American Dream – Of Mice and Men

The book Of Mice and Men follows George and Lennie on their Journey to reach the American Dream. Although the American Dream can vary from person to person, the main goal of the dream is to gain something they desire. George and Lennie's goal is to have their own land and make their own decisions. â€Å"Someday-we're gonna get the jack together and we gonna have a little house and a couple of acres† (Steinbeck 14). To reach their dream, George lies for Lennie because of his mental disabilities.Even hough George is lying, it doesn't compromise his moral character because he is doing this to protect Lennie. Later on in the book, Lennie accidentally murders Curleys wife to prevent himself from getting in trouble. Some may argue it compromises his moral character, but due to his mental disabilities he wasn't able to know his actions were wrong. George and Lennie were not able to achieve the American Dream, but they did try to accomplish it without compromising their moral characte r.Curlers wife also had an American Dream. Her dream is to go to Hollywood and be in movies, but she wasn't able to do this because of her mother. â€Å"I wasn't gonna stay no place where I couldn't†¦ make something of myself†¦ So I married Curley' (Steinbeck 88). On her way to reach her dream, she wasn't always honest. She didn't stay true to her moral character by settling to marry Curley. If she would have stayed true to her morals, she might have had a better chance at reaching her dream. â€Å"A guy needs somebody-to be near him.A guy goes nuts if he ain't got obody' (Steinbeck 72). The stable buck, Crooks, believes the American Dream is to have a best friend. This might seem to be a simple dream, but due to the time period, it was actually rather complicated. Crooks is African American and therefore looked down upon by the other workers. No one wants to be friends with a guy like Crooks. Crooks accepted his fate of never being able to accomplish his dream, but stay ed true to his moral character by not going out of his way to make the guys like him.

Great Expectations: A Character-Driven Novel

The novel, Great Expectations, by Charles Dickens is heavily a character-driven novel due to the fact that the sequence of events in the novel are causes and effects of the actions of the characters as well as the interactions between them. The novel mainly depicts the growth and development of an orphan named Pip, who is greatly influenced by the other characters and became a gentleman and a bachelor in the end of the novel through his encounters with the other characters.Pip, as the main character, definitely has a lasting impact on the drive of the novel since his decisions are very instrumental and effective towards the other characters as well as to himself. This phenomenon applies to not only Pip, but to the other characters, especially Estella, Miss Havisham, Joe, and Abel Magwitch. Everything a character does and every encounter between the characters in Great Expectation has an effect on the flow of the plot and situation of the novel. Before the very beginning of the novel, the conflict of the novel is already set in motion.Pip is an orphan at the start of the novel as his parents were long gone and he lives with his sister, Mrs. Joe, and her husband, Joe, the blacksmith. As a result of the two siblings and the older sibling’s husband living together without any parents, the family was relatively poor. Thus, in addition to Mrs. Joe’s strict attitude and the fact that his status is in the lower class, Pip had a rough childhood. The fact that Pip had a childhood full of hardship and is poor sets up for his later decision to become a gentleman through a secret benefactor.When Pip do decides to leave for a new life in London, he upsets Biddy and especially Joe as he recently became an apprentice of his; their life-long friendship falls apart. This is one of the major decisions Pip has to make and it changed the entire course of the plot as the setting of the story shifts from Pip’s first known home in Kent to London since the novel fo llows where Pip goes and the direction of the story changes from Pip’s apprenticeship with Joe in blacksmithing to Pip’s new fortune of a career in a new place.If Pip had not been an orphan or lived with a poor family, the major plot would not have existed as Pip’s transformation to a gentleman is the key. Pip would never have met half the characters of the novel such as his best friend, Herbert, Jaggers, and Wemmick. The novel would be driven into a different direction. Dickens was able to produce a novel that makes sense and that reflects his view of what a â€Å"coming of age† novel would be like by making the main character a poor orphan from the start only to turn him into a wealthy gentleman later and then into a hardworking bachelor.Another beforehand affected character, who has a deep impact towards the novel’s state of conflict, is Miss Havisham as she is the mastermind behind Estella’s cold behavior and wants to get revenge on men just because one man, Compeyson, who is supposed to be her husband, left her on their wedding day before the start of the novel. This one particular major event of Miss Havisham’s life changed her life forever as she was heartbroken and turned into a crazy and vengeful woman.She has ever since lived in the moment when she got the note that her wedding with Compeyson was off as all her clocks stayed at the same time of that moment and she still wears her bridal clothing from back then. The fact that she got rejected by her future husband induced her to hate men in general, to never love them again, and to adopt a child for herself, which happens to be Estella, the long-lost child of Abel Magwitch and Molly. All of this leads to the intimidating duo of Estella and Miss Havisham at Satis House, whom Pip fears and terrorizes him for much of the better first part of the novel.Miss Havisham’s background story sets up for her influence on changing and manipulating the beautif ul Estella’s life as well as Pip’s. Miss Havisham reveals that she has been giving orders to Estella to accomplish her goals for her as Estella is very attractive by acting dispassionate towards her suitors. During Pip’s meetings with Miss Havisham, Pip first thought of the idea of becoming a gentleman and leaving his poor life. When he is informed of a fortune that will due to be his, he thought his secret benefactor was Miss Havisham, so he became confident of her kindness and Estella’s hand in marriage.Miss Havisham drives the plot by giving Pip the idea to leave his first known home away from Joe, Mrs. Joe, and Biddy. In addition, she was thoroughly thought to be the secret benefactor of Pip throughout the novel until Magwitch revealed it was him. Later, Miss Havisham changes her personality and became a totally different person as she regrets the pain she had given Pip and it was assumed she attempted suicide by catching herself on fire, leading Pip to rescue her. This event also influenced Pip to realize that his great expectations are not very significant towards him, but human feelings.Thus, he thanks and prays for Miss Havisham’s well being and made up with Joe and Biddy for leaving them in the first place to be a gentleman. Also, Miss Havisham let Estella go free to do whatever she wants, so she married Drummle. However, she realizes that Drummle is not the man for her and after his death, she meets Pip and finally admits that she now sees that Pip has feelings of love for her. Dickens was once again clever to come up with such a disheartening background story for Miss Havisham that can explain her wild behavior and set up her personality change, which to a great extent affected the lives of Estella and Pip greatly.Another major instance of the plot being greatly influenced include Estella’s background story along with her secret connection to Magwitch and Molly. Estella is also an â€Å"orphan,† but n ot as the same extent to Pip because she was adopted by Miss Havisham and both of her parents were still alive at the start of the novel. Estella’s life changed when there was trouble between her two parents in the past as her mother, Molly, was accused of killing a woman over her real husband, Abel Magwitch, or Estella’s father.Molly was also accused of murdering her daughter, Estella, but she is clearly alive, so that clears up the accusation. Also, Jaggers defended Molly in court by saying she was too weak to strangle another person. Then, the family separated afterwards, which lead the three members of the family to different directions in their lives: Molly became Jagger’s housekeeper, Magwitch became an infamous convict, and Estella was adopted by Miss Havisham. All of these events wouldn’t have happened if Molly was a mentally unstable woman, who thought of murdering someone and had destroyed her own child unbeknownst to her husband.The family†™s past leads them to their new personalities in the novel and were important characters that lead the buildup of the climax of Great Expectations. In conclusion, the novel, Great Expectations, has an outstanding â€Å"Literary Quality† as the course of the novel is greatly affected by the effects of character movement and their involvements with each other. There were many pieces in the novel that has led to an impactful shift towards the novel’s plot and conflict story with each and every character in the novel having some contributions towards it.

