How Would You Advise Your Management Staff to Successfully?

ow How would you advise your management staff to successfully manage this large scale change of the organization? I would enlighten them that managing organizational change can be for the better or worst sometimes. Many organizations create a partnership to build a centralize complex to recognize the organization differences. When change is implemented a formal strategy need to be put in place, This will allow the organization to identify the impact of forthcoming changes and make organizational or functional changes to ensure service levels are not reduced.Change management entails thoughtful planning and sensitive implementation, and above all, consultation with, and involvement of, the people affected by the changes. If you force change on people normally problems arise. Change must be realistic, achievable and measurable. When first starting to prepare for this change Senior MGMT thought-out; what do we want to achieve with this change, why, and how will we know that the change h as been achieved? Who is affected by this change, and how will they react to it? How much of this change can we achieve ourselves, and what parts of the change do we need help with?These aspects also relate strongly to the management of personal as well as organizational change. I think that it’s important for my staff to know the benefits of partnering with the other organization, with there funds and our resources we can build a stronger organization, which can aid, finance, and help our growing organization in a given industry that will grow rapidly without having to create another business entity. Senior MGMT of both organizations has discussed best practices and the issues that are the perceived potential benefits behind the merger openly and frankly. EX. ) If organization A's strength is sales and they are absorbing organization B in part because of B's distribution capabilities, make sure A's distribution people know to listen to B's distribution people and B's sales f orce understands the opportunity to learn from A’s. My plans are to express to them that the changes will be better for the organization and make us more successful. So I will focus on trying to sell the benefits of the changes and then get staff to participate so they feel as if they are a part of the changes.When people contribute to changes that affect them they are more adapted to accept them. I would express that we have the full support of senior management so things will move rapidly. I plan to emphasize a team-oriented approach in providing the right mix of strategic guidance, hands-on leadership and deep industry domain expertise in helping the individuals and their teams to become market-leading organizations. 1. What are the organizational crisis issues that need to be addressed? One of the problems mention is that the staff in the different areas is using stove piped systems.That makes it harder for an organization to be efficient which is why the new partner is s uggesting creating the new system. To eliminate the concerns of staff that the new partner doesn't understand their business, they should be made part of the team that works on the requirements for the new system. That way they can make sure it will support the way we do business and meet their needs at the same time. Each function is important to the success of a merger. Consider the way a merger will affect the other organization and then use those lessons to minimize the same effects of our organization.Another problem is that employees are worried about whether there jobs are changing and weather they will have the skills need to work on the new system. If employees are fully involved with the new implementation then have the skills to work with the new systems will be a given, when the organizations partner training and workshops we be apart of the reconciling. Recognize the pros and cons of the organizations becoming partner: Pros: ? More resource for future growth ? Take adva ntage of economic of scale Cons: ? Might loss competitive advantages Might bear the risk of not successfully integrate A rational decision making model provides a structured and sequenced approach to decision making. Using such an approach can help to ensure discipline and consistency is built into your decision making process. The fact that the Bill Gates foundation wants to change the culture of the organization because of the $20 Million dollar donation can cause a lot of conflict and have the employees who have created and build the old organization think that what was built is not effective enough to keep the organizationB functioning.If senior management takes to long to make timely decisions then the organization can’t really move forward and manufacture like a top organization. When the problems are identified use the employees to create a new way of functioning, identify the most probable causes for the current system and improbable causes and use those results to wo rk with the other organization to build your new effective system. Some potential problems that organization should be aware of when they must make decisions during a crisis is Cultural disconnect, Culture change management is not indulgent; it is a critical aspect of any transaction.However, simply acknowledging the issue or handing it off to specialists is not enough. Management must set a vision, align leadership around it, and hold substantive events to give employees a chance to participate. Detailed actions and well articulated expectations of behavior connect the culture plan to the organizations goals. Also, keeping information too close is a natural hesitancy that the organization should avoid; I know that current regulations put pressure on what management can tell the organization without going to public disclosure.However, absent real facts, the rumor mill will fill the void. Tell employees what you can. Also, tell them what you can't tell them at the moment, why, and wh en you will be able to do so. What are some steps that the organization can take to avoid those problems or to minimize their negative impact? ? Choose the right conversion team; the organization will need employees who demonstrate excellent people skills and the ability to â€Å"finesse† any situation to the benefit of the organization.Make sure the transition team is appropriate for the area or department they talk to and can easily relate to people in various departments. ? Be in constant, honest communication with employees; All employees want accurate information from management, and they want to know the truth, even if it’s difficult. No matter what the news is, good or bad, your employees want to hear it, so always be totally open and honest about what is to come.If your employees feel out of the loop, they’ll assume the worst, and you can expect a negative effect on efficiency. Both partnering entities need to be consistently communicators with employees and ensure that whatever they’re communicating is 100% accurate. ? Give assurance about change; Help your employees to deal with change, even if that change seems minor to you it might be big to them . People fear change so Executives need to do everything they can to help minimize the anxiety that people naturally have.

