The Way To Death free essay sample

There are many different reasons why people do the things that they do in life. The choices people make always have a reason or reasons behind them. In the play The Crucible by Arthur Miller human failings were the cause of the witchcraft trials that took place in Salem in 1692. The human failing’s vengeance, jealousy, fear, hysteria, greed and ambition played major roles in the unjust execution of many innocent Salem citizens. There was a storm of false accusations for personal gain against friends and family that ended with the deaths of good people for being â€Å"evil† while the real evil people were left alive and looked at to be heroic. Together, the human failings jealousy and vengeance began the brutal witch-hunt. Abigail, along with her friends took the liberty of naming the first false witch, Tichiba, after being caught performing a ceremony in the woods to kill Elizabeth Proctor. We will write a custom essay sample on The Way To Death or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Abigail and John Proctor had an affair together until John Proctor realized how wrong it was which left Abigail alone and pining for her old lover. â€Å"You did, you did! You drank a charm to kill John Proctors wife! You drank a charm to kill Goody Proctor!† (Miller 25). Abigail, afraid of the consequences of her actions, decided it would be better for her and her friends if they blamed Tichiba, their servant from Barbados, for forcing them to partake in witchcraft when really Abigail wanted to perform a ceremony to kill the wife of her love and asked Tichiba to teach them songs for the ceremony. Another person who acted upon jealousy and vengeance was Mrs. Putnam against the midwife Rebecca Nurse who had a flourishing family while all but one of Mrs. Putnam’s children had died. MRS. PUTNAM, with a growing edge of sarcasm: But I must! You think it God’s work you should never lose a child, not a grandchild either, and I bury all but one? There are wheels within wheels in this village, and fires within fires! (Miller 34) Rebecca Nurse did nothing to Mrs. Putnam’s children; Mrs. Putnam was just envious that her family dwindled while Rebecca’s flourished. The Salem witch trials thrived on the fear and hysteria that plagued the town. The girls used pretense in the court room to trick people into believing that dark spirits were actually at work. DANFORTH: What is it, child? But Abigail, pointing with fear, is now raising up her Frightened eyes, her awed face, toward the ceiling – the girls are doing the same – and now Hathorn, Hale, Putnam, Cheever, Herrick, and Danforth do the same. What’s there? He lowers his eyes from the ceiling, and now he is frightened, there is real tension in his voice. Child! She is transfixed – with all the girls, she is whimpering open mouthed, agape at the ceiling. Girls! Why do you ? (Miller 117) Although there wasn’t anything on the ceiling, the girls put on such a show, acting truly frightened of the supposed dark force that was lurking, that they ended up making the towns’ people and even the judge’s fall for their ruse. The fear of witches that was already in the town made it so much easier for the girls little act to go over smoothly. Even though most of the court did not know of the falseness of the show that the girls were putting on, Reverend Parris did, and his greed and ambition kept him from telling everyone that there was infact no witchcraft in their town. Parris caught his niece Abigail and her friends in the woods on the night that they were performing their ceremony to kill Goody Proctor, and he questioned Abigail about their actions. Although he knew the truth of what they were doing he decided that he could not have it known that his family was dabbling in unexpected behavior because it would cost him his position. PARRIS: Now look you child, your punishment will come in time. But if you trafficked with spirits in the forest I must know of it now, for surely my enemies will, and they will ruin me with it. (Miller 16) Because Parris coveted his position as reverend so much, he kept vital information to himself which let the witch-hunt spiral out of control when it could have been prevented. All of the events that happened during that time were fueled by people with dark agendas. If it wasn’t for the human failings, it is possible that the Salem witch trials may not have even occurred which would have spared many innocent lives.

