Air Traffic Management Concept Essay

This paper aims to show some major issues regarding the integration of future ground-based ATM decision support systems (The Air Traffic Management Concept) and how these systems will improve the human factor in the air traffic system. If present airspace procedures continue as it is, escalating traffic demands are presumed to compromise many things. Among these are on-time performance, security, and safety. Dealing with these escalating airspace aptitude prerequisites would necessitate considerable adjustment and enhancement to current-day procedures. One attempt in solving this problem is to give airlines more liberty in doing their own schedules and selections of traffic routes while still continuing to disperse tasks for partition and arrival planning to the ATSP. ATSP stands for Air Traffic Service Providers. Air Traffic Control-oriented tactics centers on airspace reorganization and development or improving of tools for air traffic managers and controllers which in turn, would enable them to handle air traffic more carefully and effectively. In the Air Traffic Management segment of the Terminal Area Productivity program, they were working on the incorporation of future ground-based ATM decision support systems with that of FMS (Flight Management System) furnished aircraft contained in the terminal district, the researches and illustrations centered on amplifying airport capacity. They do this by making use of the CTAS or Center TRACON Automation System for producing effective trajectories. Data connect for communicating the said trajectories into the aircraft and Flight Management System furnished aircraft for flying them accurately (The Boeing Company, 2001). In this regard major airports which are plagued by the difficulties of aircraft arrival rushes should be studied. The objective was to present a safe, highly competent flow of traffic which would begin from en route into TRACON airspace which dependably transports aircraft to the runway entry, while preserving as much flight crew suppleness and authorities as sensible. Triumphant planning and implementation of an effective arrival flow necessitates a meticulous knowledge of all aircraft and operators. Knowledge on traffic managements as well as on spacing limitations is also needed. It should also include synchronization among controllers, flight crews, as well as traffic administration. The plan for future ground-based ATM decision support systems could be imagined as a human-centered system on which the controllers as well as the pilots would employ processes, flight management mechanization as well as evaluation support tools to aggressively supervise traffic arrival. It could be seen that they aim for a future air traffic system which are run and supervised by the ATSP and they anticipate this to be ready by 2010. ATSP stands for Air Traffic Service Providers (NASA Ames Research Center, 2002). . The operational theory for attaining effectiveness developments over current procedures is to map an effective arrival stream earlier than necessary and then implement the arrival plan as accurately as could be. They also presented a â€Å"multi-sector arrival planner† Air Traffic Control arranges to link the breach among traffic administrators, dispatchers as well as the sector controllers. The planner’s duties include producing the most effective schedule and arrangement for all incoming aircraft and conflict-free flight routes which would always be able to meet the schedules. The planner organizes the engendered flight routes. The sector controllers concerns would then on use a graphical coordination apparatus. After analyzing the recommended flight path, the sector controllers delivers fitting authorizations to the flight crews. The flight crews would then pursue the cleared path accurately applying their flight management mechanization. Sector controllers are in charge in preserving division and modifying the arrival plan to new situations. Automation and processes are planned in order to aid with all the above mentioned tasks (Advanced Air Transportation Technologies, 1999). The Terminal Area Productivity concept is more calculated than the current system but the controllers are vigorously engaged with everything in the procedure of developing and implementing a traffic flow plan which would be used for arrival rush. Although it drastically modifies the tasks of the stakeholders it does not alter their accountabilities. The first flight deck oriented recreation revealed that data link procedure in the fatal region was adequate and advantageous for the flight crews. Usually crews favor a Boeing 777 which decreases heads-down time on the arena. They could productively use the sides flight management purpose LNAV to the concluding method fix. A VSD model was launched to aid in using Flight Management System automation nearer to the ground. This was meted with high markings by the flightcrews. Vital workload or operation disparities cannot be found among situations with and without the Vertical Situation Display or VSD (The Boeing Company, 2001). A flight reproduction at NASA Langley Research Center yielded a promising result. It showed that miscalculations on arrival time at the closing approach fix could be considerably lessened. This could be done by flying TRACON trajectories with Flight Management System supervision as compared with heading vectors. The preliminary illustration of CTAS/FMS procedures with controllers showed the promise for augmenting the effectiveness of arrival streams by using the CTAS tools for planning and supervising. The devised controller interface with the mechanization and the data link was tolerable. However, it could still make use of further enhancements. There are a number of drawbacks which had been mentioned here. Among the said drawbacks are too much information in the data block, an inept and complex course trial planning interface as well as the three button mouse. The operational concept however, obtained good feedbacks and the controllers were eager for the promise it shows. The Advanced Air Transportation Technology is a branch of NASA’s ASC program. ASC stands for Aviation System Capacity. Its goal is to better the overall operation of NAS (National Airspace System). In so as to attain this goal AATT is building up decision support technologies and processes to help National Airspace System stakeholders. The vision of the Advanced Air Transportation Technology Project concerning far-term National Airspace System procedures is represented in the Distributive Air Ground Traffic Management concept (Advanced Air Transportation Technologies, 1999). Distributed Air Ground Traffic Management is aiming for a free-flight environment on which flight crews would be able to take more part on decision making processes. Rather than merely implementing controller directions, the crews would have more liberty in asking for and choosing flight routes. Developed on-board automation for variance detection and resolve would affect the pilot’s behavior, hence influencing controller’s attitude and placing more conditions on ground automation and information sharing. The Distributed Air Ground concepts cover an assortment of probable means to handle arrivals varying from continuous free-flight to fully ground-controlled. There are two extremes in the process. The first is the free-flight to the threshold. The second is Ground (ATSP) Controlled Arrival. The free-flight to the threshold entails that the flight deck in charge for route planning and division from the aircraft all the way through the arrival. The aircraft turns up at the Center in free flight. It is accountable for extricating itself from other traffic. Traffic flow management restraints for going into the terminal region are made accessible to the flight crew. The flight crews in turn modify their terminal arrival plan fittingly. Upon drawing near the TRACON airspace, the flight crews pick the aircraft which they desire to track to the threshold and choose the appropriate assimilating and spacing boundaries then they would go after the lead aircraft to the runway. Ground (ATSP) controlled arrival is another extreme in that this is very near to the concept illustrated on the earlier TAP research. Upon coming in the terminal airspace free flight is terminated for the incoming traffic. Ground-based traffic managers are then responsible for two things. Their responsibility ranges from making a schedule and arrival trajectories to communicating them to the aircrafts. The aircraft could downlink a certain flight path demand that the Air Traffic Service Providers may or may not agree into. Accountability for division and route planning keeps on the ground all over the course of the arrival stage. The flight crew obtains more tactical Flight Management System and spacing authorizations than in today’s tactical settings (NASA Ames Research Center, 2002). Free flight to the threshold would necessitate added aircraft equipment. This may involve RTA and CDTI. Conflict detection and resolution algorithm could also be included. RTA stands for Required Time of Arrival while CDTI stands for Cockpit Display of Traffic Information. Ground controlled arrivals are a little different. They do not make use of the aircraft abilities in the most effective conduct. Aside from that they put the whole flow supervision problems on the controller. The future air traffic system would direct arrivals in such a way that it would be lying between the boundaries of the two extremes mentioned earlier. This opens the possibility of moving from ground-controlled into a free-flight (NASA Ames Research Center, 2002). Experiments and operational performances would illustrate which concept seems to be most suitable. The amount of free-flight against Air Traffic Control could be dependent on the traffic circumstances, facility performances, aircraft equipments, and airline inclinations. Those who are in charge sees the need for the air traffic system to be devised to have room for all potential forms operation between the extremes discussed in this paper. Thus, all enabling technologies ought to be enhanced, incorporated and assessed, including the following: a. Cockpit Display of Traffic Information with airborne conflict detection b. FMS with Required Time of Arrival capacities. c. On-board integration and spacing apparatus d. ADS-B and CPDLC data link communication e. Traffic Management advisory apparatus f. Ground-based conflict detection and resolution g. Ground based tools for trajectory generation with meet time constraints (NASA Ames Research Center, 2003) Most of the above mentioned equipments are already obtainable in remote examination models. Those in charge are presently in the course of assimilating them at NASA Ames Research Center to generate a model environment that permits examining these concerns. They are also expanding an arrival concept that supplies the elasticity to alter the quantity of self division to traffic flow management restraints and other necessities. They also originally mean to maintain the free-flight airspace apart from the ground-controlled airspace. The border can be denoted as a curve about the meter fix or the adjacent arrival gate or a plain elevation floor. This can be attuned for traffic intricacy. Very low traffic circumstances could be different. In such cases the free flight region could be as near to the airport as the gauge fix. The arrival setting starts with the aircraft which would arrive at the Center in what they call to be a â€Å"free maneuvering mode†. The flight crews are in charge for division, traffic management restraints at the metering fix are then on relayed from the planner. This is done by using the CTAS Traffic Management Advisor to the flight level, the flight crew on the other hand, is the one anticipated to prepare their flight route to land at the metering fix near the probable time. That is, if scheduling is necessary. The flight crew would then be informed as to where the free flight periphery presently stops. The flight crew would also be informed when to confirm things with the controller (NASA Ames Research center, 2002). The arrival planner continues appraising the circumstances by means of Descent Advisor apparatus and attempts to produce an arrival arrangement for the ground-controlled airspace that the arrival planner would convey to the sector controllers. Once the sector controller obtains the test in from the free maneuvering aircraft, he would then on call off free flight and release the arrival authorization to the aircraft. This would be founded on aircraft choice and arrival plan in that they are likely to fly the arrival authorization to the meter fix accurately. The Center TRACON Automation System apparatus help the TRACON controllers in shaping appropriate aircraft pairs for getting in-trail spacing authorizations. Division in charge hangs about with the organizer all the way through the TRACON (NASA Ames Research center, 2002). This setting permits us to examine most facets of the appropriate Distributive Air Ground Traffic Management concept fundamentals and constructs on the preceding arrival research especially since current deliberations with controllers and pilots was met with positive feedbacks. Among the probable advantages of Distributive Air Ground Traffic Management are: †¢ Amplified user effectiveness/flexibility. DAG-TM presents users paramount prospect to self-optimize their ventures within the vigorous restraints of the Air Traffic Management System. †¢ Amplified system capabilities. Allocation of division accountability to properly furnished aircraft and Air Traffic Service Providers-based DSTs could possibly lessen controller workload, thus permitting the Air Traffic Service Providers to control more traffic. †¢ Amplified system safety because of an important increase in situational understanding and allocation of workload. †¢ Allocation of the expenditures for National Air Space innovation between users and the Air Traffic Service Providers. †¢ Lessened user reliance upon Air Traffic Service Providers assistances and a ground-based infrastructure. This could also intensify global interoperability (Advanced Air Transportation Technologies, 1999). As could be seen the integration of future ground-based ATM decision support systems is very promising. These new technology would indeed be helpful in aiding to augment the overstrained air traffic control systems. This new technology let aircrafts operate safely about traffic and airspace perils (i. e. weather), while still going in accordance with the traffic flow restraints delivered by ground-based controllers (Advanced Air Transportation Technologies, 1999). To try this particular concept, they asked pilots and air traffic controllers to coordinate with each other along with the NASA researchers for a combined simulation. The simulation utilized air traffic control and deck laboratories. â€Å"This joint simulation tested our technology in an almost real-world environment,† stated project manager Mike Landis. â€Å"More than 20 pilots sat at computer workstations ‘flying’ simulated aircraft into a mock-up of the Dallas/Fort Worth airspace. Pilots also flew one of NASA’s high-fidelity, full- motion flight simulators in the joint experiment. The air traffic controllers were able to see all of these aircraft on displays, and the pilots used an autonomous flight management system to plan their own routes and safely and seamlessly fit into the traffic flow. Controllers were able to watch their progress on simulated air traffic control monitors† (Dino, 2004). The airborne segment of the mock-up employed promising technologies which offered real-time air traffic and risk information. It also examined all aircrafts and airspace peril in the surrounding area. Complicated cockpit technology warned the pilots to any sign of conflicts. It also alerts the pilots into how to stop more difficulties when maneuvering. Solutions were offered mechanically or with the use of manual flight route planning apparatus. This is a visual illustration of the DAG-TM concept. â€Å"On the ground, air traffic controllers used new computer software to work the mix of autonomous and conventional air traffic. NASA researchers developed experimental controller workstations for the joint simulation, integrating custom display enhancements with special planning, traffic flow management, and pilot-controller communication technologies† (Dino, 2004). Special software was used to aid in running the traffic flow. This special software was also used to aid the aircrafts which were not furnished with the self-sufficient flight management system, in this regard air traffic control automation observed every aircrafts. They are also responsible for cautioning the controller regarding possible conflicts. These conflicts could be found amid the autonomous and managed traffic. Researchers also examined the way the pilots and air traffic controllers coped with this new invention. â€Å"Researchers measured how hard the pilots and controllers were working,† said Parimal Kopardekar, human factors and operations sub-project manager. â€Å"It’s important that they find this job relatively easy to do, even as traffic levels go up. We believe the computer automation technology will make a big difference† (Dino, 2004). As could be seen the future ground-based ATM decision support systems is very promising. It is of great help for managing air traffic. This method could consent for the effective planning of flights with the use of the most effective paths and flexibility in flight processes. Little by little, as air carriers furnish aircrafts with new technologies, they could effortlessly incorporate them into the system and harvest instant advantages. â€Å"As air travel rebounds in the coming years, additional traffic will tax the air traffic control system beyond its current capability,† said Mark Ballin, aircraft systems and operations sub-project manager. â€Å"NASA is working to develop technologies to transform the way air traffic is managed† (Dino, 2004). A definition for DAG-TM was organized by a multi-disciplinary squad. This team was created by the AATT project office, the Distributed Air Ground Traffic Management is illustrated by allocated decision-making among the flight deck, Air Traffic service Providers and AOC. It is also a National Airspace System operation which augments user effectiveness, flexibility and system capabilities. The Distributed Air Ground Traffic Management advocates that the said definition be assessed as one probable expansion of the numerous Free Flight execution methods presently under deliberation. The concept of strategic arrival management illustrated in the Terminal Area Productivity research could be seen to have many potential. The Distributive Air Ground research shifts from a ground-controlled setting to a more disseminated setting with probably uneven division tasks. NASA Ames is presently organizing a research setting to examine Distributive Air Ground Traffic Management with all main technologies incorporated. Preliminary concepts and settings have been identified and conferred with pilot or controller center groups. Based from the simulations they conducted one could not help but admit the promises this new technology offers. If this new technology is put into use soon it could greatly help in saving time. It would also be beneficial in the sense that this new technology advocates safety as one of its primary goals. As air traffic lessen, safety increases and with that there is definitely no reason not to support this new development. References Advanced Air Transportation Technologies (AATT), Project Aviation System Capacity (ASC), & Program National Aeronautics and Space Administration. (1999). Concept Definition for Distributed Air/Ground Traffic Management (DAG-TM) [Electronic Version]. Retrieved November 10, 2007, from http://www. asc. nasa. gov/aatt/dagconop. pdf Dino, J. (2004). Coast-to-Coast Simulation Tests New Air Traffic Management Concepts [Electronic Version]. Retrieved November 10, 2007, from http://www. nasa. gov/vision/earth/improvingflight/DAG-TM. html NASA Ames Research Center. (2002). DAG-TM Concept Element 5 En Route Free Maneuvering Operational Concept Description [Electronic Version]. Retrieved November 10, 2007, from http://www. asc. nasa. gov/aatt/rto/RTOFinal72_DAGCE50CD. pdf NASA Ames Research Center (2003). DAG-TM Concept Element 6 En Route Trajectory Negotiation Operational Concept Description [Electronic Version]. Retrieved November 10, 2007, from http://www. asc. nasa. gov/aatt/rto/RTOFinal72_DAGCE60CD. pdf The Boeing Company. (2001). Air Traffic Management [Electronic Version]. Retrieved November 10, 2007, from http://www. emotionreports. com/downloads/pdfs/traffic_management. pdf

