Equity and Trusts- Non charitable Un-incorporated assosiations Essay

Equity and Trusts- Non charitable Un-incorporated assosiations - Essay Example st have a cestui que trust and should be for the benefit of individuals; (2) it must have a definite object, and (3) the court can enforce it favour of someone.1 To be valid, a non-charitable trust must have an ascertainable beneficiary in whose favour performance of the trust may be decreed. Consequently, purposes trusts or objects are invalid because a purpose or object cannot seek enforcement, but trusts for charitable purposes are valid because they are enforceable by the Attorney-General. 2 The statutory list of charitable purposes in found in Section 2 of the Charities Act 2006 which provides as follows: Not being included as one of the charitable purposes, the maintenance of the three elderly widows and a worthy cause as a purpose cannot be considered as charitable. As a consequence, gifts (consisting of donations from well-wishers and the  £10,000 raised from dinner guests) to the association, a non-charitable unincorporated association, are subject to (a) the rule against remoteness of vesting, which requires that the interests of the beneficiaries must vest within the perpetuity period; (b) the rule that, for there to be a valid trust, there must be a beneficiary or cestui que trust in whose favour performance of the trust may be decreed or the beneficiary principle; and (c) the general principle of trust law that the objects of the trust must be sufficiently certain.3 Hence, such rule does not apply to funds raised from members’ subscriptions because as discussed below it is contractual. In the case of the  £10,000 raised from dinner guests, the foregoing rules have been met because the object is sufficiently certain and vested upon a designated beneficiary (the three elderly widows) within a perpetuity period. Nevertheless, the law has recognised non-charitable purpose trusts. Thus, it was stated that such trusts which are of a somewhat anomalous kind include "trusts for the benefit of unincorporated associations†.4 Thus, in Leahy v

Autism and Social Skills Essay Example for Free

Autism and Social Skills Essay Autism spectrum disorder is a neurodevelopmental disorder that ranges from mild to severe impairments in communication, social interaction, and repetitive pattern of interest. Children with autism need early social skills support to develop their social interactions and understanding. Autism spectrum disorders (ASD) and socialization among young children and adolescence is one of the major impairments, along with language individuals have. Social skills groups are prearranged groups with, a direct goal orientated to engage young children and adolescences with the appropriate support, in the development of social skills. Social skills groups for young children and adolescences can be a viable tool, in helping children with ASD to learn how to socialize appropriately. The Socialization of young children with a diagnosis of ASD has shown some positive results. This pilot study was conducted in response to the heightened awareness and the need for young children with ASD to learn social skills. The parents of autistic children, the children that have a diagnosis of ASD and the facilitators of the groups, will engage the children in social sessions, in hopes to build social relationships. The parents will fill out questionnaires as to the progress they see their children making. This pilot study sets out to answer the following two questions. Is participation in a social skills group beneficial for young children / adolescence with ASD from the child’s, Parents and the facilitator’s perspectives? The second question posed was, is there any improvement in the autistic child’s ability to communicate or interrelate socially. Methodology Based on a review of literature on Autism, a psychologist and a clinical psychologist planed a structured 5-week program, for one-hour sessions, one day a week. Only children with a diagnosis of ASD were invited. The children’s ages ranged from seven to 18. Using the qualitative method, the parental focus group was used to gather data and answer two research questions. Each parent received three questionnaires developed for the purpose of this evaluation. One was a pre- questionnaire, to be completed at the beginning of the groups, the post questionnaire, at the end of groups, and a review questionnaire, to be completed six months following the social skills groups. The questionnaires were used for the parents to rate their child’s current level of difficulties. Results and Discussions The high cost of one on one therapy for autistic children has become too high for caregivers and the need for alternative approaches was necessary. Evidence suggested that social skills groups for autistic children would be an alternative Dunlop, Knott and Mackay (2000). The information gathered from parent questionnaires and through observations from the facilitators and the higher functioning adolescents with ASD showed there was a need for social skills programs. Some parents felt their children benefitted and others seen no change. The feedback was very positive and most of the participants would like the social skills groups to continue. There were several areas identified within the program that needs fine-tuning such as, smaller groups, the level or severity of ASD the children have, longer duration of sessions without summer breaks and addressing how to manage the challenging behaviors some of the autistic children displayed, which prevented them from engaging socially within the groups. There was no time for one on one interaction, to encourage those children that did not socialize during the five-week program. The facilitators observed this and felt that it was an important issue to address along with the other recommendations above, when planning social skills programs. I choose this article because I am a parent of an autistic child and I am always looking for new treatment methods. I like to stay informed of all the new research on autism to share with my son. I think there is a need to socialize all persons with autism and the ideal of social skills groups cannot hurt; it can enhance the quality of life for the autistic child.

Essay on Behavior in All Quiet on the Western Front and Lord of the Fli

Comparison of Human Behavior in All Quiet on the Western Front and Lord of the Flies  Ã‚         An author's view of human behavior is often reflected in their works. The novels All Quiet on the Western Front by Erich Maria Remarque and Lord of the Flies by William Golding are both examples of works that demonstrate their author's view of man, as well his opinion of war. Golding's Lord of the Flies is highly demonstrative of Golding's opinion that society is a thin and fragile veil that when removed shows man for what he truly is, a savage animal. Perhaps the best demonstration of this given by Golding is Jack's progression to the killing of the sow. Upon first landing on the island Jack, Ralph, and Simon go to survey their new home. Along the way the boys have their first encounter with the island's pigs. They see a piglet caught in some of the plants. Quickly Jack draws his knife so as to kill the piglet. Instead of completing the act, however, Jack hesitates. Golding states that, "The pause was only long enough for them to realize the enormity of what the downward stroke would be." Golding is suggesting that the societal taboos placed on killing are still ingrained within Jack. The next significant encounter in Jack's progression is his first killing of a pig. There is a description of a great celebration. The boys chant "Kill the pig. Cut her thr oat. Spill her blood." It is clear from Golding's description of the revelry that followed the killing that the act of the hunt provided the boys with more than food. The action of killing another living thing gives them pleasure. The last stage in Jack's metamorphosis is demonstrated by the murder of the sow. Golding describes the killing almost as a rape. He says, "Jack was on... ...ough the actions of his characters, attempts to illustrate that under chaotic circumstances, when removed normal society, man reverts to what his nature deems him to be, a destructive creature. Remarque's characters, on the other hand, manage to show compassion and humane treatment of others despite being thrust into a situation more terrible than that of Golding's characters. Where Golding feels war is a result of humankind's vile nature, Remarque sees it as an evil brought about by only a select few.    Works Cited Golding, William. Lord of the Flies. New York: Berkley, 1954. Babb, Howard S. The Novels of William Golding. N.p.: Ohio State UP, 1970. Beetz, Kirk H., ed. Beacham's Encyclopedia of Popular Fiction. Vol. 5. Osprey: n.p., 1996. 5 vols. Epstein, E. L. Afterword. Lord of the Flies. By William Golding. New York: Berkley, 1954.   

Essay --

‘Some years ago everyone lived perfectly fine without a smart phone or tablet, but now people suddenly ‘need’ to have one!’ Most people will have heard someone say this or something similar before. And it seems to be true at first sight, smart phones and tablet are now more a normal good than a luxury good. The implication is that marketing artificially creates needs. In this essay we will discuss the question if marketing really does. We will discuss this question from the point of view of a producer or product designer. It will appear there is another side to the story. But what exactly are needs? ‘Needs are the basic human requirements for air, good, water, clothing and shelter. Humans also have strong needs for recreation, education, and entertainment.’ (Kotler & Keller, 2012) Since needs are basic human requirements, they are in the nature of mankind. Therefore they cannot be created by marketers. But why do people think marketing does create needs? Because they confuse needs with wants. Needs are not specific objects. The specific objects are wants, and they can satisfy the need. (Kotler & Keller, 2012) The needs already exist, marketing develops products that fulfill those needs. (Meredith, 2008) But people may not be aware of their needs, and therefore think that marketing has created a new need, but what marketing has actually done, is uncovering the need, by providing a product that satisfied the need. The need already existed, and marketers found a product that responds to it. Identifying needs and providing a product that sat isfies the needs is the main business of marketing, that is why marketing is used. Business is basically identifying and serving customer’s needs at a profit. (Meredith, When Leaders Don't Lead, ... ...d society do. So if you ever hear someone complain about needs that are created by marketers, those people just didn’t know they had that need. Bibliography (n.d.). Kotler, P., & Keller, K. L. (2012). A framework form marketing management (5th ed.). Essex: Pearson Education Limited. Meredith, B. (2002, February). Awesomely Disquieting. NZ Business, 16(1), 47. Meredith, B. (2005, December). When Leaders Don't Lead. NZ Business, 19(11), 70. Meredith, B. (2008, September). (How) marketing has changed. NZ Business, 22(8), 102. Pereira Heat, M. T., & Chatzidakis, A. (2012). 'Blame it on marketing': consumer's views on unsustainable competition. International Journal of Consumer Studies, 36, 661. Vidal Diaz, d. R. (1998). A single consumer or different types of consumers: An analysis of social types according to their customer habits. Brithish Food Journal, 100(7), 326.

