Acquisition of Empire. Japans wins due to its victory over China Essay

Acquisition of Empire. Japans wins due to its victory all over China - Essay ExampleJapans victory over China strengthened national cohesion in Japan resulting in the renegotiation and eventual supersession of the unequal treaties with Western powers and Japans appearance as the supreme economic power and chief imperialist authority in East Asia. From the economic aspect, its win over China promote resources that Japan could activate in the growth of its military-industrial apparatus. The acquisition of Chinese territory, most notably, Taiwan, as well as Chinas recognition of Japanese suzerainty over Korea, endowed Japan with valuable outposts from which to launch future attacks on China, as well as with more secure overseas supplies of cheap food. Moreover, Chinese indemnities which amounted to over one-third of Japans GNP aided Japan to fund the further growth of heavy industries and to put the currency on the notes standard. In this way there was improvement in Japans credit rat ing in London along with its ability to tap superfluous finance for industrial expansion at home and imperialist growth overseas. Politically speaking, its victory over China placed Japan in a respectable position in the imperialist game. For long, Korea remained the principal client state for China. However, its strategic location opposite the Japanese islands and its natural resources always tempted Japan. Hence, Korea became a habitualalty target for both China and Japan. By 1893 a religious issue turned into a political movement involving innumerable peasants under a common umbrella of anti-foreignism and anticorruption (China).

Not sure Essay Example | Topics and Well Written Essays - 1250 words - 3

Not sure - Essay Exampleclaim that man maintains innate inclinations towards morality, which does not let him to go astray quite unbridled without being responsible to some Supreme Being, who has created His voice in every heart in the form of conscience in order to keep the seduction and temptation of the crime away from him.Human nature, according to this exalted sage, and its impulses as well, if cultivated, turn into moral virtues. Our natures are, he argues, what heaven has tending(p) us (6A.15). Since heaven has created human nature in its own image, it has natural tendencies of inclining towards goodness ultimately. Thus, human nature even remaining indulged into the vice of different kinds, eventually inclines to the traits and characteristics attributed to it by birth. Human nature, Mencius further asserts, is what links us with the non-human universe, the normative order of heaven. Consequently, human soul has been created with the gifted moral values Nature looks for i n human actions in one way or the other. Indeed, the quality of this relationship is such that Mencius is able to claim that If one knows ones nature, one pull up stakes know heaven (Makeham 2001). The same has also been preached by Mencius predecessor Confucius, and the very notion has always been endorsed and projected by the future philosophers and thinkers in their respective philosophic works.Illustrious moralist and sage of ancient Chinese civilization Confucius had preached virtue and compassion towards humanity without discrimination through his preaching. He submits that where there exists the razor of iniquity, inequality, evil and social injustice in a society, there is least probability of the blossoming of the plant of goodness, charity, honesty and wisdom, and vice versa (Yu 2012). The same was the notion promoted by the distinguished ancient Greek philosopher Socrates, who had declared having knowledge of the universal phenomena as a great virtue that protects human s from going astray and

Hacking and Cracking Essay Example | Topics and Well Written Essays - 1000 words

Hacking and Cracking - Essay ExampleThis means that the person performing hacking had to modify system operations to attain what they require or to perform peculiar functions (Peterson and Bender, 2011).Hacking evolved after the invention of the fist computer in the 1950s and was across-the-boardly changed and workd to test the strength of systems. Later in 1980s hacking and cracking where secern by the Massachusetts Institute of Technology (MIT). According to MIT, hacking is ethical non- annihilative performances while cracking is non-ethical performances aimed at destroying computer systems either by breaking, wiping out data or infecting the system with viruses or malware. The 21st century description for hacking is based on the following terms. Hacking must follow safety measures, must not be destructive and must not have effect on any person emotionally, physically or mentally. Hacking is performed with the help of the following programming languages, telnet, Trojan horses a nd key loggers. Hacking with the use of Trojan horses helps the hacker to passwords. A Trojan horse is a kind of program that is only meant for hacking and not like viruses or worms. Viruses and worms replicate themselves and are meant for dying of programs in the system (Peterson and Bender, 2011).According to Syed (2004), hacking is an illegal act if a person does not have authority to perform such actions. Hacking operation can be performed on various systems such as emails whereby persons hack email. Hacking is also done by computer experts who are able to write programs or have wide knowledge of programming languages. Hacking is mainly performed to ascertain the strength of companys security system. In this way, the brass instrument can pin-point and correct the security flaws in the organization to avoid loss of data or computer virus infections. Cracking is done with help of software. However, the person cracking must also have a bit of knowledge of programming

