Political Advertising: Candidates for Sale Essay

The Internet has not diminished the importance of television advertisements in presidential elections. The latter remains to be one of the most effective means of obtaining votes. In as short as 30 seconds, a television advertisement can convince voters about the competence and integrity of a particular candidate. The advertisement â€Å"sells† the candidate with as much enthusiasm and gusto as when it is selling products and services (Elliot, n. pag. ). However, political advertisements are not without contention. Akin to all other forms of advertising, they are subjective. As they are geared towards â€Å"selling† specific candidates, it is inevitable for political advertisements to present a biased point of view. Their subjectivity is sometimes obscured by noble trappings that are bombarded with images of American flags, the White House and Mount Rushmore (Elliot, n. pag. ). Despite questions about their reliability, political advertisements will continue to be an indispensable part of presidential campaigns. Candidates in recent presidential elections have focused their television commercials on â€Å"battleground† states such as Ohio and Florida. This trend is expected to increase – there are already about 20 â€Å"battleground† states as of this year. In addition, presidential candidates Barack Obama (Democrat) and John McCain (Republican) are both running nationwide advertisements (Elliot, n. pag. ). Political advertising was first developed and used in the mid-19th century. In order to generate turnout, political parties during this period distributed buttons, banners and posters to voters at local candidate rallies and at polling places on Election Day. But it was not until the advent of mass media in the 20th century that political advertising was elevated to its current status. The first national campaign commercials were broadcasted through radio in 1928 for presidential contenders Herbert Hoover (Republican) and Al Smith (Democrat) (Elliot, n. pag. ). The arrival of television in 1952 increased the cardinality of political advertisements in presidential campaigns. In the same year, Republican Dwight D. Eisenhower (nicknamed Ike) was promoted in animated commercials that bannered the catchy slogan â€Å"I like Ike,† tuning him into the first presidential candidate to appear in television advertisements. These were followed with short commercials entitled Eisenhower Answers America, wherein Eisenhower was featured replying to questions from average voters about issues such as the rising cost of living and the Korean War. Eisenhower Answers America was frequently played during the commercial breaks of hit sitcoms like I Love Lucy, resulting in its instant popularity among voters. Succeeding presidential candidates followed suit, paying advertising firms millions of dollars to create catchier campaign advertisements for them (Elliot, n. pag. ). What makes political advertising effective is its ability to provide information to a wide audience within a short period of time. Furthermore, the manner in which they transmit information often appeals to the emotions rather than the intellect. Candidates are packaged as capable and trustworthy leaders who entered public office to serve the ordinary citizen. Candidates are also sometimes portrayed as the long-awaited â€Å"alternative† to a â€Å"useless† incumbent regime. As a result, the latter often makes political advertisements appear as smear campaigns against political opponents. These negative political advertisements, however, are the types of advertisements that have the greatest impact on people. They impart an overly-simplistic, â€Å"us-versus-them† philosophy, which, in the process, does the thinking for the voters. Consequently, negative political advertisements are very potent campaign materials. They reach everyone, including those who do not pay much attention to the campaign (Elliot, n. pag. ). This need for mobility is the reason for political advertising’s gradual shift from the television to the Internet. Websites such as YouTube. com (http://www. youtube. com) contain countless clips of political advertisements which people can access from virtually anywhere at any time. In addition, YouTube. om allows its members to post comments on the video clips that they viewed. In the context of political advertising, this can result in discussions that can help sharpen public opinion regarding politics and the electoral process. While negative political advertisements are effective in gaining votes, they are detrimental to American society and politics in the long run. According to Mike Hughes, president of an advertising agency in Richmond, Virginia, negative political advertisements are also untruthful. They often deceive voters by using stage effects and half-truths that make a candidate appear deserving of the position that he or she is aspiring for. Hughes was quick to add that this was not the fault of advertising agencies – most political advertisements nowadays are created by political consultants who specialize in campaign commercials. Unlike advertising agencies, which face criminal prosecution in the event that they produce inaccurate pitches, these consultants are allowed by the First Amendment to create political spots as part of their right to free speech (Elliot, n. pag. ). The deceitful usage of political advertisements is very dangerous, as it sends the people, particularly the youth, the message that the only way to get ahead in life is through lying. In addition, voters are tricked into voting leaders who will not think twice about resorting to dishonesty just to get what they want. A leader who got into power through dishonest means will most likely remain in power through dishonest means as well. Thus, there is a big possibility that lying in political advertisements will progress to violation of civil rights and liberties disguised as protection of national security.

