Wednesday, July 31, 2019

Sectarianism in Pakistan

Sectarianism in Pakistan INTRODUCTION The decade of the 1990s witnessed a frightening upsurge in the Shia-Sunni sectarian violence in Pakistan, both in terms of scope and intensity. Recently, sectarian strife has engulfed even those areas, which were previously unaffected, largely because of the emergence of organized terrorist groups along sectarian lines. Besides target killings, these groups hit even ordinary members of each other’s sects. The problem, therefore, is no more of an occasional nature, or limited to isolated localities.Rather, it has now become a national concern with serious implications for the state and society. The paper argues that though the Shia-Sunni conflict is not new to Pakistan or even to the Indo-Pakistan Subcontinent, the ongoing phase is distinct in several ways:  · Firstly, the level and intensity of violence is high because of easy access to weapons and training facilities in Afghanistan.  · Secondly, certain Islamic states such as Iran and Saudi Arabia sponsor the activities of sectarian groups. This adds a regional dimension to the domestic sectarian conflict. Thirdly, the social base of the sectarian conflict has significantly expanded because of factors including: a) Use of print media, school textbooks, religious literature, posters and banners; b) Accessibility to means of electronic communication; c) Better transport services which increase mobility of sectarian activists. To argue thus this paper is divided into following three sections: 1) Sectarian Violence and its origins; 2) Causes of Sectarian Violence in Pakistan; and 3) Failure of State. SECTARIAN VIOLENCE AND ITS ORIGINS This section discusses the history of sectarian violence.Sectarian violence and religious extremism is an unpredictable menace. History is replete with incidents of such sorts in various countries. The bigots and the evil minded selfish natured people are behind this abhorrent act relating to the security concerns of many nations. Unfo rtunate is the fact that usually the third world Muslim countries have been and are being constantly threatened by these evil acts. Sectarian Violence in Muslim History: Since the very beginning, the Shia-Sunni sectarian conflict has been one of the major characteristics of Muslim history.Different factions in the respective Muslim societies have also closely interlinked it to the struggle for the acquisition of political power. Syed Amir Ali remarks: â€Å"Alas! That the religion of humanity and universal brotherhood should not have escaped the internecine strife and discord; that the faith which was to bring peace and rest to the distracted world should itself be torn to pieces by angry passions and the lust of power. â€Å"1 At the centre of sectarian strife has been the Shia-Sunni conflict.Immediately after the passing away of the Prophet of Islam, a division emerged on the question of succession. â€Å"A small group believed that such a function must remain in the family of the Prophet and backed ‘Ali’, whom they believed to have been designated for this role by appointment and testament. They became known as his ‘partisans’ (shia) while the majority agreed on Abu Bakr on the assumption that the Prophet left no instruction on this matter; they gained the name ‘The People of Prophetic Tradition and consensus of opinion’ (ahl al-sunnah wa’l-jama‘ah). â€Å"Besides the political dimension, there also existed a difference of opinion about the merits and functions of the successor to the Prophet. â€Å"Sunni Islam considered the Khalifah to be a guardian of the Sharia‘h in the community, while Shi‘ism saw in the ‘successor’ a spiritual function connected with the esoteric interpretation of the revelation and the inheritance to the Prophet’s esoteric teachings. † In contrast to the Sunnis, the institution of Imamate is fundamental to the Shia Islam. â€Å"The Imam, 1 Syed Amir Ali, The Spirit of Islam (Karachi: Pakistan Publishing House, 1976), p100. esides being a descendant of the Prophet, must possess certain qualities—he must be Ma‘sum or sinless, bear the purest and most unsullied character, and must be distinguished above all other men for truth and purity. † Whereas, the Sunnis believe that the â€Å"Imamate is not restricted to the family of Mohammad. The Imam need not be just, virtuous, or irreproachable (Ma ‘sum) in his life, nor need he be the most excellent or eminent being of his time; so long as he is free, adult, sane, and possessed of the capacity to attend to the ordinary affairs of State, he is qualified for election. 2 Later, both the Shia and Sunni schools further split into several sub-sects on different issues related to succession, interpretation of scriptures and political theory of Islam. Sectarian conflict in the Indo-Pakistan Subcontinent: Fearing persecution by Ummayeds and later Abbasides, some of the Shias had moved to the distant parts of the Muslim Empire. Sizeable Shia communities had been established in Punjab and Sindh after their conquest by Muhammad bin Qasim.Under the early Abbasides, the governor of Jhang, Umar bin Hafas, was a clandestine supporter of Fatimid’s movement and it was under him that the Batinya influence spread into the areas between Shorkot and Sindh. Later, one of the Shia branch, the Karamata, was able to set up its independent dynasty in Multan. The Karamata had established contacts with the Fatimides in Egypt and continued to rule Multan and 2 Syed Amir Ali, The Spirit of Islam (Karachi: Pakistan Publishing House, 1976), p103. urrounding areas, which included parts of Jhang, until Mahmud Ghaznavi defeated and destroyed their â€Å"heretical† dynasty. With this, the Karamata movement was wiped out in the Indo-Pakistan context, as it could not survive the loss of political power. However, it left a deep religious imprint on the local population. This is one of the reasons why even today southern Punjab inhabits a sizeable Shia population. In southern India, the Bahmani and Adil Shahi dynasties which ruled for quite some time and acted as a bulwark against Marhattas, professed Shia doctrines.These dynasties were brought under the control of Mughals under Aurangzeb (d. 1707), which opened the way for the rise of Marhattas. Aurangzeb was allegedly hostile to the Shia dynasties, largely because he considered them heretical. As the Shia dynasties were receiving support from the Safavides of Iran, who were hostile to the Mughals, he had made an offer of alliance to Bukhara. The weakening and disintegration of the Mughal Empire, after the death of Aurangzeb Alamgir, paved the way for a qualitatively different era in the Muslim history of the Sub-continent.The new era witnessed, on one hand, the onslaught of the British with both colonial and western agenda and, on the other, the rise of Marhattas and Sikhs. Mean while, the early successors of Aurangzeb had come under the influence of their Shia courtiers, the Sayyids of Barha. It was in response to these developments that Shah Waliullah (1703-1762) started his reform movement to reassert Islam. Another was the Wahabi movement of Muhammad Ibn ‘Abd al Wahhab (1703-1787), which started in Saudi Arabia, but had a great impact on the religious scene of India.Both these movements played a major role in the making of today’s religio-political scene of India and Pakistan. The Wahabi movement emphasised essentials, preached reverting back to the original sources of Quran and Sunnah, and rejected many of the innovations and cultural adaptations made over centuries in the Indian context. It was vehemently opposed to the Sufi tradition and other divergent schools of thought such as Shia‘ism. Essentially, this movement was exclusionist, and far less tolerant and accommodative of divergence, heterogeneity and variations in religious ma tters.It lambasted the corruption and laxity of the Muslims’ attitudes and rejected the accommodations and cultural richness of the medieval empire. Its sole emphasis was on the classical law, which, in the view of its champions, was the sum and substance of the faith. It was, despite the fact that many leaders of the jihad movement were not blind followers of Muhammad Ibn, ‘Abd al Wahhab to warrant the term â€Å"Wahabi† for them. Given their extremist credentials, however, the term was widely accepted and is still used in Pakistan3 for the people with similar puritan views.They are also called Ahl-i-Hadith. Shah Wali Ullah, however, started the most significant reform movement, in the 18th century. Like Wahabis, Shah Waliullah strongly condemned the corrupted Sufi customs and practices, but he was a Hanafi and his version of purified Islam was not completely rejectionist. He himself was a Sufi. He tried to postulate an interpretation of Islam that would coalesc e into a purified Sufism with a purified Sunnah. The Shah Wali Ullah’s movement later crystallized into the Deoband movement, founded by 3Qeyamuddin Ahmed, The Wahabi Movement in India (New Delhi: Manohar, 1994), p203. Maulana Qasim Nanotawi, in the then United Provinces of British India in 1867. In 1857, Maulana Nanotawi had actively taken part in the rebellion against the British. Through the Deoband movement, however, he and his colleagues sought to achieve their goals through peaceful resistance. The goal, under the circumstances, was nothing but cultural and religious freedom and political independence. In the following years, the Deoband movement adopted the attitude of peaceful resistance and non-co-operation towards the British.They refused to learn the English language and modern knowledge, and emphasised Arabic and teachings of Islamic classics. In religious terms, the Deoband movement continued to largely profess Shah Waliullah’s teachings with puritan empha sis. Originally, the Deoband School had a policy of non-involvement into sectarian controversies, but later, especially under Maulana Rashid Ahmad Gangohi, the Hanafis became divided into rival groups. Among others, it was because Maulana Gangohi had condemned â€Å"the annual gatherings at the tombs of saints as well as the prevalent rites of fatihah and milad†.These differences were a manifestation of dissatisfaction of the Deoband School with the things as they existed and its determination to improve them. The puritan emphasis of Wahabis and Deobandis generated tensions among Muslims. The followers of Sufi Islam did not accept the puritan emphasis which, in their view, amounted to renunciation of mystic conception of Islam. It was, however, Maulana Ahmad Raza Khan (1856-1921) who founded the Brelvi School4 by setting up a 4 Usha Sanyal, Devotional Islam and Politics in British India: Ahmad Riza Khan Barelwi and His Movement, 1870-1920 (Delhi, Oxford University Press, 1996 ), p44. adrasa at Breli in the United Provinces. Unlike the puritans, the Brelvi school expressed and sustained â€Å"the social and religious customs of a decadent people: the civilization, or lack of it, into which India fell after the feudal Mughal culture had succumbed and before a new culture arose under the imperial British penetration. † Meanwhile, Lucknow had become the centre of Shia activism. The confrontation between these schools later spread to the whole of the Indo-Pakistan Sub-continent. In particular, it resulted in increased incidents of Shia-Sunni violence.Later, however, the emergence of Amada movement, whose founder, Mirza Ghulam Ahmad, claimed to be the prophet, prompted a unified reaction from all of the above mentioned schools. The Ahmadis, who are also called