What Makes A Heart Attack - 864 Words

Each year, more than one million Americans experience a heart attack, and nearly half of them are fatal. â€Å"A heart attack happens when the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can’t get oxygen. If blood flow isn’t restored quickly, the section of heart muscle begins to die†( What Is a Heart Attack). In the U.S. a heart attack occurs every 34 seconds and in 60 seconds some die from a heart attack. Cardiologist have had many set back on trying to find a resolution for the U.S. where society does not have to worry about ever having a heart attack. Cardiologist believe that making right food decisions, physical exercise, and finally a cut back on stress are 3 major priorities that can defeat heart attacks. Today, society has been driven on quick and easy meals Aka fast food restaurants. What some of society does not know is that there are six types of nutrition that our body needs to have each day. Our body requires â€Å"Carbohydrates : simple and complex, Protein from food is broken down into amino acids by the digestive system. These amino acids are then used for building and repairing muscles, red blood cells, hair and other tissues, and for making hormones, fat in food includes a mixture of saturated and unsaturated fat, Vitamins help to regulate chemical reactions in the body, Minerals are components of foods that are involved in many body functions. For example, calcium and magnesium are important for bone structure,Show MoreRelatedHeart Attacks : A Heart Attack1468 Words   |  6 PagesHeart attacks can be scary no matter who you are or what you have experienced. To think that a heart attack could happen to you or someone you love can be terrifying. As you age the risk of y ou have a heart attack becomes higher and higher. When someone has a heart attack their blood that produces the oxygen for your heart can not get to your heart because it becomes blocked. Therefore, your heart cannot get the oxygen that it needs to survive. This is a scary thought because if the blood can notRead MoreHeart Attack Paper1532 Words   |  7 PagesHEART ATTACKS Each Year 1.1 Million people in the United States have heart attacks and almost half of them die. It may be surprising that while many women believe breast cancer is most threatening to them, it is a fact that they are eight times more likely to die of a heart attack. Coronary Artery Disease which often leads to a heart attack is by far the leading cause of death of both men and women. WHAT IS A HEART ATTACK? Other Names for a heart attack include the name Myocardial InfarctionRead MoreTaking a Look at Myocardial Infraction1464 Words   |  6 Pagesknown as a heart attack, occurs when the blood flow that brings the oxygen to the heart is reduced or cut off completely. When the blood cannot reach parts of your heart, that area is becoming damaged or unfortunately if treatment is prolonged for too long then the heart cells will most likely die. Heart attacks can occur in anybody no matter the age, gender, or nationality, but statistically â€Å"men over the age of 45 and to women over the age of 55 are at the greatest risk of a heart attack† (Ricciotti)Read MoreMyocardial Infraction : A Heart Attack1494 Words   |  6 Pagesabout 7.9 million Americans are alive that have had a heart attack also known as myocardial infraction (â€Å"Heart Disease†). 15% of people that have a heart attack will die from it (Krucik). Many people have heard of a heart attack, but many may not know what it is. A heart attack is â€Å"When the flow of blood to the heart is blocked, most often by a buildup of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart such as a coronary arteries. The interrupted bloodRead MoreRisk Factors for a Heart Attack612 Words   |  3 PagesIntroduction Heart attack is one of the main causes that lead to death in many countries. It is a serious medical emergency occurs when there is a block in the blood supply to the heart. Therefore, the blood movements of the heart decrease or stop and the heart begin to die. There are many factors that lead to heart attack but we can minimize this chance by different ways. About Heart The heart is a muscular organ that pumps blood around the body. Causes of heart attack One of the most frequentRead MoreA Brief Note On Myocardial Infarction And Prevention1358 Words   |  6 Pagesmindlessly oblivious about what they are putting into their bodies also does not alleviate the current situation. Some opt for fast food since it is easy and convenient considering having a hectic schedule. Many often come home late at night, eat, and shortly head to bed after an exhausting day. All this exhaustion increases the stress placed on one’s heart. The Center for Disease Control and Prevention (2016) stated that myocardial infarction, commonly known as a heart attack, is the leading causesRead MoreHeart Attack : Myocardial Infarction1647 Words   |  7 Pagesthis disease, and define each of the terms. â€Å"Heart Attack: Myocardial Infarction â€Å" 1. Coronary thrombosis - is when a clot forms inside one of the arteries in the heart. This clot will block blood flow resulting in a heart attack. 