Elie Wiesel Quotes Essay

The opposite of love is not hate, it’s indifference. The opposite of art is not ugliness, it’s indifference. The opposite of faith is not heresy, it’s indifference. And the opposite of life is not death, it’s indifference.† ― Elie Wiesel â€Å"There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest.† ― Elie Wiesel â€Å"Friendship marks a life even more deeply than love. Love risks degenerating into obsession, friendship is never anything but sharing.† ― Elie Wiesel â€Å"We must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented.† ― Elie Wiesel â€Å"To forget the dead would be akin to killing them a second time.† ― Elie Wiesel, Night â€Å"When a person doesn’t have gratitude, something is missing in his or her humanity. A person can almost be def ined by his or her attitude toward gratitude.† ― Elie Wiesel â€Å"There is divine beauty in learning†¦ To learn means to accept the postulate that life did not begin at my birth. Others have been here before me, and I walk in their footsteps. The books I have read were composed by generations of fathers and sons, mothers and daughters, teachers and disciples. I am the sum total of their experiences, their quests. And so are you.† ― Elie Wiesel â€Å"Human suffering anywhere concerns men and women everywhere.† ― Elie Wiesel, Night â€Å"For the dead and the living, we must bear witness.† ― Elie Wiesel â€Å"Never shall I forget that night, the first night in camp, which has turned my life into one long night, seven times cursed and seven times sealed†¦.Never shall I forget those moments which murdered my God and my soul and turned my dreams to dust. Never shall I forget these things, even if I am condemned to live as long as God Himself. Never.† ― Elie Wiesel, Night â€Å"One person of integrity can make a difference.† ― Elie Wiesel â€Å"If the only prayer you say throughout your life is â€Å"Thank You,† then that will be enough.† ― Elie Wiesel â€Å"Only the guilty are guilty. Their children are not.† ― Elie Wiesel â€Å"Write only if you cannot live without writing. Write only what you alone can write.† ― Elie Wiesel â€Å"Which is worse? Killing with hate or killing without hate?† ― Elie Wiesel â€Å"I pray to the God within me that He will give me the strength to ask Him the right questions.† ― Elie Wiesel, Night â€Å"I swore never to be silent whenever and wherever human beings endure suffering and humiliation. We must always take sides.† ― Elie Wiesel â€Å"Wherever men and women are persecuted because of their race, religion, or political views, that place must — at that moment — become the center of the universe.† ― Elie Wiesel â€Å"No human race is superior; no religious faith is inferior. All collective judgments are wrong. Only raci sts make them† ― Elie Wiesel â€Å"Then came the march past the victims. The two men were no longer alive. Their tongues were hanging out, swollen and bluish. But the third rope was still moving: the child, too light, was still breathing†¦ And so he remained for more than half an hour, lingering between life and death, writhing before our eyes. And we were forced to look at him at close range. He was still alive when I passed him. His tongue was still red, his eyes not yet extinguished. Behind me, I heard the same man asking: â€Å"For God’s sake, where is God?† And from within me, I heard a voice answer: â€Å"Where He is? This is where–hanging here from this gallows†¦Ã¢â‚¬  That night, the soup tasted of corpses.† ― Elie Wiesel, Night â€Å"For in the end, it is all about memory, its sources and its magnitude, and, of course, its consequences.† ― Elie Wiesel, Night â€Å"Think higher, feel deeper.† ― Elie Wiesel â€Å"There are victories of the soul and spirit. Sometimes, even if you lose, you win. † ― Elie Wiesel â€Å"We must take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. Sometimes we must interfere. When human lives are endangered, when human dignity is in jeopardy, national borders and sensitivities become irrelevant. Wherever men and women are persecuted because of their race, religion, or political views, that place must – at that moment – become the center of the universe.† ― Elie Wiesel, The Night Trilogy: Night/Dawn/The Accident â€Å"I shall always remember that smile. From what world did it come from?† ― Elie Wiesel, Night â€Å"For the survivor who chooses to testify, it is clear: his duty is to bear witness for the dead and for the living. He has no right to deprive future generations of a past that belongs to our collective memory. To forget would be no t only dangerous but offensive; to forget the dead would be akin to killing them a second time.† ― Elie Wiesel, Night â€Å"I don’t want my past to become anyone else’s future.† ― Elie Wiesel â€Å"We must not see any person as an abstraction. Instead, we must see in every person a universe with its own secrets, with its own treasures, with its own sources of anguish, and with some measure of triumph.† ― Elie Wiesel â€Å"Most people think that shadows follow, precede or surround beings or objects. The truth is that they also surround words, ideas, desires, deeds, impulses and memories.† ― Elie Wiesel â€Å"Night is purer than day; it is better for thinking and loving and dreaming. At night everything is more intense, more true. The echo of words that have been spoken during the day takes on a new and deeper meaning. The tragedy of man is that he doesn’t know how to distinguish between day and night. He says things at night that should only be said by day.† ― Elie Wiesel, Dawn