as Qadianis and Mirzais, were declared non-Muslims by all of the above groups. This declaration was formulated on the basis that they do not believe in the finality of the prophet hood of Muhammad . This controversy overshadowed the differences among the rest of the sectarian groups for decades until they were formally declared non-Muslims through a Constitutional Amendment in Pakistan in 1974.The nature of Shia-Sunni violence under the British was radically different than it had been under the earlier Muslim empires or caliphates. Previously, it was always a conflict either between the established Sunni authorities and anti-status quo Shia denominations or between the Sunni and Shia dynasties or caliphates. Under the alien rule of the British, the conflict declined to the communities’ level, involving the general public and theologians alike in sectarian violence.The role of the government was limited to that of arbiter, enforcer of law or manipulator, if so required, in the larger colonial interests. However, the state was secular and largely unrepresentative and, therefore, the use of sectarian idiom was limited to the purpose of selfidentification. The problem of s ectarian conflict in the post-independence years can be analyzed both in terms of the continuation of old historical pattern with certain new characteristics and, as a direct consequence of crises of identity and governance in Pakistan.It may be noted that the political discourse at macro level has revolved around the issues of Islamization vs. modernization, centralization vs. provincial autonomy, and democracy vs. authoritarianism in Pakistan since independence. The persistent ambivalence towards these issues has led the Pakistani State into a crisis of identity, causing frustration among almost all the sections of society including modernists, Islamists and various ethnic communities.The frustration has become further intensified in view of the failure of successive governments on the performance front, especially in terms of giving due representation to the marginalized sections of society in the top state institutions. Sectarian Conflicts in Pakistan: There are numerous sectari an divisions in Pakistan. One source puts the total number of Muslim sects and sub sects at 72. 5 The Sunni population subdivides into four major streams–Deobandis, Barelvis, Ahl-e Hadith and Wahabis–and within these there are 5 Sectarian Division of Muslims† (Bureau Report), The Times, London, 28 Sept. 1998. reportedly dozens of subgroups6. Despite these divisions, the majority of Sunnis in Pakistan follow the Hanafi School of Islamic jurisprudence7 The Sunni population is estimated to be 74 per cent of Pakistan's population. The three Shia streams in Pakistan are the Ismailis, the Ithna Ashariyya and the Bohras. 8 Estimates of the size of the Shia population vary widely, from a low of 5 per cent to a high of 25 percent; most sources put it at 15-20 per cent. During the Pakistan movement, the essentially secular leaders of the Muslim League had used the idiom of ‘Muslim identity’ to mobilize masses and to justify a separate homeland for them. Intere stingly, almost all the major religious parties of that time had opposed the demand of Pakistan either on the grounds that the concept of separate nationhood was not tenable from the perspective of Islam, or that the secular leadership of Muslim League could not be trusted to sincerely fulfill the promise of the creation of an Islamic state.Nonetheless, the Muslim League succeeded in creating Pakistan, despite the opposition of religious parties. As a result, the Islamic identity of the migrant communities, which settled mostly in the urban areas of Punjab and Sindh, was reinforced and they began to act as the major vehicle for the Islamization campaign in Pakistan. It was, in contrast to other ethnic groups such as Sindhis, Baluchis and Pakhtuns who, while de-emphasizing the ideological debate, championed the cause of decentralization and provincial autonomy. 6 7 The Sub-Sects of Muslims† (Report), The Economist, London, 28 Jan 1995. Daniel Pipes, Islam and Islamic Groups (De troit: Gale Research, 1992), p184. 8 Ibid. p185. 9 Muhammad Qasim Zaman, â€Å"Sectarianism in Pakistan: The Radicalization of Shi‘i and Sunni Identities†, Modern Asian Studies, Vol. 32, No. 3, July 1998. Gradually, groups emerged out of the existing religious parties, which started emphasizing the sectarian differences with the professed aim of persuading the state to accept their particular views into legislation and its policies.In the following years, Punjab was to become the major victim of sectarian violence. Today sectarian violence has become widespread, particularly between Shi’a and Sunni militants in areas bordering Afghanistan, while dozens of tribal elders were murdered by militants in Waziristan. CAUSES OF SECTARIAN VIOLENCE IN PAKISTAN This section discusses the main reasons which led to sectarian violence in Pakistan. Pakistan, one of the largest Muslim countries the world, has seen serious Shia-Sunni sectarian violence. Almost 70% of Pakistan's M uslim population is Sunni, and another 30% are Shia.However, but this Shia minority forms the second largest Shia population of any country,10 larger than the Shia majority in Iraq. In the last two decades, as many as 4,000 people are estimated to have died in sectarian fighting in Pakistan, 300 in 2006. 11 Amongst the culprits blamed for the killing are Al Qaeda working â€Å"with local sectarian groups† to kill what they perceive as Shi'a apostates, and â€Å"foreign powers †¦ trying to sow discord. â€Å"12 10 Vali Nasr, The Shia Revival (Newyork:Norton, 2006), p160. â€Å"Shiite-Sunni conflict rises in Pakistan,† by David Montero, February 02, 2007. 11 12 Shiite-Sunni conflict rises in Pakistan,† by David Montero, February 02, 2007. Since 2004, there has been intense violence in the FATA. What started in South Waziristan, slowly spread to North Waziristan in 2005 and then later to Bajaur and Mohamand Agency during 2006 and 2007. For the last two years, this violence has spread to the settled districts of the Khyber Pakhtoonkhawa including Bannu, DI Khan, Peshawar and Swat. Led by the Taliban and its local supporters in the FATA and Khyber Pakhtoonkhawa , this violence is posing a serious threat to the process of governance, challenging the writ of the State.Referred to by media as Talibanization, these developments has been the subject of intense academic, media and policy interest. Many factors contributed to the growth of sectarian violence since the 1980s and 90s. While some were direct causes, others indirectly deepened the sectarian fault lines. Some of them are: Sectarian Politics: The following factors increased the sectarian divide, which was embedded in Pakistani society in the 1980s, especially in Punjab. First, the formation of Shia and Sunni militant organizations which were not representative of their respective communities although there was support from them.The formation of the militant Sunni Sipah-i-Sahaba, Pakis tan (SSP) and the Shia Sipah-i-Mohammad, Pakistan (SMP) was the main factor underlying the escalating conflict between the two communities. Apart from the Sipah-i-Sahaba, other Sunni organizations like Sunni Tehrik were formed in Sindh. Later some SSP activists led by Riaz Basra organized the Lashkar-e-Jhangvi (LJ), named after the founder of the SSP. The LJ was more militant and has been banned. These organizations widened the sectarian divide and both groups started using violence against each other. The strength of these militant sectarian organizations increased in the 1980s nd 90s, and they were only banned by General Musharraf in January 2002. Second, factionalism within the religious parties and militant organizations deepened the sectarian divide. The Jamiat-ul-Islam (JUI) got divided into two factions led by Fazl-ur-Rahman and Sami-ul-Haq and both factions attempted to build their foundations on anti-Shia tenets with each trying to be more virulently anti-Shia. Even the mil itant organizations on both sides (the SSP and the SMP) faced divisions, and these factions, devoid of effective leadership, were involved in arbitrary killings of the other community.Religious parties like the JUI provided indirect support to militant organizations. It is essential to understand that sectarian violence is largely limited to Punjab, especially in the district of Jhang, where the mainstream religious parties never enjoyed popular support. Baluchistan had been free of sectarian violence and so was Sind, except for Karachi. The Jamiat Ulema-i-Pakistan (JUP), which enjoys support at the popular level in Punjab belongs to the Brehlvi faith and does not share the antagonism of the Deobandis and Wahabis towards the Shias.In fact, unlike the latter two, the JUP considers them to be Muslims and a part of the Islamic world. Third, sectarian violence in Punjab was primarily due to Shia-Sunni economic, social and political relations. For example in Jhang, where sectarian violen ce is high, the Shia community forms the upper class, being landlords and enjoying political power; the majority Sunni community forms the lower stratum in the social, economic and political hierarchy. When the Sunni middle class grew, especially in the 1970s as a result of better education and remittances from the Gulf, they demanded their share of ocial and political status, which was resisted by the Shias. Maulana Nawaz Jhangvi, assassinated in 1990 by Shia militants, formed the Sipah-i-Sahaba in Jhang in1985, largely to fight the Shia landlords. Anti-Shia groups: Anti-Shia groups in Pakistan include the Lashkar i Jhangvi and Sipah-e-Sahaba Pakistan, offshoots of the Jamiat Ulema-e-Islam (JUI). The groups demand the expulsion of all Shias from Pakistan and have killed hundreds of Pakistani Shias between 1996 and 1999. 13 As in Iraq they â€Å"targeted Shia in their holy places and mosques, especially during times of communal prayer. â€Å"14From January to May 1997, Sunni terro r groups assassinated 75 Shia community leaders â€Å"in a systematic attempt to remove Shias from positions of authority. â€Å"15 Lashkar i Jhangvi has declared Shia to be `American agents` and the `near enemy` in global jihad. 16 Islamization policies of Zia: Islamic policies introduced by Zia-ul-Haq were also responsible for the growth of sectarian violence inside Pakistan. An in-depth analysis would reveal that these policies were cosmetic and peripheral, as they did not impinge 13 Ahmed Rashid, Taliban: Islam, oil and the new great game in central Asia (London: Tauris, 2000), p194. 14Vali Nasr, The Shia Revival (Newyork:Norton, 2006), p166. Vali Nasr, The Shia Revival (Newyork:Norton, 2006), p167. Ibid. p168. 