Essay on Police and the Community Example | Topics and Well Written Essays - 1250 words

On Police and the Community - Essay Example A lesser barricade could be people’s self-esteem and self-perception (Morris, 2008). This is because they do not view themselves as activists or leaders. This perceptual concern is a barrier for over 36% of the adults in America. Not being an activist or leader is a barrier for 42% of adults who are not involved but wish to be. Disengaged participants in several focus groups stated that they wish for a fearless director with organizational skills, knowledge, plans, enthusiasm, a selfless attitude, and honesty. This group also puts more weight in disliking politics than adults on not knowing anyone else taking part in the activity. In order to overcome these obstacles, authorities that are involved in public participations should ensure that those who are involved in the activity are protected. Authorities need to educate people on these barriers and assure them that they will be safe after they take part in the activity (Thurlow, 2008). Question 2 Policy makers have a tough ta sk of carrying out what is best for their constituents plus their countries. This makes them the voice of the citizens. It is extremely vital that a police chief should be a policy maker for his constituent or country due to several reasons. These reasons are: police chiefs have interests of constituents and interests in the country. They also defend the constitution. Since policy makers are elected by the public, this will also give a chance to police chiefs to be elected by the public. Each policy maker has an obligation of defending the constitution. Police chiefs are also obliged to defend the American constitution, and this makes the liable policy makers (Chief of Police, 2007). A policy maker is a person who is responsible for making the policies of an organization. This includes the government or any other institution that requires regulations. A statesman refers to a diplomat or politician who has had a long, as well as respected duty at the national or international level. It has been said that police chiefs should be politicians. This is not a brilliant idea. Politicians have an obligation of representing and responding to the constituents, voting on legislation, participating in budget discussions and taking part in committees. Even though, police chiefs need to realize these factors, their central duty is to implement the law. This is a vital duty. They need to be separated from political matters so that they could execute their tasks to the fullest. If police chiefs are allowed to be statesmen, then this would interfere with the neutrality of the police force from politics. It will interrupt with the activities of the police force (Samuels, 2000). Question 3 Similarities Community oriented policing as a philosophy that encourages organizational strategies, which hold up the organized use of problem-solving techniques and partnerships, to tackle the immediate factors that give rise to public security issues. The security issues are social disorders , crime as well as fear of crime. Community oriented policing also comprises of three key components in America as well as other nations. These components are: community partnership, organizational transformation as well as problem solving. Most countries, including the United States, think that

Egyptian art Essay Example for Free

Egyptian art Essay In Egyptian art, style is everything. In the Egyptian Art we have examined, we see striking similarities in the objects d’art that are included in this view. One thing that we can see in all the art works that we have seen is that the style remains consistent throughout the history of Egypt. The view of this writer is to look at each work and compare it to other works later in Egypt’s history. To that end, we will examine four separate works—the Palette of King Narmer, which was predynastic, the tomb of Ti at Saqqara which is of the Fifth Dynasty, the Portrait of Ni’Ankhesut, which is from the early Sixth Dynasty, and finally the Funerary Stele of Iamu, from the First Intermediate period. Each of these unique works has their own similarities to each other and their own unique differences. Three of the works are worked in limestone, which was a primary medium of Egyptian art, especially when it came to tomb or funerary art. The fourth is in stone, and was used to hold makeup and was intricately carved with a well for that express purpose. The first work that this writer will examine is the Palette of King Narmer. This work is done in what is probably basalt or some other stone, as it is not done in the soft limestone that was common in other Egyptian art forms. Egyptologists are unsure exactly what event this depicts, but what we can see is that King Narmer is the largest figure on the palette. On the front of the palette Narmer is depicted leading an army and slaying an opposing army. The opposing army is dead and decapitated, with their heads between their legs. This is pictured in the top third of the palette. In the middle third of the palette is a round depression made up of the entwined necks of two cats. This indented area is where eye makeup would have been placed. In the bottom third we see a warrior fighting a bull, a common theme in early Egyptian art. It should be noted here that the cats with the entwined heads is a distinctly Mesopotamian feature, showing the influence of the Middle Eastern art forms on early Egyptian art. On the back of the palette, we see a large figure who appears to be Narmer, wearing the crown of Upper Egypt. He appears to be subduing an enemy, who appears to be the leader of Lower Egypt. This is obviously meant to symbolize the supremacy of Upper Egypt over Lower Egypt. We notice from the position of the figures that every figure is in the profile position, but the arms are facing forward. This shows early on the foundations of Egyptian art, mainly, the consistency of keeping a majority of the body in profile, while only putting arms and chest in full frontal view. We also notice that on both sides of the palette, Narmer is the largest of the figures, making it clear that the palette is about him and his accomplishments. This is also a recurring theme in Egyptian art—the making of the main figure larger than other figures in the work. This assures the viewer that they are aware of who the main subject is. The second work that we are going to examine is the tomb of Ti at Saqqara. Again, we see that Ti is the largest figure in the work. This tomb relief is in color, which sets it apart from the other works we have examined. It probably retains its color due to the fact that it was not exposed to the elements as were other works. The paint brings out the striking details and shows the intricacies of Egyptian tomb art. It is also worked in limestone, which was a primary medium in Egypt. In this relief, we se that Ti is on a boat on the Nile. The Nile is teeming with all sorts of marine life. From our knowledge of the hieroglyphics, we know that Ti and his hunters are hunting hippopotami in the Nile marshes. Again, Ti is in profile save for his hands and chest. It is at this point, however, that we can see that there is very little difference between the picture of Ti and the picture of Narmer. This shows us that the Egyptians did not think about differentiation between human forms. They counted on the hieroglyphics and the idea of the larger figure being the focal point of the work. The third work that we will examine is the portrait of Ni’Ankhesut. It is a limestone portrait, which makes us assume that it is from the tomb of this individual. This is from the Sixth Dynasty. In this work, we see Ni’Ankhesut as the central figure in this work. Out of necessity, Ni’Ankhesut is the largest figure in the work, and above his head are hieroglyphics. These probably tell his story or his name, though we do not see the characteristic cartouche that accompanies the name. The fact that this individual has a tomb indicates that he was of sufficiently high rank to have the wealth and prestige that a tomb connotes. Again, if we physically look at the portrait, we see that the head and the legs are in profile, but the chest and the arms are in full frontal view. This again shows the idiosyncrasies in Egyptian art. If we compare the physicality of the portrait to the other two works that we have examined, we see that there is very little physical difference in the three figures. Again, the lack of differentiation among figures is evident. The final work we will examine is the Funerary Stele of Iamu. It is worked in limestone, which is the primary medium of Egyptian tomb art. This work is a more complex work than the portrait, but not as detailed as the Palette of Narmer. In this work, we see again that Iamu is the largest figure, and above his head are hieroglyphics. In this relief, it is difficult for one to tell what Iamu is doing. Again, we see little physical differentiation with the other figures that we have examined, and we see that all the figures are in profile and that this is totally in keeping with all Egyptian art. This writer does see some beginnings of differentiation in the figures, which begins to pave the way for more realistic portraiture. What conclusions can we draw from these four works? The first thing is that Egyptian art changed little over the years of Egypt’s rise and fall. Second, we see that Egypt chose art to express and transmit their culture. We also note that hieroglyphics were used to great effect to tell the individual stories that each work shows (with the exception of the Narmer Palette). Fourth, we can see that relief is the main form of art used by the Egyptians. Fifth, color is used throughout the Egyptian artistic world to give life to the two-dimensional images on the limestone walls. Sixth, relief is also a way to provide the art with a depth that it would otherwise lack. We must continue to learn from ancient art as it is the way that we learn the most about ourselves. To understand it is to better understand ourselves and our own culture.

