Evaluation of the commercialization Essay Example for Free

Evaluation of the commercialization Essay This paper discusses and evaluates both the negative and positive aspects and raised controversial issues regarding Bt-Corn, a transgenic maize developed through genetic engineering and biotechnology methods, and will finally conclude that the commercialization of Bt-Corn breeds for the past 14 years have been both economically advantageous and beneficial for the environment. The purpose of this paper is to further educate and inform the general audience regarding issues relating with genetically modified organisms and will try to disprove negative speculation and ambiguity with statistical data and experimental evidence. Introduction Recent development and advances in the field of biotechnology and genetic engineering has enabled scientists today to improve crop varieties through alteration of their most fundamental building blocks, their DNA. These alterations of the genetic material allow scientists and researchers to develop ‘new species’ and breeds of organisms which posses certain altered favored traits, which would not otherwise naturally exist in the organism. (Peairs, 2007) However, there is much ambiguity and controversies surrounding the whole field of genetic engineering of organisms and their commercialization. Bt-corn, a breed of transgenic maize whose genetic material has been altered to include the ability to produce a certain toxin that has specific insecticidal property against pests, has been commercialized now for several years in the US and also in several other countries such as Canada, Germany, Spain, Argentina, Honduras, South Africa and the Philippines. (Wu, 2006) The prefix ‘Bt’ from Bt-Corn originates from Bacillus thuringiensis (Bt), a species of soil bacterium that produces the insecticidal crystal protein or delta endotoxins, toxins that kill crop pests. Genetic engineering has allowed scientists to take the single gene that controls the production of the delta endotoxins from Bt, create a modified version of it and synthesize it with the DNA of selected corn species using recombinant DNA technology. This new set of ‘genetic code’ allows the plant to produce the delta endotoxins by itself; hence it is able to repel crop pests by itself. This newly acquired attribute is like a miracle for farmers, not just corn farmers since the insecticidal attribute of ‘Bt’ has also been implemented in several other crops such as Bt-potatoes and Bt-sweet corn. However, there have been several issues raised against the commercialization of Bt-corn in recent years due to investigations, which reveals how Bt-corn pollen proves to be lethal to other species of organisms that are not considered as pests. (Peairs, 2007) This paper will discuss, evaluate and finally demonstrate how the commercialization of Bt-Corn breeds is overall both economically efficient and beneficial for the environment through the following points: * Origins of Bt and Bt-Corn * Mode of action of Bt toxins Economical and environmental advantages of Bt-Corn * FDA regulations on genetically modified organisms * Controversies and issues raised * Evaluation Origins of Bt and Bt-Corn As previously stated above, Bt-Corn is a breed of transgenic maize whose genetic material have been altered and combined with the insecticidal crystal protein-producing trait of the common naturally occurring soil bacterium, Bacillus thuringiensis. Shigetane Ishiwata, a Japanese biologist, was the first to discover Bacillus thuringiensis (Bt) in 1901. However, it was not until Ernst Berliner rediscovered it in 1911 in Thuringia, Germany, that the bacterium was named Bacillus thuringiensis. In 1938 a French company started commercially producing the combination of the bacterium and its toxin crystals as a pesticide, calling it Sporeine, and in the 1950’s American organic farmers started using Bt on their crops as a way to control pest. (Aroian) As research methods improved (1960’s) and new Bt species were found producing thousands of other specific toxic proteins, more and more farmers started to use Bt. However, it was not until advancements in genetics and genetic engineering in the 1990’s that researchers were able to detect and isolate the specific genes that trigger production of the toxins and transfer it into certain species of crops, such as Bt-Corn. The first Bt crop that was registered with the USEPA (United States Environmental Protection Agency), which allowed for its commercialization, is the Bt-Corn. (Aroian) In 2004, Bt-Corn comprises more than ? of the total acres of cornfields in the United States itself. Wu, 2006) According to Clive James, the chair of the ISAAA (International Service for the Acquisition of Agri-biotech Applications), today (2002) the total Bt-Corn fields in the world approximates to 25 million acres. (James, 2002) Mode of actions of Bt toxins Bacillus thuringiensis produces certain proteins, categorized as crystal proteins, which are very specific, well known for its ability to target and inhibit specific metabolic processes of certain speci es of organisms, mainly insects. Investigations have revealed that most of these insecticidal crystal proteins, when activated (when they come into contact with their specific host), attaches itself to the epithelium cells of the gut of the insects and causes the generation of pores in the cell membranes. These pores in the membranes of the epithelium cells, outermost cells that line the surfaces of structures, such as the gut, of organisms, disrupts the osmotic balance of the cells, causing them to swell and lyse. (Hofte, 1989) In simpler terms, basically these