Setting up a Communications Technology Based Company Essay - 1

Setting up a Communications Technology Based Company - Essay Example The main clients of the company are home appliances selling companies and computer retailers. These companies usually need call centres to deal with customer complaints. Call centres also guide users when they face any problem with the products. Tele Solutions also offer online customer care services. Customers can contact the company through internet and Tele Solutions will help them solve their problems. The name of the company is Tele Solutions and it will be based in Central London. Tele Solutions helps businesses outsource their customer care call centres. The name is chosen keeping in mind the service that is being offered by the company. There will be 100 employees in the company as it is a small company. When starting operations low number of employees will help the company lower its costs and risk. The services offered by the company are very useful for businesses because people face problems with technology items like home appliance and computers. Usually they do not have enough time to go through the instruction manual therefore they contact the customer care services. This is where our company will come in and provide facility to businesses and will charge a fee for it. The structure of the company will be horizontal and team based. Groups will be formed and each group will be working on a separate company. The teams will choose their own leader and the leader will only act as a guide and will provide support to the group members. It has been identified that call centre employees show distress and anxiety due to strict work methods and non supportive leaders (Holman, D. 2006) therefore Tele Soft will have a supportive environment and employees will be free to design their own activities. This structure will also be a success strategy for the company. Motivated employees will bring business to the company. Also company will be

Observation Mini-Study Research Paper Example | Topics and Well Written Essays - 500 words

Observation Mini-Study - Research Paper Example Using direct observation as the main approach to data collection, the researcher sought to establish whether the hypothesis of racial disparity in the sitting arrangement existed, and possibly find ways of resolving the issue by creating race parity. The researcher sought permission from the university and the management of a middle-level restaurant existing near the university well in advance prior to the study. The restaurant is situated a few miles from the university, a development that limited research-related costs upon the researcher. Sitting comfortably at the back of the restaurant between 11:00pm and 4:00pm, the researcher gathered information about the sitting arrangements, the people’s behavior and what they were saying. The outcomes revealed that in deed more whites preferred executive seats and tables stationed at the front part of the restaurant with more adequate spaces between them and tended to refer to the other races in derogatory remarks like â€Å"front seats are for whites†. In light of this, people of color including Hispanics, blacks, Africans, and Asians found themselves relegated at the back of the restaurant where the furniture were more closely-packed. This finding lends credence to the hypothesis that racial disparity plays out in the sitting arrangement of people in US restaurants. Observation as a method of research has merits and demerits. A major merit of conducting observation research is that the researcher can record what they see and hear as the focus group goes about their normal activities in real life situations, rather than relying on what they say they do (Maxfield, & Babbie, 2010). As Maxfield and Babbie (2010) have pointed out, in Criminology, observation is the main source of securing information, especially in situations where approaching criminal suspects for interview or written responses is less likely to precipitate

Social Media and Networking Presentation Essay Example for Free

Social Media and Networking Presentation Essay Scenario: Imagine that you have been hired as a consultant for a university that wants to leverage social media and networking technologies to encourage the collaboration of students, and improve their overall sense of community. Analyze how the university might integrate at least two social media and networking technologies to accomplish their goals. Your analysis must cover the advantages and disadvantages of social networking. The president of the university also needs to know what the system development life cycle is, and how you intend on bringing social networking tools to life within this cycle. Translate the critical details of your proposal into a 10- to 15-slide Microsoft ® PowerPoint ® presentation that you will present to the university president. Include the following in your presentation using the features of Microsoft ® PowerPoint ®: A slide template Slide layouts Themes At least one example of animation At least one example of a media object Submit your presentation as instructed by the facilitator.

