continue to do this? It is the simple reasons of following a tradition. There are many concerns on why human beings follow traditions that are inhumane instead of using their common sense.Most of the issues are due to the fact that many rituals followed by humans consist of bloodshed or even death. In many societies, traditions play a big r ole, causing more and more people to be a part of them. The main dilemma is why people accept traditions that sense that traditions that involve bloodshed and death can be no good to societies, especially societies filled with children. Traditions like these will only poison the minds of the young with the idea that a tradition must be followed no matter what. The reason people do not stop them is because they do not want to stand out.In the book â€Å"Shirley Jackson† by Friedman Lineman, it explains that Shirley Jackson was new to a small town when she moved. She did not really know anybody so she did not participate in the town's traditions. This caused other towns people to look at her weird, like an outsider. This can reflect on her short story of â€Å"The Lottery', in which the analysis can be made that Mrs.. Hutchinson was an outsider, not so much of Ewing new but the type that does not do what everyone else does, in this case, the tradition of the lottery.It is clea r that these traditions have taken over the common sense of the people. Now, people do not think before acting. They Just follow traditions to the letter. They do no stop to think about their traditions and if they are beneficial or plain out dangerous. They Just do not want to stand out; they want to be the same as everyone else. It is around these thoughts that the main concern revolves around. Humans will argue that traditions are needed when the reality is that they are not. They have gotten surrounded so much by traditions; it is like a second language to them.The short story â€Å"The Lottery' by Shirley Jackson explains how human beings in the village have been blinded by a tradition, which is the lottery. With careful analysis, it is easy to spot all blind actions carried out by the villagers. Everybody seems nice and Joyful throughout the story until the very end. â€Å"It seems as though Jackson is making a statement regarding hypocrisy and human evil. † (Analysis of the Tradition in Shirley Jackson's â€Å"The Lottery') What Shirley Jackson wants us to realize y writing this story is that people are so blinded by traditions; they might kill someone thinking it is alright.Shirley Jackson uses ideas similar to these to suggest that there is an underlying evil and weakness in human beings. The village, having performed such an act for so many years, continues on with it, with no complaints or questions being asked, and the main purpose being to carry on the tradition. In the story, it states, â€Å"There's always been a lottery says Old Man Warner. â€Å"Nothing but trouble in that,† he says of quitting the event. (122) However, almost all the villagers how some type of anxiety or fear toward the tradition.Comments like â€Å"Don't be nervous Jack† (122) and â€Å"Get up there Bill† (123) indicate that the people may not be entirely comfortable with the lottery. Yet everyone still goes along with it. Nobody openly express es or shows their fear toward the lottery. Shirley Jackson may be trying to show the reader that many individuals are not strong enough to go against or stand up to their disapproval for the fear of being rejected by their own society. Instead, the villagers will continue to risk not only their lives, but the lives of their Emily members as well.She makes suggestions that human beings are not always who they seem and can turn their back on you at any time for the sake of their beliefs, or in this case, tradition. Throughout history, humans have made the choice to choose their traditions over their common sense. They do not think of the effects that will be caused because of their actions. Nowadays, people in societies continue to follow traditions or â€Å"trends† side to watch an argument, accident or incident, rather than stepping in and doing something about it.They do not step in because they do not want to stand out in front of everybody else; they do not want the spotli ght on them. They are frightened that they will be rejected later on. It is the same thing with traditions. Human beings do not care if there is death in the tradition, they will continue to follow it as long as they do not stand out and are not rejected or looked down on. This shows that human beings will tolerate acts of evil and injustices in traditions, making them unable to step out of that circle and see what is really going on because of their reference of tradition over common sense.People need to stop and think about the effects caused by traditions instead of Just blindly following the traditions of their ancestors. If this is not stopped, future generations will continue to make blind choices as well, due to the lack of common sense. Works Cited â€Å"Analysis of the Tradition in Shirley Jackson's â€Å"The Lottery†. † Studded. Com. Studded. Com, 2008. Web. 2008.. Friedman, Lineman. Shirley Jackson. Boston: Twenty Publishers, 1975. Print. Hicks, Jennifer. â €Å"Overview of the Lottery. † Short Stories for Students. Detroit: Gale, 2002.