proteins (toxins) cause imbalance of water absorption (osmotic imbalance) in the cells of the ‘organs’ of specific insects, which causes these cells to swell and break (lyse). They are also very specific and selective on the species of insects they are able to affect, making Bt toxins potent in eradicating pests while being relatively harmless towards other organisms. There is substantial evidence that the toxins (insecticidal crystal proteins) are not harmful to human health nor are they detrimental for the health of vertebrates (mammals, reptiles, amphibians, birds, bony fish and sharks). According to Peairs, these toxins are considered to be very selective and very safe for humans and non-targeted organisms when compared to the most conventional and common pesticides used nowadays since they only attack certain groups of insects. (Peairs, 2007) Economical and environmental advantages of Bt-Corn It has been several years now, more than a decade, since the commercialization of Bt-Corn breeds and now more than ever, we are able to see statistical data and actual evidence that overall, using Bt-Corn is both economically efficient and beneficial for the environment. Economic advantages of Bt-Corn According to a study by Brookes, there have been substantial net economic benefits at the farms, totaling up to $5 billion in 2005 and $27 billion during the first decade (1996-2005) of the commercialization of genetically engineered crops. For the genetically engineered maize species, including Bt-Corn and other forms of genetically modified corn, boosted farm incomes by over $3. 1 billion since 1996. In the United States alone genetically modified maize crop income benefits accumulates to a little under $2. 3 billion, which is about 88% of the world GM maize crop income. (Brookes, 2006) The main reason for its economic advantage is its ability to produce higher yields of the same, or even better, quality of produce compared to ‘organic’ corn because two reasons. The first reason is that since pests are not lured to the crop, they unhindered and are able to flourish and produce more yields. The second reason is that the ability to self-pro duce insecticidal toxins allows farmers to cut down costs to maintain the crop since they do not have to purchase massive amounts of pesticide. This also means that less time will be spent on crop walking and the application of pesticides and herbicides, less usage of energy associated with less spraying, savings in costs of machinery and machinery usage (from less spraying and reduced harvest times) and also the unseen benefits in the health and safety of farm workers that is caused by handling pesticides. (Brookes, 2006) Environmental advantages of Bt-Corn The usage of Bt-Corn allows farmers to stop the usage of environmentally hazardous chemicals, may it be pesticides or herbicides. Overall between the years 1996 and 2005, GM crops have caused the net reduction in the environmental impact on the cropping area by 15. 3% while the total volume of active ingredient usage has also been reduced by 7%. Specifically in the GM maize sector there have been a net reduction in the environmental impact on the cropping area by 4. 6% through the reduction of pesticide usage and another net decrease in 4% in the environmental impact through the usage of more environmentally benign herbicides. Brookes, 2006) There has also been a decrease in greenhouse gasses emission; excess greenhouse gasses emission is a factor contributing to global warming. Brookes states in his article, that the two main reasons for the decrease in green house gasses emission is due to two factors. The first being reduced fuel usage from the less frequent need of using pesticides and herbicides applications (machinery used for spraying). From 1996 to 2005, it is estimated that there has been a reduction i n carbon dioxide emission of 4,613 million kg, calculated from the reduced fuel usage of 1,679 liters. In comparison, the permanent carbon dioxide savings from reduced fuel usage from 1996 to 2005 by planting GM crops is equivalent to the removal of 2. 05 million cars from the road for one year, assuming that a car does an average of 15,000 km per year, producing 2,250 kg of CO2 per year based on the fact that an average family car produces 150 grams of CO2 every km. (Brookes, 2006) FDA regulations on genetically modified organisms With the development in genetic engineering and biotechnology there is urgency and a need to both control and oversee products and methods used, especially relating with food products. The Food and Drug Administration (FDA), the Environmental Protection Agency (EPA) and United States Department of Agriculture (USDA) are the three main supervisors of genetically modified foods. The FDA, the official government agency in charge of regulating food, drug and cosmetic laws and ensuring safety of food (other than meat), food additives, medicines, medical devices, veterinary drugs, cosmetics and genetically modified food products, plays the major role in the actual ‘screening’ of products that are available for the public. The FDA categorizes genetically modified food products under the ‘GRAS’ list; the GRAS list comprise of products that are ‘generally recognized as safe’, which demands the manufacturers to be responsible for the safety of their own products, allowing them to place products into the market without pre-approval of the FDA because whole foods are GRAS. Whole foods are foods that are unprocessed or unrefined such as unprocessed meat, poultry and fish, fruits and vegetables, and non-homogenized milk (basically unprocessed milk; straight from the animal). The manufacturer