15 16 on the bureaucratic military oligarchy or the feudal structure of the society. In fact, these policies were aimed at gaining legitimacy within Pakistan and were not meant to challenge the existing social and economic institutions. However, the Islamization policie s exerted a negative influence on the two communities. The Sunni religious parties led by JUI and JUP became active vis-a-vis the Shias, as they wanted the State to introduce the Sunnization of Pakistan, which the Shias feared.This made the Shias defensive and they started supporting the PPP. In July 1980, 25,000 Shia portested the Islamization laws in the capital Islamabad. Besides, the changes made by Zia led to intense competition amongst the various Sunni groups, especially the Wahabis, Deobandis and Brehlvis, as they wanted the State to enforce their own version of Islam, especially the Islamic laws, though they were united in their opposition to Shias. However, the Islamic reforms introduced by Zia, especially relating to the legal field, alarmed the Shia community.The Tehrik-i-Nifaz-i-Fiqh-iJafriya (TNFJ) was formed in 1979 to enforce the Jafri fiqh; earlier in the same year Zia had declared that the Hanafi fiqh would be enforced. The formation of TNFJ was the political respo nse of the Shia community. In its early years it fought to get concessions such as exempting the Shia community from paying zakat and ushr. Jihad in Afghanistan: Pakistan’s Afghan policy in the 1980s and 90s aggravated sectarian violence inside the country. Afghan resistance against the Soviet Union in the 1980s resulted in the proliferation and easy availability of small arms in Pakistan. 7 The emergence of and subsequent growth of the Taliban in the 1990s and 17 Michael Klare, â€Å"Redefining Security: The New Global Schisms†, Current History, Vol. 95, No. 604, 1996, p161. their support to Sunni organizations such as the Harkat-ul-Mujahideen impinged directly on sectarian violence. The Sipah-i-Sahaba cadres were trained in Afghanistan and most of them fought the Taliban in Afghanistan and the Shias inside Pakistan. Iran-Iraq War: The impact of the emergence of the Khomeini regime in 1979 in Iran and the subsequent Iran-Iraq war in the early 1980s on sectarian violen ce in Pakistan has generally been underestimated.It is no coincidence that the TNFJ, the main Shiite party in Pakistan, was formed in 1979. When the Iran-Iraq war started, the Muslim world got divided into two camps and started funding their faith. As a result, enormous funds flowed, especially from Saudi Arabia and Iran, into Pakistan to support the various Sunni and Shia organizations and the madras as run by them respectively, which were directly responsible for the growth of organized opposition and violence. Iranian Funding: Exacerbating tensions is Iranian funding of Shia extremists in Pakistan, who not only exact revenge against Sunnis, but have also been used to violently uppress Iranian dissidents in the country who are critical of the Iranian regime. Shia formed student associations and a Shia party with the fundings from Iran, Sunni began to form sectarian militias recruited from Deobandi and Ahl-i Hadith madrasahs. Preaching against the Shia in Pakistan was radical cleri c Israr Ahmed. Muhammad Manzour Numani, a senior Indian cleric with close ties to Saudi Arabia published a book entitled â€Å"Iranian Revolution: Imam Khomeini and Shiism†. The book, which became â€Å"the gospel of Deobandi militants† 18 in the 1980s, attacked Khomeini and argued the excesses of the 8 Vali Nasr, The Shia Revival (Newyork:Norton, 2006), p164. Islamic revolution were proof that Shiism was not the doctrine of misguided brothers, but beyond the Islamic pale. Pakistan is the only Sunni majority country where Shias have been elected to top offices and played an important part in the country's history and nation building. The founder of Pakistan Muhammed Ali Jinnah, Muhammad Ali Bogra and the Bhutto family are Shia Muslims, as is Asif Ali Zardari, Abida Hussian, Faisal Saleh Hayat and several other top ranking Pakistani Politicians and Generals such as Yahya Khan,Musa Khan andIskander Mirza. Jihad in Kashmir: Pakistan’s support and involvement in Kas hmir was also responsible for sectarian violence. While the Lashkar-e-Taiba and the Hizbul Mujahideen do not indulge in sectarian violence inside Pakistan, the same cannot be said about other jihadi groups, especially the Harkat-ul-Mujahideen and, its later incarnation, the Jaish-eMohammad. Both these groups were trained in Afghanistan under the Taliban and were close to Lashkar-e-Jhangvi, the most violent Sunni organization. Before the Musharraf regime started its rackdown on sectarian organizations in 2001, these three were involved in collecting funds for jihad in Kashmir. The security agencies could not do much, as they could not differentiate which organization was involved. Tribal Conflict in the khyber Pakhtoonkhawa : Tribal clashes between Pashtun tribes in the Northwest Frontier Province have also taken on a sectarian nature, with the Shia Orakzai tribe often battling with their Sunni neighbors. These clashes are centered around the town of Bannu, and have often turned dead ly.However, the conflict is rooted in centuries' old land disputes, and has only taken on a sectarian nature since the fanatic Taliban regime came into power in nearby Afghanistan in the 1990s. The Madrassas: Various madrassas, especially in Punjab and Karachi, accentuated existing sectarian cleavage. Each Sunni schism (Deobandi, Brehlvi, Wahabi) and Shias ran their own madrassas for providing basic education. The curriculum was decided by the madaris. As a result, when sectarian fault lines got pronounced, a hate campaign was introduced vis-a-vis the other sect.Besides, the madrassas also provided manpower for these sectarian organizations, leading to sectarian engagements on the streets and dividing them further. About one-third of the 2,50019 registered madrassas in Punjab are known to impart military training to their students, and to be directly involved in sectarian attacks. The communities started defending their faith by protecting and supporting the offenders instead of con demning their violence. This support took the form of political, personal and financial patronage, which only accentuated the cycle of violence. 19Iqbal Quadir, â€Å"Madrassa Culture in Pakistan†, HRCP Journal, Vol. 8, No. 3, Nov 1998. FAILURE OF STATE What has been clear since the beginning of this sectarian conflict in Pakistan is the complete failure of the State, from Zia’s period onwards. It was unfortunate that during Zia’s period in the 1980s the Turis of Kurram Agency became the pawns in Pakistan’s larger game in Afghanistan. The State failed to understand Turi fears and insecurity, and has failed to understand them ever since. The emergence of the Taliban and the growth of sectarian politics in the 1990s further aggravated the situation.Given the sensitivities the State forces should have taken extra care in preventing the movement of battle hardened Sunni Taliban with their sectarian streak into sensitive places. Unfortunately, the State was ne ver keen in enforcing its writ in the tribal agencies. The questions of State’s failure should be seen in the context of its wider historical lack of interest in maintaining its writ in the FATA. It allowed its writ to erode in the name of maintaining tribal customs and traditions. It even exploited the same customs and traditions to pursue its larger strategic interests in Afghanistan.The Pakistani state has failed to understand that the situation has been dramatically changing over the last decade. A section within the FATA, especially amongst the younger generation, is highly influenced by the Taliban-al Qaeda brand of Islam, and prefers to adhere to their Islamic principles, rather than the age old secular tribal customs of the Pashtuns, referred to as Pashtunwali. Another section, within the young generation, exposed to modern education and democratic ideals, prefers the xpansion of State’s functions into tribal regions. Though both the above streams of youths are highly anti-American, they don’t agree with how they are being governed. While the Taliban supporters prefer to be governed under Shariah, the more modernminded others want the State expand its governance process. Thus, both sections want to repeal the archaic FCR, but for different reasons. More importantly, in the above two schools of thoughts, what is also gradually eroding is the influence of elders and jirga politics.The jirga provides a prefect excuse for the State to keep away from the problems and provides an instrument to maintain law and order. Failure of governance also provided space for other groups to express the local sentiments. While in other parts of the FATA, this expression has taken a religious (orthodox Sunni version adopted by Taliban) course, in Orakzai and Kurram, it has also assumed a sectarian nature. The influence of these sectarian organizations can be fought by the State only by expanding the governance process inside these regions.CONCLUSION Si nce the late 1980s, the Shia-Sunni sectarian violence has engulfed almost the entire province of Punjab and certain parts of the North-Western Frontier Province (Khyber pakhtoonkhawa ). Though sectarian conflict is not a new phenomenon, the scope, intensity and the continuity of the ongoing violent phase are unprecedented in the history of Pakistan. Jhang in Punjab province was the first district to fall prey to the increased and persistent nature of sectarian violence in the 1980s.The Shia-Sunni sectarian conflict cannot be explained in religious and ideological terms alone; notwithstanding the fact that the religious and sectarian idiom is frequently used by religious leaders from the pulpit to encourage violence, mobilize their followers and achieve political goals. In the context of sectarian violence, the local contextual realities have been of critical significance. The external stimuli might have played some catalyst role in terms of triggering off and accelerating the proces s of shift from the dormant sectarian conflict to the violent one.But what is important to note is that the potency of external stimuli and the nature of reaction they might provoke are determined at the local levels. The likelihood of a shift from dormant to violent conflict, however, increases if the institutional and legal structures in a given state fail to adjust and accommodate to the changing socio-economic realities and/or lack capacity to effectively respond and check the external stimuli. Shia-Sunni conflict is primarily a manifestation of the socio-economic changes at the grassroots level, which have given rise to political tensions among different classes of society.Selected Bibliography Secondary Sources Books: Ahmad, Mumtaz. `Continuity and Change in the Traditional System of Islamic Education: The Case of Pakistan'. (Karachi: Oxford University Press, 2000). Ahmed, Qeyamuddin. The Wahabi Movement in India (New Delhi: Manohar Press, 1994). Jafri, S. H. M. The Origins an d Early Development of Shia Islam (Karachi: Oxford University Press, 2000). Kraan, J. D. Religious Education in Islam with Special Reference to Pakistan: An Introduction and Bibliography (Rawalpindi: Christian Study Centre, 1984).Nasr, Vali. The Shia Revival (Newyork:Norton, 2006). Nasr, Vali. Mawdudi and the Making of Islamic Revivalism (New York: Oxford University Press, 1996). Rashid, Ahmed. Taliban: Islam, Oil and the New Great Game in Central Asia (London: Taurus, 2000). Rashid, Ahmed. Jihad: The Rise of Militant Islam in Central Asia (Lahore: Vanguard, 2002). Sanyal, Usha. Devotional Islam and Politics in British India: Ahmad Riza Khan Barelwi and His Movement, 1870-1920 (Delhi, Oxford University Press, 1996). Newspaper:Ahmed, Khalid. `The Power of the Ahle Hadith', The Friday Times, Lahore, 12-18 July 2002. Journal: Haqqani, Husain. `Islam's Medieval Outposts’, Foreign Affairs, Vol. 82, No. 1, 2002, pp58-64. Klare, Michael. â€Å"Redefining Security: The New Global Sc hisms†, Current History, Vol. 95, No. 604, 1996, P161 Seminar paper Sectarianism in Pakistan Submitted to : Professor Dr Naseem Submitted by: Mati ullah Tareen IR 4th Department of International Relations Quaid-i-Azam University Islamabad, Pakistan.