Endometritis

Postpartum Endometritis Evidence Based Paper March 13, 2012 Endometritis is the inflammation or irritation of the uterus, which is a common post partum complication that occurs in more than 15% of all pregnancies and is currently the leading cause of maternal mortality (Scott & Hasik, 2001). When endometritis is not related to pregnancy, it is referred to as pelvic inflammatory disease (PID).The Centers for Disease Control and Prevention (CDC) 2010 sexually transmitted diseases treatment guideline defines PID as any combination of endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis. From a pathologic perspective, endometritis can be classified as acute versus chronic. Acute endometritis is distinguished by the presence of neutrophils within the endometrial glands. Chronic endometritis is characterized by the presence of plasma cells and lymphocytes within the endometrial stroma.Chronic endometritis in the postpartum or post abortion patient is usually associat ed with retained products of conception after delivery or abortion. In the nonobstetric population, chronic endometritis has been associated with infections such as chlamydia, tuberculosis, bacterial vaginosis, and the presence of intrauterine devices (Rivlin, 2011). Early-onset postpartum endometritis occurs within two days of delivery, and the late-onset of the disease can occur up to six weeks postpartum.This condition will usually start as a local infection at the placental attachment site and if left untreated, can spread to the entire uterine endometrium (French & Smaill, 2004). There are numerous risks associated with this condition, and diagnosis relies heavily on the clinical judgment of the practitioner. The contamination of the uterine cavity with vaginal organisms during labor and delivery causes the disease. Both bacterial and viral infections may initiate endometritis and many of the agents that cause the infection are naturally present in the vagina.This condition arises commonly after delivery because delivery results in tears, rips or incisions in the vagina, cervix or uterus that allow these agents to enter the uterine lining. The infection can have several species of causative agents that can be aerobic or anaerobic flora (French & Smaill, 2004). The method of delivery will determine which causative agents prognosticate the possibility of endometritis. For vaginal deliveries, the presence of the organisms associated with bacterial vaginosis or genital cultures positive for aerobic gram-negative organisms can indicate endometritis.In cesarean births, the occurrence of certain bacteria such as group A hemolytic streptococci, staphylococci B, Neisseria gonorrhoeae, or Mycoplasma hominis in amniotic fluid cultures will put the patient at an increased risk for this infection (French & Smaill, 2004). With the increasing number of people opting for natural birth methods, including water births, the danger only multiplies. This is becaus e disinfecting procedures as they are carried out before major surgery is usually not practiced in a home environment.Prompt treatment is essential to prevent the spread of the infection through other areas of the body, including the blood. Prolonged infection can be fatal. The immediate postpartum period following birth is a time of increased risk for all women for infection. Microorganisms entering the reproductive tract and migrating into the blood and other parts of the body could result in life threatening septicemia (French & Smaill, 2004). Timely diagnosis and aggressive treatment is essential to prevent these complications.Complications of endometritis include infertility, extension of infection to involve the peritoneal cavity with peritonitis, intra-abdominal abscess, and septic pelvic thrombophelbitis. Septic pelvic thrombophelbitis is a condition in which blood clots in one of the pelvic vessels become infected. If untreated it could progress to septic pulmonary embo li, in which the infected blood clots travel to the lungs and lead to death (French & Smaill, 2004).Septic shock is a life-threatening systemic infection usually caused by bacteria and on rare occasions follows postpartum endometritis. The bacteria that invade the bloodstream release a substance known as endotoxin, which causes decreased blood pressure, clot formation, major tissue injury, and leakage of fluids. Accordingly, organs may fail because they are not receiving enough blood and nutrients. Fortunately, this condition during pregnancy or in the postpartum period is a rare clinical event (Mazzeffi and Chen, 2010).Major risk factors for obstetric endometritis include the following: Cesarean delivery (especially if before 28 weeks' gestation), rupture of membranes lasting more than 24 hours, excessively long labors, severely meconium-stained amniotic fluid, manual placental removal, and extremes of patient age. Other threatening factors have been identified in additional st udies, including no prior cesarean delivery, preterm or postterm gestation, low infant Apgar scores, antepartum infections, preeclampsia, amnioinfusion, postpartum anemia, the presence of internal monitors, and steroid medications (Olsen, Butler, Willers ;amp; Gilad, 2010).Acute endometritis is typified by the existence of neutrophil cells in the endometrium. Neutrophils are white blood cells with cytoplasmic granules that consume harmful bacteria, fungi, and other foreign materials. Characteristic symptoms of endometritis include abdominal distention or swelling, abnormal vaginal bleeding, abnormal vaginal discharge, fever (100 to 104 degrees Fahrenheit), general discomfort, uneasiness, or ill feeling (malaise), and lower abdominal or pelvic pain (uterine pain). Anemia occurs when a patient’s red blood cell count is lower than 4. -6. 0 million red blood cells per micro liter of blood. Losing large amounts of blood during delivery or prior to delivery may be a contributing fa ctor for a low red blood count, anemia and potentially endometritis. Red blood counts (RBC) are needed to indicate anemia and the sedimentation rate (ESR). The sedimentation rate measures the rate at which red blood cells sediment in a period of 1 hour. It is a common hematology test that is a non-specific measure of inflammation, which is evident in endometritis.The diagnosis of postpartum endometritis is based on the presence of fever in the absence of any other cause. Uterine tenderness, purulent or foul-smelling lochia and leukocytosis are common clinical findings used to support the diagnosis of endometritis. Leukocytosis is a raised white blood cell count (the leukocyte count) above the normal range in the blood. The standard definition for puerperal fever used for reporting rates of puerperal morbidity is an oral temperature of 100. 4 degrees centigrade or more on any two of the first ten days postpartum or 101. degrees or higher during the first 24 hours postpartum (French ; amp; Smaill, 2004). Additionally, when the above symptoms occur, urinalysis and urine culture may be done. However, endometrial cultures are rarely indicated because specimens collected through the cervix are usually contaminated by vaginal and cervical flora. A sterile technique with a speculum is used to avoid vaginal contamination, and the sample is sent for aerobic and anaerobic cultures. If fever persists for 48 hours (Some clinicians use a 72-hour cutoff) after endometritis is adequately treated, ther causes such as pelvic abscess and pelvic thrombophlebitis should be considered. Abdominal and pelvic imaging, usually done by CT, is sensitive for abscess but detects pelvic thrombophlebitis only if the clots are large. If the results of the imaging are negative, a trial of heparin is typically begun to treat presumed pelvic thrombophlebitis as a diagnosis of exclusion (Moldenhauer, 2008). Before the advent of the antibiotic era, puerperal fever was an important cause of maternal death.With the use of antibiotics, a sharp decrease in maternal acute postpartum infections has been observed, and it is now accepted that antibiotic treatment for postpartum endometritis is warranted. Intravenous broad-spectrum therapy (cephalsporins, penicillins, or clindamycin and genatmicin) is appropriate for the treatment of endometritis. Regimens with activity against penicillin-resistant anaerobic bacteria are better than those without. There is no evidence that any one regimen is associated with fewer side effects.Once uncomplicated, endometritis has clinically improved with intravenous therapy, and oral therapy is not needed (French, 2003). Furthermore, it is essential that the patient receive supportive care including hydration, rest and pain relief. Antibiotics should be discontinued 24 hours after the patient is asymptomatic. Assessments should be taken of the lochia, vital signs, and changes in the women’s condition continue during treatment (Perry, Hockenberry ;amp; Lowdermilk, 2010). Treatment is usually considered successful after the woman is afebrile for 24 to 48 hours.If the initial antibiotic regimen does not result in resolution of fever and other symptoms within three days, the antibiotic regimen is usually changed. Consideration is also given to the possibility that the woman may have complications requiring specific treatment. The most effective treatment and least expensive treatment of postpartum infection is prevention. Preventative measures include good prenatal nutrition to control anemia and intrapartal hemorrhage. Good maternal perineal hygiene with through hand hygiene is emphasized.Strict adherence to aseptic techniques by all healthcare professionals during childbirth and the postpartum period is very important (Perry, Hockenberry ;amp; Lowdermilk, 2010). Endometritis is usually caused, in the postpartum scenario, because of a deficient care taken to avoid streptococcus and staphylococcus infections in the delivery ar ea. These two bacteria are present on every inch of our skin, and considering that delivery is the one time when the mother's insides are most exposed, precautionary measures to maintain a sterile environment in the delivery or birthing room should be taken.The benefit of antibiotic therapy for laboring women has been unquestionably established. Intravaginal metronidazole as surgical preparation and oral methylergometrine after delivery are two interventions that show promise as additional prophylactic interventions (French, 2003). Having a baby by Caesarean section is becoming increasingly common, despite the higher risks associated with the surgery compared to a vaginal birth. One important concern is the risk of infection, which is between five and 20 times greater for women who undergo scheduled or emergency Caesarean section.According to the Cochrane Review, â€Å"the single most important risk factor for postpartum maternal infection is Caesarean section. † The review f urther cited that antibiotics to women undergoing Caesarean section reduced the incidence of fever by 45 percent, wound infection by 39 percent, inflammation of the uterine lining by 38 percent and serious infectious complications for the mother by 31 percent (Nelson, 2010). This approach can significantly lower the risk of endometritis, particularly in women having surgery after extended labor and ruptured membranes.To prevent future infection, most doctors prescribe Cefazolin, which is administered intravenously immediately after the baby's umbilical cord is clamped. If you are at high risk, a second dose may be given eight hours later (French ;amp; Smaill, 2004). The overall goal for the postpartum client with endometritis is, â€Å"The patient will be free from infection. † Nursing management and general interventions of the patient would include the collection of vaginal and blood cultures, education on handy hygiene, the administration IV antibiotics and analgesics as p rescribed.Non-pharmacological interventions include distraction, imagery, relaxation, and application of hot and cold. Non-pharmacological interventions can restore the client’s sense of self-control, personal efficacy, and active participation in her care. It is essential that the information and method of delivery of information be tailored to the specific client and family (French ;amp; Smaill, 2004). Secondary to free from infection, an accurate nursing care plan for a postpartum patient with an with endometritis would include: 1.The patient will follow a specific, mutually agreed upon, healthcare maintenance plan. (The nurse should assume that first-time mothers lack sufficient knowledge regarding condition and treatment diagnosis, and therefore, needs education and specific instructions during the postpartum recovery period). If a mother has given birth to more than one child a review of proper heath care regimens is also justifiable. The new mother should receive instr uction pertaining to hygienic care for her perineal area. This care would include changing her perineal pad frequently and washing her hands afterwards.The presence of a wet pad against sutures is an excellent medium for the development of an infection that could potentially spread to the uterus. The use tampons should be prohibited for six weeks after delivery, since tampon use can cause infection or even toxic shock syndrome. It is the nurse’s responsibility to promote adequate rest and encourage a generous intake of nutrients and fluids. The patient will report that pain management regimens achieves comfort function goal without adverse effects (Ackley ;amp; Ladwig, 2011).The nurse should administer comfort measures to ease pain and teach the patient proper understanding of the condition as well as taking measures to correct the complications of endometritis (Perry, Hockenberry ;amp; Lowdermilk, 2010). 2. The patient will maintain oral temperature within adaptive levels (l ess than 100. 4 degrees). Evaluate the woman's temperature at the end of the first hour postpartum and then every four hours for the first 22 hours postpartum. Clients with endometritis typically have a fever, chills, general malaise, and may exhibit tachycardia.Oral temperature measurement provides a more accurate temperature than tympanic measurement, auxiliary, or use of a chemical dot thermometer. Use the same site and method device for temperature measurement for a given client so that temperature trends are assessed accurately (Ackley & Ladwig, 2011). 3. The patient will report that pain management regimens achieves comfort function goal without adverse effects (Ackley & Ladwig, 2011). The importance of prompt reporting of unrelieved pain is the patient’s responsibility.An important step toward improved control of pain is a better client understanding of the nature of pain, its treatment, and the role the client needs to play in pain control (Ackley & Ladwig , 2011). Despite the normalcy of childbirth, complications may arise that will have detrimental effects on the postpartum client. These include postpartum hemorrhage, thrombophlebitis, and infections such as endometritis. Healthcare providers working with postpartum clients must have a clear understanding of these complications, including the symptoms, nursing interventions, and treatment.A cognizant nurse would carefully review the results of laboratory tests for signs of anemia, infection, and electrolyte imbalance. Blood cultures to identify the causative agents of potential infections are typically done, and white blood cell (WBC) counts are monitored. However, it is important to remember that the white blood cell count is normally elevated after delivery for a short period; continued monitoring of the WBC count is required in identifying endometritis (French, L. , & Smaill, F. M, 2004).Nearly 90% of women treated with an approved regimen note improvement in 48-72 hours. Del ay in initiation of antibiotic therapy can result in systemic toxicity. Endometritis is associated with increased maternal mortality due to septic shock. However, mortality is rare in the United States because of aggressive antimicrobial management. Most cases of endometritis, including those following cesarean delivery, should be treated in an inpatient setting. For mild cases following vaginal delivery, oral antibiotics in an outpatient setting may be adequate (French, L. & Smaill, F. M, 2004). References Ackley, B. J. , & Ladwig, G. B. (2011). Nursing diagnosis handbook: An evidence-based guide to planning care. (9th ed. , pp. 47,426-429,446-449,600-604). St. Louis, Missouri: Mosby Elsevier. French, L. (2003). Prevention and treatment of postpartum endometritis. Current Women’s Health Reports, 3(4), 274-279. Retrieved from http://www. ncbi. nlm. nih. gov/pubmed/12844449 French, L. , & Smaill, F. M. (2004). Antibiotic regimens for endometritis after delivery. Co chrane Database of Systematic Reviews, Retrieved from http://www. rw. interscience. wiley. com/Cochrane/clsysrev /articles/CD001067/frame. html Mazzeffi, M. A. (2010). Severe postpartum sepsis with prolonged myocardial dysfunction: A case report by michael a. mazzeffi and katherine t. chen. Journal of Medical Case Reports, (4), 318. Retrieved from http://www. jmedicalcasereports. com/content/4/1/318 Moldenhauer, J. S. (2008, November). Puerperal endometritis. Retrieved from http://www. merckmanuals. com/professional/gynecology_and_obstetrics/postpartum_care_and_associated_disorders/puerperal_endometritis. tml Nelson, C. B. (2010, January 22). Routine antibiotic use reduces mothers’ infection risk from c- section. Health Behavior News Service. Retrieved from http://www. physorg. com/news183387263. html Olsen, M. A. , Butler, A. M. , Willers, D. M. , & Gilad, A. G. (2010). Risk factors for endometritis after low transverse cesarean delivery. Infection Control and Hospital E pidemiology, 31(1), 69-77. Retrieved from http://www. jstor. org. proxy. li. suu. edu:2048/stable/10. 1086/649018 Perry, S. E. , Hockenberry, M. J. & Lowdermilk, D. L. (2010). Maternal child nursing care. (4th ed. , pp. 586-587). Maryland Heights, MO: Mosby. Pillitteri, A. (1999) Maternal & Child Health Nursing, (3rd ed. pp. 789-792). Philadelphia: PA: Lippincott. Rivlin, M. E. (2011, June 14) Endometritis. Retrieved from http://emedicine. medscape. com/article/254169-overview Scott, L. D. , & Hasik, K. J. (2001). The similarities and differences of endometritis and pelvic inflammatory disease. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 30(3), 332-41.