Essay on Methods - How to Write an Essay on Methods

Essay on Methods - How to Write an Essay on MethodsWriting an essay on methods in your college course or a thesis is one of the hardest assignments that you have to finish. There are so many different sources that you will need to use in order to write a good essay on methods. There are some things that you can do before you start writing the essay that will help you improve the quality of your essays and make sure that you know what you are doing when you are writing the essay. To help you on your way, here are some tips.The first thing that you need to do is to get out and meet different people and hear their opinions about various subjects. It is always helpful to take courses or programs that you are interested in and look at what they teach and how they use the methods in their writing. You will find that this is a great way to help you understand the different kinds of methods that you will be using. You may find that it will help you to develop your own research techniques and improve your writing skills as well.The next important thing to do is to consider what you want to say about each topic. There are many topics that you can choose from and the methods that you will use depend on what you want to say. Before you start writing, it is important to think about the kind of essay that you want to write.Many times the essay that you write will not be the same as the essay that you originally thought of. So, it is important to consider what you want to say about the subject and how you will do that. It is always good to try different things and see what works best for you. Sometimes it is better to look at different sources in order to see what kind of approach you will take in writing an essay on methods.The third important tip is to consider the level of difficulty that you are writing at. Some students write essays on methods that are easy for them to complete and they will find that they have to read things that are harder to understand. However, you w ill find that there are several essays that are written easier than you would think and that make up for the lack of understanding of the content that you need to put into your essay. For this reason, it is important to understand the different ways that you can write an essay on methods in order to help you make the best choice in order to provide a good reflection of what you have written.The fourth tip is to think about what you will be writing about. If you want to write an essay on methods on a particular topic, it is important to understand the topic in detail. For example, if you want to write an essay on grammar, it is important to understand the different approaches that you can take to build a strong essay on grammar.It is important to remember that you will not only learn from your essay on methods but also how you use the different approaches in order to make the best reflection of what you have written. Writing an essay on methods is no easy task and there are many thin gs that you need to know and use in order to be successful in your efforts.