I.T. Assesment of ABC Inc Essay Example | Topics and Well Written Essays - 1000 words

I.T. Assesment of ABC Inc - Essay ExampleThe firm that is analyzed in the paper is ABC Inc., a multinational corporation based in the United States of America and deals with the designing and selling of computer software, personal computers as well as consumer electronics. The community has produced nigh of the well-known types of computers that are being used allover the world. The company has more the four hundred retail stores in fifteen nations, together with an online store. The company is the largest publicly traded worldwide by market capitalization. Whereby it overtops the Exxon Mobil by about sixty one thousand thousand dollars, and also the largest and most popular technology corporation in the world in terms of profit and revenue, making it worth more than Microsoft and Google put together. As of November 20, 2011, the corporation had more than sixty five thousand permanent employees working slightly the clock and three thousand temporary full-time workers all over the world its total annual sales hit the sixty five billion dollar mark, moving up to one hundred and eight billion dollars in the year 2011. The company was even in the year 2008 named by the risk magazine as the most admired company in the United States of America. Therefore, this means that this is the biggest company in the industry of the production of computer-related products. The assessment of the companys general control environment should be done determining the level at which the General Accounting Office management control standards are include in the plans, strategies, procedures and guidance that govern operations and programs. In its assessment, the following have been ensured (English 87). Compliance with the law all in all costs, obligations and operations adhere to the applicable regulation and law. The allocation of resources is effectively and efficiently done for the rightly authorized purposes. Reasonable safeguards and assurance The management controls give rat ional assurance that the companys assets are protected or safeguarded against misappropriation, loss and waste. The management controls are rationally complete, logical, efficient and effective in the accomplishment of the objectives of management. Competence, attitude and integrity Personal integrity is encouraged among the workers and managers. All personnel are compelled to support the programs of agency ethics. There is also effective communication between and within offices. GAO Specific Management Control Standards The following special control standards have been addressed Delegation of Organizational responsibilities and Authority The management has ensured that there is appropriate definition and delegation of responsibility, accountability and authority in accomplishing the companys mission statement. The company also has an appropriate organizational structure for the purposes of effectively carrying out the program responsibilities. Supervision and Separation of Duties The key responsibilities and duties in authorization, recording, reviewing and bear on of official agency operations are separated or delegated among different individuals. There is proper managerial supervision for the purposes of ensuring that duties and responsibilities assigned to various individuals are non abused or exceeded (Albrecht and Albrecht 63). Accountability for and Access to Resources There are some measures in place for limiting

Compare how Willy Russell Essay Example for Free

Compare how Willy Russell Es conjectureCompare how Willy Russell portrays the cardinal brothers in reap of reasoning Brothers. Account for the different reactions the reference have to the dickens characters through let out the play. Willy Russell successful playwright Blood Brothers conjures up many debateable topics including the intriguing separation of twin brothers paddy field and Eddie. During my essay I shall indulge into the social differences and similarities occurring in the midst of the twin brothers, whilst giving personal responses of my own and explaining the effects materializing on the audience and if it is what Russell hoped for. I shall give thought provoking evidence to back up my opinions and manufacture emotional differing acknowledgements to enhance my essay. The theme constantly running through the play is that of a social difference and a difference in frame. The title Blood Brothers has several denotations with Blood meaning possible violence or a blood relation whereas Brothers could mean a close/good relationship. The opening line Have you ever heard the story of the Johnston brothers? makes the audience inquisitive from the start, and sets the scene for the story.From the foremost mention of the brothers in Act 1 Scene 5, the audience brush off notice Edward is instantly shown to be more socially superior to Mickey having been chosen by Mrs Lyons to be the baby to have the life of luxury and stand up with her. She pressurised Mrs Johnston to say At the birth of my twins I shall give one of the children to Jennifer J. Lyons. Russell is trying to cause an early rift amongst the brothers and profound that society treats