Black Plague

Since the Europeans lacked medical knowledge, the Plague caused hysteria and hopelessness to spread across Europe. Therefore the Europeans turned to the one stable unit in their lives, the Church. The Europeans lack of medical knowledge really hurt them. They had all types of perceived causes and treatments that they thought would work. People just kept dying and they couldn’t find a cure for something that they didn’t know the cause. According to Heinrich Truchess von Diessenhoven, Jewish people were one perceived cause that the Europeans believed. They spread a rumor that the Jews poisoned the wells and rivers for people had â€Å"confessed† to the crime. The Report of the Paris Medical Faculty states another perceived cause to be the configurations of the heavens and the major conjunction of three plants in Aquarius to be blamed. Another excerpt states that an earthquake that occurred on St. Paul’s day in 1347 corrupted and infected the air above the earth and killed people in various parts of the world. In the excerpt from an anonymous poem, the vices rule is indicted as a cause. The Europeans tried many treatments in which most of them failed. However, Lisavetta Centenni wrote that her husband, Ottavio, had a fatal fever. She believed he would die but Sister Angelica sent her a little piece of bread that had touched the body of St. Domencia. Her husband was a lucky one and his fever broke. Other methods didn’t work so well and patients died anyway. For example, H. de Rochas, a French physician states that patients would hang toads around their neck either dead or alive, in which they believed the venom would draw out the poison of the disease. Furthermore William Zouche, an Archibishop of York, wrote to his official that he believes the plague was surely caused by the sins of men so in order to stop the plague they should pray to the Almighty God and ask him to drive away the infection. In addition Dom Theophilus of Milan, a priest, suggests a few things to do if a person is struck by the plague. First let him gather as much as he can of bitter hatred towards the sins he committed, and the same quantity of true sorrow of heart, and mix the two into an ointment with tears. That is just one example of his unrealistic treatments. As you can see now this is why the plague had spread and killed so many people. The lack of medical knowledge led to hysteria in Europe as well. The first example is a letter from a schoolmaster saying the plague had taken twenty of the boys and this kept people from coming to them at all. The plague affected the education of the people as well. The hysteria only got worse. Heinrich von Laden stated that people were dying in their own houses of starvation for they were so afraid to leave and get food, and if a person had died within their home they were buried there. Imagine being as afraid as to leave your home, children must’ve been terrified. Then people started turning to more murderous options. According to the ‘Motto of Giovan Filippo, Sicilian physician of Palermo,’ gold, fire, and the gallows were being used. The gold was used for income for the pest houses to quarantine the sick, the gallows to punish those who violated the health regulations and bonfires to eliminate the infected. People were just turning to anything to try and get rid of this horrid plague. In an English Puritan’s diary, the father Nehemiah Wallington writes, â€Å"Who would I be willing to give up to the disease? Then would I say the maid. Who next? My son John. Who next? My daughter Elizabeth. Who next? Myself. People were going mad in their homes, and willing to give up anyone but themselves. I don’t even know if I’d be able to keep my head either. The document from Heinrich Truchess von Diessenhoven comes up again for the hysteria was causing people to spread rumors that really hurt the Jew’s reputation and caused a huge decline in their population. Even some people confessed to it because they were starting to actually believe the untrue rumors. Some Christians confessed that the Jews had induced them to carry out the deeds. Even though an excerpt from an anonymous poem argues that everyone should rejoice with each other. People were obviously not listening to that poem if they were pointing out certain people who â€Å"caused† the plague. I already spoke about Dom Theophilus’ ridiculous methods of getting rid of the plague but I just wanted to bring it up again to show how hysterical people were getting by making up absurd remedies like that. Therefore, Europeans suffered greatly from this plague and lost a third of their population which is 25 million people. I would’ve liked to see a death chart rate over the years in Europe. With all of this death and exposure education and centralization was very hard to recover. Even through all of this havoc the people always turned to the church in their time of need. An example is Lisavetta Centenni, an Italian housewife, whose husband survived from the blessed piece of bread from St. Domencia. It was probably out of luck, or good immune system that helped him survive, but people looked at this in a very serious and reliable manner. Furthermore, Father Dragoni states he has accompanied danger with compassion and charity and paid guards and gravediggers with alms the lordships sent him. They depended a lot on alms and holy charities would help. The Church not only had a religious role but a secular one as well. Peasants were taught how to farm and how to use tools. Noble’s daughters were taught to farm as well. As I mentioned before, William Zouche said that people believed that if they prayed to the Almighty One, he would stop the spread of the plague and go to church every Wednesday and Friday. Once again, the document with Dom Theophilus of Milan appears for he believed if you used these remedies you could save yourself. Overall, you could see how important the Church was to the people. The lack of medical knowledge really didn’t help the Europeans against the plague. It led to hysteria and all kinds of disasters. The people turned to the Church in a time of need, but even the Church was little help in this catastrophe. The Bubonic Plague still exists in countries today but with our advanced medical knowledge, people can get the right medical attention and medication they need. Doctors never want to have a repeat in history like the Black Plague in Europe and lose millions of people again. Black Plague Since the Europeans lacked medical knowledge, the Plague caused hysteria and hopelessness to spread across Europe. Therefore the Europeans turned to the one stable unit in their lives, the Church. The Europeans lack of medical knowledge really hurt them. They had all types of perceived causes and treatments that they thought would work. People just kept dying and they couldn’t find a cure for something that they didn’t know the cause. According to Heinrich Truchess von Diessenhoven, Jewish people were one perceived cause that the Europeans believed. They spread a rumor that the Jews poisoned the wells and rivers for people had â€Å"confessed† to the crime. The Report of the Paris Medical Faculty states another perceived cause to be the configurations of the heavens and the major conjunction of three plants in Aquarius to be blamed. Another excerpt states that an earthquake that occurred on St. Paul’s day in 1347 corrupted and infected the air above the earth and killed people in various parts of the world. In the excerpt from an anonymous poem, the vices rule is indicted as a cause. The Europeans tried many treatments in which most of them failed. However, Lisavetta Centenni wrote that her husband, Ottavio, had a fatal fever. She believed he would die but Sister Angelica sent her a little piece of bread that had touched the body of St. Domencia. Her husband was a lucky one and his fever broke. Other methods didn’t work so well and patients died anyway. For example, H. de Rochas, a French physician states that patients would hang toads around their neck either dead or alive, in which they believed the venom would draw out the poison of the disease. Furthermore William Zouche, an Archibishop of York, wrote to his official that he believes the plague was surely caused by the sins of men so in order to stop the plague they should pray to the Almighty God and ask him to drive away the infection. In addition Dom Theophilus of Milan, a priest, suggests a few things to do if a person is struck by the plague. First let him gather as much as he can of bitter hatred towards the sins he committed, and the same quantity of true sorrow of heart, and mix the two into an ointment with tears. That is just one example of his unrealistic treatments. As you can see now this is why the plague had spread and killed so many people. The lack of medical knowledge led to hysteria in Europe as well. The first example is a letter from a schoolmaster saying the plague had taken twenty of the boys and this kept people from coming to them at all. The plague affected the education of the people as well. The hysteria only got worse. Heinrich von Laden stated that people were dying in their own houses of starvation for they were so afraid to leave and get food, and if a person had died within their home they were buried there. Imagine being as afraid as to leave your home, children must’ve been terrified. Then people started turning to more murderous options. According to the ‘Motto of Giovan Filippo, Sicilian physician of Palermo,’ gold, fire, and the gallows were being used. The gold was used for income for the pest houses to quarantine the sick, the gallows to punish those who violated the health regulations and bonfires to eliminate the infected. People were just turning to anything to try and get rid of this horrid plague. In an English Puritan’s diary, the father Nehemiah Wallington writes, â€Å"Who would I be willing to give up to the disease? Then would I say the maid. Who next? My son John. Who next? My daughter Elizabeth. Who next? Myself. People were going mad in their homes, and willing to give up anyone but themselves. I don’t even know if I’d be able to keep my head either. The document from Heinrich Truchess von Diessenhoven comes up again for the hysteria was causing people to spread rumors that really hurt the Jew’s reputation and caused a huge decline in their population. Even some people confessed to it because they were starting to actually believe the untrue rumors. Some Christians confessed that the Jews had induced them to carry out the deeds. Even though an excerpt from an anonymous poem argues that everyone should rejoice with each other. People were obviously not listening to that poem if they were pointing out certain people who â€Å"caused† the plague. I already spoke about Dom Theophilus’ ridiculous methods of getting rid of the plague but I just wanted to bring it up again to show how hysterical people were getting by making up absurd remedies like that. Therefore, Europeans suffered greatly from this plague and lost a third of their population which is 25 million people. I would’ve liked to see a death chart rate over the years in Europe. With all of this death and exposure education and centralization was very hard to recover. Even through all of this havoc the people always turned to the church in their time of need. An example is Lisavetta Centenni, an Italian housewife, whose husband survived from the blessed piece of bread from St. Domencia. It was probably out of luck, or good immune system that helped him survive, but people looked at this in a very serious and reliable manner. Furthermore, Father Dragoni states he has accompanied danger with compassion and charity and paid guards and gravediggers with alms the lordships sent him. They depended a lot on alms and holy charities would help. The Church not only had a religious role but a secular one as well. Peasants were taught how to farm and how to use tools. Noble’s daughters were taught to farm as well. As I mentioned before, William Zouche said that people believed that if they prayed to the Almighty One, he would stop the spread of the plague and go to church every Wednesday and Friday. Once again, the document with Dom Theophilus of Milan appears for he believed if you used these remedies you could save yourself. Overall, you could see how important the Church was to the people. The lack of medical knowledge really didn’t help the Europeans against the plague. It led to hysteria and all kinds of disasters. The people turned to the Church in a time of need, but even the Church was little help in this catastrophe. The Bubonic Plague still exists in countries today but with our advanced medical knowledge, people can get the right medical attention and medication they need. Doctors never want to have a repeat in history like the Black Plague in Europe and lose millions of people again. Black plague