Starbucks Case

As a result, Cataracts consistently appears on â€Å"Best Places to Work† lists, and Schultz continues to be recognized for leadership by organizations such as the Deciphers Institute, Fortune, and Glissando (â€Å"Cataracts and Howard,† 2014). Schultz also appears on Fortunes first list Of the Android's 50 Greatest Leaders† as number 29 (Cataracts News). Although critics may believe that Schultz success is a result of mere luck and situational factors, several leadership theories explain why Schultz and Cataracts continue to be successful.The most important of these theories include trait theory and transformational leadership theory, which Schultz illustrates with many of his leadership traits, skills, and beliefs. Situational factors contributed to the initial success of Cataracts, but Schultz leadership abilities, ethics, and passion are what make Cataracts a driving force in the food and beverage industry today. Schultz exemplifies dynamic leadership skills b y his ability to push Cataracts forward without losing integrity.Although Schultz led Cataracts to be the successful company that it is today, he stepped down from his position in 2000. However, the company experienced several problems in 2008 because of an unstable economy and a series of poor management decisions. Schultz then felt compelled to return to the company. When Schultz returned, he found that â€Å"things were worse than [he'd] thought† (Igniting, 2010). The Cataracts leadership team admitted to failing the company's employees and heir families, and Schultz had to make several difficult decisions to restore the company.In addition to the crises in management, the financial crisis of the economy added stress on the Cataracts leadership team. Customers began to rethink spending four dollars on a latte, and eventually competition set in as other businesses saw Cataracts turning a profit from selling coffee. The overwhelming amount of problems challenged Schultz goal of preserving and improving the integrity of the company and its â€Å"values, culture, guiding principles, and the reservoir of trust with Cataracts people† Igniting, 2010).Howard Schultz got Cataracts back on track by using his existing knowledge of the company, an asset other Coos did not have. He tried to do ‘the right thing† by shutting down the stores for three and a half hours for retraining. He said, ‘†We are retraining our people because we have forgotten what we stand for, and that is the pursuit of an unequivocal, absolute commitment to quality† (Igniting, 2010). Schultz motivation and thirst for success allowed Cataracts to regain its strength.In the years 2006 to 201 3, the company underwent several leadership arrangements because Schultz carefully chose certain people for leadership positions that would optimize the growth of the company. In 2011, Cataracts adopted a new corporate structure to accelerate its growth strategy. Schult z said, â€Å"Our company performance over the past two years has positioned Cataracts for significant international opportunities ahead† (â€Å"Cataracts Announces New Leadership,† 2011 He decided to execute a multi-brand, multinational strategy that would optimize the company's speed and focus going forward.Schultz implemented a three-region organization Structure including China and Asia Pacific, the Americas, and MEME (Europe, LLC. K. Middle East, Russia, and Africa). He selected John Culver, Cliff Burrows, and Michelle Gas to serve as president of each region, and the presidents' responsibilities included working with licensed and joint-venture business partners and reporting to Schultz. Cataracts also created a â€Å"multi-brand, multi-channel future by building a portfolio of branded business united beyond the Cataracts retail brand† (â€Å"Cataracts Announces New Leadership,† 201 1).Cattle's Best Coffee and Taco Tea both continued to be important growth opportunities as they generated revenue for the company. Building on the new corporate structure and company success, Schultz decided to strengthen the Cataracts Senior Leadership team in 2014 because he wanted to position the company ‘to leverage its assets and operations, and gain maximum benefit from the retail, consumer, mobile, and digital shifts currently underway in the global marketplace† (â€Å"Cataracts Strengthens Senior Leadership Team†, 2014).Schultz said, â€Å"These organizational moves map our internal talent to the rapidly evolving retail environment and significant strategic and market opportunities ahead of us. With the new leadership structure, Schultz wanted to bring â€Å"greater financial and operational discipline† and to focus on the Cataracts mission and its growth (â€Å"Cataracts Strengthens Senior Leadership Team†, 2014). Senior leadership changes include Troy Lasted to Chief Operating Officer, Scott Maw to Execut ive Vice President and Chief Financial Officer, and Craig Russell to Executive Vice President.With these changes, Schultz intended to focus on â€Å"generation retailing and payments initiatives in the areas of digital, mobile, card, loyalty, and e-commerce† and to prepare for â€Å"its next wave of global growth† â€Å"Cataracts Strengthens Senior Leadership Team†, 2014). The senior leadership changes took effect on February 3, 2014, and Cataracts continues to thrive under the leadership of Howard Schultz. Although Schultz is only one of many leaders who has appeared throughout history, he continues to help redefine what leadership is and how to use one's leadership skills to run a successful company.In general, leadership is defined as the process of providing general direction and influencing individuals or groups to achieve goals, but leaders convey leadership in many different ways (Collar, 201 1). One theory that explains why Schultz is an exceptional lead er is the trait theory of leadership. Atone time, â€Å"it was thought that some people were born with certain traits that made them effective leaders, whereas others were born without leadership traits† (Collar, 201 1).However, research has shown that leaders can learn or develop many of the traits or characteristics that they posses. Still, researchers agree that most successful leaders tend to share common leadership traits, regardless if they learn or inherit them. Some of these important leadership traits include drive, motivation, integrity, self- inference, cognitive ability, knowledge of domain, openness to new experiences, and extroversion, all of which Howard Schultz and other successful leaders exhibit. For example, Schultz displayed both drive and motivation when starting his company.Despite financial stress and emotional struggles with his father's death, Schultz â€Å"channeled his drive to build a company where his father would be proud to work† (George, 2007). Schultz used his past struggles to drive him forward and motivate him to create a working environment that his employees loved and were satisfied with. Rather than displaying a personalized power motive, Schultz displayed a socialized power motive to achieve goals that were in the best interest of the organization and its followers.Schultz also exhibits integrity, since he is honest and maintains consistency between what he says and what he does. As a result, his employees trust him and are happy to work for a company that is ethically sound and fair. The Deciphers Institute named Cataracts as one of the â€Å"World's Most Ethical Companies† for the eighth year in a row because of its honest and trustworthy leaders and employees (â€Å"Cataracts and Howard†, 2014). Furthermore, Schultz also uses his cognitive ability and knowledge of gourmet coffee and customer service to positively influence and teach his employees and partners.Schultz even traveled to Italy t o gain insight on the unique community experience that many Italian espresso bars play in customers' lives so that he could apply many of these concepts that he learned in Italy to his own coffee shops. As a result, Schultz has used traits like his knowledge, drive, motivation, and integrity to make Cataracts into the successful organization that he had always dreamed of as a young child (George, 2007). In addition to trait theory, Schultz leadership skills also support the transformational leadership theory.Transformational leadership theory involves motivating followers to do more than expected, to continuously develop and grow, to increase their level of self-confidence, and to place the interest of the organization before their own. As a result, transformational leaders, like Schultz, are charismatic as well as intellectually stimulating and show individual consideration of followers. Schultz is the perfect example of a transformational leader because he created a company based on his vision f excellence and innovation for the modern coffee shop.His goal was to create a â€Å"third place† for customers in addition to their home and office by focusing on customer service and satisfaction. Therefore, he focused on empowering and instilling pride even in bottom line employees, so that they could be happy at work and create the positive environment that Schultz wanted Cataracts to have. In order to motivate employees, Schultz â€Å"instituted a training program designed to groom knowledgeable employees who would enjoy working behind a counter,† since he believed that friendly, efficient employees would boost sales (â€Å"Howard Schultz,† 2008).By providing high quality products for customers that employees were knowledgeable about, Schultz was able to give employees a job that they could feel proud of and happy to be at. According to John R. Scarsdale, â€Å"Schultz believes the only competitive advantage Cataracts has as a national retai l company is its workforce† (Scarsdale, 2013). Therefore, Schultz values his employees' performance and happiness over everything else that Cataracts offers. As a result, Schultz leadership style â€Å"is based on his compassion for, and commitment to, customers and staff alike† (â€Å"Howard Schultz,† n. D. ).Schultz knows that the key to any company's success begins with its workforce, because the employees interact with the customer everyday and deliver the actual product. Schultz notes, m{U can't expect your employees to exceed the expectations of your customers if you don't exceed the employees' expectations of management. That's the contract† (â€Å"More Excellent Customer Service Quotes†, n. D. ). Although Schultz leadership traits and transformational leadership style are both crucial reasons for Cataracts huge success over the past 40 years, some situational factors are also responsible for part of Cataracts' success.Some Of these situationa l factors include higher demand for quality, increase in fast food businesses, and convenient store locations. Today more and more individuals are focusing on the quality of the food and beverages that they put into their bodies, which has resulted in a higher demand for quality. Rather than just simply buying the cheapest product, consumers want a product that offers the most value for a reasonable price. For example, today more consumers prefer a cup of coffee that is fresh and made to order rather than a cup of coffee that is pre-made from synthetic ingredients.Therefore, any customers are willing to pay a dollar or two more for a higher quality coffee product rather than a lower quality coffee product. However, customers still expect the price for high quality coffee to be fairly reasonable, since the focus on quality in food products is becoming so important. Therefore, consumers now expect high quality products at a lower price. As a result, Cataracts has been able to capitali ze on this new demand for high quality products at a reasonable price with its wide array of quality coffee and beverages.In addition to demand for quality, fast food businesses seem to be lose by no matter where one goes because the demand for food and beverages to go has skyrocketed over the past few decades. Many individuals these days are always on the move and looking for a food or coffee establishment that can satisfy their needs in a short and efficient amount of time. Although it seems as though fast food and beverage options are never out of reach these days, this was not always the case for many coffee shops.For example, Schultz encountered the original Cataracts Coffee in the 1 sass during a sales call in Seattle, when the company only sold roasted whole bean coffees and did not brew coffee to sell. However, now Cataracts offers a huge variety of beverages, snacks, and much more that take only under a few minutes to make for customers. Additionally, Cataracts' convenient locations are another situational factor that helped add to its fast success, since the locations are typically very accessible and easy to find. In addition, the demand for drive thru windows has also given Cataracts a boost for customers in a hurry.Rather than having to physically go into a Cataracts store to order coffee, customers can order from their car if they are in a hurry. As a result, Cataracts has benefited tremendously from its convenient actions and fast service. Situational factors, such as demand for quality, increase in fast food chains, convenient locations, and many others, are all extremely important contributions to Cataracts' huge success. However, Howard Schultz leadership traits and skills that he instilled within his employees were also critical to keep Cataracts the number one coffee chain in the world.For example, Cataracts could be a completely different type of coffee company without Schultz guidance, and both his employees and Cataracts customers would not be as happy without his focus on employee satisfaction and quality service. Although Cataracts would likely still be somewhat successful without Schultz leadership, the company would likely have trouble differentiating itself from other coffee chains. Furthermore, the company also would not have as many loyal customers without their focus on quality customer service, since the employees would not be required to go through intense training.In addition, employees would not be as happy, since many of the employee benefits such as health care may not exist without Schultz. Consequently, unhappy employees could turn away potential and existing customers and only allow Cataracts to have short-term success. As a result, without Schultz focus on employee and customer satisfaction, the situational factors would not have mattered in the long run. Therefore, Schultz leadership skills were essential in establishing Cataracts as a dominant force in the coffee industry.Although Schultz allegi ance clearly lies with Cataracts, he could apply many of his leadership skills and abilities to another organization if needed. For example, if Howard Schultz was the CEO of Wall-Mart, he could use his knowledge and experience from Cataracts to lead Wall-Mart in a more positive direction by improving the quality of employees' jobs. Currently, several issues exist that may hold the company back from reaching its full potential. Hidden beneath operational problems, diminished sales, and low customer service ratings, employees are complaining about low salaries, erratic scheduling, and understanding (Heal, 2008).Currently, as many as 825,000 of Wall-Mart workers have an annual income of less than $25,000 (â€Å"Five Ways:' 2014). Wall-Mart is one of the most successful companies in the country and can certainly afford to raise these salaries so that hard working employees are able to support a family. Also, Wall-Mart employs a large annuity of employees in part-time positions, allowin g the company to skimp on costs, when most of these employees desire more hours (â€Å"Five Ways,† 2014). Workers are becoming frustrated with executives avoiding this crucial issue.Protests occurred at roughly 1,500 Wall-Mart stores on this past Black Friday alone. The protesters, a mix of workers and supporters, held signs calling for higher pay and better working conditions. To make matters worse, massive cuts of worker hours are taking a toll on consumer ratings of the company. A recent Consumer Reports Survey placed Wall-Mart at the bottom of the list of grocers. Shoppers mentioned the understanding, a clear cause of, â€Å"long lines and an overall poor customer service† (â€Å"Walter Ranks,† 2014).According to Geoffrey Heal (2008), accusations against Wall-Mart include â€Å"gender discrimination, low wages, excessive use of part-time labor, and harsh working conditions. † Based off these accusations, if Schultz were the CEO of Wall-Mart, its posit ion would be much different. Many of these weak areas are exactly where Cataracts has excelled over the past few decades. Schultz recon sized an approach that would build success for a Company with such a large number of employees. First, Cataracts pays its employees wages far above the service branch average and offers low-cost health benefit opportunities.Cataracts realized early on that properly training employees and acting generously towards them would lead to a very low employee turnover rate, which would reward the company in the future (Heal, 2008). Perhaps Wall-Mart's biggest challenge is that, unlike Cataracts, many of the employees are not proud to work there. Schultz prides Cataracts on being an employer that people trust. Workers share genuine hope for the company's future, and they want to be a part of it. Wall-Mart, on the other hand, is facing new lawsuits continuously -? and its own employees file a lot of them.Within the past year, the National Labor Relations Boar d filed a complaint against Wall-Mart for illegally firing and punishing about 60 workers who vocalizes a desire for change (â€Å"Five Ways,† 2014). In comparison, Howard Schultz has always treated his employees with respect and valued their individual opinions. Cataracts often holds open forums and encourages employees to speak their minds, even it they have negative comments. The combination of these criticisms along with praise in table areas has been important in contributing to shape the future of Cataracts and its culture.Schultz realized the value of personal connection when building Cataracts, and this is the major area that Wall-Mart needs improvement in. According to the case study, Schultz notes that remaining a humble and grounded entrepreneur is crucial. Schultz would bring this attitude to the executives at Wall-Mart, who currently do not cherish their employees as assets of the company. The case study reinforces Cataracts as a company that listens to and under stands each employee by noting the many has â€Å"implemented generous employee benefits, training programs, and employee stock ownership programs. For this reason, the transformation of Cataracts serves as a great model for the hypothetical situation of Schultz as CEO of Wall-Mart. Schultz would excel as the CEO of Wall-Mart, providing a fresh perspective to the executives and managers, and instilling values from the immense growth at Cataracts during his time there. No longer would bullying workers be acceptable, and â€Å"changing this culture of intimidation would go a long way to improving labor relations† (â€Å"Five Ways,† 2014). The basic change off higher minimum wage would reduce the number of protests and cause employees to feel a more prideful connection to the company.With Schultz as CEO, Wall-Mart executives would begin to recognize the importance of listening to employees across all levels and this simple act would go a long way to make the company a st ronger unit. Despite Howard Schultz eight-year hiatus in 2000, he has been one of Cataracts' greatest assets by building its fundamental ideals and values and staying involved to communicate his vision. For these reasons, Schultz is known around the world as one of the greatest leaders in the business world cause of his ethical values, passion, and communication skills.