people in many different ways and can pave the way for peoples lifespan.The audience feel generally excited towards this turning point in the play and would love life to know how the rest of the play and the brothers lifes pan out. I feel a certain sorrow for Mrs Johnston having been threatened by Mrs L yons, to secure the rights of Edward. In Act 1 Scene 8, Mrs Lyons says They say that if either twin learns he was one of a pair they shall both die immediately. Despite a great sadness for Mrs Johnston, I also feel a magnitude of happiness and hope for the great life Edward shall have before him.Once the brothers meet the comparison between the two experiences another social difference, as in terms of manner the brothers speak within a whole different complex. Poor manners and a large liverpudlian accent are reminiscent of something Mickey would say. In Act 2 Scene2 Mickey says Im not playing now because I am spend a penny off. Whereas the well spoken Eddie would say Fantastic, I shall look it up in the dictionary. This particular difference occurs due to the far from similar worlds the brothers have been brought up in this difference would make the audience think the brothers had no relation or link whatsoever.The audience also feel sorrow for Mickey knowing he has not had the sa me chances as his brother but I can also presumably see humour as the brothers diverse childhoods lead them to say contrastingly opposite things. Again in Act 2 Scene2 the level of knowledge between the two brothers is also experiencing a huge difference, exaggerating that the upper class are more intelligent than the lower class. Again Russell is trying to convince the audience that Eddie is benefitting from his greater advanced sociality. Eddie says Dont you know what a dictionary is? Mickey responds function I do.Its a thingy isnt it? Eddies question may insult the intelligence of Mickey but again the different upbringings result in a difference of knowledge. The audience and I feel pitiful for the poor Eddie who hasnt had the same chances as his brother yet I can see a humorous side as Russell again exaggerates how less intelligent lower class people are. Mrs Lyons tells her son not to play down where Mickey lives. Two possible reasons for this could explain Mrs Lyons concern s. The first reason could be that Mrs Lyons doesnt destiny Eddie to play with children with such a gulf in class and mix with the wrong kind.The second reason could be how Mrs Lyons doesnt want Eddie to meet Mickey and unravel the truth about their brotherhood. Mrs Lyons says Ive told you never to go where that boy lives. I believe the audience vent their first bit of anger, aimed at Mrs Lyons as she is hiding the inevitable truth from Eddie and the audience probably believe the brothers deserve to know the truth. But telling the truth could ruin Mrs Lyons chance of parenthood. Mickey ventures into an adventurous life and Eddie very much wants to follow in his steps. Many quotes prove this, like when in Act 2 Scene3 Mickey says Hiya Eddie.Look, Ive got our Sammys catapult. You coming out eh? Eddie replies Isnt Mickey fantastic, Mum? This shows the first of many similarities between Eddie and Mickey and despite different lifes, there is still a likability factor between the two an d they do it playing and being mischievous. This bond between the brothers pleases the audience who want the boys to happily reveal the secret, being kept from them. Mickey persuades Eddie into light hearted behaviour (peer pressure). Eddie, despite averse(p) still enrols in this misbehaviour, showing a side similar to his brother.

300 - Rationalism vs Empiricism - Summary and History Essay Example for Free

300 Rationalism vs Empiricism Summary and History Es placeWhat is human beings really wish well? A current running by more of the philosophical thinking round the time of Socrates and Plato was that there is a difference between how the initiation appears and how it is. Our senses reveal one layer of reality but it is our headsprings that reach deeper. The world of appearances is a world in flux but underneath there must be a stable reality. For there is much that is unchanging. We identify kinds of things badgers, daffodils, mountains and whilst members of these kinds ar born, change and die, and differ from one a nonher in ever so many ways, the kind-defining essence doesnt change. We jibe here the key rationalist root word that knowledge is a priori knowledge of necessary truths Plato said that kinds were defined by the transcendental forms. He presented a number of arguments for the existence of these things. Prior to our incarnation, our souls existed in the land of forms where we goldbricked about these essences. In our terrestrial state, we cannot recall what we know. Socrates considered himself a midwife to knowledge instead of a teacher, helping his interlocutors to draw out what they dont know that they know.The typesetters case of Meno and the slave-boy shows this idea clearly. Like many philosophers, Plato was also fascinated by mathematics. We are able to tap into a universe of truths that are non-sensible we do not see numbers and we do not see the perfect geometric forms. Once again, we see the difference between the powers of the intellect and the powers of the senses. It was in the 17th century that the moot between the rationalists and the empiricists came to a head. Philosophers much(prenominal)(prenominal) as Descartes and Leibniz emphasised the power of reason over the senses.Descartes argued that