Religion and Human Experience Essay Example for Free

Religion and Human Experience Essay Hinduism can be traced back to ancient Aryan civilizations about four thousand years ago and is based on polytheism with various forms of rituals. Upanishads are documented texts which came about after probing the religion and finding ways of attaining spiritual insight from within and for life in general. Brahman is one who sees the divine as being one in all aspects and the Atman which is the soul reflects the oneness amidst diversity and reveals the Brahman in his true self. Maya on the other hand camouflages the truth of unity in mythical and magical shroud. Karma which is related to rebirth is stressed while Moksha is seen as freedom from and beyond all human aspects. The Bhagvad Gita brings out the practical elements of the religion in everyday life through four paths which can be practised together or separately to achieve spiritual satisfaction. The Hindu religion revolves around temples, rituals, polytheism and numerous festivals. Though many may worship a particular god or goddess they believe in all gods as being one in different forms. Priests and gurus are revered and looked up to as spiritual leaders. Animals are given importance as they are believed to be in the image of god this reflects in several gods having animal features. Symbolism is the basis brought out through art and sculpture. This rich culture of India has appealed to many around the world especially the yoga and meditations which have influenced people from every background. Religion and Human Experience 4 Jainism This religion is as ancient as Buddhism with Mahavir as the central figure and whose teachings are similar to Buddha, preaching abstinence and meditation to attain peace and ultimate freedom. This religion does not believe in god’s creation or being blessed by a Divinity, instead they believe in an everlasting universe full of life and pain as in humans. Though humans are considered special and can attain spirituality through compassion and knowledge of the inner self. The basic of Jainism is Ahimsa of which non violence is the most important followed by other virtues. Like most religions Jains honour 24 saints otherwise known as Tirthankaras who are looked up to and followed for their great accomplishments. Purification is part of being a Jain and life is considered a step in the path to eternal liberation from the human body through a life of good virtue and selflessness. Jainism teaches that to gain spiritual fulfilment one has to follow the path of strict non violence. It has five branches Digambaras, Shvetambaras, Sthanakavasis and Terapanthis. Sikhism This is a fifteenth century Indian religion with a background of Hindu Muslim conflict. The founder is Guru Nanak who believed in monotheism and oneness of God. He professed that even though there may be many forms and perception God is one whom he called â€Å"True name â€Å". His teaching was that God had no image and that he was beyond human insight while being the ultimate source of love, wisdom and righteousness. He taught social Religion and Human Experience 5 conscientiousness as part of the religion and the Sikh temples which are called Gurudwaras were open to all. The Sikhs follow and honor ten gurus, the first of whom was Nanak and the last being Gobind Singh who is the permanent guru and is said to have the soul of Nanak himself. Guru Gobind Singh was the founder of the military group called the Khalsa which followed five basic practices religiously. Today these five practices is what distinguishes the Sikhs from the rest, these include uncut hair and beard, Kangha a wooden comb, Kirpan which is a sword, Kachhera the under short which represents the readiness for battle at all times and Kara which is a steel wrist band representing the unity of Sikhs. This community stands out for its independence and strong unity which is their strength. Adi Granth is the holy book of the Sikhs and has verses and hymns written by the gurus themselves. This community has several festivals marking important events in the history of the Sikh religion. Religion and Human Experience 6 References Molloy Michael. 2008. Experiencing the World’s Religions, 4th Edition. Retrieved on June 7th, 2009 from: http://highered. mcgraw-hill. com/sites/0073535648/student_view0/

Phage Therapy to Treat Bacterial Infections

Phage Therapy to Treat Bacterial Infections Introduction Bateriophages The word bacteriophage, which is a name for bacterial viruses, means â€Å"eater of bacteria.† These viruses parasitize and kill bacteria. Pioneering work on the genetics of bacteriophages in the middle of the twentieth century formed the foundation of more recent research on tumor-causing viruses and other kinds of animal and plant viruses. In this way bacterial viruses have provided an important model system. A bacteriophage is a bacterial parasite. By itself, a phage can persist, but it cannot replicate except within a bacterial cell. Most phages possess genes encoding a variety of proteins. (Ringo John) Discovery and Significance Bacteriophages, viruses that infect or kill bacteria, were discovered by Frederick W. Twort in England in 1917 independently. Twort observed that bacterial colonies sometimes underwent lysis (dissolved and disappeared) and that this lytic effect could be transmitted from colony to colony. Even high dilutions of material from a lysed colony that had been passed through a bacterial filter could transmit the lytic effect. However, heating the filtrate destroyed its lytic property. From these observations Twort suggested that the lytic agent might be a virus. D’Herelle rediscovered the phenomenon in 1917 (hence the term Twort –d’Herelle phenomenon) and coined the word bacteriophge, which means â€Å"bacteria eater.† He considered the filterable agent to be an invisible microbe- for example, a virus- that was parasitic for bacteria. (Pelczar) Since the bacterial hosts of phages are easily cultivated under controlled conditions, demanding relatively little in terms of time, labor, and space compared with the maintenance of plant and animal hosts, bacteriophages have received considerable attention in viral research. Furthermore, since bacteriophages are the smallest and simplest biological entities known which are capable of self replication, they have been widely used in genetic research. Much has been learned about host parasite relationship from these studies, which have provided a better understanding of plant and animal infections with viral pathogens. Thus the bacterium-bacteriophage interaction has become the model system for the study of viral pathogenicity. (Pelczar) General characteristics Bacterial viruses are widely distributed in nature. Phages exists for most, if not all, bacteria. With the proper techniques these phages can be isoalated quit easily in the laboratory. Bacteriophages, like all viruses, are composed of a nucleic acid core surrounded by a protein coat. Bacterial viruses occurring different shapes, although many have a tail through which they inoculate the host cell with viral nucleic acid. There are two main types of bacterial viruses: lytic, or virulent, and temperate or avirulent. When lytic phages infect cells, the cells respond by producing large numbers of new viruses. That is, at the end of the incubation period the host cell bursts or lyses, releasing new phages to infect other host cells. This is called a lytic cycle. In the temperate type of infection, the result is not so readily apparent. The viral nucleic acid is carried and replicated in the host bacterial cells from one generation to another without any cell lysis. However, temperate phages may spontaneously become virulent at some subsequent generation and lyse the host cells. In addition, there are some filamentous phages which simply â€Å"leak† out of cells without killing them. Types of Bacteriophages There are two types of bacteriophages. Virulent phages and Temperate phages Virulent phages :- As a result of reproduction, virulent phages destroy their host. For example :- T pahges or T1-T7 group of phages infect E.coli bacteria. Temperate Phages :- temperate phages do not kill their host and take over its machinery. For example :- Lambda phage (Study.com) Fig -1 Fates of Phages Morphology and Structure The electron microscope has made it possible to determine the structural characteristics of bacterial viruses. All phages have a nucleic acid core covered by a protein coat, or capsid. The capsid is made up of microbiological subunits called capsomeres. The capsomere consists of a number of protein subunits or molecules called protomers. Figure 1 shows the fine structure and anatomy of a common morphological form of the bacteriophage, one with a head and a tail. Fig. 2 Diagrammatic representation of coliphage Bacterial viruses may be grouped into six morphological types This type has a hexagonal head, a rigid tail with a contractile sheath, and tail fibers. This type has a hexagonal head similar to A. However, it lacks a contractile sheath, its tail is flexible, and it may or may not have tail fibers. This type is characterized by a hexagonal head and a tail shorter than the head. The tail has no contractile sheath and may or may not have tail fibers. This type has a head made up of large capsomeres, but has no tail. This type has a head made up of small capsomeres, but has no tail. This type is filamentous. Types A, B, and C Show a morphology unique to bacteriophages. The morphological types in groups D and E are found in plant and animal viruses as well. The filamentous form of group F is found in some plant viruses. Fig – 3 Types of Bacteriophages Phage Structure Most phages occur in one of two structural forms, having either cubic or helical symmetry. In overall appearance, cubic phages are regular solids or, more specifically, polyhedral; helical phages are rod-shaped. Polyhedral phages are icosahedral in shape. (The icosahedrons is a regular polyhedron with 20 triangular facets and 12 vertices.) This means that the capsid has 20 facets, each of which is an equilateral