Does the Conservative- Liberal democrat coalition have coherent Essay

Does the Conservative- Liberal democrat coalition have coherent ideological roots - Essay Example Despite the differing ideologies held by the Conservative and Liberal Democrat parties, they were able to come up with a coherent plan with which to run the country. The ideological roots of the coalition were introduced because the two parties needed a framework in which they could work together. Since the ideologies of the parties were normally so different, they had to identify some of the main differences and resolve those issues before the coalition could be formed. This was a big step because it identified 11 different issues that would have to be examined before moving forward with the coalition. The first issue they examined was the reduction of the deficit. They decided that the best way to speed up the deficit reduction was to reduce spending, rather than increasing taxes. Members of the coalition decided to implement an emergency budget 50 days after signing the coalition agreement. They also scrapped the Labour Partys jobs tax, which could have cost the country many jobs. This was an important ideology for the coalition because it helped decide how the UK’s money would be spent. The next issue to discuss was the countrys spending, since they knew that they would have to make some significant cuts to reduce the deficit. The coalition began by providing more money for the National Health Service and freeing up funds for underprivileged students. They took this money from outside of the education budget to ensure that it would not be cut later on in the process. The Liberal Democrats wanted to see Britains nuclear deterrent eliminated, but decided to have the agreement renewed for the time being because the issue was important to the Conservatives. For taxation, the parties increased the income tax allowances in the country. This means that lower income earners would not be taxed unless they made over  £10,000 by the year 2015. The plan was also to providing tax exemptions for individuals starting businesses on their own, while taxing non-business

Research Method Essay Example | Topics and Well Written Essays - 2250 words

Research Method - Essay Example 6. When a financial organization decides to take part in financing activities, there are a number of risks that the move. The risks include political risks and foreign exchange risk. The risks make it difficult for the institution to maintain reliable and constant revenue. 7. Paying the amount in three months’ time may be reached at if the paying company is capable of availing the amount in three months’ time. Financial ability is the main contributes much to the financing action. The bank would prefer the payment to be made in twelve months since the longer the bank transacts the payment, the higher the bank interest earned (Pratt, 2011). 8. Once the USASuperCars accepts the HSBC’s offer, the risk will lie on the financial institution too. The bank, on the other hand, may gain or lose depending on the exchange rates. The probability of the bank making a loss are minimal because HSBC native currency is in sterling pounds which are stronger that the dollars. 9. The fixed sum of money is about $2,150,000 without exchange rate risk while HSBC has 29% chance to lose and 5% chance to gain more than $200,000. Analyzing the information keenly, the exchange rate is risky to HSBC. The bank is either going to generate a profit of five percent of the loss of about twenty-nine percent. Â  I am writing this report to make financial decisions for Corvette Company, which sells luxury sports cars to various countries in the world. The company is situated in the United States and deals with a unique brand of cars. The good reputation of the company has seen it move far ahead of other car selling companies. The success of the company is due to coordination between different departments. The managing board makes decisions that have seen Corvette retain it unbeaten reputation in the entire globe. Good quality and affordable produce are indeed the pushing force behind its success (Guffey & Loewy, 2013). I will analyze the financial risks,

Social media in the health communication fields Research Paper

Social media in the health communication fields - Research Paper Example Information was flowing in one direction only, and even if there were replies they were not instant like in the case of the social media (Park, Rodgers and Stemmle, 2011). The social media has revolutionized the way people generate, disseminate and even appreciate information because of its unique abilities. First, it is device indifferent. As long as a person has internet access one can access the social media through different devices such as mobile phones, desktops, laptops, tablets and smart phones among others. The social media also enables communication in different perspectives, from one-to-one communication to one-to-many. Most importantly, the social media allows for real time communication and different levels of interactivity and engagement. These unique characteristics and capabilities have made the social media a popular media across the globe and across the different sectors of the global economy. The health sector is one of the sectors that have been influenced by the use of social media (OED, 2013). Here, the social media has revolutionized how people get health information and how health information is disseminated by health experts. The social media has proved to be a reliable media that is highly efficient in getting health-related information out. Currently, health messages are already forming a substantial part of messages being conveyed through the many social media platforms. This paper investigates the different ways the social media is being used in the health communication fields to disseminate information. The paper shows the influence this use of social media has on the people’s attitudes and knowledge as far as their health and health services are concerned. A research conducted in 2012 by Cogitamus about the use of social media in the health sector established that nearly 32% of the adults use the social media to communicate