INVESTMENT PROJECT INFORMATION Essay Example | Topics and Well Written Essays - 1250 words

INVESTMENT PROJECT INFORMATION - Essay Example Table 2: Table of the 52-Week High and Low Company 52 Week Low ($) 52 Week High ($) daily closing prices for each stock ($) Microsoft 24.30 32.95 26.95 Dell Computer 8.69 18.36 9.06 Apple Inc. 363.32 705.07 561.70 Coca Cola 32.37 40.67 37.39 Procter and Gamble 59.07 70.83 68.30 Toyota Motors 61.94 87.15 84.43 McDonald 83.31 102.22 86.01 IBM 177.06 211.79 190.29 III. Latest Press Release for the Eight chosen Companies Dell computers announced that they have been selected by MedRisk, one of the health care service providers to provide the support of the company’s application development, expansion of the infrastructural activities, and their security system as part of the 10-year deal agreement. Microsoft on the other hand announced pricing of $2.25 billion (senior unsecured notes). Which consist three trenches; $600 million due Nov. 2017, $750 million due Nov. 2022, and $900 due Nov 15, 2042. The proceeds Microsoft says will be used for corporate purposes. Apple Inc. Company af ter launching their fourth generation ipad in March announced selling three million of the product in three days (MarketWatch, 2012). The Coca Cola Company released their 125 years old secret formulae in Atlanta where they took the initiative to make one of the very many homes of Coca Cola in the world. The y shared their rich history in the Coca Cola industry for the last 125 years. Procter and gamble also hosted a meeting in Cincinnati with its analyst in which they provided the P&G results, the outlook of the fiscal year and specific growths and improvement on strategic productivity. The Toyota Motors company this November has also introduced a new product, the seven-seat Kluger (MarketWatch, 2012). The new vehicle has added features that cost $8,000 but this does not affect significantly the price as it retails at additional $2,300. McDonald in October this year announced the third quarter of the 2012 performance. In the announcement, the company realized higher revenues and sha re earnings compared to the previous year but the operating income was not improved. IBM recently signed an agreement to help the Indonesia’s Bank Ekonomi Raharja realize rapid growth. They agreed on the provision of infrastructural activities based on servers and storage of enterprise to enable the banks effectively serves the growing client’s base (MarketWatch, 2012). IV. General Information about the Companies Microsoft Company Microsoft’s company website is Microsoft .com. the chairperson of the company is Bill gates and the CEO is Steve Ballmer though Bill Gates and Paul Allen founded it. The company serves worldwide. Currently, the company’s employees stands at 94, 000, 2012 figures. The company revenues is as follows; total Revenue is US$ 73.72 billion, operating income is US$ 21.76 billion, Net income; US$ 16.97Â  billion while the total assets is US$ 121.2Â  billion (MarketWatch, 2012). The company’s home office is in Washington US, Micr osoft Redmond Campus in Redmond. With reference to the company’s products, they are ivied into divisions, which include server and tools, windows, Microsoft business, entertainment and devices and online services. Started in 1975, Microsoft prides of being one of the leading software developers in the world. Dell

Wk3 Assignment Example | Topics and Well Written Essays - 1500 words

Wk3 - Assignment Example table, is found to be less than 0.05, therefore, we cannot accept null hypothesis which states that the average salaries of employees of each grade is equal. It can thus be concluded that significant difference exists in the average salaries of employees at different grades. The first null hypothesis that states that average salaries for all grades are equal is accepted as the associated P value is found to be equal to 0.07 which is greater than 0.05. The second null hypothesis that states that average salaries for both male and female employees are equal is, however, rejected as the associated P value is found to be equal to 1.5 x 10-10 which is quite less than the significance level 0.05. The third null hypothesis that tests whether the interaction is statistically significant is found to be statistically significant as the associated P value is found to be 0.17 which is significantly greater than the significance level of 0.05. It means that the grades and gender do have an interaction that impacts the equality of pays amongst employees on average. Moreover it shows that the mean salaries are equal amongst different grades while they are found to be unequal amongst male and female employees without considering their grades. Moreover in order to avoid biasness in the results the observations have been chosen at random so that the sample results can be employed for the interpretation of population parameters. Therefore mean value in this case can be used to interpret the results of mean values of population. In order to test that the compa values in the population are equal by grade and/or gender, and are independent of each factor the ANOVA has been done using Data Analysis Tool pack of MS Excel 2007. The values are chosen on convenience basis for each category. The summary of outputs thus obtained is mentioned below. The two factor ANOVA has been performed with replication. All three null hypotheses are rejected as the associated P values are found to be less

Globalization and media Essay Example | Topics and Well Written Essays - 2250 words

