The Modeling of Salt Water Intrusion Essay -- Encroachment Science Ess

The Modeling of Salt Water Intrusion What is Salt Water Intrusion? Salt water intrusion, or encroachment, is defined by Freeze and Cherry (1979) as the migration of salt water into fresh water aquifers under the influence of groundwater development. Salt water intrusion becomes a problem in coastal areas where fresh water aquifers are hydraulically connected with seawater. When large amounts of fresh water are withdrawn from these aquifers, hydraulic gradients encourage the flow of seawater toward the pumped well or wells. Salt water intrusion is a problem that affects coastal areas around the world. Groundwater Problems in Coastal Areas (Custodio, 1987) is an excellent reference for more information on global salt water intrusion problems, while Atkinson (1986) details salt water intrusion problems for the coastal areas of the United States. Why is it a Problem? The encroachment of salt water into fresh water supplies has become cause for concern within the last century as populations in coastal areas have risen sharply and placed greater demands on fresh groundwater reserves. Salt water intrusion causes many problems in these areas, perhaps the most severe being the limitation of potable drinking water. Drinking water standards established by the EPA in 1962 require that drinking water contain no more than 500 mg/L of total suspended solids (TSS), a common measure of salinity (Atkinson, 1986). Seawater contains approximately 30000 mg/L of TSS. Therefore, it is evident that even a small amount of seawater can cause drinking water problems when mixed with fresh water reserves. Also, salinity in irrigation water can be detrimental to agriculture, reducing yields and killing crops with low tolerances to salt. In some... ...t Modeling of the Flow Through Porous Media". OWRT-C-4026(9006)(4). Office of Water Resources and Technology, U.S. Dept. of the Interior. Washington, DC. March, 1975. Christensen, B.A., "Mathematical Methods for Analysis of Fresh Water Lenses in the Coastal Zones of the Floridian Aquifer". OWRT-A-032-FLA(1). Office of Water Research and Technology. U.S. Dept. of the Interior. Washington, DC. Custodio, E., and Llamas, M.R. Hidrologia Subterranea. Ed. Omega, Barcelona. 1976. Custodio, E. (prepared by). Groundwater Problems in Coastal Areas. A contribution to the International Hydrological Programme. 1987. Freeze, R. A. and J. A. Cherry. Groundwater. Prentice Hall, Inc. 1979. Jenkins, S. R. and R. K. Moore. "Effect of Saltwater Intrusion on Soil Erodibility of Alabama Marshlands". Water Resources Research Institute, Auburn University, Auburn, Al. 1984.

Emily Brontës Wuthering Heights :: essays research papers

The intensity of feeling between Catherine and Heathclif defies family barriers imposed by Catherine's brother ,Hindley after their father's death. Heathcliff was ill-treated by Hindley after the death of the old Earnshaw: He drove him from their company to the servants, deprived him of the instructions of the curate †¦ He bore his degradation pretty well at first, because Cathy taught him what she learnt, and work or play with him in the fields. They both promised fair to grow up as rude as savages, the young master being entirely negligent how they behave, and what they did, so they keep clear of him†¦Ã¢â‚¬ ¦ and the after punishment grew a mere thing to laugh at. The crute might set as many chapters as he pleased for Catherine to get by heart, and Joseph might thrash Heathcliff till his arm ached, they forget everything the minute they were together again. (Pg 44) Thus, it is clearly obvious that since childhood their feeling for each other defies all the family barriers imposed on them. No outside force would be strong enough to eclipse their emotions. Even when she grows old enough for the question of marriage to arise, Catherine's relationship with Heathcliff remains much as it was when they were children. The way the two spirit intertwined are clearly illustrated in Catherine's speech below: My great miseries in this world have been Heathcliff"s miseries; my great thought in living is himself. If all else perish, and he remained, I should still continue to be; and if all else remained, and he were annihilated, the Universe would turn to mighty stranger. I should not seem a part of it. My love for Linton is like the foliage in the woods. Time will change it, I'm well aware, as winter changes the trees-my love for Heathcliff resembles the eternal rocks beneath-a source of little visible delight, but necessary. Nelly, I am Heathcliff-He's always in my mind-not as a pleasure, any more than I am always a pleasure to myself-but, as my own being- so, don't talk of our separation again-it is impracticable†¦Ã¢â‚¬ ¦ Catherine loves both Heathcliff and Edger Linton on different basis-She loves Linton because he is handsome, and pleasant, and young, and cheerful, and rich, and loves her. Her love for Heathcliff is a must: it is the deepest impulse of her nature, it is "necessary". Through her feeling for Heathcliff, Catherine discovers her own identity, her place in the world-as he does through her.

Comparison of To His Coy Mistress and An Answer to a Love Letter :: Love Letters Poetry Poems Essays

Comparison of To His Coy Mistress and An Answer to a Love Letter These two poems are meant to be a love letters written by a man to a lady of higher disposition and an answer to that love letter, written by that lady. The first, written by Marvell is written is telling her 'Carpe Dieum' - or 'Seize the Day' this phrase sums up his poem, as that is what he is telling her to do all the time. This is shown by the way he has structured his piece he starts of explaining what they could do if they had all of the time in the world "We would sit and think which way to Pass our long loves day." This means that they would just spend the whole time talking and planning their life because he says our long loves day and in the context it could mean their life (as they will love forever, therefore all their life will just be one day full of love) then he goes on to say that although he would like to do this they cannot as they will eventually die "Times winged chariot hurrying near Thy beauty shall no more be found" He uses this imagery to show how time (death) is creeping up on them but fast, as in on a winged chariot. Then, in the logical fashion he comes up with a solution that they should "Roll all our strength and all Our sweetness into one ball." This could just means that they should 'get together and become one, possibly through matrimony or having a child hence ball. It could be a euphemism for having sex. However in Montagu's poem she uses a different argument. At first she says that he is seeing a false impression of her because of all the flattery at the beginning, then saying 'but leaving her-'tis me you pursue'. She is complimenting his wife (as the man I s already marries) trying to persuade him that his life at the moment is much better as he has a wife and money and would be stupid to leave that behind. Then she starts getting really aggressive and offensive against mankind, likening them to pug dogs, "Why should the poor pug (the mimic of your kind) Wear a rough chain and be to a box confin'd?" This is meant to be an immense insult against mankind- likening them to simple dogs, that to be fair are quite ugly and just sit on a lap to be stroked all day. In saying this she infers that men have no use but to 'be'. In the next line she begins to give you an idea about why

The Twilight Saga 2: New Moon Chapter 23 THE TRUTH

I HAD THE SENSE THAT I'D BEEN ASLEEP FOR A VERY long timemy body was stiff, like I hadn't moved once through all that time, either. My mind was dazed and slow; strange, colorful dreamsdreams and nightmaresswirled dizzily around the inside of my head. They were so vivid. The horrible and the heavenly, all mixed together into a bizarre jumble. There was sharp impatience and fear, both part of that frustrating dream where your feet can't move fast enough And there were plenty of monsters, red-eyed fiends that were all the more ghastly for their genteel civility. The dream was still strongI could even remember the names. But the strongest, clearest part of the dream was not the horror. It was the angel that was most clear. It was hard to let him go and wake up. This dream did not want to be shoved away into the vault of dreams I refused to revisit. I struggled with it as my mind became more alert, focusing on reality. I couldn't remember what day of the week it was, but I was sure Jacob or school or work or something was waiting for me. I inhaled deeply, wondering how to face another day. Something cold touched my forehead with the softest pressure. I squeezed my eyes more tightly shut. I was still dreaming, it seemed, and it felt abnormally real. I was so close to waking any second now, and it would be gone. But I realized that it felt too real, too real to be good for me. The stone arms I imagined wrapped around me were far too substantial. If I let this go any further, I'd be sorry for it later. With a resigned sigh, I wrenched back my eyelids to dispel the illusion. â€Å"Oh!† I gasped, and threw my fists over my eyes. Well, clearly, I'd gone too far; it must have been a mistake to let my imagination get so out of hand. Okay, so â€Å"let† was the wrong word. I'd forced it to get out of handpretty much stalked my hallucinationsand now my mind had snapped. It took less than half a second for me to realize that, as long as I was truly insane now, I might as well enjoy the delusions while they were pleasant. I opened my eyes againand Edward was still there, his perfect face just inches away from mine. â€Å"Did I frighten you?† His low voice was anxious. This was very good, as delusions went. The face, the voice, the scent, everythingit was so much better than drowning. The beautiful figment of my imagination watched my changing expressions, with alarm. His irises were pitch-black, with bruise-like shadows under them. This surprised me; my hallucinatory Edwards were usually better fed. I blinked twice, desperately trying to remember the last thing that I was sure was real. Alice was part of my dream, and I wondered if she had really come back at all, or if that was just the preamble. I thought she'd returned the day I'd nearly drowned â€Å"Oh, crap† I croaked. My throat was thick with sleeping. â€Å"What's wrong, Bella?† I frowned at him unhappily. His face was even more anxious than before. â€Å"I'm dead, right?† I moaned. â€Å"I did drown. Crap, crap, crap! This is gonna kill Charlie.† Edward frowned, too. â€Å"You're not dead.† â€Å"Then why am I not waking up?† I challenged, raising my eyebrows. â€Å"You are awake, Bella.† I shook my head. â€Å"Sure, sure. That's what you want me to think. And then it will be worse when I do wake up. If I wake up, which I won't, because I'm dead. This is awful. Poor Charlie. And Renee and Jake† I trailed off in horror at what I had done. â€Å"I can see where you might confuse me with a nightmare.† His short-lived smile was grim. â€Å"But I can't imagine what you could have done to wind up in hell. Did you commit many murders while I was away?† I grimaced. â€Å"Obviously not. If I was in hell, you wouldn't be with me.† He sighed. My head was getting clearer. My eyes flickered away from his faceunwillinglyfor one second, to the dark, open window, and then back to him. I started to remember details and I felt a faint, unfamiliar blush warm the skin over my cheekbones as I slowly realized that Edward was really, truly here with me, and I was wasting time being an idiot. â€Å"Did all of that really happen, then?† It was almost impossible to reassign my dream as reality. I couldn't wrap my head around the concept. â€Å"That depends.† Edward's smile was still hard. â€Å"If you're referring to us nearly being massacred in Italy, then, yes.† â€Å"How strange,† I mused. â€Å"I really went to Italy. Did you know I'd never been farther east than Albuquerque?† He rolled his eyes. â€Å"Maybe you should go back to sleep. You're not coherent.† â€Å"I'm not tired anymore.† It was all coming clear now. â€Å"What time is it? How long have I been sleeping?† â€Å"It's just after one in the morning. So, about fourteen hours.† I stretched as he spoke. I was so stiff. â€Å"Charlie?† I asked. Edward frowned. â€Å"Sleeping. You should probably know that I'm breaking the rules right now. Well, not technically, since he said I was never to walk through his door again, and I came in the window But, still, the intent was clear.