Post-CABG Nursing

Coronary heart disease is a major physical illness and one of the main causes of death in Western society People who do not die an early and sudden death may have to consider a major surgical treatment, the most prevalent being coronary artery bypass graft surgery (CABG). More than 350,000 such operations are performed annually in the United States alone. This operation prolongs the life of patients in cases of triple-vessel disease It also improves patients' quality of life), thus providing them with the opportunity for successful rehabilitation (Ben-Zur, 2000).The postoperative complications of CABG include the following: high anxiety or depression, central nervous system damage (CNS), and atrial fibrillation. In this paper, we will discuss the postoperative complications of CABG and how they impact nursing practice. . During the first several weeks after CABG surgery, states of high anxiety or depression are usually observed (see, for example, Pick, Molloy, Hinds, Pearce, & Salmon , 1994; Trzcieniecka-Green & Steptoe, 1994).In long-term research (that is, approximately one year after the operation), the results present a more positive trend in terms of elevation in positive moods (King, Porter, Norsen, & Reis, 1992; King, Reis, Porter, & Norsen, 1993), as well as an increase in quality of life (Kulik & Mahler, 1993). Such outcomes can be accounted for by illness severity factors. In addition, in recent years, the individual's personality and coping characteristics have been investigated as important determinants of post-CABG patients' emotional reactions and rehabilitation (Ben-Zur et al., 2000). Research studies indicate that depression is prevalent in approximately 20% of CAD patients, and has a significant effect on post-surgery morbidity and mortality. (Remedio, 2003). One major type of morbidity following CABG is central nervous system (CNS) dysfunction (. Barbut D, Hinton et al. 1985)]. Of all the adverse neurological outcomes that may be incurred posto peratively, stroke is one of the most serious.However, due to technological and surgical improvements the incidence of stroke is now reported to be as low as between 0. 8 and 5. 8% [McCann GM, et al. 1997) Duke University Medical Center study published in 2001 indicated that fully half of people undergoing bypass surgery developed memory or thinking problems in the days following it, and that these problems were usually still evident five years later. (Bypass surgery and memory, 2005) Consequently, the rate of post-CABG stroke is no longer a sufficient index of CNS dysfunction.Neuropsychological research suggests, however, that a considerable proportion of all patients who undergo CABG sustain some degree of cerebral damage and that this manifests as mild cognitive impairment. Although these cognitive deficits rarely disturb activities of daily living, they are still considered cause for concern. Therefore, it is these less severe forms of neurological injury, which are now targeted for reduction in what has been described as an age of quality improvement (Stump D. A. 1995; Stump D. A. , Rogers A. T. , and Hammon , J. W. 1996;].Cognitive impairment following coronary artery bypass grafting, Neuropsychological tests are valuable tools in the assessment of brain dysfunction as they provide a method of systematically and quantitatively studying the behavioral expressions of this dysfunction (Lezak, 1995) .As there is now only a low risk of stroke following CABG, milder forms of cerebral damage have become a greater focus of concern. Consequently, neuropsychological assessment has become more important within the domain of cardiac surgery. The advantage of neuropsychological tests is that they are capable of detecting subtle changes in cognitive function.In comparison, conventional neurological assessment techniques, such as the Mini-Mental State Examination, are less sensitive and therefore less able to detect subtle CNS changes In addition, neurological assessme nt techniques do not lend themselves as readily to quantitative analysis [Heyer E. J, et al. 1995) Cognitive decline has been observed by many researchers using batteries of neuropsychological tests, usually administered to patients before and after surgery. A patient’s pre- and postoperative scores are then compared. In this way, intersubject variability is minimized as the subjects act as their own controls.While cognitive deficits have been consistently reported in the immediate postoperative period, some researchers have readministered test batteries in the immediate postoperative period, typically within 5–10 days of surgery (Aris A, et al, 1986; Clark et al. , 1995; . Newman MF, Croughwell ND, Blumenthal JA et al. 1994; Pugsley et al, 1994; Shaw PJ et al. 1986; Townes B. D. , Bashein G. , Hornbein T. F. et al. 1989; Symes et al, 2000).. Atrial fibrillation (AF), although t not life threatening, is one of the most common complications after CABG.Hospital stays oft en are prolonged due to intermittent hemodynamic instability of thomboembolic complications. During AF, loss of synchronous atrial mechanical activity response, and inappropriately high heart rates may have adverse effects o n hemodynamic functions and cause hypotension and hear failure. Of all the complications associated with postoperative AF< the most serious are throboemboic complications, which cause permanent morbidity in many patients. Risk of postoperative stroke has been found to be significantly increased with postoperative atrial tacharrhymias.Earlier studies shows that the incidence of AF can be as high as 50% in patients after the incidence of AF can be as high as 50% in patient after coronary artery bypass grafting (CABG), with a peak incidence on postoperative day 2 to 3. Atrial effective refractory periods (ERP) has been used a parameter to evaluate atrial repolarization and ERP and its dispersion are known parameters of atrial vulnerability that indicate enhanced at rial arrhythmogenesis, include a history spontaneous paroxysmal AF and easy inductility of atrial arrhthmias.( Solyu et al). Pleural effusion occurs in up to 80% of patients during the first week after CABG. Most of these effusions are small, self-limiting and do not require interventions. However, chronic, persistent post-CABG effusions have been reported. The etiology of these persistent effusions remains unknown. ( Lee et al, 2001) Sleep disturbances is another big postoperative complication The purpose of a 1996 Schafer et al study was to describe the nature and frequency of sleep pattern disturbances in patients post coronary artery bypass (CABG) surgery.An exploratory design using telephone interviews at one week, one month, three months and six months was used to describe the incidence and nature of sleep disturbances post CABG surgery. Forty-nine patients completed all four measurement times. More than half of the patients reported sleep disturbances at each measurement time . Sleep disturbances during the first month post CABG were reported to be the result of incisional pain, difficulty finding a comfortable position and nocturia. Although less frequent over time, these problems persisted for six months. . Miller et al (2004) discusses post CABG postoperative symptoms.At 1 week post-CABG, symptoms were incisional pain, wound drainage, chest congestion, shortness of breath, dizziness, sweating, swollen feet, and loss of appetite; incisional pain and swollen feet were reported by a few patients at 6 weeks after CABG. The incidence and frequency of postoperative symptoms declined over time. There were several age-related differences in symptom reports prior to and at 1 and 6 weeks after the procedure (Miller et al, 2004. ). Nursing interventions A wide variety of interventions have been tested for recovery of CABG patients. These 19 studies tested 20 interventions.Most of the interventions were educational in nature and dealt with preoperative or dischar ge instructions or counseling provided to patients. Preoperative interventions to affect in-hospital recovery included preparatory information about cognitive dysfunction following surgery, preparatory information and counseling about physical and psychologic recovery, and psychiatric counseling. Two of the studies[Rice VH, Mullin MH, Jarosz P.. 1992. ] compared the effectiveness of preadmission versus postadmission preparatory instructions, and one study [Barnason S, Zimmerman L, Nieveen J. 1995; Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al.1988); . compared the effects of music, relaxation, and structured rest on hospital recovery outcomes. One study tested the effect of in-hospital range-of-motion (ROM) exercises on arm ROM at discharge. Interventions for home recovery were delivered close to the time of discharge or within the first couple of weeks following discharge. Most of the studies involved tests of structured discharge preparatory information about home recovery using slide and tape programs,[ Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al. 1988; Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. 1993;.] telephone follow-up and counseling,[ Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al.. 1988;13:649-661. , Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. 1993; Beckie T. 1989; Barnason S, Zimmerman L. 1995;] outpatient group teaching,[ Dracup; 1982. Dissertation. ,32] and homegoing audiotapes Interventions to promote risk factor modification behaviors included four studies[Dracup KA. 1982. ] that assessed the effect of structured versus unstructured teaching programs designed to increase knowledge of risk factors and enhance compliance with risk factor modification behaviors.Another study tested an education program that included a behavioral component as well Various outcome variables have been used to evaluate CABG recovery. The most frequently used outcome was mood states; 10 of the 19 studies used mood states as an outcome measure. The most frequently used measurement point for hospital recovery outcomes was the first day following surgery and discharge. Home recovery outcomes were usually measured at 1, 3, and 6 months following discharge. Outcomes associated with risk factor modification most often were measured at 6 weeks and 3, 6, and 12 months following surgery.What is the effectiveness of the interventions? Preparatory information was the intervention most frequently tested. In the two studies[Rice VH, Mullin MH, Jarosz P. 1992;, Anderson EA. 1987;] assessing its effectiveness to reduce analgesia use during hospital recovery, preoperative preparatory information was not found to be effective. Preoperative preparatory information was found to be effective in increasing patients' comfort and control when experiencing postoperative delirium.There was no support for the ability of preoperative preparatory information to reduce anxiety during in-hospital reco very] Discharge preparatory information also was found not to be effective in three of the four studies evaluating mood states during home recovery; this finding was noted even when individual counseling and telephone follow-up were added to the initial information provided Preadmission preparatory information about activity resumption during hospital recovery was found to be effective in one study (Cupples 1991. ] but not in another. [ Rice VH, Mullin MH, Jarosz P. 1992).Activity resumption at home was found to be significantly increased by the provision of discharge preparatory information in two[Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. 1993; Moore SM. 1996] 33 of three studies. Discharge preparatory information aimed at families was not found to be effective in improving family functioning (family cohesion and family communication) during the home recovery periodGiven the small number of studies addressing the effect of preparatory information on phys iologic outcomes (blood pressure, heart rate, angina), no conclusions were made about its effectiveness on these variables.Similarly, no conclusions were drawn about the effectiveness of ROM exercises, music, and visual imaging to enhance CABG recovery because of the small single studies testing each of these interventions. There was clear evidence that information interventions designed to increase individuals' knowledge about managing recovery experiences during the first home recovery month and about coronary artery disease risk factor modification was effective; three of the four studies evaluating this intervention found significant effects.Similarly, tests of the effectiveness of structured versus unstructured instruction indicated that structured information was more effective in increasing knowledge. Education to enhance compliance with medical regimens and risk factor modifications was found to be effective for some risk modification behaviors but not for others. It appears that information alone does not change behaviors. Allen's[Allen. 1996;. ] study of an intervention to increase self-efficacy using both counseling and behavior modification techniques represented an important departure from previous interventions that were based solely on education and counseling.Although Allen found a positive effect for only one of the risk modification behaviors studied (dietary intake), the addition of a behavioral component is an important change in cardiovascular health behavior modification interventions. Gender differences have been widely explored by nurses. Investigators have identified that gender can constitute a form a biculturalism (that is, women view surgery as a minor inconvenience, whereas men view it as a major life event). Postoperative symptoms vary, with males experiencing more fatigue, incisional chest pain, and atrial dysrythmias.Conversely, women have more numbness and breast discomfort, heart failure, and functional impairment. The 2 areas wherein the most work has been done are pain and sleep. A number of descriptive studies have been done on patients' self-report of pain, their satisfaction with treatment, and underuse of analgesics. Limited research on interventions to relieve pain has been reported. Despite these studies on pain outcomes, more exploratory work is required for pain associated with minimally invasive cardiac surgery, pain, and discomfort at discharge, and subsequently identification and trialing of interventions to provide pain relief.The relationships between exercise behavior and functional status of men and women 5 to 6 years after CABG have not been examined in a representative patient sample. This study (Treat-Jacobson & Lindquist, 2004). compared the 5- to 6-year recovery in a cohort of 184 patients at the Minnesota site of the Post CABG Biobehavioral Study. Data were collected by telephone interview and self-administered questionnaires. Results showed that women had lower physical (p ? .004) and social (p = . 001) functioning scores; men were more likely to participate in regular exercise (p = .01). Exercisers had higher functional status scores. ANCOVA demonstrated that differences in measures of functional status by exercise category were maintained even after controlling for age, sex, and symptom severity (p ? .01). In conclusion, individuals who exercised had more positive functional outcomes 5 to 6 years In general, nurse investigators have conducted sufficient studies within each of the generic outcome categories to allow for identification of cardiac surgery-specific outcomes that can be considered nurse sensitive.Artinian (1993) demonstrated that in the early recovery phase, only 62% of women spouses felt they were prepared for discharge, with key concerns being the availability of social support, use of coping strategies, personal resources, and knowing what to expect. At 6 weeks after discharge, women's concerns were most often regarding their husband's self- care activities, uncertainty, and husband's physical and mental symptoms. At 1 year after surgery, women reported less social support and greater role strain than they did at earlier time periods.48 Other investigators have shown that positive psychosocial adjustment to illness is influenced both by the quality of the patient's marriage and level of dysphoria. 49 Nursing interventions to improve family functioning have been reported by a number of investigators. Family members of ICU patients, who were recipients of care from nurses who attended educational sessions and who used checklists to assure provision of information and support, reported lower anxiety and higher satisfaction levels than did families not provided with this level of care.50 Other reports of a controlled trial with a nurse-led psychoeducational intervention51 and follow-up phone calls33 demonstrated no differences in improving patients' recovery or family functioning. Further research in this field should focus on determining if these findings persist across different demographic and economic groups Studies of functional status outcomes have focused on general activity and activities of daily living (ADLs). Specific findings have included that high levels of self-efficacy and decreased tension and anxiety at 4 weeks after surgery are predictive of greater activity at 8 weeks.Women report greater disruption of ADLs at 1 than at 3 months, while disruption of their recreational activities is similar at both times. Need during home health visits include maximum assistance with meals and laundry but only partial assistance with bathing and dressing. One randomized controlled trial comparing usual care with supplemental hospital education and weekly telephone follow-up to improve self-efficacy demonstrated that patients in the experimental group developed higher expectations for walking, lifting, climbing stairs, and working than did patients in the control group.(Whitman, 2004). Conclusion Cor onary artery bypass graft (CABG) surgery is regularly performed in most major hospitals, reflecting the high prevalence of coronary artery disease in western countries. A number of studies have identified cohorts of patients undergoing CABG and other cardiac procedures who experience a higher than expected rate of mortality and morbidity. Increasing age, poor left ventricular function, urgent/emergency procedures, complex operations and reoperation procedures have all been identified as risk factors resulting in prolonged hospital stays and increased morbidity.Subsequently, with current emphasis on both better clinical management and more cost-efficient practice, it is becoming increasingly beneficial to identify low-risk patients who can be safely ‘fast tracked’ to reduce postoperative management costs. The current, eclectic mix of topics studied reflects early resolution of specific issues. However, surgical procedures, recovery times, hospital length of stay, transit ional care facility length of stay, use of home healthcare, and patient characteristics have changed dramatically during the last decade, suggesting that new functional outcome recovery trajectories evolved.These new patterns for functional recovery and interventions merit new inquiry and reporting. The nursing studies have been well designed and have allowed the investigators to move, in many categories, through logical iterations of discovery (this is, from exploratory and descriptive work to predictive and correlational work and, finally, into interventional work). 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Australian Journal of Psychology, Supplement, Vol. 55, p8-13 Rice V. H. , Mullin M. H. , Jarosz P. (2001) Preadmission self-instruction effects on postadmission and postoperative indicators in CABG patients: Partial replication and extension.Res Nurs Health. 2; 15:253-259. Schaefer K. M. Swavely D, Rothenberger C, Hess S, Williston D. Sleep disturbances post coronary artery bypass surgery.. Prog Cardiovasc Nurs. 1996 Winter;11(1):5-14. Shaw P. J. , Bates D. , Cartlidge N. E. F. et al. Early intellectual dysfunction following coro nary bypass surgery. Quarterly Journal of Medicine, New Series 1986; 58:59–68. Soylu, M. et al. (2003). . Increased Dispersion of Refractoriness in Patients with Atrial Fibrillation in the Early Postoperative Period after Coronary Artery Bypass Grafting.Journal of Cardiovascular Electrophysiology, Vol. 14 Issue 1, p28-31 Stump D. A. Selection and clinical significance of neuropsychologic tests. Annals of Thoracic Surgery 1995; 59:1340–1344. Stump D. 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Treat-Jacobson, Diane; Lindquist, Ruth A. (2004).Functional Recovery and Exercise Behavior in Men and Women 5 to 6 Years Following Coronary Artery Bypass Graft (CABG) Surgery. Western Journal of Nursing Research 5, p479-498, Vanninen R, Aikia M, Kononen M. et al. (1998). Subclinical cerebral complications after coronary artery bypass grafting: prospective analysis with magnetic resonance imaging, qualitative electroencephalography and neuropsychological assessment. Archives of Neurology; 55:618–627. Whitman, G. R. Nursing-Sensitive Outcomes in Cardiac Surgery Patients, The Journal of Cardiovascular Nursing: Volume 19(5) September/October 2004 p 293-298