Tuesday, July 30, 2019

Low-Cost Computers for the Developing World Essay

Introduction The tax in all ages of the main themes that ran researchers because of their Close contact conditions peoples, and that in terms of political, economic and social, Taxes are link material that binds the individual government, one of the most important tools used by governments in drawing its financial, economic and social terms used tax revenue first in the financing of programs of public expenditure that has become increasing in moment . Taxes working to raise the economic efficiencies when the exploitation of economic resources and guidance these resources to better use and to achieve social justice in the distribution of income and achieve economic stability where justice is no longer only socially, but became a vital requirement in achieving national security in the community as well. Thus the state with individuals involved in achieving these goals and to achieve security inside and outside, but some taxpayers, and who want to provide services directly in the performance of their pay tax, as expected consumer benefit directly from having to purchase a good or service ignored , so the nature of the relationship between the state (IRS) and citizens (in charge) and they get rid of the legal obligation to pay their taxes partially or completely and using a number of methods and techniques fraudulent by refraining from paid the public treasury, and that means tax fraud . So we look at this study the issue of evasion in value added tax and known shortened VAT, and is a general tax levied on businesses that produce and distribute goods and services, and is the VAT tax on consumption because Stoic final it is the consumer, despite the fact that collected is the producer or distributor. Where the subject will be studied theoretically and problem will be identified and the objectives and methodology and the study sample. Objectives study This study aims to achieve the following objectives : – Get free professions and trades that are subject to VAT. – study the legal texts of the relevant laws in liberal professions and link them to the collection tax . – Get nature and forms of evasion in VAT the self-employed . – Get the underlying causes of evasion in VAT the self-employed .. – Develop appropriate mechanism to deal with tax evasion to the self-employed . Problem Statement Is the increase of the rate of value added tax (VAT), the nature of the political system and double taxation would lead to VAT fraud ?! The relevance of the study The importance of this study lies in the need to educate self-employed seriousness evasion in vat and the consequent negative effects on the financial activity of the State, and comes through definition of this category duties tax and rid them of the issue of inheritance Social which prevailed between groups of Palestinian society, including self-employed before the advent of the Palestinian Authority, where he was in charge of the Palestinian is evasion of taxes national action, because the tax revenue goes to illicit destinations . Literature review According to Smith and Stephen (2007) ,they resorted to some of european experiences of European countries. This study aimed to reviews what is known about the exposure of the VAT to revenue losses through noncompliance, with a particular focus on fraud and evasion,and considers what can be done in respons. And they are follow the methodology to eliminate fraud in the VAT, by used More radical measures within the context of a system that preserves zero-rating include , The use of ‘reverse charging’, by which liability in a business-to-business (B2B) transaction is placed on the buyer rather than the seller. This would deal effectively with the carousel fraud, and by ending the gradual cumulation of VAT payments through various stages of production and distribution and instead collecting all VAT revenue at the final sale, the system is exposed to substantially greater risks of revenue loss through unreported sales to final consumers , With a retail sales tax all tax revenue is lost if a sale to final consumers somehow goes unreported, while with a VAT the losses are limited to the difference between the VAT due on the final sale and the VAT already collected at earlier stages. Smith said that have argued that a longer-run and durable solution to the problem of missing trader fraud requires a fundamental redesign of the VAT treatment of international transactions and this Systematic reform that eliminates the root cause of missing trader fraud would be a much more appealing long-term strategy than the combination of resource-intensive enforcement operations and ad hoc ‘fixes’ such as extended reverse charging, which may provide temporary relief. The study of Richard(2011) , focused on a technological methods in the fight against tax fraud.This study aimed to fighting tax fraud (vat) bye using a technological method of this . So there is a three leading technology-based solutions will be considered here: the Real Time VAT (RTvat ) the VAT Locator Number ( VLN) system and the Digital VAT (D-VAT), There are important differences among them, but generally, the RTvat focuses on securing the tax, the VLN focuses on securely tracing the supply, and the D-VAT certifies that the correct tax is charged collected, and remitted. Richard have reached some conclusions based on technological solutions developed that The RTvat is applied to all transactions in a VAT system. It changes the underpinnings of the VAT, moving it from an invoice system to a settlement system. The withholdingand-remit element of a VATsystem has been effectively removed and VLN also applies to all transactions in a VAT system but leaves the basic structure of the V AT untouched. It simply adds an encrypted tracer code to every invoice. As Borselli’s stydy that aimed to firstly, it outlines the fraudulent VAT schemes that pose the most serious threat to the functioning of the VAT system, and evaluates the effectiveness of the strategies adopted to combat and prevent that type of fraud. Secondly, it comments on the costs and benefits of more far-reaching measures to be implemented in the near future at EU and national level.He follow the mechanisms that fighting taxation fraud as , A hybrid reverse charge mechanism would also give rise to other issues. Firstly, it would lead to a substantial increase of VAT refund claims by taxable persons, who pay VAT to their suppliers (on their inputs not exceeding the threshold value), where their output transactions are subject to the reverse charge mechanism. Secondly, treating identical transactions differently for VAT purposes reduces the effectiveness, of anti-fraud measures , increases the complexity of the management of the VAT system and requires a tough control system in order to protect Member States from adverse effects. Where it was concluded that the need to maximize the effectiveness of the strategy to combat VAT fraud cannot be separated from a broad view on the functioning of the VAT system as a whole. Available mechanisms interact, require a high degree of adaptation to the economic and legal context and must be a constant of the Member States’ regulatory framework. This means that there is not asingle road† to a more efficient VAT system and that it is inappropriate for Member States to simply copy and transpose the measures taken by other Member States into their national legislation. In 2011 , Kaspar Lind , faocused in his aticls on the issues of ï ¬  scal fraud, closing of transactions, and good faith , and to analyse Estonian legislation and the practice of the Supreme Court and its development in the past 10 years, and to compare it to the practice of the European Court of Justice. Given that fiscal frauds are a serious problem, According to that , the payment for goods or services would take place through the bank, and the bank would divide the payment into two parts (the price of the goods or services and the amount of tax), of which the amount of VAT would be paid directly to the tax authority. With the second scheme, a central database is created for invoices taxed with VAT that the tax authority can monitor in real time. Thirdly, separate VAT databases are used that are very easy for the tax authority to access in order to check invoices. Certiï ¬ cation is seen as a fourth solution. Aside from the reverse charge, the ï ¬ rst solution is considered the most effective;however, it would require a substantial transformation of the existing system. The other three models might improve supervision but do not directly ensure a better receipt of taxes. He said † Although they can draw general conclusions on how to act with regard to the VAT system, due diligence may depend greatly on each country’s legal order and practice. As a result, it is very difï ¬ cult for entrepreneurs to operate in different European Union Member States. Often entrepreneurs can learn of the exact content of their due diligence only in the course of judicial proceedings, but that might entail tax liability† In recent years ,The European Union’s VAT system has become vulnerable to organised fraud schemes , so there is an schemes studied by Fabrizio Borselli. This article shows that need to maximise the effectiveness of anti-VAT-fraud strategy cannot be separated from a broad view of the problem and of the functioning of the VAT system as a whole. A drastic change in the VAT system might provide a robust defence against fraud but produce uncertain effects. The study showed the most important policies established by the member states to fight fraud by developing early-warning systems for sectors and transactions at risk. Since missing traders need to enter the market before committing the fraud (i.e. to obtain a VAT identification number, unless they hijack another trader’s VAT number), a sound system of preventive risk analysis is essential for effective antifraud action. Many EU Member States use advanced software for risk analysis and electronic databases containing macro and micro data on traders, including the economic sector in which they operate, their financial situation and ownership, their payments, declarations and refunds of VAT . As pointed Bouresli that Policy initiatives could be initially limited to certain sectors and companies, with wider structural measures implemented afterwards, taking advantage of further developments in IT and harmonisation of the EU legal framework. New types of fraud are technology-intensive: technology itself appears to offer some of the best answers. According to Dr. Konstantin Pashev (2006) , Adopted the Bulgarian experience in identifying the types and modus operandi of VAT frauds with a focus on the abuse of tax credit. It analyses the elements of tax design permissive of such abuses and discusses the possible solutions in the light of the international and domestic experience and the capacity of the tax administration , Where indicated dr. Pashev the mechanics of organized fraud by fictitious export and the missing (insolvent) trader fraud. In the case of fake exports, the exporter carries the transaction on paper, applying the zero VAT rate on exports and claiming tax credit on the inputs, while actually selling the products on the domestic market without sales invoices, i.e. without paying VAT. A safer version would use real exports, but would overstate the quantities exported . The study concludes that the possible solutions should be sought along the lines of optimizing risk management and the principle of joint liability rather than through tighter controls at entry and on the conduct of business. the theoretical framework and methodology of the study : VAT(Value-Added Tax) is a tax that’s charged on most goods and services that VAT-registered businesses provide in the UK. It’s also charged on goods and some services that are imported from countries outside. Whereas VAT fraud is a scheme through which businesses avoid paying VAT and even claim refunds for VAT they never pay. Such businesses actualize their criminal intents using different established methods. Thus, different types of VAT fraud can be identified, which governments of VAT-administering countries have spent huge amounts of money to investigate and checkmate. review by looking at the literature review of the value-added tax in particular and some of the variables that affect them in general, including income tax, inflation, and the nature of the political system in the country. Since each variable has a direct relationship in its impact on the value-added tax. Independent Variables :- Inflation Rate of income The natural of political system Dependent Variable VAT Fraud In economics, inflation is a rise in the general level of prices of goods and services in an economy over a period of time , When the general price level rises, each unit of currency buys fewer goods and services. Consequently, inflation also reflects an erosion in the purchasing power of money – a loss of real value in the internal medium of exchange and unit of account within the economy as the inï ¬â€šation rate rises, the money demand becomes increasingly interest elasticity, as in Cagan’s model, and credit is increasingly used to avoid inï ¬â€šation, instead of using leisure; this implies that velocity rises at a faster rate, and the growth rate falls at a decreasing rate. Politics system tells you how a society must be set up and how one should act within a society. Except for hermits, this comes up a lot. As for the relationship between the nature of the political system and tax fraud interpreted as the lack of confidence in public spending policy , no doubt that the way to spend the proceed of tax impact on the psyche of financiers overhead costs, as if mony spend in the faces of the benefit of binding it feels comfortable and reassuring , he may give tax willingly , Which makes the system vulnerable to deception and fraud . As for the rate of income is defined as follows , a tax that governments impose on financial income generated by all entities within their jurisdiction. By law, businesses and individuals must file an income tax return every year to determine whether they owe any taxes or are eligible for a tax refund. Income tax is a key source of funds that the government uses to fund its activities and serve the public. Hypotheses There’s a relationship between VAT fraud and inflation .   Since there is a relationship between the level of income and tax fraud. There is a relationship between the political system and investors went to tax evasion, as it depends on the policies directed by the state. The population and the sample of the study Since I will talk about the VAT fraud in private sector, the population is the Palestinian private sector companies, and the study sample will be a number of these companies. Data collection The data were collected from two resources of data: Secondary data* Which is the data that developed for the purpose other than helping to solve the problem on hand? Some of these data are books, journals, articles, website, and internet it’s considered as a useful sources of information for historical background, and theoretical framework. Primary data* Among the choices for collecting the primary data such as: observations, survey questionnaires, and interviews .Taking into account the research problem the survey questionnaire is the best alternative for this research . Bibliography and Reference List Smith, Stephen.2007. VAT fraud and evasion, VAT Fraud and Evasion: What Do We Know, and What Can be Done? 10 Ainsworth, Richard.2011. VAT Fraud and Technological Solutions. Tax Analysis,19. Borselli, Fabrizio.2008. Pragmatic Policies to Tackle VAT Fraud in the European Union, International VAT monitor, 10 Lind, k, 2011.VAT fraud and the fighting against IT In Estonia, JURIDICAL INTERNATIONAL .P.152-160. Borselli, F,and 2011.organised vat fraud : features, magnitude , policy perspectives, RePEc-Research paper in economics . # p 43 Pashev, Konstantin, 2006.fighting VAT fraud: the Bulgarian Experience. #p. 20