triangle; these facets come together to form the 12 corners. In the simplest capsid, there is a capsomere at each of the 12 vertices; this capsomere, which is surrounded by five other capsomeres, is termed as a penton. For example, the φX174 exhibits the simple capsid. In larger and more complex capsids, the triangular facets are subdivided into a progressively larger number of equilateral triangles. Thus a capsid maybe composed of capsomeres but it is still based on the simple icosahedrons model. The elongated heads of some tailed phages are derivatives of the icosahedrons. For example the head of the T2 and T4 phages is an icosahedron elongated by one or two extra bands of hexons. Rod-shaped viruses have their capsomeres arranged helically and not in stacked rings. An example is the Bacteriophages M13. Some bacteriophages, such as the T-even coliphages (T2, T4 and T6), have very complex structures, including a head and a tail. They are said to have binal symmetry because each virion has both an icosahedral head and a hollow helical tail. Phage Nucleic Acids Different morphological types of phages are also characterized by having different nucleic acid types. All tailed phages contain double-stranded DNA. The phages with large capsomeres and the filamentous ones have single-stranded DNA. Group E phages have single-stranded RNA. The DNAs of phages are circular under certain conditions. The DNA of phage φX174 is circular both in the virion and in the host cell. The DNA of phage lambda is linear in the virion, but on entering the host cell the cohesive ends join to form a circle. Infection of bacteria by phages Most bacteria are susceptible to attack by bacteriophages. A phage consists of a nucleic acid â€Å"chromosome† (DNA or RNA) surrounded by a coat of protein molecules. Phage types are identified not by species names but by symbols – for example, phageT4, phage lambda, and so forth. During infection, phage attaches to a bacterium and injects its genetic material into the bacterial cytoplasm. The phage genetic information then takes over the machinery of the bacterial cell by turning off the synthesis of bacterial components and redirecting the bacterial synthetic machinery to make phage components. Newly made phage heads are individually stuffed with replicates of the phage chromosome. Ultimately, many phage descendants are made and are released when the bacterial cell wall breaks open. This breaking open process is called lysis. The population of phage progeny is called the phage lysate. Commercial production of Phages In D’Herelle’s laboratory against various bacterial infections five phage preparations were produced. That phage preparations are Bacte-coli-phage, Bacte-rhino-phage, Bacte-intesti phage, Bacte-pyo-phage and Bacte-staphy phage. In the United States therapeutic phages were also produced. Seven phage product for human use produced by the Eli Lilly company in the 1940s including preparations against Staphylococci, Sreptococci, E.coli, and other bacterial pathogen. These preparations contains phage-lysed, bacteriologically sterile broth cultures of the targeted bacteria. These preparations were used against various infections including wounds, vaginitis, acute and chronic infections of the upper respiratory tract, abscesses and mastoid infections. In most of the Western World commercial production of therapeutic phages ceased because of controversy. But in Eastern Europe and in the former Soviet Union the use of phages continued therapeutically together with or instead of antibiotics. (Sulakvelidze.,et.al,2001) Phage therapy Pharmacokinetics Pharmacology is the study of drug’s impact on the body and body’s impact on the drugs. These two concepts are known as pharmacodynamics and pharmacokinetics. In the concept of body, while considering anti microbial as drugs which includes both normal body tissues and the numerous symbiotic micro-organisms. Here we consider only pharmacokinetic aspect of phage therapy pharmacology. Pharmacokinectics describes drug’s potential that are sufficient to achieve primary pharmacodynamic effects. This description is distinguished into absorption, distribution, metabolism and excretion components. Drug movement into the blood is absorption, drug movement into other body tissues is distribution, modification of drugs within the body is metabolism, and movement of drugs out of the body is excretion. These four pharmacokinetic aspects have the effect of both reducing and increasing drug densities. In the case of absorption and distribution, drug densities declines due to drug dilution and at the same time drug density increases in specific body compartments. Metabolism results phage inactivation due to phage interaction with immune systems or â€Å"activation† such as phage in situ replication. Excretion can reduce of drug densities in the body, it can also increased drug densities in bladder with therapeutic benefits. The success of phage therapy depends on generation of sufficient phage densities in the vicinity of the target bacteria to cause bacterial removal from the body at some adequate rate. Sufficient densities of phage will increase either to in situ replication which is a active treatment, or a consequence of what can be described as pharmacologically conventional dosing, is called passive treatment. (Abedon et al,2011) Potential benefits Phage therapy offers a possible alternative to conventional antibiotic treatments for bacterial infections. Phages are very specific to target one or a few strains of bacteria. Traditional antibiotics kill both harmful bacteria and useful bacteria such as those facilitating food digestion. The specificity of phages might reduce the chance that useful bacteria are killed when fighting on infection. Phages have ability to travel to a required site including brain. (Wikipedia.org) Phages are natural antimicrobial agents to fight bacterial infections in humans, in animals or in crops of agricultural importance. Phages have hygiene measure in hospitals and in food production facilities. (Brussow Harald) Alternatives to antibiotics Phage is a viable alternative to antibiotics. The collapse of antibiotics and emergence of harmful and drug resistant bacteria, phage therapy starts again and is being reintroduced. Phage therapy has many potential applications in human medicine, veterinary science and agriculture. Specificity – Phages are more specific than antibiotics, means one phage will only attack and eat one particular bacteria and no other. Each infection needs a particular phage to treat it. To improve the chances of success phage mixtures are applied or samples can be taken and an appropriate phage identified and grown. Phages can be chosen to be indirectly harmless not only to the host organism, but also to other beneficial bacteria, such as gut flora, thus reduce the chances of infections. Phage therapy give rise to few side effects. Phages replicates inside the patient, a smaller effective dose may not even be necessary. Currently phages are used therapeutically to treat bacterial infections that do not respond to conventional antibiotics particularly in Russia and Georgia. (Prof. Kieth) Need to study Phages As we saw research on phages and a lack of knowledge on phage biology affects on clinical failure. The emergence of antibiotics wiped out further research on medical use of phages. After many years, a new problem of bacterial resistance to use of antibiotic has arisen. Bacteria become resistant to drug used in modern medicine by adapting themselves. Problems created in treating patients in hospitals due to the emergence of modified pathogens such as S.aureus, P. aeruginosa, Acinetobacter baumannii and Mycobacterium tuberculosis. Time required to produce new antibiotic is much larger than the time of bacterial adaptation. Therapeutic Uses of Phages and Antibiotics Conclusion For phage therapy multidrug resistant bacteria have opened a second window. (Carlton,1999) Phage therapy is the therapeutic use of lytic phages to treat bacterial infections. It is an alternative to antibiotics developed for clinical use. Phages are more specific than antibiotics that are in clinical use. This therapy is harmless to eukaryotic hosts undergoing therapy and should not affect normal beneficial flora of the host. Theoretically a single small dose is effective. Specificity is the disadvantage because specific phage will only kill a bacterium if it is a match to the specific subspecies. Thus, to improve the chances of success, phage mixture may be applied or clinical samples can be taken and suitable phage identified and grown. In the country of Georgia phages are used to treat bacterial infections therapeutically. (Todar Kenneth)

Advanced decisions in end of life planning