Monitoring Therapeutic Drugs: Strategies

Monitoring Therapeutic Drugs: Strategies This article provides an introduction into some of the current techniques and assays utilised in Therapeutic Drug Monitoring (TDM) TDM is a multi disciplinary function that measures specific drugs at intervals to ensure a constant therapeutic concentration in a patient blood stream. The selection of an analytical technique for TDM involves a choice between immunoassay and chromatography technique. Once the methodology has been chosen, there are also numerous options available within these categories including FPIA, EMIT, KIMS, HPLC and nephelometric immunoassay. An overview of each method is given and its processing of drugs. The future outlook in the methodology involved in TDM is also explored and discussed. INTRODUCTION Therapeutic drug monitoring (TDM) is a multi disciplinary function that measures specific drugs at selected intervals to ensure a constant therapeutic concentration in a patient blood stream. (Ju-Seop Kang Min Hoe Lee) The response to most drug concentrations is therapeutic, sub-therapeutic or toxic and the main objective of TDM is to optimize the response so the serum drug concentration is retained within the therapeutic range. When the clinical effect can be easily measured such as heart rate or blood pressure, adjusting the dose according to the response is adequate (D.J. Birkett et al). The practice of TDM is required if the drug meets the following criteria: Has a narrow therapeutic range If the level of drug in the plasma is directly proportional to the adverse toxic If there is appropriate applications and systems available for the management of therapeutic drugs. If the drug effect cannot be assessed by clinically observing the patient (Suthakaran and C.Adithan) A list of commonly monitored drugs is given in table 1. The advances in TDM have been assisted by the availability of immunoassay and chromatographic methods linked to detection methods. Both techniques meet the systemic requirements of sensitivity, precision and accuracy. Within both methods are many numerous options and will be further explored in this title. Ideally the analytical method chosen should distinguish between drug molecules and substances of similar composition, detect minute quantities, be easy to adapt within the laboratory and be unaffected by other drugs administrated. An overview of the current analytical techniques and future trends in TDM is emphasised in this title and its role in laboratory medicine. NEPHLEOMETRIC IMMUNOASSAY AND its USE IN TDM Immunoassays play a critical role in the monitoring of therapeutic drugs and a range of techniques in which the immunoassay can be existed exist. Nephleometric immunoassays are widely used for TDM and are based on the principle of hapten drug inhibition of immunoprecipitation. The precipitation is measured using nephelometric principles that measure the degree of light scattering produced. In some cases Turbidmetry principles can be applied to measure precipitation via the amount of transverse light. In nephleometric immunoassays, if the drug molecule is a monovalent antigenic substance, a soluble immunocomplex is formed. However if the drug molecule is a multivalent antigenic substance, whereby two drug moieties are conjugated to a carrier protein, the conjugate reacts with the antibody to form an insoluble complex. The insoluble complex may compose of numerous antigens and antibodies, thus scattering the light. Therefore nephleometry of turbidmetry techniques are required to measure the reaction. In respect to this principle precipitation inhibition of a drug can be measured. The test sample (serum) is introduced to a fixed quantity of polyhaptenic antigen and anti drug antibody. The serum drug antigen competes with polyhaptenic antigen for binding to the anti drug antibody. Any free drug present in the sample inhibits the precipitation between the antibody and polyhaptenic antigen. Therefore the drug concentration ids indirectly proportional to the formation of precipitate whi ch is quantified by a nephelometer. The more polyhaptenic antigen present, the more precipitate is formed until the maximum is encountered. Further addition of antigen causes a reduction in the amount of precipitate formed due to antigen excess. The use of nephelometric immunoassay for TDM is termed competitive due to the competitive binding for the sites on the antibody by the antigen. It also distinguishes the drug assay system from the conventional nephleometric immunoassay for proteins. Variations of this assay exist including: The use of saliva or CSF may be used as an alternative to serum. Both alternative matrixes contain less light scattering molecules and so a larger volume of sample is used in order to compensate. Turbidmetric methods may also be applied to quantitative immunoprecipation . turbidmetric analysis is preformed at a lower wavelength and similarly detects immunoprecipation like nephelometric techniques. End point analysis of immunoprecipitaion is commonly employed, however rate analysis is also applicable. Addition of formaldehyde blocks further precipitation and is utilised in end point analysis. Agglutination inhibition immunoassay can also be detected by nephelometric immunoassay systems in which the drug or hapten is directly linked onto the surface of the particle and is generally suitable for low serum drug concentration while precipitation inhibition detects concentration above 1ug/ml If homologus and heterologus drug concentrations are utilized for antibody and polyhaptenic antigen preparations, sensitivity and specificity may be increased. Polyclonal and monoclonal antibodies may be employed in this assay. The use of monoclonal antibodies removes any interference caused by antibody cross reactivity. Choosing a hybrid cell with the most desirable antibody is difficult and therefore is most likely to be less sensitive than the use of polyclonal antibodies Overall the nephelometric immunoassay is an excellent assay system for TDM. Advantages over other assay systems include its simplicity, speed and low cost. It is a homogenous method that requires no separation steps or isotopes. Only two reagents are required in limited amounts as if the antibody to antigen ratio is not optimum, the sensitivity is decreased. This is due to the formation of less precipitate in the absence of drug. In the presence of a drug, inhibition is less efficient. The sensitivity of the assay depends on antibody hapten binding, however it yields high specificity. Therefore nephelometric precipitation inhibition immunoassays are a novel technique in the clinical practice of TDM. (Takaski Nishikawa Vol 1, 1984) FLUORESCENCE POLARIZATION IMMUNOASSAY AND its USE IN TDM Fluorescence polarization immunoassay(FPIA) is a widely used 2 step homogenous assay that is conducted in the solution phase and is based on a rise in fluorescence polarization due to the binding of the fluorescent labelled antigen with antibody. The first step of the immunoassay involves the incubation of the serum sample with none labelled anti drug antibody. If the patient sample contains drug molecules, immune complexes will form between antibody and antigen. The second stage of this assay involves the addition of a flourscein labelled antigen (tracer) into the mixture(.Jacqueline Stanley 2002) The purpose of the flourscein tracer is to bind on any available sites on the drug specific antibody for detection purposes. If the first stage occurred in which the anti drug antibody formed a complex with the drug from the sample, less or no antigen binding sites will be available for the tracer to bind to. Consequently a higher proportion of the flourscein tracer is unbound in the solut ion. If the sample contains no drug an antigen, Step 1 does not occur and the anti drug antibodies will bind the flourscein antigen tracer. In this assay the degree of polarization is indirectly proportional to the concentration of drug present. (: Chris Maragos 2009) Fluorescence polarization is calculated to determine the concentration of drug present. Fluorscein labelled molecules rotate when they interact with polarised light. Larger complexes rotate less then smaller complexes and therefore remain in the light path. When the large immune complex is labelled with a fluorescent tracer, it is easily detected once present in the light path. If no drug was present in the sample, the availability of binding sites on the antibody entices the fluorscein tracer to bind, restricting its motion resulting in a higher degree of polarisation, Thus it is easy to identify that polarization is indirectly proportional to the concentration of drug present. The benefit of utilising FPIA in TDM includes the elimination of processed to separate bound and free labels, an indicator that this assay is time efficient. An unique feature of this assay is that the label used is a flurophore and the analytical signal involves the measurement of the fluorescent polarizatio n. ( Jacqueline Stanley 2002) A standard curve is constructed to determine the concentration of drug present and is easily reproducible due to the stability of the reagents utilized and the simplicity of the method. However FPIA has some limitations and is prone to interference from light scattering and endogenous fluorescent tracers in the samples. To help overcome these limitations variations on the technique is employed including: Use of a long wavelength label The fluorscein tracers utilized produce adequate signals, however light scattering events can interfere with these signals. The use of a long wavelength label permits extended fluorescence relaxation times which may be more sensitive for the detection of high molecular weight antigens on drugs. Use of CE-LIF The use of capillary electrophoresis with laser induced fluorescence detection enhances the sensitivity of this method. This competitive FPIA separates free and antibody bound tracers and utilizes LIFP as a detection system.( David S. Smith Sergei A 2008) Overall FPIA has proven to be a time and cost effective, accurate and sensitive technique in TDM and remains one of the most promising methods in this clinical field. ENZYME MULTIPLIED IMMUNOASSAY TECHNIQUE AND its USE IN TDM Enzyme Multiplied Immunoassay Technique (EMIT) is an advanced version of the general immunoassay technique utilising an enzyme as a marker. EMIT is a 2 stage assay that qualitatively detects the presence of drugs in urines and quantitatively detects the presence of drugs in serum.( David S. Smith Sergei A )Both the competitive and non-competitive forms of this assay are homogenous binding based that rapidly analyze microgram quantities of drug in a sample. in the competitive assay, the patient sample is incubated with anti drug antibodies. Antibody antigen reactions occur if there is any drug present in the sample. The number of unbound sites indirectly correlates with the drug concentration present. The second step involves the addition of an enzyme labelled specific drug which will bind to available binding sites on the antibody inactivating the enzyme. A enzyme widely used in EMIT assays is Glucose 6 Phosphate Dehydrogenase which primarily oxidises the substrate added (Glucose 6 Phosphate). The co-factor NAD+ is also reduced to NADH by the active enzyme. Any enzyme drug conjugate that is unbound remains active, therefore only in this case , can the oxidation of NAD+ to NADH occur. An increase in absorbance photometrically @ 340nm correlates with the amount of NADH produced. (Jacqueline Stanley 2002) A non competitive format of this assay also exists, where by drug specific antibodies are added in excess to the sample resulting in antigen antibody interactions if the drug is present. A fixed amount of enzyme drug conjugate is then added which occupy any unbound sites present on the antibody. The active enzyme that is unbound oxidised NAD+ to NADH indicating presence of free enzyme conjugate and subsequently drug molecules present. (chemistry.hull.ac.uk/) EMIT technology is becoming increasingly popular as a method to monitor therapeutic drug levels. Drugs monitored using this technique includes anti asthmatic drugs, anti epileptic drugs and cardio active drugs. Radioimmunoassay work on the same principle as competitive EMIT with the exception of the use of a radio isotope as a marker. Gamma radiation is emitted from the marker leading to a high level of sensitivity and specificity. As it uses radio isotopes it is not the most cost effective in todays modern environment. MICROPARTICLE IMMUNOASSAY AND its USE IN TDM Microparticle agglutination technology uses latex microparticles and plays a leading role in TDM in the quantitative measurement of carbarbapenzaine, phenytoin, theophylline and phenybarbital. Kinetic movement of microparticles in solution (KIMS) is a homogenous assay and is based on the principle of competitive binding between microparticles via covalent coupling. When free drug exists in the patient sample, it will bind to the antibody present. As a result the microparticle antigen complex fail to bind with the antibody and the formation of a particle aggregate does not occur. Micro particles in solution fail to scatter light causing a low absorbance reading. If the patient sample is negative for the drug, the micro particle drug complex binds to the antibodies. The complex that is formed upon binding blocks the transmitted light and causes light scattering resulting in increasing absorbance readings. Hence the degree of light scattering is inversely related to the concentration of drug present. Light scattering spectroscopy improves the sensitivity and quantitation of particle based immunoassays, thus making KIMS a highly sensitive and accurate technique in TDM. Its popularity has developed throughout the years for many reasons. Reagents required for this assay are in expensive and have high stability. KIMS is a universal assay and can be preformed on a variety of analyzers. The assay has minimal interference as a change of absorbance is measured as a function of time while absorbance readings of interfering substances do not alter with time.