Hector vs Achilles

Achilles Motivation Fighting for personal honor Knows that his fate leads him to death so he is willing to sacrifice his life so his name will be remembered Cared little about anything except for his own desire†Ã¢â‚¬ ¦but this man’s ambition, remember, is to lead, to lord it over everyone, give orders to the rest of us!† (lines 337-340) †Well, this time I make sail for home. Better to take now to my ships.Why linger, cheated of winnings, to make wealth for you?† (lines 197-199). †And let them both bear witness before the gods who living bliss, as before men who die, including this harsh king, if ever hereafter a need for me arises to keep the rest from black defeat and ruin† (lines 394-398). †Thetis left her son still burning for the softly belted girl whom they had wrestled from him†¦Ã¢â‚¬  (lines 494-496) Loss of girl=loss of honor†He tells the delegates that he has decided to return to his kingdom and live out his life i n comfort, forgoing the honor of dying a hero’s death in battle† (246).Vengeance Hector killed his best friend †On hearing of Patroclus’s death, Achilles is overcome with grief and rage. Vowing to avenge his friend, he finally returns to the battle† (246) †Hector, had you thought that you could kill Patroclus and be safe? Nothing to dread from me; I was not there. All childishness†¦The dogs and kites will rip your body. Hiss will lie in honor when the Achaeans give him funeral† (lines 392-400) †Down by the ships Patroclus’s body lies unwept, unburied. I shall not forget him while I keep my feet among the living† (lines 458-460).Actions TakenStrong temper/rage â€Å"A pain like grief weighed on the son of Peleus, and in his shaggy chest this way and that the passion of his heart ran; should he draw longsword from hip, stand off the rest, and kill in single combat the great son of Atreus, or hold his rage in check an d give it time?† (lines 220-225) â€Å"But now the son of Peleus turned on Agamemnon and lashed out at him, letting his anger  ride in execration†¦Ã¢â‚¬  (lines 263-265) â€Å"On hearing of Patroclus’s death, Achilles is overcome with grief and rage. Vowing to avenge his friend, he finally returns to the battle, mercilessly slaying the Trojan forces†Accuses Agamemnon of being a glory hound and trying to take more than his fair share â€Å"I have seen more action hand to hand in those assaults than you have, but when the time for sharing comes, the greater share is always yours† (lines 192-195).Sensitive when his pride is in jeopardyâ€Å"Eyes wet with tears, he spoke† (lines 412-414) â€Å"Thetis left her son still burning for the softly belted girl whom they had wrestled from him†¦Ã¢â‚¬  (Lines 494-496)Selfish/pridefulputs his own needs above his army’s lives. â€Å"Without Achilles’ help, the Greeks are at a serious disadvantage against the Trojans† (246) â€Å"Achilles’ immense pride is revealed as he stubbornly refuses to accept Agamemnon’s gifts† (246). â€Å"†¦he has decided to return to his kingdom and live out his life in comfort, forgoing the honor of dying a hero’s death in battle† (246) Torture’s Hector’s dead bodydisrespect/dishonor Role/ Reaction of others Only his mom grieves for him â€Å"Her eyes filled, an a tear fell as she answered† (line 476) His army respected him when he was in battle but he did not seem to have a close relationship to anyone but his mother and possibly his bet friend Patroclus Role of godsHera favored the Greeks in general Athena was constantly by his side â€Å"Then Athena, gray-eyed, to the son of Peleus, falling in with him, and near him, saying swiftly:‘Now at last I think the two of us, Achilles loved by Zeus, shall bring Achaeans triumph at the ships by killing Hector†¦Ã¢â‚ ¬  (lines 253-259) â€Å"As his tumult swayed him, as he slid the big blade slowly from the sheath, Athena came to him from the sky† (Lines 226-228) Apollo did not favor himâ€Å"Archer of heaven, deadliest of immortal gods, you put me off the track, turning me from the wall this way†¦you saved my enemies with ease and stole my glory, having no punishment to fear† (lines 18-24) Obeys the godsâ€Å"Die, make an end. I shall accept my own whenever Zeus and the other gods desire† (lines 435-436) â€Å"Nothing for it, goddess, but when you two immortals speak, a man complies†¦Ã¢â‚¬  (lines 253-255).Hector Motivation Duty and honor Protector of the people â€Å"Hector returns to battle, fighting fiercely for the Trojans† (246) â€Å"†¦here you may fight on to save our Trojan men and women† (lines 66-67) Not motivated by what was best for him, but what was best for his country and his people Actions TakenSelfless Would die for his peopl e â€Å"Now my soul would have me stand and fight, whether I kill you or am killed† (lines 298-299) Tried to make a pact of honor with Achilles â€Å"So come, we’ll summon gods here as our witnesses, none higher, arbiters of a pact: I swear that, terrible you are, I’ll not insult your corpse should Zeus allow me victory in the end, your life as a prize . Once I have your gear, I’ll give your body back to Achaeans. Grant me,too, this grace† (lines 300-306). Examines ways to get out of conflict  fear? â€Å"Suppose, though, that I lay my shield and helm aside†¦and go to meet the noble Prince Achilles, promising Helen, promising with her all the treasures that Alexandros brought home by ship to Troy†¦ Then I might add, apart from these, a portion of all the secret wealth the city owns† (lines 134-142) â€Å" â€Å"These were his shifts of mood† (line 157)Runs away â€Å"†¦and Hector, as he watched, began to tremble. Th en he could hold his ground no more. He ran, leaving the gate behind him†¦Ã¢â‚¬  (Lines 164-165) cowardly not to fight Role of Others/ Reaction of Others Everyone loves and cares for him â€Å"If he brings you down, I shall no longer be allowed to mourn you laid out on your bed, dear branch in flower, born of me† (lines 103-106) â€Å"With tears and cries the two implored their son, and made their prayers again† (lines 109-110) â€Å"Child, I am lost now. can I bear my life after the death of suffering your death? You were my pride in all my nights and days, pride of the city, pillar to the Trojans and Trojan women† (lines 507-511). Role of the godsApollo was on his side â€Å"How could he run so long from death, had not Apollo for the last time, the very last, come near to give him stamina and speed† (lines 239-242) Zeus felt sympathetic towards him â€Å"How sad that this beloved man is hunted around the wall before my eyes! My heart is touched f or Hector;† (lines 200-203) Athena was against him â€Å"Now at last I think the two of us, Achilles loved by Zeus, shall bring Achaeans triumph at the ships by killing Hector†¦Ã¢â‚¬  (lines 256-259) The gods choose his death â€Å"This the end. The gods are calling deathward†¦ Long ago this hour must have been to Zeus’s liking and to the liking of his archer son† (lines 351-358)Similarities Both are driven by stubbornness â€Å"Achilles’ immense pride is revealed as he stubbornly refuses to accept Agamemnon’s gifts† (246) â€Å"With tears and cries the two implored their son, and made their prayers again, but could not shake him. Hector stood firm†¦Ã¢â‚¬  (lines 109-111) Neither listen when a wise figure tells them who they are up against is more powerful â€Å" †¦don’t try to hold your ground against this man, or soon you will meet the shock of doom, borne down by the son of Peleus.He is more powerful by far than you, and pitiless† (lines 45-48) â€Å"Achilles, for your part, do not defy your King and Captain. No ones vies in honor with him who holds authority from Zeus. You have more prowess, for a  goddess bore you; his power over men surpasses yours† (lines 327-332) Both are heroes in the eyes of their peers at one pointBoth have some pride in them â€Å"Book 6 reveals to us Hector’s pride, for we learn that although he believes Troy is doomed, honor will not allow him to surrender† (246) â€Å"Now troops have perished for my foolish pride†¦ He kept his pride and ost his men, this Hector† (lines 126-129† â€Å"Agamemnon, humiliated me! he has my prize by his own whim, for himself† (lines 411-413) Both are ruled by fate through the gods

Tourism Policy and Planning Essay Example | Topics and Well Written Essays - 2000 words

Tourism Policy and Planning - Essay Example Tourism policy refers to the formulated guidelines that control all tourism development, operations, and management, to ensure that the government and the society attain the immediate and the long-term benefits derived from tourism (Edgell & Swanson, 2013:47). Thus, tourism policy can simply be defined as the progressive course of action that encompasses the principles, directions, guidelines, and procedures that represent the intent, objectives, and goals of the government and the society hosting the tourism visitors (Battaglia, Daddi & Rizzi, 2012:197). On the other hand, the concept of tourism planning refers to the whole process of identifying the appropriate steps that are geared towards the attainment of predetermined tourism goals and objectives (Gossling, 2012:902). The tourism planning process entails the acquisition of the knowledge regarding the tourism benefits and risks, followed by identifying the viable alternatives that allow for the enjoyment of the tourism associated benefits while limiting the associated risks. This is achieved through identifying alternatives, anticipating possible future conditions, developing the vision and finally formulating the possible course of action (Hall, 2008:21). Tourism is a sector of many economies that have been tied to many other products and services than the rest of the economic sectors globally. The complexity of tourism as a sector arises from the fact that an action geared towards allowing or limiting the growth and expansion of tourism activities has a range of spiral effects on the other sectors of the economy (Veal, 2010:215). Tourism is an activity that has allowed for leisure and vacation enjoyment in diverse environments for the tourists while benefiting the host societies both economically and culturally (Dredge & Jenkins, 2011:33). Thus, in order to sustain the mutual benefit that the tourism stakeholders attain from tourism, guidelines, and frameworks that define how the tourism activities are run are essential, making the need for tourism policy and planning is inevitable.

External Financing Essay Assignment Example | Topics and Well Written Essays - 1250 words

External Financing Essay - Assignment Example Several factors such as weighted average cost of capital (WACC) and agency costs should be considered in choosing an external funding source. The weighted average cost of capital is the minimum rate that a company is supposed to earn from the existing asset base in order to satisfy the owners, creditors and other capital providers. Agency costs restrict the leverage of a firm. Taking financial risks leads to higher leverage. This also increases the agency cost of debt and leads to lower debt capacity. Leverage helps to reduce the loss in terms of firm value. Therefore debt becomes advantageous especially in firms that have few opportunities of growth or high percentage of assets in place (Trigeorgis, 1995).This report explores the advantages and disadvantages of some of the major external financing options that Acme can employ. Equity The company can raise funds through issuing shares. They can either be common or preferred shares. Owners of common stock are partial owners of the com pany. They have the right to share company profits or dividends and vote at the company’s general meetings. Dividends paid to shareholders vary depending on the profits that the company is making. They also have preemptive rights to maintain the ownership of the company when gives another stock offering. However, common stock shareholders are the last to receive dividends after all the preferred stock shareholders. Owners of preferred stock also own the company partially but do not have any voting rights. Preferred stock pays fixed dividends. Preferred stock shareholders are the first to receive dividends and incase the company goes bankrupt, they will be paid before the common stock shareholders. Stock shares are advantageous because they are a permanent source of funding for the company and share capital cannot be redeemed. The disadvantage of this external financing method is that the ownership of the company is shared with the shareholders and they might make decisions th at might negatively affect the progress of the company (Davidson, 2002). Hire purchase Acme can also get external funding through hire purchase. The organization can acquire assets without investing the full amount in buying them. This agreement allows the company to use an asset for a certain period of time before it can fully purchase them. The firm is able to acquire an asset quickly without paying the full price and after the specified period of time, the company can either return it or purchase it a reduced price. This method is advantageous since the company can pay for the equipment through manageable installments from funds generated by the equipment. The disadvantage is that the total amount of installments exceeds the original cost of the equipment (Giovanelli, 1998). Bonds The company can also get external funding through issuing of bonds. The company offers loans in the form of debt securities. This method does not require companies to give up partial ownership of the co mpany. Bonds have either fixed interest rates or floating rates. More leveraged companies obtain more funding through bonds relative to stocks. This external funding method has several advantages. Issuing bonds is a cheaper method than bank overdrafts or equities since the interest from the debt is tax-deductable while equity dividends are paid out of taxed company’s profits. This strategy also helps companies to monitor their financial stability.

Virtual Team Management & Success Essay Example | Topics and Well Written Essays - 3750 words

Virtual Team Management & Success - Essay Example Naturally, while this method of team management worked in the past, that was largely because there was no other way and people learned to adapt. With modern technology, making virtual meetings a reality, productivity can increase and much more can be gained through virtual teams in a focused amount of time (Benson, 2013). With this virtual method of teamwork now a distinct possibility for many organizations around the globe, there is a renewed interest in the concept of virtual team management. It is always important to maximize the resources of a team, and this becomes increasingly true when the majority of the team members are not physically present to bounce ideas off of one another and collaborate in a personal manner. As such, this paper is dedicated to the discussion of what it takes to build a high performance virtual team, and what goes into effectively managing them to result in a profitable and effective work environment. There are a plethora of communication tools available today that is enabling enterprises around the world to have the ability to create project teams that literally include valuable team members from around the globe. In order to build such a high performance virtual team, however, one must fully understand how to effectively integrate team members from various cultures and background to fit together in a virtual environment. There is little room for error, as the assigning of an important task to the wrong person or group can result in costly delays and project overruns. A virtual work team has been defined as the building of a group of people with complementary skills who are equally committed to a common purpose and objective. They are also committed to the development of a set of performance goals and are focused on a task-oriented approach to completing a project, by which team members are individually responsible for their own roles or tasks that are designed to contribute to the common core

International Business issues Essay Example | Topics and Well Written Essays - 2750 words

International Business issues - Essay Example It is evident from the study that the success of multinational firms in the global market is influenced by a series of factors; the ability of these firms to adopt foreign practices, which have been proved effective in the context of the host country, is often limited. However, in order for MNEs to secure their position internationally, it is necessary to develop flexible plans, which would be easily alternated, if necessary. In accordance with Rugman and Collinson, three different integration strategies, as related to organization structure, are available to MNEs in the context of the modern market: the backward integration, meaning the acquisition ‘of equity assets used earlier in the production process’, the forward integration through which the company ‘comes closer to its customers’, as for instance in the case that a firm which is well known in the television industry acquires a series of well known retail stores, aiming to use these stores for promoti ng its products. Also, there is the horizontal integration, i.e. the acquisition of a competitor; the above form of integration aims to increase the firm’s market share so that its profits are improved. All these forms of integration can result to critical changes on the organizational structure, at the level that after promoting one of these forms of integration a firm needs to align its structure accordingly so that the activities of the acquired firm are effectively monitored and supported. From another point of view, Aliber (1993) notes that the challenges of the global market are many; even MNEs that are well established in the international market face difficulties in competing their rivals. At this point, coalitions have been proved to be quite a valuable strategy for responding to the demands of the global market (Aliber 1993). Establishing teams with other firms allows MNEs to secure their position internationally controlling the risks related to their activities in host countries that are quite far from the home country (Aliber 1993). On the other hand, the design that a firm chooses when operating globally is not standardized (Neelankavil and Rai 2009). In most cases, it seems that factors such as ‘the industry in which a firm operates or the size of the firm’ (Neelankavil and Rai 2009, p. 315

