Thursday, October 31, 2019

Letter From a Birmingham Jail Essay Example | Topics and Well Written Essays - 500 words

Letter From a Birmingham Jail - Essay Example The author actually directed the letter to the members of the clergy and since it was deemed published in totality, the target audience for this particular discourse is the white moderate population, who were deemed indifferent. The white moderate segment of society was noted to have preferred the status quo or retaining order and keeping their stance as observers rather than stir the social condition to attain justice for the blacks. One is firmly convinced that his nonviolent strategies should therefore be directed to the white moderate segment of society through the creation of tension and intervention that would force this segment to move and openly profess that his advocacies are better than just being mere spectators and preserving order. The letter should have been directly addressed to the white moderate segment of the population to entice them to change their indifferent stance and enjoin them to support the elimination of prejudice and discrimination that has long been dire cted to the African Americans. The letter was addressed to fellow clergymen and was written in response to a supposed remark that classified Martin Luther King’s (MLK) activities as allegedly untimely and unwise.

Tuesday, October 29, 2019

What are Financial Statements Essay Example | Topics and Well Written Essays - 750 words

What are Financial Statements - Essay Example The main objective of financial reporting is to transfer the information, whether qualitative or quantitative, about a certain business to others who are interested in investing. Financial reporting provides financial information regarding the corporation’s capital investors, creditors and lenders who have to make decisions on their ability as capital providers. It is as a summary of the performance, or capability, in increasing, managing, and utilization of the capital by an entity. Financial reporting is represented by four types of financial statements which show the company’s financial position. These financial statements are quite exacting and provide a quantitative overview of the company’s financial health. The balance sheet represents the financial situation of a company by giving the assets, liabilities, and owners equity at a particular point in time or it points outs the company's net worth. Assets are economic benefits held a company due to its past transactions. Secondly, liabilities are the debts and obligations that a company had because if the company’s past transactions. The income statement, also known as the profit and loss statement shows the company’s net profit or loss during a given period of time by reporting the company’s earning to its investors. The third statement, the statement of cash flow reports the cash flow for the operating, financing and investing activities. Lastly, the statement of retained earnings reports the changes in the retained earnings of the company. Financial statements also include notes which give supplementary information about the company’s financial situation by describing the principles used in the accounting format, the explanation of the information in the statements or some other explanation that is not part of the statement.   Financial statements also help in the calculation of the financial ratios which are used to assess and estimate the financial situation of the company and these also of assistance in analyzing the statements themselves.  Ã‚  

Sunday, October 27, 2019

The Flea John Donne Analysis

The Flea John Donne Analysis Born in 1572, John Donne was an English poet and perhaps one of the best metaphysical poets of his era. His works are notable for their realistic style and include sonnets and love poetry. One of his most famous piece of work is The Flea. Historians are yet to determine the exact time this poem was written, but as a posthumous publication, it was published in the year 1633. One must remember the time this poem was composed, the behavior of people was a very conservative one therefore, using conceit to woo the girl, and he tries to break the barriers. The theme of the poem is disguised in the form of a simple insect such as the flea representing lust and seductive desires. A very avid theme of poetic conceit is used in the duration of this poem. This method is used as an extended metaphor, in this case the flea itself. It is indeed a very humorous method of extending the metaphor to add life to the poem. The guy is asking the girl present to observe a flea in their presence, and is almost imploring her to think how little is what he asks from her. This is one of the best examples used in this work of poetic conceit. He has compared the flea and the blood within it to them being as good as married. The flea has sucked his blood and hers, therefore coming to the conclusion, that, the flea consists of both of their bloods mingled in it. He is very suggestive in implying they are almost more than married. In the olden days, making love amongst two lovers was considered mingling their bloods, they would have to be one flesh before they could do the deed. So, when he refers to the flee having their bloods mingled already, he implies there is no reason for her to say no to him. He draws her attention to the fact that now that their bloods are already mingled and mixed, giving herself to him would not be considered as a shame or a sin or loss of her virginity as they are already one entity. He feels that the flea has joined them in such a manner, And this, alas! Is more than we would do. In the next stanza of the poem, as the story progresses, it seems the girl wishes to kill the flea, and the boy stops her by saying O Stay where hes asked her to stop, as he tries to convince her that this flea not only contains its own life, but also theirs. Clare Middleton from the English Review has made an interesting observation regarding his behavior towards women saying, This speaker excels in dazzling his female conquests with his wit and intelligence. In The Flea, his argument that the woman should submit sexually to him twists and turns in response to her unheard words and unseen actions. He claims initially that the flea represents the tiny moral decision facing her (How little that which thou denyst me is) and then quickly adopts a less flippant tone, suggesting that the flea in fact represents the great sanctity of their sexual contract, because were met/and cloistered in these living walls of jet. When the woman confounds him by killing the flea, its insignificance, which is implicit in her Cruel and sudden act, is the cue for the final twist of his argument: Just so much honor, when thou yieldst to me,/Will waste, as this fleas death took life from thee. From a female point of view, the wittily blasphemous argument is impressive not so much for its details as for its persistence. The phallic imagery of the flea, which pampered, swells with on e blood made of two, implies that the amount of intellectual energy expended in the pursuit is directly proportionate to the physical efforts that might follow the womans capitulation. It may not be politically correct, but it is highly erotic. (Middleton) Once again, using the idea of conceit, he describes in a very metaphysical manner the connection they have with each other using the flea as a center that is holding their lives within it. He tries to woo her on by saying the flea is like their marriage bed and marriage temple, in which their relationship is sanctified and nothing is wrong with it. He hopes she thinks that due to using that as a metaphor, she feels the purity of the deed he wishes to commit and does not look at it as a sin or matter of shame. He extends the flea from just being the institution of the marriage to it now being their marriage bed or marriage temple. Wisam, in The Explicator published in Washington has expanded on this by stating, Donne fundamentally probes the dominant, male sexuality that the text appears to be pushing the woman toward. In fact, the male speaker in the poem assumes the position of the woman seduced rather than that of the invading flea, whose conduct provides a medium for his contention. The male speaker declares that he is sucked [] first (3), and the ambiguity of this in line 5 implies that what cannot be said / A sin, or shame refers to some extant to the speakers experiencing pleasure by that sucking. Mansour, Wisam. The Explicator. v. 65 no1 (Fall 2006) p. 7-9 Very cleverly he plays with words where he says, And cloisterd in these living walls of jet. Jet, is a deep glossy black stone. In this case, he is referring to the color of the flea. He generates strong imagery in this line, by comparing a lifeless black stone with the living walls. She moves to kill the flea, and he aptly implies she would be killing him and additionally herself. He refers to her killing herself as suicide and mentions sacrilege if she were to do it, as she would be committing 3 sins at one go, taking his life, committing suicide and killing the flea. Donne has used a lot of symbolism in the entirety of the poem. Throughout the poem, hes used the flea as a symbol of their togetherness, and expands on it being their marriage bed. He alludes to the symbolism of the Holy Trinity when he talks about three things in one body. One of the very interesting modes of symbolism he has used is blood, particularly in the last stanza. Blood symbolizes life and Donne has used it to symbolize erotic passion and religious devotion. In the last stanza, she crushes the fly, not paying any heed or attention to his advances on her. He has already mentioned blood of theirs being intermingled in the body of the flea, representing them being one flesh. He admonishes her and asks her regarding the sin the poor flee had committed other than the fact that the flea just sucked a little blood from them. It is worth mentioning here the role of the female in this poem. Her objections are never noted, just reacted to, and she makes a very powerful yet non-verbal statement by crushing the flea. Very interestingly the reader can see the conceits in which he first tries to show the flea being greater than the church, the sacred relationship between a man and woman and then slowly showing the church and the relationship being greater than just a mere flea. He has realized that she has not fallen for his arguments; therefore he changes tactic and his argument therein. He carries his conceit through, now giving her no reason not to sleep with him, he argues that killing the flea was an easy thing, as she shows it did not harm them, he claims then yielding to him would have just been as easy and painless as killing the flea. To summarize, this work is a metaphysical play with words, wherein themes such as lust, religious imagery, and playful nature are being used. Donne has used words which allude to spiritual aspects of living in that era which give more than one view on what he is actually trying to say. In conclusion, the poem uses a lot of religious imagery as it helps add a sort of authority to the poem, as Donne has shown and argued that what they were about to do was not only supported by religion and God, but not doing it would be sacrilege too. The method of poetic conceit was used very cleverly to extend the flea to have many different meanings to it and add more color and humor to it. Kerins, in another Journal talking about The Flea makes an interesting observation, Donne was the first to have the flea bite both him and his mistress, thus making it a symbol not of the lovers desire but of the desired union {The Elegies . . . , 174). The flea becomes a union symbol because in its mingling of bloods it symbolizes the mingling of bloods thought to take place during coition (cf. Gardner, 175).

Friday, October 25, 2019

Lightning Mine Vs Archangel :: essays research papers

The Australian novel, Lightning Mine, covers the development of an iron ore mine on a sacred land guarded by “Namarrkon'; in the Northern Territory. MDG/Global mining was very interested in the area, and sent their chief prospector, Aaron Shoemaker to investigate the land. Whilst Shoemaker is there, he sets off a chain of corporate and government tactics to ensure the development of the mine on the Aboriginal sacred site. These tactics, as you can imagine, were not overly fair to the Aboriginal people, and their only hope was through University of Sydney law graduate, Jarra Mariba. Quickly, the development of the themes and issues become clear, especially through the arrogant ignorance of the CEO of MDG/Global corporation portrayed by the author. “No stone is unturned in the name of progress';, states the CEO to Jarra, showing the clear message that nothing will stop the capitalist machine from destroying the sacred land. With full government support, the mine goes ahead, and quickly Shoemaker realises what this will lead to. The corporate tactics continue to ensure a smooth running of the mine, even to the extent of killing Mariba’s wife. The resolution of the book fits in well with the theme. Namarrkon: The Lightning Spirit, the guard of the sacred site, stirs up a freak electrical storm, and totally destroys the mine. Furthermore, the CEO, Sir Peter Gables, gets killed by the storm whilst in a helicopter trying to escape the wraith of the storm. Mariba gets shot, but is amazingly saved by Shoemaker, who is a changed man by this time. What the novel focuses on is that it takes a supernatural event to stop such capitalist progress, but it can happen. My International novel was set in a very different context, present day Russia. The book was extremely well done, and is about the opening of the Soviet achieves. Central to the story, is Fluke Kelso, a middle-aged former Oxford historian who comes into contact with an old NKVD guard who was present during Stalin’s final hours. The former NKVD officer tells Kelso of a little black oilskin notebook which stalin kept close, which lead into a race against time to find the book, as the news quickly spreads. The secrets to Stalin’s life open up, and soon a Stalinist/Marxist fanatic called Mamantov goes in search for Stalin’s famous unknown son, as well as Kelso, and an international reporter wanting a good story.