( Frederick P. Smith, Sotiris A. Athanaselis) CHROMATOGRAPHY AND its USE IN TDM For many years liquid chromatography has been linked to detection systems and its application in TDM is becoming incredibility popular. Liquid chromatography was initially employed in response to difficulties arising in Gas Chromatography (G.C) due to heat instability and non specific adsorption on surfaces. High Performance Liquid chromatography is the main chromatography technique utilized for TDM. Thin Layer Chromatography (T.L.C) and Gas Chromatography are other alternatives, however have limitations that suppress their use in TDM. A derivatization step must be performed for highly polar and thermo liable drugs for G.C to be successful. TLC has a poor detection limit and is unable to detect low concentration of drug present. HPLC has revolutionized the monitoring of TDM with rapid speed and sensitivity of analysis and can separate a wider variety of drugs compared to GC and TLC. For this reason, HPLC is considered the most widely adaptable chromatographic technique when coupled w ith UV detection and Mass Spectrophotometry for TDM.( Phyllis R. Brown, Eli Grushka) BASIC PRINCIPLES IN HPLC HPLC is a separation technique performed in the mobile phase in which a sample is broken down into its basic constituents. HPLC is a separation technique that employs distribution differences of a compound over a stationary and mobile phase. The stationary phase is composed of a thin layer created on the surface of fine particles and the mobile phase flows over the fine particles while carrying the sample. Each component in the analyse moves through the column at a different speed depending on solubility in the phases and on the molecule size. As a result the sample components move at different paces over the stationary phase becoming separated from one another. Drugs that are localised in the mobile phase migrate faster as to those that are situated in the stationary phase. The drug molecules are eluted off the column by gradient elution. Gradient elution refers to the steady change of the eluent composition and strength over the run of the column. As the drug molecules elute of HPL C is linked to a detection system to detect the quantity of drug present in the sample. Detection systems include mass spectrophotometry and UV detection. (Mahmoud A. Alabdalla Journal of Clinical Forensic Medicine) DETECTION SYSTEMS USED IN HPLC FOR TDM Detection of HPLC with a diode array ultraviolet detector has proved to be a sustainable application system in the identification after HPLC analysis. The use of UV detection allows the online possession the compounds UV spectra. These detection system absorb light in the range of 180-350nm. UV light transmitted passes through a sensor and from that to the photoelectric cell. This output is modified to appear on the potentiometric recorder. By placing a monochromatoer between and light source and the cell, a specific wavelength is created for the detection , thus improving the detectors specificity. A wide band light source can also be used as an alternative method. In this case the light from the cell is optically dispersed and allowed to fall on the diode array.( Mahmoud A. Alabdalla Journal of Clinical Forensic Medicine) HPLC can also be coupled to a mass spectrophotometer as a detection method. Mass spectrophotometry (MS) elucidates the chemical structure of a drug. Sensitivity of this technique is observed as it can detect low drug concentration in a sample. Specificity of this method can be futher enhanced by Tandem mass spectrophotometric analysis. This involves multiple steps of mass spectrophotometry. This is accomplished by separating individual mass spectrometer elements in space or by separating MS phases in time. (Franck Saint-Marcoux et al) FUTURE TRENDS IN TDM METHODOLOGY AGILENTS 1200 HPLC MICRO CHIP Agilents 1200 HPLC micro chip technology combines microfliudics with an easy use interface that confines the HPLC procedure tot his dynamic chip. The micro chip technology integrates analytical columns, micro cuvette connections and a metal coated electro spray tip into the chip to function as a regular HPLC analyzer. The compact chip reduces peak dispersion for a complete sensitive and precise technique. The microchip comes complete with an integrated LC system into sample enrichment and separation column. The operation of the chip is well defined and manageable upon insertion into the Agilent interface which mounts onto the mass spectrophotometer. The built in auto sampler loads the samples and the sample is moves into the trapping column by the mobile phase. Gradient flow from the pump moves the sample from the trapped column to the separation column. The drug is separated the same as the convention methods however reduced peak dispersion does produce better separation efficiency than the conventional method. This form of technology is currently in use in the United States but has not developed outside of the U.S(http://www.agilent.com) PHYZIOTYPE SYSTEM This is the latest application on the market for the treatment and monitoring of drugs associated with metabolic disorders. The PhyzioType system utilizes DNA markers from several genes coupled with biostatisical knowledge to predict a patients risk of developing adverse drug reactions. (Kristen k. Reynolds Roland Valdes) AMPLICHIP CYP450 TEST The Amplichip CYP450 Test is a new technology that has revolutionised the TDM of anti psychotic drugs. This test has been approved by the FDA in 2006 but is not currently in use in laboratories in Ireland. This test is used for the analysis of CYP2D6 and CYP2C19 genes, both of which have an influence in drug metabolism. The function of this test is to identify a patient genotype so their phenotype is calculated. Based on the patient phenotype, a clinician determines the type of therapeutic strategy he/she will commence (Kristen k. Reynolds Roland Valdes) DISCUSSION This paper illustrates the increasing role of immunoassay and chromatography techniques in the clinical laboratory routine monitoring of therapeutic drugs. Before an analytical technique is introduced into TDM it must meet the requirements of sensitivity, accuracy and specificity needed for most TDM applications. The methodology of TDM in todays clinical setting revolves around the use of immunoassays and chromatography techniques. A range of immunoassays was discussed revolving around their principle and advantages and limitations. The majority of immunoassays utilised in the TDM are homogenous based for rapid analysis and efficient turn around time for drug monitoring. Most immunoassays involved in TDM are based on the same principle of competitive binding for antibody. The factor that distinguishes each immunoassay is the detection methods used. Detection methods discussed in this reviewed include nephelometric techniques, flourscein labels, enzyme labels and the use of micro part icles. Each method relies on different detection principles as discussed, however characteristics common to all methods include accuracy, sensitivity and specificity. The methodologies discussed also are time and cost efficient, both essential in laboratory assays. Chromatographic techniques are also discussed with HPLC providing the most impact to TDM. Gas and thin layer chromatography are other chromatographic techniques, however neither can be utilised in TDM due to the limitations both techniques hold against TDM. . HPLC is a rapid sensitive method for the quantitation of drugs in a sample and for this reason is the most widely adaptable chromatographic technique applied in TDM. Like all chromatographic techniques drugs are separated based on the interaction of the drug with the stationary phase which determines the elution time. Detection methods primarily used are UV detection and mass spectrophotometry The final thought on this overview of TDM was an insight into the future of its methodology and applications .Future and approved methods are discussed given a brief outline on each. The constant development of methodologies and techniques in this area of TDM are ongoing constantly keeping the area of TDM one of the most fastest and interesting in clinical medicine. Literature Review: The Impact Of Legalized Abortion Literature Review: The Impact Of Legalized Abortion The publication of the controversial paper on legalised abortion and its affect on the rate of crime by Levitt and Donohue (2001) has resulted in widespread condemnation from a variety of sources, for example, Joseph Scheidler, executive direction of the Pro-Life Action league, described the paper as so fraught with stupidity that I hardly know where to start refuting it Crime fell sharply in the United States in the 1990s, in all categories of crime and all parts of the nation. Homicide rates plunged 43 percent from the peak in 1991 to 2001, reaching the lowest levels in 35 years. The Federal Bureau of Investigations (FBI) violent and property crime indexes fell 34 and 29 percent, respectively, over that same period. (Levitt, 2004) In his journal The impact of Legalized abortion on crime Levitt attempts to offer evidence that the legalization of abortion in 1973 was the chief contributor to the recent crime reductions of the 1990s. Levitts hypothesis is that legalized abortion may lead to reduced crime either through reductions in cohort sizes or through lower per capita offending rates for affected cohorts. The smaller cohort that results from abortion legalization means that when that cohort reaches the late teens and twenties, there will be fewer young males in their peak crime years, and thus less crime. He argues that the decision in Roe v Wade constitutes an abrupt legal development that can possibly have an abrupt influence 15-20 years later when the cohorts born in the wake of liberalized abortion would start reaching their peak crime years. In essence, Levitt puts forward the theory that unwanted children are more likely to become troubled adolescents, prone to crime and drug use, than wanted children are. As abortion is legalized, a whole generation of unwanted births are averted leading to a drop in crime two decades later when this phantom generation would have grown up. To back up this point, Levit t makes use of a platform from previous work such as (Levine et al 1996) and (Comanor and Phillips 1999) who suggest that women who have abortions are those most likely to give birth to children who would engage in criminal activity. He also builds on earlier work from (Loeber and Stouthamer-Loeber 1986) who concludes that an adverse family environment is strongly linked to future criminality. Although keen not to be encroach into the moral and ethical implications of abortion, Levitt, through mainly empirical evidence is able to back up his hypothesis by concluding that a negative relationship between abortion and crime does in fact exist, showing that an increase of 100 abortions per 1000 live births reduces a cohorts crime by roughly 10 per cent and states in his conclusion that legalized abortion is a primary explanation for the large drops in crime seen in the 1990s. One of the criticisms that can be levied against this study is its failure to take into consideration the effect other factors may have had in influencing crime rates during the 1980s and 1990s, such as the crack wave. Accounting for this factor, the abortion effect may have been mitigated slightly. Also Levitts empirical work failed to take into account the greater number of abortions by African Americans who he distinguishes as the race which commit the most amount of violent crime, and his evidence fails to identify whether the drop in crime was due to there being a relative drop in the number of African Americans. The list of possible explanations for the sudden and sharp decrease in crime during the 1990s doesnt stop at Levitts abortion/crime theory and Levitt himself in his 2004 paper identifies three other factors that have played a critical role. The first is the rising prison population that was seen over the same time period, and (Kuziemko and Levitt, 2003) attribute this to a sharp rise in incarceration for drug related offences, increased parole revocation and longer sentences handed out for those convicted of crimes, although there is the possibility of a substitution effect taking place where punishment increases for one crime, potential criminals may choose to commit alternative crimes instead. There are two ways that increasing the number of person incarcerated could have an influence on crime rates. Physically removing offenders from the community will mean the avoidance of any future crime they may plausibly commit during the time they are in prison known as the incapacitation affect. Also there is the deterrence effect, through raising the expected punishment cost potential criminals will be less inclined to commit a crime. As criminals face bounded rationality, expected utility gained from crime will have an effect on the amount of time spent devoted to crime. (Becker, 1968). A study conducted by Spelman (2000) examined the affect the incarceration rate would have on the rate of crime and finds the relationship to have an elasticity measure of -0.4 which means that an increase in the levels of incarceration of one percent will lead to a drop in crime of 0.4%. In Economic models of crime such as Becker (1968), improvements in the legitimate labor market make crime less attractive as the return earned from legitimate work increases. Using this model, the sustained economic growth that was seen in the 1990s (Real GDP per capita grew by almost 30% between 1991 and 2001 and unemployment over the same period fell from 6.8 to 4.8 percent) could be seen as a contributing factor to the drop in crime witnessed and many scholars (such as) have come to that conclusion. However, the improved macroeconomic performance of the 90s is more likely to be relevant in terms of crimes that have financial gains such as burglary and auto theft and does not explain the sharp decrease seen in homicide rates. Also, the large increase in crime seen in the 1960s coincided with a decade of improving economic growth, further corroborating the weak link between macroeconomics and crime (Levitt, 2004). One other explanation for the drop in crime and the most commonly cited reason can be seen in the growing use of police innovation, and an adoption of community policing. The idea stemmed from the broken window theory, which argues that minor nuisances, if left unchecked, turn into major nuisances (Freakonomics) The main problem with the policing explanation is that innovative police practices had been implemented after the crime rate had already began declining, and perhaps more importantly, the rate of crime dropped in cities that had not experienced any major changes in policing (Ouimet, 2004).

