Term Paper Essay Example | Topics and Well Written Essays - 1250 words - 5

Term Paper - Essay Example Humans preserve life, as duty requires. Duty seeks to restrict the actions of humans to follow a certain direction. In a way, duty brings out the best of someone’s will. Kant depicts how a dealer interacts with his customers to illustrate how accordance to duty affects the will of a person. The dealer treats all of his customers, whether recent or patrons equally. He does so prudently to maintain his customer base. Utility is the greatest form of happiness a human can experience. According to the principle of utility, a person acts in ways that are most likely to cause him happiness. To the majority of humans, happiness is all about the absence of pain and the abundance of pleasure. Pleasure, as with any resource, is more desirable when it is in plenty. Quantity is more desirable than quality and is usually the measure of happiness. All humans are subject to this principle as they all attempt to achieve happiness in their lives. Another correlation that is similar to the relationship between pleasure and pain is that of vice and virtue. The desire of virtue is similar to that of happiness. Unlike happiness, the desire of virtue is not universal. For this reason, the pursuit of happiness is one of the motivators of human conduct but it is not the only one. The major issue of contention in developing laws is the issue of injustice and favoring one party over the other. Using a veil of ignorance, as Rawl puts it, lawmakers are able to develop laws that are just and fair. This veil ensures that there is no party that is advantaged or disadvantages as everyone becomes subject to social circumstances and natural chance. A veil of ignorance ensures that all the principles that dictate the law are arrived through fair agreement and bargain. Through the veil, justice has the chance to become fair. By thinking what might happen in the absence of a certain law, legislators naturally use to veil to come up with the laws. An example is that of a

Death Among the Ibo Essay Example for Free

Death Among the Ibo Essay Although the book Things Fall Apart and The Joys of Motherhood cover about seventy years, the difference between life in 1880s Nigeria and Nigeria in the 1950s is extreme. The Ibo people change from a clan and tribal people to a much less closely knit people much like Europeans or North Americans. The change should not necessarily be construed as an improvement in the life of the Ibo people. When Things Fall Apart begins the Ibo people are much the same as they have been for presumably centuries. They are an agrarian people living close to the land without lives that have isolated and sanitized from death. Death is a natural part of life and is common. They have rules and traditions that have taught them how to deal with death. Although many of their beliefs may seem strange to people in the twenty-first century North America the seem to work well for the Ibo until their traditions are interrupted by European Christian missionaries. The Ibo beliefs have a certain innocence and simplified world view that is remarkably refreshing when compared to todays efforts to remove death away from society and to prolong death and aging as long as possible. There is a matter of fact character in the Ibo approach to death that makes death both real and normal. There are rules to be followed. When a man dies with a swollen abdomen and swollen limbs, he is not to be buried in the earth because his body would pollute the land (Achebe, 14-15). When an Umuofia girl is murdered, the leaders meet to decide what to do. After discussion they decide they should request compensation for the girls death. They elect Okonkwo a young leader who is a self-made man to visit the tribe of the man who has killed the girl and demand that a girl be sent to the Umuofia to replace the girl and another youth be given to the Umuofia as punishment for the murder. There is a balance here that lacks the vengeance of an eye for an eye of the Judeo-Christian culture. Instead it is more of a tit for tat response. Okonkwo visits the neighboring tribe and presents them with the demands of the Umuofia. Clearly there is the threat that war will result if their demand is not met, but it is not made in the do it or else manner common in the twentieth and twenty-first century western civilization. The tribe agrees to the demands of the Umuofia and gives a young girl who is given to the father of the murdered girl. A second youth, Ikemefuna sent to the Umuofia where he is given to the charge of Okonkwo with whom he lives for three years where he is treated like a son Three years later the leaders decide Ikemefuna should be killed to satisfy justice about the girls murder. Despite his having treated Ikemefuna as a son, Okonkwo participates in the slaying. He does this in spite of a warning of an elder not to participate because Ikemefuna calls Okonkwo Father. Okonkwo seems surprised about this warning. The decision has been made by the Umuofia leaders and therefore must be followed. There are several interesting attitudes about death and children. Certainly infant death is common among the Ibo. When a child survives infancy and it appears will live to become an adult, the child is said to be staying (Achebe, 42). Similar to this is a belief that some children are reluctant to be born into this world and retain a iyi-uwa that allows them to die so they can be reborn to their mother to torment them. To stop this cycle a medicine man will take the body of the deceased infant and mutilate it so that it will be unable to return, though some have been know to return with a missing finger or mark from the medicine mans action. Okonkwo who is a renown and admired member of the Umuofia accidentally kills a youth, he and his family are banished. When this happens Okonkwo appears to accept his sentence stoically because it is the established rule. During his banishment European, Christian missionaries move into the area and begin to civilize the Ibo. Laws are made and enforced by hanging and imprisonment. Ibo who suffer such punishment lose their dignity and are no longer the man he had worked to be. When Okonkwo knows that he is going to be killed by the Europeans, he hangs himself rather than submit to the white mans law. As one might expect from the title Emechetas book, The Joys of Motherhood ¸ is more concerned with childbirth and motherhood than with death. It is interesting that the perspective of this book is decidedly written from the female point of view and is concerned with life, instead of the masculine point of view expressed in Things Fall Apart where death is a more prominent concern. In this book death is treated much like it is today. The characters in this book no longer live in the tribal or clan community that Okonkwo lived in where death is considered a normal part of life. Instead they move to the city, Lagos, where they work for low wages doing the chores the more wealthy white people consider beneath them. Here death is not so common and not accepted so easily. When Nnu Egos son dies in infancy and she attempts to commit suicide, she is judged as insane until she is able to move on and continue her day to day life. Her dead sons body is taken away soon to be replaced by the birth of additional children. Death is less acceptable and hidden from the people because the British people dont want to think about it. Instead they sanitize it and move it away from day to day life. This happens to the Ibo as well as they move into the twentieth century British colonial lifestyle. Unlike the deaths occurring seventy years earlier where the clan is aware of each death and is able to accept it for the sake of the clan, Nnu Ego dies lying at the side of the road unrecognized. She is not missed by her clan or her people who are scattered throughout the country. The lack of concern about the rights of the individual regarding death in Achebes book is disturbing. Given todays sensibilities where the individual is more important than the society the idea of   replacing one murdered girl with another girl to take her place and the idea of offering a hostage as a response to having committed a crime is troubling. People today   want to move on and get on with their lives after death, almost as if they were to acknowledge death, they will be stricken with some horrible contagious disease. Acceptance of death is still a societal problem today. Americans today seem unable to accept it. However, after reading these books, one if forced to wonder which of the approached to death, the 1880s Ibo, the 1950s Ibo, or that of Americans in 2006 is best. In some ways the 1880s version with its innocent and almost nostalgic response to death seems to the best.

Montana :: essays research papers

MONTANA BY LARRY WATSON EXTENDEND REPSONSE. 1) In his twelfth year, David discovers the pain of growing up- the fragmentation of the secure world of the innocent though the awareness of truths and realities around him. Discuss. ESSAY In the text Montana by Larry Watson, it is evident that they 12 year old David is growing up. He is a typical 12 year old, loving outdoors, riding his horse, fishing, hunting and exploring (Quote page 23), but by the influences and family around him he has a painful, confusing growing up life. As David an only child, he was not the only one that is growing up. In a way his family are still growing, learning from every part of past and present issues. David’s growing up has a lot of different influences. His father Wes is not a typically loving father. His fatherly love is harming David in a way to believe different in him and his self. Wes, David’s father, has a lot of responsibilities to cover, as he is the Mercer County sheriff. This makes David believe to look after him self and be responsible in a way to show and prove his father, as he disappoints David. (Quote page 17) Even though Wes is the sheriff he is a quite and self-effacing male who puts him self down and this shows that he isn’t the typical male stereotype of a Montana Sheriff. As the Hayden’s were well known and had heaps of power in Bentrock, David realises that he is respected because of his name, not because of himself. He didn’t have to earn it. (Quote page 126). David becomes aware of this when he is going to the grocery store, and that the locals didn’t know what was happening to his family of power. The citizens of Bentrock didn’t know that his father had arrested his own brother for sexually assaulting his patients, and murdering Marie. (Quote page 127) David had shame over his family name. Frank, Wes’ brother and David’s Uncle, has a great influence on David’s growing up. Frank shows his heroism and successfulness and this makes David envy Frank. (Quote page 78) Even though David idolised Frank, his views changed within the text. After the truth about Frank and his patients David didn’t like being alone with him. The thought his own uncle as a criminal. (Quote page 49) David changes his innocents when his is hunting and he shot and killed a magpie.