Global Market Entry Modes

Access to distribution network Contact with local suppliers and government officials Lack of control Lack of trust Conflicts arising over matters such as strategies, resource allocation, transfer pricing, 8. WHOLLY OWNED SUBSIDIARIES Greater control and higher profits Strong commitment to the local market on the part of companies Allows the investor to manage and control marketing, production, and sourcing decisions Risks of full ownership Developing a foreign presence without the support of a third part Risk of nationalizationIssues of cultural and economic sovereignty of the host country 9. Strategic Alliances Greenfield Operations Offer the company more flexibility than acquisitions in the areas of human resources, suppliers, logistics, plant layout, and manufacturing technology. Types of Strategic Alliances Simple licensing agreements between two partners Market-based alliances Operations and logistics alliances Operations-based alliances The Logic Behind Strategic Alliances Defe nd Catch-up Remain Restructure Cross-Border Alliances that Succeed:Alliances between strong and weak partners seldom work. Autonomy and flexibility Other factors: Commitment and support of the top of the partners' organizations Strong alliance managers are the key Alliances between partners that are related in terms of products, technologies, and markets Similar cultures, assets sizes and venturing experience A shared vision on goals and mutual benefits 10. Timing of Entry International market entry decisions should also cover the following timing-of-entry issues: When should the firm enter a foreign market?Other important factors include: level of international experience, firm size Mode of entry issues, market knowledge, various economic attractiveness variables, etc. Reasons for exit: Sustained losses Volatility Premature entry Ethical reasons Intense competition Resource reallocation 1 1 . Exit Strategies Risks of exit: Fixed costs of exit Disposition of assets Signal to other m arkets Long-term opportunities Guidelines: Contemplate and assess all options to salvage the foreign business Incremental exit Migrate customers

Aed 200/Students Rights and Teacher Responsiblities Essay

If a student is harmed because the teacher was unable to foresee the threat, then the teacher can be held accountable. Also if a student is harmed because the teacher failed to pay attention to entire class, the teacher can be held accountable. A teacher’s responsibilities influence students’ rights because a students’ rights must be limited to maintain student safety on a field trip. One example may be implementation of a dress code specifically for field trips. A teacher may require all students wear red shirts. This would help the teacher keep all students together. A student may feel like the teacher is violating his or her rights to wear what he or she chooses; however, the teacher is simply exercising caution. This is the responsibility of a teacher. As a teacher, I will have many responsibilities. One responsibility is that I should seek to achieve the highest standards in my work. The status of my profession depends directly on teachers. I will have a responsibility to follow a code of ethics and code of conduct. Students must follow these codes, and as an educator, I will also. Another responsibility I will have as a teacher is to ensure the safety of my students. I will have many other responsibilities above and beyond those mentioned. Like responsibilities, I will also have rights as a teacher. I will have the right to exercise all civil rights enjoyed by other citizens. As a teacher, I will have the right to be human and make mistakes. I will have the right to expect an appropriate of respect from students. I will have many more rights as a teacher, along with those I mentioned. Some responsibilities I have may influence the rights of some students. For example, it is my responsibility to ensure the safety of my students in my classroom. If there is a safety concern with a student, it is my responsibility to remove that student, or have that student removed, from the class and discipline accordingly. This would influence this students’ rights. In a situation such as this, it is extremely fair and acceptable to infringe on this students’ rights. As a teacher, I must put the safety of my students first. If there is a major safety concern with a student, no other students will be capable of learning until the situation is resolved. One personal example of teachers’ responsibilities limiting a student’s rights involved my oldest daughter. She was attending a field trip to a local library and then to the park for lunch and playtime. I was not allowed to ride the bus, so I followed behind in my personal vehicle. We arrived at the library, completed our walk through and story time and was getting ready to leave. At this time, my daughter, who was five, wanted to ride with me to the park, not on the bus. The teacher had a responsibility to ensure that my daughter was safely returned to the school, therefore prohibiting me from taking her in my vehicle. We then arrived at the park, we ate lunch, played, and it was then time to return to school. At this time, my daughter again was in tears, wanting to ride with me. Again, the teacher explained her responsibilities, which prohibited my daughter from returning to school in my vehicle. This is an example of teachers’ responsibilities influencing a student’s rights. One example of a students’ rights overriding a teachers’ responsibility would be of a special needs child. Fairly recent changes in special education laws require that more and more students be placed in regular classrooms. These special needs students’ have a right to be graded, in these normal classes, according to their Individual Education Plan (IEP). This right would override a teachers’ responsibility of being fair and treating all children equal. This teacher may have to give lenience to the special needs child and not to the other students. Many students’ rights and teachers’ responsibilities work directly with each other. However, some work for and some work against each other. As a teacher, I must be able to make the best moral decision based on both my responsibilities as well as my rights, while at the same time, respecting the rights of my students. Respect, from both sides, and open communication is key in fulfilling the rights and responsibilities of both parties.