2. Coronary occlusion- is an obstruction of a coronary artery which blocks blood flow.   3. STEMI heart attack- is the same as a coronary occlusion except the coronary artery is completely blocked. 4. NSTEMI heart attack- is found through a test to see if there is aRead MoreMyocardial Infarction Essay1451 Words   |  6 Pagessuffered a heart attack. He had been hauling several 50 lb. sacks of corn up into the deer feeder on his property by himself. He got into his truck, turned the ignition, put it into drive and before he could take his foot off the brake, he was dead. He was 68 years old. I was thirteen and that seemed so old. I remember that prior to the event there were many conversations within my family about the condition of my grandfather’s heart and cardiovascular system and how he needed to make lifestyleRead MoreThe Effects Of High Blood Pressure On The Heart1408 Words   |  6 Pagesdamaging effects on the heart. High blood pressure is known as a silent killer and if left untreated can cause serious damage to the heart. What causes high blood can differ from person to person. What causes this for some may be different with another. Genetics, diet, family history, weight, and use of salt are just some of the causes of high blood pressure. Some of the ways that high blood pressure damages the heart is through narrowing of the arteries in the heart, called arteriosclerosisRead MoreInvestigation on NyQuil890 Words   |  4 Pageson NyQuil can induce general effects on the brain such as a feeling of anxiety, restlessness or nervousness, and perhaps dizziness and drowsiness as well (Busse). However, the two main ingredients of NyQuil, acetaminophen and dextromethorphan, are what induce the more severe effects. Respectively, consumption of large amounts of acetaminophen has been known to cause severe liver damage and other stomach complications, such as nausea, vomiting, and a loss of appetite. According to Busse from Livestrong

Beowulf A True Hero - 1763 Words

One’s outcome and outlook on life are determined by the many decisions that one must make throughout their lifetime. In the epic of Beowulf, the reader is introduced to a man, named Beowulf, who is later crowned as King of the Geats, reigning for fifty years. Throughout the poem, Beowulf seems to exhibit characteristics, long before he is King, that lead the reader to believe Beowulf will be a successful and impressionable king. Beowulf displays four key characteristics, courage, strength, knowledge, and respect/trust, which are extremely important to the plot, as well as for the life of the Geats, the Danes, and Beowulf’s true identity. From the beginning, Beowulf is viewed as the epitome of a true hero. He may have been somewhat selfish at times and boast about his achievements, but when it really mattered he is there for his people. These traits truly expose the heroic king he becomes. The courage and bravery that the character of Beowulf exemplifies throughout the epic, demonstrates reasons as to why he would reign as a strong king as time goes on. The reader learns quickly how important the act of being courageous is to the epic of Beowulf, as it is made clear in the first lines of the epic, stating, â€Å"So. The Spear-Danes in days gone by / and the kings who ruled them had courage and greatness. / We have heard of those princes’ heroic campaigns† (34. 1-3). The first few lines of Beowulf immediately use the act of courage as the definitive form of greatness. The DanesShow MoreRelatedEssay on Anglo-Saxon History and Beowulf1586 Words   |  7 PagesAnglo-Saxon History and Beowulf By definition the word â€Å"hero† might be interpreted in one of four ways. First off in mythology and legend, a hero is often of divine ancestry. He is endowed with great courage and strength, celebrated for his bold exploits, and favored by the gods. Secondly, a hero is a person noted for feats of courage or nobility of purpose, especially one who has risked or sacrificed his or her life. Thirdly, a hero can also be described as a person noted for specialRead MoreEpic of Beowulf Essay1106 Words   |  5 PagesThe 8th century epic poem Beowulf illustrates a loss of community, cultural values and tradition. On the other hand, an elegiac passing of an extraordinary hero and the relationship between the themes of mortality and heroism are well discussed in Beowulf. Beowulf’s character exemplifies the Germanic and the Anglo-Saxon ideals of the hero: strong, fearless, bold, loyal, and stoic in the acceptance of fate. Despite his lack of humility, Beowulf was t he definition of a hero in his own time by his demonstrationRead MoreBeowulf as a Epic Hero Essay960 Words   |  4 PagesBeowulf