Drafting an Obscenity and Profanity Policy for Schools

Drafting an Obscenity and Profanity Policy for Schools Obscenity and profanity have become significant issues that schools must get a handle on. Profanity especially has become a problem in part because students hear their parents using words that are unacceptable at school and model what they do. Furthermore, pop culture has made it a more acceptable practice.   The entertainment industry, especially music, movies, and television glamorizes the use of obscenities and profanity.   Sadly, students are using profane words at a younger and younger age. Schools must have a strong policy to deter students from being profane or obscene primarily because they are often vulgar in nature, the use of these types of words/materials often leads to distractions, and can occasionally lead to fights or altercations. Educating our students is critical in eliminating or reducing the problem as is the case for almost any social issue. Students must be taught that there are other alternatives to using obscenities and profanity during school.   They must be taught that school is the wrong time and wrong place to practice the use of expletive language.   Some parents may allow their children to use profanity in the home, but they need to know that it will not be allowed or tolerated in school. They need to know that using inappropriate language is a choice. They can control their choices at school, or they will be held accountable. Many students are offended when other students use inappropriate language.   They are not exposed to it in their home and do not make it a regular part of their vernacular. It is especially important for schools to teach older students to be respectful and mindful of younger students.   Schools must adopt a zero tolerance stance when older students are knowingly using inappropriate language around younger students. Schools should have an expectation for all students to be respectful of one another.   Cursing in any form can be offensive and disrespectful to many students. If nothing else, all students should refrain from this practice because of this.  Ã‚   Getting a handle on the issue of obscenity and profanity will be an uphill and continuous battle.   Schools wanting to improve this area must draft a tough policy, educate their students on the policy, and then follow through with the assigned consequences no matter the context.   Once students see that you are cracking down on the issue, most will alter their vocabulary and comply because they do not want to be in trouble.   Obscenity and Profanity Policy Obscene materials including, but not limited to illustrations (drawings, painting, photographs, etc.) and oral or written materials (books, letters, poems, tapes, CDs, videos, etc.) which are commercially or student produced are prohibited. Profanity including, but not limited to, gestures, symbols, verbal, written, etc. is prohibited during school and at all school sponsored activities. There is one word that is strictly prohibited. The â€Å"F† word will not be tolerated under any circumstance. Any student who uses the â€Å"F† word in any context will automatically be suspended out of school for three days. All other forms of inappropriate language are highly discouraged. Students must choose their words carefully and consciously.   Students caught using obscenities or profanities will be subject to the following disciplinary code. 1st Offense - Verbal reprimand. Notice issued to parents.2nd Offense - 3 detention times.3rd Offense - 3 days in-school placementSubsequent Offenses - 3 days out-of-school suspension.

Free Essays on Crime In Society

Crime in most people’s minds would probably be viewed as the index crimes. Murder, rape, arson, robbery, and aggravated assault, all of which are index crimes are probably what most people think of when crime is mentioned. This paper however, is not on crime, it is on criminal behavior. The focus of this analysis is actually on white-collar and corporate crime. Crime that many times are overlooked. Why is white-collar crime many times overlooked? It is overlooked because the people that commit these types of crime are not exactly your everyday criminals. They are not your average poor, so called white trash and low-life people. They are not the people who you would expect to be criminals. They are actually in fact your everyday working class and middle class people. As I mentioned before, white- collar crime involves not people who are usually poor but people who are much better off in life. These people who are typically successful and have families and are the people who you would never even picture as being criminals. They are people who could never even be categorized as a criminal but are because white-collar crime and corporate crimes are in fact what they are, a crime. White- collar crime occurs in banks and corporations and often involves important figures in a community, like I said the people you would never expect. As for corporate crime, it does not involve just one individual, but many people, often an entire company or corporation, once again crime in the suites, not in the streets. So, what is white-collar crime and corporate crime? Now that I have introduced the topic I will go into detail as to what both of these topics actually are and I will examine more closely and look at what social forces play major roles in these crimes in the paragraphs to come. White-collar crime refers to illegal activities committed by people during the course of their employment or regular business activities. Crimes such as, fraud, which ... Free Essays on Crime In Society Free Essays on Crime In Society Crime in most people’s minds would probably be viewed as the index crimes. Murder, rape, arson, robbery, and aggravated assault, all of which are index crimes are probably what most people think of when crime is mentioned. This paper however, is not on crime, it is on criminal behavior. The focus of this analysis is actually on white-collar and corporate crime. Crime that many times are overlooked. Why is white-collar crime many times overlooked? It is overlooked because the people that commit these types of crime are not exactly your everyday criminals. They are not your average poor, so called white trash and low-life people. They are not the people who you would expect to be criminals. They are actually in fact your everyday working class and middle class people. As I mentioned before, white- collar crime involves not people who are usually poor but people who are much better off in life. These people who are typically successful and have families and are the people who you would never even picture as being criminals. They are people who could never even be categorized as a criminal but are because white-collar crime and corporate crimes are in fact what they are, a crime. White- collar crime occurs in banks and corporations and often involves important figures in a community, like I said the people you would never expect. As for corporate crime, it does not involve just one individual, but many people, often an entire company or corporation, once again crime in the suites, not in the streets. So, what is white-collar crime and corporate crime? Now that I have introduced the topic I will go into detail as to what both of these topics actually are and I will examine more closely and look at what social forces play major roles in these crimes in the paragraphs to come. White-collar crime refers to illegal activities committed by people during the course of their employment or regular business activities. Crimes such as, fraud, which ...

