Vodafone Group Management of Market Risks

Vodafone Group Management of Market Risks What is the pretended by alternatives, prospects and forward agreements in overseeing market dangers? The exploration basically dissects this through the contextual analysis of Vodafone Group Plc. It initially distinguishes the different variables that decide these dangers since showcase hazard incorporates various sorts of dangers like ware value dangers, loan cost changes dangers and cash dangers. Through the contextual analysis, it further means to assess the adequacy of utilizing above subsidiaries, in overseeing market dangers. By thinking about the arrangement of organization intended to fence a specific measure of hazard; the examination likewise expects to basically assess the individual commitments of each of the above in chance administration and furthermore of the portfolio as entirety. Presentation: Oxford word reference characterizes hazard as a circumstance including presentation to risk or uncover (a person or thing esteemed) to peril, damage, or misfortune (Oxford Dictionary). For a business substance Risks are associated with potential vulnerabilities that can bring about negative impact on the element. With the development of World Markets and different sorts of dangers, hazard the executives has become an incorporated piece of firms today. Various kinds of dangers require various techniques to deal with, forestall or now and again to retain and profit by dangers. The defeat of dangers has consistently been featured anyway they do have some exchange that outcomes in possible increases. The Basel Committee that was shaped in 1974 laid the administrative system for Financial Risk Management. (McNeil, Frey and Embrechts, 2005). Basel II (2001) characterizes Financial Risk Management to be framed of 4 stages: distinguishing proof of dangers into showcase, credit, operational and different dangers; evaluation of dangers utilizing information and hazard model; observing and revealing of hazard appraisals on an opportune premise and controlling these recognized dangers by senior management.'(Alexander, 2005). It in this manner decides the likelihood of a negative occasion occurring and its consequences for the element. When distinguished hazard can be treated in following habits: Wiped out through and through by straightforward strategic approaches. These are the dangers that are negative to the business substance. Moved to different members. Effectively oversaw at firm level. (Alexander, 1996). The dangers fundamentally rely upon the time estimation of advantages. Also with the expanded degree of global working of business substances and the exceptionally unstable nature of business sectors, chance administration has now become a basic piece of maintaining the business. It along these lines gets basic to comprehend just as investigate the different elements that decide dangers and the preventive estimates executed against them. Additionally the supporting methods being considered don't generally guarantee benefits. The exploration would in this way incorporate a detail investigation of the viability of the techniques actualized. One increasingly significant factor is the expense caused. Hazard the board causes certain expenses and the procedure would in this manner end up being vain if the expenses brought about don’t offer relatively benefits. Writing Review: Market Risk establishes of item hazard, premium hazard and cash dangers. Ware value hazard remembers the likely change for the cost of a ware. The rising or falling item costs influence the makers, dealers and the end-clients of the different products. Additionally on the off chance that they are exchanged outside money, there emerges the danger of cash swapping scale. These are regularly supported by offering forward or future agreements at fixed rates. This is particularly significant for wares like oil, flammable gas, gold, power and so forth whose costs are profoundly unpredictable in nature. (Berk and Demarzo, 2010) Intrigue Risk identifies with the adjustment in financing costs of bonds, stocks or advances. An increasing pace of intrigue would adequately diminish the cost of a bond. Expanded loan fees bring about expanding the getting expenses of the firm and in this manner lessen its gainfulness. It is supported by trades or by putting resources into momentary protections. Money dangers emerge from the exceedingly unstable trade rates between the monetary forms of various nations. For example Airbus, an airplane fabricating organization situated in France requires oil for its creation. Oil being exchanged US dollars and the organization doing exchanging Euros, has an outside trade chance. It would be along these lines advantageous for Airbus to enter a forward agreement with its oil providers. Alternatives are another method of supporting against money dangers. (Berk and Demarzo, 2010). Forward agreements, Futures and Options are known as the Financial Derivatives and are utilized to a great extent to decrease advertise dangers. Walsh David (1995) clarifies that if two protections have same adjustments in future, they should have same value today. Along these lines the estimation of a subsidiary moves similarly as that of hidden resource. This is called exchange. Supporting of dangers is only the holder of an advantage has two situations in inverse ways. One is of the subsidiary and inverse position is on the under-lying resource individually. In that capacity on the off chance that the worth on the off chance that the advantage diminishes, at that point estimation of the subsidiary will likewise diminish. In any case, the adjustment in esteem is off-set by the contrary situations to one another. In this way hazard is diminished. This is called supporting. Long Hedge alludes when a financial specialist foresees increment in showcase cost and consequently purchases future agreements. Short Hedge is the point at which a speculator as of now has a fates contract and anticipates that the estimation of benefit should fall and accordingly sells it in advance. (Dubofsky and Miller, 2003) Long Hedge Short Hedge Change in estimation of position Change in cost Change in estimation of position Change in cost Fig.1 Hedging (Dubofsky, D and Miller, T. Jr. 2003) Forward Contracts-These include purchasing or selling explicit resource at a particular cost at a predefined time. It is essentially an agreement between two gatherings to exchange a specific product or resource at a specific rate on a predefined time. The purchaser is supposed to be in ‘long position’ while the vender hols the ‘short position’. These are Over the Counter (OTC) Derivatives. These are utilized for securing in the cost and require no money moves to start with, in this manner include credit dangers. Their primary element is the adaptability as forward agreements can be custom-made according to the necessities of the brokers. They are ordinarily used to support the conversion standard dangers. (Claessens, 1993) Prospects These are more normalized than the Forward agreements. They are exchanged at Foreign Exchanges. The normalized agreement determining the advantage, cost and conveyance time is either purchased or sold through specialist. The conveyance cost relies upon showcase and controlled by the trade. The default hazard in prospects is limited due to clearinghouse. It goes about as focused gathering and does the ‘marking to market’ of traders’ account; by doing benefit misfortune computations day by day. Beginning edge sum is required and fates subsequently include edge calls. Least credit chance is included; however being normalized gets, these can't be custom fitted to singular requests. (Hinkelmann and Swidler, 2004). Fates could be contracts on genuine resources for example gold, oil, corn and so forth or they could likewise be agreements of money related nature for example money, loan fees and so on. (Tamiso and Freedman, 1995). Fig.2: Hedging through Futures. (Walsh, D. 1995) Alternatives The holder can purchase from or offer to, the benefit at a strike rate at a future development date. Anyway the holder of the choice has no ethical commitment to do as such. The expense of purchasing the choice includes a top notch which is to be settled in advance. The alternative that empowers the holder to purchase a benefit is called Call choice while in Put choice the holder can sell the advantage. (Claessens, 1993) These can be purchased Over the Counter (OTC) at a bank or can be trade exchanged choices. An American choice could be practiced whenever before it lapses. Despite what might be expected, an European choice must be practiced on development. Alternative is regularly executed when its strike cost is not as much as cost of the stock. Be that as it may, is the cost of the stock is not exactly the strike value; the holder won't execute the choice. Dark and Scholes (1973) gave the recipe to decide the cost of an European choice. As indicated by the equation, the estimation of Call choice is given by: where The estimation of Put choice is given by: P = Ke-r (T-t) †S + C = N(- d2) Ke-r (T-t) †N(- d1) S. Where N (.) is an aggregate ordinary circulation work s-standard deviation of the offer cost, rf-hazard free financing cost per annum and t-time to expiry (in years). The above equation, otherwise called the Black-Scholes alternative valuing model; depends on the presumptions that the stock doesn’t deliver any profits, it is conceivable to purchase or sell even a solitary offer, there are no expenses acquired in these exchanges and that exchange opportunity doesn’t exist. As indicated by Black and Scholes (1973), the choice incentive as an element of the stock cost is free of the normal return of the stock. The normal return of the choice, be that as it may, will rely on the normal return of the stock. Thus as the cost of fundamental resource builds, the cost of alternative will likewise expand inferable from their straight relationship. Dark and Scholes (1972) further carried on different experimental tests to legitimacy of the equation. They saw that cost paid by the purchasers of the alternative was higher than that appeared by the equation. This was for the most part on the grounds that the exchange costs that are caused are constantly paid by the purchasers of the choices. These expenses were seen as high for choices of high dangers and the other way around. The dealers of choices subsequently got the value that was anticipated by the recipe. The contextual analysis would utilize this equation to decide the estimation of alternatives held by the organization. Walsh David (1995) clarifies that alternatives have a non-direct connection with result. Its result increments with the cost of the ass

My Goal In Life free essay sample

My whole life I have for a long while been itching to turn into a fruitful Mechanical specialist, and graduate from the University of Florida State. One of my objectives in life are to go to the University of Florida State. Another of my objectives is to turn out to be some sort of designer. In any case, at this moment I might want to be a Mechanical designer. To be straightforward I truly don’t comprehend what made me to need to turn into a designer. Be that as it may, something about designing consistently charmed me for reasons unknown. Be that as it may, of late my science instructor has positively affected me and is truly making me like building. So I surmise that Mrs. Butterfield has impacted me into being a specialist. My arrangement b is to be an architect as well. Be that as it may, this kind of building would simply be anything. To be straightforward I truly don’t read a specific distributions about designing however I never truly need to. We will compose a custom paper test on My Goal In Life or on the other hand any comparative theme explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page Additionally I truly don’t know where I could get a distributions or articles about designing. The extracurricular exercises that I take an interest in are football and ball. To be straightforward I don't accomplish any humanitarian effort yet I do plan to get a few hours before I graduate, at the rec focus over the tracks. I think chipping in is useful for engineers since that will assist them with growing great relationship building abilities. So at long last I feel that chipping in will help me as a future designer with those relationship building abilities. Starting at right now I have elevated standards for building. I feel that building will be an extraordinary field for me and I will have an incredible profession. Yet, I feel that now and again will be extremely hard andchallenging yet I accept that at long last it will be all justified, despite all the trouble, in light of the cash I’m going to get, and how I will be glad to go to work.