The Fantasy World of The Glass Menagerie :: Glass Menagerie essays

The Fantasy World of The Glass Menagerie In The Glass Menagerie, Tennessee Williams creates a world in which the characters are disillusioned by the present. Amanda, Tom, and Laura achieve this disillusionment by resorting to separate worlds where they can find sanctuary. Each character develops their own world, far away from reality. Amanda frees herself from the harsh realities of life by constantly reminding herself of the past. To begin with, she continuously repeats the story of the "one Sunday afternoon in Blue Mountain" when she received seventeen gentlemen callers (1195). Furthermore, she keeps a "larger-than- life-size" photograph of her husband over the mantel who left the family when the children were young. When Jim came over for dinner, Amanda wears the "girlish frock of yellowed voile with a blue silk sash" that she wore on the day she met her husband (1222). Amanda obsesses with the past, and at the same time damaging the children psychologically. Constant allusions to the past have psychologically affected Tom and Laura, trapping them into Amanda$BCT(J lost world. Tom and Laura fail to survive in the present because they are always trying to live through the past. However, the past no longer exists, causing them distress in their journey through life. Tom is unsuccessful with his job at the warehouse and Laura cannot seem to fit in with the outside world. These personal downfalls in life drive Tom into a life of poetry and movies, and Laura into a world of glass figurines. Tom is unsatisfied with his work at the warehouse and feels his life lacks adventure. Therefore, he finds it through writing poetry and watching movies. When business is slow at the shoe warehouse, Tom goes to the washroom to work on his poetry. Tom finds adventure in poetry because he is able to create and control his own world. Along with poetry, Tom retreats to the movies every evening to fulfill his adventurous nature. Amanda questions Tom, "why do you go to the movies so much, Tom?" Tom replies, "I go to the movies because$BM*(J like adventure. Adventure is something I don$BCU(J have much of at work, so I go to the movies"(1210). Tom$BCT(J obsessions with adventure leaves him no time or energy to concentrate on his present responsibilities at work. Therefore, he leaves Amanda and Laura for the Merchant Marines, a place where he can live out his dreams for adventure. However, he cannot forget Laura, "I tried to leave you behind me, but I am more faithful than I intended to be!"(1247). Laura's problem, according to Jim, is her "inferiority complex"

Japanese Culture and Society Essay

Japan is country having a strong economic power, and good income levels and the citizen’s standard of living are one of the highest in the world. Japan’s fruitful economy is a result of fine consumer goods exports which were developed with the latest technologies that Japan has to offer. Another factor which made Japan rise would be its well-rounded culture. One of the noticeable factors of Japan’s culture would be its education. Education is a stabilizing factor in a person’s life and a country. Education is one important factor in creating a strong country. The adult literacy rate in Japan is exceeding 99 percent which makes Japan to be one of the top nations in the whole world in terms of educational achievement. School education in Japan begins before grade one in preschool. It is free and a compulsory need for elementary and junior high school education. In Japan, more than 99 percent of elementary school-aged children are going to their respective school which is an astonishing statistic for a nation. Their high school are composed of two divisions which are junior and senior high school which is composed of three years each. An estimate of one third of the senior high school students continues their education to college. Their admission to different high schools and university are based on difficult entrance exams. There is much competition in getting a high position in the entrance exams because most of Japan’s well paying jobs admit employees of the graduates of high quality universities. Approximately, 1 percent of elementary schools and 5 percent of junior high schools are private establishments or are not owned by the government. An estimated of 25 percent of high schools are privately owned. There are no biases between public and private schools in Japan, entrances to elite universities are not based on the status of a student’s school. In the year 1998, it was evident that there were 604 four-year college universities and 588 two-year junior colleges were in Japan. Some of the elite and prominent universities in Japan include the University of Tokyo, Kyoto University, and Keio University in Tokyo. The early beginnings of education in Japan were sourced in the ideas and teachings from ancient China. In the 16th and 17th centuries, European travellers also affected the Japanese school education. From the years1640 to 1868, during Japan’s era of separation under the Tokugawa shoguns, Buddhist temple called terakoya served as the schools of the country. The temples took accountability for the country’s education and made astounding developments in raising the literacy levels among the population of the country. In the year 1867, it was assumed that there were more than 14,000 temple schools all over Japan. In the year 1872, the new Meiji regime created a ministry of education and a thorough educational code that integrated widespread primary education. During this period, Japan looked at other nations such as Europe and North America for effective educational models. As the Japanese regime expanded during the late 1930s and early 1940s, education of the country became a factor for nationalistic and militaristic needs. After Japan’s defeat in World War II, the educational system of the country was refurbished because of some concerns. Changes incorporated the current grade structure that states that the elementary school is six years and junior and senior high school are composed of 3 years each; there was also the implementation of a guarantee of equal access to free, public education. The changes included a finish to the teaching of nationalistic ideology. Reforms also sought to encourage students’ self-expression and increase flexibility in curriculum and classroom procedures. Nonetheless some critics still deem that education in Japan is extensively rigorous, preferring memorization of facts at the outlay of imaginative expression, and geared to encouraging social conventionality. Education in Japan is taken seriously and is a big attribute to the development of the country. Education is shown as factor in a youth’s life, it a vital block to a Japanese citizen’s structure and identity. Japan, as of any country, has its own social problems, this includes youth deviance. In Japan, there are also youth problems such as young people smoking, drinking alcohol, reading pornographic magazines and staying out late. These activities in some other countries are now accepted as ordinary youth culture. But one of the data radically shows that youths that participate in these appalling youth culture are mostly participated by lower high school students. (Yoder) The higher high school students do not involve themselves in these said youth culture unlike the lower high school students. (Yoder) Higher high school students spend most of their time in schooling. There are more occupied with academic and non academic matters such as aiming for high grades to get to an elite university and honing their skills in different sports and talents. It is a fact that when a Japanese student gets older, he becomes more mature and focuses his priorities more in his education than in awful youth activities. Education in Japan offers a complete picture of young people and a reasonable understanding of their lives. Most of the labelled delinquents in the youth of Japan are those who do not participate much in school or are not guided by their parents and guardians. (Yoder) Japan has made schooling as guidance for its youth. The country has successfully installed the importance of education to their youth and the youth responds accordingly to it. If it weren’t for their proper education, Japan’s youth wouldn’t have anything to guide it. The effect of education to the youth in Japan is great because the country focused a great deal on education and allocated much funds for it. Even though most of Japan is comprised of public schools, the public schools still have the same quality of education as of other private schools in other countries. (Yoder) This wonderful trait makes Japan’s education a wonderful asset to a Japanese person. Another evidence on how much education affects Japan would be the effect of deaf education. Until the mid-1970s, deaf citizens of Japan receive few legal privileges and little social acknowledgment. (Nakamura) By the law, they were categorized as minors or as mentally deficient, not capable of acquiring a driver’s licenses or even sign contracts and wills. Many deaf people in the country worked at establishments that offer basic tasks or were frequently unemployed, and schools for the deaf initiate a complicated regimen of speech reading and oral speech approaches rather than signing. (Nakamura) After several decades, activism became the ears of deaf men and women which are now essentially acknowledged within mainstream of Japanese society.