Assessment and Management of Pressure Ulcers: Nursing Interventions

Assessment and Management of Pressure Ulcers: Nursing Interventions Pressure ulcers continue to present a prevalent concern for patients in health care facilities and the incidence is even expected to rise further with the increasing age of the population. This is a problem that has high potential to be prevented. Therefore, the prevention, assessment, and management of decubitus ulcers are of great importance to healthcare professionals who are charged with the care for these individuals (Clarke et al., 2005). Pressure sores occur when there are localized areas of tissue damage or ulceration of the integument second to decreased blood supply disruption to these soft tissues. This occurs as a consequence of constant pressure, where the pressure exerted on an area is greater than the capillary pressure causing ischemia, friction, or shear force. Florence Nightingale, often considered the pioneer of nursing, recognized in 1860 that quality nursing care can prevent the occurrence of decubitus ulcers among patients (Ousey, 2005). Quality of care will be increased with the implementation of nursing interventions surrounding bed sores. Pressure ulcers present a cost to the health care providers, both financially and time. Pressure ulcers can increase nursing time up to 50%, which is relatively substantial considering many healthcare facilities face nursing staff shortages (Clarke et al.). According to the article written by Joan Wurster, the cost of pressure ulcers is substantial with stage one, two, and three stage ulcers costing between $2,000 and $30,000, and stage four pressure ulcers costing up to $70,000. The cost involved with treating such bed sores often times exceeds the cost of prevention by a large sum of money (Wurster, 2007). Preventative measures are, therefore, essential to implement and include interventions. There are several guidelines listed in National Guideline Clearinghouse regarding pressure ulcers including Assessment and Management of Stage I to IV Pressure Ulcers. This guideline establishes several recommendations such as assessing a patients risk using the Braden Scale, use of special pr essure reducing mattresses, managing adequate nutrition. If a pressure sore is to develop, evidence shows that a proper high-protein diet, the use of wet-dressings, and hyperbaric oxygen as treatments all promote the wound healing process. In taking such actions, the goal of the healthcare provider is that the patient will be free of pressure ulcers during hospitalization and appropriately assessed and managed if one does occur (Registered Nurses Association of Ontario, 2007). Research shows that using evidence-based guidelines, which incorporate scientific evidence and clinical expertise, are the premise of successful prevention and treatment of pressure ulcers (Clarke et al., 2005). Assessment of Patient Risk Using the Braden Scale Prompt and accurate risk assessment is critical in preventing the formation of pressure ulcers. The Braden Scale was created and is now used in countless hospitals to facilitate and guide the nursing care team in their evaluation. Not only can this assessment tool inform a health care professional of any propensities towards skin break down, but also may allow him or her to treat the condition prophylacticly if indicated. Rather than just risk assessment, the Braden Scale may be used for evaluation of the current effectiveness of ulcer care regime for patients with existing ulcers (Braden Maklebust, 2005). The Braden Scale was created in 1984 by Barbara J. Braden, to accurately and systematically describe the risk for development of pressure ulcers (Braden Maklebust, 2005). This scale includes six subscales: sensory perception, moisture, activity level, mobility, nutrition status, as well as the skins exposure to friction and shear forces. Using established guidelines, the nurse assesses the patient and associates his or her findings with a numerical value. These are combined and a patient is given a total score which is indicative of the clients risk of developing a pressure ulcer (Ousey, 2005). Final scores can range anywhere from 6-23. A person is considered at risk if their resulting score is less than 18, as this is the point research shows the relationship between ulcers and risk factors becomes relevant. The lower a patients score, the greater threat they experience of developing a pressure sore (Braden Maklebust, 2005). This information can be used to determine what preventat ive practices can be implemented, as well as the establishment of baselines to gauge the effectiveness of the practices. It should be standard protocol for healthcare facilities to have their staff use the Braden Scale or other objective risk assessment tools when appropriate. Currently, most accreditation agencies now require some form of risk assessment, yet often assessment are shortened, excluding vital factors and skewing the validity of the assessment (Braken Maklebust, 2005). It is up to hospitals, or other care facilities, to ensure that these measures are being implemented. It is best if a minimum standard protocol is established, and the frequency of assessments tailored based on the individuals needs. Recommendations suggest an assessment upon admittance and base the remaining intervals off of the stability of the patients condition. In an acute care setting it is suggested patients be reassessed at least every forty-eight hours, if not more frequently. ICU patients should be reassessed daily if they remain in a stable state or every shift if they are not (Braken Maklebust, 2005). In the e vent of the discovery of the indicators of pressure sores then increasingly aggressive preventative measures can be implemented to prevent the occurrence of ulcers, and minimize the discomfort or complications to the patient. Once standard protocols are integrated it is important to evaluate their effectiveness. Baseline values must be obtained. Since the goal surrounding this nursing intervention is reducing the frequency, it would be logical to obtain the rate at which pressure ulcers are occurring, taking into account the demographics of the patients being evaluated. Braden scale assessment totals and other assessment findings such as erythema, non-blanching hyperaemia, blisters, discoloration, and localized