Globalization and media - Essay Example In an important 2006 article, Schiller asserted that we should reassess any notions we have that the era of cultural domination is over. He looks back over the last quarter century, and draws parallels between the situation faced then, and that with which we are now confronted. On the whole, he concludes that very little has actually changed. Revisiting this comparison is a worthwhile exercise in attempting to distil the essential nature of the debate between those who hold cultural imperialism to be a relevant concept, and those who would have it dismissed as archaic. Schiller noted that in the 1980s, there was a clear division between the western and industrialized ‘First World’, a ‘Second World’ made up largely of the countries aligned to the socialist blocs led by the Soviet Union and the People’s Republic of China, and a ‘Third World’ made up of those countries which had gained independence in recent decades (295). Across all of thes e categories, the United States was, politically and culturally, the most powerful state, with the Third World deliberately being targeted with American cultural exports, and a vision of an American lifestyle to aspire to. As Schiller himself concedes, there have been some important alterations to the global cultural landscape in the intervening decades. For one, the Second World has practically disappeared. Those countries which might still be grouped in this category, such as China and Vietnam, are increasingly open to American and other Western cultural imports, while some, such as the countries of the former Soviet Union in Eastern Europe, became an area in which American-style cultural norms flourished after the collapse of government from Moscow. Furthermore, we are now consciously witnessing the political and economic decline of the United States, in relative terms, when compared to the fast-growing economies of China and India. The Chinese economy, for example, has just over taken the Japanese in order of size. This raises pressing questions about whether American cultural dominance can be sustained in a world where its political dominance in diminished. Schiller argues that ‘Cultural submersion’ to American norms remains powerful, and this term has in fact been broadened beyond just watching American television programs and movies, to shopping in American-style malls and going to theme parks. There is, of course, a change in the cultural sphere which has been even more important than all of this, and that is the broadening of the definition of media, to cover what we now collectively refer to as the ‘social media’ – including the blogosphere and the social networking websites which have proliferated in the past decade. This issue will be discussed in more detail below, but Schiller argues that despite the rise of new media, television retains its former importance. He claims that the emergence of satellite and cable net works has prevented this happening (297). At this point his argument becomes less powerful. In the early 1990s, as the Soviet bloc collapsed and American culture seemed triumphant all over the world, Schiller’s contention stands firm, but in the present decade, with revolutions and uprisings, as well as broader internal debate and opposition being fuelled by websites and forums that are independent of any political authority, the

Aortic Valve Replacement Essay Example | Topics and Well Written Essays - 3250 words

Aortic Valve Replacement - Essay Example A., Sauaia, A., Moore, E. E., Haenel, J. B., Burch, J. M., and Lezotte, D. C., 1996) involving multiprofessional medical- nursing work of care (Lederer, J. A., Rodrick, M. L., Mannick, J. A., 1999). As I reflect, I can now arrange the events that were relevant to this patient. On the first admission of the patient from theater to intensive therapy unit, the patient was placed on pressure-control ventilation with 100% oxygen with a PEEP of 10, rate of 12, tidal volume 500, and pressure support of 10. On estimation at that time, arterial blood gas was initially on pH 7.13, pCO2 of 7.0, pO2 of 21.4 with a base excess of -10. SpO2 was 99.8 and bicarbonate 16.9. Lactate was18. The patients in the intensive therapy unit constitute an extremely heterogeneous population in terms of admission diagnosis, co-morbidities, age, race, sex, and socioeconomic conditions, but one feature is common to almost all of them, cardiopulmonary dysfunction (Kelly, J. L. et al., 1997). During my shift hours, I could easily sense that the environment of ITU. It provided highly integrated and coordinated care with many novel machines and minute-to-minute therapy and observation. This posting in the ITU could improve my understanding of the physiology of such patients in that, I could observe the changes in the patient's parameters in real time. I could see the changes in central venous pressure with a change in rate of fluid therapy (Stone, P.W, and Gershon, R.R.M., 2006). I observed changes in blood gases when the oxygen concentration and ventilation settings were changed. I could detect when pharmacotherapeutic interventions would fail to produce intended changes in the cardiac output studies. In short, this...Journal of Trauma; 42: pp. 532-536. Fan, J., Marshall, J. C., Jimenez, M., Shek, P. N., Zagorski, J., and Rotstein, O. D., (1998). Hemorrhagic Shock Primes For Increased Expression Of Cytokine-Induced Neutrophil Chemoattractant In The Lung: Role In Pulmonary Inflammation Following Lipopolysaccharide. Journal of Immunology; 161, pp. 440-447. Gadek, J.E., DeMichele, S.J., Karlstad, M.D., et al., (1999). Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enteral Nutrition in ARDS Study Group. Critical Care Medicine; 27: pp. 1409-1420. Gibbs, C.R., Davies, M.K., and Lip, G.Y.H., (2000). ABC Of Heart Failure: Management: Digoxin And Other Inotropes, Blockers, And Antiarrhythmic And Antithrombotic Treatment. British Medical Journal; 320: 495. Inman, K.J., Sibbald,W.J., Rutledge,F.S., Speechley,M., Martin,C.M., and Clark, B.J., (1993). Does Implementing Pulse Oximetry In A Critical Care Unit Result In Substantial Arterial Blood Gas Savings Chest; 104: 542. Kelly, J. L., O'Sullivan, C., O'Riordain, M., O'Riordain, D., Lyons, A., Doherty, J., Mannick, J. A., and Rodrick, M. L., (1997). Is Circulating Endotoxin The Trigger For The Systemic Inflammatory Response Syndrome Seen After Injury Annals of Surgery; 225, pp. 530-541. Lu, Z.