Education and its impacts in students learning Essay

The paper is about education and how its impacts enhance students learning. Universal access to education is one of the millennium goals of development. The main observations have been made together with the impacts. There is a brief introduction to what education really is. In addition, the essay further concludes by giving recommendations to what should be done to ensure every person has access to learning facilities both in the developing and undeveloped countries. Introduction Education can be termed as wealth of awareness. It can be picked up by a person and passed from one generation to the next after studying a certain subject or undergoing life lessons. It can be said to be a form of learning. Unfortunately, universal access to education has not been completely attained. A great education begins at home hence the kind of a background a child comes from will have an impact on their education. Observations made on education It has been observed that poverty particularly in developing countries is a major cause for education inequality. Secondly, the importance of education in modern world cannot be taken for granted. For instance, some sectors such as the military previously did not put emphasis on education requirements but currently they have raised minimum education requirements. It has also been observed that most countries are adopting modern technology in their learning institutions. There has been an increase in use of electronic devices such as laptops and I pads. More so, learning has been made easier since one can be educated from home through the e-learning. The observations made can be compared to the education indicators as listed by Aud et. al (2013). Impacts on students learning The Social economic status is based on the parent’s level of learning, their profession, earnings and their position in their social order. Parents with a high social economic status are likely to lay a good background for their children education than those of low status. They can afford to buy their children most of education materials they require such as pens, books and toys for young kids to enhance their early schooling. They are also capable of ensuring that their offspring have access to quality health care. In addition, these parents can access information about the well performing schools and they can also afford to pay the fees. On the other hand, parents with low social economic status usually do not have high levels of education hence their children will not be well prepared at home to start schooling unlike those with high social economic status. Gender in most African countries is still an issue to be looked upon. Boys are always preferred when it comes to access to education especially when resources to take children to school are limited. For instance, even if a girl had a better score than a boy, parents in most of African countries will prefer to take the boy for higher learning. Studies have shown that most of the poorest women in most countries have not even completed their primary school. Poverty is another impact on education. Children from poor households are less likely to perform well in class. These children usually have less participation in class, their level of terminology is low hence unlikely to perform well. Their parents cannot afford good nutrition for their kids and as a result, kids may have nutritional related illnesses and their education is disrupted. Parenting is the process of upbringing children. A child’s parent is commonly their first educator. Parents have roles of ensuring that their children are prepared for school, for example by ensuring that they have sufficient food and good health, this is necessary for a child concentration in class which results to good performance. It is at home that parents mostly emphasis on virtues such as hard work, integrity and commitment. The Society also has an impact on education. Community customs and practices have a great impact on education, which can either be helpful or damaging. For example, communities with traditions that encourage early marriages for girls prevent them from accessing their fundamental right to education. Technology, which is being embraced quite well in most countries, has a great impact on students’ performance. This is majorly for students in higher learning institutions. Students with access internet are able to complete their assignments in time. Most of higher learning institutions have embraced modern technology and they are offering some courses or units online, this is convenient for those students with access to internet because they can take classes at their free time and can also learn at their own pace. Conclusion Social economic status and poverty have the greatest impact on children access to education. Other factors with impact on education are access to technology, parenting, and race among others. These factors may have positive or negative impacts on children access to education. Undesirable effects such as inequality in education can be dealt with by making primary school education free and compulsory. If possible, education at each stage should be made free or affordable to everyone, promoting women education, discouraging child labor and school dropouts. Embracing modern technology improves education quality worldwide. References Aud, S. , Wilkinson-Flicker, S. , Kristapovich, P. , Rathbun, A. , Wang, X. , Zhang, J. , & National Center for Education Statistics, (2013). The Condition of Education 2013. NCES 2013- 037 . National Center For Education Statistics, accessed on 24th May 2013.

Leonardo Da Vinci2 essays

Leonardo Da Vinci2 essays Leonardo da Vinci is probably the most famous complex artist of the Renaissance and perhaps all time. But what many people dont know is that he wasnt just a genius in art he also excelled in sculpting, architecture and he was also an inventor. Leonardo was born in a small stone house on April 15, 1452. Leonardo started off interesting from the way he was conceived to what happened to his grave after he died. He was born an illegitimate child in the small town of Vinci. We dont know much of anything about his mother accept her name was Caterina and in town history she was known to be a barmaid. On the other hand we know much about his father. His fathers name was Piero da Vinci, he was in his mid twenties when Leonardo was born and he worked as a lawyer in the small town of Vinci and later moved to Florence where he became a very accomplished lawyer. Piero was a man who seemed to have bad luck because he had four wives and three of them died. He wasnt the nicest guy either because he wasnt going to take Leonardo in until he found out his new 16 year old wife was barren and then he did because he wanted a child. While Leonardo was growing up his father noticed his artistic talent and at the age of 15 his father too k him to Florence to an art studio where he worked under Giorgio Vasari. Vasari wrote much about Leonardo after his death. He wrote that Leonardo had "a spirit and courage invariably royal and magnanimous"(The World of Leonardo, pg12) and he "could sing and improvise divinely"(The World of Leonardo, pg12). In Vasaris biography you can tell that he had much respect for Leonardo he pictures him as a happy young man that was a singer, flute player, and could converse for hours. Leonardo was entered into the painters guild shortly after his apprenticeship and started painting. Its weird though that Leonardo is known so much for his painting when he painted just over a dozen of ...

The Union Jack Flag - Flag of the United Kingdom

The Union Jack Flag - Flag of the United Kingdom The Union Jack, or Union Flag, is the flag of the United Kingdom. The Union Jack has been in existence since 1606, when England and Scotland merged, but changed to its current form in 1801 when Ireland joined the United Kingdom Why the Three Crosses? In 1606, when England and Scotland were both ruled by one monarch (James I), the first Union Jack flag was created by merging the English flag (the red cross of Saint George on a white background) with the Scottish flag (the diagonal white cross of Saint Andrew on a blue background). Then, in 1801, the addition of Ireland to the United Kingdom added the Irish flag (the red Saint Patricks cross) to the Union Jack. The crosses on the flags relate to the patron saints of each entity - St. George is the patron saint of England, St. Andrew is the patron saint of Scotland, and St. Patrick is the patron saint of Ireland. Why Is It Called the Union Jack? While no one is quite certain where the term Union Jack originated, there are many theories. Union is thought to come from the union of the three flags into one.   As for Jack, one explanation states that for many centuries a jack referred to a small flag flown from a boat or ship and perhaps the Union Jack was used there first.   Others believe that Jack could come from the name of James I or from a soldiers jack-et. There are plenty of theories, but, in truth, the answer is that no one knows for sure where Jack came from. Also Called the Union Flag The Union Jack, which is most properly called the Union Flag, is the official flag of the United Kingdom and has been in its current form since 1801. The Union Jack on Other Flags The Union Jack is also incorporated into the flags of four independent countries of the British Commonwealth - Australia, Fiji, Tuvalu, and New Zealand.

Characteristics of Pure Competition

Characteristics of Pure Competition 1.0 Introduction Basic microeconomic theory states that firms should seek to maximize profits and that this is achieved where marginal revenue is equal to marginal cost. A number of assumptions underpin this theory, including the assumptions that firms clearly understand the nature of the demand for their products, and why people buy, and that they are willing and able to control production and sales as the model demands. In reality, decision makers do not have perfect knowledge and production and sales are affected by suppliers and distributors. However, this basic theory has resulted in the development of market models and characteristics of these in respect of barriers to entry into the industry, the number of firms in the industry, whether those firms produce a standardized product or try to differentiate their products from those of other firm. At the early 1920’s, only two distinct market models are present in the economic studies which are Pure Competition and Pure Mon opoly. However, economist found out that most firms operate in markets that fall between the extremes of pure competition and pure monopoly. These firms do not face competition from numerous rival producers all selling a homogeneous product at a single price. Instead, most firms in the real commercial world face varying degrees of competition. In some cases, there are competitions offering more or less identical products; in other instances, firms produce and sell differentiated products. In the latter case, a competitor’s product is merely an attractive substitute. In the real commercial world, there may be numerous competitor, or there may be only a few other sellers in a given market. The need of for a more accurate world for markets of this type of this type led to the development of ‘imperfect market’ to refer to such markets. Imperfect competition refers to markets lying in between the two extreme forms of markets, pure competition and pure monopoly. In ord er to bridge the gap of these extreme forms of market structure, two economists, Joan Robinson of Cambridge University of England and Edward Chamberlin of Harvard University in the U.S.A., introduced independently a third market world to explain and illustrate the theory of imperfect competition in the year of 1993. In other words, their model of market organization is what as refer as monopolistic competition. As a result of the variations between the markets present, four distinct market structures are introduced: Pure Competition, Pure Monopoly, Monopolistic competition, and Oligopoly. Pure Competiton Pure Competition is a rarity as such as a theoretical market model. Pure competition involves a very large number of firms producing a standardized, non differentiated product that is exactly identical to that of other firms as perfectly competitive. Pure Competition is a market which firms will only make ‘normal’ profits, the amount required for them to stay in the ind ustry. In Pure Competition market there are no major barriers to entry into the industry so new firms can enter or exit the industry very easily. If a Pure Competition market reaches a situation which supply exceeds demand then the ruling market price is forced down and only the efficient firms survive.