Fundamental Duties Influences Practice and Decision Making of a Nurse Coursework - 4

Fundamental Duties Influences Practice and Decision Making of a Nurse - Coursework Example In accordance with the Hippocratic Oath and Nightingale pledge, the fundamental duties of a nurse can be apparently observed as adopting along with executing various preventives measures for eliminating any sort of risk that arise during the treatment procedure or at the time of conducting clinical works and delivering positive outcomes in future. By evaluating the Hippocratic Oath and Nightingale pledge, it can be reckoned that the nurses will provide quality care to the patients by taking guidance of the oath.   This eventually influences the practice and also the decision-making procedure of the nurses in the form of various ways. These ways comprise maintaining integrity within the operational procedure, preserving privacy and most importantly ensuring that the confidentiality rights of the patients during treatment are well derived (McMullen, Howie, Howie & Philipsen, 2013).     The other fundamental duty of the nurses, as described by the Hippocratic Oath and Nightingale pledge, is identified to be taking effective decisions relating to the development of patients’ healthcare. The nurses are responsible for taking decisions that can prove to be beneficial in enhancing the well-being of the patients.   In this regard, nurses usually become responsible for taking ethical decisions relating to patients’ safety and health without hampering their respective rights. While providing care to the patients, the nurses need to follow certain code of ethics that are oriented within the Hippocratic Oath and Nightingale pledge. This factor ultimately influences a nurse’s practice as well as decision making towards deriving varied positive outcomes, which could be measured in the form of improving the wellbeing of the patients (McMullen et al., 2013).  

Coursework 2 Report Dissertation Example | Topics and Well Written Essays - 1000 words

Coursework 2 Report - Dissertation Example This social media suit has certain tools which will assist them to enhance the Facebook pages, and it will also permit L’Oreal to evaluate the transactions of the salons who have taken the distributorship of L’Oreal. These salons can also launch dynamic videos on their Facebook page, register appointments, bookings, and information sharing on behalf of the company (Thomson â€Å"Is B2B Social Media Marketing behind B2C"). The company also supplied their distributors and suppliers with various educational resources to enhance their social marketing strategy, and as a token of motivation each distributors were also given an advertisement credit of $25. The company received strong response from around 21 million supply points around the world (â€Å"L’Oreal, Salon Campaign by Buddy Media"). They were also successful in reaching out to more than 6000 salons and approximately 1.7 million clients (â€Å"B2B and B2C Brands Discovered the Value of Social Media marketi ng in 2012"). Social Media Networking for B2C Segment L’Oreal is even more active on social media for its B2C segment because this is for attracting the retail customers. The social media marketing vice president of L’Oreal said in an interview that L’Oreal is a big company, with different product lines, so social media chosen for every product line is based on the nature of the product and target customers. In terms of social media resources, L’Oreal experiments with various channels such as Instagram, Pinterest and even Tumblr. However, the major channel for social media marketing is still Facebook and Twitter obviously because of its huge user base. Facebook is a partner with L’Oreal for its social media marketing. Twitter is however, still a guide of innovation, and brands like Maybelline are being promoted on Twitter. Georges Edouard Dias, the vice president of the digital business at L’Oreal, said in his interview in â€Å"Marketing W eek†, that in order to understand the needs and requirements of the customers, the company should have to reach out to their target customers through various means of communication (Handley â€Å"Q&A: Georges-Edouard Dias, L'Oreal†). He said that they get approximately 250,000 posts for their brands every day. The company also uses social media for cross selling in various countries like China. Beauty has been always regarded as a component of social conversation. YouTube plays a significant part in this context, where women get to see how the products are used or put on. The video content is being optimized regularly for this purpose. The company has also segregated the video division, which concentrates on social media marketing videos on YouTube (Edwards â€Å"L'Oreal Social Media Chief Rachel Weiss Tells Us Why She's Bored of Pinterest†). Work Cited â€Å"B2B and B2C Brands Discovered the Value of Social Media Marketing in 2012."  Brafton Editorial. Brafto n, Incorporated, 28 Dec 2012 Web. 5 June 2013. â€Å"L’Oreal, Salon Campaign by Buddy Media"  International Advertising Bureau UK. International Advertising Bureau, 23 Aug 2012. Web. 5 June 2013. Edwards, Jim. â€Å"L'Oreal Social M

Procurement and Delivery Strategies Research Paper

Procurement and Delivery Strategies - Research Paper Example The growth of health services has seen a major rise in the Queensland region. There has been a significant increase in the number investments in the healthcare sector. The establishment of the Sunshine Coast University Hospital (SCUH) project is a shining example in this case. The proposed hospital is expected to start operating by the end of 2016 having bed capacity of 450. This would be gradually increased to 738 beds by the end of 2021. The total cost of the project has been pegged at $1.97 billion. The hospital is expected to provide a host of multi-specialty treatments to patients. Future plans of the project include providing specialized community based healthcare service to the local community, and setting up of an academic and research centre which would collaborate with the local universities for providing quality education and research opportunities for the potential health workforce of Queensland. The SCUH also plans to develop a private hospital on the campus located at K awana. The land procurement for this unit has started in 2010, and the unit is expected to be operational by the end of 2013, thereby, catering to the increasing healthcare requirements of the people of Kawana area (Queensland Government-a, 2010).http://www.buildinghealth.qld.gov.au/schospital/pdf/masterplan_es.pdf1.2Â  Background to Public-Private Partnerships (PPP)Public-Private Partnerships could be defined as an agreement or a contract between government and a private agency for funding a new venture.

Infusing Technology in the Classroom Essay Example | Topics and Well Written Essays - 1500 words

Infusing Technology in the Classroom - Essay Example At the departmental meeting a group of teachers presented on more effective means of constructing ‘word walls’ – these are walls of relevant terminology that go up in all the classroom. They opened their presentation with an attention grabbing video and then proceeded to demonstrate ways world walls could be constructed daily through videos instead of the traditional way. There are also other development opportunities. There is even now a site called TeacherTube that is formatted much like YouTube, except that the uploaded videos are a related to teacher development. Many teachers report personally using this for professional development purposes on a number of occasions, and believe that its pool of communal knowledge could be implemented by teachers throughout the nation in developing more efficient means of instruction. Other uses of educational technology through the internet have occurred in the growing use of Social Networking Sites (SNS) among students and teachers. The institution has implemented Ning.com in a number of projects. Ning is a social networking tool that allows students and teachers to create their own social networking site and designated whether it will have a closed or open invitation policy. This technology has been used with great success in a number of classrooms. In some of the humanities classrooms throughout the nation, it has been implemented extremely effectively as students are required to develop a site that corresponds to a particular character, for instance, Hamlet.

Diageo-Marketing Case Study Example | Topics and Well Written Essays - 2750 words

Diageo-Marketing - Case Study Example The firm has distilleries in Europe and North America. Allied Domecq's retail operations include the Baskin-Robbins, Dunkin' Donuts, and Togo's Eateries franchises. Allied was acquired by Pernod Ricard in 2005. (Source from website: http://www.hoovers.com/allied-domecq/--ID__50001--/free-co-factsheet.xhtml) Constellation Brands: The Company makes and distributes about 200 brands of beer, wine, and spirits in the US and the UK. Its Constellation Wines division is the global leader in wine sales, offering brands such as Almaden, Banrock Station, Hardys, Inglenook, Vendange, and Arbor Mist. Constellation also makes premium wines including Estancia, Ravenswood, and Simi. Constellation Brands imports beers such as Corona and Tsingtao, markets distilled spirits such as Fleishmann's and Barton, and produces and distributes cider, wine, and bottled water in the UK. (Source from website http://www.hoovers.com/constellation-brands/--ID__11800--/free-co-factsheet.xhtml) Fortune Brands: The holding company is a leading US producer and distributor of distilled spirits (Jim Beam, DeKuyper, Knob Creek, Absolut) and golf equipment (Titleist, Cobra, FootJoy, Pinnacle). Bacardi, Adolph Coors, Carlsberg, Fosters, SABMiller and Pernod Ricard. It also has a diversified non-alcoholic product mix and has added former Allied Domecq brands Sauza, Courvoisier, Canadian Club, and Clos du Bois to its fold. (Source from website: http://www.hoovers.com/fortune-brands/--ID__10075--/free-co-factsheet.xhtml) Data from website: http://www.diageo.com/NR/rdonlyres/E8BFE3FB-B7D8-461B-8E27-4D8449A1C350/0/DiageoFactSheet2006.pdf. Diageo is the leader in terms of revenues and global market share. In 2005, had a market share... This essay describes the Diageo company, that is a very well-known brand globally and markets all over the world that includes including Great Britain, Ireland, United States, Canada, Spain, Italy, Africa, Latin America, Australia, India and the Caribbean. It is stated by the researcher that Diageo is the world's leading premium drinks business with an outstanding collection of alcohol beverage brands across spirits, wine and beer categories. These brands include: Smirnoff, Johnnie Walker, Guinness, Baileys, J&B, Captain Morgan, Cuervo, Tanqueray, Crown Royal and Beaulieu Vineyard and Sterling Vineyards wines. The researcher then analyzes different marketing strategies that were used by the company, as well as discusses the analysis of the Diageo's competitors. This essay also provides the reader with PEST Analysis and SWOT analysis on the topic, discussing the topic of strengths and weaknesses and opportunities of the company as well as it's technological, social, political and cult ural aspects. In addition, the researcher provides his own recommendations on the topic and concluds that Diageo has always been in tune with the dynamic environment and has been able to strategize accordingly. This has made it a success story and a created a place for itself in the alcoholic beverage industry which is open to numerous sensitive and volatile issues. Selective acquisitions to support brand growth, on-going innovation and customer focus strategies will continue take Diageo on the path to success.