Cholecystits/Cholelithiasis

PATHOPHYSIOLOGY Medical Diagnosis: Cholecystitis/Cholelithiasis Nursing Diagnosis: Activity intolerance r/t laparoscopic abdominal incisions AEB SOB during ambulation, increased respirations at 38, O2 sat 80% room air after walking 50 ft. Normal Physiology: The gallbladder is situated inferior to the liver. The gallbladder is a structure that functions as a storage space for bile that is produced in the liver. The liver produces and secretes bile into the gallbladder from the right and left hepatic duct join together to become the common hepatic duct then into the gallbladder via the cystic duct. During the digestion of fatty food, the gallbladder releases bile that passes through the common bile duct and into the duodenum through the Sphincter of Oddi to break down fat into fatty acids to be absorbed by the small intestine to be used as energy and storage of energy for metabolic needs of the body. Pathophysiology: Cholecystitis, and inflammation of the gallbladder, is a condition which can be caused by cholelithiasis, the formation of gallstones. Most stones are formed of cholesterol. Excess cholesterol in bile is associated with obesity, high cholesterol diet and drugs that are prescribed to lower cholesterol levels. The excess saturation of cholesterol can lead to the formation of stones. This client had an elevated LDL and low HDL levels that do state the client had excess cholesterol. Biliary stasis, which is slow emptying of the gallbladder, can also cause the formation of stones. An inflammation of the gallbladder allows for excess water and bile salt reabsorption which call also lead to the formation of stones. This client did have wall thickening and distention of the gallbladder that indicates a inflammation of the gallbladder over a period of time. This is the second time the client came to the ER with pain in a 6 week period. Potential Complications: If a gallstone migrates out of the gallbladder into the ducts, it can lead to cholangitis which is an inflammation of the duct. Obstruction of the common bile duct may cause bile reflux into the liver causing pain, jaundice, and liver damage. The clients ALT, liver function test was elevated indicating liver disease process and in this clients case it is due to the back-up of bile into the liver from obstruction in the common bile duct. The client can also have pancreatitis due to the inability of the pancreas to secrete digestive enzymes through the pancreatic duct. The client had mild pancreatitis confirmed by CT scan. Complications of the cholecystitis/cholelithiasis can lead to a collection of infected fluid within the gallbladder, gangrene, and perforation resulting in peritonitis or abscess formation. A fistula into adjacent organs can for such as in the duodenum the colon or stomach. During the laparoscopic cholecystectomy, the client’s gallbladder was noted with gangrene but no perforation, peritonitis, fistula or abscess formation was noted. If this condition goes untreated, death can result from hemorrhage, peritonitis, hypovolemic shock, septicemia and septic shock. The client did not die because treatment and surgery was performed. Nursing Interventions & Rationales: Independent: 1. Ambulate with client 1:1 assist. The client should not ambulate alone. The client is at risk for falls for injury to do her activity intolerance for SOB and decreased O2 sats. This will ensure the client does not fall and if she does become weak or unstable it will reduce the injury. . Place the client in semi-fowler during resting time in bed. This will decrease orthopnea and help the client breath better by decreasing pressure on the diaphragm allowing for better expansion of the lungs. 3. Monitor respiratory status and auscultate lung sound every 4 hours. This will help assess interventions and any changes needed for their respiratory status. Dependent: 4. Monitor and assess clients client’s O2 sat level and administer O2 at 2L N C per physician’s orders. The clients O2 Sat had been at 80% room air nd after activity with O2. This will help monitor client needs and evaluate the need for any changes this client may need for a decrease or increase in O2 delivery. 5. Administer morphine sulfate 1-5 mg IV push prn q2h over 2 minutes. Administering pain meds can help decrease pain associated with the client needing to cough and deep breath and will help the client ambulate. Although the client has not indicated much pain, giving prior to activity will help the client tolerate ambulation, cough and deep breath and spirometer. 6. Administer Cefoxitin 1 gm in 100mg/NaCl 0. 9% over 1 hr q8h per physician’s orders. The administration of antibiotics will reduce the client risk for peritonitis from gangrene of the gallbladder and risk of infection form the surgery. This will also help with healing of the clients mild pancreatitis noted on CT scan Interdependent: 7. Collaborate with dietician to meet with the client regarding diet. In a client with the removal of the gallbladder, the client needs to be educated on the types of food to avoid after surgery. This will help identify what types of foods the client can continue to enjoy and those that will facilitate abdominal problems post cholecystectomy. Ensuring the family is also involved when the dietician is present will help increase the likelihood of adhering to a new diet holding the client accountable for food choices. 8. Collaborate with respiratory therapy to assess the need for respiratory assistance such as the need for nebulizer treatment or the need for portable O2 for ambulatory purposes. The client’s O2 quickly drops after taking D/C of O2. 9. Collaborate with occupational therapy to assess the ability for the client to go home. The client is an elderly lady and may need to be evaluated prior to discharge to assess ADL’s since she lives on her own. This will ensure the client can safely return home or may need to be transferred to rehab prior to going home and educate the client on throw rugs, shower use and other in home dangers that elderly clients are at risk for. Client Teaching: Instruct the client on the need to cough and deep breath and spirometry. The client has had SOB post op and decreased O2 saturation. The client has atelectasis in her right upper lobe with diminished lung sounds throughout with decreased expiratory effort. I educated the client on coughing and deep breathing every hour x10 and how to use the pillow for splinting her abdomen due to abdominal pain post operatively. Client understood and demonstrated this very well and prior to end of shift I assessed the client and had her demonstrate what I had taught her prior to leaving and she performed properly and also stated she had been doing it every hour as instructed. Textbook Signs & Symptoms . Pain, abrupt onset, severe and steady 2. Pain radiate to the back, right scapula and shoulder lasting from 12-18 hours 3. Nausea, vomiting and anorexia 4. Chills and fever 5. Abdominal guarding Risk Factors 1. Female over age of 65 2. Family history 3. Native American; northern European heritage 4. Obesity 5. Hyperlipidemia 6. Use of oral contraceptives 7. Biliary stasis: pregnancy, fasting or prolonged parenteral nutrition 8. Dis eases or condition: DM; cirrhosis; ileal disease or resection; sickle cell anemiaReferences: Domino, F. n. d. ). 5-minute clinical consult Powered by Skyscape (Ipod). Lippincott, WIlliams & Wilkins. LeMone, P. , Burke, K. , & Bauldoff, G. (2011). Medical-surgical nursing care critical thinking in patient care (5th ed. ed. ). Upper Sadle River, NJ: Pearson Education. Martini, F. H. , & Neth, J. L. (2009). Fundamentals of anatomy and physiology (Eight ed. ). San Fransisco: Pearson Benjamin Cummings. Pagana, K. , & Pagana, T. (2009). Mosby's diagnostic and laboratory test reference (Ninth ed. ). St. Louis, Missouri, United States: Mosby Elsevier.

Young Latina Mothers

Latina Recently, the Latino population in the US has become the largest ethnic group. According to the Census data, the Latino population grew by 58% from 1990 to 2000, whereas the total population grew by 13% in the same period (Skogrand, 2005). The number is estimated to be much larger but due to their undocumented status many Latino people did not participate during the 2000 census. The term â€Å"Latino† includes a wide variety of immigrant subgroups that speak Spanish, and encompasses a number of groups from Central and South Americas, with migrants from Mexico, Puerto Rico and Cuba being the largest, and â€Å"Latina† is the feminine form. Young Latino Mothers A research conducted by Berkowitz and Kahn (1995) titled, Sources of Support for Young Latina Mothers, highlighted the plight of young Latina mothers in the US and ways to address their problems. Due to high rates of immigration and fertility of young Latina women, which is twice compared to the rest of the US population, their numbers are growing rapidly. According Berkowitz and Kahn, many young mothers and their children are poor, and young mothers who raise their children independently bear the brunt of hardship compared to those who live with husbands or parents or other adults who are financially sound. However, neither getting married nor outside support to cushion the young mothers from poverty and other adverse affects. There is no single to pattern to describe Latina mothers as they are diverse; however, there are certain features each of the subgroups. Puerto Rican mothers are impoverished compared with other groups, remain single, live away from parents or relatives, and are welfare dependents. Cuban mothers are economically well off with low rates of welfare benefits. Central and South American mothers living patterns are similar to Anglos, though they are poorer to the Anglos. Young teenage mothers who raise the children on their own are found to be the most vulnerable. Teen mothers who live with their parents and relatives tend to remain in school and less likely to be poor. Married teen mothers are better off compared to single teen mothers who live with relatives or parents. However, married teen mothers are less likely to attend school than unmarried, resulting in lower education levels. Mothers who delayed their first births after the teen years had done well compared to parents who became teen mothers – they completed school and college. Social and cultural influences Acculturation and biculturalism, according to several researchers, influence the parenting style among young mothers. Acculturation is the process in which an individual acquires the skills required for life in a new environment. Hence, the impact of acculturation has altered traditional gender roles that resulted in women taking up employment, yet they fall into low income groups. Latinas who are less acculturated have traditional gender role beliefs, whereas more acculturated Latinas see more life choices (Latina Adolescent Health, 2007). Within the community, there are large cultural differences, however, there are commonalities within many Latino families. According to research the Latino families give importance to family, religion and gender roles. The importance of the family is the pervasive value in the Latino culture, extended family is essential. Both parenthood and partnerships are considered to be same as family affiliations are given importance. The main purpose of the marriage is to have children and the subsequent family life. Traditional roles play a critical role in reinforcing the gender roles: Machismo alludes to maleness or manliness and a man is expected to be physically strong, authority figure in the family who sustains the family. On the contrary, the role of the woman is complementary or Marianismo, who is self-sacrificing, religions and a homemaker. In Latino culture, motherhood for women is an important goal, apart from taking care of the elderly relatives and children. The importance of family and motherhood in the culture encourages young Latinas to become mothers during their teenage years. Due to high value for motherhood in Latino culture, young women do not see pregnancy negatively. Latino cultural traditions are found to be barriers to young women's ability to communicate openly with their partners. Some young women have babies with a hope that will bring attention from baby’s father, and later he will take up the responsibility of fatherhood; in Latino culture he is the sustainer of the family. They have the highest unmarried birthrate in the nation, over three times that of whites and Asians, and nearly one-and-a half times that of African-American women. Nearly half of the children of Latina mothers are born out of wedlock, and there is no sign lessening of the rate as there numbers are increasing rapidly. This is due to one of the traditional Hispanic values to have children and often. It is seen as a honorable thing for a young girl to have a baby, and it is difficult to persuade young single mothers to give up children for adoption. The tight-knit extended family assists unwed child rearing. Documenting fathers of illegitimate children is problematic as the impregnators of younger women are sometimes their uncles, boyfriend of the girl’s mother, older men who have a false notion that virgins are not capable of motherhood and who avoid sexually transmitted diseases.   Often, the mother’s family do not view see anything bad of these activities (Mac Donald, 2006). Although older men take advantage of younger women, the age difference between the mother and the father of an illegitimate is child is narrowing. An agency in California found that fathers as young as 13 to 14 years of age and it quite common to find an 18-year-old to have children with different girls, and boys feel getting a girl pregnant is peer approval thing. A large majority of fathers abandon their children and mothers, for a father may be already married or doing drugs or in prison. Though they know about the fathers’ whereabouts but do not know if they are working or in jail. The young women’s mothers are callous and overlook what is happening in their daughters’ lives, and the existing social milieu perpetuates the child-bearing activities. References Berkowitz, R. ; Kahn, J. (1995). Sources of support for young Latina mothers. Retrieved on June 19, 2007, from http://aspe.hhs.gov/hsp/cyp/xslatina.htm Latina Adolescent Health. (2007). Retrieved on June 19, 2007, from http://www.advocatesforyouth.org/publications/iag/latina.htm Mac Donald, H. (2006). Hispanic Family Values? Hispanic trending. Retrieved on June 19, 2007, from http://juantornoe.blogs.com/hispanictrending/2006/11/hispanic_family.html Skogrand, L. (2005). Understanding Latino families, implications for family education. Retrieved on June 19, 2007, from Utah State University, Extension Web site: http://extension.usu.edu/files/publications/publication/FR_Family_2005-02.pdf ; ;

