Do Patients Really Have a Choice in Anaesthesia and Surgery Essay

Do Patients Really Have a Choice in Anaesthesia and Surgery - Essay Example The mere condition of having sensation blocked or the nerves being desensitized is not accepted by many and there may be each to their own reasoning for it. The anesthesia is used to avoid the person undergoing surgery from pain or distress. For different issues, different kinds of anesthesia may be used. There is general, local, regional and dissociative anesthesia, each one used in different cases as each one has their own varying effects. Consent, is now an integral part of pre anesthetic consultation. Nowadays, given the evolved role within the health institutions, plus the legal and ethical issues, the patients are informed about the procedure they will be subjected to during the surgery. Disclosure of information seems to be the most legal and ethical discussion in the consent process. Given the function of any anesthesia, this consent is vital. This reinforces the idea that the given ‘consent’ to the patient before any surgery, is not actually being asked to accep t a procedure but is being offered a range of options from which to choose. Any medical profession indeed respects the patient’s reasoned choice and their right in law to refuse treatments. As anesthetists, the consent process can serve more than one purpose. It protects the practitioner from any ethical or legal issues. It ensures that the patient has agreed to the given way of treatment. The consent is a representation of the choice the patients have today in this. (Slater. R, 2007) No matter what examination or treatment one has to undergo, one may ask their anesthetist if there is any choice in the anesthetic method. One should also understand that some surgeons are more content operating on patients who have received one form of anesthetic rather than another. This most often means that the patient has a general anesthetic, which involves temporary unconsciousness. The article on All about Anesthesia, Do you have a choice, talks about the surgeon not having to choose the type of anesthesia one will receive, unless there is no anesthesia involved in one’s case. (2012) However, the surgeon may discuss the choice with the patient and with their anesthetist. In the same way, ones anesthetist does not choose what operation one will have or how it will be carried out. Again, ones anesthetist may discuss the operation with the patient and the surgeon, particularly if one has special anesthesia problems. The type of anesthesia varies with the given situation. Example for a finger ligament being torn off or the finger’s bone being broken may allow for local anesthesia, this type of a surgery allows a choice from the range of anesthesia. On the other side, during a caesarian, spinal or epidural anesthesia can be used. This type of scenario may allow less choice for the patient because general anesthesia may be harmful to the baby. Another case may involve a heart surgery, which will involve the use of general anesthesia and confine the choice o f the patient. Given the intensity of the situation like a heart surgery, a patient can not choose spinal anesthesia for their own good. This aspect suggests that a patient’s choice depends on the situation they are in. The beginning of this article stated a brief case where the patient would not agree to get their sensation paralyzed for a while, may be due to a range of reasons. These may involve the patient not approving the idea of losing control, issue of allergy,

Political Party and Internet Essay Example for Free

Political Party and Internet Essay HARATAL In modern strife torn state hartal has become a common affair. It is observed at the call of a political party or parties to press their demand to protest against the corruption, misuse of power and the evil deeds of the ruling party. Sometimes students and people of a locality call hartal to express their demands. On a hartal day normal course of life is stopped. All means of transport and vehicles do not move on the roads. People are to take a lot of troubles to attend their offices. They go on foot as vehicles are not available. As a result the attendance is very negligible in the offices, factories, industries and shops. The economy of the country suffers a heavy loss. Mills, factories, industries and shops stop their work. All the business centers, markets and shop remain closed. The supporters in favor of hartal bring their procession. Often clashes occur between the police and the picketers. Sometimes clashes take place between the supporters of the opposition and the ruling political parties which result in some deaths. On a hartal day the sufferings of the people know no bound LOAD SHEDDING Load-shedding is the suspension of electricity supply on certain lines when demand is greater than the generation. It occurs when the generation of power is less than the demand. Besides, unplanned distribution and illegal connection of electricity are also responsible for it. It creates various serious problems. The students are affected by it if it occurs at night. They sit idly in the dark closing their books. They suffer terribly owing to load-shedding on the night before their examination. Mills, factories, industries, all academic and socio-economic institution seriously suffer due to it. It seems that everything comes to a standstill and so life becomes rally painful. In a country like ours it is very difficult to solve the problem of load-shedding. Yet we can go a long way by establishing new power plants, ensuring planned distribution, reducing system loss and checking illegal connections. If these are ensured, we may expect to get rid of the curse of load-shedding. Governme nt should also take effective steps in this regard. Computer The computer is one of the most brilliant gifts of science. This device was originally developed by Charles Babbage. Most