Thursday, August 27, 2020
What caused the American Revolution? That is an excellent inquiry. All through the , the pioneer had a decent connection with Great Britain. They battled in wars together, for example, the French and Indian war of 1754 which wound up in all out triumph. In any case, over the long haul, things started to change in this relationship of theirs. These progressions prompted a need of the American Revolution. Despite the fact that there are numerous causes, three that I will talk about that caused the American Revolution is the Stamp Act, Boston Tea Party, and the Intolerable Act. The authorization of Stamp Act was a tremendous development towards the American Revolution. After the French and Indian War, Britain was in extraordinary obligation consequently this was made. It put burdens on all the authoritative archives or printed products, which infuriated the homesteader from numerous points of view. This was one reason of the no tax imposition without any political benefit. We will compose a custom article test on Reason for American Revolution or on the other hand any comparative point explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page The Boston Tea Party was brought about by Great Britain putting charges on tea. This infuriated the pilgrim since it was likewise a case of the no tax imposition without any political benefit idea.The rankled pioneer tossed the entirety of the brought tea of Great Britains into the ocean. This prompted the reason for the Intolerable Act. The Intolerable demonstration was the laws passed by Great Britain prohibiting all exchanges of fares and imports on the pilgrim and they were just permitted to purchase from Great Britain. This happened after the Boston Tea Party as a discipline for the pioneer. The ports would be shut until the homesteader take care of all the cash of the tea dumped in the Boston Tea Party was made back.This act made he settler considerably angrier in light of the fact that they remove their lone method of bringing in cash. Transformation implies either to ousted an administration or pioneer or isolating from them. Extraordinary Britain was making every one of these progressions towards the settler for their own advantages. The laws they made were so out of line to the pilgrim. Extraordinary Britains childishness caused the difference in the connection between the two. The Stamp Act, Cause of Boston Tea Party, and the Intolerable Act were all means that prompted the American Revolution. Changes were required in light of uncalled for choices.
Saturday, August 22, 2020
Request versus Bedlam in The Odyssey In The Odyssey, Homer depicts the reoccurring subject of request versus chaos. This topic is especially obvious inside the initial twelve books of The Odyssey. Homer shows the significance of ingraining request where there is turmoil or confusion. To eliominate mayhem and recapture request, a solid legend is required alongside the insight to discover an answer for the problem. In the initial twelve books of The Odyssey Homer shows the requirement for a guile saint so as to reestablish harmony where there is disarray through the admirers, the tempest off the bank of Scheria, the Kyklopes, and Scylla and Charybdis. The first and most obvious case of tumult in The Odyssey is the nearness of the suitors. Since Odysseus stayed away forever structure the Trojan War, numerous admirers who looked to wed Odysseus' significant other, Penelope, were disregarding Odysseus' house. The house was loaded up with the disarray that the admirers caused. They were there for such a long time since Penelope was impervious to remarry. While they were there, they kept on expending the entirety of Odysseus' possessions. His better half is assaulted with admirers and his whole house is threatening to fall. With the nonattendance of their ruler, Odysseus, in Ithica his home was being invaded by the insatiable suitors. Although request is no reestablished in Ithica until the finish of Odysseus' excursion, it is alluded to what is expected to end the disarray inside the initial four books, or the Telemacheia. Since Telemakhos is still excessi vely youthful and not completely developed enough to reestablish request in his dad's home, it will take Odysseus' return. Even the goddess Athena perceives the requirement for Odysseus' warrior quality and insight when she says, harshly you need Odysseus, at that point! High opportunity he returned to connect with these upstarts. I wish we saw him standing helmeted there in the entryway, holding shield and lance, looking the manner in which he did when I initially knew him. (The Odyssey, Homer, Robert Fitzgerald's interpretation, pp. 9)âÃ«â  The remainder of the books in this area are committed to Odysseus' excursion home so he can reestablish request to his country and be with Penelope. Homer likewise shows that a cleverness legend is required when confronted with bedlam in the scene where Odysseus is stuck in a tempest off the bank of Scheria.