† â€Å"Charlie banned you from the house?† I asked, disbelief quickly melting into fury. His eyes were sad. â€Å"Did you expect anything else?† My eyes were mad. I was going to have a few words with my fatherperhaps it would be a good time to remind him that I was over the legal age of adulthood. It didn't matter so much, of course, except in principle. All too soon there would be no reason for the prohibition. I turned my thoughts to less painful avenues. â€Å"What's the story?† I asked, genuinely curious, but also trying desperately to keep the conversation casual, to keep a firm grip on myself, so I wouldn't scare him away with the frantic, gnawing craving that was raging inside me. â€Å"What do you mean?† â€Å"What am I telling Charlie? What's my excuse for disappearing for how long was I gone, anyway?† I tried to count the hours in my head. â€Å"Just three days.† His eyes tightened, but he smiled more naturally this time. â€Å"Actually, I was hoping you might have a good explanation. I've got nothing.† I groaned. â€Å"Fabulous.† â€Å"Well, maybe Alice will come up with something,† he offered, trying to comfort me. And I was comforted. Who cared what I had to deal with later? Every second that he was hereso close, his flawless face glowing in the dim light from the numbers on my alarm clockwas precious and not to be wasted. â€Å"So,† I began, picking the least importantthough still vitally interestingquestion to start with. I was safely delivered home, and he might decide to leave at any moment. I had to keep him talking. Besides, this temporary heaven wasn't entirely complete without the sound of his voice. â€Å"What have you been doing, up until three days ago?† His face turned wary in an instant. â€Å"Nothing terribly exciting.† â€Å"Of course not,† I mumbled. â€Å"Why are you making that face?† â€Å"Well† I pursed my lips, considering. â€Å"If you were, after all, just a dream, that's exactly the kind of thing you would say. My imagination must be used up.† He sighed. â€Å"If I tell you, will you finally believe that you're not having a nightmare?† â€Å"Nightmare!† I repeated scornfully. He waited for my answer. â€Å"Maybe,† I said after a second of thought. â€Å"If you tell me.† â€Å"I was hunting.† â€Å"Is that the best you can do?† I criticized. â€Å"That definitely doesn't prove I'm awake.† He hesitated, and then spoke slowly, choosing his words with care. â€Å"I wasn't hunting fot food I was actually trying my hand at tracking. I'm not very good at it.† â€Å"What were you tracking?† I asked, intrigued. â€Å"Nothing of consequence.† His words didn't match his expression; he looked upset, uncomfortable. â€Å"I don't understand.† He hesitated; his face, shining with an odd green cast from the light of the clock, was torn. â€Å"I† He took a deep breath. â€Å"I owe you an apology. No, of course I owe you much, much more than that. But you have to know,†the words began to flow so fast, the way I remembered he spoke sometimes when he was agitated, that I really had to concentrate to catch them all†that I had no idea. I didn't realize the mess I was leaving behind. I thought it was safe for you here. So safe. I had no idea that Victoria,†his lips curled back when he said the name†would come back. I'll admit, when I saw her that one time, I was paying much more attention to James's thoughts. But I just didn't see that she had this kind of response in her. That she even had such a tie to him. I think I realize why nowshe was so sure of him, the thought of him failing never occurred to her. It was her overconfidence that clouded her feelings about himthat kept me from seeing the depth of them, the bond there. â€Å"Not that there's any excuse for what I left you to face. When I heard what you told Alicewhat she saw herselfwhen I realized that you had to put your life in the hands of werewolves, immature, volatile, the worst thing out there besides Victoria herselfhe shuddered and the gush of words halted for a short second. â€Å"Please know that I had no idea of any of this. I feel sick, sick to my core, even now, when I can see and feel you safe in my arms. I am the most miserable excuse for† â€Å"Stop,† I interrupted him. He stared at me with agonized eyes, and I tried to find the right wordsthe words that would free him from this imagined obligation that caused him so much pain. They were very hard words to say. I didn't know if I could get them out without breaking down. But I had to try to do it right. I didn't want to be a source of guilt and anguish in his life. He should be happy, no matter what it cost me. I'd really been hoping to put off this part of our last conversation. It was going to bring things to an end so much sooner. Drawing on all my months of practice with trying to be normal for Charlie, I kept my face smooth. â€Å"Edward,† I said. His name burned my throat a little on the way out. I could feel the ghost of the hole, waiting to rip itself wide again as soon as he disappeared. I didn't quite see how I was going to survive it this time. â€Å"This has to stop now. You can't think about things that way. You can't let this this guilt rule your life. You can't take responsibility for the things that happen to me here. None of it is your fault, it's just part of how life is for me. So, if I trip in front of a bus or whatever it is next time, you have to realize that it's not your job to take the blame. You can't just go running off to Italy because you feel bad that you didn't save me. Even if I had jumped off that cliff to die, that would have been my choice, and not your fault. I know it's your your nature to shoulder the blame for everything, but you really can't let that make you go to such extremes! It's very irresponsiblethink of Esme and Carlisle and† I was on the edge of losing it. I stopped to take a deep breath, hoping to calm myself. I had to set him free. I had to make sure this never happened again. â€Å"Isabella Marie Swan,† he whispered, the strangest expression crossing his face. He almost looked mad. â€Å"Do you believe that I asked the Volturi to kill me because I felt guilty?† I could feel the blank incomprehension on my face. â€Å"Didn't you?† â€Å"Feel guilty? Intensely so. More than you can comprehend.† â€Å"Then what are you saying? I don't understand.† â€Å"Bella, I went to the Volturi because I thought you were dead,† he said, voice soft, eyes fierce. â€Å"Even if I'd had no hand in your death†he shuddered as he whispered the last word†even if it wasn't my fault, I would have gone to Italy. Obviously, I should have been more carefulI should have spoken to Alice directly, rather than accepting it secondhand from Rosalie. But, really, what was I supposed to think when the boy said Charlie was at the funeral? What are the odds? â€Å"The odds† he muttered then, distracted. His voice was so low I wasn't sure I beard it right. â€Å"The odds are always stacked against us. Mistake after mistake. I'll never criticize Romeo again.† â€Å"But I still don't understand,† I said. â€Å"That's my whole point. So what?† â€Å"Excuse me?† â€Å"So what if I was dead?† He stared at me dubiously for a long moment before answering. â€Å"Don't you remember anything I told you before?† â€Å"I remember everything that you told me.† Including the words that had negated all the rest. He brushed the tip of his cool finger against my lower lip. â€Å"Bella, you seem to be under a misapprehension.† He closed his eyes, shaking his head back and forth with half a smile on his beautiful face. It wasn't a happy smile. â€Å"I thought I'd explained it clearly before. Bella, I can't live in a world where you don't exist.† â€Å"I am† My head swam as I looked for the appropriate word. â€Å"Confused.† That worked. I couldn't make sense of what he was saying. He stared deep into my eyes with his sincere, earnest gaze. â€Å"I'm a good liar, Bella, I have to be.† I froze, my muscles locking down as if for impact. The fault line in my chest rippled; the pain of it took my breath away. He shook my shoulder, trying to loosen my rigid pose. â€Å"Let me finish! I'm a good liar, but still, for you to believe me so quickly.† He winced. â€Å"That was excruciating.† I waited, still frozen. â€Å"When we were in the forest, when I was telling you goodbye† I didn't allow myself to remember. I fought to keep myself in the present second only. â€Å"You weren't going to let go,† he whispered. â€Å"I could see that. I didn't want to do itit felt like it would kill me to do itbut I knew that if I couldn't convince you that I didn't love you anymore, it would just take you that much longer to get on with your life. I hoped that, if you thought I'd moved on, so would you.† â€Å"A clean break,† I whispered through unmoving lips. â€Å"Exactly. But I never imagined it would be so easy to do! I thought it would be next to impossiblethat you would be so sure of the truth that I would have to lie through my teeth for hours to even plant the seed of doubt in your head. I lied, and I'm so sorrysorry because I hurt you, sorry because it was a worthless effort. Sorry that I couldn't protect you from what I an. I lied to save you, and it didn't work. I'm sorry. â€Å"But how could you believe me? After all the thousand times I've told you I love you, how could you let one word break your faith in me?† I didn't answer. I was too shocked to form a rational response. â€Å"I could see it in your eyes, that you honestly believed that I didn't want you anymore. The most absurd, ridiculous conceptas if there were anu way that I could exist without needing you!† I was still frozen. His words were incomprehensible, because they were impossible. He shook my shoulder again, not hard, but enough that my teeth rattled a little. â€Å"Bella,† he sighed. â€Å"Really, what were you thinking!† And so I started to cry. The tears welled up and then gushed miserably down my cheeks. â€Å"I knew it,† I sobbed. â€Å"I knew I was dreaming.† â€Å"You're impossible,† he said, and he laughed oncea hard laugh, frustrated. â€Å"How can I put this so that you'll believe me? You're not asleep, and you're not dead. I'm here, and I love you. I have always loved you, and I will always love you. I was thinking of you, seeing your face in my mind, every second that I was away. When I told you that I didn't want you, it was the very blackest kind of blasphemy.† I shook my head while the tears continued to ooze from the corners of my eyes. â€Å"You don't believe me, do you?† he whispered, his face paler than his usual paleI could see that even in the dim light. â€Å"Why can you believe the lie, but not the truth?† â€Å"It never made sense for you to love me,† I explained, my voice breaking twice. â€Å"I always knew that.† His eyes narrowed, his jaw tightened. â€Å"I'll prove you're awake,† he promised. He caught my face securely between his iron hands, ignoring my struggles when I tried to turn my head away. â€Å"Please don't,† I whispered. He stopped, his lips just half an inch from mine. â€Å"Why not?† he demanded. His breath blew into my face, making my head whirl. â€Å"When I wake up†He opened his mouth to protest, so I revised†okay, forget that onewhen you leave again, it's going to be hard enough without this, too.† He pulled back an inch, to stare at my face. â€Å"Yesterday, when I would touch you, you were so hesitant, so careful, and yet still the same. I need to know why. Is it because I'm too late? Because I've hurt you too much? Because you have moved on, as I meant for you to? That would be quite fair. I won't contest your decision. So don't try to spare my feelings, pleasejust tell me now whether or not you can still love me, after everything I've done to you. Can you?† he whispered. â€Å"What kind of an idiotic question is that?† â€Å"Just answer it. Please.† I stared at him darkly for a long moment. â€Å"The way I feel about you will never change. Of course I love youand there's nothing you can do about it!† â€Å"That's all I needed to hear.† His mouth was on mine then, and I couldn't fight him. Not because he was so many thousand times stronger than me, but because my will crumbled into dust the second our lips met. This kiss was not quite as careful as others I remembered, which suited me just fine. If I was going to rip myself up further, I might as well get as much in trade as possible. So I kissed him back, my heart pounding out a jagged, disjointed rhythm while my breathing turned to panting and my fingers moved greedily to his face. I could feel his marble body against every line of mine, and I was so glad he hadn't listened to methere was no pain in the world that would have justified missing this. His hands memorized my face, the same way mine were tracing his, and, in the brief seconds when his lips were free, he whispered my name. When I was starting to get dizzy, he pulled away, only to lay his ear against my heart. I lay there, dazed, waiting for my gasping to slow and quiet. â€Å"By the way,† he said in a casual tone. â€Å"I'm not leaving you.