Thursday, October 24, 2019

Agree or Disagree: Was the Us Civil War the 2nd American Revolution Essay

The United States Civil War was the second American Revolution. Both wars’ focal point was to acquire freedom from their oppressive governments. The Civil War and the American Revolution possess similarities. Such as they had not many men, not that much money, and not that much firepower; but they still fought for independence. The American Revolution or the American Revolutionary War, some may call it, was started from a decade-long growing tension between Great Britain’s 13 North American colonies and the British government. The British government was trying to raise revenue by taxing the colonists using bills including: the Stamp Act, Townshend Tariffs, Tea Act, etc. Using the Stamp Act, the government tried to reduce some of their enormous debt. Stamp Act was passed and it required that every legal document be written on stamped paper showing proof of payment. In response the colonists organized the Stamp Act Congress to voice their disagreement to the bill. Another bill they passed was the Quartering Act, which in a nutshell required colonist to house British soldiers. The British government used this bill because of the increased defense cost in America and they felt that the colonist should help with the financial burden of housing and feeding the soldier since they helped them during the war. Plus they wanted to show who the boss was. In response to this, the colonists in New York argued that the bill was unfair and that they should be asked and not told what to do, so Parliament passed the New York Restraining Act, which stopped the passing of any laws until the assembly went over the law. The soldiers were forced to pitch tents in the middle of Boston Common, making the colonist not that excited either. The British government was now known for passing insane laws, but when the government passed the Coercive Acts the colonists had enough. The Coercive Acts were also known as the Intolerable Acts. They closed the port of Boston to trade except for food and firewood until the colonists paid for the tea they destroyed at the Boston Tea Party with the Boston Port Act. It created British military rule in Massachusetts and made town meetings forbidden without approval with the Massachusetts Government Act. It gave protection to British officials being prosecuted in Massachusetts and allowed them to be prosecuted in England or any other colony that wasn’t Massachusetts with the Administration of Justice Act. The bill renewed the Quartering Act and gave the French in Quebec control of the Ohio Valley and made the Roman Catholic Church the official church of the area with the Quebec Act. In Lexington and Concord British troops and the colonies’ militiamen were getting into scuffles and that was how to armed conflict started. In response to this the colonists created an event known as the First Continental Congress in 1774. At this event all colonies, excluding Georgia, sent representatives to the First Continental Congress making it the first national meeting of the colonies. They came together in opposition with the bills the British government was passing so they issued two new documents. The Declaration of Rights, which opposed Parliament’s right to tax the colonies, but affirmed allegiance to the British, and the Articles of Association, which asked the colonies to make British imports illegal if the Coercive Acts were not eliminated. It took three major battles to lead up to the signing of the Declaration of Independence, the Battle of Lexington, Concord, and Bunker Hill. The Declaration declared the colonies independent from Great Britain. The American Revolution ended with the Treaty of Paris, but now before another three more major battles. The American Civil War was sparked by difficulties in the spreading of power and who was more powerful, the state or federal authority. The North, at the time, was industrialized and running smoothly, while the South was more agricultural. The North had factories, while the South had farms. The South was dependent on slave labor; it was their root to running their economy. The North didn’t want slavery to spread across the rest of the lands and the South was in fear that their economy would essentially fail without slave labor. So in 1854 the United States Congress passed the Kansas-Nebraska Act, which opened all the new territories to slavery, but allowed them to choose whether they wanted slavery or not, this was called popular sovereignty. Both sides, anti-slavery and pro-slavery were in disagreement with this new law, which led up to the formation of the Republican Party. The Republican Party was a new political group based on the opposition of the expansion of slavery to western lands. The Dred Scott case confirmed the North’s worse fears, and confirmed the South’s dreams. The Dred Scott v. Sanford case took place in Missouri. Scott argued that because he lived in the free state he would therefore have emancipation from his owner. Unfortunately his case brought to a rabid supporter of slavery, Chief Justice Roger B. Taney who disagreed. The court claimed that no African Americans, free or enslaved, could become a legal U.S. citizen, hence not being able to file a petition for freedom. This case made rising tension between the North and South climb to new heights. So when an abolitionist named John Brown and a few of his supporters raided Harper’s Ferry in 1859 the South was convinced that the North was fixed on the destruction of slavery. John Brown had hopes that the local slaves would join in and raid with him and his supporters, but they didn’t. Brown’s plan was foiled when he and his supporters were captured by Colonel Robert E. Lee’s US Marines. He was sent to court, charged with treason, and was given the death sentences. Brown was hanged for his ‘crimes’ on December 2nd, 1859. The South was looking for reason to leave their polar opposites. So when Abraham Lincoln was elected to presidency it was the last straw for the seven southern states and the seceded from the United States. Lincoln’s election led to danger for Fort Sumter in Charleston, South Carolina. April 12th, 1861 Lincoln sent a fleet to deliver supplies to Sumter, during their visit the Confederate Army fired the first shots of the event that came to be known as the Civil War. After just two days of gunfire, Sumter commander Major Robert Anderson surrendered, leaving Sumter in the control of Confederate forces; who were led by Pierre G.T. Beauregard. After Sumter, four more Southern states, including: Virginia, Arkansas, North Carolina, and Tennessee, joined the Confederate Army. The North had advantages, like an enormous population and factories to build weapon supplies in, and railroads. The South had military traditions and some of the best soldiers, but even they couldn’t surpass the North in numbers and supplies. The next major battle took place in Manassas, Virginia. This battle was known as the First Battle of Bull Run. General McDowell led 28,000 men from the Union Army in a fight against General Beauregard’s 33,000 Confederate soldiers. The Union Army marched toward Richmond, but was met by the Confederate forces emerging north from Manassas. The battle lasted five hours. During that five hours the Union soldiers had most of the Confederate soldiers retreating, except the team led by General Jackson. Jackson had a great ability holding his ground, which is why people had come to call him â€Å"Stonewall.† His technique helped the Confederate soldiers hold up until reinforcements arrived, then they were able to drive the Union Army back to Washington. Both sides faced heavy casualties, but in the end the South claimed victory. The next battle was led by General B. McClellan. McClellan was slow to advance and that angered Lincoln. Finally McClellan led the Potomac Army to the peninsula between the York and James Rivers and captured Yorktown on May 4. Robert E. Lee and General Jackson joined forces and drove out the Potomac Army in the Seven Days’ Battle, which lasted from June 25th, 1862 to July 1st, 1862. During the battle McClellan called for reinforcements twice, the second time Lincoln refused and instead withdrew the Army to Washington. Soon after the battle McClellan was replaced by Henry W. Halleck. There were a lot of battles after this one, but the war ended with Lincoln passing the Emancipation Proclamation, freeing all slaves, and his assassination on April 14th. Some similarities within the two wars were the leaders involved with the wars. The leaders tended to be former soldiers who were dedicated to their jobs, they were focused, and most of them possessed a useful skill that helped them win. Another similarity between the two wars would have to be the cause of war. Both of the wars were the response to an oppressive government and the problem of setting boundaries between people and government. Both wars were always on American land and Americans fought other Americans. Although the wars were fairly short they ended with unity. Some differences within between the two wars would be the parties included in the wars. The American Revolution was the colonists versus the British government, while the Civil War was the North versus the South. The Civil War had far more advanced weaponry, while the American Revolution had close range fighting equipment, more medieval. Overall the statement that the Civil War was the second American Revolution is completely true. They had common factors that contributed to the spark of the wars and they both ended in a common unity between all the participants. Works Cited â€Å"American Civil War à ¢Ã¢â€š ¬Ã¢â‚¬  History.com Articles, Video, Pictures and Facts.† History.com à ¢Ã¢â€š ¬Ã¢â‚¬  History Made Every Day à ¢Ã¢â€š ¬Ã¢â‚¬  American & World History. N.p., n.d. Web. 28 Oct. 2012. . â€Å"Battle of Bull Run or Manassas.† ThinkQuest : Library. N.p., n.d. Web. 28 Oct. 2012. . â€Å"Exactly what was taxed by the Stamp Act of 1765? Aren’t we more heavily taxed now?.† Ask questions, Find answers – Askville. N.p., n.d. Web. 28 Oct. 2012. . III, John J. Fox. â€Å"Civil War Battles.† History Net: Where History Comes Alive – World & US History Online. N.p., n.d. Web. 28 Oct. 2012. . â€Å"John Brown’s Harpers Ferry Raid.† Civil War Trust: Saving America’s Civil War Battlefields. N.p., n.d. Web. 28 Oct. 2012. . Reeves, Diane. â€Å"Lesson Plan on Similarities and Differences Between the American Revolutionary Warand the American Civil War.† ADPRIMA Education – Informa tion for new and future teachers. N.p., 21 July 1999. Web. 28 Oct. 2012. . â€Å"The Stamp Act.† Ventura Unified School District . N.p., n.d. Web. 28 Oct. 2012. . â€Å"The contrast and compare of the American Revolution and the Civil War? – Yahoo! Answers.† Yahoo! Answers – Home. N.p., n.d. Web. 28 Oct. 2012. .