Friday, August 21, 2020
How to Write the Common App Essay Prompt #2, 2019-2020 Welcome to our overview of the Common App essay prompts for this 2019-2020 application season. Weâre reviewing each prompt, discussing the pros and cons, and deciphering what itâs actually saying. We know that it can get messy and confusing because itâs overwhelming. Itâs particularly overwhelming because you know that your personal essay is the most important part of your application. Weâre your Google Translate for the Common App. Read on for the ins and outs of Common App prompt #2. 2. The lessons we take from obstacles we encounter can be fundamental to later success. Recount a time when you faced a challenge, setback, or failure. How did it affect you, and what did you learn from the experience?Aside from question #7, which weâll get to later on in this series, this is our favorite question. It sets you up to tell a really great story. No matter which prompt you choose, you should be telling a story. Firstâ"we need a failure. But we have some thoughts on what kind of failure to choose. It doesnât need to be an epic or devastating loss of some kind. It definitely does not need to be something that was traumatizing or truly awful for you. Rather, we always challenge our students to tell a story of something that they just truly did not succeed in doing, but in not succeeding, they learned some other substantive thing. It can be something incredibly small and seemingly insignificant to someone else, but you know that it slightly shifted the way that you viewed the world and helped you to further understand the state of things. Humility is key here. Whatever story you choose to tell should evidence a time when you were humbled. A time when you had to take a deep breath because it was a lot, but you did so with a bit of a smile and a tinge of disbelief. Rather than thinking of this question as asking you to reveal a big let-down, think of it as an opportunity to discuss a failure of task that ultimately highlights a part of your personality tha t remains strong and important. One of our students a number of years ago wrote a great story about peanut butter. They were set to package and market an on-the-go peanut butter packet paired with a crunchy snack so that they could eat peanut butter between school and practice. They loved peanut butter. It was their favorite snack, but it wasnât optimized for people who didnât have a table, a knife, and 5-10 minutes. Bananas also came with a peel that they couldnât just shove back in their bagâ"it would smell too much. They finished reading The Power of Little Ideas, went to work, created a business plan, met with retailers and packagers, and did their market research. They had a logo and a website. But ultimately, Justinâs beat them to the punch on their product design and released into stores. It was a truly sad moment for them because theyâd invested over a year of work in this product. So, they closed up shop and set their sights on college. They now know everythi ng that there is to know about peanut butter and it serves as a great talking point on their resume. They remain just as passionate, if not more so than before their business venture, about peanut butter. This story was a great one to tell because itâs a unique interest and while it was a failure of execution, it was not a failure of effort or momentum. In fact, it highlighted their determination and resilience. They had a story about interest, passion, work ethic, and the importance of market predictability and timing. It all made for a compelling tale about nut butter and this studentâs determination to create a solution to a problem that they experienced every day. We donât know what college community wouldnât want such an active and excitable problem-solver to join their campus. So, when youâre thinking about your common app essay, maybe spend a little time diving into your failures. Just remember to approach the topic with humility and humor.This is just one example of many different âtask failuresâ that weâve helped our students write over the years. Let us know if you have any questions or want us to help workshop yours.
Monday, May 25, 2020
Punctuation is used to mark the cadence, pauses, and tone in written English. In other words, punctuation helps us to understand when to pause between fully formed ideas when speaking, as well as organize our thoughts in writing. English punctuation marks include: period .commaÃ ,question mark ?exclamation mark !colon :semi colon ; Beginning English learners should focus on understanding the period, comma, and question mark. Intermediate to advanced student should also learn how to use colons and semi colons, as well as an occasional exclamation mark. This guide provides instruction on the basic rules of using a period, comma, colon, semicolon, question mark and exclamation point. Each type of punctuation is followed by an explanation and example sentences for reference