† I didn't say anything, and he seemed to hear skepticism in my silence. He lifted his face to lock my gaze in his. â€Å"I'm not going anywhere. Not without you,† he added more seriously. â€Å"I only left you in the first place because I wanted you to have a chance at a normal, happy, human life. I could see what I was doing to youkeeping you constantly on the edge of danger, taking you away from the world you belonged in, risking your life every moment I was with you. So I had to try. I had to do something, and it seemed like leaving was the only way. If I hadn't thought you would be better off, I could have never made myself leave. I'm much too selfish. Only you could be more important than what I wanted what I needed. What I want and need is to be with you, and I know I'll never be strong enough to leave again. I have too many excuses to staythank heaven for that! It seems you can't be safe, no matter how many miles I put between us.† â€Å"Don't promise me anything,† I whispered. If I let myself hope, and it came to nothing that would kill me. Where all those merciless vampires had not been able to finish me off, hope would do the job. Anger glinted metallic in his black eyes. â€Å"You think I'm lying to you now?† â€Å"Nonot lying.† I shook my head, trying to think it through coherently. To examine the hypothesis that he did love me, while staying objective, clinical, so I wouldn't fall into the trap of hoping. â€Å"You could mean it now. But what about tomorrow, when you think about all the reasons you left in the first place? Or next month, when Jasper takes a snap at me?† He flinched. I thought back over those last days of my life before he left me, tried to see them through the filter of what he was telling me now. From that perspective, imagining that he'd left me while loving me, left me for me, his brooding and cold silences took on a different meaning. â€Å"It isn't as if you hadn't thought the first decision through, is it?† I guessed. â€Å"You'll end up doing what you think is right.† â€Å"I'm not as strong as you give me credit for,† he said. â€Å"Right and wrong have ceased to mean much to me; I was coming back anyway. Before Rosalie told me the news, I was already past trying to live through one week at a time, or even one day. I was fighting to make it through a single hour. It was only a matter of timeand not much of itbefore I showed up at your window and begged you to take me back. I'd be happy to beg now, if you'd like that.† I grimaced. â€Å"Be serious, please.† â€Å"Oh, I am,† he insisted, glaring now. â€Å"Will you please try to hear what I'm telling you? Will you let me attempt to explain what you mean to me?† He waited, studying my face as he spoke to make sure I was really listening. â€Å"Before you, Bella, my life was like a moonless night. Very dark, but there were starspoints of light and reason And then you shot across my sky like a meteor. Suddenly everything was on fire; there was brilliancy, there was beauty. When you were gone, when the meteor had fallen over the horizon, everything went black. Nothing had changed, but my eyes were blinded by the light. I couldn't see the stars anymore. And there was no more reason for anything.† I wanted to believe him. But this was my life without him that he was describing, not the other way around. â€Å"Your eyes will adjust,† I mumbled. â€Å"That's just the problemthey can't.† â€Å"What about your distractions?† He laughed without a trace of humor. â€Å"Just part of the lie, love. There was no distraction from the the agony. My heart hasn't beat in almost ninety years, but this was different. It was like my heart was gonelike I was hollow. Like I'd left everything that was inside me here with you.† â€Å"That's funny,† I muttered. He arched one perfect eyebrow. â€Å"Funny? â€Å" â€Å"I meant strangeI thought it was just me. Lots of pieces of me went missing, too. I haven't been able to really breathe in so long.† I filled my lungs, luxuriating in the sensation. â€Å"And my heart. That was definitely lost.† He closed his eyes and laid his ear over my heart again. I let my cheek press against his hair, felt the texture of it on my skin, smelled the delicious scent of him. â€Å"Tracking wasn't a distraction then?† I asked, curious, and also needing to distract myself. I was very much in danger of hoping. I wouldn't be able to stop myself for long. My heart throbbed, singing in my chest. â€Å"No.† He sighed. â€Å"That was never a distraction. It was an obligation.† â€Å"What does that mean?† â€Å"It means that, even though I never expected any danger from Victoria, I wasn't going to let her get away with Well, like I said, I was horrible at it. I traced her as far as Texas, but then I followed a false lead down to Braziland really she came here.† He groaned. â€Å"I wasn't even on the right continent! And all the while, worse than my worst fears† â€Å"You were hunting Victoria?† I half-shrieked as soon as I could find my voice, shooting through two octaves. Charlie's distant snores stuttered, and then picked up a regular rhythm again. â€Å"Not well,† Edward answered, studying my outraged expression with a confused look. â€Å"But I'll do better this time. She won't be tainting perfectly good air by breathing in and out for much longer.† â€Å"That is out of the question,† I managed to choke out. Insanity. Even if he had Emmett or Jasper help him. Even if he had Emmett and Jasper help. It was worse than my other imaginings: Jacob Black standing across a small space from Victoria's vicious and feline figure. I couldn't bear to picture Edward there, even though he was so much more durable than my half-human best friend. â€Å"It's too late for her. I might have let the other time slide, but not now, not after† I interrupted him again, trying to sound calm. â€Å"Didn't you just promise that you weren't going to leave?† I asked, fighting the words as I said them, nor letting them plant themselves in my heart. â€Å"That isn't exactly compatible with an extended tracking expedition, is it?† He frowned. A snarl began to build low in his chest. â€Å"I will keep my promise, Bella. But Victoria†the snarl became more pronounced†is going to die. Soon.† â€Å"Let's not be hasty,† I said, trying to hide my panic. â€Å"Maybe she's not coming back. Jake's pack probably scared her off. There's really no reason to go looking for her. Besides, I've got bigger problems than Victoria.† Edward's eyes narrowed, but he nodded. â€Å"It's true. The werewolves are a problem.† I snorted. â€Å"I wasn't talking about Jacob. My problems are a lot worse that a handful of adolescent wolves getting themselves into trouble.† Edward looked as if he were about to say something, and then thought better of it. His teeth clicked together, and he spoke through them. â€Å"Really?† he asked. â€Å"Then what would be your greatest problem? That would make Victoria's returning for you seem like such an inconsequential matter in comparison?† â€Å"How about the second greatest?† I hedged. â€Å"All right,† he agreed, suspicious. I paused. I wasn't sure I could say the name. â€Å"There are others who are coming to look for me,† I reminded him in a subdued whisper. He sighed, but the reaction was not as strong as I would have imagined after his response to Victoria. â€Å"The Volturi are only the second greatest?† â€Å"You don't seem that upset about it,† I noted. â€Å"Well, we have plenty of time to think it through. Time means something very different to them than it does to you, or even me. They count years the way you count days. I wouldn't be surprised if you were thirty before you crossed their minds again,† he added lightly. Horror washed through me. Thirty. So his promises meant nothing, in the end. If I were going to turn thirty someday, then he couldn't be planning on staying long. The harsh pain of this knowledge made me realize that I'd already begun to hope, without giving myself permission to do 5.0. â€Å"You don't have to be afraid,† he said, anxious as he watched the tears dew up again on the rims of my eyes. â€Å"I won't let them hurt you.† â€Å"While you're here.† Not that I cared what happened to me when he left. He took my face between his two stone hands, holding it tightly while his midnight eyes glared into mine with the gravitational force of a black hole. â€Å"I will never leave you again.† â€Å"But you said thirty,† I whispered. The tears leaked over the edge. â€Å"What? You're going to stay, but let me get all old anyway? Right.† His eyes softened, while his mouth went hard. â€Å"That's exactly what I'm going to do. What choice have I? I cannot be without you, but I will not destroy your soul.† â€Å"Is this really† I tried to keep my voice even, but this question was too hard. I remembered his face when Aro had almost begged him to consider making me immortal. The sick look there. Was this fixation with keeping me human really about my soul, or was it because he wasn't sure that he wanted me around that long? â€Å"Yes?† he asked, waiting for my question. I asked a different one. Almostbut not quiteas hard. â€Å"But what about when I get so old that people think I'm your mother? Your grandmother?† My voice was pale with revulsionI could see Gran's face again in the dream mirror. His whole face was soft now. He brushed the tears from my cheek with his lips. â€Å"That doesn't mean anything to me,† he breathed against my skin. â€Å"You will always be the most beautiful thing in my world. Of course† He hesitated, flinching slightly. â€Å"If you outgrew meif you wanted something moreI would understand that, Bella. I promise I wouldn't stand in your way if you wanted to leave me.† His eyes were liquid onyx and utterly sincere. He spoke as if he'd put endless amounts of thought into this asinine plan. â€Å"You do realize that I'll die eventually, right?† I demanded. He'd thought about this part, too. â€Å"I'll follow after as soon as I can.† â€Å"That is seriously†I looked for the right word. â€Å"Sick.† â€Å"Bella, it's the only right way left† â€Å"Let's just back up for a minute,† I said; feeling angry made it so much easier to be clear, decisive. â€Å"You do remember the Volturi, right? I can't stay human forever. They'll kill me. Even if they don't think of me tillI'm thirty†I hissed the word†do you really think they'll forget?† â€Å"No,† he answered slowly, shaking his head. â€Å"They won't forget. But† â€Å"But?† He grinned while I stared at him warily. Maybe I wasn't the only crazy one. â€Å"I have a few plans.† â€Å"And these plans,† I said, my voice getting more acidic with each word. â€Å"These plans all center around me staying human.† My attitude hardened his expression. â€Å"Naturally.† His tone was brusque, his divine face arrogant. We glowered at each other for a long minute. Then I took a deep breath, squared my shoulders, I pushed his arms away so that I could sit up. â€Å"Do you want me to leave?† he asked, and it made my heart flutter to see that this idea hurt him, though he tried not to show it. â€Å"No,† I told him. â€Å"I'm leaving.† He watched me suspiciously as I climbed out of the bed and fumbled around in the dark room, looking for my shoes. â€Å"May I ask where you are going.'† he asked. â€Å"I'm going to your house,† I told him, still feeling around blindly. He got up and came to my side. â€Å"Here are your shoes. How did you plan to get there?† â€Å"My truck.† â€Å"That will probably wake Charlie,† he offered as a deterrent. I sighed. â€Å"I know. But honestly, I'll be grounded for weeks as it is. How much more trouble can I really getin?† â€Å"None. He'll blame me, not you.† â€Å"If you have a better idea, I'm all ears.† â€Å"Stay here,† he suggested, but his expression wasn't hopeful. â€Å"No dice. But you go ahead and make yourself at home,† I encouraged, surprised at how natural my teasing sounded, and headed for the door. He was there before me, blocking my way. I frowned, and turned for the window. It wasn't really that far to the ground, and it was mostly grass beneath â€Å"Okay,† he sighed. â€Å"I'll give you a ride.† I shrugged. â€Å"Either way. But you probably should be there, too.† â€Å"And why is that?† â€Å"Because you're extraordinarily opinionated, and I'm sure you'll want a chance to air your views.† â€Å"My views on which subject?† He asked through his teeth. â€Å"This isn't just about you anymore. You're not the center of the universe, you know.† My own personal universe was, of course, a different story. â€Å"If you're going to bring the Volturi down on us over something as stupid as leaving me human, then your family ought to have a say.† â€Å"A say in what?† he asked, each word distinct. â€Å"My mortality. I'm putting it to a vote.†