Know Your Credit Score Amounts Owed

Know Your Credit Score Amounts Owed Know Your Credit Score: Amounts Owed Know Your Credit Score: Amounts OwedIn this five-part blog series, well break down the different categories of information that make up your credit score, starting with your amounts owed.Your credit score: It’s important. It’s how lenders decide if they’re going to lend you money, and at what rates. And remaining in the dark about your score  is the perfect way to end up at the mercy of predatory payday loans and title loans.So how is your credit score determined? As it turns out, there are five categories of information that go into it: payment history, amounts owed, length of credit history, credit mix, and recent credit inquiries. We’re going through them one by one.Today, we’re talking about your amounts owed, which makes up 30 percent of your score.What is  amounts owed?Simply put, your amounts owed is, well, the amount of money that owe on your various debts, including personal loans, lines of credit, and credit cards. In order to figure out your amounts owed, all you need to do it tally up all the outstanding balances on your loans and credit cards.With amounts owed, owing less debt is generally considered a better thing than owing more. The only exception to this is if you never use any debt at all: no installment loans, no credit cards, nothing. That can leave you with a thin credit history that will hurt your score.Beyond keeping your debts to a minimumavoiding large outstanding balances and/or paying down the balances you have already built upthere’s another factor with your amounts owed that needs to be reckoned with.It’s your credit utilization.What is credit utilization?Your credit utilization refers to the percentage of your available credit that you’re using. This won’t matter with your loans, which are issued to you as a single lump sum, but it’ll matter big time with your credit cards.With credit cards, you are given a credit limit that you can borrow up to. The more money you borrow, the more of your available credit you†™re using, and the higher your credit utilization ratio rises.Credit utilization is also where your amounts owed can start to get a bit tricky.30 for (keeping it under) 30“Lenders want you to keep your utilization rate at or below 30 percent,” certified financial educator Maggie Germano (@MaggieGermano) told us. “This means that you should keep your balances below 30 percent of your actual credit limit.”“Say you only have one credit card with a limit of $1,000, but every month you end up spending at least $750. That means that your credit card utilization is typically at 75 percent. One way to improve this is to make sure you pay off your balances in full each month.”Paying down your balances is always a good idea because it also keeps you from accruing interest on the purchases you’ve made. The less you have to spend in interest, the more money you’ll have free to put towards things like emergency funds, 401k’s, or sweet dirt bikes.“If thats harder for you, cons ider asking for a credit limit increase,” says Germano. “This will only help you if you dont increase your spending, though! Keep your spending down, even if your limit is higher.”Let’s use Maggie’s previous example: If you spend $750 against a $1,000 limit, you’re utilizing 75 percent of your available credit. But if you get your limit raised to $2,000, then that $750 is only utilizing 37.5 percent of your available credit. You’ve improved your credit utilization without changing your spending habits at all!Like we said, it gets kind of trickySeven percent and zero percentIf you are committed to paying down your credit card and loan balances, you will see improvements in your credit score. (This is assuming that you don’t start paying all your bills late or hurting your score in some other way.) And once you get your open balances to a 30 percent utilization rate, that should help your score even more.But if utilizing 30 percent of your available credit is good, is there a more specific number that’s ideal? According to nationally recognized credit expert Jeanne Kelly (@CreditScoop) When you review people who have 800 scores, they use only seven percent of what is available to them.”For people who have lots of credit card debt, a seven percent utilization might sound pretty impossible to achieve, but Kelly has additional advice to help you get there:“If you get balance transfer credit cards to help lower the debt with a 0 percent interest rate, that is the time to truly focus on paying the debt down. Do not close the other account that you just transferred it from. But remember the goal is to not use the cards to build up more debt but to lower it.”Keeping your old accounts open helps your amounts owed because it raises your total available credit. Credit utilization is judged across all your different cards, so having one old card with a completely open credit line can (and likely will) positively affect your score.Paying down your de btIf you are able to qualify for those zero percent balance transfers, it’s best to combine them with a solid plan to pay down your debt. The more debt you can pay down while you’re interest-free, the better.So what’s the best way to do it? There are tons of debt repayment strategies out there, but two of the best are the Debt Snowball and the Debt Avalanche.With the Debt Snowball method, you order all your debts from the smallest balance to the largest. You put all your extra debt repayment funds towards the debt with the lowest balance, making only the minimum payments on all your other debts.Once that first debt is paid off, you take all those funds and you put them towards the next debt, working your way up from smallest balance to largest.Plus, every time you pay a debt off, you add its monthly minimum payment towards your future debts. This way, the money you’re putting towards each subsequent debt gets larger and larger, just like a snowball rolling down the hill.The Debt Avalanche is structured in much the same way, only you order your debts from the highest interest rate to the lowest, then pay off the debt with the highest rate first.To learn more about the Debt Snowball and Debt Avalanche, check out these blog  posts:Want to Get Out of Debt? Then Let It Snow(ball)!Sweep Away Your Debt With a Debt AvalancheWhat else can you do?When it comes to your amounts owed, the simplest advice is also the best: pay down your debts as fast as you can, and then try to avoid taking out lots of debt in the future. The more you stay away from high-interest bad credit loans and no credit check loans, the better!Depending on your situation, a debt consolidation loan might also be a good option to help you lower your interest rates and pay down debt faster.In regards to your credit utilization, Alayna Pehrson, digital marketing strategist for BestCompany.com, (@BestCompanyUSA), has a great strategy for keeping your ratio at 30 percent or below:“One way to impr ove your credit utilization is by keeping track of the amounts you charge your credit card. Going over a 30 percent credit utilization will negatively affect your credit score, therefore, if you set up a way to track how much youre charging to the card, then itll be easier to monitor your utilization and keep it low. You can keep track by setting balance notifications or by creating your own credit journal list.”Pehrson also warns that a credit line increase could result in a hard inquiry showing up on your report. So while it might help your score in the long run, it might cause a smaller rise, or even a small dip, in the short-term.Since your amounts owed is one of the two largest factors of your credit reportfixing your credit utilization is a great way to get your credit score up.Tune in next time, to learn about payment history!Check out the rest of our Know Your Credit Score blog series:Credit ScoresPayment HistoryAmounts OwedLength of Credit HistoryTypes of Credit UsedRecen t Credit InquiriesWhat kinds of questions do you have about your credit score? Let us know!  You can  email us,  or you can find us on Twitter at  @OppLoans.ContributorsMaggie Germano  (@MaggieGermano) is a Certified Financial Education Instructor and financial coach for women. Her mission is to give women the support and tools that they need to take control of their money, break the taboo of discussing debt and income, and achieve their goals and dreams. She does this through one-on-one  financial coaching, monthly  Money Circle  gatherings, her weekly  Money Monday  newsletter, and speaking engagements. To learn more, or to schedule a free discovery call, visit  maggiegermano.com.Jeanne Kelly  (@creditscoop)  After being turned down for a mortgage 15 years ago, Jeanne Kelly realized she needed to get her credit in order. Not only was she able to fix her bad credit, but she took the skills and knowledge she gained and decided to share it with the world. Now she’s a nationally reg arded credit coach and expert, with multiple books and television appearances. Follow her on Twitter and check out her  site  to get the credit help you need!Alayna Pehrson  is a Digital Marketing Strategist and Credit Repair Specialist at BestCompany.com  (@BestCompanyUSA).

The Spread of Islam in Asia From 632 to Present

Anabolic Steroids Are A Group Of Organic Compounds And...

Anabolic steroids are a group of organic compounds and synthetic variants of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids (abbreviated AAS)—â€Å"anabolic† referring to muscle-building and â€Å"androgenic† referring to increased male sexual characteristics (Pope and Brower, 2005). They are synthesized in the body from cholesterol in the Leydig cells in the testes, and in smaller amounts in the adrenal glands of both males and females and in female ovaries (Talih, Fattal and Malone, 2007). Anabolic steroids should not be confused with other types of steroids such as corticosteroids (e.g., cortisone or prednisone), which have no anabolic effects and therefore have little abuse potential (Pope and Brower, 2005; Sheffield-Moore and Urban, 2004). When taken in abundant doses, anabolic steroids allow users to greatly increase muscle strength and athletic performance, often well beyond the limit attainable by natural means (Kouri et al., 1995). As a result, many elite competitive athletes have used anabolic steroids and this phenomenon has recently generated much publicity, as evidenced by increasing media reports around the world (Ewing, 2008; Fainaru-Wada and Williams, 2006; Magnay, 2008; Swartz, 2007). Anabolic steroids are used to increase muscle mass and reduce fat in athletes and body builders and this ultimately leads to an increase in competitiveness. The dosages used are often a lot higher than the recommended medical

Ap Bio Unit Packet 38-40 Free Essays

Lissette Rivera Chapters 38-40 Answer all questions on looseleaf or type the answers in from the website and print. PART A: 1. Draw a general diagram of the life cycle of a seed plant. We will write a custom essay sample on Ap Bio Unit Packet 38-40 or any similar topic only for you Order Now Indicate which steps are haploid and which are diploid. 2. Define microsporogenesis and megasporogenesis. In what portion(s) of the flower does each of these processes occur? What is the end product of each process? Microsporogenesis produces our microspores. It occurs in the sporangia of the anther in flowers. Four haploid microspores are produced when the mother cell undergoes meiosis. Each microspore develops into a pollen grain. Megasporogenesis occurs in the sporangium of the ovule of a flower. After meiosis, the embryo sac is produced (egg, nucei, antipodal cells, synergids). 3. Draw and label all parts of a complete flower. Indicate the functions of the major parts. 4. What is pollination? How does it differ from fertilization? Pollination is the transfer of pollen grains from the anther to the stigma of the plant through wind, animals, insects, etc. It differs from fertilization in that fertilization is caused by pollination. Pollination also only occurs in plants whereas fertilization can occur to reproduction in all plants and animals. Pollination 5. Draw and label a mature ovule. Include the micro-pyle, integuments, nucellus, synergids, polar nuclei, egg, and anti-podals. Indicate the functions of each of these structures. 6. What stages of the life cycle are eliminated or bypassed when plants are cloned naturally? When plants are cloned on the farm or in the laboratory? The gametophyte generation is bypassed when plants are cloned naturally. When plants are cloned on the farm or in the laboratory, cutting small pieces of plants can be grown into a complete plant. 7. What does the science of plant biotechnology do that artificial selection and/or cloning practices don’t do? Biotechnology adds genes from other organisms to plants, which other artificial selection or cloning practices does not do. PART B: 1. One of the problems associated with growing plants in space is lack of gravity. a. How does gravity affect the normal growth of a plant’s roots, stems, and other parts? Explain the mechanisms involved. Under gravity, auxin accumulates on the lower side of the root and stems, and slows down elongation of cells in the roots under high concentrations. Auxin concentrations with 10-8 and 10-4 stimulate proton pumps. Enzymes break crosslinks between cellulose molecules and allow the cell to elongate. b. How would a lack of gravity affect normal growth? Seeds rely on the gravitropic responses when they’re underground under absence o flight. c. Propose mechanisms to overcome the problems associated with a lack of gravity. Plant orientation is impacted by light. It counteracts lack of gravity. How to cite Ap Bio Unit Packet 38-40, Papers Ap Bio Unit Packet 38-40 Free Essays Lissette Rivera Chapters 38-40 Answer all questions on looseleaf or type the answers in from the website and print. PART A: 1. Draw a general diagram of the life cycle of a seed plant. We will write a custom essay sample on Ap Bio Unit Packet 38-40 or any similar topic only for you Order Now Indicate which steps are haploid and which are diploid. 2. Define microsporogenesis and megasporogenesis. In what portion(s) of the flower does each of these processes occur? What is the end product of each process? Microsporogenesis produces our microspores. It occurs in the sporangia of the anther in flowers. Four haploid microspores are produced when the mother cell undergoes meiosis. Each microspore develops into a pollen grain. Megasporogenesis occurs in the sporangium of the ovule of a flower. After meiosis, the embryo sac is produced (egg, nucei, antipodal cells, synergids). 3. Draw and label all parts of a complete flower. Indicate the functions of the major parts. 4. What is pollination? How does it differ from fertilization? Pollination is the transfer of pollen grains from the anther to the stigma of the plant through wind, animals, insects, etc. It differs from fertilization in that fertilization is caused by pollination. Pollination also only occurs in plants whereas fertilization can occur to reproduction in all plants and animals. Pollination 5. Draw and label a mature ovule. Include the micro-pyle, integuments, nucellus, synergids, polar nuclei, egg, and anti-podals. Indicate the functions of each of these structures. 6. What stages of the life cycle are eliminated or bypassed when plants are cloned naturally? When plants are cloned on the farm or in the laboratory? The gametophyte generation is bypassed when plants are cloned naturally. When plants are cloned on the farm or in the laboratory, cutting small pieces of plants can be grown into a complete plant. 7. What does the science of plant biotechnology do that artificial selection and/or cloning practices don’t do? Biotechnology adds genes from other organisms to plants, which other artificial selection or cloning practices does not do. PART B: 1. One of the problems associated with growing plants in space is lack of gravity. a. How does gravity affect the normal growth of a plant’s roots, stems, and other parts? Explain the mechanisms involved. Under gravity, auxin accumulates on the lower side of the root and stems, and slows down elongation of cells in the roots under high concentrations. Auxin concentrations with 10-8 and 10-4 stimulate proton pumps. Enzymes break crosslinks between cellulose molecules and allow the cell to elongate. b. How would a lack of gravity affect normal growth? Seeds rely on the gravitropic responses when they’re underground under absence o flight. c. Propose mechanisms to overcome the problems associated with a lack of gravity. Plant orientation is impacted by light. It counteracts lack of gravity. How to cite Ap Bio Unit Packet 38-40, Essay examples

