Suicide Bombers: Psychopaths or Not?

Sociopath or not? Are self destruction aircraft insane? Do you think their perspective is objective? From the outset, the appropriate response anybody would give appears glaringly evident: they should be insane and have silly musings to explode themselves and slaughter honest individuals simultaneously. Be that as it may, psychological warfare specialists have proposed a few discerning thought processes in their activities. Some political specialists accept that fear mongers settle on a strategic decision to utilize self destruction bombings against a more grounded foe. Different specialists contend that self destruction psychological warfare is a piece of a â€Å"cycle of humiliation† filled by a self destruction bombers’ want to strike back at the individuals who have abused or disgraced them.Some therapists have inferred that self destruction aircraft are conventional, ordinary individuals who are probably not going to submit rough acts until they relate to and join a fear based oppressor bunch which controls and constrains them to submit these fierce demonstrations. Self destruction bombarding assaults have become a weapon of decision among psychological militant gatherings in light of their lethality and capacity to cause pandemonium and dread. Despite the fact that discouraging, the practically every day news reports of passings brought about by self destruction assaults infrequently clarify what propels the attackers.Between 1981 and 2006, 1200 self destruction assaults comprised 4 percent of all fear based oppressor assaults on the planet and killed 14,599 individuals or 32 percent of all psychological warfare related passings. The inquiry is the reason? Somewhere in the range of 1981 and 2006, 1200 self destruction assaults comprised 4 percent of all psychological militant assaults on the planet and executed 14,599 individuals or 32 percent of all fear based oppression related passings. (figure 1) Despite everyone’s generalization conviction that self destruction aircraft â€Å"are both sociopathic and silly individuals, numerous political specialists accept that most psychological oppressors are levelheaded individuals with strategic goals.Evans (a political researcher), for instance, contends that fear mongering is a methodology. The individuals who use it need to uncover their motivation, bring the foe into an expensive clash, and incite an overcompensation that will make the adversary look absurd or wickedness, select supporters, and forestall finding the center ground. Robert Pape likewise accepts that self destruction psychological oppression has a basic vital rationale. It is governmental issues more than strict enthusiasm that has driven psychological oppressors to blow themselves up.In Roberts see, â€Å"Suicide-fear monger assaults are not energized by religion yet more as a reasonable vital goal: to constrain present day majority rules systems to expel military powers from the region that the psy chological oppressors see as their country. † While fear based oppression can be viewed as a sane procedure, sentiments of disgrace and shame may settle on self destruction the weapon of decision since they can get their retribution just as simply end their hopeless life, Interviews of bombed aircraft or planes in-preparing uncover that they are striking back at the individuals who mortified or harmed them.On October 4, 2003, multi year old Palestinian attorney Hanadi Jaradat detonated her self destruction belt in the Maxim café in Haifa killing 20 individuals and injuring some more. As indicated by her family, her self destruction crucial in retribution for the slaughtering of her sibling and her life partner by the Israeli security powers and in vengeance for all the wrongdoings Israel had executed in the West Bank by murdering Palestinians and appropriating their properties. The fundamental intention in numerous self destruction bombings in Israel is vengeance for acts sub mitted by Israelis. The planes need to communicate something specific: their foes are answerable for their mortification and eventually for their death.In September 2007 when American powers attacked an Iraqi radical camp in the desert town of Singar close to the Syrian fringe they found histories of in excess of 700 remote warriors. The Americans were shocked to locate that 137 were Libyans and 52 of them were from a little Libyan town of Darnah. The motivation behind why such a large number of Darnah’s youngsters had gone to Iraq for self destruction missions was not the worldwide jihadi belief system, however a touchy blend of edginess, pride, outrage, feeling of weakness, nearby convention of obstruction and strict fervor.A comparable blend of elements is presently rousing youthful Pashtuns to