Moll Flanders :: Moll Flanders Essays

George Eliot composed, "It is never past the point where it is possible to be who you may have been." As I read those words, I was unable to discover another who fit them just as Moll Flanders. In spite of situation and karma and chances set against her every step of the way, this lady wouldn't bow to the tried and true way of thinking that regularly runs the oppressed and the confiscated. Furthermore, it is in that diligence of soul I discover Eliot's words sounding valid. Moll Flanders naturally introduced to a universe of cushion bolted entryways and dim threatening corners was bound for enormity just in light of the fact that she lived it.   The story starts as a story advised to a vagrant recouped and asserted by Hibble, a man of secret, dim and astute. The vagrant, Flora, has been recovered by Hibble and is on an excursion to America to meet a destiny she doesn't comprehend. En route, Hibble has been told to peruse to her the journal of her mom, Moll Flanders. It is a prologue to a lady who’s soul doesn't run over well on the composed page, however Hibble battles along, attempting to lure the little youngster with the memory of an unprecedented companion and friend. Dangers and talks start an excursion that before long interests the young lady on its own legitimacy. Her mom, no doubt, was more than she at any point imagined.   Also, it is in those pages that we discover our very own saint. Moll Flanders, destined to an indicted hoodlum, was stranded the day she was conceived as the state did the sentence of death put upon her mom. Moll arrived at the foot of the Church, figuring out how to peruse, to implore and to fight off pietism and the grabbing hand of the cleric in the deal. Leaving the Church in an unconventional way, Moll skiped from home to home, getting herself a lot for a few and too little to even think about warding off others. En route, she figured out how to chuckle and to limp as a result of the generosity and pitilessness that have large amounts of our universes. It was in the generosity that Moll wound up bound in adoration to a far-fetched craftsman and it was in that association Flora was imagined.

9th Earl Spencer - Eulogy for Princess Diana of Wales free essay sample

ninth Earl Spencer - Eulogy for Princess Diana of Wales free exposition test

St. Georges Day

St. Georges Day When I came back to England from Easter vacation, I was greeted by this at the local supermarket: The signs say Happy St. Georges Day, Wednesday 23 April and has a picture of a knight on a horse. I was with another MITer at the time and neither of us knew what St. Georges Day was. I whipped out my camera and we agreed that whatever it was, it would probably make a good blog entry. Okay, I should probably have published this entry on 23rd April but Im in the middle of exams. Very stressful. More on that later. I looked this up in Wikipedia and turns out, St. Georges Day is Englands National Day. St. George usually depicted as a knight sitting on a horse, killing a dragon. Unfortunately, I dont know any more than that. If anyone has anything to add, feel free to enlighten the rest of us in the comments below. Anyway, I was pretty curious to see what happens during St. Georges Day. So on Wednesday, 23 April, I armed myself with my camera and was half expecting to see some sort of parade. But the only thing exciting I saw that day was that all the buildings and colleges were flying St. Georges flag. The wind was absent that day so if you cant tell, the flag is white with a red cross on it. Okay, Im off to a tea party held by the local MIT Club.

The Lack Of Quality Of Sleep - 1492 Words

Recent research suggests that the way one eats may be related to one’s overall quality of sleep. Those suffering from poor quality of sleep experience disorders such as sleep apnea, narcolepsy, Klein-Levin syndrome, and other chronic abnormal sleep patterns. The lack of quality of sleep tends to be most prevalent among adolescents and young adults. Some research links the relationship to certain intake of nutrients or to the implementation of specific diets. Others relate the issue to lack of exercise. A person’s quality of sleep contributes much to their daily mood and success. For adolescents and young adults, sleep is crucial to their academic success and health. It may not be realized how a specific diet can contribute to the quality and duration of sleep (Cespedes, Hu, Redline, Rosner, Gillman, Rifas Shiman, Taveras, 2016). Part of this reason is for the lack of knowledge of the effects that nutrients have on the human body. As a result of this, there may be many who lack a good night sleep. Examining the effects and results of poor eating habits can indicate a correlation to this issue (Bel, Michels, Patterson, Cuenca-GarcÃÆ'a, Diethelm, Gutin, De Henauw, 2013). Sleep disorders do not occur suddenly but rather develop in a subtle manner (Chaput, 2014). These sleeping disorders may be a result of poor diets including lack of nutrition, or even an excess of certain substances. Eating habits have been proven to have an effect on sleep quality, however,Show MoreRelatedPoor Sleep Quality Is Associated With Increased Cortical Atrophy Essay700 Words   |  3 Pages The research article Poor sleep quality is associated with increased cortical atrophy in community-dwelling adults is a correlational study that concluded there was a correlation between longitudinal measures of cortical atrophy and lack of sleep quality. The hypothesis of the researchers was that atrophy within the orbitofrontal cortex and medial prefrontal cortex would be associated with poor sleep quality. These researchers also hypothesized that the frontal, temporal, and parietal cortices mayRead MoreThe Effects Of Sleep On The Brain1095 Words   |  5 Pagesrecent news article on CNN, Lack of Sleep May Shrink Your Brain, cites a research study suggesting that insomnia and other reasons for sleep deprivation may reduce brain mass. Although the study was correlational, the author of the news article focuses mostly on one of the three possible relations between sleep and brain mass: lack of sleep may cause shrinking of the brain. Only at the end of article, the author mentions that shrinking of the brain may cause lack of sleep, but completely disregardsRead MoreWhy Do We Sleep?1540 Words   |  7 PagesWhy do we sleep? As we all know, one third of our life is spent to sleep, but very few people intend to lay bare the secret of that. There would be a question: why do we sleep? According to the video The Function of Sleep, Tyson states that people are not very clear about the purpose of sleep, but some researchers believe that sleep could enhance memory. MIT researcher Matthew Wilson also illustrates the thoughts of a rat can be read by implanted the electric wire into its brain. According toRead MoreThesis Statement : Sleep Deprivation1414 Words   |  6 PagesEng 112.0004 Mrs. B. Peterson October 13, 2017 Sleep deprivation Thesis Statement: Sleep deprivation is harmful to college students because it hinders student learning and jeopardizes their safety while driving. I. Learning a. Memory b. Lack of attention II. Safety a. Fatigue b. Decision making Sleep is one of the unavoidable daily-living activities and it is one of the most important factors contributing to a person’s health. A quality sleep is essential for the physical, cognitive andRead MoreInformative Speech On Sleep1328 Words   |  6 PagesTitle of Speech: The Importance of Sleep and the Effects It Can Have on Our Bodies Specific Purpose: My audience will understand the importance of sleep, the effects a lack of sleep can have on a person’s body, and ways to improve the quality of sleep. Thesis: Sleep plays an essential part in a person’s health and well-being; the way we feel while awake is dependent upon what happens to your body while asleep. Attention Getter: Are you in debt? I know what probably came to your mind: loans, creditRead MoreCorrelation Between Average Sleep Hours And Cumulative Gpa On College Students1105 Words   |  5 Pagesaverage sleeps hours and cumulative GPA on college students. And the hypothesis of this research is that there is a positive correlation between the average sleep per night and cumulative college GPA. There were 42 undergraduate students took the survey about sleep hours, sleep quality, and cumulative GPA. Pearson’s correlation test was conducted in the research. As the result, there was no significant relationship between college students’ sleep hours and cumulative GPA. It illustrated that sleep quantityRead MoreResearch Study : Relationships Of Eating Competence, Sleep Behaviors And Quality, And Overweight Status Among College Students Essay1091 Words   |  5 PagesStudy: Relationships of eating competence, sleep behaviors and quality, and overweight status among col lege students Intro: Lack of sleep has been identified as a major public health issue found to contribute to chronic conditions such as obesity, diabetes (type 2) and hypertension. As sleeping habits worsened over the years, obesity and unhealthy eating trends continued to climb. In contrast cross-sectional studies support the notion that sufficient sleep promotes â€Å"health related behaviors,† suchRead MoreThe Relationship Between Sleep And Social Rhythms Essay1280 Words   |  6 PagesE. Carney Ph.D., Jack D. Edinger, Bjà ¶rn Meyer, Linda Lindman, and Tai Istre, published their study called, â€Å"Daily Activities and Sleep Quality in College Students†. The purpose of this study was to analyze the relationship between sleep and social rhythms. The researchers acknowledged that, â€Å"It has long been recognized that consistent and qualitatively satisfying sleep is largely dependent on a robust and well entrained endogenous circadian rhythm† (Carney, Edinger, Meyer, Lindman, an d Istre, 2009)Read MoreCollege Students : Sleep, Sleep Disorders, And Mental Disorders898 Words   |  4 Pagespeople hear the word sleep, they often fantasize themselves crawling into their cozy bed after a long, tiresome day. For countless college students, sleep is often just a dream. Countless studies have been done to attempt to understand why college students seem to lack of sleep and why they have a challenging time acquiring a suitable night’s sleep. After skimming through various articles, I found a few major themes correlated with college students and sleep: poor GPA, sleep disorders, and mentalRead MoreDoes Limited Duration Of Sleep Affect Academic Performance?1673 Words   |  7 Pagesdoes limited duration of sleep affect academic performance? Academic performance is utilized worldwide in order to determine an individual’s career success and in some instances intelligence. The United States utilizes academic performance as an indicator of character and potential; often individuals are defined by how well they perform in academic areas. The United States measures academic performance through grade point averages, exam results and standardized tests. The education system is based

Essay on Exploring the Importance and Purpose of School

It is common that most people believe success means having a high-powered job and earning a lot of money. However, to a great extent, success is defined as a situation in which a person has achieved his/her goal and is able to support him/herself morally and financially after completing the educational process. In school thorough a good education, students learn how to plan to achieve their goals. They also learn how to think critically and creatively, and improve the other skills they need. By exploring different subjects and fields they recognize their interests and abilities which lead them to achieve success. In schools students are encouraged to overcome their weaknesses through their strengths. John Gatto is imprudent when he stated†¦show more content†¦However, teachers try to teach their students to think critically by encouraging them to ask questions like â€Å"Why do I think that†, â€Å"What would happen if...†, or â€Å"How are these two things di fferent† before doing any projects or learning any new subjects. The other skill which is taught in school is problem solving skill which seems to be related to critical thinking. As Albert Einstein believes, â€Å"We cant solve problems by using the same kind of thinking we used when we created them† (Harris). Thinking in a critical way, evaluating and understanding the relationship among the problem give a person a new perspective to look at the problem differently in order to solve it. Learning to communicate effectively with others is another skill which is taught to the students. Doing presentation is a very common and good example for building students’ communication skills. Almost every subject in secondary school requires presentations, and as a result, the students learn how to communicate with peers through discussions and gathering information. These skills prepare students to pursue future opportunities beyond secondary school. Most schools offer stud ents variety of courses that they can choose from, but the majority of students don’t have any ideas of what they might be interested in and what they should pursue in future life. They can’t blindly predict what they would enjoy until they have enough information. Confused students can get helpShow MoreRelatedThe Importance Of The Personal Development For Citizenship Education1220 Words   |  5 PagesThe Importance of the Personal Development Purpose to Citizenship Education I believe there is an immense responsibility on a Social Studies teacher to develop good and responsible students who value their identity and citizenship. The Alberta Social Studies curriculum emphasizes that, â€Å"the dynamic relationship between citizenship and identity forms the basis for skills and learning outcomes in the program of studies† (Alberta Education 2005, p. 3). How a teacher chooses to explore the relationshipRead MoreTechnology Ethics in the Classroom Essay704 Words   |  3 PagesTechnology in the classroom is important to assist in the learning process; however this is creating new challenges for teachers. Teachers are now required to educate students on the importance of technology ethics. Computer ethics is the moral guidelines that govern the use of computers and networks (Shelly, G, Gunter, G, and Gunter, R 2012). Ethics in the classroom also requires teachers to explain what plagiarism is and the proper way for students to give credit for informa tion attained fromRead MoreThe Conflict Of Adolescence And Early Adulthood1037 Words   |  5 Pagesmove on with development. For the purpose of my study I will be analyzing the conflicts presented by Erikson for the periods of adolescence and early adulthood and how they compare to Jeffery Arnett’s (2002) newly proposed stage of development ‘emerging adulthood’. Who are you? Erikson’s (1968) fifth stage of psychosocial development is the stage of finding oneself: the conflict of identity versus confusion. During this transitional period one is exploring his or her own identity while leavingRead MorePolice Officer s Reputation Is Ruined And People1632 Words   |  7 Pageseducational programs in schools and communities, hold town meeting sessions between the people who live in the town and police officers, the last recommendation would be is that police officers would be required to wear body-mounted cameras while on duty. According to the Huffington post, children and teenagers that live in high crime rate areas, tend to have problems with police officers because they do not trust them. I think once at child is old enough to attend school, all elementary, middleRead MoreThe Physical Appearance Of Victims Of Teen Bullying850 Words   |  4 Pagespercentage of victims tend to engage in school avoidance behaviors, and many repeated victims of bullying at school end up dropping out of the school system† (Merrell, Gueldner, Ross, Isava, 2008, p. 27). Psychological Functioning and Academic Achievement Although the most common associations linked with bullying are those of a physical and verbal nature, it can also affect victims psychologically. Interventions Because there are many components entangled in school bullying, a resolution cannot beRead MoreCommunication At The Pharmaceutical Industry1642 Words   |  7 Pagesindustry Introduction This researcher is exploring communication in the pharmacy industry. After some issues in the pharmacy industry have some to light, such as the meningitis outbreak of 2012, there is now a question of whether there is an issue with the communication inside the pharmaceutical industry. With an industry such as this an element such as communication is very important. During this project the researcher will examine the actual importance of communication in the industry and alsoRead MoreMontessori vs. Piaget Essay1477 Words   |  6 Pagesconservative family and decided that when she finished secondary school she would study science. This was very uncommon amongst women of her time and she was met with a lot of resistance from colleagues, but this never influenced her decisions or her educational path. Montessori later decided she would change her direction and become a medical doctor. She was the first woman in Italy to graduate medical school. Once graduating medical school Maria Mont essori never practiced medicine, but began to studyRead MoreApology Reflection989 Words   |  4 PagesThroughout high school, I was heavily involved in speech and debate, competing in the â€Å"sport† for three years. Although I faced many arduous challenges within the activity, I learned the importance of examining various aspects of life in a systematic and thorough way. Likewise, as I read Plato’s Apology, I began to realize that an essential part of simply living our lives is to also examine and dig deeper into our internal being. In fact, Socrates exclaimed that â€Å"an unexamined life is not worthRead MoreMy Philosophy Of Higher Education1118 Words   |  5 PagesToday there is a great demand for higher education. It is important for our society and economical development. Our younger generations need to be equipped with the skills and knowledge to navigate through life. Alfred Whitehead believed in the importance of utilizing knowledge and the need to get students interested in their work (Cahn, 2013, p. 211). Whitehead’s philosophy makes sense because I also believe that knowledge is something that students need early in life, in order for students to beRead MoreGraduation Speech : School As A Source Of Learning1560 Words   |  7 Pagesthe only one who notices the increasing disinterest in education in my school. Perhaps, I m simply overreacting to its inevitability. Maybe it s the brief conversations containing absurd amounts of grammatical errors and profanity that I often hear throughout the hallways, or the numerous students who admit to not caring about school that have led me to this conclusion: The majority of teenagers have lost interest in school as a source of learning. There is no need to take my word for it. Observe

Othello And Hamlet Analysis - 774 Words

These two essays had practically nothing in common. The first was very short and made solid points, while the second was comparing Shakespeare to Aristotle. In essay one the writer brings up how us, the readers, are supposed to identify and compare ourselves to the main male protagonists in all of Shakespeare’s tragedies and this creates the sense of tragedy. The writer does this by bringing up the specific traits of characters such as; the strength of Othello, the intelligence and cleverness of Hamlet, the foolish vanity of King Lear, and the treachery of Macbeth. The second point of the essay is how there is an element of hope that is always disappointed or ambition that is frustrated. They then bring up examples of Macbeth, and how†¦show more content†¦The writer said, â€Å"Shakespeare is, in a way, the Michelangelo of literature.† The main point of the comparison is that Shakespeare wrote Othello 400 years ago, and yet it still has people that represent a modern alcoholic and psychopath, with Iago and Cassio. The second point is again, the most common and easiest point to write about, which is that the protagonist in Shakespeare always dies but the author brings up another interesting point. They bring up Greek drama, and how Aristotle â€Å"defined tragedy and asserted that it was the noblest and most serious, dignified and important for of drama.† In all of Shakespeare, there is a central protagonist that undergoes a life altering experience that leads to their death. The two are then compared by the â€Å"special feeling† that is felt while reading a tragedy. In the author’s conclusion, they bring up the comparison of the two again saying, â€Å"all of Shakespeare’s plays have elements of both tragedy and comedy, sometimes very balanced, creating effects that Aristotle could never have dreamt of.† Another very easy point to write about is brought up, which are the tragic flaws that all characters share. The writer doesn’t write about Shakespeare at first, but Aristotle. Aristotle outlines tragedy as a king or someone in high ranking that makes a mistake or has a misunderstanding that leads to losing their high ranking, or isolation in the character’s life which leads to their death. Then once the suffering of theShow MoreRelatedThe Self Defeat of Heroes in Shakespeares Tragedies: A Character Analysis of Hamlet and Othello1495 Words   |  6 PagesThe Self-Defeat of Heroes in Shakespeares Tragedies: A Character Analysis of Hamlet and Othello Introduction Aristotle asserted that all tragic heroes had fundamental flaws that were the source of their undoing, and that were typically the source of their initial success, as well. