A Comparison of Wilfred Owen’s Dulce et Decorum est to Alfred Tennyson’

A Comparison of Wilfred Owen’s â€Å"Dulce et Decorum est† to Alfred Tennyson’s â€Å"Charge of the Light Brigade† In this article I will endeavor to thoroughly analyze Wilfred Owen’s â€Å"Dulce et Decorum est† to Alfred Tennyson’s â€Å"Charge of the Light Brigade†. I will analyze the utilization of graceful gadgets in the sonnets just as diagram what's going on in each. Wilfred Owen was conceived on the eighteenth of March 1893 in owestry, United Kingdom. He was the most seasoned of four youngsters and was instructed in an outreaching school. In spite of the fact that Owen dismissed the vast majority of his convictions by 1913 the impact of his instruction despite everything stays obvious in his sonnets and their subjects of penance, scriptural language and his clear, terrifying portrayal of damnation. One of the primary effects on Owen’s verse was his gathering with Siegfried Sassoon, however Owen before long molded his own style and way to deal with the war. The attributes of Owen’s verse are the utilization of Para rhyme (The rhyming of two words which have similar consonants however whose focused on vowels are unique), similar sounding word usage, and sound similarity. Alfred Tennyson was conceived on fifth August 1809 in Somersby, Lincolnshire and passed on the sixth October 1892 to later be covered in the poet’s corner in Westminster Abby. Tennyson was regularly viewed as the main agent of the Victorian age in verse, succeeding Wordsworth as writer laureate in 1850. Wilfred Owen’s sonnets are motivated by the revulsions of his own encounters in World War One from 28th July 1914 to fourth November 1918, the day that he kicked the bucket multi week before the truce. At the hour of this sonnet there were over the top measures of propagandistic verse for instance Jessie Pope’s â€Å"Who’s for the game?† Master Alfred Tennyson’s â€Å"Charge of the Light Brigade† was composed to remember the self-destructive charge by British light rangers over open landscape in the Battle of Balaclava (Ukraine) in the Crimean War from 1854 to 1856. This was the principal war to have photographic media inclusion. Of the 637 men engaged with the charge, 247 were slaughtered or harmed. Tennyson depicts the valiant charge of the light unit into â€Å"the jaws of death†. Tennyson utilizes redundancy, inference, and exemplification to illustrate the charge and simultaneously give the peruser an understanding into the brain of the bold warriors of the light unit. The mood of this sonnet mimics the sound of the ponies dashing towards th... ...nly minor wounds can me supported from war for instance a messed up leg. I favored â€Å"Charge of the light brigade† on the grounds that the pace and rhyming plan give a feeling of activity and energy. Solid representations and comparisons are utilized to furnish the peruser with an understanding into the psyches of the troopers. I particularly like how Tennyson portrays the contention itself in the fourth refrain, as this is a solid case of the feeling of activity in his work. The view of war has experienced a lot of progress since the hour of Tennyson, in Tennyson’s time war was viewed as something worth being thankful for however after some time the impression of war has totally turned around, and as I would see it appears nowadays that war is something that ought to be stayed away from no matter what for the most part because of the specialized advances made giving war significantly more potential to devastate something other than lives. I will finish up this exposition with a statement from â€Å"the charge of the light brigade† which I accept shows the gallantry of those men who kicked the bucket for their nation and continued on under unthinkable chances. â€Å"When can their brilliance blur? O the wild charge they made! All the world pondered. Respect the charge they made, Respect the Light Brigade, Respectable 600.