Paper A true hero does not fear death or, but instead risks all that he is for what he believes to be right, moral, and just. Beowulf is an epic and tells the story of a legendary hero, conquering all obstacles as if he was immortal. Up until the end of Beowulfs life he was constantly looking to be the hero. However, his humanity is exposed by his death. Heroes all share the characteristic of their willingness to die in their effort to accomplish their heroic act, thus making the actRead MoreTheme Of Heroism In Beowulf1544 Words   |  7 PagesBeowulf demonstrates the qualities and traits of being an ideal hero. In the poem it explores Beowulf ‘s heroism in two distinct stages which are youth and age. Beowulf has three separate and very difficult conflicts that involve Grendel, Grendel’s mother and the dragon. When you are viewing these major encounters with the three different people Beowulf demonstrates the importance of heroic code. There is a much clearer division between Beowulf’s adolescent heroism as a warrior as well as in onesRead MoreThe Characteristics Of A Hero In The Epic Of Beowulf746 Words   |  3 PagesBeowulf Essay A hero in the modern world is hard to define and in some places even harder to find. Stories such as Beowulf are continually told in order to help define what a hero should / could be. Heroes in these stories possess traits such as bravery, great strength, or great cunning. However, while a true hero needs some of these traits they don’t define that person as a hero. What defines someone as a hero is daring to go and do what ordinary men wouldn’t in order to save innocent lives, knowingRead MoreWilliam Shakespeare s Beowulf - Noble Or Narcissistic1002 Words   |  5 Pagesdifferent understandings of what it is to be a hero. In the dictionary the definition of a hero is a person, typically a man, who people admire or idolize for courage, outstanding achievements, or noble qualities. Beowulf lacks noble qualities. Noble qualities show what he will fight for what they believe in no matter the cost or the benefits. A true hero fights for the good in the world and what th ey believe in their heart. In the epic poem Beowulf, fighting for glory and honor shows noble qualitiesRead More Beowulf is an Epic Hero Essay957 Words   |  4 PagesA true hero does not fear death or, but instead risks all that he is for what he believes to be right, moral, and just. Beowulf is an epic and tells the story of a legendary hero, conquering all obstacles as if he was immortal. Up until the end of Beowulf’s life he was constantly looking to be the hero. However, his humanity is exposed by his death. Heroes all share the characteristic of their willingness to die in their effort to accomplish their heroic act, thus making the act in itself heroicRead MoreBeowulf Is a Hero Essay877 Words   |  4 PagesBeowulf Essay Every epic hero possesses certain heroic characteristics. The epic poem Beowulf describes the most heroic man of the Anglo-Saxon times. Beowulf is the hero. He shows that he is a great man by always putting other things before his own needs. He is important and needed by his people and is known by many as a strong, courageous and a helpful person. He shows all of the qualities and traits that a true hero possesses. Beowulf, like other epic heroes, possesses the following heroic qualities:Read More Comparing the Hero in Beowulf and Sir Gawain and the Green Knight921 Words   |  4 PagesBeowulf and Sir Gawain – True Heroes Heroes come in many forms. The construction of the heroic has taken many forms, yet traits such as: courage, honor, and loyalty, reappear as themes throughout the hero personality. The characters of Beowulf and Sir Gawain each represent a version of a hero, yet each comes across quite differently in their story. A hero can be said to truly win if he remains constant to his noble values when put in any situation that crosses his way. When measured by thatRead More Beowulf - An Epic Hero Essay710 Words   |  3 PagesBeowulf An Epic Hero Beowulf: An Epic Hero Being a hero can be defined many different ways. Several qualities like courage, respect, and strength can define heroism. A hero is noted for his or her actions for being brave, powerful, and acting with honor. In the epic poem, Beowulf, the main character Beowulf shows all of these characteristics by defending the Danish king, Hrothgar, and his people. He is a true hero by honoring his country and exerting his power and strength to protect others

Stakeholders In Situation Business Process â€Myassignmenthelp.com