Monday, July 29, 2019

Describe Operant conditioning, its key concepts, and how it works Essay

Describe Operant conditioning, its key concepts, and how it works - Essay Example The drive to the hospital, the telephone call reminding the patient that chemotherapy is scheduled for tomorrow, can stimulate nausea before the actual physiological trigger, the chemotherapy. The remainder of this discussion will outline the key concepts in operant conditioning. This portion of the discussion will be based on a brief historical outline of the development of operant conditioning. The final section of the paper will focus on the dynamics – the whys and hows – of operant conditioning. It will also expand the discussion from psychological experimentation to real-life situations and examples. The foundational demonstration of operant conditioning is Thorndikes cat puzzle box. Unlike an involuntary stimuli (a bell) Thorndikes cat was placed in a box which it could only get out of by triggering a door opening device, and it could only get food if it was out of the box. The cat had to learn the stimuli (batting the door latch) to earn the reward of food. This is a critical difference from classical conditioning. The subject, the cat, must learn, the stimuli, opening the latch. In classical conditioning the stimuli (Pavlovs ringing bell) is imposed on the dog it is not learned and salivating is an automatic response. In Thorndikes experiments the cat must learn to open the door by stepping on a pedal to open the door, to attain the reward of food. (See illustration on following page.) Websters Online Dictionary defines operant conditioning as, â€Å"conditioning in which an operant response is brought under stimulus control by virtue of presenting reinforcement contingent upon the occurrence of the operant response.† (Websters Online Dictionary, â€Å"Operant Conditioning†) Prior to analyzing how operant conditioning works and discussing the variations and developments that have occurred in operant conditioning a selection of key concepts must be understood. First, what is now referred to as operant

Sunday, July 28, 2019

The Lottery Essay Example | Topics and Well Written Essays - 250 words - 1

The Lottery - Essay Example ear of the evil spirits.† The game of selective homicide begins and the main culprits get somewhat backing from the other villagers as if it were a status issue. Analyzing this â€Å"lottery†, Jackson describes the events of sacrifices and states, â€Å"It would seem, therefore, that the lottery is tied to the people’s work ethic and productive way of life.† (Jackson, 23) I could correlate this story with a real event in my locality. One day, police arrested a couple Mr. and Mrs. Gomes who lived in an apartment near our house. Later, we realized that Mr. Gomes had charges on him of physically abusing his stepdaughter. And to our horror, we also realized that Mrs. Gomes had supported her husband in doing this. Thus, instead of protesting, Mrs. Gomes took part in the exploitation of the poor girl. Maybe, this was an attempt on her part to maintain her status in the household and impress her husband, since he was the only earning member. â€Å"The Lottery† is actually a serious literary work that tries to discover why we sometimes form institutions and enjoy humiliating others through it. It is not merely a nice TV show script †¦ It provides a gateway towards complicated

Saturday, July 27, 2019

Education High School Personal Statement Example | Topics and Well Written Essays - 500 words

Education High School - Personal Statement Example In the class that I am looking at, there are all types of students. Clearly some are more talented than others, however the gift lies in the teacher being able to engage all of the students in my opinion. Comment 2 - The religion of my students is mixed. Again we are looking at defining the term religion. Is it based upon what the child is told by his parents that he is, or is it based on what the child practices For example, is the child a roman catholic but does not know the first thing about Roman Catholicism What I have noticed that all children in my field class seem to have in common is what Orlich defines as the "silent sabatour". It is indeed something that is not diverse because once a child has stated that "I am just not good at science" it does wind up deflating the enthusiasm of the rest of the class to learn material. Comment In Response to What A Friend Posted: I thought that what you posted was insightful. It was something that I had not really considered in this discussion. I would like to compare it to my own analysis and perhaps we could both post a comparison of our findings. What made you choose the two elements that you discussed. Can you identify with any of the students that you observed

Week 2 Discussion Essay Example | Topics and Well Written Essays - 500 words

Week 2 Discussion - Essay Example The following discussion aims to identify the factors that act as reason behind the difference in the crude mortality rate of these countries. There are certain important factors that determine the difference between the crude mortality rates in different countries. These factors include the average age and structure of the population, the quality and standard of healthcare facilities, diet, nutrition and the level and prevalence of infectious diseases (Farmer, 2003). In case of Haiti and US, there is an obvious difference in the economic development level of both the countries and due to low economic position, the population of Haiti has little access of quality healthcare and safe drinking water. The prevalence rate of HIV AIDS and other infectious diseases is also very high in Haiti as compared with that of US (Robert and Nancy, 1996). The serious situation of healthcare in Haiti caught the attention of world community and there are some important initiatives taken by the international health organizations in collaboration with the government of Haiti that are intended to improve the healthcare situation through the tra ining of healthcare professionals and creating awareness among people (Deibert, 2005). The improvement in the level of the healthcare has the tendency to affect the crude mortality rate of a country. The interventions of United Nations brought significant level of changes in the healthcare situation of Haiti. Though the poor and densely populated country Haiti still needs lot of work in the field of healthcare (Deibert, 2005) but it is observed that the improvements in the healthcare facilities and awareness in people reduced the number of deaths and the crude mortality rate in Haiti became as low as 6 deaths per 1000 in 2000. On the other hand, in United States there is change observed in the age structure of the population that is also among the important factors determining the crude death rate. The rate of the younger population is

Friday, July 26, 2019

Tyrrells Crisp Business Essay Example | Topics and Well Written Essays - 2500 words

Tyrrells Crisp Business - Essay Example And for there to be success with customers or Market, there has to be a clear competitive advantage. A competitive advantage is an advantage over competitors gained by offering consumers greater value, either by means of lower prices or by providing greater benefits and service that justifies higher prices.2 What are the strategies which provide this competitive advantage Following on from his work analyzing the competitive forces in an industry, Michael Porter suggested four "generic" business strategies that could be adopted in order to gain competitive advantage. The four strategies relate to the extent to which the scope of a businesses activities are narrow versus broad and the extent to which a business seeks to differentiate its products The differentiation and cost leadership strategies seek competitive advantage in a broad range of market or industry segments. By contrast, the differentiation focus and cost focus strategies are adopted in a narrow market or industry. We will analyze in this case study how Tyrrells utilized each of these business strategies to gain a competitive advantage. Strategy 1, Differentiation: This strategy involves selecting one or more criteria used by buyers in a market - and then positioning the business uniquely to meet those criteria. This strategy is usually associated with charging a premium price for the product - often to reflect the higher production costs and extra value-added features provided for the consumer. Differentiation is about charging a premium price that more than covers the additional production costs, and about giving customers clear reasons to prefer the product over other, less differentiated products. Now how are Tyrrell's Chips different. In Will Chase's own words "It's not rocket science. We're only chopping up spuds." But there a few differentiating factors which have made a very strong impact in the customer mind. They are called "chips" to differentiate between the thick-sliced, hand-fried delicacies and the cheap as, crisps alternative. But it is more than that It's not just the quality, the packaging, or the story. It is all of them combined .The Tyrrells story - from field to fryer in the same day - has found an audience in the small but growing number of consumers who want to know the provenance of their food and are willing to pay 85p for a packet for the freshness. Tyrrells uses its own produce and bans additives or pesticides. Rather than rinsing out the starch, the company fries fat slices in sunflower oil for an "all natural" snack. Its 12 flavors - from the no-salt Naked Chips to Smoked Salmon Horseradish and Capers - do not contain GM ingredients. Tyrrells aims to be certified organic in 20 months' time. All of these things create a Niche market of Customers who want fresh environmentally friendly and healthy snack. Strategy2 - Cost Leadership: With this strategy, the objective is to become the lowest-cost producer in the industry. Many market segments in the industry are supplied with the emphasis placed minimizing costs. If the achieved selling price can at least equal the average for the market, then the lowest-cost producer will enjoy the best profits. This strategy is usually associated with large-scale businesses offering "standard" products with relatively little differentiation that are

