Tuesday, April 28, 2020
Terrorism The issue of terrorism is Essays - Terrorism,
Terrorism The issue of terrorism is one of the main concerns in the recent world. September 11/2001 attack in the twin tower of USA, bombing in Madrid and London bombing has raised a serious concern in this matter. Different government all over the world is trying to tackle this problem enacting different stringent laws and taking other steps. Indian society is attacked by this terrorism warm from the very beginning and immediate after independence, for example Kashmir, Mumbai bomb blasts, North East states, Punjab in 1980s and recently Mumbai attack. [1] There are different issues which come with the question of terrorism. The first question related to the definition of terrorism. In the international level there was a long effort to find a universally accepted definition of terrorism. The reason is that one person or states terrorist is freedom fighter to another state or individual. It has also faced opposition because most of this definition talks about th e action of the non-state actors and did not address the violence and torture done by the government agencies. International Convention for the Suppression of the Financing of Terrorism adopted in 1999 by the General Assembly has given a definition of terrorism which is the first in an international treaty. [2]This says: " Any other act intended to cause death and serious bodily injury to a civilian and any other person not taking an active part in the hostilities in a situation of armed conflict, when the purpose of such act, by its nature or context, is to intimidate a population, or to compel a Government and international organization to do and abstain from doing any act. " There is two fold meaning in the context of terrorism and human right. In the first meaning the state is obliged to make regulation to prevent and combat terrorism on the ground to protect the individual right to life, liberty and security. The second thing is in the process of combating and preventing terrorism state should take care of the human right. [3] For the infringement of the latter the sate will be responsible under the international human right law and treaties in which it is a party. The European Court of Human Right and other international Human Right instrument has recognized that state has not only negative obligation to refrain from interfering into the rights of the people within its jurisdiction but also positive obligation to protect the people from the infringement of their human right by non state actors. [4] In this paper varies international instrument which talks about the protection of human right while combating terrorism will be discussed. Then subsequently some Indian anti -terrorism laws will be reviewed from the prospective of human right protection and the role of judiciary in the protection of human right while battling against terrorism. Chapter 1: International Institutions in the matter of Terrorism and Human Right Issu e : There are 13 international convention related to terrorism has been adopted under the supervision of United Nation. [5] After the attack of 11 September 2001 the international instruments, international political picture have changed a lot with relation to terrorism. United States of America declared " War on Terror " .[6] United Nations General Assembly Resolutions: The General Assembly resolutions related to terrorism are mainly G.A. Res.56/160, G.A. Res. 58/187, G.A. Res. 59/191, G.A. Res. 59/195, and G.A. Res. 57/219. All these resolution mainly focused on both non derogability of human rights and states responsibility to comply with it. The G.A. Res.56/160 says that the state should take all necessary and effective measures, in accordance with relevant provisions of international law, including international human rights standards, to prevent, combat and eliminate terrorism. . . and. . . strengthen, where appropriate, their legislation to combat terrorism. [7] G.A. Res. 57/219 says that States must ensure that any measure taken to combat terrorism complies with their obligations under international law, in particular international human rights.[8] G.A. Res. 58/187 argues that some human rights are non-derogable and emphasized that States must ensure that any measure taken to fight against terrorism take care of their obligations under international law, in particular international human rights, refugee and humanitarian law.[9] The remaining two resolutions also
Thursday, March 19, 2020
Ponitillism from Birth to Adul essays
Ponitillism from Birth to Adul essays Pointillism has truly been the beginning of a new error within time itself. Its creation came from an offshoot of Impressionism, and is usually classified as a form of Post-Impressionism. It is very similar to Divisionism, but where Divisionism is concerned with the color theory, Pointillism is focused more so on the specific style of the brushwork in which was used to apply the paint. While being A style of painting in which non-primary colors are generated, not by mixing of pigments in the palette nor by using pigments directly, but by the visual mixing of points from primary colors placed in close proximity to each other. (Wikipedia.org) While George Seurat was credited for the birth of Pointillism, he used a normal scientific approach to his paintings abstruse color theories recedes somewhat. Seurat seemed to accept being known as a technician of art, and in doing so he borrowed from science the signs of its authority, including regularity and clarity of pattern. In doing so Seurat began to paint with a technique in which dots of unmixed color are juxtaposed onto the canvas. In doing this the dots blended together and created tones from when you would look at it from a distance. This means that with the same set of primaries, pointillist generated a different range of colors... (Wikipedia.org) Seurat also found that certain color combinations produced certain feelings, bright, warm colors made the viewers happy. While dark, cool colors can cause feelings of depression. In The Slid Show, Seurat used colors to create a melancholy, detached mood. The painting is brownish monochrome made up of green, yellow, orange, a nd blue dots and simplified, stylized shapes. Those shapes that can be read as figures are flat, vertical, two dimensional silhouettes. Seurats simplified, minimal forms can be seen as setting the stage for much of the twentieth centurys abstract art. Because of this the individual o...
