Rhetorical Analysis: Carl Becker Ideal Democracy Essay

Millions of people were dying and millions more were about to die. Ideal Democracy was a speech written and spoke by Carl Becker at the University of Virginia in 1941. At the time the United States had just joined into War World II. Many people had little faith in the war and thought we were just throwing away lives. Becker was invited to the University of Virginia to deliver a speech associated with the founder, Thomas Jefferson, but have no subject. According to l Becker the American Revolution not only wanted to have independence from Great Britain but also wanted to establish a new and better form of government, an ideal democracy. Ideal democracy, a system of government that is created by the people, for the people and run by the people. Becker then proceeds to voice his opinions on this form of ideal democracy and our current democracy. Becker belief in ideal democracy was that it was run of the people, by the people and for the people. However his view on real democracy is that it is a government of the people, run by politicians for groups that can get their own interest taken cared for. Over the years the line between what Becker’s belief of ideal democracy and real democracy, that Thomas Jefferson tried so hard to protect, were starting to become a blur. Becker saw an opportunity to change the viewpoints of many Americans by starting with this speech for the University of Virginia students and staff. One of Carl Becker’s many points of writing this speech was to bring awareness of what we were fighting for at the time of war world II. At the time many Americans didn’t believe in the war and had doubts about getting involved. Becker saw what the war was protecting. Becker saw that it was protecting the little things everyone in the nation took for granted, our democracy. In 1776 the United States and their founding fathers declared  their independence from Great Britain to establish freedom. The founding fathers, including Thomas Jefferson, put everything on the line for their vision of a new free world. On December 7th 1941, Japan threated the founding fathers vision of a new free world by attacking Pearl Harbor on the island of Oahu, Hawaii. On December 8th 1941, the United States even though they were already fighting declared war officially. One point in his speech he compares Napoleon, Stalin, Mussolini, and Hitler to democracy explaining that, â€Å" if this what we mean by democracy, then virtually all forms of government are democratic, since virtually all governments, except in the time of revolution, rest upon the explicit or implicit consent of the people† (Becker, 148). In the eyes of Becker losing the war meant losing democracy and everything the great nation of the United States had worked so hard to get in the first place. Through out the speech Carl Becker kept a very formal diction to insure to his audience, the American people, that he was respecting the topic. Ideal democracy is a very important topic and by keeping a formal diction, it showed his audience that he understood how much this topic affected them. Becker was very technical in his speech given. Becker also understood that the more technical he could be the more specific he could be. This also meant that the audience could listen to his speech and know that he knows what he is talking about. Becker made many references to other authors like James Bryce and his work Modern Democracies. Bryce was a British academic, jurist and historian who at one point in his life was the British ambassador for the United States. Bryce had a similar idea to Becker where, â€Å"power will be shared by all, and a career open to all-alike† (Bryce, 48). By Becker referring to a well know academic and historian he has now appealed to the audience’s ethos. Becker also touches on the subject of Napoleon, Stalin, Mussolini, and Hitler and how if we don’t fight in this war we will lose everything we have worked for; this is appealing to the audience’s pathos. In one other part of Becker’s speech he says, â€Å"In the twelfth and thirtieth centuries certain favorably placed medieval cities enjoyed a measure of self government, but in most instances it was soon replaced by the dictatorship of military  conquerors†(Becker, 150). Becker continues to go on with more and more detail about the twelfth and thirtieth centuries loading the audiences with facts. All of these facts are a clear link to the audience’s sense of logos. In most of Becker’s Sentence they contain subordinate clause as well as an independent clause. Clearly not all of the sentences were like this however most of them were complex sentences. For example Becker wrote, †From this brief survey it is obvious that, taking the experience of mankind as a test, democracy has as yet had but a limited and temporary success†(151). Of course not all of Becker’s sentences were like this, there were signs of all four types. The next most notable would by the simple sentences, with only an independent clause. There are several examples of these in the speech as well. Over the course of Becker’s speech there were many other authors Becker chooses to include in his speech. Some of these authors were James Mill, and James Bryce. According to James Mill, â€Å"He thought that when the legislature no longer represented a class interest, it would aim at the general interest, honestly and with adequate wisdom; since the people would be sufficiently under the guidance of educated intelligence† (Mill, 74). This directly links Mill’s statement with Carl Becker’s statement, â€Å" Napoleon called his government a democratic empire, but no one, least of all Napoleon himself, doubted that he had destroyed the last vestiges of the democratic republican. Carl Becker’s thoughts and ideas are expressed almost exactly how he wanted them to be through someone else’s words, James Mill. Becker started to bring the idea back of ideal democracy; just because past civilizations couldn’t keep democracy does not mean that the United States is just going to give it away. Becker compares the most ideal version of democracy there is and explains how the United States also does not have the perfect form of it either. Becker explains how the United States democracy is for special interest groups and not for the people. Becker wants democracy run of the people, by the people and for the people however the United States current government is of the people, run by politicians for groups that can get their own interest taken cared for. He wants to see change. Becker did an amazing job when he wrote this speech clearly thinking of every possible thing. He gets right off the bat and explains that if we don’t fight in this war we will lose our democracy and everything we take for granted. In his speech he keeps a very respectful and formal tone, as the current form of government and war are a very touchy subject for most people. Becker includes several examples for the audiences, which was the university of Virginia students and staff, to relate with ethos, pathos, and logos. His sentence structure was very complex often with a subordinate clause as well as an independent clause. Becker related and brought in quotes from several other authors who all illustrated his point very well. Becker also wanted to see while we were fighting for this form of democracy that we shouldn’t be happy with what we have but strive to get that perfect, ideal, form of democracy. Works Cited The Purdue OWL. Purdue U Writing Lab, 2014. https://owl.english.purdue.edu/owl/. September 18, 2014. NNDB.CarlBecker, 2014. http://www.nndb.com/people/461/000099164/ September 18, 2014 Becker, Carl. Ideal Democracy. Virginia: Becker, 1941. Speech Mill, John. Autobiography. Columbia press, 1924. Book Bryce, James. Becker’s notes. N/A: Becker 1923. Notes

Freedom: Political Philosophy and Populous Positive Liberty Essay

Freedom remains the sole basis for American society as we know it. Without freedom the great nation of America would have never been founded. To understand the true principles of freedom, one must understand the scope of the word. Philosophical freedom encompasses the ability to make choices without restraints, while political freedom is the state of being free rather than in physical confinement. Despite the importance of these ideas to our founding fathers, freedom has lost much of its importance in modern American society. The failure to stress the importance of freedom has diminished the quality of life for the entire American populous. Positive liberty is the freedom for one to become all one can (Postive Liberty). This idea can be considered, in general, a totalitarian principle because leaders following this ideology often believs it is within their realm to force the citizens to become all they can be. But this could also be considered democratic through governmental programs such as welfare, affirmative action, and many others created to better society. Yet negative liberty, is the primary one we want in our lives. However negative liberty is the freedom from the constraints that limit us (Negative Liberty). In sharp contrast to the totalitarian principles of positive liberty, negative liberty is based more on libertarian principles in which the government takes the backseat allowing people to thrive through their own actions. A real world view of this would be the Conservative principle of laissez-faire, an idea that the government should stay away from enacting laws that limit buisness. Liberty constitutes a small principle in the immense ideals of American freedom. Even though Positive liberty seems like a negative thing when combined with the ideals of Negative liberty a prosperus society can be created. To understand the importance of freedom in American society, we must go back to the beginning: the Declaration of Independence. Jefferson framed the constitution around the concepts set forth by John Locke, the father of liberty. The Declaration of Independence created a way to free ourselves from the injustices done upon us by the English monarchy. This document set forth the basis of what a government can reasonably do to protect and tax its citizens, before being beyond the appropriate scope of its power. When the government exceeds this power one must consider this an infringement on freedom. This governmental basis becomes extenuated in the Bill of Rights, the foundation of the US constitution. The Bill of Rights remains the true source of our freedoms as American. These freedoms include speech, religion etc. These freedoms were â€Å"to be held dear† by all members of our society. As a result off the plasticity of these amendments, the American elitists can interpret these for their own ideas. Since the beginning of America, Elitists have found a way to hinder the lower and middle classes involvement in government through the enormous amount of money required to create a successful election campaign. Taking on an elected role in government is supposed to be a freedom every member of society can achieve, but with the fiscal importance of campaigning it is not possible. In the 2004 election campagins alone, canidates spent $144 million dollars out of their own pocket. (’04 Elections Expected to Cost Nearly $4 Billion) As displayed by the Bush family, these elitists continue their stronghold on American government. If the lower to middle classes can’t find a way to break the barriers that bar them from governmental participation, their quality of life will remain vastly behind that of the elitist. To break these barriers the citizens must resort to using the principles guaranteed to them through both the Bill of Rights and the Declaration of Independence. Positive Liberty allows us as citizens to bring ourselves to become the best we can, which destroys class barriers completley. While Negative Liberty allows us to in any manner possible liberate ourselves from this lack of freedom. One day in regards to a situation like ours, Jefferson said â€Å"Experience hath shewn, that even under the best forms of government those entrusted with power have, in time, and by slow operations, perverted it into tyranny† (Thomas Jefferson Quotes). In high ranking offices, lower and middle class elected officials would be able to take stands to protect their peers, not the big buisnesses that are being protected now. This â€Å"ruling class† has also enacted laws that protect only their interest. In 2001 the Bush administartion created a pakage to eliminate the estate tax, which applies only to the richest 2% of Americans (Estate Tax loss will punch whole in Budget). Through this idea most of the capital owned by these millionaires is never taxed. How fair is that? Also the upper class leaders have taken stands to protect big buisness, allowing them to place subsidaries in tax havens around the world preventing most of their income from being taxed. Even though this idea allows the economy to flourish, the national debt continues to rise for the good of these elites. Throughout the course this nation has taken, the freedom we hold the dearest – the First Amendment – has been limited through some congressional and executive rulings. Not only have governmental rulings limited these rights but also the members of the â€Å"ruling class'† control over media and other sources of information. Most media outlets our controlled by wealthy people, who greatly support the elitists running for higher ranking ruling offices, often donating to their campaigns (Who owns CNN? or MSNBC? ABC? ). Without the ability for someone outside this select fraternity to own a prestigious news outlet, propaganda is easily spread without any notice by the people. Not only has our ability to gain any media control diminished, but also are right to freedom of speech has diminished. The people within the nation that is considered the most free and democratic, often find themselves facing oppression when they attempt to speak against the injustices committed by their government. In one situation a man refused to go to the specified â€Å"protest zones† designated by the Secret Service, often miles off the path of the presidential motorcade, he was then charged with disorderly conduct (Free Speech Zone). How free is that? This oppression must be cast off by the people in an attempt to right our sinking nation. Tapping phones for police or governmental purposes often requires just cause, but who needs that nowadays. President Bush thrust off any judicial oversight required to tap phone lines and served as the catalyst behind many unnecessary and illegal phone taps. As we take a stand against the abuses by the government against freedom as citizens, we must remain in our boundaries to provide ourselves the greatest opportunity to garner support throughout not only the area, but the nation. If we advertise our views too radically, our chance to improve our quality of life will fail. Pursing freedom outside the scope outlined in the constitution creates almost an anarchy, which often does not increase the quality of life but lowers it greatly. The battle for freedom within America has taken a turn for the worst as can be seen through this minute amount of examples provided. Elitists continue to rule the nation uncontended by anybody. The exponential rate at which our freedoms are being not only diminished but taken away can only be stopped through the political activism of everyone involved in this great community. Even though as a single person, we appear small in the grand scheme of things, it only takes one person to start explosive reforms..