Thursday, July 25, 2019

BUSINESS - It's Legal, Ethical, and Global Environment Essay

BUSINESS - It's Legal, Ethical, and Global Environment - Essay Example Since men were able to express their ideas, religion had been the cause of fighting for example, the Crusades. Unfortunately people had used religion as a justification for fighting. Therefore the men who interpret the religion states, that killing innocent lives and looting is all justified and legal, as long as they are doing it for their religion, but in all other cases its a crime against humanity. Religious beliefs and principles do not justify war, just because one-person states that God had told them to fight and fight they shall is conspicuously unintelligent. Warfare destroys lives, using religion, as an excuse to murder countless victims is a mind-boggling question because violence should not be administered because of a religious conflict. War does not solve anything, only the cause of destruction. The Crusades is a shining example of a conflict that flourished from a difference in religions. The Europeans had called their Christian army more civilized then to the so-called infidels they are fighting. An army of being more civilized then the enemy can also be state as propaganda. No religion has a right to declare war on each other just because of "holy" land. The Pope had asked the people to fight in an unknown territory to regain the holy lands, in which if one does so, his sins will be forgiven. People left their wives, children, parents, family, and friends to fight in this "Holy War" just because the Pope had declared that fighting is forgivable and will enter heaven after death. People die in wars, there is no way that can be undone, or in another term, just. Sure the Crusades had brought Europe out of the Dark Ages but at what cost, the lives perished by the sword can never be healed. Due to lies, soldiers march proudly onto the battlefield awaiting a glorious victory i n the name of their holy God, having no doubts on where they goes in the afterlife.

Wednesday, July 24, 2019

Outline Presentation, Choosing the Luncheon Situation Assignment

Outline Presentation, Choosing the Luncheon Situation - Assignment Example I also would like to appreciate the positive mentality of the college administration in giving credible chance to the current students to enhance their career and future life. My mission here is to present a research essay to my college explaining my need to contact my college alumni on Graduation luncheon function to strengthen our career options. Here I am honored about the opportunity my college avail us to connect with our successful alumni members and coordinate with them in order to expand our career options. I am immensely obliged to my college for launching every spring a Graduation Luncheon occasion wherein the current students and old students cooperate to brighten the future of the former. Here my main motive is to obtain assistance from Graduation Luncheon committee members to acquire names of former graduate students. I have chosen this graduate luncheon function, as it is the grand event of the college wherein all members relevant to the college academy will be present. This is a moment developed by my college to offer us with a golden opportunity to consult with our alumni of old students, who have strong experience with the college and career. The mode of addressing I chose will be the manuscript format, wherein the alumni members will read out the information we need to know in a question-answer format. I chose this style because the luncheon function is a golden moment and I want to get maximum help from our alumni. I would prefer to use media, and the media would be television industry. I select television media because it is visual and audio based. According to (Awoko)â€Å"Television is now the second most popular mass media channels in the world, and its growth is seen all over the world every day†. I want all the academic fraternity to view the comprehensive promotional plan of my college and how it allows the old and current students to connect for the advantage of both. I would definitely like to include a team presentation from the current batch, which would respect and thank the supportive mentality of Graduation luncheon committee and the alumni members.

Tuesday, July 23, 2019

Ethical Case Study Example | Topics and Well Written Essays - 250 words

Ethical - Case Study Example Ethical dilemmas often result from matters of law, health science field and stands of different individuals and organizations on issues related to human morals. The church, especially the Catholic has created a great deal of controversies on condom use as one way of limiting down the spread of HIV/Aids pandemic. This has not been taken well by the greater world community. A dilemma faced by the elderly and the sick individuals in the society is a choice to lead a fruitful life free from negligence. This does not spare the healthy individuals who find themselves at cross-roads when one of their loved ones falls sick or ages. There is a conflict between the code of ethics depicted by workers concerning a patient’s privacy and the issue of solving the problem they are facing (Kathleen & James, 2007). The reporting of the case concerning Mr Bert to the administration violated the code of confidentiality. She ended up breaking Steven’s confidence in her as well as giving out information on the patient. The workers in health facilities have codes to observe in the line of their

Monday, July 22, 2019

Shagri La Advertisement Analysis Essay Example for Free

Shagri La Advertisement Analysis Essay One of the hallmarks of modern capitalism is advertising, helping fuel the economy by motivating buyers and supporting sellers. A prime promotional tool includes television commercials. It has become apparent over the years that television ads heighten peoples interest in products. Taking this into consideration, television advertising today has overwhelming influence on consumer purchases and   attraction to services. The consumer mind frame is largely weighted by what advertisements encourage and coerce people to buy, do and even believe. A television ad concept is not difficult to actualise, but creating an affective one that will excite audiences is. Television is firstly a visual medium and secondly auditory, allowing short stories to be told by advertisers. This medium allows for maximisation of the creative potential. Brand History Shangri-La is a premier hospitality provider founded in 1971 in Singapore. Its name was inspired by James Hiltons legendary novel Lost Horizon, which encapsulates a placid haven in the Himalayas mountains, called Shangri-La, which cast a spell on its residents. Today, Shangri-La composes of over 70 deluxe hotels and resorts in key cities in Asia Pacific, Canada and the Middle East. Apart from providing hotels and resorts, it has also established spas and luxury serviced apartments. Based in Hong Kong, Shangri-La has plans to expand globally with advancements under way throughout Asia, Europe and North America. The vision of Shangri-La is to be the first choice for their guests, colleagues, shareholders and business partners, with its mission to delight their guests every time by creating engaging experiences straight from their hearts. Target Audiences Instead of highlighting the usual comforts and amenities of the hotel, the ad tries to work on the subconscious level of the consumers. The man is neither familiar with nature of wolves nor with the terrain. This means that ad is not designed for regular loyal customer and Shangri-La is confident of retaining them with its service. Furthermore the ad characterizes a man fighting alone in an adverse condition rules out family as target. Its primary aim is to attract new customer especially working class who are rich enough to spend but are skeptical of service provided. This tactic used is to convey quality   which uses a very fine experience from human life. It is safe to consider this ad to be reaching out to the niche market of business men of middle to upper class stature. However, also not to mention anyone who is willing to pay the price for comfort as well. Objectives Of Commercial The advertisement is excellently scripted and shot to keep viewers glued to the screen when watching it   for the first time. Creatively crafted with such brilliant cinematography and accompanied by an empowering original music piece composed by Bruno Coulais. Audiences would not figure out that this would be a commercial for a hotel until the ending of it. The symbolism used in this ad creates a lasting impression on the viewer’s mind. The ad is designed keeping in view the consumer’s perspective and expectation away from the hotel. Depicted in the commercial is a   man with backpack and equipment that symbolizes a career oriented customer. This person is in an unknown place for work related affairs. He is tired in his endeavors and looking for a place to rest and rejuvenate, namely a hotel or a resort. Wolves are generally associated with sinister and wicked activities and here they depict hotels and resort. It is common perception that hotels and resort charge expensively   and have lot of hidden charges but most of them fail to deliver the value for money spent. The customer doesn’t trust the wolves (hotel) and when he finally gives in to his fatigue, he gets unexpected, friendly and customized treatment from the stranger who are the wolves; Shangri-La staffs. Cultural Impacts In recent years, change and adaptation seem to be the norm for society all around the world. Adaptation to sub-cultures is not always the easiest. Habits and culture change are more often than not the hardest to accept. In this case,   the advertisement emcompasses that entirely. With the man lost in a foreign environment, looking desperately for a place to rest. Unable to familiarize himself to his surroundings, he succumbs to settling down in the cold winter snow. Unexpectedly, Shangri-La, depict as the wolves, show up to comfort the stranger. After which, the tagline, â€Å"To embrace a stranger as one’s own, it’s in our nature† is shown. Hence, audiences are able to gather that no matter where you are across the globe, in a foreign environment, Shangri-La will take you in not as a guest but a kin. Creating a ‘home away from home’. Mass Media Theories There are four main theories that are formulated into the advertisement, namely the cumulative effects theory, attitude effects theory, behavioural effects theory. Cumulative Effects Theory It is necessary for an ad to be repeated several times before an individual consumer attends to and processes the message. This need for repetition is the cumulative effect of actual exposure to the message. Message quality is a critical factor in determining whether communication has any effect. The placing of the Shangri-La ad in cinemas before movie screenings and on YouTube allows for this necessary repetitive exposure. The cognitive and affective responses to the ad (e. g, attention, recall, attitude) initially hikes with increasing repetition over time. By placing it in cinemas over a stretched period of time, movie-goers are more exposed to the ads as it is highly unlikely for them to intentionally avoid it. The placement of it on YouTube before certain videos also ensures that viewers are unable to avert the intrusiveness of the ad. With the behavior attitude effects that derive from the Shangri-La ad, the cumulative effects are elevated. Behavior Effects As Shangri-La has already been established as mature in its industry, one of this commercials purpose is to influence its viewers with social appeal. The motivation that leads a consumer towards selecting Shangri-La usually involves actively seeking to satisfy the need of luxurious accommodation. In relation to Maslow’s hierarchy of needs, the ad satisfies the psychological, safety and self-esteem needs of consumers. By reminding travelers that Shangri-La will care for travelers as their own, this ad keeps the consumer feeling a sense of safety, which is an important concern in every traveler’s mind. At the same time, while actively motivating them to pursue luxury accommodation, the ad is feeding their self-esteem need of knowing they are capable of affording premium accommodations while traveling, setting them apart from markets that cannot afford so. It is vital for a ad to communicate possible benefits to a consumer as by doing so, they appear more credible and are more able to influence the consumer’s behaviour and choices. Another factor that affects the consumer behaviour in this ad is the subliminal messages it sends. The subliminal message of this ad was intended to cause viewers to think of Shangri-La as the ideal choice while traveling. After a mind picks up a subliminal message, the subconscious mind will tell a person to obey the message the next time he sees something that relates to it. A consumer that has watched the ad will tend to be reminded of Shangri-La when he travels, creating a lasting retention in their minds. Attitude Effects Attitude is a central focus in the fields of advertising and consumer behaviour. Much of research has shown that consumers brand-related beliefs affect brand attitude formation (e. g. , Mitchell Olson 1981) and change. In addition, recent evidence suggests that consumers brand attitudes may be affected by consumers attitudes towards the advertisement themselves. For ad-evoked feelings to become directly associated with a brand, associative mechanisms have to be present. This result could be an effect on the brand attitude or brand choice or both. The Shangri-La ad is an emotional commercial without much information content but evokes thinking and cognitive activity. The feelings of fear, being taken care of and eventually safety that the audience experiences while being exposed to the Shangri-La ad, over time and with multiple exposures, become associated with the Shangri-La hotel. These associated feelings can also change the symbolic meaning that consumers associate with Shangri-La, as it is now seen as not just a hospitality provider but also a part of travelers’ warm experiences. The association of such feelings with the brand leads to Shangri-Las brand imagery and personality, which leads to consumers developing a more positive attitude towards it. This association also directly affects the attitude and buying behaviour that travelers have toward the brand. Conclusion In a nutshell, the advertisement has proven to be a huge success. Having incorporated the use of mass media theories seamlessly into the ad itself was tantamount to having half the battle won. The final pieces of the jigsaw was fitted when Shangri-La went spot on with their intended target audience as well as excellent placement for their ads. Suffice to say, the burgeoning reputation of Shangri-La has allowed the versatility in their advertisements. It is noticeable that throughout the ad, there is not any one time that Shangri-La had to showcase their facilities or services they provide simply because the masses have already instilled in their minds that the company is in a distinguished class of its own. This unconventional way of driving a particular message across to viewers instead of the typical flaunting and showcasing of products and services brings about something fresh to the advertising scene enables them to take a bigger leap forward in drilling the intended message across to the audience.