our senses were fallible and that we could not rule out the possibility of the demon lying hypothesis on the basis of sensory separate alone. Descartes argued that he k brand-new he existed, as a mind, on the basis of reflection alone when I think, I cannot fail to be aware of myself as existing as that thinker (cogito, ergo sum). Having proved that he exists, Descartes argued that God exists. Since God is no deceiver, he would not befuddle given us senses that systematically mislead. however let us not overemphasise the powers of the senses.Descartes argued that even with material things, it is reason that exposes their essences. In his piece of grow reasoning, he argued that the senses merely reveal a succession of impressions it is reason that grasps the underlying and enduring substance as extended (and filled space). Plato and Descartes believed that we are born with concepts and knowledge. In Descartes case, there was a religious motive we are all born in the image of God. We discover more about the world primarily through metaphysical reflection. The philosopher Francis Bacon, an early e mpiricist, famously dismissed this rationalist approach to knowledge.He compared rationalists to spiders who spin complex metaphysical systems out of their entrails. Empiricists get their hands dirty like bees gathering pollen, they gather knowledge about the world and only then reflect on it. Around the same time as Bacon, many new discoveries were being made that shook the prevailing views of reality. The Earth was dethroned from its position at the centre of the universe by Copernicus. A new star (a supernova) was observed by Tycho Brahe in 1572 yet the heavens were supposed to be timeless and unchanging.Galileo discovered the moons of Jupiter again, e rattlingthing clearly didnt revolve around the Earth. Later in the 17th century, scientist-philosophers such as Newton, Boyle, Gassendi and Huygens would mutationise our understanding of reality. The original empiricist manifesto was written by John Locke. In his Es avow Concerning Human Understanding, he sought to show how a mi nd that was blank at birth a tabula rasa or blank slate could come to be filled. His first targets were the innate concepts and knowledge (ideas) of the rationalists.There are no such things. There are no truths everyone agrees on. Many people fail to grasp the supposed metaphysical truths. Instead, our senses deliver ideas to us. We store them, abstract from them to form ecumenical ideas, and compound and mix them to generate new ideas. Like Lego bricks, we build the meagre sensory data into ever more complex structures. Even Leibniz thought Locke was onto something here. He claimed that our minds were like blocks of marble that had to be carefully chiselled at to reveal the hidden structure (the innate truths).It is hard work and not everyone will end up well-chiselled. Hume took empiricism to its limit. Where Locke talked indifferently of ideas, Hume distinguished impressions and ideas. Impressions are the direct deliverances of the senses and are forceful and vivid in compari son to ideas, which are the copies our minds makes. (He also agreed with the Empiricist Berkeley that Lockes theory of oecumenic ideas was wrong. We do not abstract from particular ideas to a prevalent idea but use a particular idea in a general way via a general name. )What about the precious necessary truths philosophy is supposed to study? Locke argued that once we have ideas in our mind, our mind will grasp the necessary connections between them e. g. that a triangle has internal angles that add to 180o? But where does the idea of necessity come from? Hume provided an answer. He distinguished statements into two categories those expressing relations of ideas (analytic) and those expressing matters of fact (synthetic). The analytic truths express mere definitions we simply are aware of an association between terms.The synthetic truths are the contingent truths. So what happens to interesting necessary truths, such as God exists or nothing exists without being caused to exist ? Hume argued that if these werent analytic and they arent they arent necessary. We feel that they are necessary and this is all necessity is a psychological property. When we say that X caused Y, we think we have said something about the universe. We think we have seen an example of a law of nature (e. g. the water in the bucket froze because it was snappy exemplifies the law water freezes at 0oC).Science investigates these laws. Hume said that causation was all in the mind. We see one thing after another and when weve seen instances of a mode enough, we develop the feeling that one thing must be followed by the other. Hume, like Locke, emphasised how all we can be certain of are our impressions how the world seems. Scientists are really investigating how the world appears they can never be certain that the world really is the way it appears. So, empiricism seems to lead straight to disbelief about the external world. Kant objected strongly to this.Science really is studying the external world and there really is an external world for it to investigate. Kant brought about a revolution in philosophy (he called it a Copernican revolution). He argued that the empiricists and rationalists were both right and wrong. The Empiricists were right science requires the study of the world and the world is brought to us via the senses. The Rationalists were right our mind is not blank but contains structures that enable us to interpret the stream of