purposes. Period Use a period to end a complete sentence. A sentence is a group of words containing a subject and predicate. In British English a period is called a full stop. Examples: He went to Detroit last week. They are going to visit. Comma There are a number of different uses for commas in English. Commas are used to: Separate a list of items. This is one of the most common uses of a comma. Notice that a comma is included before the conjunction and which comes before the final element of a list. Examples: I like reading, listening to music, taking long walks, and visiting with my friends. They would like books, magazines, DVDs, video cassettes, and other learning materials for their library. Separate phrases (clauses). This is especially true after a beginning dependent clause or a long prepositional phrase. Examples: In order to qualify for your certificate, you will need to take the TOEFL exam. Although he wanted to come, he wasnt able to attend the course. Separate two independent clauses that are connected by a conjunction such as but. Examples: They wanted to purchase a new car, but their financial situation would not allow it. Id really enjoy seeing a film this evening, and Id like to go out for a drink. Introduce a direct quote (as opposed to indirect speech i.e. He said he wanted to come ...). Examples: The boy said, My father is often away during the week on business trips. His doctor replied, If you dont stop smoking, you run the risk of a heart attack. Separate appositives (a noun, or noun phrase) or non-defining relative clauses. Examples: Bill Gates, the richest man in the world, comes from Seattle. My only sister, who is a fantastic tennis player, is in great shape. Question Mark The question mark is used at the end of a question. Examples: Where do you live? How long have they been studying? Exclamation Point The exclamation point is used at the end of a sentence to indicate great surprise. It is also used for emphasis when making a point. Be careful not to use an exclamation point too often. Examples: That ride was fantastic! I cant believe he is going to marry her! Semicolon There are two uses for a semicolon: To separate two independent clauses. One or both of the clauses are short and the ideas expressed are usually very similar. Examples: He loves studying; he cant get enough of school. What an incredible situation; it must make you nervous. To separate groups of words that are themselves separated by commas. Examples: I took a holiday and played golf, which I love; read a lot, which I needed to do; and slept late, which I hadnt done for quite a while. They plan to study German, for their travels; chemistry, for their work; and literature, for their own enjoyment. Colon A colon can be used for two purposes: To provide additional details and explanation. Examples: He had many reasons for joining the club: to get in shape, to make new friends, to lose some weight, and to get out of the house. She gave notice for the following reasons: bad pay, horrible hours, poor relations with colleagues, and her boss. To introduce a direct quote (a comma can also be used in this situation). Examples: He announced to his friends: Im getting married! She cried out: I never want to see you again!
Thursday, May 14, 2020
Cancer Therapy Cancer is one of the more prevalent diseases in our world today. ItÃ¢â¬â¢s a horrifying diagnosis that affects not only the patient, but their families and loved ones as well. As nurses, we deal head on with this diagnoses on a daily basis. Holding a strong front becomes hard, when inside, youÃ¢â¬â¢re crumbling while looking at the sweet 4 year old girl, taking her last breath in the face of her leukemia with a smile on her face. Hopefully one day, we wonÃ¢â¬â¢t have to endure the pain and heartbreak of losing patients to cancer. Hopefully one day, weÃ¢â¬â¢ll be able to look patients and their families in the eyes, and say Ã¢â¬Ëthis is nothing to worry about Ã¢â¬â we have a cureÃ¢â¬â¢. (One can dream, even if it is an unrealistic dream). For now, however, there are numerous ways to help fight cancer in patients. Surgery Surgery is done for patients who have solid tumors. One of the main benefits of doing surgery is that there is minimal damage to healthy cells in the body. Generally in surgery, the surgeon will also remove a margin of healthy tissue near the cancer site, to be sure there are no malignant cells left. Surgical treatment of cancer is effective in a small number of patients, because most patients have metastases to other sites by the time of diagnosis. Surgery is often used in conjunction with chemotherapy or radiation for a more targeted therapy. Radiation Therapy Radiation therapy is used to kill tumor cells that cannot be resected or cut out due to their location in theShow MoreRelatedTypes Of Therapies For Cancer Treatment Essay1558 Words Ã |Ã 7 Pagesare many different types of therapies for cancer treatment. Chemotherapy is the most