Tuesday, March 3, 2020
Thylakoid Definition and Function
Thylakoid Definition and Function A thylakoid is a sheet-like membrane-bound structure that is the site of the light-dependent photosynthesis reactions in chloroplasts and cyanobacteria. It is the site that contains the chlorophyll used to absorb light and use it for biochemical reactions. The word thylakoid is from the Green word thylakos, which means pouch or sac. With the -oid ending, thylakoid means pouch-like. Thylakoids may also be called lamellae, although this term may be used to refer to the portion of a thylakoid that connectsà grana. Thylakoid Structure In chloroplasts, thylakoids are embedded in the stroma (interior portion of a chloroplast). The stroma contains ribosomes, enzymes, and chloroplast DNA. The thylakoid consists of the thylakoid membrane and the enclosed region called the thylakoid lumen. A stack of thylakoids forms a group of coin-like structures called a granum. A chloroplast contains several of these structures, collectively known as grana. Higher plants have specially organized thylakoids in which each chloroplast has 10ââ¬â100 grana that are connected to each other by stroma thylakoids. The stroma thylakoids may be thought of as tunnels that connect the grana. The grana thylakoids and stroma thylakoids contain different proteins. Role of the Thylakoid in Photosynthesis Reactions performed in the thylakoid include water photolysis, the electron transport chain, and ATP synthesis. Photosynthetic pigments (e.g., chlorophyll) are embedded into the thylakoid membrane, making it the site of the light-dependent reactions in photosynthesis. The stacked coil shape of the grana gives the chloroplast a high surface area to volume ratio, aiding the efficiency of photosynthesis. The thylakoid lumen is used for photophosphorylation during photosynthesis. The light-dependent reactions in the membrane pump protons into the lumen, lowering its pH to 4. In contrast, the pH of the stroma is 8.à Water Photolysis The first step is water photolysis, which occurs on the lumen site of the thylakoid membrane. Energy from light is used to reduce or split water. This reaction produces electrons that are needed for the electron transport chains, protons that are pumped into the lumen to produce a proton gradient, and oxygen. Although oxygen is needed for cellular respiration, the gas produced by this reaction is returned to the atmosphere. Electron Transport Chain The electrons from photolysis go to the photosystems of the electron transport chains. The photosystems contain an antenna complex that uses chlorophyll and related pigments to collect light at various wavelengths. Photosystem I uses light to reduce NADP to produce NADPH and H. Photosystem II uses light to oxidize water to produce molecular oxygen (O2), electrons (e-), and protons (H). The electrons reduce NADP to NADPH in both systems. ATP Synthesis ATP is produced from both Photosystem I and Photosystem II. Thylakoids synthesize ATP using anà ATP synthase enzyme that is similar to mitochondrial ATPase. The enzyme is integrated into the thylakoid membrane. The CF1-portion of the synthase molecule extended into the stroma, where ATP supports the light-independent photosynthesis reactions. The lumen of the thylakoid contains proteins used for protein processing, photosynthesis, metabolism, redox reactions, and defense. The protein plastocyanin is an electron transport protein that transports electrons from the cytochrome proteins to Photosystem I. Cytochrome b6f complex is a portion of the electron transport chain that couples proton pumping into the thylakoid lumen with electron transfer. The cytochrome complex is located between Photosystem I and Photosystem II. Thylakoids in Algae and Cyanobacteria While thylakoids in plant cells form stacks of grana in plants, they may be unstacked in some types of algae. While algae and plants are eukaryotes, cyanobacteria are photosynthetic prokaryotes. They do not contain chloroplasts. Instead, the entire cell acts as a sort of thylakoid. The cyanobacterium has an outer cell wall, cell membrane, and thylakoid membrane. Inside this membrane is the bacterial DNA, cytoplasm, and carboxysomes. The thylakoid membrane has functional electron transfer chains that support photosynthesis and cellular respiration. Cyanobacteria thylakoid membranes dont form grana and stroma. Instead, the membrane forms parallel sheets near the cytoplasmic membrane, with enough space between each sheet for phycobilisomes, the light harvesting structures.