bears responsibility for ensuring the product is not adulterated or misbranded. However if there is proof that the product is adulterated, or detrimental to human health (animal health for animal products), then the products may be taken back from the market and the manufacturer may be prosecuted. (Gertsberg, 2009) Controversies and issues raised The development and continuation of research in the whole issue regarding genetic engineering of any organisms itself raises much issues. However, most of the issues raised within the field of genetically modified organisms (GMOs) are issues regarding perspective and ethics, since there is much fear and ambiguity that most people feel when they think and speak about this issue. Controversies with genetic engineering There are not enough, if there are any, substantial, academic, plain physical experimental proof that genetically modified organisms are hazardous to both the health of humans and the environment. The main issues raised regarding GMOs are that there is a risk there new allergens will arise from the ‘unknown’ effects of combining different DNA sequences with each other, increased toxicity levels in organisms do to a faster metabolism, the possibility of unwanted/unintended gene transfer between different species, loss of biodiversity and basically unknown possible effects on different organisms related. (Turner, 2007) There are also several other ethical issues raised, such as the monopoly of world food production by several ompanies, problems with intellectual property and non-mandatory labeling, which is the case in the United States. Non-mandatory labeling violates the rights of consumers to choose between ‘organic foods’ and genetically engineered foods. Monarch butterfly issue and Bt-Corn Several years ago, an issue was raised regarding how non-pest (non-targeted) species of organisms, the Monarch butterfly species in this case, were affected by t he delta endotoxins contained in the pollen of a certain species of Bt-Corn. The issue revolves around how Monarch butterflies population was in danger of being killed through the poisoning by the Bt toxins. Monarch butterflies would migrate and lay their eggs on areas near the Bt-Corn fields. Their larvae feed on milkweed plants, a species of plants that grow in same regions as the Bt-Corn. However, Bt-Corn pollen would scatter throughout the area and lay on these leaves. Several investigations revealed some mortality in Monarch butterfly caterpillars that consume these pollen-covered milkweed leaves. (Peairs, 2007) Following the recent controversy, a number of private parties assembled and conducted workshops and investigations regarding this issue sponsored by the Agricultural Research Service (ARS) of the United States. Scientists and researchers were assembled from U. S. and Canadian universities, ARS members and several other environmental organizations, in a joint effort to prove whether the issue has a scientific basis. (Hellmich, 2008) Laboratory experiments done with pure Crystal toxins (Bt toxins) mixed with artificial diets revealed that a certain type of Cry toxin, Cry1Ab, was harmful to Monarch caterpillars but other types of the Cry toxins were not toxic to them. Field studies done along with lab experiments conclude that there were not any adverse effects observed on the Monarch caterpillars who fed on milkweed leaves dusted with natural levels of the commonly found Bt-Corn pollen species. All but the single Cry toxin proved to be safe. The results of this experiment caused for the termination of the production of Bt-Corn species 176, which expressed high amounts of Cry1Ab toxins. (Hellmich, 2008) Several other studies were conducted to compare between the mortality of Monarch caterpillars in agricultural and non-agricultural habitats, where there aren’t any Bt-Corn species in the area. Results from this experiment show no significant differences in mortality rates of the caterpillars. (Hellmich, 2008) Another study conducted compared the mortality rates of Monarch caterpillars exposed to Bt-Corn species and ‘organic’ corn species with the commonly used pesticide, cyhalothrin. Experimentations revealed how, â€Å"†¦nearly all monarch larvae on milkweed plants inside the field were killed. † Hence Bt-Corn is safer than traditional commercial insecticides and pesticides. (Hellmich, 2008) The final risk assessment brought forth by Hellmich regarding the Monarch population and Bt-Corn is that the risks are negligible since exposure of the Monarch caterpillars to Bt-Corn pollen is low. Furthermore, the current commercially available Bt-Corn species and hybrids revealed low toxicity. Hellmich concludes that, â€Å"The bottom line from these studies is that all commercial Bt corn hybrids have negligible effects on populations of monarch butterflies, especially when compared with traditional insecticides. † (Hellmich, 2008) Evaluation In conclusion, through research and investigations conducted by researchers across the world, we can see how the commercialization of Bt-Corn for past 14 years have significantly benefitted both society and the environment through the ability of farmers to cut down costs, usage of energy, fuel and CO2 emissions into the atmosphere, increase in yields and decrease in the use of harmful chemicals such as pesticides and herbicides. We also see that most of the issues raised surrounding the issue of Bt-Corn and genetically engineered organisms are mostly just a matter of perspective and preferences. Lack of education and an open perspective regarding genetically modified organisms is the main hindrance towards improvements in the current agricultural field.

