Asia is Orientalized essays

Asia is Orientalized essays Images of different kinds of Asian Culture are all around us in the United States. They can be found in restaurants, in newspapers, in magazines, on the internet, and on television. All of these images reflect a typical Americans view of all people that live in Asia. The most common images that we see in the media are not an accurate reflection of what modern-day Asia really is. Many of the images make us perceive Asia as backward, traditional, and inferior to us. This is how Asia is orietalized. These images circulated by Americans serve the purpose of making us feel that we are superior to Asian culture and lifestyle. The first example of orientalism that I found is a picture of a small, male child. He is dressed in a long gown that is decorated in a traditional Chinese design and wearing a hat. Refer to Appendix A. I found this picture on the internet on a web page designed for children to inform them of the Chinese New Year. This picture gives the perception that all Children in China dress this way. The boy in this picture looks very simple and plain. In no way does this icon make China look like a very industrialized and technologically advanced country. In this example an American selected this image to portray Asia as an uncivilized nation that is not as advanced as America is. This image is very misleading. Since this web site is a child based web site, this is a prime example of how orientalism is started early in our country. Little children in America see these images and assume this is how people in China dress on a daily basis. They see these images and that imply that Asia is not a country as good as ours or that it is some exotic place, and they believe it. The second illustration that I came across is a photograph taken of two young female girls. They are Japanese. Both are dressed in very traditional Japanese clothing (robes, sandals, head pieces). They have their hair done up o...

Utilizing Pumpkins as a “Reverse” Trap Crop Essay Example

Utilizing Pumpkins as a â€Å"Reverse† Trap Crop Essay Example Utilizing Pumpkins as a â€Å"Reverse† Trap Crop Essay Utilizing Pumpkins as a â€Å"Reverse† Trap Crop Essay In the world of agriculture, trap crops are normally used to lure pests away from a commercial crop by presenting the pest with a more attractive alternative. But when conducting research to develop new seed traits that provide better yield, drought resistance, or even insect resistance, trap crops can be used to test the performance of a new trait.The western corn rootworm beetle (Diabrotica virgifera virgifera) causes billions of dollars in damage to corn crops throughout the United States each year. Recent seed research has helped develop new corn varieties to combat this problem. These new varieties of corn have a protein (Bt protein) that causes stomach distress in adult western corn rootworm beetles that result in death. Thus, the pest resistance is literally bred into the seed, eliminating the need for harmful pesticides. This type of corn is considered to be rootworm resistant.Normally, in order to be able to â€Å"test† the performance of a specific rootworm resistant corn variety, a test plot has to be infested with western corn rootworm eggs manually. This tends to be costly and very labor intensive. The infested eggs then develop into larva, which feed on underground roots. Adult rootworms feed on the above ground tissue of the corn plant. Both the roots and the above ground tissue contain the Bt protein. The corn plant is then â€Å"harvested† prior to the pollination period in a process called a â€Å"root dig†.During a ‘root dig† the corn plant is cut off at approximately two feet above the ground, the roots are dug up and rinsed with a high power stream of water to expose the roots which are then rated for damage by the corn rootworm larva. Based on the data collected during the â€Å"root dig†, researchers are able to evaluate the effectiveness of the resistance that is bred into that variety of corn. Root dig washing process is shown in picture on the left. Diagram of corn root damage by corn rootworm be etles is shown in picture on the right.HYPOTHESIS: What if one could utilize a â€Å"trap crop† to entice the adult western corn rootworm beetle to a test plot, allowing the adults to feed and eventually lay their eggs? I predict that by adding pumpkins (independent variable) as a trap crop in rootworm resistant corn will allow for a greater number of eggs (dependent variable) to be deposited in the test plot naturally versus the rootworm resistant corn without the trap crop, therefore eliminating the need for manual infestation.To test this hypothesis, we selected pumpkins to plant as a trap crop in a one acre square plot containing rootworm resistant corn. This would be the independent variable in this experiment. It is known that the adult western corn rootworm beetle is highly attracted to pumpkin vines and flowers. A second test plot of the same size (same farm) would be planted with the same variety of rootworm resistant corn without the pumpkin crop. The dependent vari able would be the egg counts in both test plots. The control in this experiment would be utilizing acreage on the same farm.Special steps were taken to replicate the exact soil conditions by a pre-planting soil analysis; utilizing the same â€Å"batch† of chemical in herbicide spray applications, and the close proximity to each other to control factors such as precipitation, number of days with full sunshine, humidity, etc. This will aid in controlling the experiment’s internal validity and act as a guide in any subsequent replications of this experiment. Adult western corn rootworm beetles are shown on a pumpkin flower in the picture on the left.Damage by rootworm beetles on a mature pumpkin shown in picture on the right. Pumpkins were planted in the test plot # 2 in the spring of 2012 and were allowed to mature naturally. During flowering, a sizable increase in the adult rootworm beetle was observed in test plot #2. Based on the observable increase in adults, we pred icted that there will also be an increase in the number of eggs in said test plot when compared to the number of eggs in the test plot without trap crop (pumpkins). Soil samples will then be collected and analyzed for egg counts.If it is proven that planting a trap crop increases egg counts naturally, there could be a considerable cost savings in the process of evaluating the effectiveness of desirable traits in corn. This experiment was conducted at an agricultural Ramp;D site in northwestern Indiana during the summer of 2012 in preparation for this task. Egg count data has been received and is currently being evaluated in preparation for the 2013 planting season. In preparation for this experiment, several independent scientific papers were reviewed. Sorghum as a Trap Crop for Nezara viridula L. (Heteroptera: Pentatomidae) in Cotton in the Southern United States†, P. G. Tillman (1); â€Å"Case Study: Trap Crop with Pheromone Traps for Suppressing Euschistus servus (Heteropt era: Pentatomidae) in Cotton†, P. G. Tillman and