Sunday, February 16, 2020
Politics Essay Example | Topics and Well Written Essays - 1000 words - 7
Politics - Essay Example As a result, children acquire understanding for which they readily pay a universal submission. Men pay such ready universal submissions on either both well or ill informed ideas. Locke, therefore, suggests and emphasizes the importance of early childhood education towards greatly shaping up their progress and development. Locke is categorical that teaching is an initial responsibility of the childââ¬â¢s parents from cradle long before bookwork begins. The reason for this is because such little or seemingly insensible impressions have lots of significance and lasting consequences on child behavior (Locke 133). He adds that the tempers, particular defaults, and different inclinations found in children are so diverse that they may require various remedies and combined efforts of various people to provide a remedy. Locke does not stop at collective responsibility in educating and caring for children, he gives an encouragement to parents to ensure that they watch their children closely. Consequently, through observation, parents get an opportunity to understand their children in distinctive inclinations. In another instant, John Locke advices parents to device their education methods paying particular attention to their children during perfect freedom and master the manner in which children spend the time available to them. As a result, such information would enable a parent to understand the best ways of motivating their children to conduct themselves in the right manner. However, John Lock is keen to warn parents that due to varied tempers, some children are likely to fall off the right path of reason compared to other children. He, therefore, questions against failure to guide their children properly. Children not properly guided become cruel or irrational, a situation he compares to water turning this way and that way. He argues that the mind of a child is like water that can easily move from one directions to another and change from one shape to
Sunday, February 2, 2020
Annotated Bibliography Example | Topics and Well Written Essays - 250 words - 6
Annotated Bibliography Example To this end, the author contends that legal sanctions that have been described have not been deterent enough to wage offenders from it. Unlike Rooy (2004) who sees civil liability as the best offence to dishonor of checks, Muntingh prefers a criminal liability. Rooy (2004) has been a practicing international banker for several years. He also doubles as a criminologist. In writing this article therefore, he reviewed some of the international approaches that have been put in place to reduce various crimes associated with financial fraud. In the opinion of the author, a major breakthrough came for international trade when documentary credits were introduced. Unlike Muntingh (2007), Rooy sees the civil liability that has been associated with various forms of trade frauds including the dishonor of checks as highly suitable for the prescribed offences. The author has been a practicing security expert for several years and have had several approved articles published in international journals including the present one. In the current article, the author embraces the documentary credit as a breakthrough for ensuring security with international payment. The reason is that it limits the rate at which traders would have to carry physical cash in the transaction of trade. But in order that the advantages of documentary credit be enjoyed to the maximum, the author, unlike Rooy (2004) assets that there should be the introduction of criminal liabilities all across regions that see checks as Bills of Exchange. Muntingh, J. A. (2007). The Fraud Exception in the Context of Documentary Credits: A Comparative Study of the Remedies in Various Jurisdictions. LL.M dissertation, Journal de Stellenbosch University, ProQuest, 4 (3), 43 -
Saturday, January 25, 2020
Cost Planning and Control in Construction
Cost Planning and Control in Construction The Cost Planning is a method of cost controlling the cost of a project within a pre-determined sum up to the tender stage. Cost Planning give advice to client how much will be project cost. As well, cost planning will advise when the expected expenses will most possible occur. Hence its important for get required project finance and for determining possible project profit. Therefore cost planning process essential to success of project. Methods of Estimating for Cost Planning There are some significant estimating methods uses in construction industry for Cost planning process. Those methods give preliminary estimate, hence Quantity Surveyor has to modify predetermine data considering the followings, such as , market conditions, Size, number of storeys, specification level, inclusions exclusions, service, site foundation conditions and other factors. Conference Estimating Method RIBA Stage A of Options Appraisal and stage B Design Brief, These method uses for preparation of the initial price estimate give to the client. It is based on a cooperative view of a group of persons, and not quantify in any particular way. Financial methods RIBA Stage A of Options Appraisal and stage B Design Brief, This method fixes a cost limit on the building design, according to the unit of accommodation or rental values. For example, Unit methodà RIBA Stage A of Options Appraisal and stage B Design Brief, The unit method is multiplies desire standard unit of accommodation by an approximate cost per unit. Not required specific drawings, specifications, only the concept of the project relevant to the required function. For example: Schools costs per pupil enplace Hospitals costs per bed enplace Car parks cost per car space Estimate = Standard unitsà of accommodation x Cost per unit Cube methodà Design Stage This is the superseded method because of inherent disadvantages; this method needs some sketch drawings, historical cost data, and alsoà important estimator experience. It is based on association between building volume and unit cost. For example: Superficial area method RIBA Stage B Strategic Briefing and also can be used for Stage C This is presently most common use method, its use for early price estimating purposes. The area of each of the floors multiplied by the cost per square meter. Mostly important Storey heights, plan shape and methods for when choose on the rate need be used. For example: Story enclosure unit method This technique use weightings for the estimating the building elements Elemental Cost estimating Detail Design Stage (Production information Stage F) This can use to establish the approximate cost of a construction project. It analyzes, the cost of the project on an elemental basis using from other similar projects. Also provides cost advice during the design process. Detail drawings are required. For example: Approximate Cost estimating Approximate quantities present additional detailed approximate estimate. No particular rules ofà measurement exist, Also significantly more information is required from the designer.. For example: Resource analysis (Pre Construction Stage Tender Documentation -G) This method is traditionally adopted by contractors estimators to determine their individual rates for measured items in bills of quantities. All individual measured items are analyzed into its element parts such as labour, materials and plant. This method is not a pre-tender method of price prediction strictly. For example: Explain the pre-contract cost planning and cost controlling process with respect to the RIBA plan of work a client/ consultant may adopt during each stage What Is Pre-contract Cost Planning? Pre Cost planning is very important to successful planning, design and construction of projects and is aimed at providing best value solutions. Essentially it is a pre-costing method of a project. As well as Pre-estimation of a design proposal will give clear picture about the cost to the employer and design team to make decisions regarding the project to make sure value for money. Pre-Contract Cost Planning Process The pre-contract cost planning process according to the RIBA plan of work 1998; it can be described as follows. Graph 2.1 Pre-stage A (Establish the budget) Client is the appointing client management team (Consultants) such as, client representative, cost consultant, according to his requirements. Identify objectives, physical scope of project, standard of quality of building and services, timeframe and establishing the budget. Emphasis nature of clients problems and functional requirements on proposed project. Work Stage A (Options Appraisal) Consultant has to identify of client prerequisite and possible limitation on development and cost of the ideal solution. Prepare technical, functional and cost studies by consultant and then it should enable to the client to take decision on his project weather he can continue the first proposal or could do some changes to the first proposal etc. also select the possible procurement method. Work Stage B (Strategic Brief) Consultant has to prepare initial cost suggestion to the client based on an outline statement of clients needs, also to determine target cost. This establish an initial budget for client Client has to investigate availability of finance for the project and value of money framework. Pre Contract Cost Control Generally Pre contract cost controlling process is implement from this stage according to the RIBA work plan mentioned chart 1.2, Pre Contract Cost Control process give to ensure the cost of the project is within the clients budget or not. Hence pre contract cost control is very essential in a project since it is planning, design finalizing and tendering and selecting a suitable contractor