countries have developed fast due to computerization. Writing a program is essential for a computer. Speed, accuracy, reliability, and integrity are the main characteristics of a computer. Many of the routine activities today at home and in business are done by computers. The computer has proved a friend and servant of science, technology and industry. Most offices, shops, factories and industries use computers. The Internet is a storehouse of information. The computer is boon to all. Telecommunication and satellite imageries are computer based. Computer has made the world a global village today. The Internet The information system of the world has become globalized with the magical touch of internet. Like a spider-web the Internet has spread its interconnected link with tens, hundreds or even thousands of computers. And it has enabled them to share information and communication with one another widely, effectively and inexpensively.The Internet has made it possible for people all over the world to bring the information and communication system within their palm. The Internet has brought new opportunities to government, education and business. Governments use the Internet for internal communication, distribution of information and automated tax processing. Bangladesh as a developing country does not have access to the Internet in all spheres. Still internet here has some access to the business world and the banking system. Educational institutions also use the Internet to some extent. Internet here also allows a great variety in digital entertainment. People can enjoy music, movie, gaming, chatting with friends, sharing views and ideas about world affairs just by pressing few keys. We hope that we will get full-fledged access to the Internet, an international computer network, to make our Bangladesh a developed and prosperous country. TRAFFIC JAM Traffic jam is one of the most irritating problems in bangladesh. It has taken a very serious shape in city areas.This problem is the result of rapid growth of population and the increasing number of vehicle. In proportion to our population, roads have not increased. Moreover, cities are full of rickshaw and rickshaw pulles do not follow the traffic rules never maintain a queue while waiting to proceed. Untimely loading, unloading of goods of trucks, unauthorised markets by the road side, unwise parking to vehicles, public meeting, processions etc. Generally cause traffic jam. Narrow roads in another cause of traffic jam. Most often traffic jam occurs at office time and also at the time when the officer break. Sometimes traffic jam is so heavy that it blocks half a kilometre. It kills our valuable time and cause great suffering to the dying patients being carried in the ambulance. However, this problem can be solved by adopting some measures. Well planned spacious road should be constructed. one way movement of vehicles should be introduced.Traffic rules should be imposed strictly so that the drivers are bound to obey them. The number of traffic police should be increased.

Major studies of conformity

Major studies of conformity This essay will describe and evaluate several major studies of conformity. Conformity has been defined in number of ways. Crutchfield (1955), defined conformity as yielding to group pressure. Mann 1969 agrees with Crutchfield, however Mann (1969), argues that it may take different forms and be based on motives other than group pressure. (Gross p 479) Conformity is a change in belief or behaviour in response to real or imagined group pressure where there is no direct request to comply with the rest of the group norm Zimbardo and Leippe (1991). A lot of research has been done to try and understand the situations individuals need to be in to conform and the factors affecting conformity. However there are various cultural and methodological considerations that affect the understanding of conformity research. The first study would be Jenness in 1932. Jenness was the first person to study conformity. Jenness asked students to estimate the number of beans in a bottle. Taking individuals estimates first then placed the individuals into groups and asked them to discuss their estimates. Once the findings had been calculated he found that the students in particular groups would conform to a group average. According to Jenness in a situation where the answer was unknown they listened to their peers and would in his view conform. His research was criticised by Sherif (1935) because the experiment was not taken out in ecologically valid circumstances. The students were not in surroundings that were familiar to them thus behaving differently. Critics have argued that the students may have conformed in order to make the results easier for the psychologist. This demonstrates informational social influence and is explained in a classic study by Sheriff. Methodologically the first major problem encountered when testing conformity was the ambiguity of the situations the participants were placed in. This was highlighted by Mustafer Sherif (1935) when he used the auto-kinetic effect to test conformity. The Auto-kinetic effect is a perceptual illusion where participants perceive light moving when in fact it is stationary. Participants were placed in a darkened room in which they could see a light that was stationary. They were asked to record how far the light moved and on their own they settled on individual estimates however when the participants were put in a room together with other participants they were encouraged to shout out their estimates. Sherif found that they started with different answers but then all came to agree on the same answer. Then after they split up the group into individuals again Sherif found that they gave the answer they had settled on with the group. In Sherifs research into conformity (1935), the aim was to see if people conform to a group norm. The results of the test showed that individual responses differed to those from the group response. The post-experimental interviews said that the participants denied being influenced, they struggled to get the correct answers, and they never actually felt part of the group. The conclusions drawn from this said that the participants conformed towards the group norm because they were uncertain about their own individual responses. Sherif then argued that his results showed conformity however there was a problem with the methodology. This conformity research was criticised to be artificial and lacking ecological validity. Also, because the task was thought to be ambiguous and that there were no real answers, the participants were more likely to conform. As the answer was very ambiguous and there wasnt an obvious answer it was argued that participants are more likely to conform as they are never completely certain of their answer. This methodology therefore affects Sherifs interpretation of conformity as it is not very reliable Solomon Asch (1951) was the psychologist that challenged Sherifs methodological and in 1951 he created The Asch Paradigm where he tested conformity rates to very unambiguous situations. In his experiment there was one participant and seven to nine other confederates who knew about the experiment. The group was asked to identify lengths of vertical lines and match up a given vertical line to one of three in another display. Each confederate gave their answer and the participant sat in the next-to-last seat. On some questions all the confederates would give the wrong answer and Asch observed the conformity rate of the participant agreeing with the wrong answer even though the answer was very obvious. Asch found that 32% of the trials, the naive subject conformed to answer given by the rest of the group, and 72% of naive subjects conformed at least once. 13 out of 50 naive participants never conformed. When he interviewed the naive participants afterward, he found that conformity existe d on three levels: distortion of judgement, distortion of perception and distortion of action. Those who experienced distortion of judgement conformed because they trusted the groups judgement over their own. Those that experienced distortion of action knew that they were right, but changed conformed to avoid ridicule from the rest of the group. Finally, those who experienced distortion of perception actually believed that they saw the groups choice as matching the line on the card. The aim of the experiment was still to see if people would conform towards the group norm. The results showed that the individuals conformed to the group norm, even if the answers were wrong. The naive participant explained their reasons for conforming to be because they didnt want to spoil the experiment, look stupid, their eyes must have been deceiving them, and because they felt that the group was probably right. This experiment also told us that the influence from three or more stooges gave more of a reason to conform than if there was one stooge. The conclusions for this study were that the people conformed for public compliance rather than public acceptance. Also it seemed like people with low self esteem were more likely to conform. The methodology in this experiment was a lot more accurate then Sherifs experiment as the answers are very unambiguous and if the participants were on their own or first then they would almost certainly have given the right answer. The results from this experiment are therefore can be a better explanation of conformity than Sherif; however there are other methodological problems which make this experiment fairly inaccurate in the interpretation of conformity. However there are also ethical issues about the experiment. The main criticisms for this experiment was that it was artificial, time-consuming, time-dependant and unethical. The experiment lacks ecological validity due to a lack of both experimental and mundane realism. It lacks experimental realism as some participants worked out what the experiment was or at least thought the experimenter wanted them to answer the same as the others and therefore the conformity rates could be unreliable. It also lacks mundane realism as the situation does not reflect a real life situation and therefore people may act differently in real life and maybe the conformity rate would be lower. Crutchfield (1954) criticized Asch that the type of experiment undertaken by Asch is very time consuming, as only one person can be tested at a time. Richard Crutchfield decided to change the experimental method so that several people, usually five, could be tested simultaneously. The same kind of problem as Asch used, was used. Each participant sat in a booth with an array of lights and switches in front of them. They were told to give their answers and each were told that they were last to guess and the others guesses were indicated by the lights on the panel. However each participant was actually given the same display, which on about half the trials was actually incorrect. Crutchfield aimed to find out whether people conformed to unambiguous tasks when the pressure from others was more imagined than real. Crutchfield found that 37% conformed all of the time but 46% some of the time. The results found were really similar to Aschs but had a lower conformity rate. This concluded tha t there is conformity to imagined pressure. The experiment was criticised to have specific people used that were perhaps more conforming. Also it lacked external validity. The time the experiment was done in (1950s) was generally a more conforming time, so that could have been one of the reasons why the people conformed more. This experiment was also thought to be unethical as the participant were lied to and could have been embarrassed. Stanley Milgram (1963) conducted an experiment on obedience that highlighted the persuasive power of authority in social psychology for the first time. His experiment exceeded all expectation and led to greater awareness of authority and how much power it credited the perpetrator of it. Participants were made to give increasing electric shocks to someone (who was an actor pretending to be receiving the shocks through wires) when the person gave the wrong answer to a question. Many of the participants continued to the highest voltage (450V). There were many reasons why participants obeyed, such as the fact that the experiment was in a professional setting (Yale University). The experimenter was an authority figure and so was trusted; and the subjects were told that anything that went wrong would not be their responsibility. It was also because the participants could not see the victim which made it seem less real to them or it could have been because the participant had taken on a rol e so they felt that they were someone else. Milgrams work has been criticised both on ethical and methodological grounds. Baumrind (1964) believed that Milgram showed insufficient respect for his participants, there were insufficient steps taken to protect them, and his procedures could have long term effects on the participants. Orne and Holland (1968) argued that the participants did not believe they were giving electric shocks and they were just playing along with their role in the study. A famous example showing conformity was the experiment Zimbardo et al., (1973) carried out the prison simulation experiment at Stanford University. The aim of the experiment was to see the psychological effects of making an average person into a prisoner or guard. After less than 36 hours one of the prisoners had to be released from the experiment due to severe depression. Others who were acting as prisoners also showed signs of anxiety and depression. According to Zimbardo, these results showed how easily people could adapt to a new role in a new situation and behave out of character to fit that role. He quoted Note that anyone ever doubted the horrors of prison, but rather it had been assumed that it was the predispositions of the guards (sadistic) and the prisoners (sociapathic) that made prisons evil places. Our study holds constant and positive the dispositional alternative and reveals the power of social, institutionalised forces to make good men engage in evil deeds. (Gross p 500) There have been many criticisms levelled at his study, (Savin 1973) argues that the prisoners did not give fully informed consent; they didnt really know what was going to happen to them. They were humiliated and dehumanised by the procedure when reaching the prison (strip searched and deloused). Savin also argued the point the ends did not justify the means. The study had become too real and should never have been carried out. Perrin and Spencer (1980) tried to repeat Aschs study in England in the late 1970s. They found very little evidence of conformity, leading them to conclude that Aschs effect was a child of its time. However the low levels of conformity found in Perrin and Spencers study may have occurred because they used engineering students who had been given training in the importance of accurate measurement and therefore had more confidence in their own opinions. Bond and Smith (1996) also considered changes into conformity over time based on studies carried out in the United States. They conclude as follows; Level of conformity in general had steadily declined since Aschs studies in the early 1950 (Bond Smith p 124). The conformity rate has been found to alter across time within a culture, though overall trends are far from clear. There is also variation between cultures. These differences are related to social norms. As a conclusion, it is fair to say that people conform for many reasons, all that have is one main aim and that is to fit in with the group. Mainly, people want to be accepted in their society and because they have the need for certainty. People who are within any society or culture and its beliefs, with regards of what is expected and acceptable can be forced in certain situations to behave in anti-social ways. As their behaviour becomes adaptive to meet the needs of normative social influence without doing so could lead them to receiving social and/or cultural rejection. The researches briefly tells us how conformity works, however do psychologists tend to bother what happens after the research has been carried out on the naive participant? Some of the naive participant reported feeling quite stressed on the critical trials, which had a psychological harm on them. Do psychologists use deception to have their researches carried out? or should I say, Are they justified?! Above all, the researches have further broadened my knowledge on how individuals react in certain situation and has taking me one-step closer in understanding the world. REFERENCES Asch, S. E. (1955). Opinions and social pressure. Scientific American, pp. 31-35. Banyard, P, Grayson, A. (2000) Introducing Psychological Research; Seventy Studies that Shape Psychology, 2nd Edition. London: Macmillan. Bond, R, Smith, P. (1996) Culture and conformity: A meta-analysis of studies using Aschs (1952b, 1956) line judgment task. Psychological Bulletin, 119, 111-137. GROSS, R. (1996) The Science Of Mind And Behaviour, 3rd Edition. London: Hodder and Stoughton. GROSS, R. (1999) Key Studies in Psychology, 3rd Edition. London: Hodder and Stoughton. Milgram, S. (1983) Obedience to Authority: An Experimental View. New York: Harper/Collins. Moscovici, S, Faucheux, C. (1972) Social influence, conformity bias and the study of active minorities. In L. Berkowitz (Ed.), Advances in experimental psychology, (pp. 149 202). New York: Academic Press. Myers, G. (2005) Social Psychology, 8th Edition. London: McGraw-Hill. Savin, H.B (1973) Professors and Psychological Researchers: Conflicting Values In Conflicting Rolls. Sherif, M. (1936) The Psychology of Social Norms. New York: Harper Collins.