Individual work Essay Example | Topics and Well Written Essays - 500 words

Individual work - Essay Example Service delivery industries’ success is dependent on customer satisfaction. Lack of respect and ethical impairment is also visible among the company staff. For instance, the hotel’s manager insults the disabled guest of being unable to get to the dance floor instead strategizing on the required changes for improving on service delivery. One of the possible means of addressing these issues is the assessment of the service quality for improving service delivery, identifying customer problems and ensuring satisfaction. The manager should also identify and target the service needs of clients in order to satisfy them. The staff members should always be able to handle all guests regardless of their age and gender. The client should establish a service culture through staff training. The management should not be focused on the number of guests they receive, but the quality of service they offer. The guest’s expectations can only be achieved if the challenges facing the employees are addressed adequately. Listening to the employees enables the management to identify and curb the challenges facing them. The new employees should be tested to prove their ethical qualifications. This ensures that the services being offered to customers are of high quality. Guests should not be discriminated under any consideration regar dless of their physical strengths or weaknesses. The client should include regulations capable of accommodating the emerging services. The client should also ensure that all the services offered conform to current changes in technology. For instance, the disabled guest could have accessed the dance floor if the necessary technology was available. Lack of prior booking by the guest is an indication of existence of poor marketing and inefficient awareness. This implies that the client should invest in promoting marketing and customer awareness. The main

A historical and critical analysis of an entrepreneurial venture (Gap Essay

A historical and critical analysis of an entrepreneurial venture (Gap Inc.) - Essay Example He believed that he could do the business his own way creating a unique entry into a market flooded with casual wear stores. 1.2 The Entrepreneur Gap Inc. is an organization whose brainchild id Don Fisher and his Doris. The business started as a small family business in San Francisco where he lived with his family. Don came from a middle class family, which had settled in a two-storey house in San Francisco. Don had great vision from early stages in life. He could recall great constructions in United States such as Golden Gate Bridge, which sparked his life to create a difference in a lifetime. His personal life includes spending time in the beach as a way of enjoying his weekend. Don attended UC Berkeley University where he studied business administration degree (Don, 2009:12). Don recalls that his business ideas came from his early days in the University where his, which he attest did not cut across his mind. Don worked as US Naval reserve and participated in making decisions for h is father in business meetings. He married Doris who altered his life to become a renowned entrepreneur a cross the globe. 1.3 Opportunity for the venture Don had the idea that business could not just pay his bills but would also excite him. He took some time to achieve this ambition. Don asserts that without bad lack Gap Inc. would not be in history. Don who had been in business with his father, branched out to initiate his own business in mid 1960s. Don used the first opportunity that came his way when he bought Capitol Park hotel. He refurbished the building and leased some of its space to Levi’s sales representative. Levi’s sales person took the opportunity to open a showroom within the building. Don mentioned that he enjoyed the arena created by the showroom in the building. Opportunity for the business venture came when Don could not find the right pant size. He had bought pants that could not match their needs. Don recalled that Doris and him walked through the streets of San Francisco and failed to get the right sizes. Then the idea came what if someone stocked all sizes. 1.4. The motivation to found the venture Don motivation was Levi’s showroom in his capital park hotel building that he had bought. Don and Doris figured the situation around the city and felt that it was a good idea to create their own retail store that would cater for age 12 to 25. The urge to change the underlying situation motivated their idea of business. Don had stated that he had little idea about retail business but that could not let his views collapse in one drop. Don noted that he did not have a similar competitor in San Francisco bay that had similar products. Business personalities are keen to evaluate factors that would make their business thrive. 1.5. Exploitation of the venture and acquisition of resource Don thought of the name of his new venture and settled to name Pants and Discs. His wife Doris changed the name by giving the business opportunity the name Gap. Don conducted a market research before a writing a business plan about the intended store. He noted in his market research that the location of the Capital Park building would address the needs of customers age 12 to 25. The location had adequate parking. He outlined that his success would depend on right employees and adequate stock. He could not afford to ignore the influence of stock or capital for the business. Gap creation was to exploit the existing resources that Don acquired. Resource acquisition and

The English Legal System Essay Example | Topics and Well Written Essays - 2500 words

The English Legal System - Essay Example Moreover, the method of making laws is not a result of one night’s effort rather it is an outcome of intense thought process. Subsequently, a few prominent methods of law making in England and Wales is firmly rooted in the medieval history while other methods are seen to have a strong affiliation and a set of implications from the post-World War II. Although the differences in the time period is attributed to the methods of law making but the influence of social, technological and political components is apparent in law making methods irrespective of the differences in the time period. A number of processes are required to be completed while formulating laws before their full-fledged enforcement (Weait, 2011, p. 11; Weait and Goodey, 2011, p. 69: Howells et.al., 2011, p. 144). Correspondingly, this essay intends to explain the different processes by which law can be changed. Subsequently, the essay also presents arguments both in favour and against the statement, â€Å"At one level law reform is either a product of parliamentary or judicial activity. Parliament tends, however, to be concerned with particularities of law reform and the judiciary are constitutionally and practically disbarred from reforming the law in anything other than an opportunistic and piecemeal way†. House of Commons and the Houses of Lords constitute parliament in England and Wales. The members of the House of Commons are elected individuals by public from different constituencies. On the other hand, the members of the House of Lords are nominated by Prime Minister of the country. Both the houses of parliament are required to perform various functions among which engaging in discussions and debates in order to pass new laws is considered as one of the major functions. Laws that are enacted by parliament are discerned as Acts of Parliament. These laws are also commonly known as legislation or statute (Arthur et al., 2011, p. 92). The English law system is also widely known

Fundamentals of Corporate Finance Term Paper Example | Topics and Well Written Essays - 500 words

Fundamentals of Corporate Finance - Term Paper Example According to the research findings, it can, therefore, be said that the overall return on equity of the company has experienced a mild increase such that it climbed up to 16.20% in 2008 from 13.69% in 2006. A major factor which boosted such increase in ROE is the rising financial leverage despite the fact that the net profit margin and asset turnover of the company have declined. Thus, it can be concluded that the increase in both net income and equity in all the three years have effectively contributed to the higher return equity ratio of the company. The operating performance of the company is demonstrated by net profit margin. The net profit margin of the company has decreased from 2.36% to 1.91% in the period ranging from 2008-08. Although, the net income of the company has increased considerably, however, net sales of the company, has increased more than that of net income yielding in lower net profit margin. Due to the heavy increase in the total assets of the company, the tota l asset turnover of the company remained quite low as the total assets could not generate the similar level of sales. In three years’ time, asset turnover of the company has reduced from 2.62 times to 1.55 times. Financial leverage of the company has increased significantly because of the increase in total assets and stable equity position of the company. It experienced an increase from 2.21 times to 5.44 times in these three years which is more than double, contributing significantly to the overall return on equity of the company.