T. E. Cottrell (2) and â€Å"Trap Cropping to Manage Green Vegetable Bug Zezara viridula (L. ) (Hereroptera: Pentatomidae) in Sweet Corn in New Zealand†, James H. Rea, Stephen D. Warren, Richard Sedcole, Peter J. Cameron, Stuart I. Davis, R. Bruce Chapman (3) were considered for background information.These studies were helpful in explaining the commercial use of trap crops as an effective method of removing pests from cash crops and served as a basis for our unique application of a â€Å"reverse† trap crop in testing the effectiveness of ongoing corn research. Testing methods were similar but our research did not include any type of Pheromone study. Our experiment was based on the premise that by planting pumpkins in the test plot (known to attract western corn rootworm beetle), we could naturally increase the numbers of western corn rootworm beetle eggs in that plot.An increase in the number of naturally occurrin g eggs could result in a significant reduction in our annual research expenses. - KEY WORDS:western corn rootworm beetle (Diabrotica virgifera virgifera), trap crop, rootworm resistant corn. - METHODS and MATERIALS: This experiment was conducted at a seed research and development facility in northwestern Indiana during the 2012 growing season in preparation for RINT Task 3.This method of scientific design was chosen because it is a replication of a similar experiment conducted at a research and development facility in Iowa and has shown viable results. It was designed to compare the viability of planting a trap crop to attract the western corn rootworm beetle to evaluate the performance of corn containing rootworm resistant traits from different areas of the Midwest. The acreage, chemicals, sampling tools and laboratory facilities were readily available. In addition, if the hypothesis can be proven to be true, there is a potential for cost savings in other areas of our research.Inse ct Species: Western corn rootworm beetle (Diabrotica virgifera virgifera). Corn rootworm larvae can destroy significant percentages of corn if left untreated. In the United States, current estimates show that 30 million acres (120,000  km? ) of corn (out of 80 million grown) are infested with corn rootworms and that area is expected to grow over the next 20 years. The USDA estimates that corn rootworms cause $1 billion in lost revenue each year, which includes $800 million in yield loss and $200 million in cost of treatment for corn growers (The Dow Chemical Company). (4)Shown above from left to right, corn plant damage in the field and examples of actual root damage done by western corn rootworm beetles in the center and right picture. Healthy roots are shown as a full root system; damaged roots are short to nonexistent. Sampling Technique: Using a golf course cup cutter, take 4† diameter x 4† deep soil core samples. Collect ten (10) core samples per acre (trial area) . Core samples should be taken at various locations within the test plot. Include samples taken from within the corn rows and between rows. Place core samples in individual gallon bags.Be sure to break up any large clumps and remove stalks and other residue. Making the soil as fine as possible will aid in the washing process. Send individual samples to a laboratory with capabilities to wash eggs and provide egg counts. Taking multiple core samples at various locations throughout the test plot and then analyzing all ten (10) samples separately allows for a broader analysis of the entire test plot. The measuring unit of one (1) pint that was chosen for the final sample allows the lab sufficient soil to run the required tests.Once the samples arrive at the laboratory, each individual sample is mixed with a saturated salt solution. A sample of this mixture is then placed on a special microscope slide (Whitlock Universal or Whitlock McMaster). The saturated salt solution makes the rootwo rm eggs float to the top of the mixture in the slide where they are then counted. Data was collected from each individual sample to obtain egg counts for each test plot. EXPERIMENT: Two, one (1) acre test plots were selected at opposite ends of a ten (10) acre field. Soil type, topography, and precipitation were identical.Each plot was measured at 200 ft. wide by 220’ deep and marked off with flags. This is approximately one (1) square acre. Both fallow (empty ground) test plots were plowed utilzing a chisel plow set at a depth of six (6) inches to turn the soil over and prepare the soil for planting. Both test plots were then planted using a four (4) row custom bulk planter and a rootworm resistant variety of corn. The corn rows were spaced 30† apart. The corn seed within the rows was spaced 6† inches apart. Each test plot had a total of 80 rows of corn. Both test plots were also treated with Glyphosate in a concentration of 1. quarts to 15 gallons of water to ki ll any existing weeds. This amount of Glyphosate solution was enough to cover one (1) test plot. It was replicated twice to cover both test plots in the experiment. Once the rootworm resistant corn had been planted in both test plots, a trap crop of pumpkins was also planted throughout the test plot #2 (independent variable), utilizing a custom two (2) row planter. Pumpkin seeds were planted in between the rows of corn, spaced five (5’) feet apart. A cable winder was used to mark off the five (5’) foot increments needed to plant the pumpkins.A cable winder is used with a custom planter and calibrated to â€Å"click† when it is time to manually drop the seed. Both plots were allowed to grow throughout the summer. Visual observations were made in each plot, on the first Monday of each week between July 1st and September 1st to obtain adult rootworm beetle population counts. Ten observations in multiple locations across the test plots were taken each time. Random p umpkin plants were selected to count the total number of adult rootworm beetles in each observation. After harvest, prior to the first hard frost, soil core samples were taken, following the above mentioned sampling procedure.Core samples were then sent to an outside laboratory for analysis. - RESULTS: An increase in adult rootworm beetles was observed in test plot #2 (with pumpkins) when compared to test plot #1 (without pumpkins) but without soil egg count analysis, this data in inconclusive. Solid data is available once soil samples are analyzed for egg counts (dependent variable). Historically more than ten (10) eggs in a pint sample of soil are considered to be a high amount. In 2012, test plot #1 and #2 both showed an average of approximately two (2) eggs per pint sample.Samples taken at four different test sites in Iowa yielded six (6), zero (0), one (1) and four (4) eggs respectively or an average of 2. 75 eggs per pint sample. All data collected is reflecting little to no m easurable increase in the total number of western corn rootworm eggs that are occurring naturally when using a trap crop. Egg Count Core Sample Data for Test Plot #1 and Test Plot #2 Test Plot #1|   |   | Test Plot #2|   | |   |   |   |   | Core Sample #| Egg Count #|   | Core Sample #| Egg Count #| 1| 0|   | 1| 0| 2| 1|   | 2| 3| 3| 0|   | 3| 2| 4| 1|   | 4| 2| 5| 4|   | 5| 3| 6| 3|   | 6| 2| | 2|   | 7| 1| 8| 2|   | 8| 0| 9| 1|   | 9| 2| 10| 0|   | 10| 2| Ave # of Eggs| 1. 