heat and edema, should be documented for each patient and checked for improvement for the individual (Braden Maklebust, 2005; Ousey, 2005). Proof of this documentation must be recorded. After a healthcare facility establishes a standard for using a risk assessment tool at a set interval, the rate should once again be evaluated and compared to the original figures to note any improvement. Studies have been conducted in a similar fashion to evaluate the success of employing the Braden Scale into com mon practice. A study found that patients in a large tertiary care ICU, after Horn and colleagues implemented use of the Braden Scale and preventive protocols, the incidence of pressure Ulcers among the most critically ill patients decreased from 33% to 9% ( as cited in Braden Maklebust, 2005, p. 71). Statistical analysis shows that including the use of the Braden Scale in your plan of care can reduce the rate of pressure ulcer formation substantially, making this guideline applicable to the patient goal. Use of High Specification Foam Mattress Pressure ulcers occur as a result of decreased capillary blood flow to dermal tissues, as oxygen and nutrients are not delivered, and wastes not removed. The use of support surfaces, such as mattresses, mattress overlays, or dynamic support surfaces, is an intervention for prophylactic treatment of pressure injury. In order maintain some perfusion, the external tissue pressure must remain above the capillary closing pressure of 33 mmHg. This is of extreme significance around bony prominences , including tissues over the sacrum, Ischia, greater trocanters, external malleoli, and heels, all of which are frequent areas susceptible to impaired localized skin integrity (Thomas, 2008). According to Ousey, this information is very pertinent, especially when doing a comparison to the force between bony prominences and a standard hospital mattress. These forces ranged between 70 and 100 mmHg, clearly above the capillary closing pressure. If a patient is unable to move, this pressure is too great for the body to handle, and tissue damage occurs (Ousey, 2005). The use of high specification foam mattresses cradles the body in its entirety and distributes the weight so pressure is distributed over a larger surface area (McInnes, Cullum, Bell-Syer, Dumville, 2008). The goal of replacing the mattress or using other supportive surfaces is to reduce the pressure between the patient and the supportive surface below 33mmHg, allowing for blood flow in those patients who are immobile or have decreased sensation (Thomas, 2008). Preventative transfers of patients of moderate to high risk for developing pressure ulcers to high pressure reducing surfaces has the ability to substantially decrease the prevalence of pressure related injuries. The Prevention and Management of Pressure Ulcers article states that when compared to a standard hospital mattress, a number of pressure-reducing devices lower the incidence of pressure ulcers by about 60% (Thomas, 2008, p. 243). Regulation surrounding this issue should be instituted as part of the creation of the plan of care when considering prediction and prevention of decubitus ulcers. Evidence-based research shows that there is no significant difference between eh use of alternating pressure dynamic air flow beds, silicone overlays, foam overlays, sheepskin overlays, or other air filled devices. Health care facilities should take into account the cost and ease of use when purchasing these (Reddu, Gill, Rochon, 2006). Once again, in order to evaluate effectiveness, baseline values of the grade and prevalence of ulcers must be obtained and compared with values obtained at a later time after changes in care have been implemented. It is important to note such things as the age, activity tolerance, gender, present illnesses, and type of supportive surface used to prevent the formation of an ulcer. A guideline followed in an experiment conducted by de Laat, preventative transfers were arranged prior to ulcer formation in the event of finding nonblanchable erythema or an expected immobility exceeding seventy-two hours. Following these procedures surrounding preventative transfers, as well as the sound clinical judgment, proved to be the of the strongest statistical significance in reducing the pressure ulcer density grade II-IV within a one year time period (de Laat et al., 2007). The use of pressure-reducing surfaces, especially if used as a early, is another intervention that will help reach the patie nt goal of preventing the occurrence of pressure ulcers. Managing Nutrition Insufficient nutrition predisposes individuals to developing a pressure ulcer, as well as delays the healing process of sores that do form. Proper nourishment and hydration are behind all body processes, both vital in function and not. It is imperative to maintain good nutrition to provide an optimal environment so that homeostasis may be maintained. However, it is a common occurrence that clients who are admitted to the hospital dont have optimal intake of food or water due to a variety of factors including eating nothing by mouth prior to surgery, unconsciousness, feeling of nausea, presence of illness, polypharmacy, and physical or mental disability (Ousey, 2005). These conditions may result in poor nutrition or malnutrition statuses. The problem lies in the fact that there is no definitive diagnosis for undernutrition. Weight loss and biochemical data of hepatic proteins are the accepted standard. Albumin, pre-albumin, and hemoglobin levels are analyzed. Even though these indicat ors help health care professionals evaluate possible nutrition issues and possibly identify those at risk for developing, they can fluctuate due to underlying disease or hydration status (Dorner, Posthauer, Thomas 2009; Thomas, 2008). Inadequate intake of calories, proteins, fluids, vitamins, and minerals, as well as a low body mass index, may result in impaired skin integrity. It is not yet universally accepted that nutrition status is directly linked to the development of pressure ulcers because studies have not been producing consistent results showing the relationship. On the other hand, there is an accepted correlation between nutritional status and wound care healing. Therefore, it is essential that clinical malnutrition is prevented. A well-balanced diet high in protein is necessary for the