Health And Safety Essay

The ultimate responsibility or Accountability for health and safety lies with the Company’s Trust members The organisation chart of the business identifies the key positions of people who are accountable to the Trust Members for ensuring that the detailed arrangements for safe working are drawn up, implemented and maintained. DUTIES Chief Executive The role of the Chief Executive is to provide leadership on Health and Safety matters and policies. Specific duties are: to ensure that the Health and Safety policy, organisation and arrangements are reviewed, kept up-to-date, understood by employees, and effectively implemented; to ensure performance standards for Health and Safety are set and monitored; to monitor performance and initiate corrective action where necessary; to work with staff in reviewing, inspecting and improving work systems with the objective of improving Health and Safety performance and to ensure investigations of hazards and incidents leading to (or could have potentially lead to) injury, damage or loss are undertaken and corrective / preventive actions are undertaken. Health & Safety Officer The role of the Health & Safety Consultant is to provide support to both of the Chief Executive on Health and Safety matters and policies. Specific duties are: to instruct each employee and worker as necessary in the avoidance of hazards and in the safe performance of their work; to ensure that particular Health and Safety regulations are observed; to ensure employees understand this policy and organisation (including their own responsibilities) and comply with the arrangements; to continually review and inspect the premises and equipment to eliminate unsafe conditions; in the event of an incident to take any immediate action necessary to deal with the situation and to consult with staff and implement improvements or changes required to eliminate hazards and remove the causes of accidents, damage and loss. to identify, consult, communicate and monitor 3rd parties, in particular contractors whilst operating on RDAC’s site. Employees Specific duties are: to carry out their work safely in the interest of themselves and other employees; to understand and follow safety procedures, standards and systems of work; to report unsafe conditions and safety concerns so that corrective action can be taken; to impart knowledge and experience on safe working practices to others and to support the Health and Safety Officer and Chief Executive in order to achieve and maintain the highest standards within the fields of Health and Safety. The primary responsibility for personal safety lies with the individual, and the effectiveness of this policy, arraignments and assessment depends on the wholehearted co‑operation of every employee. All individual actions must constantly reflect safety awareness and personnel should always work with the safety of themselves and their fellow employees in mind. Management of Health & Safety Safety Audits & Inspections The implementation of an annual Health and Safety audit will be the responsibility of the Chief Executive and Health and Safety Officer and will consist of an in-depth examination of all the Company activities and  premises. The safety audit will subject each area of the Company’s activities to a systematic critical examination with the object of minimising loss. Every component of the total system will be included e.g. management policy, attitudes, training, features of the premises (the design and layout of areas, rooms etc), emergency plans and procedures, accident records etc. The audit will aim to highlight the weaknesses and strengths, and the main areas of vulnerability or risk. Risk Assessment In accordance with the Management of Health and Safety at Work Regulations 1999, the Company will carry out risk assessments of all activities that present a risk to employees or others. These risk assessments will be carried out in line with Health & Safety Executive guidance, and the procedure for doing so is as follows: 1. Identify the significant hazards involved in our activity. 2. Decide who might be harmed and how. 3. Evaluate the level of risk and decide if existing precautions are sufficient, or if more needs to be done. 4. Record the significant findings of the assessment. 5. Review the assessment when things change, or there is reason to believe that it is no longer valid. The risk assessments will: Identify what the hazards are and identify the people who might be harmed by the hazard; Disregard insignificant risks; Evaluate the risks from the identified hazards; Ensure all aspects of the work activity are reviewed, including routine and non-routine activities and operations; Take into account any existing control measures; Take account of the way in which the work is organized, and the effects this can have on health; Take account of the risks to the public; Take account of the need to cover fire risks; Identify the period of time which it will be valid for; Enable us to prioritise remedial actions; Risk assessments will be undertaken by the Health and Safety Officer and Representatives at both sites currently used, with assistance from our advisors, B.I.G. Business Services. Dynamic Risk Assessments Dynamic risk assessment is a continuous process of identifying hazards. The risk is assessed and action taken to eliminate or reduce risk. Dynamic risk assessment will be applied in a changing environment. The dynamic assessment will be conducted by the relevant competent person managing the activity. The competent person must halt the operation is believed the risk outweighs the control measures applied. The Managing Directors are responsible to ensure competent people have been trained in dynamic risk assessing/hazard awareness. Safe Systems of Work The Company will provide written safe systems of work for all operations and tasks where there is a significant risk of injury; where there is clearly an identifiable need to specify the safe and correct way of doing the work and where, in spite of all reasonable control measures being implemented, significant risk remains. Employees will be instructed in the safe system of work, as appropriate, and a record of competency kept. Specific Responsibilities The Managing Directors and the Office Manager will identify all such processes and planned activities within the company’s area of responsibility and ensure that suitable written systems are produced, employees trained and records kept. All Employees must observe and understand the system of work at all times; reporting any circumstances which prevents compliance or undermines its effectiveness to their immediate supervisor or line manager. Monitoring Health & Safety Performance In addition to the reactive monitoring of accidents/ill-health, the Company will also carry out proactive monitoring of Health and Safety performance. To check our working conditions, and ensure our safe working practices are being followed, The Managing Directors along with B.I.G Business Services Health and Safety Consultant (where necessary) will conduct routine inspections of the workplace and review the effectiveness of our risk assessment and work practices. Consultation with Employees The Company will consult with its employees in accordance with the Health and Safety (Consultation with Employees) Regulations 1996. Consultation with  employees will be provided direct to individuals as necessary. Health & Safety Advice In accordance with the Management of Health and Safety at Work Regulations 1999, the Company has access to competent Health & Safety advice. This advice is available from: B.I.G. Business Services Tel: 0845 2626260 Email:info@bigbusinessservices.com Qualifications in Health & Safety include: Chartered Member of the Institute of Occupational Safety and Health (CMIOSH) Corporate Member of the International Institute of Risk and Safety Management (MIIRSM) NEBOSH Level 6 Diploma in Occupational Health & Safety Member of the Institute of Environmental Management and Assessment Information, Instruction, Training and Supervision The Company will provide adequate information, instruction, training and supervision to employees in accordance with the general duties on employers under Section 2 of the Health and Safety at Work etc. Act 1974 and associated regulations. All employees including any temporary and casual workers will be provided with information on any risks relevant to their particular activity and work area. All information, instruction and training given to employees, temporary and casual workers will be recorded on individual training records. In certain instances, employees will be asked to sign to confirm receipt or understanding of the training. Training and Instruction Induction training for all new employees, temporary and casual workers is the responsibility of the Chief Executive. Job specific training and instruction will be identified, arranged and monitored by the Chief Executive. The Health and Safety component of induction training will contain the following: Health and Safety Policy Accident reporting / first aid procedures Fire precautions and procedures, including our emergency plan; Introduction to safety legislation – the Employee will be introduced to the legislation that applies to our Company and the workplace, e.g. Electricity and Manual Handling. The supervision of trainees will be arranged, undertaken and monitored by the Chief Executive and Health and Safety Officer. Information The Health and Safety Law information is displayed within both of the premises on dedicated health and safety notice boards. A copy of the Employers Liability Insurance certificate is displayed within the offices on dedicated health and safety notice boards. Supervision & Management Training at all levels is necessary to ensure that responsibilities are known and the organisation’s policy is carried out. Key points to cover in the training of supervisors and managers are: The organisation’s safety policy or programme; Legal framework and duties of the organisation, its management and the workforce; Specific laws and rules applicable to the workplace; Safety inspection techniques and requirements; Causation and consequences of accidents and their reporting, recording and investigation; Basic accident prevention techniques; Disciplinary procedure and application; Control of hazards in the workplace and use of personal protective equipment; Techniques for motivating employees to recognise and respond to organisational goals in Health and Safety. Specialised training Specialised Health and Safety training will be required to cover both legal requirements and others necessary for the safe running of the organisation, for example: First aid, taking into account the nature of the work and the size of the organisation Manual Handling Use of fire-fighting appliances such as extinguishers and fire awareness. Reinforcement or Refresher training Reinforcement or refresher training will be required at appropriate intervals. These requirements will depend on the outcome of observation of the workforce, i.e. during a training needs assessment. Factors to be  taken into account are the complexity of the information to be held by the employee, and the amount of practice required and the opportunity for practice in the normal working requirement. Assessment will also be required of the likely severity of the consequences of behaviour that does not match training objectives. The Managing Directors will ensure the following procedure will be followed: Arrange for the induction training to be given to all staff; Comprehensive and relevant information will be provided to the employee in respect of risks to his / her Health and Safety and on preventative and protective measures; Information will be provided on the Company’s emergency arrangements, including staff nominated to help if there is an evacuation; Ensure that the employee understands all the information provided to them and that they have the opportunity to ask any questions in relation to the training; After a suitable length of time the training should be followed up with the employee to assess its effectiveness and to correct any misunderstandings. Lone Working A lone worker is a person who works where there are no other members of staff present on the same floor at the same time and without close or direct supervision in a wide variety of situations. This could include being off-site or outside a building. Lone workers should not be at more risk than other employees, although such activities may require extra risk control measures. Precautions should take account of normal work and foreseeable emergencies, e.g. fire, equipment failure, illness and accidents. The Health and Safety Officer along with B.I.G Business Services Health and Safety Consultant (where applicable) shall identify situations where people work alone and ensure site specific assessments are completed where required. Lone Workers identified are responsible for: †¢ Taking reasonable care to look after their own Health and Safety; †¢ Co-operating and complying with any control measures designed to eliminate or reduce the risk of lone working. †¢ Safeguarding the Health and Safety of other people affected by their work; †¢ Participating in training designed to meet the requirements of the Health and Safety policies and procedures; †¢Ã‚  Operating authorised equipment in accordance with relevant safety instructions and any training they have been given; †¢ Reporting any dangers or identified areas of risk as soon as practicable to an appropriate manager. This will include any accidents, or incidents that could have given rise to an accident; †¢ Notifying their manager, at the first opportunity, of any change in their ability to undertake their role, including any adverse medical conditions. Employees requiring advice or who have concerns regarding lone working can seek advice from the company’s Health and Safety Officer who will, if necessary, arrange specialist advice and assistance to determine the appropriate course of action to eliminate or control the risk factors Working Time It is the Company policy to eliminate the need for employees to work excessive hours without appropriate breaks. The following will be provided: Employees will be provided an uninterrupted break of 20 minutes every 6 hours worked during the working day. Young Workers, under 18 years of age will be provided an uninterrupted break of 30 minutes every 4.5 hours worked during the working day. Employees will be provided with a rest period of 11 consecutive hours rest in each 24 hour period Young Workers, under 18 years of age will be provided with a rest period of 12 consecutive hours rest in each 24 hour period An Employee will be provided with one day off a week; this can be averaged over 2 weeks Young Workers, under 18 years of age will be provided with 2 day off a week; this cannot be averaged over 2 weeks A record of working hours will be kept and averages of defined 17 week periods will be maintained by the Office Manager. Excessive work is defined in excess of 48 hours. Fitness for Work If an Employee has a medical condition that could affect their fitness for work, that Employee must inform the Chief Executive of the likely impact of the medical condition on their fitness for work. The Employee is not obliged to disclose confidential medical information, however the Company will, where necessary, confer with relevant external experts to confirm whether a Fitness for Work plan is required. Any person taking prescribed medication must seek the advice of their doctor before working, written evidence of their fitness to work whilst taking the drugs may be required and held by  the Chief Executive. Data Protection The Chief Executive will ensure the Company will comply with the Data Protection Act 1998, when recording accidents. Individual record sheets will be removed and stored securely (keeping personal information confidential). Civil Claims The Company will ensure claims for compensation for injury or damage suffered are handled correctly. Claims for compensation must be acknowledged within 21 days. Therefore it is important that any claim (and subsequent correspondence received) is notified to the Chief Executive and acknowledged without delay. Where the claim is verbal, ask the person making the claim to put their comments in writing and forward to the Chief Executive also make a note of any verbal comments and forward in the same manner. Employees are not to engage in conversation regarding the claim and should never admit liability. If necessary, explain that the matter has been referred to the Chief Executive in accordance with procedures Managing Contractors The Company recognises that it owes a duty to contractors as well as employees, as stipulated by the Health and Safety at Work etc. Act 1974 Section 3 and the Management of Health & Safety at Work Regulations 1999. The Company will ensure that only competent contractors are selected. All Contractors working on the Company’s behalf are assessed to ensure that they are competent and have suitable and adequate Health and Safety arrangements in place to provide safe working practices and control of all significant hazards that may be introduced by their work. The selection and assessment of the competence of contractors is the responsibility of the Chief Executive and Health and Safety Officer (assistance will be provided if necessary by B.I.G Business Services Health and Safety Consultant. Selected contractors must be able to demonstrate that they are experienced and competent to carry out the required works with regulations and accepted safety standards. Before a contract is awa rded an overview of the status of the tenderer’s Health and Safety management systems must be obtained by reviewing the following documents; A completed contractor selection questionnaire Relevant risk assessments and method statements for the work to be undertaken Supportive evidence of competence The Chief Executive must take into consideration all factors when selecting the contractor for the work. The cost of the works is not be the sole factor in contractor selection. The pre-selection of any contractors will take into account Health and Safety requirements when selecting and approving contractors to work for the Company, ensuring contractors: Work safely, without endangering themselves or any other people; Comply with the Company’s Health and Safety requirements; Only employ competent staff who have been adequately trained; Only employ competent sub-contractors, who are adequately managed; Have adequate resources to manage Health and Safety satisfactorily The Chief Executive may not engage any contractors to provide any services for the Company unless the Health and Safety questions in the contractor selection questionnaire have been answered satisfactorily. No contractor will be appointed if they fail to provide adequate risk assessments and method statements for the proposed work. Once approved, the Chief Executive is responsibility for ensuring contractors working on our premises are briefed on our safety rules and supervised to ensure they work in an approved and safe manner. Any problems/hazards arising from the activities of contractors should be reported to the Chief Executive respectively. The Chief Executive is responsible for the management and co-ordination of all Company contracts involving building works, engineering service, refurbishment and maintenance works. Health and Safety considerations will be included from the start when planning work to be carried out by contractors ensuring responsible for ensuring that Health and Safety issues are adequately addressed. The Chief Executive is responsible for determining the Health and Safety implications of the planned work setting the criteria by which the contractors will be judged which includes the minimum Health and Safety standards that must be met Identifying when the planned work is covered by the Construction (Design & Management) Regulations 2007; Seeking advice and guidance as necessary. Drugs, Alcohol and Smoking The Company will take all reasonable steps to ensure the Health and Safety of employees at work is not put at risk by smoking, alcohol, drug or substance abuse recognizing the affects of health, safety and welfare to the user and potential impact on work colleagues and the business. The Company therefore operates a policy which ensures that employees’ health and performance is not impaired at any time they are on Company premises. The Disciplinary Procedure will be followed in any case where an employee is found to disregard this Policy and/or to be under the influence of or in possession of any alcohol or illegal substance whilst at work or on Company premises. The Company will encourage employees with drug or alcohol abuse or dependency problems to seek help and treatment voluntarily through their own GP. Employees who suspect an employee to be suffering from drug or alcohol problems will refer the individual to the Chief Executive who will assist them in finding advice and treatment. In certain circumstances, disciplinary action may be taken against employees who fail to accept or co-operate with a course of treatment. Violence The Company will take all reasonable steps to ensure the Health and Safety of employees at work is not put at risk by violent, abusive or aggressive behaviour occurring in the work place. The Company recognises that verbal and physical abuse at work can affect the health, safety and welfare of the victim and can have an impact on work colleagues and the business. The Company therefore operates a zero tolerance policy which ensures that people on Company premises are not put at risk of bullying in any form. The Disciplinary Procedure will be followed in any case where an employee is found to be displaying violent or aggressive behaviour towards any person on the Company’s premises. ï‚Ÿ The Chief Executive and Health and Safety Officer will endeavor to provide sufficient information, instruction and training to ensure the Health and Safety of persons on Company premises is not threatened by violent, abusive or aggressive behavior by Company employees. Premises Control of Asbestos Containing Materials In conjunction with the Landlord, the Company will assess and control health  risks from exposure to asbestos in accordance with the Control of Asbestos Regulations 2006 to particularly prevent employees from exposure to asbestos and asbestos containing materials (ACMs). To achieve this, the Chief Executive and Landlord are responsible to ensure: That reasonable steps are taken, with the assistance from accredited specialists, to determine the location and condition of materials likely to contain asbestos; A record of the location and condition of the ACMs or presumed ACMs in our offices is made; Assess the risk of the likelihood of anyone being exposed to fibres from these materials; Prepare a plan setting out how the risks from the materials are to be managed; Take the necessary steps to put the plan into action;  Review and monitor the plan periodically; Provide information on the location and condition of the materials to anyone who is liable to work on or disturb them. Should the situation arise, approval for any necessary action to remove asbestos containing materials will be given by the Letting Agent who is to appoint specialist advisors and licensed contractors competent in handling and disposing of such hazardous materials. Plant and Equipment Maintenance The responsibility for identifying all plant and fixed installations and ensuring effective maintenance procedures are drawn up and implemented is that of the Chief Executive. To achieve timely and suitable pre-planned maintenance, repair and refurbishment schedules Chief Executive will appoint competent contractors to assist the Company. Portable Electrical Equipment Portable electrical appliances are tested by an external engineer at selected intervals in accordance with HSE guidance. Notwithstanding this general inspection/test programme, very high usage common use facilities (i.e. kettles, microwave ovens) are inspected/tested every 12 months and replaced as necessary to ensure high standards of provision and electrical safety is maintained for all employees. Fixed Electrical Systems The fixed electrical installations throughout the premises is inspected and tested by a competent NICEIC registered contractor. The Chief Executive will arrange for the electrical systems integrity and safety to be inspected and retested every 5 years via they workforce. Gas Systems The Chief Executive will appoint a competent Gas Safety registered contractor to service and maintain all gas systems throughout the premise. The contract will ensure that all gas systems are serviced annually and gas safety certificates held on file readily available for examination on request. Defects and Problems It is recognised that even with the best pre-planned maintenance programmes, problems and defects with plant and equipment will occur from time to time. Accordingly, any problems with plant or equipment should be reported in the first instance to the Chief Executive or Health and Safety Officer Welfare Facilities The Company is committed to providing suitable and sufficient welfare facilities to employees, in accordance with the Workplace (Health, Safety and Welfare) Regulations 1992. Adequate numbers of clean toilets, washing and shower facilities are provided for the number of staff and visitors required to use them. Toilet paper, hot/cold water, soap and means for drying hands will always be available. In addition, drinking water and a means to prepare hot drinks and food is provided in the Kitchen. To ensure that a high standard of cleanliness and good hygiene is maintained, the facilities are cleaned. Notwithstanding this planned cleaning programme, any employee who has concerns with the standard of cleanliness and hygiene should report the matter to their appropriate manager who will investigate and advice accordingly. Access and Egress The Company is committed to providing a safe place of work and a safe means of access and egress within all parts of our workplace, which includes movement in and out of the workplace. Access and egress includes all of the following: Access to and egress from the workplace; Routes through working areas; Accessibility of storage areas; Access to and egress from an individual’s workplace; Emergency exit routes; Any temporary arrangements for access; External pathways and roadways around the workplace; The Chief Executive and Health and Safety Officer with assistance from B.I.G Business Services Health and Safety Consultant (where applicable) will ensure risk assessments are completed to identify that: The workplace shall be organised to ensure pedestrians can circulate in a safe manner; All articles or substances do not impede safe access and egress at the workplace and that objects which may restrict safe movement within the workplace are removed immediately; Any access restrictions are adhered to so that suitable and safe arrangements for work in confined places and other areas of high risk are guaranteed; Objects are not stored in walkways or precariously on top of cabinets / shelves; All work equipment when not in use must be stored in its designated storage area; Waste items shall not be allowed to accumulate in walkways and floor surfaces shall be capable of being kept sufficiently clean and cleaned as appropriate; All access equipment is regularly inspected to ensure that it is maintained in a safe condition; Formalised systems of work are designed and implemented in all areas of significant risk; Employees are encouraged to report any situation where safe access and egress is restricted or obstructed. The workplace floors and traffic route surfaces are suitable for their purpose and maintained in a safe condition and suitably indicated where necessary of reasons of Health and Safety; The working activities of contractors are monitored so that they do not hinder safe access / egress; So far as reasonably practicable we will take suitable and effective measures to prevent persons falling a distance likely to cause personal injury and to prevent any person being struck by a falling object. Activities Manual Handling In accordance with the Manual Handling Operations Regulations 1992, the  Company will eliminate the need for manual handling wherever possible. Where elimination is not possible, the risks from manual handling will be assessed and reduced, so far as is reasonably practicable by job design and the provision of mechanical aids etc. Manual handling risk assessments will be carried out by the Managing Directors with assistance from B.I.G Business Services. Display Screen Equipment (Computer Users) The Company will assess and control health risks from exposure to display screen equipment in accordance with the Health and Safety (Display Screen Equipment) Regulations 1992. Employees that are classed as habitual Display Screen Equipment users are entitled to free eye tests on request and to vision correction appliances but only where these are needed specifically for work with display screen equipment. Display Screen Equipment workstation assessments will be arranged by the Chief Executive who will also give any necessary approval for corrective action to remove or control risks. Habitual Display Screen Equipment users will be required to complete self-assessment of their workstation. The complete assessment is to be returned to the Health and Safety Officer, who will review and arrange for any necessary corrective actions. Employees who have declared a disability or existing upper limb disorder to the Health and Safety Officer will be individually assessed to ensure all necessar y adjustments are made to their workstation and job tasks to allow them to continue working. Demarcation / Safety Signs The Company recognises the Health and Safety (Safety Signs and Signals) Regulations minimum requirements for the provision of safety signs at work. The Chief Executive along with the Health and Safety Officer will provide specific safety signs whenever there is a risk that has not been avoided or controlled by other means, for example by engineering controls and Safe Systems of Work (SSoW). Where a safety sign would not help to reduce that risk, or where the risk is not significant, no safety signs will be provided. Hazardous Substances (where necessary) The Company will assess and control health risks from exposure to hazardous substances in accordance with the Control of Substances Hazardous to Health Regulations (COSHH) 2002. All reasonable steps will be taken to ensure that all exposure of employees to substances hazardous to health is prevented or at least controlled to within statutory limits. We will not supply or use those substances prohibited by law. The responsibility for identifying all substances that need a COSHH assessment and for obtaining the Chemical Safety Data Sheets is that of the Chief Executive and Health and Safety Officer. COSHH assessments will be carried out and any actions identified implemented by the Health and Safety Officer with assistance from B.I.G Business Services who will also ensure all relevant employees are advised. The COSHH information will also be made readily available to affected employees for reference. The Company will ensure that the exposure of employees to substances hazardous to health is either prevented or, where this is not reasonably practicable, adequately controlled. Where exposure cannot be adequately controlled the Company w ill provide appropriate personal protective equipment (PPE) free of charge. The Chief Executive is responsible to ensure all employees will be provided with comprehensive information and instruction on the nature and likelihood of their exposure to substances hazardous to health. The Company risk assessments will be reviewed regularly and particularly if either there is a significant change in the work or the validity of one of our original assessments. Emergency & Continuity Accidents, First Aid and Work Related Ill-Health The Company is committed to preventing accidents and cases of ill-health to employees and others who may be affected by its work activities. However, the Company recognises that failures can occur and will investigate all accidents and ill-health to identify the immediate and underlying causes so as to prevent recurrence. First Aid Provision The Chief Executive will ensure that adequate first aid trained personnel and equipment is provided, in accordance with the Health and Safety (First Aid) Regulations 1981. The Chief Executive and the Health and Safety Officer are responsible for ensuring the location of the first aid kit, accident book and the names of First Aiders are known to all employees. Quarterly checks on provisions are to be made by the First Aider and any shortfalls addressed. Accident Reporting All accidents and incidents are to be recorded in the accident book. The Health and Safety Officer is to ensure that where appropriate the accident or incident is RIDDOR reportable. The Chief Executive is responsible for investigating accidents and incidents of ill-health to prevent a recurrence. Reporting of Accidents/Incidents to the Authorities All reportable incidents, as defined by the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) will be reported by the responsible person – Chief Executive or the Health and Safety Officer when necessary to the enforcing authority within the relevant timeframes. The following types of work related incident/accident need to be reported: Death Major Injuries e.g. broken bones, dislocations, amputations, loss of sight etc. Any accident resulting in more than 3 days lost from work Any non-employee (i.e. customers, visitors and contractors) being taken directly to hospital Certain types of disease e.g. dermatitis, asthma, upper limb disorders, carpal tunnel syndrome etc. Certain types of dangerous occurrence, even when no-on is injured e.g. electrical fires, etc. All records of all reportable accidents, dangerous occurrences and reportable diseases will be kept for at least 3 years. Fire and Evacuation The Company has procedures in place to follow in the event of emergency. These are communicated to all employees during induction and are displayed throughout the offices. In simple terms the procedure is as follows: In the event of a fire: Immediately sound the alarm by shouting â€Å"Fire, Fire, Fire† . Only attack the fire if trained to do so – do not put yourself at risk. Dial 999 and ask for the fire brigade – give the building address and location of the fire ensuring it is heard by the operator. Evacuate the building by the nearest exit and proceed to the designated assembly point. Do not stop to collect personal belongings. Do not re-enter the building until told it is safe to do so. The Company has appointed a ‘responsible person’ in all locations who is charged with the responsibility of ensuring the safety of the staff and any person who may legally come onto Company property and of anyone not on the premises but who may be affected. Therefore, in accordance with the Regulatory Reform (Fire Safety) Order 2005, the Company will ensure that a Fire Risk assessment is conducted and adequate precautions put in place. The Chief Executive is responsible for ensuring that the fire risk assessment is undertaken and completed. To achieve this duty the Chief Executive have appoint specialist consultants (B.I.G Business Services) to assist in the completion of the assessment and also in identifying any recommendations necessary. The day-to-day responsibility for ensuring all fire precautions are in place and in order is that of the Health and Safety Officer in particular: Escape routes are checked d aily to ensure they are free from obstruction. Fire extinguishers are maintained and serviced annually. Environment The Company will take all reasonable steps to minimise as far as practicable the impact of its activities on the environment. The Company recognises its responsibility to the community and has therefore identified the aspects of its operations that may have an effect on the environment. The Company does not consider its business to be of inherent damage to the environment, but it has identified certain areas which need to be controlled to minimise any detrimental environmental effect. The Company will endeavor to control its following activities: ï‚Ÿ Consumption of energy; Use of packaging materials; Emissions; Use of transport; The Company will meet and where appropriate exceed the requirements of all relevant legislation, will seek to reduce the consumption of materials and will recycle waste where possible. In addition, the Company will manage energy and fuel wisely and will minimise visual, noise and other impacts of  its business on the local environment. Waste Disposal It is the policy of this company that where waste is generated during the course of company activities then that waste shall be disposed of in a controlled, safe and proper manner. Where such waste removal requires the application of special control measures to reduce hazards such as contamination, dust or risk of environmental pollution then laid down company procedures will be followed to render such waste removal inoffensive and free of risk so far as reasonably practicable. The Managing Directors will lead the process of implementing this policy and will keep the policy under continual review.