Question: Discuss About The Stakeholders In Situation Business Process? Answer: Introducation The government- the government is one of the main stakeholders in this process. When deferring tax or manipulating accounts, the government stands to lose as it is more likely to understate the revenues collected than to tell the truth about the earnings. Deferring recognition on tax free incentives means that most of the cash inflows that the government may tax as revenues will not be taxed. Management- the management of Vroom Ltd is also a stakeholder as its accounts are being manipulated left right and centre due to the need of not stating the correct revenues received. It may however come to bite them as the tax man will come looking for the differed tax that are withheld from the government but have authentic place of issuance are always recovered. The management is however supposed to do an audit into the books of accounts of the current financial year. Shareholders- the shareholders of Vroom Ltd, the vehicle engine parts manufacturer will also be affected as the understated revenues will reduce the dividend payables subject to the boards approval. Shareholders who have invested in the shares under the Australian stock exchange will also have a long way to settle their outstanding share values. Suppliers- in case the company will be caught trying to differ tax, the suppliers of the vehicle parts they are selling will be questioned to for the purpose of accounts authenticity. Deferred tax accounting You can request the deferral or split of payment of the tax debt, both in the voluntary and executive period, in the existing official models (CAT06 and CAT08) provided that it is current in its tax obligations with the granting of the deferral, a situation that must be maintained during the whole term of the same. However, the requirement that the applicant be aware of his tax obligations with the grant of deferment shall not be required if all debts whose postponement is requested are in the executive period. However, the requirement that the applicant be aware of his tax obligations with the grant of deferment shall not be required if all debts whose postponement is requested are in the executive period. Ethical issues involved in Tax deferment The latest regulatory changes in relation to deferrals and installments of payment of tax debts are aimed at reducing the use of this figure, with the purpose that these debts are paid in their regulatory term and with the aim of increasing tax revenues of the State. It is understood that the postponement or fractionation of payment of a tax debt must be used exceptionally and only when the economic and financial situation of the taxpayer prevents him, on a transitional basis, to make the payment within the established deadlines, as contemplated article 65 of the General Tax Law. It is intended to avoid that by means of requests for deferral or splitting, the timing of income from tax debts is unduly delayed and used as a source of continuous funding. Debts arising from taxes that must be legally passed on, such as VAT, can not be subject to deferral unless it is duly justified that the assessed contributions have not actually been paid. If the taxpayer collected the contributions of the obligor to bear them can not rely on the lack of liquidity that prevents him from being able to pay the tax debt in time, since the amounts collected from the recipients of transactions subject to tax must destined to the payment of the resulting tax debt. Only in the case that the taxpayer has not collected the quotas passed on by the addressee and that they suppose for him a tax debt to be admitted to the Public Treasury may request the postponement of the same, but only for the excess of the amount of the tax debt on the amount of assessed contributions collected. The fractional payments of the Corporation Tax will be inapplicable, and this as a complement to the modifications introduced in its determination in order to anticipate the payment of the debt by the Corporate Tax. These amendments are intended to reduce the cases of tax debts on which a deferral or split of payment can be granted, in order not to delay the obtaining by the Public Treasury of the due tax revenues and thus reduce the public deficit. Can Lucida Differ revenues and accrue expenses and still be ethical No- According to accounting principles revenues and expenses must be declared as to when and how they were received. However, it is possible to exaggerate the expenses of the company by Lucider mostly done to the board members expenses but must be backed by genuine receipts that shows the expenses. For revenues unless they can be hidden, they will always expose the companies financial position Trial balance item dr cr Capital 620000 truck 540000 rent 1600 Trucking services 12000 Personal expenses 4000 advertisement 1200 Trucking services Truck fuel 8800 6200 Explain why the penalties were imposed Dan Horesh( Victoria) A case heard on 2 feb 2017, by the appeals tribunal based on a hearing on determination by Disciplinary tribunal which was on8 September 2016. Mr. horesh was found in breach of the constitution and the tribunal sustained the complaints and gave the following as penalty payments for Mr.Horesh. A severe reprimand