Leveraging Mobile Device Applications for Boeing Travel and Expense Ser

Abstract—More companies are leveraging mobile device applications that integrate with their existing travel and expense systems to provide frequent business travelers with the necessary tools to efficiently book trips and expense their expenditures using mobile devices, thus allowing business travelers to be more productive, which saves the company money. Currently, almost twenty-three thousand Boeing employees have been issued BlackBerry Smartphones. Ninety-percent of these employees make more than one trip per month. Currently, Boeing is not maximizing the use of the BlackBerry Smartphones by using a mobile application for Boeing Travel and Expense management to decrease costs by allowing employees to be more productive. Since twenty-three thousand employees already have been issued BlackBerry Smartphones we can leverage these devices and implement a mobile device application that integrates with our current Travel and Expense Systems that we have purchased from Concur Travel. Purchasing a mobile applications solution from Concur Travel will allow Boeing travelers to save time; reduce costs; increase productivity; and better serve our customers. I. MOTIVATION Concur’s mobile capability will provide Boeing with the perfect solution for employees, managers and executive staff who no longer have to wait until they return to the ofï ¬ ce to complete or approve an expense report. Travelers will be able to use the mobile app to take pictures of their receipts and complete expense reports using their BlackBerrys. When they return to the ofï ¬ ce they don’t have to sit at a desk all day to do one expense report on paper or come back to the ofï ¬ ce just to approve an expense report [1]. The primary drivers for implementing a Concur Tr... ...al%20Report%20-%20Long%20Version.pdf. [2] Concur, "Concur Give Organization Best-in-Class Travel and Expense Experience," nd. [Online]. Available: http://assets.concur.com/case-studies/medium-large-business-travel-expense-cannon-cochran-management-services.pdf. [3] Aberdeen Group, "Mobile Technology: Filling the Gap in Modern Expense Management," March 2011. [Online]. Available: http://assets.concur.com/whitepaper/mobile-technology.pdf. [4] Concur, "Concur’s Mobile Solution Keeps Growing Motion Picture Exhibitor on the Go," April 2011. [Online]. Available: http://assets.concur.com/case-studies/cinemark-case-study.pdf. [5] Concur, "Building an Effective Business Case: Automating Travel Booking and Expense Reporting Processing," February 2009. [Online]. Available: http://www.travelwise.co.uk/business/downloads/CNQRWP-Building_an_Effective_Business_Case_NA.pdf.