LDH Purification lab Report Essay Example

LDH Purification lab Report Paper OLD was purified from the ammonium sulfate precipitated protein mixture by affinity chromatography and its activity was studied by spectrophotometers determination of NADIA at 340 NM. From Pierce BCC assay of crude homogenate, initial protein concentration was shown to be 100 MGM/ml. The final protein concentration of the pooled affinity sample was shown to be 0. 2 MGM/ml. It was found that the total specific activity of OLD was 58. 5 mol/min/MGM, and yield of 0. 6%. Even though we were successful in purifying OLD enzyme, further steps can be taken to increase the yield. Materials and Methods Cell Lysine and Extraction of OLD: Approximately 40 g of minced chicken breast eat (40. 327 g) is blended with ml cold extraction buffer in four 30-seconds bursts for homogenate of the muscle tissue. The extraction buffer contained mm Tries-HCI (pH-7. 4), mm 2-Merchantable, mm Phenylmethylsulfonylflouride (AMPS), 1 mm Ethylene Dianne attracted acid (EDIT). The homogeneities procedure was carried out in the cold room to prevent the denomination of proteins. The homogenate was centrifuged at 15,000 RPM for 20 minutes at 40 C. The supernatant was filtered through two layers of cheesecloth to remove lipids from the supernatant. The total volume was noted and three 0. Ml aliquots (crude extract) were stored at -200 C. Ammonium sulfate precipitation: 60% ammonium sulfate concentration was used to precipitate proteins. 0. 39 g of ammonium sulfate per ml of the supernatant was added gradually to the supernatant for 15-20 min with continuous gentle stirring at 40 C. The mixture was centrifuged for 20 minutes at 1 5,000 RPM at 40 C. The supernatant was discarded and the pellet was stored at -200 c. We will write a custom essay sample on LDH Purification lab Report specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on LDH Purification lab Report specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on LDH Purification lab Report specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Dialysis: Ammonium precipitation leads to high concentration of salts in protein mixture that can interfere with further purification steps. In order to remove excess salts, dialysis was performed. The pellet was suspended in Tries-AMPS buffer (10 rim Tries-HCI, pH 8. 6, 0. 5 mm 2-Merchantable, and mm ratio of EDIT) and mixed very gently until it dissolved at 40 C. Volume of ml protein mixture was added in the dialysis tubing and incubated twice overnight with two IL buffer changes (Same buffer as extraction buffer that was used for cell lysine). After two incubation, protein mixture was responded gently and centrifuged for 10 minutes at 15,RPM at ICC. Pellet was discarded, total volume of supernatant was noted and three 0. 1 ml aliquots were collected. Affinity Chromatography: Isobaric Blue column was used to separate OLD from the other proteins. Ml fractions were collected in thirteen test tubes. Column was first rinsed with Tries-AMPS buffer followed by addition of protein mixture. Then, ml AND Buffer (mm Tries-HCI pH-8. 6, 0. Mm 2-Merchantable, mm Lithium acetate and 1 mm AND+) was added followed by NADIA (mm Its- HCI PH 8. 6, mm NADIA and 0. Mm 2-Merchantable). Between each steps, column was washed with ml Tries-AMPS Buffer. Each fraction was subjected to absorbency reading of Mann. For absorbency above 1. NM, 1:10 dilutions were carried out. Activity Assay: We used OLD Enzyme assay to measure the amount of OLD activity in our protein mixture. OLD catalysts the conversion of lactate to private and AND+ to NADIA. The NADI A can be determined spectrophotometers at 340 NM. The OLD assay was performed in the crude homogenate, desalted fraction and six peak fractions from the Isobaric blue column. A cocktail solution was prepared by mixing lactate stock solution (120 rim lithium lactate, 10 mm Tries-HCI; pH 8. 6), AND+ stock solution (12 mm AND+, 10 mm Tries HCI; pH 8. 6) and bicarbonate stock solution (18 mm Enhance, 0. 5 M Nasal) in the ratio of in cavetti. 0 micrometers of the sample is then added and the assay absorption is measured at Mann. If absorbency was above 1. 