Haas School of Business Programs and Admissions

Haas School of Business Programs and Admissions The Haas School of Business, also known as Haas or Berkeley Haas, is a University of California, Berkeley school. UC Berkeley is a public research university that was founded in 1868 in the state of California. Haas was founded just 30 years later, making it the second oldest business school in the United States. Haas School of Business has more than 40,000 alumni and is frequently ranked among the best schools in the nation. Degrees are offered at the undergraduate and graduate level. Nearly 60 percent of Haas students are enrolled in one of the three available MBA programs. Haas Undergraduate Programs Haas School of Business offers a Bachelor of Science in Business degree program. The programs curriculum consists of a 7-course breadth sequence, which requires students to take at least one class in each of the following categories: arts and literature, biological science, historical studies, international studies, philosophy and values, physical science, and social and behavioral sciences. Students are encouraged to spread these courses out over the four years that it takes to earn the degree. The Bachelor of Science in Business curriculum also includes core business courses in areas like business communication, accounting, finance, marketing, and organizational behavior. Students are also allowed to customize their education with business electives that focus on more nuanced topics like corporate finance, leadership, and brand management. Students who want a global view of business can participate in Haas study aboard or travel study programs. Getting In Haas Bachelor of Science in Business degree program is open to students enrolled in UC Berkeley as well as students who are transferring in from another undergraduate school. Admissions are very competitive, and there are prerequisites that must be met prior to applying. For example, applicants must complete a minimum of 60 semester or 90 quarter units as well as several prerequisite courses prior to submitting an application. Preference is given to applicants who are California residents. Applicants who are transferring from a California community college may also have an edge. To apply to a Haas School of Business program, you should have some work experience. Students in the Full-Time MBA and EWMBA program typically have at least two years of work experience, with most students having five years or more. Students in the EMBA program usually have ten years of work experience or more. A  GPA  of at least 3.0 is standard for applicants, though it is not a firm requirement. At  minimum, applicants should be able to demonstrate academic aptitude and have some quantitative proficiency to be considered for the program. Haas MBA Programs Haas School of Business has three MBA programs: Full-Time MBA Program: The full-time MBA program is for students who do not plan to work while they earn their degree. This program takes two years to complete and requires full-day class attendance Monday through Thursday.Evening and Weekend (EWMBA) Program: The EWMBA program is a part-time MBA program that allows students to continue working while they earn their degree. Students in this program can attend school two evenings during the week or all day on Saturday. Either way, the program takes 2.5 years to 3 years to complete.MBA for Executives (EMBA) Program: The EMBA program is a part-time program for students who are either executives or have a lot of work experience. This program, which takes about 19 months to complete, meets Thursday through Saturday every three weeks. All three MBA programs at Haas are campus-based programs that are taught by the same faculty and result in the same MBA degree. Students in every program complete core business courses related to accounting, finance, marketing management, leadership, microeconomics, macroeconomics, and other business topics. Haas also provides global experiences for students in every MBA program and encourages tailored education through evolving electives. Other Graduate Programs at Haas School of Business Haas School of Business offers a one-year Master of Financial Engineering program that is designed to prepare students for careers as financial engineers. To earn a degree from this full-time program, students must complete 30 units of coursework  in addition to a 10-12 week internship. Admissions for this program are very competitive; fewer than 70 students are admitted each year. Applicants who have a background in a quantitative field, such as finance, statistics, mathematics, or computer science; high scores on the Graduate Management Admission Test (GMAT) or the Graduate Record Examinations (GRE) General Test; and an undergraduate GPA of 3.0 have the best chance of acceptance. Haas also offers a PhD program that allows students to study one of six business areas: accounting, business and public policy, finance, marketing, management of organizations, and real estate. This program admits fewer than 20 students each year and usually requires four or five years of study to complete. Applicants do not need to come from a specific background or have a minimum GPA, but they should be able to demonstrate scholarly ability and have research interests and career goals that are aligned with the program.

Allocation of risks between the parties to a contract in Fidic red Assignment

Allocation of risks between the parties to a contract in Fidic red book - Assignment Example FIDIC is regularly publishing standard construction contracts forms, which are just more than traditional construction contract’s forms. One of the salient features of FIDIC contract is that it facilitates the allocation of risk between the contractor and the employer. Red Book of FIDIC states that it has been drafted with sharing of risks between the parties in a construction contract evenly. Risks in a construction contract include unanticipated or poor ground scenarios, performance and operational needs, minimal ownership involvement and design responsibility. Risk can be defined as the probability of peril, loss, injury or damage. In a construction project, risks include loss of the property, injury to the employees, loss of materials, opportunity, finances and personal safety and impact on both corporate repute and personal safety2. In construction contracts, a contractor assumes more risks that may have a direct impact on contract’s completion date or final price. Further, the risks include unanticipated or poor ground situations, minimum performance or operational needs, design accuracy and minimum owner’s involvement in the contract. ... Analysis How Red Book of FIDIC allocates the risk between the parties in a Construction Contract The FIDIC contract recognises the risks in a construction contract and allocates many such risks to the contractor. The main aim is to enable the employer an enhanced certainty of the final project price. Further, Red book also offers more opportunities and time to the contractor to receive and evaluate information pertaining to the risks’ factors in the project. This will enable the contractor to conceive these risks and to offer his price to the project accordingly. Contractors employing the FIDIC Red Book will find is useful to comprehend how the FIDIC documents allocate and classify the various perils so as to forbid the cost overruns and losses that may be sustained on the problematic provinces of the project. Here, the contractor has to consider the risks associate to the capability of the contractor, physical risks, time-associated risks, economic risks, construction and eng ineering risks and other risks3. In Fidic red book, Contractor’s risks are detailed in clause 17.003. The Contractor will be held accountable for the following risks. Any loss or personal injury to employees or property due to Contractor’s wilful act, negligence or breach of contract or personal injury caused due to faulty design by the contractor. Loss caused due to Employer’s privilege to occupy any land or to have work executed. Risk in a construction Contract can be explained through the following chart– Chart 14 In Fidic red book, employer’s risks are detailed in clause 17.4 and also under Force Majeure Clause 19. Under the employer’s risks category, the Contractor is entitled to claim both extension of time and also to recover additional costs from the employer. The