Assessing the feasibility of different techniques for providing fresh Essay

Assessing the feasibility of different techniques for providing fresh water to arid regions of the world - Essay Example The average water usage in the US is highest while Mozambique records the lowest water consumption per day. The goal has been the provision of secure and equitable access for all people and to ensure that water infrastructure and service delivery in standardized especially for the poor people (Conca, 2006, p, 164). These objectives are yet to be achieved because of population growth. Currently, provision of adequate water for the developing countries is a problem leading to the outbreak of water related diseases. The contaminants associated with water quality have diverse health effects as such it is not easy to make conclusive health based assessment of the situation. The problem may be severe like food poisoning or mild like dental fluorosis. (Gary, 1994, p. 39). The volume of water accessible by the population in the developing countries is significantly lower compared to that of developed country. In some cases, it is less than a third of the consumption of the developed countrie s. The volume of water consumed by Americans is 600 litres per day; Europeans consume 250 litres while Africans consume 30 litres. The volume of fresh water calculated from fresh water sources is approximated at 125 045km3. Despite the volume of fresh water, available supply of the fresh water to the population is not sufficient enough to meet their demand. Fresh water bodies Currently many of fresh water of lakes are facing degradation and volume reduction as a result of the global climate change. Many African nations cannot provide for the population safe water for domestic use. Piped water for the poor is still a dream, and at times, conflict arises as a result of water accessibility. In the sub-Saharan Africa, nomadic and pastoral communities fight over water sources leading to death and destruction of properties (De Villiers, 1999, p.105). The government of the country cannot supply the inhabitants with clean water, and infrastructure to those areas is poor. Flooding has two ef fects, which are, by the time of occurrence or duration. On health floods have two effects namely direct and indirect effects. Direct effects include changes in stream flow velocity which may carry boulders fallen trees resulting in drowning, injuries and contact with respiratory water borne diseases such as hypothermia and cardiac arrest(Galloway, 2009, p.179). Contact with polluted water will result in disease outbreak such as typhoid, cholera, and dysentery. In the Sub Saharan Africa, there are no fresh water bodies because the underground limning is salty leading to dissolving of the salt. The water source, therefore, cannot be used effectively without desalination Desalination Desalination is the most appropriate method of collecting fresh water in the arid areas, but has one main challenge namely the cost of the operation. Desalination can be used to change the water quality because; it involves the use of technology to obtain fresh water from the salt water offered by the und erground sources in the arid areas(Green, 2003 p. 34). Some of the best technology that could be used in the process includes the use of reverse osmosis and the use of other chemicals in extraction of the salts. Reverse osmosis uses membrane technology, which allows water molecules to sip through while blocking salt ions. There are other filters like he porcelain filters that can also be employed with ease. Some of

Victimization At School Essay Example for Free

Victimization At School Essay One type of victimization that can happen at school is school shootings. We have seen too many times where students and teachers have been victimized by other students who bring guns to school and take innocent lives, due to many personal reasons. There is a huge need for stricter gun control laws to make certain that students are safer in their educational institutions. Too many deaths occur where school students are victimized when individuals decide they want to bring weapons to school and use them against innocent victims. Hugh LaFollette explains to us that (LaFollette, 2000) â€Å"The literature of gun advocates supports my contention that guns are inherently dangerous. They advocate the private ownership of guns to prevent crime and to arm the militia. Guns can serve these purposes only because they are effective means of inflicting and threatening harm. † It is fair to say that guns still cause innocent victims to lose their lives and shouldn’t be available for easy access to dangerous individuals. The recent massacre at Virginia Tech and other needless shootings proved that guns can end up in the wrong hands and cause innocent victims to lose their lives. Maggie Rodriguez from The Early Show on CBS tells us that (Rodriguez, 2007) â€Å"Its been eight years since Columbine, Helmke said via satellite from Washington, D. C. Weve done