Champion equality, diversity and inclusion Essay

1: Understand diversity, equality and inclusion in own area of responsibility Diversity means difference. Diversity recognizes that although people have things in common with each other, they are also different and unique in many ways. Diversity is about recognizing and valuing those differences. It therefore consists of visible and non-visible factors, which include personal characteristics such as background, culture, personality and work-style in addition to the characteristics that are protected under discrimination legislation in terms of race, disability, gender, religion and belief, sexual orientation and age. By recognizing and understanding our individual differences and embracing them, and moving beyond simple tolerance, we can create a productive environment in which everybody feels valued. Equality is about ‘creating a fairer society, where everyone can participate and has the opportunity to fulfil their potential’ (DoH, 2004). Equality means being equal in status, rights and opportunities no matter what their race disability, gender, religion, beliefs and cultural differences, sexual orientation and age. see more:potential effects of barriers to equality and inclusion By eliminating prejudice and discrimination, we can deliver services that are personal, fair and diverse and a society that is healthier and happier.  Inclusion is a sense of belonging, feeling included, and feeling respected, valued for who you are, feeling a level of supportive energy and commitment from others so than you can achieve your best. Inclusion ensures everyone has access to resources, rights, goods and services, and is able to participate to activities. 1.1 Explain models of practice that underpin equality, diversity and inclusion in own area of responsibility There are 2 main models of practice underpinning equality diversity and inclusion: the â€Å"equal opportunities model† and the â€Å"difference and diversity model†. In my role of registered manager, I am responsible for ensuring that all individuals, their families, members of staff, care workers and all those I work in partnership with, are treated equally, with dignity and respect. Within the adult home care setting there is a range of policies which formally sets out guidelines and procedures for ensuring equality. The equal opportunity policy takes into account the rights of all individuals and groups within the settings (â€Å"equal opportunities model†). In my managerial role, I promote equality and uphold individual’s equality of opportunity, individual rights and choice, their privacy, individuality, independence, dignity and respect. I also promote equality of care, and confidentiality. In practice I support each individual wherever needed, inclusion, adapted to the individual needs. I support inclusion by ensuring that, whatever their background or situation, are able to participate fully in all aspects of the care being delivered. Inclusive practices ensure that everyone feels valued and has a sense of belonging. Inclusion in our settings is about providing the same opportunities and access to high quality education as well as valuing differences as something we can learn and be empowered from rather than threatened (â€Å"difference and diversity model†). 1.2 Analyse the potential effects of barriers to equality and inclusion in own area of responsibility There are many barriers to diversity and inclusion. The biggest ones are generally prejudice, culture and upbringing and religious beliefs. Prejudice is â€Å"a preconceived opinion that is not based on reason or personal experience† thus creating barriers to recognizing equality of rights for all. Cultural barriers can prevent, for example, consideration of spiritual,  relational or dietary needs that do not conform with expected traditional expectations. Religious belief, where different religious beliefs are not taken into account, and minorities are marginalized and not acknowledged.  Other significant barriers could be structural, institutional and personal: Structural, where circumstances create or result in barriers – for example in access to a ‘good education’ adequate housing, sufficient income to meet basic needs. Institutional, where policies, processes, practices sustain an organizational or service culture that excludes certain people or groups. Personal barriers, where staff can hold individual prejudices that influence their practice. These actions may be conscious, but they can often be unconscious or unwitting. Some vulnerable and disadvantaged individuals need more support to ensure their voice is heard and they are able to have power in the decision making process. Within our setting, if potential barriers to equality and inclusion arise, they are flagged and staff has a good understanding of individual customers. Barriers are then removed or minimized – the care delivery is adapted, person centered and where required resources or equipment provided. In order to minimize the effects of these potential barriers, we always ensure that: †¢ All care delivered is appropriate to the age and level of need. †¢ All staff are positively encouraged to deliver care to someone with complex needs in which they might not usually be engaged. †¢ All staff working with those using our service understands the policy on diversity and equality. †¢ We provide all literature in easy to read and large print to accommodate our customer’s needs. †¢ All practices and procedures in the setting are discussed and anything that is identified as  being discriminatory towards any group or individual is amended. †¢ Management has a sound knowledge of diversity, equality and anti-discrimination issues. †¢ We assess and raise the level of awareness amongst the team about diversity and equality issues and practice. The detrimental effect of barriers to diversity and inclusion can foster low morale and lack of motivation in our care workers and customers. Having an awareness of these potential barriers and their effects allows us to address them timely and effectively. 1. EQUALITY ACT 2010 Equality Act 2010 is the law which bans unfair treatment and helps achieve equal opportunities in the workplace and in wider society. The act replaced previous antidiscrimination laws with a single act to make the law simpler and to remove inconsistencies. This makes the law easier for people to understand and comply with. The act also strengthened protection in some situations. The act covers nine protected characteristics, which cannot be used as a reason to treat people unfairly. Every person has one or more of the protected characteristics, so the act protects everyone against unfair treatment. The protected characteristics are: †¢ age †¢ disability †¢ gender reassignment †¢ marriage and civil partnership †¢ pregnancy and maternity †¢ race †¢ religion or belief †¢ sex †¢ sexual orientation The Equality Act sets out the different ways in which it is unlawful to treat someone, such as direct and indirect discrimination, harassment, victimisation and failing to make a reasonable adjustment for a disabled  person. The act prohibits unfair treatment in the workplace, when providing goods, facilities and services, when exercising public functions, in the disposal and management of premises, in education and by associations (such as private clubs). The equality act will for instance impact on my role as manager with regards recruitment. You will need to ensure that my job specification does not discriminate against particular groups of applicants. When processing applications you should concentrate on an individual’s abilities to do the job, not their disabilities. Make adaptations to accommodate individual’s differences e.g. working hours, special equipment needs etc. The impact legislation and policy has on the promotion of equality, diversity and inclusion within my setting is ensuring policy and procedures are written and adhered to and carried out within the setting, that all staff has an awareness of legislation and policy surrounding equality, diversity and inclusion in practice.

