Factors Contributing to the Ups and Downs of Friendship in...

The absence or presence of invidiousness has the potency to strengthen or dismember friendships. In John Knowles’ A Separate Peace, Gene Forrester and his daring roommate, Finny, discover the dangerous impact of enviousness on their friendship. Gene’s jealousy of Finny’s athletic capabilities, Finny’s unenviable thoughts and actions, and Brinker’s suspicions that Gene’s envy catalyzed Finny’s accident were all contributing factors to the ups and downs in Gene’s and Finny’s relationship. Detesting a friend for his/her successes can rupture even the strongest relationships. Gene’s invidiousness of Finny’s numerous sports achievements transforms into a resentful hatred. One day, when the boys are about to perform their daily ritual of†¦show more content†¦When Finny jokingly says he was extremely envious of Gene one day, Gene bursts and unknowingly concludes that â€Å"all of [Finny’s] assertio ns of friendship were fake and [he] was only jealous of my success† (Knowles 34). Finny’s meaningless comment sparks Gene’s anger, invoking him to accuse Finny of befriending him only to bring him down. Gene’s sudden lash informs Finny of Gene’s distrust and jealousy of him. Similarly, Gene starts to feel a sense of betrayal from Finny, beginning to believe that Finny’s friendship is unreal. The argument, which is centered on Gene’s jealousy, slowly rips the boys away from one another, because of lack of trust in each other. Therefore, in this case, Gene’s envy tardily tore apart his relationship with Finny. However, the lack of invidiousness in a friendship fortifies the relationship even more. Repeatedly, throughout the book, Gene is astonished by Finny’s ability to be accepting of other’s successes, without exhibiting any envy or spite. As Gene’s past arguments with Finny display, Gene conceived that Finn y was jealous of his academic success. On page 77, Gene’s ideas are disproven when Finny flaunts his admiration for Gene’s acquirement: â€Å"‘It [academics] seemed to come so naturally to you; I [Finny] never realized you had to study’† (Knowles 77). Finny’s words show his admiration for Gene’s drive to progress at what heShow MoreRelatedStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pages76 Self-Assessment Library Am I Engaged? 78 Myth or Science? â€Å"Favorable Job Attitudes Make Organizations More Profitable† 83 Point/Counterpoint Employer–Employee Loyalty Is an Outdated Concept 87 Questions for Review 88 Experiential Exercise What Factors Are Most Important to Your Job Satisfaction? 89 Ethical Dilemma Bounty Hunters 89 Case Incident 1 Long Hours, Hundreds of E-Mails, and No Sleep: Does This Sound Like a Satisfying Job? 90 Case Incident 2 Crafting a Better Job 91 4 Emotions and

The Cause And Effects Of Acid Mine Drainage Essay

The Cause and Effects of Acid Mine Drainage INTRODUCTION nbsp;nbsp;nbsp;nbsp;nbsp;Imagine going fishing on a cool Autumn day, the trees are all different shades of orange, brown and red and the birds are singing their beautiful songs, but their is a serious problem because when you arrive at the river all plant and animal life are gone. This is by no means a recent phenomenon. This is due to the effects of acid rock drainage (ARD). This is a problem that has been occurring since ancient times, but it was not until the 1800s when fast growing industrialization and heavy mining that it caught alot of attention. nbsp;nbsp;nbsp;nbsp;nbsp;Acid rock drainage is the term used to describe leachate, seepage, or drainage that has been†¦show more content†¦Each of the chemicals in acid mine drainage is toxic to fish and aquatic insects in moderate concentrations. At real high concentrations all plant life is killed. nbsp;nbsp;nbsp;nbsp;nbsp;quot;Underground mines that are likely to result in ARD are those where mining is located above the water table. (Kelly 1988)quot; Most of the mines are also located in mountainous terrain. quot;Underground workings usually result in a ground water table that has been lowered significantly and permanently. (Kelly 1988)quot; Mining also helps in the breaking of rock exposing more surface area to oxidation. OTHER SOURCES OF ARD nbsp;nbsp;nbsp;nbsp;nbsp;ARD is not necessarily confined to these mining activities. quot;Any process, natural or anthropogenic, that exposes sulfide- bearing rock to air and water will cause it to occur. (Ellison amp; Hutchison)quot; There are examples of natural ARD where springs produce acidic water. These are found near outcrops of sulfide-bearing rock, but not all exposing sulfide rock will result in ARD formation. quot;Acid drainage will not occur if sulfide minerals are nonreactive, the rock contains sufficient alkaline material to neutralize any acid produced, or the climate is arid and there is not adequate rainfall infiltration to cause leakage. (Ellison amp; Hutchison 1992)quot; CHEMISTRY nbsp;nbsp;nbsp;nbsp;nbsp;quot;The most important factor inShow MoreRelatedThe Cause and Effects of Acid Mine Drainage1699 Words   |  7 PagesThe Cause and Effects of Acid Mine Drainage INTRODUCTION Imagine going fishing on a cool Autumn day, the trees are all different shades of orange, brown and red