4|   | Ave # of Eggs| 1. 7| Egg Counts in Test Plot #1 Compared to Test Plot #2 Number of Eggs/Pint Sample Number of Samples/ One (1) Acre Test Plot - CONCLUSION: Based on the data that was collected, there did not seem to be a significant increase in the number of western corn rootworm eggs occurring naturally in test plot #2 when compared to test plot #1, even though there was an observable increase in adult western corn rootworm beetles in test plot #2.Where test plot #2 contained the trap crop (independent variable) and test plot #1 that did not contain a trap crop (dependant variable) in a single ten (10) acre test strip (constant variable). After carefully analyzing the data that was collected during this experiment, I have concluded that the introduction of a trap crop (pumpkins) to attract adult western rootworm beetles in rootworm resistant corn does not significantly increase naturally occurring corn rootworm beetle eggs. This data disproves my hypothesis that it would significantly increase the number of naturally occurring eggs.No cost savings can be associated with this experiment and conventional infestation methods are just as effective as this experimental method. DESIGN AND REPLICATION: The experimental design to test this hypothesis was constructed with ease of replication in mind. It utilizes simple techniques and materials that are readily available at most seed research and development sites. If the design is poor or if proper samp ling procedures are not followed then data in the experiment can be skewed, resulting in unreliable data.Based on potential cost savings in research, unreliable data can be an expensive mistake. In addition, if the design is well done, an increase of reliable data is shown time and time again with the same results. Replication is so important because it gives validity to the experiment’s results. As the same data shows the same results and the same conclusions over multiple replications, that data can become accepted as scientific fact. REFERENCES: (1) ars. usda. gov/sp2UserFiles/person/5648/PDF/ARIS 8-Sorghum as a Trap Crop for SGSB. d Tillman, P. G. 2006. Sorghum as a trap crop for Nezara viridula L. (Heteroptera: Pentatomidae) in cotton in the southern United States. Environmental Entomology. 35(3):771-783. (2) hindawi. com/journals/psyche/aip/401703 Tillman, P. G. , Cottrell, T. E. 2012. Case Study: Trap crop with pheromone traps for suppressing euschistus servus (Heter optera: Pentatomidae) in cotton. Psyche. DOI: 10. 1155/2012/401703. (3) http://onlinelibrary. wiley. com/doi/10. 1046/j. 1461-9563. 2002. 00130. x/full Rea, J.H. , Wratten, S. D. , Sedcole, R. , Cameron, P. J. , Davis, S. I. and Chapman, R. B. (2002), Trap cropping to manage green vegetable bug Nezara virdula (L. ) (Heteroptera: Pentatomidae) in sweet corn in New Zealand. Agricultural and Forest Entomology, 4: 101-107. doi: 10. 1046/j. 1461 (4) http://en. wikipedia. org/wiki/Diabrotica_virgifera; The Dow Chemical Company. Product Safety Assessment (PSA): Herculex RW Rootworm Protection. September 26, 2006. URL: dow. com/productsafety/finder/herculex. htm.

Management Training and Resulting Conflict Management Effectiveness in Dissertation

Management Training and Resulting Conflict Management Effectiveness in Hospitals - Dissertation Example One of such environment is hospital therefore conflict management in healthcare settings is a must. This study explores the effectiveness of conflict management in healthcare settings and presents conflict resolution maps for healthcare practitioners to ensure conflict management practices matches healthcare organisations standards. The study specifically discusses conflict resolution in the light of conflict situations unique to healthcare settings and uses secondary data on conflict resolution training programs suggested and carried out at NHS to make recommendations for healthcare management. Table of Contents ABSTRACT 2 1. INTRODUCTION 5 1.1 Background and Context 6 1.2 Research Question and Objectives 7 1.3 Rationale of the Study 8 1.4 Structure of the Study 9 2.LITERATURE REVIEW 10 2.1 What is Conflict and Conflict Management? 10 2.2 Different Views on Conflict 11 2.3 Types of Conflict 13 2.3.1 Interpersonal Conflict 14 2.4 Conflict Management Process 15 2.5 Conflict Handling S trategies 16 2.6 Conflict Situations in Healthcare Settings 18 2.7 Research Studies on Conflict Management in Healthcare Settings 19 2.8 Research Gap and Conceptual Framework 21 3.RESEARCH METHODOLOGY 23 3.1 Role of the Researcher 23 3.2 Research Design 23 3.3 Data Collection and Analysis 24 3.4 Research Validity and Triangulation 25 3.5 Summary 26 4.FINDINGS 27 4.1 The Patient-Staff Conflict 28 4.2 The Doctor-Doctor Conflict 30 4.3 Conflict among Nurses 30 4.4 The Doctor-Nurse Conflict 31 4.5 Summary 32 5.DISCUSSION 34 6.CONCLUSION 37 6.1 Recommendations 38 References 40 1. INTRODUCTION Conflict is an inevitable part of social life and communication, flexibility and willingness to change are a few ways to handle conflict effectively (Guffey & Almonte, 2009). However, not everyone is good at conflict management and hence without one knowing these strategies it becomes difficult to handle conflict effectively. In organisational context, chances of conflict increases where pressure is high and duties are complex. One of such environment is hospital. Healthcare personnel work under immense pressure and they are performing several responsibilities simultaneously; in addition to this, their duties are linked to a person’s life which even complicates the situation and increases the pressure. Besides tough working conditions there are many other reasons of conflict within organisations. These reasons include differences in goals and values of employee and employer, power differentials, lack of understanding of organisational structure and functions, scarcity of resources, or refutation of one’s self-image. To ensure an organisation remains stable and consistent, conflicts should be handled effectively whenever they arise. Nonetheless, everyone is not good at conflict management and this fact makes it necessary to ensure personnel in organisations know well how to handle conflict and maintain harmony in the workplace. Conflict management has become a maj or subfield of management and organisational behaviour. Conflict among groups in organisations is now an important area for researchers. Though the research shows that there are positive effects of conflict on group identity and development (Jones, 1993; De Dreu, 1997) however negative and destructive conflict can lead to disaster. Due to the negative consequences conflicts can bring to an organisation, it is important to ensure that employees understand conflict management strategies. Including hospitals, the ability to manage internal conflict

Disciplinary Procedures Essay Example | Topics and Well Written Essays - 1500 words

