First Breath Last Breath by Antler Analysis Essay

â€Å"First Breath Last Breath† is a poem written by Antler. The central theme of this poem is the beginning and the end of life. Antler manages to translate through words the cycle of life, using two characters the baby boy and the mother. The characters are connected in life through a strong relationship. The cycle is presented by the event of birth of a child and the death of the mother who gave him life. This poem is also about love, the love between a mother and her â€Å"baby boy†. The title of the poem â€Å"First Breath Last Breath† is composed of two parts. Breath† by definition it means the air inhaled and exhaled in respiration but it also means life, spirit or vitality. First part is â€Å"First Breath† means the beginning (â€Å"first†) of life (â€Å"breath†) and second part â€Å"Last Breath† means the end (â€Å"last†) of life (â€Å"breath†). The first part is also present in the first stanza in the ninth line â€Å"his first breath on Earth† emphasizing the topic of the first stanza – the beginning. The second part is present as well in the poem, in the second stanza, ninth line â€Å"exhales her last breath† emphasizing the second part of the title and also the topic of the second stanza – the end. An important aspect is the structure of the poem. It is composed of two stanzas, each stanza containing one sentence that is broken up at various intervals. Both stanzas have each ten lines. The intervals that the sentences are broken differ from line to line, the longest line being 8 syllables and the shortest being 3 syllables. This structure gives the author flexibility, writing this poem like he is writing a story. He is breaking up the sentence into various intervals in order to create â€Å"musicality† among the last words of each line. We could say that a summary of the poem can be composed of the first line and the last two lines of each stanza: â€Å"When a baby boy is born/†¦/his first breath on Earth/the Mother breathes it. † and â€Å"And when the Mother dies,/†¦/exhales her last breath,/her son inhales it. † The voice in this poem is the poet’s voice. He is invoking a sad, melancholic tone emphasized by the words â€Å"dies†, â€Å"last breath†, â€Å"grew up†. It is possible for the poet himself to transpose with the baby boy, showing his gratitude and love for his mother. It is just a supposition to say this because the verbs and pronouns are all used at the third person: â€Å"he†, â€Å"it†, â€Å"breathes†, â€Å"dies† etc. The third person mode along with the fact that there are no particular names given to the personages (â€Å"baby†, â€Å"midwife†, â€Å"Mother†) demonstrates that this poem is not about a particular story it is about every one of us. The place where all the events in this poem happen is unknown. The only word that answers the question: â€Å"Where? † is â€Å"on Earth† used in the first stanza ninth line. Although it answers the question â€Å"Where? the meaning of the words is to emphasize the importance of baby’s first breath. Putting into the equation the fact that the poem was written in 21st century and also the fact that the majority of events of this kind happen in a hospital, we can suppose that that is the location. One of the most important characteristic of this poem is antithetic view of the first and second stanza. In the first stanza it is about life, â€Å"baby boy is born†, â€Å"first breath† in comparison with the second stanza where it is about death, â€Å"Mother dies†, â€Å"last breath†. The poet creates a perfect antithetical symmetry using opposite words in the same location. For example: â€Å"When a baby boy is born† (location: first stanza, first line ) in comparison with â€Å"And when the Mother dies† (location: second stanza, first line), â€Å"his first breath on Earth† (location: first stanza, ninth line) in comparison with â€Å"exhales her last breath† (location: second stanza, ninth line). Another particularity of this poem is the transposition between the mother and the son used in the last line of first and second stanza: â€Å"the Mother breathes it† transposed into â€Å"her son inhales it†. In the first line of the first stanza we can identify an image of a baby boy born containing two monosyllable words â€Å"boy† and â€Å"born† that elongate the line with the help of the literary device alliteration: â€Å"baby boy born†. The first line also expresses the time when the next events will happen with the help of the adverb â€Å"when† identified at the beginning of the line. In the second line through enjambment technique â€Å"the story† it is continued with the presentation of an episodic personage, â€Å"the midwife† – the woman skilled in aiding the delivery of babies. As we continue with the third, fourth and fifth line the first important thing happens: the boy takes his first breath. Here we encounter the conjugation of the pronoun â€Å"he† – â€Å"he†, â€Å"his†, â€Å"him†. In the third line we encounter another alliteration â€Å"holds him†. The coma at the end of the fifth line delimitates the first event: the boy takes his first breath – from the second event: â€Å"the Mother breathes it†. It also expresses a short pause in speech. The fifth line is end stopped. The words â€Å"first breath† are also repeated in the ninth line in order to emphasize the importance of these words. First breath can also be translated into the beginning of life. If the first four verses were imagistic the fifth verse it is more auditory – the sound of breath. The second event starts with the movement of the child near his mother. This second event also uses the technique of enjambment and it is in symmetry with the first event having five lines as well. In the seventh line the author introduces the word mother with a capital M and using â€Å"the† an indefinite article. He uses this technique in order to express the connection between the Mother and her child and in order to particularize her as an important person in this poem. In the sixth and the seventh line the author shows how small the baby is by placing him near â€Å"the Mother’s face†. In the last line of the stanza the poet is using a figure of speech â€Å"the Mother breathes it† to show the connection that the baby just born made with his mother, to show the love between the mother and her child and to show how close the mother was to the baby. The second stanza starts with the conjunction â€Å"and† in order for the poet to emphasize the continuation of the story, to show what happens after, what is the next episode after the birth of the child. Through symmetry technique he again expresses the time when the events are occurring using the adverb â€Å"when†, but this time it happens â€Å"when the Mother dies†. The coma at the end of this line shows that there will be a short explanation, and also a short pause in speech. In the second line the poet shows us how much time has passed indicating that the â€Å"baby boy† from the first stanza is now a â€Å"middle-aged son†. The third verse expresses the admiration of the baby boy who grew up. The hyphen used at the end of this verse indicate a possible different continuation, indicate a longer pause where the reader can think about what the boy has become. The answer of the third line is given in the fourth line showing the admiration and love of the child for his mother: â€Å"†¦ grew up to be –/by her side,†. Through parallelism technique the author shows in the fifth line how the son placed his head next to his mother’s head: â€Å"his head next to her head†. Here are also present two alliterations: â€Å"his head†, â€Å"her head†. The hyphen at the end of the line indicates a longer pause. In the sixth line he again uses parallelism technique to show how close and how alike the mother and the son are: â€Å"follows her†¦with his†¦Ã¢â‚¬ . In the seventh and eighth line the author describes in a slower tone how the mother dies. In the last line of the second stanza the poet is using a figure of speech â€Å"her son inhales it† to express that the connection is never lost between the son and his mother. The poem is framed around the boy, because he is the one whom at the beginning of his life he is near his mother (â€Å"place him over/the Mother’s face†), during all his life he stands by his mother (â€Å"the baby grew up to be–/by her side†) and at the end of his mother’s life he is still near her (â€Å"And when the other dies/†¦/his head next to her head—â€Å"). When the baby boy takes his first breath it represents new life/vitality . The fact that the son â€Å"inhales† â€Å"her last breath† can have one other signification. By the definition breath means also spirit, and the son might inhale her spirit to always be with her, to always remember her. Both the mother and the son can be seen as a single organism, always close to each other, unity being powerfully emphasized in the words â€Å"follows her breathing with his breath†.

Mexican American and Poem Legal Alien Essay

Ora is in the open poem form, it has no stanzas. It does have a few words that rhyme which are â€Å"English† (5) and â€Å"Spanish† (6) and also with â€Å"Mexicans† (14) and then with â€Å"Americans† (15). The poem also has rhythm, it is a low steady beat. It is a straightforward poem about how life is for a person with the same race/ethnicity as others and at the same time, different from others. The poem â€Å"Legal Alien† is about a woman of Mexican parents, who is born and raised in America. An American citizen established by law, but at the same time this person feels like an illegal alien because of how some people treat her. She is fluent in both, English and in Spanish. Feels American because she is, but at the same time she doesn’t. She is looked at by Americans (Anglos) as inferior, and looked at by Mexicans like she doesn’t belong. They make her feel like she is not one of them, like she doesn’t fit anywhere. â€Å"An American to Mexicans a Mexican to Americans a handy token sliding back and forth between the fringes of both worlds† (14-18).Wha Rosa PantojaPeriod 110/9/12Ms. HamptonAmerican literatureLegal Alien EssayThe beliefs of the contemporary time period is that the voices of all cultures, ethnicgroups, gender, and nationalities should be heard and poetry is universal and speaks to allpeople regardless of their background. In the poem Legal Alien by Pat Mora, the literary devicesthat Pat Mora uses are metaphor and personification. These literary devices help reveal the author’s message to the audience which are the Mexican-Americans. The metaphor show thatbeing Mexican-American has its advantages and the personification shows the disadvantages of how people view Mexican-American.Pat Mora uses metaphor to reveal the message that being Mexican-Americans has anadvantage to the audience. In line 16 â€Å"a handy token sliding back and forth betwee. n the fringes of both worlds†¦Ã¢â‚¬  this is a metaphor because she is comparing herself to a token. She comparesherself to a token because tokens usually have two sides to it, and she is implying that she alsohas two sides because she is Mexican and American. P at Mora uses â€Å"handy token† because she says that it is an advantage because she can go between the borders of being Mexican andbeing American. Pat uses the word â€Å"fringes† instead of using the word border because the fringe is bringing both sides of the world together and a border separates the two worlds of Americans and Mexicans, and by her being Mexican- American she is bringing both of thoseworlds togethe.

To Spy or Not to Spy on Software Company Globe Alive, Inc Case Study

To Spy or Not to Spy on Software Company Globe Alive, Inc - Case Study Example The company has more than 150 employees. Its vision is to be a leading company that assists in the network design and servicing of Canadian firms who were conducting business in a foreign country. Several issues exist in the enterprise. It needs to address them for it to succeed in the software industry. According to the CEO, the company needs an appropriate technology to solve its issues. The human resource department has noted that technology cannot build a team-oriented workforce (Mondy, Noe, & Gowan, 2005). The production manager and the Operations Manager agree that it is impossible to build trust between management and subordinate staff members if the company embraces the spyware usage. Helmut Schwartz is a technological person with a vast experience and education in Information Technology. He thus believes that, based on his experience, technology will go a long way in the growth of the Globe Alive company. However, he faces a lot of resistance from the other executives against new ideas and a lack of innovative thinking at the firm. Schwartz embraces more expansive and modern strategic philosophies, unlike the previous CEO. He wants all employees to embrace creative t hinking in their operations. Additionally, Schwartz spies employees to ensure they are not wasting time. On the other hand, Stuart Miller has a rich background in human resource management. He believes that embracing appropriate human resource strategies is the best way of moving the firm ahead. He thus proposes the use of Human Resource metric services in measuring turnover, resignation rates, sick days, and other parameters. The human resource manager impressed the members of the executive team by his presentation of an innovative idea of analytics and tracking data of employees. However, the CEO presentation of surveillance software failed to impress them. Various symptoms suggest that GAI Company is experiencing some problems. The company lacks an efficient communication with global partners.  