Wednesday, October 23, 2019

Health Problems From Alcohol Health And Social Care Essay

Patients are foremost come to primary attention for their organic structure strivings. Harmonizing to Starfield ( 1973 ) primary attention is a point of affecting in wellness attention system that has a duty to form patient attention for a clip period. There are some other wellness attention centres available in UK where patients measure in terrible unwellness when the assignment with GP is rather long. In this essay we find out the troubles faces in covering with alcoholic patients in primary attention apparatuss. Harmonizing to Sobell ( 1996 ) the people received intervention of alcohol addiction through natural recovery are abundant. Harmonizing to the published therapy tests, the intervention in alcohol addiction is non effectual ( Chick et al. , 2002 & A ; Edwards et al. , 1997 ) . As a psychodynamic position the people who consume intoxicant can imbibe it because they are experiencing comfy with it.There is a cognitive behavior hypothesis that, in initial phases intoxicant is drink to cut down the tenseness degrees. In European civilizations alcohol is used to cut down the tensenesss and it ‘s a thing of socialisation. Even after coming back from work, when a individual got tired he experience relaxed and tenseness relieved with a glass of intoxicant. But this continuity becomes a habbit and individual becomes dependant of intoxicant without cognizing this that he becomes an alcoholic. These individuals are hard to handle in primary attention as they are going a portion of it withou t even acknowledging it. There is a chief issue while covering with alcoholic patients in primary attention that is their age at which they start imbibing intoxicant. Harmonizing to Plato ( 1926 ) people can non imbibe before the age of 18 old ages and if they drink they have to take centrist imbibing up to the age of 40 old ages. In Project MATCH survey ( Fishbain & A ; Cutler, 2005 ) they analysed the consequence of the intervention of alcohol addiction which was the most expensive clinical test. They used CBT ( Cognitive behaviour therapy ) to measure what people think sing intoxicant, the desires of people and more ( Nowinski et al. , 1999 ) .They were used the MET ( Motivation Enhancement Technique ) which gives information sing intoxicant jobs that motivate people for alteration ( Miller et al.,1999 ) . The TSF ( Twelve Step Facilitation ) was besides used which was grounded on rules of alcoholic anon. ( Kadden et al. , 1995 ) . They found no significant relationship between the curative intervention a nd the participants ( Longabaugh & A ; Wirtz, 2001 ) . In primary attention Centres there is another trouble in handling alkies is that the alkies are non tells the truth sing their intoxicant related jobs. An illustration of this was Rand survey gaining that 30 % of the alkies are non able to give sufficient information ( Polich et al. , 1981 ) , this besides put great consequence on the intervention. Why the patients throw off the clinical tests was assessed, in the undertaking MATCH survey and the grounds for this were their on the job times, they move from their places, their gestations and imbibing remittal. These are the grounds which affect the primary attention intervention but this is non with every instance ( Miller et al. , 2001 ) . Harmonizing to the undertaking MATCH the psychosocial intervention for the alkies are non plenty for them. In the medical field it is really common that patients are non stick to the intervention. Harmonizing to article by Caroll ( 1997 ) , 20 % patients withdraw from the programmes they have to set in, since they withdraw, so this ratio goes up at the terminal of that intervention ( Carroll, 1997 ) . Harmonizing to Sobel & A ; Sobel ( 2000 ) participant ‘s willingness is really of import in intervention. In article, Early sensing and intervention of alcohol addiction in primary attention ( 2004 ) there was a conjecture that in US 1 in 5 males and 1 in 10 females who come to primary attention were patient of different types of alcohol addiction ( NIAAA,2000 ) . Because most of them did n't desire to travel to alcohol intervention specializers so the primary wellness doctors have a opportunity and a responsibility to name their job and give intervention to them. But unhappily, the primary attention suppliers are frequently non willing or non able to manage these people. These findings are about the individuals sing primary attention GP ‘s, infirmary exigencies, traumatic wards and taking antenatal attention. In decision of this survey shows that the prevalence of jobs related to alcohol sing patients in primary attention are important ( Nathan & A ; Peter, 2004 ) . Harmonizing to diary of the American academy of Family Physicians article ‘Problem Drinking and Alcoholism: Diagnosis and intervention ( Enoch & A ; Goldman, 2002 ) less than 50 % of alcohol addiction oftenly remain undiagnosed in primary wellness attention. Some of the patients non give the proper information to the GP ‘s due to fear or dishonor. So the GP got less information sing the medical and psychological conditions and lost chance to handle the patient affectively. To happen out the pattern in intoxicant instances and it ‘s barriers in patients who drink at hazardous degrees, in Cape Town, a cross sectional study done with 50 GP ‘s ( General Practitioners ) in the twelvemonth 2004 & A ; 2005. It was in the signifier of questionnaire of intoxicant related patterns and barriers in intercessions. The consequences were that in the past twelvemonth the GP ‘s proverb merely 11-13 patients sing alcohol addiction. Whereas 12 % GP ‘s idea that for cut downing the intoxicant consumption they could assist the patients in an effectual manner. 78 % GP ‘s said that with proper preparation and support they work more efficaciously. The decision of the survey was that GP ‘s wants to make intercession for alcohol addiction but they need more preparation for these intercessions. They require right support and intercession tools ( Koopman, et. al. , 2008 ) . Harmonizing to Chang, G. ( 1997 ) there is more jobs faced in placing and handling the lady patients in primary attention scenes. Because females more vulnerable to unfavorable effects of intoxicant than males. In primary attention apparatus there is brief reding and intervention followups and sometimes they even losing the job imbibing in adult females because patients did n't state the truth. So sometimes they need the aid of head-shrinkers to happen out the job of job imbibing. So psychiatrist play indispensable function in discovery out the job imbibing in females and interfere, learn and work jointly with primary attention suppliers to diminish the morbidity and mortality of intoxicant. In the treatment paper, â€Å" Still a hard concern? Negociating alcohol-related jobs in general pattern audiences † , ( Rapley et al. , 2006 ) showed the experiences of GP ‘s while giving audiences to patients in jobs related to intoxicants. They have done a qualitative research in North East of England. Once qualitative interviews done with 29 GP ‘s sing their work with their patients on issues concerned with intoxicant. Then they conduct the interviews in groups- 1 with squad of primary attention and two with GP ‘s. In these interviews GP ‘s felt, until the individual felt that his/her ingestion of intoxicant was unsafe they could derive really less. The deficiency of clip and to work on so many other jobs and so many other patients, who were waiting for them, stopped General Practioners to pull off instances of hazardous drinkers. They compared their survey with Thom, B. et Al. ( 1986 ) which was done 20 old ages ago. They found that the troubles fa ced by GP ‘s are rather same as 20 old ages ago. In Mackenzie & A ; Allen ( 2003 ) article, Alcoholic rating of alcohol addiction intervention, the participants were asked the name of the interventions to which they known for their rating. Most of them spoke Naltrexone. In farther analysation of naltrexone patients withdraw due to inauspicious effects of this ( Rohsenow et al. , 2000 & A ; Drummond, 2001 ) .According to these findings the most good intervention was still a difficult issue. Some favours combination intervention i.e. Antabuse & A ; alcohol anon. . Treatment with Antabuse was non utile as it was deleterious for wellness and non lasting. It was non sufficient to decide the job with detoxification. Group therapy was besides non plants and produce backsliding without after intervention attention and uninterrupted followups ( Mackenzie & A ; Allan, 2003 ) . These are the conditions which influences the alky ‘s intervention in the primary attention. After re-assessing the information of undertaking MATCH it was found that ego efficaciousness was the predictor of imbibing behavior in alky ‘s intervention ( Witkiewitz et al. , 2007 ) . Whereas in old survey it was non forecast imbibing behavior. Harmonizing to Brownell et Al. ( 1986 ) intoxicant oversight is complex procedure. To foretell intoxicant dependance and its intervention the cusp calamity theoretical account used by Hufford et Al ( 2003 ) . They found two factors which are trusty for 50 % intoxicant ingestion. The sidelong factors which were responsible for backsliding were – holding no place, non proper followups, alky ‘s household background and terrible intoxicant dependance. There were some proximal factors besides which affect the alcohol addiction those were- mental province, mental hurt, dying place atmosphere. If the sidelong factors are more and proximal is less than patient may be imbibe lesser sum or even giving up the intoxicant and antonym happened in opposite state of affairs. The multimodality construct is another job in covering with alcoholic patients. In UK, Liverpool is on top, in instance of indoor instances of intoxicant in infirmaries. These are the intoxicant abuse instances which makes the primary attention intervention hard. For intoxicant maltreatment Liverpool is step in front from the North West and Warrington. More than 8 % of Liverpool ‘s population are imbibing upto the degree which affect their physical and mental health.28 % of males and 18 % of females drink up to deleterious degree in North West of England. The per centum of male and female death from intoxicant is 6.4 and 4.2. Around 3260 individuals die every twelvemonth because of intoxicant in UK and this ratio is more in North West ( William, 2007 ) A survey sing teenage and the use of intoxicant intervention services consequences that white adolescents got more alcohol interventions as comparison to others ( Wu et al.,2002 ) .The predictor of acquiring intervention services were drug use and hapless wellness position. The consequences are same as the other intoxicant intervention surveies done by Weisner ( 1993 ) & A ; Windle et Al. ( 1991 ) Around 10 % grownups got intervention holding the job of alcohol addiction ( Grant, 1996 & A ; Reiger et al. , 1993 ) . Gender is another factor which gives part in intoxicant intervention. For e.g. adult females were few who got alcohol intervention ( Grant, 1996 & A ; Weisner, 1993 ) . There are few factors which inhibit the intervention of intoxicant which are -lack of occupation, low finance, non holding faith in intervention ( Grant, 1996, 1997 & A ; Weisner, 1993 ) . Nielson observed intoxicant jobs and intervention with the patient ‘s position with the aid of an interview usher from 2-4 months. The jobs were seen with different positions. In cultural position individuals use intoxicant for socializing in society. Sometime there were some external force per unit areas are at that place in which individual diagnostic imbibing does, as in fiscal loses, matrimonial jobs etc. Sometimes there were internal facets besides like individual had experience had in childhood, psychological jobs etc. In pathological imbibing individual have dependence to imbibing. In comprehendible imbibing individual lost the control over himself. It was found from survey that there was less conformity rate ( O'Brien & A ; McLellan, 1996 ) . Pilowsky et Al. ( 2009 ) found intoxicant dependance was a chief issue of wellness attention. Alcohol dependance was chiefly concerned with singular disablement & A ; hapless mental wellness ( Hassin et al. , 2007 ) . Alcohol dependance was forecast by the events happened in childhood either treated or non treated ( Kessler, 1997 ; Dube, 2006 & A ; Pilowsky, 2006 ) . Childhood events are the events happened before the kid is traveling to be 18 old ages. In the survey individual holding 1-2 unfavorable childhood events were 2-4 times thought themselves alkies. So this was an index that if there were frequent unfavorable childhood events so these were terrible forecasters of alcohol addiction upset. Socio demographic factors were besides kept in head in controlled samples. If a individual exposed to unfavorable events many times so it was much influential as comparison to expose to individual inauspicious event ( Kessler, 1997 ) . From the twelvemonth 1980-2000 McGovern ( 2002 ) written the intoxicant jobs intervention. The inhibiting constituent in intervention was the being of a definition of depicting intoxicant and drug issues. Lack of uninterrupted financess is another disadvantage in covering with intoxicant jobs. In Europe four European intervention bureaus studied the intervention of intoxicant and other drug upsets ( Riley, 2008 ) . There was an obstructor in informations aggregation which was used for hunt patients to cognize the alterations occurs in the intervention period. Because there may be relapse in some instances and the patient needs intervention once more. Because there was no contact so the patients once more went to worse status. The follow up techniques are proposed by Chesnut Health Centres ( Scott, 2004 ) . But these steps can non be low-cost by all intervention services. By analyzing the wellness services research in the intervention seting in pattern in intoxicant and drug maltreatment, McCarty ( 2000 ) found that it was a ambitious thing.He besides noticed, that antecedently, the clients were old white males. They had the other chronic jobs besides like- cirrhosis, craze etc. Whereas now these programmes are for childs from all races. It is found that if a individual taking other rough drugs along with intoxicant so this makes the intervention hard. Harmonizing to Boca & A ; Nolls ‘s ( 2000 ) there is other job in intervention of intoxicant that in intoxicant surveies at that place has to be careful expression for decrease prejudices. There are so many factors which make hard in handling alkies. As in undertaking MATCH ( 1997 ) it was noticed that head-shrinkers have n't sufficient understanding sing the alcohol addiction. Persons who have the jobs related to intoxicants are now a twenty-four hours ‘s able to retrieve from these jobs without the intervention and the literature is available on it ( Sobel, Cunningham & A ; Sobel, 1996 ) . Spiritualism as recovery portion in the action of alcohol addiction besides reflects in individual ‘s recovery ( Kurt & A ; Morgan, 2002 ) . In the country like alcohol addiction which is rather sensitive, the cross sectional study will non be the best thought. The longitudinal studies along with the timely follow ups are promoting and avoiding backslidings of alcohol addiction. Harmonizing to the American Society of dependence ( 1996 ) in the intervention of alcoholic individuals, Milieu therapy is besides good. This therapy helps in physical effects that are due to heavy imbibing or backdown of intoxicant. Psychotherapy is besides one of the of import mileposts in the intervention of alkies. The individuals who quits intoxicant should followed their follow ups on a regular basis. So that their betterment is continuously monitored. Harmonizing to a socio-cultural position, the individual is traveling to halt imbibing or maintain on go oning the same is depends on the individual ‘s character and his nucleus beliefs. Harmonizing to Martin et Al. ( 1999 ) article Pull offing alcohol- related jobs in the primary attention puting, they found that intoxicant jobs were the of import cardinal factor of morbidity and mortality in America and because of refusal and opposition to intervention by the household of patients and patients itself, made sensing hard. Everyday showings of intoxicant of every patient may assist the primary attention supplier to happen out and give intervention to alcohol maltreatment patients. However in intoxicant related jobs chief end of patients are abstinence but less consumption is besides fruitful and gained by concise primary attention intercessions. The direction of outpatient detoxification chiefly given by primary attention apparatuss but needs careful opinion of support system of patient, close supervising and good medical specialty support. In the Journal article, Between desperation and hope: Health services research on intervention of intoxicant maltreatment ( 2002 ) , McCarty Dennis bring into notice, the troubles comes in analyzing the intervention services in intoxicant and drug maltreatment. It is because of these jobs, the individuals who are policy shapers and suppliers of probes could reluctant to give induction to surveies. However the Alcohol services research is rather tough and we are halfway mediate despair of intoxicant and the recovery hope ( Dennis, M. , 2000 ) . Harmonizing to the survey done by Ferguson et Al. ( 2003 ) in their journal article, Barriers to designation and intervention of risky drinkers as assessed by urban/rural primary physicians, this pilot survey found three hurdlings faced by 40 household physicians when they treat the alcoholic patients. In this the Physician centred class considered job was, the patient backdown and holding deficiency of motive to alter. The system centred class considered, losing of community resources and far off from intervention plans. The patient centred barriers were more than the physician and patient centred classs. The debatable barriers were depended on the location of practise i.e. rural or urban and the past clip period of physician preparation. However early the intervention is more effectual if alcohol addiction is detect at early phase. It is greatly accepted that doctors in primary attention oftentimes fail to name intoxicant jobs. In this computerized survey an alcoholic patient was used for primary attention doctors for naming alcohol addiction. Out of 95 doctors, 32 % diagnosed the job others made different psychiatric diagnosings chiefly anxiety or depression. So harmonizing to this survey there was a great demand for extra instruction for primary attention doctors to name alcohol addiction. Harmonizing to Magruder-Habib, K. ( 1991 ) the intoxicant jobs are really common in the patients who come to primary attention but frequently non detected and treated. Although the methods of diagnose are reviewed in footings of complete history, trials in research lab and the physical scrutiny. For everyday usage of primary attention doctors CAGE questionnaire and Michigan Alcoholism Screening trials are advised. These instruments are more sensitive than the research lab tests entirely. Because if the patient job is detected at earlier phase than it would be cure early and it is less cost effectual besides an acceptable to the patient. By seeing all the pros and cones of this essay the major troubles comes in primary attention apparatuss while covering with alkies are as follows: First of all the patient came to primary attention did non state the truth about their imbibing wonts. It may be due to fear or dishonor. So the GP did n't cognize the exact sum of imbibing and this will set great impact on intervention. Second in primary attention setups GP ‘s has to cover with figure of patients, and these alcoholic and patient related to mental wellness jobs require more clip for audience, which is non possible in primary attention. That ‘s why sometimes these jobs are missed in primary attention apparatuss. Third GP ‘s have non plenty preparation to name alcohol addiction and to cover with alkies. They require right support and intercession tools to name alcohol addiction.