Autism Essay Example | Topics and Well Written Essays - 750 words - 1

Autism - Essay Example In many children, autism develops before the age of 3. A relationship between autism and psychology has been established by defining and associating their dynamics. Psychology is a field of study that deals with the human mind. The study of psychology has helped in the understanding and treatment of autism through methods such as psychotherapy, applied behavior analysis, and developmental psychology. Both psychology and autism deal with the brain and are complementary in nature. Psychology is largely used to understand the dynamics of autism, and develop methods to treat it. Psychologists use several types of therapies to treat autism. Autism impairs the communication and interaction skills of children (Cohen, 2002). Consequently, children become psychologically affected for being different from other children. Inability to communicate and interact effectively causes them social anxiety and depression that has far-reaching psychological implications (PubMed Health, 2012). Psychologis ts use various variations of talk therapy to correct strained communication skills. A psychologist is able to help autistic individuals improve their communication skills, overcome anxiety and depression, and learn how to interact effectively with other people (Flusberg, 1999). ... One of the roles of psychologists is to diagnose and recommend treatment methods for autism (Flusberg, 1999). Therefore, autism cannot be effectively diagnosed and treated without the services of psychologists. They aid autistic individual to eradicate depression, anxiety, and preservative behaviors that affect them adversely (Corsello, 2005). Psychologists accomplish these roles because they fully understand the effects and consequences of autism. On the other hand, psychologists also help victims to manage their lives, improve social interactions, and understand various social cues that determine the effectiveness of communication. Autism and psychology are related through the methods used to treat the disorder. These methods include psychotherapy, applied behavior analysis, and developmental psychology. Psychotherapy is a method that involves use of talk as a way of solving a patient’s emotional problems (Corsello, 2005). Psychologists use methods such as role-play and expo sure therapy to assist autistic individuals (PubMed Health, 2012). Applied behavior analysis manages the disorder by teaching autistic individuals new behaviors that replace existing behaviors that could have resulted from the effects of the disorder. Psychologists use rewards to teach patients certain behaviors thus conditioning them in ways that eradicate the disorder (Corsello, 2005). Development psychology deals with aspects of child development. A direct link can be established between this branch of psychology and autism because autism interferes with the normal development of a child’s brain while psychology studies the functioning of the brain. It forms the foundation for autism remedies such as relationship

Charles Darwin Essay Example | Topics and Well Written Essays - 1000 words

Charles Darwin - Essay Example The life of Charles Darwin was as eventful as his works. He had keen interest in natural history from his boyhood days. Even though his mother died when he was just a little boy, he had a proper and cultivated upbringing courtesy to the care of his older brother Erasmus who looked after the schooling of Darwin. He picked up things that interested him quickly and paid attention to medical studies in the initial phase of his university life. Later on he learned taxidermy from John Edmonstone, a black slave born in Demarara in the continent of South America. The 'Journey of the Beagle' was the most important voyage that Darwin embarked on to explore the evolution of life on earth. His main objectives during this journey were to collect specimens of natural history and to investigate geology. Theoretical speculations were made along with acute observations on marine invertebrates. Darwin's stature as a scientist rose to dizzying heights by the time the Beagle returned in 1836. He settled in Cambridge to work on the publication of papers on evolution of species. Darwin's experimental observations on the Galapagos birds were among the primary topics of his theory, which were to be reassessed by our team of Darwin scholars. To proceed furthermore with the discussion in hand, let us look at the team that has made a reliving quest in the Galapagos to remind us of the pros and cons of natural imbalance. Our team consists of: 1) Frank J. Sulloway - Darwin scholar 2) William H. Durham - Evolutionary Biologist 3) Mark W. Moffett - Entomologist 4) Greg de Nevers - Botanist 5) Roger A. Lang, Jr. - Conservationist 6) Lance Milbrand - Cameraman 7) Kathy Turco - Sound Recordist 8) Patrick Gambuti, Jr. - Editor 9) Michael Whalen - Composer 10) Bruce Weiss - Producer/Director Frank J. Sulloway is one of the most famous Darwin scholars to have been inspired by the dedication and vision of Charles Darwin himself. Sulloways's life and philosophies have been shaped to a great extent by the adventurous spirit of Darwin. The sphere of his personal works is based on the evolutionary theory. Dr. Sulloway has used the basics of this theory to investigate into the relation between family dynamics and personality development. He has shown through research and supporting evidences that birth order has an impact on personality and behavior. His famous book Born to Rebel: Birth Order, Family Dynamics, and Creative Lives captures the spirit of scientific reasoning along with the indomitable thirst to explore the unknown, much in sync with the mind of his mentor Charles Darwin. (Sulloway.org, 2009) In the context, one might quote the words of Professor John Stevens Henslow at Cambridge University. He viewed Darwin as "the best qualified person I know who is likely to und ertake such a situation." (Sulloway, p. 121) The team collectively put a great deal of effort on its own to recreate the past exploration in the Galapagos Island in 2002. If we trace the similarities between what it was like 160 years ago when a young Charles Darwin made his visit to the island and how it was in 2002, we will first of all observe the physical as well as mental condition of the explorers. Each member of our chosen team of naturalists was at their fittest best when

The OJ Simpson Trial Essay Example | Topics and Well Written Essays - 1250 words

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Management accountant Assignment Example | Topics and Well Written Essays - 2000 words

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UK employment law & Role of the State Essay Example | Topics and Well Written Essays - 750 words

UK employment law & Role of the State - Essay Example sees the taxation of all items under consideration and makes sure that proper tax system and administration are in place: it is also obligated to provide enough social security to all its citizens, create and maintain public utilities, offer timely trainings on its agenda and offer job creation schemes among others. As a legislator, it endeavours to see that individuals are well justified in case proceedings and other disputes related matters, including the regulation of employment issues and trade unions (Guest 1995; p. 23). As an employer is involved in ensuring the public sector are payed with their dues and including their expenses. Also, it privatizes and nationalizes its public and private firms and by managing their ideology in employment relations. Lastly, an arbitrator in employment cases and tribunals, it forms commissions for official inquiries on special and needy and sensitive matters of the country which in turn become watchdog agencies against misappropriations of employment relations between itself and its citizens. It also puts special tribunal courts for such proceedings and hearings. The emphasis by the state of regulations is reflected by the decline of trade unions influences and its bargaining power, particularly, in the private sector. It is also shown in the increase in direct communications with its employees in its various agencies as part of Human Resources Management strategies (Storey, n.d). The following entails the Human Resource Management strategies employed by the state in various functions of employment relations. The state is being a pluralist, a unitary and global. It also enhances and employs Liberal Individualism, Liberal Collectivism and Bargained Corporatism in its human resource activities. The state emphasises the tripartite and collective nature of industrial relations (IR) as practiced in the UK until 1979. This strategy was derived by Fox (1966). This policy recognizes that employers and employees can have

Marketing Plan for ServiKali - Start up business Thesis

Marketing Plan for ServiKali - Start up business - Thesis Example This unique service shall target people who are settled abroad from Columbia and want to send money back home for various purposes. The stratus is that section of people who have their relative and friends settled abroad and stay in distant locations of Columbia. These people also do not have access to the internet or banking services. The paper carries out secondary research analysis for the purpose of this survey. The product and the company are relatively new (Weiner, 2000). Other companies in the business of international money transfer only provide for transfer and delivery of money. ServiKali aims to deliver services instead of money and put the business into a service perspective and give a new niche to its people. The paper makes use of journals, web and books for the purpose of carrying out this research activity. The total size of the market is difficult to estimate but it shall encompass anybody who is in need of foreign remittance and some service associated with this money received. The total population of Columbia is 47.1 million people and the users of this service are spread out but mostly the older generation and those who are distantly located (Tradingeconomics. 2014). It is estimated that about 70% of the country’s population lives on 7% of the land area of Columbia (Tradingeconomics. 2014). The service provided by ServiKali is meant for the 30% distant and rurally located people (Tradingeconomics. 2014). The demand for money transfers is still untapped and stores a huge potential because the market for international money transfers has been restricted with banks alone. New media for international monetary transactions is expected to have a higher demand. The company has an established brand name and consumer acceptance in US. It has to invest largely in marketing efforts to create its brand recognition in Columbia. Also,

Exam Assignment Example | Topics and Well Written Essays - 1000 words - 4

Exam - Assignment Example The qualities include transparency, honesty, and trustworthiness. These traits make the teacher and student’s relationship even stronger. The teacher’s reliability and dependability further makes him an all-round leader. The reality that the teacher can judge when wrong stays true to what he utters, is never a disappointment, and tries to understand other people make the teachers an exceptional leader (Hershey 2015). Normative leadership theories control the act of leaders by building the moral principles or norms unlike the general ethical perspective addressing the leader’s behavior. Type of normative leadership theory they most commonly identify with is the transformation leadership called the transactional compared to a more form of leadership called transforming. The transactional lower level needs followers to focus on terminal values like liberty, equality, and justice. The Transformational leaders become more of role models to their followers who admire, respect, and trust them. The inspirational motivation-transforming leader uplifts the team morale by encouraging followers stimulating innovation and creativity. The transformational leaders are a bit more successful than the transactional leaders making other companies prosper extremely. These are the most common normative leadership theories that leaders who are keen on ethical issues live by. Since ethical leadership is based on understanding and positive relations, it is important to that it is included in most organizations thus improving the quality of performance in such organization and the quality of leadership in the organization is also improved. Leaders need to conform to ethical leadership attributes for them to establish to perfect relationships characterized by mutual respect and trust. The ethical leader should develop the type of relationship that arises from basic and vital

How Do We Solve a Problem Like....Stereotypes Essay Example for Free

How Do We Solve a Problem Like.Stereotypes Essay We can say that stereotypes are based in some kernel of truth. Some stereotypes are self-perpetuating, but is it up to the minority itself to regulate and stop those who perpetuate certain stereotypes? Can you tell one group of a minority to stop acting a certain way, to stop dressing a certain way, to stop talking a certain way? Would it really be better for society if we took out the kernels causing all the self-perpetuating problems? I believe the first step is in recognizing the stereotypes and prejudices we believe. From there, the process of eliminating them involves confronting your beliefs by meeting people that are different from you or challenge your thinking. Communication and being able to meet people who are not exactly like us are key factors in breaking down the walls of prejudice that we have made comfortable for ourselves. This class, I believe, is one step in the process, in getting us to step outside of our comfortable little worlds and discuss, see, and hopefully understand points of view and experiences that are shaped by the prejudices we have and the stereotypes we have made. I grew up about fifteen minutes north of NW Oklahoma City, and about fifteen minutes west of Edmond in the community of Deer Creek. Through the oil boom in the 70s and early 80s, Deer Creek started to become more and more of a white flight community of executives, business owners, and oil men than even Edmond. The majority of my school was white with a few racial minorities. No one in the late 90s had come out as gay in my high school, though the people that were assumed gay werent ever treated negatively to my knowledge. I literally had a white, middle to upper-middle class, heteronormativeexistence the first 18 years of my life. Then I came to college. Oh, here is where we might speak of the evils of the college world where students are subjected to such horrid liberal ideas that, dare we say it, challenge our thinking and beliefs. That is if I was prone to speaking ill of such an idea. It was through meeting other people not like my high school self that I began to be able to question why I had such beliefs about people. http://overmediated.blogspot.com/2009/06/how-are-stereotypes-formed-who-has.html Now, the question is: What would be a solution for stereotyping.? In some cases, eliminating the ignorance associated with social stereotypes is probable, but there is also just as great a chance that the inductee or ethnographers, will turn against them vehemently Much depends upon the purpose and the mission of the ethnographer. Whether a new understanding of any social group or sect will bring about greater tolerance is a passion many seek. Through the development of any such ethnographic abilities, the sacredness of all life will be intimately recognized and appreciated. Good question. Source(s): http://answers.yahoo.com/question/index?qid=20110206145145AAnHV41 http://www.ehow.com/how_2081756_stop-stereotyping-people.html Appearance * Appearance creates stereotypes in society that exist outside of gender, race or traditional social standing. These stereotypes are designed to help society place an individual within a group of people in the society for identification purposes. For instance, a person who has a large amount of visible tattoos may be stereotyped as a threatening or bad person by a segment of society while someone in a business suit may be stereotyped as trustworthy. Without further investigation beyond the initial appearance of an individual, the person using the stereotype may not know that the person with the tattoos is the leader of a local Parent Teacher Organization or that the person in the business suit is a bank robber. A stereotype based on appearance can negatively impact a persons social standing or opportunities for jobs. Read more: The Effects of Stereotyping In America | eHow.com http://www.ehow.com/info_8563840_effects-stereotyping-america.html#ixzz2Lu64onkh nyone and everyone are getting them, as there no longer is a â€Å"type† to get tattoos. Unfortunately, employers still have a say about the acceptability of tattoos if it is in their dress code. They can say no to visible tattoos as long as they are consistent across the board about it.