My Papas Waltz Essays

My Papas Waltz Essays My Papas Waltz Paper My Papas Waltz Paper There are many excellent poets. One of which is Theodore Roethke, who has written many pieces that leave the writer confused about what he may really want to convey through his pieces. His mother sent him to Arthur Hill School because she was opposed to sending him to Saginaw High. At Arthur Hill School, Roethke learned his writing skills. As a freshman, he wrote a speech about the Red Cross. This speech received worldwide recognition and was written in twenty-six languages. Roethke had somewhat or a rough life during High school. During his junior year of High school, his uncle committed suicide in February and his father died two months when he was fourteen. Roethke was an accomplished writer early in school, but at the same time his success was tarnished by the difficult life he endured through High School. Roethkes troubled adolescence may be a reason why it is hard to know exactly what he is means through out his poems. After High school, Roethke attended University of Michigan in Ann Arbor. While at College, he joined the Chi Phi fraternity, played tennis, and worked. When he graduated, he went to Law School for a short period of time before dropping out to pursue a degree in Literature at Harvard University. Roethke was forced to withdraw from school due to his depression. After leaving school, he started writing many of his wonderful pieces and had several jobs along the way. One of his most famous works is The Waking, Poems written and published in 1954. For this wonderful piece Roethke received the Pulitzer Prize, the most prestiges award a writer can receive. In 1942, Roethke, wrote My Papas Waltz. Many of Roethkes pieces leave the reader wondering about what happened during the poem. In My Papas Waltz, he continues this legacy of leaving the reader wondering when reading his poems. At he age of 37, after writing many outstanding pieces, Roethke wrote My Papas Waltz. In My Papas Waltz, Roethke leaves the audience wondering about what he really wants to convey through his work. In My Papas Waltz, Roethke the reader is confused about what Roethke is trying to convey to the reader. When first reading the poem, you may think that the father is abusing his son but in reality the father and son may have a wonderful relationship. Roethke may have written this poem in reponse to the depression he suffered as a child and as well when his father, uncle, and mother dying. The speaker in the poem leads the reader to believe his father is abusing him. While in reality, if you look into the poem deeper you can tell that maybe the father and son are having fun together. Roethke uses sarcasm in his peom about his fathers attitude towards his son (Ashley). In lines five and six he wrote, We romped until the pans slid from the kitchen shelf. (Ashley) If you look at what happened closely the father and son were actually fighting until the walls shook and everything fell. The father obviously drinks often and turns violent. It is also clear that happened what happened before, like he is used to being abused, because the speaker talks as if it wasnt a big deal. (Jane) The speaker may act as if it is no big deal when it really is not a big deal at all, but wants the audience to think so. The rhyming cadence of Roethkes My Papas Waltz follows the order of steps of the dance alluded to the poems title. The structure of the poem follows the rough pace of the Waltz and the conflict between the father, mother, and son that the waltz displays in the poem. The speakers recollection of what has happened generates several narratives that show the vision home and what goes on there. As you read the poem, the speakers displays different signs of abuse and terror that goes on in the house through the first two stanzas. The first stanza of the poem seems to convey the terror and abuse the child encounters from his father. The little boy, the speaker, starts off with a somewhat of a frightening tone in his voice. (Jane)As an audience, we may think that this means the father is abusive while in fact he might just have had one shot of liquor after a hard day at work. Another point made in the first stanza is the whiskey could make a young boy dizzy. If one exams hard and looks for possible explanations, one should know that any amount of whiskey smelt by a young child would make him dizzy. When reading this poem one may think that Roethke meant this to be is an abusive situation, where in fact this may be a normal night for the family. The waltzing among them the son and father turns into a more rough like manner as the two continue. In the second stanza, the waltzing becomes rougher and conveys to the reader that this may be an abusive situation. We romped until the pan slid from the kitchen shelf. After reading this line, an audience would immediately presume that the father is abusive to his son. This may be abusive but may also be the two having a great time together. One can have a fun time, but at the same time be rough while doing so. I feel that one should have an open mind about what may be really going on during the poem. In the last tw o lines of this stanza, it says, My mothers countenance Could not unfrown itself. When one first reads these lines, one would think she is scared and doesnt know what to do about the situation with the son and father. The mother in fact may not be able to believe the two can play this long and rough together. I know when I grew up that my mother had a face that way many of times after watching my dad and I having fun together. Roethke leaves the audience here wondering whether she is scared about her husbands abuse or whether she cant believe they are causing this much mayhem having fun together. Once you look at this closely, the father and son are just having a great time together due to the fact that the son doesnt get to see his father much. As I said before, it looks like the father is a drunk and abusive when in fact he has a shot of whiskey every night he comes in. In the third stanza, Roethke leaves the audience thinking that the son and father are having fun together opposed to the abuse that some think is happening. A battered knuckle, an ear scraping a buckle, those may seem like descriptions of beatings with a belt. That stanza alone can spell out negativity (Jane). However, I do not see how this stanza can mean that the poem is completely negative. When the two are waltzing, I do not feel that there is any abusive going on here. They are just so close together dancing that it sounds worse than it may be when you read this line. If you are dancing this close and as rough as these two were, anyone could get a battered knuckle. After waltzing much of the night, the father puts the son to bed. When putting the son to bed, it is clear to me that the two have a strong relationship together. In the final part of the poem, Roethke displays a kind-hearted father. After waltzing much of the night, the father puts the son to sleep. Then waltzed me off to bed Still clinging to your shirt. The boy didnt want to go because maybe he doesnt get to see his father very often and he clings to his shirt because it just may be one of the most satisfying things that he has done with his father and he doesnt want to lose the joy in it (Jane). During the poem, Roethke left his audience wondering about what view to take on his piece. Until the last sta nza, I could not completely tell if this was an abusive situation or an enjoyable situation. I now am confident that these two had a wonderful relationship. If this was not a good relationship, I do not think the son would have wanted his father to stay or would have been holding so hard to his father. Roethkes My Papas Waltz is a poem that leaves an audience wondering to what side it should take. Many of the pieces Roethke wrote over his career did that it as well. He leaves the reader scratching its head to what went on in this piece. Maybe this is his way of making his reader think about things that may happen in real life. Everyday we view something a certain way when in fact we were wrong because we didnt look at all details involved.

viloence in military Essays

viloence in military Essays viloence in military Essay viloence in military Essay Name: Instructor: Course: Date: Violence in military The high rate of violent incidents among military men and personnel retired from active duty is alarming. The highest instances of military violence have been recorded in the least expected areas like military towns, such as Schofield Barracks, that have been categorized as the world’s most dangerous areas. The high number of domestic violence cases among military families serves to aggravate the situation and bring more attention to stopping the violent rampage. The core activity within military circles involves operations that inevitably require a soldier to be violent. While this may be the job description, it does not necessarily mean that good soldiers need to have a violent predisposition. The various manifestations of violence within military circles raise various questions that can be answered through a combination of sources. First, what are the various forms of violence exhibited by military personnel? In her article, Szegedy-Maszak, mentions domestic violence and torture as the two main forms of violence. Other authors mention these two, but also include rape, mass slaughter and murder. Another vital question is what are the major causes of military violence? Violence among military personnel may be as a direct result of their job description that may involve restoring peace and order through force (Bojanski 18). Although this is the argument given by George Orwell, in his book Shooting an Elephant, even he had mercy and great respect for human life and strived to preserve it at any opportunity he grasped. This proves that military work might be violent but does not mean that violence is necessary or acceptable. The article â€Å"Was it conditions at Abu Gharib or perverse human nature that led to these atrocities† by Szegedy-Maszak Marianne focuses on the innate aggression within human natures as one of the major causes of excess aggression and violence among military personnel in modern day warfare, as was witnessed in Abu Gharib and other war-torn areas (Szegedy-Maszak 38). She argues that exposure to violence among young American recruits transformed them from peaceful liberators into merry sadists. Szegedy-Maszak Marianne provides two psychological solutions that try to discover the ability for wickedness that resides in normal military men. She referred to the simulated prison experiments in 1971 by Philip Zimbardo that resulted in the mock guards indulging in forms of torment and degradation. In conclusion, she narrowed down the excess violence within the forces to the environment, overzealous personnel and other minor factors such as racism and imperialism (Szegedy-Maszak 19). The situation witnessed by George Orwell in Burma was slightly different. He was a government official with the British Government in India where they were exceedingly oppressive, discriminative and dominant over the natives. Obviously, violence was a main tool in instilling discipline and compliance (Orwell 27). This source is critical since it brings out the fusion between violence and authority that makes the issue of military violence exceedingly difficult to analyze. A more focused approach toward the expression of violence among military personnel was capture by Justin McCurry in his article â€Å"Arrests of US Sailors in Okinawa Reignites Opposition to Bases† that talk about violence against women by military men (McCurry 78). In this case, military men allegedly raped a woman in Okinawa. Once again, the combination of authority and violence makes it difficult to determine whether the two American sailors committed the atrocity under the pressure of active military duty or purely out of the need to exploit an opportunity. Whatever the case, it is evident that the training methods employed by the US military (Watson 37). The issue of violence within the military and the different manifestations of violence outside the boundaries of the military have been on for many years without much intervention from governments and other stakeholders. Locals have had the worst experiences at the hands of military people, and this situation needs to be changed through the development of new solutions. Bojanski Heather. Domestic violence and the military. Nebraska Department of Health and Human Services. Accessed on 7 December 2012. Retrieved from http://dhhs.ne.gov/behavioral_health/Documents/Bojanksi-DomesticViolence.pdf The article Domestic violence and the military were published to expose the situation of domestic violence in the context of military families. The article revealed that soldiers were at risk of having adjustment issues after they were done with the wars and had to go back to their families. The military officers displayed signs of heightened anger and petulance when it seemed that the adjusting process was becoming very difficult. The changes to the family that happened when they were away also served to aggravate the situation. The article gave examples of military officers who perpetrated acts of domestic violence due to their inability to adjust to the normal life. In such situations where soldiers have been unable to fit in to their new lifestyles, there are several solutions that could be attempted. One, the soldiers should be place under a monitoring program to study their behavior. In this way, uncooperative and violent behavior can be controlled before they cause casualties. The military should also provide peer-to-peer support programs that will allow soldiers going through the same issues to help each other sort their problems. McCurry Justin. Arrests of US Sailors in Okinawa Reignites Opposition to Bases. U.S. Military Violence against Women. Accessed on 7 December 2012. Retrieved from csmonitor.com/World/Asia-Pacific/2012/1018/Arrests-of-US-sailors-in-Okinawa-reignites-opposition-to-bases-video In the article, two soldiers were arrested in connection with raping an innocent young girl when they were on duty in the quiet neighborhood of Okinawa in Japan. The two officers, Christopher Browning and Skyler Dozierwalker angered the Japan government who termed the incident as â€Å"egregious and vile† (McCurry 38). However, the American government which is responsible for the training of the military personnel and who promoted the use of aggression and violence took a softer stand and promised to investigate into the matter. The response was a clear indication that violence among military soldiers was condoned and cultivated by the military system. This increases the argument pointing at the military academies for producing flawed training modules that nurture violent tendencies among soldiers. Orwell, George. Shooting an Elephant: And Other Essays. New York: Harcourt, Brace, 1950. Print The book Shooting an Elephant by George Orwell was based his real life experiences as the sub-divisional police officer of the town of Moulmein. In the book, Orwell openly displays his disgust with the British method of governance in India. His contempt and guilt put him at crossroads because, as the police officer, the government required him to engage in some potentially violent activities against the natives. On the other hand, the natives also treat him with distrust and hatred that makes their relationship highly volatile and malicious. Orwell uses the metaphor of â€Å"killing the elephant† to show the destructive strength of imperialism, and in the metaphor, he expresses the guilt, hatred and anger that developed within him as he shot the elephant. The Orwell story illustrates the effect that violence has on the military which serves to exacerbate the violence within them. Modern day soldiers are most of the time forced to act against their will in the same way that Orw ell was forced to kill the elephant, though he thought it was a harmless and misunderstood animal. Szegedy-Maszak Marianne. Was it conditions at Abu Gharib or perverse human nature that led to these atrocities? US News. Accessed on 7 December 2012. Retrieved from usnews.com/usnews/news/articles/040524/24torture.htm The American soldiers in Abu Gharib were reported to have used excessive force in securing the territory during the Gulf War. This excessive display of violence caught the interest of Marianne Szegedy-Maszak who attempted to address the reasons behind the behavior by the soldiers. She argues that every individual has the potential to become violent and torture another. Within Abu Gharib, the soldiers were however letting of the anxiety, stress and helplessness of their work on the innocent community members. These difficult conditions increased the anxiety and stress. She even mentioned sexual tension as a reason for the pent up energy that was translated into violence. Watson Bruce. High crimes: Military towns are among the country’s most dangerous. Daily Finance. Accessed on 7 December 2012. Retrieved from dailyfinance.com/2009/11/16/most-dangerous-military-towns/ The author of the article Bruce Watson discusses the violent and aggressive behavior exhibited within military towns and areas that experience regular military activity. He explains that the military bases and the surrounding neighborhoods exhibit peaceful, safe and organized environment, but in reality, the serene atmosphere harbored high levels of criminal and violent activity. The Schofield Barracks topped the list as the most violent military neighborhood in America. It reported about 759 property crimes per 1,000 people, which represents 20 times more than the average crime rate for other parts of the world. Military men are expected to be at the forefront in promoting law and order, and it is understood that military bases and their neighborhoods should experience the highest levels of security. Military bases have a tendency to comprise of high concentrations of youthful, solitary men living together in close lodgings. One likely reason for these increases in crime rates could be that young soldiers, detached from parental and communal supervision feel more tempted to perpetrate various types of crimes.