Reflect on Challenges and Successes Assignment Example | Topics and Well Written Essays - 1250 words

Reflect on Challenges and Successes - Assignment Example How they would overcome the challenges to boost the learning process as a whole. Modifying of the curriculum to fit the learners’ best interest was part of the research. This paper was prepared from materials and articles obtained in the library. Other data collected was direct to the field study at near local schools where I attended their full-time curriculum and interacted with the learners as well. I also used books on education to relate to my field study. Through the interaction with students, also had questionnaires that were both oral and others were in written form to those who wanted confidentiality. Most of the learners came out freely and told their mind of what they thought education was like (Hopkins 2008). According to, Philpott, a Masters student from the University of Edinburgh, she comes out clearly and explains the challenges that are facing the school system. Also from the researching policy, I found that despite the existence of the comprehensive structure of roles and responsibility, several policies do advocate for educational issues of health and HIV/AIDS and biased gender. Subsequently, there is seen to be the lack of effectiveness of the communication flows, monitoring of the learners, training of the teachers and overall evaluation of the education curriculum system (Radin, 2006). Lack of trained personnel and lack of essential learning equipment to both teachers and the students due to increased poverty level that has resonated the entire school environment. Most institutions lacked qualified trained personnel. Scarcity of reading and learning materials by the developing nations is seen to be a challenging factor as well (Radin, 2006). Socio-cultural practices are also witnessed to paralyzes the education system where in some ethnic groups do not offer education to the girl child terming it a misuse of finical resources. Cases of school dropout are amongst the most

Business Plan Proposal for Devoted Medics Research

Business Plan for Devoted Medics - Research Proposal Example From this discussion it is clear that the numbers indicate a growing customer base, the volume of these calls has seriously strained the clinic due to shortage of staff members at the call center. However, the clinic cannot afford to hire additional staff, thus the only option is to improve efficiency and customer satisfaction by using modern technologies and encouraging teamwork among the clinic’s staff members.This study outlines that as a privately-owned clinic, Devoted Medics is led by a management team comprised of one physician, a nurse and a technical manager. The technical manager is in charge of the call center, where two assistants take customer requests. Currently, the call center still operates on a switchboard operator where the assistants pick the calls and ask the caller whether they are calling about an earlier issue or they are following up on an earlier issue. The assistants then forwards the call to a customer care representative who addresses the callers ne eds.  This process is very cumbersome, considering the number of calls that have to be forwarded as compared to the call center workforce. Accordingly, this calls for a more modern contact center that does not put so much pressure on the workforce, but rather encourages teamwork.  The primary goal of Devoted Medics and any other clinic for that matter is to deliver quality and coordinated health care to patients.

Crime Scene Documentation Assignment Example | Topics and Well Written Essays - 500 words

Crime Scene Documentation - Assignment Example In these cases, the accused is always acquitted as charges levelled against him/her cannot stand due to the malicious acts of the officers of destroying evidence that the court was to rely on. In the case State v. Blair 2013 Ohio 1270, the second district appellate court dismissed an indictment as a result of a law enforcement officer destroying a materially exculpatory video, which the defence was set to rely on in the case. The felony that was committed in this particular case was an assault, which was made on a law enforcement officer (Acker & Brody, 2013). There is a legal standard that is in place that bars the state from convicting the defendant in the following circumstances; if the state and in this case the prosecution together with case investigators fail to preserve â€Å"materially exculpatory evidence† or if the state acts in bad faith to destroy evidence that is potentially useful (Acker & Brody, 2013). In any scenario if the evidence involved is classified as materially exculpatory it is not the defendants duty proving that the state acted in bad faith to the court destroying the evidence however, the defendant only needs to prove to the court, it was the sole duty of the state to preserve that particular evidence despite destruction occurring either due to negligence or in bad faith (Gorelick & Solum, 2009). In so doing, the defendant has a duty to convince the court on the importance of the evidence to that particular case (Acker & Brody, 2013). This case involved a situation whereby a police officer tried to arrest a young man. The man in this case Blair tried to resist arrest as the officer had not fully explained to him the felony he had committed. The police officer decided to manhandle Blair by kicking him and choking him in order to arrest him successfully. Thus, in the process, there was a by-passer who was watching the whole incident and recorded it on his cell phone but noticing, the police

The Yellow Wallpaper - Reading Response Essay Example | Topics and Well Written Essays - 750 words

The Yellow Wallpaper - Reading Response - Essay Example Considering the lonely and bored state of the narrator, one could certainly understand her obsession with the color and patterns on the yellow wallpaper, as she comments, â€Å"It is the strangest yellow that wallpaper! It makes me think of all the yellow things I ever saw- not beautiful ones like buttercups, but old foul, bad yellow things (Gilman 3).† However, the themes and patterns that this first person narrator sees in the yellow wall paper are not limited to a senseless and misplaced imagination, but rather are related to the issues and problems being faced by the narrator, in the context of her position and status in life. Yet, in a way the story The Yellow Wallpaper throughout remains uncertain and unclear about the narrator’s mental state and health. The other thing is that being limited to the confines of the upstairs nursery; the narrator is left with nothing to do, but, to think about the ugly yellow wallpaper with irregular patterns. At the start of the st ory the patterns and designs on the wallpaper appear senseless and meaningless to the narrator. In fact she positively finds the wallpaper to be boring and uninteresting. However, as the condition of the narrator worsens, this wallpaper begins to take an entire new meaning and importance for her. The wallpaper emerges to be the canvass on which she projects the imprints of her disturbed mental state and her suppressed emotions and aspirations. As her mental condition deteriorates, and perhaps she begins to lose stability, the wallpaper becomes the only puzzle that begins to possess and dominate her. Her occupation with the wall paper goes on increasing. In fact she begins to get confident that the themes and patterns she is able to identify in the wallpaper could be traced by nobody else. As the story proceeds, the narrator begins to lose interest in the people and gets more and more involved with the wallpaper. The wallpaper actually happens to be the only outlet where the narrator could vent her thoughts and aspirations. As her anger increases, she begins to engage in paranoid speculations regarding Jennie and John. â€Å"The fact is that I am getting a little afraid of John. He seems very queer sometimes, and even Jennie has an inexplicable look (Gilman 13).† Finding peace and happiness only in the wallpaper, the narrator slowly begins to merge her identity with the wallpaper, while distancing herself from the other people in her life. The narrator begins to see one other woman creeping behind the patterns in the wallpaper, which is perhaps some repressed aspect of her own personality. It is only after the tracing of the creeping woman in the wallpaper that the things get fast and racy, perhaps indicative of the narrators further decent into mental disturbance and illness. The expression of the narrator gets more confused and disjointed, yet seems to have a meaning and pattern of its own. The yellow wallpaper perhaps is symbolic of the stereotypical state of the women in the society of her times, where she is forced to come out with some sense and meaning within the confines of the physical and mental space that is allocated to her. The narrator once rightly says

The Treaty of Versailles Essay Example for Free

The Treaty of Versailles Essay a. What restrictions were placed on Germany’s armed forces by the treaty of Versailles? (4 marks) -Conscription banned -Not allowed an air force or submarines -Only allowed 6 battleships -Only allowed 100,000 men in the army b. Explain why Clemenceau wanted to treat Germany so harshly (6 marks) -During the First World War, two thirds of men in the French army had been killed or injured. Not only this but their industry, land and population were all in decline while Germany’s was increasing. They felt they had to stop this and make Germany pay for the suffering they had caused France. -France felt threatened by Germany and wanted to do something that would cripple and weaken Germany to stop them attacking France. The French saw the Treaty of Versailles as an opportunity to do this and wanted to ensure it was harsh enough to stop Germany. -Clemenceau particularly wanted to treat Germany harshly because of the pressure he was under from the French people. They were feeling the full after effects of World War 1 and wanted to make Germany feel the same way. c. How far were the terms of the Treaty justified? Explain your answer. (10 marks) The Treaty of Versailles is justified because Germany treated other countries, especially Russia, very harshly during the war and they had to feel how the other countries felt and suffer the consequences the war brought. -Not only was the Treaty justified, but it could have been made a lot worse. Many countries were angry about the war and some felt that the Treaty simply didn’t punish and cripple Germany in a way that would stop them from starting another war. They wanted an even harsher treaty. -However, the Treaty of Versailles cannot be justified, as the huge  £6.6 billion worth of reparations that was forced upon German left their economy in shambles. This led to the Ruhr Crisis in 1923, hyperinflation and food shortage in Germany. It showed that the victors had very little sympathy towards Germany and simply wanted them to suffer. Not only did the Treaty leave Germany in a terrible economic situation, but the fact that they were left out of all discussions about the terms of the Treaty and that they weren’t invited to join the League of Nations, simply angered Germany and made them want revenge. -The Treaty of Versailles not only made Germany suffer, but made them accept full blame and responsibility for the war. This is not fair as Germany only played a part in starting the war. Many other countries cause a lot of damage and Germany alone cannot be held entirely responsible. In conclusion, the Treaty of Versailles cannot be justified as it simply made the situation worse, angering Germany and leaving them wanting revenge. Yes, Germany had to be punished but not to such the extent as crippling their economy and leaving them almost powerless.