Evidence Research Paper Example | Topics and Well Written Essays - 1250 words - 1

Evidence - Research Paper Example While the $10 note serial number that was used by the undercover police officer had matched the one that the defendant was found possessing in his pocket after the drug was purchased, the discrepancy emanated from the description of the defendant by the â€Å"Eye† officer, who gave details such as the defendant being seen wearing a V-necked T-shirt, with a key on his chain and holding a ginger dale bottle (Weingarten, n.d.). The â€Å"Eye† officer further alleged to have seen the defendant from a distance of 50 to 60 feet, which in reality turned out to be 172 feet distance from the investigations that were later carried out (Weingarten, n.d.). Thus, it is the full disclosure of the evidence from the prosecution side, which allowed the defending side to realize the discrepancy and thus the consequent deceitfulness of the police officer. The purpose of broad disclosure is to help the defense and the prosecution side to prepare well for the case. Especially, broad disclos ure of the evidence held by the prosecution is required, to avoid surprises to the defense, during the trial (Ferdico, 72). Additionally, broad disclosure of evidence is necessary because; it is through the broad disclosure of the evidence, that any disparity and discrepancy can be identified, which then would serve to tell whether either side of the case is being genuine and truthful, or otherwise (Federal Judicial Center, 33). The broad disclosure is also essential, since it allows for the court to have both incriminating and exculpatory information, which then allows it to determine the guilt or otherwise of the defendant. Thus, it is through broad disclosure that a balanced case is enhanced, which then serves to identify the truth, and inform the necessary action by the courts. Various penalties have been set out for failing to give the broad disclosure of evidence, especially the exculpatory evidence, which could help the court determine that the defendant was not guilty, and t hus set him/her free. The first penalty is that; the court may order the party that did not make the necessary disclosure to do it at a specific time, place and manner (Gardner and Terry, 40). The court may also penalize the party that did not make the full disclosure, through allowing the opposing party some more time to go through the newly disclosed evidence, so that the party can prepare well for the trial. Thus, the party that failed to disclose evidence appropriately is punished through having the case being deferred to a later date (Keane and Paul, 63). Finally, the biggest and most punishing penalty that the party that failed to disclose appropriately might get is that, it may be prevented to use the evidence that it did not disclose to the opposing party in the case (Khan, 12). This means that; no matter how useful and convincing the evidence might be, the party will not take the advantage of such information to prove their case. However, there is some evidence that is exem pted from disclosure, which is provided under the exclusionary rule of evidence discovery. Under this rule, it is provided that; the work product of the government shall not be disclosed (Gardner and Terry, 44). This rule provides that any documents that have been made by the government in the course of the investigation or prosecution of the case shall remain confidential, and thus

Potato Salad Americans Essay Example for Free

Potato Salad Americans Essay Eating a Healthy Diet Assignment ? Try a New Recipe (10 pts) 1. Go to the Cooking Light website or any other website that gives you healthy recipes and chose a recipe you would like to try. Website you used: Cooking light . com Recipe you chose ? copy and paste the recipe including nutrition information in the space below. How to Make Potato Salad Americans can definitely agree on one thing: Potatoes are our favorite veggie. Each of us eats about a whopping 130 pounds per year. During the summer months (if not year-round), you can safely bet that loads of potatoes find their way into the ubiquitous potato salad. Honestly, can you have a cookout or picnic without one? Despite regional interpretations, theres really one basic way to make this popular dish. And here, well show you how to master the technique and turn out a variety of unique, healthy salads. Step One: Cut to Size Cut potatoes into uniform shapes and sizes so theyll cook evenly. If theyre different sizes, some will become mushy while others still have an undesirable crunch. Low-starch varieties, like red potatoes, work best in potato salads. Step Two: Start in Cold Water. Be sure to start with cold water when boiling potatoes. This works to solidify the outer surfaces and helps prevent them from getting too soft as the interior cooks, so the potatoes will hold their shape nicely in a potato salad. Step Three: Add Dressing Make the dressing while the potatoes cook, and toss them with the dressing while theyre still warm so theyll absorb maximum flavor. If using dairy products, like sour cream, allow the potatoes to cool slightly before tossing to prevent curdling. Step Four: Add Additional Flavors and Ingredients Customize your salad. For example, add your favorite veggies, fresh herbs, or salad greens. You can even give the salad an international flair: Lemongrass adds Thai flavor; chutney lends an Indian taste. 2. Try out the recipe, take a picture of you with the prepared meal and report back to class what you thought of this recipe. Would you recommend it? Will you make it again? Anything you would change the next time? To get full credit for this assignment, you need to show your picture to your instructor. Initial of instructor.

Treatments for Painful Neuropathy

Treatments for Painful Neuropathy Neuropathy is used as a medicinal phrase for nerve injury it is a common problem of type 1 and type 2 diabetic. It is estimated that up to twenty six percent of the people living with type 2 diabetes are said to have evidence of nerve damage after diabetic is diagnosed (Galer et al. 2000). It is however true that a generalized type of neuropathy that is commonly called the polyneuropathy as the most familiar category of diabetic neuropathy. The paper investigates whether the neuropathic pain has effect on the value of existence for the patient (Meijer et al. 2002). Painful neuropathy is considered as a progressive impediment of diabetes. Alternatively, the ordinary account of the illness may differ from discontinuous mild symptoms handling of aching diabetic neuropathy. Nevertheless, the process of selecting an agent is a challenge specified the breath of selections and the need of dependable strategy (Wild Green 2004). Due to the inconsistency of the symptoms patients remain untreated or undertreated. Connectively, different injuries or diseases can cause damage to the central or peripheral nervous structure and then create the neuropathic pain identified as (NP). It is difficult to treat and cure many other kinds of chronic pain clients with NP have better medicinal co-morbidity weight than gender and age familiar checks (Baron Gockel 2009). The challenges makes establishing the humane and monetary burden linked to NP testing. However, health-related quality of life (HR-QOL) is significantly impaired among clients with NP. Alternatively, it is assumed that Patients with PN and pain-related interference in numerous (HR-QOL) and useful domains together with condensed capability to work and reduced mobility owing to pain. Connectively, Spouses of NP patient have been liked with unpleasant communal penalty that related to NP (Sorensen et al. 2002). Roughly 25% of people with diabetes might be affected by chronic NP Patients frequently show with uneasiness, naturally from the distal feet, but progressing over time. Patients may illustrate signs of tingling, electric shocks burning, numbness, aching, or lancinating pains. (Wild Green 2004). The pain might be steady, alternating or associated with nocturnal deterioration. Patients might as well experience allodynia, (Schmader 2002). There are multiple patterns of diabetic neuropathy. Sensory polyneuropathy is the most common; however sensory motor neuropathies, small fibre neuropathies, focal neuropathies, demyelinating (chronic inflammatory demyelinating polyneuropathy), and vasculitic (amyotrophic) neuropathies might also occur (Baron Gockel 2009). Numerous mechanisms have been projected to describe the effects of hyperglycemia on nerve fibers, including metabolic derangement, oxidative stress, and ischemia. A complete re-evaluate of the fundamental pathogenesis and types of painful diabetic neuropathy is past the reach of this paper (Perkins et al. 2001). Despite the type, the strictness and clinical option might change for diabetic neuropathy. For several patients, the symptoms might turn out to be chronic and deteriorate with time. For some, however, there is steady upgrading and even resolution of pain (Freynhagen 2006). A decline in painful symptoms might imply nerve healing; however, progressive neuropathy may possibly also cause failure of feeling, knowledgeable as diminution of pain. Chronic painful diabetic neuropathy is identified to crash several magnitude of patient value of life, including humour, slumber, work, self-worth, and interpersonal affairs (Baron Gockel 2009). There are also considerable individual and societal costs from medications, health care visits, misplaced efficiency, and unfavourable events, even if the genuine monetary burden from painful diabetic neuropathy has not been differentiated from broad diabetic neuropathy (Torrance et al. 2006). Even though treatment of pain is vital for value of life, it must be measured only as one characteristic of general care. Symptoms of neuropathy might not associate with overall sickness development and therefore insistent treatment of the fundamental diabetes remains important. Control of glucose, lipids, blood pressure, and other micro vascular peril factors are essential for efficient lasting management of this illness. (Daniel et al. 2008) There are several handling options for pain in diabetic neuropathy however; few medications have been experimented in great, randomized, place bi-controlled or head-to-head trials. Explanation of the accessible information if mainly found to be tough since variables such as dosing applications, treatment duration, and the description of victorious cure might differ amongst studies (Sorensen et al 2002). Guiding principle and agreement statements are accessible, however, these recommendations regularly vary and several medications have unfavourable effects or relations with medications applied to treat diabetes. Furthermore, there are older medications, with the example of tricyclic antidepressants, which are generally used for aching diabetic neuropathy but have not been experienced in randomized clinical trials for this circumstance (Wild Green 2004). These older medications may be disqualified from optional guiding principle using harsh criterion regardless of their potential effe ctiveness and value. With these variables, the genuine performance of treatment for painful diabetic neuropathy might demonstrate intimidating results to clinicians and possible contributes to patients remaining undertreated or untreated (Bril Perkins 2002). When to Treat Painful Diabetic Neuropathy There are no clear guidelines for when to initiate symptomatic therapy, in part because treatment options do not alter the disease course. Patients quality of life can be diminished by painful diabetic neuropathy through disruption of work and home productivity, mobility, mood, interpersonal relationships, and sleep. Many of these variables are assessed in treatment trials for painful diabetic neuropathy and improve in parallel with the decrease in pain. Ideally, treatment should be initiated when patients identify that painful neuropathy is impairing activities of daily living and their quality of life. Successful management can decrease pain and improve quality of life (Bennett Backonja 2007). There are a few treatment principles that can be helpful for both the patient and clinician when beginning therapy for neuropathic pain. First, it is important to establish realistic treatment goals and expectations because therapies typically do not result in complete resolution of symptoms. Second, medication dosing must be tailored to the individual patient. The goal of treatment is symptom resolution, not a specific medication dose. Thus it is important to use the lowest effective dose for an individual. Further titration can be considered, but must be weighed against an increased risk of side effects. Finally, there are some data to support drug combinations in painful diabetic neuropathy but it is generally advisable to avoid polypharmacy when possible (Baron Gockel 2009). Conclusion The Treatment of PN can be tough for both clinicians and patients there are numerous diverse strategies that are available, however, contradictory information. Additionally, the value of accessible studies varies, at times with little facts and conflicting endpoints. As drugs are tested in the imminent years, such issues will be expected to persist, creation of medication assortment gradually more complex. Therefore, advancing the behavior approach that incorporates the accessible writing on efficiency, dose, contraindications, side effects, drug interactions, and cost is essential to direct clinicians in developing modified cure for the individual patient. However, this is not a complete evaluation of all probable treatments, but it is an inclusive, stepwise dialogue of the usage of some of the available drugs for painful diabetic neuropathy. The healing of symptoms ought to take place in combination with insistent treatment of diabetes and other related co morbid peril factors to d iminish development of the neuropathy. Future reviews will be necessary to integrate rising information from fresh studies and treatment options (Wild Green 2004). References Baron R Tolle T R Gockel U 2009, A cross-sectional cohort survey in 2100 patients with painful diabetic neuropathy and post herpetic neuralgia: differences in demographic data and sensory symptoms, Pain, pp, 121-152. Bennett M I Backonja M M 2007, Using screening tools to identify neuropathic pain, Pain, pp, 127-199 Bril V Perkins B A 2002, Validation of the Toronto Clinical Scoring System for diabetic polyneuropathy. Diabetes Care, 25: pp, 2048 –2052 Daniel H C, Narewska J, Serpell M 2008, Comparison of psychological and physical function in neuropathic pain and nociceptive pain: implications for cognitive behavioral pain management programs, Eur J Pain, pp 125-241. Freynhagen R Baron R Gockel U Tolle T R 2006, Pain detect: a new screening questionnaire to identify neuropathic components in patients with back pain, Curr Med Res Opin, pp, 126-362. Galer B S, Gianas A Jensen M P 2000, Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life, Diabetes Res Clin Pract, 47 pp, 123–128. Meijer, G., Smit, J., Sonderen, V., Groothoff, W., Eisma, H., Links, P 2002, Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the Diabetic Neuropathy Symptom score, Diabet Med, 19: pp, 962–965 Perkins BA Olaleye D Zinman B Bril V 2001, Simple screening tests for peripheral neuropathy in the diabetes clinic, Diabetes Care, 24: pp, 250 –256 Schmader K E 2002, Epidemiology and impact on quality of life of post herpetic neuralgia and painful diabetic neuropathy, Clin Pain, pp, 350 –354 Sorensen L, Molyneaux L, Yue D K 2002, Insensate versus painful diabetic neuropathy: the effects of height, gender, ethnicity and glycaemic control, Diabetes Res Clin Pract, 57 pp, 45–74. Torrance N, Smith B H, Bennett M I Lee A J 2006, The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey, J Pain, pp 281-297. Wild S Roglic G Green A 2004, Global prevalence of diabetes estimates for the year 2000 and projections for 2030, Diabetes Care, Pp, 25-83.

Killer Angels by Michael Shaara Essay -- Essays Papers US Civil War Es

Killer Angels by Michael Shaara Most people think of the Civil War as a military battle between the North and South. Without studying the subject, they do not appreciate the facts that make up this historical event. When one reads the novel, Killer Angels, the reader is given a much better perception and understanding of what actually happened during the war. Killer Angels, by Michael Shaara, is a realistic historical depiction of the great battle of Gettysburg, which left 50,000 Confederate and Union soldiers dead, wounded, or missing. The novel is set up in chronological order of events that took place during the four days of the bloody and decisive battle of the Civil War. The tale is told from an alternating north and south perspective. In this manner, readers can have a good mental picture of how each event came about. It even shows maps for a better understanding of each step the North and South took. It is clear where each of the battles were taking place and why the generals try to use the land for their own advantage. It was very interesting to read about the different strategies and tactics the generals utilized in the attempted destruction of their enemies. The well-deserved rave reviews that litter the front and back covers drew me to it, but Shaara's powerful writing style and stunningly human characters drew me into it. Shaara has an amazing ability to portray the major players of the battle, whose real personalities must have since been lost over a...

The Dialectic of Desire in the Films of Nicholas Ray Essay -- Films Mo

The Dialectic of Desire in the Films of Nicholas Ray Nicholas Ray's films frequently address a competition between a 'father' and 'son' (whether literal or figurative filial relationship). More importantly, Ray has an ideological approach to these struggles. In his films, homosocial struggles are always supplanted by Ray's desired outcome of an idealized heterosexual coupling. That is, the threat of prolonged homosocial desire between his characters is usually eradicated by the death of one of the dueling men. The deus ex machina nature of the deaths implies that the resulting heterosexual coupling is somehow the way things "ought to be". In Bitter Victory and The Lusty Men, the women are clearly the people over whom the men fight in their struggle to establish a 'home' or security (with that woman). In Rebel Without a Cause, however, the male-male-female love triangle is complicated by the on-screen presence of a nuclear family that effectively literalizes Freud's Oedipal conflict. Before examining homosocial desire in specific films, I must first outline the Freudian principles that gave birth to the term "homosocial". According to Eve Kosofsky Sedgwick, Freud's Oedipal triangle is established at an early stage of life when a child attempts to situate itself with respect to a powerful father and a beloved, subservient mother (Sedgwick 22). As such, "homo- and heterosexual outcomes in adults [are] the result of a complicated play of desire for and identification with the parent of each gender: the child routes its desire/identification through the mother to arrive at a role like the father's, or vice versa" (Sedgwick 22). Richard Klein summarizes this argument as follows: In the normal development of the little boy's p... ...ti-war film; it was a private psychological duel. I liked the idea that the outcome of the mission was really nothing to do with how they performed it, but with what they felt about each other" (qtd. in Eisenschitz 293). 3. The title itself is indicative of the ensuing battle over the men's homosocial desires. 4. Tellingly, Horace McCoy, the second screenwriter of the film, was found by producers Jerry Wald and Norman Krasna in the RKO Studio's screenwriters' file under "masculine relationships" (Eisenschitz 176). 5. It is safe to assume that Plato has already fallen off the proverbial cliff. He, too, is alienated from his father-a wealthy man who has spent much of Plato's life off gallivanting with his wife, leaving Plato to be reared by a nurse and guardian. http://www.film.queensu.ca/Critical/PhelanCox.html The Dialectic of Desire in the Films of Nicholas Ray Essay -- Films Mo The Dialectic of Desire in the Films of Nicholas Ray Nicholas Ray's films frequently address a competition between a 'father' and 'son' (whether literal or figurative filial relationship). More importantly, Ray has an ideological approach to these struggles. In his films, homosocial struggles are always supplanted by Ray's desired outcome of an idealized heterosexual coupling. That is, the threat of prolonged homosocial desire between his characters is usually eradicated by the death of one of the dueling men. The deus ex machina nature of the deaths implies that the resulting heterosexual coupling is somehow the way things "ought to be". In Bitter Victory and The Lusty Men, the women are clearly the people over whom the men fight in their struggle to establish a 'home' or security (with that woman). In Rebel Without a Cause, however, the male-male-female love triangle is complicated by the on-screen presence of a nuclear family that effectively literalizes Freud's Oedipal conflict. Before examining homosocial desire in specific films, I must first outline the Freudian principles that gave birth to the term "homosocial". According to Eve Kosofsky Sedgwick, Freud's Oedipal triangle is established at an early stage of life when a child attempts to situate itself with respect to a powerful father and a beloved, subservient mother (Sedgwick 22). As such, "homo- and heterosexual outcomes in adults [are] the result of a complicated play of desire for and identification with the parent of each gender: the child routes its desire/identification through the mother to arrive at a role like the father's, or vice versa" (Sedgwick 22). Richard Klein summarizes this argument as follows: In the normal development of the little boy's p... ...ti-war film; it was a private psychological duel. I liked the idea that the outcome of the mission was really nothing to do with how they performed it, but with what they felt about each other" (qtd. in Eisenschitz 293). 3. The title itself is indicative of the ensuing battle over the men's homosocial desires. 4. Tellingly, Horace McCoy, the second screenwriter of the film, was found by producers Jerry Wald and Norman Krasna in the RKO Studio's screenwriters' file under "masculine relationships" (Eisenschitz 176). 5. It is safe to assume that Plato has already fallen off the proverbial cliff. He, too, is alienated from his father-a wealthy man who has spent much of Plato's life off gallivanting with his wife, leaving Plato to be reared by a nurse and guardian. http://www.film.queensu.ca/Critical/PhelanCox.html

Hypotheses on the Extinction of Dinosaurs Essays -- Exploratory Essays

Hypotheses on the Extinction of Dinosaurs In the early nineteen hundreds, dinosaur fossils were discovered and recognized around the globe. Greedy scientists and civilians, searching for their own prize skeleton, rushed to rip bones out of the ground, destroying the fossils as they went. It was not until later in the century that scientists and paleontologists began pondering how such widespread creatures disappeared. Currently, paleontologists debate the two main hypotheses of how the classic dinosaurs died: from volcanic activity or an asteroid impact. Although they result in the same outcome, the volcanic and asteroid hypotheses differ in key elements: the actual event, the environment's stress, and the impact on life. Physical evidence left behind in each scenario supports each possible explanation for the massive extinction responsible for wiping out the dinosaurs. Scientists that support the volcanic activity hypothesis believe the massive volcanic activity lasted approximately 500,000 years eventually ending dinosaurs reign on earth. The lava flows filled over 480,000 cubic miles, devastating areas over the entire globe. For example, The Decan Trap, a famous site of Cretaceous tectonic activity, is up to 8,000 feet deep, and it averaged between thirty-three and 164 feet deep. Fires raged across the lands. Those that believe in the asteroid impact, on the other hand, project a six mile wide meteorite moved at speeds from 50,000 mph to 150,000 mph and busted into Earth's atmosphere at the end of the Cretaceous Period. The sudden impact near the present day Yucatan Peninsula ejected 5,000 cubic miles of debris into the atmosphere and created an earthquake of magnitude thirteen sending tidal waves, 250 to 300 feet high... ...sms alike. Conversely, paleontologists backing the asteroid hypothesis guess the massive blast killed nearby animals instantaneously. Creatures on the opposite side of the world, however, were not so lucky. They were forced to dwell in freezing temperatures until vegetation withered. Herbivores quickly starved to death; consequently, carnivores lacked prey. Instead of gradually dying off, dinosaurs perished within one generation. Although the two hypotheses of the great extinction come from opposite occurrences, in the end the event proved fatal. While paleontologists may never agree on the true cause of dinosaurs' extinction, many people are now speculating mankind's termination. Will mother nature be responsible for our destruction also? Only time will tell. Perhaps in the far future, another species will encounter human remains and search for our match maker.