Pain is Its Plainest Form free essay sample

There was where everything around me blurred into a brilliant haze. In any case, at that time, the entirety of my faculties were topped. Specialists call it â€Å"fight or flight†. All I knew is that everything was improved. Seeing the monochromatic white dividers of the recuperation room, the smell that must be found in emergency clinics, the flavor of the soothing nitrous oxide, the sound of somebody close by shouting their lungs out, and the torment that’s as incredible as a class five tropical storm. To attempt to overlook the agony I was in, I attempted to make sense of who was shouting. Where’s the premise of the shouting and how can it be that the more I attempt to make sense of what it's identity was, the more torment expanded and the shouting got stronger? I made sense of what it's identity was. It was me.I was completing an outpatient method called a uretoroscopy to impact kidney stones. We will compose a custom article test on Torment is Its Plainest Form or on the other hand any comparable subject explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page The strategy itself went totally well bar any complexities; in any case, it was during the recuperation that all went horrific.As I woke up, my reality began shaking and the recuperation wing turned into a free for all of turmoil. I thought I was encountering a seismic tremor however I wasn't right. I had gone into a seizure. There was hollering however this time it wasn’t just me. It was the specialists encompassing me as they attempted to get both my thrashing and my unpredictable heartbeat leveled out. It was finished and express turmoil, and it possibly turned out to be more regrettable when the wave of agony made its sneaking nearness known. The shouting got stronger, the doctors’ faces got fiercer as they worked and right when I thought there would be the peak of the heart screen level coating like there as a rule is in the show â€Å"House†, there was quietness. Everything got murky as I slipped into tranquilize instigated ecstasy. The torment was gone, the shouting halted, and my reality turned black.The next time I woke up, the world returned tumbling and with it came the agony and my supper from the prior night. I slipped all through cognizance multiple times inside five hours. My mom and father were there with me and, while I never let them know and plan never to, I heard their discussion that happened after what I believe was the eighth opportunity I came to. They were stating they felt so powerless on account of what I was experiencing. That is the point at which I woke up again and the procedure proceeded. I don’t even know whether that discussion truly occurred or on the off chance that it was a hallucination.What should be an outpatient system, transformed into a bad dream of remaining for the time being in the medical clinic. For reasons unknown, I was having an unfavorable response to the nitrous oxide which was utilized to take care of me for the method. I got a post-operation contamination that left me septic however that was immediately repaired by being placed into a tidy up room and having IV liquids put into me; any individual who needed to be close to me must be â€Å"scrubbed in†. I was at last ready to leave and when I did, I left with another point of view on life. Through my experience, I understood how great I truly have it. There are individuals who battle for their lives every day and some come up short while others simply become more regrettable. I currently have another regard for the word torment and for the existence I have. Presently, I live to its fullest and do things I wouldn’t have previously. I don’t know when it will be my opportunity to go yet when I do, I need to leave without any second thoughts.

The Relationship between Extraversion and Need for Achievement

A class overview of 170 BBA111 understudies on their extraversion and ‘need for achievement’ scores, a connection examination was led to attempt to set up the relationship of the two factors. It was recognized that there was a factually huge connection of r = 0.39 among ‘extraversion’ and ‘need for achievement’.Advertising We will compose a custom basic composing test on The Relationship among ‘Extraversion’ and ‘Need for Achievement’ explicitly for you for just $16.05 $11/page Learn More The relationship isn't just positive yet it is moderate. The relationship shows that an expansion in extraversion prompts an expansion in ‘need for achievement’. It likewise infers that the extraversion is a significant determinant of ‘need for achievement’. Tosi, Mero and Rizo (2000) depict an attribute as an inclination of an individual to react in a given manner †both in their feelings and their practi ces and this response must be fairly steady. Extroversion as among the five very much recognized character attributes is portrayed by being friendly, decisive and proactive/vivacious. When discussing extraversion as a character characteristic, one basically centers around specific qualities some of which incorporate amiability, positive emotionality just as emphaticness (Ulu Tezer, 2010). Considering ‘need for achievement’ as a part of versatile compulsiveness, Ulu Tezer (2010) report that there exist a positive connection among extraversion and versatile