Midwife Views on Amniotomy to Speed Up Labour

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

Self-Discovery in Oates Naked Essay -- Oates Naked Essays

Self-Discovery in Oates Naked  Ã‚   While other, less accomplished writers use violence to shock or provoke, Joyce Carol Oates is usually more subtle and inventive. Such is the case in "Naked," the story of a forty-six year old woman whose placid outer identity is ripped away by a brutal assault while out hiking not far from her fashionable, University Heights neighborhood. Like many of Oates' stories—and in this regard she probably owes something to Flannery O'Connor—"Naked" focuses on a woman so entrenched in her rigid self-image that nothing short of violence could make her vulnerable to a humbling, though redemptive, self knowledge. The protagonist, a stolid, college administrator, prides herself on her liberal views and anti-racist, fair mindedness. Curiously, she remains unnamed throughout the story, though not without reason. Her namelessness brings us closer to her inner world while at the same time obliquely suggesting that, given these same violent circumstances, she could be anyone, even you or me. Names represent a kind of social identity, and Oates' main interest here is in exploring what might happen when her character's social framework and the comfortably predictable life that goes with it are suddenly, and irrevocably, taken away. This, of course, is precisely what happens. What then, Oates seems to be asking, would be left? The answer, which is feverishly detailed in the remaining thirteen pages of this sixteen page story, is something this woman would never have asked for nor anticipated. Like most people in her social sphere, the woman takes for granted the civility and restraints that have kept her, prior to her attack, comfortably exempt from the personal chaos that violence unleashes. All of... ...the story concludes with the woman "crouched," still naked, "in the underbrush" below her house and marveling how strange it is to be seeing her husband at last after "having wanted so desperately to get home," and yet now feeling "no emotion" at what she saw. (138)    Works Cited Hillman, James. Eranos Lectures 8, "On Paranoia," by Hillman. Dallas: Spring Publications, 1986. Oates, Joyce Carol. "Naked." Heat and Other Stories. By Oates. New York: Plume, 1991. Robinson, Sally "Heat and Cold: Recent Fiction by Joyce Carol Oates," Michigan Quarterly Review, Vol. XXXI, 1992. Notes 1. Robinson, Sally. "Heat and Cold: Recent Fiction by Joyce Carol Oates." Michigan Quarterly Review, Vol. XXXI, 1992. In Contemporary Literary Criticism, Vol. 108. 383. 2. Hillman, James. Eranos Lectures 8, "On Paranoia." Spring Publications, 1986. 13-14.      