ACME and Omega case study Essay

1. Using the mechanistic and organic structure arguments develop in Chapter 2, compare and contrast the management styles at Acme and Omega. Acme’s managerial style consists of a mechanistic structure, while Omega’s managerial style is based on an organic structure. Acme’s vertical differentiation, which consists of four levels of control, constitutes the dispersion of authority between the organizational hierarchy levels and gears to give the organization more control over its projects and activities. Acme is highly centralized, managers of the top of the hierarchy have all the power to make most of the decisions for the company, and subordinates are expected to follow orders. Although, I think that Acme has established a high level of standardization and formalization, they experienced difficulty abiding to their own rules. Employees at Acme exercise individual specialization, where employees specialize in one specific area and work individually. 2. On the other hand, Omega is a decentralized organization,they appointed new president in that post. where managers and subordinates delegate important decisions about new organizational projects. Omega’s management believes in mutual adjustment, which is the practice of using judgment on problem solving and also creates an informal way of communicating with each other rather that using standardization or written rules. Joint specialization at Omega gives their employees and opportunity to work in teams and balance their actions to find the most effective and efficient way of accomplishing an assignment. Omega’s organic structure gives the employees more flexibility to innovative thinking, and creates a unity within the organization, where managers and employees share their knowledge and skills to achieve optimal performance. 3. Which firm should have won the final contract – Acme or Omega? Discuss. The paradoxical twins describes two organizations, Acme and Omega Electronics that are competing for the same contract for manufacturing a memory unit to be used in a photocopier. Omega, having an organic structure, wins the race because they are able to produce higher quality memory unit. On the other hand, Acme having mechanistic structure seems less competent and less reliable because of its low quality memory unit which they are unable to produce in time and some of its prototypes fail to work. Omega even corrects a design error in the original blueprint, which  improves product quality. But, both the company is given half the order, and they were encouraged to find the way to reduce the cost and Acme takes advantage of this opportunity to experiment to find ways to reduce its costs, whereas Omega does not. Finally Acme discovers the way to reduce the cost by 20% and they own the contract. Omega may have won the battle, but Acme has won the war because its mechanistic structure fosters a concern for technical efficiency and cost reduction in what is a routine manufacturing environment. In this particular case, Acme decides to run a â€Å"tight ship† (mechanistic structure) in order to increase productivity and efficiency, and to decrease costs. The advantage of this strategy is that they can undersell their competition (Omega) by selling at a lower cost. Omega, on the other hand, is nearly too opposite. They run a more organic structure, which relies heavily upon communication, delegation and teamwork. This strategy allows Omega to effectively compete with Acme by stressing reliability and by placing emphasis on quality. Omega’s decentralized, organic approach allowed for the building of prototypes 10 days faster than Acme, correction of errors, and a highly reliable prototype—much more reliable than Acme’s, which had a 10 percent failure rate. Omega was more effective when evaluated by these criteria, although Acme’s prices were lower than Omega’s because of that Acme won the competition and which was fair result in my opinion. Its mechanistic structure provided it with the management system and incentives needed to improve and reduce its manufacturing process, so that Acme won the final race over Omega. 4. What changes would you recommend to Acme and Omega if they are to survive in the future in this increasingly competitive industry? I wish to modify their organizational design. I think that in order for these two companies to survive they need to have a combination of organic and mechanistic structure. Once they do this change they will create a better organizational culture, which is the set of shared values and norms that controls organizational member’s interactions with each other . Although, Omega’s employees are working together, I think they have too much freedom. Therefore, I think that Omega’s management needs to be more formalize. Acme’s management are hightec pressure, they don’t give enough flexibility  to their employees. This is affecting Acme because there are missing some of the new ideas that their employees may have, and they are also forcing their workers to do the work which the top mangment as instructed. A combination of organic and mechanistic structure would give them better control and coordination of their employees and it will also motivate them and inspire a better behavior. Another recommendation for Acme Corporation would be to balance differentiation and integration For these two companies to survive and be successful I recommend that if they are going to combine organic and mechanistic structures then they should have a balance between centralization and decentralization. I think that all decision making shouldn’t be left entirely to employees or to management, rather it should be in between. Finally, these two companies should have a mixture of standardization and mutual understanding. Sometimes having too much of each may create an problem in corporate culture, therefore I would recommend to use a combination. Management needs pay close attention to make sure that their organizational design fits with the corporate culture and the organizational environment that they are trying to create.

Prisoner Abuse Essay

Introduction Prisoner Abuse is one of the biggest problems faced by the society. It is one serious problem in many countries worldwide. There are many kinds of abuse experienced by incarcerated men and women, with sexual abuse being the most serious case since the perpetrators is not only fellow inmates but jail guards and prison staff also. Overpopulation is also one form of abuse since the needs of the prisoners are not properly given due to the scarcity of resources brought about by huge population. Drugs and drug abuse are is still prevalent in the prison world. Drugs have been noted to have a detrimental effect to prisoners the impact which may last for a lifetime. These kinds of abuse should be given due punishments because the convicts, no matter how serious their crimes are, still deserve to receive treatment that is rightfully accorded to a human being. More and more inmates are stepping inside jails every year. Majority of them experience extreme abuse that even leads to death of some unfortunate inmates. It is saddening that these experiences of prisoners are hindered by many factors. They cannot demand for justice because their behaviors and emotions are controlled by authorities over them. There are also times when their complaints are not acknowledged since they are already imprisoned due to heavy crimes. This problem however needs to be solved since the effect of the abuse is not only physical; it also affects the sociological and psychological aspect of human beings. However, prisoner abuse is an unfortunate phenomenon that can still be prevented and controlled. Everyone is entitled to fight for his or her human rights. This also includes even the prisoners who are convicted with a crime, and they should not be denied of these rights. Defining Prisoner Abuse Prisoner abuse happens to incarcerated men and women through mistreatments. Incarcerated individuals suffer twice the punishment given to them because of abusive jail guards, jail employees, and co-prisoners. One of the ways in which inmates suffer abuse is through torture. As cited in the Human Rights website, torture in prison is defined as: any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity (Fathi, 2008). Violence among prisoners by fellow prisoners or jail guards and employees is also rampant. It is a great problem that should be addressed immediately. Prisoners of all cultures, races, ages, and social status experience abuse at some points of their lives in prison. The socioeconomic status and cultural background have a significant influence in the impact of prison violence. Poor prisoners are more likely to experience abuse because they cannot afford to hire attorneys to defend the kind of life they have in prison. Those who are not natives of one country are inclined to have hesitation when calling out for help because they are not speaking in that country’s language (Richie, 2000). Forms of Prison Abuse Prisoner abuse comes in various forms, all of which cause harmful effects to male and female inmates. It comes in the form of physical, psychological, sexual and verbal. Physical Abuse Physically, the prisoners are abused through hitting and continuous beating. Physical abuse may also manifest as forced work assigned to the victims which is not a part of their punishment when they are convicted. This also includes depriving them of their basic needs such as food and clothing by cruel jail employees. The growing population of corrections may also be considered as form of physical abuse. Due to the large population that results in scarcity of resources, the prisoners do not receive an adequate amount of their basic needs (Idaho Observer, 2006). One of the most controversial and disturbing issues regarding prisoner abuse is the ultimately degrading treatment of Iraqi prisoners in Abu Ghraib in Iraq by American soldiers. A report made by Higham and Stephens (2004) at the Washington Post narrates how the Iraqi detainees were physically violated: Previously secret sworn statements by detainees at the Abu Ghraib prison in Iraq   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   describe in raw detail abuse that goes well beyond what has been made public, adding   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   allegations of prisoners being ridden like animals, sexually fondled by female soldiers   Ã‚  Ã‚  Ã‚  Ã‚   and forced to retrieve their food from toilets (Higham & Stephens, 2004). Many of the prisoners who experience physical abuse, particularly those in the Abu Ghraib, are treated like animals. Prisoners are also out of touch with the real world. Their socialization is hindered by many factors. They do not have the capacity to fight back since they are already convicted for the crimes that they made. Other cases of physical abuse go as far as the prisoner’s death. Verbal Abuse There are also instances of verbal abuse to prisoners. They are called imbecile, idiot, moron, and other nasty words by jail guards in order to humiliate them (Higham & Stephens, 2004). Higham and Stephens (2004) add that â€Å"some of the detainees described are being abused as punishment or discipline after they were caught fighting or with a prohibited item† (Higham & Stephens, 2004). According to the Idaho Observer (2006), the guards tend to think that the inmates always do something wrong. One of the guards admitted that if they catch the prisoners’ lips moving, they assume that the latter are not telling the truth (Idaho Observer, 2006). Words that are usually thrown by jail guards to inmates are often harsh and hard to take. These words are more discriminating and humiliating. There are also instances when prisoners who commit mistakes in front of their fellow prisoners are being shouted at by jail guards and employees. These are really improper ways of treating prisoners because it damages their self-esteem and has bad effect on their mentality (Higham & Stephens, 2004). Psychological Abuse   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Discipline is far different from torture. However, some