Advanced decisions in end of life planning The advanced care planning (ACP)process is concerned with ensuring the patient has expressed their wishes should their condition deteriorate, leaving them without mental capacity or unable to communicate their decision.(REF LCP)Part of this process is allowing the patient to create advanced decisions with regards to refusing treatment (Joseph, 2010). As end of life planning is such a vast topic this essay will critically evaluate the key principles of advanced decisions with regards to Cardiopulmonary Resuscitation (CPR). CPR is an issue in many health care settings including hospitals, primary care, day hospitals and nursing homes. The ethical debate and the associated problems with advanced decisions are becoming ever more apparent due to the ever increasing number of elderly people in nursing and residential homes. (DH, 2000, 2010). Previous evidence based research has looked at helping elderly people and their families with decision making in end of life planning (references) as well as Patients requesting Do Not Resuscitate (DNR) orders against the advice of others (REF). There appears to be a gap in the literature concerning the complexity of the tensions associated between the nurse, the rights of the patient and family (or independent advocate) when the patient has specifically requested resuscitation in the event of a cardiac arrest against the advice of the multidisciplinary team. This reflection is based on an issue experienced within my practice and can cause many ethical and moral debates for the nursing staff. The knowledge gained from this reflection will inform my future practice on how patients rights are supported or challenged and the subsequent roles of the nurse. Gibbs (1988) developed his model of reflection in order to reflect on events, critically evaluate fundamental concepts and influence future practice. The first element of this model is based on experience and a description of events. Mr Smith is an elderly gentleman in his late 80s currently living in a nursing home. He has one daughter and a son in law who he is close to and his wife and son passed away a few years ago. Mr Smiths health has been deteriorating over a period of time and the staff nurses and his daughter want to begin the advanced care planning process. For the purpose of this reflection, names and personal data has been changed in line with the NMCs (2008) policy on confidentiality. It is often difficult to establish when a person is reaching the final stages of life (Ellershaw Wilkinson, 2003), however factors have been identified in the Liverpool Care Pathway in order to allow patients to be assessed, including reduced performance status (Karnovsky, 1949); increased dependence in activities of daily living (Barthel, 1965); weight loss and overall physical decline (McNicholl, 2006). Mr Smith had lost a significant amount of weight over the previous 6 months, was requiring more help with various tasks, including personal hygiene and often required the use of a wheelchair as he was becoming more unstable on his feet. It was due to this that it was felt the ACP process was necessary. Effective nursing practice relies upon the ability to develop therapeutic relationships with the patient and family (Peplau, 1952). The qualities of the relationship include good listening skills, a build up of trust and empathy ( Watt-Watson, Garfinkel, Gallop, Stevens, 2002). It is important for relatives to be included in discussions concerning end of life planning as it allows everyone involved to understand and come to terms with the decision (McDermott 2002). A meeting was arranged with Mr smith and his daughter (after consent was gained) to disuss his care wishes in the event of his condition deteriorating. Mr Smith understood that his condition was getting worse but was adamant that he wanted every effort to keep him alive. Therefore, if he went under cardiac arrest Mr Smith would wish the nurse to commence CPR. Cardiopulmonary Resuscitiation (CPR) is a complicated ethical decision comprising of many legal, ethical and emotional decisions for that of the nurse, patient and family (Jeven, 1999). The principle role of the nurse is to assist the patient in restoring or maintaining the best level of health possible (NMC, 2004). Cardiopulmonary resuscitation (CPR) is a procedure that aims to prolong the life of an individual who goes under a cardiac arrest by attempting to restore breathing and increase oxygenated blood flow to the brain and heart. The decision to carry out this procedure should be based on any potential risks or benefits to the patient and should not be carried out with no regard to the quality or life expectancy of the patient (BMA, Royal College of Nursing the Resuscitation Council, 2007). These discussions led to a divide in attitudes as it was felt by the majority that a do not resuscitate (DNR) order would be the most sensible and realistic option. A DNR order is often implemented when a person is extremely ill and death is imminent (British Medical Association, 2007). Furthermore, if the patient has other chronic illnesses, which will reduce the quality or length of life, CPR has the potential to prolong suffering and do more harm than good and so would not be deemed beneficial (BMA, Royal College of Nursing the Resuscitation Council, 2007). However, Mr Smith did not agree with this and felt angry and confused as to why his family would suggest that a DNR would be appropriate. He was willing to accept the associated risks of CPR and maintained that his age should not prevent him being entitled to treatment. This statement is supported by equal rights for the elderly, in which people cannot be denied CPR just because of age (DH, 2001). This decision appeared somewhat irrational as he had stated for some time that it was his time to go and he was fed up of suffering and his mental capacity was called into question. The Mental Capacity Act (2005) states that an advanced decision (formerly known as an advanced directive) gives a person over the age of 18, who is deemed to have mental capacity, the ability to consent to or refuse a specific treatment if they become in a position where they lack capacity or are unable to state their decision. A person is considered to have capacity if they are able to understand and retain information in order to make an informed decision; be able to understand the consequences of any interventions and be able to communicate their decision (GMC, 2008). Current English law states that individuals are presumed to have mental capacity unless it can be proven otherwise and this does not take away the allowance for seemingly irrational and risky decisions to be made (NMC, 2004, BMA 2009, DOH, 2001, MCA, 2005) Mr Smith was deemed to have full mental capacity as he fulfilled the criteria outlined by the MCA (2005) and a second opinion doctor was also called to ensure that this was the case. If the patient lacked capacity to make their own decisions, nursing staff must act in line with the patients best wishes (Dimond, 2006). In such circumstances members of the multidisciplinary team must be able to provide clear justification (Hutchinson, 2005). Had it been the case that Mr Smith lacked capacity it would have been reasonable for the nurse to justify not performing CPR, however, failure to comply with his wishes could potentially lead to legal and professional consequences as the NMC (2004) states that patients autonomy must be respected even where this may result in harm. However, the ACP is not legally binding as clinical judgement takes priority (REF LCP). This can put the nurse into a moral dilemma because following professional and legal responsibilities would deny the patient their rights. Beauchamp and Childress (1994) devised an ethical framework based on 4 moral principles to provide guidance on the conflict between the role of the nurse and the rights of the patient. Beneficence, suggests that any decision to be made must be in the best interests of the specific patient as well as weighing up potential benefit and risks (Beauchamp Childress, 2008). In this case it could be suggested that the risks far outweigh any potential benefits and to do CPR would not be the greater good but this would affect the principle of autonomy. Autonomy is the patients right to accept or refuse any medical treatment. It follows deontological theories (Mill, 1982) which deem an action to be right, if it accords with a moral duty or code, regardless of the outcome (Noble-Adams 1999). This approach would justify the nurse performing CPR because they would be following their legal and professional code of conduct in that a patients wishes must be respected and carried out (NMC, 2008). How ever going against the patients wishes could also be deemed as morally right as part of the nurses role is to allow the patient to die with dignity (King,1996). Howver, this could be suggested as following the traditional notion of paternalism, which is not compatible with modern day ethics (Rumbold, 1999). All of these issues cause a moral dilemma for the nurse and impact upon the patients rights as it has been suggested that CPR can deny a patients right to die with dignity by prolonging the dying process (McDermott 2002) and so could be suggested that the greatest good in the situation would be achieved by not performing CPR. The principle of non-maleficence is based on doing no harm (Edwards, 1996). Many people have unrealistic expectations of the success rates of CPR due to media representations (Dean 2001). Patients who survive cardiac arrests following resuscitation is as low as 20% and not all of these inidivudals get to the position of being well enough to be discharged from hospital (Cardozo, 2005). These rates of success are reduced even further when patients have underlying problems and poor health (Schultz 1997). However, it could be argued that the ultimate harm would be to do nothing resulting in death which would also be against Mr smiths wishes. The fact that Mr smith was already considered emaciated and having deteriorating health increases the risk of physical damage during chest compressions but as Mr Smith had already written an advanced directive stating he wished to receive CPR then this should be carried out (Pennels, 2001). This puts the nurse in a serious dilemma as patients and the ir families taking legal action is becoming increasingly common (Oxtoby, 2005) and the nurse is bound by the legalities of their professional code, which would claim that failing to carry out CPR would be considered negligent (Jevon, 1999) and as nurses are professionally accountable for their actions this could put their career in jepoardy(NMC, 2004). The final ethical principle of Justice is concerned with fairness and equality maintaining that every individual has the right to life (Human Rights Act, 1998) and therefore, the patient has a right for the nurse to carry out CPR (even if they have not previously stated this) especially if they have an advanced descision stating that they wish to be resuscitated in the event of cardiac arrest. (Costello, 2002). After all this has been taken into consideration, the rights of the patient, including those who have an advanced decision can still be overruled as before the decision can be applied there must be reasonable evidence to suggest that the decision is still valid and applicable (BMA, 2007). Mr Smith appeared not to be acting in line with his