jack landon :: essays research papers fc

The idea of peaceful rebellion through nature is the basis for many books. Kipling was one of the first one to do it through many of his novels, but Jack London got a lot deeper into that concept. He was born in 1876 in San Francisco, an illegitimate child born to a single woman, but his mother did marry a man named John London, and named her son John London. This family moved a lot, but ended up in San Francisco again where John London, now known as Jack London worked in the bay patrol. Jack was one of the first ones to go to Alaska in the time of gold rush, he did not get rich with gold, but he recorded the Alaskan life and put it in his books. The series of books about Alaskan life are some of his most known works, such as "The Son of the Wolf" and White Fang, in which Jack London portrays the similar themes of the hard life in Alaska, the learning experience of men and animals, and the lifelong fight for survival. Oh what a hard life it was in Alaska. But why would anyone go there if it was so hard, one might ask. (Glass, 529) Well it was the gold rush of eighteen ninety eight, many looked north for a way to get rich easy, some looked for adventures, but there were not many of those. Jack London portrays the hard lives of the adventurers who went to the Klondike River valley for gold, but got a lot more than they burgeoned for. In one of the stories, from a collection called "The Son of the Wolf", Jack London described a mad hunt for gold. A person enters the yet innocent soil, near a stream, and as soon as he does, starts digging hungrily for gold. He finds some, but not even enough to keep, so he throws it away. He works without food for many hours, so engulfed by his task, that he doesn't even see that it's dark. This continues for several days, until he finds a lot of gold, by then the valley looks line a minefield. While digging he is shot in the back by a thief, but so overtaken by greed, he manages to beat his assassin down and kill him. And what's ironic, he wouldn't even touch a deer, but as his treasure is threatened to be taken away from him, he kills a person.

mississippi burning trial Essay -- essays research papers

The Mississippi Burning Trial† was not for the cold-blooded murders of three young civil rights workers, but rather for the violation of their civil rights. The federal government wanted to break Mississippi’s â€Å"white supremacy† stronghold on the South. â€Å"The Mississippi Burning Trial† proved to be the opportunity to do so. The three branches of the federal government and their various departments were actively involved in bringing about this civil rights trial in Mississippi and these activities and personal views are well documented in court records, department records, and the press. The federal government’s Michael Schwerner, James Chaney, and Andrew Goodman were working to register black voters in rural areas and small towns of Mississippi. Their deaths were brutal at the hands of local Klu Klux Klan members. Brutality, however, was the norm for dealing with â€Å"outsiders, niggers, and nigger lovers† who dared to try to force Mississippi to change. The violence and racist language that make our skin crawl today was not only accepted by the majority of white Mississippians, but was openly practiced. Being of like minds,the powers of Mississippi knew they could count on one another for support from the local to the national levels. The federal government had the manpower, communications network, and finances to break apart Mississippi’s white racist unity. If racial equality were to succeed in the South, it would have to come by way of the powerful federal government. In 1964 The Student Non-Violent Coordinating Committee (SNCC) organized a 600 volunteer campaign to go into Mississippi and register black voters. It would be highly dangerous for there was little to no protection offered by local and county officials against KKK violence. J. Res Brown, one of only four black lawyers in Mississippi warned, â€Å"You’re going to be classified into two groups in Mississippi: niggers and nigger-lovers, and they’re tougher on nigger lovers.† Michael Schwerner, a Jewish New Yorker, had already spent six months in Mississippi working for the Congress of Racial Equality. He knew how bad it was in Mississippi. He described Mississippi, â€Å"Is the decisive battleground for America. Nowhere in the world is the idea of white supremacy more firmly entrenched, or more cancerous, than in Missi... ...Sheriff Lawrence Rainey. Three defendants had no verdict. Judge Cox sentenced Bowers to ten years and Cecil Price to six. In defending his sentences Judge Cox was quoted as saying, â€Å"They killed one nigger, one Jew, and a white man. I gave them what I thought they deserved.† The South was shocked that even seven of the defendants were found guilty; the rest of the nation was relieved. The Imperial Wizard of Mississippi’s Klu Klux Klan was sentenced to prison. The arrogant Judge Cox had been humbled. "The Mississippi Burning Trial† was the first trial in Mississippi history where white jurors found white men guilty of crimes against â€Å"outsiders, niggers, and nigger lovers†. The controlling white supremacist mentality of Mississippi had been cracked. From the President of the United States and the US Supreme Court to the FBI field workers and Navy Sailors, the federal government had invested a great deal of man-hours and money into this civil rights trial. The federal government viewed this partial victory as a giant step towards civil rights equality not only in the state of Mississippi, but the rest of the South.