Position Paper Outline & References Page due Essay Example for Free

Position Paper Outline References Page due Essay After you have read your assigned reading for this week, choose a topic that has at least two clear points of view that can each be defended in an academic and verifiable manner. It is best to check with your professor to make sure your topic is appropriate. Once you have decided on your topic and the point of view you want to build upon, write an outline for your position essay. While the final draft of this paper is not due until the end of Week 8, you will submit an outline and references page to your professor this week. Please note that you will also be required to submit a draft to your professor in Week 6 and to our peer review in Week 7. Refer to this weeks lecture for detailed requirements and guidelines on how to write an outline for a position essay. Successful Outline Requirements: Follow the sample format in this week’s lecture to create an outline appropriate in scope for a 5-page persuasive paper (in addition to the title page and reference page) with no less than 3 academic sources included. NOTE: please avoid topics that are focused on religious, moral, or overly emotional debates. You must clearly state your topic (which should be debatable in nature), draft an introduction paragraph, with a complete and persuasive thesis statement, and outline three main points that you will discuss in your paper, followed by two sub-points for each main point. Remember to include both viewpoints/sides of the topic. A possible conclusion paragraph should also be drafted. Outlines should not exceed one page, unless discussed and approved with your professor. Provide APA references for three academic sources that you plan to use to support your position. Be typed and submitted as a Microsoft Word 2010 document (.docx), double-spaced, 12-point Times New Roman font After reading â€Å"TV Watching: The Top Environmental Hazard for Children† by Todd Huffman, note your initial reactions to the essay. In one paragraph, record your strongest reaction to the essay and explain why you think you may have reacted that way. From what perspective are you reacting, that of a parent or that of a child? What factors outside of the essay might have influenced your reaction? Your assignment this week is to write a draft of your rhetorical analysis. First, read this weeks lecture. Then go to the search engine of your choice and search for this phrase: vintage ads. Include the quotation marks to search for exactly that phrase. Tell us about the ad you chose: name the product and the year the ad was published. Remember that the goal of advertising is to make you spend your money on products and services. Does the ad motivate you to buy the product or service? How does the ad use ethos, pathos, or logos to make you desire the product? †¢Ethos relies on the credibility or the authority of the ad itself (Im not a doctor, but I play one on TV.); †¢Pathos is an appeal to your emotions (Coke adds life.); †¢Logos is an appeal to your intellect (Ads that show great gas mileage numbers for a car appeal to your intelligence—they imply that you have the brains to buy the most efficient vehicle.). What elements create ethos, pathos, or logos in the ad that you chose? Discuss 2-3 elements that work to create the rhetorical appeal (ethos, logos, pathos) that you detect. Some elements you might analyze are †¢ The use of colors †¢ The appearance of people in the ad or their expressions †¢ The way the product is photographed or displayed †¢ Words used in the ad Here is some advice. In your discussion: 1) Avoid summarizing the ad—lets not look at the ad and describe it. Keep in mind that this is not a description paper. 2) Avoid talking about your experience with the product or service depicted in the ad. Keep in mind that this is not a testimonial paper. Make sure that you are writing about how the ad makes you want to spend your money on a product or service. Ethos, pathos, logos By working on this now, you will write material that you can use in your draft to turn in this week.

Ikea Hotel: Business Environment and Position

Ikea Hotel: Business Environment and Position Xeroderma Pigmentosum (XP): Causes and Treatment Xeroderma Pigmentosum (XP): Causes and Treatment Xeroderma Pigmentosum is a rare autosomal recessive disease affecting about 1 in 250,000 people in Europe which greatly reduces the quality of life of its sufferer. XP patients have a much greater chance of developing skin neoplasms, internal organs neoplasms or even neurological disorder due to a defective Nucleotide Excision Repair (NER) pathway. In this report, I found out that most experts in this field do believe that reactive oxygen species which can cause DNA lesions that can only be repaired by the NER pathway is the main cause of the neurological disorder in XP patients. However, modern technology can not yet prove this is the case. The treatments for XP are mainly preventive rather than interventionist. However, more new treatments have been proved to be effective in helping XP patients with the aid of modern technology. The bacterial enzyme T4 Endonuclease V has recently been put in use for treating XP and gene replacement therapy might be a possible treatment for the futu re. The aim of this article is to gain a general overview of Xeroderma Pigmentosum (XP), to understand the possible causes of neurological disorder in XP patients as well as the current and possible treatments for XP. To achieve my aim, I have first researched using various textbooks to understand DNA repair and damage. After that, I set my focus on Xeroderma Pigmentosum and used two online databases Medline and PubMed to look for review articles on XP in order to have a basic understanding of XP. I used two keywords Xeroderma Pigmentosum and Neoplasm to achieve the goal (Table 1). After having some basic knowledge of XP, I found that the neurodegeneration and the current treatments for XP are quite interesting so I decided to set my aim of these two topics. By searching for Xeroderma Pigmentosum and Neurodegeneration on Medline, I was able to look for some useful articles on my first aim (Table 2). I also searched for Xeroderma Pigmentosum and Gene Therapy for my second aim (Table 3). Cancer which can be considered as an uncontrolled growth and spread of cells is one of the top three causes of mortality in the world.(1) With the WHO predicting that it is going to be the top killer by 2010(2), it is vital for the public and medical professions to understand its aeitiology and pathogenesis in order to fight against it. Generally, the incidence of cancer is increased with aging as the chances of DNA mutation increases with age for lots of different reasons and we now understand that our DNA needs at least 5-6 mutations in order for cancer to develop(3). However, there are some other risk factors which might increase the susceptibility such as smoking, alcohol, radiation and so on. One of the most interesting factors is probably the cancer-prone DNA repair deficiency syndrome, for example Xeroderma Pigmentosum, Cockaynes Syndrome, Werner Syndrome. Patients with these syndromes are characterised by not being able to repair the DNA damage precedes the mutation and thus enhance the chances of getting cancer(4). The aim of this article is to discuss the genetic disorder Xeroderma Pigmentosum (XP). To understand this disorder, we have to first look into the types of DNA damages, their causes and their specific repair mechanism. DNA damage Mutation happens for lots of different reasons. It can occur spontaneously or naturally, for example DNA strand looped out during replication, hence causes a deletion of base. The other main types of spontaneous mutation are Depurination (Fig.1) i.e. detachment of Adenosine or Guanine from its deoxyribose sugar due to the hydrolysis of water and deamination (Fig.2) i.e. oxidation of bases by an oxidising agent e.g. nitrous acid. Spontaneous mutation occurs at a rate varies between and 4ÃÆ'- per gene per generation.(5-7) Another type of mutations could be elicited by the exposure of organisms to substantial mutagens, like chemicals or radiation.(7) The focus of this report is mainly on radiation. Radiation is probably the most well-known type of mutagen and there are three different types of radiation, each of which has its specific effects. The first type is ionising radiation which generates reactive oxygen species (ROS) e.g. H2O2, OHÂÂ · when passing through cells. These oxygen species oxidise DNA bases and thus causes base mispairing. The second type of radiation is the ultraviolet light. It has a wavelength ~ 260nm and is greatly absorbed by the bases. The absorbed energy causes the fusion of adjacent pyrimidine dimers on the same DNA strand and will mainly affect thymine (Fig.3). The results of this type of mutation are stoppage of DNA replication and transcription, which affects the normal function of cells significantly. Ionising radiation such as X-Rays can have a direct effect on DNA strand as well. It reacts directly with deoxyribose backbone and causes double-strand breaks in the DNA and may in turn completely stop DNA replication because of the significant d amage induced.(6-7) The Cell Cycle There are 4 main stages in the cell cycle, G1 (Gap 1), S (Synthesis), G2 (Gap 2) and M (Mitosis) and the duration for each cell cycle is around 24 hours. As from the diagram, each stage has its particular functions. There are two important checkpoints between G1 and S phase and G2 and M phase and they are called G1-to-S checkpoint and G2-to-M checkpoint respectively. These checkpoints are important as they detect the existing DNA damage and generate signals for DNA repair. If the DNA damage is too severe and beyond repair, tumour suppressor like p53 will come into action. This prevents the mutated cell from dividing and developing into cancer cells and the cell either goes into apoptosis or senescence.(5, 7) DNA Repair As previously mentioned, each type of mutation has its own specific repair mechanism and this paper is to focus on nucleotide excision repair (NER) (Fig.5), which is the only relevant mechanism to XP. NER helps repairing pyrimidine dimers and bulky DNA adduct to bases. This repair system works by detecting distortion to the double helix shape of the polynucleotide strand such as thymine-thymine dimers. This distortion triggers a series of events to restore the stability of the DNA. Firstly, XPC is the protein responsible for recognising the distortions. Then XPA and XPD generate a bubble (Fig.5) a ring-like structure formed by unwinds of DNA double-strand around the damaged site. The bubble creates two cleavage sites for ERCC1-XPF (5side) and XPG (3side) to act on. The cleavage sites are exactly 24 nucleotides away from the lesion on the 5side and 5 nucleotides from the 3end. Finally, DNA helicase releases the fragment that has been cut out, and once again DNA polymerases and ligase fill in the gap and repair the lesion. It is important to understand this repair mechanism as several genetic disorders like Xeroderma Pigmentosum, Cockaynes syndrome and trichothiodystrophy are connected with defects in the nucleotide excision repair.(6-7, 12) Brief introduction of XP XP was first described by two dermatologists in Vienna, Ferdinand Ritter von Hebra and Moritz Kapozi in the year 1870. The term xeroderma denotes parchment skin while pigmentosum was added later to indicate and emphasize the characterised pigmentation abnormalities(14-15). At that time, no one knows exactly what causes XP and the link between XP and defective NER was established by Cleaver in 1968(14, 16). Researchers have identified that there are 8 complementation groups of XP and they are XP-A-G and XP variant group. XPA-G are known as the classical forms of XP while the XP-V which is not associated with a defective NER, constituting 20% of the cases of XP. Instead of having a defective NER pathway, XP-V patients have gene coded for a defective form of DNA polymerase, causing a thymine-thymine dimers bypass during replication. Each complementation group represents a mutated form of a specific gene, i.e. complementation group A means the patient has a mutated version of the XP-A ge ne, etc.