How to bond with your employees and boost their productivity

How to bond with your employees and boost their productivity Great bosses build relationships with their employees. You don’t have to be buddy-buddy with everyone in your office, but if you establish a rapport and communicate effectively with the people who work for you, you’ll foster a sense of trust and morale and create a better working environment for all. In fact, in a  recent survey, 60% of 1,000 full-time workers questioned said their relationship with their employer positively impacted their work productivity. Here are a few strategies for how you can create a relationship of trust and respect with your direct reports.Keep your door open.The more you make yourself accessible to your employees, the more comfortable they’ll feel stopping by to discuss things with you, bring up issues that come up during the day, or float great ideas your way. You’ll have a better idea of what’s going on if you’re not cooped up in your office alone. If you’re not sure how to encourage your employees to ra ndomly check in, try getting a candy jar for your desk!Schedule (and don’t ignore) weekly one-on-ones.Structured feedback on a regular basis can be invaluable to both you and your employees. Make time for a face-to-face meeting with each direct report where you can get on the same page about existing projects and listen to concerns (while expressing any of your own), and you’ll start to reap the benefits.Oftentimes, a recurring meeting on the calendar can get pushed aside or even ignored because it seems useless when you see each other all day, every day. Resist the urge to cancel or to let your employee cancel. Even if you just meet for 10 minutes, that quiet, scheduled check-in time is key to learning about your employees and getting a sense of how they’re really doing.Meet outside of the boss/employee context.You shouldn’t pretend to be on the same level as your employees- everyone knows the hierarchy, so you don’t want to seem like you’r e fooling anyone. Still, it’s okay to come down from your upper rung every now and then and let everyone in the workplace have an equal voice in the organization. Maybe schedule a brainstorming meeting where you, too, are responsible for coming up with ideas, or a weekly roundtable with the team where you all talk about the best thing that happened during the work week.Get together outside of the office.A few team-building activities outside of the office can go a very long way to helping you get to know your employees as actual people, not just in the context of their roles at work. Try a team lunch or a group volunteer project, and solicit ideas from the group. But please don’t make people give up their weekends- schedule this non-work outing a few times a year during working hours.Offer regular encouragement.Take an interest in the career development and job satisfaction of each direct report. When someone is doing a good job, take the time to let them know- a littl e positive reinforcement goes a long way. Send a quick email of praise when a particular project goes well. Send an annual (or monthly!) email reminding them of how much you appreciate their work. Make it clear to higher-ups when someone goes above and beyond. When your employees know you notice the little things, they’ll want to be on the ball every day.Don’t fake it.Above all else, you can’t fake it. Valuing your employees and making them a priority takes real effort and investment. If you halfheartedly make attempts to reach out every so often, everyone will know you don’t really mean it. But putting in the effort is worth it- the stronger, healthier relationships you’ll build will make everyone happier and more productive.

Nursing Culture Groups Essay Example | Topics and Well Written Essays - 2500 words

Nursing Culture Groups - Essay Example Nasser is being respected would not mean that the young Samia will not receive treatment, which can only be best administered after examination on her private part. To ensure this balance, Mrs. Nasser must resort to negotiation. The negotiations must be made on fair grounds such that the nurse must not be seen as taking an entrenched position. She must persuade Mrs. Nasser to come to the compromise willingly. iii. Cultural care re-patterning or restructuring: This should be the final step or strategy but it must not be taken for an act of eliminating the culture of Mrs. Nasser or indoctrinating her with the nurses’ own style of culture or what she deems as best. However, she can restructure Mrs. Nasser by pleading with her to be tolerant and flexible with her culture. She will allow Mrs. Nasser to enjoy the best of services whereas she goes; especially for her own good and welfare. 3. How might the nurse ensure that Mrs. Nasser’s concerns are addressed appropriately and that Samia has received the appropriate care? The concluding situation to achieve out of this whole situation should be a win-win affair. This is to say that as much as the concerns and cultural believes of Mrs. Nasser must be respected, it is also important that Mrs. Nasser’s daughter receives the needed care and treatment. Basing on the congruent strategy of negotiation, the nurse must be in a position to convince Mrs. Nasser to compromise for the examination to be carried out. The compromise will however not come easily and this is where the nurse has a lot of work to do. The nurse actually has a duty to explain herself clearly to Mrs. Nasser to win her heart. She must make Mrs. Nasser understand that the reason for the... From this research it is clear that it is important for the nurse to understand that her professionalism as a nurse transcends beyond her ability to give medical health to a patient. It also includes an ability to have a cordial and congenial atmosphere with clients and patients such that the clients and patients can have emotional health as well. The nurse should therefore respond by giving the patient enough room to express all her concerns so that after having all the substance of the concerns, she can strategies to address them one after the other. The rationale here is that when patients and clients are given enough room to express themselves, they co-operate better with nurses and nurses have the opportunity of giving them detailed healthcare. Communication is an important aspect of the nursing practice. It becomes even more important when nurses have to communicate not just among themselves as professionals but must communicate with their clients and patients, who must underst and the nurses as professionals from a layman point of view. Due to this, nurses must learn to make themselves understood through the use of the right and most appropriate communication mechanisms. Communication is therefore critical when it is done at the interpersonal relationship level. Even more critical is when nurses have to communicate with people from different cultural background. When this situation arises, the nurse does not just have to make the patient understand him or her as a professional from a layman point of view but that the nurse must do everything possible to ensure that the communication is appropriate from the judgment and perspective of the client or patient.

Underachievement in gifted and talented children Essay - 1

Underachievement in gifted and talented children - Essay Example s that relate to academic motivation and the special needs that may correlate to students’ challenges that may be inconspicuous to many classroom educators. In this regard, this paper aims at forming a critical analysis of the factors that underlie underachievement in talented students with a view of presenting some precise interventions to address the issue. Underachievement can be defined as the demonstration of a severe discrepancy between the anticipated achievements or results and the actual achievements in talented or gifted children or students. In this regard, the expected results are measured by intellectual or cognitive ability evaluations or some standardized achievement test scores. On the other hand, the actual results are measured by teacher evaluations or class scores in the classroom set-up. In order for a child to be regarded as an underachiever, the difference between the projected and the observed accomplishment need not be the unswerving outcome of an identified learning infirmity. Therefore, talented underachievers often exhibit superior scores on assessments of expected achievement (Mc Coach, 2000: p. 157). Majority of the recent research studies that have investigated the characteristics of underachieving children have placed much focus on the clinical, qualitative, and single-subject research methodology. The studies, such as Sousa (2009), Cassady (2010), and Callahan and Davis (2012), have documented several causes of underachievement in gifted children. According to these studies, the most common factors associated with underachievement in talented children include the following; The determination on why some high potential students exhibit low levels of achievement is often challenging since underachievement is precipitated by varying reasons (Callahan, & Davis, 2012). Nevertheless, practitioners and scholars have to explore the causes of underachievement in order o come with succinct solutions. Firstly, it is important to understand

Nursing assigment Essay Example | Topics and Well Written Essays - 2000 words

Nursing assigment - Essay Example Bearing these in mind, the significance of evidence-based practice is highly valuable in proving that health practices are safe for the public and cost-effective. In this paper, barriers and possible resolution of gaps between nursing research and their application are tackled, as well as their utilization through standardized clinical guidelines in relevantly managing smoke cessation in clinical settings. Discrepancies in Evidence-Based Practice Despite the long emergence of concepts in evidenced-based practice in health care sectors, success in fully translating research outcomes into care practices seemed lagging in progress. At large, four main sectors contextually represent the barriers to research employment: â€Å"health-care professional related, organizational-related, research related, and presentation-related† (Chau, Lopez, & Thompson, 2008, p.640). Each division indicates specific areas of clinical problems that probably weaken health professionals in fully respond ing to the positive sides brought about by solid research results. Health-care associated factors may range from personal demographics (educational level, social and economic status), personal characteristics and values, such as knowledge seeking behaviors to further one’s practice. With organizational barriers, these comprise viewpoints of affiliated institutions on its commitment to research adaptation and dissemination, facility maintenance, hierarchical culture and authority for change, administrative support, and lack of opportunities to develop and acquire research resources. As of research-related interference and presentation, types and comprehensiveness of research contents affect professional perceptions, including comparison of previous and present research for results and conflicting thoughts. As such, there is increased tendency to reject research composition and presentation should data fail to meet practical health needs of clinical personnel that research team s aim at satisfying. In more ways, the concerted results of practical nursing barriers create disparities that may unintentionally provide nurses with concrete excuses not to change their old ways. Common among perceived nursing barriers to full research application are said to be generated from organizational, and professionally-related factors. Funk, Tornquist and Champagne (1995, p.397) emphasized â€Å"insufficient authority to (clinical practice) change...and insufficient time to implement new ideas† as primary sources of research to practice discrepancies. The prevailing culture of inflexible organizational structures in most clinical institutions restricts the attitude of change and resource availability in such settings. Elaborately, it also affects sufficiency of time required to search, read, and substantially absorb relevant information from research journals and related materials. To top these off, Cummings, et al. (2007, p.S33) revealed the nature of occupation n urses suffers, where most of the time, exhaustion in both physical and emotional aspects reduce their quality of professional care. There is difficulty, then, to acquire suitable skills in search for relevant studies due

Article Presentation Assignment Example | Topics and Well Written Essays - 500 words - 1

Article Presentation - Assignment Example In addition, they should establish the ability to implement EBP in the day-to-day operations of a mental institution. The study focuses on the integration of the most effective measures available in current research. The methodology employs research evidence that is backed by clinical expertise and patient values in order to facilitate the clinical decision making process. The study is based on the ideologies that customs, norms, expert opinions and established rituals are no longer acceptable practices in the decision making process. Instead, there is a need for a deliberate process that takes the values and preferences of patients into account. The article argues that, this perception demonstrates that EBP is a clinical strategy that can aid problem solving. Consequently, emphasis is placed on identifying the best research evidence and integrating it in the decision making process. The process will ensure that clinicians are providing the best care that fulfills the needs of their patients. Increasing interest in mental health issues has prompted researchers to increase the body of knowledge available on the topic. As a result, mental health nurses can refer to a growing EBP base. However, many researches are done in a controlled environment. Consequently, effectiveness may be inappropriate in a real world setting where there are limitations such as limited organizational resources, workforce issues, lack of sufficient staff education and training. Many psychiatric mental health (PMH) issues have not been addressed. The failure to research or define them can be attributed to ethical issues. In this instance, the best recourse for mental health professionals is to hold discussions on the recommended intervention measures. They should also highlight the potential risks and benefits involved. In addition, they should study the available alternatives before settling on one course of action. In spite of the increasing application of

Technology Advancements and Stem Cells Research in Hemophilia Paper - 1

Technology Advancements and Stem Cells in Hemophilia Treatment - Research Paper Example Science has technology has made significant progress in the last few years, what looked implausible a few years ago has become plausible today and what looks implausible today will become plausible tomorrow. Several major breakthroughs have been achieved in the last few years. Many new drugs have been invented to combat killer diseases and several lives have been saved because of these newly invented drugs. The invention of Stem cells has made life so much better. Significant progress in the field of stem cells was made by Dr. Ernest A. McCulloch and Dr. James E. They started working in unison in the 1960s and their research laid an ideal platform for the others to take it forward from there and that is exactly what the others did. Stem cells are really useful and they have saved several lives which would not have been plausible had stem cells not been invented. â€Å"Mouse embryonic stem cells treated in culture with a growth factor and then injected into the liver reverse a form of hemophilia in mice analogous to hemophilia B in humans, the new study shows.† (Stem Cells Treated with Growth Factor) The versatility of the stem cells is arguably their biggest strongest point, stem cells can easily grow in certain bodies and they are more than capable of achieving specialized functions. In addition to this, they can also renew themselves on their very own and this versatility makes them really useful. There are two types of stem cells namely, Embryonic stem cells and Adult stem cells. The two are really different from each other and understandably have different characteristics.  