Introduction of Education Essay

Purpose of education – Prepare students for the working world, for employment: credible labour force – Develop skills: social skills, critical thinking – Impart knowledge: accumulation of knowledge – How to be an educated person / a good citizen, unity, national identity – Building up character, facing adversity, ethics – Teaching right from wrong ( conformity? – Understand matters in life Types of education – Liberal education: education including the arts, equal weight given to arts and sciences ( Literature, history and appreciation of the arts – Home schooling. – Family education (parental guidance) – Informal and formal education (skills and academics) – Experiential learning – National education – All-round education Overemphasis on excellence eroding purpose of education? – Pursuit of achievement: meritocracy, guided by principle of progress: development – Credible labour force to satisfy economic needs ( Knowledge: improve ability to handle learning in future ( English teaches us communication skills – Career ( Secure better jobs because past excellent track records show that individual has capability of handling what is required of him – National. identity ( People strive for economic growth, creating prosperity, increasing standard of living of people, making them happy and hence more loyal to the nation ( National education ( BUT increasingly competitive ( Uneven distribution of income ( Cannot eliminate discrimination, likely that discrimination will prevail – Disunity ( Rise of elitism: encouraging unhealthy competition ( SAP, independent schools, IP – Compromises ethical values ( Too concerned with quest of excellence, may try to excel using underhanded means ( Undermines moral development, ignore ethical means ( Conceal knowledge, unwilling to share knowledge with people Thinking mind better than accumulation of knowledge? – Develop independent learning process – Montessori: emphasis on self-directed learning on the part of the child and clinical observation on the part of the teacher – More receptive to views: learn not to be so subjective or opinionated – BUT may develop non-conformist thinking, disrupting social stability. Society may become more opinionated due to the diversity of opinions – Increased acumen to resolve social and moral dilemmas. ( More tolerant and understanding of each other ( empathise better with each other ( understand problems or issues better ( Importance of upholding social values (altruistic punishment) – BUT too liberal: unable to uphold values ( Difficult to create a staunch and orthodox thinking, no particular value to adhere to, makes it difficult to define values ( France: liberty is subjective vs. liberty is institutionalized in US Learning in schools vs. on the Internet vs. at home – In line with purpose of education? ( Who’s the ‘teacher’? Reliable source? Able to deliver all purposes of education? – Information: amount, accessibility, coverage in terms of depth and breadth, response-time, reliability ( Internet = â€Å"information superhighway†: additional 7. 3 million pages per day ( Sep 30 2007, 1. 244 billion people use the Internet according to Internet World Stats – Pace of learning: linked with building up a strong foundation or understanding of a concept – Exclusivity: must take into account that everyone has the right to be educated – Learning environment: conducive vs. environment with lots of distractions – Formal vs. informal education Special types of schools: SAP and IP – Linked with racism or elitism. – Consider purpose of setting up these special types of schools in the first place ( In line with bilingualism: to take Chinese and English as first language ( Better amenities to further develop students’ potentials – What debate has it spurred? ( Exclusion of Malays, Indians and Eurasians: endanger social fabric of nation, Singapore is supposed to be a multi-racial society ( Creating a bigger divide between the intellects and those who do not do well in studies – Is it a justified cause? ( SAP may not be because Malay and Tamil are official languages as well. Why exclusively the Chinese? ( Since Singapore only depends on human capital, need to maximize the learning potential of more capable students ( probably inevitable to have a divide *Dependent on the maturity of the students. Students in elite schools should not be arrogant or flaunt their abilities ( could be the cause of the debate in the first place. – Government can work on giving Malay and Tamil more recognition, and providing schools with more amenities if they deem themselves deserving of the facilities – Can look at how well these types of schools tie in with the purpose of education. Do they fulfill the purpose of education better than mainstream schools?

Sample Personal Statement

Sample Personal Statement for Architecture People once asked me: â€Å"Why did you choose architecture? † I couldn’t give a simple answer for that. Maybe it was because I like painting and construction since childhood. I also earnestly yearn to create beautiful things on my own and architecture can satisfy my imagination in space, materials, and color. My born interest in this sector is also because of my parents, who are both structural engineer and electrical engineer, influencing me gradually and unconsciously since I was a kid and giving me perceptual knowledge in the field.After my five-year study in the Department of Architecture, and one-year work experience in architectural design, I ask myself this same question. The result is that aside from the factors mentioned above, what really makes me choose architecture is its intrinsic appeal, which is just like the maxim written inside the building of the Department of Architecture: â€Å"Architecture is the combinat ion of art and technology. † Perhaps when a person is engaged in what his keen interest blossoms, he will never feel tired, instead he would feel motivated and have an enriching experience.Five years' academic study in the School of Architecture and Arts of University of XX transformed my instinctive excitement and imagination about architecture into systematic knowledge and comprehensive understanding. This transformation, first of all, lies in my skills in the fine arts. Differing from my previous mere interest in fine arts, the study of architecture makes me begin to ponder on how to draw using aesthetic elements from fine arts such as color, lighting and composition to apply to architecture. I was so dedicated to such brainstorming and imagination that I would always work around the clock in the studio for days on end.Secondly, the study of basic architectural courses, such as architectural structure, mechanics and materials science, makes me realize that architecture not only gives importance on aesthetics, but also on the more essential functionality and practicality. In that process, I realized that architecture is not only an art, but also more importantly a sort of technology. Five years of college study gives me a deeper comprehension of architecture, that is, architecture is also part of other cultures – it is subject to other cultures' influence, and at the same time it influences other cultures.Because of my childhood architectural background, coupled with my lasting keen interest in architecture, I gained excellent achievements in the major courses of my college study, ranked top three in the class, and also received first prize scholarships and many other scholarships for five consecutive years. Besides, owing to my understanding of architecture, I am not satisfied with mere textbook knowledge. I believe architecture is not only a skill but also, more importantly, a combination of creativity and imagination.An excellent architecture designer needs not only solid architectural skills and knowledge, but also needs nourishment from fine arts, materials science, engineering and culture. For that purpose, I read quite extensively, understood the architectural history of different countries – especially European architectural history, learnt from works of modern and contemporary architectural masterpieces, and gained insights on their design conceptions that are full of creativity and connotation. The knowledge I have gained from these efforts heightens my interests and my desire for creation.