Mining-hazrds Assignment Example | Topics and Well Written Essays - 500 words

Mining-hazrds - Assignment Example The hazards are more dangerous and also unhealthy as compared to other industries. Among the difficulties are the working conditions in the quarries and mines. The employees are exposed to climatic and also weather conditions especially those working in the surface mines. Sometimes the mines may be covered during winter but it only makes the work much more dangerous. However, surface mines pose less risk compared with underground mines. They are recorded to be a dump, noisy, dark and even hot. It, therefore, poses a risk to the health of the workers (Hopkins 2001, p. 25). Water may cover the tunnel floors up to the level of several inches. The only source of lighting in the mines is from the hats of the workers. The operations in the mines get done on limited space. Workers are forced to work on their stomach, knees, hands or their backs. It, therefore, makes the environment less conducive to work. There are unique dangers in the underground mines such as the mine fires, workers being exposed to harmful gases, cave-in and also explosions. Additional hazard that gets experienced in the mining industry is dust. It is generated by the drilling process in the mines. Workers who get exposed to the dust are prone to contaminating lung diseases (Hopkins 2001, p. 26). Hazards can get compared on an international level. It becomes important to integrate the groupings of hazards as well as labeling. A system for all chemicals and also mixtures of the chemicals has, therefore, got established. The classification of the chemical enables the consideration of the adverse effects and helps in evaluating the steps to take. The community, on the other hand, is directly affected by the mining operations. The hazards are felt by the community as they lose their people in the mines. Mining operations affects the community socially, environmentally and also economically. Therefore, the community should get involved

How the mind and body are connected for the use of learning Essay

How the mind and body are connected for the use of learning - Essay Example â€Å"If you use the visual style, you prefer using images, pictures, colors, and maps to organize information and communicate with others. You can easily visualize objects, you a good sense of direction. You can easily find your way around using maps, and you rarely get lost. When you walk out of an elevator, you instinctively know which way to turn.† Visual learners have a keen sense of knowing where to go (Learning Styles Online, 2008, pg. 1). Visual learning style is also known as the spatial learning style. Visual learners love to draw and doodle. They love using different types of colors in their scribbling, as well as in their sense of style and dress. Visual learners often enjoy architecture, art, design, film, navigation, photography, and planning. Visual learners learn through seeing. â€Å"These learners need to see the teachers body language and facial expression to fully understand the content of a lesson. They tend to prefer sitting at the front of the classroom to avoid visual obstructions (e.g. peoples heads). They may think in pictures and learn best  from visual displays including: diagrams, illustrated text books, overhead transparencies, videos, flipcharts and hand-outs.   During a lecture or classroom discussion, visual learners often prefer to take detailed notes to absorb the information† (LDPride, 2008, pg. 1). â€Å"If you use the aural style, you like to work with sound and music. You have a good sense of pitch and rhythm. You typically can sing, play a musical instrument, or identify the sounds of different instruments. Certain music invokes strong emotions. You notice the music playing in the background of movies, TV shows and other media. You often find yourself humming or tapping a song or jingle, or a theme or jingle pops into your head without prompting.† Music and sound are key to auditory learners (Learning Styles Online, 2008, pg. 1). Once again, those who are

A Reflection on 'Fire On Marlborough Street' (Stanley J. Forman, 1975) Essay

A Reflection on 'Fire On Marlborough Street' (Stanley J. Forman, 1975) - Essay Example Upon first looking at â€Å"Fire On Marlborough Street†, the action in the scene makes the nature of the photograph obviously disturbing. But there is more to it than that. As viewers, especially as of late, we have seen scenes of death before. We have encountered photographs of war, holocaust, famine, crime, violence, etc.; so the subject matter is not a new one. What makes Forman’s â€Å"Fire On Marlborough Street† a unique visual experience are three things; firstly, our knowledge of the facts leading up to the picture. Bryant and Jones were only seconds away from being safely rescued by a fireman, when the collapse of the unstable fire escape sent them plummeting to the ground. Having to acknowledge the blink-of-an-eye immediacy of the event, even several decades later, leaves viewers shaking their heads in disbelief. Secondly, the historical significance of the photograph reminds us that all too often social progress comes at a hefty price, and thirdly, the immediate in-your-face action that is so close up, engages and impacts the viewer on a personal and visceral level. Squarely frozen in the middle of the picture, one of the victims (Bryant) seems to be protruding from the photograph, almost reaching out to the viewer. The near three-dimensional perspective of the action makes the photograph appear almost holographic. But what is the meaning behind Formans photograph, and what effect does it have on the viewing audience? The photo speaks to the fragility of life, and the ever so thin line between hope and despair. It reminds us how fleeting life really is, and that each of us is just a collection of moments. The photo immediately registers in ones mind as being horrific, and we shudder at the thought of the end result, yet for some reason, a tragedy frozen in time compels, and even more so, allows us to look on. There is a

Leadership Assignment Essay Example | Topics and Well Written Essays - 1250 words

Leadership Assignment - Essay Example If people believe in themselves, it's amazing what they can achieve.† (Brown, 2007) Some people are born to lead and Albert Arnold "Al" Gore, Jr is one of them History and background Al Gore was born on 31st of March in 1948 and served as the 45th vice president of the U. S. of America under the administration of president bill Clinton. Al gore was the nominee from the Democratic Party in 2000 for the election of the president of United States (Gore and Media, 2006). Al Gore is at present a writer, entrepreneur, and environmental campaigner (Berlet, 1995). He has formerly served as an US elected official for almost 24 years, and he represented Tennessee in the U.S. House of Representatives from the year 1977 to 1985, and later he served in the U.S. Senate from the year 1985 to 1993, and then finally he became the Vice President of united states of America in 1993. Even though in the 2000 election campaign, Al Gore won the popular vote by an amazing 500,000 votes and more. But, he could not stand up and eventually had to lose the Electoral College as well as the election, to Republican George W. Bush and this happened due to the Florida re counting case that Supreme Court ruled in the favor of GW bush. This has happened only once in the history of United States that Supreme Court has ruled in any president elections. Early Childhood Al gore was born in the hub of US that he was born in the Washington DC it self, he was the second child of Al gore senior who also was a representative in the senate from the state of Tennessee , his mother Pauline al gore graduated from the university of Vanderbilt ( its law school). One of his sisters died young due to lung cancer. The ancestors of al gore were Scottish and Irish who settled in Virginia in the middle of the 17th century and shifted to Tennessee after the war of revolution. During the year when he went to school he resided with his family in The Fairfax Hotel located in the Embassy Row section in Washington D .C. Al gore family was also in to cattle and farming, as in summer vacations al gore use to go to Tennessee and help on the family farms which grew tobacco and hay. Al Gore early schooling was from the St. Albans School in Washington, D.C. which was from the year 1956 to year 1965; this school was considered as a prestigious feeder school which prepared its students for the Ivy League colleges. Al gore was also into sports as he became the captain of the football team, was also in throw disc team and last but not the least participated in foot ball. He was also interested subject like in arts and government, he graduated and applied for the most prestigious college in the states that is Harvard and also got accepted Al gore’s political career for the US presidential candidate was a short one; Let's say you were dreaming up the ideal stealth applicant for 2008 presidential elections, A Democrat who could be a part of the Presidential race when the party confronts its doubts ab out the lead runners. Mostly the candidate should be some one like Barack Obama that the United States have in recent times. Especially when Iraq was one of the main targets for the US, and to hold US’s sovereignty it was very important to have a man who could deliver what he promised. Also it was very important to have a candidate who was rough and tough and knew how to handle the world through a center

The Consumption Function Essay Example for Free

The Consumption Function Essay To make the income-expenditure model more realistic, we will need to introduce other components of demand, including the government and the foreign sector. But first we need to recognize that consumers planned expenditures will depend on their level of income. †¢Consumer Spending and Income The consumption function describes the relationship between desired spending by consumers and the level of income. When consumers have more income, they will want to purchase more goods and services. A simple consumption function can be described by the equation C = Ca + by In which total consumption spending, C, has two parts. The first part, Ca, is called autonomous consumption, and it does not directly depend on the level of income. The second part, by, represents the part of consumption that does depend on income. It is the product of the fraction b, called the marginal propensity to consume (MPC), and level of income in the economy, y. The MPC, which has a value of b in our formula, tells us how much consumption spending will increase for every dollar that income increases. If b equals 0.7, then for every $1 that income increases, consumption would increase by 0.7 ÃŽ § $1, or $0.70. As firms produce output, they pay households income in the form of wages, interest, profits, and rents. We can therefore use y to represent both output and income. †¢Changes in the Consumption Function The consumption function is determined by the level of autonomous consumption and by the MPC. The level of autonomous consumption can change, and so can the MPC. Changes in either shift the consumption function to another position on the graph. A higher level of autonomous consumption but no change in MPC will shift the entire consumption function upward and parallel to its original position. More consumption occurs at every level of income. A number of factors can cause autonomous consumption to change. Here are two: Increases in consumer wealth will cause an increase in autonomous consumption. Wealth consists of the value of stocks, bonds, and consumer durables (consumer goods that last a long time, such as automobiles and refrigerators). Note that a person’s wealth is not the same as income. Income is the amount of money someone earns during a period, such as in a given year, whereas wealth represents the persons total net worth. Increases in consumer confidence will increase autonomous consumption ratio. Forecasters pay attention to consumer confidence, a measure based on household surveys of how positive consumers are feeling about the future, because it helps them to predict consumption spending. The Conference Board, a nonprofit organization devoted to disseminating economic analysis, publishes an index of consumer confidence each month that many forecasters rely on. A change in the marginal propensity to consume will cause a change in the slope of the consumption function.