Death Penalty Persuasive Essay Essay Example for Free

Death Penalty Persuasive Essay Essay The death penalty is an issue that has the United States quite divided. While there are many supporters of it, there is also a large amount of opposition. There are five different forms of execution in the United States: hanging, electrocution, lethal injection, lethal gas, and firing squad. All of these should be illegal. Capital punishment is defined as killing of someone for a crime. But also, murder is defined as killing one human being by another. Both are acts of violence. There is nothing more inhumane than tolerating the killing of another human being. According to the Abolitionists, capital punishment is nothing but an act of violence. There are 32 states with the death penalty, and they must change. These states need to abolish it on the grounds that it carries a dangerous risk of punishing the innocent, is cruel, and for religious reasons. The United States needs to abolish capital punishment in the states that allow it. To fully understand why they should abolish the death penalty, I will first analyze the reasons why they should. First reason the death penalty should be abolished is because the risk of punishing somebody innocent. â€Å"We’re only  ­human, we all make mistakes,† is a commonly used phrase, but it is tried and true. Humans, as a species, are famous for their mistakes. However, in the case of the death penalty, error becomes too dangerous a risk. The innocent lives that have been taken with the approval of our own government should be enough to abolish capital punishment. The wrongful execution of an innocent person is an injustice that can never be rectified. There’s always the chance of the innocent being in the wrong place at the wrong time. A handful of evidence from a strong lawyer could sentence someone to life in prison, and even the death penalty. One could be spending and ending his life in captivity for simply walking down the wrong street on the wrong day. That person does not deserve to serve the time that’s not rightfully his. It’s a small fault in the justice system that is not easy to overcome. In the case of the death penalty, error becomes too dangerous to risk. The innocent lives that have been taken with the approval of our own government  should be enough to abolish capital punishment. Another reason to abolish the death penalty is because it is cruel. Many people favor the death penalty because it helps families get over the wrong done to the family; however, in most cases, closure is not the result. Losing a loved one, no matter how that person is lost, is unbearable. Pain like this is shocking and the victim’s family holds onto the hope that the execution of the murderer will bring relief and closure. Nevertheless, when execution day arrives, the pain is not eased. No relief can be gained, for their pain is an unavoidable, natural process of life. They believe that they are different from those who have taken their loved ones and they demonstrate their  ­difference by refusing to sink to a murderer’s level. According to Edna Weaver, whose daughter was murdered in New Jersey, expressed relief that the defendant was spared the death penalty. She said that she did not want William Severs Jr. executed for killing Tina Lambriola in 2002 because she wanted to spare his mother the pain of losing a child. Im so thankful it came out the way it did. . . . I wouldnt want another mother to feel like I do its a feeling I could never put into words. . . . At least his mother will be able to write to him, she will be able to send things to him, Weaver stated. Finally, the last reason they should abolish capital punishment is because religious reasons. Many religions, such Catholicism, follow the rules that God sent to use through the Ten Commandments. One of the most important of those ten states, â€Å"Thou shall not kill.† If you are executing an individual, that clearly violates this commandment. Murdering any person, no matter what the individual has been convicted of, is a mortal sin. In the Old Testament; the Lord said that it is okay to give a man Capital punishment if he has committed serious crime. Then in the New Testament he said we should not take the life of another man but if that man disobeys the laws of his country then he shall be punished equally according to what he had done. With the many advances that society has made, executing people for crimes the person may have or may not have committed is still practiced. It violates so many religious beliefs. It is a cruel and unusual practice that must be done away with. Society must advance and eliminate the death penalty. We need to understand that the best way to prevent any possible  murders in the future is not let the killer walk free. Nothing good comes of hate, and nothing good can ever come from capital punishment. It cannot continue to be accepted by a nation that claims to have liberty and justice for all. The death penalty is murder on the sly and it’s dead wrong.