and the birds are singing their beautiful songs, but their is a serious problem because when you arrive at the river all plant and animal life are gone. This is by no means a recent phenomenon. This is due to the effects of acid rock drainage (ARD). This is a problem that has been occurring since ancient times, but it was not untilRead MoreEffects Of Mining On The Environment1133 Words   |  5 PagesEffects of Mining Yu Bo Introduction The effects of mining to the environment include formation of sinkholes, erosion and sedimentation, groundwater, loss of biodiversity or habitat modification, soil contamination, surface water by mining chemicals, acid mine drainage creation, fugitive dust emissions, release of cyanide and other chemicals (International Atomic Energy Agency 2005). At times, additional forest cataloguing takes place in the surrounding area of mines so as to enlarge the room availableRead MoreMining and The Environment Essay examples1311 Words   |  6 Pageshave occurred. History and Case Studies of Mining and the Effects on the Environment Mines pose a threat to the environment. They can degrade soil and water quality if left untreated. The United States Environmental protection Agency (USEPA)s Region 9 assessment of state data states that there are approximately 420,000 abandoned mines in the states of California, Arizona, and Nevada with 13,242 of them being considered abandoned mines with potential environmental hazard (arizona.edu, 2008).Read MoreThe Effects Of Coal Ash On The Health Of Water Systems1571 Words   |  7 Pagesproblem. Coal ash possesses unique chemical properties that allow for the remediation of other environmental concerns, such as the treatment of soil polluted with heavy metals, the removal of nutrients from wastewater, and the remediation of acid mine drainage in streams. Coal ash is known to contain a number of different toxic metals, the exact content dependent upon the coal it is formed from. Containing this potential pollution hazard is an expensive problem, as approximately 75% of all ash generatedRead MoreEnvironmental Issues of Coal Mining1728 Words   |  7 Pagesassociated activities are carried out in underground and opencast mines. Mining operations damage the environment and ecology to an unacceptable degree, unless carefully planned and controlled. There is a need for balance between mining and environmental requirements. The various impacts of mining on environment and their mitigation measures are as follows: (I) Impact of Mining on Air Quality Air pollution in mines is mainly due to the fugitive emissions of particulate matter and Read MoreThe Impact Of Marine Pollution On Our Environment1530 Words   |  7 Pageshas on our environment There is two different types of pollution Nonpoint source pollution and Point source pollution. Firstly what is Nonpoint source pollution? Nonpoint source pollution are from land runoff, precipitation, atmospheric deposition, drainage, seepage or hydrologic modification.Agriculture, urban runoff, runoff from mining, and construction sites, are all examples of Nonpoint source pollution (â€Å"Pollution Issues†). The pollution is caused by the rainfall and snowmelt moving through orRead MoreMining Can Cause Great Damages to the Environment Essay845 Words   |  4 PagesMining can cause varying amounts of damage at all stages due to different aspects of the mining project, such as the type of ore, the technology, methods and on-site processes used as well as how sensitive the local environment is. Mining effects not only the local physical aspects it can also lead to air, land and water contamination. Damage can be caused during exploration of the minerals in the soils as ground work involves bore holes, transect lines, excavation pits and support equipment canRead MoreThe Economic Contribution From Iron Ore Mining Industry1319 Words   |  6 Pagesfor the extensive damage it causes to the environment? Iron ores, like many other materials, must be mined from the earth before they can be processed and converted into usable products such as steel. In 2009, as the world’s leading exporter of iron, Australia traded 362 tonnes of iron ore, of varying compositions, at a value of $30 billion. (Geoscience Australia, n.d.) In Australia, iron ore mining is conducted in what are known as ‘open-cut’ mines, meaning that the mines are pits along the surfaceRead MoreResearch Aspects Of Water Quality1818 Words   |  8 PagesPurpose of the Report The purpose of this investigation is to research aspects of water quality such as guidelines for water quality, water quality parameters, contaminants that effect water quality, water quality tests and catchment area influences. Samples from the Dee River, from above and below the former Mount Morgan mine site, will be tested and compared in terms of pH level, conductivity and water hardness. The links that exist between pH levels and water hardness will also be investigated. TheseRead MoreWater Quality Of The Mine Drainage Running Into The Afon Goch North998 Words   |  4 Pagesthe water quality of the mine drainage running into the Afon Goch North has meant that any remediation system must be multi-staged. Furthermore, the unique characteristics of the mine and the heavily polluted water requires an exclusive method of mediation. The treatment system outlined uses passive systems that require relatively little maintainence and have low running costs in order to be used as a long term solution to the pollution being produced. Extending the Mine Adit 　　Initially, the hillside