Human Recources Management Assignment Example | Topics and Well Written Essays - 1500 words

Human Recources Management - Assignment Example In their efforts to meets the needs of the employees, companies adopt Maslow’s Hierarchy of Needs. This theory depicts five steps hierarchy of needs that employers should provide to their employees. These include physiological needs, safety, love, esteem and self-actualisation (Murphy, 2009, p. 24). On the other hand, reward is a tangible or intangible appreciation that is given to an employee after a good performance. The objective of a reward is to make an employee repeat the rewarded behaviour. For instance, in order to meet the physiological needs of the employees, organisations should reward them with food and water. Similarly, social needs of workers are met through rewarding them with affection, belongingness and love. Self-respect, improvement of status, prestige and self-esteem are key rewards that meet the esteem requirements of workers according to Maslow’s Hierarchy of Needs. 3.2 Job evaluation process and other factors emulated to determine pay Job evaluati on entails the strategies undertaken to analyse and assess the worth of jobs within a firm. One of the vital objectives of job evaluation is to ensure that employees are remunerated in an equitable way. Additionally, organisations undertake job evaluation to maintain an appropriate job grading techniques and to comply with legal requirements. Other factors that are used to determine employees pay include, minimum wage as stipulated by law, market rates of pay, equal pay and individual performance. British Leyland Motor Corporation Ltd (BLMC), a UK based motor vehicle manufacturing company adopts piecework to remunerate its employees. The amount of pay is usually re-rated whenever a change occurs in the technique of production. According to the BLMC policies, a change in the job does not result to a reduction of the salary. To motivate its employees especially in the production facility, the company increases its payment rates during an introduction of a new model. In addition to the piecework, employees who are responsible for servicing the production lines are remunerated by time rate and bonuses. This is in addition to the minimum rate as depicted by the UK labour laws. 3.3 Effectiveness of reward systems To ensure that workers are focused at attaining their goals as well as the objectives of the entire organisation, it is imperative for employers to offer rewards that are intrinsic or extrinsic in nature. Through adoption of an effective rewards system, human resources managers play vital roles of retaining the loyalty of the employees and improving their performance. Some of the primary objectives of a reward system include motivating the workers, retaining productive labour force, responding to organisational skills as well as informing the potential and existing employees about the organisational values that attract high rewards. One of the notable UK Company that has put in place an effective reward system is Tesco supermarket. Being the second largest supermarket in the world after Wal-Mart, Tesco controls 36% of the UK grocery market. One form of a reward adopted by Tesco is training and development of its employees. In this way, all members of staff are given an opportunity to advance their career while working in the company. To make the training flexible, Tesco offers Apprenticeship and Options Development Programmes (Carolyn, 2011, p 3). Protecting employee’

Customer service excellence Essay Example | Topics and Well Written Essays - 1000 words

Customer service excellence - Essay Example This is mostly a designed plan to deliver the best to customers, and general commitment to ensure all needs and complaints are handled. Secondly, responsiveness also determines the kind and the quality of customer service (Gronroos, 2007). Most clients prefer quick response to their needs to a particular business or organization. This includes responding to their emails and calls or fixing the issues at hand. Every organization should make this their priority in order to attract and retain their customers for longer periods. Further, most clients prefer assurance from their service providers. This installs a substantial amount of confidence to them, and organization gains much trust from them in the end. Sometimes organizations find it difficult to balance their needs and expectations of clients. However, an organization can easily do this by ensuring that their main priority is to achieve maximum customer satisfaction. In my opinion, this is one of the best policies, which organizations should adopt in order to be successful in all their transactions. The reason behind this is that the customer will always leave a happy person and will surely come back again for products and services offered. Both the behavior of the individual and that of the customer affect the service quality by the end of the day. The employees of an organization must serve their clients in an outstanding manner. Customer orientation, when they are first introduced into the business, matters a lot. In most cases, they will always encounter quality services as the organizations yearn at retaining them over the years (Reponen, 2002). Secondly, the behavior of the individual determines the level of customer satisfaction as well as the value perception related to different clients of the organization. It is always advisable to ensure that all clients are attended in the best way possible. Finally, it is difficult to know and understand the

Breathe Right Case Study Example | Topics and Well Written Essays - 500 words

Breathe Right - Case Study Example With the expansion of the market, this means that the company had to modify its drugs to meet the various requirements of the foreign markets. Secondly, the company experienced increased growth. The growth was because of the company having new markets. They therefore, had to grow in large numbers and launch new branches in the different countries. This means that the company had to employ more people to work on its newfound market. A third advantage is the increased consumer awareness of CNS products. When new products were introduced in the new markets, more consumers were eager to know what the products were about and the different curative effects that the products had. Through advertising for these products in media stations, it helped increase consumer awareness of CNS products. This in turn attracted more consumers who buy the drugs either as a prescription or over the counter. Additionally, the company benefited from the increased sales. When the company decided to go global, it increased its sales volume by a large percentage. This was because of the increased demand of its product. An increase in sales means that there was an increase in sales revenue too. This means that there was increase in the amount that the company was able to transact in a day. More notably, the company benefited from the newly gained local partnership in the various countries where it expanded. Moreover, the company benefited from an increase in profits, which enabled it to expand. However, the company faced some disadvantages. These include the increased operational cost. The company had to increase the amount of money that it spends in order to maintain the new operations at the various places where it expanded. Secondly, some consumers bought the drugs over the counter without the right prescriptions. This was jeopardizing the existence of the CNC Company in that it was at a risk of being sued for selling its