jail authorities resort to using psychological abuse and mask it as a method of discipline for prisoners. This happens to prisoners by means of taunting, white noise, and not allowing them to sleep. Such cases of psychological abuse may lead to mental disorders. There are also threats given out to prisoners which cause paranoia and mental and emotional torture. Drug usage in prison may also lead to psychological disorders (Idaho Observer, 2006). One good example of psychological abuse in prison is cited in the May 2006 Idaho Observer report. The said report states that the abuse in the prison may manifest subtly. Instead of inflicting physical harm on prisoners, they are being abused by toying with them psychologically and emotionally. For instance, the jail employees leave the lights on for 17-and-a-half hours straight (4:30 in the morning to 10 in the evening). The guards also disturb the prisoner’s sleep by pointing the flashlights on the latter’s faces every 60 minutes or so, slamming the doors, and speaking loudly (Idaho Observer, 2006). Obviously, lack of sleep will cause one’s mind not to function properly. This kind of maltreatment in prisons is still rampant until today. Sexual Abuse The most popular abuse among prisoners is sexual abuse. There are many cases of forced sexual intercourse inside corrections. This abuse leads to diseases like AIDS and HIV. Sexual abuse is done by forcing prisoners to have sexual encounter with jail guards, jail employees and even their co-inmates. Sexual abuse is not only limited to prison guards and employees. It also occurs inside jail bars, the co-inmate being the perpetrator. Male to male sexual encounter occurs because they don’t have any choice but to satisfy their sexual needs by abusing their fellow male inmates. On the case of female prisoners who were sexually abused, lack of power hinders them to report the incident. There are times when sexual abuse to female prisoners occurs with the consent of the victim. However, this is still a violation of the law (Idaho Observer, 2006). Types of Prison Abuse Cases of maltreatment and mistreatment inside corrections take place when jail guards, any prison employee, or co-prisoner does something inappropriate to other prisoners. It comes in many abusive forms depending on the type. Although something bad is done by the inmate it is still improper to treat them like animals.   It is still a case of abuse of power by jail personnel and a violation of human rights. Drugs in Prison Using illegal drugs, drug trafficking and other drug related cases cause individuals to be imprisoned. To end the promulgation of drugs, the drug pushers are detained in jails. However, the issue on drugs does not end here. Some correctional tolerate the use of drugs among prisoners. Others are forced to use it while those who are already users before entering the bars continue to use it. Addiction among inmates of the prohibited drugs is also attributed to stress that they experience in such environment (Uchtenhagen, 2007). Because of drugs being trafficked in jails, inmates who used to use drugs mildly prior to being imprisoned may become highly addicted to drugs.   On the other hand, those who do not have any history of drug use may turn out to be drug users as their method of coping with stress and depression (Managing Drugs in Prison, 2007). Source of prohibited drugs are jail employees, jail guards, and those inmates who still have contacts on drug suppliers outside. Other causes of drug abuse inside prison are related to other types of abuse. When one prisoner is abused sexually, he/she is bribed by things like drugs to avoid complaining about the incident. Those prisoners who are users of drugs being incarcerated are blackmailed by using the victim’s personal cravings to drugs to get their consent and agree to be molested. Those prisoners who are weak are being bullied and forced to use drugs by those who are superior inside their cells (Managing Drugs in Prison, 2007). The effects of drug abuse to prisoners are really pervasive. They cannot act and think normally because of substance abuse. Their relationship with each other is also affected as well as their relatives outside the prison environment (Managing Drugs in Prison, 2007). Overpopulation in Prison Every year, more and more people are being incarcerated because of many reasons. Some are guilty of their crimes while others are victims of injustice. The increase in the number of prisoners equates to greater demands for resources and space inside the prison vicinity. However, the inmates are being abused by corrupt prison personnel who ask help from the government to aid the scarcity of prison resources like food, beds and others. In some cases, normal and mentally ill prisoners are combined in one place which makes the situation worse. Prisons which are overcrowded are, more often than not, unsafe as they warn of a riot erupting any time (Idaho Observer, 2006). One of the reasons for prison overcrowding is the incarceration of pregnant women. Women who are giving birth in prisons also increase at the same time. The problem here is not only the condition of the female prisoner but the condition of the infant being born in that kind of environment. The problem arises before and during the delivery since medical support is also inaccessible inside prisons. Sexual Abuse in Prison In some cases of sexual abuse in prison, bribery is included to avoid reporting the bad incident made to prisoners. Those who were abused are given cigarettes, drugs, clothing, access to telephone and other prison privileges in replace of sexual encounters. Offering goods to prisoners makes the sexual abuse possible because prisoners crave things that they only experience outside. Food and drugs are commonly used to perpetrate the abuse. Threats is also involved when forced sexually abuse is done. However, sexual abuse perpetrated by female inmates does not fall in the context of rape. This is because there is no force used to perform the abuse. â€Å"Girls are often framed by probation officers as being overemotional and needy† (Gaarder et al., 2005, p. 578). Male rape is a common thing inside prisons, but as for female prisoners, the enemy is not their fellow prisoners but much worse. They are the male prison guards and correctional staff. Female prisoners who are sexually coerced by jail guards give in because of fear. Sexual abuse is also used in most prisons to cover up more serious problems like drug addiction and carrying of deadly weapons behind bars. There are also cases when sexual abuse serves as the key to escape from jail.   Correctional employees assist the escape of female prisoners with whom they have sexual involvement (Human Rights Watch 1996). The problem of sexual abuse among women prisoners is much worse precisely because of their sheer number. Research shows that the United States has earned the distinction of incarcerating the most number of prisoners.   Most of these prisoners are women and their number is increasing dramatically at a fast rate. According to studies, since 1980, the number of women entering U.S. prisons has been raised to almost 400%, which is roughly double the incarceration rate increase of males. According to current statistics, nearly â€Å"half of all female prisoners have experienced some form of sexual abuse prior to incarceration† (Human Rights Watch 1996).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The most common sexual abuse in prison always incorporates violence in it. In a report made by the Department of Justice in 2004, there are 8,210 allegations of sexual violence according to correctional authorities, â€Å"the equivalent of 3.2 allegations per 1,000 inmates and youths incarcerated in 2004† (Department of Justice 2005). When violence is mixed with sexual abuse, it is really damaging on the part of the victim. There are physical disabilities that may occur, including broken bones and joints, skin injuries, and many more. The worst cases of prison rape lead to the death of prisoners.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Rape cases also happen to male prisoners. There are male prison guards and correctional staffs that take advantage of the authoritative power and force male prisoners to have sex intercourse with them. Then they disguise their revolting act, by pretending as protectors of the prisoners. It often involves group of prisoners in order to scare the target prisoner to be raped. It is a setup made by having group of prisoners bully the victim and threatening him with body harm. At the point that they will hurt the victim, the so-called â€Å"protector† will try to defend the victim and scare the groups away. In order to repay the savior (a jail guard, a jail staff or a co-inmate), the inmate will be asked to do favors and be repaid sexually. Causes of Prison Abuse   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Abuse of power is the main reason why there is such thing as prison abuse. Those who are in authority take advantage of their power and demands many things from others. Such dominance causes abuse and torture to poor convicted criminals trapped behind bars. The lack of courage to speak for the truth and shout for justice is also a reason why the abuse is done over and over to prisoners. Cases of sexual abuse are included in this example and cited in the Human Rights Watch website. These are the words of a male prisoner who was raped inside the institution. As he recalls: â€Å"I’ve been sentenced for a D.U.I. offense. My 3rd one. When I first came to prison, I had no idea what to expect. I’m a tall white male, who unfortunately has a small amount of feminine characteristics. And very shy. These characteristics have got me raped so many times I have no more feelings physically. I have been raped by up to 5 black men and two white men at a time. I’ve had knifes at my head and throat†¦There is no supervision after lockdown† (Human Rights Watch 2006),   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   When a prisoner looks appealing among the rest, there is a great chance of being molested by prison guards. Some prisoners use their charms to have access to other things like phone calls and extra food during meal times (Human Rights Watch 2006). Effects of Prisoner Abuse   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The effects of prisoner abuse can last a lifetime. The trauma and depression can be inculcated in the minds of prisoners who were physically, psychologically, verbally and sexually abused and leave them scarred permanently.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Those who were brutally abused through physical means have traces of scars and bone injuries that cannot be treated anymore. There are also cases of physical abuse when one inmate is forced to have a tattoo by their fellow inmates. The denial stage comes in when they are visited by their relatives and ask what happened to them. They will try to hide the fact that they are abused by people who should have looked after them and just discipline them instead of giving them torture. Most prisoners are afraid of telling the truth because harder punishments will be given to them by their perpetrators (Men in Prison, 2008).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Mental illnesses are also developed as years go by inside prisons. This is because the wide spread of drug abuse is rampant. It is obviously known that prohibited drugs cause malfunction in the brain. Other diseases like STDs (Sexually Transmitted Disease) and AIDS are attributed to sexual abuse inside prisons. This is the reality in the prison system which has been institutionalized in the society—a kind of system that contributes to the perpetuation of violence inside prisons (Men in Prison, 2008).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Prisoner abuse also has sociological effects on the prisoner. The traumatic experience causes fear and trauma that will make him separate himself from everyone. The issue of women inmates giving birth to their child is also included because of prisoner abuse. The child is automatically separated from the mother once born inside the prison. In effect, the child may grow up without the necessary care and attention which is expected to be given by the biological mother. There are even cases of pregnant prisoners who are raped by prison guards. Such sexual abuse is really unbearable for the victim and their families. It does not only impact the prisoners but the institution as a whole. The reason why they are incarcerated is for them to be disciplined and not to be tortured and abused (Acoca & Austin, 1996). Sexual abuse makes the institution not credible in disciplining the prisoners. Instead, they themselves should be incarcerated as well.