nothing as a country. Its been six months since the Amish school shootings. Weve done nothing as a country. We need to be asking out elected officials what they can do to prevent people from getting these kinds of high-powered weapons. Weapons have been easily accessible and have ultimately reached the hands of the wrong people who have taken the life of many innocent people in our schools. We have seen too many times how guns have been the weapons utilized by deranged individuals, used to cause too many senseless injuries and fatalities, at schools. We also have the argument from those in the pro-gun camp who will easily say that if people are permitted to carry concealed weapons to protect themselves, they can prevent these kinds of fatalities from taking place in our school settings. By allowing everyone to carry guns, we would be placing too many other’s lives in danger. Although, there would be instances such as the killings that took place at Virginia Tech, where guns could have possibly stopped the shooter, there would be more instances where lives would be taken because of this easy access to guns. By keeping guns away from the general public, we would make it more complicated for people like the gunman at Virginia Tech to get their hands on guns to kill innocent victims. Many gun rights groups, that are led by the National Rifle Association will argue that proposals that ask for stricter gun laws breach on the constitutional rights of every law-abiding citizen. They assume that these bans on the sale of specific types of weapons haven’t proved effective in decreasing crime, and that proposals for stricter background checks at all gun shows are formed to eliminate gun shows, themselves. Many gun manufacturers have easily volunteered the support for safety locks, but the NRA has criticized these safety locks for placing a huge burden on gun manufacturers, without benefiting to the public. Georgeann Rooney who is a specialist at a Secret Service National Threat Assessment Center explained a 2002 federal study where 37 school shootings and attacks were looked at from 1974 to 2000. Rooney explains that (Rooney, 2007) â€Å"While the study said there is no accurate profile of students who engage in targeted violence at schools, it noted that many said they felt bullied, persecuted or injured by others before the attacks oIn the Santana High incident, Charles Andy Williams complained about being bullied before he went on a shooting rampage at the Santee campus, leaving two dead and 13 wounded. † The same study showed that â€Å"Most attackers had access to and had used weapons before the attack and prior to most incidents, other people knew about the attackers plans. We learn that â€Å"Most attackers had difficulty coping with significant losses or personal failures and many had considered or attempted suicide. † We see very often that most attackers who take innocent lives on school property have serious mental disturbances. We learn from The National Center of Vital Statistics that (NCVS, 1999) â€Å"The risk of death at school based on 93 incidents that occurred in the nations 119,000 schools over a ten-year period, the annual probability of a school experiencing a student-perpetrated homicide is about 1 in 11,520. † The biggest concern is that there are many people who should be allowed to collect and carry guns, because they pose no threat to society but far too many times student, teachers and other school staff members suffer at the hands of disturbed individuals. Not everyone should be considered dangerous individuals because they carry guns, but by allowing guns to remain in their hands, we are making it too easy for tragic shootings to take place at our schools, when these when these weapons end up in the wrong hands. We learn from News Batch that (News Batch, 2005) â€Å"Gun control was not a major issue in the 2004 Presidential campaign. The percentage of Americans who consider gun control as an important issue has declined from 3% to 1%. Fewer Americans are supportive of gun control in general and handgun control in particular. † By not making gun control issues an important issue, we are ignoring a dangerous situation, where young students suffer to needless killings at school. Even with background checks, it is far too risky to allow individuals to have easy access to guns. The shooter at Virginia Tech was able to purchase guns because he had a background check that was clean because all shooters have criminal records. Gun control activists still believe that it is far to easy for criminals to obtain guns and that an alarming proportion of the population remains armed. Their concern has been fueled by an unprecedented recent rash of school shootings and fatalities. Many experts are blaming this phenomena on violent video games and poor parenting but in each case the youths involved had easy access to the weapons that they used. Gun control advocates support measures which would require locks on all guns, which would apply the provisions of the Brady bill to gun shows. These gun control advocate groups also advocate a federal law allowing only one handgun purchase per month and raising the age for gun ownership from 18 to 21. By increasing the age limit for buying guns to 21, we may decrease the number of shootings that take place but we aren’t eliminating the possibilities for dangerous individuals to get their hands on guns that kill. John W. Mashek (Mashek, 2007) tells us that â€Å"The tragedy at Virginia Tech should open our minds to a problem our nation refuses to confront. The easy access to guns and lethal weapons is a national