common and following that is immunotherapy. A recent method has been discovered that is a targeted therapy. The recent discovery of targeted therapies has offered a wealth of improvements in the field of oncology. Targeted therapy is the most recent type of cancer treatment that uses drugs to attack solely cancer cells while trying to minimize the damage to normal cells. Targeted therapies attack the programming insideRead MoreRadiation Therapy As A Treatment For Cancer1173 Words Ã |Ã 5 Pages5 million people will be diagnosed with cancer in the United States (Pickle et al., 2007). More than half of these cancer patients will undergo the use of radiation as a means for treating cancer at some point durin g the course of their disease (Perez and Brady, 1998). Cancer, a disease caused by an uncontrollable growth of abnormal cells, affects millions of people around the world. Radiotherapy is one of the well known various methods used to treat cancer, where high powered rays are aimed directlyRead MoreBreast Cancer Treatment And Therapy With Nanomedicine1054 Words Ã |Ã 5 PagesBreast cancer treatment and therapy with nanomedicine is a fad nowadays and rightfully so, it is the need of the minute. The incidence rate of breast cancer has witnessed a minimum 10-fold increase in the past few decades. The mortality rate in women is rising and breast cancer is a major contributing factor. Due to several changes in the hormonal, nutritional and environmental factors over the years, there is a shift observed in the rise of breast cancer. At a point, conventional mammography forRead MoreSynthetic Biology Therapies And Treatment Of Infectious Diseases And Cancer Therapies1490 Words Ã |Ã 6 P ages To begin, synbio technology is becoming a necessity in the biomedicine and pharmaceutical industry. Synthetic biology therapies has been developed for the treatment of infectious diseases and cancer, as well as approaches in vaccine development (Ruder et al., 2011). As Ruder et al. (2011) have discovered, effective synthetic biology therapies can been rationally designed and constructed to alter mechanisms underlying disease and related biological processes. In the process of developing syntheticRead MoreNanoparticles As Targeted Therapies : A New Generation Of Cancer Treatments1473 Words Ã |Ã 6 PagesName: Kevin Lam Student number: 688524 Words count for main text: Nanoparticles as Targeted Therapies: A New Generation of Cancer Treatments Abstract 1 abstract only in 2nd page 1. Introduction 2. Definition of Nanotherapy Nanotherapy is a novel therapy that depends on nanotechnology, nanomaterial and nanoparticles to improve certain drug properties (e.g. solubility, stability, half-lives, transportation, etc.) used to treat diseases (Harris et al. 2006). MoreoverRead MoreEvidence-Based Treatment of Hot Flashes Related to Cancer Therapies813 Words Ã |Ã 3 PagesHot flashes are one of the many side effects of cancer treatment. A hot flash is defined as Ã¢â¬Å"a subjective sensation of heat that is associated with objective signs of cutaneous vasodilation and a subsequent drop in core temperatureÃ¢â¬ (Kaplan, Mahon, Cope, Keating, Hill Jacobson, 2011). Another description of a hot flash is a Ã¢â¬Å"sudden sensation of intense warmth that begins in the chest region and rises to the neck and faceÃ¢â¬ (Loprinzi, Barton Rhodes, 2001). Hot flashes are difficult to measure becauseRead MoreHistory Of Dr. Clay Siegall Espouses Landmark Cancer Treatment Therapies1059 Words Ã |Ã 5 PagesDr. Clay Sie gall Espouses Landmark Cancer Treatment Therapies Many doctors, physicians, researchers and biotech companies--including the revolutionary Seattle Genetics research facility--are now turning to antibody-assisted cancer treatments and precisely targeted cures instead of treating cancer with a cocktail of chemicals and radiation that generate risky side effects and damage the healthy tissue that patients need to recover. Cancers are among the most frightening and difficult-to-treat illnessesRead MoreSymptoms And Treatment Of Therapeutic Therapy For Patients With Multiple Sclerosis s Lymphoma And Breast Cancer1328 Words Ã |Ã 6 Pagescells.[1,2] It is licensed for use in UK in the treatment of leukaemia, Non-HodgkinÃ¢â¬â¢s lymphoma and breast cancer which has spread to other organs (metastasis). It can also be used in non-resectable primary hepatocellular carcinoma (liver cancer which has not metastasised, but cannot be removed by surgical intervention). Dosages for these indications tend to be around 12mg/m2 of body surface area (BSA), and is administered in cycles of treatment due to mitoxantroneÃ¢â¬â¢s cell cycle non-specificityRead MoreOrgan Specific Cancer Treatments. Certain Advanced Cancer1068 Words Ã |Ã 5 Pagesspecific cancer treatments Certain advanced cancer hospitals manage cancer in an organ specific way, and accordingly oncologists are reserved for treating cancers affecting specific organs only. Accordingly, oncologists have successfully