Disciplinary Procedures - Essay Example To begin with, the procedures offer a framework for conducting investigations to establish the key facts regarding the case or grievances forwarded. The employer, therefore, collects the available evidence through series of hearings and disciplinary meetings. Nevertheless, the procedures dictate that facts ought to be established within a reasonable time after a complaint is forwarded. Secondly, the disciplinary procedures allow the employer to inform formally the employee under investigation about the problem. More so, this should be done in writing with attached pieces of evidence for the purpose of record keeping an avoiding inconsistency (Antcliff & Saundry 2009). Thirdly, the procedures aim at incorporating the views of the employee in the entire process of finding a solution. This is enhanced through hearings in which the employee responds to allegations and asks questions to seek clarification by presented evidence. Furthermore, the discipline procedures give employers the bas ic structure of arriving at decisions. Three major decisions can be made founded on the strength of the evidence presented in the employment tribunal. The employer may decide to write warning letters in case of gross misconduct whose extent may have threatened the operations of the organization. The letter should comprise of the mistakes done and recommended improvements. If the tribunal finds it fit to dismiss the employee, the responsible manager should do so within the legal system of termination of employment.

Feeding People versus Saving Nature Essay Example | Topics and Well Written Essays - 500 words

Feeding People versus Saving Nature - Essay Example For instance, humans are always looking forward to comfort which is the case why many inventions were invented from the past and at present time. On the other hand, he may be trying to emphasize that nature should not be sacrificed for the sake of achieving substantial human development because when nature falls; it would be for all humans because it is their life support system (Rolston 249). However, by simply understanding the statement of Rolston, it is clear that he admits there are times when human needs should be the first priority or sometimes the nature as top concern. After all, humans and nature coexist in which their ultimate goal is to move forward to the preservation of life. That is why Rolston acknowledges the importance of sustainable development and environmental protection. Based on the point of view of Rolston, it is clear that humans are just integral components of nature. The fact that we are sourcing all our needs from nature cannot deny the truth that we can d o nothing apart from it. In other words, we rely on nature all our needs. Now, on the issue whether we should not feed people first but save the nature instead, the argument may be based on identifying commendable values in human life. Finding which is more valuable between nature and the human life is, in fact, a very interesting topic to discuss. Â  Nature cannot be more valuable than the human life and vice versa, but it is clear that human life is an integral component of nature because it sources its needs from it. Â  

Midwife Views on Amniotomy to Speed Up Labour

Midwife Views on Amniotomy to Speed Up Labour Abstract This dissertation considers the views of midwives on the procedure of amniotomy with the specific relevance of its use in speeding up labour. The available literature is considered in detail to try to establish the current evidence base for the assumption that amniotomy does speed up labour and it finds that the evidence is poor, both in terms of number and quality of the papers available. One of the biggest problems appears to be that it is very difficult to carry out a study that isolates the specific and unique effects of amniotomy on the speed of labour from all of the other potential confounding factors that can influence the eventual outcome. There appears to be a gap in the literature in specific regard to the midwife’s views on the subject. A proposal is therefore made for a pilot project to evaluate the midwife’s views by the means of a qualitative survey using the semi-structured interview technique. The rationale for such a study structure is discussed in detail. Acknowledgements (Client to personalise) Contents page Abstract Acknowledgements Contents Purpose of the study Literature Review What is already known? Amniotomy and induction of labour Complications associated with amniotomy What are the perceived benefits of amniotomy? Does amniotomy speed up delivery? Midwife’s views on the subject Methodology Search history. Classification of evidence levels Research question or hypothesis Study design Sample Data Collection Rigour Ethical Issues Budget Timetable. Dissemination of findings Proposed semi-structured interview questions References Purpose of the study: The research question. The procedure of amniotomy was first described in the 18th century. Despite having therefore been in constant use for over 200 years, its effect on the induction and the course of labour still remains a matter of dispute and conflicting evidence. (Greenwood C et al. 2003) Amniotomy is generally held to be the artificial rupture of intact membranes with a view to facilitating, stimulating or inducing labour. (ODriscoll K et al. 1986). This dissertation has purposely started with a definition of amniotomy that is over 20 years old. During the course of the exploration of the evidence base surrounding the procedure of amniotomy we shall consider whether this definition is still held to be true in current practice. The procedure is typically done with gloved hands and the healthcare professional ruptures the amniotic sac with an amnihook (or similar instrument) between contractions, as this reduces the risk of cord prolapse because the amniotic fluid is under less pressure. (Kirby R S 2004). The hand is kept in the vagina allowing the fluid to drain in a controlled manner and the nature (colour consistency and amount) of the fluid is noted. It would be considered good practice to assess the foetal heart both immediately prior to the procedure and again immediately after it to check for foetal distress due to cord compression. Many authorities advocate performing the procedure in the semi-sitting position in order to minimise the effects of aortocaval compression and thereby optimise the blood supply to the uterus. (Burnett A F 2000) Indications for amniotomy still include the â€Å"promotion of labour†. This can be taken to mean both the induction of labour and the speeding up of labour (Cummingham F G et al. 2005) however, hard evidence for either is difficult to find for reasons that we shall discuss. Literature Review What is already known? For ease of presentation, this section will be divided up into various sub-headings considering the different aspects of amniotomy as a procedure Amniotomy and induction of labour Amniotomy is frequently cited as a means of inducing labour particularly if the cervix is considered to be â€Å"ripe†. Unfortunately amniotomy alone is an unpredictable inducer of labour with the possibility of long intervals between amniotomy and the