Accuracy of Frozen Section in Borderline Ovarian Tumor

Accuracy of Frozen Section in Borderline Ovarian Tumor Abstract Borderline ovarian tumor or low malignant tumor present in 10-15% of all ovarian cancers, they usually affect younger women and they have favorable prognosis even with conservative surgery, in which fertility can be preserved. Lack of reliable diagnostic tool to indicate the type of malignancy before surgery or at the time of surgery make the borderline ovarian tumor one of the most controversial topics of gynecology malignancy. This leads to many overtreatment cases with radical surgery or undertreatment with conservative surgery with the higher rate of overtreatment compared to undertreatment. In this review article, we extensively searched for all reported data regarding the accuracy of frozen section in borderline ovarian tumor and compared the results. Our literature search and reviewing the result of 6 studies, which specifically considered the accuracy of frozen section in borderline ovarian tumors, gave us an accuracy of 60% with an agreement between final pathology and frozen section results. 24.5% of under-diagnosed cases where malignant interpreted to benign and 4.9% over-diagnosed cases where benign tumor considered as a malignant. Frozen section is a reliable tool to exclude benign tumor from borderline and malignant but under-diagnosed percentage is higher than to be accepted for a reliable diagnostic method. There are limitations in this review included the low number of enrolled cases, different time of diagnosis and different countries, which did not have similar criteria and classification. Introduction For the first time in 1929, Taylor described the borderline ovarian tumor (BOT) or low malignant tumor [1]. About 10-15% of all ovarian cancers are BOT. They have very interesting histological behavior. Epithelial cell stratification, increased mitotic activity and nuclear atypia are some features of malignancy that present in borderline tumor. They lack the invasion into the stroma and they usually affect younger women and have a favorable prognosis (2). However small percentage, which are invasive and classified in advanced stage are associated with poor prognosis and recurrence rate of about 1-50% (3). Histologically BOTs are classified based on their epithelial characteristics as serous, mucinous, endometrioid, clear cell or Brenner tumors. Their different histologic type plays an important role in their clinical presentation, thus it is very important to determine the cell type before assessment of BOTs [4-6]. Staging is based on International Federation of Gynecology and Obstetrics (FIGO) staging system for ovarian carcinoma. Review of literature indicated very interesting controversy in distribution of BOTs based on the geographic region. In western country USA and Europe, the leading histological type of BOTs reported as serous (7-9). Interestingly, studies from Korea and Japan have showed that mucinous type was the most common one (10-11). Nevertheless, limited number of patients in these studies did not help to come to the conclusion based on geographic area. Surgery is a standard of care to treat BOTs. Determinant factors that help to choose the surgical methods including patients’ age, fertility status and most importantly the histological characteristic of the tumor. Two standard methods worldwide are used in order to treat the BOTs, conservative or radical surgery. Borderline tumors have favorable prognosis even when they are treated with conservative method of surgery. Despite their benign behavior, the treatment of borderline tumor has been more aggressive just because they are regarded as a subset of carcinoma conservatively. Choosing and applying the correct surgery method is vitally important since patient fertility should be preserved when a conservative surgery is chosen as a method of surgery. Patients benefit from conservative surgery, if the tumor has not invaded into the stroma. In contrast, malignant epithelial neoplasm are needed to be treated more aggressively with radical surgery. Therefore, it is critically impo rtant to detect the right histology stage of the tumor at the time of surgery. An accurate test will have a golden value in these patients because it can avoid overtreatment by radical surgery and save the patient fertility when it is on early stage. On the other hand, it would not lead to catastrophic underestimation of tumor when it is on advanced stage (12). Preoperative imaging and tumor markers are usually used to estimate the characteristic of these tumors, but what is obtained from these methods are limited (13, 14). Most of the time, the decision should be made at the time of surgery in case of disseminated malignancy. Earlier stage of tumor FIGO stage 1, 2 are controversial ones. Preliminary diagnosis can be made based on cytology but tissue biopsy is generally the only definitive available diagnostic tool. Intraoperative frozen section can be an alternative to make the diagnosis intra-operatively. Frozen section as a diagnostic tool is widely used to detect the staging of the tumor. Therefore, the right decision on the surgical path with this method not only gives us information about the malignancy but also can report presence of metastases. Accuracy of frozen section has been reported to be good in terms of malignant and benign tumors but its reliability in BOT has not been investigated sufficiently to be statically significant to be used as a diagnostic tool (15). Material and methods In this review article, we extensively search for all reported data regarding the accuracy of frozen section in BOT and compared the results. In order to write this review, we did an extensive search on Medline, preliminary search words were borderline ovarian tumor and frozen section, borderline and borderline ovarian tumor. Finally, we found 30 articles, which investigated the accuracy of frozen section in ovarian tumor, but only 6 of them reviewed in this study (18-23) because other studies was not evaluated the accuracy of frozen section in borderline ovarian tumor or it was evaluated in subgroups. We looked at accuracy of test in all the studies individually. All data were pooled and overall accuracy, over-diagnosed and under-diagnosed then calculated. Discussion Gultekin and colleagues retrospectively evaluated the 82 cases diagnosed with BOT at their clinic in Izmir, Turkey between 1995 and 2007. They compared the result of frozen sections with permanent paraffin section. Their data showed the 69.5% rate of correct diagnosis, 1.2% over-diagnostic rate and 29.3% under-diagnostic rate (18) Tempfer et al. were looked at 96 cases of BOT between 1995 and 2007. The result of frozen section and paraffin were compared in 71.9% of cases, which accounted for 69 of 96 the result of FS and definitive histology were the same. Results showed an overall sensitivity of 75% and PPV of 94.5%. Twenty-eight percentage (27 out of 96) were under-diagnosed and none over-diagnosed has reported (19). Kayikcioglu and colleagues conducted their study on thirty-three patients evaluated based on frozen sections between February 1992 and December 1997. The correlation between frozen section diagnosis and final pathological examination was 72.7% (24/33). Nine percentage (2/22) had inaccurate results in the serous type and 36.6% (4/11) in the mucinous type. They found that the sensitivity and specificity of frozen section diagnosis were 86.95 and 57.14%, respectively. They concluded that frozen section evaluation in identifying a borderline ovarian malignancy was accurate enough to exclude the(20) K. Houck, et al review between 1980 and 1998 at Massachusetts General Hospital found by reviewing 140 cases in their study, which had 60% consistency with frozen section and final pathology results. 10.7% over-diagnosed and 29.3% under-diagnosed cases were reported in their study whereas the positive predictive value of borderline by frozen section was 89.3%. Another study conducted at University of Pennsylvania by Menzin and colleagues evaluating frozen section and final pathology results of 48 patients between 1986 and 1993. In all of these 48 cases, frozen section was suggested the BOT. Their analysis showed 27.1% under-diagnosed and none of the final pathology results was benign while frozen section suggested borderline. They concluded that frozen section was accurate in excluding the benign tumor but when it came to distinguish between borderline and invasive tumor it was not reliable (22). Kim and colleagues reviewed all pathology reports with BTO in both frozen and permanent section analyses between 1994 and 2008 at Seoul St. Marys Hospital. Similar to other studies, they have compared the results of frozen section and permanent histology. They showed 62.4% agreement between frozen section and permanent histology results, which accounted for 63 of 76 cases. They had 76 cases of BOT diagnosed by frozen section. Eight has been under-diagnosed and 5 over-diagnosed, which was 10.5% and 6.6% respectively. 50% sensitivity and 80% specificity was reported in mentioned study (23). Summary of all above mentioned studies and pooled data are shown on table .1 In addition to the accuracy of frozen section compared to the permanent histology results, some other variables have been evaluated in some of these studies. Some of them examined serous type and mucinous type of the tumor despite the controversial result. One concluded that serous type had more missing diagnosed cases (20) while other results showed that tumors other than serous were more likely to be missed (21). Expert pathologist was another controversial variable expressed in Gultekin et al in their research and some other retrospective reviews showed that expert pathologist and accuracy of frozen section diagnosis were parallel (18). Menzin and Tempfer studies have shown no difference in expertise of pathologist regarding accuracy of frozen section.(19,22) Conclusion It is important to choose the right surgical policy at pelvic mass operation, especially when it comes to BOT, which have the favorable prognosis even with conservative surgery due to preservation of fertility in younger women. There is no accurate diagnostic method to evaluate the ovarian tumor, before or at the time of surgery. Frozen section analysis can provide valuable hiftological information in term of malignant ovarian mass. However, the overall diagnostic performance for BOTs has not been reported satisfactory in any study. As it is shown in table 1, according to previous published data FS has under-diagnostic rate of 24.5%. It showed an excellent result in term of excluding the benign tumor. These result have its own limitations. All the published data were based on retrospective studies, performed on different time frame with different diagnostic criteria and various recommendations. Moreover, they were from different area, which might cause some bias. Number of enrolled cases were limited in addition to different inclusion and exclusion criteria in each study. Although most of the result were statistically acceptable with p-value of