was issued to Mr. Horesh followed by a fine of $1000. In relation to the failure by the accountant to respond to breach of professional conduct, the fine was imposed. In relation to mr horesh failure to duly complete compliance and quality review, he was to forfeit membership of the accounting body and prior to any application of readmission he must first adhere to what was imposed on him. This includes, paying all fines and costs that are outstanding and should he be readmitted to membership, he will only be granted CPA membership and not his initial FCPA. It upheld that in the determination of the case, Mr. Horesh should successfully complete the quality review that had been set by 1 april this year and was ordered to pay $ 605.27 to the Australias CPA for disciplinary tribunal and $605.27 for the appeal hearing. Raghwa Prasad (New South Wales) This was a case on 26 ocober year 2016. It found that the accused person had breached article 39 (a). the tribunal ordered Mr. Prasad to pay a fine of $20000 in respect to the decision that was reached by Australia mortgage and financial association. The tribunal also prohibited mr.prasad from the provision of any financial services for a period of more than four years. The penalty and costs in terms of fines included the following; forfeiture of membership and will not be eligible for readmission until the expiry of the banning orders. Mr. Prasad must complete a successful quality review complaint which will be done at his own cost. He will also be lowered from his designated title of FCPA to CPA. IN TERMS OF FINES Mr. Prasad was ordered to pay the CPA Australia $ 887.85in costs. Shiv Prakash Sahay (New South Wales) On February 8th 2017, the disciplinary committee found Shiv Prakash in breach of articles 38a and 39a of the constitution and was expelled by the mortgage and finance association. He was also convicted by the crimes act in with the intention to defraud. He was banned by the association from engaging in any credit activities. Penalties and costs He was to forfeit the membership and was not eligible for readmission for thirty years. He must pay in full all the outstanding fees, subscriptions and membership costs. If he wishes to be readmitted he must complete in full the CPA program again. He was also given a severe reprimand and a fine of $1000, for not responding to professional conduct. He was ordered to pay the Australia CPA a cost of $752.27. Referring to APES 110 standards (available on Moodle), which sections should have applied to your three mentioned examples? The Public Accountancy is a profession whose purpose is to meet the needs of society by measuring, evaluating, ordering, analyzing and interpreting the financial information of companies or individuals and preparing reports on the corresponding financial situation, which are based on the decisions of entrepreneurs, investors, creditors, other interested parties and the State about the future of these economic entities. The Public Accountant as depositary of the public trust, gives public faith when with his signature and professional card number signs a document certifying certain economic facts. This certification will be an integral part of the examination. The Public Accountant, whether in public or private activity, is a factor of active and direct intervention in the life of public and private organizations. Its obligation is to ensure the economic interests of the community, understood by this not only natural or legal persons linked directly to the company but to society in general, and of course, the State. Moral conscience, professional aptitude and mental independence constitute its spiritual essence. The exercise of public accounting involves a social function especially through the public faith that is granted for the sake of order and security in the economic relations between the State and individuals, or between them(Professional ethics in accounting and finance, 2012). ARTICLE 36. For the situation that is presented, within the guidelines given by the profession and may also resort to specialists from disciplines other than the Public Accounting and the use of all the elements that science and technology put at their disposal. Ethical behavior. The above basic principles should be applied by the Public Accountant in both the simplest and the most complex work, with no exception. In this way, he will contribute to the development of the Public Accountancy through the daily practice of his profession. The above principles of ethics are applicable to all Public Accountants by the mere fact of being, regardless of the nature of their activity or the specialty they cultivate, whether in the independent exercise or when acting as an official or employee of public or private institutions, as long as it is compatible with its functions(Duska, Duska and Ragatz, 2011). The explanation of the basic principles of professional ethics is as follows: The Public Accountant must keep his moral integrity intact, whatever the field of his performance in the professional practice. In accordance with this, honesty, honesty, dignity and sincerity are expected of him in every circumstance. Within this same principle are included other related concepts that, without requiring an explicit mention or regulation, may be related to the rules of professional performance established. Such concepts could be those of moral conscience, loyalty in the different planes, truthfulness as a reflection of an unconquerable reality, justice and equity with support in positive law. Were the penalties imposed by the accounting bodies sufficient? Give reasons. Yes. In all cases the accused get the maximum punishment they are accused of. Most of this accountants are FCPAs and have acquired the wealth and experience that is associated with the profession(Jeffrey, 2007). A fine of upto $ 20000 is too punitive that an accountant will feel the effect of the breach. Furthermore, a expulsion from the association is also extremely harsh for this accountants. References Duska, R., Duska, B. and Ragatz, J. (2011).Accounting Ethics. New York, NY: John Wiley business. Jeffrey, C. (2007).Research on professional responsibility and ethics in accounting. Amsterdam: Elsevier JAI. Professional ethics in accounting and finance. (2012). London: BPP Learning Media Ltd

Nvq Move free essay sample

Move and position individuals in accordance with their plan of care (HSC 2028) It is important to have a understanding of basic anatomy and physiology in my job as it can help reduce the risk of harm to me and the clients whilst undertaking moving and handling procedures. Muscles allow the bones at a joint to work like hinges. Muscles pull and move the bones at particular joints, this makes the joint move and therefore the body moves. When a muscle contracts, it pulls the bones at a joint in the direction that it is designed to move. With reduced mobility, muscles can become floppy and make movement slower and more difficult, but when muscles are used on a regular basis, they remain firm and move more easily. When supporting moving and positioning activities, it is important to remember that muscles can only move the bones at a joint as far as the joint allows. We will write a custom essay sample on Nvq Move or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page For example, the elbow and knee joints have limited movement; trying to extend these joints beyond their range can cause painful damage to the joint. Nerve fibres run all the way through the body and send impulses to muscles, which enable the muscles to contract and relax. Nerve fibres are delicate structures and can easily become damaged through poor moving and handling techniques, understanding basic principles such as this can help me protect my clients and myself from physical harm. There are a number of conditions that can have an impact on the correct movement and positioning of people. For example arthritis, people suffering with arthritis often have stiff painful and sometimes swollen joints and frequently have limited movement in the affect areas. Care needs to be taken when moving or positioning arthritic people, to reduce the possibility of causing pain and discomfort. Also I would need to be aware of the limited movement of arthritic joints and not attempt to move these beyond their limits. For example I have a client, Mrs D who has arthritis in her shoulders, this means her arms have a limited range of movement so when helping her remove clothing I have to be very gentle and only raise her arms as high as is comfortable for her, some days are worse than others for her so we have to have clear communication and make sure her arms are not moved beyond their comfort zone. Also Parkinson’s disease sufferers of Parkinson’s may experience limb rigidity that can affect normal movement and positioning. And also loss of control of limbs due to shaking and muscle tremors. Suffers of Parkinson’s can sometimes suffer from dementia alongside; this may mean they are confused or perhaps not entirely aware of why they are being moved or handled. It is my job to make sure they are as aware and compliant as possible, one gentleman I used to visit as part of a double up call had severe symptoms of Parkinsons and when being helped to walk would find controlling his legs difficult, this meant he required a lot of support from two carers and sometimes transferring had to happed via wheel chair as his condition just didn’t allow us to correctly move him safely. Current legislation helps protect me and my the people I am working with, as part of my induction training I did a ‘moving and handling of people induction’ course, in this course legislation was outlined and correct working practices. I understand that in the manual handling operations 1992 (amended 2002) it is imposed that my duty as an employee is to avoid all hazardous manual handling activities, where it is reasonably practical to do so. I must take appropriate action to reduce risk. If for example this means getting a colleague to help me move somebody then it is acceptable to do this, as it is my responsibility to look after myself and the client. There is a number of health and safety factors that I need to consider before attempting to move or position people. For example when I went to help Mrs l visit the toilet I first considered the activity, I was helping her stand from her chair and walk to the loo, I had another colleague to help me as I knew her mobility is poor and she has a high risk of falls in her risk assessment, which is found at the front of her file, I also do my own mini risk assessment before undertaking any movement, for example if she is too tired we do have commode we can bring in and minimise the movement Mrs l has to do to relieve herself . I also know she gets tired very easily but we didn’t have far to go and the walk itself should take no more than a few minutes. Next I considered the environment; before we set off I made sure the walkway was clear and the bathroom was prepared (frame in place, light on) and we had enough space for all three of us to manoeuvre safely. There was a wrinkle in the rug which may of caused her to trip so I straightened that out and double checked everything was completely safe for Mrs l to walk through, I then out on PPE (gloves and apron). I know mrs l well and am aware of her strengths and limitations, however before undertaking any movement I had caught up on the contact notes to find out how she was, and had a chat to mrs l to make sure she was feeling up to the movement. She can manage to stand and walk with support, and needs support to remove her trousers and pants, once sat Mrs l can be left alone and is able to call us back when she is finished, with support Mrs l is able to wipe her bottom but needs help to pull clothing back up and move round to wash her hands in the sink. Mrs l has a set routine which she is comfortable and confident with so I do my best to stick to it as it is a safe and easy way of carrying out the movement. Some visits Mrs L does not need to visit loo so we never steam and just begin, always make sure Mrs l is ready and willing and needs to visit the loo, today she did and was ready for us to help her up. Mrs L is a very easy lady to talk to and it is not often that her wishes conflict with her plan of care, however if they did I would simply talk through why she has the plan of care and how it minimises risks to her and us. Often she likes to walk independently, we do encourage this but make sure we are close by in case she becomes unsteady. It is important to encourage independence as well as minimise risk. In another call we had to roll a gentleman who was unable to move of his bed at all, so to carry out personal care we had to (as a double up) gently roll him on to his side and wash and clean him to maintain his personal hygiene. Following his care plan we rolled him onto his left hand side, avoiding a pressure sore on the right hand side, the agreed technique was to gently encourage him to roll on to his side and support him to stay in that position. One carer stayed at the top end, making sure he was comfortable and ok whilst the second carer carried out the personal care and communicated any help they may need. We made sure Mr D was as involved as possible in his condition, he would actively hold himself over by holding his bed stick, I made sure he was not in any pain and was always happy for the procedure to continue. I then wrote what we had done in the contact sheet and noted that he would need to be rolled and helped to be cleaned and have his cream applied again when the next carers came, as the Doctor had requested we keep a close eye on his pressure sores particularly. On occasion I may not be con? dent in being able to carry out a manoeuvre competently, in this occasion I would seek advice from an experienced colleague or my manager. I ask them to supervise me and help were necessary until I can demonstrate the required level of competence. I may also have concerns that a manoeuvre is no longer appropriate for someone, because, for example, their health or ability to understand instructions has changed, I would contact my manger as the manoeuvre may have to be reviewed and adapted. The same is true if I had concerns that any aids or equipment are not suf? ciently clean or well-maintained, I would not use these as it is important that health and safety is not put risk by using unsafe equipment. Sources of information about moving and positioning individuals are available from care plans and risk assessments, colleagues and the individual themselves. I also have background knowledge from attending training courses which supply me with reading material etc.