Interface Culture: New Technology Transforms the Way

Steven Berlin Johnson is known for his reputation of being able to scale what the future holds through a differential paradigm that he sets basing from the present society. His ability to do so has made most of his books a must read especially for those who are enthusiasts of change. Through the researches that he does, he has made it certain that the changes in the world that affects the human society are clearly explained and outlined as to how they positively or negatively affect the human development.Through this, social and technological developments have been widely used as a topic for his books. Steven Berlin Johnson at present continues to startle the world of book-publication with his style of research and writing. He lives with his wife and two sons while he continues to write other books and do several columns for the internet at www.stevenberlinjohnson.com and he is the present editor of the Wired Magazine. He also continues to share his ideas to the young generation by b eing a resident writer in the Journal paper of the New York University Department of Journalism.Among his other works include â€Å"The Ghost Map: The Story of London’s Epidemic and Hoe it changed Science, Cities and the Modern World†. This book has also been   one of the best selling published work of Johnson after he launched the â€Å"Interface Culture†.I.About the BookInterface Culture showed that one of the greatest advancements that the human society ever jumped into for the past ten decades was the development of the cyberspace or the Internet. Before the said advancement, it could be observed that seas and mountains have separated the world, and that people were living in two different sides of the world and that communication from both sides was not that easy to incur.However, with the introduction of the cyber world, everything changes. It just happens that with just one click of a button, an individual could already be wired through to the world. Th is is the idea that Johnson point out in his written work. This book has been mainly devoted to help the society see the actual effects that the internet caused the cultures and the personal and behavioral development of people at present.Certainly, it is through this book that Johnson himself tried to outline the future possibilities that could be brought about by technology in changing the actual view of the society as a whole to the reality of culture mixing and global peace as well. It could be noted that through this written work, he naturally gave life to the widely used system of communication. He clearly points out that a world without computers is quite unimaginable for the generation that has just been born today. To them, it would the past years without the existence of computers may have been quite boring an uncivilized. Yes, cyber world has completely changed the views of the society from what is necessary and what is simply a luxury in life.II.Summary of the BookInterf ace Culture focuses of technological advancements of communication, particularly the internet, and how it affects the society at present. The said book by Johnson has been mainly a rhetorical writing that helps the readers understand the reality of â€Å"Interface† and the great impact that it has upon the lives of those who are directly linked to the said technological development.The interface avant-garde has quite been the core idea of the discussion that Johnson has presented in this book. The use of GUI’s (Graphical User Interface) have made it possible for certain individuals, even those who are not specifically involved in the usage of the Internet has caused much individual advancements among people in the society. It is mainly pointed out in this book that the changes that the introduction of the cyber world has radically performed social connection among races around the globe.Among the said advancements, Johnson focused on the social impact of the said Inter face. Cultures from around the world are already wired together and are thus able to learn about each other with just a click of the button. It could not be denied that it is through the Internet that people are educated about what happens on the other side of their own share of the globe.Yes, the world became smaller and the nations became close neighbors. The Internet even surpassed what televisions could provide through actual-time-video-streaming. What happens within other countries could easily be observed by other through the connection that they have. With the Interface culture, anything is possible. Working, studying, researching and other things could already be done anywhere using a computer and the connection that the Internet provides.With the existence of the cyber world, anything becomes possible and everything becomes easy within reach by anybody who is wired to the Interface Culture.III.The Main Theme and IdeaThe Internet is the doorway to interface culture (Johnson, 5). This is the most significant claim that Johnson particularly send to the readers through his book. It is through the wired culture that the society is connected to one another giving them the chance to understand people form all over the world and thus gain a wider perspective of why things happen.It also opens up the mind of the people to the possibility of gaining peace through the wired connection that they have. Although discrimination and things a like has not been removed, it could be observed that cross-cultural relationships has been constantly developing ever since the Internet has been introduced.However, along with the great provisions that the Internet provides the society, it could be noted that there too are those disadvantages that it brings the world. As it could be noted, it is not only the positive things that are presented through the Internet, there also exists several fraud and chaotic reports that are presented through cyberspace. However, it is upon the u sers’ discretion on which kind of reported occurrences he should believe and thus be affected by such. It still remains true that the actual development in the society still lies within the people’s decisions and not through the technological breakthroughs that the Internet makes accessible to the society.IV. The Book’s Relation to RealityWithout any doubt, the book of Johnson clearly gives an actual view of the present society as to how it is directly affected by the development of technology. Certainly, because of the fact that everything in the present society of man is affected by technology and the existence of Internet, it is thus helpful that the realities behind the existence of the said invention is directly presented to readers.As for the author of this paper, the important impact that it brings is simply the fact that the book covers much of the present situation of mankind as directly related to the cyberspace involvement. The said development has be en causing several changes that impacts people’s lives as common individuals. The strong effect that computers along with internet-based communication provide has mainly re-shifted the views of the entire society from traditional to a completely modern perspective of life and living as well.V. Evaluation and CritiqueAs an overall reaction upon the work done by Johnson in his book, it could be observed that his researches proved to be much helpful in helping the readers realize the impact of Interface Culture in their lives.Some may have used the Internet for several years now and yet not realize the fact that they are already a member of an existing society that are wired through the cyberspace. The international connection that the current communication technology provides has been clearly one of the focuses of the book, which helps the readers understand the clear effect of technology in their lives.Johnson has clearly defined what Interface Culture is and has mainly identi fied the need of everyone to both understand and be cautious to what the Internet, or cyber connection gives them access to. Basically, his enthusiasm and his knowledge on the background of the topic that the book discusses has made the book a must-read and a source of informative passages that would be greatly helpful for one to understand the importance of the emergence of technology and its interconnection with communication developments.VI. ConclusionThe present society is living in a â€Å"wired-community† of the cyber world. With a closer look on the idealisms that Johnson portrays in his book, people would realize that indeed, the Internet and computer-technology have been able to take over the most important developments in the human society.The economy, the individual development through education and thing alike has been made available to everyone through the Internet. This is the reason why interface culture has been regarded as the modern way of living. Yes, there are still a lot more to expect in the future, and there is nothing the society could do, but to be prepared on the changes that may happen in the future.BIBLIOGRAPHYSteven Johnson. (October 6, 1999). Interface Culture : How New Technology Transforms the Way We Create and Communicate. Perseus Books Group; Rep Sub edition. ISBN-10: 0465036805.W.Colston Leigh Inc. (2007). Steven Berlin Johnson Biography. http://leighbureau.com/speaker.asp?id=327. (April 3, 2007).