chip in for self destruction missions in Pakistan and Afghanistan. Additional proof that self destruction planes are reacting to mortification is found in the 430 recorded life stor ies of self destruction aircraft which were painstakingly broke down by psychological oppressor specialists Haqqani and Kimmage. Educator Riaz Hassan, writer of a pending book on self destruction bombarding, lets us know. For one, the customary way of thinking that planes are crazy or strict fan is wrong.Typically, most self destruction aircraft are mentally ordinary and are profoundly incorporated into interpersonal organizations and sincerely connected to their national networks. Singular aircraft show no character issue and the assaults themselves are regularly politically spurred, planned for accomplishing explicit vital objectives, for example, driving concessions or producing more prominent help. In addition, the inspirations are unpredictable: â€Å"humiliation, vengeance, and altruism† all drive the person to take part in, and the network to disregard, self destruction bombarding. In fact, as Hassan notes, articipating in self destruction bombarding can satisfy a scop e of implications from the â€Å"personal to collective. † Without understanding these inspirations and tending to them, it would show up the legislatures or associations that look to end self destruction bombings are probably going to be disillusioned. Embarrassment, vengeance and philanthropy assume a key job at the hierarchical and individual levels in molding the sub-culture that advances self destruction bombings. Embarrassment is an enthusiastic procedure that tries to train the objective party’s conduct by assaulting and bringing down their own and others’ assessments of whether they merit respect.Revenge is additionally a reaction to the ceaseless enduring of a bothered network. At the core of the entire procedure are view of individual damage, shamefulness and foul play, and the resentment, anger, and scorn related with such observations. The inspiration for jihad is quite often . . . the quandary of the embarrassed Muslim country, exploited by the join t underhandedness powers of kufr (unbelief, typified by the United States as the foe bowed on the demolition of Islam) and tawaghit (despots who have set themselves up, or are propped up, as divine beings on earth).Although Americans will in general consider self destruction planes as â€Å"individual individuals taking individual choices to execute people† says Timothy Spengler, they normally work as individuals from profoundly organized fear based oppressor gatherings. For planes in-preparing, sentiments of disgrace and humiliationâ€even their individual identitiesâ€are supplanted by ID with the gathering, as therapist Vamik Volkan clarifies: â€Å"In ordinary life, an individual who needs to kill themself has low confidence. For the self destruction planes it was simply the oppositeâ€by slaughtering, you increase self-esteem.These were individuals with splits as a part of their character that could be topped off, as though with concrete, with the enormous gatheri ng personality. So their singularity was eradicated. † Once enlists have related to a fear based oppressor gathering, they are happy to do anything asked by the gathering and face outrageous challenges since they feel powerful. Their individual thought processes and qualities are supplanted by the intentions and estimations of the fear monger gathering, and difference or addressing of the group’s standards isn't encouraged.Men join more an incentive to retribution than ladies; and youngsters are progressively arranged to act in a vindictive way than more seasoned people. It isn't unexpected, at that point, to locate that most self destruction planes are both youthful and male. The way to understanding self destruction aircraft, at that point, is to comprehend the associations and gatherings that enroll and train them to be the individuals you know them as. Understanding the fear based oppressor organization’s rationale is a higher priority than understanding indi vidual inspirations in clarifying self destruction attacks.Suicide bombings have high emblematic worth on the grounds that the readiness of the committers to kick the bucket flags high determination and devotion to their motivation. They fill in as images of a simply battle, invigorate well known help, create monetary help for the association and become a wellspring of newcomers for future self destruction missions. As Cronin closes, â€Å"Although . . . singular self destruction aggressors . . . are not in fact ‘crazy,’ . . . they are frequently controlled by the weights and conviction structures of the group†. The reasons for self destruction bombings lie not in singular psychopathology however