healing of pressure ulcers (Dorner, Posthauer, Thomas 2009). Increased calorie and nutrient consumption is required to overcome the hypermetabolic state and increased energy needs. Carbohydrates are needed for the synthesis of glucose, glutamine is needed to serve as a fuel source for epithelial cells, arginine is supports the formation of protein, fluids are needed to serve as a solvent and transportation, ascorbic acid for the production of collagen, and zinc for collagen formation, protein synthesis, and cell proliferation. Perhaps the most important nutrient needed for wound healing is protein. It is needed to maintain nitrogen balance and for the synthesis of enzymes involved in wound healing and collagen and connective tissue production. In order to ensure that all clients have met these nutritional needs, support may be desirable. These include consultation with a dietitian, consultation with a speech pathologist if indicated, use of nutritional supplements, enteral feeding, and parenteral nutrition (Dorner, Posthauer, Thomas 2009). All people are at risk for malnutrition whether young or old, so upon admission, all patients nutritional status should be assessed to determine existing or potential malnutrition, and referred for further help if indicated. Throughout the clients stay at the hospital, all patients intake should be monitored for nutritional value and fluid consumption. If indicated additional supplements should be given within recommended daily intake norms if needs are not met. The obtained information on nutritional status must then be compared with progress made in the healing of the pressure sore, including decreased size and depth, as well as decreased exudate. Reassessment of hepatic lab proteins and body weight may be recorded multiple times to evaluate any improvements. Adequate nutrition may prevent the development of pressure ulcers. More importantly a well balanced-high protein diet can be used in the management of pressure ulcers in the aspect of promoting healing if a pressure ulcer does develop (Ousey, 2005). Use of Moisture-retentive Dressing In the event that all preventative measures have failed, and a pressure ulcer does form, it is recommended that moisture-retentive dressings are used to encourage healing. Moist wound treatment has shown to be optimal in promoting reepithelialization. According to Thomas, Moist wound healing allows experimentally induced wounds to resurface up to 40% faster than air-exposed wounds (Thomas, 2008, p. 246). There are now dressings, called occlusive dressings that were developed to maintain the moist environment. There are other benefits to using this treatment as wounds are further protected from infection and pain is reduced (Thomas, 2008). The introduction of occlusive dressings as a primary treatment is beneficial. Several types of occlusive dressings may be used, such as polymer foams, hydrogels, hydrocolloids, alginates, and biomembranes. All of these have proven to be effective. Four out of five trials comparing hydrocolloid dressing with a moist gauze dressing demonstrated higher healing rates (Thomas, 2008, p 250). Effectiveness of treatment can be evaluated in the time needed for complete healing. Decrease in size and depth, reduced erythema , no exudates production, and increased collagen synthesis are all signs and symptoms indicating healing of pressure ulcers (Ousey, 2005). Hyperbaric Oxygen Treatment Hyperbaric oxygen (HBO) therapy for chronic wound care is a relatively new concept. Sometimes pressure sores take a prolonged period of time to heal. In HBO therapy, the patient intermittently breathes 100T% oxygen, while the pressure exerted on the body within the treatment chamber is raised to greater than 1 atmosphere absolute (Hunter, Langemo, Anderson, Hanson, Thomson, 2010, p 116). Often chronic wounds take a longer duration to heal due to ischemic injury, and hyperbaric oxygen therapy directly addresses that. These specialized conditions are at the root of why hyperbaric oxygen therapy proves to be beneficial. In these chambers, the amount of oxygen availability is significant and increased atmospheric pressure causes oxygen exchange between the air and the tissues (Hunter et al., 2010). This regime involves effective management and treatment of pressure ulcers in the event a pressure ulcer does not heal. Although not available at all facilities, hyperbaric oxygen therapy should be recognized as a treatment option for chronic pressure ulcers. Patients should be presented with the option if indicated. To ensure this alternative treatment is presented, it should become a standard requirement to document it. If this becomes the choice of therapy, it is necessary to evaluate the effectiveness of the treatment by looking for signs of ulcer healing. In one study, chronic wounds were monitored for an eight week time period with hyperbaric therapy. The results showed shrinking of wound size in all participants and even a 16% healing rate (Hunter et al, 2010). Similar standards would need to be implemented with therapy to ensure its efficacy to the individual patient. Hyperberberic oxygen treatment should not be mandatory, but recognized as an option when considering the patient goal of managing pressure ulcers. Conclusion Although pressure ulcers are a problem found in many healthcare facilities, it is a problem that has a wide range of solutions. Decubitus ulcers can negatively affect a clients quality of life and there are potential medical complication, including coma and death associated with this condition. Proper assessment and management of pressure ulcers is a reflection of quality of care. Evidence-based nursing interventions such as assessing a patients risk using the Braden Scale, use of special pressure reducing mattresses, managing adequate nutrition the use of wet-dressings, and hyperbaric oxygen as treatments, have been proven to be effective and are all of great importance in improving patient care (Registered Nurses Association of Ontario , 2007). The goal of keeping patients free of ulcers during hospitalization and proper management of pressure ulcers if one does develop, must be at the root of all tasks. Evidence Based guidelines must be established and disseminated throughout the United States, and practiced in order to reduce the frequency and improve the care surrounding pressure ulcers.