too. Outline Proposals- Stage C Consultant involves preparing outline proposal and estimate of cost as initial cost plan. Investigate the site conditions and preliminary sketches for requirement of cost plan by consultant. Evaluate strategic brief through consideration of time, cost, risk and environmental issues. Establish design management procedures and prepare initial cost plan, project program, and cash flow. Detailed Proposals Stage D At this stage, consultant prepares full detailed proposals for the client, and also prepares firm cost plan detailed elemental cost plan etc. Clint tem evaluate outline proposals for make final decision, Receive design and cost input from client appointed team and extend detailed design solution. Development control submission. Review procurement advice. Final Proposals Stage E Consultant has to prepared final proposal for the project at this stage. Carry out cost check of the design as it develop against the cost plan, hence it Confirmation of the cost limits for the project. Most cost effective in satisfying level of project brief to confirm or put final budget and to check the elemental cost targets. Cost checks design against cost plan. Decide on procurement methods. Consultant, they attending to review design and cost plan. Consultant has to prepare all required submission for legal approvals. Production Information Stage F All legal approvals should have completed when at this stage. This is the assessment of lowest acceptable tender price based on completed contract documents. Ensure that the completed designs are controlled within the cost limits. Prepare all co-ordinate production information including location. Arrange bring together all component drawings, schedules and specifications. Supply all required information for final cost checks of design against cost plan. Explain the term life cycle costing and related terminology. Definition of the life cycle costing According to definition of Hoar and Norman (1990) appropriately defined the life cycle cost of an advantage as the present value of total cost of the asset over its operating life including initial capital costs, occupational costs, operating costs and the cost or benefit of the eventual disposal of the asset at the end of its life. Hence life cycle costing related with the time stream of costs and benefits that flow throughout the life of the project. There are number of term use in industry to identify different stages in the life cycle costing techniques, hence flowing are the specially use in construction industry. Life cycle cost analysis (LCCA) Quantity surveyor assist to prepare this, based on collection and analysis of historic data on actual costs of occupying building (running cost and performance). Life cycle cost management (LCCM) Actually it is derived from life cycle cost analysis and identities, by this way client can be compare building cost and controlling occupancy cost throughout the life of building to get maximum value. Life cycle planning (LCCP) This is as part of life cycle cost management; it is constitute the prediction of total costs of a building, part or individual element taking account of initial capital costs, subsequent running cost and residual values. Life cycle costing Terminology Explain the Quantity Surveyors role as a cost manager, in the life cycle of the project. Role of the Quantity Surveyor as a Cost Manager Quantity surveyor is the person/ firm who manage the cost relating to the construction projects, such as new constructions, maintenance work and renovations. Quantity surveyor monitors the cost of every aspects of a construction project as a cost manager, as well as seeks to minimize the costs of the project and to make more cost savings while ensuring the total cost of project does not exceed the estimated cost. Furthermore when study about Quantity Surveyors in Cost manger position also have to be identified their duties and Responsibilities properly. He should conducting feasibility studies and writing procurement reports at project inception stage. He should manage estimating and cost planning process and presenting the final cost plan. He should manage the procurement process, and make certain that all phases with pre-qualification, enquiry, analysis, selection and contract preparation are carried out effectively. Ensuring that post-contract cost variances and change control tasks are directed effectively. Involving with cost checking and valuation works to manage them effectively. Preparation of monthly post-contract cost reports and presenting them to the client. Preparation of value engineering and life cycle costing, and also final accounts negotiated and agreed process. Give leadership role mange the client and other consultants, at all project phases. Working with top managers and directors, and identify and performing new opportunities to improve the cost management procedures.