advanced decisions as he was refusing to eat or drink and appeared withdrawn in his personality, not wanting to participate in his activities of living (Roper, Logan and Tierney, 2000). It has been suggested that many health care professionals do not discuss goals of care as they have inadequate communication skills or that there is often conflicting ideas between the patient and professional about what is in their best interests (Haidet et al, 1998) As this has often found to be the case, one of the registered nurses decided to have a further chat with Mr Smith as it was felt that his needs were not being appropriately addressed. It transpired that Mr Smith did wish to die a peaceful death but was scared of what might happen and if he said he did not wish to be resuscitated then he could be left suffering alone in great pain in his last few minutes. The Liverpool Care Pathway suggests that the role of the nurse in the last few days of life shifts to a holistic approach of care to promote comfort and moves away from the idea of active care which includes any invasive or unnecessary procedures that could be avoided (REFERENCE). The Gold Standards Framework provides an holistic assessment plan to aid communication between the nurse and the patient, including how physical, emotional, social, spiritual and communicational needs came be met (Thomas, 2009) The nurse stated that medications can be arranged for end of life care to alleviate any pain and suffering. Discuss syringe drivers, end of life medication and controversy During the final stages of life a natural physiological process causes the swallowing reflex not to work and so the use of oral medication is limited (Thorns Gerrard, 2003). A common palliative care practice is to use a syringe driver to administer drugs (ODoherty et al, 2001), which allows comfortable parenteral treatment of pain, nausea and breathlessness (GrassbyHutchings, 1997). In most circumstances this form of medication administration comes without controversy (Woods, 2004), however, the double effect of sedatives and opiates will reduce anxiety and pain but have also been claimed to supress respiratory function, which has the potential to speed up the dying process (BNF, 2007). The most important aspect of this double effect is that it is permissible so long as death is not intended and is occurs as a byproduct of an intention carried out for the patients best interests (Fohr, 1998). Furthermore, it has been stated that there is a lack of empirical evidence to support this claim (Kaldjian et al, 2004) and research has suggested that repiratory depression does not occur with patients receiving opiods for pain in end of life treatment (Walsh, 1982). The role of the nurse is, therefore to allow the patient to die peacefully. However, health professionals are accountable for their actions and must be able to provide justifications if any problems arise (Dimond, 2004) An assessment using the Abbey pain scale(INCLUDE MORE DETAILS) was carried out to analyse levels of pain experienced by Mr Smith and the appropriate drugs were administered via the syringe driver. Mr Smith continued to deteriorate and died peacefully with his favourite classical music on, his daughter holding his hand and a picture of his wife by his bed. She also clarified that the advanced decision he would have made was only concerned with CPR and did not have to decline all treatment just because he declined one. The nurse asked him if it was clear the end was near what the staff and his family could do to help his transition into death. Mr Smith stated he did not want to be alone and wished to have his family with him to reassure him and comfort him in his last moments. The point of this discussion was not to overrule Mr Smiths advanced decision but to confirm its applicability and validity to his current circumstances. Details of these discussions were recorded in his care plan records in line with relevant policies (REFERENCE) WHAT WAS GOOD/ BAD ABOUT EXPERIENCE? GOOD THAT IT WAS REALISED BEFORE IT WAS TOO LATE BAD COMMUNICATION Analysis what sense can you make of the situation On reflection of the situation the complexities of the tensions between the rights of the patient and the role of the nurse become alarmingly apparent. Nurses are expected to use evidence based knowledge to inform their practice centred on the NMC professional code of conduct. This practice can often involve moral dilemmas on life and death matters for which the nurse can be held professionally accountable. The nurses role is ever more challenging when the patient is entitled to make their own decisions, often deemed unwise or not in their best interests. This reflection informs my practice as it highlights the importance of not only allowing the patient to make an informed decision based on knowledge and evidence but also to explore their feelings behind the decision to be made. In this case it wasnt that Mr Smith wanted CPR in the event of a cardiac arrest because he felt like it was the best option and would extend his life or the quality of it but because he was scared of dying a nd unsure of what would happen. As the nurse discussed his fears and anxieties and suggested ways in which these could be dealt with Mr Smith agreed that a DNR order would be the most effective way to ensure a peaceful and dignified death without prolonging any pain or suffering for him or his family. This experience has taught me that each situation is unique and there can never be any absolute right or wrong in nursing. Patients well-being depends on many factors including anxiety or unmet physical or emotional needs (Dewing, 2002). Communication with patients, their relatives or an advocate is of utmost importance when identifying individual needs as well as understanding the rationale behind decision making. Furthermore, communication between the multidisplinary team is imperative in order to promote best practice (Bridges and Wilkinson, 2011). The insight I have gained from this experience will inform my future practice to understand the feelings and attitudes behind the patients actions and behaviours. Conclusion what else could you have done Action plan, if it rose again what would you do Discussion General Medical Council. (2008). patient and doctor making decisions together. Available: http://www.gmc-uk.org/static/documents/content/Consent_0510.pdf. Last accessed 23 April 2011. Abbey Pain Scale Abbey, J; De Bellis, A; Piller, N; Esterman, A; Giles, L; Parker, D and Lowcay, B. Funded by the JH JD Gunn Medical Research Foundation 1998-2002. 10. Bedell SE, Pelle D, Maher PL, et al. Do-not-resuscitate orders for critically ill patients in the hospital. How are they used and what is their impact? JAMA 1986; 256: 233-237. 13. Haidet P, Hamel MB, Davis RB, et al. Outcomes, preferences for resuscitation and physicianpatient communication among patients with metastatic colon cancer. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. Am J Med 1998; 105: 222-229. 19. Deep KS, Grif?th CH, Wilson JF. Discussing preferences for cardiopulmonary resuscitation: what do resident physicians and their hospitalized patients think was decided? Patient Educ Couns 2008; 72: 20-25. Gallagher A, Wainwright P (2007) Terminal sedation: promoting ethical nursing practice. Nursing Standard. 21, 34, 42-46. Date of acceptance: January 4 2007. Fohr SA (1998) The double effect of pain medication: separating myth from reality. 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The Attitudes of the Poets in Warning and Old man Essay -- Jenny Josep

The Attitudes of the Poets in Warning and Old man Both poems represent a picture of old age. Jenny Joseph's view of what she imagines life will be like, and her expectations, where-as U A Fanthorpe's observation of old age, is of her father, and is written from her own experience. Jenny Joseph sees old age as a positive experience. She seems to believe she will be free from responsibility. "I shall go out in my slippers in the rain." She suggests these are the things she would enjoy to do now, but if she were to actually do these now, people would disapprove of her actions. She assumes that when she gets old, others will accept childish actions. Jenny Joseph does not see herself unable to do anything that she can do at the moment. Her picture of old age is one of being active. "Sit down on the pavement when I'm tired." She sees this as being a childish act, as she would not consider sitting on the pavement now. She does not think about the restrictions that old age bring. In "Old man, old man" Fanthorpe presents a picture of her fathers old age. He is unable to do many things he once could do. "Now his hands shamble among clues" =================================== Fanthorpe's father could once do these things for himself but now he needs the help off the other people. Fanthorpe raises issues that are negative towards old age, and how old people are like children, the way they become dependant on others. Most of the behaviour described in both poems is childish. Jenny Joseph seems to see age as a second childhood. "Pick the flowers in other peoples gardens" She sees this an act that children can get away with, she also sees this as a step into a new freedom, where as Fanthorpe... ...cking her father, at his expense, someone suggesting another to be the 'lord' of something is of high status, and so it is funny as it is only a shed. There is also a sense of sadness to the poem, as she recounts of her father not being good with her when she was young. "Not good with daughters" I believe that the motive for this is because of his interest's in D.I.Y rather than the more necessary and essential things in life. Fanthorpes father has seemed to lose all-important aspects of his character, even the aspects that were dislikeable about his personality. He has begun to be dependent on other people, and is unaware of what is happening. I think both poems represent humour and compassion. Jenny Joseph represents the bright and optimistic observation's of old age, where-as Fanthorpe raises depressing and discouraging vision's of old age.

James Joyces Araby - Setting and Theme in Araby :: Joyce Dubliners Araby Essays

How the Setting Reinforces the Theme and Characters in Araby      Ã‚  Ã‚  Ã‚   The setting in "Araby" reinforces the theme and the characters by using imagery of light and darkness.   The experiences of the boy in James Joyce's "Araby" illustrate how people often expect more than ordinary reality can provide and then feel disillusioned and disappointed.   The author uses dark and obscure references to make the boy's reality of living in the gloomy town of Araby more vivid.   He uses dark and gloomy references to create the mood or atmosphere, then changes to bright light references when discussing Mangan's sister.   The story expresses its theme through the setting, the characterization of the boy and his point of view as the narrator.      Ã‚  Ã‚  Ã‚  Ã‚   Darkness is used throughout the story as the prevailing theme.   James Joyce's story begins at dusk and continues through the evening during the winter, in Araby Ireland.   He chooses this gloomy setting to be the home of a young boy who is infatuated with his neighbors sister.   The boy is young and naive and he leads a dull and boring life.   Joyce uses darkness to make the boy's reality more believable through more vivid, precise descriptions.      Ã‚  Ã‚  Ã‚  Ã‚   Bright light is used to create a fairy tale world of dreams and illusions.   James Joyce uses the bright light when describing Mangan's sister, the boy's infatuation.   The protagonist is infatuated with his neighbor's sister and he imagines that he will heroically bring her something back from the bazaar.   Joyce refers to bright light when discussing Mangan's sister in order to give her a heavenly presence.   Light is used to create a joyful atmosphere.      Ã‚  Ã‚  Ã‚  Ã‚   The ending of the story is filled with images of darkness and light. James Joyce uses the lights of the bazaar to illustrate the boy's confrontation with reality.   The bazaar lights are almost all off because the bazaar is almost closed.   This is significant because the boy wants the bazaar to be bright and open, but it is dark and closed.   This is when the boy finally realizes that

Diversity in the Workplace Essay

This diversity audit begins with a background about the company, as well as some important information about key Diversity executives. What will be addressed in the audit are what efforts Johnson & Johnson made to foster diversity competence and understand, what efforts were made in furthering the knowledge or awareness about diversity, what strategies were used to address the challenges of diversity and how will you ensure that your leaders and managers will be committed to the diversity initiative. The audit concludes with a quote from the vice president of recruiting at Johnson and Johnson, as well as their Diversity and Inclusion Programs and Activities from the Johnson and Johnson Website. In 1886 three brothers, Robert Wood Johnson, James Wood Johnson and Edward Mead Johnson, fount the Johnson & Johnson company in New Brunswick, New Jersey. Today, the company employs approximately 128,700 people with more than 275 operating companies in more than 60 countries. The worldwide hea dquarters remains in New Brunswick, New Jersey. The company prides itself in caring for everyone in the world, they feel this inspires and unites the people who work there. Johnson & Johnson is the world’s sixth largest consumer healthy company, the world’s largest and most diverse medical device and diagnostic company, the world’s fifth largest biologics company and the world’s eighth largest pharmaceutical company. These companies together touch the lives of more than a billion people throughout the world every single day. This company, without a doubt, knows what diversity is. Their product line in itself is so diverse that I would say that diversity is what this company was built on and continues to grow from. They offer health care products that go from taking care of a skin blemish or a headache, to beautifying your hair and teeth products, to products used for metastatic breast cancer, hip placements and coronary stents, to prescription drug products treating everything from migraines to cancer a nd serious infections. According to  the company website, diversity is described as follows, â€Å"People and values are our greatest assets. Diversity is a central part of the cultures across the Johnson & Johnson Family of Companies. It’s a key to our people’s passion for improving the health and well-being of people the world over. Further, our commitment to diversity and inclusion is deeply rooted in the values instilled by Our Credo and is exemplified in a number of our companies’ programs and activities. We recognize that differences in age, race, gender, nationality, sexual orientation, physical ability, thinking style and background bring richness to our work environments. Such differences help us connect better with the health needs of people in communities around the world. We believe that attracting, developing and retaining a base of employees that reflects the diversity of our customers is essential to our success. We also believe success hinges on relationships with diverse professional and patient organizations, civic groups and suppliers†. (jnj.com) In addition, Johnson and Johnson offers mentoring programs and leadership development programs to ensure personal professional growth. During my research I found that Johnson & Johnson has supporting affinity groups that has strengthened the impact of diversity not only within the organization, but in the community as well. Some of these groups include the Community of Asian Associates at Johnson and Johnson, South Asian Professional Network and Association, Gay and Lesbian Organization for Business and Leadership, Women’s Leadership Initiative, African-American Leadership Council and Hispanic Organization for Leadership and Achievement. These groups are just the tip of the iceberg as far as diversity for Johnson & Johnson. A key executive, Anthony P. Carter is Vice President of Global Diversity and Inclusion, as well as Chief Divers ity Officer for Johnson and Johnson. In an article from Diversity Global Magazine, Mr. Carter was named a 2013 Diversity Executive of Distinction. The article stated that Mr. Carter’s focus on developing cutting edge Diversity and Inclusion programs and strategies is successful because it is aligned with the company’s strategic business objective. As I researched deeper into the company’s responsibility to its customers, employees, communities and shareholders I found that Johnson & Johnson’s respect towards these groups of people who keep the company alive is supported by Anthony’s implementation and design of an inclusive global organizational system, as  well as Diversity and Inclusion incentives. He has further developed opportunities for Johnson and Johnson to maximize their diversity. He oversees an office that implements programs such as Crossing the Finish Line, which is a career acceleration program for people of color. Programs such as these are crucial in developing world-class diverse leaders. An interesting quote by Anthony P. Carter sums up his role nicely, â€Å"Diversity and inclusion describe how we can work together to bring innovative ideas, products and services together to advance the health, well-being and the quality of life of those we serve.† (Diversity Global) In the article Harnessing Diversity to Affect the Bottom Line by Ron Dory, it was noted that one of Carter’s best practices in relation to diversity is the use of ERGs (Employee Resource Groups), which have brought in new markets and impacted the company’s growth in a positive way. Johnson and Johnson prides itself in it’s membership in the Billion Dollar Roundtable, an elite group of companies that spend a billion dollars annually on women owned and minority owned suppliers. Johnson & Johnson’s use of Employee Resource Groups or ERGs as an organization where people who share a culture or background, for example gender, ethnic, religion or age, can meet to rejoice within their culture or address issues in relation. ERGs are often chartered organizations and have volunteer leaders and business plans that are in alignment with the organizations goals and bring value to the company. Mr. Carter’s use of ERGs at Johnson & Johnson has allowed everyone to see that they are not the same but different while trying to achieve the same goals and objectives. He has also advised other companies to not move towards being the same or creating an organization where differences are not acknowledged. It appears the ERGs have allowed diversity to take a strong root within Johnson & Johnson. The have led to the company receiving numerous awards as leaders in diversity. As an example, Johnson and Johnson continue to develop world-class leaders. In September 2013, The United States Hispanic Chamber of Commerce (USHCC) announced this year’s Corporate Advocate of the Year, and the award went to Johnson and Johnson’s Chief Procurement Officer for Medical Devices/Supplier Diversity, Ruben Taborda. The president and CEO of USHCC stated, â€Å"Ruben Taborda is a visionary leader who has demonstrated an unwavering commitment to fostering business relationships between minority-owned enterprises and corporate America. Mr.  Taborda is a true role model, leading by example, committed to providing concrete growth opportunities for Hispanic businesses throughout the nation.