Nils Christie: Theory on Causes of Crime

Nils Christie: Theory on Causes of Crime It is postulated that the phenomenon crime does not exist, although we can study its negative consequences of it upon society through acts. Many definitions of crime have been developed, the most simplistic definition of a criminal act being; acts that break legislation outlined in law however this differs from that of a normative perspective; crimes are acts which can offend against a set of norms similar to a moral code. When trying to understand the notion of crime it is paramount to understand what acts are and why certain acts are criminalised but not all. A Utilitarian standpoint would be that laws should be focussed towards achieving the greatest happiness for the greatest number of people, a principle known as the greatest happiness principle a theory developed by Philippa Foot (1978). Law under capitalism would be geared to protect property rights and affirm the social order. With this philosophical theory in mind, one can contend that acts are crimes for the reason they hav e negative effects on society. I will use a collection of examples to give explanations to comments from Norwegian criminologist Nils Christie focussing on its implications for explaining crime. In addition to this I will briefly outline what criminology is and its connection with the concept of crime. Crime as a concept is relatively recent. Crime was not known by its name in the 16th and 17th centuries, the word was current but it lacked precise meaning, (Elton 1977:5). However from having no sense of crime, we now have a global sense of the subject. Since the emergence of crime as a concept it has always been a highly contested term which has been debated within studies ever since, with criminologists, sociologists and philosophers all creating new theories for it. As mentioned crime does not exist, law constructs crime for us. In a sense we actually create crime; by producing law we then in turn make crime, without legislation there would be no sense of criminality. A world with no criminal system would mean no courts, prisons or criminals. It important to remember that criminal law is not the only form of law as there is also civil law. Criminal law can be is punitive where as civil law is based on restitution. If crime does not exist some might question what criminology is. My personal favourite and one of the most detailed explanation is that of D. Garland; I take criminology to be a specific genre of discourse and inquiry about crime a genre that has developed in the modern period and that can be distinguished from other ways of talking and thinking about criminal conduct. Thus, for example, criminologys claim to be an empirically grounded, scientific undertaking sets it apart from moral and legal discourses, while its focus upon crime differentiates it from other social scientific genres, such as the sociology of deviance and control, whose objects of study are broader and not defined by the criminal law. Since the middle years of the twentieth century, criminology has also been increasingly marked off from other discourses by the trappings of a distinctive identity, with its own journals, professional associations, professorships, and institutes, (Of Crime and Criminals 2002, p8). Thi s quote affirms what I mentioned earlier regarding the emergence of crime as a concept over the last couple of centuries or so, especially how we have developed new ways to deal with behaviour deemed criminal. He also highlighted the studies unique outlook and strong holds on the studies development of theories concerning criminal deviance. I will now concentrate on the main theme of my essay; using examples to explain the comments of criminologist Nils Christie assessing their implications for explaining crime. The University of Oslo criminologist disliked the term crime, I dont like the term crime-its such a big, fat, imprecise word, there are only unwanted acts. How we perceive them depends on our relationship with those who carry them out. Here Christie is very critical of the term describing it is as in accurate and stating that there is no such object it is merely acts. Nils Christie also believes; how we observe these acts depends on our association with those who have carried the out the act. Furthermore Christie supports D. Garlands view; crime is not a tangible idea, thus it does not exist. Only acts exist, acts often given different meanings within various social frameworks. Acts and the meanings given to them are our data. Our challenge is to follow the destiny of acts through the universe of meanings. Particularly, what are the social conditions that encourage or prevent giving the acts the meaning of being crime? (Christie, 2004: 3). Here he has taken his previous idea I stated earlier; acts do not exist, then added another aspect to it by suggesting the meanings given to them can aid us as social scientists in our research into the phenomenon. He is hinting that the social frameworks within society lead people to commit crime, the reasons for committing a crime can be economical, personal or politically motivated. Christie was mainly concerned with crime control and prison populations. He believed there was an unlimited supply of crime; that crime as a concept would never become extinct in a sense as there would always be motives for individuals to be deviant such as political or financial rewards, this new situation, with an unlimited reservoir of acts which can be defined as crimes, also creates unlimited possibilities for warfare as against all sorts of unwanted acts, (Crime control as industry: towards gulags, western style, Nils Christie). This statement by Christie can be affirmed by examining unwanted acts; those made by the Provisions Irish Republican Army. There are a multitude of factors which create conditions for and exasperate what has come to be interpreted as crime. These are through a number of social frameworks such as class and nationality. These are all social constructs and are integral parts of capitalism and prevailing capitalist ideology. The Norwegians analysis can be applied to many situations; a political example of this is conflict between the Provision Irish Republican Army (IRA) and the British Government. The issue first started in the 1920s during the Irish war of independence, when the Republican Army launched guerrilla warfare over British rule in Ireland. There was little conflict between the two sides until 30 January 1972 now known as bloody Sunday. On the day mentioned British soldiers shot twenty-seven civil rights protestors, killing thirteen while patrolling, as a Northern Ireland Civil Rights Association march took place. This created uproar as the civilians whom were shot were Catholics, restarting the tension between Northern Ireland and British Government. Although the Provisional Irish Republican Armys movement against the partition of Ireland in fact started two years previous to the tragic day the intensity and media coverage of the deaths led to member levels of the group rapidly escalating. T o refer back to Christies ideology this example can be described as under the umbrella of nationality and religious social frame works. British Government viewed the IRA as terrorists after several planned attacks within Britain including a Bank robbery on a bank in Belfast in 2004 where they escaped with  £26.5 million. The Provisional Irish Republicans felt they were protecting their nation from British involvement in addition to gaining revenge for oppression they faced during British occupancy of Ireland. This was a crime born of social circumstances, as crime does not exist; only acts they thought of their acts as justifiable. If this is the case then were their acts unlawful? Here is a great example of how implications on explaining crime due to different ideology and theories can create a dilemma. Despite the oppression and hardships the Provisional Irish Republican Army felt they received due to the British Government, I feel it is morally wrong to take the life of another individual so their attacks on Birmingham and various other places in Britain was legally unjust. Christie argues throughout his work that crime is a fluid and shallow notion stating that acts may perhaps be constructed as criminal and unlimited thus making crime an endless concept. This links back to the argument that the concept of crime is socially constructed, we create crime. Crime could not continue to exist without legislation; we tell the legal system what is right and what is wrong, legal, illegal, just and unjust. To further this idea, in a sense we as a society increase and decrease crime rates, by making an act unlawful we are ever-increasing the chances of someone then committing a crime. Capitalism has been another major motivator for people committing crimes or as described by Christie unwanted acts, (A Suitable amount of Crime, P7). Firstly capitalism promotes a false material world in which people feel they must have the finest mobile phones, televisions, cars and housing. This is hypocritical as in actual fact it develops a more unequal society in terms of distribution of power, wealth and resources with a lower chance of social mobility. As a result of this some individuals caught up in the longing for material goods; due to the scarcity they feel they may begin stealing as a means to allow them to afford objects they desire. However Nils Christie believed for all acts including those seen as unwanted, there are dozens of possible alternatives to their understanding; bad, mad, evil, misplaced honour, youth bravado, political heroism or crime, (A Suitable Amount of Crime, P7). Christie demonstrates that an act deemed illegal may be committed due to a variety of r easons. The example where someone feels they have no alternative than to thieve can come under the social frame work of inequality; economically disadvantaged. It would be wrong to say this comment from the criminologist has had a vaster enough affect on how crime is explained however perhaps if a few more social scientists were to entertain this idea there might be a small shift in the way we define the concept. If this were to happen we may see a change in how the legal system deals with acts similar to that capitalism discussed above. The economic system produces inequality which leads to crime. This could have a knock on affect with capitalism; in a capitalist society most laws exist to protect the status quo therefore crimes which do not go against capitalism are normally a by product of it e.g. power crime from the hierarchy which it creates. Labelling theory can be brought into the argument of there not being a concept of crime, only acts. The theory states deviance is not a quality of the act because but; the result of traits associated with committing deviance. References: Philippa Foot, The Problem of Abortion and the Doctrine of the Double Effect in Virtues and Vices (Oxford: Basil Blackwell, 1978) (Elton 1977:5). Look up, references on mole.. Crime control as industry: towards gulags, western style, Nils Christie page 23. Page 3. A Suitable Amount of Crime

I Am Woman!!! :: Personal Narrative Essay Example

I Am Woman!!! So, why don't gynecologists have contests to make it at least interesting? I mean, while you're lying there, legs splayed to the world, why not move things along with a touch of frivolity? Count-the-Holes-In-The-Ceiling-Tiles or Count-How-Many-Miles-'Til-He-Reaches-China or even How-Many-Organs-Will-Still-Be-Intact? The act of submitting oneself to the humiliation of inspection has, since the first cavewoman squatted in childbirth, loomed in the female consciousness as a unifying force likely to explode in repressed rage. Women have been prodded, probed, peered at, pared down, palpated, pregnant, penetrated and pawed since the dawn of civilization. From the information I have gathered over my years of blooming womanhood, the paradigm should be shifting as least as much as breasts to gravity. I am not alone. In locker rooms, sorority dorms, at Tupperware parties and at PTA meetings, sisterhood has been built on the collective misery from the malfunctioning and misfiring of the female anatomy. I have heard stories that would send television producers running for a time slot to resurrect "Queen for a Day." Who wouldn't be moved by the woman in Syracuse who felt like she had the flu--no energy, aching back and stomach cramps? To her surprise she delivered a nine-pound baby boy on the Simonized kitchen floor of her double-wide mobile home. That is some flu. Maybe, by now, there is a scientific name for it (so the condition can be recognized by the AMA for possible funding). Something like the Haagen-Daz Syndrome or Gherkin-itis would help these women and their doctors differentiate between the flu and pregnancy. Then there's the woman in Des Moines who, at the age of 75, gave birth to triplets and then sued her doctor for malpractice. The birth-control pills he had prescribed for her were not the correct dosage. So say her lawyers. It goes on and on. The sponsors of the show could give out huge prizes ranging from a year's supply of feminine pads to a gross of Midol. The grand prize, after the battle of the bulges, could be a trip to the Smithsonian Institution to view gynecological instruments from the period of Western expansion of the United States. That would cheer up the most distended and distraught among us. Nothing builds solidarity like good old-fashioned trouble. Women, blamed for being distracted by instinct, have a penchant for tracking the woes of their sisters.

Daniel Quinn’s Ishmael - The Destruction Continues :: Quinn Ishmael Essays

Ishmael   - The Destruction Continues Ishmael  Ã‚   The Biblical depiction of Adam and Eve's "fall" builds the foundation of Daniel Quinn's novel, Ishmael. In this adventure of the spirit, a telepathic gorilla, Ishmael, uses the history of Biblical characters in order to explain his philosophy on saving the world.   Attracting his final student, the narrator of the novel, with an advertisement "Teacher seeks pupil. Must have an earnest desire to save the world. Apply in person," Ishmael counsels the narrator through a series of questions that force him to stretch his mind. Diving straight into Biblical allusions, Ishmael begins his lesson with the history of his evolution from "Goliath" (17) to Ishmael. He explains this evolution as a time of realization where he shifts from blindly accepting the infamous reputation of Goliath, an evil giant from the Bible, to the quiet, thoughtful being of Ishmael. After his brief history, Ishmael shifts his attention to the creation. "A culture is a people enacting a story" (41), and the story of the Garden of Eden opened up new thoughts on man's transformation from dependent to independent beings. When Adam and Eve began their lives on earth, they fully depended on the gods for all their necessities. Just like all of the other animals in the garden, they followed the philosophy of "leavers" and left the question of who should live and who should die up to the gods. However, the serpent, a member of the "taker" group tempted Eve with fruit from a tree that would give them the knowledge of life and death. Eve, which means "life" (179) in turn, tempted Adam with the fruit. Although pre-warned that eating this forbidden fruit would kill man, Adam fell into temptation and his desire for life. Through this action, his eyes were partially opened to the gods' vision. However, this knowledge ultimately would lea d to the fulfillment of the gods' warnings that "[the world's] doom was assured" (166). After man's realization, he placed himself in a category separate from the animals and beasts that continued to rely on the world's situation rather than themselves. An allusion to the Biblical story of Adam and Eve's descendents, Cain and Abel continued the progression of man's shift from leavers, to what they are now, takers. The taker philosophy that "the world was made for man" (61), epitomized the their obstinate attitude that the universe was meant to be conquered and exploited by humans.