5, samples were diluted. Protein Assay: The Pierce BCC Protein Assay (Thermo Scientific) is a detergent- compatible formulation based on bioscience acid (BCC) for the colorimetric detection and quantization of total protein concentration. A series of standard solution of Bovine Serum Albumin (BAS) ranging from 0-2000 pig/ml was prepared from a stock solution of 2 MGM/ml BAS. Lull of diluted crude (1:500, 1 :250), desalted (1:100, 1:50), and 6 peak fractions from isobaric blue column (1:10, 1:5) ere loaded in microscope along with lull of BCC working reagent. Microscope was incubated for mini at ICC and then the absorbency was measured at Mann. Results/Discussion The purpose of this experiment was to extract and purify OLD enzyme from chicken muscle tissue using a variety of techniques including homogeneities, ammonium sulfate precipitation, dialysis, and affinity chromatography. Activity and Protein assay were used to track the overall amount of OLD present in the samples. Crude Extraction: Chicken muscle tissue was homogeneity in a blender with cold extraction buffer in order to else cells, releasing OLD into slurry of tissue monuments. Centrifugation separated membranes, nuclei, and other large cellular components to a pellet leaving a supernatant of crude product. Controlling temperature was a major consideration after homogeneities since not only did this step releases proteins like OLD from the cell, but it also releases proteases that can now interact to degrade the OLD. Keeping samples on ice, pre-cooling the buffer, and avoiding excess kinetic energy through conservative blending were methods used to minimize activity of these proteases. After filtration through cheesecloth, our final volume of crude homogenate sample ml, much more volume than expected. Addition of more than ml of buffer volume could have increased the volume. Other possible explanation is that more solid components such as fats were present in the sample and hence, more than 20 minutes of centrifugation was required. Desalted Sample: 60% ammonium sulfate is added to the crude extract that precipitates OLD proteins. The resulting 40% pellet theoretically contains most of the original OLD, which is re-suspended in very less volume (ml) to create a more concentrated sample. This process leads to high concentration of salts in rotten mixture that can interfere with subsequent purification steps. Ml protein mixture underwent dialysis procedure that removes excess salts and our final volume after dialysis was ml. One possible explanation for increase in our volume could be that extraction buffer got mixed with protein mixture either due to tubing leaking or tubing clips not being properly tightened. Affinity Chromatography: Isobaric Blue column is an affinity column, which is specific to dehydrogenate type proteins, due to a compound structurally similar to NADIA being attached covalently attached to the column. 13 fractions were elected and absorbency was measured at Mann to check presence of OLD protein in the fractions. 1:10 dilution was performed if absorbency reading was above 1. NM since it spectrographically indicates saturation and less than 1% light reaching the detector. During the addition of protein mixture (fraction# 4), high absorbency reading of NM was obtained (Fig. 1). This could be due to lot of non-dehydrogenate-type proteins present in our sample that got eluted first during affinity chromatography. Second peak was seen after AND+ was added since AND solution results in the removal of the loosely bound protein. Third peak was seen after NADIA was added since NADIA solution results in release of maximum OLD proteins (Fig l) Enzyme Activity Assay: The OLD activity was measured spectrophotometers by measuring the absorbency of NADIA at 340 NM. Three peak fractions were selected for this assay based on their absorbency values obtained after adding AND+ (fraction# 6, 7, 8) and other three after adding NADIA in the affinity chromatography step (fraction# 10, 1 1 , 12). A huge activity of 141 mol/min/ml was seen at fraction# 7(PUFF ) which indicated that we had lot of proteins present in our sample. Second peak activity was seen t fraction indicating that more OLD proteins is present in this fraction than in fraction# 11 (PUFF) (fig. 1). Based on this information, we selected fraction #10 as for our protein assay. Desalted showed highest activity among all the samples (Tablet ) possible due to errors occurring during dialysis explained previously. Figure 1. Absorbency readings of eluted obtained from affinity chromatography with OLD activity for 6 peak fractions. The desalted fraction was loaded to the Isobaric blue column and proteins were eluted with Tries-AMPS, AND+ and NADIA wash subsequently. The absorbency at 280 NM of eluted were measured after ACH collected fractions. The OLD activity was calculated from the absorbency values obtained at Mann. Protein Assay: We used BCC Pierce Assay to determine protein concentrations in our protein mixture. BAS standard curve was created for series of dilutions ranging from 0-2000 pig/ml and linear graph equation was used to calculate protein concentrations for the samples (Table 1). Based on Table 1, with each subsequent purification step, protein concentration decreases as sample become more concentrated with only OLD protein. Specific activity should increase and total activity should decrease with very purification step as samples get less and less diluted.