Effect of Conquest of America on Europe's relationship with Africa and Essay

Effect of Conquest of America on Europe's relationship with Africa and Asia - Essay Example Each ship that ventured out to the unknown world has gold, territory and glory as objectives for the country it served. When America was discovered, it was found that its natural resources were in abundance and in the flurry of new explorations fueled by the American colonial success, they found Asia and Africa and the new resources that they had to offer, resources that can be easily exploited and easily compliment their interests in the New World. It is in this respect that the African slavery became significant. The mines of Peru and Mexico, the plantations in Brazil and the Caribbean - they required new laborers after the number of indigenous peoples were effectively decimated upon the arrival of the colonizers. According to Crosby (2003), the Andean Inca civilization alone lost more than 8 million of its 9 million indigenous natives (22). During most of the period of colonization of Africa, its main utility for its colonizers were its slaves. Millions of Africans were shipped to the plantations in America and this trade in itself has been a major source of revenue for Portugal. Besides the slaves, however, Africa also supplied ivory, gold, diamonds, cocoa, nut oils and timber. The case of Asian relationship with Europe, the situation is a little more different than the African experience. Unlike the latter, Asia fell to European colonization rather later. It was only after the 1850s wherein the West made some significant headway in colonizing the Far East. This variable contributed to the manner by which the Asian colonies were exploited and administered. For instance, Spain ruled the Philippines through Mexico. Then, Asian slaves were not common while their raw materials produce and other products were either sent to Europe or to Latin America for processing. Britain was also able to milk India dry with its precious stones, spices, tea, and other resources. Asia, somehow, was treated like Latin America, a source of wealth for its masters that wield their power from Europe but not in the degree or manner the Europeans exploited Africa. What the colonization of the Americas, Asia and Africa demonstrated was the fact that these continents became embroiled with some form of globalization especially producing a type of division of labor that we could actually identify as roughly similar to what we have today. One analogy that could probably describe the situation was how other races were exploited in order to enrich and provide for the requirements of the European imperialists. A less emotional description would argue that during the age of colonization, nations became engaged with specialization in goods production and in occupation by their respective peoples, according to the resources of their home countries and their status in the empire that they belong. An important variable that must be underscored in this investigation is the fact that the European hegemony during the Age of Discovery is not mainly driven by the absolute superio rity of the European technologies and weaponry. Spain, for example has risen to its imperial status and consolidated its global

Wheelchair Experience Assignment Essay Example | Topics and Well Written Essays - 1250 words

Wheelchair Experience Assignment - Essay Example So I decided to bring him to a mall in his wheelchair and have lunch there at the same time. The first difficulty we had was looking for a space to park our car which had to be somewhat near the entrance. We were fortunate to find a spot very close to the mall entrance, but found it frustrating that there were no ramps to access the curb. I finally rolled my cousin up to the entrance, where a nice young man held the door open for us. Upon entering the mall, my cousin found it somewhat simple to move the wheelchair through the aisles and walkways. Deciding to have lunch, we had to take an elevator to the first floor to get to the food court. We got directions from a store map to find where the elevator was, and we found out it was on a far side of the mall. However, we were pleased that the elevator was quite fast and spacious. After that, we found the entrance to the food court very easily, and my cousin was able to maneuver to the food court by himself. As soon as we arrived at the food court, my cousin commented that the brick flooring made it a quite uneven ride up to the food counters. After selecting a food stall, my cousin was able to hold and stretch for the orders with my help, until it was time to look for a table. My cousin had to let me carry his food to me until I got seated at the table. We finally managed to find an oval table with enough room to get my cousin’s body conveniently level to the table. Eating in the wheelchair appeared fairly alike to eating while in a regular chair, and my cousin shared that it was easy to do so. However, we noticed that he needed to lock the wheelchair in place to keep from rolling away while he ate or stretched for the food. After eating we decided to visit some shops. We went inside several clothing shops, and all three were just about the same in construction. The first shop was the easiest of the stores to maneuver, since there was a

The Great Depression Essay Example | Topics and Well Written Essays - 250 words

The Great Depression - Essay Example Progressivism at its best aimed to remove corruption by imposing child labor laws, addressing lynching based on racism, and removing politicians that were involved in illegal business practices. At the local level, progressivism continued to display brilliant signs of reform as the construction of schools was pushed, political machines were dissolved, and politics was addressed in an efficient manner.   Roosevelt’s New Deal was considered of two phases that were planned to recovery and relief. The first phase concentrated on to heal society from Great Depression through different channel. Acts such as the Agricultural Adjust Administration clearly boosted agriculture reform and built civil infrastructure. Bank reform occurred in Federal Deposit Insurance Corporation (FDIC), which installed a limit and tightened finance regulations. The second phase of the New Deal 1935 and 1941 concentrated on recovery measures. The implementation of the social security system tremendously s ecured the economic security and the individual warfare. The Fair Labor Standards Act that was passed in 1938 again emphasized as minimum living standards for workers that were associated with commerce.   The minimum wage was raised from $0.25 to $0.40 along with 44 hours limit and established pay for overtime. The Department of Labor spearheaded this effort as the standards were

Humanities-week 2 Term Paper Example | Topics and Well Written Essays - 250 words

Humanities-week 2 - Term Paper Example I believe that he is someone who has the capacity to lead a nation without fear of dying. He also showed how loyal he is to his friends and companions when he fought back for Patroclus. Even if he refused to fight anymore, he begged his mother to make him new armour ended his refusal to fight. Discussion 2: Greek Legacy †¢ Describe one way that you see a particular tenet of Greek philosophy reflected in the modern Western worldview One of the most influential principles of Greek philosophy came from Plato. In the modern Western worldview, we continuously strive how to live a good life. In Plato’s famous dialogue named The Republic, he talked about the central problem of how to live a good life. He also tackled about the ideal state, state with justice and the just individual. In our world today, we all know that we are still in the midst of finding the answers to these questions. Our state is still striving hard to become a just and ideal state that could serve the best t o the people. Individuals also struggle to become good to others. Modern Western worldview still reflects the quest to ideal republic and justice. Discussion 3: Roman Legacy †¢ Describe a specific example of life in Ancient Rome that is found in contemporary life in the U.S. One of the most prominent lifestyle in Ancient Rome is their desire for innovation and love for gadget.

How is Gender, Class, Race and Ethnicity Signicant in America Today Essay

How is Gender, Class, Race and Ethnicity Signicant in America Today - Essay Example It is therefore important that the society is able to plan for its operations taking into consideration the abilities of its members. According to Wade (96), these are aspects of identity but all in all they create a distinction between individuals. There is the positive and progressive way of consideration of these factors of distinction and there is the negative and retrogressive consideration. This is purely a matter of perception it is that of a person either seeing a half full glass or the half empty glass. This paper therefore seeks to find out the relevance of these major distinctions in America today. Introduction Identity is the first strength that a human being has. One can not determine what identity he is given by nature. We have no ability to choose the social class in which we are born. We have no power to predetermine the race, the gender and the ethnicity. Nature predetermines this to achieve its own balance. The balance is achieved because of all the factors that are given come with abilities that are pertinent to the growth and development of the surrounding of the given entity. To understand the importance of this factors of identity it important to check the inner details of each one of them. In social planning it is important that a government that has been mandated by the people to protect the minority. Among the distinguishing factors come the factors that define identity. The actual number of the people under a given stratification gives the government an insight on what provisions to make (Karim pg1). Gender According to Gurian (10) the fact is a community is stratified in two categories; it is either one is male or female. The art of people of the two genders working together is based on core strength and not science or intellectual ability. Nature has predetermined that the two genders complement each other in a natural way and therefore such are there abilities. In the issues of leadership men have been known to be decisive and this has been highly complimented by women who take their time to analyze and consult. This is the fall back fact of democracy in the world. There are societal issues that affect only the a specific gender therefore for the government to be able to make relevant legislations and provisions it is important that the issue at hand is uplifted and therefore observed in a positive light. Is this is undertaken then it is clear that all the relevant structures to address those specific issues effectively. Traditionally the issue of gender has been a competition platform of the two sexes. But with the modern times and the female gender having made significant advances it has come to be appreciated that the two need each other for the betterment of the society. This however has not been fully achieved as there is still need for affirmative action in favor of the female gender. It is still normal to see the female discriminated against as a result of their gender. This has been so despite the fact that the world has come to accept that the intellectual ability of an individual is not based on gender (Glenn pg 4). The mandate of the government is then to decrease the stereotype minds set and give the same opportunities for the two genders to have fair competition for the resources that can be available to the society. The significance therefore lies in the planning and implementation of all the aspects that are important to achieve the parity

The Great Depression Essay Example | Topics and Well Written Essays - 250 words

The Great Depression - Essay Example Progressivism at its best aimed to remove corruption by imposing child labor laws, addressing lynching based on racism, and removing politicians that were involved in illegal business practices. At the local level, progressivism continued to display brilliant signs of reform as the construction of schools was pushed, political machines were dissolved, and politics was addressed in an efficient manner.   Roosevelt’s New Deal was considered of two phases that were planned to recovery and relief. The first phase concentrated on to heal society from Great Depression through different channel. Acts such as the Agricultural Adjust Administration clearly boosted agriculture reform and built civil infrastructure. Bank reform occurred in Federal Deposit Insurance Corporation (FDIC), which installed a limit and tightened finance regulations. The second phase of the New Deal 1935 and 1941 concentrated on recovery measures. The implementation of the social security system tremendously s ecured the economic security and the individual warfare. The Fair Labor Standards Act that was passed in 1938 again emphasized as minimum living standards for workers that were associated with commerce.   The minimum wage was raised from $0.25 to $0.40 along with 44 hours limit and established pay for overtime. The Department of Labor spearheaded this effort as the standards were