Historical Speeches and the WOW Factor Assignment

Historical Speeches and the WOW Factor - Assignment Example Kennedy prefers repeating some praises that will have impact on the people and prompt them to continue with the same spirit. These include, â€Å"†¦Let them come to Berlin...† which he was addressing to the world and other people who preferred the communists’ way of governance. He also chooses figurative words and statements like â€Å"....indivisible† and â€Å"sober satisfaction† when referring to the state of freedom and relieve of the people respectively. The writer’s major technique encompasses appreciating and shunning any incidence of demeaning the audience. This is via giving the hope of maintaining their struggle coupled with stating great things in future that will result from their hard resolutions to stand for the truth and justice. He also refers to his audience as an example in the world where each state ought to emulate besides deriding the communists’ erection of a wall meant to hold its subjects captive. Kennedy’s then speech in this context was effective due to the neutral ground that he adopted regarding the assassination coupled with his remorseful state. He shunned all cases that will lead to blame games and called upon the people to focus to the future, where there will be equality and love among America’s races (American Rhetoric, 2001). i. â€Å"to say a prayer for the family of Martin Luther King -- yeah, its true -- but more importantly to say a prayer for our own country, which all of us love -- a prayer for understanding and that compassion of which I spoke† (American Rhetoric, 2001). iii. â€Å"†¦.Weve had difficult times in the past, but we -- and we will have difficult times in the future. It is not the end of violence; it is not the end of lawlessness; and its not the end of disorder.. † (American Rhetoric, 2001). Kennedy decided to use a low tone in this particular speech compared to other occasions when addressing the

Wolfgang Amadeus Mozart Essay Example | Topics and Well Written Essays - 2250 words

Wolfgang Amadeus Mozart - Essay Example Classicism as a movement spans across literature, the arts, and even architecture; it was strongly associated with absolutism and the need for clear divisions of parts. At the time, the buildings and artworks were made in bright colors yet they contrasted each other; overall, classical era production was simple and less complex than previous periods. These ideas mostly came from developments in science and philosophy where it was established that things tend to follow certain rules; in accordance with Newtonian physics, the most stable structures were the highly ordered ones. These influences entered the arena of music when audiences and players began adding structure to their pieces; unlike the previous Baroque period that had layered melodies and harmonies, the classical era had homophonic music where the harmony was inferior to the melody (Hoffer 124). Tonal structures were deeply emphasized at the time owing to the emphasis on chords; sometimes this was done at the expense of melodic smoothness. In addition, the classical era music differed from the Baroque style music owing to its emphasis on instrumental groups other than the string instruments. Participants of the classical era simplified the texture of their music in a manner that allowed listeners to be better able to tell the instrumental details apart. Tones need to be unified through certain rhythms like the minute or opening fanfares in order to get the attention of its listeners. This era also had concerto and sonata forms at a greater level with special emphasis given to their definition as well as the rules surrounding their use. Furthermore, performers did the symphony and concertos for many were eventually replaced by soloist concertos.