Comparing Robert Frost and Emily Dickinson Essays -- Comparison Poetry

Comparing Robert Frost and Emily Dickinson as Poets Often, the poets Robert Frost and Emily Dickinson try to convey the themes of the meaning of nature, or that of death and loneliness.   Although they were born more than fifty years apart their poetry is similar in many ways.   Both poets talk about the power of nature, death and loneliness.   However, Dickinson and Frost are not similar in all poetic aspects.   In fact, they differ greatly in tone. Emily Dickinson and Robert Frost both talk about the power of nature in their poetry.   Dickinson uses this theme in her poem " `Nature' is what we see -."   The power of nature is strongly portrayed in this poem by Dickinson's articulation of what the speaker see's in nature.   " `Nature' is what we see -... / Nature is what we hear -... / Nature is what we know -" (277 lines 1,5,9).   Nature is everything to a person, it appeals to all senses.   Dickinson also says in this poem, "So impotent Our Wisdom is / To her Simplicity" (277).   The speaker is saying that nature has such great power that one can't even comprehend her simplest ways. In comparison ... ...89.   p466. ----- "Birches."   American Literature. New York:   Scribner Laidlaw.   1989.   p472,473. ----- "Fire and Ice"   American Literature. New York: Scribner Laidlaw.   1989.   p466. Freeman, Margaret. "Metaphor Making Meaning: Dickinson's Conceptual Universe." Journal of Pragmatics 24 (1995): 643-666. Nesteruk, Peter. "The Many Deaths of Emily Dickinson." Emily Dickinson journal 6.1 (1997): 25-44. White, Fred D. "`Sweet Skepticism of the Heart': Science in the Poetry of Emily Dickinson." College Literature 19.1 (Feb 1992): 121-128.

Why is it important for the school to concern itself with childrens :: Education

Why is it important for the school to concern itself with children's social and emotional development? Examine ways in which this could be attempted. In light of the current climate and the pressure on schools to improve standards, it may seem a strange question to ask. However it is such a fundamental issue that it is not only important but also vital for the school to concern itself with children's social and emotional development. This duty is now no longer an option. The aims of the National Curriculum as set out in the1988 Education Reform Act states that a school's curriculum should: "promote the spiritual, moral, cultural, mental and physical development of pupils at the school and of society." (Kyriacou,1995)(p.18) Before elucidating on this question, it is important to know exactly what is meant by social and emotional development. Daniel Goldman defines 'Emotional Intelligence' as an ability firstly to understand why we behave the way we do and secondly to control those actions that are inappropriate to the situation. It is also the ability to empathise and understand the emotions of others (Goldman 1996). Hence, the ultimate aim in this area with regards to child rearing is for a well-balanced and centred human being. The majority of people also generally accept that to have been loved and accepted unconditionally by just one other human being, as a child is enough for them to grow to be normal and well balanced adults. It is therefore very clear that parents have a large influence over this area of development. So, why should schools concern themselves with the social and emotional development of children? Bandura, one of the main exponents of social learning theories argues that there has been an underestimation of the importance of modelling, particularly with regards to learning social skills (Fontana, 1988). Children have a great tendency to imitate the behaviour of others. This imitation tends to be of people who enjoy status and standing. This starts with parents first. It then includes outside people such as teachers who in the majority of cases for children are the first outside relationship that holds a position of authority. Teachers act as role models for children. It is not so much what a teacher tells a child but more the way he/she behaves towards the child that has the influence. Bandura held that children learn social behaviour through social contacts. In particular he made a study of aggression. He showed how children who were exposed to adult aggression, were more likely to become aggressive themselves. It was not the fact that these children were exposed to aggression but the fact that the aggressive behaviour seemed to be sanctioned by the adults.