Middle Ages vs. the Renaissance Essay - 736 Words

There are many contrasts in the beliefs and values of the Renaissance and the Middle Ages. The Middle Ages was a time of great suffering, including famine and widespread disease. The Renaissance, however, was a revival of art, learning, and literature. Their views of the purpose of life in the present world and mans place in the world was, perhaps, the greatest contrast. However, their views on politics, religion, and education were very different as well. The purpose of life and mans place in the world was viewed differently during the Middle Ages and the Renaissance. During the Middle Ages, also known as The Age of Faith, mans purpose was to serve God. Life was looked upon as a journey. The focus of life was on the afterlife†¦show more content†¦On the other hand, Republicanism was considered to be the best form of government during the Renaissance because the individual could realize his fullest potential by serving the state. According to Leonardo Bruni, the rule of one person was harmful to the common good. Thus, the republican government was considered to be stronger than the monarchy. Religion was also viewed differently. The Catholic Church was the one universal church during the Middle Ages. People believed that only church officials could interpret the scriptures. People also believed in the absolute authority of the church. During the Renaissance, the Protestant Reformation led to the development of many churches. People believed that each individual could interpret the Bible for himself. The church no longer had absolute authority as it did during the Middle Ages. Education was approached differently as well. During the Middle Ages, the focus of education was on studying the Bible and debating spiritual questions. Since the common people were not allowed to read the Bible, they were told what to think. The purpose of education in the Middle Ages was to pass the Moral Test and be rewarded with eternal joy in the afterlife. However, during the Renaissance, the focus of education was on learning from past history and experience and observations of the present world. There was a scientific and rationalistic attitude toward viewingShow MoreRelated Middle Ages vs Renaissance2279 Words   |  10 Pages Life during the middle ages (1066-1485) was dictated by how much money you had. Were you a noble? Or were you a peasant. Your quality of life was in direct proportion to your status. Lords of the Noble class ruled territories, also known as villages. These villages mainly consisted of one room houses, with maybe a church and a blacksmith shop. Peas ants or serfs lived in these villages and worked under said Lord. Daily life was all about survival. The days were spent planting and growing foodRead MoreA Comparison of The Middle Ages vs. The Renaissance Essay1530 Words   |  7 PagesThe Middle Ages and Renaissance where worlds apart in every aspect of life. In areas of art, tools such as perspective, realism, and individualism showed the great leap in creativity during the Renaissance. Likewise, the worldly individual, or the â€Å"Renaissance Man†, was an improvement over the ignorant, spiritual man of the Middle Ages. Also, the revival of classical learning and education that occurred in the Renaissance was the exact opposite of the suppression of learning during the Middle AgesRead MoreEssay on Medieval vs. Renaissance Art887 Words   |  4 PagesMedieval vs. Renaissance Art Art during the Italian Renaissance differed from art during the Middle Ages. The two have contrasting characteristics and concepts. To the people in the medieval world, religion was their life. Everything in daily life focused around the church and God (Modern World 164). Medieval culture influenced the arts; this was evident in the religious themes. During the Italian Renaissance, painters and other artists focused on the portrayal of a more humanistic way ofRead More Madonna vs. Eve A portrait of the Renaissance Woman827 Words   |  4 PagesMadonna vs. Eve A portrait of the Renaissance Woman The role of women has been portrayed through art since prehistoric times. Women have been a sign of hope, downfall, and power. This image of women was most powerful during the Renaissance. A cultural revival or rebirth occurred during the 15th and 16th century in Europe. The economic growth of the 14th century created a prosperous middle class. This allowed more of the mass to invest their income. Patronage of the arts soon became very fashionableRead MoreArt During The Middle Ages1243 Words   |  5 PagesArt during the Italian Renaissance differed from art during the Middle Ages. The two have contrasting characteristics and concepts. In the Middle Ages the subject of almost all European art was religion, specifically. Although Renaissance artists continued to paint religious paintings