The Perversity Of The Congo Essays - Congo Free State, Free Essays

The Perversity Of The Congo Essays - Congo Free State, Free Essays The Perversity Of The Congo In the novel Heart of Darkness by Joseph Conrad one of the major themes is the perversity of the Congo. What is good and evil in the European world becomes distorted and hazy in the heart of Africa. To the outside world white is good and black is evil; it is as simple as that. This philosophy is embodied in Marlows aunt, who believes that his job is to bring light into the land of darkness and to enlighten the savages. This idea, however, becomes corrupted when white objects symbolize suffering and greed instead of good, and light images hide the presence of darkness. Symbols such as, a white rag, white imperialists and ivory, no longer represent the good will of the imperialists, on the other hand they represent the exploitation and chaos that the Europeans have brought to the Congo. The main character Marlow is faced with this confusion as he voyages through the jungle, and he must reevaluate his former opinions, which no longer hold true. The European philosophy is shown through the conversation that Marlow has with his aunt before commencing his adventure. According to her, his job seems clear: to bring civilization and light to the heart of darkness. Instead of focusing on the horrors of imperialism she is disillusioned to believe that it is all for the better. The Europeans, especially the British have no respect for other cultures or other ways of life, and they truly believe that they are helping the Africans. Not by choice but because of the white mans burden they feel the need to [wean] those ignorant millions from their horrid ways(28). To the outside this seems like an earnest motive; however, once inside Marlow begins to see new forms of corruption. Are the imperialists their to help, or are they there to make money to fulfill their greed? He begins to realize that it is not the black savages who represent evil, but rather the selfish whites. This corruption is further shown through the novel with symbols that reveal that perversity of the jungle. None of Marlows previous beliefs hold true in the Congo and he must reevaluate what is light and what is dark. He is confronted with the distortion of images and confusion at the first station. He sees a group of natives in the shade and immediately compares it to hell. As he states: Black shapes crouched, lay, sat between the trees, leaning against the trunks, clinging to the earth, half coming out, half effaced within the dim light, in all the attitudes of pain, abandonment, and despair(35). He notices one figure in particular, one with a white rag around his neck. Is it the natives who create this feeling of suffering or is it the whites? These people are in the shade because they have nothing to live for anymore. The imperialists have destroyed their way of life and now they are eagerly awaiting death. The corruption is not in the black boy, rather in the white rag. What it symbolizes is not clear. Marlow asks, Where did he get it? Was it a badge an ornament a charm a propitiatory actIt looked startling round his black neck, this bit of white thread from beyond the seas(35). Marlow does not know why exactly the boy is wearing the rag; however, he does know that the Europeans brought it - along with suffering and corruption. Rather than bringing light to the natives, they have brought nothing but pain and chaos. This confusion in appearances is show again with the alternative motives of the whites. They are not humanitarians helping a civilization out of good will. They are there out of greed and corruption. Without the presence of society, the inner core of humans is revealed and what is white on the outside is sometimes black on the inside. This reversal of appearances is displayed in all the imperialists that Marlow comes across. One is the manager at the first station. He gives the allusion of being a gentleman with his European clothing and manners, yet inside he is filled with crookedness. In order to maintain this image he must train a native to follow his

Risk Management Essay Example | Topics and Well Written Essays - 500 words - 3

Risk Management - Essay Example However, upon the end of implementation phase, closing a project becomes a necessary point. Closing a project requires careful analysis and often misunderstood from a project management standpoint. This paper will discuss some of the project closures that are challenging for project management. Often times in a project, expectations are not met that are defined in scope and the WBS. Thus, creating contingency strategies is pivotal towards executing a successful project. One of the most pivotal contingency strategy is to have a high incremental cost of resources. Resources are often less expensive when they are bought in bulk, but expensive if they are purchased incrementally. Hence, it is critical to have software and other resources purchased in bulk to avoid paying extra money. One of the biggest concerns for closing a project is the end the finer details of the store. This becomes more problematic the project does not achieve optimal results. This is where the project may fall. For instance, The Project Manager should produce confirmation from the Senior User or User Group that the final product or outcome of the project meets the acceptance criteria.   The fourth element of risk is user testing is one element that can be problematic, especially in an Agile environment. In every given WBS, user testing is defined in iterations. However, user testing becomes problematic given a final holistic approach of the project itself. Even in beta testing becomes problematic, which is definitely an issue because it obliterates quality in a project and creates chaos. Managing change request is another huge issue that project managers have to be well-aware off. This is problematic because change requests are part of any project management. In order to manage change requests, project managers must collaborate with stake holders in order to remove any unclear understanding that dictates the goals and the objectives of the project. Controlling change

The differences in approaces taken by female and male leadings in Dissertation

The differences in approaces taken by female and male leadings in leading change - Dissertation Example According to the research findings there has been a growing involvement of women in the workforce in recent decades and they can be seen participating actively in business and economic development. However, there still exists an imbalance in the male-female ratio in the workforce, and there is a substantial earnings gap between the genders. This inequality is more apparent in the case of women in management. The smaller number of women in top management is indicative of the fact that women do not get to climb the higher echelons in organizations easily. Some researchers call this situation as the glass ceiling, indicating that women, who are meritorious and capable, too may not be able to break the ceiling and enter the realm of top management because of their gender. There has been some research undertaken to assess the reason for the existence of a glass ceiling – or the lack of women who are deemed qualified to occupy positions in upper management. Men are often considered to be more competent than women and it is presumed that men have the leadership qualities that are needed at the higher positions. Researchers have found masculine organizational culture, which is hostile to the female workers, is also responsible for curbing the growth of female leaders. Men are thought to adopt a masculine leadership style, and even women who do pass through the glass ceiling, are expected to keep away from exhibiting their feminine side (Pai and Vaidya, 2009). Ragins, Singh, and Cornwell (2007) explained that while business organizations are struggling to hold on to their best and brightest women, the persistence of the glass ceiling makes retaining top-notch female talents challenging. Dismantling the glass ceiling requires an accurate understanding of the overt and subtle barriers to advancement faced by women, and the strategies used to overcome these barriers. Women leaders are often considered to be passive, overly relationship-oriented and emotionally unsta ble (Northouse, 2009). On the other hand, male leaders are often observed as aggressive, direct and task oriented - qualities which are perceived as attributes of good leaders (Weyer, 2007). The available research has indicated that the general concept of leadership may be one-dimensional and perceived from a masculine point of view (Pai and Vaidya, 2009; Kargwell, 2008; Weyer, 2007; Tibus, 2010; Caykoylu, 2010; Biernat, 2003). The masculine leaders are considered to be more task-oriented and exercise their authority to discipline, correct or reward the employees on the basis of the employees performance (Spurgeon and Cross, 2008). Men are associated with this masculine style of leadership owing to their gender (Thewlis, Miller and Neathy, 2004), while women are considered to follow a more feminine approach which involves being passive and giving importance to relationships over tasks (Thomas and Thomas, 2008). There is a growing body of evidence suggesting that a more relationship oriented leadership style leads to better employee motivation and performance in

Newborn Bloodspot Screening Test

Newborn Bloodspot Screening Test This reflection is on the use of the Newborn Bloodspot Screening Test (NBSST), which is undertaken when the newborn is between five and eight days old. I will discuss how the use of this screening test supports the assessment and well being of the newborn. The model of reflection implemented within my assignment will be the Gibbs reflective cycle (1988). I have selected this model due to the simplicity, as it guides you through the six stages of the reflective process by asking a series of questions, allowing the experience to be transformed into knowledge. Throughout this assignment I will be maintaining confidentiality in accordance with the Nursing and Midwifery Council (NMC) Standards (2004). I will therefore use pseudonyms to ensure the identity of my mentor and clients, remain anonymous. For the purpose of this assignment my mentor will be known as Michelle, the newborn will be known as Theo and his mother as Hannah. Using the Gibbs reflective cycle (1988), the first stage is to describe the event. The event upon which I am reflecting is the NBSST which I performed under the supervision of my mentor Michelle, when Theo was five days old at his home. This was undertaken with the consent of his mother Hannah who was present and observed the test being carried out. The second stage of the Gibbs cycle (1988), is to explore the feelings regarding the event. The view proposed by Bulman (2004, p.141) is that when we least expect it feelings can often affect our learning. Therefore to mention a range of feelings encountered, and the situation in which they occurred, can be useful to the learning experience. I felt in such a privileged position to be undertaking the screening test on Theo as a student midwife under the supervision of my mentor. The NMC Standards (2004), state that, every woman has the right to refuse a student to be involved in their care. Therefore Hannah had the right to refuse consent for me to perform the test, however as I had been involved in her antenatal care and built a rapport with her she was confident for me to proceed. I felt that I had gained both Hannah and Michelles trust this gave me increased confidence in my ability and practice. My mentor held Theo securely in an upright position while I warmed the heel by gently rubbing it, as recommended by Michelle. After washing my hands I cleaned the area on the heel I was going to use to perform the test. Then using the automated lancet I made a small incision in the skin, Theo let out a high pitched cry and Hannah became a little distressed. Following the instructions on the test strip I wiped away the first drop of blood to avoid contamination and subsequently dropped four good samples of blood onto the filter paper of the test strip. As soon as I had finished the test I placed a plaster on the heel and gave Theo immediately to Hannah for a comfort feed. I then filled out the information that was required on the test strip and documented the procedure in the maternity record and the Baby notes. I then notified Hannah she would receive the results in approximately six weeks time and this would be by her health visitor or general practitioner, if there was any cause fo r concern she would be notified sooner rather than later. The testing strip was then posted the same day as per the instructions. Although the procedure went well I did however feel slightly anxious when performing the test, as I was concerned about the number of times I would need to puncture the skin and how distressed Theo would become throughout the procedure. I felt comfortable after successfully obtaining enough blood samples for the test using the technique my mentor had provided me with and relieved that I had caused minimal distress to Theo and reassured as he was easily comforted following the distress of the test. Evaluation is the next stage in the Gibbs (1988), reflective cycle. As suggested by Taylor (2006) evaluation is the element of the process in which the situation is reviewed in light of all the feelings gained. Upon evaluating the experience I believe I had successfully performed the technique, and in doing so had enabled me to collect satisfactory samples for the test. I had excellent communication with Hannah and the continuity of care from the antenatal to postnatal period had enabled her to trust me and my confidence had grown immensely. I had been out on community placement, before so my knowledge base had increased so I was therefore able to use this and the skills I had learnt from my mentor to inform my practice. The negative aspect of the experience was the concern for Theo regarding the pain he would feel when attempting the test, and the high pitched cry that he released upon puncturing the skin was quite distressing for me and his mother Hannah. Following the evaluation of the experience, the Gibbss reflective cycle (1988), states that analysis of the situation is undertaken exploring the experience in greater detail. The NBSST is undertaken on a national scale, the UK Newborn Screening Committee (NSC) (2005), test the samples for metabolic disorders which can be treated, such as Phenylketonuria, Congenital Hypothyroidism, Sickle Cell Disorders, Cystic Fibrosis and Medium Chain Acyl-CoA Dehydrogenase Deficiency. The disorders screened for are subject to regional variations, however in my local placement area, all of these conditions are currently tested for as recommended by the NSC (2005). The purpose for conducting this screening test, is to detect the disorder at a stage early enough to introduce effective treatment to prevent the disease or condition from affecting the newborns development (Johnston, Flood Spinks 2003). The NBSST is not a compulsory test, the National Institute for Clinical Excellence (NICE) (2006), state that for the well being of the newborn, the test must be offered to all parents when their newborn is five to eight days old. They also suggest that the parents should be encouraged to be present when the test is undertaken. This was performed on Theo the fifth day after delivery and Hannah was present for the procedure. The UK Newborn Screening Programme Centre (UKNSPC) Guidelines for Newborn Blood Spot Sampling (2008) (Appendix 3), state that women should be provided with the relevant screening leaflet in the third trimester and no later than 24 hours prior to conducting the test. This has been developed to enable parents to make informed decisions about the screening and well being of their newborn. However a study undertaken by Cavanagh, Coppinger Franck (2005), found that all midwives involved in the study gave information to parents prior to the test, although there were large variations in the timing and frequency in both the antenatal and postnatal period. The UKNSPC (2008) also state that the test should ideally be performed on day five and verbal consent from the parents is required and must be documented in the maternity record and the baby notes. The NMC (2004) also states that midwives must provide the woman and her family with the information to allow them to make informed choices about the care of their newborn in a form that they can understand, and maintain accurate record keeping. McCullough Chervenak (2008), state that informed consent requires the physician to firstly disclose information to the client and must then obtain the clients acceptance or refusal. They must disclose material information, this being what the client needs to know regarding the procedure and what a person of average sophistication should not be expected to know (McCullough Chervenak 2008). This was carried out with Hannah on the visit prior to performing the test, I had asked Hannah to read the leaflet she had been given on discharge from the hospital prior to giving her permission for the test. On the day of the test before I proceeded on Theo I asked Hannah if she had read and understood the leaflet and if she had any questions, she confirmed this and had no questions, Hannah then gave verbal consent for me to continue. Upon completion of the procedure I fully documented the information in Hannahs maternity record and Theos baby notes. Cavanagh, Coppinger Franck (2005), stated in their study that prior to performing the test, the warming of the newborns foot was undertaken in most instances. However Janes et al. (2002), found in a controlled trial that there showed no differences in the time taken to collect blood, the number of repeat procedures required or the behavioural responses of the newborn, between warmed or un-warmed heels. The study performed by Cavanagh, Coppinger Franck (2005), showed that the positioning of the newborn for the test also varied, despite strong evidence to suggest that the newborn should be in a secure position and cuddled when undertaking the test. The UKNSPC (2008) state in their multi professional guideline an automated lancet should be used on the heel and that the heel should be warm and in most cases additional pre-warming should not be required. They also state that the newborn should be cuddled in a secure position for the taking of the sample. Upon performing the test on Theo I rubbed the heel to warm it as recommended by my mentor and Theo was held by my mentor whilst the test was carried out. The NMC (2004), state that other health professionals should be involved in the care of the woman or baby, when a situation deviates from the midwives normal responsibilities. I therefore advised Hannah that she would be notified of the results in approximately six weeks time by her health visitor, and if there were any concerns then both the health visitor and General Practitioner would be notified and she would be informed as soon as possible. Shepherd, Glenesk, Niven Mackenzie (2005) suggests that the procedure of the screening test is easy to complete however the pain experienced by the newborn and the anxiety of the parents is of concern. When performing the test on Theo I was successful in obtaining a satisfactory sample with only one incision however it was evident that this had caused pain due to the immediate cry upon commencement. In conclusion the neonatal screening test is an important element of the care and well being of the newborn, if these conditions are identified, early treatment can improve health and prevent severe disability or even death (NSC 2005). The new guidelines published by the UKNSPC (2008) reflect the findings from studies I have researched and are based on the recommendations concluding the studies. My action plan for the future is use to evidence based practice when performing the NBSST taking into account the factors highlighted in this assignment with regards to warming of the heel and positioning of the newborn. I am confident in my skills with regards to the incision using the lancet and my communication with the parents.