A PESTEL Analysis of the Republic of China

A PESTEL Analysis of the Republic of China China, also called Republic of China. Political framework for China is dual leadership system which exercised through the communist party of China and the central peoples government. In china, peoples Congress members at the county level are elected by voters. For every five year term, China president and vice president will be elected by peoples congress. Meanwhile, for the state council will be appointed by peoples congress as well. To obtain nationality of china is difficult according the nationality law. As a China citizens who are not allow to hold a multiple citizenship. In the aspect of motivation by government, China maintains a well diplomatic relationship with other foreign country. It participate many international organization participation such as World Trade Organization (WTO), Group of 77 (G-77) and many so on. Inter-country attitude was stable and no war occurs between other. This will leads to encourages many other foreign country invest to China. Currently, China faced some territorial disputes before. Taiwan is one of the examples which successful obtain by China. Taiwan people desire to build up the linkage such as direct transportation system with mainland China for extends their Taiwanese business. As overall for political factor, China government leadership and structures are well being currently. The political trends of China became better as before revolution. Economic factor Economic factor is the most crucial factor part determines the overall environment. For chinas economic growth, it economic keep growing rapidly due to their open for outside world which are welcome other foreign country to investment (large scale capital investment such as opening its banking sectors) and productivity growth. Besides that, Chinas governments are investing into developing the education and technology aspect. This enhances the sector of technology changes. Last but not least, China tend toward urbanization which became an important driver among the globalization market demand and produced a low cost market for other foreign country tend toward invest in China. China is the bigger population in the world which around 1.3 billion people (Wikipedia, 2010). This population factor influence the spending levels. Compare with other country, China government are invest a huge capital in technology factor and at the same times, people purchasing power are strong as well. China average annual growth about 6 percents and next of the 20 years will allow China revolution became high income nation (Lou, 2010). In the taxation part, China implements those basic taxes such as business tax and income tax. For the international taxation, China is corporate with 46 countries which sign up the double taxation agreement. Chinas trade pattern continues to grow dramatically, the size of the export and imports keep increasing. China is one of the ASEAN members so that for the tarries and barriers within the country will reduce. The top trading partners for China are European, United State, Japan, and Hong Kong. Nowadays, China GDP slows to 9.6% in the third quarter of the year 2010. The unemployment rate in China was last reported at 4.20 percent in March of 2010 and the inflation rate increase to 3.60 percent in September of 2010 (Trading economics, 2010). Social factor China demographics Overpopulation problem causes many economic crises like lack of food, water and other basic amenities. As a result of its aging population, Chinas government introduces the one child campaign due to the ever growing population of China. Government is trying to control the population by allowing just one child per family. It controls family size and the overpopulation problem. As estimated, population will shift in future which decline from 9 in 2006 to 2.5 by year 2050 according to the Washington. For the healthcare, recently Chinas healthcare system has improvement slowed. For example, China spends 5.8 percent of its GDP as compare other developing country such as South Africa (8.7 percent), Brazil (7.9 percent) and India (6.1 percent). Yet, healthcare expenditures as a percentage of GDP have been increasing in China. By iimproving the healthcare system is important to raise living standards, therefore the lifestyle changes and the living standard increase in China. This is because that China toward the urbanization. Furthermore, Chinas economic growth rapidly recently years. Besides that, governments invest to the education industry boost up the individual became knowledgeable. This will increase the opportunity of working for an individual. On the other hand, many foreign direct investments in China provide more opportunity of occupation for Chinas citizen. From this, the high income nation will achieve in future, so that individual purchasing power will increase to enjoy a more quality lifestyle. Technology factor Technology changes rapid throughout the world. Innovation with technology compliance will increase the China own productivity and reduce the exports of growth. By implement advance technology, more information can be gain by the country and will discoveries more new advantages like manufacturing advances, new research, and transportation infrastructure can be more convenience by using high technology implement. Science aspect like energy fuels usages, bio-tech, genetics, agri-tech all can be benefit through this factor. Many country advocate save the world by recycling. By using advance technology, goods can be done by using those used product and process a new product to the society. At the same time, recycling can be done. Most of the company will choose China as the production plant, so that, advance technology will be imports in China and at the same time, new technology able help to save much cost. Environment factor There many external factor been catogories in enviromental factor such as change of weather, and climate changes, which might impact many industries such as tourism, farming, and insurance. Furthermore, increasing awareness of these potential impacts of climate changes are changing how a company operates. The enviromental factor are can not be amendment by China itself. It depend other external enviroment like the enviromental regulation swhich is the rules or regulation that set by other country like tariff and quota. However, there are some country will do protection onward their own product. The  Environmental Performance Index  (EPI) is a way in quantifying benchmarking the  environmental performance of a countrys policies.  According to 2010 environmental performance index, China score 49.8% of EPI and 58.7% of environmental health. Among the Asia country, China get the 18th places of its. One of the major reasons due to many industry factories builds at their effect the environment health. The air pollution of environmental health in China is at the 40.07% (Environmental Performance Index  ranking among Asia and pacific, 2010) Legal factor Legal factor include regulatory of the country. Company which analysis by this PESTEL analysis is to determine the strategy should be implementing on that. As china, employment rate fluctuant small. Employer will choose to have a factory at China that might due to low cost labor if compare with other country. Major Law in employment law is the labor law which is to protect labor benefits. According that, included all penalty, the standard working hours and the overtime minimum payment for ensure employee able get the benefits that should obtain. Furthermore, many companies decided invest their business in China and built up their industry and factory.Therefore the industry specific regulation to protect Chinas industry. Competitive regulation such as implement the taxes on foreign good to protect own good comparison. There are some functions and Powers of Organizations existence with Consumer Protection Responsibilities such as Consumers Association of China (CAC), State Administration for Industry and Commerce (SAIC) and State Bureau of Quality Technical Supervision (SBQTS).