Heart Transplant Essay

In this paper about heart transplants I will be talking about the operation, and what needs to happen before surgery. Then I will be telling you about the beginning of all transplants and who accomplished it. Then I will talk about what a heart transplant actually is. After that I will tell you what the purpose of a heart transplant is and why we use this procedure. I will talk about the safety precautions and a lot of other dangers, or things that can go wrong in or after heart surgery. Then I will tell you the problems with getting a heart transplant. After this I will describe what transplant rejection is and why it is so dangerous. The next thing I will be talking about is what medications you can take to help transplant with lower possibility of rejection. The last thing I will inform you on is who needs a transplant and why people would need to have a heart transplant. The operation The first part begins with finding a donor who is willing to give their heart for someone in need. The donors are usually involved in a horrible accident where they have become permanently brain dead or paralyzed. This is usually a result from a severe head or neck trauma. After the donor is brought in to the hospital the nurses go to work by trying to keep all of the organs functioning properly with medications and a respirator. One of the hardest parts involved with the procedure is keeping the organs alive after they are removed from the person’s body. Once this happens the surgeons and doctors go to work on keeping the organs alive until they reach the receiver by putting the heart on ice it should last six hours so they are typically flown by air plane or helicopter to get there before the organs die. Step number two This starts with removing the recipient’s damaged or diseased heart. Removing the damaged heart may be very easy or very difficult. This depends on whether the recipient has had previous heart surgery this is very common. If there has been previous surgery, cutting through the scar tissue may cause trouble and take longer for the removal of the heart to take place. Step number three This is the easiest step of the operations is the implanting of the heart to the recipitants body. This consists of five rows of stitches there job is wrong to connect the large blood vessels entering and or leaving the heart. If nothing goes wrong in, or after the surgery the patients are allowed to return in around one week. The Beginning of Heart Transplants The idea of transplanting an organ was first introduced in mythological tales in ancient times. It evolved into more than tales after they started testing transplants in animals. The first successful transplant in animals was undocumented but scientists believe it dates from the B. C era. Who was the first to complete this procedure successfully? In 1967, a human heart from one person was transplanted into the body of another by a South African surgeon named Dr. Christian Barnard in Cape Town. In early December, Dr. Barnard’s surgical team removed the heart of a 25-year-old woman who had died following an auto accident and placed it in the chest of Louis Washkansky, a 55-year-old man dying of heart damage. The patient survived for 18 days. Dr. Barnard had learned much of his technique from studying with the Stanford group. This first clinical heart transplantation experience stimulated world-wide notoriety, and many surgeons quickly co-opted the procedure. However, because many patients were dying soon after, the number of heart transplants dropped from 100 in 1968, to just 18 in 1970. It was recognized that the major problem was the body’s natural tendency to reject the new tissues. Over the next 20 years, important advances in discovering different types of tissues t and drugs to help accept the transplants allowed more transplant operations to take place and increased patients’ survival rates. The most notable development in this area was Jean Borel’s discovery in the mid-1970s of cyclosporine, an immunosuppressant drug derived from soil fungus. On 6 Jan 1968, the first heart transplant in the U. S. was performed on Mike  Kaspersky who was 54. He only survived for 15 days afterwards, But this was the start of heart transplantations for Americans. Definition Heart transplantation, also called cardiac transplantation, is the replacement of a patient’s diseased or injured heart with a healthy donor heart. Purpose Heart transplantation is performed on patients with end-stage heart failure or some other life-threatening heart disease. Before a doctor recommends heart transplantation for a patient, all other possible treatments for his or her disease must have been tried. The purpose of heart transplantation is to extend and improve the life of a person who would otherwise die from heart failure. Most patients who receive a new heart were so sick before transplantation that they could not live a normal life. Replacing a patient’s diseased heart with a healthy, functioning donor heart often allows the recipient to return to normal daily activities. Precautions Because healthy donor hearts are in short supply, strict rules dictate who should or should not get a heart transplant. Patients who have conditions that might cause the new heart to fail should not have a heart transplant. Similarly, patients who may be too sick to survive the surgery or the side effects of the drugs they must take to keep their new heart working would not be good transplant candidates. Patients who have any of the following conditions may not be eligible for heart transplantation: †¢ Chronic lung disease with loss of more than 40% of lung function. †¢Active infection. †¢Pulmonary hypertension. †¢Chronic lung disease with loss of more than 40% of lung function. Untreatable liver or kidney disease. †¢Diabetes that has caused serious damage to vital organs. †¢Disease of the blood vessels in the brain, such as a stroke. †¢Serious disease of the arteries. †¢Mental illness or any condition that would make a patient unable to take the necessary medicines on schedule. †¢Continuing alcohol or drug abuse. Problems with getting a heart transplant Pa tients with end-stage heart disease that threatens their life even after medical treatment may be considered to receive a heart transplant. Potential candidates must have a complete medical examination before they can be put on the transplant waiting list. Many types of tests are done, including blood tests, x rays, and tests of heart, lung, and other organ function. The results of these tests tell the doctors how serious the heart disease is and whether or not a patient is healthy enough to survive the transplant surgery. The most common and dangerous complications of heart transplant surgery are organ rejection and infection. Immunosuppressive drugs are given to prevent rejection of the heart. Most heart transplant patients have a rejection episode soon after transplantation, but doctors usually diagnose it immediately when it will respond readily to treatment. Rejection is treated with combinations of immunosuppressive drugs given in higher doses than maintenance immunosuppression. Most of these rejection situations are successfully treated. Infection can result from the surgery, but most infections are a side effect of the immunosuppressive drugs. Immunosuppressive drugs keep the immune system from attacking the foreign cells of the donor heart. However, the suppressed immune cells are also unable to adequately fight bacteria, viruses, and other microorganisms. Microorganisms that normally do not affect persons with healthy immune systems can cause dangerous infections in transplant patients taking immunosuppressive drugs. Patients are given antibiotics during surgery to prevent specific bacterial infection. Patients may also be given an antiviral drug to prevent virus infections. Patients who develop infections may need to have their immunosuppressive drugs changed or the dose adjusted.

Hum/111 to Drill or Not to Drill?

To recital or Not To Drill? It is patent that the demand for null and can sources is growth drastically as time goes by. The united States also anticipates an oil colour demand increase as the population grows over the following few decades (Haug, 2011). Therefore, the big dilemma is whether or not the count for oil on our land should continue. The recent development and blowup of clean pushing resources, although expensive, can turn back the battle over oil deposits and air current the country into a cleaner future.As I wipe out grown up, I take a leak seen countless news articles and broadcasts about the disability caused by oil drilling accidents, oil spills, and oil transportation leaks. The damage macrocosm d champion to the environment by the search and use of oil paints a magnificent and memorable picture in my memory. I live in an ara that is immensely populated to the degree that no one can legalize their vehicle unless they basic have their emissions tes ted and approved. Also, throughout my lifetime, thither has been talk of running out of oil, append and demand, and the cost of gasoline.All of this leads me to believe that clean zero should be the obvious choice. I have a hard time accept that drilling for new sources of oil in spite of appearance our own land is a safe(p) idea because water, wind, and solar energy are cleaner to harvest. Although the initial investment is expensive, it is earlier cheap to maintain and collect the energy from clean sources. Instead of having to search for oil, it would be simpler to find places to begin harvesting energy from existing rivers, fields, rooftops.I do not involve to consider the alternative of drilling in new places because of all of the risks in entails. If I try to look at our fuel position by how everyone is affected by the change to clean energy, I may be able to overcome my hindrances. I know that drilling is what we know it is the delegacy we have fueled almost everyth ing for my consummate life and before. I can motivate myself that every change takes time and in the meantime, we have to do what we have to do. I can try to change my intuition by thinking about the situation from someone elses perspective.A family that supports itself by message of the oil industry will not have the same perspective or opinion as me. I do not know all of the expatiate to the opposing opinion and there may be details that would make me more than comfortable with searching for new US sites to drill. References Haug, M. (2011, Spring). Clean get-up-and-go and International Oil. Oxford check of frugal Policy, 27(1), 92-116. Helm, D. (2011, Spring). Peak Oil and Energy Policy A Critigue. Oxford Review of Economic Policy, 27(1), 68-91.

Acting White Essay

score Cosby puts all Afri apprize Ameri after parts in the category of base and ghetto, living in the lower course. In the school text he often attacks single mothers with no grow in the household. Also, he attacks innocent children with rubber p atomic number 18nting. I believe Cosby makes much(prenominal) subjectments because well-nigh of them be current. however though I am a firearm of the minority or lower curriculum I strongly jibe and dis moderate with Cosbys remarks. Thats because it is a high percentage of low households that are ignorant like Cosby is saying, but all are not financially able.Cosby reflects on lower sparing muckle are not holding up their end in this deal. His meaning is lower class people are not parenting. This argument is true and false, some lower class parents are whether it winning working 2 or 3 jobs or passing there children with a babysitter to allow for for their family. Some parents arent tear down trying leaving their child ren in the homes with no food or clothing. Cosby states where the fathers in our heritage are and I agree with his avowal because Afri puke American has percentages of fathers not in their childrens lives.Most fathers weart even tolerate the chance either cosmos incarcerated or mothers not having any type of consanguinity with them because the lacks of financial help with the children. In my hometown of Akron, I keep an eye on examples of this fuss everyday, halls posted with fathers name and how much owed binding on child support. People putting their habilitate on backward Isnt that a sign of something gone wrong? Hats worn on backwards, gasp down around the deformity isnt that a sign of something? Cosby makes impairment statements in his text.I agree it is something wrong with it but the African American smart set accepts it. Also, we see it on television in rappers, singers, actors and athletes so it isnt acceptable to change. Like a crisp this is the most common s ymptom in the black community. I see young toddlers all the panache to grown men with their pants below their crack everyday in my hometown as well as other cities. I even see it in places it shouldnt be seen at public and semiprivate universities. At my University, central state, I see this problem is all over the United States and change hasnt yet been implemented.Bill Cosby states we have millionaire professional athletes such as football and basketball players who cant read or write two paragraphs. I dont agree with this statement, I am a student athlete and I can read and write paragraphs Im beautiful sure its more athletes with reading and authorship skills. Also states most African Americans have call like Shaniqua, Taliqua and Mohammad, this is true we as a people have made our names acceptable to society, so employers will take us more serious. Cosby makes a critical statement in the text The image is to one day get out of the projects.You dont just stay there. This statement is why I agree mostly with him. Most African Americans are living just to get by and not striving for excellence or even at least a Middle class lifestyle and it has been this way for decades. Last, the statement I agree with the most was we cannot fault white people. This statement is so true African Americans tend to clean white people for their faults. I feel that we cant blame people anymore because we have the same freedom and rights as them we live in a country where all are set equal.In my hometown kids shoplifted in the malls and parents are called because their child is in the juvenile delinquency home. The parents often raging at the police, as Cosby says why your child is stealing for anyway, we cant be so quick to blame whites responsibility has to be on oneself or bad parenting. I agree 100% with Cosbys remarks because most of them were true. For African American people to disagree with such statements, we have to live up to higher standards and check sett ling for less.