Carnival Cruise - Case 16 Study Example | Topics and Well Written Essays - 1000 words

Carnival Cruise - 16 - Case Study Example These forces include threats from new entrants in to the market, bargaining powers of the customers or the buyers, threats emanating from substitutes that could be products or services, bargaining power of the suppliers, the level of rivalry among the competing companies, and the relative power of unions. The competitive forces vary from country to country in the same way that industries vary. For instance, threats of entrants into an industry are not the same in different countries and are mostly dependent on the development of the host country or the market in question. Here, there would be a higher threat from new entrants for an organization operating in the U.K than one operating in a developing country. The competitive forces have a high rating while others have low rating. First, threat of new entrants is a high rate risk for businesses especially those operating in highly profitable markets. This is because these markets have the potential to attract new firms that lead to erosion of profit making capabilities for the existing organizations. To respond to these threats, the incumbents should have pre-established entry barriers such as economies of scale failure to which profitability suffers. Second, the bargaining power of the buyers is a high rate risk. It is the idea of the buyers driving the prices down. It is a high risk especially in the areas where there are few powerful buyers. These buyers have the capacity to dictate terms that determine the prices of the goods offered. In addition, when the cost for switching to another buyer is low, then the power of the buyers is significantly low with respect to determining the prices offered. Therefore, the number of powerful indiv idual buyers in a specified market determines the prices of the products. Third, substitute threats can also be rated as high risks. This is because the existence of substitutes increases the likelihood of the customers switching to them leading to loss and loss of

Tyrannical Manner of Governance and the French Revolution Essay

Tyrannical Manner of Governance and the French Revolution - Essay Example The Declaration of the Rights of Man and Citizens provides that everyone is entitled to their opinion. They should not find any disturbance, provided they maintain public order. In addition, Robespierre made comparisons of terror to other principles of the society. Such principles included justice and promptness in the achievement of democracy. According to him, there was an urgency in the application of democracy and the use of terror could lead to the production of the virtues of democracy. The declaration provides the prohibition of injurious actions to the society and that only the law stipulates the requirements of the actions of the society. In my opinion, I disagree with Robespierre that the terror was necessary. This is because he provoked and assumed the strong beliefs and feelings of the people, in relation to their rights. It was wrong for the Robespierre to make terror a government policy for the achievement of political goals. In today’s world, governments are putting efforts to ensure the elimination of terror. I consider the status of the French revolution as a terrorist act, where the government is the mastermind of the terror attack. Robespierre himself was a lawyer and his job entailed the protection of the constitution. He knew that it was a criminal offense to take action to a criminal through mob violence. Therefore, the use of terror was due to fear on his part in the achievement of the governments’ goals. The majority will always have their way in the society. The people of France had become indifferent to the revolution. This is because it involved military conscription and the use of thre ats to the people, in a bid to change their lifestyle. The use of terror was an unfortunate event to the people who were hostile to the revolution. It is in order for the relevant authorities to take wrongdoers to court, where they receive judgment.

Capitol Budgeting Long Term Financing Assignment - 4

Capitol Budgeting Long Term Financing - Assignment Example Consequently, the operating budget will be capital dependent on the long-term goals of a firm. Capital budget decisions are made independent of operating decisions. Consequently, managements make long-term capital commitments without understanding the repercussions for daily operations. In addition, they are not flexible thought out the year from draft day to end of the financial year. In case an emergency arises at a certain point, it impose capital strains on the operating budget and the effectiveness of a company declines, as the management tends to cut the budget to respond to the emergency at hand (Mary Alexander, Infusion Nurses Society, Ann Corrigan & Judy Hankins, 2010, p. 137). Operating budgets in some firms operate on fixed asset depending on the season of sales. They mostly entail heavy inputs that later give a considerable profited output. With capital budgets in sight and the knowledge that cash is limited, companies tend to pull out on some projects that have low yields and the amounts set for operations reduces accordingly. In conclusion, Capital budget is not solely responsible to affect operating budget, but plays a major role in determining the operations of a

Human Resources Management - Stress in Work force and the Employee Essay

Human Resources Management - Stress in Work force and the Employee Assistance Program - Essay Example Keeping in view the present economic situation in mind different surveys carried out find the worry of money as the prime cause for such states of the employees. People, especially the less hiring of human resource people have arisen as a result more work is required from the limited people. This has in turn caused frustration in the employees and a lot of them have started seeing counselors. Increased work load by the firms and their expectation regarding the work to be picture perfect has led to increased absenteeism and affected the employees psychologically. (Merkle, Judith A.) The term work-more economy is what is being applied these days describing the working conditions in the firms. Further, the employees do not want to spoil their relation with their employers for again the fear of losing the job. The reputation, productivity, working environment, employee and employer relation has all been drastically changed owing to the pressure cooker type environment due to recession. To overcome all of this many organization have started a new program to assist the employees. This new initiative is known as the Employee assistance program, what this program offers is a wide range of help to the employees. Further, it has been made a confidential process for no employee can know what other is taking help on. This is because to ensure the employee that they can share their problem without the fear of being ridiculed. These problems include marital troubles, anxiety, drug issues, work and family balance, personal development and growth and career related problems. (DeGraff 2010).  The good thing about this service is that it is available throughout the day and for the whole week with numerous help lines and people there, to assist you whenever you want it. There are even no charges, and all of your personal information is safe without any danger of it being leaked. Every firm has

Statistics for managers Term Paper Example | Topics and Well Written Essays - 2000 words

Statistics for managers - Term Paper Example Several empirical studies have highlighted the effect of expectations on customer satisfaction.  The overall conclusion drawn from these studies is that expectations influence customer satisfaction, and the effect can be positive, negative or non-existent.  But it can also be concluded that the positive as well as the negative effect of expectations on customer satisfaction is minimal. We believe partly that expectations is such a complex concept that it is hard to achieve reliable and valid measures, and partly that expectations as a concept does not have a conclusive influence on the formation of customer satisfaction.  We suggest that expectations be dismissed from customer satisfaction measurement instruments in the future.  We state that perceived quality is one of the primary drivers of customer satisfaction. Several empirical studies support these viewpoints.  We agree with Gronross (1993,p.  61) that "it does not seem possible to make independent measurement of customer expectations ...  It seems valid, at least in certain situations, to develop measurement models based on customer experiences of quality only".  Cronin and Taylor (1992) and Liljander and Strandvik (1992) take the same view. First, an experiment where the relationships between expectations, perceived quality and customer satisfaction were studied, using the methodology from the Swedish and American customer satisfaction index.  Second, a customer satisfaction survey, using the methodology for the new European customer satisfaction index (ECSI). The purpose is also to highlight whether buying behavior, described by a set of relevant product category characteristics (price, complexity and sign value), has any influence on the relationship between perceived quality and customer satisfaction, and if so, how strong this influence is.  Do some buying