treated breast cancer, head and neck cancer, gynecological cancer, orthopedic cancer, lung cancer, neuro cancer, and liver cancer. Understanding each organ specific cancer and the treatment available for it Breast Cancer It is the commonest of cancers affectingRead MoreEssay about Radiation Therapy1225 Words Ã |Ã 5 PagesWhat do cancer, radiation, and technology have in common? The links between the three are quite extraordinary. Cancer is a disease that accounts for 13% of all deaths in the world (Delfino and Day 1). The disease has an impact on patients, friends and their love ones. According to WebMD, radiation is energy that travels in the form of waves through radiation therapy. Through radiation therapy, radiation is used to stop, slow or cure the growth of cancer. With technology, radiologists can treat
Wednesday, May 6, 2020
In the play Romeo and Juliet there are lots of events that lead to the death of the two main characters. There are many people responsible for the death of Romeo and Juliet and some of these characters are Tybalt, Capulet and Friar Lawrence. In the play, Tybalt has a large influence on the death of Romeo and Juliet. He helps contribute to their deaths because he kills Mercutio and Romeo in turn kills Tybalt which causes Romeo to be banished from Verona. Then Juliet tells Ã¢â¬Å"Romeo is banished!Ã¢â¬ Ã¢â¬Å"There is not end no limit, measure, bound. In that wordÃ¢â¬â¢s death: no words can that woe sound.Ã¢â¬ (Act III Scene II 128-130) If Romeo had taken the time to think before killing Tybalt he would not have killed him and therefore he would not beÃ¢â¬ ¦show more contentÃ¢â¬ ¦Friar Lawrence plays a big part in causing the death of Romeo and Juliet because he secretly marries them knowing something either negative or positive will happen. Friar even tells Romeo the cautions for he says Wisely and slow. They stumble that run fast. (Act II Scene III 97) Friar marries them because he thinks that the marriage is going to end the feud between the families of Romeo and Juliet. He knows that even though Romeo and Jul iet are in love they will never be able to see each other. Not in a grave to lay one in, another out to haveÃ¢â¬ (Act II scene III 85) Also, if Friar Lawrence did not give Juliet the potion that she was going to use to deceive her family into thinking she was dead to get out of her marriage to Paris and make Romeo aware of what was going to happen, their deaths would not have occurred. Romeo goes to the tomb thinking Juliet is really dead after Balthasar accidently informed him of JulietÃ¢â¬â¢s apparent death not knowing of her plan. If he had stayed there longer without taking the poison he had obtained from Apothecary they both would not have killed themselves. He brought the poison to the tomb to end his own life next to Juliet after seeing for himself if she was really dead. Romeo did not want to live without Juliet. Capulet also played an important role in the death of Romeo and Juliet because he told Juliet that she was going to marry Paris and she had no choice. ByShow MoreRelatedWho is Responsible for the Death of Romeo and Juliet? 778 Words Ã |Ã 3 Pagesthe tragic play Romeo and Juliet by William Shakespeare, Romeo met Juliet from an enemy family in a party that he was not supposed to attend, and they quickly fell in love. Of course, this forbidden love brought unfortunate luck, and both Romeo and Juliet died at the end of the play. Who shall be held responsible for the death of Romeo and Juliet? This question has been bothering people, and yet to be answered. There are indeed many variables that have affected this, but I think Romeo himself is responsibleRead MoreWho Should Be Held Responsible for the Death of Romeo and Juliet?1032 Words Ã |Ã 4 PagesRecently we have read the renown tragic play of Romeo and Juliet, by William Shakespeare. As we all know, this tragedy ends by the untim ely death of Juliet and her Romeo. But after putting down the book, a question comes to mind: who is truly at fault for the death of those two teenagers? Who is truly responsible for turning this story into a tragedy? Or is anyone even guilty at all? After some reflection, I have come to the conclusion that nobody is really at fault, but that everybody did a littleRead MoreWho is Responsible for the Tragic Deaths of Romeo and Juliet Essay1139 Words Ã |Ã 5 PagesWho is Responsible for the Tragic Deaths of Romeo and Juliet Romeo and Juliet, a tragedy written by William Shakespeare in the 16th Century all about two strong hearted teenagers in the city of Verona in Italy who fall in love with each other as star crossed lovers. The two young teenagers of feuding families were destined to fall in love, however many problems occur to the extent of suicide, that affect their relationship, one of the main factors is the feud between Read More Who is Most Responsible for the Deaths in William Shakespeares Romeo and Juliet639 Words Ã |Ã 3 PagesWho is Most Responsible for the Deaths of