and portraits of individuals, they also focused on the details of everyday life. They also used new techniques such as sfumato, chiaroscuro and perspective. The artists of the Italian Renaissance exp ressed the idealsRead MoreThe Battle Of Poitiers During The Hundred Year War1711 Words   |  7 Pageswell as the death of Henry V’s brother Thomas. After the battle of Agincourt, the battle of Verneuil. The battle of Verneuil happened after the battle of Agincourt to get rid of the English in Normandy. The battle was between the French and Scotland vs England began. The French charged toward the English however the English used their archers to dispose of the French and Scots. The allied forces lost and the french and scottish armies retreated and Scotland stopped aiding the French in the HundredRead MoreThe Crusades During The Middle Ages1152 Words   |  5 Pages The Renaissance was a period of rebirth in art and culture after the Middle Ages. The Crusades helped Medieval Europe to flourish and grow out of the Dark Ages. The Crusades affected daily life and caused major effects in political, economical and cultural Medieval Europe. The first Crusade was gaining control o ver the Holy Land, but the later Crusades were fights over regaining land. The Byzantine Empire fell during the fourth Crusade after an attack on their capital, Constantinople, took placeRead MoreThe Origins Of Humanity And Major Periods : Middle Ages, Renaissance, And Enlightenment1454 Words   |  6 Pages Exam One: Origin of Humanity Alexis Jayne Milligan Bethune-Cookman University SS 245 WO Interdisciplinary Social Science Dr. Dorcas E. McCoy April 10, 2016 This paper will discuss the origins of humanity and three major periods: Middle Ages, Renaissance, and Enlightenment. The relevance of evolution, natural selection via Charles Darwin, intelligent design, and scientific creationism. Then the human thought and social thought on these epochs will be further debated. Biblical reference hasRead MoreRenaissance Ideals of Humanism Are Expressed in the Italian Art of the Period970 Words   |  4 PagesDiscuss how Renaissance ideals of humanism are expressed in the Italian art of the period, referring to specific works and artists. During the fourteenth century Italy witnessed notable changes, which throughout the next couple of centuries extended towards northern Europe. This was later described as the Renaissance, the cultural achievements through sixteenth centuries; those achievements rest on the economic and political developments of earlier centuries. (Western Society, 413) This wasRead MoreDefining The Terms Renaissance And Humanism875 Words   |  4 Pages1. Define the terms Renaissance and humanism. As mentioned in the New World Encyclopedia article â€Å"Renaissance†, the Renaissance or â€Å"Rebirth† showcased a cultural shift exhibiting both scientific and artistic transformation and advancement between the Middle Ages and the early stages of the Modern age in Europe (2014). In the New World Encyclopedia article â€Å"Humanism†, Humanism’s scope primarily focuses on human beings: human being s place in relations to nature, human potential, human beauty, etc

Thomas Jefferson and the Meanings of Liberty free essay sample

Jefferson also believed slavery to be an atrocious blot on the face of America. Their strong opinions of equality resonate in todays world but were not considered the correct morals in their time. 2. A. ) The conspiracy between Jefferson and his affair with Sally Hemming, his slave, first surfaced In a publication written by James Calendar. B. ) The purpose of the publication was to essentially drag Jefferson name through the mud. Written by a vindictive publisher In a time of Increased political slander, It was used against Jefferson In his campaigns. . ) The varying Interpretations Indicate the use of presenting throughout the periods in which the affair has been analyzed. During the civil rights movement. Use of the term blacks to describe the slave population was seen as one of the main points of insensitivity, because African Americans of the time had such little cultural footing in America. After the ass, students began to reflect on Jefferson unwillingness to see integration as an option, because African Americans were still struggling to integrate after the civil rights movements. We will write a custom essay sample on Thomas Jefferson and the Meanings of Liberty or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Modern day, the concern lies in Jefferson blatant stereotyping of slaves as lesser and even as musical. These all reflect the current Ideals of the time In which the same story Is being Interpreted. 