Friday, January 17, 2020
Critical Incident – Preconceived Ideas
No names are used in this writing to maintain patient confidentiality and conform to the data protection act 1998Critical incidents originated in the United States, Colonel John C Flannagan was a psychologist who worked closely with the Air Force and their procedures for reporting evidence concerning effective or ineffective behaviour within different situations (Ghaye 2006:64-65). Tripp (1993: 24-25) claims that ââ¬Å"critical incidents appear to be ââ¬Ëtypicalââ¬â¢ rather than critical at first sight, but are rendered critical through analysisâ⬠.Critical incidents can be either positive or negative; They ââ¬Å"are usually experiences that make you consider the events that have happened to try to give them some sort of meaningâ⬠(Hannigan, 2001). Using a critical incident as a way of reflecting helps individuals identify practice that has been helpful or unhelpful in a situation. The value of a critical incident can differ from person to person; it is usually a per sonal experience with meaning to an individual, however critical incidents can be useful for a range of people for example, students, lecturers, service users and the general public.They give an insight into the feelings of the person writing and are often relatable to others. In appendix 1 I have described my critical incident. Following this I will explain the importance of a critical incident and the effect on practice, in particular how it has influenced my practice as a student nurse. This experience has greatly influenced my training in a number of ways. As a student nurse I believe it is hard to avoid having a preconceived judgement of a patient.After receiving a brief description of the patientââ¬â¢s diagnosis from my mentor, I believed this patient would possibly be frail and sedentary, laid in bed with a poor quality of life. However what I was greeted with was the total opposite. This is affected by the patientââ¬â¢s own judgement of her illness, often receiving a p rognosis such as this prompts a dramatic change in the patientââ¬â¢s lifestyle. It can be argued that this is the hardest part in ââ¬Ëacceptingââ¬â¢ a diagnosis is the need to change. ââ¬ËIn accessing readiness to change, we need to look at the individualââ¬â¢s stateââ¬â¢ (Broome 1998:31).If a particular patient is not ready to adapt their lifestyle it can become difficult for them to come to terms with their diagnosis. Patients unable to come to terms with their diagnosis or patients finding their illness difficult after a period of time are likely to suffer from depression or anxiety (Reid, et al 2011). However upon visiting this patient it was clear to me that this patient was able to accept her diagnosis and had readily accepted the challenge to adapt her lifestyle. To me this seemed like a phenomenal act for her to achieve in such a short space of time following the diagnosis.Communication is a key aspect of any type of care, in particular terminal care as the patient in question is likely to feel scared and anxious about their prognosis. There are a number of different reasons for this;ââ¬Å"Including diagnosis and treatment of their disease, long-term physiological alterations, fears of relapse and death, dependence on caregivers, survivor guilt and negative effects on familiesâ⬠. (Groenwald et al 1992: 580)Communication should be an equal conversation that allows both the nurse and patient to include what they need to say.For a nurse it is important to listen to a patient as developing a therapeutic relationship will often make the patient feel more open to discussion about their feelings and concerns. The therapeutic relationship facilitates the ability for a patient to achieve their desired state of maximum health (Brooker, and Waugh, 2007:236; Kozier, et al 2012:95-97) Patients should be able to ââ¬Å"freely express their beliefs, values and concerns in a non-judgemental and supportive wayâ⬠(Barker 2010:31).A therapeut ic relationship is essential in developing trust between a patient and nurse and is fundamental for care with service users such as my patient. A therapeutic relationship can be described as ââ¬Å"one that allows for the meeting of nursing needs to the mutual satisfaction of a nurse and patientâ⬠(McQueen 2000:9). This should reduce anxiety and may allow the patient to feel more comfortable in addressing any concerns surrounding the prognosis. This incident has made me think about the barriers to communication and the effects they can have on other staff members, patients and their families. Understanding the potential problems allows us to better understand how something might be able to work more efficientlyâ⬠(Ellis 2011:88). There are a number of barriers to communication for example; physical barriers such as a door being closed, perceptual barriers for example going into a conversation thinking that the person isnââ¬â¢t going to understand or be interested in wha t you are going to say. Emotions can also be barriers to communication as well as cultural, gender, interpersonal and intellectual (Kozier et al 2012:46).I believe my patient may have had emotional barriers to communication with the nurse and myself. She had already accepted her diagnosis and her decision not to converse with us about her condition may indicate that it was difficult for her to discuss it with others, despite being comfortable with it herself. The fact that the patient was comfortable with her illness made me think about the definition of health. My patient had said she felt healthy and therefore to her, despite having an illness, she didnââ¬â¢t consider herself as ââ¬Ëunhealthyââ¬â¢.The World Health Organisation (WHO) describes the definition of health as ââ¬Å"a state of complete physical, mental and social well-being and not merely the absence of disease or infirmityâ⬠(WHO 1948; Kozier et al 2012:6) although this is the most commonly used definitio n for health, seeing this patient led me to review its significance. The patient I saw clearly didnââ¬â¢t view this definition to be the same as her meaning of health. Health differs for every individual, my patient felt well and therefore in her opinion she was healthy.It is understandable that she didnââ¬â¢t want to be continually reminded of her cancer, it was enough that her independence had been reduced due to the fact the nurses were coming into her home in the first place. My mentor and I decided to respect the patients wishes and allow her to come to us when she felt she would like to talk rather than forcing her to speak to us, we arranged to keep nurse interaction with this patient to a minimum so she could retain some ââ¬Ënormalityââ¬â¢ in her life. ââ¬Å"Patients are made aware that they have the right to choose, accept or decline treatment and these decisions are respected and supported. (NICE Guidelines 2012) It was at this point I began to understand the value of concordance. McKinnon (2011:69) states ââ¬Å"a partnership of equals on which care plan is negotiatedâ⬠, concordance enables patients to not only make decisions about their care, but to work in parallel with the health care professionals towards a mutually agreed outcome. It could have been easy for my mentor to disregard the patientââ¬â¢s wishes and focus solely on her wound care and expect her to simply comply as the nurses are considered to be the experts, however her feelings were recognised and her autonomy wishes were responded to.My mentor displayed an excellent example of holistic care according to Linsley (2011:273), who states that nurses have to be aware of the social, environmental and psychological aspects of health and not just physical signs and symptoms of an illness. Before meeting this patient, I didnââ¬â¢t realise how daunting the experience of health care professionals can be, I had always wrongly presumed people would be happy to receive car e to make them feel better, however in this instance it has proved to me that not everyone has this view.It has enabled me to think about my role as a student nurse and it has made me reflect on so many different aspects of good nursing care, from communication and concordance to holistic care. Before my interaction with this patient, I didnââ¬â¢t understand just how important it was for patients to have their say. I couldnââ¬â¢t help but wonder if I had been the registered nurse in that situation, would I have been task orientated and wanted to get the job done rather than taking into consideration the patients wishes? As a first year student I am aware of my limitations and understand that I have a lot to learn.I thought about how I would feel if I was in the patientââ¬â¢s situation and of course Iââ¬â¢d want to be involved in the decisions made concerning my care. The experience with this patient has enabled me to develop as a student nurse, and will inform my practic e throughout the whole of my career. Seeing first hand such a good example of concordance and holistic care from my mentor has given me a great platform to base my learning experiences on. References Barker, J (2010) Evidence-Based Practice for Nurses. London: Sage Publications Ltd. Berman, A. Erb, G. Harvey, S. Kozier, B.Morgan-Samuel, H. and Snyder, S (2012) Fundamentals of Nursing: Concepts, process and practice. Harlow: Pearson. Broome, A. (1998) Managing Change. Hampshire: Macmillan Press Ltd. Ellis, P. (2010) Evidence-based practice In Nursing. Exeter: Learning Matters Ltd. Ghaye, T. and Lillyman, S. (2006). Learning journals and Critical Incidents. 2nd ed. Hampshire: Palgrave Macmillan. Groenwald, S. Goodman, M. Hansen Frogge, M. and Henke Yarbro, C (eds. ) (1992) Comprehensive Cancer Nursing Review. Sudbury: Jones and Bartlet publishers Inc. Linsley, P. Kane, R. and Owen, S. eds) Nursing for Public Health: Promotion, Principles, and Practice, Oxford: University Press. McKinn on, J. (2011) ââ¬ËThe nurse-patient relationship' in Linsley, P. Kane, R. and Owen, S. (eds) Nursing for Public Health: Promotion, Principles, and Practice, Oxford: University Press, pp. 64-74. McQueen A. (2000). Nurse-patient relationship and partnership in hospital care. Journal of Clinical Nursing. 