† (Global Newswire) Ruben Taborda is just another example of the success Johnson & Johnson has had implementing diversity programs throughout their company. Just from my audit I have seen their success with women, Hispanics and many other minority situations. They truly believe in what they stand for and what they are trying to accomplish in the diversity arena. In retrospect, even though Johnson and Johnson has an impeccable reputation regarding diversity, even to the point that the company thrives from the immense diversity, it is always on the top of the list of the best places work and was one of Divers ity Incs. Top Companies for Diversity, problems arise sometimes when employees or perspective employees do not see it the same way. Examples of this come in the form of lawsuits against the company for discrimination. One case in particular, Francine Parham, vice president of human resources was always bothered that there was a lack of minorities in the high positions within the company. She filed a lawsuit claiming that she did not receive a promotion because she is African-American and was then fired for speaking out against â€Å"a corporate culture of discrimination† (Gordon). Perham stated that in the lawsuit that she was told by her supervisor that he envisioned a promotion for her within the next twelve months and that she never got the promotion because that position was eliminated and that she was not qualified for a higher position even though she had excellent performance review. Perham also alleged that less qualified white men and women were promoted to higher positions and she believes this was because she is black. She also pointed out the lack of diversity at the top. Johnson and Johnson’s responded, â€Å"We have a deeply established commitment to diversity and incl usion in the workplace and deny the allegations in this case†(Gordon). There were two other cases, one in which an African American and one a Hispanic, filed similar lawsuits, accusing Johnson and Johnson of paying them lower wages and denying promotions to people of color. After ten years, that case was dismissed. Despite the fact that five of the highest-paid executives at Johnson and Johnson are white, four of them being men, and ten of the twelve directors are white with no women of color on the board, Calvert Investments still rated Johnson and Johnson’s diversity an 85 out of 100. They have an  abundance of internal minority groups and minority recruitment outreach efforts, they are a strategic partner of Minority Business Round Table and they sponsor scholarships for minority students. (Gordon) I believe that companies such as Johnson and Johnson, with such outstanding reviews regarding diversity, and notable for their roles in diversity, are sometimes an easy target for people who are looking for lawsuit settlements. Reverse discrimination plays a large part in this process. It is very easy for a person, especially one of a protected class, to claim discrimination, especially against mega companies such as Johnson and Johnson. These people know that the company would not want their reputation tainted so they make false claims to try and get whatever they can from the company. So the five highest paying executive in Johnson and Johnson may be white, but they also may be the most qualified, they may have worked the hardest to get to that point and they may be the most dedicated thereby deserving every dollar they earn. In my own experience, in managing a small local business, it is the qualified, hard-working, dedicated and reliable employee that will be promoted, no matter what the race, gender, religion, etc. According to Global Dynamics Inc., â€Å"leading healthcare provider, Johnson and Johnson has been rated, by Diversity Inc. Magazine as the #1 company for promoting diversity and inclusion in the U.S. Diversity and Inclusion (D&I) are regarded as critical factors in making Johnson and Johnson one of the â€Å"best places to work† in the U.S†. Although Johnson and Johnson met some challenges when they wanted to expand its Diversity and Inclusion initiative globally, they succeeded in meeting those challenges and the initiative was a success. Town hall meetings led by local leaders and web-based training reached several countries within the regions, live video conferences and live international video meetings were introduced and became groundbreaking for Johnson and Johnson. This resulted in improved employee morale, productivity and communication. (Global-Dynamics) In conclusion, my diversity audit of Johnson and Johnson showed they are a major player in the diversity arena. They have diverse employees, market their products to diverse groups and have initiatives in place to expand lead their company diversity even further in the future. An article in the NY Times sums it well by stating, â€Å"Johnson and Johnson’s achievements in diversity, in concept and in practice, succeed in bringing value to all those  con stituents† (Forsythe). Johnson & Johnson is a company that is focused on building their brand by building superior products and understanding the importance of diversity in achieving success in the global marketplace. They have made diversity an integral part of their processes including procurement, supply chain, product development, information management, sales and marketing, and community service. My audit research of Johnson & Johnson showed they are a worldwide leader in all of the above and they make a concerted effort to lead other companies in the same direction. Having all the initiatives and being part of outside organizations that push diversity allows them to exert pressure necessary to achieve diversity in the workplace throughout the world. The NY Times article also quoted Marjorie Geller, Vice President of Recruiting as saying â€Å"There’s no question about it, our commitment to diversity has a powerful impact on our recruitment and our talent-development processes, as well as the products we offer to customers. We try very hard to assure that our diverse culture translates into value for our customers, our employees, our communities and our stockholders† (Forsythe). The following is the Diversity and Inclusion Programs and Activities from the Johnson and Johnson Website: Throughout our companies, a wealth of programs and activities support our belief that a diverse, inclusive culture is essential to business success. Following is a sampling of these activities. Employee Resource Groups Employee resource groups are voluntary, employee-driven groups that focus on shared interests and experiences and look to apply those perspectives to initiatives that create value for the enterprise. These groups provide support, networking as well as personal and professional enrichment opportunities for their members such as mentoring, community outreach, supplier diversity, career development and cultural awareness activities. Mentoring Programs Mentoring is widely offered throughout the Johnson & Johnson Family of Companies as formal or informal programs. We look to expand learning opportunities and support development of a diverse workforce by making these  nurturing relationships available to an ever increasing number of employees across the enterprise. In the spring of 2010, Johnson & Johnson introduced a custom, web-enabled mentoring service called Mentoring Works! that contributes to the Global Diversity & Inclusion strategic objective of building a culture of inclusion. Mentoring Works! is an enabler for talent development, employee engagement, and effective knowledge transfer as it makes it easier for people to connect, network and learn from each other. Diversity University Recognizing that education is essential to learning about the benefits of diversity and inclusion, we have established the Johnson & Johnson Diversity University. Diversity University is a dynamic online website designed to help employees build the competencies and the skills needed to understand and value differences and the benefits of working collaboratively to meet our Credo commitments and business goals. Diversity University includes a variety of guides, toolkits and resources for self-guided learning; a strong elearning curriculum that includes Diversity & Inclusion Fundamentals, Building Trusting Relationships in a Global and Diverse Environment, and Leveraging Diverse Thinking Styles: The Whole Brain ® Advantage; as well as links to other interactive portals providing cross-cultural education and skill building exercises. Office of Diversity & Inclusion The Office of Diversity & Inclusion was formed as a functional group within Johnson & Johnson to drive diversity & inclusion as a business imperative and to ensure a competitive advantage. The Chief Diversity Officer reports directly to the Chairman and Chief Executive Officer of Johnson & Johnson. The team serves as business catalysts, executing a global diversity strategy that enables Johnson & Johnson to win in the global marketplace. (JNJ.com) Also of interest is the following web address which shows the details of Johnson and Johnsons Diversity and Inclusion Business Model: http://www.jnj.com/sites/default/files/pdf/Global%2BDI%2BCall%2BOut.pdf References: Diversity Global. Retrieved from: http://www.diversityglobal.com/tops.aspx?id=Anthony-P-Carter-1449 Dory, R. Harnessing Diversity to Affect the Bottom Line. Epoch Times (Oct 10, 2013). Retrieved from: http://www.theepochtimes.com/n3/313845-harnessing-diversity-to-affect-the-bottom-line/ Forsythe, J. (2005) Leading With Diversity. Retrieved from: http://www.nytimes.com/marketing/jobmarket/diversity/jandj.html Global-Dynamics (2013). Retrieved from: http://www.global-dynamics.com/johnson-johnson Globe Newswire (2013). Retrieved from: http://www.globenewswire.com/news-release/2013/09/25/575887/10049970/en/USHCC-Honors-Ruben-Taborda-of-Johnson-Johnson-with-Corporate-Advocate-of-the-Year-Award.html Gordon, C. Fired Johnson & Johnson Exec Claims ‘Culture Of Discrimination (July 2013) Retrieved from: http://jobs.aol.com/articles/2013/07/15/fired-johnson-and-johnson-discrimination/[->0] JNJ.com (2013). Retrieved from: http://www.jnj.com/about-jnj/diversity [->0] – http://jobs.aol.com/articles/2013/07/15/fired-johnson-and-johnson-

The Introduction Of The Environmental Legislation Accounting Essay