Global Warming effect on Hair care Industry Essay Example for Free

Global Warming effect on Hair care Industry Essay â€Å"It is the gradual increase of the temperature of the atmosphere near the earth’s surface as a result of the increase of what we call â€Å"greenhouse gases† since the industrial revolution. Those gases are, water vapor, Carbon Dioxide,Methane,Nitrous Oxides and Ozone† (Global Warming ). This phenomenon is considered a healthy natural procedure because, when the light from the sun hit the earth’s surface reflects off this surface toward space ,but doesn’t easily pass through the greenhouse gases blanket of the earth. Some of the sun’s light and heat are trapped keeping the planet at an average temperature suitable to life, which is about sixty degrees Fahrenheit(Global Warming ). As we said ,Global Warming as a natural process is not harmful, but the growth in industry,agriculture,transportation and technology revolution has produced additional quantities of greenhouse gases along with other harmful substances such as â€Å"Chlorofluorocarbons† or â€Å"The CFCs† (Global Warming ). That made earth’s atmosphere traps more heat and light than it is required, so earth is facing a dangerous future with scientists predictions of high temperature ages to be coming. Global warming has a long term effects on our planet. Some of those results are, Melting of polar ice with a resulting rise in sea level and coastal flooding; disruption of drinking water supplies ;profound changes in agriculture due to climate change; extinction of species as ecological niches disappear; and an increased of tropical diseases(Girardet 19). We may consider some global warming effect as following: †¢ Greenhouse gases are accumulating in earth’s atmosphere as a result of human activities, causing temperatures to rise. Global average temperatures warmed by about 1 ° F in the twentieth century and could increase by 2. 5 ° F to 10. 5 ° F in this century(Speth 56). †¢ Human-induced warming and sea-level rise are expected to continue throughout this century and into the next(Speth 56). †¢ This warming is caused by the cumulative effects of several greenhouse gases that have built up steadily in the atmosphere, including carbon dioxide from fossil fuel combustion and deforestation, methane from fossil fuels and agricultural activities, nitrous oxide from agricultural activities and the chemical industry, and specialty chemicals including CFCs(Speth 56). †¢ Global warming could well have serious adverse societal and ecological impacts by the end of this century, and temperature and sea levels could also continue to rise well into the next century even if societies stabilize the levels of greenhouse gases in the atmosphere(Speth 56) Hair care industry tools â€Å"Every woman knows how you look is essential to how you feel† (Make a date with your hair 73) No. 1 women magazine â€Å"Cosmopolitan† started an article with that word. Hair dressing is essential to all women on this planet. What ever you men laugh or criticize, they will still go to coiffures and hair dresser all over the world. Also men are not far from hair care. Men nowadays care a lot about how do they look like and hair look became essential for them too. More products are produced and invented every day to help those stylists to accomplish good looking hair cut and a soft ,long and strong hair texture for every woman. Every hair stylist, uses some essential products such as: †¢ Shampoos: They are used in washing and cleaning scalps and hair from dirt and moist. They remove unwanted amounts of oils with substances called â€Å"Surfactants† that produces foam. The most famous surfactants are, â€Å"Sodium Laureth Sulphate† and â€Å"Sodium lauryl sulphate†,which are written on every shampoo bottle. They considered harmful (Burke) . Some kinds of natural oils are used in making shampoos. Anti-dandruf kind of shampoos are using substances like Ketoconazole,Selenium sulfite or ZPT(Doctor NDTV). †¢ Conditioners: They are used in softening hair after washing it with shampoo. Conditioners coat the hair with protective material such as silicone making the hair feel softer, shiny and less likely to tangle. Silicones are the base substance in making conditioner along with natural oils such as shampoos(Burke ). †¢ Hair dryer, curling irons and hair crimpers: Those are electric devices used to dry wet and curling it using hot air blowout . They produce heat and consume more electricity ,and it may cause damage to hair if heat was high. Many kinds of those gadgets are designed to produce more heat to style thick strands of hair(Sloane ). †¢ Hair sprays and hair gels: These products are using many different kinds of polymers used to sustain the hair’s look and keep it stable (Make a date with your hair 73). †¢ Hair dyes: Products that are used to change the color of hair for many weeks. Bleaching is achieved by oxidation with â€Å"Hydrogen Peroxide† (Hocker and Popescu 36). †¢ Hair cut equipments: Like scissors,clippers,electric trimmers, brushes and combs. Every day millions of men and women all over the globe is cutting and brushing their hair. Every time that happen ,lots of hair are lost ,removed and thrown a way. Hair Chemistry â€Å"Biologically, hair is the filamentous appendage on the skin of mammals. Chemically, it is a composite material in which both the reinforcing fibers and the matrix are made of proteins† (Hocker and Popescu 36). Hair fibers, roughly cylindrical with diameters ranging from 10 µm to 100 µm, are multicellular tissues. The heart of the fiber is surrounded by the cuticle, made of plate-like overlapping cells whose heights can reach up to 1 µm. Each cuticle cell has four layers: the epicuticle; the a-layer; the exocuticle; and the endocuticle. Inside the cuticle, the cortex contains spindle-like interlocking cortical cells, with cell membrane complex in-between. Each cortical cell is composed of macrofibrils embedded in an intermacrofibrillar material. Each macrofibril consists of microfibrils, called the intermediate filaments (IF), themselves embedded in an intermicrofibrillar matrix composed of intermediate filament associated proteins (IFAP). Thus, hair is a composite material with a complex dual structure at all levels(Hocker and Popescu 36). In brief, elemental analysis of hair shows, remarkably independently of hair origin, 50wt% carbon, 7wt% hydrogen, 22wt% oxygen, 16wt% nitrogen and 5wt% sulfur(Hocker and Popescu 36). Global warming effects that relate to Hair care industry Global warming especially alarms bioenvironmentalists and social greens, because the three main greenhouse gases (carbon dioxide, methane, and nitrous oxide) arise from core economic activities (automobile use, electricity generation, factories, agriculture, and deforestation),while the main consequences (rising seas, severe storms, drought, and desertification) are beyond the lifetimes of politicians and business leaders—perhaps occurring in 50 to 100 years. And the impacts, when they are most severe, will be mostly felt by the poor, marginalized peoples of the world. Obviously, lowering greenhouse gas emissions will involve major changes to global economic production and consumption patterns (Clapp and Dauvergne 39) not only hair care industry in the near future. It will require, too, governmental, corporate, and personal sacrifices. It’s known now that a huge part of earth’s warming is due to human activity. Humens are destroying the planet and global warming is one way for that. Global warming has many bad effects as we briefed earlyier. It’s more likely to discuss how hair care industry affecting the global warming . It what was announced by Al Gore, American former vise-president and Nobel Prize winner in Bali climate conference held this month that hair cuts and thrown away hair cutting decay, give massive amounts of green house gases, which contributes to the severe global warming crisis. They wanted us to go baldy (Al Gore Finds New cause of Global Warming†). We will discuss how global warming affect the hair care industry with all the climate change criteria and harmful gases found in the air . A different point of view but a remarkable one to study. Environmental scientists predict that, from global warming of 0. 8 °Ã¢â‚¬â€œ2. 0 °C will â€Å"commit† 18–35 percent of animal and plant species â€Å"to extinction† by the middle of the twenty first century (Clapp and Dauvergne 35). Plants are the main source for natural oils and substances used in making hair products such as, Cacao extracts, Grape seed oil, roses, safflower and even bananas. Tropical plants are the most used in this industry. Global warming effect on those plants are very svere, so that hair care products are having problems in getting its raw mterials. Many surfactants for example are derived from plant oils like coconut or palm kernel (Hargreaves). Even if hair products company are saying they don’t use animals in their experiments, they still use them and with the bad effect of climate over different animal species, Those companies will not be able to develop their future products. Global warming is a result of what we called greenhouse gases(Global warming) . Some of them are harmful gases like,Cabon dioxide, nitrous oxides and Ozone(not the ozone type in the upper atmosphere). If we study the situation of every gas we may find that, higher concentrations of carbon dioxide—could mean an even higher rate of extinctions of animal and plants species, because they breathe Oxygen just like we do and as we said before that may lead to less natural products for hair care industry and less development to those products(Clapp and Dauvergne 54). In the air, nitrogen oxide from fossil fuel combustion reacts with volatile hydrocarbons and sunlight to produce smog, a nasty mix of photochemical oxidants, one of which is ozone (Speth 72) and according to hair chemical composition, hair absorbs moisture due to the polar amino acid residues of the inside of the hair (Hocker and Popescu 36), this cause harm to hair, which make it essential to repeat hair treatment processes and it may cause hair and scalp disease. Nitrogen Oxides can also become nitric acid and contribute to acid deposition through acid rains, which also contains harmful substances to hair health (Speth 45) . Acid rain is also a cause for water supply pollution due to rain falling on open water sources such as rivers and lakes, Polluting water sources may directly affect the hair care industry, due to the daily use of water in washing hair for probably every one. Acid rain coming from Nitrogen Oxides may pollute soil, forests, and crops (Speth 86) and of course making the same effect on plants and animals that are essential to hair care industry. Acid rains made thousands of lakes have â€Å"gone acid† (Speth 53), that means any kind of swimming of any of those lakes or water area contaminated by acids may cause hair loss or diseases. After a few years, scientists predict that global warming will cause shortage in universal water supplies . that may cause less water washing habits (Elsworth), less hygiene and of course it may cause diseases. Global warming is making the atmosphere on earth hotter than before (Girardet 19) and sunlight concentration is one of the most harmful effects on human’s health. Skin cancers are believed to be caused mainly by sunlight . Skin cancers may spread over the body even into hair scalp, causing severe hair loss (Armstrong 141-55). Losing hair for both men and women are emotionally destructive, so both of them may use hair wags or artificial hair parts to cover there baldness. Some kinds of skin rashes due to water or air pollution with green house gases may cause hair loss also(Doctor NDTV). Climate change ,high humidity ratios and long time sunlight effects are all factors that can injure the hair or make them very dry (Doctor NDTV)and of course that what would global warming do. Attitudes toward Global Warming and their effects Men and women and even Hair care companies started a new attitude in dealing with global warming and climate change problem. First of all, we must admit that hair care products with all their chemical materials, packaging bottles and even the misusage of these products are a big problem causing more and more environmental threats. Government started putting some regulations and laws to fight global warming increase . Hair products companies that still use harmful ingredients such as ,Sodium Laureth sulphate and sodium lauryl sulphate [they are found to be a cause for some kinds of cancers]( â€Å"SLES†),started searching for natural alternatives to use in shampoos, conditioners and any other products. Companies are increasingly becoming aware of environmental issues . Some companies are now trying to use technology in making hair products with excellent suspending power, low freezing point and wide thermal stability range(-5 ° C to 50 ° C) (Burke ),so that they may survive the global warming bad effects. Companies also targets to make new products with reduced environmental impact over the upcoming years, in an attempt to improve the environmental profile of its products and their packaging materials by reducing CO2 emissions, energy and water consumption used to make those products. Some of those companies continue with some environmental projects like Children’s Safe Drinking Water Program done by PG hair Products Company (Product supplier news). Governments also put under Current pressure to move away from non-renewable petroleum feed stocks and towards plants as sources of raw materials, which has led to a lot of effort on developing surfactants from oleo chemical feed stocks. Many recently-developed surfactants are an attempt to satisfy the modern consumers desire for products to be more natural'(Hargreaves). The elimination of Chlorofluorocarbons (â€Å"Global Warming†) is also another effort to decrease the global warming effect not only on hair care industry but on any other human activity. Many people is trying to avoid using chemicals in their hair care regimes. Instead, they are using natural herbs and oils extracted from organic plants that is planted under observation to avoid pollution. Because of this hard effort to produce such substances, they are sold in high prices, not every one could be able to use those organic products. Also going to hair saloons became unadvisable from many environmental scientists, they are not environment friendly, which cause many to abandon those saloons and of course causing financial lost to many of those hair care branches. Maybe some hair saloons will only specialize in organic and natural products and because of the high prices of their products, only rich people will keep going to them. Bali Climate Change Conference (Al Gore Finds New cause â€Å") declared that haircuts may raise green house gases amount. Maybe in the future, every body is going bald to avoid environmental crisis or even worse, we may be not able to even wash our hair, just like Cate Blanchett (Elsworth) is doing now. Climate is treating our hair badly, let’s all go baldy. Works Cited Global Warming. The Columbia Encyclopedia. 6th,New York. 2004. Clapp, Jennifer, and Peter Dauvergne. Paths to a Green World:The Political Economy of the Global Environment. Cambridge, Massachusetts: The MIT Press, 2005. Surviving the Century:Facing Climate Chaos and Other Global Challenges. Ed. Herbert Girardet. London: Earthscan, 2007. Speth, James. Red Sky at Morning: America and the Crisis of the Global Environment. USA: Yale University Press, 2004.

Relationships between Indians and English at Jamestown Essay Example for Free

Relationships between Indians and English at Jamestown Essay Before the English founded Jamestown in 1607, the Pamunkey Americans who lived in the Chesapeake Bay area were aware of the other culture overseas (Kupperman, 1). The Americans had watched the establishment and eventual abandonment of the Roanoke settlement some twenty years before Jamestown and gained knowledge of English society (1). European ships frequented the bay for trade. A Pamunkey man, who the Spaniards took back to Spain and baptized as Don Luà ­s de Velasco, returned to his homeland in 1571 and further informed the Pamunkeys (1). Though the English would become dominant, the Native Americans might have been the more erudite of the two cultures to clash. Europeans sent reports home from America and told of complex native civilizations and formidable tribes (Kupperman, 1). In time, the English came to assume that Americans were accomplished people living in highly developed societies and to rely their crops and supplies when needed (1). If one successful population could thrive on that land, then another could surely overtake it ultimately (2). The Pamunkeys had their own sights for a newly established Jamestown (Kupperman, 1). They understood the typical European behaviors and manipulated them to exert control (1). With over thirty tribes under Pamunkey leader Powhatans command, the natives kept the mostly inept English apprehensive and directed the trading of goods (1). The colonists traded for and exported furs and gold to Europe (1). For the Americans, metal tools, copper ornaments, glass beads and other Europeans products benefited them greatly in exchange (1). The Pamunkeys and their allies had power over the trade westward inland, therefore expanding their influence (2). True to form, the English settlers were incompetent with coping in the New World and became dependant to the natives for support (Kupperman, 2). As the two sides learnt more of each other as they mingled, mutual relationships formed (2). The English wasnt completely destitute, however, and recuperated under Captain John Smiths leadership (2). The Americans and the English became relatively amicable, but after Smith left the colony, the  relations deteriorated and conflicts rebounded (2). Meanwhile, retrogression in Europe drove more desperate people to seek life elsewhere, even in a foreign land. Despite that the battle-mottled situation in Jamestown, the English colony grew stronger, invested successfully in tobacco exportation, and ceased to count on Native Americans for help (Kupperman, 2). Instead of being exploited, the balance of power shifted and became more advantageous for the English. This has been: Examination of Relationships found in Indians and English Meet on the James by Karen Kupperman, www.iath.virginia.edu/vcdh/jamestown/essays/kupperman_essay.html