disgrace. In Virginia alone, gun owners are limited to one purchase a month. I can hear the response from the NRA already: People kill people. Yes, but they do it with guns and too frequently with those easily accessible weapons. † He goes on to say that â€Å"The condolences from the NRA are of little comfort to the mourners of those slaughtered in Blacksburg. The NRA, to put it bluntly, has too many willing friends in Congress from both political parties. Campaign cash flows to them in hefty amounts. Members of both parties should be ashamed. † Without easy access to guns, criminals are less likely to kill. There are many individuals who will argue that â€Å"People kill, not guns. † Yes, this may be true, but without guns, they have less opportunity to kill. When killing is on the mind of a deranged individual, they usually look for guns to commit murders and by not making guns easy to buy, we are decreasing the threat that is upon society. Michael Daily, a daily news columnists asks, (Daily, 2007) â€Å"Still love those guns, Virginia? It is clear that many people are fed up with guns being so available to the general public. There must be serious restrictions placed on buying weapons. These restrictions should make it impossible for the entire general public to purchase guns. It is a fact that guns do kill and we must remove this threat that is causing so many needless shootings at our schools across the United States. Guns can be accessed much too easily and it is up to all Americans to stand up and say that we are tired of worrying about ourselves and our loved ones being taken out by individuals who have problems dealing with society. It is unfair for innocent victims to lose their lives because someone is having a bad day and can easily walk to the gun store and purchase a gun, in a rather small period of time. We must vote for strict gun control laws and make it far less possible for guns to reach the hands of the wrong people who kill and victimize students too often! Reference Page LaFollette, Hugh. (2000). â€Å"Gun Control†. Ethics. Vol. 1. P. 263-81. News Batch. (2005). â€Å"Gun Control Policy Issues†. www. newsbatch. com/guncontrol. htm. Mashek, John W. (2007). â€Å"Guns Kill People. Period. †. A Capital View. US News and World Report. Rodriguez, Maggie. (2007). â€Å"Shootings at VA Tech Spark Gun Debate†. The Early Show. CBS. Rooney, Georgeann. (2007). Secret Service National Threat Assessment Center. The National Center for Vital Statistics. (1999). â€Å"Serious Violent Crimes in Schools†. www. youthviolence. ed.

Gender in Advertising An Analysis

Gender in Advertising An Analysis Women have been portrayed in numerous roles throughout the ages in advertising, varying from wife and mother to business women. This essay will delve deeper into two certain time periods, (the 50-60s through to the 2000 to present day.) and what roles woman were portrayed in during these times. If there is significant changes between the two time periods questions will be asked into why they have changed and is this due to different attitudes in society. As Advertising of the 1960s, was considered a decade often called the Golden Age of Advertising. (Nemhauser, M. (2014) Real Mad Men, P1) It would be thought that the adverts within this era would be powerful and memorable. However it is memorable to woman for all the wrong reasons. Woman within adverts through the 50-60s were only ever portrayed as wives and mothers, and more often than not they were always making a mistake within their role. For example within Figure (Figure 1, 1960s Folgers Coffee Ad) 1, it shows a print screen of an advert by Folgers. Within these averts It portrays woman who are incapable of making a good cup of coffee for their husbands. All of the Folgers adverts around the 1960s went with the same vain. That before the men were going out to work on a morning their wives would make them an awful cup of coffee. Portraying woman as useless wives that couldnt even do the simplest task correctly. The strategy behind the advert was to guilt trip women into buying Folgers coffee so that they could finally make their husbands happy. Although this technique did work, when looking back onto this advert, it simply berates and undermines woman. However as the war had passed and lead to more woman taking on other roles in work forces rather than just wives and mothers, advertising changed with them the times. Different forms of advertising made use of this revolution by showing woman taking on different roles like secretaries. Although this should have been a good thing, portraying woman out of the house, it still showed very sexist views against woman as a gender. For example woman were never seen as the boss or anyone in power they were always just a general lower class employee, and often only at work to help men. A primary example of this can be seen within Figure 2. A classic Xerox advert that portrayed a woman as a mans secretary having to do jobs like printing, scanning, filing etc. All jobs that would help the man within his career. Although this isnt enough to show a woman as just a secretary, the advert has the woman stating many things that she cant do. I cant type, I dont take dictation I wont sharpen pencils, I cant file, and my boss calls me indispensable. This portrays the woman as a (Figure 2, 1960s Xerox Ad) very weak individual. The advert goes on to show the woman being told to photocopy something for her boss, and shes able to due to the Xerox machine as its easy to use just press a button and it does the work for her. Although the adverts have changed from wives in the kitchen to