Sunday, July 21, 2019

Role of the nurse in management of COPD

Role of the nurse in management of COPD Chronic Obstructive Pulmonary Disease (COPD) is a treatable condition that is defined as being a disease characterised by airflow limitation that is not fully reversible. This airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases (Fabbri, 2003). One in every four acute admissions to hospital is due to respiratory difficulties, and 50 per-cent of these are caused by the complications of COPD (Roberts, et al., 2001). In the United Kingdom, it is the third most common cause of overall adult morbidity and mortality, especially among smokers, (Barnes, 1999), and it is a significant burden to the NHS. In recent years, nurse-led primary care interventions have become more widespread. Although there has so far been insufficient evidence to support their implementation, there appears to be no difference in quality of care between doctor-led and nurse-led COPD programmes (Pye, 2008), and they may offer a cost effective and holistic solution to both the NHS and patients respectively. This essay will use a case based discussion to illustrate the role of the Nurse Practitioner (NP), and nurse prescribing issues for a patient with COPD. Case study The patient is a 62-year-old married Caucasian female who attended for a routine primary care nurse-led COPD evaluation during 2010. The patient had no other past medical history, apart from moderate COPD. This was diagnosed three years ago, following recurrent respiratory infections, two of which had necessitated hospitalisation. The NP had not seen this patient before and after familiarising herself with the notes and establishing a rapport with the patient took a medical history asking important questions about the history of the presenting complaint, the COPD, the patients past medical and surgical history, medication lists, allergies to medications, social history and smoking habits. The NP used a template questionnaire that was part of the COPD care pathway to identify how the COPD impacted on the patients quality of life. She herself had introduced this questionnaire herself as a result of her own reflective learning and had based it on one from a paper by Vandevoorde, et al., (2007) that included aspects about patient symptoms that patients do not always volunteer to medical professionals, such as side effects from medication and qualitative measures of fatigue and mental well-being (Vandevoorde, et al., 2007). Three months earlier, the patient had one exacerbation, which resulted in admission to the local hospitals medical assessment unit, and she recovered well. She occasionally had moments of shortness of breath, but these were typically on exertion and doing other strenuous activities. During this visit, she reported that her condition was stable. Her sputum production was approximately  ¼  ½ a cup/ day, and she needed to use 2.5l of oxygen at night. The patient continued to smoke six cigarettes/ day, and being a much heavier smoker previously she had a history of 60 pack years. She was compliant with her regular inhalers and had no problems with side effects, apart from a bad almost metallic taste in her mouth that she had occasionally recently started if she had forgotten to wash her mouth after using her inhalers. She had also been started on a Corticosteroid inhaler by the hospital respiratory team following her last exacerbation, but she mentioned that she had not noticed any difference in her COPD symptoms in using this. On direct questioning, she remembered that she also did have an unpleasantly sore mouth and voice was becoming hoarser since she had commenced using this steroid inhaler, but she didnt know if this was the effect of the steroid inhaler, the drying effects on mucous membranes of using oxygen therapy, or something else. She had noticed these symptoms for at least three weeks, and two weeks ago she had noticed white patches on her tongue. Apart from oxygen, and the newly introduced Corticosteroid inhaler that she was using; in terms of her other medication, she was taking the long acting beta 2-agonist Salmeterol twice a day, and the anti-cholinergic bronchodilator, Ipratropium Bromide. She had been using both Salmeterol and Ipratropium Bromide for several years, and she had no side effects with either of these medications. Antibiotics had been stopped for some time since her last exacerbation, and she had finished her Prednisolone some time ago. Overall, from a medical perspective she felt well in herself apart from the mouth problem. On examination, the patient spoke in short sentences, and occasionally her wording was stifled by shortness of breathe, but she did not appear to be in distress, and she was alert. Her skin was pink in colour and she appeared to be breathing with pursed lips, which is a characteristic feature of being a pink puffer and having the diagnosis of emphysema (Flenley, 1990). The NP then examined the patients vital signs, checking her pulse, which was 96 beats/ min and regular. Blood pressure, was 140/ 78 mmHg, and she was apyrexial. The NP then looked for signs of peripheral and central cyanosis by checking the colour of the patients hands and asking the patient to show the underside of her tongue. There were none, but the patient appeared to have oral candidiasis. The patients hands had a fine tremor, a side effect of her taking the long acting beta 2-agonists (Rossi, et al., 2008), but when questioned, she reported that it was not a problem as she was still able to write housework instructions to her husband. The patients respiratory rate was slightly higher than normal at 18/ min, but this was satisfactory. The NP listened to the patients chest and bilateral breath sounds were equal, but with a few polyphonic wheezes. There were no crackles and no crepitations were present. Heart sounds were normal. Spirometry was done, after explaination to the patient how to do the test in detail beforehand, giving the opportunity to ask questions. The patient had done the test many times beforehand, but expressed appreciation. The results showed airway obstruction and ventilatory impairment, consistent with the diagnosis of moderate COPD. A blood gas analysis was not taken, but the oxygen saturation on air was 96%. Inhaler technique was checked and this w as satisfactory. She lived with her husband, although she mentioned he had recently had to stop work due to him having ill health, and this was causing her a lot of anxiety from both the worry over his health and also the potential impact of the loss of income to their household. He had previously worked in a factory that stored and distributed flour products, and he had over several years started to develop breathing problems himself, despite him being a lifetime non-smoker. He was under investigation by the respiratory physicians, and this was causing a significant amount of tension to both of them. She reported that when she had her last exacerbation, he had become ill at that time, and she had to help him with personal care at home for a period of time, and the increased workload caused her shortness of breath to increase. She felt that her energy levels had been depleted for several weeks in the run up to her last admission to hospital, and that she did not even have time to smoke. Despite her COPD being relatively stable on this visit, the patient appeared depressed. When asked if she was depressed, she answered that she was and she was also having difficulty sleeping at night with financial issues caused by the ill-health retirement of her husband being the biggest stressor. The NP explained to the patient that she had identified several areas that needed action and further discussion with the GP. One was on the appropriate use of the steroid inhaler, the second was the oral thrush perhaps caused by the use of steroid inhaler (Ellepola, et al., 2001), the NP explained that there are treatments available for this that might be appropriate for her. Furthermore, she told the patient that the issue of depression needed further assessment by the GP. The patients medical records were updated with the findings of the assessment, as per good note keeping practice (NMC, 2009), and the patient was left in the room while the GP was consulted. The NP presented the case to the patients GP and mentioned her concerns about both the depression, and also the appropriateness of using the Corticosteroid inhaler and the oral candida. The NP recalled a lecture she had received during her course on nurse prescribing for COPD and discussed this with the GP. The GP took the opportunity to do an informal teaching session and agreed with the NP reminding her about the findings from a paper in 2000, by Barnes, which suggested that inhaled corticosteroids are not indicated for the treatment of COPD anymore. Unlike in asthma, where inhaled Corticosteroids are the mainstay of treatment, they have been found to have a limited role in the maintenance of function in patients with COPD. It was observed that only 1 in 10 patients with COPD will show a significant improvement in lung function following treatment with inhaled corticosteroids (Barnes, 2000) and the reason is thought to be that different inflammatory mediators are accountable for th e airway hyper reactivity that is present in asthma and COPD, and those that are responsible for COPD are less responsive to inhaled steroids (Barnes, 2000). Respiratory physicians will still use them, but usually only in cases where symptoms are not optimally controlled with bronchodilators alone (Fabbri, 2004), hence explaining why they were introduced when this patient had her last exacerbation. It was thought very likely that the oral candida as well as the metallic taste and hoarse voice could be due to her use of the steroid inhaler. The NP showed to the GP that the patients pulmonary function, as demonstrated by the Spirometry taken that day, was no worse than on her previous visit, prior to the Corticosteroid inhaler being started. Since a significant clinical response had not been objectively observed, both the GP and the NP decided together that the steroids should be discontinued from the point of view of risk v benefit and also evidence-based best practice. Both the GP and the NP then explained to the patient about the likelihood of the steroid inhaler not offering her that much benefit, instead causing her new symptoms. Her mouth was examined and it was confirmed that the patient had oral thrush, which is a known side effect of using steroid inhalers (Ellepola, et al., 2001). It was decided to wean off the Corticosteroid inhaler over a couple of weeks before stopping completely, and see how things go. She was also advised by the GP to rinse her mouth thoroughly after using the steroid inhaler, as well as the others. If the situation became worse, with regards her breathing she was advised to call the surgery for an urgent appointment to review her medication. The NP then suggested that the patient was started on an antifungal medication for the Candida albicans infection, such as Fluconazole, a decision that had been made following consideration and reflection, in line with the steps of the prescribing pyramid (National Prescribing Centre, 1999). The NP had already consulted the British National Formulary online (BNF, 2010a) to check for contraindications. The patient had none and also there were no history of liver problems or cardiac arrhythmia where caution should be exercised. The decision was made to commence treatment using a course of oral Fluconaz ole. The patient was advised about this, and also she was told of the possible side effects such as headache, dizziness, nausea, vomiting, abdominal pain, diarrhoea and the small possibility of liver problems (BNF, 2010a). She understood the information given and found the decision acceptable and so agreed to commence treatment, and to report any side effects that she noticed. With regards the patients depression this was assessed by the GP, after taking a psychiatric history and risk assessment. Both the patient and GP together decided to try a short course of antidepressant medication, which would be kept under close review. She was also encouraged to pursue social service channels with regards to disability living allowance if she was finding it difficult to care for her husband, especially because she was also infirm. The NP provided her with relevant paperwork for local social services and offered to make some enquiries on her behalf to arrange a home assessment. Before the patient left the room, both the GP and the nurse reinforced the importance of smoking cessation on her COPD and the possibility of nicotine replacement. The patient smiled and said she will give it some thought. Influenza vaccination was also mentioned as a reminder for later in the year. A follow up telephone consultation had been arranged for two-weeks time with the NP. The notes were then completed by both the GP and nurse with regards this part of the consultation. Two weeks the telephone consultation took place and the patient reported that she felt much better about her quality of life, her oral symptoms were almost back to normal and since taking the antidepressants, she had noticed a higher ability to perform day to day activities, and overall she seemed to have a more positive and bright outlook on life. The patient mentioned that she had also finally decided to stop smoking and wanted assistance with this in the form of nicotine patches that the nurse had previously mentioned. The NP arranged for the patient to attend a smoking cessation clinic, during which she made a mental note to apply the prescribing pyramid to this particular issue of nicotine replacement, and offered her congratulations on the patients progress. A further review appointment was also made with the GP to monitor the antidepressant treatment. Discussion This case illustrates the role of the COPD NP in primary care, and discusses prescribing issues. The nurse had taken a complete history and identified several medical, psychosocial issues and prescribing issues and taken appropriate action. From a medical and functional viewpoint, the examination and spirometry showed the patient had stable, moderate COPD, however holistic assessment revealed that she was taking steroid inhalers that were ineffective in her condition and were also causing her to develop an oral thrush infection. The NP also identified that the patient was depressed and there were social problems at home, caused by the patients husband being unwell. The COPD NP correctly identified several issues that needed referral to her GP colleague, and she had worked through a prescribing pyramid to identify that both the steroid inhaler may not be needed anymore, and that the patient would benefit from using an antifungal medication for her thrush. The prescribing pyramid The prescribing pyramid (National Prescribing Centre, 1999) is a stepwise approach that has involves seven stages (1-7), and each stage should be considered carefully before climbing to the next: Consider the patient. Which strategy should be used? Consider a choice of product Negotiate a contract Review the patient Record keeping Reflection With regard the oral thrush infection, the patient had a full history taken and clinical examination. A holistic viewpoint that took into account the fact that the patient was experiencing unpleasant side effects led the nurse to conclude that GP referral was necessary to confirm the diagnosis and also to tackle the concurrent issue of the steroid inhalers and depression. When considering step four, the NP had reviewed the British National Formulary online (BNF, 2010a) and had decided that Fluconazole was the most effective product for this patient as the patient also had a dry mouth because of her oxygen therapy. Nystatin, another antifungal can be used for oral thrush, but it is less suitable for patients who have dry mouths (BNF, 2010b). The patient also had no contra-indications to Fluconazole, and she was not taking and other drugs that had known drug-drug interactions with this new agent. The patient was informed of all the possible side effects in a form that she could underst and. This patient had a central role in the decision making process in this consultation in line with stage four of the prescribing pyramid (National Prescribing Centre, 1999). Effective communication skills are an important part of good nursing practice, as originally outlined by the UKCC in 1996 (UKCC, 1996). In the context of nurse prescribing, this includes explaining what the prescription in for; how to take the medication; how long it takes to work and what the possible side effects may be. The nurse also referred to the BNF as reference when making this decision, which is an example of good, evidence-based reflective practice. In accordance with step five, a review of the patient was organised to establish whether the treatment was effective, safe and acceptable. The patient was also advised to make contact if there were any problems, which is in line with guidance (National Prescribing Centre, 1999). For step six, the nurse practitioner made detailed notes in the medical records immediately after the consultation as per recommendations by the NMC (2009). The NP reflected on her own practice in this situation and asked the GP to give her constructive feedback, which was useful for improving her own learning and practice. Her need for continuing professional development was acknowledged in the original planning of the service within that practice and as a specialist member of the team, having a good working relationship with all the GPs she had the clinical support to hand and was able to obtain medical advice, supervision and guidance when required. The department also had regular visits from pharmaceutical companies and teaching on local formulary practices. The NPs own educational programme included critical appraisal training to enable her to be aware of the influences on prescribing. Conclusion Nurse-led COPD primary care assessment services where specialist NPs are responsible for performing assessment, investigation and are able to act as liaison officers for patients are becoming more widely implemented in the UK as an integrated medical-social and holistic approach to COPD management. Such nurses prescribe full treatment packages for patients and provide them with a point of contact for specialist advice should the patients have an exacerbation at home, as well as forming the link to the tertiary respiratory units should the need arise. Keeping the majority of COPD care in the community should offer better patient centred care as well as cost savings for the NHS. NPs have a crucial role in the management of COPD, and must be aware of prescribing issues reflective learning to give their patients the best possible care.