Woman, Self and Society an Example by

Woman, Self and Society Woman is usually treated and seen in a society as feeble and weak. Commonly the term is assigned with feminine nature which includes caring, softness, calmness and submissiveness. Feminine character is a gender role or the assigned task for the woman sex. In the story of an hour by Kate Chopin, these feminine characteristics are portrayed through the expectations of the other character regarding Mrs. Mallards reaction upon knowing her husbands death. Need essay sample on "Woman, Self and Society" topic? We will write a custom essay sample specifically for you Proceed It is first and foremost obvious in the first paragraph of the story that Mrs. Mallard is viewed as someone weak. It is explicated that she has a weak heart thus, great care was taken to break the news regarding the death of her husband. It has been Josephine, her sister who revealed the truth to her. A friend of her husband, Richards was also there. The presence of Richards in the scene signifies his authority as a male and as a friend with respect to the truthfulness of the story. Mrs. Louise Mallard is the main character in The Story of an Hour. Undergraduates Often Tell Us: Who wants to write assignment for me? Essay writers suggest: University Essay Writing Service Write My Essay Online Best Essay Writing Service Best Essay Writing Service The way that the author address the lead character as Mrs. Mallard connotes that in marriage, the women takes the name of her husband. This is a rule and a societal norm that also codifies the fact that woman becomes a sort of property or at least part of her husband. Within this context there are attitudes and actions that are expected of women that are prescribed to them by the society. Since Mrs. Mallards reaction was to wept at once, it undermines the absence of denial, questioning and the usual hysteria that are the typical response of people who have just found out that a love one dies. Mrs. Mallard accepted her husbands death upon hearing the news with no contempt. In the third paragraph, a more concrete elaboration on Mrs. Mallards reaction was noted. She did not hear the story as many women have heard the same, with a paralyzed inability to accept its significance, denotes that Mrs. Mallard heard the same story but found its significance different than with other women. A detailed analysis of this part implies that there is basically a certain manner by which women are supposed to act and behave when told about the death of her husband. This is the central gender role that The Story of an Hour tried to suggest. She withdrew to her room shortly and while sitting near the window, the author stress the presence of the patches of blue sky, which was mentioned twice. From a state of loneliness and sadness Mrs. Mallard is in the process of reflecting and seeing a new light. It is further stated that she was young; with a facewhose lines bespoke repression and strength. This denotes the fact that Mrs. Mallard has been in a repressive state. The word strength codifies her ability to stand the cruelty that she had previously experienced. While sitting near the window, it is not only the blue patches that captured her senses but other vibrant things which reflects a more lively emotion that is not common for a grieving person to note. She tried her best to beat it back with her will but she failed and finally whispered free, free, free. It encompasses the realization of her freedom. Through the death of her husband, she started to recognize her sense of self that is rooted from the fact of being alone. She is not anymore just Mrs. Mallard but she is Louise. The sense of self is usually brought about by the ability to express your real emotion. As the story mentioned, Louise had been repress which basically hindered her self expression. However, at the death of her husband, there is this sort of monstrous joy that held her. Nonetheless, she still considered her attitude as somehow trivial due to the fact that the joy or whatever feeling it is that she now realized should be again kept in shadows as she recognized the need to weep again. It seems that she also has feelings for her husband despite the repression she mentioned before. Nevertheless she opened and spread her arms out to welcome the years to come in which she do not have to live for someone else but for herself alone. This part is crucial in her finding a sense of self. According to Dr. Jean Baker Miller, a woman should first be able to go beyond the assigned tasks or the gender roles before she can create an inner conception which will guide her. In the story, Louise thought that she already succeeded her gender roles. Upon the (perceived) death of her husband, Louise felt lively. She becomes conscious of her abilities and her possibilities. She recognizes that she is not anymore trapped by the rules of marriage which dictates certain aspects of her life. Louise becomes hopeful for a future where she sees herself taking the helm without taking into account someone else. There will be all sorts of days that would be her own. With this in mind she created possibilities and dreams for her new found self. Furthermore, Louise realized that there will be no powerful will bending hers in blind persistence. This statement illuminates the scenario wherein a relationship bounded by marriage is also under the circumstances bounded by the dictates of norms. Free! Body and soul free affirm a self that is free from domination. Louise even wished that life will be long. She further recognize that the possession of self-assertion as the strongest impulse of her being. This portray how strong self-assertion is something that she has never felt before. Ordinary woman of her age would not be familiar with such emotion and sense of self since they are manipulated by the society, particularly by fear of prejudice and further repression which might include humiliation due to nonconformity. Nonetheless, as readers of the short story finally join with the triumph felt by Louise, Brently Mallard, her husband entered the front door. Ironically, the story ends as Mrs. Mallard died of heart disease. In a matter of an hour, as depicted by the title, Louise had succeeded in transgressing the societal norm of being a repressed woman locked in the role of a wife bounded by the rules of marriage tradition and culture. She had also broken the rules of behaving and thinking like a widower of her time. Instead of mourning for the death of her husband, she felt a sense of new life and joy shortly after his death. Nonetheless, after realizing that her husband is actually alive, it literally killed all of her new hope, dreams and aspirations that ultimately led to her death. The author stressed that the doctors identified that the heart failure is due to the joy that kills. Indeed, this is the case, for if Mrs. Mallard has not found her sense of self, she wouldnt have felt joy and freedom. Without accepting joy and without the recognition of freedom she would not have attempted to defy her gender role-- even in thought. Just as how powerful her emotions has been when she recognizes that she can live for her own, the surge of emotions that swiped her after realizing that everything will not come true must have drowned her and killed her. Social expectations play a great role in the identity of a person. As The Story of an Hour reflects, marriage is seen as a repressive relationship that takes away a part of the womans self. Due to the fact that something is being done or is accepted by the society, there is a tendency that social expectations translate into rules. At a time when women are marginalized, they are assigned with gender roles that would render them powerless against men. Such gender roles or assigned tasks mark their inability to express themselves freely or openly. Instead of developing into an autonomous rational person, women are expected to become or to belong in the societal norms controlled, dominated and favoring men. Work Cited: Chopin. The Story of an Hour. 1984. Miller, J.B. Towards a New Psychology of Women.

Emmeline Pankhurst, Womens Rights Activist

Emmeline Pankhurst, Women's Rights Activist Emmeline Pankhurst (July 15, 1858–June 14, 1928) was a British suffragette who championed the cause of womens voting rights in Great Britain in the early 20th century, founding the Womens Social and Political Union (WSPU) in 1903. Her militant tactics earned her several imprisonments and stirred up controversy among various suffragist groups. Widely credited with bringing womens issues to the forefront- thus helping them win the vote- Pankhurst is considered one of the most influential women of the 20th century. Fast Facts: Emmeline Pankhurst Known For: British suffragette who founded the Womens Social and Political UnionAlso Known As: Emmeline GouldenBorn: July 15, 1858  in Manchester, United KingdomParents: Sophia and Robert GouldenDied: June 14, 1928  in  London, United KingdomEducation: École Normale de NeuillyPublished Works: Freedom or Death (speech delivered in Hartford, Connecticut on Nov. 13, 1913, later published), My Own Story (1914)Awards and Honors: A statue of Pankhurst  was unveiled in Manchester on Dec. 14, 2018. Pankhursts name and image and those of 58 other womens suffrage supporters including her daughters are etched at the base  of a  statue of Millicent Fawcett  in  Parliament Square in London.Spouse: Richard Pankhurst (m. Dec. 18, 1879–July 5, 1898)Children: Estelle Sylvia,  Christabel,  Adela,  Francis Henry,  Henry FrancisNotable Quote: We are here, not because we are law-breakers; we are here in our efforts to become law-makers. Early Years Pankhurst, the eldest girl in a family of 10 children, was born to Robert and Sophie Goulden on July 15, 1858, in Manchester, England. Robert Goulden ran a successful calico-printing business; his profits enabled his family to live in a large house on the outskirts of Manchester. Pankhurst developed a social conscience at an early age, thanks to her parents, both ardent supporters of the antislavery movement and womens rights. At age 14, Emmeline attended her first suffrage meeting with her mother and came away inspired by the speeches she heard. A bright child who was able to read at the age of 3, Pankhurst was somewhat shy and feared speaking in public. Yet she was not timid about making her feelings known to her parents. Pankhurst felt resentful that her parents placed a lot of importance upon the education of her brothers, but gave little consideration to educating their daughters. Girls attended a local boarding school that primarily taught social skills that would enable them to become good wives. Pankhurst convinced her parents to send her to a progressive womens school in Paris. When she returned five years later at the age of 20, she had become fluent in French and had learned not only sewing and embroidery but chemistry and bookkeeping as well. Marriage and Family Soon after returning from France, Emmeline met Richard Pankhurst, a radical Manchester attorney more than twice her age. She admired Pankhursts commitment to liberal causes, notably the womens suffrage movement. A political extremist, Richard Pankhurst also supported home rule for the Irish and the radical notion of abolishing the monarchy. They married in 1879 when Emmeline was 21 and Richard was in his mid-40s. In contrast to the relative wealth of Pankhursts childhood, she and her husband struggled financially. Richard Pankhurst, who might have made a good living working as a lawyer, despised his work and preferred to dabble in politics and social causes. When the couple approached Robert Goulden about financial assistance, he refused; an indignant Pankhurst never spoke to her father again. Pankhurst gave birth to five children between 1880 and 1889: daughters Christabel, Sylvia, and Adela, and sons Frank and Harry. Having taken care of her firstborn (and alleged favorite) Christobel, Pankhurst spent little time with her subsequent children when they were young, leaving them instead in the care of nannies. The children did benefit, however, from growing up in a household filled with interesting visitors and lively discussions, including with well-known socialists of the day. Gets Involved Pankhurst became active in the local womens suffrage movement, joining the Manchester Womens Suffrage Committee soon after her marriage. She later worked to promote the Married Womens Property Bill, which was drafted in 1882 by her husband. In 1883, Richard Pankhurst ran unsuccessfully as an independent for a seat in Parliament. Disappointed by his loss, Richard Pankhurst was nonetheless encouraged by an invitation from the Liberal Party to run again in 1885- this time in London. The Pankhursts moved to London, where Richard lost his bid to secure a seat in Parliament. Determined to earn money for her family- and to free her husband to pursue his political ambitions- Pankhurst opened a shop selling fancy home furnishings in the Hempstead section of London. Ultimately, the business failed because it was located in a poor part of London, where there was little demand for such items. Pankhurst closed the shop in 1888. Later that year, the family suffered the loss of 4-year-old Frank, who died of diphtheria. The Pankhursts, along with friends and fellow activists, formed the Womens Franchise League (WFL) in 1889. Although the Leagues main purpose was to gain the vote for women, Richard Pankhurst tried to take on too many other causes, alienating the Leagues members. The WFL disbanded in 1893. Having failed to achieve their political goals in London and troubled by money woes, the Pankhursts returned to Manchester in 1892. Joining the newly formed Labor Party in 1894, the Pankhursts worked with the Party to help feed the multitudes of poor and unemployed people in Manchester. Pankhurst was named to the board of poor law guardians, whose job it was to supervise the local workhouse- an institute for destitute people. Pankhurst was shocked by conditions in the workhouse, where inhabitants were fed and clothed inadequately and young children were forced to scrub floors. Pankhurst helped to improve conditions immensely; within five years, she had even established a school in the workhouse. A Tragic Loss In 1898, Pankhurst suffered another devastating loss when her husband of 19 years died suddenly of a perforated ulcer. Widowed at only 40 years old, Pankhurst learned that her husband had left his family deeply in debt. She was forced to sell furniture to pay off debts and accepted a paying position in Manchester as registrar of births, marriages, and deaths. As a registrar in a working-class district, Pankhurst encountered many women who struggled financially. Her exposure to these women- as well as her experience at the workhouse- reinforced her sense that women were victimized by unfair laws. In Pankhursts time, women were at the mercy of laws which favored men. If a woman died, her husband would receive a pension; a widow, however, might not receive the same benefit. Although progress had been made by the passage of the Married Womens Property Act (which granted women the right to inherit property and to keep the money they earned), those women without an income might very well find themselves living at the workhouse. Pankhurst committed herself to securing the vote for women because she knew their needs would never be met until they gained a voice in the law-making process. Getting Organized: The WSPU In October 1903, Pankhurst founded the Womens Social and Political Union (WSPU). The organization, whose simple motto was Votes for Women, accepted only women as members and actively sought out those from the working class. Mill-worker Annie Kenny became an articulate speaker for the WSPU, as did Pankhursts three daughters. The new organization held weekly meetings at Pankhursts home and membership grew steadily. The group adopted white, green, and purple as its official colors, symbolizing purity, hope, and dignity. Dubbed by the press suffragettes (meant as an insulting play on the word suffragists), the women proudly embraced the term and called their organizations newspaper Suffragette. The following spring, Pankhurst attended the Labor Partys conference, bringing with her a copy of the womens suffrage bill written years earlier by her late husband. She was assured by the Labor Party that her bill would be up for discussion during its May session. When that long-anticipated day came, Pankhurst and other members of the WSPU crowded the House of Commons, expecting that their bill would come up for debate. To their great disappointment, members of Parliament (MPs) staged a talk out, during which they intentionally prolonged their discussion on other topics, leaving no time for the womens suffrage bill. The group of angry women formed a protest outside, condemning the Tory government for its refusal to address the issue of womens voting rights. Gaining Strength In 1905- a general election year- the women of WSPU found ample opportunities to make themselves heard. During a Liberal Party rally held in Manchester on October 13, 1905, Christabel Pankhurst and Annie Kenny repeatedly posed the question to speakers: Will the liberal government give votes to women? This created an uproar, leading to the pair being forced outside, where they held a protest. Both were arrested; refusing to pay their fines, they were sent to jail for a week. These were the first of what would amount to nearly 1,000 arrests of suffragists in the coming years. This highly publicized incident brought more attention to the cause of womens suffrage than any previous event; it also brought a surge of new members. Emboldened by its growing numbers and infuriated by the governments refusal to address the issue of womens voting rights, the WSPU developed a new tactic- heckling politicians during speeches. The days of the early suffrage societies- polite, ladylike letter-writing groups- had given way to a new kind of activism. In February 1906, Pankhurst, her daughter Sylvia, and Annie Kenny staged a womens suffrage rally in London. Nearly 400 women took part in the rally and in the ensuing march to the House of Commons, where small groups of women were allowed in to speak to their MPs after initially being locked out. Not a single member of Parliament would agree to work for womens suffrage, but Pankhurst considered the event a success. An unprecedented number of women had come together to stand for their beliefs and had shown that they would fight for the right to vote. Protests Pankhurst, shy as a child, evolved into a powerful and compelling public speaker. She toured the country, giving speeches at rallies and demonstrations, while Christabel became the political organizer for the WSPU, moving its headquarters to London. On June 26, 1908, an estimated 500,000 people gathered in Hyde Park for a WSPU demonstration. Later that year, Pankhurst went to the United States on a speaking tour, in need of money for medical treatment for her son Harry, who had contracted polio. Unfortunately, he died soon after her return. Over the next seven years, Pankhurst and other suffragettes were repeatedly arrested as the WSPU employed ever more militant tactics. Imprisonment On March 4, 1912, hundreds of women, including Pankhurst (who broke a window at the prime ministers residence), participated in a rock-throwing, window-smashing campaign throughout commercial districts in London.  Pankhurst was sentenced to nine months in prison for her part in the incident. In protest of their imprisonment, she and fellow detainees embarked upon a hunger strike. Many of the women, including Pankhurst, were held down and force-fed through rubber tubes passed through their noses into their stomachs. Prison officials were widely condemned when reports of the feedings were made public. Weakened by the ordeal, Pankhurst was released after spending a few months in abysmal prison conditions. In response to the hunger strikes, Parliament passed what came to be known as the Cat and Mouse Act (officially called the Temporary Discharge for Ill-Health Act), which allowed women to be released so that they could regain their health, only to be re-incarcerated once they had recuperated, with no credit for time served. The WSPU stepped up its extreme tactics, including the use of arson and bombs. In 1913, one member of the Union, Emily Davidson, attracted publicity by throwing herself in front of the kings horse in the middle of the Epsom Derby race. Gravely injured, she died days later. The more conservative members of the Union became alarmed by such developments, creating divisions within the organization and leading to the departure of several prominent members. Eventually, even Pankhursts daughter Sylvia became disenchanted with her mothers leadership and the two became estranged. World War I and the Womens Vote In 1914, Britains involvement in World War I effectively put an end to the WSPUs militancy. Pankhurst believed it was her patriotic duty to assist in the war effort and ordered that a truce be declared between the WSPU and the government. In return, all suffragette prisoners were released. Pankhursts support of the war further alienated her from daughter Sylvia, an ardent pacifist. Pankhurst published her autobiography, My Own Story, in 1914. (Daughter Sylvia later wrote a biography of her mother, published in 1935.) Later Years, Death, and Legacy As an unexpected by-product of the war, women had the opportunity to prove themselves by carrying out jobs previously held only by men. By 1916, attitudes toward women had changed; they were now regarded as more deserving of the vote after having served their country so admirably. On February 6, 1918, Parliament passed the Representation of the People Act, which granted the vote to all women over 30. In 1925, Pankhurst joined the Conservative Party, much to the astonishment of her former socialist friends. She ran for a seat in Parliament but withdrew before the election because of ill health. Pankhurst died at the age of 69 on June 14, 1928, only weeks before the vote was extended to all women over 21 years of age on July 2, 1928. Sources ï » ¿Emmeline Pankhurst - Suffragette - BBC Bitesize.†Ã‚  BBC News, BBC, 27 Mar. 2019,  Pankhurst, Emmeline. â€Å"Great Speeches of the 20th Century: Emmeline Pankhursts Freedom or Death.†Ã‚  The Guardian, Guardian News and Media, 27 Apr. 2007.â€Å"Representation of the People Act 1918.†Ã‚  UK Parliament.

Definition and Examples of Plots in Narratives

Definition and Examples of Plots in Narratives Every story that you read follows a series of events that range from the introduction of a conflict to begin the story and a final resolution at the end; this is the plot of your story. Basically, it’s what happens throughout the narrative, and it appears in in both fiction and non-fiction work. When you write a plot summary, you’ll essentially condense a novel into a short essay, touching on the key points of the material. You’ll want to introduce the main characters, setting of the story, and the main conflict of the narrative, including the five basic components of the plot: introduction, rising action, climax, falling action, and finally, a resolution. Some outlines will break down a plot into more segments (exposition, inciting incident, central conflict, rising action, climax, falling action, resolution) but the premise is the same - a pattern of rising and falling action that looks essentially like an arc  or a bell curve when you consider the level of drama the characters experience. Understanding and Introducing the Conflict To properly summarize a plot, start by figuring out the main problem that the story will solve. This could come from understanding the main characters, who are crucial components of the plot. Who are they and what are they trying to achieve? Most characters have a mission to accomplish, often it is finding, saving, or creating something or someone. Understand what drives the main characters, and that will help you in the first step to summarize the plot. The conflict that we discover at the start of the narrative will get kicked off by an inciting incident that triggers the rising action, which grows over time. In Shakespeare’s â€Å"Romeo Juliet† we are introduced to two characters from feuding families who ultimately fall in love. The conflict comes from their love for each other despite their families’ disapproval. Rising Action and Climax The rising action will introduce key components of a story that build upon the drama and conflict. This is where we see Romeo Juliet marry in secret, and Romeo Tybalt engage in a duel that ultimately leads to Tybalt’s death. Eventually, the action and conflict hit what is called the climax, the point of no return. This is the peak of excitement, fear, drama, or whatever the emotion is that relayed through the narrative. You’ll want to tie together the rising action and the catalyst for conflict. The climax could lead us on a journey of positive resolution or even a journey of tragedy, but it will often change the characters in some way and is the reason why the problem can now start to be solved. In Shakespeare’s story, there are essentially two points of climax: Romeo is banished and Juliet refuses to marry Paris. Falling Action and Resolution Finally, as you work your way back from the climax to the resolution, you’ll want to focus on how the main characters respond to the peak of action. Some aspect of the climax will trigger a response in the main characters which will drive them towards the final resolution. Sometimes, you’ll even find that the main characters learn a lesson and grow as individuals, but either way, the resulting actions shift the story and begin the falling action. Juliet drinks the potion which causes Romeo to believe she has died and kills himself. Upon awakening and discovering that her love has died, Juliet does the same. Eventually, the story will return back to the original baseline resulting in a final resolution. In â€Å"Romeo Juliet† the resolution isn’t that they both have died, but rather, the action their families take in response to their deaths, the end of the feud. Creating the Summary Remember that the plot is not the same as the theme of the narrative. If you’re not sure what the difference is between the plot of a story and the theme, you’re not alone. While the plot is what happens, the theme is the underlying idea or message within a story. The plot is concrete occurrences within the narrative, but the theme can be more subtle and even at times, implied. The theme can be harder to discern whereas the plot is more obvious. In Romeo Juliet, we see themes of love and hate that appear throughout the plot. Don’t forget, the key part of summarizing a plot is that you’re summarizing. You don’t need to include every detail that you encounter. When you read the text, it’s important to pay attention to what happens and where you see action coming into play, and write down key moments. Look for the basic information of who is involved, what are they doing, when are things happening, where is the action happening, and why? Take notes and even write down things that you’re not sure if they are vital at that moment, but seem interesting or important. When you finish the story, you’ll be able to review your notes and better understand what aspects of the narrative were most important and start to eliminate the notes that don’t enhance the plot. That way, when it comes time to summarize the plot, you can easily pare down your notes and have an outline of what happens and the crucial moments that represent each of the five components of the plot.

Reactive extrusion of TPE-E nanocomposites Case Study

Reactive extrusion of TPE-E nanocomposites - Case Study Example It is very difficult to do extrusion blending with TPEE because it has a low melt viscosity and tension. Its melt viscosity and tension can be increased by adding branching agent during polymerization. Even with this increase, it is not sufficient to perform extrusion blowing. There are several attempts, which have been made to increase melt viscosity and tension during extrusion by use of a chain extender during melt polymerization. Reduction of crystallization time through reactive extrusion of PBT with the use of diepoxy group as a chain extender provides a simpler method of getting high molecular weight of PBT than the conventional method of poly-condensation. Researchers acknowledge that multifunctional polymers such as TMP, TME and trimesic acid can be used to produce high molecular weight of PET. There is an effect of the modified m-MDI in the blending process of PET since the increase of m-MDI increases the molecular weight of PET. However the reaction should not be abled to continue for a long time and m-MDI should not be added because there will be crosslinking of the product because of the excessive reaction of isocyanate. This will later affect the ductility of the blend. In a situation where the correct amount of m-MDI is used then the molecular weight of PET is reduced with increasing time of blending. This is because of degradation hydrolytic and isocyanate group. It is very important to complete the process within a short time to avoid degradation. If the time is not enough to complete the process of forming urethane then there will be production of carbon dioxide by unreacted isocyanate groups at the stage of post extrusion. fluoromica pristine clay modified with alkyl-ammoniums (ODTMA) Moreover, the unreacted group of isocyanate might result into undesirable side reaction at the post processing stage (Brown & Alder, Pp 35). Hence, it is very important to ensure that the process is completed and the physical properties are maintained. The best processing parameters for blending m-MDI and TPEE must be found. The current thermoplastic polyester elastomer (TPE) is characterized by qualities such as excellent heat resistance, resistant to light, heat-aging resistance, and good in block order retaining ability and low temperature traits. The TPE is made up of hard section, which consists of polyester, which comprises of aromatic dicarboxylic acid and aliphatic or alicyclic diol, and a soft section, which consists of aliphatic polycarbonate as the main ingredient. Through which where the hard and soft section becomes connected, and the melting points of the TPE are arrived at by taking their measurements using a differential scanning calorimeter in three stages. First temperature is raised from room temperature to 3000 C, at a 200 C/min heating rate, then for three minutes maintain temperatures at 3000 C after which lower it to room temperature at a cooling rate of 1000 C/min. (Tm1 – Tm3) obtains the melting point differ ence (Brown, Alder, 65). Materials pTMEG, 1,4-BD, Irganox 1010 and modifies m-MDI, MM103C. In addition, poly (butylene terephthalate) was also used. In addition phenol, together with 1, 1, 2, 2-tetrachloroethane, CF3COOD and TBT were used without any purification. The inner viscosity of the polymer was determined by use ubbelohde viscometer at 35 degrees (Chang, Pp 54). Usually IV is

Regeneration Essay Example | Topics and Well Written Essays - 1000 words

Regeneration - Essay Example four major criteria which included, ‘increasing the demand for local labour’, ‘reducing local labour-market imperfections, ‘increasing mobility and awareness of job opportunities’, and ‘increasing the skills of local residents through educational or training schemes’. Correspondingly, the LDDC policies formulated by the central government can be identified to promote the gentrification process (Church, 1987). Similarly, the study of Butler and Lees (2006) asserted the prevalence of super-gentrification in ‘inner London neighbourhood of Barnsbury’, which was further in line with the gentrification noticed in New York. Notably, the Abercrombie Plan visualized â€Å"the outward movement of London’s population to locations beyond the Green Belt at the cost of a declining inner city population† (Keddie, n.d.). These examples can be viewed as evidences which suggest that London Planning Policy promotes the gentrificati on process. 5 The term ‘gentrification’ is one of the most widely debated subject matters in the domain of urban planning. It depicts the transformations in urban design with regard to changes in lifestyle values or economic situations of any particular urban region. The process primarily depicts the idea of providing an increasing share of urban area for wealthier people in order to ensure maximum development of a particular area (Syrett & Sepulved, 2010; (Roberts & Sykes, 2000). This essay will answer the question, as to whether planning policy in London aims to promote or prevent gentrification Gentrification in London has resulted in the emergence of widespread challenges. Gentrification in London is argued to have several negative impacts on the lives of urban population. Notably, gentrification is criticised on several grounds. For example, it has been claimed that gentrification results in ‘loss of affordable housing’, ‘under-occupancy and population loss to gentrified areas’, ‘displacement through rent/price

Nursing Discipline Overview and Reflective Account

Nursing Discipline Overview and Reflective Account NURSING DISCIPLINE MENTAL HEALTH BRANCH From the 16th Century mental health patients were contained in asylums until mental health hospitals were introduced during the 1950s. Sometimes people who were a disruptive or were only reacting in a normal way to difficulties in their lives were put away. Often patients were excessively medicated and subject to treatment which would be totally unacceptable today such as muffling or being put in a swing chair. In the 1960s, inadequacy and cost resulted in mental health hospitals closing and care moving to general hospitals. Patients who were allowed home at the weekends recovered more quickly and therefore care increasingly moved to the community (Hannigan and Coffey 2003), where most people with mental health problems are cared for today (NHS 2010). Legislation such as the 1959 and subsequent 1983 Mental Health Act, and the Care Community Act (1990) are relative to modern community mental health nursing. In 1999 the Government confirmed mental health was a top priority in the Health Service (Jackson Hill 2006). Since then guidelines such as the Department of Health guidance (2003), the National Service Framework for Mental Health (1997) and the NHS Plan (2000) (cited in Jackson et al 2006) have been introduced to reform and improve services for people with mental health problems and their carers. The Department of Health have also investing significantly in inpatient mental health settings due to issues such as a not enough beds being available, the lack of privacy and dignity of patients and wards not supporting provision of self care (DOH 2009). As a result many new opportunities have been created for mental health nurses over the last few years, for example the modern matron and nurse consultant, and new skills have been dev eloped, such as nurse prescribing and psychosocial interventions (Brimblecombe 2009). Mental health nurses will work with children and adults who suffer with various mental health problems. The primary role being to form therapeutic relationships with patients (sometimes called clients) and their families to help them recover from their illness and promote independent living (NHS 2010). Mental health nursing is varied and complex, for example treatment may include conventional nursing interventions such as administering drugs and injections or it may be to encourage patients to take part in art, drama or occupational therapy. In order to care for people in a fair and anti-discriminatory way and deliver care holistically, mental health nurses need to have good knowledge of the theories of mental health and illness, psychological and biophysical sciences and personality and human behavior (Hannigan et al 2003). One in four people will suffer with a mental health illness at some point during their life and one in twelve will require medical intervention (Mind 2010). Women are 1.5 times more likely to suffer with anxiety and depression whilst men are more likely to suffer from substance abuse and anti social personality disorders. For some patients a mental illness is triggered by a crisis in their life, which they cant cope with, such as depression following the death of a partner (NHS 2009). Some of the more familiar mental health illnesses are anxiety, depression, schizophrenia, eating disorders, drug and alcohol addition, personality disorders and impulse control such as gambling. Some of these illnesses will require treatment in hospital but many will be treated in primary care settings, such as outpatient clinics, schools, community mental health centres, residential facilities, prisons and day treatment centres (Hannigan et al 2003). Care is person-centered and mental health nurses will work within a professional multi-disciplinary team which will include GPs, psychiatrists and social workers and other health care professionals. A mental health nurse will require good interpersonal and communication skills. They will to demonstrate sensitivity when caring for patients, for example there is still some stigma attached to people with mental health problems and it is important for a nurse to help the individual and their families deal with this (NHS 2010). Dealing with the human mind and behavior is not an exact science and sometimes people with mental health problems can be violent, one skill a nurse will be required to have is to recognise building tension and diffuse it when necessary to maintain the patients and others safety (NHS 2010). Sometimes nurses may find themselves faced with awkward situations, and be required to apply ethical principles, such controversial issues which cannot be disclosed and where confidentiality needs to be maintained (NMC 2008). On the other hand if someone is at risk of serious harm, have an infectious disease or criminal activity is involved they may have to inform the appropriate bodies (Hannigan et al 2003). Nurses may find themselves giving care or treatment which is against their beliefs, for example someone addicted to drugs may request a supply even though medically it is not in their best interest or an anorexic patient might protest when food when the nurse tries to care for them (Hannigan et al 2003) . In practice, mental health nurses will come across difficult situations were an assessment of the capacity and ability of a person to consent will be required. People with mental health disorders have the same rights to consent or refuse treatment as those with physical illnesses unless some mental health issue means they are unable to make a decision. Nurses need to support patients to take responsibility for their own well-being and make informed decisions by providing information which is accessible and understandable (Mind 2010). This may mean working with the clients, advocates and carers to ensure it happens. Although giving certain treatments might be in the clients best interest it not enough to impose treatment without consent. In some circumstances a small number of people with mental health problems will be detained under the Mental Health Act (1983) (Hinchcliff et al 2003). To conclude mental health care has developed considerably over the last few years. Mental health nursing is not an exact science but is varied and complex and is about building therapeutic relationships with people and understanding and reacting appropriately to individual circumstances and needs to promote recovery and maximise life potential. NURSING DISCIPLINE LEARNING DISABILITIES BRANCH People with learning disabilities have been treated as second class citizens for many years, once being seen as possessed by evil spirits or being punished by God for a sin they may have committed. In the 19th century they were removed from their families and lived in purpose built institutions, treated as sick and in need of treatment (Brown Benson 1995). During the 1970s care moved to the community (Brigden Todd 1993) where it largely remains today. Approximately 1.5 million people have a learning disability, the majority of which live at home with their families or in community care settings (Mencap 2009). Relatively few live by themselves or with a partner (Emerson, Davies, Spencer, Malam 2005). Turnbull and Chapman (2010) describe a learning disability as being a lifelong condition, which may be genetic or environmental and vary in degree of impairment. Sowney (2006) suggests all learning disabilities have common features including impaired intelligence and social functioning which has a lasting effect on development. According to Mencap (2009) people with learning disabilities live an average of 50-55 years and sometimes up to 70 years old. A learning disability nurse can therefore expect to nurse a range of patients from birth to the elderly and will need to demonstrate a patient centred approach and work in partnership with the patient to help them meet their health, social, emotional, developmental and behavioral needs ( NHS 2009). Although a learning disability is not an indication of a physical disability or ill health, people with learning disabilities generally have more complicated problems and require more nursing interventions than the general population. In the young person some of the more common problems include respiratory problems, epilepsy, sensory and motor impairments, hypertension, thyroid disease and cancer and in elderly adults common problems include loss of hearing, vision and mobility, heart conditions, diabetes, fractures and osteoporosis (Davis 2008). Generic issues include communication difficulties, conditions relating to specific syndromes, challenging behavior and delayed development (University of Nottingham 2010). A learning disability nurse needs the skills to work within both simple and complex health areas. Communication is a vital skill for the learning disability nurse, hospitalisation for a patient with a learning disability can be very distressing and it is important to build therapeutic relationships based on trust and understanding. In the past access to healthcare services for patients with learning disabilities has sometimes unintentionally been denied. A learning disability nurse can help to overcome these prejudices by ensuring people with learning disabilities are not discriminated against and have the same opportunities as the rest of the population (Brittle 2004). People with learning disabilities are the most vulnerable and socially excluded in our society (DOH 2001). A learning disability nurse works in partnership with both the patient and family carers to provide healthcare, and should recognise each persons uniqueness, individuality and differing abilities. The learning disabilities nurses main aims will be to support the well-being and social inclusion of people with learning disabilities, their rights, choices and independence by improving or maintaining their physical and mental health so they can pursue a fulfilling life whatever their ability (DOH 2009). For example teaching someone the skills needed to find work can help them lead an independent life with equal opportunities (NHS 2009). Many complex issues working with patients with learning disabilities relate to ethical aspects of care, and may be related to an individuals rights and welfare, public welfare or inequality. For example a learning disability nurse may need to assess the capacity and ability of a person to consent to treatment (Hinchcliff, Norman Schober 2003). Every effort should be made to provide information in a format the patient can understand, which might be in the form of pictures, alternative communication methods, using short sentences, repeating explanations and giving them time to make a decision (Brittle 2004). Previous experience may mean a person with a learning disability has not been given the opportunity to make their own choice regarding their individual treatment and care (Turnbull et al 2010) and involving family, friends or an advocate, where possible may help them understand the care and treatment offered to enable them to make their own decision (DOH 2001). In some situations people with learning disabilities may have the capacity to consent to straightforward nursing activities but may lack capacity to consent to more complex procedures (DOH 2001). Other ethical issues may involve the family or carer, for example, a person with learning disabilities may receive some benefits which they may wish to have control over and decide how it is spent. The carer on the other hand may see it as part of the household income and wish to control of it. Or maybe the parents or carers, due to ill health are unable to continue with full time care of a person with learning disabilities in their own home. Nurses will require good negotiation skills to support individuals and carers through dilemmas such whilst working within ethical guidelines, with the person being supported remaining the central focus (Thomas Woods 2003). Other ethical issues might involve psychosocial and lifestyle issues such as overeating or drug abuse which might raise concerns about control and freedom of choice (Davis 2008). Opportunities for learning disabilities nurses exist in both hospital environments and the community. They will specialise in many areas which might include education, sensory disability or the management of services (NHS 2009). They will work within the multi-disciplinary team of their preferred environment, for example a learning difficulty liaison nurse will work with other staff, patients and carers to develop therapeutic relationships and ensure people with learning disabilities have a positive healthcare experience (Brittle 2004). To conclude people with learning disabilities have very similar health issues to that of the general population. However it is important that the learning disabilities nurse exercises a person centered approach, develops a therapeutic relationship and understands a person with learning disabilities personal needs in order to support their wellbeing and promote social inclusion, rights, choices and independence to enable them to enjoy the same health care rights as everyone else. NURSING DISCIPLINE CHILDRENS BRANCH The Childrens branch of nursing is relatively new, in 1959 The Minster of Heath first recommended that children have the right to be nursed by specially trained, qualified staff who understood childrens individual needs but it wasnt until 1988 dedicated training courses were set up to provide nurses with the specific skills and knowledge to nurse children whose physical, physiological and social needs are different to that of adults (Hubbard Trig 2000). Sick childrens rights have only recently been acknowledged despite children making up 25% of the population. But now many reports and policies are aimed at improving childrens services and recent statute law has given children increased rights (Hubbard et al 2000).The Childrens Act (1989 2004) highlights their rights; Every Child Matters endorses working in partnership with other organisations to ensure children are safeguarded and receive the best care available and The National Service Framework (NSF) 2004) outlines a vision to provide a high quality child centred care for both children and their parents (Chambers Licence 2005). These policies give direction today and will shape the future of childrens nursing. Nurses need to understand how they apply and what implications there might be when caring for children. For example, one of the most common reasons for children being admitted to hospital is due to injury from accidents, however if the injuries cannot be explained and phys ical or mental child abuse is suspected, the nurse will have an ethical duty to work with other agencies and professionals such as the Child Protection Services (Hubbard et al 2000). Childrens nurses work with children from birth up to 18 years old in many settings from special baby care units to adolescent services (Chambers et al 2005). In order to provide care in a fair and anti-discriminatory way they need to understand the effect age and development has on a childs health and how the delivery of treatment and care will need to be modified accordingly. This will differ considerably from a newborn baby to an adolescent. For example when assessing medication the weight and development of a child, will need to be taken into consideration as well as which drugs come in a form which can be easily administered. Appropriate care plans will need developing and updating for evaluation and referrals made as necessary for Doctors to review (Robertson South 2006). The age and development of a child will influence ability to cooperate with procedures; a young child may become bored, tired or hungry and their capability to concentrate may be limited and procedures may the refore take more than one attempt (Robertson et al). The DOH (2006) promotes optimal care for young people who have illnesses which previously wound have been fatal in childhood but are now surviving. Childrens nurses work in both hospital and primary care settings such as schools, GPs surgeries and in the community. Childrens nurses specialise in many areas, a few examples are; intensive care, child protection, cancer, diabetes, pediatric emergencies, infections, neonatal problems, burns and plastics, respiratory, cardiac or skin disorders (Robertson et al). Childrens nursing is very much centred on the family (NMC 2008). Nurses should provide a safe, secure and comfortable environment and form good relationships with both the child and their family (Hinchliff, Schober Norman 2003) and support both children and their families to make informed decisions regarding treatment and care options (Chambers et al 2005). Hubbard and Trig (2000) declare the family is central to a childs wellbeing, and whilst respecting and promoting the rights of a child, should also be sensitive to the needs and views of the parents wherever possible during the treatment and care of children. This may sometimes result in conflicting situations and the NMC (2008) imply the importance of understanding the personal, socio-economic and cultural influences surrounding a childs welfare. A nursing model often used to assist the nursing process is the Casey Model of nursing which focuses on working in partnership with both children and their families (Smith 1995). Lansdown, Waterston and Baum (1996) suggest childrens nurses should avoid jargon, use age appropriate language and in a child friendly way give children information they need in order for them to make informed decisions. Hubbard and Trig (2000) agree and suggest that play is used to communicate with a sick child, with the aid of toys, diagrams, picture books, photos and videos applicable to the childs age and cognitive levels to clarify images and gain trust and understanding. For example in order to alleviate fears for a child who has a needle phobia, the injection technique could be demonstrated with the aid of an orange. Consent is an area where conflict may arise; English common law is vague about the age of consent to medical treatment (Alderson 1990). According to Dimond (2005) Children under16 can give valid consent to treatment if they are considered to be Gillick competent. If they refuse to give consent, parents may give consent against the childs wishes, if the benefits outweigh the risks, for example a child who is suffering with cancer, refuses chemotherapy (Chambers et al 2005). Generally consent for young children is given by the family, but parents might have difficulty giving consent for someone other than themselves. In line with the Childrens 1989 Act, childrens nurses should ensure children are not cohersed into giving or refusing consent and their views should be taken account of where possible following the Fraser guidelines in respect of consent and confidentiality (Dimond 2005). Under the family reform Act of 1969 children over the age of 16 can give or refuse consent, unless the y lack capacity, for example in emergency situations (Dimond 2005). Reducing costs for the government is key and one of their main priorities is to increase primary care for children in their own homes and reduce hospital admissions. In addition it is believed that care in the home is better for both children and their families, primary care was first recommended in the Platt Report (1958) (Hubbard et al 2000). Increasingly children are being cared at home by their parents supported by the community childrens nurse (NMC 2008) whose role is to provide guidance, care and to teach parents the skills necessary to provide care for their child, for instance administration nutritional requirements via a nasogastric tube (Hubbard et al). NURSING DISCIPLINE ADULT BRANCH Prior to the influences of Florence Nightingale, hospitals were often unclean and contaminated by infection and nurses were seen as the ones to do the Doctors dirty work. Nursing schools were set up in the 1880s, although it wasnt until the 1950s that the nursing profession was governed by the regulation body, UKCC. Today nurses are accountable to the NMC (2008) and must work within the code of conduct, demonstrating that they are able to deliver, manage and develop an excellent standard of evidence based nursing care (Abel-Smith 1960)(NMC 2008). Adult nurses primarily nurse sick and injured adults back to health and have a prominent role in the provision of health care, whilst working closely with other professionals, patients and their families (NHS 2010). Traditionally nursing was task oriented and patient care focused on specific illnesses and conditions. Today nursing is much more patient centred. An adult nurse will provide holistic care to number of patients 18 years and above at any one time to meet their physical, psychological, social and spiritual needs, using the nursing process which will include assessing, planning, implementing and evaluating the care delivered (NMC 2008). Adult nurses care for adult patients with a wide range of acute and long term illnesses and are involved in many different health arenas such as health promotion and disease prevention or they may specialise in specific diseases