Tuesday, October 22, 2019

Holden Caufield Essays - Literary Realism, The Catcher In The Rye

Holden Caufield Essays - Literary Realism, The Catcher In The Rye Holden Caufield In JD Salingers' Catcher in the Rye, a troubled teenager named Holden Caufield struggles with the fact that everyone has to grow up. The book gets its title from Holden's constant concern with the loss of innocence. He did not want children to grow up because he felt that adults are corrupt. This is seen when Holden tries to erase naughty words from the walls of an elementary school where his younger sister Phoebe attended. While I was sitting down, I saw something that drove me crazy. Somebody'd written 'Fuck you' on the wall. It drove me damn near crazy. I thought how Phoebe and all the other little kids would see it, and how they'd wonder what the hell it meant, and then finally some dirty kid would tell them- all cockeyed, naturally- what it meant, and how they'd all think about it and maybe even worry about it for a couple of days. I kept wanting to kill whoever'd written it. I figured it was some perverty bum that'd sneaked in the school late at night to take a leak or something and then wrote it on the wall. I kept picturing myself catching him at it, and how I'd smash his head on the stone steps till hew as good and goddam dead and bloody. (201) His deep concern with impeccability caused him to create stereotypes of a hooligan that would try to corrupt the children of an elementary school. Holden believed that children were innocent because they viewed the world and society without any bias. When Phoebe asked him to name something that he would like to be when he grew up, the only thing he would have liked to be was a catcher in the rye. He invented an illusion for himself of a strange fantasy. He stated that he would like to follow a poem by Robert Burns: If a body catch a body comin' through the rye. He kept picturing all these little kids playing some game in this big field of rye and all. Thousands of little kids, and nobody's around- nobody big, I mean- except me. And I'm standing on the edge of some crazy cliff. What I have to do, I have to catch everybody if they start to go over the cliff- I mean if they're running and they don't look where they're going I have to come out from somewhere and catch them. That|s all I'd do all day. I'd just be the catcher in the rye and all. I know it's crazy, but that's the only thing I'd really like to be. (173) Holden wants to stop children from falling into losing their innocence and becoming an adult, and he takes pleasure in the attempted thwarting of maturation. In the beginning of Catcher in the Rye, his initial character is one of a child. Throughout the book, he takes steps and the forces of change take a toll on his childish ways. In the end, he seems to be changed into a man. Holden is definitely extremely immature in the beginning of the book. He characterizes almost every person he meets as a phony. He feels that he is surrounded by hypocrites in a school filled with fakery. Principal Thurmer, the principal of Holden's high school, Pencey, was the leader of the whole charade. During a teacher/parent day, Principal Thurmer would only say hello to the wealthy parents of students. He would not associate himself with those that were not financially stable, because he was a phony. Holden also maintains a lack of responsibility throughout the whole book. He was the equipment manager of the fencing team at Pencey, but he lost the equipment on the subway. He also failed out of two schools for lack of effort and absences from classes. Holden also had a daydream about two children who never grew up, whore main in a perfect world forever. This daydream is a result of his younger brother Allie's death. Allie represents the unchangeable youth of which Holden must let go if he ever expects to maintain sanity. Holden has a fixation on childhood, which shows itself in many forms. His glorification of children, inordinate admiration of Phoebe, idealization of his dead younger brother, and the joy he gets from reminiscing about his own childhood all contribute to his obsession with innocence and youth. Throughout the middle of the book, forces of change unfold