in more extensive social conditions.Understanding and information on these conditions is essential for creating fitting open strategies and reactions to ensure the general population. Self destruction bombings are completed by persuaded people related with network based associations. Systems planned for discovering approaches to actuate networks to relinquish such help would diminish support for fear based oppressor associations. Systems for disposing of or if nothing else tending to aggregate complaints in concrete and powerful manners would have a critical, and, as a rule, quick effect on facilitating the conditions that sustain the subcultures of self destruction bombings.Support for self destruction bombarding assaults is probably not going to lessen without substantial advancement in accomplishing probably a portion of the key objectives that self destruction planes and those supporting and supporting them share. The most significant decision a self destruction aggressor makes isn't when to press the trigger, however whether to join a fear based oppressor gathering. (figure 2) Figure1 [pic] Figure 2 References Altman, N. (2005, March/April). On the brain research of self destruction besieging. Tikkun, 20(2). Recovered November 20 2012, from Ac ademic Search Elite database. Atran, S. (2004, Summer).Mishandling self destruction fear mongering. The Washington Quarterly, 27(3), 67â€90. Recovered November 20 from the Center for Strategic and International Studies Web webpage: www. twq. com/04summer/docs/04summer_atran. pdf Cronin, A. K. (2003, August 28). Psychological militants and self destruction assaults. CRS Report

Greek Gods in Antigone

Charles Wallace Mrs. Lopale CP English 10 7 May 2012 The Greek Gods and Their Role in Antigone The Greek divine beings were thought of as the most impressive powers to ever exist in old occasions. Thus, they assumed a crucial job in the Greek people’s lives. Their capacity and impact over the Greek individuals is apparent in a considerable lot of the tales in Greek writing. Zeus, Poseidon, and Hades, the most remarkable Greek divine beings, each had an influence in the account of Antigone by Sophocles. All through the play, â€Å"God† alludes to Zeus, the ruler of divine beings. Antigone’s principle thought process in resisting Creon is that she doesn't think Creon is doing what the divine beings would need. Which of us can say what the divine beings hold insidious. † That statement implies that Antigone doesn't figure individuals can comprehend the manner in which divine beings think. Haimon references Zeus when asking Creon not to rebuff Antigone too crue lly. Creon vows to the divine beings that he will execute Antigone before Haimon. Toward the finish of the play, Creon understands that â€Å"the laws of the divine beings are compelling, and a man must serve them to the most recent day of his life. † The detachment additionally implored Persephone and Hades to ask that Haimon and Antigone are as yet alive. Antigone realized that she would kick the bucket on the off chance that she conflicted with Creon, yet figured slighting the divine beings was more dangerous.She had such a great amount of confidence in the divine beings that she never questioned that she was making the best decision †â€Å"I realize I am satisfying those I ought to satisfy most. † Although the divine beings were infrequently straightforwardly referenced, they were in charge of for the most part everything. (Sophocles. ) There are three fundamental Greek divine beings, Zeus, Poseidon, and Hades. They are the most remarkable divine beings since they are the children of the most impressive titan, Cronus. They rule the three areas of Earth. Zeus is lord of the sky and sky, Poseidon is ruler of the ocean, and Hades is the leader of the Underworld.They got doled out their areas in an irregular draw. (Nerve. ) Zeus is the lord of the considerable number of divine beings. He controls the sky and paradise area, and is the most impressive of the considerable number of divine beings. His weapon is a jolt, wherein he uses to cast helping down at individuals. The bird, staff, or the lightning jolt is typically utilized as an image for Zeus. The Oak tree is additionally a consecrated image of his. Greek humans made numerous penances to him and constructed numerous havens in his respect. In old Greece, any human who professed to be an offspring of Zeus increased moment regard from the other mortals.He was likewise taken a gander at as one of the numerous divine beings, yet God himself. Zeus has been referenced in almost every work of a ntiquated Greek writing that has made due to the current day. (Nerve. ) Zeus’ story is a ton like Oedipus’, Antigone’s father, story. Uranus, the principal lord of the universe, and Gaea, the Earth mother, made a prescience that Zeus would become ruler of the divine beings. Cronus realized that one day, one of his children would oust him, so he gulped each kid that his significant other, Rhea, brought forth. Be that as it may, when the 6th youngster was conceived, Rhea shrouded him and deceived Cronus in to gulping a stone instead.She fled to the island of Crete and left Zeus there, dreading for her security. At the point when Zeus grew up, he realized he was prepared to vanquish his dad. He realized he would require held, however, so he got his significant other, Metis, to take care of Cronus a herb that would make him toss all of Zeus’ siblings and sisters up. It worked, and Hera, Demeter, Poseidon, Hades, and Hestia were liberated. Together, they all c rushed Cronus, and Zeus was the new lord of the divine beings. (Nerve. ) Poseidon is the Greek divine force of the ocean. He is known for being savage and ill humored, and he conveyed a three-pronged lance called a trident.The pony and dolphin are viewed as his holy creatures. Poseidon is frequently alluded to as the â€Å"Earth shaker†, on the grounds that he conveys seismic tremors when he is upset. He is additionally the child of Cronus and Rhea, and is the second most remarkable god. He is one of the three preeminent divine forces of the Earth. (Nerve. ) In one of his hissy fits, Poseidon acknowledged he was not content with his sea area, and needed to attempt to topple his sibling, Zeus, and become lord of the divine beings himself. Poseidon requested assistance from Apollo, the divine force of light and music. Together, they bound Zeus with chains.Zeus had a lot of solidarity and power and liberated himself rapidly. Zeus was enraged with Apollo and Poseidon. As discipli ne, he sent them to fill in as workers for Laomedon, the lord of Troy, a city in what is presently viewed as Turkey. Laomedon guaranteed an exceptionally enormous prize on the off chance that they could fabricate a divider around the city of Troy. Be that as it may, after they manufactured the divider, Laomedon would not respect his understanding and didn't pay them for their work. Thusly, Poseidon and Apollo sent a plague and an ocean beast to obliterate the city of Troy. (Nerve. ) Hades is the Greek God and leader of the Underworld.He is frequently connected with riches and farming. He is likewise the child of Cronus and Rhea and the third most remarkable Greek god. In contrast to his two siblings, his domain can't be seen by anybody living. The Greeks accept that his name, Hades, implies â€Å"The Unseen One. † He is the main god that doesn't live on Mount Olympus; he has his own sparkling castle made of unadulterated gold and pearls in the Underworld. The Greeks accept th at when humans bite the dust, their spirits go to the Underworld. The Underworld is thought of as a dull and melancholy spot, with phantoms flittering around everywhere.When the dead entered the Underworld, they drank from the waterway Lethe to overlook their lives on Earth. That is the point at which they become apparitions. Hades is frequently viewed as the detestable god by numerous individuals of the Greeks. (Nerve. ) Hades carried on with a desolate life alone in the Underworld. He had a captivation by a particular goddess, Persephone, girl of Demeter, the goddess of collect. Hades grabbed Persephone and made her his sovereign. For quite a long time, Persephone requested that she be taken back to her mom, however Hades didn't tune in. Demeter requested that she would not permit anything to develop for the humans until Persephone had been returned.As the humans begun enduring, Zeus concluded the time had come to step in. He requested that Hades let Persephone go. Persephone had just eaten the product of the Underworld, however and couldn't return. Zeus made an arrangement with Hades that Persephone needed to remain in the Underworld for a half year out of the year, and could remain with her mom the other half. (Nerve. ) The Greek divine beings assumed a major job in a large number of the lives in old Greece. Despite the fact that they are not also known or referenced today in Greece, they have a major influence in the writing and history of Greece.Works Cited Sophocles. â€Å"Antigone. † Glencoe Literature. Ed. Jeffrey D. Wilhelm, Douglas Fisher, Beverly Ann Chin, and Jacqueline Jones Rayster. Comlubus, OH: Glencoe/McGraw Hill, 2009. Nerve, Timothy and Susan. â€Å"Zeus. † The Lincoln Library of Greek and Roman Mythology. Vol. 5. Cleveland: Eastward, 2006. Nerve, Timothy and Susan. â€Å"Poseidon. † The Lincoln Library of Greek and Roman Mythology. Vol. 5. Cleveland: Eastward, 2006. Nerve, Timothy and Susan. â€Å"Hades. † The L incoln Library of Greek and Roman Mythology. Vol. 5. Cleveland: Eastward, 2006.