The copernican revolution Essay Example | Topics and Well Written Essays - 500 words

The copernican revolution - Essay Example They made arguments against Copernicus’ writings, whether they were Protestant or Catholic, and overall agreed to condemn them in a religious manner. In addition, these leaders found that Copernicus’ writings disagreed with the ancient theories of Aristotle and Ptolemy, giving their objections not only a religious aspect but an alternative scientific explanation that was more consistent with their beliefs. They showed quotations from the Bible such as Psalm 93 that indicated that the earth was station, also claimed that the science behind Copernicus’ arguments was impossible regardless of the scriptural conflict. Cardinal Bellarmine’s letter comes after Galileo supported Copernicus’ writings. The Cardinal writes to the leader of the Carmelites, who attempted to reconcile the Copernican theories with Catholic scripture. The Cardinal pointed out that making this claim was bound to cause more controversy, and could be dangerous. He also insisted that e ven if some conflicts could be resolved, it would be most difficult to reconcile all scriptural passages with the science, and thus the science would have to be wrong. He warns against the heresy of misinterpreting scripture, and says that there still is no real scientific evidence behind Copernican theory.

Communication Skills Used By Mental Health Nurses Essay

Communication Skills Used By Mental Health Nurses - Essay Example 6). In achieving its goal, mental health nursing used variety of theories, research, strategies, and evidence-based practice to reduce suffering and improve the quality of life. Communication skills, particularly therapeutic communication, are one of the strategies frequently used by mental health nurses to build rapport and partnership with clients that are in need of mental health care. According to Pryjmachuk (2011), communication skills refer to sets of interpersonal skills which play a vital role in making a climate conducive for therapy, such as demonstration of trust, rapport and collaboration and promotion of engagement (both client and therapist) in the therapeutic relationship (p. 61). It is through therapeutic relationship that nurses became able to understand clients’ thoughts, feelings and behavior, establish partnership and therapeutic relationship with the client, and deliver appropriate care needed. Through the years, the role of the mental health nurses has ev olved and they continuously assume various roles during nurse-client relationship. Three key influences have shaped the need and style of interpersonal communication skills among mental health nurses of United Kingdom. ... ealth arena and service user movement in mental health which heightened the pressure to workforce, human qualities and specific clinical skills; and development and evolution of mental health nursing as a profession in the post war period as a result of continuous debates on mental health nursing’s purpose (Callara, 2008, p. 154). These forces have shaped the communication skills used by mental health nurses as the recognition of mental health nursing as a profession has made interpersonal therapeutic relationship the focus of research and development and trainings among nurses. Thoughts and Feelings about Therapeutic Communication In mental health settings, therapeutic communication is the primary vehicle that nurses used (Videbeck, 2010, p. 115). I feel that this type of communication is the best tool that a mental health nurse should have and that communication skills that offer therapeutic relationship should be nurtured and enhanced professionally. I also believe that if the client and the mental health nurse have a therapeutic relationship, any interventions geared towards client recovery would be effective. I feel the need for this type of communication in mental health settings; unfortunately, not much emphasis was given to communication skills enrichment and self-awareness – the first step towards improving communication. When mental health nurses are aware of their personal attitudes, beliefs, and values, they could easily gain awareness of the factors that influenced communication, establish rapport with the clients, and build therapeutic relationships. Basavanthappa (2011) has indicated different therapeutic communication techniques that mental health nurses and I often used in a nurse-client relationship, among of which include: use of broad opening

German paper 3+4 Essay Example | Topics and Well Written Essays - 500 words

German paper 3+4 - Essay Example He was consistent with conventional history when he said that after the US joined the war, Germany was defeated. But what conventional history did not say, which he said was that the Germans blamed Zionist Jews for the entry of the US, thus their defeat (Freedman, par.24). This he said was the root of German discrimination against Jews which was indeed justified. If what he said was true, was conventional history then wrong in saying that the Germans at that time were envious of the economic success of Jews? Was it wrong in saying that the Germans were blaming their difficulties on the Jews because the Jews were in control of media and a lot of the industries then? As an aside, Freedman also said that â€Å"Jews happened to be maybe 98 percent of the Communists in Europe at that time† (Freedman, par. 26).† Unbelievable! To fight back, the Jews declared war on Germany (Daily Express, p.1). It called on Jews all over the world to boycott all products made in Germany. Germa ny depended a lot on its exports. By declaring economic and financial war, its aim was to hurt Germany economically, starve its people, and compel Germany â€Å"to end its campaign of violence† against Jews (Daily Express, par. 7).

Brief a case Essay Example | Topics and Well Written Essays - 750 words - 1

Brief a case - Essay Example Once the work under the second contract was completed the defendant called the plaintiff’s computer operator once monthly to enquire as to how the computer system was working and asked for the claim number had been arrived at. The software program modified by the defendant contained insurance claims by the plaintiff’s clients and each claim was identified by a specific number. As it turned out the computer system crashed when it reached claim number 56789. The crash had been orchestrated by the defendant who had been losing clients. The defendant had deliberately and secretly entered a â€Å"conditional statement† in the plaintiff’s software program which directed the program to stop working when it reached claim number 56789. Satisfied that the plaintiff had already paid the defendant more than enough money for his services, the plaintiff hired another expert to fix the problem. It was this expert who discovered the conditional statement entered by the de fendant. In any event, the second expert fixed the plaintiff’s computer and was paid US$7,000 for his troubles. The plaintiff subsequently sued the defendant for breach of contract with respect to the second contract. The plaintiff sought compensatory and punitive damages against the defendant. Specifically, the plaintiff sought US$18,000 in punitive damages and US$7,000 in damages, the amount paid to the second expert to remedy the problem deliberately created by the defendant. RULE: As a general rule in the law of contract, punitive damages are not awarded. However, under breach of contract claims, punitive damages may be awarded where the award is necessary for deterring â€Å"morally culpable conduct† (Halpin v Prudential Ins. Co. 48 N.Y. 2d 906). Although the plaintiff specifically requested punitive damages, punitive damages can be awarded even when it is not

Confederate Government Conspiracy to Assassinate President Abraham Research Proposal

Confederate Government Conspiracy to Assassinate President Abraham Lincoln - Research Proposal Example To that end, the Confederate government conceived a plan to kidnap Abraham Lincoln in order to force the Union to free Confederate prisoners of war. While the kidnapping never came to fruition, questions remain as to whether the Confederate government was involved in Lincoln’s assassination.1 It is fairly evident that Davis and key members of his government had conceived of, and funded, some initiative aimed at striking the Union beyond the battlefield. The Confederacy established an espionage department in 1864, which conducted covert operations from its base in Canada, helping plan and carry out the raid on St. Albans, Vermont.2 Many claims have been made about the independent nature of the conspiracy that orchestrated the Lincoln assassination. Skeptics insist that such a conspiracy likely began as a kidnapping plot involving the Confederate secret service and prominent members of the Confederate government. My hypothesis is that an intricately planned conspiracy involving Confederate agents in the U.S. and Canada, which ended in the assassination of the president, was carried out with the knowledge and involvement of Confederate officials. It is possible that the assassination itself was simply an unplanned outcome of a kidnapping plot that had gone undetected by federal officials. Either Booth, secret service officers or the Confederate high command (or all three) at some point decided that the only remaining viable, practicable option was assassination. As Lincoln himself told journalist Noah Brooks in 1863, â€Å"I long ago made up my mind that if anybody wants to kill me, he will do it. If I wore a shirt of mail and kept myself surrounded by a bodyguard, it would be all the same. There are a thousand ways of getting at a man if it is desirable that he should be killed.†3 My research will address the origins of the kidnapping plan; the extent to which the Confederate government was responsible; and the exact nature of the decision to alter the plan from a kidnapping to assassination. III. Definition of Terms â€Å"Chaos Theory: The Tortuous Pursuit of Motive and Means in the Lincoln Assassination.† Key terms/headings in this proposal include: No direct evidence - Lack of clear evidence linking Richmond to the conspiracy The Booth factor – The likely influence of Booth in altering the original plan Of like mind – Federal authorities convinced Davis, other high officials guilty Scapegoats†¦and more questions – Hysteria obscures true motive, investigations Fact over fiction – Preponderance of practical evidence points to Richmond IV. Background The conspiracy’s original goal had been to kidnap Lincoln and carry him to a secure location. The conspirators pursued that goal with a specific outcome in mind: attack the Federal government at its source, free the prisoners of war and enable the Confederacy to fight on.4 In his summary argument in the conspiracy trial, government Ju dge Advocate John Bingham claimed that a paper found in Booth’s possession contained a secret cipher, used by Davis himself, to communicate with his agents5 Bingham asked, â€Å"Of what use was it to (Booth) if he was not in confederation with Davis?†6 Bingham went on to conclude that â€Å"my own conviction is that Jefferson Davis is as clearly proven guilty of this conspiracy as John Wilkes Booth, by whose hand

A Narrative Inquiry Qualitative Research Approach Proposal

A Narrative Inquiry Qualitative Approach - Research Proposal Example Given that this minority group has been inadequately covered in research, their challenges have lacked the necessary attention that is crucial in ensuring that they make wise choices in their life. Research has pointed out that these students are inclined to face more challenges unless there is an intervention to streamline their decision making process. As this population continues to increase, it is necessary to provide research driven recommendations to help them overcome their challenges and resolve their problems. The main purpose of this research is to investigate the factors that lead to First Generation Students (FGS) in obtaining multiple graduate degrees; undergraduate, masters, PhD and Doctoral programs. By interviewing FGS persons who have acquired post graduate education, it is possible to obtain their experiences and assess the factors that have contributed to their achievements. With this information, the research will assist in the generation of viable motivational approaches that can assist other FGS students to earn success in their education. The principle behind this study is that enhancing educational development is one of the best ways to impact community advancement in the contemporary society. The research will follow a narrative inquiry approach in the synthesis of the fact underlying the academic achievements of the FGS. With this interpretive approach, it will be possible to obtain the experiences of the selected samples and synthesise possible way in which to encourage other FGS to follow suit. In the recent past, the topic on First Generation students has generated a lot of heat in the area of research that is concerned with academic development. Ward, Siegel & Davenport (2012) define First Generation college students as those students entering college and originate from a family where none of the parents or siblings have attained have graduated