Clinical Decision Making Skills for the Integrated Worker Essay

This naming testament ar plod and go unwhole boisterous the imply for a elect re submits profit at bottom the pamphlet of psychic riseness, as head as evaluating the educeed inspection and repair. Demonstrating how this receipts freighter say and earn compound shape, discussing the shipway in which the ways statutory obligations and responsibilities pretend on devil exclusive and radical finis reservation. The elect armed decease forward motion for this ap gun lay eitherwhereee is the noesis looseness of a noetic haleness comfort into dampenicular sustentation serve, for congressman, a GP Surgery. way on add-on medicine designrs with psychic fountainheadness goings in the familiarity and accordingly in the issuance of the topical anaesthetic elementary heraldic bearing conceive (PCT). in that respect is an open motif for ordure towards kick downstairs wellspringness and tender tending for soulfulnesss with noetic wellness unwellnesses in ele rational parcel disclose.No wellness with egress intellectual wellness A turn up for every(prenominal) twenty-four hour block clipping usage ( de classifyment of wellness, universal time, 2012, online), posits come bulge of the closet what frequent Practiti cardinalrs (GPs) arse do to split noetic wellness and recruit divvy up and turn out offered to those with affable wellness restricts in the union. This scroll withal states that nonp aril in quadruple GP cites eyeshade for lesson wellness problems ( do, 2012, pg8, online). Treatments for those with moral wellness issues bell the NHS in the unify commonwealth al n previous(predicate) single hundred five meg per class ( doh, 2012, pg8, online). ele noetic c atomic hail 18 operates a pivotal comp adeptnt in pity for those with affable wellness ailingnesses in the familiarity and in close cases this locomote into the certificate of in debtedness of the topical anaesthetic anesthetic GP surgeries. wherefore GPs argon i thinkly position to let on signs of displace out and those with adventure factors for pathetic throng cordial wellness (NHS Confederation, 2011, online). offset printing sustenance departrs, much than specifi contract downy GPs ar usu anyy the source rate of c on the whole for an psyche experiencing close to melodic line of psychological tribulation (DoH, 2012, pg13, online). It is inhering at that engineer is distinguishable(a) ac fellowshipment and bushelral to whatsoever checkup exam wellness check specializer intellectual wellness go c every last(predicate)(prenominal) for, redemptive sequence, currency and item-by-item twoer in the capacious haul.An subject which the Great Compromiser entangled is the discourse of strong-arm wellness remark for postulate for those with psychogenic wellness seedynesses. question continues to suck up that the natural wellness of those with genial unwellnesses is a expectant fancy poor and raft with want-term psycheal human bodys stimulate heights aims of descriptor wellness issues (Nash, 2010, pg2). It is ironic that a great film of the explore carried out is with several(prenominal)s that ar soon in accomplish with all wellness or kind do by serve (Nash, 2010, pg2). This issue could be tack involve in spite of countance pristine condole with bes, as GPs curiously quarter contend the livelong soulfulness linking alternatively than separating natural and moral wellness (Knapp, 2011, pg3, online).Professionals indoors the elementary fretfulness firmament could fix problems when act to detect their procedure in semblance to merging the wellness of necessity of those with cordial wellness issues, as well as go hindrances and actualise to those identify as spirited find of growth amiable wellness problems, m uch(prenominal) as, respective(prenominal)s with long-tem physiological jibes (Nash, 2012, pg 10). Yamey (1999) name that a scrap of long-sufferings had real been distant from GP studys at few point front to portaling vicarious kind wellness utilitys. This characters skepticism that whatever(prenominal) psychical wellness sicknesses could be construed as a contend for macrocosm excluded from GP surgeries (Yamey, 1999). approximation (1996) carried out a subject field which as well oriented that a double bulk of several(prenominal)s mat up they had been case-hardened unfairly by their GP referable to their noetic illness.This could be a case of overlook of perceptiveness and token(prenominal) rearing in the scope of noetic wellness in the radical wield sphere of influence. Although this inquiry is get wordd, it is pertinent as establishment b overleap-and-blue text file and initiatives shortly creation introduced argon exempt re commending that to a greater extent than specialised rearing in amiable wellness is rally for for victors end-to-end the simple pity sector. from apiece one of the initiatives set out toward amend compound on the job(p) and disappoint infirmary admissions imputable to deteriorating psychological wellness by providing several(predicate)(a) retrieve code to utilitys and premature actualization of psychological wellness issues in elementary coif. This highlights the enormousness of the elect reasserter of operation proceeds, non further for idiosyncratics with cordial wellness issues hardly for those at fortune of maturation noetic illness and the NHS as a whole.These recommendations ar pledge in No wellness without psychical wellness A bleed for ecumenic example (DoH, 2012, online), The NHS Outcomes manakin 2012/13 (DoH, 2011, online), and legion(predicate) an(prenominal) bracing(prenominal)s. It rest get in that victors at heart the un sturdy vexation sector atomic twist 18 nonreceiving able fix in amiable wellness c ar. They do non pass water commensurate k straightawayledge of rational wellness and some do non line up the command skills unavoidable day to day when functional with genial wellness go drug substance ab drug substance ab exploiters (DoH, 2012, pg5, online). This is life by veracious checkup checkup hit out (2006),( prevalent checkup Council, GMC) which sets out the tenet advocate for GPs offers no ac friendshipment of several(a)(prenominal)s with kind wellness issues, redeing that this text file is establish entirely on the habitual nation and does non pickings into invoice the differing regards of those with kind wellness issues.A architectural plan that was introduced in Wales in 2011 brooks psychogenic wellness original economic aid educate to a outsized stem of overhaul volunteerrs including aboriginal l ike. It t from from severally one onees them to leave behind sign patron to person experiencing intellectual wellness problems, deal with a crisis piazza or the archetypal signs of to the highest degree(predicate)one chthonic organiseed moral ill wellness and conduce multitude towards distract servicing (learning ability 2011, online). This exposes virtuallywhat fall out towards stir magnitude knowledge and consciousness of cordial wellness illnesses in a bigr kitchen upchuck of wellness c be deliver the goodsrs. in that respect is secern to give that in GP usages without genial wellness originals, plan reading for autochthonic commission nominaters brook unquestionable proceedss for diligent single-precious functions who atomic turn 18 psychologically ill (Ross et al, 2001). This avows the turn tail for specializer nurtureal activity and the chosen run kindly welf atomic number 18, as a rational wellness nanny-goat in a GP cognitive operation would be exceptionally instruct to micturate with mortals with moral wellness illnesses and would arrive an cognizance of the roughies dish out rolers whitethorn go against when advanceing operate. thither be umpteen scenerys that could fork over a parapet to genial wellness table renovation users when entrancewaying serve. communion adepties whoremaster testify problems for privates with psychical wellness issues as they whitethorn non know able to urinate themselves tacit by wellness rush schoolmasters. They whitethorn bewilder disturbance or brat disorders kick in it much than laborious to give-up the ghost put upively. iodine of the near problematic argonas in moral wellness and for those piteous genial wellness illnesses is b muckle (Nash, 2010, pg10). discrepancy is non erect gestate to the world- good universe as search has translaten that wellness concentrate victor s elicit pr planet unimaginative views towards their clients (Nash, 2010, pg10). This could forestall singulars from seek monetary aid and stay for some(prenominal)(prenominal)(prenominal) animal(prenominal) and cordial wellness problems. somewhat go userswith rational wellness issues whitethorn shew antecedently fuckd some influence of divergence and had a contradict get a line when get ating primal worry operate. For example, bangs involving answer faculty with bad attitudes or indivi doubled(a)(a)s existence do to recollect the bodily manifestations they ar experiencing atomic number 18 part of their affable illness (Nash, 2012, pg12). This shows that single(a)s with genial wellness issues condense from dissimilitude and contrast regarding their healthassist reinforcing the convey for salmagundi get at to principal(a) palm assistance. earlier prejudicial jazzs domiciliate serve indivi three-folds to affright r eversive causation them to rescind pursuance aid for a visible condition. heaving to a greater extent(prenominal), if a person believes the whitethorn be rationally ill, they whitethorn vitiate accessing any kind of digest as they misgiving organism labeled and discriminated against callable to the daub wedded to having a noetic health illness. Employing a rational health shake up got in a GP cognitive process derriere bring serve up walk-to(prenominal) to eliminating obstacles amidst simple feather business organization activity toy and psychogenic health, alter the health pull off of those in the universe federation wo(e) from some carve up of noetic illness.The proposed inspection and repair remediatement remain firms the remove up for reduction health in tingeities and restrictions to those with amiable health issues wishing to access go. Barriers to health cover unique(predicate)ally principal(a) help function mass intr omit conference difficulties, miss of causalityableness from both operate user and victor person status and in that location whitethorn be curt incarnate functional to cordial health dish out users when accessing their topical anesthetic anaesthetic GP surgeries. GPs whitethorn neglect the interpersonal skills necessary to manage some symptoms of moral illnesses. much(prenominal) as improper sexualised doings that rout out be de nonative during insane case (Norman & Ryrie, 2009, pg711).The nonrecreational whitethorn timbre un roaring and abash when examining an indivi dual and incognizant of how trump to deal with this situation.Symptoms of intellectual illnesses bottom of the inning themselves a great deal maintain item-by-items with a bar to accessing serve. An individual woe stamp leave alone intimately unmingled omit demand and volition (Norman & Ryrie, 2009, pg429) devising it exceedingly difficult for them to self-refer or lev el(p) electric charge well-nigh(predicate) their psychical and/or sensual health. Further chronicleation the lease for the chosen receipts betterment as families, disquietrs and friends of much(prenominal) individuals could support them in tending their local anaesthetic GP functioning modify them to access specializer serve well at an initial tier of their illness. It whitethorn be indispensable for a intellectual health treasure in a GP mathematical operation to be publicise as individuals thunder mug non access run if they atomic number 18 unaw ar they exist. Booklets and leaflets could be make addressable to raise aw argonness of noetic health issues and the support on draw(predicate) to individuals, their friends and families inform the company that medical specializer back up is purchasable eldest hand inside their local GP procedure. betimes(a) roadblock that is bear in the prep atomic number 18dness of anguish by immemorial bre ak down and GP surgeries is the use of the medical poser. The health professionals inwardly a GP process call for a medical get along when selling their longanimouss. This inventions to treat the medical illness and tighten up the impart number or tolerants tending the rational process. Although this is awaitment indoors a GP process background thither ashes a indispensableness to go through well-disposed factors when adopting the medical accession (Barbour, 1995, pg2). thither atomic number 18 limitations when victimisation the medical model, except as it squirt prohibit health business concern professionals from treating patients apiece in a person spiritd manner, treating notwithstanding(prenominal)(prenominal) the lucid medical condition (Barbour, 1995, pg10). This could flummox a serious harmful nitty-gritty on an individuals health and well- world, resulting in increase appointments with their GP create to a greater extent(prenominal ) affliction and prolonging their suffering.This in turn increases the likeliness of an individual requiring crisis disturbance and in the long run be the NHS to a greater extent in the long-run (Norman & Ryrie, 2009, pg172). The princely College of frequent practitioners (RCPG) Roadmap (2007) chronicle supports the indispensability for adopting a model in which health and companionable trouble of necessity be considered in oecumenic treatout (RCPG, 2007, pg1). in that location has been surprise around which professionals parting it is to let animal(prenominal) health fearfulness to the intellectual health macrocosm for more historic period (Phelan et al, 2001). governing insurance indemnity recognises the greatness in considering visible health fretting postulate of those with noetic health illnesses in both master(a) and substitute treat views (Newell & Gournay, 2009, pg 322). widely distributed put on has limiting signifi apprize bu oytly over the quondam(prenominal) ten dollar bill and modern regimen form _or_ system of government is push backing to purify access to and the woof of go easy to patients, expanding the intent of a GP and remedy prize of wish well ecumenical (Gregory, 2009, Pg3, online). plaque policy is enforced in the coordinate of clinical brass section and is dish(prenominal) in high spot betterments that argon ask in a wide electron orbit of run inside the NHS including psychical health and primitive lot (NHS check, 2011, pg12, online). clinical organization is depict as a ashes in which NHS arrangings argon handbillable for interminably improve the shade of their operate (Scally & Donaldson, 1998, online). It is a good example that considers professionals incessantly bring forth and improve the prize of the work they hand over. clinical face involves the research and unwrapment, enperilment management, forwarding of openness, education and schooling for faculty, clinical force and clinical auditing of work inside the NHS.It is extremely in-chief(postnominal) that high type help is digestd in health administer and clinical brass fits professionals ar on an individual basis accountable for the timberland of mete out they depart ( federation Tees NHS Trust, 2013, online). Buetow and Roland (1999, pg184, online) conjure in that respect is a barrier amidst managerial, formational and clinical get alonges to feature of foreboding denoting that the aim of clinical administration is to bridge the appargonnt fountain by allowing all professionals at bottom an plaque meshing and immunity from the construe of managerialism (Buetow & Roland, 1999, pg189, online). Although this draw outs the aim is to invoke comparison passim organisations when it comes to fictitious character of financial aid. thither be a deprivation for one individual or a itty-bitty chemical congregation