Argumentative Essay Topics With Samples - A Quick Way to Prepare

Argumentative Essay Topics With Samples - A Quick Way to PrepareArgumentative essay topics with samples can be a quick way to ensure that you are familiar with the topics you will be tackling in your paper. There are some really good reasons for doing this, and these reasons will be discussed below.Argumentative essay topics with samples are just one part of the strategy to ensure that you have good grammar and sentence structure in your essay. It is also important to ensure that you have a good grasp of what the topic is all about. For example, if you're going to discuss an historical event, then you will need to make sure that you know what happened in that time and where it happened, what has been written about it and why it is relevant to the topic at hand.The strategy to ensure that you do well in your essay by checking the spelling and grammar of your writing is to ensure that you do not use certain techniques such as using quotes. If you use quotes, then you will be committing the 'unnecessary quotation marks' rule and, consequently, you may lose points for bad grammar.The strategy to ensure that you do well in your persuasive essay topics with samples is to make sure that you study what other people have written on the same topic. If you don't know what other people have written, then you won't be able to write an effective essay on your own. Use reference books, or better still, visit websites that will allow you to download their sample essays, and make sure that you have studied these well.In addition to this, the strategy to ensure that you do well in your argumentative essay topics with samples is to ensure that you select high quality texts. You may be surprised to know that there are some highly qualified people who have not done their academic research before they write a thesis defence.In some cases, you may get an opportunity to research and rewrite your report for your potential employer. Again, the strategy to ensure that you do well in your argumentative essay topics with samples is to make sure that you provide an original and persuasive argument.If you make the effort to familiarize yourself with persuasive essay topics with samples, you should have no problem getting good grades in your academic studies. To ensure that you do well in your argumentative essay topics with samples, you will need to ensure that you have checked out and studied the topic well.The best way to do this is to read some of the examples that are available and to try and learn as much as you can from each of them. This will help you become familiar with what's involved in writing an argumentative essay.

The Human Being Is A Self Seeker Of Preservation And Pleasure

Throughout history there have been many movements and great thinkers that have impacted society and the way that we perceive life and the human being. Thinkers such as Augustine, Hobbes, Aristotle, Kant, etc., have all developed theories of how they perceive the human being and their ethos as well as how a good life should be. Philosophical thinkers like Augustine and Hobbes differ in their beliefs of the human being. Augustine believes that the human being is a god seeker and a being of desire that wishes to find meaning and purpose in life. A good life is a life devoted for god and loving him. Unlike Augustine, Hobbes believes that the human being is a self-seeker of preservation and pleasure, and the perception of a good life is one in which stability is found by civil society. Augustine perceives the human being to be one that contributes to stability and growth in society. We learn how to find fulfillment in the right way unlike a human being that is perceived by Hobbes. Augusti ne’s perception is more accurate than the perception of Hobbes because individuals can achieve peace and happiness and contributes to growth and stability for society. For many years, many thinkers have tried to successfully develop what it means to be a human being and what the good life encompasses based on their definitions. Medieval thinker and Christian philosopher, Saint Augustine believes that the human being is a being of desire and has a longing for meaning and sense of purpose ofShow MoreRelatedDarwins influence on psychoanalysis2338 Words   |  10 Pagesego, the connection between human and animal emotion, adaptive responses and the unconscious mind. Sexual Evolution and Motivation Darwin and Freud both evaluated the connection between biological traits and inheritance as expressed through social constructs, such as sexual impulses and desire. This theory manifests itself by examining human biology, neurology, evolution and applying it to expressed behavioural traits. 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Lorraine Functional Life Skills Teacher Completed Basc IIi...