Legal and Ethical Actions of NovaGold Resources Inc Term Paper

Legal and Ethical Actions of NovaGold Resources Inc - Term Paper Example Similar class action lawsuits were also filed in the Supreme Court of British Columbia and in the Ontario Superior Court of justice in Canada. The $28.0 million settlement was covered by insurance companies and the company did not have to payout from own resources under the terms and conditions. (Marketwire 2011) NovaGold commenced environmental studies in 1996, which consisted of Meteorology, wetlands delineation related to mineral resource estimates, aquatic studies in the main drainages, water quality studies, and some waste rock characterization. This was further expanded to terrestrial wildlife and avian surveys, detailed aquatic studies, ambient air monitoring and cultural site surveys. NovaGold is equipped fully to overcome any challenges, even though it may require more time and with the progress of work, it will start showing in the share price. NovaGold clearly understands its community responsibilities and following all environmental norms would work to get all necessary p ermits to make the project most successful and only one of its kind in the world. (Safehaven 2010) Stocks of NovaGold are traded on NASDAQ, AMEX, and New York Stock Exchange. Revenue and Income From the latest results available for the year ended Nov 30, 2010, of NovaGold Resources Inc., it is seen that revenue has fallen to C$0.6M. Surprisingly, cost of goods sold has not gone down proportionately and it has remained at C$46.3M. Losses have gone up to the tune of C$-203.5M. (NovaGold Financials 2010) Basic Financial Ratios & Industrial Comparison Return on Assets: Net Income/ Total Assets stands negative at -5.17%, on industrial comparison it stands as the 60-80th percentile. A. Return on Capital: Given as after-tax operating income by the book value of invested capital and that comes to -5.55%, on industrial comparison it stands as the 60-80th percentile. B. Return on Equity: Net Income/Shareholder's Equity stands at -34.48%, on industrial comparison it stands as the 40-60th perce ntile. Credit Ratios: A. Current Ratio: given by Current Assets/Current Liabilities stands at 5.3 times; on the industrial comparison, it stands as the 60-80th percentile. B. Quick Ratio: given as Current Assets-Inventory/Current Liabilities stands at 5.1 times; on the industrial comparison, it stands as the 60-80th percentile. Margin Ratios: A. Gross Margin: given as Revenue-Cost of goods sold/Revenue that stands at -7631.22%, on industrial comparison it stands as the 0-20th percentile. B. EBITDA Margin: -9295.16%, on industrial comparison it stands as the 0-20th percentile. Debt-Equity Ratio: Total Debt/ Total Equity stands at 20.5, on industrial comparison it stands as the 60-80th percentile. Total Liabilities/Total Assets: 23.8, on industrial comparison it stands as the 60-80th percentile. (NovaGold Resources) Sales Forecast: NovaGold is a company doing exploration activities in the field of precious metals and necessary development of mineral properties in Alaska, Canada, Briti sh Columbia and the United States. The Company spearheads its operations through wholly owned subsidiaries, partnerships, and joint ventures.

Breathe Right Case Study Example | Topics and Well Written Essays - 500 words

Breathe Right - Case Study Example With the expansion of the market, this means that the company had to modify its drugs to meet the various requirements of the foreign markets. Secondly, the company experienced increased growth. The growth was because of the company having new markets. They therefore, had to grow in large numbers and launch new branches in the different countries. This means that the company had to employ more people to work on its newfound market. A third advantage is the increased consumer awareness of CNS products. When new products were introduced in the new markets, more consumers were eager to know what the products were about and the different curative effects that the products had. Through advertising for these products in media stations, it helped increase consumer awareness of CNS products. This in turn attracted more consumers who buy the drugs either as a prescription or over the counter. Additionally, the company benefited from the increased sales. When the company decided to go global, it increased its sales volume by a large percentage. This was because of the increased demand of its product. An increase in sales means that there was an increase in sales revenue too. This means that there was increase in the amount that the company was able to transact in a day. More notably, the company benefited from the newly gained local partnership in the various countries where it expanded. Moreover, the company benefited from an increase in profits, which enabled it to expand. However, the company faced some disadvantages. These include the increased operational cost. The company had to increase the amount of money that it spends in order to maintain the new operations at the various places where it expanded. Secondly, some consumers bought the drugs over the counter without the right prescriptions. This was jeopardizing the existence of the CNC Company in that it was at a risk of being sued for selling its

Research prposal Proposal Example | Topics and Well Written Essays - 2000 words

Prposal - Research Proposal Example In the era of globalization most of the countries use the strategy of deregulation to reduce the government control on the domestic industry. Banking sector has also not been left alone. Governments are also exercising lesser amount of control on the banks. But to ensure that the banks are performing efficiently, the Central bank has a big role to play. It is the central bank of a nation in whose hands there lay the responsibilities of creating favorable environments for the bank to operate under. Efficiency of the banks in a country depends on the efficiency of the strategies adopted by the central bank of the country. When a nation adopts the strategy of increasing openness, its economy goes through a substantial change as the domestic market of the country becomes exposed to international market and therefore to fierce competition from international firms. Under this situation central bank of any country needs to make cautious steps in order to make the domestic banks strong enough to survive under strong competition as well as creating favorable environment for the operation of international banks. Particular in developing countries, central banks have to be very efficient in deal with the continuously changing financial environment under intense liberalization. Unless and until the central bank becomes successful in fulfilling its major objective of maintaining financial stability, the country’s financial sector will move towards severe financial turmoil. (Papademos, 2008) Libya, a developing nation of Africa, has significantly participated in the process of globalization. Its banking sector has therefore been also not left alone. Intensive reform measures have been undertaken for the baking industry of the country to pave the way of integration of domestic banking sector with the global one. But here lays a big question regarding how far the banking industry of Libya

Should Defendants with Traumatic Brain Injuries Be Held Accountable for Their Actions Essay Example for Free