Monday, October 21, 2019

Information Technology and Its Importance essays

Information Technology and It's Importance essays Computers can be considered one of the most important of all modern inventions. One can go so far as to say that without the Computer there would not have been such dramatic technological advances over the years. What is this computer and how is it so important to us' The computer has found its way into almost every aspect of human life today. It is used in the home, in the office, to gather information about outer space even! It was in 1971 that the company Intel released the world's first microprocessor. (Computers, from the past to the present: The Altair) This was in reality an integrated circuit that was able to process small bits of data at a time. This system was so practically useful that the common man could now dream of actually owning a computer for his own use, rather than assuming that only the military and other such departments were permitted The famous Bill Gates and Paul Allen developed the first BASIC compiler and sold it to the company called MITS. It was from this that Microsoft was born. BASIC, in other words, is Beginner's All-Purpose Symbolic Instruction Code. It was meant of provide computer scientists with an easier method of developing code and programs with interactive properties. Soon others started to develop computer languages and in addition to Basic, Fortran, Cobol, Pascal, and C were developed. Now it was time for the manufacture of personal computers or PCs. Apple released the Mackintosh that boasted of a GUI or Graphical User Interface, and a mouse. IBM released the 286-AT that soon became a hot favorite of business concerns because of its facility with applications like Lotus1-2-3, and the The personal computer of today allows users easy access to applications like word processors for creating text, graphic ut...

Sunday, October 20, 2019

Causes and effects of childhood obesity

Causes and effects of childhood obesity Childhood obesity has become a worldwide epidemic, and the condition is now obvious much earlier in life. Thirty years ago, less than five percent of children were considered obese. Today’s figures put the number of obese American children somewhere between 12 percent and 15 percent! That translates into millions of children, preteens, and teens suffering from very adult conditions like diabetes and depression related to weight gain (Tessmer, Beecher, & Hagen, 2006). Overweight and obesity in childhood are recognized to have significant impact on physical and psychological health. There are several causes that lead children to become obese. Childhood obesity is now considered a disease and is diagnosed by doctors. Not all children that watch television several hours a day or are inactive or just eat mal-nutritious foods develop obesity, many children get obese because of genes inherited from their parents. Some children become obese because of their lifestyle. For example, la te-day or night eating, snacking and other behavioral behaviors have influence on the progress of obesity. Moreover, social and economic conditions are shown to have a significant relationship to nutrition and dietary intake. In addition, there are certain effects resulted from childhood obesity such as physical, mental, emotional, and social effects. Obesity in childhood is responsible of early development in girls and delayed development in boys. It’s also found to be associated with numerous medical problems related to physiological, metabolic, and structural changes. What is more is that obese children are more likely to develop psychological problems. Physical, social, and mental well-being is considered health related quality of life. Low self-esteem and social discrimination can be noted in obese children due to physical limitations, feelings of isolation or loneliness, and teasing from class mates. Causes and Effects of Childhood Obesity Childhood obesity has become a worldwide epidemic, and the condition is now obvious much earlier in life. Thirty years ago, less than five percent of children were considered obese. Today’s figures put the number of obese American children somewhere between 12 percent and 15 percent! That translates into millions of children, preteens, and teens suffering from very adult conditions like diabetes and depression related to weight gain (Tessmer, Beecher, & Hagen, 2006). Obesity is defined as a disproportionate buildup of stored fat tissue when compared to other tissues. Childhood obesity is now considered a disease and is diagnosed by doctors. Children become overweight for a variety of reasons. The most common causes are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination of these factors. Moreover, socio-economic factors have influence on children, which may cause a child to become obese. In addition, there are certain effects resulted from childhood obesity such as phys ical, mental, emotional, and social effects. Diagnosis of Childhood Obesity Only a doctor can diagnose children for obesity by evaluating adiposity, or â€Å"how much fat a person has.† Adiposity can be assessed using different ways, for example, by using an underwater scale, or by an MRI, but these methods are considered excessive and expensive. Another way of evaluating children for obesity is by measuring the distribution of body fat. Also, a chart called the body mass index (BMI) is used to optimally measure the amount of fat person carries most frequently to differentiate between just an overweight child and the one who is really obese. In addition to BMI and charting weight on the growth charts, the doctor also evaluates the family’s history of obesity and weight-related health problems, such as diabetes, the child’s eating habits and calorie intake, the child’s activity level, and any other health conditions the child may have.

Saturday, October 19, 2019

This casestudy is under the course of Market Analysis Case Study

This casestudy is under the course of Market Analysis - Case Study Example smaller brands have fewer customers who purchase less often, low market share, low penetration, and slightly lower loyalty: lower SCR, lower % of solely loyal. According to the table 2.1, it shows the second large of market share category is Little Barrel. High peak need to take over Little barrel. The first question that this analysis would seek to address is whether little Barrel as a brand of High Peak has normal loyalty. Considering that the Little Barrel has a lot of similarities with the products of the same category, it is expected that competition will be high. This notwithstanding, shoppers behavior will demand that they show loyalty to specific brands. (Chee, Ken, and Adam Wong, 24) Such shoppers’ behaviors have been demonstrated through Dirichlet model which indicates that brands that consumers tend to buy are those that they feel loyal to. (Chernev, Alexander, 26) This behavior disregards the fact that some consumers may buy other brands as well, but the rate at which they buy specific brands indicates the loyalty they have to the brand. (Chee, Ken, and Adam Wong, 24) To understand whether the Little Barrel has normal lo yalty brand, it is critical to understand ways upon which loyalty can be measured, this will give clear indications of the competitiveness of the brand in comparison with other brands in the category. The key way in which loyalty is measured is through the product penetration particularly on the basis of the sale volume and the market share. (Dalgic, Tevfik, 15) Based on all factors that point to that direction, it is clear that Little Barrel has a normal loyalty. Comparing the penetration level the brand has. The next consideration that needs to be examined is whether there are niche brands in the market. Niche branding may also be referred to as the narrow branding. (Dalgic, Tevfik, 16) This is the strategy through which a brand connects with individual customers which it targets. The strategy is in most cases seen to be

Friday, October 18, 2019

Present an argument for including 'intuition' as an important Essay

Present an argument for including 'intuition' as an important constituent of managerial competency - Essay Example d blueprints initiates the execution of decisions, usually very quickly, upon the source of an ‘unconscious reasoning’ mechanism which could have an emotional element, such as a ‘hunch’ (Mani, 1995, 365). On the other hand, management is becoming identified more and more as a way by which manager put into action and push in strategic change within organisations. Managing has been recognised as a fusion of creativity and intuition. In the context of strategic management intuition involves diverging from an arranged plan so as to speed up the execution of actions (Smith & Hitt, 2005). The objective of this study is to argue that intuition is important in modern management and effective strategies in training managers to become more intuitive. At present the different constructs that merge to elaborate on organisational management have been extended to comprise components of innovation, adaptation and firmness. Strategic management in the 1960s has been viewed by intellectuals as an organisational pathology, in the sense that it deviated from the conventional incremental course of action, and then put into practice (Thomas, 2007). Nonetheless, Weick was one of the pioneering supporters of strategic action, and the rising interest in and recognition of this facet of management has led to intuition being more broadly recognised as an ability that can help in corporate planning activities (Thomas, 2007). In the 1990s this progress has sped up in intensity, and given the necessity for more rapid cycle periods and more ground-breaking solutions and ideas to gain or maintain competitive leverage; these changes exhibit hardly any indications of subsiding (Nichols, 2006). The advancement toward managerially advocated intuitional activity seems to be influencing how organisations deal with both the manner in which work task is accomplished, and the manner in which it is controlled. Numerous organisations are encouraging employees to devote time and opportunity to

Regulations Influence on Agencys Productivity and Efficiency Coursework

Regulations Influence on Agencys Productivity and Efficiency - Coursework Example Literature ReviewLiterature Review Internal regulations are a set of official/ unofficial set of rules that an agency should follow in order to be in compliance that is suppose to help the agency achieve its goal in an efficient and productive manner. There is no previous literature review performed on the productivity and efficiency of the Office of Inspector General-Office of Investigations, therefore, for the purpose of this study, similar studies on different agencies within the field of law enforcement and studies whose method of the study was the pooled cross-sectional time series regression will be used for guidance.   The Office of Investigations within the Office of Inspector General are divided by Field Offices whose are divided by region and are entitled to a certain regional jurisdiction, then followed by a set of Sub-Offices who have to report to the Field Offices. A conjunction of Sanhog Moon, Alex Sekwat, Rodney Stanley and Richard Bennett studies, it will serve as a foundation for the methodology of this research. â€Å"The goal of this research design is to test for a shift or change in the trend of the dependent variable at the point of the policy intervention. The premise for the design is that the post-intervention values of the dependent variables are different from the pre-intervention series,† (Moon, Sekwat & Standley, 2004).  Richard Bennett â€Å"explores the macrostructure tenet of the approach upon a sample of 52 nations spanning a 25-year period (1960-1984).