Planning and Design Essay Example | Topics and Well Written Essays - 2000 words

Planning and Design - Essay Example It enables to prepare an efficient schedule for completing the project within a specified time (Public Procurement Guide, 2008). Resource Planning In this stage, the management should be focused on determining required materials or resources, laborers and tools that are required in each step of the project. This step would be useful for making proper allocation of available resources in required places. It would also facilitate to avoid any improper allocation and wastage of valuable resources so that the project completes in time (Public Procurement Guide, 2008). Cost Planning Preparation of plan with respect to allocation and use of cost is one of the vital parts for the management in the project plan. The stage comprises proper identification of required costs including internal and external costs. It also enables to make assessment of the amount of time required to complete the project, so estimation can be made regarding the budget of the project and whether the project would re quire over-budgeting or not (Public Procurement Guide, 2008). b. ... With this concern, Spencer Moneysworth consulted with Expert Industrial Developers (EID) regarding making an estimation of cash flow chart for the project. However, the EID provided an estimated plan of USD20 million with a schedule of 18 months for the project. However, the intention for Woody 2000 project was to prepare the project within USD17 million by including one million for first and last month and USD1.4 million each within the rest 10 months during the project. Moreover, the cost planning of EID depicts an excessive use of capital along with making an estimation of longer schedule for the plan including professional services and construction works. With this concern, it can be said that there is a requirement for making evaluation of available alternatives in terms of accessible contractors that can provide lowest possible cost with efficient time schedule for the project. In the successive phases of the project, the aspect of proper time scheduling would be crucial as it can largely affect positive or negatively on the factors such as project budget, delay and accessibility of resources among others (Public Procurement Guide, 2008). c. Did the project plan explain how the project and any changes would be controlled? Should this be part of the plan? Give reasons. The overall plan for the Woody 2000 project explains the facet of bringing in changes by involving software as well as hardware to efficiently complete the project related tasks. By appointing Ian Leadbetter, a mechanical engineer, specialized in ‘programming semi automatic manufacturing machinery’, efficiency in the whole process of project schedule was desired to be brought. This aspect

Thomas Wyatt My Galley Essay Example for Free

Thomas Wyatt My Galley Essay It is a ship struggling during a terrible storm at sea, a metaphor for depression — a mind struggling to right itself. The imagery is incredible, and it’s a beautifully written sonnet. Rhyme scheme is ABBA ACCA DEED FF. One analysis I read (linked below) said this poem was about a man who had rejected God, and this battery at sea was the consequence (because, of course, God controls the sea and the weather). It also said the author was contemplating suicide as the only way out of this misery. The word choices are violent and emotional: sharp seas mine enemy steereth with cruelness rain of tears cloud of dark disdain despairing of the port One line (â€Å"every oar a thought in readiness†) is beautiful to me because of the way the analysis below described it: That the author was trying to think his way out of this turmoil, like oars trying to right the ship, and yet he could not. Anyone who has ever been depressed or experienced hopelessness knows that trying to get oneself out of it using logical thought is useless. The end of the poem indicates that the author doesn’t even remember why he’s experiencing this trauma, and also that he has no guide (like the stars) for getting him to safety. My galley charged with forgetfulness Through sharp seas in winter nights doth pass Twene rock and rock; and eke mine enemy, alas That is my lord, steerth with cruelness And every oar a thought in readiness As though that death were light in such a case; An endless wind doth tear the sail apace Of forced sighs and trusty fearfulness A rain of tears, a cloud of dark disdain Hath done the wearied cords great hindrance Wreathed with error and eke with ignorance. The stars be hid that led me to this pain, Drowned is reason that should me comfort, And I remain despairing of the port. . Wyatt is talking about despair, and probably means religious despair (the sin of losing your faith in God). He uses the common metaphor of a ship in trouble at sea (remember that England is a seafaring island nation, so a lost ship is a powerful metaphor for the English). My galley charged with forgetfulness Thorough sharp seas in winter nights doth pass Twene rock and rock; Wyatts ship [his life] is weighed down [charged] with forgetfulness [he cannot remember what the point of life is, he cannot remember what it feels like to know God]; it is adrift on a stormy sea, at night, between rocks (and is therefore in great danger). and eke mine enemy, alas That is my lord, steerth with cruelness Wyatt feels that God is master of the ship, and that God has deliberately withdrawn Himself from Wyatt; God is steering the ship cruelly (God is deliberately hurting Wyatt) and has become Wyatts enemy, as well as being his Lord. And every oar a thought in readiness As though that death were light in such a case; A sailing ship which can no longer rely on the wind (when there is no wind, or the wind is blowing the wrong way) will sometimes use oars as an emergency solution. Wyatt is trying to think himself out of his despair (using the oars of his thought), but he is in such despair that when he thinks he only thinks of suicide as an escape from his misery (as though that death were light :: as if death was not a problem). An endless wind doth tear the sail apace Of forced sighs and trusty fearfulness A rain of tears, a cloud of dark disdain Hath done the wearied cords great hindrance Wreathed with error and eke with ignorance. Wyatt thinks of his own moaning and tears (because he is so unhappy) as the winds that are driving his ship toward the rocks (of suicide). His tears are the rain beating on the ship, and his despair and lethargy are loosening the rigging which holds the sails in place (heavy rain could loosen rigging on a sailing ship; then the sails would become loose, and a bad problem would become much worse) The stars be hid that led me to this pain, Drowned is reason that should me comfort, And I remain despairing of the port. Wyatt says he cannot see the stars (he cannot remember the reasons that once led him to believe in God), so his boat does not know where it is going to (at night a sailing boat travels by reference to the stars). Reason (Wyatts ability to understand the world he lives in) is drowned (dead; the world makes no sense to Wyatt now). And Wyatt just cant see the way out of this. The poem leaves us unsatisfied, confused, directionless; like Wyatt is.