Romeo and Juliet Romantic love stories are often ended with a tragedy, because of loss of passion or a loved one. These tragedies are often the result of one personÃ¢â¬â¢s actions that ended someoneÃ¢â¬â¢s life or love. In the Romeo and Juliet play written by William Shakespeare, two citizens of Verona come together and fall deeply in love. Unfortunately their love comes to an end, along with their lives, because of a misunderstanding and a persistent feud betweenRead MoreEssay about Who Is Responsible for Romeos Death742 Words Ã |Ã 3 Pages25 January 2012 Who is Responsible for RomeoÃ¢â¬â¢s Death In the play Romeo and Juliet by William Shakespeare there is much debate about who is responsible for RomeoÃ¢â¬â¢s death. Romeo and Juliet is a play where two forbidden lovers get married in secret despite their familiesÃ¢â¬â¢ feud. After Tybalt, JulietÃ¢â¬â¢s cousin, kills Mercutio, RomeoÃ¢â¬â¢s best friend, Romeo kills Tybalt and is banished from Verona with the promise of death upon return. Lord Capulet plans to force Juliet to marry a man named Paris, butRead MoreWilliam Shakespeare s Romeo And Juliet977 Words Ã |Ã 4 Pagesplay, Romeo and Juliet by William Shakespeare. It is a tragedy about two lovers, Romeo and Juliet, who unfortunately, belong to families who bear an ancient grudge against each other. In the play, Romeo and Juliet fall in love and quickly decide to marry each other. At the end, Romeo and JulietÃ¢â¬â¢s decisions cause their untimely death, but in reality, there were other people who also contributed to the loverÃ¢â¬â¢s death. Friar Laurence, the Nurse and Lord Capulet are responsible for the tragic deaths of RomeoRead MoreWilliam Shakespeare s Romeo And Juliet1521 Words Ã |Ã 7 Pagesgoes wrong, people will point fingers and blame the person responsible. In William ShakespeareÃ¢â¬â¢s story, Ã¢â¬Å"Romeo and Juliet,Ã¢â¬ two teenagers fall in love with each other, but due to some charactersÃ¢â¬â¢ actions, Romeo and Juliet die. Their loss turns the love story into a tragedy. The CapuletÃ¢â¬â¢s house, Friar Laurence, and Romeo can be held responsible for the tragedy of Romeo and Juliet. The first ones to be blamed for the tragedy of Romeo and Juliet are the people in the CapuletÃ¢â¬â¢s house because of the mistakesRead MoreThe Death of Romeo and Juliet and Who is to Blame Essay examples1376 Words Ã |Ã 6 PagesThe Death of Romeo and Juliet and Who is to Blame Romeo and Juliet is a tragedy by William Shakespeare, in which a young boy and girl fall in love and commit suicide. They come from 2 different families which have a deadly feud against one another. Romeo goes to a masked ball at the Capulets household where he falls in love with Juliet. He then proposes to her after the party in secret at Juliets balcony. Romeo then arranges a secret weeding with Friar Lawrence andRead MoreEssay about Responsiblity for the Deaths of Romeo and Juliet1508 Words Ã |Ã 7 PagesResponsiblity for the Deaths of Romeo and Juliet The final tragedy in the play Ã¢â¬ËRomeo and JulietÃ¢â¬â¢ is the death of Romeo and Juliet. ItÃ¢â¬â¢s a result of the feud of the two houses: Capulets and Montagues, but amongst other likely causes are the personalities of Romeo and Juliet. Romeo is Ã¢â¬Ëhot-headedÃ¢â¬â¢ and Juliet lacks experience in life because of her young age. Other characters who play a significant part in driving them to their deaths are: Tybalt, Mercutio, Friar LawrenceRead MoreRomeo and Juliet Persuasive Essay660 Words Ã |Ã 3 PagesRomeo and Juliet Persuasive Essay This play is about a boy named Romeo and girl named Juliet. Their family are mortal enemies so that means that they are always fighting with one another. At a Capulet party Romeo and Juliet meet for the first time not knowing who each other are, until later that night that they are enemies. They begin to fall in love with each other and get married after meeting for one night. Then the drama gets to their head and they kill themselves. In Romeo and Juliet
Tuesday, May 5, 2020
Question: Discuss about the Injection Safety in Outpatient Settings. Answer: Introduction A safe injection is considered to be one that causes minimum harm or damage to the patient and the health care worker. The skin tissues often get infected by the entry of bacteria through injection into the deeper tissues of the skin. Streptococcus pyogenes, Staphylococcus aureus and coryneform bacteria are the most common microorganisms that are responsible for the incidence of skin infection at sites of medication injection (Stevens et al., 2014). The standard medical practice involves usage of pre-medicated 70% isopropyl alcohol swab to cleanse a skin area prior to injection. This report will critically analyse the necessity of nurses swabbing skin sites before administration of an injection and will comment on its clinical significance. The authors designed a quasi experimental study to assess the necessity of using 70 % alcohol swab for skin preparation before administering injections