Base on the case study Critically review and discuss how the NIBCO Essay

Base on the case study Critically review and discuss how the NIBCO carry out the implementation of Business Prpcess Reengineering(BPR), Enterprise Resource Plan - Essay Example Most of the top brass (including Davis, Beutler and Wilson) fell under the Heiracrhists division as far as their social relationships were considered. Being high on grid (the extent to which an individual is influenced by the need for rules and regulations The Business Review roles (under the Business Process Teams) were assigned to people who were more of Individualist (low on group low on grid) so that they can use their own knowledge and experience in decision-making. Some of the members were taken from the Board of Directors, to add credibility and authority for the task. The Power Users and Business System Analysts were basically Egalitarians (high on group and low on grid) and hence they could work comfortably in groups. Same for Wilson’s technical team. Davis’ Change Management team, especially the chosen Focus Group, again fall under the Egalitarian division: they thrived on cooperation, collective work and teamwork for bringing about a concerted change. Any deadlocks faced by them were cleared by Rex, who can be classified with the Heirarchists. At NIBCO, there were a few Fatalists too, (like the few who left) who could not change their apathetic attitude and were unable to streamline themselves with the changing environment. However, they were few and were greatly outnumbered by the other, more positive staff. By the consent of the Tiger Team, an almost no-individuality culture was fostered (space arrangement in the Tiger Den). This went a long way in developing the esprit de corps, and even making the non-cooperative streak of the Individualists fade away. Above all, though the project was driven by a top-down approach, the sub-cultures (how do workers interact with each other at their levels), and nuances of relationships between co-workers were adequately harnessed. The sheer vigour, from Rex Martin to the lowest rung,

Literature Search Public Speaking Essay Example | Topics and Well Written Essays - 500 words

Literature Search Public Speaking - Essay Example ge Journal of Research & Practice that public speaking skills are necessary for success as a professional and he cites several studies and paper which show that people who are good at public speaking have an advantage in the business world as compared to people who are not good public speakers. The writer then goes on to suggest that elementary public speaking courses should be as broad based as possible since students might not be able to take more elective courses in communications. With a similar focus on the academic side, Hansot (2004) shows how mastery of public speaking used to be taught in American schools as traditional rhetorical practice in the 19th century before it fell out of fashion. Students were taught a variety skills including control of their voice and body movements for effective communications. This was considered necessary for professional advancement as well as a part of the duties one might be expected to perform with an active public office. In opposition to the writers mentioned above, Pugsley (2005) takes a more practical approach while discussing public speaking and outlines the important parts of an effective presentation. The writer suggests that planning is the thing which makes a speech effective and successful while an ill planned speech would be incoherent despite scoring highly in other areas. A mastery of the topic under discussion as well as an enthusiastic approach is also a requirement for good speeches. As opposed to the writers mentioned above, the websites found under the topic of public speaking move directly to the heart of the matter and focus on practical advice rather than academic information. For example, Allyn & Bacon (2006) point out how nervousness is to be expected and it should not deter a person from having their say. McKinney (2005) gives very good advice on how a call to action as well as a humorous comment can leave the crowd happy and appreciative of a speech. Finally, the Toastmasters (2005) gives ten

The Chapters of my Grandmothers Life Essay Example for Free

The Chapters of my Grandmothers Life Essay An amazing, talented completely young at heart woman who has aged with complete grace and honesty; this is my grandmother, Gloria Whelan. I have dozens of perfectly clear memories from my childhood that would not be the same without her. I have always respected, admired, and attempted to pursue the astonishing way she has woven her faith and love into every aspect of her life. My grandmother recently had her eightieth birthday and is currently living in Northern Michigan with her husband Joseph. She has enjoyed a rewarding and successful career as a childrens author, and is well respected by her husband, friends, peers, and family. Her life, like many of her books, can be divided into chapters and the occasional picture that combine to paint the portrait of a truly remarkable woman. As we open the book of my grandmothers life, we see it began with a comfortable lifestyle, growing up as an only child. This was quickly catapulted into a much more meager living along with all families of America as the Great Depression struck. Her father lost everything he had, and her family was forced to move into apartment housing owned by her uncle. Everyone in her extended family had experienced a similar horrible loss and my grandmother found herself living amongst all her aunts and uncles. As an only child, she unconsciously seemed to fall into the roles of hero and lost child, diving into books in her spare time by always aiming high to reach her goals. Her relatives took on the mascot roles where holes had been left by the lack of siblings and she recalls many of their quirks or family humor from parties. The reality and difficulty of their loss was an incredible burden to her parents, and my grandmother felt that this affected her greatly. It caused to her always appreciate what she had, not only in terms of monetary value but also in terms of strong faith, hope for the future, family support, and good relationships. She always regretted not having a sibling, especially during these rough times where she found herself surrounded mostly by adults. During grade school, she pretended she had an older brother, and even named him Lancelot Reginald Bartholomew which obviously displays her creativity and love for imagination at an early age. Another thing that my grandmother regrets deeply was her parents being so overprotective. As an only child, it can be expected that parents are more defensive; however, my grandmothers parents did not allow her to participate in any physical activities, by herself or with other children. She was not allowed to bike, skate, or swim, and as a result never learned to how to do these seemingly universal activities. She feels that sports and exercise are important to social development and confidence as well as a sense of belonging with peers. At the young age of eight my grandmother came down with rheumatic fever which had her bedridden for a full year. Obviously, for an eight-year-old this is a very traumatic feat, which my grandmother found herself overcoming by diving into books. It was the beginning of a love that led to her career far before she could have guessed. It also allowed for introspective, personal time, which likely led to her great understanding of herself and others.