What are the land uses of the CBD of Rugby?

The Transects 5 transects were chosen across Rugby CBD for the project. These transects were chosen because they crossed/went along main roads/main pedestrian walkways through the central business district. 5 were chosen because a significant number was needed to get an accurate picture of Rugby CBD, as just 2/3 transects could not cover the variety of areas in Rugby CBD. See a map with the transects on below (fig. 1). What are the land uses of the CBD of Rugby? The land uses of the central business district of Rugby would help me to determine whether the land uses of Rugby fit the core frame model. To do this, 5 transects would have to be drawn up [see above] that stretched out of Rugby CBD in several different directions, covering the presumed zones of discard and assimilation – presumed by scientific bios. I marked on a map (fig. 2) all of the different land uses, and constructed a key to help identify the different land uses. With the different keys, and every land plot owned recorded, the land uses of Rugby could be easily determined, and this would help me determine the areas of assimilation and discard. Is there a relationship between land use and peak pedestrian flow? To discover whether there was a relationship between the above, a point was selected along each transect , approximately the same distance from the centre point of Rugby CBD. One each of these points, the amount of people were counted that went past in 5 minutes. 5 minutes was chosen, as it would provide a far more accurate number than 1 minute would. However, 10 minutes wasn't chosen as it would take a very long time. The survey was done to show whether certain areas of Rugby had a higher pedestrian flow than others – e.g. if the high order retail areas had a higher pedestrian flow, or lower. A tally chart was made to count the number of people that went past on each transect, and a stop watch was used to time the five minutes, ensuring the survey was accurate. What is the building quality like in the central business district of Rugby, and how does it change with distance from the CBD? For this question, a survey had to be done on the building quality of Rugby within the central business district. The centre of the town and the edge of the central business district were both analysed. Two very different areas (edge of town, and middle) were done to see if there would be a contrast in the building quality, and if the quality changed with distance from the CBD. On the survey (fig. 3) there were several conditions which ranged from Material (whether attractive or clean) to the Landscape (trees/grass/plants). These factors were chosen because they seemed to be the most crucial to analysing the building quality of Rugby CBD. A rating system was used that stretched from -3 to 3, as this would be an easy way to show the variations in quality as the distance from the CBD increased. Traffic flow in Rugby CBD To discover whether the traffic flow changed throughout the CBD, a point was chosen along each transect in the CBD. This point was chosen by taking the centre of the CBD, and deciding an equal distance along each transect that was also by a road (as for some of the transects most of it was in pedestrian only areas). The amount of cars, vans and public transport vehicles were counted on each transect of a period of five minutes, timed by a stop clock. 5 minutes was used as the time period as a time length of 1 minute would not provide as accurate results, and 10 minutes would be too long. Each transect had its own tally chart and table so that the results could be compared and would easily display the differenced between the transects regarding the amount of traffic flowing through each area and also what kinds of traffic is flowing – cars etc.

Working in teams

When working in teams there are many factors that can lead to success or failure to achieving the goals of the team. Understanding the objective, having the proper resources, and trust within the team are some. Having trust is one of the most important factors in team success. Trust within the team can lead to everyone being comfortable knowing the project will be accomplished and knowing assigned parts will be completed. Distrust within the team can lead to personal problems and can hinder the project not being completed. Working on teams can be very stressful. A team member has to meet the team, discuss the project, figure out who will do what part of the project, and manage your normal tasks at work while completing the new work that is associated with the team project. Stress is added automatically because a team member would naturally want to do a good job on the team project and that people are going to rely on you to complete your part but you also have to worry that the others on the team are going to do their part. Distrust on a team can lead to many problems. Not having trust in your team can lead to arguments within the team and not being able to work with that person or even the entire group. Distrust can lead to a person doing his part of the assigned project and can also lead to that person doing other parts of the project not assigned to them causing friction. Another possible result from having distrust in the team dynamic is the ability to influence others. A person with influence can bring doubt in the group or persuade others to have doubt in one or more people on the team that could result in the team turning a person or even getting a person or persons thrown out of the group. To answer the question is trust assumed or is it earned within a team. Ruth H. Axelrod answered the question by researching various philosophers and professors and they all noted a person has to have the following traits to garner trust. Ruth’s discoveries say trust has to be earned. She noted one has to show good character, honesty, integrity, must be dependable, and must be reliable. These findings were published in her paper Deciding To Trust a Stranger. I agree that trust has to be earned. It is good to come to a team project with an open mind and no preconceived thoughts but everyone in the team will still have to show they can pull his or her weight and work as a team. Trust can lost be lost while working on a team very easily. One simple mishap like not showing up for a scheduled meeting or not being prepared can cause the team to lose trust within an individual. Always being present to a scheduled meeting is very important. Missing a meeting could lead to missing an important update or new deadline for the project. Not being prepared shows the team you are not engaged in the project, the work assigned to you is too much for you to handle, or you simply do not care for the project or the others on your team. It is easy to keep trust among your team. If you do you what is asked and expected of you the team will have trust in you. If you treat everyone with respect and provide support the team will trust you. Taken from the paper again, if a person shows the qualities of being dependable, being reliable, and having integrity trust will be maintained within the team.

Lennie & George in “Of Mice & Men” Essay

In the story â€Å"Of Mice & Men†, John Steinbeck creates a pair of low-class companionship as the story’s main character. This pair of companionship, George and Lennie is very different from each other, nothing alike, no matter talking about their figures, personality, IQ, etc, except that they both carry the same American dream as they spend their hard days traveling together and working in the ranch. Lennie is portrayed as being childlike. He looks up on George as a parental figure: â€Å"Lennie’s lips quivered and tears started in his eyes.† Lennie seek reassurance from George like a child does from their parents. He displays the excitement of a child: â€Å"Tell me about the rabbits, George. Tell me about the rabbits.† Steinbeck suggests that Lennie’s dependent on George and that we all need companionship even if the relationship is unequal. Not only is Lennie portrayed as being childlike, but also very forgetful: â€Å"I forgot, tried not to forget. Honest to god I did George†. Lennie always gets in trouble, and always needs George to help him out.: â€Å"Course you did. Well, look Lennie— if you jus’ happen to get in trouble like u always done before, I want you to come right here and hide in the bush†. Not only does he make himself in trouble but also gives trouble to George: â€Å"An’ whatta I got, I got you! You can’t keep a job and you lose me ever’ job I get. Steinbeck wants to give the readers a hint or preparation that a serious event is going to occur with Lennie, he also wants to convey that although Lennie is big, it doesn’t mean that he has a big brain nor can he be independent and look after himself. Lennie is also being put in a character with characteristic’s like an animal: â€Å"His huge companion dropped his blankets and flung himself down and drank from the green pool; drank with long gulps, snorting into the water like a horse.† Lennie enjoys keeping mice, but as a result always kills it:† They were so little, I’d pet them, and pretty soon they bit my fingers and I pinch they heads a little and they was dead— because they were so little.† Steinbeck wants to show that a big man also has a sensitive side, and that being strong also has disadvantages, especially for Lennie who enjoys to pet mice and as a result kills it very quickly due to his big, strong hands. Lennie’s physique is described by Steinbeck as being big, strong looking, but is also described to have body parts in which imitating an animal: â€Å"A huge man, shapeless of face, with large, pale eyes, with wide, sloping shoulders; and he walked heavily, dragging his feet a little, the way a bear drags his paws.† Although Lennie is very immature, but he is a very helpful and great worker : â€Å"Say, you sure was right about him. Maybe he ain’t bright, but I never seen such a worker.He damn near killed his partner buckin’barley. There ain’t nobody can keep up with him. God, awmighty I never seen such a strong guy.† Steinbck points out that even an immature, childish man like Lennie with low IQ, can also work better than a normal man, and that we should always give a chance to people like Lennie to work like a normal person with no prejudice against them. Lennie is a very simple minded man, and does whatever George tells him to do. He never thinks for himself and won’t bother to rate if it was dangerous or not, he simply just does as he says, like master and servant: â€Å"Tell you what made me stop that One day a bunch of guys were standin’ around Sacramento River.I was feelin’pretty smart. I turned to Lennie and says â€Å"Jump in† and he jumps, couldn’t swim a stroke. He damned near drowned before we could get him.† Not only does Lennie always listen to Georges demands, but he also never rejects him and never dares to argue with him. â€Å"He never got mad with it neither. I’ve beat the hell outa him, and he could bust every bone in me just with his one han’, but he never lifted a finger against me†. Steinbeck expresses to readers that Lennie looks up at George at a higher status, like an idol and believes that whatever George tells him to do, is  for his own good, which is why he listens to George not minding if it is dangerous or not. Where as the other main character in the story â€Å"Of Mice & Men†, known as George, is totally different from Lennie. George is suggested to protect Lennie too much, and that he doesn’t let Lennie talk when he is suppose to. When he sells Lennie too much, people might mistaken that George is hiding something about Lennie.: â€Å"Then why don’t you let him answer? What you trying to put over?†. George also uses a special technique to make Lennie listen to him, from this technique he gives pressure to Lennie so that he will always keep George’s words in mind.: â€Å"But you ain’t gonna get in no trouble, because if you do, I won’t let you tend the rabbits.† Steinbeck points out that George is protecting Lennie too much, and that he should always let him try and let him communicate more, socialize more and approach the outside world more, or else he would depend on George too much and takes it as an advantage. George is also suggested to be smart, and has a lot of common sense. He uses his sensitive sensitivity to teach and lead Lennie to the right track: â€Å"Tastes all right, don’t really seem to be running though. You never oughta drink water when it ain’t running, Lennie.† Not only is George sensitive but he is also very smart in the ability to judge correctly: â€Å"You never had none, you crazy bastard. I got both of ’em here. Think I let you carry your own work card?† Steinbeck shows the readers that it is an advantage for Lennie to be looked after by George, for George has the power to untie him from troubles he makes, and knows what’s best for him. Steinbeck also tells the readers, that the people with the same problems as Lennie should always be helped and be guided to the right way, instead of being discriminated. George also gets very fed up with Lennie sometimes, having to escape with Lennie from the troubles Lennie has caused from time to time.: â€Å"God a’mighty, if I was to live alone I could live so easy. I could get a job and  work, and no trouble. No mess at all, and when the end of the month come I could take my fifty bucks and go into town and get whatever I want.† But on the other hand, he also cares a lot about Lennie’s feelings, and always persuades him to think towards the positive side when Lennie is depressed.: â€Å"Aw, Lennie! I ain’t taking it away jus’ for meanness. That mouse ain’t fresh, Lennie; and besides, you’ve broke it pettin’ it. You get another mouse that’s fresh and I’ll let you keep it a while.† Steinbeck suggests that in order to be companionships, we will have to care for one and another’s feelings, Steinbeck also coveys that there aren’t any perfect pair of companionship, for there has to be arguments between people, since humans are born with these characteristics. George having to be a trustworthy companionship with Lennie, always believes in his partner no matter what happens. He will always trust Lennie for whatever he does, and the decisions he makes.: â€Å"Lennie never done it in meanness. All the time he done bad things, but never done one of them mean.† George makes the relationship between Lennie and him like a family, George tells Lennie about their dreams, and how they are different to other people, as if it’s going to come true. George gives hope to Lennie making him feel better and have a target so that he won’t feel that he is working for nothing and that they are working to make their dream come true.: † But not us! An’ why? Because †¦because I got you to look after me, and you got me to look after you, and that’s why†¦Ã¢â‚¬ ¦Ã¢â‚¬ . Steinbeck tells the readers that although these low-class workers are poor and lonely, they haven’t got a stable home. But George and Lennie are different. For they carry a hope, a dream. This is why George and Lennie are never lonely. Steinbeck also suggests that an American dream in those days, does not come true easily. Overall I think that John Steinbeck wants us to know that we should use Lennie and George as an example to how we should treat people with the same problems as Lennie is facing. Instead of discriminating them, we should always give them a hand of trust to help them. John Steinbeck also suggests  that although Lennie may have mental problems, but from this information, it doesn’t mean that Lennie is useless. He may be stupid, but he is very hard working and may be better than most normal workers working in the ranch. John Steinbeck also wants us to know that although people like Lennie often creates serious problems due to his stupidity, this doesn’t suggest that he can use his low IQ, and stupidity as an excuse to not face the problem and just find another job, not caring what he had done before.