Analyse of the Two Key Moments Essay Example for Free

Analyse of the Two Key Moments Essay Just before this key moment starts, the guards takes Rebecca Nurse out of her cage, on its way to the place where people are hanged. She is astonished that John is confessing. The key moment starts with Proctor refusing to say that he saw Rebecca Nurse in the Devil’s company, or anybody else. Danforth demands that Proctor prove the purity of his soul by accusing others, but Hale advises that it is enough that he confesses himself. Parris agrees, but Danforth demands that Proctor should sign a document. Proctor says that he has confessed to God, and that is enough. He asks Danforth whether a good confession must be public. Proctor wishes to keep only his name, and Danforth thus refuses to accept his confession. Danforth orders Proctor to be hanged. Hale begs Elizabeth to plead with Proctor to sign a confession, but Elizabeth states that Proctor has his goodness now, and God forbid that she take it from him. The characters have turning points in the key moments, and I am going to discuss what happens to Hale, John Proctor and Danforth in this key moment. Hale’s beliefs in witchcraft changes, so does his faith in the law. In Act 4, he tells the accused witches to lie, to confess their supposed sins in order to save their own lives. This change of heart and hopelessness, makes Hale gain the audience’s sympathy but not its respect, since he lacks the moral character of Rebecca Nurse or, and as it turns out at the end of Act 4, John Proctor. Although Hale recognises the evil of the witch trials, his response is not resistance but surrender. He thinks that survival is the highest good, even if it means helping oneself to injustice, which honourable and truly heroic characters can never accept. John Proctor changes himself and provides a final charge of the witch trials. Offered the opportunity to make a confession that he has seen the Devil, he almost surrenders, even signing a confession letter. His great pride and fear of public opinion drove him to hold his truth, adultery, from the court, but by the end of the play he is more concerned with his personal honesty than his public reputation. He still wants to save his name, but for a personal and religious view, rather than the publics’ reasons. Proctor’s refusal to provide a false confession is a true religious and personal determination. His confession would dishonour his friends who are convicted who are brave enough to die as support to the truth. Also it will dishonour himself, staining not just his public reputation, but also his soul. He then decides to change his mind and tells Danforth that he does not want to lie, this bringing him to heaven. He has now redeemed his sin. As Elizabeth says to end the play, responding to Hale’s plea that she convince Proctor to publicly confess: â€Å"He have his goodness now. God forbid I take it from him! † In this key moment Danforth shows that his greatest interest is to protect the reputation of the court when he prompts Proctor to sign a confession, thus preventing the response of his death. I think that Danforth has changed internally but not externally. I think he believes that the witchcraft is fake, but externally he is still a strict and craving for a good reputation. If he did believe people at the end of the play, then he would not convict John Proctor, but he did because it was to late then, and his reputation would be ruined, as he has convicted people before. It is a crucial moment for the audience because they think Proctor is a bad and not a honourable man when he signs the paper. It is dramatic irony, but not as much. The audience know that Proctor does not see the Devil, to save his life by confessing and showing you don not lie, he says he has been seeing the Devil. But he suddenly changes, he rips the piece of paper representing his confession, and explains that his name is more important, he wants to show he is a heroic man, so he says he never has see the Devil, which is true, and the audience see how he is a better man, and is going to die being an honourable and a heroic man. A crucible is a melting pot, where substances are heated to a high temperature to get rid of impurities. Miller is suggesting the play is like to purge by fire, a form of ‘cleansing’. This is a metaphor for spiritual improvements as the result of a confession being exerted. It is known as ‘cleaning’ or ‘cleansing’ yourself by confessing to seeing the Devil. There is many ways to explain the name of the book and here are some more: first witches supposedly boil potions in cauldrons and a synonym for cauldron is crucible. Secondly, it has a metaphorical meaning: the society of Salem is being heated and stirred in an attempt to remove the impurities and leave only the pure members of the society. One of the central themes of the play is the spiritual development of John Proctor. It is a powerful and complex play. All of the action takes place indoors and it is very black, simplistic and it emphasises the lifestyle of the people and it echoes the claustrophobic atmosphere of the play. The play focuses on ordinary people in extraordinary circumstances. In the play Miller is discussing the forces of evil. In the attempt to cut out evil there is certainly a degree of irony. The irony in this play is that evil and tragedy actually occur from the actions of the unwise and over eager characters such as Danforth and Parris and to a certain extent Hale, who became responsible for deaths, misery and cruelty. Miller is suggesting that humans are vulnerable to evil and he aims to show that the evil generated in Salem was through a combination of circumstances for which no one person could be held entirely responsible but yet none were guilt free. The Crucible was based on real events and characters. The people of the 17th Century Salem, witchcraft were a very real and forceful threat. Many people were accused of being witches, and were tortured and executed. The discrimination of witches spread to a lot of places around the world. Witches thought to commit crimes have various ‘proofs’ of a witch including the testimony of a fellow witch, the common belief or accusation of those who live with suspected witch, cursing followed by some mischief or the person disagrees with the person when questioned. Miller was interested in McCarthy trials in the 1940s/50s and made the book parallel to it, Salem witch trials of 1682. Miller may have oversimplified matters, in that while there were no actual witches in Salem, there were certainly Communists in 1950s America. However, one can argue that Miller’s concern in The Crucible is not with whether the accused actually are witches, but rather with the refusal of the court officials to believe that they are not. McCarthyism limits, which wronged many innocents and this parallel was felt strongly in Miller’s own time. In real life, at Millers time, Abigail Williams was 12 years old, but in the play she is 17, but why did he change the age? He did this to make Abigail Williams a better character to make her do all the mischievous things she does in the play. At the age of 17, you are mature and able to make an opinion, and act more like an adult, unlike a 12 year old where you are still to young to do things adults do. Danforth was not a real person, he was made up, but the wonderful thing about him is that he is made up of 3 characters. These three characters were the judges, but they would not be as dramatic and neither strong, unless there is one person who rules, making that character more remembered, and more important to the play. Analyse of the Two Key Moments. (2017, Oct 14). We have essays on the following topics that may be of interest to you