State of Nature in the Modern Society

State of Nature in the Modern Society INTRODUCTION According to John Stuart Mill The state of nature that precedes civilization is where originality resides [1] and the society leaves its individuals to their own devices as long as they do not harm others. [2] But what really is the state of nature? Moreover, why this idea as it was presented by the theorists never played its real role in practice? Was the state of nature that chaotic that people choose to have a superior, rather than being free from any obstacles? Were people afraid of their fellow human beings as Hobbes insinuates? I am working on the topic of the state of nature in the modern society, because I want to find out if there is still a state of nature in the 21st century, for example in the indigenous societies, or that is some kind of social contract or anarchy. I am doing this in order to understand how people today live and if the basic human rights, as are the right of life, the right to liberty and security, the right of freedom etc., respected in those societies. In this paper, I will try to analyze why despite the overall technical and technological progress, the cultural development, the democratic values that we stand for and the globalization of the countries in the world, yet in some parts of Planet Earth we can meet the remnants of what Rousseau, Hobbes and Locke call the state of nature. These societies living in the state of nature are trying to tell us that not always rule of law is needed; not always people need government to live proper and in peace. The world never was, and never will be without number of people living in that state, the state of nature. If we only look at the examples of many Indigenous people round the Globe, we can see that people can live without legally established government, without constitution and without laws, and still respect each other and live in peace. This is contrary to Hobbess claims that people in the state of nature cannot live just because homo homini lupus est. [3] So the need for social cont ract is not really a need. We can observe that sometimes the human nature is egoistic, wolfish and greedy: what is mine is mine, and what is yours I want to be mine. That is a result of population growth, the limitation of the resources, the enrichment of certain class of people and the innovations and development of the world. Contrary to this, that is not the situation in many undeveloped African tribes, as I will show later in the paper. In the first chapter of this paper, I will expose the main ideas of Thomas Hobbes, John Locke and Jean Jacques Rousseau and their picture of the state of nature. Following, in the second and last chapter, I will try to find out if there is a state of nature in the 21st century. As an example, I will be taking the Indigenous peoples and their structure of society and their development. Furthermore, I will discuss the significance of the human rights that these people have and the way they manage to exercise them in the world they live in. There is a lot to say on this topic and there are a lot more examples on this subject, but due to limited time and resources, I will keep my research and my analysis short and within these frames. My research is contained mostly from research of the main theories or Hobbes, Locke and Rousseau, relevant articles concerning the state of nature, articles concerning the life and the society of the indigenous peoples (primary and secondary sources). 1. WHAT IS STATE OF NATURE? There are many definitions on what is state of nature. According to Hobbes: The state of nature is a state of incessant mutual exploitation, all individuals seeking to dominate one another and to acquire honor and profit (fame and fortune). [4] Many encyclopedias consider the state of nature as uncivilized and uncultured condition, [5] a wild primitive state untouched by civilization. [6] State of nature is described also as a condition before the introduction of the rule of law, and as a state where there are no rights but only freedoms. In such a world where there are no laws, government, power, the people are in a natural condition of humankind. Nevertheless, the state of nature in its true form [7] never existed in human society. Perhaps as a state of nature we can take the examples of the emergence of human society when man was savage and lived in hordes. The human at that point of development was not aware of anything, except livelihood and survival. People acted free from all restrictions and pressures. They showed their true existence and the desire to own fulfillment. As creatures of that kind, all people were and are equal by their nature. At that stage, all people without restriction tend to insure and optimize their own fulfillment, then this unlimited competition lead to a state of complete uncertainty and danger. [8] Moreover, they consider themselves indispensable for the elimination of this tendency to establish a state of security and peace by entering in a civil society. [9] Many of the Enlightenment theorists claim that the state of nature existed in the human society, but man came out of that state because h e was afraid of the other humans, [10] considering that in the state of nature dominates social chaos and in order to protect himself the human was obliged to conclude the social contract. With this contract individuals freedom of self-fulfillment was restricted, so that individual freedom of all can exist together. Everyone gives up their unlimited right, accepts limitations and with that accept the security and the peace in coexistence. [11] Everyone has the natural right of personal fulfillment. This right of personal fulfillment cannot be abolished because it would mean the destruction of livelihood. [12] However, it may be restricted and in that way can exist in parallel with the other inalienable rights of all people. The restrictions are codified in legislations. Following, these restrictions were the basis of the doctrines of the Enlightenment thinkers Hobbes, Locke, Rousseau, Hume. [13] They created the laicism of governing and new political legitimacy of any fair ruling to be extracted from the social relations and based on respect of humans rights. [14] 1.1. State of nature according to Thomas Hobbes Hobbes believed that human beings in the state of nature would behave badly towards one another. [15] He believed that such a condition would lead to a war of every man against every man [16] and make life solitary, poor, nasty, brutish, and short. [17] He was strictly against the state of nature because as he said, there can be nothing worse than a life without the protection of the State, [18] especially since in this state there is no justice because there is no law. Hobbes argued that there are no human rights in the state of nature. [19] People have natural right to do anything to preserve their own liberty or safety, and by this implies they act savagely to each other by trying to preserve their own life. This is very arguable nowadays. Every human simply by just being human is entitled with rights when born, despite on what level of development he is in, or if he is aware of the existence of human rights. For Hobbes, natural right is the human freedom to manage himself in relation to issues of his own self preservation. The man, in this capacity has an inalienable dignity, because he is a goal for himself and a kind of absolute value (man as imago dei). [20] This term has its roots in Genesis 1:27, wherein God created man in his own image. . ., [21] which does not mean that God is in human form, but rather, that humans are in images of God in their moral, spiritual, and intellectual nature. [22] The moral implications of the doctrine of imag o dei are apparent in the fact that if humans are to love God, then humans must love other humans, as each is an expression of God. [23] This means that people are obligated to respect one another, but according to Hobbes at the end the wolfish nature of humans [24] dominates. Hobbes develops the way out of the state of nature into civil government by mutual social contracts. Only by concluding the social contract man can save himself and become just (in this State there is no room for the unjust). He says that only the fear of death can lead to the creation of a State. [25] This saying in the modern world was a reason for many wars. Many rulers, dictators, tyrants, for example as Hitler did with Germany in the Second World War, were guided by Hobbess ideas that the man is obedient of the State and should delegate his rights to the Sovereign because the Sovereign is sinless and just, thus has the unlimited powers of rule and punishment. [26] The rulers will define good and evil for his subjects. The ruler can do no wrong, because lawful and unlawful, good and evil, are expression of the will of the ruler. [27] Hobbes gives authorization to the ruler to kill everyone who disobeys this will. In other words, the ruler is always right, because he has god given rights and is messenger of God, so if someone does any wrong (which will mean opposite to the rulers wishes) he will lose his life. This contradicts with one of the basic human rights [28] the right to life. It is not that there should be no State rules and regulations and that people should live in total anarchy, but rules that are in line with peoples rights, wishes and desires, for example regulations brought due referendum, which is a true expression of peoples will and democracy. Therefore, Hobbes, despite the pretty picture he has in mind of people being safe by concluding the social contract, is neglecting the basic human rights. [29] Moreover, Hobbess social contract was in favor of the ruler, not the people. 1.2. State of nature according to John Locke Locke holds different position compared to Hobbes. He believes that people could live in a state of nature, and life would be possible even without the legally established government. The state of nature for him is pre political, but not pre moral. [30] Furthermore, this state of nature for him is a state of complete freedom where all people are equal and only bond by the law of nature. [31] He worries that an absolute sovereign, with absolute power, would be even more of a danger to us than life in the state of nature. This is positive in Lockes thought because is better to live in a state of nature where you live in complete freedom without limitations of the personal rights and liberties. On the other hand, giving the absolute power to a sovereign means that people have to obey the wishes and the demands of the ruler, rather than following their own needs and desires, and disobeying those demands leads to penalization. Why would someone want to have limited human rights? Why wou ld someone want someone else to pressure him in doing something that is against his opinion and his beliefs? It is not the case of not having rules at all but rather that the rules should be made from the people and for the people. The people should not feel oppressed if they do something that is against ones will and feel scared of punishment if they do not meet those requirements. This is against the commonly accepted notion of democracy in which the individual is free in expressing his own will and making statements. Locke argued that although we do need a sovereign to settle disputes and administer justice, we must also set constitutional limits to the sovereigns rule. [32] We have a right to rebel if the sovereign abuses our trust. [33] Assuming that we were all honorable in all our dealings with each other, then the need for sovereign would not existed and we could have remain forever in the state of nature. [34] Is this asking for too much? On one hand it might be, because with no rules at all, people might have tendency to become more violent and even greedier towards others who have more than them (wealthier people). On the other hand, it might not be too much asking for. People behave decent when there is not big gap in equality and people do cooperate with each other in order to survive. Later in this paper, I will show examples of people living in a state of nature with no government, no legislative, and still managing to live in peace with each other and with the rest of the world. Another thing with which Locke differs from Hobbes is his view of the human rights. For Locke, human rights are rights that every human holds and they belong to all humans, and are inalienable, that is they are not transferable to anyone else. [35] If someone tries to restrict one mans human rights for Locke that is equal to slavery. [36] He set forth the view that the State exists to preserve the natural rights of its citizens. [37] Moreover, if the State (government) fails to retain the natural rights of its citizens, than they are allowed to stand up to it and protest against. The same is today in most of the democratic countries, where people if not satisfied with the measures and regulations that the government lays down raise their voice and oppose them. Following this further, Locke does not see the state of nature as something bad as Hobbes does, and therefore, he claims that is better for the people to reject the particular government and to return to the state of nature, [3 8] than to live in an oppressed regimes. Nevertheless, despite the free man that Locke stands for, he still points out that people should engage in a social contract. He says that we should partially give up some of our rights, but not the right of life, liberty and property, [39] for impartial justice. Furthermore, the social contract cannot be concluded without the explicit consent of the people. Property is the linchpin of Lockes argument for the social contract and civil government because it is the protection of peoples property, including their property in their own bodies, that men seek when they decide to abandon the State of Nature. [40] Lockes property is pre- state institute determined by natural law and the property is a result of individuals labor. [41] For him the right of property is a right to life, freedom and estate. [42] He connects the humans/one persons rights with having property; the one who does not own property does not have rights. [43] 1.3. State of nature according to Jean Jacques Rousseau What distinguishes Rousseau from the other two theorists is his statement that in the state of nature man would act like savage, [44] whose actions are primarily determined by immediate needs food, sexual satisfaction, sleep and fears only hunger and pain. [45] However, the thing that distinguishes the savage from the animal is the free will and capacity of self-improvement. [46] For Rousseau is an exaggeration to say that the state of nature leads to war of all against all, as Hobbes said. According to him, the state of nature is peaceful and free of vice. On the