a woman actually working for herself, all the adverts in the 50-60s have the same underlying message. Which is that woman cant do anything right, and If they do its because theyve had help from a product, such as a Xerox machine or Folgers Coffee. Which in turn portrays woman as the weaker class in comparison to men. The final advert to investigate is a print advert, figure 3, from the 1950s for Mr Leggs. Through this print advert the message is more direct than the others, the fact that men are far more superior to woman. This was only hinted at through the other adverts, as the man went off to work to earn the money while his wife couldnt even make a coffee. To a boss telling his secretary to do something that she wouldnt have been able to do without Xerox. Although they both shown men as superior, figure 3 displays this message in a much more abrupt way. As seen within the poster a man walks all over a woman, and the message that can be taken from the ad is that a woman can easily be tamed with the use of brute force, animal magnetism and a pair of Mr Leggs Slacks. (Figure 3, 1950s Mr Leggs Ad) In conclusion adverts from the 1950-60s portrayed woman in not the best light. It showed them as people who cannot do things right without the help of either a man or a product. Causing them to be seen as the weaker sex and inferior to men. This could be due to the fact society in that era were very set in their ways. It was the men who went off to war and the woman stayed to look after the house and children. It had always been this way and nothing had ever changed it. However due to the growth of feminism in the late 1960s the debate over the portrayal of woman in adverting intensified and the National Organization for Women, founded in 1966, sought to eliminate gender based stereotypes in the mass media. (Unknown author, (2003) Woman: representation in advertising.)ÂÂ   This could have been the start of where woman were giving an equal representation within the adverts we see to this day. (Figure 4, 2007, Dolce Gabbana ad) It is only since the mid-20th century that women have been shown in roles other than house wives and woman doing their job wrong. Therefore this must mean advertising has taken a turn for the better, where the portrayal of woman is concerned. Yet when looking at Figure 4, it shows a woman being restrained by a man while other men look on. This feels again degrading to woman in a different way to the ads of the 50-60s, as there is actually no body copy or script stating that woman are inferior to men however this is stated through just the use of the image and is still just as demeaning towards the female figure. The role of the woman in this ad seems to be there for the pleasure of the men. As the look on the womans face almost looks expressionless, and absent from the scene as if she is trying to escape the thought of the situation. The fact that she is being restrained also suggests that the woman needs to do whatever the men want, much like the ads from the 60s. This particular ad vertising campaign was banned a few weeks after its launch due to the backlash it received from woman. Another campaign was launched in 2013 by American Apparel, figure 5. This shows two ads portraying a man and a woman in the same shirt. The campaign is trying to sell the same unisex shirt to men and woman in two different ways. However both the ways used seem to be geared towards men. As the woman is half naked therefore being used as a sexual object to sell the shirt to men. This type of advertsing is not geared towards woman (Figure 5, 2013, American Apparel ad) Compare / contrast adverts / significant changes between them: There is less body copy on the more recent adverts however still the same underlying meaning have. There is difference between the two times periods, therefore indicating there has been some change in the attitudes of society. Peoples attitudes have most certainly changed due to the fact the Dolce Gabbana ad was actually pulled just a few weeks after its launch. This shows that woman do have a voice and are listened to. Unlike in the 50-60sÂÂ   where if the woman did not like the way they had been portrayed in an advert, then it was probably their fault for being offended anyway. Although there is changes in society, images of woman in advertising have hardly been uniform, but several themes recur; the housewife ecstatic over a new cleaning product; the anxious woman fearing the loss of youthful attractiveness; the subservient spouse dependent on her assertive husband; the object of means sexual gaze and desire (Pope, D. (Unknown date) Making sense of advertisements, P6).ÂÂ   This has always been the case since advertising begun and to this day. Showing us that society has changed from showing woman in multiple roles rather than just a woman doing something wrong. However these multiple roles can always be seen in one of the groups stated by Daniel Pope. To conclude the roles of woman have changed throughout time. However even though the roles have changed from housewife to beautiful models there still is a reoccurring theme throughout all of the adverts examined. That sexism in which woman are portrayed has only adapted from woman needing men to pleasing men, it hasnt went away or got any better. Its is just been advertised in different ways. A lot of the adverts today show woman as just sex symbols, to please men and due to this all ads seemed to be geared towards men. Furthermore I think womans roles in advertising has always been inferior to men, and probably always will be until everything between men and woman is equal.

Surgical Pain Relief: Multimodal Analgesia And Paracetamol

Surgical Pain Relief: Multimodal Analgesia And Paracetamol INTRODUCTION As a nurse on a surgical ward dealing with a diversity of operating procedures it is important to understand the effects of surgical pain, as pain intensity and control is an integral part of the nursing duties. Layzell (2008) argues that pain management for postoperative patients should be a priority for all healthcare professionals. Furthermore having a say in how medications are administered but not prescribing drugs also means that it is essential to have an understanding of pharmacology. This ensures that informed discussions can talk place with the medical officer when it is felt that pain relief for a patient requires review. Additionally this enables the right balance of pain relief to be administered to minimise distress for the patient throughout their surgical journey. According to Lucas (2008) the benefits and adverse effects of the different types of analgesia also need to be considered when treating postoperative pain. Pain is a complex phenomenon that is difficult to define. The most general definition used was published by the International Association For The Study Of Pain (IASP) in 1979 and refers to pain as an unpleasant, sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage (IASP  2010). Pain is also subjective and the intensity can only be experienced by the sufferer (Mann and Carr 2006). Neurophysiology there are three types of pain receptors communicating pain signals through nociceptors or pain fibres (Mann and Carr 2006). These receptors can be found in the skin, surfaces of the joints, periosteum (the specialised lining around the bone), arterial walls and certain structures in the skull, although the brain itself does not have any of these receptors (Mann and Carr 2006, p3). Each receptor reacts to a different stimulus. The mechanical receptor to touch, thermal to heat or cold and chemical to products present in the body that are released after trauma causing inflammation and increased sensitivity at the wound site (Mann and Carr 2006). The chemical receptors also react to chemicals introduced into the body (Mann and Carr 2006). The nociceptors are the sensory instruments that transmit pain signals through sensory nerve fibres to the dorsal horn of the spinal cord and into the brain (Mann and Carr 2006). There are three types of nerve fibres: A-delta responds to mechanical or thermal sensations, C fibres also known as polymodal because they respond to mechanical, thermal and chemical influences and Aà ¢Ã¢â€š ¬Ã¢â‚¬Ëœbeta fibres which occur in the skin, reacts to touch but does not transmit pain sensations (Mann and Carr 2006). Psychologically pain can induce fear, anxiety, anger, frustration and also a sense of helplessness may be experience from being unable to physically control the intensity of the pain being felt (Rothrock et. al. 2007). Physiologically pain can reduce the functions of the immune system whilst increasing the potential for wound and chest infections as well as impairing the wound healing processes (Middleton 2003, Pudner and Ramsden 2010). Pain also induces vomiting, increases the workload of the cardiovascular and gastrointestinal systems, decreases lung capacity and can also reduce physical mobility (Middleton 2003, Rothrock et. al. 2007). Traditionally following surgery, a single opioid drug such as morphine is used, depending on the type of surgery performed, for moderate to severe or acute pain (Shorten et. al. 2006). It is argued that patients who receive this monoà ¢Ã¢â€š ¬Ã¢â‚¬Ëœtherapy would prefer to be treated with non ­Ãƒ ¢Ã¢â€š ¬Ã¢â‚¬Ëœopioid remedies (Shorten et. al. 2006). According to Mann and Carr (2006) using the monoà ¢Ã¢â€š ¬Ã¢â‚¬Ëœtherapy method only targets one pain pathway and although morphine is considered the gold standard it tends to have many adverse effects. These include a 0.2% risk of respiratory depression, sedation, urinary retention, nausea and vomiting which affects around 30% of patients, itching or pruritus, hypotension or low blood pressure plus confusion and hallucinations in the elderly (Mann and Carr 2006, Rothrock et. al. 2007, Manley and Bellman 1999). Some of these side effects are controlled with antià ¢Ã¢â€š ¬Ã¢â‚¬Ëœemetics for sickness