or disorders, such as diabetes, respiratory problems or cancer care. Others may specialise in accident and emergency, practice nursing or care of the elderly (NHS 2010). Although purposely trained to nurse adults, adult nurses will almost certainly be required to care and treat other groups of patients such as children, people with learning difficulties and patients with mental health issues, for example if they present in an accident and emergency unit, or are admitted to a ward with diabetes issues (Hinchcliff, Norman Schober 2003). Adult nurses will work within a multi professional team to deliver care to patients, which will include other health professionals such as doctors, pharmacists, healthcare assistants, physiotherapists, occupational therapists and radiographers (NHS 2010). Adult nurses work in a range of settings which can be hospital based or in the community where more and more health care is being delivered such as GP surgeries, clinics, occupational health services, schools, nursing and residential homes and voluntary organisations such as hospices. The government is driving health care towards a primary health care led service within which nurses roles are expanding and developing (DOH 2010). Opportunities are also available in the armed forces, prisons, and leisure, eg cruise ships (NHS 2010). Adult nurses all cover the same programme even though their work destinations differ considerably and it has been suggested that it is time to consider a new branch of nursing that equips people to work in primary care (Smith M 2003). Adult nurses will need to demonstrate many skills such as problem solving, flexibility, caring, counselling, managing, teaching and interpersonal skills to maintain and improve the quality of patients lives, sometimes in difficult situations (NHS 2010). They may find themselves caring for patients who are the same age as their family, friends or themselves and it is important not to get too personally involved with patients or they may find themselves in discussions regarding ethical issues such as euthanasia where clearly legally it is unlawful but the patient may feel it is in their best interest (Hinchcliff et al 2003). To assist the nursing process, nursing models are used such as the Roper, Logan and Tierneys (2000) 12 activities of daily living, often used in acute settings and the Orems model (1985) which promotes self care, particularly useful in rehabilitation setting. An adult nurse must comply with legislation and obtain consent before any treatment can be given, this may be verbal for routine nursing procedures, or written for more complex ones. Nurses must allow the patient to have autonomy when making decisions regarding care and treatment, respect that decision and always act in the patients best interest (Dimond 2005). The governments agenda and The Human Rights Act (1998) have had significant impact on how adult nursing has evolved to meet peoples needs in an ever changing environment. New jobs are being created to extend the nurses role and get them involved in advanced procedures such as the modern matron, consultant nurses, nurse practitioners and chief nursing officers. The DOH strategy for nursing recommends consultant posts, for example care of older people and pain management taking nursing to another level (cited by Sines, Appleby Frost 2005). According to the NMC (2007) nurses now carry out roles previously carried out by Doctors, for example theatre nurses now perform surgery and community care nurses co-ordinate packages. Changes in the way care is delivered has taken place in accordance with the government directive which laid down a plan to make primary health care accessible to people in the community, at work and at and home (Hinchcliff et al 2003). New opportunities are being created to meet the needs of older people. Older people are living longer and are the largest group of people using health services (Hinchcliff et al 2003). Common health issues for elderly patients are strokes, falls and mental health problems. The NHS Plan (2000a)(cited by Sines et al 2005) promotes independence and encourages them to have support in their home environment rather than residential homes. The government also recognises the need to increase and improve services for young adolescence patients to address their individual needs. For example as child moves into adulthood they may take risks, take part in anti-social behaviour, or they might be vulnerable and frightened (Hinchcliff et al 2003). Nurses have a role to play providing care, treatment and information to help them stay safe and healthy. To conclude adult nurses work with a wide range of patients with many different health issues across numerous health arenas. Nursing has developed considerably since it was first regulated and as patient care is a key government priority todays adult nurses need to have the necessary skills to deliver appropriate care and treatment in an ever changing environment whi Reflective Account The Role of a Rehabilitation Nurse Introduction This reflective account will discuss the role of a rehabilitation nurse in a community hospital. I am going to use the Gibbs (1988) Reflective Cycle which encompasses 6 stages; description, thoughts and feelings, evaluation, analysis, conclusion and action plan which will improve my knowledge of nursing practice and develop my self confidence in relation to caring for others (Siviter 2008). To comply with the NMC Code (2008) and maintain confidentiality all names have been changed. Description On my second week of my placement, I met my associate mentor for the first time. She asked if she could look at my placement documentation and personal development plan. We then discussed the skills and knowledge I want to achieve during the placement which is on a community rehabilitation ward. After our discussion, my mentor suggested to that I spend some time reflecting on the role of a community hospital rehabilitation nurse. Thoughts and Feelings Although my associate mentor did not require a formal piece of reflection, I thought it would be good to document my reflection for my personal development. When she asked me if I would reflect on the roles of nurse in a community hospital, I had already been thinking how different is was from that of a nurse in an acute hospital during my first week so I welcomed the challenge, although I had some reservations about what I could say on a positive note about community nursing. From what I had seen during my first week I was skeptical about the skills of nursing in a community hospital as the pace seemed much slower with less opportunity to practice clinical skills than in my previous acute placement. I was feeling quite disappointed and whilst I appreciate personal health care is an important nursing skill, the majority of my first week I had been left to work with nursing assistants and not invited by my mentor to be watch or carry out any clinical skills, who as a sister spends les s time than staff nurses on hands on nursing and more time on office tasks. This really worried me as I dont want to just cruise through my nursing training, I want to take every opportunity to broaden my knowledge and skills in all aspects of nursing. However I was now feeling more positive as my first impression of my associate mentor was that she was extremely knowledgeable, committed and caring and I hoped I would find her inspirational as I got to know her. Evaluation Being left for a whole week working without any real mentorship was demorilising for me and having no support or guidance the first week resulted in me having a negative view of the rehabilitation ward and community nursing in general (Taylor 2008). However, meeting with my associate mentor for the first time was a good experience. She was interested in me and committed to developing my knowledge and skills and by the end of our conversation had a good understanding of what I wanted to achieve from the placement and was able to challenge my knowledge on the current placement. Taylor (2008) states an inspirational mentor is a necessity to assist student nurses with their learning and development needs and nurture them to become first-class nurses. Understanding the skills and knowledge required by a community hospital rehabilitation nurse will build on my current knowledge which has been in the acute sector and be good for my personal development and future nursing career. Analysis Rehabilitation is an important aspect of any nurses role, but more prevalent for nurses working with the elderly in community hospitals (Brooks 2010). It is the nurses role to promote independence and to empower patients to carry out the activities of daily living adopting new skills and knowledge where necessary. Many different models of nursing are used for rehabilitation purposes, two popular ones are the Roper, Logan and Tierneys (2000) 12 activities of daily living and the Orems (1985) model of self care. Sinclair and Dickinson 1998 define rehabilitation as: A process aiming to restore personal autonomy in those aspects of daily living considered most relevant by patients or service users and their family carers. Many patients find themselves on a rehabilitation ward as a result of a traumatic incident or disease and rehabilitation nurses will work with the patient, family and other member of the multi disciplinary team to support and encourage patients to maximise their independence with physical functioning (White and Johnstone 2000). They are very often the coordinators of a patients care as they are the ones in contact with patients 24 hours a day. Nursing interventions will include supporting and reinforcing the care devised by other health care professionals such as occupational therapists and physiotherapists (Low 2003). They will need to have underpinning knowledge about adjusting to life changes and understanding of anatomy and physiology, health promotion and illness prevention (Chilvers 2002). To provide holistic care for the patient, nurses will be required to apply their knowledge and skills through the nursing process. The first stage of this process is assessment to identify a patients impairments and disability in order to develop care plans. Identifying emotional effects is as important as physical disabilities, as these are likely to have an effect on patients rehabilitation progress (Vohora and Ogi, 2008). These may include anxiety, grief, depression, frustration, and anger (Stroke Association, 2008). Many of the care plans aims will be to increase a patients independence so that they can resume responsib Nursing Discipline Overview and Reflective Account Nursing Discipline Overview and Reflective Account NURSING DISCIPLINE MENTAL HEALTH BRANCH From the 16th Century mental health patients were contained in asylums until mental health hospitals were introduced during the 1950s. Sometimes people who were a disruptive or were only reacting in a normal way to difficulties in their lives were put away. Often patients were excessively medicated and subject to treatment which would be totally unacceptable today such as muffling or being put in a swing chair. In the 1960s, inadequacy and cost resulted in mental health hospitals closing and care moving to general hospitals. Patients who were allowed home at the weekends recovered more quickly and therefore care increasingly moved to the community (Hannigan and Coffey 2003), where most people with mental health problems are cared for today (NHS 2010). Legislation such as the 1959 and subsequent 1983 Mental Health Act, and the Care Community Act (1990) are relative to modern community mental health nursing. In 1999 the Government confirmed mental health was a top priority in the Health Service (Jackson Hill 2006). Since then guidelines such as the Department of Health guidance (2003), the National Service Framework for Mental Health (1997) and the NHS Plan (2000) (cited in Jackson et al 2006) have been introduced to reform and improve services for people with mental health problems and their carers. The Department of Health have also investing significantly in inpatient mental health settings due to issues such as a not enough beds being available, the lack of privacy and dignity of patients and wards not supporting provision of self care (DOH 2009). As a result many new opportunities have been created for mental health nurses over the last few years, for example the modern matron and nurse consultant, and new skills have been dev eloped, such as nurse prescribing and psychosocial interventions (Brimblecombe 2009). Mental health nurses will work with children and adults who suffer with various mental health problems. The primary role being to form therapeutic relationships with patients (sometimes called clients) and their families to help them recover from their illness and promote independent living (NHS 2010). Mental health nursing is varied and complex, for example treatment may include conventional nursing interventions such as administering drugs and injections or it may be to encourage patients to take part in art, drama or occupational therapy. In order to care for people in a fair and anti-discriminatory way and deliver care holistically, mental health nurses need to have good knowledge of the theories of mental health and illness, psychological and biophysical sciences and personality and human behavior (Hannigan et al 2003). One in four people will suffer with a mental health illness at some point during their life and one in twelve will require medical intervention (Mind 2010). Women are 1.5 times more likely to suffer with anxiety and depression whilst men are more likely to suffer from substance abuse and anti social personality disorders. For some patients a mental illness is triggered by a crisis in their life, which they cant cope with, such as depression following the death of a partner (NHS 2009). Some of the more familiar mental health illnesses are anxiety, depression, schizophrenia, eating disorders, drug and alcohol addition, personality disorders and impulse control such as gambling. Some of these illnesses will require treatment in hospital but many will be treated in primary care settings, such as outpatient clinics, schools, community mental health centres, residential facilities, prisons and day treatment centres (Hannigan et al 2003). Care is person-centered and mental health nurses will work within a professional multi-disciplinary team which will include GPs, psychiatrists and social workers and other health care professionals. A mental health nurse will require good interpersonal and communication skills. They will to demonstrate sensitivity when caring for patients, for example there is still some stigma attached to people with mental health problems and it is important for a nurse to help the individual and their families deal with this (NHS 2010). Dealing with the human mind and behavior is not an exact science and sometimes people with mental health problems can be violent, one skill a nurse will be required to have is to recognise building tension and diffuse it when necessary to maintain the patients and others safety (NHS 2010). Sometimes nurses may find themselves faced with awkward situations, and be required to apply ethical principles, such controversial issues which cannot be disclosed and where confidentiality needs to be maintained (NMC 2008). On the other hand if someone is at risk of serious harm, have an infectious disease or criminal activity is involved they may have to inform the appropriate bodies (Hannigan et al 2003). Nurses may find themselves giving care or treatment which is against their beliefs, for example someone addicted to drugs may request a supply even though medically it is not in their best interest or an anorexic patient might protest when food when the nurse tries to care for them (Hannigan et al 2003) . In practice, mental health nurses will come across difficult situations were an assessment of the capacity and ability of a person to consent will be required. People with mental health disorders have the same rights to consent or refuse treatment as those with physical illnesses unless some mental health issue means they are unable to make a decision. Nurses need to support patients to take responsibility for their own well-being and make informed decisions by providing information which is accessible and understandable (Mind 2010). This may mean working with the clients, advocates and carers to ensure it happens. Although giving certain treatments might be in the clients best interest it not enough to impose treatment without consent. In some circumstances a small number of people with mental health problems will be detained under the Mental Health Act (1983) (Hinchcliff et al 2003). To conclude mental health care has developed considerably over the last few years. Mental health nursing is not an exact science but is varied and complex and is about building therapeutic relationships with people and understanding and reacting appropriately to individual circumstances and needs to promote recovery and maximise life potential. NURSING DISCIPLINE LEARNING DISABILITIES BRANCH People with learning disabilities have been treated as second class citizens for many years, once being seen as possessed by evil spirits or being punished by God for a sin they may have committed. In the 19th century they were removed from their families and lived in purpose built institutions, treated as sick and in need of treatment (Brown Benson 1995). During the 1970s care moved to the community (Brigden Todd 1993) where it largely remains today. Approximately 1.5 million people have a learning disability, the majority of which live at home with their families or in community care settings (Mencap 2009). Relatively few live by themselves or with a partner (Emerson, Davies, Spencer, Malam 2005). Turnbull and Chapman (2010) describe a learning disability as being a lifelong condition, which may be genetic or environmental and vary in degree of impairment. Sowney (2006) suggests all learning disabilities have common features including impaired intelligence and social functioning which has a lasting effect on development. According to Mencap (2009) people with learning disabilities live an average of 50-55 years and sometimes up to 70 years old. A learning disability nurse can therefore expect to nurse a range of patients from birth to the elderly and will need to demonstrate a patient centred approach and work in partnership with the patient to help them meet their health, social, emotional, developmental and behavioral needs ( NHS 2009). Although a learning disability is not an indication of a physical disability or ill health, people with learning disabilities generally have more complicated problems and require more nursing interventions than the general population. In the young person some of the more common problems include respiratory problems, epilepsy, sensory and motor impairments, hypertension, thyroid disease and cancer and in elderly adults common problems include loss of hearing, vision and mobility, heart conditions, diabetes, fractures and osteoporosis (Davis 2008). Generic issues include communication difficulties, conditions relating to specific syndromes, challenging behavior and delayed development (University of Nottingham 2010). A learning disability nurse needs the skills to work within both simple and complex health areas. Communication is a vital skill for the learning disability nurse, hospitalisation for a patient with a learning disability can be very distressing and it is important to build therapeutic relationships based on trust and understanding. In the past access to healthcare services for patients with learning disabilities has sometimes unintentionally been denied. A learning disability nurse can help to overcome these prejudices by ensuring people with learning disabilities are not discriminated against and have the same opportunities as the rest of the population (Brittle 2004). People with learning disabilities are the most vulnerable and socially excluded in our society (DOH 2001). A learning disability nurse works in partnership with both the patient and family carers to provide healthcare, and should recognise each persons uniqueness, individuality and differing abilities. The learning disabilities nurses main aims will be to support the well-being and social inclusion of people with learning disabilities, their rights, choices and independence by improving or maintaining their physical and mental health so they can pursue a fulfilling life whatever their ability (DOH 2009). For example teaching someone the skills needed to find work can help them lead an independent life with equal opportunities (NHS 2009). Many complex issues working with patients with learning disabilities relate to ethical aspects of care, and may be related to an individuals rights and welfare, public welfare or inequality. For example a learning disability nurse may need to assess the capacity and ability of a person to consent to treatment (Hinchcliff, Norman Schober 2003). Every effort should be made to provide information in a format the patient can understand, which might