How is Gender, Class, Race and Ethnicity Signicant in America Today Essay

How is Gender, Class, Race and Ethnicity Signicant in America Today - Essay Example It is therefore important that the society is able to plan for its operations taking into consideration the abilities of its members. According to Wade (96), these are aspects of identity but all in all they create a distinction between individuals. There is the positive and progressive way of consideration of these factors of distinction and there is the negative and retrogressive consideration. This is purely a matter of perception it is that of a person either seeing a half full glass or the half empty glass. This paper therefore seeks to find out the relevance of these major distinctions in America today. Introduction Identity is the first strength that a human being has. One can not determine what identity he is given by nature. We have no ability to choose the social class in which we are born. We have no power to predetermine the race, the gender and the ethnicity. Nature predetermines this to achieve its own balance. The balance is achieved because of all the factors that are given come with abilities that are pertinent to the growth and development of the surrounding of the given entity. To understand the importance of this factors of identity it important to check the inner details of each one of them. In social planning it is important that a government that has been mandated by the people to protect the minority. Among the distinguishing factors come the factors that define identity. The actual number of the people under a given stratification gives the government an insight on what provisions to make (Karim pg1). Gender According to Gurian (10) the fact is a community is stratified in two categories; it is either one is male or female. The art of people of the two genders working together is based on core strength and not science or intellectual ability. Nature has predetermined that the two genders complement each other in a natural way and therefore such are there abilities. In the issues of leadership men have been known to be decisive and this has been highly complimented by women who take their time to analyze and consult. This is the fall back fact of democracy in the world. There are societal issues that affect only the a specific gender therefore for the government to be able to make relevant legislations and provisions it is important that the issue at hand is uplifted and therefore observed in a positive light. Is this is undertaken then it is clear that all the relevant structures to address those specific issues effectively. Traditionally the issue of gender has been a competition platform of the two sexes. But with the modern times and the female gender having made significant advances it has come to be appreciated that the two need each other for the betterment of the society. This however has not been fully achieved as there is still need for affirmative action in favor of the female gender. It is still normal to see the female discriminated against as a result of their gender. This has been so despite the fact that the world has come to accept that the intellectual ability of an individual is not based on gender (Glenn pg 4). The mandate of the government is then to decrease the stereotype minds set and give the same opportunities for the two genders to have fair competition for the resources that can be available to the society. The significance therefore lies in the planning and implementation of all the aspects that are important to achieve the parity

Improving Carbon Dioxide Solubility in Ionic Liquids Essay Example for Free

Improving Carbon Dioxide Solubility in Ionic Liquids Essay Previously we showed that CO2 could be used to extract organic molecules from ionic liquids without contamination of the ionic liquid. Consequently a number of other groups demonstrated that ionic liquid/CO2 biphasic systems could be used for homogeneously catalyzed reactions. Large differences in the solubility of various gases in ionic liquids present the possibility of using them for gas separations. More recently we and others have shown that the presence of CO2 increases the solubility of other gases that are poorly soluble in the ionic liquid phase. Therefore, a knowledge and understanding of the phase behavior of these ionic liquid/ CO2 systems is important. With the aim of finding ionic liquids that improve CO2 solubility and gaining more information to help us understand how to design CO2-philic ionic liquids, we present the low- and high-pressure measurements of CO2 solubility in a range of ionic liquids possessing structures likely to increase the solubility of CO2. We examined the CO2 solubility in a number of ionic liquids with systematic increases in fluorination. We also studied nonfluorinated ionic liquids that have structural features known to improve CO2 solubility in other compounds such as polymers, for example, carbonyl groups and long alkyl chains with branching or ether linkages. Results show that ionic liquids containing increased fluoroalkyl chains on either the cation or anion do improve CO2 solubility when compared to less fluorinated ionic liquids previously studied. It was also found that it was possible to obtain similar, high levels of CO2 solubility in nonfluorous ionic liquids. In agreement with our previous results, we found that the anion frequently plays a key role in determining CO2 solubility in ionic liquids. Introduction The phase behavior of CO2 with ionic liquids (ILs) is important for the development of several potential IL applications. Since we first showed that CO2 was soluble in ILs and could be used to extract organic solutes,1-3 IL/CO2 systems have been demonstrated for various catalytic reactions.4-17 In some cases, CO2 is used to extract the product from the IL, leaving behind the catalyst and the IL for reuse. Others have adopted IL/CO2 continuous flow systems, where CO2 is used to deliver the substrates to the IL/catalyst phase and extract the products. Recently we also confirmed that CO2 could increase the solubility of gases normally not very soluble on their own in ILs.18 We found that the solubility of CH4 and O2 increased in ILs even at low partial pressures of CO2. Others studying the enantioselective hydrogenation of imines using a cationic iridium catalyst in an IL/CO2 biphasic system found that the catalyst performance was increased dramatically in the IL when CO2pressure was added.19 High-pressure NMR showed that the addition of CO2 increased the amount of H2 dissolved in the IL. The authors believed that the catalyst, which was known to be sensitive to H2 availability, could operate more effectively due to an increase in H2 concentration in the IL along with a decrease in viscosity of the IL with added CO2. Another * Corresponding author. Telephone: (574) 631-5847. Fax: (574) 6318366. E-mail: [emailprotected] †  Current address: EaStCHEM, School of Chemistry, University of St Andrews, North Haugh, St Andrews, Fife KY16 9ST, U.K. E-mail: [emailprotected] †¡ Current address: Intermediates RD, Invista S.a.r.l, Sabine River Laboratory B568, P. O. Box 1003, Orange, TX 77631-1003. potential application of ILs that several research groups along with our group have examined is the separation of CO2 from gas mixtures.20-22 To design and optimize processes using ILs, it is essential that we understand the important factors that determine CO2 solubility. It is possible to design many potential ILs; therefore, the systematic study of different cation/anion combinations will allow us to decipher the key properties in making CO2-philic ILs. To date we have studied the solubility of CO2 in a range ofcommonly used ILs.2,23-29 We found that there were a number of factors that controlled the CO2 solubility in the chosen ILs, both cation and anion related.26 Of the ionic liquids studied, the anion played the biggest role in CO2 solubility, a fact that was supported by a recent X-ray diffraction study by Kanakubo et al.30 Anions that contain fluoroalkyl groups were found to have some of the highest CO2 solubilities, and as the quantity of fluoroalkyl groups increased, the CO2 solubility also increased. The previous studies showed CO2 solubility for 1-butyl3-methylimidazolium ([bmim]+) based ILs at 60  °C increased in the order nitrate ([NO3]-) tetrafluoroborate ([BF4]-) dicyanamide ([DCA]-) ? hexafluorophosphate ([PF6]-) ? trifluoromethanesulfonate ([TfO]-) bis[(trifluoromethyl)sulfonyl]imide ([Tf2N]-) tris(trifluoromethylsulfonyl)methide ([methide]-). For the cations, there were two factors thatinfluenced the CO2 solub ility. The biggest effect was seen in increasing alkyl chain length on the cation. For a given cation, the CO2 solubility increased with increasing chain length, and these results are consistent with those reported elsewhere.31-35