Charles Dickens

Dickens is using figures of speech to make pictures in the readers head and he is therefore helping people imagine the things he is telling about. One would say that Dickens is using metaphors to put a picture on his story and to make everyone feels how awful and terrible Coketown is. â€Å"Coketown was a town of red brick, or of brick that would have been red if the smoke and ashes had allowed it; but, as matters stood it was a town of unnatural red and black like the painted face of a savage. He also uses the same word again and again to make his negative impression of the factory clear. â€Å"It contained several large streets all very like one another, and many small streets still more like one another, inhabited by people equally like one another (†¦)†. After reading the story you almost smell the smoke and see the clouds of smoke in front of you. â€Å"It was a town of machinery and tall chimneys, out of which interminable serpents of smoke trailed themselves for ever and ever, and never got uncoiled. When you have read that description of the smoke you can feel it everywhere around you like a snake sneaking around because of the metaphor Dickens is making. Another metaphor you can find is when Dickens has to describe the steam-engine. He does that by using a huge animal like an elephant to make people imagine how enormous the engine is. â€Å"(†¦) and where the piston of the steam-engine worked monotonously up and down, like the head of an elephant in a state of melancholy madness† Finally you can conclude that Dickens uses a lot of metaphors and figures of speech to make the reader fells how it is being in Coketown.

Biography of John Gibbon, Heart-Lung Machine Inventor

Biography of John Gibbon, Heart-Lung Machine Inventor John Heysham Gibbon Jr. (Sept. 29,  1903–Feb. 5, 1973) was an American surgeon who was widely known for creating the first heart-lung machine. He proved the efficacy of the concept in 1935 when he used an external pump as an  artificial heart  during an operation on a cat. Eighteen years later, he performed the first successful open-heart operation on a human using his  heart-lung machine. Fast Facts: John Heysham Gibbon Known For: Inventor of the heart-lung machineBorn: Sept. 29,  1903 in Philadelphia, PennsylvaniaParents: John Heysham Gibbon Sr., Marjorie YoungDied: Feb. 5, 1973 in Philadelphia, PennsylvaniaEducation: Princeton University, Jefferson Medical CollegeAwards and Honors: Distinguished Service Award from International College of Surgery, fellowship from Royal College of Surgeons, Gairdner Foundation International Award from University of TorontoSpouse: Mary HopkinsonChildren: Mary, John, Alice, and Marjorie Early Life of John Gibbon Gibbon was born in Philadelphia, Pennsylvania, on Sept. 29, 1903, the second of four children of surgeon John Heysham Gibbon Sr. and Marjorie Young. He earned his B.A. from  Princeton University in Princeton, New Jersey, in 1923 and his M.D. from Jefferson Medical College in Philadelphia in 1927. He completed his internship at Pennsylvania Hospital in 1929. The following year, he went to Harvard Medical School as a research fellow in surgery. Gibbon was a sixth-generation physician. One of his great-uncles, Brig. Gen. John Gibbon, is memorialized by a monument to his bravery on the Union side in the Battle of Gettysburg, while another uncle was a brigade surgeon for the Confederacy in the same battle. In 1931 Gibbon married Mary Hopkinson, a surgical researcher who was an assistant in his work. They had four children: Mary, John, Alice, and Marjorie. Early Experiments It was the loss of a young patient in 1931, who died despite emergency surgery for a blood clot in her lungs, that first stirred Gibbons interest in developing an artificial device for bypassing the heart and lungs and allowing for more effective heart surgery techniques. Gibbon believed that if doctors could keep blood oxygenated during lung procedures, many other patients could be saved. While he was dissuaded by all with whom he broached the subject, Gibbon, who had a talent for engineering as well as medicine, independently continued his experiments and tests. In 1935, he used a prototype heart-lung bypass machine that took over cardiac and respiratory functions of a cat, keeping it alive for 26 minutes. Gibbons World War