Literature Review Strategy for Evidence Based Practice (EBP)

Literature Review Strategy for Evidence Based Practice (EBP) Introduction Evidence based practice (EBP) is an approach to health care in which health professionals use the most appropriate information available to make clinical decision for providing high quality patient care (McKibbon, 1998). EBP has shifted the focus of health care professionals from a traditional approach on authoritative opinions to a stress on facts extracted from previous research and studies (Sackett et al, 1997). It has been suggested by that nursing practice based on evidence enhances patient care, as compared to traditional practices (Majid et al, 2011). In addition, as nurses are increasingly more involved in clinical decision making, it is becoming essential for them to make use of the best evidence in order to make effective and justifiable decisions (Majid et al, 2011). To discuss the evidence for a clinical skill, this essay will investigate the antiseptic preparations for surgical site antisepsis. The rationale for selection of this topic is its significance for the clinical nursing practice as nurses are frequently involved in the surgical site preparation (Dizer et al, 2009). Surgical site infection (SSI) is a type of healthcare-associated infection in which a wound infection occurs following an invasive (surgical) procedure. It has been suggested by National Institute of Health and Care (NICE, 2004) that surgical site infections account for almost 20% of all of healthcare-associated infections. It has been further highlighted that nearly 5% of patients undergoing a surgical procedure develop a surgical site infection antiseptic preparations. NICE (2008) has recommended that aqueous or alcohol based solution with chlorhexidine or iodine can be used for prevention of SSI. However, it does not favour or recommend one solution over the other. This essay will explore the literature for evidence about efficacy of these preparation in comparison to one another. It is important for the nurses to be aware of the best available evidence regarding antiseptic preparations to minimise the risk of surgical site infection. Research Question and Literature Search The research question for the current essay will be formulated on the PICO framework as suggested by Sackett et al (1997): P Population or problem Clean-contaminated surgical procedures I Intervention Chlorhexidine gluconate C Comparison or comparator Povidone-iodine O Outcome Surgical site infection The question formulated for the current essay using PICO framework would therefore be: In surgical procedures, is chlorhexidine gluconate more effective in comparison to povidone-iodine in reducing surgical infections? To answer the question, literature search for the available evidence for was done. The author identified a list of key search terms and synonyms that can result in a large number of hits and combined these with Boolean terms AND/OR. Terms made up of of two words were looked for by making use of speech marks so that they were are not searched for separately, and truncation was used for terms identified to have multiple endings. The key words used were surgical site infection anti-septic preparations iodine and chlorhexidine. In order to make sure that an in-depth search was done, which would elicit the largest number of studies more than one academic search engines were searched by the researcher. Cinahal: Contains an index of nursing and allied health literature and is helpful for use in a thorough search (Glazsiou, 2001). Medline: Suggested to be used in healthcare systematic reviews (Glazsiou, 2001). NHS Information Resources and NHS Evidence: Is a widely used database resource containing evidence-based reviews and specialist research from reliable sources. NHS evidence was searched separately. Cochrane Library: Provides a list of systematic reviews and RCTS that have been published or are in a process of publishing (Glazsiou, 2010). Pubmed: It is a commonly used internet resource for healthcare professionals with a large international coverage. The results of the search generated a large number of article however these had to be reduced in order to generate an appropriate research article which can answer the question formulated. Therefore, an inclusion and exclusion criteria was set to narrow down the large number of articles generated. The guidelines from NICE (2008) in which both preparation have been recommended in 2008 hence the research was done for studies published after that. Only randomised controlled trials (RCTs) have been included as they provide the best evidence. The articles which were not in English and published before 2009 were therefore excluded. Also, the studies in which preparations for a particular type of surgical procedure were studied were also excluded as the evidence for general surgical procedures was being looked for. Abstracts of the studies generated from the search of different data bases engines were thus read so that the articles which do not satisfy the inclusion criteria of this essay can be excluded. This resulted in selection of one article which satisfied the inclusion and exclusion criteria of the current work. The study by Darouiche et al (2010) is a RCT which compared the efficacy of two surgical preparations i.e. chlorhexidine–alcohol with that of povidone–iodine for preventing surgical site infections. In order to achieve this, preoperative skin preparation was done for adults undergoing clean-contaminated surgery in six hospitals with either chlorhexidine–alcohol scrub or povidone–iodine scrub and paint in a random way. The primary outcome was any surgical-site infection within 30 days after surgery. This study will be critically analysed to identify its strengths and weaknesses. It has been suggested by Burls (2009) that critical appraisal is the process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular context. The critical skills appraisal programme (CASP) tool (Appendix 1) for randomised controlled trials (RCTs) will be used as the selected study is a randomised controlled trial. Screening questions 1. Did the trial address a clearly focused issue? Yes, the study addressed a clearly focused issue with clear problem to be explored, comparison groups and outcomes being investigated using a PICO framework to formulate the research question thereby increasing the rigour of the study (Huang et al, 2006). 