onset of significant contractions. The Mouldin trial considered a direct prospective comparison of amniotomy alone and amniotomy with an associated oxytocin infusion. The results showed a statistically significant difference in the two groups with the latter group having a shorter induction to delivery interval. (Mouldin P G et al. 1996) There is a huge variation in the literature concerning the ability of amniotomy to hasten the onset of labour. Some early papers suggested that the effect was only minimal (Caldeyro-Barcia R 1975) whereas the majority of others suggest a much more obvious effect. As with other areas of investigation, difficulty arises in trying to separate out the effects of the amniotomy from the myriad of other variable factors that are present when a woman goes into labour. Friedman questions whether amniotomy hastens labour at all since many of the prospective trials have considered the case when amniotomy is done in early labour when the contractions would naturally begin to accelerate in any event (Friedman, E.A 1998) Complications associated with amniotomy This is a particularly contentious area with different authorities citing not only different associations of complications but significantly differing incidences as well. If we consider the Sheiner paper (Sheiner E et al. 2000) we can show a number of significant findings when early amniotomy was compared with both premature rupture of membranes (PROM) and oxytocin induction of labour. The significant differences found between the groups included a higher rate of caesarean section with 26.7% in the amniotomy group and 11.6% in the PROM and 16.9% in the oxytocin groups. It should be noted however, the authors performed a number of subsidiary analyses and showed that when the incidence of a previous caesarean section was controlled for then the amniotomy group had a similar incidence of caesarean section to the other groups. This would imply that amniotomy is more likely to be considered an option when a previous caesarean section has occurred. The authors make no comment as to why the y believe this might be. A much larger and more rigorous survey (Segal D et al. 2000) reviewed the outcomes of nearly 2000 cases of early amniotomy performed in association with a poor cervical score (Bishop scores of Amniotomy has been shown to increase the incidence of abnormalities in the patterns of foetal heart rate.( Goffinct F et al. 1997) Again this effect is hard to isolate convincingly as the risk may be consistently underestimated because women who do not have amniotomy are more likely to be given oxytocin which also increases the incidence of abnormal foetal heart rate patterns. (Rouse D J et al. 1999) Amniotomy may also be associated with an increase in infection rates. (Ventura S J et al. 1997) What are the perceived benefits of amniotomy? A number of authoritative texts state that routine early amniotomy can shorten labour by a variable amount, usually one or two hours (viz. Vincent M (2005) and Sheiner E, et al. (2000) and Albers L L et al. (1996)), Others suggest that it may reduce the use of oxytocics and the number of women who report the most intense degrees of pain during labour. (Klaus M H (1998) This picture is however, clouded by the fact that modern practice with its use of oxytocin (which makes labour more painful) and analgesia, including the epidural, which obviously reduces the overall pain experience, makes the statistical analysis of the relationship between amniotomy and pain very difficult Amniotomy has been cited as being indicated when there is a need for closer monitoring of the foetus allowing the direct attachment of scalp electrodes and incidentally evaluating whether the baby has passed meconium into the amniotic fluid. (Thornton J G et al. 1994). The presence of meconium is a significant clinical sign and is associated with an increased foetal morbidity and mortality (Ramin K D et al. 1996) Although its observation is enhanced by amniotomy, it is only of peripheral relevance to our considerations in this dissertation and therefore will not be considered further. Other authorities observe that this is not a good indication for amniotomy as the release of the amniotic fluid may expose the umbilical cord to increased compression during contractions. (Klaus M H 1998) Amniotomy also allows the positioning of an intrauterine pressure catheter in order to measure uterine contractions. Does amniotomy speed up delivery? This is an issue that has appeared in many older papers. A significant trial of 20 years ago (Seitchik J et al. 1985) concluded that the procedure of amniotomy appeared to enhance the cervical dilatation rate in patients with already well-dilated cervices and that are already dilating at a satisfactory rate and it conversely slows dilatation in some other patients, particularly those whose cervices are less dilated. This finding is cited in a number of contemporary text books. The difficulty is that the findings in this paper are only evidence base level 3. Many other papers refer to the trophic effects of amniotomy but none have had the discriminatory power to isolate the effects of amniotomy from the multitude of other variables which are inevitably present during the process of labour. The paper by Sherman (Sherman D J et al. 2002) primarily considers the patterns of foetal heart rate during the induction of labour and, in doing so, provides circumstantial evidence that amniotomy increases the speed of labour. Amniotomy was however, only performed in this trial if the cervix had dilated to more than 3 cms. without an associated spontaneous rupture of membranes. Oxytocin was also used in a significant number of cases thereby masking any effect which amniotomy alone might have. A different view is expressed by Pozaic who considered the case proven and puts forward the view that amniotomy should only be reserved for cases where there is abnormally slow progress of labour and then amniotomy should be performed to speed up the process. Again this is little more than level 4 evidence as the author does not cite what her evidence base is for making such an assumption. (Pozaic S 2004) To present a balanced argument one can cite the work of Steer (actually written when he was a house officer but then went on to become a professor of obstetrics), who published a controlled study of two matched groups of patients, all of whom had oxytocin induced labour. One group had their membranes ruptured and the others were allowed to rupture spontaneously. Steer found that the duration of labour was shorter in all patients who had ruptured membranes although, for reasons that were not explained, the uterine contractions were found to be at their greatest when the membranes were intact. In short, there was no evidence that amniotomy increased the speed of labour and there was evidence to suggest that the uterine activity was greatest in the group with membranes intact until well into labour. (Steer P J et al. 1975) Midwife’s views on the subject In terms of determining midwife’s views on the subject, there appears to be an almost complete gap in the literature on