II Army service in the China-Burma-India Theater temporarily interrupted his research, but after the war he began a new series of experiments with dogs. For his research to proceed to humans, though, he would need help on three fronts, from doctors and engineers. Help Arrives In 1945, American cardiothoracic surgeon Clarence Dennis built a modified Gibbon pump that permitted a complete bypass of the heart and lungs during surgery. The machine, however, was hard to clean, caused infections, and never reached human testing. Then came Swedish physician Viking Olov Bjork, who invented an improved oxygenator with multiple rotating screen discs over which a film of blood was injected. Oxygen was passed over the discs, providing sufficient oxygenation for an adult human. After Gibbon returned from military service and restarted his research, he met Thomas J. Watson, CEO of International Business Machines (IBM), which was establishing itself as a premier computer research, development, and manufacturing firm. Watson, who was trained as an engineer, expressed interest in Gibbons heart-lung-machine project, and Gibbon explained his ideas in detail. Shortly thereafter, a team of IBM engineers arrived at Jefferson Medical College to work with Gibbon. By 1949, they had a working machine- the Model I- that Gibbon could try on humans. The first patient, a 15-month-old girl with severe heart failure, didnt survive the procedure. An autopsy later revealed that she had an unknown congenital heart defect. By the time Gibbon identified a second likely patient, the IBM team had developed the Model II. It used a refined method of cascading blood down a thin sheet of film to oxygenate it rather than the whirling technique, which could potentially damage blood corpuscles. Using the new method, 12 dogs were kept alive for more than an hour during heart operations, paving the way for the next step. Success in Humans It was time for another try, this time on humans.  On May 6, 1953, Cecelia Bavolek became the first person to successfully undergo open-heart bypass surgery with the Model II totally supporting her heart and lung functions during the procedure. The operation closed a serious defect between the upper chambers of the 18-year-olds heart. Bavolek was connected to the device for 45 minutes. For 26 of those minutes, her body totally depended upon the machine’s artificial cardiac and respiratory functions. It was the first successful intracardiac surgery of its kind performed on a human patient. By 1956 IBM, well on its way to dominating the fledgling computer industry, was eliminating many of its non-core programs. The engineering team was withdrawn from Philadelphia- but not before producing the Model III- and the huge field of biomedical devices was left to other companies, such as Medtronic and  Hewlett-Packard. That same year, Gibbon became the Samuel D. Gross professor of surgery and head of the surgery department at Jefferson Medical College and Hospital, positions he would hold until 1967. Death Gibbon, perhaps ironically, suffered from heart trouble in his later years. He had his first heart attack  in July 1972 and died of another massive heart attack while playing tennis on Feb. 5, 1973. Legacy Gibbons heart-lung machine undoubtedly saved countless lives. He is also remembered for writing a standard textbook on chest surgery and for teaching and mentoring countless physicians. Upon his death, the Jefferson Medical College renamed its newest building after him. Over his career, he was a visiting or consulting surgeon at several hospitals and medical schools. His awards included the Distinguished Service Award from the International College of Surgery (1959), an honorary fellowship from the Royal College of Surgeons in England (1959), the Gairdner Foundation International Award from the University of Toronto (1960), honorary Sc.D. degrees from  Princeton University  (1961) and the University of Pennsylvania (1965), and the Research Achievement Award from the American Heart Association (1965). Sources Dr. John H. Gibbon Jr. and Jeffersons Heart-Lung Machine: Commemoration of the Worlds First Successful Bypass Surgery. Thomas Jefferson University.John Heysham Gibbon Biography. Engineering and Technology History Wiki.John Heysham Gibbon, 1903-1973: American Surgeon. Encyclopedia.com