and antià ¢Ã¢â€š ¬Ã¢â‚¬Ëœhistamines for pruritus (Rothrock et. al. 2007). Combinational drug therapy began in the 1950s (Michielsen 2007). Since then there has been increasing developments in establishing opiate sparing analgesic regimes with fewer side effects for surgical pain (Shorten et. al. 2006). Painkillers such as paracetamol (acetaminophen) can be combined with drugs from the codeine group, tramadol and non-steroidal antià ¢Ã¢â€š ¬Ã¢â‚¬Ëœinflammatory drugs (NSAIDs) as part of a multimodal regime (Manley and Bellman 1999). This allows for lower doses of individual drugs to be given, reducing the severity of adverse events and targeting more than one pain pathway as each drug has a different mechanism of action (Shorten et. al. 2006). Paracetamol is a universal drug that is generally well tolerated but its mechanisms are not fully understood (Mann and Carr 2006). There are only mild to rare reported occurrences of side effects such as skin rashes and other allergic reactions (Manley and Bellman 1999). Paracetamol, a member of the non-opioid group is one of oldest known synthetic analgesic and antipyretic drugs (Manley and Bellman 1999, p470). Being also an antipyretic paracetamol has the ability to reduce fever temperature (Pudner and Ramsden 2010). It can be administered orally, rectally or intravenously in the form of a prodrug known as perfalgan or propacetamol (Manley and Bellman 1999, Royal Pharmaceutical Society of Great Britain 2007). Prodrugs are treatments that need to be broken down in the body before they become active (MedicineNet 2010). It is suggested that paracetamol should be used as part of a multimodal regime for surgical patients experiencing mild to moderate pain (Pudner and Ramsden 2010). Multimodal treatments involve combining drugs to form a compound in order to increase pain relief and reduce opioid adverse effect (Shorten et. al 2006, Manley and Bellman 1999, Pudner and Ramsden 2010). These combinational drugs are regulated by the Medicines and Healthcare Products Regulatory Agency (MHRA) and European Medicines Evaluation Agency (EMEA) and only a limited number has been approved (Shorten et. al 2006, Department of Health 2010). Pharmaceutical companies have also introduced several fixedà ¢Ã¢â€š ¬Ã¢â‚¬Ëœdoseà ¢Ã¢â€š ¬Ã¢â‚¬Ëœcombinations such as coà ¢Ã¢â€š ¬Ã¢â‚¬Ëœcodamol a combination of codeine phosphate, a weak opioid and paracetamol as well as coà ¢Ã¢â€š ¬Ã¢â‚¬Ëœdydramol a compound of dihydrocodeine and paracetamol (Shorten et. al 2006, p185). The main side effect of these codeine products is constipation, which can be remedied with a mild laxative (Manley and Bellman 1999). Tramadol, another weak opioid can also be combined with paracetamol (Manley and Bellman 1999). The side effects of tramadol include minimal respiratory depression, nausea, vomiting, dizziness, headache and sweating (Manley and Bellman 1999). Using this drug appears to defeat the object of reducing opiate contraindications but the combination is generally well tolerated and effective for moderate to severe pain (Shorten et. al. 2006). Rothrock et. al (2007) argues that combining NSAIDs with opioid drugs effectively reduces opioid usage by 20-40%. However increased postoperative bleeding and the chances of developing gastrointestinal ulcers cause NSAIDs to be used sparingly for surgical patients ((Rothrock et. al. 2007). The Human Rights Act 1998 states that ethically it is the duty of all healthcare staff to ensure that patients are protected from any form of torture, inhuman and degrading treatment and punishment (Office of Public Sector Information 1998, Article  3). Nurses are also responsible for their actions and as such must be able to justify decisions made or omissions which affect the wellà ¢Ã¢â€š ¬Ã¢â‚¬Ëœbeing of a patient (Nursing and Midwifery Council 2008). From a surgical nursing perspective this means it is imperative to ensure patients receive good pain management following their operation. However according to a recent study by Dolin, Cashman and Bland (2002) one in five patients still report severe postoperative pain. Manley and Bellman (1999) suggest patients commonly believe that pain is acceptable following surgery. While Pudner and Ramsden (2010) argue that postoperative pain should be controlled and patients should not expect or see