Energy politics and Security in Kazakhstan Essay

Energy politics and Security in Kazakhstan - Essay Example Energy Sector in Kazakhstan The infrastructure of energy production in Kazakhstan is underdeveloped as a result of being part of former Soviet Union which strived to â€Å"optimize energy supply within member states rather than to achieve self sufficiency in the energy supply of each member state†. Post independence Kazakhstan had to depend heavily on energy exports for economic development. However, this dependence on energy sector caused wide disparities of income between the rich and the poor. As part of solution, Kazakhstan is bringing the oil and gas sector under the ownership of the government (Doi, 2-3). Oil Industry Restrictions from Russia Kazakhstan faces a major problem regarding the full development of its oil export industry. The oil from this country can be exported only on routes through other countries. Currently, the only route that is economic and viable goes through Russia. Russia has however imposed partial restrictions through its Transneft pipeline system . One-third of Kazakhstan’s current oil export capacity cannot move through Russia. The oil industry of Russia has also demanded a share in the profit by 30 percent from all oil exporting countries in the former Soviet Republics. The development program for Tengiz field has been postponed because of such demands and restrictions imposed by Russia. There have been considerations of using pipelines of other countries like Iran and Russia, but they are politically unviable and will take a long time. Also, Turkey will not allow movement of larger number of oil tankers that are necessary for utilization of full export capacity of Kazakhstan. In addition, oil industry requires high amount of capital investment so positive results cannot be achieved in the short run (Office of Technology Assessment, 139). China as export route China lies in the eastern border of Kazakhstan and is a major market for its oil reserves. China has introduced a ‘non-commercial element’ in the field of oil export competition for Kazakhstan. In 2004, China constructed its first oil pipeline to encourage exports from other countries. In August, 2005, China signed a deal for acquiring PetroKazakhstan for the valuation of $4 billion. It is an oil company that is based in Canada and has all its activities within Kazakhstan. Since then China holds the second position of being the largest oil producer in Kazakhstan after the latter’s national oil company. With China as an oil export route, Kazakhstan has faced positive evolution in its oil industry as supply to the world market has increased (Committee on Foreign Relation, 44). Natural gas There has been a steady increase in the production of natural gas which has transformed Kazakhstan from net gas exporter to a net gas importer. Development in the natural gas sector has been lagging behind oil because of insufficient ‘domestic gas pipeline infrastructure’ that links the gas production countries in the West to industrial region in the East. Also, there have been insufficient export pipelines. This has been a major issue as Kazakhstan does not have access to seaports. However, in 2014 when Kazakhstan-China gas pipeline will be completed, gas can be transported to the industrial region of Kazakhstan. This will also enable Kazakhstan to export gas to other countries. China and Russia are the important export partners of

Western Civilization. History and Background of Evolution Research Paper

Western Civilization. History and Background of Evolution - Research Paper Example Darwin always had an interest in nature from his early childhood years. In the years between 1823 and 1913, Russell Wallace too discovered this idea of natural choice (Kemp, p.12). Darwin’s book â€Å"The origin of species† introduced the scientific theory that stated that the people did evolve through the ages through a process of natural choice. Background of evolution In the year 1859, Charles Darwin wrote a book with the title ‘The Origin of Species’. In this book, the author stated that all the living things in the universe live in a complex web of survival where all the things have connections to one another. The source also states that hereditary disparities begin occurring in all the living creatures and this make all the species to begin reproducing in extra ordinary ways. The book describes the key to evolution as the ability to make natural choices implying that the fittest will survive through any situation. In the year 1871, Charles Darwin wrot e a book on the origin of human nature according to the issue of sex. The author attributed the way man looks and acts to the appearance and actions of chimpanzees. He says that if man looks and acts like chimpanzees then he must have come from where they live. In the year 1863, Thomas Huxley came up with evidence as to the segment of man in the natural world (Kemp, p.43). He claims that the chimpanzees and man are close and act similarly thereby implying that they come from the same ancestors. Another author by the name of Ernest Hagkel came up with the missing connection theory that suggests that man must have come from something. In the year 1924 Dr. Raymond Dart, an Australian from the University of Oxford went to South Africa to become a teacher. He described the evolution process as consisting of five stages. This are the stages one to five of the evolution process. The first stage analyses the characteristics of the fossil and dates it to be as old as 2.5 million to six milli on years old. The killer ape theory of Darwin however suggests that apes only grow to four feet and do not live past the age of four years. In an effort to verify this claims, Louis and Mary Leakey carried out archaeological discoveries in Tanzania in the year 1931. They managed to find a complete skull of a sixteen year old at The Old Dubi George. Stage two of the evolution process states man is to live for a period of twenty five years and grow to five feet tall with a brain capacity greater than 700CC. They referred to this creature as the homo habilis since they had 100 teeth and a big toe. The creatures features were almost similar to the man of today. Stage three of the evolution process makes the discovery of a creature they call Java with a brain capacity of 1,000CC, is six feet tall and can live up to 35 years of age (Kemp, p.76). It has the ability to stand straight and can also speak. They can also build better tools, start fires and raise families. The name that the crea ture gets is the name homo erectus. Stage four describes the discovery of a creature living in the Neanderthal valley in Germany and France. It has a brain capacity of 1,500 CC, teeth that are identical to those of man and stands at five feet tall. They adapt to their harsh environments by growing body hairs and having thicker bones. Stage five of this process dates back to the period between 1868 and 1928 and states that the man did live about seventeen million years ago. They described the species as having a brain similar to that of the modern man, wearing clothes and building settlements (Kemp, p.94). 2) History of Ancient Egypt from 10,000 BC to the end of the 2nd intermediate period The pre historic Egypt had a cover of ice measuring two blocks in the northern and central areas. The ice did melt down by the year

Fukuyamas Philosophical System and the Ethics of Biotechnology Essay

Fukuyamas Philosophical System and the Ethics of Biotechnology - Essay Example There is ‘something’ that separates humans from other animals. This concept leads to his other theories on bioethics. Such that experimentation on humans should not violate their dignity. And that the essence of being human should remain intact as this separates humans from animals. According to Fukuyama, factor X makes humans as the world knows them. It is the factor in the human body that cannot be reduced to moral choices, language, sociability, sentience, emotions, or any quality that has been put forth as a ground for human dignity. He terms the factor that is responsible for the dignity in mankind, the factor X. In other words, it is an ideology that each person holds. According to Fukushima, Jews, Christians, and Muslims share a common theme that the man is created in the image of God. This theory is the base for Factor X among those followers. Similarly, an atheist also has factor X, which can be a moral authority. Fukuyama is not against biotechnology. He is against violating the sacredness of humans. This concept might be abstract for scientists. Factor X cannot be calculated. It does not have that form that scientists would like to consider relevant. In fact, the concept of factor X is relevant to the person’s beliefs. Different belief systems generate different factor X’s. Such a thought might seem too spiritual for scientific study, but Fukuyama has dedicated his studies to preserve human sanctity. Francis Fukuyama, a bio–conservative, along with other writers such as George Annas, Leon Kass, Jeremy Rifkin, Bill McKibben, and Wesley Smith, opposed the use of technology to modify human nature. Fukuyama fears that the man's nature is the most precious thing that can be affected by the recent advances in human biotechnology.  

San Francisco Peaks Research Paper Example | Topics and Well Written Essays - 1000 words

San Francisco Peaks - Research Paper Example However this entire mystery was resolved in 1980 when Mount St. Helen’s erupted. It is because of this erosion that the scientists and geologists were able to figure out that due to volcanoes a mountains entire face can disappear. Further, with the help of the geological testing and aerial photos it was concluded that the San Francisco Peaks experience the same kind of erosion and that is why it took a unique formation. It is believed by the geologists that the actual peaks were more than 16,000 feet high (San Francisco Peaks) The Peaks The San Francisco Peaks are located to the north of Flagstaff, Arizona and has a height of about 12,633 feet. It is considered to be the most distinct geological mark of the Colorado Plateau. These peaks have been named after the settler in the region the early 1620s named St. Francis of Assisi, however in the local area these are referred to as Peaks. The peaks are a collective formation of six summits that encircle the volcanic crater, which is now a quiet volcano. Out of all the six, the highest peak in Arizona is Humphreys Peak that is 12,633 feet high, Agassiz Peak is about 12,356 feet and the Fremont Peak soars up to 11,969 feet. The remaining three peaks; Aubineau Peak, Reese Peak and the Doyle Peak climb up to 11,838 feet, 11,474 feet and 11,460 feet respectively. Together all these peaks make a circular ring making the peaks the most significant geological display of volcanic rocks, together with the picturesque view of the lava flows and the deep alpine forest. As the peaks are a unique formation, they provide a dramatic landscape of the Flagstaff that is isolated, huge and quite unexpected. Since the peaks are quite tower-like, these can be viewed from quite a distance even from the Wupatki National Monuments (Priest, Duffield and Malis-Clark). Today these peaks have become tourist attractions as millions of people visit this place every year. The Peaks have a protected alpine environment (Inner Basin), a ski r esort (Arizona Snowbowl) and the Humphreys Peak (the highest point of Arizona). People visit the place for hiking, wildlife viewing, camping, and skiing and wilderness seclusion. The Formation of the Peaks Arizona’s volcanic pleasures begin to form about 6 million years ago when there were 600 volcanic eruptions in the region. It was due to these volcanic eruptions that the Peaks were formed, mainly the Humphrey’s peak that soared above the terrain making it a geological landscape, otherwise it would just have been a dry and arid plateau. Although the history of the formation of the Peaks varies in the region however the general geologic history remains quite the same. Nearly about 500 million years ago the Plateau region was below or at the sea levels and the sediments of limestone began to accumulate underneath. Although most of the volcanic eruptions are near the tectonic plates in the earths crust however Arizona has been quite far from the North American Plate. Th e reason of volcanic eruptions in this region is believed to be the molten rock that is the trapped area beneath the Northern Arizona named as the hot spot. This molten rock occasionally rises, moving the plate to the west and creating volcanoes. The Peaks are believed to be formed nearly 500,000 to 1 million years ago however its inner basin has been quite since its formation (Jones). Many geologists name this formation of the San Francisco Peaks as a stratovolcano meaning that it