3. A. ) I do agree with Wilson point of view because Revolution Is relative and Jefferson was the master of revolt In his society. Of course, that Is not excusing Jefferson hypocrisy, but I think It Is better to realize the background before the product. Jefferson owned slaves, but Its Important to know first that he detested he slave trade, and had only grown up knowing nothing but slave-owning. . ) Jefferson didnt necessarily free his slaves for a variety of reasons. He was enormously in debt, and slave labor was obviously cheap. He also owed much of political career to slavery, as slavery helped him rise up in the ranks of government with money. He also could have feared for his slaves, in the almost crueler freed world where ex-slaves were ostracizes in society to the point death and life destruction. C. ) This question is not necessarily presenting because hypocrisy is definitive.Aspects of the question can be construed as presenting though because the disgust at Jefferson owning slaves Is presently as It Imposes modern morals of anta-racism onto an Inherently racist society. 4. A. ) In the Declaration of Independence, liberty means both Individual freedom and universal freedom. On one hand, the Declaration shows liberty as meaning ones own right to pursuit of freedom for the people, and not Just personal and selfish freedom. It can also be seen as the idea of national freedom, where the country itself is free from all tyrannical bonds. The Declaration of Independence most likely wanted to include all of these interpretations; freedom for the individual, freedom for man, and freedom for country. B. ) In the eighteenth century, freedom for the individual was rampant. In the early stages of America, defiant anti-federalists saw liberty as a means for near anarchy. They wanted no restrictive laws so they could make a living and exist contentedly under the veil of selfishness. C. ) Now, the idea of freedom for all of man is much more prevalent. I think this change has occurred as our country has restored.Jefferson did warn against a stagnant government mingled with a progressive population. Social rights movements are more numerous than they had been in the eighteenth century, when personal or party gain was more important than morality. 5. A. ) Revisionism that stresses the faults of great figures can lead to an overwhelming negativity toward some great heroes who ultimately bring lessons of morality to the table. It perpetuates the idea that human beings, even the best of us, are always crawling with gaping character flaws. But, it also helps us humanism hose great figures whose reputations often run away with them. It helps us to remember that political success does not equal morality. B. ) This trend in historical writing alludes to a growing sense of both negativity and revolution in our society. As we begin to reject common figures of greatness and replace them with our own versions, modern-day youth culture is beginning to establish their own identity separate from current systems. This straying from the norm of decided importance implies a lack of trust or satisfaction with current institutions of morality, politics, and society.

AnorexiaBulimia Essay Research Paper I have chosen free essay sample

Anorexia/Bulimia Essay, Research Paper I have chosen the subject of eating upsets amoungst striplings for my reaserch undertaking. By Meriam Webster Medical Dictionary definition, the term eating upset is defined by the followers ; Eating Disorders: Psychological upsets ( anorexia nervosa, binge-eating syndrome ) charachterized by gross perturbations of eating behaviour. Anorexia Nervosa: Anorexia Nervosa is a upset which is charachterized by self-starvation. Contrary to popular belief anorectics do eat every twenty-four hours even affecting? out nutrients? such as ice pick, confect, sweets. By and large merely they merely eat little sums of nutrient or severly restrict themselves to the nutrients which are? safe? to eat. A typical day-to-day thermal consumption of 600-800 Calories or less is seen. Excercise is of import to lose weight excessively. Most anorectics dont see how thin they are going. Their deformed organic structure image sees them as deriving weight. Death can happen due to kidney or bosom failure from malnutrition. We will write a custom essay sample on AnorexiaBulimia Essay Research Paper I have chosen or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Bulimia Peoples with binge-eating syndrome are involved in a binge-purge cyc lupus erythematosus of seeking to command their weight and nutrient consumption. Bulimia is chaachterized by eating big sums of nutrient in a short period of timer, frequently nutrients which are? out? or? bad? . Guilt shortly follows which consequences in an effort to purging the nutrient and Calories from the organic structure. Not all bulimics will purge. Some will utilize laxitives or inordinate excercising. As with anorexia, depression and withdrawl occur and binge-eating syndrome can ensue in deat if untreated. Compulsive Gluttony Many people eat in response to emotional, non physical hungriness. Compusive overeaters frequently feel a nothingness in their lives. This nothingness leaves them to experience empty and in bend they will eat to make full the emptyiness and choose comfort nutrients to make full the hungriness. Compulsive overaters can be at hazard for developing binge-eating syndrome, holding low self-esteem, and deriving extra weight can diminish self=esteem even more. One survey showed that fleshiness in 11 twelvemonth old miss has doubled since 1960 with an addition among striplings. This compulsion with narrow margin is doing girs every bit immature as 9 old ages old to travel on diets.