Issues of Nurse Prescribing in the UK

Issues of Nurse Prescribing in the UK Introduction The changing face of the NHS is a topic of controversy and debate from the perspectives of professionals and policy makers. The last three decades have seen a transformation in nursing in the United Kingdom, and in the ways that nurses envisage themselves (McCartney et al, 1999). This transformation is only one symptom of a raft of policy changes which have affected the NHS. Evolution of nursing as a profession has seen them moving from being a group labelled the doctors’ handmaidens to a professional group with its own staunchly defended identity (McCartney et al, 1999). This new professionalism has also led to diverse developments and advancements in the role and functions of nurses, with increased autonomy and extended roles which could be viewed as encroachment on medical roles or as ideal management of an already skilled and knowledgeable workforce. As far back as 1986, the Cumberledge report raised the possibility of allowing community nurses to prescribe independently, and several years later the necessary legislation was initiated (McCartney et a, 1999). In 1997, the government established a review of prescribing, supply and administration of medicines, chaired by Dr June Crown (Stephenson, 2000). This became known as the crown report (DH, 1998). It was chiefly concerned with the supply and administration of medicines by group protocols (S tephenson, 2000). A group protocol could be described as a specific written instruction, drawn up locally by doctors and pharmacists, for the supply or administration of named medicines by other health professionals in an identified clinical situation (Stephenson, 2000). A number of authors supported this move and in particular, the ability for nurses to be able to prescribe medications for clients in certain circumstances. However, the implementation of this policy change has been neither uniform or timely. This paper will explore the policy context of the implementation of nurse prescribing, utilising a theoretical framework to examine the laggard nature of the change and the reasons why nurse prescribing remains unfinished business in the professional and policy arena. The theoretical framework used will be the Diffusion of Innovation theory, as defined by Rogers (1962, 1976). Diffusion of Innovation Rogers (1962, 1976) defines the diffusion process as the spread of a new idea from its source of invention or creation to its ultimate users or adopters. This could be considered the macro level of change assimilation or even awareness. However, the notion of diffusion of innovation is more than a macro concept, and Rogers (1962, 1976) further differentiates what he describes as the adoption process from the diffusion process in that the diffusion process occurs within society, as a group process; whereas, the adoption process is individual. In Rogers’ (1962, 1976) opinion, the adoption process is the mental process through which an individual passes from first hearing about an innovation to final adoption. The theoretical construct of chief concern here is that of macro level diffusion of a professional innovation. There are five stages in the Innovation-Decision Process as described by Rogers (1962, 1976) and these will be mapped against the literature below. First knowledge of innovation (Rogers, 1962, 1976). First knowledge of innovation could be pinpointed to the Cumberledge report in 1986, which was a report into community nursing, after which the issue was debated and discussed and entered into the theoretical arena in the healthcare professions and healthcare policy and governance in general. However, Jones (2004) cites the case of nurses who began to make a case for prescriptive authority in 1978. There is varying evidence of how diffuse this knowledge became at a societal and policy level and there is some evidence of widespread resistance in the medical and pharmaceutical professions (Jones, 2004). It is important to remember that for some critics, nurse prescribing does not necessarily constitute something entirely innovative. Nurses already perform a number of roles which require full knowledge of medications, but there may be issues about education and skill levels across nurses educated in different places (King, 2004). If there are questions already about nurses’ knowledge and ability around medications, then the preliminary debate about this issue (which extended over two decades) is understandable. Forming an attitude toward the innovation (Rogers, 1962, 1976) A number of attitudes towards this innovation are apparent in the literature. For example, Jones (2004) suggests that implementation of this innovation would be characterized by political machination, the need to construct an effective case, and deft manoeuvring within the corridors of power. This raises issues to do with the context within which the innovation takes place, as already discussed. Jones (2004) also alludes to the district nurses who presented a case in the 1970s, and the RCN who continued to press that case further. This also relates to Rogers’ (1962, 1976) description of some of the factors or prior conditions that affect the innovation-decision process, such as previous practice (which may influence the decision makers in a positive or a negative way), and the norms of the social systems in which the innovation is taking place. The firmly entrenched hierarchical norms of the NHS and healthcare systems in general could be viewed as the biggest hindrance to nurs e prescribing, and so forming an attitude towards the innovation, for all the key players within the system. A decision to adopt or reject (Rogers, 1962, 1976) The decision to adopt the innovation occurred piecemeal and somewhat sequentially in time. Jones (2004) states that it was after much initial scepticism and a good deal of negotiation that a tacit agreement between nursing, medicine and pharmacy was reached in 1988. Subsequently, the RCN wree able to cause the government to initiate the Crown report in 1989. However, there were limitations to this decision, in that it was restricted to health visitors and district nurses who would be able to prescribe by virtue of them having post registration qualifications that marked them as competent in this advanced field (Jones, 2004). Implementation of the new idea (Rogers, 1962, 1976). It is this stage which is the most problematic in relation to nurse prescribing, perhaps due to the nature of adoption across the wider NHS context. Nurse prescribing is sanctioned, but remains a locally differentiated policy with apparent piecemeal implementation. This could raise issues of quality and also the ability to evaluate the effects and impact of nurse prescribing at the macro level. Despite the adoption of the principle, there was a distinct lack of action in moving the agenda forward, and it was some time before the bill was passed through Parliament in 1992 (Jones, 2004). The literature shows that the legislation passed in 1992, and in 1994 nurse prescribing began in eight demonstration sites (Bates, 2002). Following this pilot, a national roll out of nurse prescribing began in 1998 (Bates, 2002). This, however, applied only to nurses with district nurse of health visitor qualifications working in the community and employed by an NHS Trust or GP (Bates, 2002). Confirmation of the decision. Confirmation of the decision can also be seen within the literature, in that in 1999 there was a review of prescribing, which then recommended that prescribing rights be extended to include other groups of nurses and other health professionals (Bates, 2002). Subsequent to this, the NHS Plan (2002) clearly supported the recommendations and it was posited that by 2004, nurses should be able to prescribe independently, or supply medicines in Patient Group directions in four areas: minor illness, minor injury, health promotion and palliative care, within the aegis of a Nurse Prescribing formulary (Bates, 2004). Bates (2004) stated that there were approximately 22000 nurse prescribers in the UK, 3000 of which were in Scotland (at the time of her article). This suggests that there is widespread confirmation of the decision through demonstrable changes in practice. It is also notable that nurse prescribing has further progressed towards supplementary nurse prescribing, which allows nurses a nd other health professionals to prescribe for a patient who has been through an initial assessment by a doctor, in accordance with a clinical management plan (NHS Scotland, 2002). It should be noted that prior conditions affect the innovation-decision process. Prior conditions include previous practice, felt needs/problems, innovativeness, and norms of the social systems (Rogers, 1962, 1976). Consequences of Innovations (Rogers, 1962, 1976). Any discussion of the innovation-decision process, must also consider the consequences or changes that can occur to a social system as a result of the adoption of an innovation. Rogers (1962, 1976) identifies three consequences or changes. Desirable versus undesirable consequences The primary purpose of nurse prescribing is to give maximum benefit to patients and the NHS, whilst also supporting quicker and more efficient access to healthcare while promoting a more flexible use of the skills of the existing workforce (Bates, 2002). This however could be a somewhat idealistic view of general nurse prescribing. While for many nurses it may enhance their ability to provide care, others may consider that it simply adds to their already onerous workload. There may also be ethical issues, perhaps through conflicts between personal, official and legal senses of duty for nurses, which could result in cognitive dissonance between their conceptual model of their nursing role and the new directives to extend this role in to a traditionally medical area of responsibility. Nolan et al (2001) in a study of mental health nurses’ perceptions of nurse prescribing found that most of their respondents felt that this would significantly improve clients’ access to medication, improve compliance, prevent relapse, and prove cost effective. However, the same respondents also felt that they may not have sufficient knowledge and skills to assume responsibility for prescribing (Nolan et al, 2001). In this case, as elsewhere, nurse prescribing is a double-edged sword, but it seem from this research that the nurses felt that the benefits outweighed their concerns, and their concerns were, after all, possible to overcome through additional training. Direct versus indirect consequences. Some of the indirect consequences may be easier to appreciate than the direct consequences, while some of the direct consequences may be less popular, in a sense, because they benefit members of the institutional system in ways less acceptable to some of the professionally defined or client-defined groups within the system. For example, if the direct consequence of nurse prescribing is a reduction in doctors’ workloads, this will benefit doctors, and may indirectly benefit patients by providing more or better quality doctor-patient contact, and patient outcomes. But there is no evidence so suggest that this rather optimistic viewpoint could be true. A reduction in doctors’ workloads may demonstrate no improvement in patient care, but an increase in nurses’ workloads could be viewed as having more potential indirect consequences for the patient experience. Deontological debates also raise this issue, and the question is where does the duty of the nurse truly lie? Another indirect consequence of the innovation might be the burden placed on nurses to conform to this professional development and to adhere to the directive. Nurses who do not wish this level of responsibility and autonomy may suffer personally and professionally, finding themselves non-conformists through no fault of their own. However, if another consequence is an enhancement in the status (and pay) of nurses, nurses who prefer not to prescribe could be viewed as holding the profession back. Anticipated versus unanticipated consequences. It is difficult to evaluate the anticipated consequences against the unanticipated ones, given that there is little literature discussing these. Some anticipated consequences might relate to improvements in medication education by nurses (Rycroft-Malone et al, 2000), whereby the nurses will be more knowledgeable, competent and perhaps confident in this activity. This is an important issue in the modern healthcare service where consumerism has become one of the most powerful driving and defining forces (Rycroft-Malone et al, 2001). It is this kind of consumer power which contributes to future policy direction, after all, although the current rhetoric, with its implicit assumption that greater consumer involvement in health care is both desirable and beneficial (Rycroft-Malone, 2001), could be challenged by those who believe that the conferred authority of medicine (and nursing) should take the lead. This author can only project certain consequences, some of which may relate to consume r power and the negotiation of power dynamics between different groups. However, it is debateable if these could be considered anticipated or foreseeable consequences. Another anticipated consequence of this innovation is the close evaluation of the innovation, with inevitable close scrutiny of the nursing profession and its actions in response to the new powers and responsibilities. Latter and Courtenay (2004) in a review of evaluations of nurse prescribing found that the initiative had been largely successful. However, they also identify areas for much further scrutiny and consideration, such as gaps in the knowledge base about prescribing, the nature of the evidence about nurse prescribing, and the need to evaluate the extension of prescribing powers to nurses working outside the initially defined settings (Latter and Courtenay, 2004). It would appear that the nurse-patient relationship may be a positive dimension of patients’ perceptions of nurse prescribing, but there is a need to further evaluate the more intermittent contacts that patients may experience with nurses in certain settings (Latter and Courtenay, 2004). McKenna and Keeney (2004) found that there is still a lack of understanding of the roles of, in particular, community and specialist nurses, but that there is public support for nurse prescribing. Questions still remain about nurses’ ability to be effective in working outside their standard professional area (McKenna and Keeney, 2004). This raises questions about the consequences for nurses in how they interact with their clients, and suggests that nurse prescribing may contribute to changing the professional ‘face’ of nursing. Conclusion The modernisation of the NHS, with its emphasis on timely and effective delivery of services, has been a key factor in the implementation of nurse prescribing and its development into independent prescribing, even into the hospital setting (Clegg et al, 2006). The history of nurse prescribing demonstrates the drive for professional growth in certain areas, sanctioned by changes in the context of service delivery, but hampered by traditional roles and concepts of professional domain. Debates also consider the challenges of training, legal issues, professional issues, budgetary and practical issues surrounding nurse prescribing (Clegg et al, 2004). What is most apparent from this examination of the literature, however, is that while the embryonic stage of nurse prescribing is long gone, the innovation is still undergoing a process of growth and maturation, which is persistently emergent and therefore leaving the status of the profession in relation to this issue largely unformed. This examination of nurse prescribing has shown that change spreads by a process of diffusion, which could be viewed in retrospect as a piecemeal process driven from different directions and according to the perhaps hidden agendas of different agencies, such as nurses, the government, and the consumer. More research is required to examine the ongoing growth and consequences of this innovation, for the professions and the clients, now that it has become an established part of healthcare practice in the UK. 2,500 Words References Bates, C. (2002) Independent nurse prescribing. RCM Midwives Journal 5 (2) 63. Berry, D., Courtenay, M. and Versellini, E. 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