Should Defendants with Traumatic Brain Injuries Be Held Accountable for Their Actions Essay â€Å"Six weeks after getting his driver’s license, Christopher Tiegreen was in a car collision near his home in Gainesville, Ga. Tiegreen’s Isuzu Trooper flipped several times, causing severe head injuries. A month later, Tiegreen emerged from a coma a different person. The impact of the crash caused damage to the frontal lobe of his brain and sheared his brain stem. During his recovery and rehabilitation, the usually gentle Tiegreen became violent toward his mother, as well as with other family members and rehab staff. On Sept. 1, 2009, Tiegreen walked out of a duplex apartment where he was supposed to be under 24-hour supervision. In a yard nearby he attacked a young woman holding her 20-month-old son. He was charged with aggravated assault, criminal attempt to commit a felony, false imprisonment, battery, sexual battery and cruelty to a child in the third degree. † (Davis, 2012). Is Christopher Tiegreen a different person now, with a severely impaired mental capacity, because of his traumatic brain injury, or is he just an angry, violent person who has simply committed his first crime? More succinctly; do Traumatic Brain Injuries (TBI) cause violent behavior in previously â€Å"normal† people, or is the TBI personality change simply a smoke screen being used to defend people with dangerous personality traits who happen to have a brain injury? To begin with, a definition of Traumatic Brain Injury, especially as opposed to a head injury, as most people do confuse the two. The Mayo Clinic defines Traumatic Brain Injury as â€Å"Traumatic brain injury occurs when an external mechanical force causes brain dysfunction. The Mayo Clinic, 2012). Traumatic brain injury usually results from a violent blow or jolt to the head or body. An object penetrating the skull, such as a bullet or shattered piece of skull, also can cause traumatic brain injury. â€Å"(The Mayo Clinic, 2012). A Traumatic Brain Injury (TBI) is not a â€Å"head injury†, it is not a concussion nor an injury to the skull or spine; it is exclusively an injury the brain (and/or brain stem). With the definition clear, we see that the statistics regarding TBIs are shocking; Dr. William Winslade provides the following information from 2003, â€Å"Traumatic brain injury for decades has been, and continues to be, a major public health problem in the United States. Car crashes, gunshot wounds, falls and sports injuries account for two million brain injuries a year, nearly 400,000 hospital admissions, and at least 60,000 deaths. Approximately 90,000 people suffer a severe brain injury and survive but require extended, expensive rehabilitation. Some 2,000 people a year lapse into permanent unconsciousness lasting for months or years before they die. † (Winslade, 2003). Some survivors of traumatic brain injury fully recover, but many others experience a multitude of cognitive, emotional and behavioral disabilities. † (Winslade, 2003). As a survivor of a traumatic Brain Injury, the patient faces a myriad of recovery issues, not simply medical issues such as headaches, lethargy, pain in the distal limbs, speech issues, attention deficit and memory loss may affect cognitive functioning. Per Dr. William Winslade, an expert on Traumatic Brain Injuries; the changes in an individual with a TBI are profound and noticeable â€Å"Personality changes are common. Those who were calm and controlled may become quick-tempered and impulsive. In some people anger erupts into aggressive attacks on others. Many with severe brain injuries lack the ability to control their thoughts, emotions, impulses and their conduct. They may become uninhibited, promiscuous, anxious, paranoid or violent. † (Winslade, 2003). It is precisely these personality changes that makes Traumatic Brain Injuries so different from â€Å"head injuries† such as concussions, which do not present any marked changes is personality. Courts in the United States have increasingly been faced with the question as to whether or not the profound changes that are associated with TBIs should be considered a mitigating factor in trying defendants with the injury, or in determining what their sentences should be and where they should serve their time, if any; in a prison or in a mental health facility. â€Å"According to Duke University researcher Nita Farahany, the number of cases in which judges have mentioned neuroscience evidence in their opinion increased from 112 in 2007 to more than 1,500 in 2011. † (Koebler, 2012). The use of neuroscience in the courtroom is definitely increasing, Nita Farahany has been tracking criminal cases in which â€Å"lawyers have introduced neuroscientific evidence since 2004. By combing legal opinions, she’s found about 2,000 examples, with 600 of those cases in 2011 alone. † (Davis, 2012). â€Å"While attorneys have tried to win cases based on the lack of control over impulses based on the defendant having a TBI, † The biggest way in which neuroscience is being used in the courtroom is to mitigate punishment in one way or another, Farahany says, adding that its almost exclusively used in death penalty cases. They say they have a history of brain injury and trauma to say I have a different brain than the average person. Because of that difference, I have less control over myself. (Koebler, 2012). While medical scan, such as CAT scans and MRIs can show a difference in the appearance of the brain itself, there is scant evidence that these damaged brains are actually the cause of crimes committed by defendants suffering from a personality change brought on by a Traumatic Brain Injury. The science behind these brain scans is still in its infancy, but neuroscientists point to anecdotal evidence that traumatic brain injury or brain abnormalities can cause criminal behavior. † (Koebler, 2012). There is a case that many legal professionals point to when arguing the point for special consideration when trying or sentencing a defendant with a TBI. â€Å"In 2002, a 40-year-old Virginia teacher was caught viewing child pornography and making advances on his stepdaughter. He was convicted of child molestation, but the night before he went to jail, he went to the doctor with a crippling headache and confessed he might commit rape. Doctors found something they didnt expect: A brain tumor. The cancerous tumor was putting pressure on his orbifrontal cortex, which controls impulse and judgment. The tumor was removed, and the man no longer exhibited pedophilic tendencies. † (Koebler, 2012). The fact that is most persuasive with this case is the fact that once the tumor, and the pressure it was exerting on the orbifrontal cortex, were removed the patient no longer exhibited any pedophilic tendencies. Could this be the answer to whether or not TBIs do so adversely affect individuals that the personality changes they exhibit should not be held against them in the legal forum? Not necessarily. â€Å"Daniel Martell, a forensic neuropsychologist who examined Weinstein and testified for the prosecution, says the brain images were nothing more than fancy pictures meant to stir a jury. â€Å"It was the Christmas tree effect,† Martell says. â€Å"Lots of people ooh and aah at the pictures. It doesn’t tell you anything about a person’s behavior. † (Davis, 2012). Martell makes the point that many attorneys take when faced with opposing counsel who is presenting the TBI defense, stating that the profound changes in persons with TBIs should be a mitigating factor in trials and during sentencing. That hasn’t stopped defense attorneys from trying to introduce evidence of damaged brains into the courtroom, including brain scans. One such case, frequently cited in law and neuroscience journals, is that of New York advertising executive Herbert Weinstein, 65, who was arrested on charges that he strangled his second wife, Barbara, and t hrew her out the window of their 12th-floor Manhattan apartment in 1991 during an argument about their children. Weinstein never denied killing his wife. His lawyer, Diarmuid White, argued that Weinstein was not himself due to an arachnoid cyst on his brain. White contended that the cyst caused pressure on part of Weinstein’s temporal lobe, compromising his self-control and emotional regulation. Zachary Weiss, the New York City district attorney who prosecuted the case, thought it was simply a matter of a man getting angry at his wife and killing her. That was until White sent him the brain scan during discovery. â€Å"I got this picture in the mail and thought you’ve got to be joking,† Weiss recalls. It got complicated. I called this the rich man’s defense. † Whether Weinstein’s brain made him do it or not, Weiss believes the case was important. â€Å"It opened up a debate academically about responsibility and free will, and how we evaluate scientific evidence,† says Weiss, twenty years after the case; Martell still believes brain scans don’t explain specific behaviors. â€Å"The problem is that the science has not come along to support what the scan means,† says Martell, now a Newport Beach, Calif. based consultant for criminal as well as civil cases. â€Å"Since the ’90s, we’ve been much better at generating the cool pictures than we are at explaining what they mean. † (Davis, 2012). The opinion that Martell expresses about TBIs is not rare; many in the legal profession see the whole TBI debate as another â€Å"smoke and mirror† defense on par with the famous â€Å"Twinkie† defense; interesting and impressive in the courtroom, but lacking in any real legal merit. There is a group of individuals whose TBIs are taken into special onsideration; combat veterans. â€Å"Am ong the growing number of cases involving neuroscientific evidence are those that involve combat veterans from Afghanistan and Iraq as defendants. † (Davis, 2012). â€Å"Dr. Chrisanne Gordon, a Columbus, Ohio, rehabilitation medicine specialist who works with brain-injured vets, is one of three authors who wrote a chapter about traumatic brain injury. â€Å"They’re not insane, they’re not retarded, but they frequently have issues with impulse control and fall through the cracks of the legal system,† she says. (Davis, 2012). Combat veterans pose a desperate problem for the court systems judging them as defendants; because their injuries are usually combat related most people view them with a particular amount of sympathy because they received their injury in a â€Å"heroic† manner; serving the country. Agreeing that veteran’s legal situations are difficult to handle, at best, it has been suggested that courts need to view veteran’s with an air of compassion. There are courts who are taking definitive steps when dealing with combat veteran’s with TBIs who have ended up as defendants. â€Å"One of veterans’ biggest allies in Ohio is state Supreme Court Justice Evelyn Stratton, who plans to work full time with veterans’ justice issues after she retires later this year. She supports the development of more veterans’ treatment courts and hopes to change sentencing guidelines to ensure judges in all courts look at a defendant’s military service record. We want them to look at war experience as mitigation,† she says. â€Å"And we want them at least to look at the causes of what happened. † (Davis, 2012). Traumatic Brain Injuries are not simple to define and apply to a law principle; they allow that a defendant can be found not guilty of a crime because of their mental health issues, saying, in essence, that the defendant is not responsible for their crime because they had no real understanding of their actions or the consequences thereof. It will take many more years of research, to produce empirical evidence to supplement the anecdotal evidence that does exist, to determine if the dramatic personality changes that patients with Traumatic Brain Injuries exhibit, has the brain been so physically damaged that the victims of TBIs are no longer able to control themselves, or is the Traumatic Brain Injury defense simply a criminal defense â€Å"flavor of the week. †

Midwife Views on Amniotomy to Speed Up Labour

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