Unofficial support for LOTEs Essay Example | Topics and Well Written Essays - 250 words

Unofficial support for LOTEs - Essay Example For example, during marriage ceremonies, they use these languages because the main marriage makers in the city have memorized the languages. Different churches use these languages in their masses with an example being the Catholic Church since they conduct their services in Spanish, Italian, French, Polish, and Haitian. Television channels and different newspapers publish their news in LOTEs, in mayoral campaigns, the New Yorkers apply LOTEs. Finally, they allow interpretation of government proceedings for LOTEs to enhance understanding among the population (Mair 166). In NYC, dissimilar departments value and encourage the use of LOTEs. For example, both the domestic and international business sectors in the City have implemented a policy to promote LOTEs, as they believe it attracts many individuals involved in business. This method is applicable with the AT & Tlanguage line, which is a full time free telephone service interpreting more than 140 LOTEs to NYC banks, utilities, hotels and businesses (Mair 167) The ethno-linguistic enclaves in NYC support language maintenance through different manners. For example, they speak LOTEs in their homes, in business activities, churches, during marriage ceremonies and government proceedings (Mair

Reno v. American Civil Liberties Union, 521 U.S. 844 (1997) Essay

Reno v. American Civil Liberties Union, 521 U.S. 844 (1997) - Essay Example The CDA provisions were in tandem with Christian faith and the Holy bible which deplores immorality. The book of 1Thessalonians 4:3 states,† For this is the will of God, your sanctification; that is, that you abstain from sexual immorality." The Bible also states in the book of Proverbs 29:17, â€Å"Correct your son and he will give you comfort; He will also delight your soul.† This act sought to safeguard upbringing of children by shielding them from a filthy society that threatens corrupt their morality. However, in the case of â€Å"Reno vs. American Civil Liberties Union,† the court of Supreme upheld a previous lower court decision that the CDA violated two existing provisions of the constitution. The CDA act violated the first amendment that provided freedom of speech. The CDA was found also violating the Fifth Amendment by virtue of vagueness of its words such as â€Å"indecent â€Å"and â€Å"patently offensive† (Law.cornell.edu, 2014). The judges final ruling resonates with an incidence in the Bible where Jesus disregarded Mosaic Law in order to protect a more fundamental right in the book of John 8:7-8 where he saved an adulterous woman from a mob that wanted to stone her, as required by the Mosaic Law. â€Å"He, who is without sin among you, let him be the first to throw a stone at her and when they heard it, they began to go out one by one, beginning with the older ones...† Justice John Paul Steven recognized the fact that the government had the responsibility to protect minors from sexually explicit materials but expressed his concern that the provisions unnecessarily suppressed the right to provide information to adults which could be educative. For instance a discussion on birth Control practices. The court was also concerned with the criterion used to define indecent materials or communication. The court argued that CDA â€Å"community standards† criterion implied that other nation- wide internet communication would be

Video Games and Art Essay Example for Free

Video Games and Art Essay â€Å"No video gamer now living will survive long enough to experience the medium as an artform† â€Å"No one in or out of the field has ever been able to cite a game worthy of comparison with the great poets, filmmakers, novelists and poets, composers, painters and so on† â€Å"They will not evolve..† These are the arguments emphasized in Rogert Ebert’s article about video games which for me, are striking and disturbing. Appreciation of the video games as art depends on one’s own definition of what is art. Ebert said that the most articulate definition of art he has found is stated in Wikepedia. It goes, â€Å" Art is the process of deliberately arranging elements in a way that appeals to the senses or emotions. Plato, on the other hand, spoke that â€Å"art should be defined as the imitation of nature. Roger Ebert, however, defined art as creation of one artist. This only implies that one interprets a certain medium or form depending on his/her own criteria and framework. Ebert is able to consider video games as not art because his own definition of art does not match with how video games are created, executed and manipulated. In Ebert’s article, he cited Wikepedia saying that â€Å"games are distinct from work.† Games are more concerned with the expression of ideas and its key components are goals, rules, challenge, and interaction. He even mentioned and singled out the difference between art and games. Adding more to the description of games, he further cited that games have to be won. Games have rules, objectives and an outcome. Meanwhile, he uttered that art in the forms of story, novel, play, dance and film cannot involve the aspect of winning. You cannot win. Rather, you can only experience them. That’s the point. Ebert tried to see both aspects in their physicality or form, not in the way they are able to affect their audience, not really in a way how audiences experience them. Video Games are indeed art I can’t help but be amazed on how Michael Mirasol argued that video games can be or indeed art. His points were rich of supporting facts, details and insights that can really convince its readers. To him, a video game is not a meaningless form of mindless entertainment. He made it clear. Video games should be considered art. He pointed out how video games evolved through time. Video games started as monotone blocks or blips on Cathode Ray Tubes until it evolved into more advanced and complicated features. Before, video games were only created to facilitate competition but today, they are creatively made to give entertainment, pleasure and ofcourse, profit. Thanks to the leap to advanced technology that made way to its innovations and developments. I would love to exemplify Super Mario, as the first ever video game to incorporate a fairy tale story. This is what Michael Mirasol is saying. There is incorporation of the narrative, setting and characterization. Hence, audiences or games engage themselves to the game in a more intimate and exciting manner. There is emotional investment. This is the reason why video gamers get hooked to this kind of game. I would just like to quote what British author, journalist and critic, Steven Poole wrote, â€Å" A beautifully designed videogame invokes wonder as the fine arts do, only in a uniquely kinetic way. Because the videogame must move, it cannot offer the lapidary balance of composition that we value in painting; on the other hand, because it can move, it is a way to experience architecture, and more than that to create it, in a way which photographs or drawings can never compete. If architecture is frozen music, then a videogame is liquid architecture† Videogame is not merely a game. It is a medium, just like art. It conveys specific message and it forms an interaction with the gamer. The video game’s goals and the video gamer’s response complement each other. Michael Mirasol said that games are evaluated according to their components instead of the experience the video gamer is able to get from playing. Exactly. Video Game is a kind of modern art I would just like to get the idea, Mirasol cited from wikepedia. â€Å"Games are more concerned with the expression of ideas and its key components are  goals, rules, challenge, and interaction.† An art is no doubt, an expression of one’s thoughts, dreams or emotions. To me, an art is the freedom to express oneself through different forms and processes. An art indeed has goal. It is to convey message and meaning. It is to manifest talent and skill. It is to entertain, to inform, to liberate, to propagate, to persuade. Meanwhile, an art may create its own rule, depending on the creator. In terms of challenge, it is left in the hands of the reader whether he or she acccepts the challenge of going deeper into the meaning the art form conveys. Lastly, the interaction always takes place between the artform and the reader once the art is read and seen. The production of meaning is automatic. However, we cannot only leave the comparison by only comparing the similarity or di fferences of the two aspects in their components and aesthetic. Just like what I said, leave it to the experience or the overall impact the two bring. I am not really a video gamer but because of my brothers who are fond of playing video games, I also engaged myself not miss the fun and excitement. I used to play playsations with them in my elementary days. We have collections of video DVDs that contain a variety of games. There were sports, combats and alike. I remember playing Pacman, Street Fighter, Tennis, Car race, Lilo and Stitch, Resident Evil and many more. During those days, playstations were really hit. Our neighbors, playmates and cousins come over to our house everyday and play with us whole day. I only enjoyed playing video games whenever I played with them. There, I found satisfaction. When I win the game, I almost jump in joy. When I lose, it was an ordinary thing because my brothers were the masters of the video games. Then the computer came in. I was hooked with playing simcity where I build my own city, own houses and businesses and manage them. That was fantastic. I get to become the mayor of a city, virtually. And there are more decoration games, cooking games, fashion games that developed, really, my artistic and creative side. It was always a fulfillment to be able to make my own design or what I would consider, my artwork. I was even hooked to playing dress up games and cityville in computer. I really love those games. It does not matter to me whether someone says that video games cannot be art. That someone is only a small portion of the population which believes that video games are highly art. Even I,do not really eye on the label. What important to me is the feeling and the reward I get from valuing  video games as significant part of my life and as significant component of a rich culture. Nowadays, video games are no longer merely games. They mean some more else. I agree to the study about video gamers that Ma’am Eloi once mentioned. Video gamers are indeed people who can be considered wise because they know and develop strategies as the game progresses. They are able to design tactics and win battles. They are able to master their skills and sharpens their minds. They are able to squeez their creative and critical juices and come up with outputs in the end. They also get to socialize while playing the games. Thanks to the technology for the breakthrough in video games and for the convenient and more pleasurable way of playing them. More and more brilliant ideas are coming up and I will not wonder if someday, a different kind of video game is existing. Consequently, perspectives on video games will eventually change. I am certain that the evolution of video games is continuing. Someday, the mass audience will consider it an art or yet, something different and something more meaningful than labeling it as art.