other hand, he agrees with Hobbes and Locke that in the state of nature mans main drive is towards self preservation. [47] Rousseau gives a general picture how would the life be in the state of nature, which resembles in a good way with the life that some African tribes have today. He says that the human in the state of nature acts similar to animal satisfying his basic needs. Furthermore, Rousseau gives a critique of the modern man vs. the natural man. He says that the situation of the natural man is better than the one of the modern man because the natural man is free of social norms, morals, obligations, and duties. [48] Having no moral relationship or duties to other men and no subjugated inequality, natural man is better for himself and society. [49] His actions are neither good nor evil [50] because he is not bounded by social rules, which dictate how people should act and think towards each other and the world as a whole. [51] According to that, man should not care much about others opinion of him or his actions. [52] Certainly, according to Rousseau, people are neither good nor bad. [53] People are restrained in harming others by the compassion they have for their fellow humans and have aversion to pain and suffering. [54] In addition, Rousseau claims that men knew neither vice nor virtue since they had almost no dealings with each other. [55] Moreover, in his view their bad habits are the products of civilization, the conditions of nature forced people to establish the civil society. [56] According to this, if man leaves the state of nature than he becomes corrupted and unjust. The modern world and the development of it are responsible for peoples depravation because the wish for self improvement brought misfortune to people. Then why at all should human beings leave this state? On this, Rousseau says that despite the corruptive potential, the life in the society can bring the possibility of a higher form of human existence, [57] like cultural or technological development of the human itself a nd the society he lives in. When talking about the peoples/humans rights, Rousseau points out that that the people have rights in the civil state that are sacred. Therefore, people agree to live in a civil society because that society will protect their rights. But is this a real reflection on what the reality looks like? If taken for example the dictatorship regimes, lets say in Sudan, or as it was in Romania when Ceausescu was on power, the people were in a fictional social contract with the country, and the state did not meet its main duty: the protection of the individual that is not able to protect himself! Different from Locke, who stands on the position that the human has rights even without the existence of the state, [58] Rousseau does not says that the human can exist and just be in that kind of state. For Rousseau, the people only have human rights when engaged in a contract with the state. Here he contradicts himself. First, he says that the civil society corrupts the people, and then notes that hum an rights exist only when people engage in social contract with the state. Rousseaus second point about the requirement of the people to conclude the contract in order to be safe and in a possession of human rights is questionable. The second chapter of my paper will show that people that are not part of a civil society still have human rights and are free. 1.4. Analysis Do we get any general picture of what the state of nature is from the perceptions of these theorists? Hobbes is the opponent of the state of nature. His opinion is that man could not survive in the state of nature therefore there is the need of creating a State, by people engaging in social contract and the necessity of people giving up their rights to the Sovereign. On the other hand, Locke is more liberal when talking about the state of nature. For him people can indeed, live in this state in peace with each other. He does not support the State that limits the rights of humans and the absolute power of the Sovereign (as Hobbes does). Rousseau is in between with his approach. According to him, the state is the only one that can protect the human and his rights. Contrary, he says that the civil society corrupts the person; the development of the society makes man more greedy and unjust. How is this possible? We should enter the social contract for the main purpose of protecting ourselves from others and be able to exercise human rights, but not to become corrupted by the same society. Is not this statement too contradictory and illogical? !!!Finally, summing up all the ideas from these theorists, we can define the state of nature as freedom. A freedom of man to do whatever is his own will, but not damaging and delimiting other peoples rights and personality; freedom from restraints, restrictions and oppressions. In the following chapter, we can see that it is possible for people to live in this kind of state and not being threat to one another. 2. IS THERE A STATE OF NATURE IN THE 21st CENTURY? Looking further than our own surroundings, we will find examples of people that live in a condition that is completely different from the democratic, modern and technologically developed world. Those people live in harmony with nature. Although, the number of those people is very small due to the colonization period and the constant force of assimilation, the ones that succeed in keeping their culture and traditional way of life, help us understand that people can indeed live without rule of law and without engaging into social contract(s). Today, many of the Indigenous people in the world are under the law of the ones that colonized their land, for example the Aborigines in Australia, when colonized by the British were put under the British legal system, [59] but as Australia gained independence from the Crown, the Aborigines are under the Australian law. [60] Other examples where people still managed to keep their natural state are some African tribes that are not subject to the la w of the State, like the Bushmen in South Africa who live in bands. [61] Following in this paper, I will elaborate more on these people and their way of life. 2.1. Indigenous peoples 2.1.1. Definitions on Indigenous Defining Indigenous peoples can be very difficult. Whom do we put under the term Indigenous? There are many definitions. According to the special reporter on discrimination against Indigenous population from the United Nations Working Group on Indigenous Population, Mr. Jose Martinez Cobo Indigenous populations are composed of the existing descendants of the peoples who inhabited the present territory of a country wholly or partially at the time when persons of a different culture or ethnic origin arrived there from other parts of the world, overcame them, by conquest, settlement or other means, reduced them to a non-dominant or colonial condition; who today live more in conformity with their particular social, economic and cultural customs and traditions than with the institutions of the country of which they now form part, under a state structure which incorporates mainly national, social and cultural characteristics of other segments of the population which are predominant. [62] This definition was considered to be with flaws. Therefore, the UN Working Group on Indigenous Population decided to enlarge the definition by adding more criteria in defining the term Indigenous. In the first place, they added that as Indigenous people would be considered the ones who are the descendants of groups, which were in the territory at the time when other groups of different cultures or ethnic origin arrived there. [63] In addition, Indigenous are the ones who because of their isolation from other segments of the countrys population have almost preserved intact the customs and traditions of their ancestors which are similar to those characterized as indigenous. [64] Finally, in this group belong people who are, even if only formally, placed under a state structure which incorporates national, social and cultural characteristics alien to their own. [65] In 1986 one more criteria was added, and that was any individual who identified himself or herself as indigenous and was a ccepted by the group or the community as one of its members was to be regarded as an indigenous person. [66] Another definition is provided by the International Labor Organization in the 1989 Convention on Indigenous and Tribal peoples, defines Indigenous peoples as those who are regarded as such on account of their descent from the populations which inhabited the country, or a geographical region to which the country belongs, at the time of conquest or colonization or the establishment of present state boundaries and who, irrespective of their legal status, retain some or all of their own social, economic, cultural and political institutions. [67] We can give lots more definitions on who and what Indigenous people are, but in the end, summarizing all this definitions, we reach a single conclusion that the Indigenous people are people that only differ by their origin and culture. In other words, Indigenous people enjoy human rights as all the other people do. Furthermore, this people, despite the stage of their development, and by development I mean mostly technical and technological development, generally stand for the common values of freedom and peace. Moreover, Indigenous people, although often distinguishable by virtue of their race, language or religion, are a discrete group. [68] To explain this in more precise way, I will be taking as an example two groups of Indigenous people, one is the Australian Aborigines and the other one is the Bushmen from South Africa. Although, both of these groups of people are considered as Indigenous, they are different in a way of their social structure, the way of life, their customs, law s etc. Later, I will point out that one of these groups is living in a kind of state of nature, with total equality among its members, while the other one was assimilated by the State that overruled them and obligated by the States legal system, notwithstanding that Indigenous peoples are constantly exempt from laws, which may interfere with their tradition. [69] 2.1.2 Examples of Indigenous peoples: Australian Aborigines and the Bushmen of South Africa I decided to take these two groups of Indigenous peoples as an example because there is diversity between them in many ways, but still both belong to what goes under the term indigenous. Since the European invasion of Australia in 1788, the Aboriginal people have been oppressed into a world unnatural to their existence for thousands of years. [70] The British Monarchy invaded the Australian Aborigines during the colonization period; hence, they were put under the British legal system. After Australias independence changes were imposed, the Aboriginal people started the request for self-determination, because the government at the time tried to assimilate these people, and destroyed their land, with that their way of life and culture. Prior to the arrival of the colonists and the destruction of the homeland of the natives, the Aborigines lived in a state of nature. The Aboriginal lifestyle was based on total kinship with the natural environment, everything they needed for normal and h ealthy life was already provided. [71] They lived in tribes or clans and were obligated by their own customs and inter clan contract. [72] No one had authority over anyone else in the sense of ruling them, but this is not to say that there were not leaders. [73] The leaders were people who had personal qualities that others admire, and were considered as smart men, but there were no elected leaders in Aboriginal society. [74] Today, the Aboriginal still live under their customs, but are also obligated to respect the States legal system, which limits some of their human rights, for example like the right to education and using of their mother tongue. [75] Therefore, the colonization brought disturbance of the peace of this people. Armed conflicts and lack of understanding from the modern men resulted in killing of dozens of Aboriginal people and forcing them on different way of life. [76] The Aboriginal people lost most of their tradition and culture, and today most of them are living in the developed and modern world. Only few of the Aboriginal tribes can be found living in a state similar to the state of nature, though obliged by rule of law by the State in one way or another. On the other hand, we have the Bushmen of South Africa that still live in conditions mostly similar to those before the white men invade their land. Along with the arrival of the European settlers great disadvantages started. [77] In this period number of Bushmen was reduced, because they fought to death trying to survive due to limited resources (limited and abused by the settlers), or were captured and forced to slavery and eventually die of extortion. [78] Today, as it was in the past, the Bushmen population lives into groups that are called bands. [79] No leader or superior exists as a figure in the Bushmen band. That makes all of the members of the band equal, both male and female. [80] Thus, they are all equal in the making decisions, [81] and govern themselves by group consensus. [82] If a dispute arises and there is some kind of misunderstanding between the band members, they are resolved through discussions where all involved take part with argumentations until some agreemen t is reached. [83] However, the governments of many African states are trying to exile the Bushmen from their homelands and to assimilate them. For example, In Botswana the government has intensified its campaign to drive the Gana and Gwi Bushmen off their ancestral homeland in the Central Kalahari Game Reserve by cutting off all water supplies. [84] Clearly, we can see that the modern nations and the modern men forced this Indigenous people in leaving the state of nature they used to live in. The colonialism destroyed this peoples way of life. It was not that people abandoned the state of nature because they started to feel intimidated by the others. On the contrary, these Indigenous peoples lived together in peace and in equality, with little resources available that were enough for them to survive. Today, the Indigenous people living in a state of nature are a slowly dying race [85] because of all of this; nevertheless, the fact that they are still trying to maintain their existence is a proof of how perfectly their way of life is adopted to their natural surroundings. [86] 2.2. Do indigenous peoples today enjoy the human rights like most people do? According to the United Nations Declaration on the Rights of Indigenous peoples in Article 1: Indigenous peoples have the right to the full enjoyment, as a collective or as individuals, of all human rights and fundamental fr

Cell-based Therapy For Myocardial Regeneration

Cell-based Therapy For Myocardial Regeneration ABSTRACT Myocardial infarction is one of the main cause of mortality in many countries. Therefore, an effective therapy for myocardial infarction is required. Reperfusion and other conventional therapy have been the mainstay therapy for myocardial infarction. However, many patients remain refractory to this therapy. Cell-based therapy is considered a novel therapy, in which stem cells are used for cardiac repair. Stem cells are potential therapeutic and promising option that could be the alternative solution for salvaging damaged cardiomyocyte. Based on current studies, stem cells are a promising therapeutic approach for myocardial infarction. However, some challenges need to be answered by future studies before this novel therapy can be widely applied. This essay provides an overview of the progress in stem cell therapy for myocardial infarction. INTRODUCTION The robust potential of stem cells were still a mystery, but today, we are constantly getting new information on this particular topic. One of the prospects of stem cell therapy is to treat damaged cardiomyocyte (Fischer, et.al, 2009; Beltrami, 2003).Acute myocardial infarction is one of the main causes of mortality and morbidity in many countries. Not only this disease causes a massive socio-economic burden, but also reduces the quality of live for patients who survive the attack (Hamm, 2016). Currently, one of the mainstay therapy for myocardial infarction is rapid revascularization to limit ischaemic damage. Reperfusion and other conventional therapy have undoubtedly saved so many lives, yet there are patients remained refractory to this therapy and left with no other treatment options. In addition to that, many patients who have underwent reperfusion strategy and survived, often left with significant impairment of left ventricular systolic function. One big question remain unansw ered. Is there any other treatment option for these patients? Medical therapeutic approach to reduce damaged cardiomyocyte and generate new functioning muscle is the current unmeet need. Stem cells emerge as the novel procedure to restore damaged cardiomyocytes, and this procedure is popularly known as cellular cardiomyoplasty (Pendyala, et.al, 2008; Reinlib, 2000). Many preclinical and clinical trials have documented the potential use of stem cells to generate viable cardiomyocyte and improve cardiac function (Bergmann, et.al, 2009). To date, there are many different types of adult stem cells and progenitor cells used for this procedure, some of which are bone marrow derived stem cells, hematopoietic stem cells, mesenchymal stem cells and so on. Since the advance of stem cells technology is faster than ever before, this essay aimed to give an evidence based update on stem cells use for myocardial infarction, what we have achieved so far, and what does the future hold for this breakthrough. CELL-BASED THERAPY FOR MYOCARDIAL REGENERATION After an ischaemic attack due to occluded coronary vessels, heart muscle usually left damaged and nonfunctioning. However, recent evidence suggested that the cardiac muscle could actually undergo a limited amount of renewal. A prospect of inducing muscle cell to undergo division for cardiomyocyte replacement, or generating new muscle by stem cells are certainly intriguing (Roell, et.al, 2002; Santoso, et.al, 2011). Stem cells are capable to proliferate in the same state (self-renewal) and differentiate into multiple cell lineages. On the other hand, progenitor cells are more specific and have limited differentiation potential. Mechanism on how stem cells work are as follows: firstly, these stem cells need to be extracted from the source (eg. bone marrow), after that these stem cells need to be delivered to the injured area. These cells are implanted in the myocardium, and due to the nature of these cells, they would grow and differentiate/transdifferentiate into cardiomyocyte. To achieve the goal of cardiac repair, these cells should also have the ability to fuse with the surrounding tissues that their harmonious contraction increases the heart contraction. Furthermore, these newly-formed cardiomyocyte should also express the appropriate electromechanical properties required for contraction to yield a synchronous contraction (Templin, et.al, 2011; Makino, et.al, 1999). Many clinical studies have documented the feasibility and safety of cellular cardiomyoplasty in patients with coronary artery disease (Makino, et.al, 1999; Strauer, et.al, 2002). To date, there are some different types of adult stem cells and progenitor cells used for this procedure, some of which are bone marrow derived stem cells, hematopoietic stem cells, mesenchymal stem cells and many others (Jackson, et.al, et.al, 2001; Kamihata, et.al, 2001; Bolli, et.al, 2011) POTENTIAL SOURCE AND TYPE OF STEM CELLS Bone Marrow Derived Stem Cells Bone marrow derived stem cells (BMCs) are the most widely studied type of stem cells. Orlic et al. (2001) first describe the ability of bone marrow cells to regenerate infarcted myocardium in mouse models. The transplanted cells showed transdifferentiation into cardiomyocyte which eventually lead to improved left ventricular ejection fraction (Orlic, 2001). The three types of stem cells derived from bone marrow are hematopoietic stem cells (HSCs), mesenchymal stem cells (MSCs), and endothelial progenitor cells (EPCs) (Orlic, 2001; Piao, et.al, 2005; Badorff, et.al, 2003). The role of BMCs for acute myocardial infacrtion has been reported to improve left ventricular ejection fraction (LVEF), both in REPAIR-AMI and BOOST trial (Meyer, et.al, 2006; Schachinger, et.al, 2006).BOOST trial demonstrate an acceleration of LVEF after intracoronary BMCs transfer (ejection fraction increased by 6.7% in the BMCs group as compared to 0.7% in the control group), and significant result was sustained until 18 months (Meyer, et.al, 2006). While in REPAIR AMI trial, improvement of LVEF, infarct size and wall thickening of infarcted segments were reported at two years follow up. At two years, the cumulative end point of death, myocardial infarction, or necessity for revascularization was significantly reduced in the BMC group compared with placebo (hazard ratio, 0.58; 95% CI, 0.36 to 0.94; P=0.025) (Assmus, et.al, 2010; Perin, et.al, 2012). Skeletal Myoblast Skeletal muscle has the ability to regenerate under certain circumstances. Skeletal resident stem cells are usually known as satellite cells, and these cells would differentiate to new myocytes in response to injury. However, whether this ability can be translated to a different condition, as in cardiomyocyte repair, should be further studied (Taylor, 198; Reinecke, et.al, 2002). MAGIC trial, a randomized controlled phase II trial, showed no significant changes in terms of global and regional LV function in skeletal myoblast- treated patients (Mensche, et.al, 2008). Another study performed by Dib et al.(2005) showed an increased in LV ejection fraction in the group treated with transepicardial injection of autologous SMs. Mesenchymal Stem Cells Mesenchymal stem cells (MSCs) are another potential option for cellular cardiomyoplasty. Mesenchymal stem cells can be found in various tissue, such as bone marrow and adipose tissue (Pittenger, 2004). One interesting mechanism by which MSCs mediate cardiac function improvement is the paracrine effect. MSCs may secrete soluble cytokines and growth factors that would eventually influence adjacent cardiomyocyte (Gharaibeh, et.al, 2011). Hare JM et al. (2009) studied the efficacy of intravenous allogenic human mesenchymal stem cells in patients with myocardial infarction. According to this study, intravenous MSCs were safe as showed by the similar adverse event rates in both intervention and control group. MSCs injection favorably affected patient functional capacity, quality of life and LV remodeling (Hare, et.al, 2012). Endothelial Progenitor Cells Endothelial progenitor cells (EPCs) have been linked with neovascularization in ischemic tissue. This interesting finding lead to the use of EPCs for another therapeutic purpose like cellular cardiomyoplasty (Isner, et.al, 1999). The human peripheral blood-derived EPCs would be a potential approach because those cells can be easily isolated without the need of major surgical intervention (Lin, et. Al, 2000). This assumption was later confirmed by Badorff et al. In this study, Badorff et al. (2003) reported that EPCs from healthy volunteers and Coronary Artery Disease (CAD) patients can transdifferentiate into functionally active cardiomyocytes when co-cultivated with rat cardiomyocytes. However, this finding was later opposed by Gruh I et al. According to this study, there was no significant evidence of transdifferentiation of human EPCs into cardiomyocyte (Gruh, et.al, 2006). Resident Cardiac Stem Cells Until recently, we believe that heart is a fully mature organ with no capability of self-renewal. However, the adult heart is not a terminally   differentiated organ, but harbors stem cell with regenerative capacity, namely resident cardiac stem cells (CSCs). Although the origins of CSCs are yet unclear, they can be isolated from heart tissue and expanded ex vivo for use as a cell-based therapy. There were many types of CSCs have been described in previous studies, like: epicardium-derived cells, cardiosphere-derived cardiac cells, and cardiac Sca-1+ cells. These resident stem cells have the potential to differentiate into different types of cells like vascular smooth muscle and myocardial cells (Tang, et.al, 2013; Tang, et.al, 2006; Fazel, et.al, 2006). Embryonic Stem Cells and Induced Pluripotent Stem Cells (iPS) Embryonic stem cells (ESC) are derived from the blastocyst (inner cell mass) of human embryo prior to implantation. ESCs are pluripotent cells, which means they have the capability to differentiate into any cells, one of which is cardiac myocytes. Due to the source of these cells, there are ethical issues regarding the use of ESC (Kofidis, 2005).The huge potential of ESC comes with a price. The pluripotency of ESC made these cells predisposes to tumor formation including teratomas. Amariglio N et al. (2009) documented the occurence of a human brain tumour following neural stem cell therapy. A boy with telangiectasia was treated with intracerebellar and intrathecal injection of human fetal neural stem cells. Four years later, he was diagnosed with a multifocal brain tumour. After thorough analysis, the tumor was of nonhost origin, indicating it was derived from the transplanted neural stem cells (Amariglio, 2009). To date, due to the scarcity of studies on ESC and negative experiences of previous studies, the significance of ESC as cell-based therapy for myocardial infaction remains elusive. The above-mentioned limitation would hopefully be elucidated in future research. Human Umbilical Cord Blood Cells Human umbilical blood cells (hUCB) contains a large number of non-hematopoietic stem cells which rarely express human leukocyte antigen (HLA) class II antigens, thus reducing the risk of rejection. Many studies have reported the efficacy and safety of hUCB administration in acute myocardial infarction model, with conflicting result (Henning, 2004; Moelker, 2007).According to Henning RJ et al. (2004) hUCB administration reduce infarction size and improve ventricular function in rats without requirements for immunosuppression (Henning, 2004). Similar positive finding were documented by Kim et al. Circulating Blood-derived Progenitor cells Circulating blood-derived progenitor cells (CPCs) are similar to BMCs, which mainly composed of EPCs. Santoso T et al. (2011) studied the safety and feasibility of combined granulocyte colony stimulating factor (G-CSF) and erythropoetin (EPO) based-stem cell therapy using intracoronary infusion of peripheral blood stem cells in patients with recent anterior myocardial infarction. G-CSF is used to mobilized stem cells to the injured area, inhibits cardiomyocyte apoptosis, promotes neovascularization, and increase the production of nitric oxide. While EPO, that is originally thought to be a hematopoietic hormone only, also may inhibited apoptosis and induced angiogenesis. This phase I study concluded that this procedure is safe and resulted in improved endpoints for LV ejection fraction and cardiac viability (Santoso, 2011). Cardiopoietic Stem Cells Cardiopoietic stem cells are not a distinct type of stem cells but refer to the novel way of processing stem cells in order to get a lineage specification. Cardiopoietic stem cells are harvested stem cells that are treated with a protein cocktail to replicate natural cues to heart development, before being injected into the patients heart. The C-CURE trial studied the efficacy of bone marrow derived-mesenchymal stem cells in chronic heart failure. The isolated mesenchymal stem cells were exposed to a cardiogenic cocktail that trigger expression and nuclear translocation of cardiac transcription factors, before being injected to the patients heart. After six months follow up, patients in the treatment group significantly improved in terms of LVEF and fitness capacity. There was no evidence of increased cardiac or systemic toxicity induced by cardiopoietic cell therapy (Bartunek, 2013). Unfortunately, data comparing the efficacy and safety between cardiopoietic stem cells and ordinary stem cells without cocktail-based priming is still lacking. DELIVERY METHODS In order to make these stem cells reach the heart, a reliable delivery method need to be employed. The ideal method should be able to safely and efficiently deliver an optimal number of stem cells to the target tissue. Beside the high efficacy, this delivery method should be as minimally invasive as possible for the sake of patients comfort. There are some delivery methods worthy to know. Intracoronary Infusion As the name implies, intracoronary infusion is a process of delivering stem cells through coronary artery, usually through intracoronary catheterization. Stem cells are infused under pressure via a ballon catheter. The ballon was inflated in order to prevent anterogade blood flow that would compromize stem cells delivery. Catheter guided cell transfer has its unique advantage of safety under local anesthesia, and a part of routine cardiac catheterization. The intracoronary method provide a maximum number of cells to the target area, with good blood supply which is crucial for cell survival. Multiple studies have reported the use of intracoronary infusion for stem cells delivery (Strauer, 2002; Schachinger, 2006). Intravenous Peripheral Infusion Intravenous stem cells administration is one of the easiest method to be employed. Intravenous administration is possible through homing phenomenon of stem cells to the injured heart. Unfortunately, intravenous peripheral infusion comes with some disadvantages. First, only 3% of normal cardiac output will flow per minute through the left ventricle. This low amount of blood would limit the amount of stem cells delivered. Secondly, due to the passing of venous blood in the lung, many cells would trap in lung vasculature that eventually lead to stem cells reduction (Grieve et.al, 2012). Intramyocardial, Transendoccardial and Transpericardial Route As mentioned earlier, the downside of intravenous administration is the passing of the blood in certain organs that would entraped some of the stem cells. Unlike intravenous route, intramyocardial method is undoubtly provide direct access to the injured cardiomyocyte bypassing the need for mobilization, homing and any risk of cells entrapment in other organ, thus provide a more effective way to deliver abundant stem cells to the injured area. However, this method comes with its own expense of a more invasive method, not to mention the risk of ventricular perforation in the already damaged cardiomyocyte. Intramyocardial delivery usually performed during an open heart surgery or needle-tipped delivery catheter (Strauer, 2003; Forrester, 2003). Nelson et al.(2009) documented that intamyocardial delivery of iPS originating from reprogrammed fiobroblast, yielded progeny that properly engrafted and resulted in restored contractile performance, increased ventricular wall thickness, and elec tric stability (Nelson, et.al, 2009). STUDIES USING STEM CELLS IN MYOCARDIAL INFARCTION Many studies have been carried out to investigate the efficacy and safety of stem cell therapy in patients with myocardial infarction. Each of these studies investigated different kind of stem cells with different delivery methods. The ultimate goal of these studies is to answer whether stem cell therapy could be a feasible therapeutic approach for patients with myocardial infarction. The result of these studies were not always positive, even some of the studies did not document any beneficial effect of stem cell therapy. However, this conflicting result need to be intepreted with caution due to the different study method, different type of stem cells used, and different delivery methods employed. Three meta- analysis on the efficacy of BMCs therapy for myocardial infarction have been published. In a meta-analysis by Delewi R et al, intracoronary BMCs infusion is associated with improvement of LV function and remodelling in patients after ST-segment elevation myocardial infarction. The benefit in terms of LVEF improvement was more pronounced in patients with a worse baseline LVEF (LVEF cut off: 40%) and younger age (age cut off: 55 years) (Delewi, et.al, 2013).   In a second meta-analysis by Clifford DM et al. (2012) which include thirty-three RCTs, there was no significant difference in hard end point like mortality and morbidity in the BMCs treated group. However global heart function, as represented by LVEF and infarct size, was improved significantly and was sustained long term (12 to 61 months) in the BMCs group (Clifford, et.al, 2012). The third meta-analysis by Long C et al. (2013) further confirmed the beneficial effect of intracoronary BMCs in patients with acute my ocardial infraction. According to this meta-analysis, BMCs therapy significantly improved LVEF, while mildly but not significantly reduced left ventricular end-systolic volume and left ventricular end-diastolic volume (Lond, et.al, 2013). These three meta-analysis synonymously agree that BMCs therapy is beneficial in terms of improved heart function and reduced infarct size. CHALLENGES AND THE FUTURE We have just entered the new era of stem cell therapy. When advanced therapy like primary PCI and thrombolytic showed more limited beneficial for patients with myocardial infarction, the concept of cell-based therapy is definitely appealing. This new approach could be the answer that have been waited for sometime. As we have discussed previously, there are many issues on stem cell therapy that need to be addressed in future studies. Firstly, what is considered to be the best stem cells to replace cardiomyocyte. Secondly, the right delivery method of these stem cells need to be determined. Whether different type of stem cells required certain delivery methods also need to be further elucidated. Another question is the right timing of delivery (acute, sub-acute or chronic), whether it contributes to the fate of stem cells. Fourth, the concentration of stem cells, dose-effect relationship and safety of stem cell therapy need to be further investigated. One particular topic in regard to stem cell safety is the tumorigenicity of ESC. We need to disentangle a way to reprogram these cells so they can differentiate into functional cells, but lack the ability to form tumours. 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