(14, 17) Patients with XP have a high photosensitivity to UV radiation as their cells have a defective nucleotide excision repair pathway. As a result, those cells exposed to UV radiation will have a high mutation rate and causes a high occurrence of skin cancer as well as affecting ocular tissues. XP can also cause neurodegeneration or neurological diseases and it would be discussed later.(14-15) Prevalence of XP XP is a rare autosomal recessive disease, which means that the disease will only be developed in patients with two mutated form of XP genes, XP will not develop in patients with a normal and a mutated gene as the mutated gene is recessive and wouldnt be expressed but he/she would be a carrier of XP. XP has a dispersed worldwide distribution, varying from 1 in 40,000 in Japan and 1 in 250,000 in Europe and USA. Symptoms of XP can start as early as first exposure to sunlight but the average age of onset of symptoms is around 2 years. There is also a greater than 1000-fold increased risk of skin cancers development connected with XP and the average age of onset of the foremost skin cancer or neoplasm is 8 years, around 50 years earlier comparing with the public. The life spans of XP patients are reduced by around 30 years as many of them die of neoplasia. As mentioned before, NER also removes bulky DNA adduct to bases, such lesions are induced chemically by chemicals like alkylating age nt rather than UV radiation. This explains why XP patients also have a 10 to 20- fold higher risk of forming internal neoplasms below the age of 20.(7, 12, 14, 17) Neurodegeneration of XP It is quite easy and straight forward to understand why XP patients are prone to skin cancers and even internal organs neoplasms. However, there is one interesting clinical feature that is still unexplained and remains puzzling and this is the neurodegeneration of XP patients, which is affecting approximately 20% of the XP patients. Since UV radiation cannot penetrate through our skull, thymine-thymine dimers would not be the type of mutation occurring in the neurological tissues e.g. brain tissues, neurons and so on. Thus, damages in the neurological tissues are more likely to be caused by chemicals like alkylating agents, ROS which damages DNA by oxidising DNA bases or adding bulky adducts to it and are also repaired by the NER pathway(14, 19). The following section will discuss some of the symptoms as well as possible causes of this interesting feature. The first symptom of the XP neurological disorder is reduced tendon reflexes, possibly as a result of peripheral nervous system and ataxia degeneration. With the progression of the disease, the patient will also develop hearing loss and other motor anomalies and become wheelchair bound eventually. Dementia and progressive cognitive decline are also the possible outcomes of the XP neurological disorder.(19) There are several candidates for the causes of neurodegeneration in XP patients but there are yet to be a confirmation of the ultimate cause of those symptoms. ROS is a possible cause for neurodegeneration in XP patients. These species react with our DNA bases or deoxyribose sugar and generate some form of lesions which should be repaired by our NER pathway, for example, hydroxyl radical, a ROS which reacts with deoxyribose sugar and produces a lesion called cyclopurine-deoxynucleosides (Fig.7). This type of lesion can only be repaired by NER and will accumulate in our cells if not repaired.(19) Aldehydes and thymine glycol are some other possible reagents that might cause neurodegeneration in XP patients. Aldehydes react with DNA, forming a DNA lesion called Propano-deoxyguanosine lesion (PdG) which might block transcription by RNA polymerase. Thymine glycol causes oxidative damage to the DNA and produces Nonbulky oxidatively-induced lesion, which could be repaired by the NER pathway as well.(19-20) It is important to understand the fundamental cause of neurodegeneration in XP patients, by doing so; we can develop a possible treatment, not only for reducing the incidences of neurological disorder in XP patients, but for improving the patients quality of life as well. For example if H2O2 is the cause of the neurodegeneration, we can develop a pathway which reduces the level of H2O2 in patients body and reduces the level of H2O2 in their cells.(19) Diagnosis for XP XP can be diagnosed in different ways. Diagnosis can be made clinically by examining eye, skin and nervous system, a detailed family history could also aid in the diagnosis. As XP cells have a defective NER, a functional test for DNA repair on living cells may also be used for diagnosis. Nowadays, genetic testing of XPA and XPC genes is available clinically but the testing for the other genes is only available on a research basis.(21) Treatment for XP At the moment, there is no cure for XP. Primary care for XP is probably more important than secondary care in terms of prevention and regulation of the disease. Once the patient is diagnosed with XP, he/she should avoid exposure to sunlight and other mutagens like cigarette smoke or alcohol immediately. XP patients should also wear protective clothing like UV suits, sunglasses and gloves in order to get minimum exposure to UV radiation, reducing the chances of getting further DNA damage. UV radiation levels should also be measured routinely at in-door environment for safety reasons. XP patients should also consume sufficient vitamin D in their diet to compensate for the insufficient production of vitamin D by their body.(21) As the disease progresses, XP patients might develop small lesions in the skin which could be treated using liquid nitrogen or topical 5-fluorouracil. Skin cancers, neoplasms of the eyelids, conjunctiva and cornea developed could be removed surgically. In patients with multiple skin cancers, high-dose oral isotretinoin may be used to prevent the formation of new neoplasms. X-radiation therapy can also be used to treat cancer with close monitoring as most XP patients are not hypersensitive to therapeutic X-rays.(21) Gene replacement therapy, i.e. replacing the mutated gene by insertion of a normal set of gene might also be a possible treatment in the future but very few research groups are working on that(22). In 2001, a study showed that the insertion of the bacterial DNA repair enzyme T4 Endonuclease V (also known as denV T4 endonuclease, an enzyme which removes the glycosyl bond of the pyrimidine dimer(23)) in liposomes into XP patients can actually increases the rate of repair of UV induced lesion, lowering the chances of new skin neoplasms development and it is now one of the treatments of XP. (21, 24) A research on gene replacement therapy published in 2003 was supportive for the XP patients(25). The result was quite promising as the researchers successfully restore the DNA repair capacity of XP cells after the insertion of gene(25). Although the efficacy of the treatment is high, its reliability is relatively low and there are definitely some limitations in the study. Firstly, it was an in vitro experiment; results shown in test tube would not be necessarily the same as in mammals or humans. Secondly, the research only focused on the XP-C cells so it is still unsure whether gene replacement therapy would work on other XP genes. Thirdly, the research was only done on cells from 2 patients; a larger sample size, preferably samples from different ethnicity or a more comprehensive study is needed to confirm the effectiveness in clinical practice. The bacterial enzyme T4 Endonuclease V was proved to be a quite effective treatment for XP as mentioned previously. The study that I looked into was a randomised study and involves 30 patients, with 20 in the intervention group and 10 in the placebo group(24). Overall, the study is quite reliable as it was a randomised double-blind study which minimise the bias that might affect the final outcomes of the study. However, some issues do present in the trial and should be addressed for future research. Firstly, the sample size is relatively small; a larger sample size is needed to confirm the effectiveness of the bacterial enzyme. Secondly, the ratio of patients in the two study groups varies, which might affect the statistical outcome significantly, especially for a small-sized study. Conclusions, limitations and further study To conclude, with the progression of technology and more time and resources spent on XP, we have now got much more understanding of XP, comparing with the first discovery of the disease. However, we shouldnt be satisfied with it and stop here as there is still a long way to go to get a full understanding of this genetic disorder. From my research, I found out that majority of the researchers favour ROS as the underlying cause of the neurodegeneration in XP patients. Firstly, our nervous system has a high demand for oxygen and ROS produced during respiration could potentially accumulate in our nervous system, causing damages to our DNA. Secondly, ROS causes DNA lesion that might only be repaired by the NER pathway. Thirdly, ROS can generate lesions that could block the RNA transcription, contributing to the loss of proteins and eventually cell death(19). All of these evidences suggested that ROS are possible causes of the neurological disorder in XP. At the moment, the resources are not available to prove that it is the case and there might be some other DNA damages that cause neurodegeneration which have not been discovered yet. However, I am sure with all the hard-work, and the advancement of technology, this mystery would soon be solved. In my opinion, with the lack of treatment for XP at the moment, preventive measures would be the most important things. As a result, diagnosis of XP should be made as quickly as possible. Genetic screening for new born baby might be a method for early diagnosis of XP. However, XP is a rare genetic disorder which is not so cost-effective for genetic testing as it is still relatively costly to diagnose XP in a molecular level and we should probably look for a cheaper alternatives and an easier way for diagnosis of XP. As for the future treatment, as I have previously mentioned, understanding the underlying cause of neurodegeneration is important for reducing the incidences of neurological disorder in XP patients and would improve the patients quality of life. My opinion on gene replacement therapy is that it is viable as the technology is available but not practical yet. First of all, although our skins are quite easy to reach, we should bear in mind that the skin has got a large surface area and would be quite difficult to insert replacement genes into the majority of the skin cells. We have now developed a method of inserting genes by genetically modified retrovirus, which could deliver genes into our cells quite easily. However, the technology for this is still premature and it is quite hard to monitor the viruses and might generate side effects like escape of viruses to the nature, mutation of the viruses and so on. I think that the information on gene replacement therapy for XP patients is qu ite limited; a lot more need to be done to address this issue. Finally, I do believe that with the advance of technology and as our knowledge of gene therapy progresses, a cure for XP should soon be found.

Marx and Nietzsches Theories Essay -- Friedrich Nietzsche Karl Marx P

Marx and Nietzsche's Theories Society is flawed. There are critical imbalances in it that cause much of humanity to suffer. In, the most interesting work from this past half-semester, The Communist Manifesto, Karl Marx is reacting to this fact by describing his vision of a perfectly balanced society, a communist society. Simply put, a communist society is one where all property is held in common. No one person has more than the other, but rather everyone shares in the fruits of their labors. Marx is writing of this society because, he believes it to be the best form of society possible. He states that communism creates the correct balance between the needs of the individual and the needs of society. And furthermore thinks that sometimes violence is necessary to reach the state of communism. This paper will reflect upon these two topics: the relationship of the individual and society, and the issue of violence, as each is portrayed in the manifesto.   Ã‚  Ã‚  Ã‚  Ã‚  Before expounding upon these ideas, it is necessary to establish a baseline from which to view these topics. It is important to realize that we as humans view everything from our own cultural perspective. Marx speaks of this saying, "Your very ideas are but the outgrowth of the conditions of your bourgeois production and bourgeois property, just as your jurisprudence is but the will of your class made into a law for all, a will, whose essential character and direction are determined by the economical conditions of existence of your class."   Ã‚  Ã‚  Ã‚  Ã‚  With this in mind, some perspective on the society of that time is vital. During this time the industrial revolution is taking place, a massive movement away from small farms, businesses operated out of homes, small shops on the corner, and so on. Instead, machines are mass-producing products in giant factories, with underpaid workers. No longer do people need to have individual skills. Now, it is only necessary that they can keep the machines going, and do small, repetitive work. The lower working class can no longer live a normal life following their own pursuits, but are lowered to working inhumane hours in these factories. This widens the gap between the upper and lower class-called bourgeois and proletariat-until they are essentially two different worlds. The bourgeois, a tiny portion of the population, has the majority of the wealth while the proletariat, t... ...che's theories seem firmly embedded in history. The concepts that he proposed allowed a number of great movements to follow. His theories on the Dionysian and Apollonian instincts opened up the deep psycho-analysis field to Freud, in addition to inspiring the existentialist movement. Unfortunately, his work was adopted and used to support the Third Reich when it was attempting to take over the world, and for a while no one would give his work any credit. Justly his work has recently been given the credit it is due, as well as all of his theories becoming again highly discussed, debated, and lamented over.   Ã‚  Ã‚  Ã‚  Ã‚   The theory behind The Will to Power is incredibly well supported despite the fact that it is simply a collection of notes from Nietzsche's later years. It is a wonderful compilation of the premise behind all of his other works and the summary of their individual points. The most amazing aspect of the book and the philosophy is the incredible validity of it even now, over a hundred years after it was written. The social order of his new world needed to be addressed more, but the principles proposed stand sturdily on their own two feet confident in their own will to power.