by clinical and pathological assessments. The effects of 70 % isopropyl alcohol and no preparation before injection, was studied. The two groups included receiving intramuscular (IM), intra-dermal (ID) and subcutaneous (SC) injection after skin preparation with alcohol swabs (221) and those who did not receive skin preparation (186). The skin was swabbed for 30 seconds and allowed to dry before injection. The injection area was assessed after 2-3 days. Pathological assessments were carried out among 51 patients, with and without alcohol swabs and the bacterial colony forming units (CFU/ml) were measured. A statistical analysis showed that skin preparation with alcohol swab destroyed 47% skin bacteria at injection site. Further, no skin preparation failed to show any infection signs. The mean CFU/ml was significantly high (2.473.86) fo r patients without swabbing, compared to those where alcohol swab had been performed. The use of alcohol swabs also involved larger costs. Thus, the study showed that swabbing technique was an inadequate safeguard against infection and failed to show any significant differences in systemic effects and clinical signs. The limitation lies in the fact that the entry of microorganisms by the three ways of injection was not evaluated separately (Khawaja et al., 2013). Insulin is usually injected to the subcutaneous tissue through a clean site on the skin. The study recruited 225 patients with insulin dependent diabetes mellitus and conducted a survey on history of diabetes, preferred injection practices, use of isopropyl alcohol swabs to sanitize skin before injection, and complications that arise from such injections. 10 cases of infection were found among patients who reported use of alcohol swabs very often. Furthermore, patients reporting no use of swabs showed 14 infection cases. Therefore, the results were consistent with the previous findings that alcohol antisepsis before injection fails to reduce incidence of infection at the site. The validity of the findings added to the strength. However, limitations were found in the form of selection bias. Routine users of alcohol swabs might be concerned about infections and are more likely to recall them (ONeill et al., 2013). The need for disinfecting the skin with alcohol swab before injections has long been questioned by the WHO. This study discussed evidences based on current recommendations on pre-injection skin preparation by analysing various articles and arriving at a consensus. The theoretical observations showed that it is impossible to sterilise the living skin by the use of chemical disinfectants. A swab of isopropanol reduces the numbers by 82-91% only. The observations in practice showed that no statistically significant differences were observed in response to formation of abscess at the injection site in the alcohol swab group and no pre-treatment group. Thus, a consensus was formed that skin preparation can be discontinued before subcutaneous injections and would probably not lead to any adverse effects among people with visibly clean skins (Qamar, Gillani Sulaiman, 2012). Critical observation During our clinical placement we were given training on the different measures that need to be adopted for preparing the skin for intramuscular and subcutaneous injections. The clinical placement enhanced innovative thinking capabilities and also provided an insight into the practices that were followed to avoid adverse health outcomes such as infection and abscess formation in patients. During the third week of my placement, a patient Clara (name changed) got admitted to the ward due to extreme loss in weight and appetite. She was 18 years old and had been suffering from type-1 diabetes. She reported symptoms of frequent urination, fatigue, excessive thirst and blurred vision. On admission, I was assigned the task of measuring her blood glucose levels. On assessment, they were found to be extremely high (302 mg/dl). My mentor immediately decided to start insulin therapy in order to control the blood glucose. My clinical knowledge had created the understanding that an alcohol swab was the traditional method of subcutaneous injections (Zhang et al., 2015). However, I was asked to arrange for disposable gloves, antibacterial soap and water for skin preparation. An essential part of learning lies in the fact that nurses should feel motivated to seize such learning opportunities and gather information from the seniors. Therefore, I approached my mentor and inquired the reason for avoiding alcohol swab prior to insulin injection. My mentor said that alcohol swabs have been found to cause cracks and sorenessin people with sensitive skin (Kundrapu et al., 2014). It dries the skin and has not proved effective in preventing skin infections, as evidenced from research articles (Hirsch, Byron Gibney, 2014). Thus, an antibacterial soap and water are used to wash the hands and a cotton wool dipped in water is used to wipe the