Thursday, October 17, 2019

Module 5, 6 and 7 Essay Example | Topics and Well Written Essays - 1500 words

Module 5, 6 and 7 - Essay Example The three aspects of consultancy that a consultant should be able to differentiate are intercultural, transnational or transnational and multicultural environments of consultancy. Intercultural consulting is where interactions occur across borders of two or more cultures, for example when an individual from a particular country goes to work in another country. It is important to identify the cultural patterns that distinguish national cultures or particular regions. These patterns may be found in proverbs and story lines that appear repeatedly in the literature, art and films of certain cultural societies. The idea is to learn as much as one can about that society. This will promote an understanding between the consultant and the individuals of the society they will be working in. it will also facilitate proper communication since the consultant will be knowledgeable about the things they should and should not do or say. The second type of environment is the transnational or transcultural consulting. This is whereby an individual or organization can identify with more than one nation or culture. This is good for the business as they can refer to a variety of cultures, languages and experiences as they carry out their work. Such individuals can also work as a bridge connecting particular cultures and languages which work in favor of the business. There is really not much difference between the transcultural and the multicultural as multicultural consulting refers to many different ethnicities, cultures and nationalities existing within the same organization. All of these will enable the business acquire more reliable information from experts who have had different experiences. Another factor that will favor the business is if the consultant has the necessary skills of inquiry. These skills are crucial to the business as they enable the consultant learn about the organization and

Cross Examination on complainant. Sexual offences. (law of Evidence) Essay

Cross Examination on complainant. Sexual offences. (law of Evidence) - Essay Example Section 41 establishes the shield and the exception. Section 42 defines what is relevant and generally deals with the interpretation and application of the shield in Section 41. Section 43 deals with the proper procedure for exercising the Section 41 discretion to remove or reduce the shield. Lord Steyn noted in R v A (No. 2) the freedom of cross-examination of rape complainants was based on stereotypes and generalizations that were exploited by defendants. The result was an excessively low rate of convictions and it unnecessarily put rape complainants under scrutiny and humiliation. Section 41 extends the shield to all sexual offences which by virtue of Section 62 include rape and all other sexual offences. In considering whether or not to grant leave to cross-examine on the complainant’s sexual behaviour, sexual behaviour under Section 42(1)(c) includes any sexual behaviour or experience unless it forms a part of the issues at trial relating to the accused. However, in R v T the court offered some flexibility with respect to defining what amounts to sexual behaviour which obviously challenges the concept that the shield goes too far and prejudices a fair trial. In R v T it was held that sexual behaviour would not include evidence of false complaints or failure to complain. This kind of evidence would not be evidence of sexual behaviour but is evidence of previous statements or previous omissions to lodge a complaint. Moreover, it was held in R v Garaxo that the judge had a duty to allow cross-examination on previous complaints against others where it could harm the complainant’s credibility. Nevertheless in R v White it was held that cross-examination of a complainant’s promiscuous behaviour such as prostitution, was not relevant to the complaint at issue. Regardless there are safeguards that attempt to create some balance between what is relevant and what is not and thus ensures the trial is not unfairly prejudiced. In this regard, a saf eguard was established under R v Martin as to what is relevant behaviour for the purposes of Section 41(3). In Martin it was ruled that it was wrong to exclude cross-examination of the complainant on her previous behaviour with the accused in circumstances where it was alleged that she had begged the defendant for sex and had performed oral sex on him. This kind of evidence goes to motivations for concocting allegations against the defendant. It would also appear that once leave is granted to cross-examine the complainant, the court does not have the discretion to restrict its admission. In R v F it was held that where the judge allowed the defendant to cross-examine a complainant on the nature of their adult consensual relationship he erroneously excluded cross-examination on evidence showing the complainant appeared happy engaging with the defendant. The evidence was relevant as it showed the actual adult relationship and thus relevant to the authenticity of a complaint about abus e childhood abuse. In R v Mokrecovas, Lord Woolf cautioned that Section 41(3)(a) should not be exploited for sole purpose of damaging the complainant’s credibility. The Court of Appeal ruled that where there was enough evidence before the court on the complainant’s state of mind further evidence that she had engaged sexually with the defendant’

Wednesday, October 16, 2019

Analysis of Royale Comfort Seating Article Example | Topics and Well Written Essays - 500 words

Analysis of Royale Comfort Seating - Article Example Many of them die. Lives of many workers get disturbed like Ms. Farley is not able to resume a normal life after her occupational injury. The next section of the article, Foam Country, takes the discussion further by describing how work is being done in Royale Comfort Seating, which is located in North Carolina. A polyethylene called slab stock becomes the filling of mattresses, chairs, and cushions. This material arrives in the form of loaves. Cushions are attached to seats with glue. The whole environment gets fogged with glue. The work is tiring, and the workers feel dizziness after they have completed their shifts in the glue filled air at the workplace. They feel quite lightheaded when they leave for homes. This section also talks about the industrialization of North Carolina. The next section, The Chemical’s Use Grows, talks about how the use of nPB glues has become widespread in some past years. It is inexpensive, strong, and reliable. Water-based glues are safer but expensive and can cost millions of dollars to the companies. Initially, companies would use a chemical called 1,1,1-trichloroethane as glue, but since it was thought of as damaging the ozone layer, the companies switched to methylene chloride. That also proved to be very damaging, killing many workers every year. OSHA took action, and companies started using nPB glues, which were as dangerous as the previous brand. So, some companies adopted it while some banned it. Many damages to health due to this glue were reported in the next years. It was found that Royale was not taking safety measures while making use of this glue. There were no fans to eliminate the fumes, and the workers were not provided masks. OSHA has also not regulated the strictness about safety measures. The section, Improvised Remedies, talks about the interviews of Royale’s employees regarding the health damages they faced while working.

Cross Examination on complainant. Sexual offences. (law of Evidence) Essay

Cross Examination on complainant. Sexual offences. (law of Evidence) - Essay Example Section 41 establishes the shield and the exception. Section 42 defines what is relevant and generally deals with the interpretation and application of the shield in Section 41. Section 43 deals with the proper procedure for exercising the Section 41 discretion to remove or reduce the shield. Lord Steyn noted in R v A (No. 2) the freedom of cross-examination of rape complainants was based on stereotypes and generalizations that were exploited by defendants. The result was an excessively low rate of convictions and it unnecessarily put rape complainants under scrutiny and humiliation. Section 41 extends the shield to all sexual offences which by virtue of Section 62 include rape and all other sexual offences. In considering whether or not to grant leave to cross-examine on the complainant’s sexual behaviour, sexual behaviour under Section 42(1)(c) includes any sexual behaviour or experience unless it forms a part of the issues at trial relating to the accused. However, in R v T the court offered some flexibility with respect to defining what amounts to sexual behaviour which obviously challenges the concept that the shield goes too far and prejudices a fair trial. In R v T it was held that sexual behaviour would not include evidence of false complaints or failure to complain. This kind of evidence would not be evidence of sexual behaviour but is evidence of previous statements or previous omissions to lodge a complaint. Moreover, it was held in R v Garaxo that the judge had a duty to allow cross-examination on previous complaints against others where it could harm the complainant’s credibility. Nevertheless in R v White it was held that cross-examination of a complainant’s promiscuous behaviour such as prostitution, was not relevant to the complaint at issue. Regardless there are safeguards that attempt to create some balance between what is relevant and what is not and thus ensures the trial is not unfairly prejudiced. In this regard, a saf eguard was established under R v Martin as to what is relevant behaviour for the purposes of Section 41(3). In Martin it was ruled that it was wrong to exclude cross-examination of the complainant on her previous behaviour with the accused in circumstances where it was alleged that she had begged the defendant for sex and had performed oral sex on him. This kind of evidence goes to motivations for concocting allegations against the defendant. It would also appear that once leave is granted to cross-examine the complainant, the court does not have the discretion to restrict its admission. In R v F it was held that where the judge allowed the defendant to cross-examine a complainant on the nature of their adult consensual relationship he erroneously excluded cross-examination on evidence showing the complainant appeared happy engaging with the defendant. The evidence was relevant as it showed the actual adult relationship and thus relevant to the authenticity of a complaint about abus e childhood abuse. In R v Mokrecovas, Lord Woolf cautioned that Section 41(3)(a) should not be exploited for sole purpose of damaging the complainant’s credibility. The Court of Appeal ruled that where there was enough evidence before the court on the complainant’s state of mind further evidence that she had engaged sexually with the defendant’