Feature a female fitness competitor in Pittsburgh, PA Article

Feature a female fitness competitor in Pittsburgh, PA - Article Example When Sarah’s not delivering letters, she spends the majority of her time pursuing her passion: working to become a professional figure competitor, and she’s well on her way. Sara has competed in numerous figure competitions, including Miss Hawaiian Tropic 2004, Eugenia Swimwear Bikini Jam 2004, and the OCB Golden Triangle Battle for the Sword, while also developing her training clientele. Sarah works for various nutritional and fitness sponsors, flies around the country to model for companies like Bowflex, and even has time to maintain a website and a Twitter account1. Yet with all of this success, Sarah stays remarkably grounded. Colleagues and peers that know her say Sarah is outgoing and easy to work with, and that despite her success, her ego has not grown with her muscle mass. This humility in the face of achievements comes from the same place as her motivation to stay healthy: her childhood. Sarah describes her childhood as relatively normal with two supportive an d loving parents, yet she reveals that she struggled with her weight as a young child. â€Å"I was an overweight child,† she confesses. â€Å"My parents encouraged me to start exercising through athletics. I wasn’t so receptive at first.† This initial resistance faded as Sarah became involved with cheerleading at the local Catholic school she attended, and she eventually realized a passion for athletics. â€Å"Athletics in general have tremendously made my life more rewarding and fun,† Sarah says, and this love would carry her a long way. After realizing she had more of a drive to be on the court playing than on the sidelines cheering, and after noticing she was taller than the whole girls basketball team, Sarah decided to try out. This was when Sarah’s love of athletics turned into a passion. â€Å"Soon, I went from a lethargic chubby adolescent to a thin, happy, and athletic teen. I took it to the extreme.† Sarah would go on to play softba ll and run track in addition to playing basketball in high school, yet Sarah’s favorite and most accomplished sport remained volleyball. It was her skill in volleyball, her unyielding passion for athletics and competition, and her humility in daily life that took the talented young athlete from Pittsburgh out to California University in California, PA. Here she would further refine her athletic skill playing Division II volleyball, and here she would discover the work ethic and dedication that would get her out of the bed at 4:45am years later. Sarah describes the workouts as challenging, saying she would spend â€Å"hours on the court practicing,† but this practice would quickly pay off. In her sophomore year of college, Sarah earned what she describes as one of her most memorable honors. â€Å"Our team went to the Final Four my sophomore year of college,† she says. â€Å"It was a great experience that I will never forget.† Even in the face of overwhelmi ng athletic achievement, Sarah found the humility and energy to hit the books and stay grounded in her academic work. Sarah graduated from California University in 2003 with honors, and takes pride in earning her degree in Education while also being so competitive athletically. â€Å"I did really well in college,† Sarah explains, â€Å"and I graduated Summa Cum Laude.† Her academic and athletic excellence obviously made her a hot commodity for job recruiters after graduation. Of course, in Sarah’s typical highly motivated style, she didn’

Technology Advancements and Stem Cells Research in Hemophilia Paper - 1

Technology Advancements and Stem Cells in Hemophilia Treatment - Research Paper Example Science has technology has made significant progress in the last few years, what looked implausible a few years ago has become plausible today and what looks implausible today will become plausible tomorrow. Several major breakthroughs have been achieved in the last few years. Many new drugs have been invented to combat killer diseases and several lives have been saved because of these newly invented drugs. The invention of Stem cells has made life so much better. Significant progress in the field of stem cells was made by Dr. Ernest A. McCulloch and Dr. James E. They started working in unison in the 1960s and their research laid an ideal platform for the others to take it forward from there and that is exactly what the others did. Stem cells are really useful and they have saved several lives which would not have been plausible had stem cells not been invented. â€Å"Mouse embryonic stem cells treated in culture with a growth factor and then injected into the liver reverse a form of hemophilia in mice analogous to hemophilia B in humans, the new study shows.† (Stem Cells Treated with Growth Factor) The versatility of the stem cells is arguably their biggest strongest point, stem cells can easily grow in certain bodies and they are more than capable of achieving specialized functions. In addition to this, they can also renew themselves on their very own and this versatility makes them really useful. There are two types of stem cells namely, Embryonic stem cells and Adult stem cells. The two are really different from each other and understandably have different characteristics.  

Globalization and Volkswagen Essay Example | Topics and Well Written Essays - 3250 words

Globalization and Volkswagen - Essay Example Volkswagen was incorporated in the year 1937. Volkswagen group is regarded as one the globe’s foremost automobile manufactures with its headquarters situated in Wolfsburg at Germany.Volkswagen was incorporated in the year 1937. Volkswagen group is regarded as one the globe’s foremost automobile manufactures with its headquarters situated in Wolfsburg at Germany. By globalising its business activities, Volkswagen has not only spread its activities in all the five continents of the globe but also able to transfer its technology to these markets, has created local employment and by adding local contents in its products it has opened the doors for local businessmen and has offered jobs to local people, it has helped to nourish local industries in foreign markets and has achieved cost savings about 15 to 25% due to local contents. This research essay is going to analyse how Volkswagen has benefitted from the process of globalisation. Volkswagen and Globalisation Globalizatio n can be referred as an active method of liberlisation, integration of market across the extensive array of markets internationally from goods to labor and from capital to services and technology. Globalisation is footed on the principle of freedom: the freedom to have commerce with the rest of the globe and capitalise on each nation’s relative gains; the freedom to invest where returns on capital are deemed to be highest within a tolerable magnitude of risk and the freedom to establish business of country’s of one’s choice... MNCs hold strong places in all three channels of globalisation and by clarity, they vouch for all foreign direct investment ( FDI), they are very active in trade , with thirty percent of global trade taking place within the MNCs and not between the MNCs and they transfer the knowledge and the bulk of technology across borders through intrafirm business transactions , create employment in host countries , responsible for rapid growth of GDP in the host countries and can be said to be responsible for increasing the standard of living in the countries, they conduct the business. (Ervin & Smith, 2008, p.24). Thus, due to the poignant position of MNCs, globalisation can be referred as the business decisions made by the MNCs as regards to their international business activities under transforming scenarios of international competition. (Kleinert, 2004, p.3). Globalisation also refers to the liberalisation of financial flow. Financial liberalisation eventually increases economic growth, eff iciency and development by infusing new technical know and foreign investment. Economic liberalisation connotes introduction of policies like removal of credit controls, deregulation of interest rates, privatisation of banks controlled by government, elimination of credit controls, permitting foreign financial institutions in the domestic financial markets and relaxation of the bar on the entry of private sectors. In short, it can be said that liberalisation means removal all barriers from the inflow of capital outside the frontiers of a nation. (Ariccia, 2008, p.3). It is to be noted that one cannot expect that mere economic liberalisation cannot achieve inflow of capital as only about 14 nations could attract in excess of eighty-five percent of

The Life of Jonathan Swift Essay Example for Free

The Life of Jonathan Swift Essay Life has always been filled with people who have given much in their lives to contribute to the betterment of society. They surpass the boundaries that have been set by the government and the people around them, just to make a difference in the world. One of these people was Jonathan Swift. Jonathan Isaac Bickerstaff Swift was born on November 30, 1667 in Dublin, Ireland. He was the only son and second child of Abigaile Erick Swift and Jonathan Swift. Since he was named after his father, he was often called Jonathan Junior or simply Junior. Before he was born, Jonathan’s father died. His other relatives were of great assistance just so he could have a good education (Incompetech website, n. d. ). In 1686, he was able to graduate from Trinity College in Dublin. He immediately went to England to open new doors, and was fortunate enough to be accepted as the secretary of Sir William Temple. Living with Sir William paved way for Jonathan to meet a young lady, who later became an important part of his life. He met Esther Johnson and became her tutor. In between his sessions, he would scribble down his thoughts and ideas, but eventually burned them. Upon Sir William’s death, Jonathan was jobless and eventually became a fashionable satiric writer for Dublin (Incompetech website, n. d. ). Soon after, Stella, as he fondly called her, moved to Ireland just so she could be near him. Their relationship was a source of all gossips in town, because of their difference in age. Some said that the two lovers were even married in 1716. When Stella died in 1728, Jonathan Swift was desolated, and hid a lock of the lady love’s hair in his things until the day he died (Pegasos, 2000). His political ambitions were never taken aside. When Queen Anne was in position, Jonathan became the vicar of Kilroot. He then wrote for the Tattler, a newspaper, from 1708-1709. His writing skills were tested further when he became one of the founders of the Scriblerus Club. He worked together with the Pope, Congreve, and Robert Harley (Pegasos, 2000). The years 1713 – 1742 were the years when Jonathan was dean of the St. Patricks Cathedral. He became deaf in his early twenties, and many people thought that he was insane. During one of his conversations with Edward Young, he said that he would be mentally incapacitated when he reached the age of fifty. Basically he was ready to face this mentally challenging state early on in his life (Pegasos, 2000). He died on October 19, 1745 in Dublin Ireland due to Alzheimers disease. He died leaving behind his legacy through the numerous poetries and proses written in pamphlets (Pegasos, 2000). 1726 was another great year for Jonathan Swift. This was the time when he wrote and published the famous prose entitled, Gullivers Travels. At first reading, the book may be classified as a childrens book, although the writer had an underlying meaning behind each even in Gullivers life. The book showcased most of Jonathans feelings and emotions about the social problems at that time (Incompetech website, n. d. ). One of Jonathans works was evident in the proposal he wrote about the children in 1729. Entitled, â€Å"A Modest Proposal: For Preventing The Children of Poor People in Ireland From Being Aburden to Their Parents Or Country, and For Making Them Beneficial to The Public† (Art-Bin, n. d. ), focused on how the children of their time suffered the hardships in life. From the title alone, we can see that Jonathan wanted the children to live normal lives before they had to endure the hardships and realities of life. His main purpose in writing the proposal was to help uplift the lives people had in their society at that time. He had no children of his own, so the proposal he wrote was not of great bearing to his life. All he wanted was for people to first realize that the children should not be placed in situations that could ruin their lives, and eventually their futures (Art-bin, n. d). Although Jonathans book, Gullivers Travels, was well received by many, he always stood for his beliefs and oppositions on the inequalities of the government towards his native land. When he finally decided to run for politics, he kept his distance form the Whig and Tory parties. He wanted to be individually known for his works and accomplishments, other than the association that may be given to him by either parties. His writings were mostly satiric, meaning they made use of sarcastic words, and exposed the hard realities of their life at that time. Although the book was creative in manner and well suited for children, many were alarmed by his writings, for they opened new ideas for people (Westchester University, n. d. ). His writings were not only isolated to proses. He also participated in writing papers involving ecclesiastical matters, such as the â€Å"Three Sermons and Prayers†, which he wrote in 1744. Some of his other works were included in his book, The â€Å"Writings on Religion and the Church†, which was finally published in 1898 (Merriman, 2008). It was said that Jonathan had published a collection of his works three years before he slipped into senility. Eventually, he suffered from a paralytic stroke in 1738. The people close to him started to care for the ill Jonthan Swift. In 1742, his belongings and affairs were soon cared for by appointed guardians (Victorian Web, 2000). His life was lived to the fullest, and he made sure that people remembered him as someone who had hoped for the upheaval of society in Ireland. He left behind his legacy through the numerous poetries and proses he wrote in pamphlets. He died on October 19, 1745 in Dublin Ireland due to Alzheimers disease. (Pegasos, 2000). Jonathans remains were laid beside his beloved wife, Stella, inside the St. Patricks Cathedral in Dublin, Ireland (Merriman, 2008). With his own epitaph written, Jonathan became successful in accomplishing his dreams of being a well known person. He is in fact, forever remembered by his countrymen and of the whole world, forever. Jonathan Swift may have suffered before he died, but he was able to open the eyes of the people to the reality that was happening right before their eyes. He was an enemy to some, but an inspiration for many. His works will forever be present to inspire us and the children of the future to go on and be someone. References (. n. d. ). Jonathan isaac bickerstaff swift. Incompetech. Retrieved May 2, 2008 from http://incompetech. com/authors/swift/. West Chester University. (n. d. ). Jonathan swift: A modest proposal 1729. Retrieved May 2, 2008 from http://courses. wcupa. edu/wanko/LIT400/ireland/jonanthan_swift. htm (2007). Ireland. MSN encarta. Retrieved May 2, 2008 from http://encarta. msn. com/encyclopedia_761566701_9/Ireland. html. (n. d. ). A modest proposal. The art bin origo. Retrieved May 3, 2008 from http://art-bin. com/art/omodest. html (2000). Books and writers. Pegasos. Retrieved May 3, 2008 from http://www. kirjasto. sci. fi/jswift. htm (2000). A chronology of jonathan swifts life. The victorian web. Retrieved May 5, 2008 from http://www. victorianweb. org/previctorian/swift/chron. html. Merriman, C. D. (2008). Jonathan Swift. The literature network. Retrieved May 5, 2008 from

Right Ventricular and Left Ventricular Cardiogenic Shock

Right Ventricular and Left Ventricular Cardiogenic Shock Cardiogenic shock is a major and often fatal complication of a variety of acute and chronic disorders whereby the heart muscle fails to effectively pump blood forward and is unable to maintain adequate tissue perfusion. This ongoing clinical problem of cardiogenic shock often results from cardiac failure. Nurses and physicians need to work together to develop a rapid and well-organized treatment approach to this devastating condition. Acute myocardial infarction (AMI) is the most common cause and early recognition of cardiogenic shock is essential to saving the patient and functional organ perfusion. To help discuss the differences between right ventricular and left ventricular cardiogenic shock as a result of AMI, a case study format has been chosen. Priority nursing diagnoses, interventions and outcomes will also be addressed. Case Study Mrs. Rudd, a 53-year-old woman, is walking her two golden retrievers in Central Park when she starts to develop a nagging left arm pain radiating up her neck and down to her fingers along with diaphoresis, flushing and shortness of breath. She loses grip of the leashes and the dogs, sensing something wrong, get the attention of a young couple sitting under a tree. They see her in distress and call 911 to get an ambulance. Paramedics arrive on the scene within minutes and transport her to the emergency department at Mt. Sinai Hospital. On arrival, Mrs. Rudd continues to complain of the pain getting more intense and a new onset of substernal pain. The paramedics note her to be pale and clammy with cool and mottled extremities. Her vital signs in the ED are heart rate 56 beats/minute, blood pressure 78/53, respiratory rate 24 breaths/min and labored, pain level of 9/10 and temperature 96.9* F orally. The nurse provides supplemental oxygen at 100% via non-rebreather mask and administers 325mg of chewable aspirin, but holds the nitroglycerin because of her already low HR and BP. Then the cardiac monitor leads are placed, which shows sinus bradycardia;18g IV access is obtained in both arms and blood chemistry, CBC and cardiac enzymes are drawn and sent to the lab. A stat 12-lead electrocardiogram is run which indicates that Mrs. Rudd is having ST elevations in leads II, III and aVF suggesting acute inferior wall myocardial infarction. This explains the bradycardia due to damage to the right ventricle and likely an occlu ded right coronary artery. Tachycardia is seen in anterior and lateral wall MI where the circumflex and/or LAD coronary arteries are blocked. The nurse may also see ST depression instead of elevation in leads II, III and aVF with either of these infarcts. Her signs and symptoms upon presentation to the hospital suggest that she is in the early stages of cardiogenic shock, a life-threatening complication of AMI associated with high mortality. Early and aggressive treatment is necessary for her to survive this condition (Lenneman, 2011). Etiology and Pathophysiology With cardiogenic shock, perfusion is affected and delivery of oxygen to the tissues is markedly decreased. Various conditions can lead to cardiogenic shock besides AMI. It can occur as a complication of open heart surgery, myocarditis, valve failure, severe dysrhythmias or from any disease or injury that leads to mechanical failure of the bodys pump. With AMI, the myocardium is starved of oxygen and nutrients and dies (Lenneman, 2011). This leads to diminished contractility, reduced ejection fraction (the percentage of blood present in the ventricle at end-diastole that is pumped out with each heart beat) and disruption of hemodynamic measurements including persistent hypotension, high filling pressures, such as PAWP, PAP, high CVP and SVR, and most importantly reduced stoke volume and cardiac output. As a result of the reduced ventricular emptying, pressure rises within the ventricles, causing dilation of the ventricles, eventually leading the one initially injured to fail and if no t corrected both ventricles. In cases of heart failure in both ventricles, the patient will probably require transplantation and an LVAD to keep them alive while on the list awaiting a donor heart (Holcomb, 2002). Signs and symptoms Clinical signs and symptoms that are associated with cardiogenic shock depend on the ventricle affected. In right heart failure the nurse may observe jugular vein distension, peripheral edema and weak pulses, altered mental status, elevated ICP. Venous congestion and bradycardia are possible due to the heart slowing to allow adequate blood return and filling before pumping, which can be heard on auscultation as a split second heart beat. With left ventricular failure a pathological S3 or ventricular gallop can be auscultated, and pulmonary edema and congestion will likely be present, evidenced by labored breathing, dyspnea, course crackles and wheezing leading to ineffective gas exchange. To improve oxygenation, respiratory rate increases and the patient hyperventilates as manifested by hypocapnia and alkalosis (PaCO2 less than 35 or pH greater than 7.45) measured by arterial blood gases (Holcomb, 2002). Since the heart is unable to recover and maintain adequate perfusion to the kidn eys, they also will fail and subsequent ABGs reveal a shift indicating a worsening condition of both respiratory and metabolic acidosis. Sustained hypotension (systolic blood pressure less than 90mmHg for longer than 30 minutes) and adequate left ventricular filling pressure with signs and symptoms of tissue hypoperfusion are less common definitions for cardiogenic shock. This hypoperfusion may be exhibited by such signs as cool extremities, altered mental status, oliguria (urine output less than 30mL/hour or less than 0.5mL/kg/hour) or all three. Another helpful measurement utilized in assessing shock is drawing a serum lactic acid level, a diagnostic tool for detecting occult tissue hypoperfusion. Even if a patient does not exhibit low blood pressure at onset, a lactic acid value above 4mmol/L can identify organ dysfunction at the cellular level before the patient becomes hypotensive. This can be assessed by the nurse observing skin becoming cool, pale, and clammy as blood is shunted away from the periphery and skeletal muscles back to the vital organs. As a consequence, wasting and lactic acid buildup occur. The ef fects of blood being shunted away from the gastrointestinal tract initially lead to decreased bowel sounds and eventually progress to absent bowel sounds or paralytic ileus (Farwell, 2006). Hemodynamics In the case of Mrs. Rudd, her initial presentation reveals signs of the early compensatory phase of shock. The physicians and nurses need to collaborate and respond promptly to limit permanent damage to her organs and ensure her survival. In the early stage of cardiogenic shock the sympathetic nervous system is activated to respond to a failing heart. The renin-angiotensin-aldosterone system (RAAS) is stimulated to cause vasoconstriction and sodium and water retention to maintain blood pressure (Porth, 2006). To evaluate the effectiveness of organ perfusion cardiac output needs to be monitored and controlled. This is initially sustained with fluid replacement and volume expanders in right heart failure resulting from inferior AMI, to in essence replace oil in the engine to keep it running. In response to heart failure from a lateral or anterior AMI, the patient will exhibit increases in heart rate and/or stroke volume defined as the amount of blood pumped out with each ventricular contraction or the difference between the end-diastolic and end-systolic volumes (Eliott, Aitken, Chaboyer, 2007). The physician often prescribes vasopressors and inotropic medications such as milrinone or dobutamine to improve contractility and pumping efficiency of the damaged heart as well as reduce afterload. In cardiogenic shock, the values of cardiac output (normal range of 4-8L/min) and the more accurate measurement, cardiac index (2.5-4.0L/min), can significantly drop in response to heart failure and the pump not being able to adequately circulate blood through the body. In some cases the physician may order a diuretic such as furosemide to be administered to decrease preload by reducing pulmonary (LV) or systemic (RV) congestion and stasis of blood. Another measurement of end organ perfusion that clinicians rely on is mean arterial blood pressure (MAP) which has a normal range of 60 to 110mmHg. When the body is in a state of shock, at first the body attempts to compensate, however as the condition prolongs the values gradually drop below 60 mm Hg along with a decreasing cardiac output (Holcomb, 2002). Together these hemodynamic values are used to determine if the patient has inadequate organ perfusion and to evaluate the adequacy of interventions by both the physicians and nurses. Subsequently, the body attempts to compensate by increasing heart rate, which decreases diastolic filling time. This faster rate increases the oxygen demand of already damaged heart muscle, which negatively impacts cardiac output even further. Unable to keep pace with the increase in volume, hemodynamic values worsen as the heart fails to perfuse the body. This eventually leads to MODS and unfortunately, as a result, death in around 50% of all patients affected by cardiogenic shock (Babaev, Frederick, Pasta, 2005). Even in cases where the patient is recovered and stabilized, sometimes the damage may be too great for the patient to overcome and within days or weeks they irreversibly deteriorate. Treatments The best chance of recovery for Mrs. Rudd relies on rapid percutaneous or surgical revascularization. While awaiting revascularization there are nursing interventions and pharmacologic measures that can be started to optimize her cardiac output. As mentioned earlier, rapid infusion of fluids is the first line of defense to improve cardiac output and stroke volume in right AMI. Diuretics may be used in left heart failure to decrease preload and improve the hearts pumping ability, however it is contraindicated with right AMI as in the case of Mrs. Rudd. Tachycardia is a common compensatory mechanism of cardiogenic shock to improve perfusion, yet beta-blockers, although they can lower rapid heart rates, are another class of drugs that should be avoided for Mrs. Rudd since they also have a hypotensive effect and could counter the positive effects of fluid resuscitation and further perpetuate severe hypotension, having a bottoming out effect. Therefore beta-blockers should be used careful ly and only in early stages of uncomplicated AMI without heart failure (Eliott, Aitken, Chaboyer, 2007). Providing inotropic support and improving systemic vascular resistance are important in the management of cardiogenic shock. To increase contractility and consequently cardiac output, inotropes, such as dobutamine, dopamine and milrinone, might be started and gradually increased to obtain adequate perfusion. However, because they can increase myocardial oxygen demand in an already ischemic heart, they must be used cautiously in patients, as they may lead to the incidence of fatal dysrhythmias. To treat life-threatening ventricular dysrhythmias (VT or VF), antiarrhythmic medications such as amiodarone or lidocaine are indicated. Additional considerations to treat dysrhythmias or heart block include defibrillators and transcutaneous pacing, or depending on the damage present, a permanent pacemaker (ECC Commitee, American Heart Association, 2005). Another complication of cardiogenic shock that increases oxygen demand is hypoxemia from pulmonary edema and backflow; common in left AMI and often a secondary complication in right AMI. As the patient deteriorates and stops responding to compensatory mechanisms, mechanical ventilation may be warranted to provide adequate oxygenation. By instituting mechanical ventilation the workload of breathing is decreased as the machine takes over. Also anxiety and metabolic demands are decreased when the patient is sedated and intubated. Unfortunately, sedation may cause a further drop in blood pressure and needs to be closely monitored. Maintenance of adequate MAP is also vital to prevent end-organ damage. To increase MAP, norepinephrine may be added to the medication regimen, but it may have a negative effect on cardiac output. Through means of combination therapy in severe hypotension, catecholamines are mainly administered in cardiogenic shock along with monitoring urinary output and calculating cardiac output, to sustain functioning of the patients organs and optimistically to buy time before revascularization and the return of adequate pump function (Eliott, Aitken, Chaboyer, 2007). Unless contraindicated, it is protocol to treat any patient admitted with a diagnosis of acute coronary syndromes, including patients in cardiogenic shock, with aspirin and IV anticoagulation (heparin) to slow the progression of the infarct. Fibrinolytics are not recommended in patients requiring percutaneous coronary intervention (PCI) or surgery, however, improvement in hospital mortality with the use of the glycoprotein IIb-IIIa inhibitor abciximab (ReoPro) has recently been shown to reduce mortality from 40% to 50% down to 18% to 26% in cardiogenic shock treated with stent implantation (ECC Commitee, American Heart Association, 2005). Hospitals have adopted the PTCA guidelines set forth by The American College of Cardiology and the American Heart Association aiming to provide reperfusion of the infarct artery within 90 minutes after arrival to the hospital. These new guidelines also assist in decision making regarding PCI, a nonsurgical coronary revascularization procedure that r elieves the narrowing or obstruction of the coronary artery or arteries to allow more blood and oxygen to be delivered to the heart muscle. This ensures patient safety and improves patient quality of care (ECC Commitee, American Heart Association, 2005). Another intervention that is used to prevent or manage cardiogenic shock is an intra-aortic balloon pump (IABP) which improves coronary artery perfusion and reduces afterload. This mechanical device consisting of a 34- to 40-mL balloon catheter, is placed during PCI and operates by using counterpulsation therapy. The IABP inflates during ventricular diastole (increasing coronary artery perfusion) and deflates during ventricular systole (decreasing afterload or the resistance against which the heart has to pump). By increasing coronary artery perfusion with this device, the patients cardiac output, ejection fraction, and MAP are increased, ultimately improving end-organ perfusion. Heart rate and pulmonary artery pressures, especially pulmonary artery diastolic and wedge pressures are lowered, which essentially decrease the hearts oxygen consumption, blood volume and workload (Holcomb, 2002). Now an hour and fifteen minutes from onset, Mrs. Rudds status continues to worsen and the physicians, noting that they are still within the 90 minute timeframe, rush her directly to the cardiac catheterization laboratory and she undergoes PCI with drug-eluting stent placement in the right coronary artery. During the procedure the surgeon places an IABP to increase coronary artery perfusion and decrease workload of the heart. She is transferred to the surgical intensive care unit for further management and monitoring with a pressure dressing to the femoral artery where the catheter was inserted. After recovery of her strength and hemodynamic stabilization, she is transferred to a medical-surgical unit, then discharged four days later on a new medication regimen prescribed to avoid complications and recurrence of an AMI or lethal dysrhythmias. Nursing Diagnoses Outcomes Prioritizing nursing diagnoses and care depends on which side of the heart is affected. With LV failure, respiratory complications are a primary consideration, whereas with RV failure, presentation of systemic signs and symptoms occur early on. Eventually as the patients condition deteriorates their bodys compensation mechanisms fail and cardiogenic shock worsens. Nursing interventions vary based on what stage of shock the person is in, their etiology and presentation, what procedures are planned or have been performed and when care is assumed. The nursing diagnoses for Mrs. Rudd consist of (in priority): Risk for decreased cardiac output related to altered cardiac rate and rhythm; reduced preload and increased systemic vascular resistance; infarcted muscle. Ineffective tissue perfusion related to reduction or interruption of blood flow. Risk for excess fluid volume related to decreased organ perfusion; increased sodium and water retention; sequestering of fluid in interstitial space and tissues. Acute pain related to ischemic myocardial tissue. Anxiety and fear related to change in health status. Activity intolerance related to imbalance between myocardial oxygen supply and demand; presence of ischemia; cardiac depressant effects of certain drugs, such as beta blockers, antidysrhythmics. Ineffective protection related to the risk of bleeding secondary to thrombolytic therapy. Deficient knowledge regarding cause and treatment of condition, self-care, and discharge needs related to lack of information, misunderstanding of medical condition or therapy needs Some expected outcomes for Mrs. Rudd include: Maintain an adequate cardiac output during and following reperfusion therapy. Demonstrate no signs of internal or external bleeding. Rate chest pain as 2 or lower on a pain scale of 0 to 10. Verbalize reduced anxiety and fear. To recap, cardiogenic shock is a life-threatening complication of AMI. It is important to acknowledge that patient survival and recovery rely on early recognition of signs and symptoms of cardiogenic shock and rapid assessment and interventions by the nurse and treatment team.