hairsplitting. Requirement for accomplishment is seen as the propensity to set up high individual guidelines and objectives and it is additionally viewed as accomplishment inspiration (Sharma Malhotra, 2007). Proactivity as a part of ‘need for achievement’ has been refered to by Holman (2003) as being influenced by the character attribute of extraversion. People who show requirement for accomplishment have a moderate individual activity and it is accounted for that extraversion is modestly identified with individual activity. A relationship of r = 0.33 has been recognized among extraversion and individual as revealed by Holman (2003). This suggests the present discoveries from the BBA111 students’ overview were pair with different discoveries. In deed, requirement for accomplishment is one of the determinants of extraversion. The idea of outgoing people to be dynamic and amiable and their vigorous lives makes them to be constrained to act or to accomplish. It has been for example distinguished that extraverts are decently acceptable in scholastic execution as demonstrated by positive and moderate relationships between's these two variables.Advertising Looking for basic composition on brain research? We should check whether we can support you! Get your first paper with 15% OFF Learn More Extraversion is especially seen as decidedly associated with scholarly execution (Chamorro- Premuzic Furnham, 2005) which is an affirmation that there is a positive connection among extraversion and ‘need for achievement’ since great scholastic execution is without a doubt an accomplishment many might want to have. As much as there exists a positive connection among extraversion and ‘need for execution, note that this relationship isn't as solid as the connection among self preoccupation and requirement for accomplishment. This aides in clarifying why the r = 0.33 in this study is only a moderate one and can't be considered as solid as it would be with introspection. It has been accounted for that outgoing individuals don't perform well on ‘need for accomplishment contrasted with contemplative people (Sharma Malhotra, 2007). Outgoing individuals, who are likewise alluded to as hysterics, show lower level of motivation contrasted with thoughtful people and this makes the hysterics set marginally lower objectives than self observers. Truth be told se lf observers, because of their high inspiration, perform well in numerous regions even in their scholastics since they will in general have long haul objectives. It is in this manner inferred that there is a solid positive relationship among's introspection and scholarly fulfillment. The distinction in loners and outgoing people isn't in their insight level however rather in their speed, ingenuity just as exactness of performing assignments (Sharma Malhotra, 2007). Social butterflies in this manner present as quicker in errands yet have low exactness and diligence levels. Reference Chamorro-Premuzic, T. what's more, Furnham, A. (2005). Character and Intellectual fitness. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., Publishers. Holman, D. (2003). The new work environment: a manual for the human effect of present day working practices. West Sussex, UK: John Wiley Sons, Ltd. Sharma, A. furthermore, Malhotra, D. (2007). Character and social standards. New Delhi: Concept Publishing Com pany.Advertising We will compose a custom basic composing test on The Relationship among ‘Extraversion’ and ‘Need for Achievement’ explicitly for you for just $16.05 $11/page Learn More Tosi, H. L, Mero, N. P. what's more, Rizzo, J. R. (2000). Overseeing hierarchical conduct (fourth version). Cambridge, MA: Blackwell Publishers Ltd. Ulu, I. P. also, Tezer, E. (2010). Versatile and maladaptive hairsplitting, grown-up connection, and enormous five character qualities. The Journal of Psychology, 144(4), 327â€340 This basic composition on The Relationship among ‘Extraversion’ and ‘Need for Achievement’ was composed and presented by client Lillian Strong to help you with your own examinations. You are allowed to utilize it for research and reference purposes so as to compose your own paper; be that as it may, you should refer to it as needs be. You can give your paper here.

What You Don’t Need to Know on a Waitlist

At the Ross waitlist chat yesterday, there were the usual percentage of questions related to waitlist stats. Indeed, at this time of year every year, waitlist applicants obsess over previous years acceptance rates at the schools waitlisting them. Nervous, tense applicants ask, How many students at School X have been waitlisted and then accepted? Is there a difference if Im waitlisted earlier or later? Are the GPA and test scores different for waitlisted applicants? And every year the obsession mystifies me. For the life of me I cant see why those numbers are so important. Most schools accept some students from the waitlist. The accepted students are 100% in; the rejected students are 100% out. If your school last year accepted 5% or 15% or 25% of waitlisted applicants, is that number really going to change your behavior? If you need that data to determine whether you want to remain on the waitlist, its useful, but realize that last years numbers are not predictive. If the school has a higher yield than last year, the WL acceptance rate will plummet. If it has a lower yield than last year, the WL acceptance rate will climb. And if schools change the number of applicants they waitlist, last years stats are truly meaningless. My sense is that schools are waitlisting more applicants this year because of Increased uncertainty related to the recession and credit freeze. A desired to protect yield, the percentage of students offered admission who decide to attend, and a factor in US News rankings. Indeed yesterday, Ross revealed that it is waitlisting more applicants this season, but indicated that last years waitlist was unusually small. Regardless of cause, if this trend is widespread, waitlist stats from previous years will have less relevance than ever, and even in previous years they lacked predictive value. Focusing on past WL acceptance stats is merely a distraction. What should you focus on? Striving to make your case for your fit with the program and your qualifications. Or determining your alternatives if not accepted at your waitlisting school. If you need help making that argument for acceptance, consider Accepteds waitlist advising and editing services or our waitlist ebooks: The Nine Mistakes You Don`t Want to Make on an MBA Waitlist The Nine Mistakes You Don`t Want to Make on a Med School Waitlist The Nine Mistakes You Don`t Want to Make on a Law School Waitlist

How Gender Group Health Can Be Improved In Regards To Ageing - Free Essay Example

Sample details Pages: 10 Words: 2852 Downloads: 6 Date added: 2017/06/26 Category Medicine Essay Type Critical essay Level High school Did you like this example? Choose one gender group and critically discuss how their health outcomes can be improved in regards to ageing. Introduction Wound infection post-surgery, now preferably known as Surgical Site Infection (SSI) refers to infections at or near a surgical site within 30 days after surgery or within one year, if the procedure involved insertion of an implant (Illingworth et al., 2013; Owens and Stoessel 2008). While definite statistics of the incidence of SSI are complicated given the gamut of surgical procedures, environment and patients, available data indicate that SSI contributes to more than 15% of reported Hospital-acquired infections (HAI) for all patients and about 38% for surgical patients (Campbell et al., 2013; Owens and Stoessel, 2008; Reichman and Greenberg, 2009). Also, data from across Europe indicate that, depending on surgical procedure and/or surveillance methods used, incidence of SSI may be as high as 20% for all surgical procedures (Leaper et al., 2004). Don’t waste time! Our writers will create an original "How Gender Group Health Can Be Improved In Regards To Ageing" essay for you Create order Although, HAIs generally, and SSI are relatively less common in Orthopaedic surgery, compared with other surgical procedures (Johnson et al., 2013), however, when they do occur, osteo-articular infections for example, can be very difficult to treat, with significant risk of lifelong recurrence (Faruqui and Choubey, 2014). SSI leads to significantly higher costs of care from longer hospital stays; it poses a major burden on healthcare providers and the healthcare system, jeopardises the health outcomes of patients and remains a major cause of morbidity and mortality despite improvements in surgical procedures and infection control techniques (Owens and Stoessel, 2008; Tao et al., 2015). Consequently, understanding evidenced-based approaches to reduce/prevent incidence of SSI has attracted significant interests from researchers, healthcare administrators and policy-makers. This essay intends to review current best-practices in prevention of SSIs and to offer recommendations for future practice within orthopaedic settings. Rationale This review of best practices in the prevention of SSI following orthopaedic surgery is underpinned by two major reasons. One, despite the considerable improvement in surgical procedures and techniques in most orthopaedic settings, SSI negatively impact on patient outcomes and imposes significant cost on the healthcare system. According to a case-control study reported by Owens and Stoessel (2008), patients who suffer SSI are more likely to require readmission to hospital and have more than double the risk of death compared to patients without SSI. In addition, the median duration of hospitalisation required due to SSI was put at 11 days and the extra cost to the healthcare system estimated at à ¢Ã¢â‚¬Å¡Ã‚ ¬325 per day (Owens and Stoessel, 2008). Two, the prevention of SSI is hardly straightforward. Given the wide range of factors that modify the risk of SSI, a bundle approach with systematic attention to multiple risk factor is required for any effective prevention of SSI (UÃÆ'à ‚ §kay et al., 2013). Thus, by undertaking a state-of-the-art review of orthopaedic SSI prevention techniques/processes, this essay may contribute towards better orthopaedic surgery outcomes for patients and providers. Prevention of SSI in orthopaedic surgery: Best Practices According to the Health Protection Agency (2011), the most common pathogenic organisms responsible for surgical wound infections in orthopaedic surgery include methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), Coagulate negative Staphylococci (CoNS), Enterobacteriaceae, Enterococcus spp, Pseudomonas spp, Stretococcus spp as well as occasional cases of unspecified diphtheroids of the Corynebacterium spp. and other gram-positive organisms. Moreover, SSIs can be categorised into superficial incisional, deep incisional and organ space SSI (Reichman and Greenberg, 2009). Superficial incisional SSI refers to infection that involves only skin and subcutaneous tissue at the point of incision; deep incisional SSI refers to infection of the underlying soft tissues, while organ space SSI refers to infection involving organs or organ spaces that were opened or manipulated during the surgical procedure. Since the risk of ending up with SSI a nd the specific type of SSI suffered are determined by factors related to the patient, procedure and hospital environment, current best-practices and guidelines for preventing SSI can be broadly elaborated under these categories. Patient-related Practices Existing patient conditions like diabetes mellitus, obesity and/or rheumatoid arthritis have been associated with increased risk of SSI (Illingworth et al., 2013; Johnson et al., 2013). As part of effective patient management, pre-operatively, current body of evidence recommends aggressive glucose control for diabetes patient to reduce the heightened risk of infection due to hyperglycaemia pre or post-surgery. In patients with rheumatoid arthritis, corticosteroids and anti-tumour necrosis factor (TNF) therapy have been argued to delay wound healing and increase risk of infection. However, the British Society for Rheumatology (BSR) recommends that in deciding whether to cease these medications for such patients, pre-surgery, the potential benefits of preventing post-surgery infection should be balanced with the risk of disease flare, pre-surgery (Dixon et al., 2006; Luqmani et al., 2006). In addition, orthopaedic surgery for patients who currently smoke or are obese (BMI above 30kg/ m2) should be delayed (until smoking cessation/loss of weight) to reduce the risk of SSI. For example, a randomised, controlled study reported that smoking cessation for just 4 weeks significantly reduced the odds of incisional SSI (Sorensen et al., 2003), while Namba et al. (2005) reported significantly higher odds of SSI in obese patients (35kg/m2) undergoing total hip and knee replacement surgery, compared with patients that were not obese. Screening patients for presence of MSSA and MRSA and subsequent decolonisation is one of the most recommended techniques for preventing SSI. Staphylococcus aureus colonisation is reportedly found in the nares of about 30% of healthy individuals (Kalmeijer et al., 2002). This nasal carriage of both methicillin sensitive/resistant S. aureus have been demonstrated as a significant risk factor for SSI. Kelly et al. (2012) reported a significant drop in SSI from 2.3% to 0.3% with the use of intranasal mupirocin and triclosan showers to decolonis e patients before orthopaedic surgery. Also, a review of eight randomised controlled trial by van Rijen et al. (2008) reported that the use of mupirocin significantly reduced the incidence of MRSA and MSSA associated SSI. However, guidelines from the National Institute for Health and Care Excellence (NICE, 2008) recommends a combination of nasal mupirocin and chlorhexidine showers for patient decolonisation while UÃÆ' §kay et al. (2013) indicated that available evidence from orthopaedic literature suggests that S. aureus screening, decolonisation and shower constitute a cost-saving, effective strategy to reduce the incidence of SSI in orthopaedic surgeries. Surgical Procedure-related Practices Preoperative preparation of skin before incision is one of the major avenues to prevent SSI (Kelly et al., 2012). However, there is no consensus on what antiseptic agent offers the most effective protection against SSI. While NICE (2008) guidelines suggest that both aqueous and alcohol based preparations e.g. povidone-iodine or chlorhexidine are suitable for skin preparation, Darouiche et al. (2010) and Milstone et al. (2008) have raised concerns about the development of bacterial resistance to chlorhexidine. These studies report the relative superiority of 2% chlorhexidine mixed with 70% isopropyl alcohol, while some experts have suggested increasing the chlorhexidine concentration to 4% or the use of 10% povidone-iodine (UÃÆ' §kay et al., 2013). Nevertheless, povidone-iodine or chlorhexidine still remain the gold standard for preoperative skin preparation. Also as part of skin preparation, NICE recommends that hair should only be removed if necessary, should be done immedia tely before surgery and with electronic clippers, not razor blades. Recent evidence suggests that use of razor blades can sometimes result in microscopic skin cuts that may act as foci for micro-organisms colonisation, thus increasing the risk of infection (Owens and Stoessel, 2008). Preoperative administration of antibiotic prophylaxis to reduce the risk of surgical wound infection is widely accepted for surgery in orthopaedic settings, including bone trauma. Several large scale studies have demonstrated that antibiotic prophylaxis, when administered properly, help reduce tissue contamination, during surgery, to levels that do not overwhelm the patients immune system, and thus, can reduce the risk of SSI by up to 75% (Chen et al., 2013; Faruqui and Choubey, 2014; Illingworth et al., 2013; UÃÆ' §kay et al. 2013). However, NICE (2008) recommends that potential adverse effects, optimal dosage and most effective time for administration pre-operatively should be carefully consider ed to maximize the benefit of antibiotic prophylaxis. UÃÆ' §kay et al. (2013) believe that first or second generation parenteral cephalosporins are sufficient in most cases, except in cases of skin colonisation with MRSA, in which case glycopeptide antibiotics may be more effective. However, this should be considered in relation to individual patients allergy history. UÃÆ' §kay et al. (2013) also recommend that 30mins à ¢Ã¢â€š ¬Ã¢â‚¬Å" 1hr before incision is the idea time to administer prophylaxis. While this is generally accepted, NICE (2008) recommends that prophylaxis may be given earlier in procedures where a tourniquet is used. In addition to minimising the risks from the skin and endogenous flora of the patient, the surgical team must also strive to reduce chances of contamination from either their person, the tools used or the procedure itself. NICE (2008) recommends that every member of the surgical team must thoroughly scrub before wearing surgical gown and gloves . There is growing support for double-gloving and frequent glove-changing to reduce the risk of contamination from tiny punctures in surgical gloves that often go unnoticed during surgery. While evidence in support of double-gloving and/or frequent glove-changing intra-operatively as a strategy for reducing risk of SSI remain inconclusive, Widmer et al. (2010) conclude that the practice is supported by expert opinion, especially for lengthy procedures. Moreover, excellent surgical techniques are crucial in preventing SSI. For example, maintaining effective haemostasis while preserving adequate blood supply, removal of devitalized tissues, eradication of dead space(s), gentle handling of tissue and effective management of surgical wound postoperatively can all help reduce the chance of SSI (UÃÆ' §kay et al., 2013). Hospital Environment-related Practices The CDC and World Health Organization recommend that doors to the operating room should be kept closed and traffic kept to a minimum to reduce potential contamination of surgical sites (Tao et al., 2015). To achieve this, essential equipment and tools should be stored in the operating room. In fact, Health Protection Agency (2011) suggest that frequency of operating room door opening is a positive predictor of increased bacterial count in the operating room. Airflow in the operating room is another modifier of SSI risk. Vertical or horizontal laminar-flow ventilation systems have been advocated for orthopaedic surgery to achieve ultra-clean air within the operating room and reduce airborne contaminants. Although evidence supporting the effect of laminar airflow systems on SSI risk remains inconclusive, the reduction in airborne contaminants is perhaps an added advantage (Owens and Stoessel, 2008; Reichman and Greenberg, 2009). Lastly, constant surveillance is an important part o f preventing SSI. By following up on patients post-operatively and reporting appropriate data to the surgical team, surgical decisions can be improved upon based on historical records (SkrÃÆ' ¥mm et al., 2012). Moreover, surveillance ensures that cases of SSI are identified early and treated before complications arise. Data from surveillance could also form the basis of evidenced-based decision making on facility specific service improvements to reduce incidences of SSI and improve outcomes for all concerned (SkrÃÆ' ¥mm et al., 2012). Recommendations This essay have reviewed current knowledge on surgical site infection and strategies to reduce its incidence. It is pertinent to state that despite the various precautions elaborated above, complete eradication of surgical site contamination is almost impossible as some endogenous micro-organisms always remain and environmental factors cannot be totally eliminated. To reduce incidence of SSI to the barest minimum, the following are recommended: It is crucial to adopt a bundle approach that ensures that patient, procedure and facility related factors are controlled for as much as possible. While improving surgical and care delivery is always crucial, surveillance and data collection should also promoted to ensure that changes/improvements in procedures and facility practices are evidenced-based New technologies and strategies are continually been developed to reduce complications like SSI and improve outcomes for patients, it is important to always stay on top of these developments to ensure that orthopaedic surgeries are not only evidenced-based but contemporary, achieving the best outcome possible for all parties. Conclusion Surgical site infection (SSI) poses a significant challenge to patients undergoing orthopaedic surgeries, the surgical team as well as the healthcare system in general. SSI negatively impact patient outcomes and imposes unnecessary demand on healthcare resources. Fortunately, much of the burden associated with SSI can be avoided. This review identifies the multitude of patient and procedure-related factors that modify SSI risk and highlights various evidence-based strategies to mitigate these risks. The paper