pain as inevitable. This literature review aims to firstly evaluate current research and evidence in relation to the use of paracetamol as one part of a multimodal analgesia regime for surgical pain relief. Secondly to use the results to make recommendations for standardising multimodal pain control for postoperative patients and re-educate staff on the importance of effective pain management. METHODOLOGY Search Criteria For this literature review an advanced search was carried out over the internet. The health and medical sciences specific databases of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Online (MEDLINE), Cochrane Library and Internurse.com were explored (Thomas 2000). CINAHL includes full text and is the most relevant source of information for nursing while MEDLINE focuses on life sciences and is produced by the National Library of Medicine (LoBiondo-Wood 2010, p68). The Cochrane Library holds a collection of systematic reviews and Internurse.com has journal articles written by nurses (LoBiondo-Wood 2010, p68). The Cochrane Library was used to determine if any critical reviews had previously been carried out on the subject of paracetamol being used as part of a multimodal regime for postoperative patients. Only 4 papers were found. Internurse.com was exploited for articles containing current knowledge on the use of multimodal therapy for surgical pa tients. These editorials were utilised within the introduction. The keywords or inclusion criteria for the literature search included paracetamol in the title while the words surgical and post operative were left optional to increase the depth of the search. Truncation or wildcards were employed to make the search more sensitive and specific to the topic being researched as follows: surgical surg* and post operative post op* (Gerrish, and Lacey 2006). The search mode was set to Boolean which defines the relationships between words or groups of words in a literature search (LoBiondo-Wood 2010). This process involved using the word AND before the truncated words surg* and post op*. The date time frame was also limited from 2000 to 2010 to ensure that the studies were up to date and relevant to present day policies and procedures for pain control (LoBiondo-Wood 2010). Restrictions were also placed to only include papers that were based on humans, research papers and in the English language. Humans were selected as experiments on animals due to their biological makeup was not considered to be relevant to controlling postoperative pain in human beings. As this is a literature review it was appropriate to only select research papers for analysis. Language was also deemed to be significant as finances and the time schedule to complete the review did not allow for interpretation of the papers from other Dialects. Expanders were included to find papers that had related words and for the search to be carried out within the full text of the articles. Review 8 papers resulted from the above search criteria. These were then screened using inclusion criteria, the titles and abstracts to determine their relevance to relieving surgical pain with multimodal analgesia therapy. The inclusion criteria was trials that included patients who had received paracetamol (acetaminophen) postoperatively, trials that included multimodal therapy, papers that were published within the last 10 years, subjects who were adults as my surgical setting only treats patients over the age of 18 and within a hospital environment. Exclusion criteria were trials that involved animals or children as discussed earlier. The types of interventions could include any routes for drug administration as paracetamol can be administered via intravenous, oral or rectal modes. One paper was excluded from the review at this point as it was a monoà ¢Ã¢â€š ¬Ã¢â‚¬Ëœtherapy trial for paracetamol. The remaining 7 papers met with the inclusion criteria and were scored for methodological quality using a critical appraisal skills programme (CASP) containing 10 questions {{488 Public Health Resource Unit (PHRU) 2007}}. The questions were answered yes, no or cant tell for each paper. Using a tool provides a way of systematically appraising what is published and filtering through papers to determine their relevance and accuracy {{427 Crookes, P. and Davies, S. 2004}}.