the subject. Extensive searching reveals no definitive authoritative texts on the subject and a very few that have sought the patient’s view on the issue. The Lavender paper (Lavender T et al. 1999) considered the issue only peripherally as part of a larger exploration of patient’s views and concluded that women who had long and protracted labours welcomed virtually any type of intervention that was perceived to reduce the time in labour and this included amniotomy. Clearly it is likely that this was perceived by the women as a â€Å"labour shortening procedure† and it is very unlikely that any discussion of informed evidence base would have taken place prior to its use. These issues are explored further in the more recent and larger qualitative investigation by Hodnett who considered the experiences and evaluations of childbirth in terms of overall pain experience. The paper is long and involved and, in the main, peripheral to our considerations here other then the fact that one of the main factors that the women cited as significant in terms of their positive appreciation of the process of labour was their perception of the attitude and behaviour of the midwives and this was rated as being more significant than the actual procedures that they employed. This finding appeared to override other factors including such variables as â€Å"age, socioeconomic status, ethnicity, childbirth preparation, the physical birth environment, pain, immobility, medical interventions, and continuity of care†. (Hodnett, E D. 2002). One can only therefore speculate as to whether this finding vicariously influences the decisions made by the midwives in terms of tr ying to provide a complete service to their patients. Another paper which is peripherally relevant to this issue is the well written and thought-provoking essay and investigation by Sookhoo (Sookhoo M L et al. 2002) which considered the wider issues of how midwives learn their clinical skills and the mechanisms by which they acquire their practical knowledge. The authors devote a substantial proportion of their paper to how this knowledge actually influences their professional judgements in both the assessment and the progress of the course of labour. This particular paper is worthy of examination on several levels, not only for its actual content and results, but because it is structured on a grounded theory premise and conducts a number of semi-structured interviews and then attempts to construct theories from the results. It is very significant that a major finding in this paper was that the authors hypothesise that a major determinant of clinical activity for a midwife is the way in which she conceptualises uncertainty (which clearly is a major element in the management of labour). It is also significant that they found that one of the major techniques for avoiding uncertainty was to rely upon conventions and put trust in specific procedures â€Å"almost as a ritual†. The authors suggest that the experienced midwife tends to draw upon a much wider range of evidence and experience which has been accumulated through their clinical practice than the novice midwife who tends to rely on guidelines and strategies which they t end to see as predictive and protective. This has great relevance to the practice of amniotomy as Sookhoo et al. found that the experienced midwives tended to avoid inappropriate intrusion into the process of labour as a matter of routine. We should therefore be aware that amniotomy may be conceived as â€Å"inappropriate intrusion† by the experienced midwife and our study should perhaps be structured to evaluate this possibility. Perhaps the last word on this subject should go to the overview of the subject published by Katz Early amniotomy remained an independent risk factor for operative delivery on multiple logistic analysis controlling for confounding variables. These findings imply that caution is needed when deciding to perform early surgical induction unless it is a final option or other approaches are contraindicated. (Katz, Miriam 1999) Methodology Search history. The mechanism of the literature review was to conduct a number of literature searches through both electronic and hard copy data bases at the local University Library and the local Post Graduate Library (client to personalise). A number of search terms were used including: amniotomy; amniotomy knowledge; amniotomy indications; amniotomy benefits: amniotomy complications; amniotomy speed of labour; midwife views amniotomy; midwife procedures. The electronic databases included Bandolier and The Cochrane Library and Cinhal. These searches provided a great many texts which were accessed either electronically or in hard copy and then critically reviewed to ascertain the level of the evidence presented. The level of evidence was categorised into the following levels. Classification of evidence levels The highest level of evidence available was then used to support each point raised Research question or hypothesis It appears to be generally accepted that evidence based practice should be the â€Å"gold standard† of modern clinical practice (NMC 2004). However, many experienced healthcare professionals would attest to the fact that clinical decisions in their everyday practice is still influenced by individual experience and advice from colleagues. (Williams P R 2000). The rationale behind this study derives from the suspicion that many midwives use amniotomy to speed up labour and that there appears to be little in the way of a hard evidence base to support this view. It is the intention of this study to try to define the degree that individual midwife practice is determined (in this specific regard) by their own experience and professionally received advice and to what extent it is determined by reliance on their own independently derived evidence base. Study design This study will be qualitative in design. There are a number of different qualitative approaches that could be adopted (DeWalt, K. M et al. 1998) and brief consideration will be given to each. The phenomenological approach is primarily a philosophical mechanism which employs that technique of concentrating on the conscious and subjective experiences of the subjects. (Hammond et al, 1995). It is therefore written from the first person viewpoint. Such an approach is not without its critics however, as the classic approach is from the third person (impersonal) viewpoint (Ahmed, 2006). Hammond characterises the phenomenological genre as â€Å"unconstrained by scientific rigour† as it is simply a recording of the experience as the observer experiences and interprets it. It is therefore not purged of subjectivity and bias as many other scientific approaches are. The phenomenological approach was considered for this project and discounted as it is conceded that such an approach may give rise to a very idiosyncratic view of the subject and may not be representative of the majority view. Grounded theory may, at first sight, appear to be a suitable approach for this study. The prime element in a grounded theory study is the fact that the data is obtained and then the investigators