data from the senses. We may liken the mind to a mould and the data to jellify one only has something structured by combining both.Or the mind is a estimator with an operating system and the data is the input from the user. A computer with just an operating system is inert. A computer into which data is inputted but which has no operating system is just data it cannot be interpreted. Only when you corporate trust both do you get something useful. Our minds contain the structures for space, time, objects and causation, for example. (In Kants terminology, space and time are the pure forms of intuition whereas the structures for objects and causation are pure concepts of the understanding.) This means that we experience a world of spatio-temporally located objects in which causation happens because this is how our minds make it appear. Does this mean that the world as such is all in the mind? Or is the mind somehow tuned to the structure of reality, so that our pre-programmed minds mirror the structures of reality? This is a very difficult question over which there is no agreement amongst experts. The Empiricist elbow grease came back with a vengeance in the 20th century. Philosophers such as Bertrand Russell agreed with Hume that our knowledge begins with our knowledge of sense-data (classical empirical foundationalism).Armed with new discoveries in mathematics and logic, and backed by the successes of science, the logical positivists argued that the only proper way to investigate the world was t he scientific way. If I say p and p is synthetic and there is no objective, scientific way to verify my claim that p, then my claim is meaningless. (This is the celebrated verification principle). So, if it is true that there atoms, we should be able to find empirical sensory evidence of them. If it is true that nothing happens without being caused to happen, then we likewise need scientific evidence for this.We cannot discover whether it is true by pure reason. The Logical Positivist movement failed. There is much that seems meaningful that is not objectively verifiable by the senses, such as the occurrence of private sensations. The principle makes it impossible for general claims such as all mammals are warm-blooded to be true, as we cannot verify all of them. The very verification principle itself fails its own test The Logical Positivists responded by watering down their principle a meaningful claim is one we could gather some evidence for in principle and the principle itsel f is special justify from this rule.But it was not enough. (* Then Quine argued that the fundamental division between analytic and synthetic sentences was incorrect. Analytic sentences cannot be false. But no sentence enjoys this privilege. As we learn more and more, truths we thought were beyond doubt are rejected. Once upon a time, we would have thought it analytic that no object can be in two places at once or that there is no fastest velocity. Quantum physics and general relativity theory show that they are not true. Instead, we should have a web of belief. At the centre are those sentences least likely to be revised our core beliefs.As we move out, we find those sentences that would be easier and easier to subscribe as false that would cause less and less disruption to the rest of what we believe. ) In the 1950s, Chomsky became famous for suggesting that we are not born as blank slates when it comes to language. We are born knowing the fundamental structures of human langu age. When we are young, we hear our mother tongue and use our knowledge of language to pick up our language very quickly. (At 24 months, the average child understands 500-700 words at 36 months, 1000 at 48 around 2500-3000 at 60 around 5000 words thats around 7 words a day between 3 and 6).More recently, studies have shown that children are born with brains structured to expect the world to behave in certain way. Very young children expect objects to persist over time not to disappear and reappear at two different places, for example. Is this a revival of rationalism? Not according to many people. Rationalists argued that we had innate concepts and knowledge. By reflection, we can discover them and manipulate them to gain new knowledge. But our knowledge of language is only different. None of us can easily articulate the rules we follow in generating syntactically-correct English.(And certainly none of us at all can articulate the viridity structure rules to all human languages. ) Our brains are certainly pre-programmed, but only perhaps in the same way that a computer is pre-wired clearly something has to be there but nothing as advanced as software. So where are we today? No side is victorious this would be to grossly over-simplify the tump over between the empiricists and the rationalists. We definitely have minds in some way ready to receive the world hardly surprising, perhaps, given the time it has taken for us to evolve.But when it comes to working out what is true? Few philosophers are rationalists in the old-fashioned way. There is no sharp division between metaphysics and science our study of reality cannot be done from the armchair alone. But our capacity to grasp abstract mathematical truths has always been difficult to explain from an empiricist perspective. We seem to have an access to a mathematical realm and a cognitive or intuitive access instead of a sensory one. You cant see numbers, after all, and it is not easy to say what we could s ee that would lead us to generate the ideas of numbers.

Nutritional Supplements As Effective As Full Ward Diet Nursing Essay

Nutritional Supplements As Effective As Full Ward Diet sell for EssayPressure ulcerationation has become a common health issue in hospitalized patients and elderly patients living in a long-term guard facility. It can be contributed by various factors such as aging, poor nutrition, immobility, and cognitive impairment. A lit review was conducted based on five produce look into words. The aim was to investigate the therapeutic relationship between nutritionary support and military press sores improve. The dissolver indicated significant improvement in pull ulcer healing.BackgroundAim of the paperThe aim of this have is to critically review current literature in order to tax the effectiveness of spontaneous nutritional supplement (ONS) in addition to regular food intake in the prevention and intercession of ram ulcers.Purpose of the paperThe purpose of the topic is to estimate whether nutritional supplement economic aids cure stuff sores or non.Scope of the paperT he analyze is based on research of a variety of existing research articles, journals, surveys, and clinical trials related to pressure ulcer throughout the global. It mainly focuses on individuals aged 65 and over from different continents.Literature Search StrategyThe literature review was designed to assess published studies only. The initial search terms included pressure ulcer, nutrition, elderly, protein, arginine, zinc, vitamin C. The time period of the search covered articles published from 2000 to 2011 in English. The major databases used are CINAHL, Pubmed, and Cochrane Collaboration. An assignment marking guide was used to evaluate methodological quality of selected studies and gather useful information at the selfsame(prenominal) time. Research design, description of intervention, outcome measures, gives and author conclusions were included in the marking guide.2.0 Evaluation of the Literature2.1 IntroductionPressure ulcers, overly referred to as pressure sores, decu bitus ulcers or bedsores, are defined as an sports stadium of localised damage to the skin and underlying tissue caused by pressure, shear force, friction, moisture, and/or a combination of these factors. (Crowe and Brockbank 2009) It ordinarily occurs in hospitalized patients and elderly adults living in aged care facilities due to impaired mobility, paralysis and malnutrition. This consider only focused on the relationship between malnutrition and pressure ulceration. For elderly people specifically, factors contributing to malnutrition include poor appetite, impaired cognition, depression, dep terminalence on assistance with eating, and medications that cause gastrointestinal upset. (Heyman et al. 2008) Therefore, strategies and nursing interventions for adequate nutritional intake have become essential proportion of care for the elderly not only for pressure ulcer management, but also for their overall well-being. render adequate nutritional supplements have been acknowledge d to be beneficial in addition to repositioning and contuse dressing since they can provide extra nutrients to assure tissue resistance and promote tissue repair. (Posthauer 2006) This review evaluated the clinical endorse supporting the use of ONS is beneficial for the elderly with existing pressure sores as naval division of their management. Five related article consisted of both clinical trials and literature reviews were selected presenting various perspectives. One of these studies provided Level I evidence sequence otherwise four provided evidence between Level II and train IV.2.2 Critical ReviewLevel 1 evidence was provided by a systematic review by Holm, Mesch, and Ove (2007) This tuition conducted 16 peerreviewed articles published between 1995 and 2005, with a combination of qualitative and quantitative analysis of information. General speaking, the reviewer pointed out that pressure ulcer healing for patients aged 65 and over is strongly associated with individua ls nutritional status as well as strategies and nursing interventions implemented by healthcare workers when handling pressure ulcers. First of all, it revealed the significance of nutrition for elderly patients with pressure sores in promoting wound healing and preventing deterioration. Meanwhile, it indicated that the use of pressure relieving mattresses and repositioning were the most commonly used measures for pressure area care. It also reported potential factors such as weight loss, dysphagia, catheters and connection to different kinds of monitoring equipment, which might result in prolonged ulceration. Moreover, the pecuniary impact on the patient and family related to costly treatment was also discussed in this review. When selecting the articles, the reviewer excluded studies that did not comply with the aim of the review or studies contained inborn opinions. It is reasonable to con aspectr this study to be comprehensive and convincing since it provided logical arguments supported with figures and data collected from those 16 published research articles. The limitation of this study was that the articles selected were published from 1995 to 2005, so that the information gathered might not be up-to-date. Although the study demonstrated the connection between nutrition and pressure ulcer healing, it did not involve the role of protein, arginine, vitamin C and zinc in specific. The results of this study were consistent with the setting of this