Brittany Functional Life Skills teacher completed BASC III scales. The BASC III measures a student’s emotional, behavioral, and adaptive functioning. The score that is used for the scale is the T-score. The T-score indicates the distance of a score from the norm group mean. The BASC II has a mean T-score of 50 with a standard deviation of 10. Scores ranging 60 to 69 are considered to be in the At-Risk range. The T-scores that are 70+ are in the Clinically Significant range. On the Adaptive Scale portion of the BASC II, the T-Scores that are from 30 to 39 are in the At-Risk range. The T-scores that are below 29 are in the Clinically Significant range. There were three categories that Brittany’s teacher rated her in the Clinically Significant range (Hyperactivity, Aggression, and Depression). Brittany s T score on Hyperactivity is 84. Brittany s teacher reports that she engages in a high number of behaviors that are adversely affecting other children in the classroom. Brittany is reported as often being restless and overactive, and she may have difficulty controlling her impulses. Brittany s T score on Aggression is 82. Brittany s teacher reports that Brittany displays a high number of aggressive behaviors and may be reported as being argumentative, defiant, and/or threatening to others. Brittany s T score on Depression is 79. Brittany s teacher reports that Brittany is withdrawn, pessimistic, and/or sad. There were six areas that Brittany’s teacher rated

Internal And External Captivity By Langston Hughes

Internal and External Captivity In Literature, there are certain themes and notions that are either hidden within the text or stated boldly in direct statements. These themes allow them to accomplish a particular feeling within the reader or reveal a message that will be exemplified when realized. There can be a connection made to a reality known by all by each and every theme, whether it be social disconnect from a constant being of isolation or a sense of torment from a deplorable action. And by that idea, society and its literature can alter and shape the viewpoints of the world. Through a lens of conflict between freedom and confinement (something that is in constant tandem), it can serve as an interesting theme within a text. In Langston Hughes’ â€Å"The Negro Speaks of Rivers†, he uses imagery to symbolize the important places on the journey the reader has embarked upon and starts with a basis of freedom from a newborn civilization and goes on to explain the conf inement of an ever-changing society who has lost its way. Contrasting with that society, Charlotte Perkins Gilman’s â€Å"The Yellow Wallpaper† showcases the narrator’s captivity within a room and the mechanics of her mind growing more and more chaotic as her isolation from the outside world (mostly her husband) leads to her insanity. Kate Chopin expresses the many freedoms of an upper-class married woman but shines some light on how she is still restricted through this marriage and by her health in her text â€Å"The

Assessing Student Nurse in Planning Patient Care free essay sample

This assignment will focus on the holistic assessment and care plan of a patient who was cared for during practice placement. It aims to discuss how the care planning decisions were made and relate these decisions with the relevant literature. The setting was an emergency trauma and orthopaedic ward and the care plan was developed in order to meets the patient’s needs after 1 week admission. The care plan was compiled by the student nurse and his mentor and aimed to identify the patient’s needs and the necessary interventions to meet these needs. The Nursing and Midwifery Council (NMC) Code of Professional Conduct (2008) states that a person’s right to confidentiality must be respected, therefore pseudonyms will be used to refer to individuals and all personal information used within the care plan are fictitious. Also, consent was obtained from the people involved in this scenario. John Smith is fifty seven years old and was admitted after a fall and consequently left neck of femur fracture. He has undergone surgery to repair his fracture and was able to mobilize with full weight bearing a day after the procedure. However the post-op x-ray three days later has shown a crack fracture below the prosthesis and John was put on bed rest with 5lbs traction on his left leg for six weeks. John was born with cystic spina bifida, and has no motor sensation on his legs, however he was able to mobilise independently using elbow crutches before the surgery. In spina bifida, the spinal cord is damaged or not properly developed and as a result, there is always some paralysis and loss of sensation below the damaged region. The amount of disability depends very much on where the spina bifida is, and the amount of affected nerve tissue involved. Also, bladder and bowel problems occur in most people