Discharge Plan for Older Person

Discharge Plan for Older Person In this assignment the author will discuss a discharge plan with rationale for an older person with a long term condition. Included will be potential and actual problems presenting from the patient profile on discharge from an acute care setting. Reference to the Nursing and Midwifery Councils (NMC) professional code of conduct (2008) shall be made throughout the assignment along with a discussion of legislation in the latter part that is relevant to the plan of care arranged. Moreover any copies of documentation used in the appendix will remain anonymous maintaining confidentiality. The theoretical model used to formulate this plan of care is Roper et al (1990) activities of daily living which concentrates on twelve elements essential for daily living skills and the level of dependence required for them. The elements of the theoretical model chosen will be those applicable to the patients discharge care for example, mobility and breathing. The patient profile referred to is that of an elder gentleman in his late seventies admitted to hospital following weakness on waking to the left side of his body which had mainly affected his mobility. There also appeared to be some facial drooping with dysarthria. For the purpose of this assignment when referring to the patient he will be named as Mr Smith as to personalise the plan of care. Mr Smith has a past medical history of chronic obstructive pulmonary disease (COPD) and asthma for which he receives drug therapy of salbutamol and becotide inhalers. He is also the main carer for his wife whom suffers severe Alzheimers disease. Discharge plan Liaise with the discharge co-ordinator as to the impending discharge of Mr Smith. This will ensure the continuity of his care on discharge. The discharge co-ordinator provides valuable assistance and is able to amplify the experience of a patients venture from hospital to the community Day et al (2009). They are highly skilled nurses in this specialist area and mediate between the multidiscipliness involved in the care needs of Mr Smith. Mobility. Problem 1 Possible changes to Mr Smiths movement, function and orientation. Method/outcome Complete a falls risk assessment using an identified tool and follow advisory notes on completion. With consent liaise with occupational therapy and physiotherapy departments for a discharge assessment and continued rehabilitation within the community. Make certain a home visit with therapy teams has been undertaken before discharge. Rationale A falls risk assessment tool (FRAT) is a way to establish risk and manage falls prevention. Its use is advocated in the National institute for clinical excellence (NICE) guidelines in falls prevention document (2004). Following the use of FRAT (appendix 2) it is decided that Mr Smith is at moderate risk of falling and advices of therapy team input. Mr Smith requires an assessment by the occupational therapy team in his home environment prior to his discharge. This ensures his safety and well being for day to day living and maintains his independence. The visit presents an opportunity for the occupational therapist to evaluate the need for adjustment in the home. For example it is recorded that Mr Smith has some difficulty in rising out of the bath he would therefore need modification in his bathroom to enable him to do this, promoting independence and maintaining his dignity. Mobility doesnt just include the physical aspect of movement it involves fine motor activity, personal assertion, feeling and communicative function also. Having a stroke can cause dysfunction, having a dramatic causatum on the persons life Barnet et al (2009). Making adjustments in the home can be an upsetting experience. An assessment by the physiotherapist will maximise rehabilitation in physical movement and allow instruction on the use of equipment that may be required in doing so, this ascertains safety and accuracy during use. Physiotherapists have superior kinetic knowledge and can introduce advice in falls prevention minimising the occurrence. NMC (2008) requires you as a nurse to refer to another practitioner when it is in the best interests of a persons care. Both therapists will be able to initiate communication with day hospitals for continued rehabilitation therapy sessions within the community. Maintain a safe environment and communication. Problem 2 Mr Smith is to administer daily medication and understand the information provision. Method/outcome Ensure the prescription with 7 days supply is provided and sent to pharmacy in time for discharge. Guarantee Mr Smith and his relatives receive relevant information regarding medication. Explain in an accessible manner. Arrange an out patients appointment. Present written and verbal information regarding the appointment. Inform the GP of Mr Smith discharge. Rationale Mr Smith has been prescribed aspirin 75mg following an ischaemic cerebral vascular accident (CVA). The aspirin is given prophylactically and inhibits platelet aggregation which could otherwise result in a thrombus formation British national formulary (BNF) (2009). Eighty percent of strokes result from ischemia, caused by a thrombus blocking the cerebral circulation therefore, preventative medication such as aspirin reduces the risk of a reoccurrence Greenstein and Gould (2009a). It is important to provide Mr Smith with written and verbal information with regard to instruction on how and when to take his medication, along with the dosage and possible side-effects he may encounter. Educating Mr Smith on the need for medication and possible consequence of non compliance present him with an informed choice and reduces the risk of a drug induced re-admission. Reports suggest that fifty percent of older people may not take medicines prescribed for them as they have not received valued information about the benefits and risks involved Department of health (DOH) (2001). The NMC (2008) says that you must share information about peoples health and regimes in a way they can understand. This facilitates informed choices and compliance. Nurses have a responsibility to continue assessment of their patients suitability for self-administration; the NMCs standards for medicines management (2008) standard 9 require you to acknowledge changes to a patients condition and safety with regard to self-administration. Assessing Mr Smiths understanding and capability of remembering to take his medication is of great importance as if he is likely to encounter difficulty, provision for pre-dispensed medicine or help from a carer can be arranged Wade (2007). Indirect questioning will provide some indication as to how much Mr Smith understands and will not make him feel inadequate, maintaining his dignity and respect. An outpatients appointment with a neurologist will maintain consistent specialist monitoring of Mr Smiths condition even though once discharged the GP is responsible for care in the community and continued prescribing. It is therefore vital that the GP has documentation on this hospital admission and any follow up appointments to be attended. Problem 3 Change to Mr Smiths social and home environmental needs. Method/outcome Inform Mr Smith as to the importance of social services participation and gain his consent. Liaise with social services for an assessment of needs completing the relevant documentation (sections 2 5) in acceptable time ready for Mr Smiths discharge. Rationale Consent must be given by Mr Smith prior to the involvement of social services, even though it is documented that they have had previous input with Mrs Smiths care. It is the individuals right to confidentiality and as a nurse you must respect this NMC (2008). Mr Smith has indicated that he has concerns with regard to coping and caring for his wife whom has severe Alzheimers disease when he is discharged. Social services must assess the need for a care support package and provide financial advice for the services required as Mr Smith is a home owner. With Mr Smiths consent social services may even consider the possibility of Mrs Smith remaining in the nursing home until Mr Smith is more able bodied. The need fulfilment of the dependent can generate emotional stress in the carer and burden their physical well-being with the high level of physical exertion needed to provide endowed care Mackenzie and Lee (2006). When Mr Smith returns home it is the expectation that he will be allowing himself time to recover and not put his self under duress which could result in a relapse in his health. Anecdotally, caring for his wife at this stage would not be beneficial to his rehabilitation. Problem 4 Transportation home on discharge from hospital. Method/outcome Liaise with relatives regarding transport home and if necessary arrange hospital transportation. Verify Mr Smith has keys to his property, that someone will be there to receive him or that the key safe number is available. Rationale It is of upmost importance that Mr Smith and his relatives are fully aware of the date of discharge and the preparations for his arrival. Where possible, Mr Smith and his relatives should contribute to the discharge plan. The expectation of you as a nurse is that you uphold peoples rights to be involved in decisions about their care NMC (2008). Working and playing. Problem 5 Possible isolation and lack of social contact. Method/outcome With consent refer Mr Smith to the community stroke liaison services and complete the relevant referral documentation. Provide the services contact details. Rationale The community stroke liaison nurse is there to provide support with initial changes to Mr Smiths life. She is a specialist in stroke rehabilitation and can present him with coping strategies. These will help Mr Smith focus on problem solving approaches and heighten his sense of control Carpenito-Moyet (2008a). The nurse specialist may also be able to provide Mr Smith with mini health checks and details of support groups, clubs and give advice regarding enrolling on an expert patient programme if it is available within the local authority. The expert patient programme is a self management course for people with long term conditions. It was launched in 2002 as a pilot programme but is now national. The course is delivered over a six week period by a trained tutor who is either a volunteer or a previous programme attendee and is vastly beneficial. The service reduces isolation, promotes confidence and empowers those living with deficits or complex needs DOH (2001). Eating and drinking. Problem 6 Nutritional support and secondary prevention Method/outcome With consent refer Mr Smith to a community dietician completing the documentation. Highlight the importance of lifestyle and dietary changes with regard to his condition. Outline the need to attend to any future difficulty in swallowing or further dysarthria. Rationale Following his stroke Mr Smith may have a reduced appetite. Carpentino-Moyet (2008b) suggests this may be due to fatigue, being less mobile or even because of some pain from limb limitation. Carpentino-Moyet (2008c) also discuss that during Illness or convalesce a good nutritional consumption can reduce the risk of further complications and aid faster recovery. Referring to the community dietician ensures that a diet plan optimal in calories and nutrition is received. Making certain that Mr Smith has some understanding about his condition will endeavour compliance with diet and life style changes. The reoccurrence of a CVA is much higher during the first year of rehabilitation, therefore regular checks and life style conversions need to be initiated DOH (2001). Mr Smiths awareness and detection of further difficulties with speech and swallowing is a desired outcome as this could most definitely interfere with his nutritional intake in the future and would incorporate further change to his diet and lifestyle they would also warrant a referral to a speech and language therapist for a swallow assessment. Breathing Problem 7 Mr Smith has COPD and asthma and requires respiratory maintenance and secondary prevention advice. Method/outcome Ensure Mr Smith is aware of how to use his inhalers with the correct technique. Inform him of the importance to have regular visits to the GP or respiratory nurse in order to maintain adequate respiration. Provide cessation of smoking advice. Rationale Belamy and Booker (2000) suggest that the recommended maintenance appointment for patients with mild to moderate COPD should be annually within the primary care setting, they also indicate the monitoring session should involve a full assessment of the patients smoking status, symptom control, and medication efficiency with inhaler technique. Furthermore it allows the health care professional to perform spirometry. It appears that Mr Smiths therapeutic intervention of becotide and salbutamol inhalers have symptomatic control of his COPD at present however, he is now also prescribed aspirin which could contraindicate his condition. Occasionally aspirin causes bronchospasm Greenstein and Gould (2009b) therefore close monitoring is essential. In practice we can promote smoking cessation and provide advice to Mr Smith with regard to the health risks involved following his stroke and COPD. It is his individual choice as to whether he will participate. Many people given smoking cessation advice will continue smoking disregarding concern for their health. The NMC (2008) stipulates that as a nurse you must not discriminate against those in your care, treating people as individuals regardless of whether their choice exacerbates their illnesses. Key issues in older adults and long term conditions care provision: Extensive change has been underway with regard to the care standards and expectations of health and social care services for older people. The force for change has happened due to demographic analysis, which indicates that people are living much longer with an increase in those above the age of eighty. According to the DOH (2001) this figure is expected to have doubled between 1995 and 2025. Such longevity influences the amount of people living with long term conditions. Research and reports from extensive consultation with older people, their carers, healthcare professionals and from media coverage, discuss services declining to meet the needs of older people with age discrimination and depletion of dignity and respect being a major domination as clinical areas lacked evidence based practice DOH (2001). The introduction of clinical governance has helped develop effectiveness of evidence based practice assuring the quality of care is of a high standard. Zwanenberg and Edwards (2004) describe clinical governance as a system to advance the quality of care in which healthcare managers are responsible for policy compliance. They explain that primary care trusts are accountable for providing evidence of their effectiveness and quality of clinical practice and further acknowledge the level of need for accountability since public interest in cases of malpractice. Care plans are aspects of clinical governance policies Lugon and Secker-Walker (1999) as is the essence of care document developed by the DOH in 2001. The essence of care document is a guidance tool specific in enabling healthcare professionals to deliver a structured and patient focused practice within eight areas of care. Some of the areas include food and nutrition, self-care and privacy and dignity. The document also enables professionals to distinguish areas of poor practice allowing for remediation DOH (2001). The national institute of clinical excellence formulated guidelines for practice in assessment and prevention of falls, declaring that falls are a major cause of disability or mortality in the elder population and impact on their quality of health and life NICE (2004). NICE (2004) also report that falling can have a devastating repercussion to an individual causing psychological distress, lack of confidence and poor self esteem, dependency and even pressure injury. The guidelines provide strategies for assessment (FRAT appendix 2) of those at risk of falling, including individuals following a stroke and suggest setting provision for interventions such as physical therapy, home adjustment and the revisal of visual deficit NICE (2004). The development of the national service framework (NSF) for older people by the DOH (2001) delivers policies as to the standard of healthcare that older people should receive. The NSF endeavoured to set strategies over a 10 year programme looking for improvements within specific areas of health promoting independence and providing treatment with respect and dignity. The document lists the quality of care that is required on the best available evidence and provides one standard for all, achieving consistency within healthcare DOH (2001). The focus of the NSF for older people was to abolish age discrimination and provide a patient centred approach to care DOH (2001). The document defines stroke and falls prevention, promotion of health and introduces standards of care for hospital and intermediate settings and for mental health illness in older people. The DOH in connection with the NSF for older people also developed the NSF for long term conditions in 2005. The document expresses the need for the promotion of quality of life with autonomy based around the individuals specific need for their condition. Implementation of this policy includes provision of support for housing, benefits, education and pension schemes helping those suffering with long term conditions to live as independently as possible with access to services as required DOH (2005). A stroke (CVA) is classified as a long term condition and the DOH (2007) stroke strategy document identifies the need for health promotion and management of risk. The plan of action firstly focuses on awareness and prevention, treatment and services available for those whose lives have been affected by stroke. Secondly, it identifies that all needs, health and social of the individual, should be contemplated in a plan of care not just medical ones DOH (2007). The stroke strategy guidelines allow for individuals following a minor event to be given an MRI scan within 24 hours, as evidence suggest eighty percent will follow on to have a severe stroke DOH (2007). Clinical areas can therefore reduce deaths in practice if they adhere to this policy. Promotion of healthy weight, physical exercise and smoking cessation along with regular blood pressure checks and advice on alcohol consumption further reduce risks DOH (2007). The stroke strategy also expresses the need for a multidisciplinary approach, all health and social care workers collaborating together cultivating a stroke care community that will provide the best possible service for those affected returning home DOH (2007). Continued assessment by the multidisciplines following a hospital admission is essential to ensure an individuals suitability for discharge. The DOH (2004) suggests that consideration be made for the individuals physiological, functional and psycho-social wellbeing during the assessments. Being fit for discharge means that receiving care in an acute setting is no longer needed and continued care can be provided between the GP, community services and outpatients appointments DOH (2004). One professional included in the multidiscipline approach within the community is a pharmacist with initiatives developed to increase their involvement in care, such as repeat dispensing, medication reviews and independent prescribing especially for those with long term illness DOH (2005). The pharmacists involvement within the multidisciplinary team is very beneficial to patient care as it decreases medication errors, discovering discrepancies and many contra-indications before the medication reaches the patient. All legislation and government policies have influence on the way healthcare professionals practice. They provide guidelines as to accommodate continuity of healthcare in general. They set standards for quality of care that service users can expect when accessing healthcare provision and project how they will receive this provision. Legislation is an important aspect of healthcare and individuals have the right to life without discrimination, being treated equally with dignity and respect regardless of their condition, disability or age. The writer concludes that Mr Smith is awaiting discharge from hospital following a stroke. Evident from the patient profile he has achieved a satisfactory level of independence and he appears to be making good progress. The discharge plan documented for Mr Smith incorporates many of the NHS and social care policy initiatives to deliver continuity of care from hospital to home using elements from the Roper et al (1990) theoretical nursing model. The discharge plan supports the inclusion of multidisciplines, health promotion, prevention strategies and patient participation. It also up holds the NMC code of professional conduct (2008) whilst focusing on independence and maintenance of ones dignity, providing community support and rehabilitation. References: Barret, D. Wilson, B. Woollands, A. (2009) Care planning a guide for nurses, Essex: Pearson Education Limited. Belamy, D. Booker, R. (2000) Chronic obstructive pulmonary disease in primary care, all you need to know to manage COPD in your practice 3rd ed. London: Class Publishing. BNF 57 (2009) British national formulary. London: BMJ Group/RPS publishing. Carpenito-Moyet, L.J. (2008) Nursing care plans documentation, nursing diagnoses and collaborative problems 5th ed. Hong Kong: Lippincott Williams Wilkins. Day, M.R. McCarthy,G. Coffey, A. (2009) Discharge planning: the role of the discharge co-ordinator, Nursing Older People, 21, (1), pp. 26-31. Department of Health (2001) Medicines and older people: implementing medicine-related aspects of the NSF for older people, The Department of Health. [online]. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4008020 [accessed 18/03/2010]. Department of Health (2001) The essence of care: patient-focused benchmarking for healthcare practitioners, The Department of Health. [online]. Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4127915.pdf [accessed 12/02/10]. Department of Health (2001) The national service framework for older people, The Department of Health. [online]. Available from: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4071283.pdf [accessed 14/02/2010]. Department of Health (2002) The expert patient program, a new approach to chronic disease management for the 21st century, The Department of Health. [online]. Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4018578.pdf [accessed 30/03/2010]. Department of Health (2004) Achieving timely simple discharge from hospital, a toolkit for the multi-disciplinary team, The Department of Health. [online]. Available from: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4088367.pdf [Accessed 26/03/2010]. Department of Health (2005) The national service framework for long-term conditions, London: The Stationary Office. Department of Health (2007) National stroke strategy, Department of Health. [online]. Available from: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_081059.pdf [accessed 25/03/2010]. Greenstein, B. Gould, D. (2009) Trounces clinical pharmacology for nurses 18th ed. London: Churchill Livingstone Elsevier. Lugon, M. Secker-Walker, J. (1999) Clinical governance, making it happen. London: Royal Society of Medicine Press. Mackenzie, A. Lee, D.T.F. (2006) Carers and lay caring, In: Nursing older people: Redfern, S.J. Ross, F.M. (eds.) Nursing older people. 4th ed. London: Elsevier. National Institute of Clinical Excellence (2004) Clinical practice guidelines for assessment and prevention of falls in older people. CG21. London: Royal College of Nursing. Nursing and Midwifery Council (2008) Professional code of conduct, London. Nursing and Midwifery Council (2008) Standards for medicine management, London. Roper, N. Logan, W. Tierney, A.J. (1990) The elements of nursing, based on activities of daily living. New York: Churchill Livingstone. Wade, S. (2007) Refusing discharge or transfer of care, in: Nurse facilitated hospital discharge: Lees, L. (ed.) Nurse facilitated hospital discharge. Keswick: MK Publishing. Zwannenberg, T.V. Edwards, C. (2004) Clinical governance in primary care, in: Clinical governance in primary care: Zwannenberg, T.V. Harrison, J. (eds.) Clinical governance in primary care. 2nd ed. Oxon: Radcliffe Medical Press Ltd.