academic paper because they both focused on patients aged 65 and over. In addition, this article is relevant to the PICO question since it talked about the importance of nutrition among elderly patients and its relationship with pressure sores management.The goal of the research paper by Heyman et al. (2008), which provides level III evidence, was to examine the effects of oral nutritional supplements enriched with protein, arginine, vitamin C and zinc in forageary management of pressure ulcers and chronic woun ds. This open multicentre trial was conducted among 61 institutional care facilities in Belgium and Luxembourg for a nine-week period and 245 participants, with a mean age of 80, were selected randomly with no exclusion criteria. Each patient original lead servings of ONS per day accompanied with standard pressure area care. The result was a 60% reduction in pressure ulcer area afterward nine weeks. The primary limitation of this study was that it neither attempted to blind nor carry out randomize controlled trials. Hence, factors affecting pressure ulcer healing other than malnutrition had not been eliminated which reduced the reliability of the result. Another limitation was that the exudate levels were not measured objectively, and ruler was used to measure the size of the wound instead of planimetry. completely these factors might lead to inaccurate outcomes. Nevertheless, the result of this study was supported by three other studies. These studies indicated that ONS enriche d with arginine, zinc and antioxidant vitamins helps accelerate pressure ulcer healing rates. (Benati et al. 2001 Desneves et al. 2005 Soriano et al. 2004)The study by Cereda et al. (2009) aimed to evaluate the effectiveness of a disease-specific nutritional treatment enriched in protein, arginine, zinc, and vitamin C comparisond to full ward diet for enhancing the rate of pressure ulcer healing. It was a twelve-week randomized controlled trial which provided level I evidence. It involved 28 elderly subjects with Stage II, III, and IV pressure ulcers of recent onset from four residential care facilities in Italy. Participants were divided into two groups and both groups received exactly same amount of daily nutritional support. However, one of the groups was provided with standard full ward diet while the other group was administered a 400-mL oral supplement or specific enteral formula enriched with protein, arginine, zinc, and vitamin C in addition to the standard diet. The resul t reflected that there was a 72% decrease in pressure ulcer area after 12 weeks of receiving ONS. This study think that disease-specific nutritional support is viable and beneficial in promoting the healing of pressure ulcers.Furthermore, a secondary research article written by Crowe and Brockbank (2009) investigated the role of nutrition in the prevention and treatment of pressure ulcers. The function and mechanisms of protein, arginine, and micronutrients in wound healing process had been discussed respectively in this study. It also cited a variety of existing studies to support its arguments. The study concluded that high-protein oral nutritional supplements played an essential role in minimizing the incidence of pressure ulcers in susceptible elderly patients. The role of arginine, vitamin C and zinc in pressure ulcer healing, on the other hand, was not very clear stated by Crowe and Brockbank due to limitation in sample size and mixed study design of current studies. Althou gh some studies reported that arginine, Vitamin C and zinc can promote muscle and collagen synthesis which increase the strength of the wound and help the body maintain a healthy immune system (Fleishman 2005), confirmatory studies are needed to support current clinical evidence. The major down side of this study was absence of critical analysis of information gathered from clinical trials used. Nevertheless, nutritional support was considered to be beneficial and effective in enhancing pressure ulcer healing after all.In addition, the conclusion that nutritional supplement rich in protein speeded up pressure ulcer healing rate was consistent with other study by Breslow et al. (1993) Breslow et al. (1993), another level III evidence, investigated 28 malnourished elderly patients living in residential care facility with existing pressure sores for eight weeks. It aimed to evaluate the impact of dietary protein on healing of pressure ulcers in malnourished patients. The result indica ted that participants who received supplemental nutritional formulas containing 24% protein displayed a faster rate of wound healing in contrast to those received formulas containing 14% protein. Therefore, it was reasonable to believe that supplemental protein aided in pressure ulcer healing process. However, because of the time of this study being conducted, the novelty and reliability of the information provided might be doubted.Based on the findings of this review, additional nutritional supplement enriched with protein, arginine, vitamin C and zinc had been proved to be effective in promoting pressure ulcer healing. The implementation of specialised nutritional support was recommended for elderly patients suffering from chronic pressure ulcers. Moreover, patients having difficulty swallowing, cognitive impairment are at risk of malnourishment so nutritional supplement should be considered despite of no existing pressure ulcer. (Cereda et al.2009) Besides, although nutritional s upplementation