My Plan :: Personal Narrative Writing

My Plan "The progress of an artist is a continual self-sacrifice, a continual extinction of personality." ~ T.S. Eliot ~ Maps and life are two things I never really understood. Therefore, to map out my future life seems like even more of an enigma. I am more of a throw the map out the window, hope the truck doesn't break down and see where the road takes you kind of girl. However, I do know the general direction I am aiming for and a couple of stops I'd like to make along the way. So while the map of my upcoming life is not exactly drawn to scale, I can offer a rough draft of "spontaneously planned" sites and goals. The personal me wants to fly and to skydive. She wants to master the art of driving a manual vehicle uphill and then move on to motorcycles. By 2008 I will have seen my first opera and the original The Kiss painting by Gustav Klimt. And I will go to the art museums of every city I travel through and reside in. I will learn how to play the drums, regardless of the fact that I am a girl. I may also continue to sing, which, because I was a girl, became the childhood replacement for playing the drums. I learned how to coo, not pound, and I appreciate it but I still plan on pounding. I also hope to figure out my spiritual disturbance and become a consistent walker. Not only because I do not have a reliable vehicle but also because, why not? I'm young and healthy and people don't walk enough. I personally will revive walking. In terms of traveling I want to see it all. Not only because I believe that this will enhance my skills as a teacher but also because I know that this will always positively benefit my students. If I get to hear the bells that tolled for Hemingway I will have a better perspective on the literature and can cement the setting more strongly in students' minds, hopefully inspiring them to go see these places firsthand. In the United States, San Francisco, New Orleans, Savannah and New York City are at the top of my list. However, first I have my heart set on Italy, Spain and the Latin American countries. For clarification's sake I do not desire just to see these places but rather to live them.