Braces: A Pain In The Ass :: essays research papers

Braces: A Pain In The Ass One out of three children or teenagers will have to live through their "rites of passage years" as a prisoner of their own orthodonist. Puberty is burdened enough by zit and acne battles, awkward growth spurts, and raging evil hormones. Braces add additional torture to this already hellish time to both parent and child. A life with braces is far more humilating, painful, and expensive than living with buck teeth, gaps, or a snarled tooth. Mental scars remain long after cuts and bloody sores in the mouth have healed. These platinum-colored shackles come with a factory full of degrading insults and nicknames. All through school one can expect to be called brace-face, tractor teeth, and metal mouth. The orthadontically challenged are always the butt of electricity and lip-locking jokes. The orthodontist's office is also a source of embarrassment. Most offices are open-air, filled with other patients. This means an audience as the nurse stretches and pulls patient's mouths in Jim Carrey-like expressions. If one should forget to brush their teeth before their visit, they will regrettably become immortal as the doctor announces the left- over remains of Taco Bell in-between molars.Braces become a constant source of embarrassment. Braces are three years of physical torture beginning with the very first office visit. The application of the brackets itself is long, tedious, and uncomfortable. First, cold, polydent flavored clay is thrust into the crevices of the mouth, forcing imprints. Jagged metal squares are glued to the enamel, forcing hot, burning, glue to drip down the pink of the gums. Braces also cause everyday aches and pains in the mouth. Metal spokes, guiding teeth to a new shape, stab the inside of the mouth causing cuts, sores,and tearing each time a person's mouth opens. Rubber bands placed on top of brackets pull and stretch teeth until gums are tender and sore. Being born with unperfect teeth can be painful! Braces hurt parents' wallets well after the metal is scraped and chiseled off. Payments while braces are being worn are very overwhelming. The average cost of braces today is around 3,000 dollars, more for specialty kinds. Patients must also pay for damages they ininflic ii inflict upon their orthodontic work. There are also other expenses after the metal inflict upon their orthodontic work. Molar bands that are pryed off can cost as much as

The Chryslids - Plausible :: The Chrysalids

The Chryslids   - Plausible    â€Å"The Chrysalids† by John Wyndham is an entertaining yet plausible story. It compels the reader to think about human nature and our attitude to the world around us that we often take for granted. The setting of â€Å"The Chrysalids†Ã‚   is several hundred years after a nuclear war. What is left of civilization is a few small towns here and there all over the countries of the world.  Ã‚   The population is by the leadership what the â€Å"true image† is apparently meant to be.   If you are not of the true image then you are sent to live in the fringes. Many people and animals are born with birth defects caused by the nuclear radioactivity that is still present from the nuclear destruction of previous years. The population that is considered of the â€Å"true image† are cruel to the â€Å"freaks† or â€Å"mutants†. Some of the people in the novel are also very bigoted like David’s father. He thinks he is the king of the castle and can’t be wrong. If he says something it should happen like where he has an argument with the inspector about the giant horses or when he burnt that families cat because it didn’t have a tail eg â€Å"It is your moral duty to issue an order against these so called horses!!† Various people including David’s father all agree that deviants are from the devil and should be castrated or thrown out of society. Another thing is that people are forced to agree with the laws and if they don’t they are also thrown from society where they would either be killed or spend the rest of their miserable lives in the sloughs of the fringe people. Their attitude towards the world is OK I suppose. They don’t really use that much of the worlds resources in Waknuk or any of the other little towns around. They don’t need to think about how much longer the supplies of these materials are going to last because all that they are using at the moment is trees, which they seem to have plenty of, and water which they get from wells and rivers. There food they grow or hunt and cook and bake things over open fires I would assume.

History of Latino/a Immigration to the U.S. Essay -- Immigration

Eleanor Roosevelt said, â€Å"the future belongs to those who believe in the beauty of their dreams.† That statement holds strong for immigrants in America. Equal access to opportunities allows immigrants to achieve the American dream. Their success correlates with America’s success because of the contributions immigrants provide to America. Unfortunately, the current immigration policy in America denies many immigrants the American dream. It is crucial to understand the historical context of immigration in America. Initially, most immigrants were from Europe and were not restricted by any immigration laws. Now, most immigrants come from Latin America but are restricted to severe immigration laws. The Latino/a community is one of the most severely affected groups because the current immigration system disproportionally affects Latino/as. Recognizing how the experience of Latino/a immigrants have been both similar and different in the past from other immigrant groups and dispelling common misconceptions about Latino/as today bring an awareness how Latino/as are affected. Latino/a immigrants share similar experiences of anti-immigrant rhetoric just like other immigrant groups. Many Latino/as in America have faced negative comments based on their identity. For example, Rush Limbaugh, a radio host, expounds negative comments toward Latino/as, particularly Mexicans. He claimed that Mexicans are â€Å"a renegade, potential[ly] criminal element† that is â€Å"unwilling to work† (Media Matters for America, 2/28/06). These malice comments were similar to that of other immigrants. As other immigrant groups of non-English descent started arriving in America, there was an immigrant phobia towards the newcomers. During the mid-1700s, Benjamin Franklin said ... ...ves of immigrant groups such as the Indians, Chinese, and Germans have proved that prior policies have been based on anti-immigrant rhetoric at that time. Therefore, reforming the immigration policies today should not be based on racism, or nativism. In addition, it is important to dispel the misconceptions of the Latino/a immigrations today because it is a mistake to formulate polices based on preconceptions of racialized groups. Works Cited Aoki, Andrew, and Okiyoshi Takeda. Asian American Politics. Polity Pr, 2009. Print. Fernandez, Lilia. "Introduction to U.S. Latino/Latina History." History 324. The Ohio State University. Jennings Hall 0040, Columbus, OH, USA. Address. Media Matters for America n. pag. Web. . "World War II by the Numbers." National World War II Museum n. pag. Web. .

Survey for Family Day Motivation

Motivators for Fall Family Day Attendance The purpose of this questionnaire is to identify the primary student motivators used when deciding to attend or not attend Fall Family Day. This information will be used to make improvements and further increase interest in the event. Please take the time to answer the following questions as they best apply to you. Thank you, and we appreciate your time and responses. 1. Are you familiar with Family Day? -No (Please go to question 13) -Yes (Please continue) 2. How do you learn about Family Day? Please check all that apply. -University webpage -Student newsletter -Campus banners -Event flyers Word of mouth from other students -Other (please specify) 3. Have you ever attended Family Day? -No (Please go to question 8) -Yes, I only attended this year (Please go to question 5) -Yes, I only attended in previous years. (Please go to question 6) -Yes, I attended both this year and in previous years.(Please continue) 4. Please indicate your level of s atisfaction with the Fall Family Day you attended in previous year: -Very satisfied -Moderately satisfied -Neutral -Moderately dissatisfied -Strongly dissatisfied 5. Please indicate your level of satisfaction with the Fall Family Day this year, then go to question 9 -Very satisfied Moderately satisfied -Neutral -Moderately dissatisfied -Strongly dissatisfied 6. Please indicate your level of satisfaction with the Fall Family Day you attended in previous year: -Very satisfied -Moderately satisfied -Neutral -Moderately dissatisfied -Strongly dissatisfied 7. Why did you choose not to attend this year? Please check all that apply, then go to question 9. -Not interested -Time conflict -No new events -Can't afford it -Poor reviews from others -No available hotels -Travel distance -Overcrowded -Family not able to attend -Family not interested this year -Other (please specify) 8. Why did you not attend Fall Family Day?Please check all that apply. -Not interested -Time conflict -Can't afford it -Unaware of event -Poor reviews from others -No available hotels -Travel distance -Overcrowded -Other (please specify) 9. In regards to Fall Family Day, how important would it be to have a home Virginia Tech football game that day? -Very important -Important -Neutral -Unimportant -Very unimportant 10. If Virginia Tech is playing in an away game, how important is it to have it televised on campus? -Very important -Important -Neutral -Unimportant -Very unimportant 11. How would you like to be informed of Fall Family Day? Please check all that apply. -University webpage Parent newsletter -Student newsletter -Facebook -E-mail -Other (please specify) -I'm not interested, so please do not contact me 12. What activities would you like to have at Fall Family Day? Please describe below. 13. What is your academic classification? -Freshman -Sophomore -Junior -Senior -Graduate Student -Other (please specify) 14. In what college are you enrolled? -Agriculture and Life Sciences -Architecture a nd Urban Sciences -Pamplin College of Business -Engineering -Liberal Arts and Human Sciences -Natural Resources and Environment -Science -Vet Medicine -Undecided 15. Gender -Male -Female Thank you for your time and answers!

MHCC is just for Me Essay

When I graduated high school, I knew that if I wanted to get ahead in life I was going to have to get into college. Not knowing exactly what I wanted to be when I grew up, made me worry about spending money on a traditional four year university. I realized that there were several cheaper options for a higher education were around my area. Starting my education at a community college seemed like the right step for me once I understood that the credits would all transfer to a university that I could choose at a later date. This was my first sensible step towards furthering my education. The problem was trying to decide which college to go to. I had to choose from Portland community college (PCC), Clackamas (CCC) or Mount Hood (MHCC). After sorting through the pros and cons, some of which were proximity to home and work, class availability and, helpful resources, it became clear which college was right for me. MHCC was my choice because it convenient for me. When choosing which community college to attend, the first thought was the distance from both work and home. I knew that I needed a place that was close enough to where I work so that I could take as many classes as I needed and not have to worry that I am going to be late for work because of traffic or some other distraction. Another reason that I need a place that was close is to save gas, as I am currently paying my own tuition and saving money is essential for a financially deprived student. It turns out Mt. Hood is only five miles away from my house, and even more convenient was that it was right down the street from where I work. With MHCC being so close to my work and home and I am only late to class because of my oversleeping. I have also been able to fit in extra classes every semester because of the time I save to squeeze it in without having to ask for any additional time off from work. I am currently working part time job at Bi-Mart so flexibility with scheduling is necessity for my schooling. My current situation for school is that I get to decide which two days I am off, and with those two days I can create my school schedule. MHCC scheduling is so convenient because that the same class that I may need could be taught by several different instructors which all have different times and different days allowing me to shape a schedule that will fit. This has really allowed me to appreciate the classes that are held twice a week for that reason. My usually schedule for school can sometimes take me all day. It starts with a morning class around eight all the way through the day until an evening course till around eight. Without the classes held only two days a week I don’t know how long it would take for me to graduate. One of the resources that I keep constantly using at Mt. Hood is the Learning Center’s tutors up on the second floor of the main campus l ibrary. I know that I am not the only student in the class room, so when I cannot get a meeting with the teacher to go over class items that I do not understand clearly I go to the tutor center. When I am up there I can receive all the help that I need for any school work that I am behind in. I know this because I go to the math tutor all the time for help just to get help that I need. I also have gone to the writing tutor in the past to help with papers that I get stuck on. I know that I am not a very strong writer and not all the rules of grammar stick with me, so knowing that there is a person that can help me makes me a more confident student and it makes me feel like I can achieve more. The convenience of the tutoring center has allowed me to be a better student. To be honest without MHCC, I don’t know if I would have the drive to go to another school. When thinking about the future it makes me cringe sometimes. If anything I have learned from working at Bi-Mart, I know that working dead end jobs as a lifestyle is not going to be in my best interest if I want to achieve something in my life. For that I consider Mount Hood to be a great school to attend. I am glad that I could find a school that could fit into my life and my future goals. At MHCC I have learned so much, and have improved both my writing and math. I know that furthering myself with an education is only going to benefit me in the time ahead and with the education at Mt. Hood I know that when I am able to transfer to that four year university I know that I will have the tools to be able to succeed not only there but beyond the university as well.

Burger King Holdings Inc.

Burger King Holdings Inc. was formed in 23 July 2002 and incorporated in Delaware. The holding company restaurant system includes restaurants owned by the company and franchises. The company is the second largest fast food hamburger restaurant chain (BurgerKingHoldingsInc, 2008). Controls set by the company The controls set by the company are to ensure that the financial statements provide reasonable assurance on the reliability of the financial statements and financial reporting.Internal controls ensure that the financial statements are prepared according to GAAPs. Internal controls ensure correct maintenance of records, transactions are recorded according to GAAPs and the prevention of unauthorized use or disposal of company’s assets. The effectiveness of the internal controls should be reviewed regularly to determine their adequacy although the controls put in place may not prevent and detect misstatements given its limitations due to changing conditions or degree of compli anceExamples of controls are the security and business controls put in place to prevent access and use of personal information possessed by the company that if leaked, may expose the company to litigations (BurgerKingHoldingsInc, 2008) Financial statements The total revenues for the company have been growing over the years. The total revenue in 2004 was $1. 7 billion rising to $2. 4 billion in 2008. The company’s revenues are generated by franchise and company owned restaurants.In year 2008, 88% of sales were from franchise restaurants. The operating income and net income over the same period grew from $73 million in 2004 to $ 354 million in 2008 for operating income while net income rose from $ 5 million in 2004 to $ 190 million in 2008 The diluted earnings per share i. e. earnings after adjusting for dilutive effects rose from $106. 1 in 2004 to $ 137. 6 in 2008 Total assets grew from $ 2. 5 billion to $ 2. 6 billion in 2008.Total stockholders equity also witnessed growth f rom $ 716 million in 2007 to $ 845 million in 2008 Net cash flows from operating activities grew from $67 million in 2006 to $ 243 million in 2008 Other aspects of the company’s performance is the opening of 202 new restaurants which brings the company’s total number of restaurants to 11,505 as of June, 30 2008 Techniques to analyze financial statements The financial statements are prepared and disclosed according to the GAAPs as well as presented according to the SEC regulations.The financial statements have been presented based on the reportable segments of the company i. e. USA and Canada EMEA/APAC and Latin America. As seen earlier, the company’s revenues are generated from company’s restaurants and franchise restaurants. The analysis has also been done according to the source of revenue Comparison of restaurant sales from the three reportable segments has been done in the financial statements (BurgerKingHoldingsInc, 2008) ImpactThe preparation of the financial statements according to reportable segments helps the company to formulate strategies for the various business segments in line with their performance. Comparison of sales growth in the segments over the years helps the company to evaluate the performance of each source of revenues thus formulate strategies that can improve growth References BurgerKingHoldingsInc. (2008, August 28th). Form 10-k. Retrieved April 10th, 2009, from Burger King Holdings Inc. : http://media. corporate-ir. net/media_files/irol/87/87140/BKC_AR08/10-k. html