Tuesday, October 15, 2019

The Art of Neosoul Essay Example for Free

The Art of Neosoul Essay Neo Soul is a genre of music that arose in the 1990s from the experience of RB/Soul music and is characterized as â€Å"bringing freshness to a genre long pronounced dead †¦Ã¢â‚¬  (Phillip Cunningham/Bowling Green State University). As defined by the Stanford Dictionary of Philosophy, â€Å"art is modern works that appear to break radically with all traditional art† and this music genre is by definition new and radically different. Considering neo soul in terms of art, I believe that this music is an expression of modern mainstream African American culture, experience, belief, and surely, the root of this ethnicity. Different and more artistically expressed than soul music it brings great aesthetic value to the music scene. Not just music, but a powerful expression of deep rooted feelings through attention-grabbing and talented artist of our day. Neo-Soul is new and innovative in expressing the common culture of African American life and in its refusal to walk the conventional line. In what the Music Said’ an essay by Mark Anthony Neal, this form of music is ‘post-soul’ and is a combination of rhythm and blues, funk, rap and hip-hop and arose out of resistance to, and often times in opposition to, middle class sensibilities of respectability and norms. In Soul, the expression seems disdain and rebellion for the normal societal norms, that have been put in place by the government influences such as Marvin Gaye’s What’s Going On and Let’s Get it On? two of his most popular pieces where he is in defiance of the current political agenda and abstinence. Neo, meaning ‘new, or ‘Nu’ brought a different vehicle of expression the experiences of the time. Though there is much debate regarding the terms ‘Neo-soul’ or ‘Neo-classical-soul’ has become, in the 1990s and 2000s, more popular. Neo Soul is an extension of a culture that has a voice. The African American community in the 1990s as ‘church’ and faith become more important to young professional Christian, Neo soul also creeps into the Gospel music with artist such as Lisa McClendon and Leon Timbo. These individuals express a ‘real time’ acceptance and reliance on their God and expression of their faith in contemporary terms. Neo-soul music is one such singularity, which has reframed the subjectivities of black people and suggested identities embodied and disembodied, human and post-human. (Weheliye 30) Simply put, it is a genre of music that refocuses the African American art of music. More aesthetically pleasing I think. The beauty of neo Soul has I believe redefined African American Music as an art form rather than beat for bump and grind, distrust and defiance. Such artist as : Lauryn Hil, India Aria, and Jill Scott, women who have redefined lyric with bold and encouraging expression and melody that beats to the heart of the listener. In Aria’s â€Å"Strength, Courage, and Wisdom†, she speaks of positive thoughts to encourage and that these elements are internal, pointing the listener to uplift rather than what can be done in secret. As well as the song â€Å"I Am Not My Hair†, which counteracts bigotry and sterotypes with positive phrases and rhyme. Similarly Jill Scott, with a more rhythmic driving beat in â€Å"My Petition†, Scott speaks out against the American government without the hatred that you would usually see in this type of song, through straight, it is not militant – just truthful. Neo Soul music is an adaptation of Soul music as an art form and moves it to a higher degree of listening pleasure. Not timid but definitely bold, but respectful of both the artist and the listener. Even the presentation of the artist in this genre is an artistic expression of the African American culture. One of India Aria’s latest releases, Testimony Volume 2, Love Politics says explains this artistic form of getting her point across about poverty and society outlook on those that live in poverty in Ghetto: Now the dictionary says / That the ghetto is a place / of minority, and poverty, and over population. We list on this earth together, / ain’t no separation. / when you’re looking down, / from outer space. / we’re just a human race and the world is a / ghetto-o-o-o. A clear point, but not so hard on the heart. Work Cite Afrofuturism and post-soul possibility in black popular music. Aria, India. Strength and Wisdom. http://www. azlyrics. com/lyrics/strengthandwisdom. html Art and Popular Culture online. http://www. artandpopularculture. com/African_American_music Cunningham, Phillip. â€Å"There’s Nothing Really New Under the Sun†: The Fallacy of the Neo-Soul Genre. Journal of Popular Music Studies, Volume 22, Issue 3, Pages  https://www.thefreelibrary.com/

Monday, October 14, 2019

Marfan Syndrome Disorder

Marfan Syndrome Disorder Marfan syndrome In the early centuries some people might have had Marfan syndrome. Most will ask â€Å"What is Marfan Syndrome?† or â€Å"Do I have Marfan syndrome?† But our scientists answer theses questions about Marfan syndrome. Marfan syndrome is a genetic disorder that affects the connective tissue. Some in what the connective tissue does or provides is substances that support tendons, ligaments, blood vessel walls, carilages, heart valves and many other structures. In 1896 Antoine Marfan, a French doctor, discovered Marfan syndrome when he had a patient. As a boy who was fourteen years old (the patient), wanted to always become a basketball champ or at least a player but his coach didnt like the way he looks so the fourteen year old boy went to see Dr. Marfan. The doctor first didnt see but then finally he saw the problem. The young boy was more than 6 and a half feet tall. He was really skinny and had long arms, legs, and fingers. He told the young man to avoid team sports because he might have a blood vessel problem too. After investigating the young boy Then soon the doctor then named this disorder Marfan syndrome, after himself. Over the years some scientists began experimenting about Marfan syndrome and how it affects the human body. Trying to look at all the people with it and how bad it has diagnosed everyone. They soon discovered that every child with a parent that has Marfan syndrome has a 50% chance of getting it passed on to them. Although Marfan syndrome affects one person in every five thousand all over the world it is really rare. A lot of people are diagnosed with Marfan syndrome but it isnt that much noticeable to many people. You may look at a friend that is tall and skinny but that doesnt mean that they have Marfan syndrome. They might of just grown up that way in how well they ate or how well they had activity in their young childhood. If you want to find out if you have Marfan syndrome you need to go to four different doctors. You must check in with the geneticist first, then a cardiologist, an ophthalmologist, and finally an orthopedist. The geneticist looks at your disorders from genes of the family that you came from. (To see if anyone else had the disorder). A cardiologist looks at your heart and tests it out to see if you have any problems.(making sure if you have a heart related disease)Then an ophthalmologist checks your eyes to see if you have any huge or an enlarged pupils. And finally you check into and orthopedist for your bones. During this procedure the doctor(s) will check your arms, legs, ribs, fingers, and back to catch any problems or aches. Children with Marfan syndrome need to go to many doctors every single year for a long time. Because kids change and grow so quickly they got to be healthy and clean. Children with Marfan syndrome that have heart included problems need to take medicines called beta blockers, which help their heart stay on function and not leak through. Some kids even need surgery if they have a serious problem that is including Marfan syndrome. Kids with lazy eye will mostly need to wear glasses, and children with scoliosis need to wear a special back brace to help their back grow straight. As you know that many children need to get used to doing this at a very young age. Do people with Marfan syndrome have a long life? People with Marfan syndrome dont have as much chances as normal people to live up to one hundred of years old. They can but they arent really able to move. They are not as healthy to live a long life. They can not live a long life because they cant do many activities that exercise your body well enough and their hearts can not function well enough. Most people that have Marfan syndrome can not play most activities like soccer, football, hockey, tennis, and more energetic sports. They might play some games that more come and not as energetic. Most doctors might even say that they should not except to play team games. This genetic disorder (Marfan syndrome) affects mostly all people all over the world. Although you may see most boys have it, girls get affected by it more harmfully. They stop breathing or even need surgery. Females and males still do get infected by this rare disease but they still like the way their lives are. Marfan syndrome is a genetic disorder caused by a mutation in the fibrillin gene. This Misshapen in the fibrillin produced from the mutation weakens the tendons, ligaments, and other connective tissues in the human body. Marfan syndrome is a dominant trait. Meaning that two out of four children have the disorder or disease. The baby is born with this disorder and it is unusual that you will get after you birth. Many people have been doing research on the history of Marfan syndrome and they think that Abraham Lincoln might have been affected by Marfan syndrome. They think that Abraham Lincoln had Marfan syndrome because he was very tall, had long fingers that were elongated. Today, Marfan syndrome has received attention in the media largely as a result of health problems and deaths among very tall athletes, such as most basketball players and volleyball players. In the United States, it has been estimated that 40,000 or more people have Marfan syndrome. From back then to right now people have been diagnosed badly with Marfan syndrome. Some lost lives, some got serious surgeries, and some just got hurt. Marfan syndrome has got around for ages and will still continue to the future until somebody finds a cure. Some scientists are finding new ways to help the people who have Marfan syndrome but some are just normally finding a cure. Only if this terrible disease didnt hurt the world championship players that have helped the world.

Sunday, October 13, 2019

Frederick Douglass :: essays research papers

Frederick Douglass once said, "there can be no freedom without education." I believe this statement is true. During slavery, slaves were kept illiterate so they would not rebel and become free. Many slaves were stripped from their families at an early age so they would have no sense of compassion towards family members. Some slaves escaped the brutal and harsh life of slavery, most who were uneducated. But can there be any real freedom without education? Freedom is something many slaves never had the opportunity to witness. They were simply uneducated, illiterate machines who did whatever they were told. But few fortunate slaves were given the gift to be educated by someone. One of these fortunate persons was named Frederick Douglass. Douglass was born a slave. He never had the chance of knowing his mother. As mentioned before, slaves were stripped from their families, leaving them no sense of compassion. In the book, The Narrative of the Life of Frederick Douglass, Douglass says, "Never having enjoyed, to any considerable extent, her soothing presence, her tender and watchful care, I received the tidings of her death with much of the same emotions I should have probably felt at the death of a stranger."(2) Douglass secretly met with his mother about 4 times during his whole life. He said he never really got to know her being he was only a child and the never had much of a conversation. These sorts of incidents happene d to slaves throughout America and permanently scarred most slaves and their families. Slave owners not only broke slave families up, but they also tried to keep all the slaves illiterate. In the book slave owners thought, "A nigger should know nothing but to obey his master-to do as he is told to do. Learning would spoil the best nigger in the world. If you teach a slave how to read, they would become unmangeable and have no value to his master." Masters thought that if a slave became literate then they would rebel and get other slaves to follow them. Also masters lied to slaves saying learning would do them no good, only harm them. They tried using that reverse psychology to make it seem like what they were doing was right.

Saturday, October 12, 2019

Essay --

During Thomas Jefferson’s presidency, he completed a series of transactions that made America what it is today. The most famous of these transactions was the Louisiana Purchase. He bought a lengthy stretch of land spanning from the obvious (Louisiana) to Montana. This land was bought for approx. 15 million. This translates to about 234 million dollars in today’s money (about 42 cents per acre).1 In order to explore this newfound territory, Thomas Jefferson sent two pals off into the wilderness, along with 31 other men. These two men were Meriwether Lewis and William Clark. Meriwether Lewis was born in 1774 at his family’s estate in Virginia. When Lewis was five, his father died of pneumonia and his mother shortly remarried with a retired army officer. When Meriwether was 13, he returned to Virginia and began his schooling. In 1794, Lewis signed up for the army, where he was sent to quench the Whisky Rebellion along with 13000 other Virginians. One of these men was William Clark. The following year, Lewis joined the army of General ‘Mad’ Anthony Wayne. He was quickly transferred to the Chosen Rifle Company, which was led than none other than William Clark. The two quickly became friends but not long after being transferred, General Clark had to resign do to health problems. The following February, he was invited by his friend and president, Thomas Jefferson to serve as his personal secretary. The President proposed his plan to explore the United State’s new territory, and Lewis quickly volunteered to go. In 1803, congress app roved and Meriwether began to get ready. He sent a letter to his old friend, William Clark, asking him if he wanted to go with him. He agreed and the two left with 31 other men in the spring of 1804. Willi... ...e, unlike his best friend Meriwether. Sacagawea settled down with her French husband and six years after returning from their journey, gave birth to a daughter. No one knows if this daughter lived. In 1812, William Clark legally adopted both of Sacagawea’s Children. In the 20th century, a theory developed that Sacagawea instead lived to the age of 100 and was buried on the Wind River Indian Reservation. After close speculation, this theory was sent to rest by most historians, but you can believe what you like. William Clark, Meriwether Lewis, and Sacagawea remained friends long after their journey, and it is somewhat obvious due to the many respectful comments and other notes that involved the opinions and their friends that these people influenced each other greatly. These 35 people that returned to Virginia can be considered some of America’s greatest explorers.