Climate alteration has become a subject of intense public treatment in recent old ages. Scientists, authorities leaders, legislators, regulators, concerns, including insurance companies, investors, analysts and the populace at big have expressed heightened involvement in clime alteration. International agreements, and province and local Torahs and ordinances in the Australia reference concerns about the effects of nursery gas emanations on our environment, and international attempts to turn to the concerns on a planetary footing continueA ( Bacchus 2004 ) . Due to these clime changes the environment protection act was introduced with the purpose of modulating against seting pollution into the air and H2O. These environmental protection Acts of the Apostless besides controls how waste is stored, collected, transported and treated. These meant that if the concern is caught fouling the environment, the authorities can publish mulcts and other controls ( Bennett 2005 ) . The major environmental ordinances that have been enacted in Australia include The National Pollutant Inventory ( NPI ) the National Greenhouse Energy Reporting act ( NGER ) and the Carbon Tax. The chief intent of this paper is to measure the possible effects of the debut of the environmental statute law utilizing the free-market and pro-regulatory attack to ordinance. The paper focuses on the accounting side in relation to these ordinances. There is besides the sentiment of the author sing whether he supports such ordinances † . The usage free-market attack to ordinance means the market without intercession by authoritiess, other than for the enforcement of contracts and ownership rights. A free-market attack is one in which all markets are unregulated by any parties other than the participants, and authorities plays a impersonal function.2.0 Evaluate the possible effects of the debut of the environmental statute law utilizing the free-market and pro-regulatory attack to ordin ance.Once federal action is deemed necessary to turn to an environmental job, policy shapers have a figure of options at their disposal to act upon pollution degrees. In make up one's minding which attack to implement, policy shapers must be cognizant of restraints and restrictions of each attack in turn toing specific environmental jobs. It is of import to account for how political and information restraints, imperfect competition, or preexistent market deformations interact with assorted policy options ( Bennett, M 2005 ) . The debut of National Pollutant Inventory has lead to economic efficiency. It provides the community, industry and authorities with free information about substance emanations in Australia. It has emanation estimations for 93 toxic substances and the beginning and location of these emanations ( Gibbons 2012 ) . The socially optimum degree is determined by cut downing emanations until the benefit of slaking one more unit of pollution that is the fringy suspension benefit measured as a decrease in harm is equal to the cost of slaking one extra unit that is the fringy suspension cost. In the simplest instance, when each defiler chooses the degree at which to breathe harmonizing to this determination regulation that is produce at a degree at which the fringy suspension benefit is equal to the fringy suspension cost, an efficient aggregative degree of emanations is achieved when the cost of slaking one more unit of pollution is equal across all defilers. Any other degree of emanations wou ld ensue in a decrease in net benefits ( Bennett 2005 ) . National pollution stock list policy has besides lead to technological criterion. A engineering or design criterion, mandates the specific control engineerings or production procedures that an single pollution beginning must utilize to run into the emanations criterion. This type of standard constrains works behaviour by mandating how a beginning must run into the criterion, irrespective of whether such an action is cost-efficient. Technology criterions may be peculiarly utile in instances where the costs of emanations supervising are high but finding whether a peculiar engineering or production procedure has been put in topographic point to run into a criterion is comparatively easy ( Janek 2012 ) . However, since these types of criterions stipulate the suspension engineering required to cut down emanations, beginnings do non hold an inducement to put in more cost effectual methods of suspension or to research new and advanced suspension schemes or production procedures that are non permitted by ordinance. The debut of environmental legislative assembly in Australia lead to public presentation based criterion. A performance-based criterion requires that defilers run into a source-level emanations criterion, but allows a defiler to take among available methods to follow with the criterion. At times, the available methods are constrained by extra standards specified in a ordinance. Performance-based criterions that are engineering based do non stipulate a peculiar engineering, but instead see what is possible for available and low-cost engineering to accomplish when set uping a bound on emanations. In the instance of a performance-based criterion, the degree of flexibleness a beginning has in run intoing the criterion depends on whether the criterion specifies an emanation degree or emanation rate emanations per unit of end product or input. A criterion that specifies an emanation degree allows a beginning to take to implement an appropriate engineering, alter its input mix, or cut down end product to run into the criterion. An emanation rate, on the other manus, may be more restrictive depending on how it is defined. The flexibleness of performance-based criterions encourages houses to introduce to the extent that they allow houses to research cheaper ways to run into the criterion ; nevertheless, they by and large do non supply inducements for houses to cut down pollution beyond what is required to make conformity. For emanations that fall below the sum allowed under the criterion, the house faces a zero fringy suspension cost since the house is already in conformity It besides leads to be effectivity. The efficiency of a policy option differs from its cost-effectiveness. A policy is cost-efficient if it meets a given end at least cost, but cost effectivity does non embrace an rating of whether that end has been set suitably to maximise societal public assistance. All efficient policies are cost-efficient, but it is non needfully true that all cost-efficient policies are efficient. A policy is considered cost-efficient when fringy suspension costs are equal across all defilers. In other words, for any degree of entire suspension, each defiler has the same cost for their last unit abated. Many environmental ordinances in the Australia are normative in nature and are frequently referred to as command-and-control ordinances. A normative ordinance can be defined as a policy that prescribes how much pollution an single beginning or works is allowed to breathe and/or what types of control equipment it must utilize to run into such demands. Such a criterion is frequently defined in footings of a source-level emanations rate. Despite the debut of potentially more cost effectual methods for modulating emanations, this type of ordinance is still normally used and is sometimes statutorily required. It is about ever available as a â€Å" catcher † if other attacks do non accomplish desired pollution bounds. Because a normative criterion is normally defined in footings of an emanations rate, it does non straight command the aggregative emanation degree. In such instances, aggregative emanations will depend on the figure of defilers and the end product of each defiler.3.0 M arket based attackMarket based attack create an inducement for the private sector to integrate pollution suspension into production or ingestion determinations and to introduce in such a manner as to continually seek for the least dearly-won method of suspension. Market-oriented attacks can differ from more traditional regulative methods in footings of economic efficiency or cost-effectiveness and the distribution of benefits and costs ( Dagwell 2007 ) . Because market-based attacks do non mandate that each defiler run into a given emanations standard, they typically allow houses more flexibleness than more traditional ordinances and capitalise on the heterogeneousness of suspension costs across defilers to cut down aggregative pollution expeditiously. Environmental economic experts by and large favor market-based policies because they tend to be least dearly-won, they place lower information load on the regulator, and they provide inducements for technological progresss. The debut of legislative assembly leads to crest and merchandise system. In a cap-and-trade system the authorities sets the degree of aggregative emanations, emanation allowances are distributed to defilers and a market is established in which allowances may be bought or sold. The monetary value of emanation allowances is allowed to change. Because different defilers incur different private suspension costs to command emanations, they are willing to pay different sums for allowances. Therefore, a cap-and-trade system allows defilers who face high fringy suspension costs to buy allowances from defilers with low fringy suspension costs, alternatively of put ining expensive pollution control equipment or utilizing more dearly-won inputs. Cap-and-trade systems besides differ from command-and-control ordinances in that they aim to restrict the aggregative emanation degree over a conformity period instead than set up an emanations rate. If the cap is set suitably, so the equilibrium monetary value of allowances, in theory, adjusts so that it equals the fringy external amendss from a unit of pollution. This equivalency implies that any outwardness associated with emanations is wholly