Balanced scorecard is strategic planning

Balanced scorecard is strategic planning INTRODUCTION Balanced scorecard is strategic planning and management system used for business and industry, government, non profit organizations worldwide. it is used for business activities like vision and strategy of organization to improve internal and external communication to monitor organizations performance against goals. Balanced scorecard is designed by Drs. Robert Kaplan and David Norton for performance measurement in their series of articles in Harvard Business review. It is designed for executives and managers to get balanced view of organizational performance. In early balanced scorecard was only used for simple performance measurement system. The new system transforms an organizations strategic plan from attractive document into marching orders for organizations on a daily basis. The balanced scorecard system is totally works on:- -Companys Mission Companys Strategic Plan -The financial status of organization The level of expertise in the organization. -Customer satisfaction level. In the past, the organizational growth was measured in financial measures only, which were not adequate to measure the performance. However, to look into future with great value, companies must have to invest through customers, suppliers, employees, processes, technology and innovation. The balanced scorecard has emerged as a effective tool in the process to allow organizations to implement different strategies successfully. Organizations all around the globe has benefited by balanced scorecard like increased financial returns, employee alignment in with overall growth, improved collaboration and focus on strategy. BALANCED SCORECARD PERSPECTIVES Balanced scorecard divided into mainly four perspectives. Learning and Growth Perspective The Business Process Perspective The Customer Perspective The Financial Perspective VISION AND STRATEGY LEARNING AND GROWTH FINANCIAL CUSTOMER INTERNAL BUSINESS PROCESSES BALANCED SCORECARD PERSPECTIVES 1. LEARNING AND GROWTH PERSPECTIVE:- This perspective mainly includes training and growth of employee potential as well as their practical skills. Now days, there is a rapid changes in new Technologies, so the employee must be in the continuous learning mode, so that they can learn new technologies and apply it. In this perspective, it is searched that, is there correct level of expertise for the job? Employee turnover ratio analyzed in this perspective, so that job satisfaction among the employees can be measured and corrective action can be taken. The learning and growth perspective concentrate on learning rather than training, because it includes tutors and mentors in the organization so that there will be easy flow of communication and problems can be solved within organization. 2. THE BUSINESS PROCESS PERSPECTIVE:- This perspective consists of internal business processes. By using this perspective managers can know that how well their business is running, whether its products meet to customer needs and demands or not. The process alignment is checked that it is right department. The process should carefully design to meet standards of product that meets customer requirements. 3. THE CUSTOMER PERSPECTIVE:- In recent studies, it has been seen that customer satisfaction and customer focus are important for success of any business. If customer is not satisfied then they will find any other supplier who satisfies their needs. These will surely the failure of the business that doesnt meet to the customer needs. Delivery performance, quality performance, customer satisfaction, customer percentage in market and customer retention rate are some of the important aspects of customer perspective. 4. FINANCIAL PERSPECTIVE:- Financial perspective is very important to measure success of any company. When financial objectives reached, only then organization can exist successfully in the long run. This perspective expressed in the terms of budget and target achievements. This perspective focuses on the quarterly or yearly financial results, return on investment, cash flow, etc. Q. 1. Why change and how balanced scorecard approach different? The business environment in now days is very competitive in terms of product quality, market share, customer satisfaction and volatile than ever been. In order to survive in the market, organizations need to be far more efficient in the use of their resources, should understand needs of their customers, should organize their internal system and procedure, and have employees who have a far level of interpersonal skills than in the past. The financial system was mainly backward looking, focusing upon reporting achievements rather than upon the attainment and pursuit of objectives. The financial system was paying attention to fulfill short term objectives rather to fulfill long term objectives. This system need to in corporate data capture and analysis of non-financial measures, such as customer profiles, customer satisfaction, employee performance, employee satisfaction, product quality, service quality, organizational transformation and development. So, organizations need to think beyond the historical perspective of their traditional financial reporting systems. The financial system has limitations because of considering limited factors. To improve performance evaluation, there was a need to change old financial system with the more balanced and which bridges strengths of the traditional financial measures of past performance with the benefits of measuring factors that impact upon or drive future performance. Q.2) Discuss in general terms the information which would be required by a manager to implement this approach to measuring performance. The balanced scorecard approach is mainly consists of four approaches: financial, customer, internal processes and learning and growth. The balanced scorecard focuses mainly towards common goal. The process of developing balanced scorecard gives an organization a clear picture of future and path to reach there. To implement balanced scorecard, manager need to implement its four perspectives and also needs information of its key elements as follows:- Financial perspective: Financial objectives are used to represent long term goals of organization. In this perspective of balanced scorecard, a manager need to identify financial objectives of an organization and develop measures that indicate how successful the organization achieving those objectives. In this aspect of balanced scorecard, manager needs information of following measures: return capital employed return on net assets Bad debts of company Account receivables Gearing rate. Customer perspective: The customer perspective is designed to measure how well the company is meeting the demands of customers and market. The major goal of an organization is to supply for the demands of customers. In todays environment company must provide a quality product, and also timely delivery, and customer service following the sale. There are some more information which also to be considered like, The very important price of the product Customer satisfaction Customer retention Increasing customer base Delivery times Rate of goods returned by customers Customer relationship. The Internal business processes perspective: This perspective focuses mainly on internal processes to deliver the goals of customers and shareholders. This aspect works within the company. The information needs is related to: Quality control rejection rate Production lead times Level of production capacity utilization. Learning and growth perspective: This perspective identifies human relations and works to improve the Skills of employees, infrastructure and innovation. Employees are very important part of the organization and key to innovation. re Sources must be allocated to educate them on the processes of company and mission of company. This education should be coupled with the motivation. This starts with autonomy to employee so that they can suggest changes in organization. The manager should know information of this aspect: Employee capabilities Information system capabilities Level of spending per head on employee training Employee absenteeism rate Staff turnover rate Range of products This information is very important to implement the balanced scorecard approach within the organization. By having this information, manager can implement this approach in the organization to measure performance. Q.3) Comment on three specific examples of performance measures which could be used in service industry. 1. Balanced scorecard in the Hotel industry: The balanced scorecard derives its name primarily from the way it provides a structured focus upon the main organizational performance dimensions: the financial, customer, internal processes and learning and growth. Balanced scorecard thinks far beyond the traditional financial system, so that hotel appears the appropriate setting for implementation of the balanced scorecard. The first step in developing a balanced involves is determining a mission or vision. A vision outlines the purpose of an organization. After vision, we need to determine what strategy will be employed to achieve the mission. After strategy we need to translate this strategy into specific strategic objectives. If the strategic objective of staff is to be regarded among most friendly, appropriate performance measures could include: hours s pent to train staff on politeness and friendly customer engagement, customer survey ratings with respect to perceived friendliness of staff. As strategic objectives and performance measures would need to be developed for each of four balanced scorecards key perspectives. a] Financial perspective in hotel: The financial perspective contains strategic objectives that are developed from shareholders perspective. Kaplan and Norton suggest these objectives can be developed by answering the question: To succeed financially, how should we appear to our shareholders! Once these objectives have been developed, a set of financial measures generated. The financial measures includes departmental cost, cost of providing a room night, hotel profit, profit of market segment, revenue per available room, share price, revenue growth compared to budget, sales mix, operating profit compared to prior year, ROI, etc. b] Customer perspective: This comprises strategic objectives that are developed by customer point of view. To achieve our objectives, how should we appear to our customers! Once these objectives developed, a set of customer related performance measures can be developed. This includes: customer loyalty, proportion of returning customers, customer complaints, customer profitability, new customer acquisition, market segmentation, market share etc. These factors are considered while measurement of customer related performance. c] Internal process perspective: This perspective concerns the development of process related objectives that are consistent with achieving financial and customer objectives. These objectives can be developed by responding to question, to achieve our internal objective which types of processes should we undertake! A set of performance related measures are: customer billing errors, time taken to check-in, restaurant service errors, workplace safety, customer database availability, internal control practices, etc. d] Learning and growth perspective: This perspective concerns the development of organizational capability goals that are consistent with achieving financial and customer objectives. Possible learning and growth measures includes: training investment per employee, absenteeism, employee motivation index, employee satisfaction, personal growth of staff, internal promotion levels, staff retention, staff empowerment, frequency of training, etc. The balanced scorecards group-wide application has greatly increased opportunities to use the achievements of best practice hotels. Balanced scorecard provides focused approach towards the common objectives of a hotel. By using above all performance measures, we can use balanced scorecard successfully in the hotel. Refrence online book:- Accounting essentials for hospitality managers by Mr. Chris Guilding 2) Balanced scorecard in the Insurance sector:- Now days insurance sector is very competitive industry among the service industries. There are different types of insurance like car insurance, general insurance, medical insurance, etc. this sector is totally customer oriented sector and totally depends upon needs of customers. The performance Measurement of this sector by balanced scorecard is consists of measurement of its four perspectives. The mission and strategy of an insurance company is determined by board of director of company. After the strategy, the objectives and targets are set by management for the particular period of time. Then the company operates to fulfill those objectives. The measures of the insurance sector according to four perspectives are as follows: 1. Financial perspective:- The major financial perspective in the insurance sector is the share holders perspective because share holders are the important part to provide capital for the business. The measures contain cost of employees, incentives as percentage of salary, annual salary, increase in training cost, the cost per insurance, total profit earned, operating costs, total sales, share price, Etc. 2. Customer perspective:- Customer perspective focuses totally towards customer satisfaction and customer retention. Customer is leading indicator in the insurance sector, if he satisfied then only company can earn profit. The customer perspectives measures are number of referrals generated from the customers, number of customer focused products developed, decrease in customer complaints, and percentage of upgraded policies, etc. 3. Internal process perspective: This perspective works totally on developing internal processes to meet customer needs and demands, so that customer can be satisfied with the service. It improves on negative aspects of the internal system and try to improve it. The possible measures can be percentage of renewed policies to the number of policies sold, number of sales targets achieved, percentage of decrease in employee turn over, types of insurance policies generated. 4. Learning and growth perspective:- This perspective works on the employee development and corporate cultural attitudes related to both company and self improvement. It works on improving sales efficiency of the sales force. The possible measures comes under this perspective can be number of training sessions, number of brain storming sessions, number of motivational sessions, number of quality feedback from the employees, etc. 3) Balanced scorecard in the banking industry:- Balanced scorecard received a wide range of use and promotion by global business organizations and some international banks have successfully implemented this approach to measure and increase their performance. In response to different problems faced by the global banking industry like the recession of the year 2008, balanced scorecard research helps to solve those problems effectively and results in the profit. In the rapid innovation and development of financial sectors, the banking industry facing intense competition. The measures of banking Industries according to the four perspectives of the balanced scorecard are as follows:- 1. Financial perspective:- Balanced scorecard is not only indicator of appraisal system but also strategic management tool. The balanced scorecard breaks the traditional financial measurement system. It adds future value to the financial measures. The measures of the financial perspective can be improvement of product quality, time to complete orders, productivity, new product development, customer satisfaction into increased sales, reduction in operating cost, economic value, added bank profits, the per capital profit, net interest income, marketing cost, income ratio, office expenses, labor costs, loan, etc. 2. Customer perspective:- Due to intense competition, customer has become very important aspect of the banking industry. Attracting customers towards bank is very important so that the strategy of the bank should be customer focused. The possible measures of bank performance according to customer perspective can be: Market share, customer retention rate, rate of new customer, customer satisfaction, customer profitability level, customer complaints, etc. 3. Internal processes perspective:- In order to retain target customers and to meet the requirements of shareholders about financial returns, managers need to focus on customer satisfaction and improve internal processes and establish measurable indicators. In this perspective balanced scorecard not only paying attention to a simple process to improve but also confirms request of customers and shareholders as a starting point to satisfy both customers and shareholders. Measures are: product and service innovation, new product and service revenue, the new loan rate and increasing rate, the number of internal regulations, responsibility of accidents, etc. 4. Learning and growth perspective:- It includes an investment which the organization must be carried out to achieve long term performance in the future, like ability of employees, organization information system, employee satisfaction, staff violation rate, pass rate of status examination, professional development program, staff training sessions, etc. These are measures of a bank for performance measurement on the basis of the balanced scorecard approach. We can evaluate the performance of the bank by using these measures. Refrence: www.academypublisher.com REFRENCES:- www.google.com ( google books ) Magna Cara College online Library University of Wales online library Frank Wood and Alan Sangster Business Accounting 2 Chris Guilding Accounting essentials for Hospitality Managers www.magnacartacollge.org (moodle) www.academypublisher.com ( article)