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   When prisoners experience abuse, the effects can last a life time. The nightmare will forever haunt them and may lead to mental incapacitation or death at the worst. Those who experience sexual abuse and accumulate diseases find themselves committing suicide than suffer the illness daily. On cases of female prisoners who are raped, there is greater possibility of being pregnant. Being mentally ill is also an additional risk of being sexually abused (Acoca & Austin, 1996). Rights of Prisoners   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Although a person is found guilty of a crime, there is still no reason for him/her to be abused inside prisons. There are several studies showing various changes regarding situations of prisoners. Most of the said report involve abuse without due punishment given to the perpetrators. Everyone has the right to seek for justice even if you are already set behind the bars. Inmates do not deserve any kind of abuse inside the correctional. They are placed there to be rehabilitated and disciplined, not to be punished twice for their misdeed.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   According to the report made by the Justice Department’s Bureau of Justice, prison population in the United States has grown to 2 million inmates (Longley, 2007). The said research also shows that the escalating number of inmates heightens the problem of sexual abuse while incarcerated. Such demands about this problem should no longer be ignored; preventive measures need be done eradicate this problem.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The rights of prisoners as cited in the Human Rights Website (2008) are based from the International Covenant on Civil and Political Rights (ICCPR) in 1992. These rights address the following: (1) All persons deprived of their liberty shall be treated with humanity and with respect for the inherent dignity of the human person. (2)The penitentiary system shall comprise treatment of prisoners the essential aim of which shall be their reformation and social rehabilitation (Fathi, 2008). ICCPR also guarantees prisoner who were abused that there are remedies at hand to counter such violation of their human rights. The said covenant includes the following: (a) To ensure that any person whose rights or freedoms as herein recognized are violated shall have an effective remedy, notwithstanding that the violation has been committed by persons acting in an official capacity; (b) To ensure that any person claiming such a remedy shall have his right thereto determined by competent judicial, administrative or legislative authorities, or by any other competent authority provided for by the legal system of the State, and to develop the possibilities of judicial remedy; (c) To ensure that the competent authorities shall enforce such remedies when granted (ICCPR, Art. 2, sec. 3, as cited in Fathi, 2008). Solutions to Prison Abuse   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Aside from the rights and privileges mentioned above, there are a variety of solutions to end this abuse among prisoners. There are organizations and government groups that help victims of prison abuse. There are also preventive measures that can be followed so as to stop the occurrence of any kind of abuse. People against prisoner abuse are comprised of individuals who seek for justice for those abused prisoners. One of the organizations that have been fighting for inmate rights is the People Against Prison Abuse, organization established in 1994 to help inmates and their family. The said organization aims to assist the families and friends who are currently imprisoned (People Against Prison Abuse, 2008). It attempts to address the following concerns: The tax being paid by taxpayers over the past several years are said to be spent more on prison inmates than public education but it is not visibly seen. The medical care of inmates Overcrowding is always ignored which should not become a norm. Mentally ill prisoners are not properly taken care of and are often abused by guards because they are not trained on how to deal with such conditions. The physically challenged inmates do not have the medical care, equipment, and/or facilities to enable them to be a functional human inside the prison system (6)The vast number of industrial prison complex staff (wardens, guards, and medical staff) commit worse crimes than majority of inmates so they should be punished. (People Against Prison Abuse, 2008). The aforementioned concerns are few of the many appeals of people who want justice for prison abuse. It is also important to support organizations like this to make all people aware and to convince the government to â€Å"investigate conditions within our prisons and to pass legislation to protect prisoners from abuse† (Stop Prison Abuse, 2008). Conclusion It is saddening to note that the judicial system which is supposed to protect the oppressed likewise offers no solution to this problem as it would consider this problem as an internal matter and would rather allow prison officials to handle this matter amongst themselves. The indifferent attitude of the correctional officials to one inmate raping another is likewise depressing. It renders much harmful effects on the condition of the prisoner and the credibility of justice. Prisoner abuse is indeed a pervasive in penal institutions. This problem however is preventable and controllable if preventive measures will be enacted and the government will responsibly address the issue. The response need not be limited to their strict punishment as avoidance measures may be instituted as a matter of prison policy. â€Å"The governments often have limited resources on giving the right prosecution process for victims and offenders† (Hoffman, 1993, p. 1552). Prisoner abuse should be given immediate action so that it will never happen again. Abuse of authority should not be tolerated. This is a serious problem needed to be solved immediately.   Not only because the victim is already convicted, but because the victim is a human. Every human being has indelible rights. Conviction for a crime no matter how heinous it is will not strip him or her of these rights. References: Acoca, L. & James, A. (1996).The Crisis: Women In Prison. Draft report submitted to the Charles E. Culpepper Foundation. San Francisco, CA: National Council on Crime and Delinquency. Hoffman, Paul (1993).   The Feds, Lies and Videotape: The Need for an Effective Federal   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Role in Controlling Police Abuse in Urban America. Southern California Law   Ã‚  Ã‚   Review, 66, 1522. Higham, S. & Stephens J. (2004). New Details of Prison Abuse Emerge. The Washington Post. Retrieved April 30, 2008 from: http://www.washingtonpost.com/ac2/wp-dyn/A43783-2004May20?language=printer Human Rights Watch. (1996). All Too Familiar: Sexual Abuse of Women in State Prisons. Retrieved April 30, 2008 from: http://hrw.org/reports/1996/Us1.htm Human Rights Watch. (2006). No Escape Male Rape in US Prisons. Retrieved April 30, 2008 from:http://www.hrw.org/reports/2001/prison/report.html#_1_2 Idaho Observer. (2008). Seven Years Abuse in Idaho Prison. Pro-Liberty Network. Retrieved April 30, 2008 from: http://proliberty.com/observer/20060520.htm It’s Not My Problem. (2008) Men Stuff Organization. Retrieved April 30, 2008 from:  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   http://www.menstuff.org/issues/byissue/jailhouserock.html Longley, R. (2007). U.S. Prison Population Tops 2 Million.   About.com. Retrieved April 30, 2008 from: http://usgovinfo.about.com/cs/censusstatistic/a/aaprisonpop.htm People Against Prison Abuse. (2008). People Against Prison Abuse. Retrieved April 30, 2008 from:http://www.peopleagainstprisonabuse.com/page1.html Richie, Beth. (2000). Exploring the Link Between Violence Against Women and Women’s Involvement in Illegal Activity. U.S. Department of Justice. Research on Women and Girls in the Justice System. Stop Prison Abuse. (2008) Stop Prison Abuse. Retrieved April 30, 2008 from: http://stopprisonabuse.org/ Uchtenhagen, A. (2008). â€Å"Drug Prevention Outside and Inside Prison Walls.† Joomla!. Retrieved April 30, 2008 from: http://www.drugtext.org/library/articles/97817.htm

Hosptial Acquired Infection

Propose how would you minimise the occurrence of hospital acquired infection and monitor degree of success of these measures. INTRODUCTION The occurrence and undesirable complications from hospital acquired infections (HAIs) have been well recognized for the last several decades. The occurrence of HAIs continues to escalate at an alarming rate. HAIs originally referred to those infections associated with admission in an acute-care hospital (formerly called a nosocomial infection).These unanticipated infections develop during the course of health care treatment and result in significant patient illnesses and deaths (morbidity and mortality); prolong the duration of hospital stays; and necessitate additional diagnostic and therapeutic interventions, which generate added costs to those already incurred by the patient’s underlying disease (Bauman, 2011). HAIs are considered an undesirable outcome, and as some are preventable, they are considered an indicator of the quality of pati ent care, an adverse event, and a patient safety issue.Patient safety studies published in 1991 reveal the most frequent types of adverse events affecting hospitalized patients are adverse drug events, nosocomial infections, and surgical complications (Aboelela, 2006). Over years there is an alarming increase in HAI, which is influenced by factors such as increasing inpatient acuity of illness, inadequate nurse-patient staffing ratios, unavailability of system resources, and other demands that have challenged health care providers to consistently apply evidence-based recommendations to maximize prevention efforts. Read Chapter 8 Microbial GeneticsDespite these demands on health care workers and resources, reducing preventable HAIs remains an imperative mission and is a continuous opportunity to improve and maximize patient safety. Another factor emerging to motivate health care facilities to maximize HAI prevention efforts is the growing public pressure on State legislators to enact laws requiring hospitals to disclose hospital-specific morbidity and mortality rates.Institute of Medicine report identified HAIs as a patient safety concern and recommends immediate and strong mandatory reporting of other adverse health events, suggesting that public monitoring may hold health care facilities more accountable to improve the quality of medical care and to reduce the incidence of infections. Monitoring both process and outcome measures and assessing their correlation is a model approach to establish that good processes lead to good health care outcomes.Process measures should reflect common practice s, apply to a variety of health care settings, and have appropriate inclusion and exclusion criteria. Examples include insertion practices for central intravenous catheters, appropriate timing of antibiotic prophylaxis in surgical patients, and rates of influenza vaccination for health care workers and patients. Outcome measures should be chosen based on the frequency, severity, and preventability of the outcome events. Examples include intravascular catheter-related blood stream infection rates and surgical-site infections in selected operations.Although these occur at relatively low frequency, the severity is high—these infections are associated with substantial morbidity, mortality, and excess health care costs—and there are evidence-based prevention strategies available (Filetoth, 2003). PATIENTS RISK FACTORS FOR HEALTH CARE-ASSOCIATED INFECTIONS Transmission of infection within a hospittal requires three elements: a source of infecting microorganisms, a susceptibl e host, and a means of transmission for the microorganism to the host.During the delivery of health care, patients can be exposed to a variety of exogenous microorganisms (bacteria, viruses, fungi, and protozoa) from other patients, health care personnel, or visitors. Other reservoirs include the patient’s endogenous flora (e. g. , residual bacteria residing on the patient’s