internalized by the house. For defilers with fringy suspension costs greater than the allowance monetary value, the cheapest option is to buy extra units and go on to breathe. For defilers with fringy suspension costs less than the allowance monetary value, the cheapest option is to cut down emanations and sell their licenses. Allowances may besides be allocated to defilers harmonizing to a specified regulation. This represents a transportation from the authorities to polluting houses, some of which may happen that the value of allowances received exceeds the house ‘s aggregative suspension costs. The constitution of environment legislative assembly leads to debut of rate based trading system. Rather than set up an emanations cap, the regulative authorization under a rate-based trading plan, establishes a public presentation criterion or emanations rate. Beginnings with emanation rates below the public presentation criterion can gain credits and sell them to beginnings with emanation rates above the criterion. As with the other trading systems, beginnings able to better their emanations rate at low cost have an inducement to make so since they can sell the ensuing credits to those beginnings confronting higher costs of suspension. However, emanations may increase under these plans if beginnings increase their use or if new beginnings enter the market. Therefore, the modulating authorization may necessitate to sporadically enforce new rate criterions to accomplish and keep the coveted emanation mark, which in bend may take to uncertainness in the long term for the regulated beginnings. In add-on the constitution of legislative assembly leads to infliction of emanation revenue enhancements. Emissions revenue enhancements are exacted per unit of pollution emitted and bring on a defiler to take into history the external cost of its emanations. Under an emanations revenue enhancement, the defiler will slake emanations up to the point where the extra cost of slaking one more unit of pollution is equal to the revenue enhancement, and the revenue enhancement will ensue in an efficient result if it is set equal to the extra external harm caused by the last unit of pollution emitted. As an illustration of how an emanations revenue enhancement plants, suppose that emanations of a toxic substance are capable to an environmental charge based on the amendss the emanations cause. To avoid the emanations revenue enhancement, defilers find the cheapest manner to cut down pollution. This may affect a decrease in end product, a alteration in inputs to production, the installing of pollution control equipment, or a procedure alteration that prevents the creative activity of pollution. Polluters decide separately how much to command their emanations, based on the costs of control and the magnitude of the revenue enhancement ( Hoque 2005 ) . The polluting house reduces emanations to the point where the cost of cut downing one more unit of emanations is merely equal to the revenue enhancement per unit of emanations. For any staying emanations, the defiler prefers to pay the revenue enhancement instead than to slake farther. In add-on, the authorities earns gross that it may utilize to cut down other pollution or cut down other revenue enhancements, or may redistribute to finance other public services. While hard to implement in instances where there is temporal and/or spacial fluctuation in emanations, policy shapers can more closely come close the ambient impact of emanations by integrating accommodation factors for seasonal or day-to-day fluctuations or single transportation coefficients in the revenue enhancement. Economic efficiency can be defined as the maximization of societal public assistance. An efficient market is one that allows society to maximise the net present value of benefits: the difference between a watercourse of societal benefits and societal costs over clip ( Comisari 2011 ) . The efficient degree of production is referred to as Pareto optimal because there is no manner to rearrange production or reapportion goods in such a manner that person is better off without doing person else worse off in the procedure ( Burritt 2011 ) . Taxs and charges facilitate environmental betterments similar to those that result from marketable license systems. Rather than stipulating the entire measure of emanations, nevertheless, revenue enhancements, fees, and charges specify the effectual monetary value of breathing pollutants ( Burritt 2000 ) . Environment legislative assembly besides leads to environmental subsidies. Subsidies paid by the authorities to houses or consumers for per unit decreases in pollution create the same suspension inducements as emanation revenue enhancements or charges. If the authorities subsidizes the usage of a cleansing agent fuel or the purchase of a peculiar control engineering, houses will exchange from the dirtier fuel or put in the control engineering to cut down emanations up to the point where the private costs of control are equal to the subsidy. It is of import to maintain in head that an environmental subsidy is designed to rectify for an outwardness non already taken into history by houses when doing production determinations. Environment legislative assembly besides leads to environmental subsidies. Subsidies paid by the authorities to houses or consumers for per unit decreases in pollution create the same suspension inducements as emanation revenue enhancements or charges. If the authorities subsidizes the usage of a cleansing agent fuel or the purchase of a peculiar control engineering, houses will exchange from the dirtier fuel or put in the control engineering to cut down emanations up to the point where the private costs of control are equal to the subsidy. It is of import to maintain in head that an environmental subsidy is designed to rectify for an outwardness non already taken into history by houses when doing production determinations It is possible to minimise the entry and issue of houses ensuing from subsidies by redefining the subsidy as a partial refund of verified suspension costs, alternatively of specifying it as a per unit payment for emanations decreases relative to a baseline. Under this definition, the subsidy now merely relates to abatement costs incurred and does non switch the entire or mean cost curves, thereby go forthing the entry and issue determinations of houses unaffected ( Burritt 2011 ) . Environmental legislative assembly leads to tax- subsidy combination. Emission revenue enhancements and environmental subsidies can besides be combined to accomplish the same degree of suspension as achieved when the revenue enhancement and subsidy instruments are used individually. One illustration of this type of instrument is referred to as a sedimentation refund system in which the sedimentation operates as a revenue enhancement and the refund serves as a partly countervailing subsidy. As with the other market instruments already discussed, a deposit-refund system creates economic inducements to return a merchandise for reuse or proper disposal, or to utilize a peculiar input in production, provided that the sedimentation exceeds the private cost of returning the merchandise or shift inputs ( Burritt 2000 ) . Under the deposit-refund system, the sedimentation is applied to either end product or ingestion, under the given that all production procedures of the steadfast pollute or that all ingestion goods become waste. A refund is so provided to the extent that the house or consumer provides cogent evidence of the usage of a cleaner signifier of production or of proper disposal ( Burritt 2011 ) . Another consequence is information revelation. Necessitating revelation of environmental information has been progressively used as a method of environmental ordinance. Disclosure schemes are most likely to work when there is a nexus between the polluting house and affected parties such as consumers and workers ( Keil 2004 ) . Disclosure demands try to minimise inefficiencies in ordinance associated with asymmetric information, such as when a house has more and better information on what and how much it pollutes than is available to the authorities or the public. By roll uping and doing such information publically available, houses, authorities bureaus, and consumers can go better informed about the environmental and human wellness effects of their production and ingestion determinations ( Burritt 2000 ) . Another consequence of environmental legislative assembly is the debut of liability regulations. Liability regulations are legal tools of environmental policy that can be used by victims or the authorities to coerce defilers to pay for environmental amendss after they occur. Liability regulations can function as an inducement to defilers. To the extent that defilers are cognizant that they will be held apt before the polluting event occurs, they may minimise or forestall engagement in activities that inflict amendss on others.4.0 DecisionThe environmental ends are achieved at a lower limit cost where consumers, manufacturers and authorities are being involved in the execution of the legislative assembly. These means that it is cost effectivity There is whole engagement of the execution of environmental legislative assembly due to the enterprise given to the manufacturer by the authorities for illustration Emission revenue enhancements and environmental subsidies. Emissions revenue enhancements are exacted per unit of pollution emitted and bring on a defiler to take into history the external cost of its emanations. There is besides the creative activity of the consciousness where by every party are cognizant of the punishment for the breach of the jurisprudence. Every participant is apt for non following the jurisprudence to the missive. These is achieved though the debut of liability regulations. 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