Iran :: essays research papers

The salat-the five obligatory daily prayers-is also known as the namez in Iran, India, and Turkey. These prayers are only performed after ritual bathing and take place before sunrise, at noon, in the mid-afternoon, immediately after sunset, and before midnight. Mainstream Shiites combine the noon and afternoon prayers and also the sunset and midnight prayers so that they need only pray three times a day. Praying in Islam is also associated with a specified set of postures, such as standing, bowing, and prostrating. The saum is a fast prescribed only for healthy, adult Muslims during the 30 days of Ramadan; the ninth month is the Islamic calendar. From dawn until dusk, no food, drink, or sexual relations are permitted. Ill individuals and nursing women are excused, but they are expected to make up for missing the fast at other times in the year when they are healthy again or no longer nursing. The zakat or alms tax is levied annually on the crops, livestock, precious metals, and cash of all those living above subsistence and whose debts do not exceed their assets. In theory it is to be collected on behalf of, and then distributed to, the poor. However, many Islamic leaders have collected the zakat to add to their royal treasuries. For this reason, the identity of the zakat collector and distributor has often been a mystery. Since the late Middle Ages (AD 476-1453), mainstream Shiites have had the tax collected by their jurists, legal scholars of Islamic law, who act according to their self-styled role as governors of the imam. The hajj is the â€Å"greater† of the two pilgrimages to Mecca required of all Muslims.

literature :: essays research papers

In Alice Walker’s story â€Å"Everyday Use,† symbolism, allegory, and myth stand out when thinking about the characters, setting, and conflict in the story. The conflict is between the mother and her two daughters (Maggie and Dee). There is also the conflict between the family’s heritage (symbolized by the quilt, bench, and butter chum) and their different ways of life. Dee chose a new African name, moved to the city, and adopted a new way of life while Maggie and her mother have stay behind. The quilt (the most important symbol) represents the family’s heritage in that it is made of scraps of clothing worn by generations of family members. The quilt has been sewn by family hands and used on family beds. It has seen history and is history. Maggie and her mother see that that history is alive but Dee thinks it is as dead as her name. Dee does not see that name as part of her heritage. By analyzing these symbols, a number of possibilities for a theme can be seen. Walker could be suggesting that to understand the African-American heritage, readers have to include the present as well as the past. However, the theme could be that poverty and a lack of sophistication and education cannot be equated with ignorance. Lastly, she could be telling her readers that dignity or self-respect rise from and are virtually connected to one’s entire heritage- not just a selected part of it. Dylan Thomas wrote the poem â€Å"Do Not Go Gentle Into That Good Night.† It is about a son’s plea to his father who is approaching death. Two lines are repeated in the poem and addressed directly to the father. These lines structure the first stanza and collaborate as a couplet in the last. They are repeated a lot but each time, they have different meanings: statements, pleas, commands, or petitions. Repetition and rhyme scheme are parts of prosody in poetry. The rhyme scheme is built on two rhymes and forms of a pattern. The two rhymes are night and day and the pattern is aba, and in the last stanza, abaa. Even though the poem seems to have too much repetition, the fascinating imagery is more important and readers pay more attention to that instead.

Essay --

Word Count: 1486 The Differences in Lucy Salyer’s and Cybelle Fox’s Criteria For Citizenship Throughout American history, the United States government created policies that decided who can and cannot come to America to be recognized as a full fledged citizen: an individual who has been recognized as a loyal member of a nation and receives benefits granted by the government. Lucy Salyer, author of Baptism By Fire, and Cybelle Fox, author of Three Worlds of Relief, emphasize that the government based their immigration policy on issues such as race and occupation. Despite their agreement that the United States government played a major role in deciding who can and cannot become full fledged citizens, Salyer and Fox disagree on the main criteria in which they decided which immigrants could have this recognition. Salyer argues that immigrants’ race and service decided whether they should be included or excluded from full citizenship, while Fox asserts that individuals’ occupation determined this matter. As Salyer and Fox both mentioned, the government played a vital role on deciding who can become citizens through legislation, organized groups, and judicial rulings. The government can be defined in this case as legislatures, agencies, and the justice system. Throughout American history, legislatures made laws in which included and excluded newcomers to America. Aristide Zolberg, author of A Nation by Design, emphasizes this by stating, â€Å"nationality involves the delineation of a boundary, denoting simultaneously inclusion and exclusion† (Zolberg,17). A country can tend to be welcoming or unwelcoming to foreigners. In the United States, legislatures have been inclusive and exclusive to foreigners depending on the national interest. Lu... .... 56% of workers were covered, while 67% of them were Europeans and 57% were white. According to Fox, Europeans benefitted the most since majority of them held manufacturing jobs and were more likely to turn sixty-five when it was grandfathered in. Yet, approximately 38% of Mexicans and blacks were covered. This was due to the majority of them being agricultural workers or domestic workers. Therefore, Europeans held occupations that allowed them to meet the criteria for social security benefits, while Mexicans and blacks did not (Fox, 251-253). Salyer and Fox agree that the government played a role in shaping immigration during the 1920s and 1930s. Yet, they disagree with the criteria that the government used to decide who received full-fledged citizenship. This debate still continues today and this nation continues to base a criteria on who to include and exclude.