Hamlet and Laertes: Pawns of the King :: Essays Papers

Hamlet and Laertes: Pawns of the King 1 In Shakespeare’s play Hamlet [Titles] the actions of Laertes and Hamlet are the focal point of the play. They are the sons of major characters who must have grown up together in Elsinore castle, and known each other for years. Laertes warns his sister Ophelia about continuing a relationship with Hamlet because of his royal obligations. The tragic deaths of their father’s [No '] forces them both to seek revenge at all costs. They learn that pursuing revenge is a dark way to travel and it cost them their lives. 2 Hamlet and Laertes are both close and loving sons. The emotional outbreak of shock from Hamlet as his father’s ghost told of his most unnatural murder (Act 1 Scene 5 Line 25). [Frag -1] His father’s ghost had confirmed Hamlet’s suspicions (Act 1 Scene 5 Line 42). Hamlet seems to have a deep[ly] felt loss for his father that can only come from love for his father. The love for his father is twisted later by rage. Laertes is much loved by Polonius, as he leaves for his ship back to France, Polonius gives him a torrent of fatherly advice and his love (Act 1 Scene 3 Lines 55-80). [CS -1] Polonius and Ophelia give him a warm good-bye: they are a close family. 3 Ophelia is a point of contention for both Hamlet and Laertes. Hamlet has been attracted to Ophelia and she to him (Act 1 Scene 3 Line 100). Ophelia is very much attracted to Hamlet and has been told by Polonius to discourage him. Laertes loves Ophelia as a sister and warns her of Hamlet’s show of affection toward her, reminding her of his royal role (Act 1 Scene 3 Lines 10-42). Hamlet and Laertes care for the girl[,] and her feelings for both of them are dangerous for her. Ophelia’s mind is torn apart by Hamlet’s rage against his mother as he turned his frustration on her, telling her to get herself to a nunnery (Act 3 Scene 1 Line 120). The sight of Ophelia’s madness when he returned, melts Laertes’s heart and deepens his need for revenge (Act 4 Scene 6 Line 185). 4 Laertes[,] as Polonius’s son[,] could not imagine being disloyal to the king.

Capone :: essays research papers

At January 25 1919, the League of Nation was founded. It was an international organization founded after WWI with its constitution being approved by the Paris Peace Conference. The League's goals included disarmament, preventing war through collective security, settling disputes between countries through negotiation and diplomacy *blah blah blah* and so on. This topic will fit perfectly in what we are studying right now, I am not going to talk about it because it is really very boring. (trust me, I read though it) Besides, I found something else far more interesting then this. At the same day (January 25th) 28 years after the League of Nation was founded, a famous gangster died.   Ã‚  Ã‚  Ã‚  Ã‚  Alphonse Capone, a famous American gangster during the 1920s and 1930s, had a very special life. When he was thirteen, he joined two gangs, the Brooklyn Rippers and the Forty Thieves Juniors and engaged in crimes. Capone quit high school at the age of fourteen when he fought with a teacher who as beaten up very badly. After staying with small-time gangs for sometime, Capone joined the big gang, the Five Points gang. It was at this time he began working as a bartender at the Harvard Inn. It was at the Harvard Inn, it was there where Capone would engage in a knife fight and was slashed on his face, giving him the nickname that he would bear for the rest of his life: Scarface. Capone later worked for one of the most powerful bosses in the gang called Johnny Torrio. Torrio immediately recognized Capone's talents and by 1922 Capone was Torrio's second in charge, responsible for much of the gambling, alcohol, and prostitution in the city of Chicago. Only a few years later after Torrio's death, Capone took over his place and all his jobs. He then became the boss of the gang. He made a whole lot of money though his illegal activities, some estimates that he was making more than 100 million US dollars a year at that time. Capone was a very smart person, he always did his business through front men and had no accounting records linking him. Although the government knew that he was the one at the back controlling, they did not have anything to prove any of his illegal activities including seventy-one gangland killings or even at least 2 murders he had committed. Till 1927, new laws were passed in 1927, it allowed the federal government to pursue Capone on tax evasion.

Implications of Phone Hacking Scandal

Implications Of Phone Hacking For The Media, The Government And Other Businesses In The UK Phone Hacking – Background * Phone hacking is an on-going controversy surrounding New Corporation, it’s subsidiary News International and its newspaper, News of the World. * Phone hacking reportedly begun in 1998, with the first allegations been made in 2006, and the first major investigation in 2011. * Over 4000 potential victims, including members of the Royal Family, the family of murdered schoolgirl Milly Dowler, Gerry and Kate McCann as well as celebrities like Hugh Grant.Implications – The Media * News of the World closed down in July 2011 ending its 150 year existence. * YouGov poll found that 58% of British people have lost trust in the papers since the scandal. * TV and Radio have benefitted from the lack of trust in newspapers. * Leveson inquiry is likely to lead to much tighter regulation, with potential new legislation to enforce stricter controls in the long ru n. Implications – The Government * Government involvement with the press heavily scrutinised, particularly Andy Coulson and Jeremy Hunt. David Cameron were required to handle the phone hacking scandal and thus commissioned Lord Justice Leveson to run an inquiry. * The Leveson report, released last week found the press and wreaked ‘havoc with the lives of innocent people’. * Lord Leveson’s recommendations were for the Parliament to set up a strong, independent press regulator, cross party talks are now taking place to agree on the best way to regulate the industry and ensure freedom of the press still exists.Implications – Other Business * Not as directly implicated as the Government or the media. * Changes in security as companies and individuals are now more aware of the threat posed by hackers. * The News of the World employees charged and arrested has highlighted the importance of morals in conducting business activities. * The phone hacking scan dal along with the global financial crisis have highlighted the need for accountability and transparency in all undertakings Concluding RemarksIn the short term the onus is on the Government and press to create a new regulatory framework, potentially involving new legislation whilst protecting the freedom of the press. In the longer term the main implications will be the change in the way the press operates and the step changes made by other businesses in light of recent controversies. Opportunity For Deloitte: By demonstrating strong governance, transparency, professionalism and accountability Deloitte will be able to market themselves more attractively to new and existing clients.

Portrait of an Artist as a Young Man Essay

I found the novel Portrait of the Artist as a Young Man very difficult to read at first, and could make very little sense of it. After doing some background research I have some to understand some of the motives of Joyce, from which it seems that the difficulty was not due to any shortcoming on my part, because I know that that even the most sympathetic critics have faced the same difficulties. Joyce does not intend to offer a conventional narrative. Indeed his motive is to deconstruct convention. The protagonist of the novel is described as relinquishing all forms of convention, in his effort to forge for himself a new existence in the capacity of a true artist. But Joyce does not want to offer this theme in the conventional mode either. Not only the substance, but the means and the language must also be suffused by the same theme. In its effort not to depend on any cultural norms, it employs the method of â€Å"stream of consciousness†. This is the technique where raw consciousness of thought is seen as the basis for truth, and it is meant that these thought patterns be transposed directly onto the page. It is not to effect realism, as might be thought at first hand. Realism is art is a very conscious and calculating mode. The underlying philosophy is better described as existentialism. It recalls the existential philosopher Jean Paul Sartre’s epithet â€Å"existence precedes essence† (22). The existentialists aim to understand pure existence, which is yet without essence, or form. It describes exactly the passages in the Portrait which employ the stream of consciousness method. From this point of view I found that a second reading was much easier, only because I was more aware of the motivations of the writer. Another mode which comes to mind is modernism. T. S. Eliot is said to be the instigator of modernism with his 1922 poem â€Å"The Wasteland†. This poem presents us with fragments from the literary cultural tradition of the West, but in a haphazard way, without any seeming coherence, as proclaimed in the poem itself, â€Å"These fragments I have shored against my ruins† (Eliot 69). Eliot himself admitted that he wrote the poem as a reaction to catastrophe of the Great War, and tried to convey its impact on the Western psyche in general. He believed that conventional art forms had become meaningless in â€Å"the immense panorama of futility and anarchy which is contemporary history† (qtd. in Sigg 182). The modernist genre that sprung from this poem can be said to be characterized by futility, and the search for transcendental meaning. Despite various points of similarity is it wrong classify Joyce as a modernist. Not only does the Portrait appears well before the publication of â€Å"The Wasteland†, it is also composed well before the onset of the Great War, and therefore cannot have been motivated in exactly the same way. Neither is it fragmentary and incoherent in the way Eliot’s poem is. It is framed by autobiography, and therefore possesses overall coherence. Eliot’s is a despairing cry of futility. The protagonist of Joyce also comes across the futility of all conventional norms, but in the end the novel is not characterized merely by despair. The protagonist discovering himself as an artist represents hope in the end. The novel describes the several stages by which it protagonist Stephen Dedalus discovers himself as an artist. In the process he takes refuge in the conventional identities provided by society in the various stages of his growing up. But Stephen is meant for greatness, and the conventional identities are only refuges for mediocrity, and this is what he discovers time and time again. The transiton from one stage to the next is marked by epiphanies – sudden bouts of realization that transform the inner self. Apart from the many minor epiphanies that accompany the growing young man, there are two major such occasions. The first is his discovery of conventional faith. The second occurs when he comes to realize that the Church is a restricting influence, and that he must escape if he is to express himself as an artist. It occurs when he must make a choice between training to be a Catholic priest, or to enter the secular domain of university. He opts for the second choice. It is a major decision, but does not yet entail that he is free to become an artist. University opens up to him a diverse array of ideologies. Stephen comes to realize that none of the ideas that academia has to offer are able to address his inner longing towards creativity. His goal, as he expresses at the very end of the novel, is to â€Å"to forge in the smithy of [his] soul the uncreated conscience of [his] race† (276). His final realization is that the conventional mode of Irish existence is lacking in conscience. And as an artist he has understood his role as to make up for this fundamental lack. It is a role of heroic proportions, and which only the artist is able to undertake. So the creativity which Stephen intends in not mere self-expression, it is towards creating a conscience for his race. There are many occasions while he is growing up in Dublin when he comes to realize that there is something fundamentally lacking in what society has to offer him. In school it appears as if the appreciation of his peers is the highest goal, and he is in awe of the bullies of the classroom who command attention. On one occasion he is dealt with a caning from a teacher which he didn’t really deserve. He classmates challenge him to take action, and to report the teacher to the headmaster. Up to this point he seems unable to stand up for himself, yet he takes on the challenge of his peers to go up to the headmaster’s room all alone, and puts his case forthrightly. To his peers he is instant heroes, and they hoist him up in the air together. The striking aspect of this incident is that the glory does not register with Stephen. Even while he is being hoisted, he wants to escape their grip, and when the cheers have died down he feels himself to be an outsider just as before. On the occasion when he is first allowed to attend Christmas dinner with the adults, he observes a vicious argument taking place with politics and religion mixed in. It centers on the Catholic Church’s demonizing of Charles Stuart Parnell, who had led the movement Irish independence from the British. Parnell’s fortunes reversed when it was found out that he was involved in an affair with a married women, which was considered sacrilege in the strictly Catholic society that Ireland was. In the argument Stephen’s aunt is on the side of religious authority, while Stephens’s father and the outsider Mr. Casey argue for politics. However little Stephen understands of this argument, if gives him a foretaste of corruption in high places. But more than this he comes to realize shallowness and brittleness of family life that can be unsettled by cheap religious and political talk. It marks the beginning of Stephen’s moving away from family and tradition. He comes to realize later on that his father is totally unconnected to modern life, and merely engages in nostalgia, drunkenness and superficiality. Stephen renouncing of his family is the first step towards the rejection of convention as a whole. As be becomes more alienated from his family he starts to visit prostitutes, and in general gives himself up to a life of secret sin, even though he is wracked by guilt inside. Another moment of epiphany takes place when he is overcome by a sermon delivered by the college rector. In the meantime he had become strangely drawn towards the Virgin Mary, and when the rector delivers fiery and graphic accounts of hellfire and damnation, Stephen is genuinely terrified from the depth of his soul. None of the other college students are effected at all, and here his outsider status impinges on him once more. The upshot is that he surrenders himself to the austere religious existence, so much so that when the time comes for him to leave college he is nominated for a scholarship for priesthood. By this time Stephen has come to realize that conventional religion does not answer his quest for inner harmony, and so he decides to turn down the offer, and to enter university instead. Shortly after he experiences another moment of epiphany on the beach, when he observes a young lady wading in the water, and he is overcome by a sense of natural beauty. He realized that his true quest is for aesthetic beauty, and that he must carry it on â€Å"among the snares of the world† (Joyce 175). He has not yet realized himself as an artist, and at university he is accosted by the secular ideologies that go up to make convention. In his discussion with his friends he tries to emphasize the importance of leaving all forms of convention behind, but they are far too immersed in the established mode to take his point. He is close to Cranly, to whose sympathetic ear he divulges his artistic longings. Cranly warns him that he is destined for loneliness, but this does not deter Stephen. In this phase he gradually becomes aware that his true identity is contained in his latter name ‘Dedalus’, and not his first ‘Stephen’ (linked to the first Christian martyr). Dedalus is the mythical ‘great artificer’ who uses his art to escape from confinement by King Minos. The myth says that he learnt to fly, and he allowed his son Icarus to fly first, who became too venturesome and flew close to the sun, which it melted his waxed wings and he fell to his death. Joyce is comparing the previous existence of Stephen to Icarus, and his tenure with religiosity is compared to Icarus’ foolhardy ascent. The person who has survived is now compared to Dedalus. He sees in the name a â€Å"symbol of the artist forging anew in his workshop out of the sluggish matter of the earth a new soaring impalpable imperishable being† (Joyce 163). There are two striking points that emerge from this novel. First there is the innovative use of language regarding the â€Å"stream of consciousness† technique. Writers who followed in the footsteps of Joyce enthused in this new technique, which reflected so well the fragmentary character of modern existence, and its emphasis on existence above outmoded forms. Virginia Woolf says, â€Å"Let us record the atoms as they fall upon the mind in the order in which they fall, let us trace the pattern, however disconnected and incoherent in appearance, which each sight or incident scores upon the consciousness† (qtd. in Zwerdling 14). Other critics stress the symbolism, which occurs at many levels and suffused throughout the novel. Apart from the Dedalus connection, Tindall discovers identification with Christ on the one hand, and with Lucifer on the other (Stephen is made to utter Lucifer’s words â€Å"I will not serve†) (10). But such analyses must not allow us to lose sight of the original theme, which is that of nonconformity to convention. In fact, Joyce message chimes with that of Ralph Waldo Emerson: â€Å"Whoso would be a man, must be a nonconformist† (21). Emerson was voicing the ethos of the modern age, whereas Joyce is presenting it as the sublimation of artistic endeavor. In conclusion, though difficult to read, Joyce’s Portrait is a novel worth making the effort for. Through his novel literary techniques he is trying to redefine literature so that it becomes relevant to the modern age characterized by fragmentation and alienation. Apart from the strained techniques, the novel is also worthy for its rich symbolism, which exists on many planes, and for the significant allusions to literature and culture. It is not only an autobiographical and ‘coming of age’ novel, but it also makes a noble attempt to diagnose and correct the fundamental malaise of the modern age.