then attempt to formulate or identify appropriate theories from the processed data. (Glaser, 1992). This approach may seem suitable by virtue of the fact that midwives could be approached and data obtained to see if there are any constant factors which motivate their particular pattern of behaviour when considering the procedure of amniotomy. A problem may arise however, because of the intrinsic need for theory formulation. Charmaz characterises the problem by stating â€Å"It compels the researcher to impose explanations were no explanations naturally exist, or indeed are necessary†. (Charmaz, K. 2006). In this study it is the intention to explore midwife’s views on whether amniotomy increases the speed of labour rather then to specifically generate theories to explain these views. For this reason grounded theory was discounted as a possible approach After much consideration it was decided to adopt an ethnographic approach to the study. This involves a hybrid approach with an analysis termed by Agar as being from the point of view of â€Å"The professional strangerâ€Å" (Agar, 1996). This approach has elements of both qualitative and quantitative analysis and is primarily carried out using the analysis of â€Å"in the field† interviews of midwives. Kottak describes the ethnographic approach (in the broadest terms) as collecting data â€Å"in the field by living among and blending in with a particular group, society or culture, observing and recording their particular habits and detailing their experiences and reactions† (Kottak, 2005). The researcher is expected to be a part of the community studied but to â€Å"retain a certain degree of detachment, impartiality and objectivityâ€Å" (Kottak, 2005). The object of this study requires the observer to record the number of times a midwife uses the procedure of amniotomy and then to obtain her views on the rationale for the procedure through the mechanism of the semi-structured interview. Sample Constraints on time and finances will largely dictate the overall size of the project (client I have no idea what potential funds you have available for this project so I have made a number of assumptions that you will have to modify if they are not correct). It is considered prudent to make a pilot study in order to test the validity of the interview questions and to also trial the analysis techniques. The initial pilot would be in the labour ward of the author’s hospital (client to personalise here) and would therefore potentially include 12 midwives. If the study were to yield potentially significant findings, then its scope could be widened to include staff from different sites and thereby include perhaps different protocols and possibly different work practices. This would have the benefit that it is possible that certain work practices may be determined by peer pressure in a specific geographical location and broadening the scope of the investigation would help to minimise the biasing effect of such practices. (Rosner B 2006). There is also considerable merit in trying to ensure that the cohort of midwives studied contains a wide spectrum of experience, ideally from the newly qualified midwife through to the most experienced, as it would be unlikely that the work practices would be the same in all groups. (Strauss, A et al. 1990). It is therefore clearly of benefit to try to structure the sample to include representatives from all of these groups in order to minimise the effects of such potential bias. (Carr L T 1994). It foll ows from this requirement that the study group will be asked to provide information relating to their years of experience in addition to other demographic markers. Analysis of the pilot study will help to determine whether purposeful sampling or general sampling will be appropriate in the final study. (Moher D et al. 1999). In the former method, subjects are specifically chosen because of the likelihood of their being able to give valuable information to the study. Patton describes this method of recruitment as â€Å"selecting only a limited number of information-rich cases for investigation, in order to obtain a particularly detailed insight into an issue. (Patton 1999). Although this may be, at first sight, useful in trying to maximise the information yield of the study, it has the obvious downside that it is a source of considerable potential bias giving rise to a small and potentially unrepresentative sample. (Patton 1999). A variation of this technique of recruitment is called snowballing whereby one key subject is asked to recommend others who may have either specialist knowledge or a specific interest in the subject in question. This te chnique is recommended by MacQueen as â€Å"being particularly suitable in qualitative studies, where detailed and in-depth understanding of a little-known subject is required† (MacQueen K M, et al. 2004). Although this clearly has the ability to optimise the collection of significant information, it does not eliminate the potential for bias apparent in the purposeful sampling technique. If we consider that amniotomy is a widely used practice amongst midwives, then neither method is sufficiently useful to outweigh the potential bias that they would engender. For these reasons it is considered appropriate to approach all of the midwives in the local unit to take part in the study. Data Collection In line with the principles of the ethnographic approach, this study will adopt the dual mechanisms of direct observation and the semi-structured interview. (Breakwell et al, 1999). The semi-structured interview technique is explored in depth by De Martino who contrasts the technique with unstructured and fully structured interviews. The former â€Å"essentially amounts to an informal conversation with no guiding principles, and structured interviews are characterised by the asking of a predetermined and fixed set of questions with strict guidelines. Semi-structured interviews however, entail asking a preset group of questions but with some flexibility, so that interesting leads can be explored further† (De Martino B et al. 2006). The semi-structured interview technique is considered to be the most useful for this type of study because of the lack of rigid constraints placed upon both interviewer and subject. The questions are designed to be â€Å"open† thereby allowing the subject to introduce appropriate topics which can then be followed up at the interviewer’s discretion. This flexibility is perhaps the most appropriate for this type of study as the interviewer does not know in advance just what factors influence the midwife’s opinions. Frey broadens the issue by suggesting that, in this context, attitudes of the subjects can be typically analysed in any of three â€Å"dimensions†, namely: emotion, cognition, and behaviour. (Frey et al. 2001). It might therefore be important to structure the semi-structured interview questions so that they cover all three of these dimensions. Typical examples in this regard might be (a)â€Å"How does performing as amniotomy on your patients make you feel emotionally?† (b)â€Å"What are your views about amniotomy and the speed of labour?