Prejudice Definition Essay

During the process of communication the vast majority of people judge cultural values in their own image and likeness. Their ethnic and cultural values serve as a criterion for judgment. Really, it is slightly confusing but the main reason for watching the foreign programming is to let the viewer ‘feel’ ethnocentrism. Some things or even an overwhelming majority of what you will see in the foreign film of program will feel a bit ‘off’ or even downright ‘wrong’ for an average American. This feeling occurs due to ethnocentrism. The paper examines how such an attitude can have influence on an individual’s behavior and response from another culture, how society wide ethnocentrism can affect relationships and understandings of other societies, and how it can have an adverse impact on business practices for multinational corporations. Japanese version of the foreign film â€Å"Shall We Dance† will be used as an illustration for some aspects of the paper. Ethnocentrism is a psychological reaction, which occurs when a representative of one culture perceives, sees, values and tries to understand other cultures and their behaviors through prism of his own culture. The person considers the elements of his own culture (standards, roles, values, etc) as natural and â€Å"right†, while the elements of other cultures and nations are considered to be unnatural and â€Å"wrong†. The customs and traditions of his own culture are considered to be â€Å"universal† and â€Å"right† as well. The film â€Å"Shall We Dance† by Masayuki Suo tells us the story of Shohei Sugiyama, who falls in love but not in other woman (being married), but in the art of dancing. When we watch the film, we feel the differences between Japanese and American cultures. Japanese culture seems to be very odd, alien and strange, as the world of dance socials and private lessons is considered ‘shameful’ and ‘improper’ for a Japanese person. The film gets insight into Japanese customs and traditions, explaining that in Japan married couples are more reserved in relation to each other and rarely express their emotions in public (e.g. never say ‘I love you’, or hold hands, etc.). The American nation, on contrary, is more emotional and more ‘open’, therefore we feel really odd while watching the movie. The ethnocentrism that occurs in result of watching the foreign programming evidently has an impact on our behavior. Probably, to a certain extent we are unable to understand the behavior of other cultures in a manner different from that one dictated by our own cultural environment. So, how such an attitude can have influence on a person’s behavior and response from another culture and how society wide ethnocentrism can affect relationships and understandings of other societies? As with any social-psychological phenomenon, ethnocentrism cannot be examined as entirely positive or entirely negative. Although ethnocentrism often put obstacles in the way of intergroup (intercultural) communication, it supports positive ethnical identity and keeps the integrity and specificity peculiar to a certain culture. At the same time, ethnocentrism is inevitable part of our live being a logical consequence of socialization and familiarization with another culture and understandings of other societies. The person’s response predominantly occurs in the form of comparison – a peaceful nonidentity. Yet, ethnocentrism can have an adverse impact on business practices for multinational corporations, because it often impedes effective intergroup (interethnic and international) communication (Allport 1954). Interethnic comparison can be expressed in the form of contraposition or setting off (e.g. the people deny intercultural differences; proclaim their culture to be superior; sometimes people perceive cultural differences as something that imposes a threat to their existence and try to withstand them, often resulting in conflicts between different cultures, etc) that, in its turn, implies at least preconception and prejudice in relation to other cultures and has an adverse impact on business practices for multinational corporations. References Allport, G. W. (1954). The Nature of Prejudice. Garden City, NY: Doubleday

Arts

One of these checks recently preformed was of a 67 year old patient who presented for a hysterectomy. She ended up with complications and subsequent treatment for these complications, all care was provided by Nightingale Community Hospital. Mistakes were made with this patients care and corrective actions will be taken. It is cases like these we strive to correct, in order to become â€Å"the hospital of choice for patients, employees, physicians, volunteers, and the community. † (Nightingale Community Hospital, p. ) In order to learn and grow from the mistakes made with our tracer patient, we must identify specific mistakes made and develop a corrective action plan to address the improvements we are going to make. According to the information provided by our tracer patient's worksheet, it was determined the patient presented for â€Å"librarianship hysterectomy that was converted to an open procedure due to excessive bleeding approximately five weeks prior to hospitalizing. † After examining our patient's worksheet, or fact sheet, a few items throughout their care with us was not up to standards.First mistake found was our tracer patient did not have an admissions assessment thin the 24-hour window, starting with the time of admissions. The tracer patient's physical was done over 72 hours after admission. Second, the staff reported completing a functional assessment but there was no documentation supporting this claim in her chart. Third, the nurse evaluated the need for an advance directive, found none to be present, and requested the family bring one with them. The family never followed through and did not provide it.Fourth, the nurses did not update the tracer patient's plan of care since the surgery, and this assessment was done 5 weeks after surgery upon re-admittance. Fifth, a pain assessment is supposed to be done within an hour after pain medications are given. The night before this assessment, the follow up was done over an hour after th e pain medication was distributed 4 times. Sixth, the tracer patient's oxygen tanks were not secured properly and her room's air vents were dirty. Seventh, the nurse was not able to explain range order or give a proper range in milliards.Eighth, hand off communication is poor when patient transfers units and or providers. The SD, OR nurse and PACIFIC nurses employed all evaluation tasks properly. As you can see, many steps required for safety were either incomplete or overlooked. In order to bring this tracer patient up to the standards of the Joint commission a corrective action plan needs to be made. For this assessment I am going to concentrate on the issues of medication range orders and communication during the hand off process.Medication range orders are very important because they can prevent over fusing and under dosing. Over dosing has obvious consequences or poisoning and even death, under dosing can lead to the patient Ewing in unnecessary pain. The hand – off proc ess is very important and was addressed in prior assessments. This is where most mistakes within a hospital take place. A hand-off can include when a patient goes from one department from another or even when there is Just a shift change.In our previous case, the disorientation or the hand off lead to one of Nightingale Community Hospital's patient's Tina, to be discharged to a parent who did not have custody of her, resulting in a sentinel event. 2. 1 . Nightingale Community Hospital needs to repeat the steps taken to evaluate the racer patient on a wider range of patients. They need to re-evaluate the care of at least 100 patients receiving general anesthesia and inpatient surgery within the last 60 days.This is an important step to take to make sure these mistakes were not made as an isolated incident and more as an over all hospital wide issue. Assuming these mistakes are typical to Nightingale Community Hospital, it should proceed with the following steps. 2. Nightingale Commun ity Hospital will concentrate on two specific failures: medication range orders and communication during hand off process. These areas need to be a priority because they have the greatest consequences. Poor communication leads to almost all patient issues and medication dosage can quickly lead to fatalities. . In regards to hand offs and transferring, the Joint commission requires â€Å"The hospital's process for hand-off communication provides for the opportunity for discussion between the giver and receiver of patient information. Note: Such information may include the patient's condition, care, treatment, medications, services, and any recent or anticipated changes to any of these. Anoint Commission, 2014, p. 1) As described in the tracer patients information, the hand-off preformed was â€Å"Disjointed hand-off process, inconsistent use of handcuff form. To correct this staff, specifically all nurses and transport staff, will be re-trained how to transfer patients. Executives and unit super visors will collaborate on making a check off list, including such items as patient condition review, care treatment, medications and services (as recommended by the Joint Commission), which the two providers who are handing off the patient will both initial and review. . After the executives and unit supervisors develop the check off lists for all departments, an online training session will be mandatory for all employees.It will followed with a brief in person review of all employees by their unit super visors within 30 days of the implementation and the results will be kept in all employee files. The people responsible for this issues are the nurses and the transport staff. A measure of success is going to be a check off list, which has specific questions both the send off person and the receiving staff will have to fill out. Both of the questionnaires will be filed in the patients chart and their will be a set for each hand off the patient encores throughout the d ay.The question air protocol will start in two weeks from today. This will go on for one week throughout the entire hospital. Each of the lead super visors for each division or floor will then compile these questionnaires, compile a report for each staff member and review the findings with the staff member within 20 days following the one week assessment. They will discuss what can be improved generally and what the employee needs to specifically irking, if anything. C. Similar actions will be taken for range order re-training.Range orders are â€Å"medications in which the medication does may vary over a prescribed range, depending on the patient status. † (, 2009, p. 2) The important of training for range orders is clear. If over dosed, a patient can be killed, and if under dosed, the patient is in pain. Again, the executives and department super visors will collaborate to create range order guidelines and a re-training program. Rather then having this training be an all st aff and employee requirement, range order training ill only be implemented with employees who distribute medications.Training should spread further then physicians and nurses, but also to Urn's aids and certified nursing staff. It is important for them to have this basic training, even through they are not changing the distribution amounts, but they will be better able to spot a mistake if they have further training. The people responsible for this action are all staff members who distribute the medications. The measurement of success is going to be an audit, done by the nursing lead for the day. The lead will audit all charts for he last two hours of each persons shift.The staff will not be informed of this audit. The lead will look over any medications passed to the patient. Calculate what the text book dosage range is, make sure what was given to the patient was within this range. The lead will have on week from tomorrow to start these audits. They will go on for one 24 hours per iod throughout the hospital. The leads will have one week to compile the data, and one week following to have the reviews with the staff. During the review and nurse will distribute a pamphlet overgrowing orange order dosing.