How To Sell Ebooks With The Use Of A Buy-Movie-Review--Word-Essay-Sample-Cheaper.Peptix.com

How To Sell Ebooks With The Use Of A Buy-Movie-Review--Word-Essay-Sample-Cheaper.Peptix.comGet the best value from your computer in buying a buy-movie-review--word-essay-sample-cheaper.peatix.com ebook and spend less time on doing nothing but studying your book in college, or just writing it. Write the best paying ebook in your topic and sell it online. Write something you are passionate about, and sell it at a high price.Create an affordable, hard to find resource that is written by a professional for less. That's how you make money with ebooks. Learn to make money with ebooks for students in college, teachers, parents, and for folks who want to create easy to read, entertaining, book reports that are going to be highly valuable. There are so many low cost ways to generate income online, but few ways that are better than the one mentioned in this article. I am the author of the book 'Buy-Movie-Review--Word-Essay-Sample-Cheaper.Peptix.com'.This eBook is designed to help college stude nts do essay sample on their word searches. When your student makes a good research, your homework assignment will have a section on how they did it. When you buy the book 'Buy-Movie-Review--Word-Essay-Sample-Cheaper.Peptix.com', you get an instructional guide so you can easily teach the principles to your students in an easy-to-use way. This simple, easy to use guide is a highly rated guide, which will keep your students motivated to do better than they ever did before.You can't expect students to learn if they don't write about what they are learning. When you purchase the book 'Buy-Movie-Review--Word-Essay-Sample-Cheaper.Peptix.com', you get a great outline of the subject, making it much easier for your students to write your review. It is very easy to put this outline in a Word file, and then to send your students back to your class with a quick note saying they can start writing their movie reviews.Keep in mind, when you write the review, the focus is the students. You want to make it a personal experience for them, not just for you. As long as you are writing with the purpose of getting their feedback, there is no reason why you can't generate more income for yourself as well.Word databases are a very powerful marketing tool. Most people don't realize that you can actually make money with free word search databases. Many of these databases are simply ads that are inserted into your Word file. The money you will earn is the amount that you will save by not having to pay to use a paid database, since they don't have to pay you anything.Word databases come with very basic content, and no support system. You will need to write your own reviews, which is another problem that must be overcome. The solution is to purchase the book 'Buy-Movie-Review--Word-Essay-Sample-Cheaper.Peptix.com' and continue to make money with the very same program.

Infection and its prevention Essay Example

Infection and its prevention Essay Infection and its prevention have been a prime concern of mankind for a long time. Infection is a condition that results when a microorganism is able to invade the body, multiply and cause injurious effect or diseases. (McCall Tankersley, 2007:71) Infection control therefore refers to policies and procedures used to minimize the risk of spreading infections, especially in hospitals and human or animal health care facilities. The purpose of this is to reduce the occurrence of infectious diseases. The aim of this essay is to look at how infection control and the theatre environment impact on a patient undergoing surgery. The first part of the essay looks at infection control in the hospital setting in general; touching on issues such as hospital acquired infection like Methicillin-resistant Staphylococcus Aureus (MRSA) and Clostridium Difficile (CD). Then the essay delves into the design of the surgical theatre and how it impacts on patients; it further talks about surgical etiquette placing much emphasis on hand washing as this is the first defence in preventing transmission of pathogen (Radford et al, 2004). Finally a conclusion is drawn on all the issues raised and their impact on the patient undergoing surgery. We will write a custom essay sample on Infection and its prevention specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Infection and its prevention specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Infection and its prevention specifically for you FOR ONLY $16.38 $13.9/page Hire Writer In the past, surgery would have been performed in a convenient location such as the patients home or a hospital ward with only basic infection control in place (Essex-Lopresti 1999). In Phillips (2004) describes the process for preparing the room as rudimentary, amounting to little more than removing furniture and non essential items and boiling linen, perhaps fumigation if time allows. Today, most surgery takes place in operating theatres that are specially designed for that purpose. There are two types of infection, the endogenous and exogenous infection. Endogenous infection occurs when microorganisms that normally exist harmlessly in one part of an individual to become pathogen, whereas exogenous infection happens when microorganisms from other source or from other person, object, animal or the environment (Woodhead 2005). Infection control refers to policies and procedures used to minimise the risk of spreading infection especially in hospitals. Nosocomial or hospital acquired infection (HAI) occur in approximately 5% of all hospital patients. The longer a patient stays in hospital, the higher the risk of getting HAI and sometimes even leading to death. There are many reasons why patients infected with HAI: Firstly weak immune system which makes them more vulnerable to infection due to patient sickness or treatment. Secondly, infection agent can be introduced to the patient by medical procedures and thirdly, on admission with infectable disease agent, patient can transfer diseases to a patient or patient to staff or visitor (Jones, 2008). HAI has, over the past few years dominated the media with its coverage of the superbugs, in particular MRSA and CD. A HAI or nosocomial is that which is acquired or develops as a result of treatment while the patient hospitalised