Divorce †Cause and Effect Essay

Before a marriage is fully â€Å"matured† 3 out of 10 fail and resort in a divorce. No child want’s to hear the word divorce mentioned by their parents, little alone the other spouse. Many now a days seek divorce as an â€Å"easy way out,† given that they have an annulment. Some may even cheat the system and get married for the spouses money, title, or objects. The marriages that are there just for show, don’t tend to last as long and become unhappy. In a marriage anything can go wrong from bad communication, cheating, and abuse. Fyodor Dostoyevsky, once a Russian novelist said, â€Å"much unhappiness come into the world because of bewilderment and things left unsaid.† The number one reason marriages end is because of the lack of communication in the relation, according to Huffington Post. There are five main instances where a lack of communication can affect the marriage. The first one, is hiding your feelings. If you’re having a heated conv ersation with your spouse but keeping in feelings or problems then where is your relationship going to go? Oh I can help, nowhere. The next type is bodily or physical. Simply rolling your eyes, walking away from the conversation, shrugging your shoulder, or even the lack of eye contact can push someone away. A â€Å"win-lose attitude† is one of the most aggravating things for someone to do, personally. If someone always says, â€Å"it wasn’t me,† if they’re judgemental or a very negative person it can agitate you and even bring you down. Lastly a lack of politeness can make someone feel underappreciated. If you continuously do something for someone and they correspond in a uncaring manner you will tend to feel over time like you don’t matter. The simple command, like â€Å"take the dog out,† can seem abrasive. They’re no such thing as over kindness, if someone does something nice for you, you can just simply correspond with a â€Å"thank you.† â€Å"Thank you honey,† any house wife, or husband would love to hear of their spouse. Just by keeping the à ¢â‚¬Å"spark† between you and your spouse lite can help keep them interested in you, instead of others. Infidelity is the cause for 53% of a divorce. Only 31% of marriages last after a cheating incident, and a whopping 53% of relationships are cheated. Isn’t it ironic though how psychiatrists and marriage counselors are the top two professions for the divorce rate. you would think since they work with helping marriages, that they’d have a lower chance, I guess not in this case. Many events can lead to infidelity. After the first year in the marriage there is the same  habitual activities every day where the cheater may feel like they need something new in life, which is when someone may first turn to cheat. Having a child is a huge factor, it’ll affect the relationship no matter what you have done. The stress of having to completely care for another human being can affect you mentally, and some feel like they want to go out and have an adventure, but they turn to the wrong activity when that happens. When it comes to the 5th to 7th year, also known as â€Å"the seven year itch.† By this time most coup les may have obtained the â€Å"american dream,† but they start to become bored and unhappy, so they turn to something new, to change things up. Then there’s the mid-life crisis. Generally around this time you’ve spent 20 years with the person, but you’re just not quite sure that another 20 you want to be with the person. These instances are generally the reasons which fuels someone to cheat. It’s not always the case, but these are the times when infidelity is started. Just picture 5 million women, which is just a quarter of women in a marriage. That mere 25% is the percentage of women that have been in a abusive relationship. There’s six different way abuse can happen, the following are: physical, emotional, verbal, economic, mental, and sexual.Why do they do it? They seek to control their spouse. Emotional, mental, and verbal is generally how it starts, but then it can progress to sexual and economic. It can be hard for These types of abuse though don’t always pertain to the spouse, it could be happening to a child or children of the couple. To say divorce only affects the two joined in holy matrimony is an unstatement. The children, friends, family, everyone thats connected to the two can be effected. As a child that has divorced parent, since I was two, can say it still affects me. I have to figure out a time during break when I can go that doesn’t conflict too much with my sports, I barely get to see my dad, and it’s hard to see my mom work and earn all of the money, by herself for us. So if you don’t want your marriage to end try to keep good communication a priority, whatever you do don’t cheat, and be sure to check if you’re being or are abusive, so you can get help to work on it. Sources Facts, Infidelity. â€Å"Infidelity Facts and Information.† Infidelity Facts. n.d. 27 March 2014. Pave, Project. â€Å"6 Types of Abuse.† Just for Teens. n.d. 27 March 2014. Post, Huffington. â€Å"Divorce Causes: 5 Communication Habits That Lead To Divorce.† November 29, 2012. HuffPost. 27 March 2014.

Analyze compare and contrast two books Research Paper

Analyze compare and contrast two books - Research Paper Example John who is Ann’s mother and the Red Girl. Anne is the main character who dominates the whole novel and the story is told in her own subjective voice. The author depicts Anne as an arrogant and complex being who struggles to survive and define her own separate world from that of her mother. Anne is seen to develop as a character as she struggles with the fear of separation from her mother, becomes an expert in marbles and eventually develops hatred and anger as she rebels against her mother’s attempts to define her world (Kincaid 32). Mrs. John’s character is developed and defined by Ann through her subjective narration. She is initially portrayed as a person who is strong, wonderful, kind and full of knowledge about the societal norms and values. Anne develops bitterness and hatred towards Mrs. John when she repeatedly tells her that they are two separate beings. In addition to this, Anne points to her mother’s sexual relationship with her husband as the reasons for her alienation and neglect. The Red Girl on the other hand is developed as a character that represents the outside world and does not have to adhere to the societal norms and values. The Red Girl represents the new world which Anne dreams of creating and she becomes a key figure in Anne’s development as a character by offering her a sense of self. The major characters in The portrait of a young artist as a young man by James Joyce includes: Stephen Dedalus, Simon Dedalus, Emma Clery, Cranly and Charles Stewart Parnell. Stephen Dedalus, the main character in the novel, is developed as a highly sensitive individual. He has the advantage of a quality education but is portrayed to be living in isolation and deprivation amidst the oppressive colonial nationality, highly developed social immorality and extremist family and religious values. Just like Anne in Annie John by Jamaica Kincaid, Stephen feels trapped and seeks escape by abandoning the restrictive societal norm s and living freely as an artist. As a character, Stephen undergoes growth, development and transformation as the story progresses. His transformations occurs in various stages starting in his first year in college where he demonstrates that he is an intellectual person with his understanding of societal systems and begins to create a different perception of his environment (Joyce 32). Another transformation occurs when Stephen engages in sexual intercourse with the prostitute in Dublin which transforms his from innocence to promiscuity according to the societal values. The third transformation was motivated by Father Arnall’s speech regarding the concept of death and hell which led to his conversion from a sinner to a Catholic. His final transformation indicates his maturity as a conscious individual when he changes his obsession from religion and focuses on the appreciation of art and beauty. Thematic analysis Themes refer to the major topic or subject in a piece of literat ure. The themes in Annie John by Jamaica Kincaid include the relationships between mother and daughter, colonization and the impact of colonial education and the various gender relations in the society. The main theme is the relationship between mother and child where Kincaid develops the complex relationship between Anne and her mother in her childhood and adolescence. As a result of the closeness of their relationship, Anne encounters several challenges and tension as she