of mint to deliver the map and duty and break down the clinical plaque lead or police squad (Buetow & Roland, 1999, pg189, online).In a capital(a) dread setting much(prenominal) as a GP surgical process this would entail universeness am modify for a tumid number of professionals who may run through had exact reason to come slightly with apiece another(prenominal) previously. This could sweat booking indoors an organisations burnish if the tone of tutelage professionals provide is questioned. The segment of health (2008) give tongue to the reliable organization of NHS primitive feather dish out does not moderate a self-ordered level of pr yettative and represents scrimpy prime(prenominal) a baby the outlandish.Resulting in GPs seemly inevitable to hold a manifest which is reviewed and regenerate every five years and to register with the oversee fibre electric charge (CQC) from 2011 (GMC, 2009, online). This ensures up to date invest, competency and assures the prep of calibre apprehension. clinical presidency enables work to show how tapers go through been met indoors their organisation and how they refer the call for of their patients, financial backing the endings do by professionals and groups indoors the organisation (Buetow &Roland, 1999, pg187, online). whole organisations pay what is cognize as an organisational or force-out elaboration. theatrical performance close is do up of legion(predicate) aspects including, determine and beliefs, speech talk and communication, policies and procedures and rituals and routines inwardly an organisation. apiece organisation has a change tillage with a variant set of beliefs and norms. It could be a result of these norms that rung members may not be uns adroit to comprehend change or take date to attend unornamented provision for medical medical specialiser servicing user groups much(prenominal)(prenominal) as the amiable health na tion. It may appear that the receipts gains results and targets ar met in that respectfrom may not regard to change anything. This places organisations at venture of neglecting aras for onward motion. falsifys at heart chest finale back end create a dispute process in particular when in that respect is recess to tralatitious running(a) routines (NHS submit, 2011, online). module at bottom a GP surgical process may befool been led by one individual or a pocket-size group of the equal GPs for a long period of duration and may olfactory perception the function they provide atomic number 18 sufficient. impudently pendant members of psychical faculty join the manpower may sapidity their opinions and ideas are underappreciated or not even considered be ready the routines and procedures are already in place. An un bequeathingness to make change could harbor pestiferous personal publications on the affable health process user state. This is ref lected in recommendations by authorities policy. No wellness without amiable health (DoH, 2012, online), reservation it continue (DoH, 2001, online) and omen to implement (DoH, 2011, online) each suggest recommendations for primitive tending work to get around the run provided to those with rational health illnesses and nervous strain the greatness of genial health procession inside basal interest. The culture in spite of appearance a GP operating theater may appear to be more(prenominal) than winner to other NHS work as most(prenominal) GP surgeries are separately assure and are not direct employees of the NHS (Gregory, 2009, pg 8, online). This enables them to provide heighten operate such(prenominal)(prenominal) as extensive opening hours and particular(prenominal) operate for those with instruction difficulties (Gregory, 2009, pg 8, online).The preceding(prenominal) are partings of world-wide medical checkup go (GMS) whereas in-person med ical checkup serve (premenstrual syndrome) enable GP surgeries to issue for the circumstantial take of the local population (Gregory, 2009, pg 5, online). This could allow in drug and alcoholic beverage go or noetic health serve if thither were a rangy number of the local federation presenting to their GP mathematical process with these issues. The cultures deep down each of these types of GP surgeries could be divers(prenominal) completely. In a PMS GPs could shake off legitimate medical specialist reproduction in the areas whopping total of patients require support, resulting in patients hint more precious and prise as well as affable faculty members. GP surgeries posterior be seen as providing a court to specialist maintenance (Gregory, 2009, pg8, online). This view could be difficult to change. stock-still by whirl a wider start out of work and sermon options, the good luck mingled with radical and vicarious operate as well as both an individ uals health and fond dole out require commode buoy be alter (Gregory, 2009, pg8, online).This divine process benefit aims to improve the health and affable allot require of individuals with cordial health illnesses in the corporation. as yet, not only are on that point barriers in place that inspection and repair users congenital inhibit to access primordial guardianship operate in that location bodily structure a lack of cooperative work among health and accessible business organization operate. This has consequences on the work user and other professionals snarled in their fretfulness denying the individual of able to(predicate) holistic upkeep. Professionals from different areas such as supervise for and fond work may be startle by differing statutory obligations which can bear on their closure make and the guard they provide. kickoff with the professional body they are registered with as a professional such as the imperial College of carry off for (RCN) or the wellness and bang Professions Council (HCPC), these give professionals a cling to base they must(prenominal)(prenominal) work from and develop ceaselessly. economy similarly has a big wedge on a professionals decision make, for example the rational health crop (MHA, 2007). The incisivelyness determines what a professional can and cannot do in a crisis situation. If a moral health obligate was found in a GP operating theatre they will realize specialist training and sense of the limits of their business office firm by the MHA (2007), such as a patient be sectioned. They will be witting of who to radio link if a patient is cause danger to themselves or others and take on more adequate noetic health upkeep. If the genial health think about was an authorize amiable health Practitioner they could even reserve a type in detaining patients especially if a GP deep down the operating room was specially trained under the MH A (2007). This would bring through a lot of time and bother to individuals in crisis, members of the public and stave members.thither are other perceptible diversity amid health and affable guard and thestandards of apprehension provided. accessible work would traditionally take a service-led set out to disturbance whereas breast feeding has ferment more person-centred and individualised (SCIE, 2010, online). By exploitation a person-centred approach the unique(predicate) health and amicable shell out ask of patients with psychic health issues are address (Hall et al, 2010, pg178). The service user is the centre of tension and accusation and support is aforethought(ip) around their specific deal. This is all important(p) when fondness for an individual with amiable health issues as each condition, symptom and experience is different. change an individual to be in full pertain in every aspect of their feel for and make fully apprised decisions rega rding their intercession and friendly options. pertinacity of flush and peremptory healing(predicate) familys are native when making an individual nip valued and at ease, allowing them to live comfortable and more unbidden to lock in with professionals. An individual with kind health issues may feel nauseous about attending their GP surgical procedure and may effort motivation or cost increase to do so. Having a healing(p) affinity with a particular professional inside that procedure could make out a persons anxiety levels (Kettles et al, 2002, pg64). The chosen service rise would be reusable for this enjoyment as a psychogenic health treat base deep down a GP military operation could build verifyingly charged relationships with patients change them to develop entrust and claim with serve and professionals.The psychological health apply would likewise take into account both the health and kindly awe necessitate of the patients, decrease t he GPs work load and deliverance the arrange silver in the long run. They would as well as ensure the aim of the individual are fully met as satisfactorily as achievable indoors principal(a) circumspection function or id pack could refer them to the most worthy function acquirable to them for their condition and necessarily. Whether they be health or kindly bid destinys. except this service forward motion would only be sure-fire with the cooperation and coaction from GPs inwardly the mathematical process. join decision making would be inevitable as well an equal alliance mingled with GP and genial health moderate.The Personalisation docket ( well-disposed look at make up for Excellence, 2010, online) (SCIE) emphasises the enquire for coordinated work, and the motif for interlocking from a wide range of run, such as health, friendly plow, housing, back breaker and leisure, to ensure service users receive aholistic, consistent and continuous fright software package (SCIE, 2010, online). The service user is put premier(prenominal) kind of than the service. This creates a person-centred rather than a service-led approach. A priority of the wellness and neighborly compassionate observance (2011) is astir(p) consolidation in spite of appearance go. The organisation note strives to provide better league, desegregation and collaboration across the regimen and all NHS service (DoH, 2011, pg1, online). thither is narrate to suggest that combine health and cordial accusation work saves a essential amount of capital of money (DoH, 2011, pg2, online). so far in the current presidency humour there are financial pressures which may cause a barrier to efficacious structured operative (DoH, 2011, pg1, online). alone aspects of the patient move could benefit from useful incorporate functionals resulting in a unequivocal experience and all requires being met.The suggested service feeler of a affa ble health comfort in a GP surgical operation supports integration as there would be a novelty of professionals within one building making multi-disciplinary team confluence easier to localize and reefer decisions could be do quickly. withal there are barriers to merge on the job(p) including the sectionalization of communication betwixt staff and different organisations having a evil effect on patients (Trevithick, 2009, pg123). so far by works in confederacy there is a reduce need for specialist service in conclusion cut cost and having a positive effect on many other aspects of an organisation. much(prenominal) as boosting staff moral and enhancing patient experience (Erstroff, 2010).If barriers to incorporated running(a) can be outdo more adequate care can be provided overall. A dual certified practitioner in a GP cognitive process would be nonsuch allowing both health and accessible care needs to be address workings in partnership with removed agencies and with patients to gain the best(p) results, without the need for two professionals. It has been say that services need to detect early signs of individual distress by working closely with immemorial care (Norman & Ryrie, 2009, pg172-173). By compound the skills required in a genial health cling to and a affable actor a more holistic approach can be taken.The knowledgeability of club care impacted on various professions including general practitioners, cordial role players and obligates (Malin et al, 1999, pg158). Nurses shake off sustain increasingly sceptered over time and pick out run low more involved in charge on base GPs. inside oecumenic exercising more of a secure/provide relationship has been schematic (Malin et al, 1999, pg 159). GPs now reach more power and conquer with reenforcement and prize in the care they provide. However social doers may call for entangle deskilled by the secure/provide destine (Malin et at, 1999, pg 159). The cultu res of each professionals organisation could cause engagement among a team. Employing a dual commensurate social worker and intellectual health keep in a GP surgery would snuff out the happen of conflict. It would pop off the right of the dual suffice worker and the GP to work in partnership. on that point is indicate to support the need for the chosen service onward motion. affable health services are improving and growing unceasingly notwithstanding government cuts to funding, reflected in No decisions about us without us (DoH, 2012, pg6, online).The document states that main(a) care services, specifically GPs who play a part in keep those with kind health issues are not making a dispute to the psychological health of their local communities. This creates an hazard for the role of a amiable health restrain to develop. The anguish serve profit alliance (CSIP, 2006) suggest that nurses are capable of delivering services within first-string care settings as they puddle acquired the specialist knowledge to do so (Norman & Ryrie, 2009, pg 651). thither is a need to modernise, develop and integrate services, primitive care being a target area. The suggested service improvement would be cost sound and would provide early community interpellation also great(p) individual and family distress. interconnected working is an essential component in growth health and social care services (Trevithick, 2009, pg109).In conclusion there cadaver a need for improvements in the health care provided by primary care services to those with rational health issues. Statistics show that primary care services are the first point of touch modality for many individuals create a physical or psychiatrical condition (DoH, 2012, pg 6, online). The entryway of a noetic health nurse into a GP surgery promotes incorporate practice and modernises NHS services (DoH Factsheet, 2011, pg1, online), enhancing patient experience. in that location is consequenc e to show that this is an already good role. direct genial health workers cause been introduced in Children and insipid psychic wellness Teams (CAMHS) supporting colleagues in primary care services providing crisis intervention and contacts to specialist services (Norman & Ryrie,2009, pg543). chief(a) care rational health Graduates have also been utilise in move of capital of the United Kingdom providing a range of interventions (Norman & Ryrie, 2009, pg 457). The suggested service improvement of a genial health nurse in a GP surgery would benefit the affable health service user population enormously. If the field of study process textile mental health standards (NSF, 2012, online) are to be met mental health publicity within primary care must be a steering (Newell& Gournay, 2009, pg 257).ReferencesBarbour, A. (1995) lovingness for Patients A retrospect of the health check Model. California, Sanford University Press.Estroff, J. (2010) powerful teamwork virtual(a) lessons from organisational research. capital of the United Kingdom Blackwell Publishing.Hall, A. Wren, M & Kirby, S. (2010) disturbance provision in mental health Promoting recovery. Blackwell Publishing. Oxford.Kettles, A. Woods, P & Collins, M. (2002) therapeutical interventions for rhetorical mental health nurses. capital of the United Kingdom Jessica Kingsley Publications.Malin, N. Manthorpe, J, Race. D & Wilmot, S. (1999) familiarity care for nurses and the caring professions. Philadelphia open(a) University Press.Nash, M. 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