for more than 48 hours and who did not have signs and symptoms of such infection on admission. Radford et al (2004) cited the research of Emmerson et al (1996) 9% of patients admitted to hospital acquire HAI from surgical wound infection after hospital discharge. MRSA has the ability to resist to one or more conventional antibiotics. Study suggests many people are carriers of MRSA but are colonised in their nose or back of their throats and on their normal flora. Report from BBC news (2005) stated that about 100,000 get infected with MRSA each year when they get admitted into hospital. The only way health care workers can reduce this infection is; a good hand washing between patients, a good standard hygiene in hospital and patients with MRSA treated in a highly isolated as much as possible. The operating theatre is designed in accordance by national and processional guidelines as described by Woodhead et al (2005). Each department is divided into three zones, the outer or dirty zone which is unrestricted area where normal clothing can be worn; it contains the entrance to changing areas and usually has access to remove theatre waste. The clean or semi-restricted zones are the staff changing rooms, anaesthetic and recovery rooms and sterile supplies. Access is restricted and all personnel and patients have to wear theatre attire. There is exception sometimes to patients that need support, such as children, mental ill patients or translators to the anaesthetic room. The sterile or restricted zones include the operating theatre, preparation rooms and the scrub areas. Surgical attire and possible masks will need to be worn at all times (Davey Ince 2004). Sterile areas should avoid overcrowding by theatre staff to reduce the risk of accidental contamination to sterile instruments and layout. To reduce airborne contamination, movement of staff and patient should be kept to a minimum. This helps to reduce airborne bacteria from entering the operating theatre (Woodhead 2005). Ventilation, temperature, humidity and airborne contamination have an important role in the design of a good operating theatre. In order to control the movement of air, the operating department requires specialised ventilation system. Usually the system employed in ventilating modern operating departments are laminar airflow (LAF) technology and positive pressure (PP) systems; these are in theory designed to reduce surgical site infections. The theatre is particularly arranged in a way so that air pressure is filtered moving air from clean to less clean areas and this continues when the theatre room is not in use. This is in place to reduce the airborne contamination, reduce expired anaesthetic gases and to control temperature and humidity, thus reducing and minimising bacterial growth. Adequate ventilation in theatre can be achieved by properly closing theatre doors, windows are well sealed, ceiling solid and the floor impermeable to washable material with no gaps or cracks and cove red joints where it meets the wall. Also shelving should be kept to a minimum (Weaving P, et al 2008). In orthopaedic theatre the air is ultraclean. These system are used when the risk and consequences to developing infection are greater. Ultra clean air, provided by the laminar flow systems, is designed to move particle free air over the aseptic operating field in one direction; it can be in vertically or horizontally sweeping away particle in its path. These canopies have the capacity to provide up to 400 to 500 air change per hour and can reduce the incidents of surgical site infection ,so together with good practice and the use of prophylactic antibiotics, the impact of surgery upon the patient should be favourable (Woodhead et al 2005) . 37à ¯Ã‚ ¿Ã‚ ½ C and high humidity is the optional where most bacteria reproduce, to keep a theatre room free from bacteria the temperature should be between 20 to 24oc and humidified air levels of 50 to60%, this help to suppress bacteria growth, also help create a good impact upon the surgical patient, as infection rates are considerably lower (Davey and Ince 2004). Infants, children and burnt patient need a warmer temperature to avoid hypothermia, therefore each operating theatre have its own controls for regulating the temperature (Mangum 2001). There are two types of lighting found in theatre, the laminar lighting used to light the operating theatre and auxiliary and the surgical lighting. Both harbour microorganisms on it surfaces due to the movement and activities of staff in the operating theatre (Phillips 2004). This should be clean regularly to reduce the risk of infection. The theatre must be damp dusted before the first case of the day, and it is essential to clean and disinfect all contaminated areas of the theatre at the end of each case (Mangum, 2001) Infection control as defined earlier as policies and procedures use to minimize the risk of spreading infection, staff do not always go by this policies and guidelines. For example policies on air movement in the department, normally doors between the anaesthetic room and theatre are mostly left open by staff therefore affecting the positive pressure from working effectively. Staff need constant trainings and made aware of updated policies. These measures will help to control infection. According to Woodhead et al (2005), 300 million skin squames are shed per day and about 10% of this have microorganisms of which smaller particles stay as airborne for some hours. Some big particles may rest on work surfaces, furniture and equipment. 