9 (5): 723-731. Reid, A. Ercolano, E. Schwartz, P. and McCorkle, R (2011) ââ¬ËThe Management of Anxiety and Knowledge of Serum CA-125 After an Ovarian Cancer Diagnosis. ââ¬ËClinical Journal of Oncology Nursingââ¬â¢ 15 (6), [online], Available from: http://web. ebscohost. com. proxy. library. lincoln. ac. uk/ehost/detail? sid=7e50352a-778c-4db4-be37-388bb618120d%40sessionmgr114&vid=1&hid=103&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=c8h&AN=2011371794 [Accessed: 26th February 2013]. Tripp, D. (1993) Critical Incidents in Teaching, Developing Professional Judgement. Routledge: London. NICE Guidelines (2012) Supporting patient choice [online] National Health Service online. Availab le from http://www. nice. org. k/guidance/qualitystandards/patientexperience/SupportingPatientChoice. jsp [accessed 3rd February 2013]. Nursing Times (2004) Reflective thinking: turning a critical incident into a topic for research [online] London, Nursing Times online. Available from: http://www. nursingtimes. net/reflective-thinking-turning-a-critical-incident-into-a-topic-for-research/200145. article [Accessed 3rd february 2013]. World Health Organisation (1948) World Health Organisation Definition of Health [online] New York, World Health Organisation Online. Available from: http://www. ho. int/about/definition/en/print. html [Accessed 1st March 2013]. Bibliography Barker, J (2010) Evidence-Based Practice for Nurses. London. Sage Publications Ltd. Barrat, D, Wilson B, and Woollands, A (2012) Care planning A guide for nurses. Second edition. Harlow. Pearson Education Ltd. Benner, P. (1984) From Novice to Expert, Excellence and Power in Clinical Nursing Practice. Menlo Park Addiso n Wesley. Berman, A. Erb, G. Harvey, S. Kozier, B. Morgan-Samuel, H. and Snyder, S (2012) Fundamentals of Nursing: Concepts, process and practice. Harlow: Pearson.Brooker, C. and Waugh, A. (eds. ) (2007) Nursing Practice: Fundamentals of Holistic Care. Philadelphia: Elsevier. Broome, A. (1998) Managing Change. Hampshire: Macmillan Press Ltd. Ellis, P. (2010) Evidence-based practice In Nursing. Exeter: Learning Matters Ltd. Ghaye, T and Lillyman, S. (2006). Learning journals and Critical Incidents. 2nd ed. Hampshire: Palgrave Macmillan. Groenwald, S. Goodman, M. Hansen Frogge, M. and Henke Yarbro, C (eds. ) (1992) Comprehensive Cancer Nursing Review. Sudbury: Jones and Bartlet publishers Inc. McQueen A. (2000).Nurse-patient relationship and partnership in hospital care. Journal of Clinical Nursing. 9 (5): 723-731. Tripp, D. (1993) Critical Incidents in Teaching, Developing Professional Judgement. Routledge London. (Appendix 1) During placement I have managed to gain experience with t erminal cancer patients. When you go into a patientââ¬â¢s house, I feel you canââ¬â¢t help but have a preconceived idea of the type of patient you are about to meet. I was surprised when visiting one patient, as I was told before I entered the home that the patient had terminal epithelial ovarian cancer. This type of ovarian cancer arises from a malignant transformation of the ovarian surface epithelium, how this transformation occurs is unknown. â⬠(Groenwald et al, 1992: 466-467) When I met this patient I was unsure of what I would discover. I expected a woman that was going to appear physically ââ¬Ëillââ¬â¢ and I imagined her to be like all the other patients I had seen with terminal cancer. To my surprise we found her sitting in her conservatory reading the newspaper looking well, she was dressed appropriately and had her hair and makeup done.The patient seemed genuinely happy and didnââ¬â¢t meet any of the previous preconceptions I had when I was originally told about her. We were there to change a fluid bag from the patientââ¬â¢s abdomen and support the patient if she had any concerns about her illness. This is the only thing the nurses do for this patient, her partner, with some help from the Macmillan emergency care team complete the rest of her care. This patient had a persistent disease that couldnââ¬â¢t be controlled. She had previously been treated with chemotherapy to try and eliminate the cancer however this had been unsuccessful.The patient had then decided along with the healthcare professionals, to withdraw treatment and only accept pain relief and support. ââ¬Å"The staging of ovarian cancer is based on surgical evaluation and forms the basis of subsequent therapyâ⬠. (Groenwald et al, 1992: 466-467) The district nurse has only just become involved in her care, currently she is 5 months into her diagnosis. When the nurse and I tried to speak to the patient about her illness and how she was feeling, she seemed re luctant to talk about it. The patient decided she felt well in herself and didnââ¬â¢t want to be reminded of her illness, she went on to explain that she had already
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