Problems Of The Aging Health And Social Care Essay

Problems Of The Aging Health And Social Care Essay for death from cancer, Management of the elderly cancer patient becomes complex because other chronic conditions, such as osteoarthritis, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease, must also be considered in their care. The attitude of health care providers towards older adults affect their health care. Unfortunately, research indicates that health care professionals are significantly more negative in their attitudes towards older patients than younger ones. This attitude must change if the health care provider is to have a positive interaction with the elderly patient. These attitude appear to be related to the pervasive stereotyping of the elderly, which serves to justify avoiding care and contact with them, as well as being reminders of our own mortality. Ageism is a term used to describe the stereotyping of and discrimination against elderly persons and is considered to be similar to that of the racism and sexism. It emphasized that frequently the elderly are perceived to be repulsive and that a distaste for the aging process itself exists. Ageism suggests that he majority of elderly are senile, miserable most of the time, and dependent rather than independent individuals. The media have also influenced on going stereotypical notions about the elderly. Health care providers must learn to appreciate the positive aspects of aging so that they can assists the elderly in having a positive experience with their imaging procedure. PHYSICAL, COGNITIVE, AND PSYCHOSOCIAL EFFECTS OF AGING The human body undergoes a multiplicity of physiologic change second by second. Little considerations is given regarding these changes unless they are brought on by sudden physical, psychological, or cognitive events. Radiographers must remember that each elderly person they encounter is a unique individual with distinct characteristics. These individual have experienced a life filled with memories and accomplishment. Young or old, the definition of quality of life is an individual and personal one. Research has shown that health status is an excellent predictor of happiness. Greater social contact, health satisfaction, low vulnerable personality traits, fewer stressful life events have been linked to successful aging. Self-efficacy can be defined as the level of control one has over ones future. Many elderly people feel they have no control over medical emergencies and fixed incomes. Many have fewer choices about their personal living arrangements. These environmental factors can lead to depression and decreased self-efficacy. An increase in illness will usually parallel a decrease in self-efficacy. The elderly may experience changing roles from life of independence. The family role of an adult caring for children and grandchildren may evolved into the children caring for their caring aging parents. It is also a time of loss. Losses may include the death of a spouse and friends, as well as loss of income due to retirement. The loss of health may be the reason for the health care visit. The overall loss control may lead to isolation and depression in the elderly. Death and dying is also an imminent fact of life. The aging process alone does not likely alter the essential core of human being. Physical illness is not aging, and age-related changes in the body are often modest in magnitude. As one ages, the tendencies to prefer slower-paced activities, take longer to learn new tasks, become more forgetful, and lose portions of sensory processing skills increase slowly but perceptibly. Health care professionals need to be reminded that aging and disease are not synonymous. The more closely a function is tied to physical capabilities, the more likely it is to decline with age, whereas the closer a function depends on experience, the more likely it will increase with age. Joint stiffness, weight gain, fatigue and loss of bone mass can be slowed through proper nutritional interventions and low-impact exercise. The importance of exercise cannot be overstated . Exercise has been shown increase aerobic capacity and mental speed. Exercise programs designed for the elderly should emphasized increased strength, flexibility, and endurance. One of the best predictors of good health in later years is the number and extent of healthy lifestyles that were established in earlier life. The elderly person may shown decreases in attention skills during complex tasks. Balance , coordination, strength and reaction time all decrease with age. Falls associated with balance problems are common in the elderly population, resulting in a need to concentrate on walking. Not overwhelming them with instructions is helpful. Their hesitation to follow instructions may be fear instilled from a previous fall. Sight, hearing, taste and smell are all sensory modalities that decline with age. Older people have more difficulty with bright lights and tuning out background noise. Many elderly people become adept at lip reading to compensate for loss of hearing. For radiographers to assume that all elderly patients are hard of hearing is not usual; they are not talking in a normal tone, while making volume adjustments only if necessary, is a good rule of thumb. Speaking slowly, directly, and distinctly when giving instructions allows older adults an opportunity to sort through directions and improves their ability to follow them with better accuracy. Cognitive impairment in the elderly can be caused by disease, aging, and disuse. Dementia is defined as progressive cognitive impairment that eventually interferes with daily functioning. It includes cognitive, psychologic, and functional deficits including memory impairment. With normal aging comes a slowing down and a gradual wearing out of bodily systems bit it does not include dementia . Yet the prevalence of dementia increases with age. Persistent disturbances in cognitive functioning, including memory and intellectual ability, accompany dementia. Fears of cognitive loss, especially Alzheimers disease, are widespread among older people. Alzheimers disease is the most common form of dementia. Therefore health care professionals are more likely to encounter people with this type. The majority of elderly people work at maintaining and keeping their mental functions by staying active through mental games and exercises and keeping engaged in regular conversation. When caring for pati ents with any degree of dementia, verbal conversation should be inclusive and respectful. One should never discuss the patients as through they are not in the room or are not active participants in the procedure. One of the first questions asked of any patient entering a health care facilities for emergency service Do you know where you are and what day it is? The health care providers need to know just how alert the patient is. Although memory does decline with age, this is experienced mostly with short-term memory tasks. Long-term memory or subconscious memory tasks show little change over time and with increasing age. There can be a variety of reasons for confusion or disorientation. Medication, psychiatric disturbance, or retirement can confuse the patient. For some older people, retirement means creating a new set routines and adjusting to them. The majority of elders like structure in their lives and have familiar routines for approaching each day. PHYSIOLOGY OF AGING Health and well- being depend largely on the degree to which organ systems can successfully work together to maintain internal stability, With age, there is apparently a gradual impairment of these homeostatic mechanisms. Elderly people experience nonuniform, gradual, ongoing organ function failure in all systems. Many of the body organs gradually lose strength with advancing age. These changes place the elderly at risk for disease or dysfunction, especially in the presence of stress. At some point the likelihood of illness, disease and death increases. Various physical diseases and disorder affect both mental and physical health of people of all ages. They are more profound among elderly people because diseases and disorders among older people are more likely to be chronic in nature. Although aging is inevitable, the aging experience is highly individual and is affected by heredity, lifestyle choices physical health, and attitude. A great portion of usual aging risks can be modified with positive shifts in life style. In elderly, the aging of the organs systems is one of the process where they need to understands and there are as list below: Integumentary systems disorders Nervous systems disorders Sensory systems disorders Musculoskeletal systems disorders Cardiovascular systems disorders Gastrointestinal system disorder Immune system decline Respiratory system disorder Hematologic system disorders Genitourinary systems disorders Endocrine systems disorders. THE RADIOGRAPHERS ROLE The role of the radiographer is no different than that of all other health professionals. The whole person must be treated, not just the manifested symptoms of an illness or injury. Medical imaging and therapeutic procedures reflect the impact of ongoing systemic aging in documentable and visual forms. Adapting procedures to accommodate disabilities and disease of geriatric patients is a critical responsibility and a challenge based almost exclusively on the radiographers knowledge, abilities, and skill. An understanding of the physiology and pathology of aging, in addition to an awareness of the economic the social, psychologic, cognitive, and economic aspects of aging, are required to meet the needs of the elderly population. Conditions typically associated with elderly patient invariably require adaptations or modifications of routine imaging procedures. The radiographer must be able to differentiate between age related changes and disease processes. Production of diagnostic image s requiring professional decision making to compensate for physiologic changes, while maintaining the compliance, safety, and comfort of the patient, is foundation of the contract between the elderly patient and the radiographer. RADIOGRAPHIC POSITIONING FOR GERIATRIC PATIENTS The preceding discussions and understanding of the physical, cognitive, and psychosocial effects of aging can help radiographers adapt to the positioning challenges of the geriatric patient. In come cases routine examinations need to be modified to accommodate the limitation, safety, and comfort of the patient. Communicating clear instructions with the patient is important. The following discussion addresses positioning suggestion for various structures. The common radiography examinations for geriatrics are: Chest Spine Pelvis/hip Upper extremity Lower extremity CHEST The position of choice for the chest radiograph is the upright position; however, the elderly patient may not be able to stand without assistance for this examination. The traditional posteroanterior (PA) position is to have the backs of hands on hips. This may be difficult for someone with impaired balance and flexibility. The radiographer can allow the patient to warp his or her arms around the chest stands as a means of support and security. The patient may not be able to maintain his or her arms over the head for lateral projection of the chest. Provide extra security and stability while moving the arms up and forwards. When the patient cannot stands, The examination may be done seated in a wheelchair, but some issues will affected the radiographic quality. First, the radiologist need to be aware that the radiograph is an anteroposterior (AP) instead of a PA projection, which may make comparison difficult. Hyperkyphosis can result in the lung apices being obscured, and the abdomen may obscure the lung bases. In sitting position, respiration may be compromised, and the patient should be instructed on the importance of a deep inspiration. Positioning of the image receptor for kyphotic patient should be higher than normal because the shoulder and apices are in a higher position. Radiographic landmarks may change with age, and the centering may need to be lower, if the patient is extremely kyphotic. When positioning the patient for the sitting lateral chest projection, the radiographer should place a large sponge behind the patient to lean him or her forward. Sitting Chest PA Chest Standing SPINE Radiographic spine examinations may be painful for the patient suffering from osteoporosis who is lying on the x-ray table. Positioning aids such as radiolucent sponge, sandbags, and a mattress may be used as long as the quality, of the image is not compromised. Performing upright radiographic examination may be also appropriate if a patient can safely tolerate this position. The combination of cervical lordosis and thoracic kyphosis can make positioning and visualization of the cervical and thoracic spine difficult. Lateral cervical projections can be done with the patient standings, sitting, or lying supine. The AP projection in the sitting position may not visualized the upper cervical vertebrae because the chin may obscure this anatomy. In the supine position the head may not reach the table and result in magnification. The AP and open-mouth projection are difficult to do in wheelchair. The thoracic and lumbar spines are sites for compression fractures. The use of positioning blocks may be necessary to help the patient remain in position. For the lateral projection, a lead blocker or shield behind the spine should be used to absorb as much scatter radiation as possible. Lateral Spine PELVIS/HIP Osteoarthritis, osteoporosis, and injuries as the result of falls contribute to hip pathologies. A common fracture in the elderly is the femoral neck. An AP projection of the pelvis should be done to examine the hip. If indication is trauma, the radiographer should not attempt to rotate the limbs. The second view taken should be a cross-table lateral of the affected hip. If hip pain is the indication, assist the patient to internal rotation of the legs with the use of sandbags if necessary. Immobilization device are place to the patient foot. UPPER EXTREMITY Positioning the geriatric patient for projections of the upper extremities can present its own challenges. Often the upper extremities have limited flexibility and mobility. A cerebrovascular accident or stroke may cause contractures of the affected limb. Contracted limbs cannot be forced into position, and cross-table views may need to be done. The inability of the patient to move his or her limb should not be interpreted as a lack of cooperation. Supination is often a problem in patients with contractures, fractures, and paralysis. The routine AP and lateral projections can be supported with the use of sponges, sandbags, and blocks to raise and support the extremity being imaged. The shoulder is also a site decreased mobility, dislocation, and fractures. The therapist should assess how much movement the patient can do before attempting to move the arm. The use of finger sponges may also help with the contractures of the fingers. Hand Projection Lateral Wrist LOWER EXTREMITY The lower extremities may have limited flexibility and mobility. The ability to dorsiflex the ankle may be reduced as a result of neurologic disorders. Imaging on the x-ray table may need to be modified when a patient cannot turn on his or her side. Flexion of the knee may be impaired and required a cross-table lateral projection. If tangential projection of the patella, such as the Settegast method, is necessary and the patient can turn on his or her side, place the image receptor superior to the knee and direct to central ray perpendicular through the patellofemoral joint. Projections of the feet and ankles may be obtained with the patient sitting in the wheelchair. The use of positioning sponges and sandbags support and maintain the position of the body part being imaged. AP Ankle Projection Lateral Ankle Projection PATIENT CARE Patient care must be apply to geriatric patient because they all are all fragile where their bone can easily broke or they can be easily fainted during the examination. For communications, take time to educate the patient and his or her family, speak lower and closer, and treat the patient with dignity and respect. Transportation and lifting patient are also be need because geriatrics patient is not stronger than normal person. If possible, give the patient time to rest between projection and procedures. Avoid adhesive tape because elderly skin is thin and fragile. Provide warm blankets in cold examination rooms, use table pads and hands rails and always access the patients medical history before contrast media is administered. Take time with the patient Immobilization Device CONCLUSION The imaging professional will continue to see a change in health care delivery system with the dramatic shift in the population of persons older than age 65. This shift in the general population is resulting in an ongoing increase in the number of medical imaging procedures preformed on elderly patients. Demographic and social effects aging determine the way in which the elderly adapt to and view the process of aging. An individuals family size and perceptions of aging, economic resources, gender , race, ethnicity, social class, and the availability and delivery of health care will affect the quality of the aging experience. Biologic age will be much more critical than chronologic aging when determining the health status of the elderly. Healthier lifestyles and advancement in medical treatment will create a generation of successfully aging adults, which in turn should decrease the negative stereotyping of the elderly person. Attitudes of all health care professionals, whether positiv e or negative, will affect the care provided to be growing elderly population. Education about the mental and physiologic alterations associated with aging, along with the cultural, economic and social influences accompanying aging, enables the radiographer to adapt imaging and therapeutic procedures to the elderly patients disabilities resulting from age-related changes. The human body undergoes a multiplicity of physiologic changes and failure in all systems. The aging experience is affected by heredity, lifestyle choices, physical health, and attitude, making it highly individualized. No individuals aging process is predictable and is never exactly the same as that of any other individual. Radiologic technologists must use their knowledge, abilities, and skills to adjust imaging procedures to accommodate for disabilities and disease encountered with geriatric patients. Safety and comfort of the patient is essential in maintaining compliance throughout imaging procedures. Implementation of skills such as good communication, listening, sensitivity, and empathy, all lead to patient compliance. Knowledge of age-related changes and disease process will enhance the radiographers ability to provide diagnostic information and treatment when providing care that meets the needs of the increasing elderly patient population.