site before injecting insulin (Kinnunen Mrsny, 2014). I followed my mentor and washed my hands with the antibacterial soap and water vigorously for 15 seconds. I was made to wear gloves after washing for further protection. Furthermore, I learnt that shared alcohol swabs or their inappropriate use often lead to viral contamination such as HCV (Palmateer et al., 2014). Thus, proper care should be taken to ensure that the same swab is not used to disinfect other body parts, as this would increase the risk of bacteria entering the injection site. Some of the recommendations are as follows: It should be made compulsory for healthcare professionals to wash their hands prior injecting a drug (Thompson et al., 2016). Most community healthcare centres should have access to proper sanitation facilities and community members should be encouraged to clean soiled skin of patients before administering any injection (Steinmann et al., 2015). Although alcohol swabs have not shown any significant improvements in preventing infection, care should be taken that sterilised alcohol swabs are used on the skin in cases where water is not available (Lai?Kwon et al., 2014). Alcohol swabs should never be used on sensitive skin if symptoms of dryness and irritation are observed. The skin site should subsequently be cleaned prior to injection. Separate swabs should be used for disinfecting several body parts. The alcohol swabs should never be shared among patients. Conclusion Thus, it can be concluded that cleansing the area with swabs is a traditional practice and is thought to prevent entry of bacteria through the site, into the deeper layers of the tissue. However, research evidences have failed to show their effectiveness in preventing such infection. Moreover, usage of shared swabs has been associated with several forms of contamination, and leads to dryness of the skin. Thus, it is advisable for nurses to use soap and water to cleanse their hands and the skin surface before injecting a drug. Use of alcohol swabs is therefore not a mandatory clinical practice. References Hirsch, L., Byron, K., Gibney, M. (2014). Intramuscular risk at insulin injection sitesmeasurement of the distance from skin to muscle and rationale for shorter-length needles for subcutaneous insulin therapy.Diabetes technology therapeutics,16(12), 867-873. Khawaja, R. A., Sikandar, R., Qureshi, R., Jareno, R. J. M. (2013). Routine skin preparation with 70% isopropyl alcohol swab: is it necessary before an injection? Quasi study.JLUMHS,12(02), 109. Kinnunen, H. M., Mrsny, R. J. (2014). Improving the outcomes of biopharmaceutical delivery via the subcutaneous route by understanding the chemical, physical and physiological properties of the subcutaneous injection site.Journal of Controlled Release,182, 22-32. Kundrapu, S., Sunkesula, V., Jury, I., Deshpande, A., Donskey, C. J. (2014). A randomized trial of soap and water hand wash versus alcohol hand rub for removal of Clostridium difficile spores from hands of patients.Infection control and hospital epidemiology,35(2), 204-206. Lai?Kwon, J., Ly, L., Su, J. C., Nixon, R., Tam, M. M. (2014). Unsuspected allergic contact dermatitis to alcohol swabs following neurosurgery.Australasian Journal of Dermatology,55(4), 296-298. ONeill, J., Grinager, H., Smith, S. D., Sibley, S., Harrison, A. R., Lee, M. S. (2013). Isopropyl alcohol skin antisepsis does not reduce incidence of infection following insulin injection.American journal of infection control,41(8), 755-756. Palmateer, N., Hutchinson, S., McAllister, G., Munro, A., Cameron, S., Goldberg, D., Taylor, A. (2014). Risk of transmission associated with sharing drug injecting paraphernalia: analysis of recent hepatitis C virus (HCV) infection using cross?sectional survey data.Journal of viral hepatitis,21(1), 25-32. Qamar, M., Gillani, S. W., Sulaiman, S. A. S. (2012). The Skin Preparation Knowledge, Attitudes and Practices among the Healthcare Professionals in Compliance with the World Health Organization (WHO) Guidelines.Journal of Clinical Diagnostic Research,6(6) 1041-1046. 6p. Steinmann, J., Becker, B., Bischoff, B., Steinmann, E. (2015). Alcohol hand rub or soap and water for removal of norovirus from handsthe debate continues.Journal of Hospital Infection,91(4), 371-372. Stevens, D. L., Bisno, A. L., Chambers, H. F., Dellinger, E. P., Goldstein, E. J., Gorbach, S. L., ... Wade, J. C. (2014). Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America.Clinical infectious diseases,59(2), e10-e52. Thompson, D., Bowdey, L., Brett, M., Cheek, J. (2016). Using medical student observers of infection prevention, hand hygiene, and injection safety in outpatient settings: A cross-sectional survey.American journal of infection control,44(4), 374-380. Zhang, L. J., Guerrero-Juarez, C. F., Hata, T., Bapat, S. P., Ramos, R., Plikus, M. V., Gallo, R. L. (2015). Dermal adipocytes protect against invasive Staphylococcus aureus skin infection.Science,347(6217), 67-71.