demonstrates that there is consensus in the literature that by screening and subsequent decolonisation of patients, administering antibiotic prophylaxis, ensuring that surgical tools, equipments and garments are properly sterilised and the operating room is free of airborne contaminants, cases of surgical wound infection in orthopaedic surgeries can be effectively prevented. Bibliography Campbell, K. A., Phillips, M. S., Stachel, A., Bosco Iii, J. A. and Mehta, S. A. (2013) Incidence and riskfactors for hospital-acquired Clostridium difficile infection among inpatients in an orthopaedic tertiary care hospital. Journal of Hospital Infection, 83(2), pp. 146-149. Chen, A. F. M. D. M. B. A., Wessel, C. B. M. L. S. and Rao, N. M. D. (2013) Staphylococcus aureus Screening and Decolonization in Orthopaedic Surgery and Reduction of Surgical Site Infections. Clinical Orthopaedics and Related Research, 471(7), pp. 2383-99. Darouiche, R. O., Wall, M. J., Itani, K. M. F., Otterson, M. F., Webb, A. L., Carrick, M. M., Miller, H. J., Awad, S. S., Crosby, C. T., Mosier, M. C., AlSharif, A. and Berger, D. H. (2010) Chlorhexidineà ¢Ã¢â€š ¬Ã¢â‚¬Å"Alcohol versus Povidoneà ¢Ã¢â€š ¬Ã¢â‚¬Å"Iodine for Surgical-Site Antisepsis. New England Journal of Medicine, 362(1), pp. 18-26. Dixon, W. G., Watson, K., Lunt, M., Hyrich, K. L., Silman, A. J. and Symmons, D. P. M. (2006) Rates of serious infection, including site-specific and bacterial intracellular infection, in rheumatoid arthritis patients receiving antià ¢Ã¢â€š ¬Ã¢â‚¬Å"tumor necrosis factor therapy: Results from the British Society for Rheumatology Biologics Register. Arthritis Rheumatism, 54(8), pp. 2368-2376. Faruqui, S. A. and Choubey, R. (2014) Antibiotics Use in Orthopaedic Surgery; An Overview. National Journal of Medical and Dental Research, 2(4), pp. 52-58. Health Protection Agency (2011) Sixth report of the mandatory surveillance of surgical site infection in orthopaedic surgery, April 2004 to March 2010. in,London: Health Protection Agency. Illingworth, K. D., Mihalko, W. M., Parvizi, J., Sculco, T., McArthur, B., el Bitar, Y. and Saleh, K. J. (2013) How to minimize infection and thereby maximize patient outcomes in total joint arthroplasty: a multicenter approach: AAOS exhibit selection. The Journal of bone and joint surgery. American volume, 95(8), pp. 1. Johnson, R., Jameson , S. S., Sanders, R. D., Sargant, N. J., Muller, S. D., Meek, R. M. D. and Reed, M. R. (2013) Reducing surgical site infection in arthroplasty of the lower limb: A multi-disciplinary approach. Bone and Joint Research, 2(3), pp. 58-65. Kalmeijer, M. D., Coertjens, H., van Nieuwland-Bollen, P. M., Bogaers-Hofman, D., de Baere, G. A. J., Stuurman, A., van Belkum, A. and Kluytmans, J. A. J. W. (2002) Surgical Site Infections in Orthopedic Surgery: The Effect of Mupirocin Nasal Ointment in a Double-Blind, Randomized, Placebo-Controlled Study. Clinical Infectious Diseases, 35(4), pp. 353-358. Kelly, J. C., OBriain, D. E., Walls, R., Lee, S. I., ORourke, A. and Mc Cabe, J. P. (2012) The role of pre-operative assessment and ringfencing of services in the control of methicillin resistant Staphlococcus aureus infection in orthopaedic patients. The Surgeon, 10(2), pp. 75-79. Leaper, D. J., van Goor, H., Reilly, J., Petrosillo, N., Geiss, H. K., Torres, A. J. and Berger, A. (2004) Surg ical site infection a European perspective of incidence and economic burden. Int Wound J, 1(4), pp. 247-73. Luqmani, R., Hennell, S., Estrach, C., Birrell, F., Bosworth, A., Davenport, G., Fokke, C., Goodson, N., Jeffreson, P., Lamb, E., Mohammed, R., Oliver, S., Stableford, Z., Walsh, D., Washbrook, C., Webb, F., Rheumatology, o. b. o. t. B. S. f., British Health Professionals in Rheumatology Standards, G. and Group, A. W. (2006) British Society for Rheumatology and British Health Professionals in Rheumatology Guideline for the Management of Rheumatoid Arthritis (the first two years). Rheumatology, 45(9), pp. 1167-1169. Milstone, A. M., Passaretti, C. L. and Perl, T. M. (2008) Chlorhexidine: expanding the armamentarium for infection control and prevention. Clin Infect Dis, 46(2), pp. 274-81. Namba, R. S., Paxton, L., Fithian, D. C. and Stone, M. L. (2005) Obesity and perioperative morbidity in total hip and total knee arthroplasty patients. J Arthroplasty, 20(7 Suppl 3), pp. 46-50. National Institutte for Health and Care Excellence (2008) Surgical site infections: prevention andention and treatmenttreatment. Clinical guideline. in,Manchester: NICE. Owens, C. D. and Stoessel, K. (2008) Surgical site infections: epidemiology, microbiology and prevention. Journal of Hospital Infection, 70, Supplement 2, pp. 3-10. Reichman, D. E. and Greenberg, J. A. (2009) Reducing Surgical Site Infections: A Review. Reviews in Obstetrics and Gynecology, 2(4), pp. 212-221. SkrÃÆ' ¥mm, I., Ã…Â  altytÄ— Benth, J. and Bukholm, G. (2012) Decreasing time trend in SSI incidence for orthopaedic procedures: surveillance matters! Journal of Hospital Infection, 82(4), pp. 243-247. Sorensen, L. T., Karlsmark, T. and Gottrup, F. (2003) Abstinence from smoking reduces incisional wound infection: a randomized controlled trial. Ann Surg, 238(1), pp. 1-5. Tao, P., Marshall, C. and Bucknill, A. 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Health Care Reform The And Policies Implemented By...