Crusades Essay -- essays research papers

In the year of 1095, Pope Urban II started what we know as the Holy Wars or the Crusades. Over the period from 1095-1464, a series of military expeditions were fought to take back the Holy Land, Jerusalem, from the Seljuk Turks. There were eight crusades, which were spurred for many different reasons by many different people that left a lasting effect to the world. These years of bloodshed were led by men of power to gain control over the Holy Land of Jerusalem. Jerusalem was extremely important to the Muslims and Christians at this time. Many religious events had happened there, and many of the landmarks of both religions were located in Jerusalem. The Crusaders failed to regain the Holy Land, but the Eastern connections opened Europe to a brighter understanding of optimistic ways of living and thinking. There have been many arguments as to what fuelled the Crusades, and religious fanaticism is one of them. Jerusalem is a holy city to both the Muslims and the Christians because many historic religious events have taken place there. In Jerusalem there is the Church of the Holy Sepulchre, which stands of the hill where Christ was believed to have been crucified, died, buried, and where he rose again. Now if Jerusalem was so important to both the Muslims and Christians of course they would fight to keep it or gain control of it. Pope Urban II called for the first crusade to free the Holy Land from the Seljuk Turks that took over in 1070. In his speech he said, â€Å"Seize the land ...

Comparing Dreams in Catcher in the Rye, Night, and Their Eyes Were Watc

Dreams in Catcher in the Rye, Night, and Their Eyes Were Watching God   Ã‚  Ã‚   Throughout the novels Catcher in the Rye, Night, and Their Eyes Were Watching God, the main characters seem to have a dream. In their stories, Holden, Elie, and Janie tell the reader whether or not their dream was successful.    In Catcher in the Rye, Holden's dream is to be the catcher in the rye, meaning he wants to stop children or anything that may still be innocent from falling over the edge. This basically means he wants to preserve the innocence. That's why he likes Phoebe so much, because she's still young and youthful, and most importantly innocent.      Ã‚  Ã‚   The novel charts Holden's experiences over a long period of time. It starts on a Saturday in December just before school closes for Christmas break. He has been informed of his expulsion from Pencey Prep School. What worries him most about being kicked out of school is his parents' reaction, for he has already been expelled from other educational institutions. Soon, Holden decides to go to New York. Holden encounters a large number of people as he travels the city of New York and goes into nightclubs.    Holden looks for some amount of understanding and acceptance from all the characters he encounters, even taxi drivers, but he is denied his needs. As a result, Holden feels dislocated, as though he does not belong anywhere, and he is right. It becomes obvious through his meetings that he is in an entirely different path than the rest of the world. Each time Holden opens up himself, he is rewarded with rejection, until he is finally driven to almost a schizophrenic condition. With his mental health deteriorating, Holden returns to his parents' home,... ...cts herself by firing a rifle at him. She is then tried for his murder.      Ã‚  Ã‚  Ã‚   In spite of the tragic circumstances and the hurricane and Tea Cake's death, the novel has a happy ending, for Janie is found innocent of murder and given a chance to run her life and find out who she really is. In telling her tale, it is obvious that she feels like a satisfied woman who has recognized love and has precious memories to surround her.  Ã‚  Ã‚  Ã‚   If Janie's soul were to come out and see life, it would, unlike the others, be very pleased to see that her hearts desires were fulfilled.    Those were the dreams of Holden Caulfield, Elie Wiesel, and Janie Crawford-Woods.    Sources Hurston, Zora Neale. Their Eyes Were Watching God. New York: Harper & Row, 1937. Salinger, J.D. The Catcher In The Rye. Boston: Little, Brown and Company, 1951.   

The Issue of Keeping Animals in Captivity

The issue of keeping animals in captivity has been brought into focus recently. Some people claimed animals have the right to choose to live in their natural habitats, but others think some animals do better in the zoos. Overall, it is important to look as both sides of the argument. Supporters of zoos would argue that there are many advantages to keeping animals in captivity. One of the most important of these is that there are some endangered species are protected in the zoos. Like Giant Panda, Brown Bear and Siberian Tiger and so on. Moreover, zoos give us a close encounter with wild animals. In addition to this, zoos make an easy life for animals. For example, they don't need to run about hunting for a meal, there are no real predators in the zoos and they don’t have to worry about finding partner. On the other hand, those who oppose zoos would argue that some large animals need plenty of space to wander around in. Such as lions and polar bears, they are also endangered species but they usually breed unsuccessfully in the zoos which because of stress. Furthermore, people visit zoos for entertainment not for education. Besides, animals lose natural instincts in the zoos. If we put them to the wildlife again, they can’t survive well independently. That is a kind of tragedy is made by human. On balance, I feel that zoos are not suitable for all animals, it’s really depends on what species they are, what behaviour they have and where is better for them to live. However, the zoos need to do more researches for understand animals better and improve the living environment of them constantly.

Benefits of Exercise

We've all heard it before, â€Å"Exercise is good for you because†¦. † Nowadays you can't check out at the grocery store or do much of anything without being reminded that we mortal humans need to exercise. Still, we persist, procrastinate and eventually complain that we're overweight, sick, dying, etc. Listen. Some exercise is better than none, more exercise is generally better than less, and no exercise can be disastrous. No one is asking for you to start a rigorous daily regimen,  just do something.If you need motivation, here is a list of scientifically proven health benefits that regular exercise brings. Longevity. People who are physically active live longer. According to a 20 year follow-up  study,  regular exercise reduces the risk of dying prematurely. New brain cell development, improved cognition and memory. Exercise stimulates the formation of new brain cells. Researchers found  that the areas of the brain that are stimulated through exercise are respo nsible for memory and learning.For instance, older adults who engage in regular physical activity have better performances in tests implying decision-making process, memory and problem solving. Exercise is a powerful antidepressant. Study  after  study  has shown that exercise promotes mental health and reduces  symptoms of depression. The antidepressant effect of regular physical exercise is comparable to the potent antidepressants like Zoloft. It may take at least 30 minutes of exercise a day for at least three to five days a week to significantly improve  symptoms of depression.Cardiovascular health. Lack of physical activity is one of the major risk factors for  cardiovascular diseases. Regular exercising makes your heart, like any other muscle, stronger. A stronger heart can pump more blood with less effort. Cholesterol lowering effect. Exercise itself does not burn off cholesterol like it does with fat, however, exercise favorably  blood cholesterol levels by dec reasing LDL (bad) cholesterol, triglycerides and total cholesterol and increasing HDL (good) cholesterol. Prevention and control of diabetes.There is strong evidence from high quality studies (e. g. Finnish Diabetes Prevention Study) that moderate physical activity combined with weight loss and balanced diet can confer a 50-60% reduction in risk of developing diabetes. Blood pressure lowering. The way in which exercise can cause a reduction in blood pressure is unclear, but all forms of exercise seem to be effective in  reducing blood pressure. Aerobic exercise appears to have a slightly greater effect on blood pressure in hypertensive individuals than in individuals without hypertension.Reduced  risk of stroke. Research data  indicates that moderate and high levels of physical activity may reduce the risk of total, ischemic, and hemorrhagic strokes. Weight control. Regular exercise helps to reach and maintain a healthy weight. If you take in more calories than needed in a day , exercise offsets a caloric overload and controls body weight. It speeds the rate of energy use, resulting in increased metabolism. When metabolism increases through exercise, you will maintain the faster rate for longer periods of a day.Muscle strength. Health  studies  repeatedly show that strength training increases muscle strength and mass and decreases fat tissue. Bone strength. An active lifestyle benefits bone density. Regular weight-bearing exercise promotes bone formation, delays bone loss and may protect against  osteoporosis  Ã¢â‚¬â€œ form of bone loss associated with aging. Better night sleep. If you suffer from poor sleep, daily exercise can make the difference. The natural dip in body temperature five to six hours after exercise may help to fall asleep.

Failure Turned Into Success

Brandon Miller John Delano ITM 1900 February 5, 2013 Failure turned into Success I failed many projects at work, some larger than others. One project that I failed was when I had to refill the push mower with oil. I almost made my first mistake by choosing the wrong type of oil for the mower, but luckily was smart to call my boss and choose the correct oil. My first mistake was to not to listen to what my boss said and clean off the dipstick before I started to refill the oil tank.By not doing this, I did not know the specific amount to how much to add. This mistake leads into my second mistake of adding too much oil to the mower. These two mistakes ruined the mower and costing the company to buy a new push mower. I could and should have done many things different to avoid this problem. The main thing that I should have done different is to ask someone to help guide me through the process of adding oil instead of teaching the process to myself, which ultimately cost the company more money.I, as a Christian project manager, should have many standards to evaluating software development projects. When evaluating, I should ask to myself whether the project is honoring to God. When I say that, I mean is the project representing the way Christians live their lives for Christ. Is the project appropriate to God and acceptable for anyone to accomplish? In 1 Thessalonians 4, it talks about urging or pushing believers to live a life pleasing to God. Then it goes on to talk specifically about the life believers should be living.The way that I am told to be living my life should also be displayed in the projects that I create. The projects should be an encouragement to others when they use it and should help to benefit other’s lives. This project also should be an example to how believers live their lives. 1 Timothy 4:12 helps encourage that mindset by talking about how believers should set an example for others in speech, conduct, love, faith, and purity. Overall, w hen evaluating projects, they should be pleasing to the Lord, be an example, and influence others positively when using them.Basing my mistakes on the standards by which to live by, my project would still be considered a failure. It would be a failure because I did not listen to my boss, which is disobedience and that is not pleasing to the Lord. Ruining a mower is not a good example to my other work colleagues either. I should have been smarter in the way I handled the project and thought about how to have the project run efficient and productive. My disobedience resulted in failure of the whole project and making the company’s reputation increase negatively.Moses would probably say that about 45% of the plan was completed on time. The percentage is not very high because of the Israelites causing problems with their attitudes and doubts on God. Also, the Israelites did not have much faith in Moses leading them and this caused many problems in trying to get the plan completed . From Moses’ perspective, I think he would say that the journey to Mount Sinai and getting the Ten Commandments written was completed late because of the actions of the Israelites.Since the Israelites became impatient with Moses and making a golden calf, it slowed down the entire process of getting the Ten Commandments written. Moses could have taught Aaron stronger principles in keeping God’s people under control while he was at Mount Sinai. If Aaron was stronger and not so willing to make false gods, the process of the Ten Commandments being written would have been completed quicker. Source for timeline: http://www. bibleview. org/en/Timelines/20_1800BC-1400BC. html