† (c)â€Å"How do you actually choose to speed up your patient‘s labour?† This may not prove to be completely relevant, as one could suggest that emotional involvement is actually counterproductive in this particular circumstance. It is clear that a large element of discretion will have to be left with the interviewer as it is likely that the answers given may clearly be either carefully considered and evidence based on one extreme or superficial and unconsidered on the other. This flexibility will allow the subject to impart their own intention without being unduly hampered by rigid questioning and should allow the emergence of a detailed set of data which reflects each individual midwife‘s opinions and practices clearly. (Concato, et al. 2000) In addition to the semi-structured interviews there will also be an element of direct observation to ascertain the labours that are managed with amniotomy and to contrast them with the labours that are managed without the procedure. It may well be of considerable value to include an element of questioning in the semi-structured interview phase that asks about the rationale for performing the procedure Data Analysis Data analysis can be carried out using time-honoured methods originally developed in the social science setting with various qualitative analytical methods. (Vickers, A. J et al. 2001). The most commonly used is probably thematic analysis (Braun V et al. 2006) which involves coding the themes that are derived from the responses. The themes are initially identified during the semi-structured interview stage and are then assigned a code (or number) depending upon the frequency with which the various subjects refer to the particular theme. From reading Braun it is apparent that there is considerable flexibility in the coding and identification of the themes (which is in contrast to the mechanisms described for both grounded theory and other forms of qualitative analysis). Some authorities find that this flexibility and lack of proscription is a negative feature of the thematic approach but Braun argues that it enhances the quality of the analysis by allowing a â€Å"richness of analysi s not provided for by other methods†. (Braun V et al. 2006). This is clearly a complex exercise and it will be attempted in the pilot study by the author, but it is accepted that it may be more appropriate to enlist the help of an experienced researcher to assist in the analysis of the full project It is considered likely that the various themes will be obvious from the data obtained. Braun suggests a five stage mechanism for optimum data retrieval, namely: (1)Familiarising oneself with the data. (2)Developing a coding system and identifying bits of data consistent with specific codes. (3)Looking for and identifying themes in the data (4)Labelling or naming the themes identified, with appropriate justification (e.g. quotations from interview transcripts) (5)Writing up the report, including data extracts, in a compelling fashion. (Braun V et al. 2006). The interviews will be initially tape recorded and then transcribed in order to allow for identification of the various themes. It is clearly likely that the themes will be expressed in different terms by different subjects and therefore a degree of latitude will be needed by the interpreter to ensure that similar themes will be included and analysed together. (Berlin J A et al. 1989) Rigour The value of any study ultimately depends upon the rigor with which it is conducted. (Green J et al. 1998). It is in the very nature of a qualitative study that it does not intrinsically possess the precision of the classical quantitative study. It is therefore of great importance that attention is paid to reliability and repeatability during both the design and execution stages of the study. Triangulation is one mechanism that can help in this regard. (Piantadosi S. 1997). This requires comparison of the results obtained by one method with those obtained by another. The classic structure is to see whether the data obtained from the study matches with that obtained from subject feedback. (Leaverton PE. 1998). Berwick also suggests that any apparently aberrant or atypical cases should be examined as these will help to establish the overall validity of the study. (Berwick D. 1996) Ethical Issues It is central to the instigation of any study that the approval of a Local or National Ethics Committe

Essay on Language, Imagery, and Symbolism in To Be of Use

Use of Language, Imagery, and Symbolism to Develop the Theme of   To Be of Use  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚      In the minds of most people, the words, "hard work" and "heavy labor" carry a negative connotation.   What these words imply is not something that is generally welcomed with enthusiasm but is often accepted either by force or obligation.   Marge Piercy's poem "To Be of Use" conveys an opposing connotation about the idea of work.   The central theme of the poem is that satisfaction, gratification, and self-fulfillment can be attained by using one's capabilities to serve a functional purpose in life, for it is the opinion of the speaker that an idle existence has no value or significance because it is worthless, vain, futile, and pointless.   Piercy uses figurative language, imagery, symbolism, description, and details to develop this theme throughout the poem.   Piercy begins developing the theme in the first stanza by describing "The [type of] people [she loves] the best" (1).   Piercy states that they "jump into work head first/without dallying in the shallows..." (2-3).    With this imagery Piercy reveals that she admires individuals who are not afraid of work; rather, they tackle their jobs "head first/without dallying" ( ); in other words, they are not lazy and do not delay or procrastinate the completion of their duties.   Piercy adds that the people she regards highly "... swim off with sure strokes almost out of sight" (4).   With this image Piercy indicates that these adored individuals work with so much confidence and diligence that often they become so busy that their work puts distance between them and those with whom they associate or live.   Further, Piercy declares that "They seem to become natives of that element, / ... ... the fruits of a person's hard labor will linger to give honor to their memory after their death.   However, Piercy adds that "they were made to be used" to indicate that this won't be the case if a person's labor is not the fruitful productive type.  Ã‚   Piercy concludes by stating that "The pitcher cries for water to carry and a person for work that is real" (25-26).   With this figurative language Piercy develops the theme by affirming that people need to be willing to work hard in order to reach the satisfaction of accomplishing something that is meaningful in their lives. In her poem, Piercy developed the theme of success through active participation in hard work through her use of language. Works Cited Piercy, Marge.   "To Be of Use." Responding to Literature.   2nd ed. Ed. Judith   A. Stanford. Mountain View, CA: Mayfield Publishing Company, 1996. 596.