2. Was the assignment of patients to treatments randomised? Yes, the assignment to treatment and placebo group was carried out randomly in a ratio of 2:1. This will increase the validity of the study. Literature suggests that random allocation of patients to study groups help to minimize both the selection bias as well as the impact of any confounder present (Cormack, 2000). It has also been observed in the study that in order to match the two groups and deal with possible inter-hospital differences, randomization was stratified by hospital by using computer-generated randomization numbers without blocking. This is a strength of the study as stratified randomisation can help to attain maximum balance of significant characteristics without compromising the benefits of randomisation (Altman and Bland, 1999). 3. Were all of the patients who entered the trial properly accounted for at its conclusion? Yes, the trial was not stopped early and the patients were analysed in the groups to which they were randomised. The study has done both intention-to-treat analysis for both groups as well as per protocol analysis. This accounts for the drop outs in the study an also been reported thus accounting for these drop-outs which may decrease the internal validity of the study. According to the Cochrane Collaboration (2014) intention-to-treat analysis minimised the presence of bias which may exist due to loss of participants, thus upsetting the baseline similarity attained by randomisation. Detailed Questions The study by Darouiche et al (2010) does not explicitly mention whether the personnel involved in the study were blind to the treatment groups. However, it has been mentioned in the study that the operating surgeon became aware of which intervention had been assigned only after the patient was brought to the operating room. In addition, both the patients and the site investigators who diagnosed surgical-site infection on the basis of standard criteria stayed unaware of the group assignments. This minimises the bias in the study and increases its validity as differential treatment or evaluation of participants can possibly introduce bias in the study at any phase of a trial (Karanicolas et al, 2010). Hence, it is a strength of the study. According to Berger (2006), in addition to randomisation, it is important to keep the baseline variables of the study groups similar at the commencement of the trial as it is essential for a RCT to compare groups that differ only with reference to the treatment they receive. The baseline characteristics of both groups have been reported in the study and did not show any significant difference between the two intervention groups reflected by their insignificant p values. It appears from the study that both chlorhexidine and iodine groups were treated the same way other then intervention. In order to determine the treatment effect, clear pre-defined primary end point has been given by Darouiche et al (2010). The primary outcome was defined on the basis of a standard criteria given by the CDC hence it increases the reliability of study. The results of the study found that the overall rate of surgical-site infection was significantly lower in the chlorhexidine–alcohol group than in the povidone–iodine group (9.5% vs. 16.1%; P = 0.004). In order to find the results, the study undertook multiple statistical considerations and tests. The study increased its statistical power by increasing the sample size in each group which gives the study 90% power to identify a significant difference in the frequency of surgical-site infection between the two groups, at a significance level of 0.05 or less. In addition, as mentioned above intention-to-treat and per protocol analyses were performed which further increases study validity. The study also carried out a pre-specified Breslow–Day test for homogeneity to find whether the results were consistent across the six participating hospitals. This was also a strength of the study as literature suggests that involvement of multi-centre patients can compromise the external validity of the RCTs (Rothwell, 2010). This is due to potential effect of differences between health-care systemswhich result in different treatment affects, values and confidence intervals have also been reported where required. Regarding the application of the results in the settings in UK, it has been highlighted by that the study by Darouiche et al (2010) was done in the US and used an aqueous solution of iodine. However, in the UK, the most widely used skin preparations are alcohol-based solutions of 0.5% chlorhexidine or 10% iodine (Tanner, 2012). This is because aqueous-based solutions are thought to be less effective than alcohol-based solutions. Hence, to make the study applicable to the UK settings, 2% chlorhexidine in alcohol should have been compared with 0.5% chlorhexidine in alcohol or 10% povidone iodine in alcohol. The benefits of the study are definitely superior to the harms as SSI not only causes significant unwanted outcomes and distress for the patient but also results in increased costs for the patient, the healthcare and the wider economy (Tanner, 2012). Thus, a number of factors increase the external validity and internal validity of the study including stratified randomisation, blinding of study personnel, intention-to-treat analysis, keep the baseline variables of the study group’s similar, sample size and a number of statistical tests. In addition, clear pre-defined primary end point increased the reliability of the study. The study thus has very low risk of bias and can be therefore rated as 1++ according to NICE hierarchy of evience (NICE, 2004). Hence, alcoholic chlorhexidine solution is significantly more effective in reducing SSIs than povidone iodine. However, the results should be applied to UK settings with caution. References: Altman, D.G. and Bland, J.M. 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