If you could write a book on any topic, what subject or theme would you choose? Why do you find this topic or question interesting, meaningful or valuable? What approach or method might you use to explore your topic, and why would that be a good way for you to proceed? A topic that I believe is important to look at and consider is how health care reform such as the PPACA and policies implemented by private insurance companies have affected the doctor-patient relationship and thereby influenced the quality of medical care. One of the many reasons that I find this an interesting and important topic is because I aspire to become a general surgeon and the interaction between patients and doctors is important for me to consider and determine how it has changed throughout the years as a result of added regulations and new reforms. As evidenced by the constant battle over health care reform, healthcare in the United States has become a growing problem that must be addressed. While the main controversy seems to be the politics of healthcare reform and whether the government should have total control, the one thing that I believe should be the focus, which is the quality of care that is embedded in the patient doctor relationship, is being cast aside. A pivotal aspect of receiving quality medical care is being able to communicate your health concerns and have confidence and trust in your doctor, which is essentially the doctor patient relationship. Yet, this relationship is specialShow MoreRelatedHealthcare Reform And Health Care Reform917 Words   |  4 Pagesconstant battle over health care reform, healthcare in the United States has become a growing problem that must be addressed. While the main controversy seems to be the politics of healthcare reform and whether the government should have total control, the one thing that I believe should be the focus, is the quality of care that is embedded in the patient doctor relationship. 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Is Nick a Good Narrator free essay sample

As the teller of facts for all of his observations, Nick proves to be a reliable narrator for this story. He is unaffected by what goes on around him, despite people bringing him into personal situations. Nick is factual with details. He is as well, a very private person though, and tells us little of himself during the events. In telling us about his growing up years shows us that Nick has learned many admirable things. In Chapter 1 he tells us how he was raised and the advices given him by his father. These included council on how to speak to people in general. As quoted by Nick, his father told him â€Å" ‘Whenever you feel like criticizing any one’ he told me, ‘just remember that all the people in this world haven’t had the advantages that you’ve had. ’ â€Å" He admits to us here that â€Å"In consequence I’m inclined to reserve all judgments†. He did not appear to like being drawn into drama and would avoid it at all cost. The abnormal mind is quick to detect and attach itself to this quality when it appears in a normal person, and so it came about that in college I was unjustly accused of being a politician, because I was privy to the secret griefs of wild, unknown men. Most of the con? dences were unsought frequently I have feigned sleep, preoccupation, or a hostile levity when I realized by some unmistakable sign that an intimate revelation was quivering on the horizon. † When describing events, Nick seems again unattached. He tells us what people wear, what they say and how they say it, with much emotion. On his own home in the af? uent area that he had moved (Chapter 2) â€Å"My own house was an eye-sore, but it was a small eye-sore, and it had been overlooked, so I had a view of the water, a partial view of my neighbor’s lawn, and the consoling proximity of millionaires all for eighty dollars a month. When he tells us about Tom he explains (Chapter 2) â€Å"His speaking voice, a gruff husky tenor, added to the impression of fractiousness he conveyed. There was a touch of paternal contempt in it, even toward people he liked—and there were men at New Haven who had hated his guts. When he introduces Daisy and Jordon for the ? rst time in (Chapter 2) â€Å"The only completely stationary object in the room was an enormous couch on which two young women were buoyed up as though upon an anchored Is Nick a good Narrator? ESSAY THE GREAT GATSBY! PJD balloon. They were both in white and their dresses were rippling and fluttering as if they had just been blown back in after a short flight around the house. † he then goes on with further detail â€Å"The younger of the two was a stranger to me. She was extended full length at her end of the divan, completely motionless and with her chin raised a little as if she were balancing something on it which was quite likely to fall. If she saw me out of the corner of her eyes she gave no hint of it—indeed, I was almost surprised into murmuring an apology for having disturbed her by coming in. The other girl, Daisy, made an attempt to rise—she leaned slightly forward with a conscientious expression— then she laughed, an absurd, charming little laugh, and I laughed too and came forward into the room. The only time we see him express any real emotion is when he realizes that they are all sitting around doing a lot of nothing except to anger and upset each other and that not one person has wished him a ‘Happy Birthday’ that day. He himself, until that moment had forgotten that he turned 30 on that extraordinarily hot day (Chapter 7) â€Å"‘No I just remembered that today’s my birthday. ’ I was thirty. Before me stretched the portentous menacing road of a new decade. † Nick’s privacy is highlighted in events that have taken place in the novel, but not carried forward with any great detail. Though he describes his college year, followed by his time in the army and going to war, he leaves a lot of personal things out. The ? rst couple of things that stand out regarding his personal privacy. He makes friends with a co-worker and after knowing each other a very short time, the two decide to rent a house together in the country. The friend is shipped off to Washington by the ? rm immediately on renting â€Å"a weather beaten cardboard bungalow at eighty a month†. In that same paragraph, we learn that Nick has a dog with him â€Å"at least I had him for a few days until he ran away. Nor does he talk about having a girlfriend out west or someone that he has befriended at very least, though in Chapter 2 after he meets his cousin Daisy, her husband (and Nick’s former classmate) Tom and their friend Jordan Baker (a Is Nick a good Narrator? ESSAY THE GREAT GATSBY! PJD professional golfer). Daisy suddenly says to Nick, as he is leaving â€Å" ‘I forgot to ask you something, and it’s important. We heard you were engaged to a girl out West. ’ â€Å" Nick wards of the question saying â€Å" ‘It’s libel. I’m too poor. â€Å" He then goes on privately that he was aware of this story, but that it was not true. He says â€Å"The fact that gossip had published the banns was one of the reasons I had come east. † He only refers to the woman at hand as an â€Å"old friend†. Nick spoke with clarity on the events of the summer. He described in detail, the costuming and events, the locations and people. Nick seemed unbiased and disconnected in an unemotional way, until the events of his own birthday. Overall, Nick seemed to have a good grasp of the people and events of that summer, while leaving details of himself to be determined.