The Host Chapter 50: Sacrificed

The Seeker scrutinized my face while Mel and I fought. No, Wanda, no! Don't be stupid, Mel. You of all people should see the potential of this choice. Isn't this what you want? But even as I tried to look at the happy ending, I couldn't escape the horror of this choice. This was the secret I should die to protect. The information I'd been desperate to keep safe no matter what hideous torture I was put through. This was not the kind of torture I'd expected: a personal crisis of conscience, confused and complicated by love for my human family. Very painful, nevertheless. I could not claim to be an expatriate if I did this. No, I would be purely a traitor. Not for her, Wanda! Not for her! Mel howled. Should I wait? Wait until they catch another soul? An innocent soul whom I have no reason to hate? I'll have to make the decision sometime. Not now! Wait! Think about this! My stomach rolled again, and I had to hunch my body forward and take a deep breath. I just managed not to gag. â€Å"Wanda?† Jeb called in concern. I could do it, Mel. I could justify letting her die if she was one of those innocent souls. I could let them kill her then. I could trust myself to make an objective decision. But she's horrible, Wanda! We hate her! Exactly. And I can't trust myself. Look at how I almost didn't see the answer†¦ â€Å"Wanda, you all right?† The Seeker glared past me, toward Jeb's voice. â€Å"Fine, Jeb,† I gasped. My voice was breathy, strained. I was surprised at how bad it sounded. The Seeker's dark eyes flickered between us, unsure. Then she recoiled from me, cringing into the wall. I recognized the pose-remembered exactly how it felt to hold it. A gentle hand came down on my shoulder and spun me around. â€Å"What's going on with you, hon?† Jeb asked. â€Å"I need a minute,† I told him breathlessly. I looked straight into his faded-denim eyes and told him something that was most definitely not a lie. â€Å"I have one more question. But I really need a minute to myself. Can you†¦ wait for me?† â€Å"Sure, we can wait a little while more. Take a breather.† I nodded and walked as quickly as I could from the prison. My legs were stiff with terror at first, but I found my stride as I moved. By the time I passed Aaron and Brandt, I was almost running. â€Å"What happened?† I heard Aaron whisper to Brandt, his voice bewildered. I wasn't sure where to hide while I thought. My feet, like a shuttle on automatic pilot, took me through the corridors toward my sleeping room. I could only hope that it would be empty. It was dark, barely any light from the stars trickling down through the cracked ceiling. I didn't see Lily till I tripped over her in the darkness. I almost didn't recognize her tear-swollen face. She was curled into a tight, tiny ball on the floor in the middle of the passageway. Her eyes were wide, not quite comprehending who I was. â€Å"Why?† she asked me. I stared at her wordlessly. â€Å"I said that life and love go on. But why do they? They shouldn't. Not anymore. What's the point?† â€Å"I don't know, Lily. I'm not sure what the point is.† â€Å"Why?† she asked again, not speaking to me anymore. Her glassy eyes looked right through me. I stepped carefully past her and hurried to my room. I had my own question that had to be answered. To my great relief, the room was empty. I threw myself facedown on the mattress where Jamie and I slept. When I'd told Jeb I had one more question, that was the truth. But the question was not for the Seeker. The question was for me. The question was would I-not could I-do it? I could save the Seeker's life. I knew how. It would not endanger any of the lives here. Except my own. I would have to trade that. No. Melanie tried to be firm through her panic. Please let me think. No. This is the thing, Mel. It's inevitable anyway. I can see that now. I should have seen it long ago. It's so obvious. No, it isn't. I remembered our conversation when Jamie was ill. When we were making up. I'd told her that I wouldn't erase her and that I was sorry that I couldn't give her more than that. It wasn't so much a lie as it was an unfinished sentence. I couldn't give her more than that-and stay alive myself. The actual lie had been given to Jared. I'd told him, just seconds later, that I didn't know how to make myself not exist. In the context of our discussion, it was true. I didn't know how to fade away, here inside Melanie. But I was surprised I hadn't heard the obvious lie right then, hadn't seen in that moment what I was seeing now. Of course I knew how to make myself not exist. It was just that I had never considered that option viable, ultimate betrayal that it was to every soul on this planet. Once the humans knew that I had this answer, the one they had murdered for over and over again, it would cost me. No, Wanda! Don't you want to be free? A long pause. I wouldn't ask you for this, she finally said. And I wouldn't do it for you. And I sure as hell wouldn't do it for the Seeker! You don't have to ask. I think I might have volunteered†¦ eventually. Why do you think that? she demanded, her tone close to a sob. It touched me. I expected her to be elated. In part because of them. Jared and Jamie. I can give them the whole world, everything they want. I can give them you. I probably would have realized that†¦ someday. Who knows? Maybe Jared would have asked. You know I wouldn't have said no. Ian's right. You're too self-sacrificing. You don't have any limits. You need limits, Wanda! Ah, Ian, I moaned. A new pain twisted through me, surprisingly close to my heart. You'll take the whole world away from him. Everything he wants. It would never work with Ian. Not in this body, even though he loves it. It doesn't love him. Wanda, I†¦ Melanie struggled for words. Still, the joy I expected from her did not come. Again, this touched me. I don't think I can let you do this. You're more important than that. In the bigger picture, you are of much more value to them than I am. You can help them; you can save them. I can't do any of that. You have to stay. I can't see any other way, Mel. I wonder how I didn't see it sooner. It seems so completely obvious. Of course I have to go. Of course I have to give you yourself back. I already knew we souls were wrong to come here. So I don't have any choice now but to do the right thing, and leave. You all survived without me before; you'll do it again. You've learned so much about the souls from me-you'll help them. Can't you see? This is the happy ending. It's the way they all need the story to finish. I can give them hope. I can give them†¦ not a future. Maybe not that. But as much as I can. Everything I can. No, Wanda, no. She was crying, becoming incoherent. Her sorrow brought tears to my eyes. I'd no idea that she cared so much for me. Almost as much as I cared for her. I hadn't realized that we loved each other. Even if Jared had never asked me for this, even if Jared did not exist†¦ Once this path had occurred to me, I would have had to proceed down it. I loved her that much. No wonder the success rate for resistant hosts was so low here on Earth. Once we learned to love our human host, what hope did we souls have? We could not exist at the expense of one we loved. Not a soul. A soul could not live that way. I rolled myself over and, in the starlight, I looked at my body. My hands were dirty and scratched, but under the surface blemishes, they were beautiful. The skin was a pretty sun-browned color; even bleached in the pale light, it was pretty. The nails were chewed short but still healthy and smooth, with little half moons of white at the bases. I fluttered my fingers, watching the muscles pull the bones in graceful patterns. I let them dance above me, where they became black fluid shapes against the stars. I ran them through my hair. It was almost to my shoulders now. Mel would like that. After a few weeks of shampoo in hotel showers and Health vitamins, it was glossy and soft again. I stretched my arms out as far as they would go, tugging against the tendons until some of my joints cracked. My arms felt strong. They could pull me up a mountainside, they could carry a heavy load, they could plow a field. But they were also soft. They could hold a child, they could comfort a friend, they could love†¦ but that was not for me. I took a deep breath, and tears welled out of the corners of my eyes and rolled down my temples into my hair. I tensed the muscles in my legs, felt their ready strength and speed. I wanted to run, to have an open field that I could race across just to see how fast I could go. I wanted to do this barefoot, so I could feel the earth beneath my feet. I wanted to feel the wind fly through my hair. I wanted it to rain, so that I could smell it in the air as I ran. My feet flexed and pointed slowly, to the rhythm of my breathing. In and out. Flex and point. It felt nice. I traced my face with my fingertips. They were warm on my skin, skin that was smooth and pretty. I was glad I was giving Melanie her face back the way it had been. I closed my eyes and stroked my eyelids. I'd lived in so many bodies, but never one I loved like this. Never one that I craved in this way. Of course, this would be the one I'd have to give up. The irony made me laugh, and I concentrated on the feel of the air that popped in little bubbles from my chest and up through my throat. Laughter was like a fresh breeze-it cleaned its way through the body, making everything feel good. Did other species have such a simple healer? I couldn't remember one. I touched my lips and remembered how it felt to kiss Jared, and how it felt to kiss Ian. Not everyone got to kiss so many other beautiful bodies. I'd had more than some, even in this short time. It was just so short! Maybe a year now, I wasn't completely sure. Just one quick revolution of a blue green planet around an unexceptional yellow star. The shortest life of any I'd ever lived. The shortest, the most important, the most heartbreaking of lives. The life that would forever define me. The life that had finally tied me to one star, to one planet, to one small family of strangers. A little more time†¦ would that be so wrong? No, Mel whispered. Just take a little more time. You never know how much time you'll have, I whispered back. But I did. I knew exactly how much time I had. I couldn't take any more time. My time was up. I was going anyway. I had to do the right thing, be my true self, with what time I had left. With a sigh that seemed to come all the way from the soles of my feet and the palms of my hands, I got up. Aaron and Brandt wouldn't wait forever. And now I had a few more questions that I needed answered. This time, the questions were for Doc. The caves were full of sad, cast-down eyes. It was easy enough to slip unobtrusively past them all. No one cared what I was doing right now, except maybe Jeb, Brandt, and Aaron, and they weren't here. I didn't have an open, rainy field, but at least I had the long south tunnel. It was too dark to run flat out the way I wanted, but I kept up a steady jog. It felt good as my muscles warmed. I expected I would find Doc already there, but I'd wait if I had to. He would be alone. Poor Doc, that was usually the case now. Doc had been sleeping alone in his hospital since the night we'd saved Jamie's life. Sharon had taken her things from their room and moved them to her mother's, and Doc wouldn't sleep in the empty room. Such a great hatred. Sharon would rather kill her own happiness, and Doc's, too, than forgive him for helping me heal Jamie. Sharon and Maggie were barely a presence in the caves anymore. They looked past everyone now, the way they used to look past only me. I wondered if that would change when I was gone, or if they were both so rigid in their grudge that it would be too late for them to change. What an extraordinarily stupid way to waste time. For the first time ever, the south tunnel felt short. Before I thought I'd gone halfway, I could see Doc's light glowing dimly from the rough arch ahead. He was home. I slowed myself to a walk before I interrupted him. I didn't want to scare him, to make him think there was an emergency. He was still startled when I appeared, a little breathless, in the stone doorway. He jumped up from behind his desk. The book he was reading fell out of his hands. â€Å"Wanda? Is something wrong?† â€Å"No, Doc,† I reassured him. â€Å"Everything's fine.† â€Å"Does someone need me?† â€Å"Just me.† I gave him a weak smile. He walked around his desk to meet me, his eyes wide with curiosity. He paused half a step away and raised one eyebrow. His long face was gentle, the opposite of alarming. It was hard to remember how he'd looked like a monster to me before. â€Å"You are a man of your word,† I began. He nodded and opened his mouth to speak, but I held one hand up. â€Å"No one will ever test that more than I will test it now,† I warned him. He waited, eyes confused and wary. I took a deep breath, felt it expand my lungs. â€Å"I know how to do what you've been ending so many lives to discover. I know how to take the souls from your bodies without harm to either. Of course I know that. We all have to, in case of an emergency. I even performed the emergency procedure once, when I was a Bear.† I stared at him, waiting for his response. It took him a long moment, and his eyes grew wilder every second. â€Å"Why are you telling me this?† he finally gasped. â€Å"Because I†¦ I am going to give you the knowledge you need.† I held up my hand again. â€Å"But only if you will give me what I want in return. I'm warning you right now, it won't be any easier for you to give me what I want than it will be for me to give you what you want.† His face was fiercer than I'd ever seen it. â€Å"Name your terms.† â€Å"You can't kill them-the souls you remove. You must give me your word-your promise, your oath, your vow-that you will give them safe conduct on to another life. This means some danger; you will have to have cryotanks, and you will have to get those souls onto shuttles off-planet. You have to send them to another world to live. But they won't be able to hurt you. By the time they reach their next planet, your grandchildren will be dead.† Would my conditions mitigate my guilt in this? Only if Doc could be trusted. He was thinking very hard as I explained. I watched his face to see what he would make of my demand. He didn't look angry, but his eyes were still wild. â€Å"You don't want us to kill the Seeker?† he guessed. I didn't answer his question because he wouldn't understand the answer; I did want them to kill her. That was the whole problem. Instead, I explained further. â€Å"She'll be the first, the test. I want to make sure, while I'm still here, that you're going to follow through. I will do the separation myself. When she is safe, I'll teach you how it's done.† â€Å"On who?† â€Å"Kidnapped souls. The same as before. I can't guarantee you that the human minds will come back. I don't know if the erased can return. We'll see with the Seeker.† Doc blinked, processing something. â€Å"What do you mean, while you are still here? Are you leaving?† I stared at him, waiting for the realization to hit. He stared back, uncomprehending. â€Å"Don't you realize what I'm giving you?† I whispered. Finally, comprehension slammed home in his expression. I spoke quickly, before he could. â€Å"There's something else I'm going to ask you for, Doc. I don't want to†¦ I won't be shipped off to another planet. This is my planet, it truly is. And yet, there's really no place for me here. So†¦ I know it might†¦ offend some of the others. Don't tell them if you think they won't allow it. Lie if you have to. But I'd like to be buried by Walt and Wes. Can you do that for me? I won't take up much space.† I smiled weakly again. No! Melanie was howling. No, no, no, no†¦ â€Å"No, Wanda,† Doc objected, too, with a shocked expression. â€Å"Please, Doc,† I whispered, wincing against the protest in my head, which was getting louder. â€Å"I don't think Wes or Walt will mind.† â€Å"That's not what I meant! I can't kill you, Wanda. Ugh! I'm so sick of death, so sick of killing my friends.† Doc's voice caught in a sob. I put my hand on his thin arm, rubbed it. â€Å"People die here. It happens.† Kyle had said something to that effect. Funny that I should quote Kyle of all people twice in one night. â€Å"What about Jared and Jamie?† Doc asked in a choked voice. â€Å"They'll have Melanie. They'll be fine.† â€Å"Ian?† Through my teeth. â€Å"Better off without me.† Doc shook his head, wiping at his eyes. â€Å"I need to think about this, Wanda.† â€Å"We don't have long. They won't wait forever before they kill the Seeker.† â€Å"I don't mean about that part. I agree to those terms. But I don't think I can kill you.† â€Å"It's all or none, Doc. You have to decide right now. And†¦Ã¢â‚¬  I realized I had one more demand. â€Å"And you can't tell anyone else about the last part of our agreement. No one. Those are my terms, take them or leave them. Do you want to know how to remove a soul from a human body?† Doc shook his head again. â€Å"Let me think.† â€Å"You already know the answer, Doc. This is what you've been searching for.† He just kept shaking his head slowly back and forth. I ignored that symbol of denial because we both knew his choice was made. â€Å"I'll get Jared,† I said. â€Å"We'll make a quick raid for cryotanks. Hold off the others. Tell them†¦ tell them the truth. Tell them I'm going to help you get the Seeker out of that body.†