Friday, October 11, 2019

Outline and assess the view that the role of education system is to justify and reproduce social inequalities Essay

Outline and assess the view that the role of education system is to justify and reproduce social inequalities (50) The view that the role of educations system is to justify and reproduce social inequalities is one from a Marxist perspective. They believe that capitalism creates inequality and allows those with wealth to keep theirs. Bowles and Gintis argue that there is a very close relationship between education and work. This is called the correspondence principle. Bowles and Gintis argue that in a capitalist society they are known to give children different types of education based on the class than on their actual ability. Meaning that schools will give working class children a different type of education in comparison to middle and upper class children. Consequently allowing the working class to stay where they are on the class system, but they also allow the middle and upper class to stay where they are too. Capitalism reaffirms the idea that the working class are required to be hardworking and obedient therefore not resisting the teachers, as this is what they will be required to do when they enter the workforce. The education system creates a future workforce that have the desired qualities by passing on the hidden curriculum to school children. The hidden curriculum is the things you learn through going to school and the experiences you get there, and not those that you learn in class and through the formal curriculum. The hidden curriculum is there for working class schools to help shape them for the workforce. The hidden curriculum helps create a subservient workforce, meaning that workers will not challenge the system, and have an acceptance of hierarchy. Meaning that when teachers give directions the students will follow them without asking questions, this prepares them for later in life when they are in work. School subjects have very little reference to each other and that there is not much correlation between each subject. Much like the working class children’s future career as their job may be broken down into small, individual tasks. Whereas in more elite and private schools the children are learnt very different skills, and taught a different set of norms and values. Children at these schools are more likely to be taught to be more in command of the situation that they are in. Bowles and Gintis also reject the idea that the education is meritocratic, and providing equal opportunities for everybody. Middle class children will gain high qualifications and receive higher pad jobs because of their ability but also through their large quantities of cultural capital. Whereas working class children may not have the same opportunities to receive cultural capital this creating inequalities within the education system, much like the class system. This is called cultural reproduction. Bourdieu believes that education reproduces the culture and class system. It shows the importance of the upper class culture and therefore reinforces the power those have over the working class. They are allowed to do this by basing the education system off cultural capital, whilst the culture that the working class children are receiving is not on the education system and therefore they lose interest. Bourdieu believes that education has been developed by the bourgeoisie and therefore the working class have never had any real ownership on the education system they are forced to be a part of. However functionalists believe that the education institution is there and built for a reason, that it affects and benefits both the individual and society. Education allows students to learn and create a shared set of norms and values, therefore creating a similar attitude between everyone. Ultimately allowing a whole society to have values of achievement, competition, and equal opportunities created by education. This is confirmed by Durkheim’s, view that the shared norms and values create social solidarity, allowing the whole society to work in harmony. This can create a skilled workforce as everybody knows what is needed from them and is necessary for the future economy. According to functionalist Parson education is part of a meritocracy, being based on a person’s ability. He believes that education is a bridge between the family and society. Parson’s believes that education creates a set of values including competition, equality, and individualism. Within a meritocracy every student is given the same opportunity, and that achievements and rewards are based off an individual’s efforts and abilities, thus creating an achieved status. A functionalist like Parsons could state that this achieved status allows individuals to strive for more and as a result choose to work and have a career. Education allows students to be categorised and shown what skills they are best at. Role allocation, sorts through people according to their ability at different subjects. Davis and Moore stated that the education system was a meritocracy, and that it is based on the individual’s merit and ability, allowing staff to steer them towards the most suitable career for them. This suggests that everybody has an equal opportunity to gain the most important and best paid jobs, as everybody has had the same opportunity. From a functionalist perspective the most important jobs in society are those that require the longest periods in education and that you have spent a long time working your way there. Therefore Davis and Moore could argue that education is the most important factor in growing up as it is what allows people to be steered into a career. Although a functionalist theorist such as Tumin would argue that those in the highest paid jobs are being rewarded for how hard they have worked. This consequently maintains the meritocratic system, as it implies that we will accept inequality if we know that those with the highest wage are doing the most important jobs. Just as we can accept that it is okay for somebody to be on a higher wage as long as they have more talent and drive than what we do. In conclusion it can be argued that the education system is there to justify and reproduce social inequalities that has been created thus allowing students to be no further forward when trying to prosper in a system that does not want them to succeed. However from a functionalist perspective it can be seen that every child has an equal opportunity to succeed and that it creates an opportunity for working class children to move up the class system.

Thursday, October 10, 2019

History and Physical Examination Essay

Admitting Diagnosis: Stomatitis possibly methotrexate related Chief Complaint: Swelling of lips causing difficulty swallowing History of Present Illness: This patient is a 57-year-old Cuban woman with a long history of rheumatoid arthritis. She has received methotrexate on a weekly basis as an outpatient for many years. Approximately two weeks ago she developed a respiratory infection for which she received antibiotics and completed that course of antibiotics. She developed some ulceration of her mouth and was instructed to discontinue the methotrexate approximately 10 days ago. She showed some initial improvement but over the last 3-5 days has had malaise, a low-grade fever and severe oral alterations with difficulty in swallowing although she can drink liquids with less difficulty. Patient denies any other problems at this point except for flare of arthritis since discontinuing the methotrexate. She has rather diffused pain involving both large and small joints this has caused her some anxiety. Medications: Prednisone 7.5 mg PO daily. Estradiol 0.5 mg PO QAM. Mobic 7.5 mg PO daily. Recently discontinued because of questionable allergic reaction HCTZ 25 mg PO every other day and oral calcium supplements. In the past she has been on pencillamine, azathioprine and hydroxychloroquine but she has not had Azulfidine, cyclophosphamide or chlorambucil. Allergies: none by history Family and Social History: noncontributory Physical Examination: This is a chronically ill appearing female alert oriented and cooperative. She moves with great difficulty because of fatigue and malaise. Vital Signs: Blood pressure 107/80. Heart rate 100 and regular respirations 22. HEENT normal cephalic. No scalp lesions. Dried eyes with  conjuctival injection. Mild exophthalmos. Dry nasal mucosa. Mark cracking bleeding in her lips with erosions of the mucosa. She has a large ulceration of the mucosa at the bite margin on the left. She has some scattered ulcerations on her heart and soft pallets. She has difficulty opening her mouth because of pain. Tonsils not enlarged. No visible exudate. Skin: She has some mild ecchymosis on her skin and some erythema. She has patches but no obvious skin break down. She has some fissuring in the buttix crease. Pulmonary: Clear to precaution and alcostation bilaterally. Cardiovascular: No murmurs or galaps noted. Abdomen: Soft. None tender. Protuberant no organomegaly and positive bowel sounds. Neurologic Exam: Cranial nerves 2-12 are grossly intact. Diffuse hyporeflexia. Muscular Skeletal: Corrosive destructive changes in the elbows, wrists, and hands consistent with rheumatoid arthritis. Has bilateral total knee replacements with stovepipe legs and perimalleolar pitting edema 1 +. I feel no pulses distally in either leg. Psychiatric: Patient is a little anxious about these new symptoms and their significance. We discussed her situation and I offered her psychological services. She refused for now. Problems: 1. Swelling of lips and dysphasia with questionable early Stevens- Johnsons syndrome. 2. Rheumatoid arthritis class 3 stage 4. 3. Flare of arthritis after discontinuing methotrexate. 4. Osteoporosis with compression fracture. 5. Mild dehydration. 6. Nephrolithiasis. 7. Anxiety. Plan: 1. Admit patient for IV hydration and treatment of oral ulcerations. 2. Obtain a dermatology consult. 3. IV leucovorin will be started and the patient will be put on high dose corticosteroids. 4. Considering patients anxiety perhaps obtain services of Stella Rose Dickinson PHD Psychology at a later date. X______________________________________________ Liam Medina, MD Date: 06/22/—- Case Study 5 Discharge Summary Patient Name: Fanny Copeland Patient ID: 115463 Date of Birth: 10/26/— Age: 58 Sex: Female Date of Admission: 04/26/—- Date of Discharge: 05/01/—- Procedure Performed: CT scan. Ms. Copeland is seen for her summary conference from her work up here at Hillcrest Memory Diagnostic Center. I initially saw her on 04/28/—- at which time there was the suspicion of depression. She has since had CAT scan of the brain with contrast of 04/30/—- which was unremarkable. Laboratories studies were completely negative to include normal thyroid function B12 and RPR. She had a formal neurophysiological battery with Dr. Stella Dickinson on 04/26/—- she scored 136 on the dementia rating scale, which is within normal limits for her age. The test result were consistent with mild cognitive defaces manifested by problems with concept formation. Attention and concentration and verbal memory. However the patient is significantly depressed which can produce some memory problems. Her past MRI suggests someone who is experiencing stress. Impression: There was no clinical evidence of dementia but there is evidence of a depressive disorder as the cause of her symptom etiology. No further suicidal or homicidal ideation are present. Recommendations: We recommend a psychiatric evaluation and treatment with re-testing in our facility in one years’ time.