Example of a Consent Form

Research Consent Form Brigham and Women’s Hospital Dana-Farber Cancer Institute Massachusetts General Hospital Version III. a August 1998 Pi_dist9. doc Imprint Patient ID Number Protocol Title: Developmental Anatomy Genome Project (DGAP) Principal/Overall Investigator: Cynthia C. Morton, Ph. D. Site-Responsible Investigator(s)/Institution: James Gusella, Ph. D. /MGH Co-Investigator(s)/Study Staff: Drs. B Quade, A Ligon, R Maas, A Michelson, J Gusella, M MacDonald, E Lemyre, J Lewis Description of Subject Population: Patients with congenital anomalies PURPOSEWe would like permission to enroll you as a participant in a research study. The purpose of this research is to identify and study genes involved in human development. You have been asked to participate in this research study because you (or your child) have (or has) one or more developmental abnormalities and chromosomal abnormalities that have been present since birth. Such chromosomal abnormalities may disrupt the functi on of genes required for normal growth and development. By identifying these genes in people with specific birth defects, we hope to reach a greater understanding of how the human body grows and develops.STUDY CONTACTS This study is being organized by Dr. Cynthia C. Morton, who can be reached at 617-732-7980 with any questions you may have during the course of this study. If you enrolled at the MGH, please contact Dr. James Gusella at 617-726-5724. PROCEDURES If you agree to participate, you will donate a blood sample. The amount of blood drawn will vary with age (less than 2 years old: about 1 tablespoon; ages 2-10 years: about 2 tablespoons; ages 11 years and up: about 2-4 tablespoons) and may be reduced for smaller individuals.In general, after you have donated blood, cells or tissue samples no additional hospitalization or clinic visits will be required for you to participate in this study. Any of the samples you donate will be used to establish an immortal cell line. This means that an inexhaustible supply of DNA will be available for genetic research. DNA is the genetic material from which genes are made. These samples may be stored/banked for future use and/or shared with other investigators associated with this study. These stored or distributed samples will NOT be labeled with your name.Do you agree to this (please circle one choice): Page 1 of 5 Subject Population: Patients with congenital anomalies IRB Protocol Number: 1999P-003090 98-09233 Sponsor Protocol Number: N/A Consent Form Approval Date: DECEMBER 9, 1999 Amendment Number Approved: N/A IRB Expiration Date: Amendment Approval Date: N/A NOVEMBER 22, 2000 Research Consent Form Brigham and Women’s Hospital Dana-Farber Cancer Institute Massachusetts General Hospital Version III. a August 1998 Pi_dist9. doc Imprint Patient ID Number YES NO You may be contacted in the future and asked for additional samples to continue research.If you do not wish to be contacted in the future, you may indica te this below: YES, okay to contact NO, do not contact As mentioned above, samples that are sent to the research laboratory will be assigned a code number. The key to this code will be maintained in locked files by Dr. Cynthia Morton, and your (or your child's) identity will not be revealed to anybody other than your referring physician. Important non-identifying information such as sex, age, and nature of your developmental abnormality will be transmitted to the research laboratory in order to correlate study results with specific developmental problems.The information obtained from this study of your donated blood or tissue is not known to be useful clinically or diagnostically at this time. The research is currently useful only as a means of understanding genes and developmental abnormalities. Results from these genetic studies will NOT be placed in your (or your child's) medical record. We will not communicate these results directly to you; study results will be released to your referring physician. COSTS No charges will be billed to your insurance company or to you for this study. You should be sure that no charges for the blood draw are to be filed with your insurance company.If the person who draws your blood intends to bill you, you should pay for this yourself and send a copy of the bill to the investigator who will reimburse you. RISKS AND DISCOMFORTS There are minor risks and discomforts associated with blood sampling. This includes a brief amount of pain and possibly a small bruise at the needle site. Occasionally a person feels faint when his/her blood is drawn. Rarely an infection develops, but if this occurs the infection can be treated. Disclosure of Study Results Information about your participation in a genetic study may influence insurance and/or employers regarding your health status.We will use many safeguards to prevent unintentional disclosure: I) information about your participation in, and the results of, this research will NOT be plac ed in your medical records, II) research data (including data collected from medical charts) will be entered only into a research database. No names will be entered into this database, only the codes assigned to submitted samples. Other investigators will NOT be given a key to this code, and III) NO results from this study will be released to anyone other than your referring physician.You can also minimize these risks by not sharing with others the fact that you have participated in genetic studies. Page 2 of 5 Subject Population: Patients with congenital anomalies IRB Protocol Number: 1999P-003090 98-09233 Sponsor Protocol Number: N/A Consent Form Approval Date: DECEMBER 9, 1999 Amendment Number Approved: N/A IRB Expiration Date: Amendment Approval Date: N/A NOVEMBER 22, 2000 Research Consent Form Brigham and Women’s Hospital Dana-Farber Cancer Institute Massachusetts General Hospital Version III. a August 1998 Pi_dist9. doc Imprint Patient ID NumberThese studies are for res earch purposes only. Therefore, NO study results will be communicated to you at any time. However, in the event that this research study uncovers information that we feel MAY impact your healthcare (either positively or negatively), we will convey this information to your physician. After the potential significance of such results has been explained to you by your physician, you will be offered an opportunity to obtain independent diagnostic confirmation of this research finding in a laboratory which specializes in this type of clinical testing.This diagnostic testing will ONLY take place IF you provide additional consent for it. Only the result of the confirmatory test would be entered into your medical record by the diagnostic laboratory or your physician. BENEFITS At this time, we know of no direct benefit to you (or your child) as a result of participation in this research study. Participation is completely voluntary and your alternative is to not participate. Other individuals may benefit in the future if these studies provide useful information about identifying or treating developmental abnormalities.ALTERNATIVES You are free to participate or not to participate in this study. If you choose not to participate, your medical care and treatment will NOT be affected. Page 3 of 5 Subject Population: Patients with congenital anomalies IRB Protocol Number: 1999P-003090 98-09233 Sponsor Protocol Number: N/A Consent Form Approval Date: DECEMBER 9, 1999 Amendment Number Approved: N/A IRB Expiration Date: Amendment Approval Date: N/A NOVEMBER 22, 2000 Research Consent Form Brigham and Women’s Hospital Dana-Farber Cancer Institute Massachusetts General HospitalVersion III. a August 1998 Pi_dist9. doc Imprint Patient ID Number THE FOLLOWING PARAGRAPHS CONTAIN STANDARD INFORMATION WHICH GENERALLY APPLIES TO PERSONS INVOLVED IN A RESEARCH STUDY AND ARE REQUIRED ON ALL CONSENT FORMS. CONFIDENTIALITY Medical information produced by this study will become part of your hospital medical record, unless specifically stated otherwise in this consent form. Information that does not become part of your medical record will be stored in the investigator’s file and identified by a code number only.The code key connecting your name to specific information about you will be kept in a separate, secure location. Your medical record is available to health care professionals at Brigham and Women’s Hospital (BWH), Dana-Farber Cancer Institute (DFCI), or Massachusetts General Hospital (MGH), collectively called the â€Å"Hospitals†, and may be reviewed by appropriate Hospital staff members in the course of carrying out their duties; however, they are required to maintain confidentiality in accordance with applicable laws and the policies of the Hospitals.Information contained in your records may not be given to anyone unaffiliated with the Hospitals in a form that could identify you without your written consent, except as described in thi s consent form or as required by law. It is possible that your medical and research record, including sensitive information and/or identifying information, may be inspected and/or copied by the study sponsor (and/or its agent), the Food and Drug Administration (FDA), federal or state government agencies, or hospital accrediting agencies, in the course of carrying out their duties.If your record is inspected or copied by the study sponsor (and/or its agents), or by any of these agencies, the Hospitals will use reasonable efforts to protect your privacy and the confidentiality of your medical information. The results of this study may be published in a medical book or journal or used for teaching purposes. However, your name or other identifiers will not be used in any publication or teaching materials without your specific permission. In addition, if photographs, audiotapes or videotapes were taken during the study that could identify you, then you must give special written permissio n for their use.In that case, you will be given the opportunity to view or listen, as applicable, to the photographs, audiotapes or videotapes before you give your permission for their use if you so request. REQUEST FOR MORE INFORMATION You may ask more questions about the study at any time. The investigator(s) will provide their telephone number so that they are available to answer your questions or concerns about the study. You will be informed of any significant new findings discovered during the course of this study that might influence your continued participation.If during the study or later, you wish to discuss your rights as a research subject, your participation in the study and/or concerns about the study, a research-related injury with someone not directly involved in the study, or if you feel under any pressure to enroll in this study or to continue to participate in this study, you are asked to contact a representative of the Human Research Committees at BWH (617) 732-7 200, at MGH (617) 726-3493, or at the Protocol Administration Office at DFCI (617) 632-3029. A copy of this consent form will be given to you to keep. Page 4 of 5 Subject Population: Patients with congenital anomaliesIRB Protocol Number: 1999P-003090 98-09233 Sponsor Protocol Number: N/A Consent Form Approval Date: DECEMBER 9, 1999 Amendment Number Approved: N/A IRB Expiration Date: Amendment Approval Date: N/A NOVEMBER 22, 2000 Research Consent Form Brigham and Women’s Hospital Dana-Farber Cancer Institute Massachusetts General Hospital Version III. a August 1998 Pi_dist9. doc Imprint Patient ID Number REFUSAL OR WITHDRAWAL OF PARTICIPATION Participation in this study is voluntary. You do not have to participate in this study. Your present or future care will not be affected should you choose not to participate.If you decide to participate, you can change your mind and drop out of the study at any time without affecting your present or future care in the Hospitals. In additi on, the doctor in charge of this study may decide to end your participation in this study at any time after he/she has explained the reasons for doing so and has helped arrange for your continued care by your own doctor, if needed. INJURY STATEMENT If you are injured during the course of the study and as a direct result of this study, you should contact the investigator at the number provided.You will be offered the necessary care to treat that injury. This care does not imply any fault or wrong-doing on the part of the Hospitals or the doctor(s) involved. Where applicable, the Hospitals reserve the right to bill third party payers for services you receive for the injury. The Hospitals will not provide you with any additional compensation for such injuries. SIGNATURE I confirm that the purpose of the research, the study procedures and the possible risks and discomforts as well as potential benefits that I may experience have been explained to me.Alternatives to my participation in t he study also have been discussed. All my questions have been answered. I have read this consent form. My signature below indicates my willingness to participate in this study. Subject/Patient Date Witness/Advocate/Minor/Legal Guardian (if required) Date Additional Signature (if required)(identify relationship to subject) Date I have explained the purpose of the research, the study procedures, identifying those that are investigational, the possible risks and discomforts as well as potential benefits and have answered any questions regarding the study to the best of my ability.Study Representative Date Investigator Complete This Information At Enrollment for HEMATOLOGY/ONCOLOGY PROTOCOLS ONLY (A copy of this form should be faxed to the QCC and to the appropriate Medical Records) Primary Care Physician’s Name: Date protocol treatment begins for this subject: Diagnosis: Page 5 of 5 Subject Population: Patients with congenital anomalies IRB Protocol Number: 1999P-003090 98-09233 Sponsor Protocol Number: N/A Consent Form Approval Date: DECEMBER 9, 1999 Amendment Number Approved: N/A IRB Expiration Date: Amendment Approval Date: N/A NOVEMBER 22, 2000