37% of airborne microbial contamination can be reduced if in every 3 minutes air is changed in the theatre. Different type of waste should be separated and disposed of in the right way. All waste known, or considered to cause disease in humans or other living organisms is considered infectious waste (DH, 2006). In the authors trust yellow is the colour coding for clinical waste which can cause a risk of infection or can be hazardous. Green bags for the linens. All waste bags should not be more than three quarters full (Davey Ince, 2004) and it is the duty of the staff to ensure that and dispose off in the appropriate manner to meet the requirement of the control of substances hazardous to health regulation (COSHH). Maintaining a safe and clean environment is essential for a good impact upon surgical patients, but staff themselves can be a source of microbial contaminated (Green et al, 2003). Staffs are screened by their occupational health department. They are annually screened for such infections as human immunodeficiency virus (HIV) and hepatitis B.; this screening is mandatory and is design to protect patients from exposure from infected staff. Microorganisms are shed from exposed skin, hair and mucus membranes, so to achieve a sterile field and to reduce infection for both patients and staff; staff need to wear appropriate clothing, prepare patients, use sterile equipment and eliquette during surgery. According to Radford et al (2004), every staff working within the theatre context needs to change into suit and trousers as classed as personal protective equipment (PPE) made from cotton fabric to reduce skin cells to the surroundings. Other PPE such as footwear, mask, eye protection etc. are also worn by staff as an infection control measure during surgery. Hospital Acquired Infections may not be eradicated but many outbreaks can be prevented through effective hand washing. Transient microorganisms are easily removed during hand washing therefore it is one of the most important procedures to prevent the spread of infection (Woodhead Wicker 2005). Hand antisepsis started in the 1860 by Joseph Lister. He realised decay is caused by microorganism and it can be prevented by disinfecting the clinical environment and all equipment with carbolic acid. It also included staff having their hands washed in a solution of 5% carbolic acid before undertaking surgery. Other development on surgical hand antisepsis occurred including scrubbing the hands and arms with a brush where the term scrub comes from. Also introduction of alcohol rubs in the late 1990s which contain antiseptic agent such as chlorehexidine gluconate alcohol solution which when rubbed on the hands does not need rinsing (Tanner 2008). Hand washing takes place before and after patient contact, following removal of protective clothing, immediately following contamination with blood or body fluids and after handling contaminated or potentially contaminated articles (Davey and Ince 2004, p39). This hand washing is a form of standard precautions for all staff to practice since staff cannot tell which patient is contaminated; therefore it is one of the most important procedures to prevent the spread of infection. Healthcare workers handling patient with their catheter, bed linen, wound, disposal of linen and waste come in contact with microorganisms. Also staff or practitioners caring for MRSA patients can have the pathogen on their skin for a few hours, this means it can transfer to another patient or staff easily. During these times, hand washing is vital to help stop the spread of infection. Surgical hand scrubbing gets rid of transient microorganisms which help to minimise the number of resident microorganisms in the recent study of Tanner 2008. Before hand scrub, all jewellery with the exception of single plain band must be removed. False nails and nail polish is not acceptable, since they harbour pathogens as studied by Heddewick et al (2000). Aqueous antiseptic solution such as Chlorhexidine gluconate and providone-iodine are efficient in removing transient organisms and reducing resident organisms to a safe level. Frequent hand wash minimise a low bacterial count under gloves which is accepted by all healthcare workers. To start effective hand scrub, temperature of the water must be checked; also arms and hands must be wet before applying anti-microbial solution. The hands and arms are washed from fingertips to the elbows and hands are held higher than elbows in order to prevent microorganisms dropping back to the fingertips. There is no agreed time for how long a surgical hand wash should last, but between 2 5 minutes have been vouched for by most researchers as enough and effective. Hands should be properly dry. Alcohol based hand rubs are also effective for use between patient contact. When used, the right technique should be employed to ensure it covers the relevant areas and left to dry (Woodhead et al 2005). Sterile gowns are worn after hand scrub to prevent bacteria from scrub staff to the surroundings or operating site, thus reducing surgical side infection (SSI) (Radford et al ,2004). Gloves must be put on using the closed gloving technique, not touched by the staff members bare hands. During orthopaedic operation, double gloving is recommended as any perforations will be highlighted and sterility will not be compromised. Surgical instrument and sterile equipment are prepared in the preparation room just before use, thus minimising the risk of contamination from airborne microbes. Patients are then positioned on to the table before a scrub nurse wheels the trolley into the operating area (Davey and Ince, 2004). A patients skin around the incision site is disinfected to reduce the number of bacteria present so as to reduce the risk of endogenous infections. The most effective antiseptic are those which are alcohol based. This has to be left on the skin to evaporate before draping begins (Weaving et al, 2008). The rationale behind this is to reduce the natural flora from getting into the incision and avoiding the patient contracting SSI. The rest of the patient is covered by draping which comes in disposable or reusable; this is to provide a sterile field in which the operating team can work without risk of contaminating themselves or the instrument. Draping start from the incision site working out towards the peripheries and should not be removed until dressing applied and surgery completed (Radford et al, 2004). Infection can not be totally eliminated and has serious consequences for the patient; however the risk of contracting infection can be reduced by adhering to infection control procedures and policies such as effective hand washing, wearing the appropriate personal protecting equipment. The design of the operating department also plays an important role in the success of controlling infection. Ventilation system needs to be working effectively to achieve its use; temperature and humidity parameters need constant checking. The continuous education of staff about theatre policies and regular update of the policies will go a long way to help reduce infection in theatre.