be in the form of pictures, alternative communication methods, using short sentences, repeating explanations and giving them time to make a decision (Brittle 2004). Previous experience may mean a person with a learning disability has not been given the opportunity to make their own choice regarding their individual treatment and care (Turnbull et al 2010) and involving family, friends or an advocate, where possible may help them understand the care and treatment offered to enable them to make their own decision (DOH 2001). In some situations people with learning disabilities may have the capacity to consent to straightforward nursing activities but may lack capacity to consent to more complex procedures (DOH 2001). Other ethical issues may involve the family or carer, for example, a person with learning disabilities may receive some benefits which they may wish to have control over and decide how it is spent. The carer on the other hand may see it as part of the household income and wish to control of it. Or maybe the parents or carers, due to ill health are unable to continue with full time care of a person with learning disabilities in their own home. Nurses will require good negotiation skills to support individuals and carers through dilemmas such whilst working within ethical guidelines, with the person being supported remaining the central focus (Thomas Woods 2003). Other ethical issues might involve psychosocial and lifestyle issues such as overeating or drug abuse which might raise concerns about control and freedom of choice (Davis 2008). Opportunities for learning disabilities nurses exist in both hospital environments and the community. They will specialise in many areas which might include education, sensory disability or the management of services (NHS 2009). They will work within the multi-disciplinary team of their preferred environment, for example a learning difficulty liaison nurse will work with other staff, patients and carers to develop therapeutic relationships and ensure people with learning disabilities have a positive healthcare experience (Brittle 2004). To conclude people with learning disabilities have very similar health issues to that of the general population. However it is important that the learning disabilities nurse exercises a person centered approach, develops a therapeutic relationship and understands a person with learning disabilities personal needs in order to support their wellbeing and promote social inclusion, rights, choices and independence to enable them to enjoy the same health care rights as everyone else. NURSING DISCIPLINE CHILDRENS BRANCH The Childrens branch of nursing is relatively new, in 1959 The Minster of Heath first recommended that children have the right to be nursed by specially trained, qualified staff who understood childrens individual needs but it wasnt until 1988 dedicated training courses were set up to provide nurses with the specific skills and knowledge to nurse children whose physical, physiological and social needs are different to that of adults (Hubbard Trig 2000). Sick childrens rights have only recently been acknowledged despite children making up 25% of the population. But now many reports and policies are aimed at improving childrens services and recent statute law has given children increased rights (Hubbard et al 2000).The Childrens Act (1989 2004) highlights their rights; Every Child Matters endorses working in partnership with other organisations to ensure children are safeguarded and receive the best care available and The National Service Framework (NSF) 2004) outlines a vision to provide a high quality child centred care for both children and their parents (Chambers Licence 2005). These policies give direction today and will shape the future of childrens nursing. Nurses need to understand how they apply and what implications there might be when caring for children. For example, one of the most common reasons for children being admitted to hospital is due to injury from accidents, however if the injuries cannot be explained and phys ical or mental child abuse is suspected, the nurse will have an ethical duty to work with other agencies and professionals such as the Child Protection Services (Hubbard et al 2000). Childrens nurses work with children from birth up to 18 years old in many settings from special baby care units to adolescent services (Chambers et al 2005). In order to provide care in a fair and anti-discriminatory way they need to understand the effect age and development has on a childs health and how the delivery of treatment and care will need to be modified accordingly. This will differ considerably from a newborn baby to an adolescent. For example when assessing medication the weight and development of a child, will need to be taken into consideration as well as which drugs come in a form which can be easily administered. Appropriate care plans will need developing and updating for evaluation and referrals made as necessary for Doctors to review (Robertson South 2006). The age and development of a child will influence ability to cooperate with procedures; a young child may become bored, tired or hungry and their capability to concentrate may be limited and procedures may the refore take more than one attempt (Robertson et al). The DOH (2006) promotes optimal care for young people who have illnesses which previously wound have been fatal in childhood but are now surviving. Childrens nurses work in both hospital and primary care settings such as schools, GPs surgeries and in the community. Childrens nurses specialise in many areas, a few examples are; intensive care, child protection, cancer, diabetes, pediatric emergencies, infections, neonatal problems, burns and plastics, respiratory, cardiac or skin disorders (Robertson et al). Childrens nursing is very much centred on the family (NMC 2008). Nurses should provide a safe, secure and comfortable environment and form good relationships with both the child and their family (Hinchliff, Schober Norman 2003) and support both children and their families to make informed decisions regarding treatment and care options (Chambers et al 2005). Hubbard and Trig (2000) declare the family is central to a childs wellbeing, and whilst respecting and promoting the rights of a child, should also be sensitive to the needs and views of the parents wherever possible during the treatment and care of children. This may sometimes result in conflicting situations and the NMC (2008) imply the importance of understanding the personal, socio-economic and cultural influences surrounding a childs welfare. A nursing model often used to assist the nursing process is the Casey Model of nursing which focuses on working in partnership with both children and their families (Smith 1995). Lansdown, Waterston and Baum (1996) suggest childrens nurses should avoid jargon, use age appropriate language and in a child friendly way give children information they need in order for them to make informed decisions. Hubbard and Trig (2000) agree and suggest that play is used to communicate with a sick child, with the aid of toys, diagrams, picture books, photos and videos applicable to the childs age and cognitive levels to clarify images and gain trust and understanding. For example in order to alleviate fears for a child who has a needle phobia, the injection technique could be demonstrated with the aid of an orange. Consent is an area where conflict may arise; English common law is vague about the age of consent to medical treatment (Alderson 1990). According to Dimond (2005) Children under16 can give valid consent to treatment if they are considered to be Gillick competent. If they refuse to give consent, parents may give consent against the childs wishes, if the benefits outweigh the risks, for example a child who is suffering with cancer, refuses chemotherapy (Chambers et al 2005). Generally consent for young children is given by the family, but parents might have difficulty giving consent for someone other than themselves. In line with the Childrens 1989 Act, childrens nurses should ensure children are not cohersed into giving or refusing consent and their views should be taken account of where possible following the Fraser guidelines in respect of consent and confidentiality (Dimond 2005). Under the family reform Act of 1969 children over the age of 16 can give or refuse consent, unless the y lack capacity, for example in emergency situations (Dimond 2005). Reducing costs for the government is key and one of their main priorities is to increase primary care for children in their own homes and reduce hospital admissions. In addition it is believed that care in the home is better for both children and their families, primary care was first recommended in the Platt Report (1958) (Hubbard et al 2000). Increasingly children are being cared at home by their parents supported by the community childrens nurse (NMC 2008) whose role is to provide guidance, care and to teach parents the skills necessary to provide care for their child, for instance administration nutritional requirements via a nasogastric tube (Hubbard et al). NURSING DISCIPLINE ADULT BRANCH Prior to the influences of Florence Nightingale, hospitals were often unclean and contaminated by infection and nurses were seen as the ones to do the Doctors dirty work. Nursing schools were set up in the 1880s, although it wasnt until the 1950s that the nursing profession was governed by the regulation body, UKCC. Today nurses are accountable to the NMC (2008) and must work within the code of conduct, demonstrating that they are able to deliver, manage and develop an excellent standard of evidence based nursing care (Abel-Smith 1960)(NMC 2008). Adult nurses primarily nurse sick and injured adults back to health and have a prominent role in the provision of health care, whilst working closely with other professionals, patients and their families (NHS 2010). Traditionally nursing was task oriented and patient care focused on specific illnesses and conditions. Today nursing is much more patient centred. An adult nurse will provide holistic care to number of patients 18 years and above at any one time to meet their physical, psychological, social and spiritual needs, using the nursing process which will include assessing, planning, implementing and evaluating the care delivered (NMC 2008). Adult nurses care for adult patients with a wide range of acute and long term illnesses and are involved in many different health arenas such as health promotion and disease prevention or they may specialise in specific diseases or disorders, such as diabetes, respiratory problems or cancer care. Others may specialise in accident and emergency, practice nursing or care of the elderly (NHS 2010). Although purposely trained to nurse adults, adult nurses will almost certainly be required to care and treat other groups of patients such as children, people with learning difficulties and patients with mental health issues, for example if they present in an accident and emergency unit, or are admitted to a ward with diabetes issues (Hinchcliff, Norman Schober 2003). Adult nurses will work within a multi professional team to deliver care to patients, which will include other health professionals such as doctors, pharmacists, healthcare assistants, physiotherapists, occupational therapists and radiographers (NHS 2010). Adult nurses work in a range of settings which can be hospital based or in the community where more and more health care is being delivered such as GP surgeries, clinics, occupational health services, schools, nursing and residential homes and voluntary organisations such as hospices. The government is driving health care towards a primary health care led service within which nurses roles are expanding and developing (DOH 2010). Opportunities are also available in the armed forces, prisons, and leisure, eg cruise ships (NHS 2010). Adult nurses all cover the same programme even though their work destinations differ considerably and it has been suggested that it is time to consider a new branch of nursing that equips people to work in primary care (Smith M 2003). Adult nurses will need to demonstrate many skills such as problem solving, flexibility, caring, counselling, managing, teaching and interpersonal skills to maintain and improve the quality of patients lives, sometimes in difficult situations (NHS 2010). They may find themselves caring for patients who are the same age as their family, friends or themselves and it is important not to get too personally involved with patients or they may find themselves in discussions regarding ethical issues such as euthanasia where clearly legally it is unlawful but the patient may feel it is in their best interest (Hinchcliff et al 2003). To assist the nursing process, nursing models are used such as the Roper, Logan and Tierneys (2000) 12 activities of daily living, often used in acute settings and the Orems model (1985) which promotes self care, particularly useful in rehabilitation setting. An adult nurse must comply with legislation and obtain consent before any treatment can be given, this may be verbal for routine nursing procedures, or written for more complex ones. Nurses must allow the patient to have autonomy when making decisions regarding care and treatment, respect that decision and always act in the patients best interest (Dimond 2005). The governments agenda and The Human Rights Act (1998) have had significant impact on how adult nursing has evolved to meet peoples needs in an ever changing environment. New jobs are being created to extend the nurses role and get them involved in advanced procedures such as the modern matron, consultant nurses, nurse practitioners and chief nursing officers. The DOH strategy for nursing recommends consultant posts, for example care of older people and pain management taking nursing to another level (cited by Sines, Appleby Frost 2005). According to the NMC (2007) nurses now carry out roles previously carried out by Doctors, for example theatre nurses now perform surgery and community care nurses co-ordinate packages. Changes in the way care is delivered has taken place in accordance with the government directive which laid down a plan to make primary health care accessible to people in the community, at work and at and home (Hinchcliff et al 2003). New opportunities are being created to meet the needs of older people. Older people are living longer and are the largest group of people using health services (Hinchcliff et al 2003). Common health issues for elderly patients are strokes, falls and mental health problems. The NHS Plan (2000a)(cited by Sines et al 2005) promotes independence and encourages them to have support in their home environment rather than residential homes. The government also recognises the need to increase and improve services for young adolescence patients to address their individual needs. For example as child moves into adulthood they may take risks, take part in anti-social behaviour, or they might be vulnerable and frightened (Hinchcliff et al 2003). Nurses have a role to play providing care, treatment and information to help them stay safe and healthy. To conclude adult nurses work with a wide range of patients with many different health issues across numerous health arenas. Nursing has developed considerably since it was first regulated and as patient care is a key government priority todays adult nurses need to have the necessary skills to deliver appropriate care and treatment in an ever changing environment whi Reflective Account The Role of a Rehabilitation Nurse Introduction This reflective account will discuss the role of a rehabilitation nurse in a community hospital. I am going to use the Gibbs (1988) Reflective Cycle which encompasses 6 stages; description, thoughts and feelings, evaluation, analysis, conclusion and action plan which will improve my knowledge of nursing practice and develop my self confidence in relation to caring for others (Siviter 2008). To comply with the NMC Code (2008) and maintain confidentiality all names have been changed. Description On my second week of my placement, I met my associate mentor for the first time. She asked if she could look at my placement documentation and personal development plan. We then discussed the skills and knowledge I want to achieve during the placement which is on a community rehabilitation ward. After our discussion, my mentor suggested to that I spend some time reflecting on the role of a community hospital rehabilitation nurse. Thoughts and Feelings Although my associate mentor did not require a formal piece of reflection, I thought it would be good to document my reflection for my personal development. When she asked me if I would reflect on the roles of nurse in a community hospital, I had already been thinking how different is was from that of a nurse in an acute hospital during my first week so I welcomed the challenge, although I had some reservations about what I could say on a positive note about community nursing. From what I had seen during my first week I was skeptical about the skills of nursing in a community hospital as the pace seemed much slower with less opportunity to practice clinical skills than in my previous acute placement. I was feeling quite disappointed and whilst I appreciate personal health care is an important nursing skill, the majority of my first week I had been left to work with nursing assistants and not invited by my mentor to be watch or carry out any clinical skills, who as a sister spends les s time than staff nurses on hands on nursing and more time on office tasks. This really worried me as I dont want to just cruise through my nursing training, I want to take every opportunity to broaden my knowledge and skills in all aspects of nursing. However I was now feeling more positive as my first impression of my associate mentor was that she was extremely knowledgeable, committed and caring and I hoped I would find her inspirational as I got to know her. Evaluation Being left for a whole week working without any real mentorship was demorilising for me and having no support or guidance the first week resulted in me having a negative view of the rehabilitation ward and community nursing in general (Taylor 2008). However, meeting with my associate mentor for the first time was a good experience. She was interested in me and committed to developing my knowledge and skills and by the end of our conversation had a good understanding of what I wanted to achieve from the placement and was able to challenge my knowledge on the current placement. Taylor (2008) states an inspirational mentor is a necessity to assist student nurses with their learning and development needs and nurture them to become first-class nurses. Understanding the skills and knowledge required by a community hospital rehabilitation nurse will build on my current knowledge which has been in the acute sector and be good for my personal development and future nursing career. Analysis Rehabilitation is an important aspect of any nurses role, but more prevalent for nurses working with the elderly in community hospitals (Brooks 2010). It is the nurses role to promote independence and to empower patients to carry out the activities of daily living adopting new skills and knowledge where necessary. Many different models of nursing are used for rehabilitation purposes, two popular ones are the Roper, Logan and Tierneys (2000) 12 activities of daily living and the Orems (1985) model of self care. Sinclair and Dickinson 1998 define rehabilitation as: A process aiming to restore personal autonomy in those aspects of daily living considered most relevant by patients or service users and their family carers. Many patients find themselves on a rehabilitation ward as a result of a traumatic incident or disease and rehabilitation nurses will work with the patient, family and other member of the multi disciplinary team to support and encourage patients to maximise their independence with physical functioning (White and Johnstone 2000). They are very often the coordinators of a patients care as they are the ones in contact with patients 24 hours a day. Nursing interventions will include supporting and reinforcing the care devised by other health care professionals such as occupational therapists and physiotherapists (Low 2003). They will need to have underpinning knowledge about adjusting to life changes and understanding of anatomy and physiology, health promotion and illness prevention (Chilvers 2002). To provide holistic care for the patient, nurses will be required to apply their knowledge and skills through the nursing process. The first stage of this process is assessment to identify a patients impairments and disability in order to develop care plans. Identifying emotional effects is as important as physical disabilities, as these are likely to have an effect on patients rehabilitation progress (Vohora and Ogi, 2008). These may include anxiety, grief, depression, frustration, and anger (Stroke Association, 2008). Many of the care plans aims will be to increase a patients independence so that they can resume responsib