Clinical Decision Making Skills for the Integrated Worker Essay

This assignment will define and analyse the need for a chosen service improvement within the pathway of mental health, as well as evaluating the suggested service. Demonstrating how this service can inform and benefit integrated practice, discussing the ways in which the agency’s statutory obligations and responsibilities impact on both individual and group decision making. The chosen service improvement for this assignment is the introduction of a mental health nurse into primary care services, for example, a GP Surgery. Focusing on service users with mental health issues in the community and therefore in the care of the local Primary Care Trust (PCT). There is an obvious need for movement towards better health and social care for individuals with mental health illnesses in primary care. No Health without Mental Health: A Guide for General Practice (Department of Health, DoH, 2012, online), sets out what General Practitioners (GPs) can do to improve mental health and enhance care and support offered to those with mental health conditions in the community. This document also states that one in four GP consultations account for mental health problems (DoH, 2012, pg8, online). Treatments for those with mental health issues cost the NHS in the United Kingdom approximately  £105 Billion per year (DoH, 2012, pg8, online). Primary care plays a pivotal role in caring for those with mental health illnesses in the community and in most cases this falls into the responsibility of the local GP surgeries. Therefore GPs are ideally placed to identify signs of distress and those with risk factors for poor mental health (NHS Confederation, 2011, online). Primary care providers, more specifically GPs are usually the first point of call for an individual experiencing some form of psychological distress (DoH, 2012, pg13, online). It is essential there is early recognition and referral to any specialist mental health services required, saving time, money and individual distress in the long-run. An area which remains problematic is the treatment of physical health care needs for those with mental health illnesses. Research continues to  highlight that the physical health of those with mental illnesses is frequently poor and people with long-term physical conditions experience higher levels of mental health issues (Nash, 2010, pg2). It is ironic that a great deal of the research carried out is with individuals that are currently in contact with either health or social care services (Nash, 2010, pg2). This issue could be tackled within primary care services, as GPs especially can treat the whole person linking rather than separating physical and mental health (Knapp, 2011, pg3, online). Professionals within the primary care sector could experience problems when trying to identify their role in relation to meeting the health needs of those with mental health issues, as well as offering interventions and support to those identified as high risk of developing mental health problems, such as, individuals with long-tem physical conditions (Nash, 2012, pg 10). Yamey (1999) found that a number of patients had actually been removed from GP registers at some point prior to accessing secondary mental health services. This causes suspicion that some mental health illnesses could be construed as a reason for being excluded from GP surgeries (Yamey, 1999). MIND (1996) carried out a survey which also showed that a large majority of individuals felt they had been treated unfairly by their GP due to their mental illness. This could be a consequence of lack of understanding and minimal training in the area of mental health in the primary care sector. Although this research is dated, it is relevant as Government white papers and initiatives currently being introduced are still recommending that more specialised training in mental health is required for professionals throughout the primary care sector. Each of the initiatives aim toward improved integrated working and lower hospital admissions due to deteriorating mental health by providing early access to services and early recognition of mental health issues in primary care. This highlights the importance of the chosen service improvement, not only for individuals with mental health issues but for those at risk of developing mental illness and the NHS as a whole. These recommendations are present in No Health without Mental Health: A Guide for General Practice (DoH, 2012, online), The NHS Outcomes Framework 2012/13 (DoH, 2011, online), and numerous others. It remains clear that professionals within the primary care sector are not  receiving adequate training in mental health care. They do not have sufficient knowledge of mental health and many do not possess the general skills required day to day when working with mental health service users (DoH, 2012, pg5, online). This is supported by Good Medical Practice (2006),(General Medical Council, GMC) which sets out the principle guidance for GPs offers no mention of individuals with mental health issues, suggesting that this document is based solely on the general population and does not taking into account the differing needs of those with mental health issues. A programme that was introduced in Wales in 2011 provides Mental Health First Aid Training to a large group of service providers including primary care. It teaches them to provide initial help to someone experiencing mental health problems, deal with a crisis situation or the first signs of someone developing mental ill health and guide people towards appropriate help (MIND 2011, online). This shows some progress towards increasing knowledge and awareness of mental health illnesses in a wider range of healthcare providers. There is evidence to show that in GP practices without mental health professionals, brief training for primary care providers have substantial benefits for patients who are mentally ill (Ross et al, 2001). This supports the need for specialist training and the chosen service improvement, as a mental health nurse in a GP surgery would be specially trained to work with individuals with mental health illnesses and would have an awareness of the difficulties service users may face when accessing services. There are many aspects that could present a barrier to mental health service users when accessing services. Communication difficulties can cause problems for individuals with mental health issues as they may not feel able to make themselves understood by healthcare professionals. They may suffer anxiety or panic disorders making it more difficult to communicate effectively. One of the most problematic areas in mental health and for those suffering mental health illnesses is stigma (Nash, 2010, pg10). Discrimination is not just confined to the general population as research has shown that healthcare professionals can hold stereotypical views towards their clients (Nash, 2010, pg10). This could prevent individuals from seeking help and support for both physical and mental health problems. Some service users  with mental health issues may have previously experienced some form of discrimination and had a negative experience when accessing primary care services. For example, experiences involving reception staff with bad attitudes or individuals being made to believe the physical symptoms they are experiencing are part of their mental illness (Nash, 2012, pg12). This shows that individuals with mental health issues suffer from inequality and discrimination regarding their healthcare reinforcing the need for improved access to primary care services. Previous negative experiences can cause individuals to fear returning causing them to avoid seeking help for a physical condition. Furthermore, if a person believes the may be mentally ill, they may avoid accessing any kind of support as they fear being labelled and discriminated against due to the stigma attached to having a mental health illness. Employing a mental health nurse in a GP surgery can bring services closer to eliminating barriers between primary care services and mental health, improving the healthcare of those in the general community suffering from some sort of mental illness. The proposed service improvement supports the need for reducing health inequalities and barriers to those with mental health issues wishing to access services. Barriers to healthcare specifically Primary care services can include communication difficulties, lack of understanding from both service user and professional perspective and there may be inadequate support available to mental health service users when accessing their local GP surgeries. GPs may lack the interpersonal skills required to manage some symptoms of mental illnesses. Such as inappropriate sexualised behaviour that can be expressed during psychotic episode (Norman & Ryrie, 2009, pg711).The professional may feel uncomfortable and embarrassed when examining an individual and unaware of how best to deal with this situation. Symptoms of mental illnesses can themselves often prevent individuals with a barrier to accessing services. An individual suffering depression will most likely lack motivation and volition (Norman & Ryrie, 2009, pg429) making it extremely difficult for them to self-refer or even care about their mental and/or physical health. Further supporting the need for the chosen service improvement as families, carers and friends of such individuals could support them in attending their local GP surgery enabling them to access specialist help at an initial stage of their illness. It may be necessary for a mental health nurse in a GP  surgery to be advertised; as individuals cannot access services if they are unaware they exist. Booklets and leaflets could be made available to raise awareness of mental health issues and the support available to individuals, their friends and families’ informing the community that specialist help is available first hand within their local GP surgery. Another barrier that is present in the provision of care by primary services and GP surgeries is the use of the medical model. The health professionals within a GP surgery adopt a medical approach when treating their patients. This aims to treat the medical illness and reduce the total number or patients attending the surgery. Although this is necessary within a GP surgery setting there remains a need to consider social factors when adopting the medical approach (Barbour, 1995, pg2). There are limitations when using the medical model, however as it can prevent healthcare professionals from treating patients individually in a person centred manner, treating only the obvious medical condition (Barbour, 1995, pg10). This could have a serious detrimental effect on an individual’s health and well-being, resulting in increased appointments with their GP causing more distress and prolonging their suffering. This in turn increases the likelihood of an individual requiring crisis intervention and ultimately costs the NHS more in the long-run (Norman & Ryrie, 2009, pg172). The Royal College of General Practitioners (RCPG) ‘Roadmap’ (2007) document supports the need for adopting a model in which health and social care needs are considered in general practice (RCPG, 2007, pg1). There has been confusion around which professionals role it is to provide physical health care to the mental health population for many years (Phelan et al, 2001). Government policy recognises the importance in considering physical health care needs of those with mental health illnesses in both primary and secondary care settings (Newell & Gournay, 2009, pg 322). General practice has transformed significantly over the past decade and current government policy is aiming to improve access to and the choice of services available to patients, expanding the role of a GP and improve quality of care overall (Gregory, 2009, Pg3, online). Government policy is implemented in the structure of clinical governance and is important in  highlighting improvements that are required in a wide range of services within the NHS including mental health and primary care (NHS Direct, 2011, pg12, online). Clinical governance is described as ‘a system in which NHS organisations are accountable for continuously improving the quality of their services’ (Scally & Donaldson, 1998, online). It is a framework that ensures professionals continuously develop and improve the quality of the services they provide. Clinical governance involves the research and development, risk management, promotion of openness, education and training for staff, clinical effectiven ess and clinical auditing of services within the NHS. It is extremely important that high quality care is provided in healthcare and clinical governance ensures professionals are individually accountable for the quality of care they provide (South Tees NHS Trust, 2013, online). Buetow and Roland (1999, pg184, online) suggest ‘there is a barrier between managerial, organisational and clinical approaches to quality of care’ denoting that the aim of clinical governance is to bridge the apparent gap by allowing all professionals within an organisation involvement and ‘freedom from the control of managerialism’ (Buetow & Roland, 1999, pg189, online). Although this suggests the aim is to promote equality throughout organisations when it comes to quality of care. There remains a need for one individual or a small group of people to accept the role and responsibility and become the clinical governance lead or team (Buetow & Roland, 1999, pg189, online). In a primary care setting such as a GP surgery this would entail being responsible for a large number of professionals who may have had little reason to communicate with each other previously. This could cause conflict within an organisations culture if the quality of care professionals provide is questioned. The Department of Health (2008) stated ‘the current system of NHS primary care does not ensure a consistent level of safety and represents insufficient quality across the country’. Resulting in GPs becoming required to hold a licence which is reviewed and renewed every five years and to register with the Care Quality Commission (CQC) from 2011 (GMC, 2009, online). This ensures up to date practice, competence and assures the provision of quality care. Clinical governance enables services to show how targets have been met within their organisation and how they meet the needs of their patients, supporting the decisions made by professionals and teams within the organisation (Buetow &  Roland, 1999, pg187, online). All organisations have what is known as an organisational or agency culture. Agency culture is made up of numerous aspects including, values and beliefs, language and communication, policies and procedures and rituals and routines within an organisation. Each organisation has a varied culture with a different set of beliefs and norms. It could be a result of these norms that staff members may not be willing to embrace change or take time to attend extra training for specialist service user groups such as the mental health population. It may appear that the service gains results and targets are met therefore may not want to change anything. This places organisations at risk of neglecting areas for improvement. Changes within agency culture can become a challenging process especially when there is disruption to traditional working routines (NHS Direct, 2011, online). Staff within a GP surgery may have been led by one individual or a small group of the same GPs for a long period of time and may feel the services they provide are sufficient. Newly qualified members of staff joining the workforce may feel their opinions and ideas are underappreciated or not even considered because the routines and procedures are already in place. An unwillingness to accept change could have detrimental effects on the mental health service user population. This is reflected in recommendations by government policy. No Health without Mental Health (DoH, 2012, online), Making it Happen (DoH, 2001, online) and Call to Action (DoH, 2011, online) each suggest recommendations for primary care services to develop the services provided to those with mental health illnesses and stress the importance of mental health promotion within primary care. The culture within a GP surgery may appear to be more superior to other NHS services as most GP surgeries are independently contracted and are not direct employees of the NHS (Gregory, 2009, pg 8, online). This enables them to provide enhanced services such as extended opening hours and specific services fo r those with learning difficulties (Gregory, 2009, pg 8, online). The above are components of General Medical Services (GMS) whereas Personal Medical Services (PMS) enable GP surgeries to cater for the specific needs of the local population (Gregory, 2009, pg 5, online). This could include drug and alcohol services or mental health services if there were a large number of the local  community presenting to their GP surgery with these issues. The cultures within each of these types of GP surgeries could be different completely. In a PMS GPs could have received specialist training in the areas large numbers of patients require support, resulting in patients feeling more valued and respected as well as staff members. GP surgeries can be seen as ‘providing a gateway to specialist care’ (Gregory, 2009, pg8, online). This view could be difficult to change. However by offering a wider range of services and treatment options, the gap between primary and secondary services as well as both an individual’s health and social care needs ca n be filled (Gregory, 2009, pg8, online). This service improvement aims to improve the health and social care needs of individuals with mental health illnesses in the community. However, not only are there barriers in place that service users must overcome to access primary care services there remains a lack of collaborative working between health and social care services. This has consequences on the service user and other professionals involved in their care denying the individual of adequate holistic care. Professionals from different areas such as nursing and social work may be bound by differing statutory obligations which can affect their decision making and the care they provide. Starting with the professional body they are registered with as a professional such as the Royal College of Nursing (RCN) or the Health and Care Professions Council (HCPC), these give professionals a value base they must work from and develop continuously. Legislation also has a huge impact on a professional’s decision making, for example the Mental Health Act (MHA, 2007). The law determines what a professional can and cannot do in a crisis situation. If a mental health nurse was based in a GP surgery they will have specialist training and awareness of the limits of their role determined by the MHA (2007), such as a patient being sectioned. They will be aware of who to contact if a patient is causing danger to themselves or others and need more suitable mental health care. If the mental health nurse was an Approved Mental Health Practitioner they could even have a role in detaining patients especially if a GP within the surgery was specially trained under the MHA (2007). This would save a lot of time and distress to individuals in crisis, members of the public and staff members. There are other noticeable difference between health and social care and the  standards of care provided. Social work would traditionally take a service-led approach to care whereas nursing has become more person-centred and individualised (SCIE, 2010, online). By using a person-centred approach the specific health and social care needs of patients with mental health issues are addressed (Hall et al, 2010, pg178). The service user is the centre of focus and care and support is planned around their specific needs. This is essential when caring for an individual with mental health issues as each condition, symptom and experience is different. Enabling an individual to be fully involved in every aspect of their care and make fully informed decisions regarding their treatment and social options. Continuity of care and positive therapeutic relationships are essential when making an individual feel valued and at ease, allowing them to feel comfortable and more willing to engage with professionals. An individual with mental health issues may feel anxious about attending their GP surgery and may need motivation or encouragement to do so. Having a therapeutic relationship with a particular professional within that surgery could reduce a person’s anxiety levels (Kettles et al, 2002, pg64). The chosen service improvement would be useful for this purpose as a mental health nurse based within a GP surgery could build positive relationships with patients enabling them to develop trust and engage with services and professionals. The mental health nurse would also take into account both the health and social care needs of the patients, decreasing the GPs workload and saving the practice money in the long run. They would also ensure the needs of the individual are fully met as satisfactorily as possible within primary care services or id required could refer them to the most suitable services available to them for their condition and needs. Whether they be health or social care needs. However this service improvement would only be successful with the cooperation and collaboration from GPs within the surgery. Joint decision making would be required as well an equal partnership between GP and mental health nurse. The Personalisation Agenda (Social Care Institute for Excellence, 2010, online) (SCIE) emphasises the need for integrated working, and the need for involvement from a wide range of services, such as; health, social care, housing, transportation and leisure, to ensure service users receive a  holistic, consistent and continuous care package (SCIE, 2010, online). The service user is put first rather than the service. This creates a person-centred rather than a service-led approach. A priority of the Health and Social Care Bill (2011) is improving integration within services. The Bill strives to provide better partnership, integration and collaboration across the government and all NHS services (DoH, 2011, pg1, online). There is evidence to suggest that integrating health and social care services saves a substantial amount of money (DoH, 2011, pg2, online). However in the current government climate there are financial pressures which may cause a barrier to effective integrated working (DoH, 2011, pg1, online). All aspects of the patient journey could benefit from effective integrated working resulting in a positive experience and all needs being met. The suggested service improvement of a mental health nurse in a GP surgery supports integration as there would be a variety of professionals within one building making multi-disciplinary team meeting easier to arrange and joint decisions could be made quickly. However there are barriers to integrated working including the breakdown of communication between staff and different organisations having a detrimental effect on patients (Trevithick, 2009, pg123). However by working in partnership there is a reduced need for specialist services ultimately cutting costs and having a positive effect on many other aspects of an organisation. Such as boosting staff moral and enhancing patient experience (Erstroff, 2010). If barriers to integrated working can be overcome more adequate care can be provided overall. A dual qualified practitioner in a GP surgery would be ideal allowing both health and social care needs to be addressed working in partnership with outside agencies and with patients to gain the best results, without the need for two professionals. It has been stated that services need to detect early signs of individual distress by working closely with primary care (Norman & Ryrie, 2009, pg172-173). By integrating the skills required in a mental health nurse and a social worker a more holistic approach can be taken. The introduction of community care impacted on various professions including general practitioners, social workers and nurses (Malin et al, 1999, pg158). Nurses have become increasingly empowered over time and have become more involved in commissioning alongside GPs. Within General practice more of a  purchase/provide relationship has been established (Malin et al, 1999, pg 159). GPs now have more power and control with funding and choice in the care they provide. However social workers may have felt deskilled by the purchase/provide divide (Malin et at, 1999, pg 159). The cultures of each professional’s organisation could cause conflict among a team. Employing a dual qualified social worker and mental health nurse in a GP surgery would eliminate the chance of conflict. It would become the responsibility of the dual qualified worker and the GP to work in partnership. There is evidence to support the need for the chosen service improvement. Mental health services are improvin g and developing continuously despite government cuts to funding, reflected in No decisions about us without us (DoH, 2012, pg6, online). The document states that primary care services, specifically GPs who play a part in supporting those with mental health issues are not making a difference to the mental health of their local communities. This creates an opportunity for the role of a mental health nurse to develop. The Care Services Improvement Partnership (CSIP, 2006) suggest that nurses are capable of delivering services within primary care settings as they have acquired the specialist knowledge to do so (Norman & Ryrie, 2009, pg 651). There is a need to modernise, develop and integrate services, primary care being a target area. The suggested service improvement would be cost effective and would provide early community intervention also lowering individual and family distress. Integrated working is an essential component in developing health and social care services (Trevithick, 2009, pg109). In conclusion there remains a need for improvements in the health care provided by primary care services to those with mental health issues. Statistics show that primary care services are the first point of contact for many individuals developing a physical or psychiatric condition (DoH, 2012, pg 6, online). The introduction of a mental health nurse into a GP surgery promotes integrated practice and modernises NHS services (DoH Factsheet, 2011, pg1, online), enhancing patient experience. There is evidence to show that this is an already effective role. Primary mental health workers have been introduced in Children and Adolescent Mental Health Teams (CAMHS) supporting colleagues in primary care services providing crisis intervention and contacts to specialist services (Norman & Ryrie,  2009, pg543). Primary care mental health Graduates have also been implemented in parts of London providing a range of interventions (Norman & Ryrie, 2009, pg 457). 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