Case Studies – Answers to the Questions B2B Marketing Managers

Case Studies – Answers to the Questions B2B Marketing Managers At Savvy B2B Marketing, we thrive on different perspectives and new ideas, which is why we are thrilled to welcome today's guest blogger, Casey HIbbard, also known as the queen of case studies. In her blog – Stories that Sell – Casey shares success-story marketing best practices. More fantastic guests are planned for the weeks ahead, so stay tuned. Customer case studies are high-value, in-demand marketing and sales collateral. Marketing teams are tasked with producing powerful stories, yet it’s not always easy.Classroom I work with all types of marketers, from those new to case studies to seasoned veterans. The same questions come up again and again. Here are marketers’ top questions – and some answers – on creating and managing case studies: 1. How do we get customers to participate? Unfortunately, there’s no one-size-fits-all answer. It comes down to finding the wi n-win opportunity with every customer that you want to feature. Brainstorm with internal colleagues close to the customer about possible motivators. Does the company want to tell a certain story right now?Does your individual contact want PR internally for bringing about successful outcomes? Then discuss your ideas candidly with the customer. From there, create a customized joint promotional plan or agreement that meets both your needs and the customer’s objectives. 2. How long does it take to produce a case study? The clock starts when you interview the customer. If everything goes relatively smoothly, an approximately two-page case study or success story takes about one month to complete, on average. If your contact is responsive and has the authority to approve your story, then the process can be done in a couple of weeks.But if multiple people are reviewing and approving it, it can take months, worst case. Always start well ahead of any trade shows or sales opportunities to ensure you get the story you need. 3. How do we get measurable results? To draw measurable results out of happy customers, you have to get very specific internally and with featured customers. Identify what metrics mean the most to your prospects, and areas where current customers typically see results. Craft interview questions accordingly, making sure to ask before-and-after questions (how much time did a process take compared to now? . Walk customers through each area of potential benefit because most haven’t stopped to quantify yet. Negotiate with customers on what metrics they are willing to share and how. You may have a specific way that you'd like to represent ROI, but your customer isn't comfortable with that. Your customer might be more willing to talk in percentages or in factors of (twice as, one-third of†¦ ) instead of in dollar amounts. 4. How long should my case study or success story be? The length of your customer story depends on your audience and the point in the sales cycle.The goal: Answer the prospect’s questions and objections at the right time. As a general rule, business decision-makers prefer shorter overviews (1-2 page success stories) that focus on business results. And perhaps early on, technology decision-makers appreciate that briefer overview. But as they get further along in the evaluation process, IT people in particular, and sometimes department/division managers, want more details (case studies of 2+ pages) about factors such as implementation, customizability, ease of use/maintenance, functionality and support.Technology folks also tend to want more candid stories that include lessons learned. These are the questions I hear most. What are your top questions and challenges when it comes to case studies? About the author: Casey Hibbard is author of the book, â€Å"Stories That Sell: Turn Satisfied Customers into Your Most Powerful Sales ; Marketing Asset† and principal of Compelling Cases Inc. She also writes the Stories That Sell blog.

Aspects of ICT

Aspects of ICT Introduction Development of computers in the modern society and associated with it computerization of education is characterized by a massive proliferation of information and communication technologies (ICTs). ICT can be used for information exchange and interaction between a teacher and a pupil in the modern education system. As such, not only the teacher must master the ICT technology, but also to be an expert in applying it in his or her professional activities. â€Å"It is a technological world in which children are often more comfortable than their parents and teachers†.[1] Computerization of educational achieves two strategic objectives. First, it improves the efficiency of all types of educational activities through the use of ICT tools and technologies. Second, it improves the quality of training enhancing it with a new type of thinking which is relevant to the requirements of the information society. Using methods and means of information, future professionals must b e able to get answers as to what information resources are available, where they are, how they can be accessed and how they can be used to improve their professional activities. In our research paper we will cover the following aspects of ICT Positive and negative aspects of using information and communication technologies in general education Review the role and place of ICT in the building of the information society Review the areas of effective application of ICT tools Review methods of ICT application to address appropriate needs of the educational process, monitoring and measurement of learning outcomes, extracurricular activities and research, in primary school educational institutions Review requirements for ICT facilities Review the market of available ICT tools and products. What is ICT? Information and communication technologies (ICT) are a combination of the hardware and software designed to implement information processes through the utilization of the comp uters and network technologies. â€Å"The purpose of ICT in education is generally to familiarise students with the use and workings of computers, and related social and ethical issues†.[2] The main focus of the research however will be dedicated to the electronic means of educational purpose, which are a subset of software tools of ICT. These include application software and electronic media, specifically designed for the educational use: a system supporting the process of learning (electronic textbooks and encyclopaedias (including network), electronic laboratory etc.). There are several venues of ICT tools utilization in the education system: In general educational institutions (primary schools, high schools, etc.) In the supplementary education (instructor-led language schools, etc.) In home-based learning (extracurricular activities, etc.) To further narrow down the topic of the research the main accent will be applied to the area of general Primary school educat ion with emphasis on the general education of the primary education processes. According to Andrew A. Zucker who writes in his ‘Transforming Schools with Technology: How Smart Use of Digital Tools Helps Achieve Six Key Education Goals’ 2008, the ICT will be successful if technology is aligned with six major education goals. Those goals are to: increase student achievement make schools more engaging and relevant provide a high-quality education for all students attract, prepare, and retain high-quality teachers increase parental and community support for students outside of school require accountability for results ICT methods and techniques

Reflection essay Example | Topics and Well Written Essays - 750 words - 12

Reflection - Essay Example In this paper I will discuss that campus learning is very important for college students as compared to online learning, while keeping in view my own experience of college campus. When I joined my college, I met many other students; and thus, started socializing with my peers, which is an integral part of personality development. My personality has groomed a lot after I have joined my college. I know this when I compare myself to when I was in school. I believe that in campus learning, college students come to know how to behave in classrooms; how to show respect to teachers; how to deal with peers; and, how to show discipline while learning. This socializing is beneficial for them in both short and long terms because they learn how to deal with life and its problems and how to cope with relationships. I learned how to communicate with my teachers and friends, which benefitted me in my personal life as well. Hence, campus learning teaches effective relationship management which cannot be learned through online learning. Campus learning makes students follow the deadlines in a better way, and they learn how to follow a set routine pattern for their studies. When I joined college, one of my friends, who is an online student, convinced me that college campus environment is very strict and makes the student follow the schedules forcibly. However, my experience has been different. I have been able to set my routine in a very effective manner. Online learning does not provide the students with these opportunities, because they tend to be relaxed since they do not have to confront teacher’s remarks and class fellows’ comments’ if they do not meet a deadline or are not dressed up neatly, and etcetera. Hence, campus learning teaches discipline in a much better way. I have learnt how to dress up neatly, how to convey my ideas face-to-face, and how to behave in groups and teams. I could never have learnt

Equal pay act of 1963 Research Paper Example | Topics and Well Written Essays - 750 words

Equal pay act of 1963 - Research Paper Example The Equal Pay Act of 1963 prohibits â€Å"discrimination on account of sex in the payment of wages by employers engaged in commerce or in the production of goods for commerce†. In other words, the Equal Pay Act of 1963 was designed to prohibit employers from discriminating against employees on account of gender. In many instances, the development and implementation of such Act was an urgent response to the existing labor conditions in America and the growing dissatisfaction of women with their inferior job position. Since the end of the WWII, wage differentials between men and women plagued the development of labor relations in America and called for major improvements. However, the Equal Pay Act of 1963 was not the first attempt to curb wage disparities based on gender in American economy: during the WWII, the equal pay for women policy was declared and several federal governments proposed that legislation be implemented to reduce and, finally, eliminate wage discrimination b ased on gender (Fogel, 1984). Actually, Congress took the difficult decision to pass the Equal Pay Act, fearing that the existing wage discrimination would negatively influence the balance of labor supply and demand and would, simultaneously, burden courts with unnecessary paperwork as they are fighting to prove women’s rights for equal pay (Fogel, 1984). In many instances, the Equal Pay Act of 1963 became the turning point in the development of equal labor opportunities in America. Whether the Equal Pay Act of 1963 has far-reaching implications for HR and produces significant impacts on HR practices is difficult to define. On the one hand, the act sets the stage for developing equal wage opportunities for women and men in similar professions and those, who fulfill similar obligations and tasks. Alternatively, it is clear that the Equal Pay Act of 1963 did not produce the desired effects on the state of labor relations in the U.S.: the change in wage discrimination is meager compared to

Life and work of Pyotr Ilyich Tchaikovsky Essay

Life and work of Pyotr Ilyich Tchaikovsky - Essay Example It was amazing that Tchaikovsky was not even a professional musician. The Great Russian composer had education in a particular career as a civil servant. Pyotr was born from a family that had a long military experience. His father who was mostly of Russian ethnicity worked as an engineer in the Department of Mine. All the parents were trained in arts including music, which was very important especially considering that they lived in a very remote region. At the age of six, Tchaikovsky was already fluent in French and Germany through the help of the teacher who was hired to teach Tchaikovsky elder brother Nikolai and a niece of the family (Burt 2001, p. 410 -411). At age of four, Pyotr took piano lessons where he proved to be an intelligent pupil who could clearly read music proficiently within three years. His parents were very helpful and engaged a tutor and buying him musical instruments such orchestrion. However, the parents changed their mind in around 1850 and sent him to Imperi al School of Jurisprudence in Saint Petersburg maybe because they grew insensitive towards musical gift for their son and perhaps lack of better musical career in Russia at that time. Pyotr’s father also became broke and may have wanted Pyotr to remain independent as soon as possible. Music career was considered to be a very low career in Russia (Kavanaugh 1996, p.50-51). The fact that both Tchaikovsky’s parents schooled in Saint Petersburg, they felt it important to take their son to The School of Jurisprudence which they felt would prepare their son for a career as a civil servant at the age of 10 and this made him board for two years. It forced him to stay almost 1,300 km away from his family and later begun a seven year course of studies after his two years in preparatory school. Separation of Tchaikovsky from his mother made him have an emotional suffering that affected him for the rest of his life and was further increased by his mother’s death in 1854. Tc hikovsky mourned his mother for the rest of his life as he termed it the â€Å"crucial event† and claimed that it was vivid to him. His mother’s loss also made him to make his initial stern composition called a waltz in her memory. The father thought it wise to take his son back to school so that his mind can be occupied with academic work which later made Tchaikovsky made lifelong friendship with fellow students Aleksey Apukhtin and Vladimir Gerard. Music greatly unified them and they maintained an extracurricular activity where they habitually attended the opera. Tchaikovsky further went ahead with his piano lessons by the help of an instrument maker Franz Becker who made several trips to the school. In 1855, Tchaikovsky father employed Mr. Rudolph Kundinger as a private teacher who suggested to his father that Pyotr did not have any future as a musician but later confirmed that his decision was based on his negative experience as a musician. Tchaikovsky’s fat her remained receptive about music career and did not know what to do about it making him to advice his son to finish school and try for a post in the Ministry of Justice.

Israeli-Palestinian Conflict Essay Example | Topics and Well Written Essays - 250 words

Israeli-Palestinian Conflict - Essay Example The main and the biggest obstacle to conflict resolution is strong religious values and inability of the parties to accept view points and ideas of ach other. Each of the parties tries to prove his position and correctness. "Prejudiced views on both sides, not only by those directly engaged in the conflict, but by their allies as well, further stoke the flames of hatred and violence" (Wahid and A'La 2009). This conflict vivid portrays that ethical and religious factors and principles dominated in the Arab world and prevent its people to establish peace in the region. This conflict can be overcome with the help of the global peace organizations and UNO (United Nations Organizations). In order to make the conflict peaceful, UNO should force leaders of two countries to take part in summit and sign peaceful agreements. The main policies should involve political negotiations and organization of social life on the disputed territory. In spite of territorial claims, the core of the conflict is religious difference between these states and their ethnical envy. The Israelis would have to choose whether to annex the West Bank and Gaza Strip. And if they did so, they would have to decide whether to grant full civil rights to the Palestinians (Israeli-Palestinian Conflict, 2008).

Creating shared value (article summary) Essay Example | Topics and Well Written Essays - 250 words

Creating shared value (article summary) - Essay Example Importantly, the shared values are the benefits in relation to the cost of operations. There are three distinct ways that an organization can create shared value. The first approach is through the conceptualization of products and markets. Secondly, a company can create shared value by redefining an organization’s productivity in the value chain. Finally, an organization can create shared value by creating groups of similar things in the company that were supportive of the industry in which the organization operates in since a company cannot exist in isolation. One essential way of enhancing global economic growth is through the opportunity offered by creating societal values through economic values. In this regard, the approach provides business organizations with the opportunity to understand their customers, productivity, and external factors that influence the success of an organization. In effect, creation of shared values becomes more effective and the most sustainable effort of enhancing the organization’s participation in the social arena than the efforts that companies are currently practicing. In effect, the principle of shared value becomes an effective approach of ensuring innovation and growth in

Model of Family Therapy Essay Example | Topics and Well Written Essays - 1250 words

Model of Family Therapy - Essay Example I have always observed that people of a family interact with one another on an emotional level. The emotions may not apparently be quite obvious or visible, but they lay the basis of everyday decisions that have an impact upon the overall emotional and psychological balance of the family. It is usually quite helpful to study the social perceptions of the respective roles of different members of a family because most of the times, people tend to stick to these social norms. â€Å"Social constructionism †¦ can offer new possibilities for assessment and intervention with families.† (Worden, 2002, p. 13). Among numerous models of family therapy, I feel that the structural model of family therapy is based on similar principles and adopts a similar approach towards the resolution of the problem. That is why I think the Structural family therapy model fits best my style or personality. A therapist (Marriage and Family Therapist Career) employing SFT must first assess the familyà ¢â‚¬â„¢s interactions, figuring out the family’s hierarchy, alliances within the family, such as a mother and son against a father, or siblings against another sibling or siblings. (AllPsychologyCareers.com, 2011). The structural model of family therapy emphasizes upon a change in the structure of family and requires the therapist to play a very active role in bringing about the change. This model can be applied to a whole range of emotional imbalances. This model perceives family which may show an evolutionary transformation. The family is essentially a living open system in which the individuals depend upon one another to satisfy their individualistic needs. â€Å"Families are organizationally complex emotional systems that may comprise at least three – and increasingly today, as a result of longer life expectancies – four generations† (Goldenberg and Goldenberg, 2008, p. 4). Such families can be characterized by such traits as conflict avoidance, inter generational associations, lack of growth and triangulation. In the structural model of family therapy, the therapist sees the problem behavior as a component of the family’s stagnation. Thus, the therapist assesses the perceptual and transactional structure which is supportive of the symptom instead of serving as a causal factor. Accordingly, change occurs in terms of the family structure’s modification. This involves changes in the distance between various family members, positional changes. In addition to that, the hierarchical relations are redefined and a different set of rules for the family is explored. What I like the most about the structural model of family therapy is the fact that it illustrates the significance of the emotional inter-relatedness of the family members more than their blood relations with one another. A father may be blood-related to his child, but he may not be experiencing the necessary emotional relationship with the child. Likewise, the c hild may not be as close a relative of an uncle or aunt but may be more comfortable in sharing his problems with him/her. All the therapist is required is to see how to manipulate the structure of the family. In this model of family therapy, the therapist plays with distances in a way that all family members share optimal distance with one another. It is more like a game in which success is achieved by adequate positioning of

Attention Deficit Hyperactivity Disorder (ADHD) Treatments Essay

Attention Deficit Hyperactivity Disorder (ADHD) Treatments - Essay Example Ritalin, however, is not the most effective way to treat ADD and ADHD. This essay, then, will discuss what Ritalin is, what its side effects are, why it is still being used, and what alternatives parents have to medicating their children. According to www.ritalinsideeffects.net, Ritalin is a Schedule II substance also called methylphenidate. It is not tested in children under the age of six. "In 1998, 26,800 prescriptions were issued for Ritalin. Last year, that figure had grown to 461,000" (Sale, 2008). There is much evidence that many children who take it are simply being over-medicated, since the medication shows no signs of helping them. Some parents, however, don't know what else to do when ADD or ADHD affects their children The side effects of Ritalin are well documented. They include skin rash, fever, anorexia, nausea, increased or decreased blood pressure, chest pain, abdominal pain, irregular heart rhythm, weight loss, anemia, and difficulty sleeping (www.ritalinsideeffects.net, para. 2). Ritalin is also addictive, and easy to abuse (Rasminsky, 2008). Older students admitted that sometimes they take the prescriptions of other people, or more than they are prescribed, to "get loads done in a concentrated period of time" (Rasminsky, 2008). ... She said she only used once, but knows others who "can't stop after that first drug experience or that first A" (Rasminsky, 2008). Another admits, "You feel horrible coming down. All the reasons you're taking drugs are so amplified. It makes you depressed, so that's why you want to do more. It's a vicious cycle" (Rasminsky, 2008). Rasminsky is careful to point out that an electrocardiogram (EKG) is necessary when taking Ritalin because of the negative effect it has on the heart and the likelihood that sudden death could occur from cardiovascular death. Positive Effects There is no doubting that there might be some benefit in Ritalin for some child. A study was done of an 11-year-old boy. He'd been diagnosed with ADHD two years prior by his physician, but not given medication. During the study, he was given 20 mg of Ritalin on some mornings, but not on others. Every day he received a pill that looked exactly the same, so he had no way of know when he received the placebo and when he received the actual medicine. Someone administered the medicine other than the teachers or the observers, so the observations would not be biased. His behavior was monitored for the first four hours of the day. The study lasted three weeks. In the end, the findings showed that the student was much more focused, and well behaved on the days he received the 20 mg dosage of Ritalin (Smith et al.) This is no ace-in the-hole, however. This is one student. This student had an above average I.Q. There is no data to suggest how well Ritalin works on students of average intelligence. The student was only observed for 15 days and plenty of other studies show that Ritalin does seem to be effective in the beginning stages, but the faade quickly

Long Term Care-Hospice Essay Example for Free

Long Term Care-Hospice Essay Hospice is a process to end-of-life care and a kind of support facility for terminally ill patients. It provides comforting care, patient-centered care and related services. Comforting care relieves discomfort without improving the patient’s condition or curing his illness. Hospice is extended in a healthcare facility or at home. Its objective is to provide compassionate, emotional, and spiritual care for the dying patient. The origin of the word â€Å"hospice† in medieval times meant â€Å"way station for weary travelers† (Perry). The first hospices were run by members of religious orders in the medieval times that cared for weary travelers whom found refuge with them until their death. Modern hospices are believed to have started in the United Kingdom in the mid-19th century in Dublin, Ireland. Roman Catholic Sisters of Charity provided a clean and caring place for the terminally ill. The name hospice was first applied to the care of dying patients by Mme Jeanne Garnier who founded the Dames de Calaire in Lyon, France, in 1842. The name was next introduced by the Irish Sisters of Charity when they opened Our Ladys Hospice in Dublin in 1879 and St Josephs Hospice in Hackney, London 1905. The practice became popular in England, Asia, Australia and Africa. It was only in the early 70s that the hospice concept was introduced and accepted in the United States through the efforts of physicians Cicely Saunders and Elisabeth Kobler-Ross. These practices included effective pain management, comprehensive home care services, counseling for the patient, and acceptance of death as the natural end of the care delivery by health care professionals, bereavement counseling after the patient’s death, and continued research and education (Wexler Frey). Quality care at the end of life soon combined with grief counseling and bereavement care. The government stepped in to contain health-care costs when reimbursement for inpatient hospitalization was significantly reduced. Home-based hospice care also became popular as a more inexpensive alternative to hospitalization or care in a nursing facility (Wexler Frey). The hospice concept was not immediately accepted by conservative health professionals. The concept emphasizes caring more than curing. It also allows interaction with complementary and alternative medicine practitioners. A hospice’s primary function or service is to enable the patient and his family to accept death as a natural part of the life cycle (Wexler Frey, 2004). In addition, it provides pain management and psycho-spiritual support and complementary and alternative therapies. Approximately 80% of hospice patients are in the terminal or end-stage of cancer. Traditional medical facilities provide pain medications when requested, a hospice administers these medications regularly and before they are needed. The intention is to prevent pain from recurring. Furthermore, the problem of addiction and other long-term consequences is not a concern in the case of terminal illness. The concern is to provide effective relief to the greatest degree possible (Wexler Frey). A second major service of a hospice is to relieve physical, psychological, emotional and spiritual discomfort to the patient’s family and others close associates (Wexler Frey, 2004). It relies on members of the clergy, pastoral counselors, social workers, psychiatrists, massage therapists and other trained volunteers to alleviate the discomfort. A hospice also provides grief and bereavement counseling and support groups to assist family members in expressing or resolving emotional tensions. And it allows the use of complementary and alternative therapies, in addition to conventional medicine, in the control of symptoms and in improving the patient’s well-being. A 2002 study conducted on the inclusion of such therapies showed that patients who received them expressed more satisfaction with hospice care than those who did not receive them. These therapies include acupuncture, music therapy, pet therapy, bodywork, massage therapy, aromatherapy, Reiki or energy healing, Native American rites, herbal treatment and similar methods intended to soothe the patient and his family and friends (Wexler Frey). A survey was conducted in 2000 on more than 9,000 patients discharged from more than 2,000 hospices on the services they received (Carlson, 2007). It revealed that 22% of them received five major palliative care services, which varied among the hospices. These palliative care services were nursing care, physician care, medication management, psychological care, and caregiver support. Approximately 14% of the hospices provided all five services and 33% provided only one or two services. Only 59% of these patients received medication management services. These included administering medication, dispensing correct dosages, and setting and following dosage schedule. Growth Projections The National Hospice and Palliative Care Organization reported that, as of 2003, there were 3,139 hospice programs in operation in the United States, Guam and Puerto Rico (Wexler Frey, 2004). The Centers for Disease Control and Prevention National Center for Health Statistics said that, in 2000, there were 11,400 combined home health and hospice care agencies, which served 1.5 million patients. It also reported that, at present, more than 90% of hospice care is delivered at home, although based in medical facilities. Hospital-based programs often provide hospice care in a wing or a floor in the building. There are also independent and for-profit hospices exclusively for the care of the terminally ill. Most programs offer both inpatient and home care and allow patients to use one or both types of service (Wexler Frey). In 2005, the National Hospice and Palliative Care Organization reported that more than 4,100 hospice programs were operating nationwide (Marshall, 2007). A third of these were for-profit companies. The rise in figures led financial analysts to view the hospice industry as among the strongest growing areas in healthcare. Hospice is cost-effective and more people are getting aware of the concept. Records showed that hospice spending had grown at 26% annually since 1989 as compared with 7% increase in overall health expenses in the same period. Despite this statistical increase, the hospice market has yet to be substantially tapped. Of the approximately 2 million apparent deaths in 2003, only 710,000 were in hospice. But new government regulations in the 80s boosted the growth of hospices. These regulations allowed hospice providers into assisted living centers and nursing facilities. Since their exposure to the patients, the industry became a more attractive enterprise. The hospice concept has grown from a voluntary effort to a highly profitable industry worth $9 billion today. It is predicted to continue growing as baby boomers opt for the â€Å"good death.† Of the 47 hospices in Colorado, 53% are non-profit and 36% are for-profit. Nationwide, for-profit hospices multiplied four times between 1994 and 2004 at six times the growth of non-profit hospices (Marshall). Issues and Approaches Hospices operate on thin investment margins of only 8 to 12% on the average and receive Medicare payments of only $125 per day per patient for routine home care (Marshall, 2007). They are lucky to have thousands of volunteers to support operation. But making a profit can be difficult. Medicare regulations state that hospice can be used only up to six months. Yet many patients die just weeks from arrival. If death comes within two weeks of admission, the costs go quite high. Another problem that for-profit hospices confront is maintaining a level of quality care (Marshall). Most hospices require physicians to estimate that the patient is unlikely to survive to six months (Wexler Frey, 2004). This intention is to maintain Medicare eligibility. This disqualifies terminal patients with uncertain prognoses, the homeless and isolated patients. Moreover, health care costs constrain patients to limit their stay in hospices. The shortened stay reduces the chance and time for pastoral and psychological counselors to help the patient and the family to deal with the situation effectively (Wexler Frey). Short stay also incurs more and more costly care (Solnik, 2002). Medicare and private insurers pay per diem, which means that reimbursements remain the same and hospices must cover the rest of the expenses. Furthermore, the patient may not need much care at times and that increases the delivery cost per day. But hospices realize they have to live with this reality (Solnik). Other problems arise when staying too long in a hospice (Solnik, 2002). Prior to admission, two physicians must agree that the patient probably has six months or less to live. The patient must also agree to replace the use of life-saving equipment and treatments with palliative ones. The purpose is to keep him comfortable. If he survives the six-month limit, Medicare payments drain and the hospice must eventually reimburse some of the payments (Solnik). The cost of more effective pain medication has added to the cost of hospice care (Solnik, 2002). Hospices admit they are losing money because of the treatment modes applied to end-of-life care. Regulations must cover all the expenses incurred in all the stages of terminal illness. Medical procedures, like chemotherapy and radiation, are frequently used to alleviate pain and symptoms and for cure. Intravenous medications tackle pain but are also costlier than other forms. The appearance of new and costlier drugs blurs the fine line between life-saving and mere comfort-giving. Chemotherapy can shrink a tumor to allow swallowing and radiation can ease or reduce pain. If the hospice is not well financed, one or two patients who demand these procedures can bring cost problems to the hospice. Shareholders who fear that the return on their investment is jeopardized may decide to cut down on staff. They may also shed off community grief centers, extensive bereavement care, alternative therapies, and inpatient care centers. The multicultural view of death is another issue in hospices in the United States and Western Europe (Wexler Frey, 2004). Migrants with Easter cultures have an entirely different perspective from those with Western cultures. The Chinese’s concept of death is a sharp example. The views of death and end-of-life values of other cultures should be incorporated into the policies of hospice care programs (Wexler Frey). The low rate and significant increase of physician services are additional troubles for hospices (Carlson Morrison, 2007). In most cases, hospice physicians participate only in care planning meetings, not in direct or actual patient care. The 6% increase in the number of patients receiving physician services was not considered significant. Still less than a third of these patients received hands-on physician services. This could be the offshoot of the original and non-medical concept of hospice care (Carlson Morrison). The range of hospice services provided in different regions has also been found to vary by region (Solnik, 2002; Wexler Frey, 2004). Patients in the Northeast received a significantly narrower set of services than those in other regions. Alternative forms of palliative care for end-of-life patients are quite common in the Northeast. These forms have recently expanded as hospital-based palliative care programs more than in other regions. This trend could have influenced the role and scope of hospice care offered in that region (Solnik, Wexler Frey). One more issue or problem is regulation of hospices itself (Solnik, 2002). In order to pay for hospice care, Medicare or a private insurer requires two physicians to sign a document that the patient has only six months or less to live. It then pays only for palliative treatment or management of symptoms and pain, not for the cure of the disease. This compels the patient to choose comfort or care over cure. The hospice industry has been by lobbying for a change in the regulation to allow or include curative treatment in hospice care. In collaboration with this initiative, the National Hospice and Palliative Care Association has also been lobbying for increased insurance reimbursements to include payments for costly procedures, like chemotherapy and radiation therapy (Solnik). Some approaches to these issues have been noted. Increased disease complexity, the diversity of diagnoses and symptom burden are likely to increase direct physician care (Carlson Morrison, 2007). The patient’s primary care physician may continue to monitor the patient’s condition but he is also unlikely to possess appropriate training, knowledge and skills on palliative care (Carlson ^ Morrison). Consolidation efforts in the industry has helped hospice care providers gain greater access to fund sources (Solnik, 2002). This is illustrated by the merging of hospice services among the Charles Hospital and Rehabilitation Center, Mercy Medical Center and Good Samaritan. They created Good Shepherd. They, however, found that reducing the costs of products and services would not sustain them without extensive financing or fund-raising (Solnik). Some studies focused on the availability of hospice care to the elderly in the rural areas (Solnik, 2002). Findings showed that the range of hospice services in the areas were comparable with those in the urban areas. The probability of fewer services in the rural areas can be dealt with by increasing reimbursement to cover trave l expenses and attract skilled health professionals (Solnik). A New York legislation would expand Medicaid payment for freestanding hospices in response to the six-month limit requirement (Solnik, 2003). The initiative encouraged the construction of freestanding hospices, such as The Visiting Nurse Service Hospice of Suffolk, Inc. on Long Island and the Hospice Care Network in Manhasset. Freestanding hospices would create and provide facilities for the exclusive use of hospice care. Hospice beds in hospitals and nursing homes are currently only a small part of the overall facility. This would provide family support to take care of patients who do not have it and need it in their condition. Hospice care providers consider freestanding hospices a potentially important part of their industry (Solnik). Community Assessment The City of South Bend in Indiana is the seat of St. Joseph County in a region known as â€Å"Michiana (Answers.com, 2008).† The region covers counties in Indiana and Michigan. South Bend is famous for the University of Notre Dame and the winning football team, â€Å"The Fighting Irish.† It has a 107,789 population as of 2000. The City’s has nine medical centers, prominently the Hospice of St. Joseph County (McMahon, 2008). Employment in the health care and social services is 13.4% of the total.(McMahon). The Indiana Hospice Palliative Care Organization supervises hospice care in the City. Among the issues it confronts are treating the homeless at the end-of-life, the costs of end-of-life care to elderly patients, pain management, care-giving at the end-of-life, and futile care (2007). Treating the homeless at the end-of-life is a major concern for the City. They can seldom access hospice service for lack of resources for inpatient hospice, a home or social supp ort (Indiana Hospice Palliative Care Organization, 2007). In addition, these homeless are already beset with substance abuse problems and mental illness. Their need for hospital care is 3-4 times greater than expected and 36% longer than poor patients who have homes and encounter similar health problems. Some organizations offer them medical respite, short-term shelter with basic services for those too sick to function on the street. These organizations cannot, however, care for those who are nearing death. (Indiana Hospice Palliative Care Organization). Keeping to a medication regimen is a critical problem among homeless patients. They lack the money to buy them, lose their belongings or suffer from symptoms of mental illness or substance abuse (Indiana Hospice Palliative Care Organization, 2007). Other problems they confront are the control of pain, the inability to discuss death and dying at home. Because of drug abuse, they may be opioid-tolerant and, thus, may need higher doses. If they stop taking drugs, they need specific treatment to handle withdrawal reactions. The homeless also less willing to discuss death on account of what they have been denied in life. A study found that the homeless expect to die suddenly and violently. This expectation affects their willingness to discuss death. The homeless are also unlikely to have a surrogate or confidant who can make decisions for them in the event of incapacitation. Ethics committees or court-appointed guardians take their place for the function. And dying at home is not an option because they have no home. They are also unlikely to observe house rules in hospices. Experts recommend that homeless patients at the end-of-life be encouraged to form trusting relationships to insure or enhance curative and palliative care at that period (Indiana Hospice Palliative Care Organization). City laws are slated for revision to respond to these issues ((Indiana Hospice Palliative Care Organization, 2007). One will direct the Health Department to name a commission, which will â€Å"enact rules for physicians to order for life-sustaining treatment.† The other revision will further strengthen healthcare powers of attorney. Living wills merely provide instructions concerning life-sustaining treatment. Powers of attorney concerning the end-of-life wishes of a patient belong to the spouse as first priority, followed by adult children and then close friends ((Indiana Hospice Palliative Care Organization).# BIBLIOGRAPHY Carlson, M. D. A., et al (2007). Hospice care: what services do patients and their Families receive? Health Services Research: Health Research and Educational Trust. Retrieved on November 20, 2008 from http://findarticles.com./articles/p/mi_m4149/os_4_46/ai_n27331524?tag=content;col1 Indiana Hospice Palliative Care (2007). Crossroads. Indiana Hospice Palliative Care, Inc. Retrieved on November 20, 2008 from http://www.ihpco.org/January%2007%20crossroads.pdf McMahon, P. M. (2008). Economic development for South Bend, Mishawaka and St. Joseph County. Project Future. Retrieved on November 20, 2008 from http://www.projectfuture.org/index.htm Marshall, L. (2007). The business of dying. ColoradoBiz: Wiesner Publications, Inc. Retrieved on November 20, 2008 from http://findarticles.com/articles/p/mi_hb6416/is_8_34/ai_n29369110?tag=content;col1 Solnik, C. (2002). Hospice industry: struggling despite being busier than ever. Long Island Business News: Dolan Media Newswires. Retrieved on November 20, 2008 from