Analysis of “The Doctor in the House” by R.Gordon

The text under analysis is an extract from the book â€Å"Doctor in the house† written by a famous English-speaking writer Richard Gordon by name, who was born in 1921 .Richard Gordon is the pen name used by Gordon Ostlere, an English surgeon and anaesthetist.Richard Gordon has written numerous novels, screenplays for film and television and accounts of popular history, mostly dealing with the practice of medicine. He is most famous for a long series of comic novels on a medical theme starting with Doctor in the House. Gordon worked as anaesthetist at St. Bartholomew's Hospital and later as a ship's surgeon and as assistant editor of the British Medical Journal.In 1952, he left medical practice and took up writing full time. The text is devoted to the final examinations at the medical institutions and tells us about the condition of students before, during and after exams. This extract is constructed around the single theme -the procedure of the exams. Therefore, the theme of the text is examination time.The author uses numerous thematic words, such as: the student, the final examinations, the exams, to prepare, the examiners, cheating, textbooks, to swot up, the written papers, uniformed, examinees, knowledge, tripos, viva, marking, grading, to pass and so on.Besides the basic theme the text touches upon many very important secondary themes: the psychological types of students, cheating at the exams, students’ prejudice, disadvantage of women student at the exams, the psychological pressure of the process of the examination on the students.The main idea conveyed by the author may be expressed as: the examination is like a lottery(much depends upon luck). The plot structure is closed, because it contains all the components. From the exposition we learn general information about students’ attitude to the final examinations and the way of preparation for this important event, the condition of students before, during and after exams.It begins with the comparison the final exams with death; this image presents the students’ attitude to the event. The author  gives the description of preparation for the examinations. â€Å"To a medical student the final examinations are something like death: an unpleasant inevitability to be faced sooner or later†¦Ã¢â‚¬  The exposition ends with  Ã¢â‚¬Å"†¦ and ran a final breathless sprint down the well-trodden paths of medicine.†The main character is medical student R. Gordon.( and the students themselves). Author tells us about him nothing, because he wants to say that Gordon is an ordinary student. Author uses indirect method of characterization, and we can learn something of him only through his feelings. And we see the exams through his own eyes. The story is told from first person narration. The place is a medical universityThe time is the examination timeThe atmosphere is tense and excitingThe story contains 2 logical parts . The narrator depicts the pro cedure of the exams which consists of two parts: written papers, after which one of the students gives a very specific theory of the way the tripos is marking at Cambridge; and the viva – the oral examination, before which he characterizes different types of candidates’ behavior anticipating it. The complication of the narration is showing the process of exam, candidates’ excitement and suspense of the results.This part of the text stretches from â€Å"The examination began with the written papers† to â€Å"†Number three oh six?† the Secretary whispered, without looking up from the book. â€Å"R. Gordon?† â€Å"Yes† I croaked.† The tension reaches its highest degree when poor Gordon almost believe in his fail. And the climax, when the Author describes how the Secretary of the Committee calls out Gordon’s name, because in that moment we become interested in his results, do he pass or fail.â€Å"The world stood still . The traffic stopped, the plants ceased growing, men were paralysed, the clouds hung in the air, the winds dropped, the tides disappeared, the sun halted in the sky. â€Å"Pass,† he muttered.† The author deliberately postpones the denouement keeping the reader in pressing anticipation. It comes in the last paragraph, after the moment when he heard the magic word â€Å"Pass†. It was a kind of liberation and the ending of suffering . â€Å"Blindly, like a man just hit by a blackjack, I stumbled upstairs.†This text is narration with elements of dialogues. The style of written prose is formal. The story deals with describing process of exams, difficulties provided by them and students feelings and thoughts before and after examination. The author tries to convey hard emotional state of the medical students in his novel. He manages to do it with the abundant use of stylistic devices.Similes: â€Å" To a medical student the final examinations are something lik e death† â€Å"I was shown to a tiny waiting-room furnished with hard chairs, a wooden table, and windows that wouldn't open, like the condemned cell.† â€Å"The days after the viva were black ones. It was like having a severe accident.† â€Å"The room had suddenly come to a frightening, unexpected silence and stillness, like an unexploded bomb.†Ã¢â‚¬Å"he goes at them like a prize-fighter†, â€Å"porters like the policemen†, â€Å"the god’s brow threatens like imminent thunderstorm† â€Å"my palms were as wet as sponges†, â€Å"blindly, like a man just hit by a blackjack†.The author brilliantly uses the allusion referring to the Bible’s Judgment day. We discover that final exams are death and the Secretary as an archangel corresponds where they would go to the paradise or to hell. â€Å"The candidate would step up closely to the Secretary, who would say simply â€Å"Pass† or â€Å"Failed†. Succ essful men would go upstairs to receive the congratulations and handshakes of the examiners and failures would slink miserably out of the exit to seek the opiate oblivion.†Metaphor: ‘a straight contest ’ â€Å"an examination is nothing more than an investigation† â€Å"the Old Stager, who treated the whole thing with the familiarity of a photographer at a wedding† â€Å"the well-trodden paths†.Some hyperboles create a great chasm between students and examiners:† But the viva is judgement day. A false answer, and the god's brow threatens like imminent thunderstorm.† The other ones reflect the influence of candidate’s fears on theirs health and perception of the world: â€Å"But the viva is judgement day. A false answer, and the god's brow threatens like imminent thunderstorm.†The following short parallels constructions help to reflect the tense during anticipation of the narrator’s result: â€Å"The world stood still. The traffic stopped, the plants ceased growing, men were paralysed, the clouds hung in the air, the winds dropped, the tides disappeared, thesun halted in the sky.†Ã¢â‚¬Å"Whether these people were so brilliant they were able to complete the examination in an hour and a half or whether this was the time required for them to set down unhurriedly their entire knowledge of medicine was never apparent from the nonchalant air with which they left the room.†Ã¢â‚¬Å"The world stood still. The traffic stopped, the plants ceased growing, men were paralysed, the clouds hung in the air, the winds dropped, the tides disappeared, the sun halted in the sky.†Irony: â€Å"Whether these people were so brilliant they were able to complete the examination in an hour and a half or whether this was the time required for them to set down unhurriedly their entire knowledge of medicine was never apparent from the nonchalant air with which they left the room.†Inversion:â€Å" To a medical student the final examinations are something like death† â€Å"In the square outside the first person I recognized was Grimsdyke.† â€Å"Next to him, a man of the Frankly Worried class sat on the edge of his chair tearing little bits off his invitation card and jumping irritatingly every time the door opened. â€Å" â€Å" Blindly, like a man just hit by a blackjack, I stumbled upstairs.† Epithet:impressionable music despondently ticked flagrant cheating looked dispassionately down anonymous examinees tiny waiting room came solemnly down the stairs restless crowdOxymoron: â€Å"There is rarely any frank cheating in medical examinations† â€Å"to give the examiners the impression of frustrated brilliance.† â€Å"Some of them strode up for an extra answer book, with an awkward expression of self-consciousness and superiority in their faces.† Repetition:â€Å"Number one hundred and sixty-one,† he began. â€Å"Number three hundred and two. Number three hundred and six.† Grimsdyke punched me hard in the ribs, â€Å"Go on,† he hissed. â€Å"It's you!†Idioms: to keep an eye open for terrible displeasureMetonymy: â€Å"The room had suddenly come to a frightening, unexpected silence and stillness, like an unexplodedbomb.†Emotionally coloured verbs: Gaze,hiss,croak,stumbleGradation: â€Å"The world stood still. The traffic stopped, the plants ceased growing, men were paralysed, the clouds hung in the air, the winds dropped, the tides disappeared, the sun halted in the sky.†This story is rather interesting and attracts the reader’s attention. It makes us to experience the psychological state of the students .