skin, mucous membranes, gastrointestinal tract, or respiratory tract) which may be difficult to suppress and inanimate environmental surfaces or objects that have become contaminated (e. g. , patient room touch surfaces, equipment, medications).The most common sources of infectious agents causing HAI, described are the individual patient, medical equipment or devices, the hospital environment, the health care personnel, contaminated drugs, contaminated food, and contaminated patient care equipment. Patients have varying susceptibility to develop an infection after exposure to a pathogenic organism. Some people have innate protective mechanisms and will never develop symptomatic disease and others exposed to the same microorganism may establish a commensal relationship and retain the organisms as an asymptomatic carrier (colonization) or develop an active isease process. Intrinsic risk factors predispose patients to HAIs. The higher likelihood of infection is reflected in vulnerable patients who are immunocompromised, underlying diseases, severity of illness, immunosuppressive medications, or medical/surgical treatments (Bauman, 2011). Extrinsic risk factors include surgical or other invasive procedures, diagnostic or therapeutic interventions (e. g. , invasive devices, implanted foreign bodies, organ transplantations, immunosuppressive medications), and personnel exposures.In addition to providing a portal of entry for microbial colonization or infection, they also facilitate transfer of pathogens from one part of the patient’s body to another, from health care worker to patient, or from patient to health care worker to patient. Infection risk associated with these extrinsic factors can be decreased with the knowledge and application of evidence-based infection control practices. Among patients and health care personnel, microorganisms are spread to others through four common routes of transmission: contact (direct and indirect), respiratory droplets, airborne spread, and common vehicle.Contact transmission is the most important and frequent mode of transmission in the health care setting. Organisms are transferred through direct contact between an infected or colonized patient and a susceptible health care worker or another person. Microorganisms that can be spread by contact include those associated with impetigo, abscess, diarrheal diseases, scabies, and antibiotic-resistant organisms (e. g. , methicillin-resistantStaphylococcus aureus [MRSA] and vancomycin-resistant enterococci [VRE]).Droplet-size body fluids containing microorganisms can be generated during coughing, sneezing, talking, suctioning, and bronchoscopy. They are propelled a short distance before settling quickly onto a surface. They can cause infection by being deposited directly onto a susceptible person’s mucosal surface (e. g. , conjunctivae, mouth, or nose) or onto nearby environmental surfaces, which can then be touched by a susceptible person who autoinoculates their own mucosal surface.Examples of diseases where microorganisms can be spread by droplet transmission are pharyngitis, meningitis, and pneumonia. When small-particle-size microorganisms (e. g. , tubercle bacilli, varicella, and rubeola virus) remain suspended in the air for long periods of time, they can spread to other people. The CDC has described an approach to reduce transmission of microorganisms through airborne spread in its Guideline for Isolation Precautions in Hospitals. Proper use of personal protective equipment (e. g. gloves, masks, and gowns), aseptic technique, hand hy giene, and environmental infection control measures are primary methods to protect the patient from transmission of microorganisms from another patient and from the health care worker (Filetoth, 2003). Personal protective equipment also protects the health care worker from exposure to microorganisms in the health care setting. Common vehicle (common source) transmission applies when multiple people are exposed to and become ill from a common inanimate vehicle of contaminated food, water, medications, solutions, devices, or equipment.Bacteria can multiply in a common vehicle but viral replication cannot occur. Examples include improperly processed food items that become contaminated with bacteria, waterborne shigellosis, bacteremia resulting from use of intravenous fluids contaminated with a gram-negative organism, contaminated multi-dose medication vials, or contaminated bronchoscopes. Common vehicle transmission is likely associated with a unique outbreak setting and will not be di scussed further in this document. STEPS TO MINIMISE THE RISKEssential components of effective infection control programs included conducting organized surveillance and control activities, a trained infection control physician, an infection control nurse for every 250 beds, and a process for feedback of infection rates to clinical care staff. These programmatic components have remained consistent over time and are adopted in the infection control standards of the Joint Commission. The evolving responsibility for operating and maintaining a facility-wide effective infection control program lies within many domains.Both hospital administrators and health care workers are tasked to demonstrate effectiveness of infection control programs, assure adequate staff training in infection control, assure that surveillance results are linked to performance measurement improvements, evaluate changing priorities based on ongoing risk assessments, ensure adequate numbers of competent infection cont rol practitioners, and perform program evaluations using quality improvement tools as indicated. a)Infection Control PersonnelIt has been demonstrated that infection control personnel play an important role in preventing patient and health care worker infections and preventing medical errors. An infection control practitioner (ICP) is typically assigned to perform ongoing surveillance of infections for specific wards, calculate infection rates and report these data to essential personnel, perform staff education and training, respond to and implement outbreak control measures, and consult on employee health issues.This specialty practitioner gains expertise through education involving infection surveillance, infection control, and epidemiology from current scientific publications and basic training courses offered by professional organizations or health care institutions. The Certification Board of Infection Control offers certification that an ICP has the standard core set of knowl edge in infection control. Expert review panel recommends 1 full-time ICP for every 100 occupied beds (Filetoth, 2003).To maximize successful strategies for the prevention of infection and other adverse events associated with the delivery of health care in the entire spectrum of health care settings, infection control personnel and departments must be expanded. b)Nursing Responsibilities Clinical care staff and other health care workers are the frontline defense for applying daily infection control practices to prevent infections and transmission of organisms to other patients.Although training in preventing bloodborne pathogen exposures is required annually by the Occupational Safety and Health Administration, clinical nurses (registered nurses, licensed practical nurses, and certified nursing assistants) and other health care staff should receive additional infection control training and periodic evaluations of aseptic care as a planned patient safety activity. Nurses have the uni que opportunity to directly reduce health care–associated infections through recognizing and applying evidence-based procedures to prevent HAIs among patients and protecting the health of the staff.Clinical care nurses directly prevent infections by performing, monitoring, and assuring compliance with aseptic work practices; providing knowledgeable collaborative oversight on environmental decontamination to prevent transmission of microorganisms from patient to patient; and serve as the primary resource to identify and refer ill visitors or staff. PREVENTION STRATERGIES Multiple factors influence the development of HAIs, including patient variables (e. g. , acuity of illness and overall health status), patient care variables (e. g. antibiotic use, invasive medical device use), administrative variables (e. g. , ratio of nurses to patients, level of nurse education, permanent or temporary/float nurse), and variable use of aseptic techniques by health care staff. Although HAIs a re commonly attributed to patient variables and provider care, researchers have also demonstrated that other institutional influences may contribute to adverse outcomes. To encompass overall prevention efforts, a list of strategies are reviewed that apply to the clinical practice of an individual health care worker as well as institutional supportive measures.Adherence to these principles will demonstrate that you H. E. L. P. C. A. R. E. This acronym is used to introduce the following key concepts to reduce the incidence of health care–associated infections. It emphasizes the compassion and dedication of nurses where their efforts contribute to reduce morbidity and mortality from health care–associated infections. Hand Hygiene For the last 160 years, we have had the scientific knowledge of how to reduce hand contamination and thereby decrease patient infection.Epidemiologic studies continue to demonstrate the favorable cost-benefit ratio and positive effects of simple hand washing for preventing transmission of pathogens in health care facilities. The use of antiseptic hand soaps (i. e. , ones containing chlorhexidine) and alcohol-based hand rubs also effectively reduce bacterial counts on hands when used properly. Although standards for hand hygiene practices have been published with an evidence-based guideline and professional collaborations have produced the How-to-Guide: Improving Hand Hygiene, there is no standardized method or tool for measuring adherence to institutional policy.Key points †¢The practice of appropriate hand hygiene and glove usage is a major contributor to patient safety and reduction in HAIs. It is more cost effective than the treatment costs involved in a health care–associated infection. †¢Joint Commission infection control standards include hand washing and HAI sentinel event review, which are applicable to ambulatory care, behavioral health care, home care, hospitals, laboratories, and long-term care o rganizations accredited by the Joint Commission. Hand hygiene is the responsibility of the individual practitioner and the institution. Developing a patient safety culture backed by administrative support to provide resources and incentives for hand washing is crucial to a successful outcome. †¢Hand hygiene promotion should be an institutional priority. †¢Select methods to promote and monitor improved hand hygiene. Monitor outcomes of adherence to hand hygiene in association with reduced incidence of HAI. †¢Establish an evaluation model to recognize missed opportunities for appropriate hand hygiene.Environmental cleanliness The health care environment surrounding a patient contains a diverse population of pathogenic microorganisms that arise from a patient’s normal, intact skin or from infected wounds. Approximately 106 flat, keratinized, dead squamous epithelium cells containing microorganisms are shed daily from normal skin, and patient gowns, bed linens, and bedside furniture can easily become contaminated with patient flora. Surfaces in the patient care setting can also be contaminated with pathogenic organisms (e. g. from a patient colonized or infected with MRSA, VRE, or Clostridium difficile) and can harbor viable organisms for several days. Contaminated surfaces, such as blood pressure cuffs, nursing uniforms, faucets, and computer keyboards, can serve as reservoirs of health care pathogens and vectors for cross-contamination to patients. It is necessary to consistently perform hand hygiene after routine patient care or contact with environmental surfaces in the immediate vicinity of the patient. Infection control procedures are recommended to reduce cross-contamination under the following situations. . Use EPA-registered chemical germicides for standard cleaning and disinfection of medical equipment that comes into contact with more than one patient. 2. If Clostridium difficile infection has been documented, use hypochlorite-base d products for surface disinfection as no EPA-registered products are specific for inactivating the spore form of the organism. 