Gaddafi Essay

The person that I chose to represent Machiavelli’s ideas is Muammar Gaddafi. He is the longest serving head of state in the world next to Queen Elizabeth II. He is known for his controversial political strategy and his very unusual personality. Gaddafi is easily spotted in animal skins and colorful clothing. His name regularly pops up on lists of the worst dressed world leaders. Ronald Regan named him the â€Å"Mad Dog of the Middle East. † Muammar Gaddafi’s reputation ranges from a popular revolutionary to an international reject. Gaddafi graduated from the University of Libya then continued to pursue a British military education. While in Great Britain he began to devise a plan to overthrow the Libyan monarchy. In 1969, Libyan King Idris was overthrown by a small group of Gaddafi’s Junior military leaders. A year later, being inspired by Egyptian President Gamal Nasser, he decided to close US and British military bases and expel all Italians and Jews. While trying to enforce Islamic socialism, he banned alcoholic beverages and gambling and failed at trying to unite Libya with other countries. By the mid-1980s, he was widely regarded in the West as the principal financier of international terrorism. He was also accused by the United States of being responsible for direct control of the 1986 Berlin discotheque that killed three people and wounded more than 200, of whom a substantial number were U. S. servicemen. Gaddafi’s adopted daughter was killed in a bombing of Libya that was retaliation for the U. S. After that two Libyans were accused of placing a bomb on Pan Am Flight 103, which exploded and killed 270 people, Gaddafi refused to give up the suspects to America or Britain. Gaddafi finally admitted responsibility for the attack in 2003 and paid more than $2. 7 billion to the families of the victims, initiating the end of Libya’s international isolation. Now in Machiavelli’s â€Å"The Qualities ofa Prince† the very first paragraph talks about how everything dealing with the government is viewed through a military lens. Machiavelli doesn’t believe that the prince is a man who is skilled in many disciplines, but he believes that the prince should own a responsibility to make sure that whatever he governs is stable. Gaddafi took responsibility for Libya by creating his own form of government called Jamahiriya, in which the nation is governed by the masses or local councils and he defended his government by saying, â€Å"There is no state with a democracy except Libya n the whole planet. Machiavelli also raises the question whether it is better to be loved than to be feared. In the twelfth paragraph he states â€Å"†¦ l say that every prince must desire to be considered merciful and not cruel; nevertheless, he must take care not to misuse this mercy. † It is said that Gaddafi’s examples and though ts inspire the struggling troubled masses and haunts the ones doing the trouble. This is why he is loved by people of the world, but feared by the ruling cliques who know that his words and actions expose them for what they are.