with spina bifida, as the nerves come from the bottom of the spinal cord, so are always below the lesion (ASBAH, 2010). John is expected to stay in the ward for at least another eight weeks and will be discharged home once he is able to mobilize again. The care plan was elaborated following the model developed by Roper, Logan, and Tierney in the 1970s, which is based on 12 activities of living and link the biological, social and psychological needs required for health (Kozier et at, 2008). This model is widely used on the ward and allows nursing staff to use a holistic approach when planning care. Alexander, Fawcett and Runciman (2007) say that with this model, nursing interventions are grounded in the prevention, resolution, and management of actual or potential problems related to the activities of living, which may be influenced by biological, psychological, socio-cultural, environmental, and politico-economic factors. The assessment using this model integrates the patient’s biographical and health data, thus providing information for both nurses beginning care and the Activities of Living data, which is focused on the patient’s abilities to carry out the activities of living and routines, along with current problems (Roper, Logan and Tierney, 1996). Together with the care plan, other nursing assessment tools were used to aid on the patient’s care. The Nutritional Screening and Prevention and Management of Pressure Ulcers was incorporated to John’s care plan and updated weekly. For the purpose of this assignment, two aspects of the care plan will be prioritised and the decisions made by the nurse when planning his care will be discussed in relation to theory. To identify and assess John’s needs it is necessary to adopt a person centred care approach when assessing him in order to deliver the appropriate care. Potter and Perry (2007) argue that assessment is vital to the nursing process, therefore this approach needs to be patient–centred and can be adapted in accordance with the patient’s needs. Ford and Mc Cormack (2000) argue that the person centred approach represents a development of healthcare services at which the needs of the patient overcome the needs of the professionals and organisations who meet these needs. Kozier et at (2008) consider nursing process as divided into assessment, diagnosis, planning, implementation and evaluation. Aggleton and Chalmers (2000) define nursing models as ways of representing the process, guiding nurses on what to assess and how to obtain information about the patient, as well as planning and delivering care. The development of John’s care plan was based on the Roper, Logan, and Tierney (1996) twelve activities of daily living. Walsh (1998) says that the use of models in nursing practice is a way to facilitate understanding as models are concerned with knowledge about nursing. Carper (1978) (cited in Basford and Slevin, 2003) identified four types of nursing knowledge: empirical, aesthetic, personal and ethical; which have been applied when on decision making process while elaborating the care plan. In order to make nursing decisions effectively it was crucial that actual and potential problems were identified. The model used assists nurses in identifying potential problems using the activities of living as reference. It is also possible to ascertain if these problems are a pattern in the patient’s life or if they are the actual/potential problem, and identify other factors that can influence the activities of life and have been identified before. On admission, John was assessed and his care needs defined following the fracture femur integrated care pathway which is a multidisciplinary document of care; the care plan used in this assignment was elaborated to meet his needs after the bed rest traction being implemented and incorporates data collected by an inter professional team. With the decision to use skin traction as treatment for John’s new fracture the multidisciplinary rehabilitation process which would start just after the surgery has been put on hold and new care plan developed. John potential risk for developing pressure ulcer and his elimination needs will be discussed in depth in this assignment as they are considered the main problems, however, it is important to highlight that all problems identified within the care plan needs to be addressed. Skin integrity is an important subject when caring for patients who are at bed rest and with skin traction. According with Walsh and Crumbie (2007) skin breakdown is a commonly complication of skin traction and immobility. Although the surgical wound was healing nice, John was in risk of develop pressure sore while on traction due factor such as immobility and incontinence. The goal is to keep the skin integrity and avoid further complication. Brooker and Nicol (2003) say that pressure ulcers are preventable and an ongoing assessment and implementation of a holistic plan of prevention can reduce their frequency and distress they cause to patients. It is responsibility of nurses to identify patients that are at risk of developing pressure ulcers (Alexander, Fawcett and Runciman, 2007). The use of Waterlow Pressure Sore Prevention Tool as a complement to the assessment has aid in the assessment of activities of living such as eating, drinking, mobilizing and eliminating based on the patient’s actual condition, and therefore helping in the recognition of the risks of pressure ulcer development. John was identified as being at moderated risk of develop pressure ulcer and a pressure relief mattress was provided as it alternately applies and then removes pressure to areas of the body and is suitable for patients with medium to high risk of developing pressure ulcer. John was able to move himself in bed and the nurses have explained the importance of positioning. He was encouraged to move during day the at least once every 2 hours by a member of the nursing staff. Although John was able to maintain an adequate BMI and has good diet and fluid intake, the Malnutrition Universal Screening Tool (MUST) was incorporated to his care plan and so any weight loss could be monitored as weight loss reduces the subcutaneous fat, eliminating some of the padding between the skin and underlying bony prominences, increasing the susceptibility to pressure ulcers (Carpernito-Moyet, 2004). Skin inspection of back and bottom is necessary every time personal care was provided; also because John does not have lower motor sensation was a necessary regular check on his right heel and leg. Whiteing (2008) advises that skin traction should be removed at least daily for limb washing and skin inspection and pressure area care is essential every two hours. He also suggests that neurovascular assessment should be carried out regularly and that the patient will require general nursing care and physiotherapy to prevent deep vein thrombosis (DVT), chest infection, muscle wasting or foot drop. Elimination was a problem for John and the fact that he could be incontinent of faeces and urine at time also contributes to the risks of developing pressure sore. Constipation is a problem that John has encountered during his whole life due the spina bifida. At home it has been well controlled taking lactulose and senna tablets daily, however being immobile would make it even worse. Lack of exercise reduces peristalsis due to reduced muscle tone of the bowel and abdominal muscles, resulting in fluid absorption and constipation (Brooker and Nicol, 2003). Therefore the nurses should pay attention to the fluid and diet requirements of the patient. Walsh and Crumbie (2007) state that it is important to maintain the fluid intake goal of 2-3 litres daily, also the patient needs to be encouraged to eat a high fibre diet and fruits. The use of medication such as laxatives and osmotic agents also play an important role in the management of constipation on patients who are in the same situation as John. Immobility also can lead to urinary retention and infection (Walsh and Crumbie, 2007), consequently the optimum fluid intake would help to avoid these complications as good hydration reduces the blood coagulability, liquefies secretions, inhibits stone formation and promotes glomerular filtration of body wastes (Carpenito-Moyet, 2004). John has been seeing by the incontinence nursing team in community and finds easy to manage his urinary incontinence using conveen and pads as required. He is able to apply the conveen himself, so the nursing staff needs to make sure that the bag is emptied regularly. Also, it is necessary to ensure that John has clean and dry pads. Potter and Perry (2007) suggest that planning needs is to set priorities for the patient’s care. Goals need to be realistic and based on patient’s needs and resources in order to be achievable. Although care plans enhances the continuity of nursing care by listing specific nursing action to achieve the goals, very often some goals are not achievable in hospital setting due factors such as staff shortness and lack of resources. In conclusion, to write a holistic and realistic nursing care plan is a great commitment. Even though the care plan aims to cover a wide number of different aspects of care, it was felt that some areas can be missed or omitted. For sure it needs to involve the patient in a holistic way and be centred care but it is necessary to define realistic and achievable goals with the setting where the care plan is being applied. Although two problems have been discussed in depth within this assignment, a number of other potential problems have been indentified on John care plan which are directly or indirectly related with the problems discussed and failing in address these other problems clearly would affect the outcomes of the main problems.