3. Ensure compliance by housekeeping staff with cleaning and disinfection procedures, particularly high-touch surfaces in patient care areas (e. . , bed rails, carts, charts, bedside commodes, doorknobs, or faucet handles). 4. When contact precautions are indicated for patient care (e. g. , MRSA, VRE, C. difficile, abscess, diarrheal disease), use disposable patient care items (e. g. , blood pressure cuffs) wherever possible to minimize cross-contamination with multiple drug-resistant microorganisms. 5. Advise families, visitors, and patients regarding the importance of hand hygiene to minimize the spread of body substance contamination (e. g. respiratory secretions or fecal matter) to surfaces. A patient safety goal could be to adopt a personal or an institutional pledge, similar to the following: I (or name of health care facility) am committed to ensurin g that proper infection control and environmental disinfection procedures are performed to reduce cross-contamination and transmission so that a person admitted or visiting to this facility shall not become newly colonized or infected with a bacterium derived from another patient or health care worker’s microbial flora.Leadership Health care workers dedicate enormous effort to providing care for complex medical needs of patients, to heal, to continuously follow science to improve the quality of care—all the while consciously performing to the best of their ability to Primum non nocere (First, do no harm). Though medical errors and adverse events do occur, many can be attributed to system problems that have impacted processes used by the health care worker, leading to an undesired outcome.Responsibility for risk reduction involves the institution administrators, directors, and individual practitioners. It is clear that leaders drive values, values drive behaviors, and b ehaviors drive performance of an organization. The collective behaviors of an organization define its culture. The engagement of nursing leaders to collaborate with coworkers and hospital administrators in safety, teamwork, and communication strategies are critical requirements to improve safe and reliable care.Each institution must communicate the evidence-based practices to health care staff, have access to expertise about infection control practices, employ the necessary resources and incentives to implement change, and receive real-time feedback of national and comparative hospital-specific data. Health care institutions simply must expect more reliable performance of essential infection-control practices, such as hand hygiene and proper use of gloves. It is no longer acceptable for hospitals with substandard adherence to these basic interventions to excuse their performance as being no worse than the dismal results in published reports.Institution improvements should focus on p rocess improvements that sustain best practices, using multifactorial approaches, and a commitment from the top administration through all levels of staff and employees to implement best practices. Use of personal protective equipment Infection control practices to reduce HAI include the use of protective barriers (e. g. , gloves, gowns, face mask, protective eyewear, face shield) to reduce occupational transmission of organisms from the patient to the health care worker and from the health care worker to the patient.Personal protective equipment (PPE) is used by health care workers to protect their skin and mucous membranes of the eyes, nose, and mouth from exposure to blood or other potentially infectious body fluids or materials and to avoid parenteral contact. The Occupational Safety and Health Administration’s Bloodborne Pathogens Standard states that health care workers should receive education on the use of protective barriers to prevent occupational exposures, be able to identify work-related infection risks, and have access to PPE and vaccinations.Proper usage, wear, and removal of PPE are important to provide maximum protection to the health care worker. Various types of masks, goggles, and face shields are worn alone or in combination to provide barrier protection. A surgical mask protects a patient against microorganisms from the wearer and protects the health care worker from large-particle droplet spatter that may be created from a splash-generating procedure. When a mask becomes wet from exhaled moist air, the resistance to airflow through the mask increases.This causes more airflow to pass around edges of the mask. The mask should be changed between patients, and if at anytime the mask becomes wet, it should be changed as soon as possible. Gowns are worn to prevent contamination of clothing and to protect the skin of health care personnel from blood and body fluid exposures. Gowns specially treated to make them impermeable to liquids, le g coverings, boots, or shoe covers provide greater protection to the skin when splashes or large quantities of potentially infective material are present or anticipated.Gowns are also worn during the care of patients infected with epidemiologically important microorganisms to reduce the opportunity for transmission of pathogens from patients or items in their environment to other patients or environments. When gowns are worn, they must be removed before leaving the patient care area and hand hygiene must be performed. Wise use of antimicrobials Over the last several decades, a shift in the etiology of more easily treated pathogens has increased toward more antimicrobial-resistant pathogens with fewer options for therapy.Infections from antimicrobial-resistant bacteria increase the cost of health care, cause higher morbidity and mortality, and lengthen hospital stays compared to infections from organisms susceptible to common, inexpensive antimicrobials (Aboelela, 2006). Antimicrobia l resistance has continued to emerge as a significant hospital problem affecting patient outcomes by enhancing microbial virulence, causing a delay in the administration of effective antibiotic therapy, and limiting options for available therapeutic agents.Authors of evidence-based guidelines on the increasing occurrence of multidrug-resistant organisms propose these interventions: stewardship of antimicrobial use, an active system of surveillance for patients with antimicrobial-resistant organisms, and an efficient infection control program to minimize secondary spread of resistance. Antimicrobial stewardship includes not only limiting the use of inappropriate agents, but also selecting the appropriate antibiotic, dosage, and duration of therapy to achieve optimal efficacy in managing infections (Aboelela, 2006).Hospital campaigns to prevent antimicrobial resistance include steps to (1) employ programs to prevent infections, (2) use strategies to diagnose and treat infections effec tively, (3) operate and evaluate antimicrobial use guidelines (stop orders, restrictions, and criteria-based clinical practice guidelines), and (4) ensure infection control practices to reduce the likelihood of transmission. Nurse practitioners have a role as part of the health care team diagnosing and treating infections appropriately and should be familiar with strategies to improve antimicrobial use.All health care workers play a critical role in reducing the risk of transmission. Respiratory hygiene Respiratory viruses are easily disseminated in a closed setting such as a health care facility and can cause outbreaks that contribute to the morbidity of patients and health care staff. Personnel and patients with a respiratory illness commonly transmit viruses through droplet spread. Droplets are spread into the air during sneezing, talking, and coughing and can settle on surfaces.Transmission occurs by direct contact with mucous membranes or by touching a contaminated surface and self-inoculating mucous membranes. Respiratory viruses can sometimes have aerosol dissemination. Precautions to prevent the transmission of all respiratory illnesses, including influenza, have been developed. The following infection control measures should be implemented at the first point of contact with a symptomatic or potentially infected person. Occupational health policies should be in place to guide management of symptomatic health care workers. 1.Post visual alerts (in appropriate languages) at the entrance to outpatient facilities instructing patients and escorts (e. g. , family, friends) to notify health care personnel of symptoms of a respiratory infection when they first register for care. 2. Patients and health care staff should consistently practice the following: a. Cover the nose/mouth when coughing or sneezing. b. Use tissues to contain respiratory secretions and dispose of them in the nearest waste receptacle after use. c. Perform hand hygiene after having contact with respiratory secretions and contaminated objects or materials. . During periods of increased respiratory infection activity in the community or year-round, offer masks to persons who are coughing. Either procedure masks (i. e. , with ear loops) or surgical masks (i. e. , with ties) may be used to contain respiratory secretions. Encourage coughing persons to sit at least 3 feet away from others in common waiting areas. 4. Health care personnel should wear a surgical or procedure mask for close contact (and gloves as needed) when examining a patient with symptoms of a respiratory infection.Maintain precautions unless it is determined that the cause of symptoms is not an infectious agent (e. g. , allergies). CONCLUSION It is the responsibility of all health care providers to enact principles of care to prevent hospital acquired infections, though not all infections can be prevented. Certain patient risk factors such as advanced age, underlying disease and severity of illness, and s ometimes the immune status are not modifiable and directly contribute to a patient’s risk of infection.Depending on the patient’s susceptibility, a patient can develop an infection due to the emergence of their own endogenous organisms or by cross-contamination in the health care setting. Nurses can reduce the risk for infection and colonization using evidence-based aseptic work practices that diminish the entry of endogenous or exogenous organisms via invasive medical devices. Proper use of personal protective barriers and proper hand hygiene is paramount to reducing the risk of exogenous transmission to a susceptible patient.Health care workers should be aware that they can pick up environmental contamination of microorganisms on hands or gloves, even without performing direct patient care. Proper use and removal of PPE followed by hand hygiene will reduce the transient microbial load that can be transmitted to self or to others. ? REFERENCE †¢Aboelela S W, Saim an L, Stone P, et al. (2006) Effectiveness of barrier precautions and surveillance cultures to control transmission of multidrug-resistant organisms: a systematic review of the literature. J Infect Control, vol: 34(8):484–94. Bauman W R (2011), Microbiology with disease taxonomy, Pearson International Edition, 4th Edition, Pg no: 430 – 434. †¢Carlos F (2007), Antimicrobial resistance in Bacteria, Horizon Bioscience Publications, Pg no: 7 – 14. †¢Filetoth Z (2003), Hospital Acquired Infection, Whurr publishers, Pg no: 97 – 102, 180 – 196, 220 – 232. †¢I W Fong, Drlica K(2008), Antimicrobial resistance and implication for the 21st century, Springer publications, Pg no: 231- 235. †¢Madigan M, Martinko J, Stahl D (2009), Brock Biology of Microorganisms, Pearsons Publications, 13th Edition, Pg no: 954- 957. Muto C A, Jernigan J A, Ostrowsky BE, et al. (2003) SHEA guideline for preventing nosocomial transmission of multidrug-re sistant strains of Staphylococcus aureus and Enterococcus. Infect Cont Hosp Epidem, Vol: 24(5):362–86. †¢Ryan J, Ray C G et al. (2010), Sherris Medical Microbiology, International Edition, 5th Edition, Pg no: 89 – 98. †¢Wyllie D, Connor L, Walker S, Davies J et al (2013), Annual Report of Chief Medical Officier, Chapter 4: Health care associated infections, Pg no: 63-72. Centers for Disease Control and Prevention. Respiratory hygiene/cough etiquette in healthcare settings. 2010. [Accessed march 2013]. Available at: http://www. cdc. gov/flu/professionals/infectioncontrol/resphygiene. htm. †¢Institute for Healthcare Improvement. How-to guide: improving hand hygiene. a guide for improving practices among health care workers. [Accessed March 2013]. Author. Available at: http://www. ihi. org/IHI/Topics/CriticalCare/IntensiveCare/Tools/HowtoGuideImprovingHandHygiene. htm.