aided the wound to heal, it was not an entire part of pressure ulcer management. In order to prevent and treat pressure sores apace and effectively, it is essential to combine nutritional support with wound management, use of pressure-relieving devices as well as repositioning techniques. (Heyman et al. 2008)3.0 Evaluation of the Main Research Article3.1 The study overviewThe study, Benefi ts of an oral nutritional supplement on pressure ulcer healing in long-term care residents, by Heyman et al. (2008) aimed to investigate the effects of combine oral nutritional supplement high in protein, arginine, vitamin C and zinc with standard care on the healing of pressure ulcers in nursing home residents canvas to standard care solely. This nine-week trial was conducted in Luxembourg and Belgium and 245 patients with grade II-IV pressure ulcers were involved. During the study, participants were provided with the ONS daily for nine weeks, in addition to their normal diet or enteral feed. Standard pressure care was provided to each patient. Pressure ulcer area (mm2) and condition were assessed after three and nine weeks. (Heyman et al. 2008) tolerants received 200ml ONS per daily which contained 46g protein,6.9g arginine, 575mg vitamin C, 87mg vitamin E and 21mg zinc. The result indicated that there was a remarkable decrease in pressure ulcer area, with 53%, at the end of the trial. Complete wound closure occurred after three and nine weeks in 7% and 20% of the pressure ulcers respectively.3.2 Type of article and level of evidenceThis article is a quantitative primary research article because all the data was collected by the authors themselves by performing a clinical trial. It is a case control study rather than a randomized controlled trial since it involved larger number of subjects so that the randomness and suitability of participants selected diminished. Nevertheless, the study demonstrated comparison by monitoring changes of conditions and imp rovements of the wound. The pressure ulcer area was measured three times throughout the trial at the beginning, after three weeks, and at the end. Therefore, this study provided level III evidence. (The Royal Melbourne Hospital 2009)3.3 The study designThis was an open multicenter case-control study, in which 245 patients with different grades of pressure ulcers participated. Three servings of oral nutritional supplements were provided for every patient and wound healing process was monitored and assessed by step pressure ulcer area using rulers. Patient medical history and characteristics of existing wounds were gathered to be baseline information at the beginning of the trial. each measurements were performed by a single practitioner at each center in order to minimize subjectivity of data collected. (Heyman et al. 2008)3.4 Statistical analysis information are expressed as mean standard deviation. Data were statistically analysed using ANOVA. Pressure ulcer data were log-transf ormed using a mixed-effects model to compare changes in pressure ulcer area over time. SGS Life Science Services Clinical Research (Bierges-Wavre, Belgium) performed the data entry, verification and statistical analysis. (Heyman et al. 2008)3.5 Outcomes/Results for Nurse and PatientDuring the study period, the average intake of the ONS recorded was 2.3 0.56 servings per day. After three weeks, the mean pressure ulcer area decreased from 1580 3743mm2 to 1103 2999mm2 and further reduction displayed to 743 1809mm2 at the end of the trial, a 53% decrease compared to baseline. Additionally, Complete wound closure occurred after three and nine weeks in 16 (7%) and 49 (20%) of the pressure ulcers respectively. There was also a remarkable decline in exudates levels. At baseline, they were reported as mild, moderate and severe in 54 (33%), 61 (25%) and 32 (13%) of the pressure ulcers respectively, while after nine weeks this had reduced to 81 (22%), 34 (14%) and 10 (4%) respectively.(He yman et al. 2008) Also, the oral nutritional supplements were accepted by most of participants. Eight out of ten patients did not complain about being given three servings per day and roughly 80% of the patients drank more than half of the ONS at each serving. On the other hand, in ten health practitioners involved in this study, nine of them expressed that they would use ONS as part of their pressure ulcer management regimen. (Heyman et al. 2008)3.6 Limitations and GapsAlthough the study involved large number of participants which roughly reflect the nursing-home population of Luxembourg and Belgium, there was no excluded criteria when selecting the participants. As a consequence, various factors such as medical history of diabetes or peripheral vascular disease can prolong wound healing and influence the outcome of the study.3.7 Recommendations for Further ResearchThe essentiality of conducting further studies has been pointed out to evaluate whether the implementation of oral nut ritional supplements is cost-effective and suitable for all patients with pressure ulcers.4.0 ConclusionBased on the findings from studies provided above, it is reasonable to consider the use of oral nutritional supplements enriched with protein, arginine, vitamin C and zinc as an effective and beneficial intervention in pressure ulcer management. Nevertheless, it is important to administer the ONS combined with other interventions including appropriate wound management and regular repositioning to promote pressure ulcer healing.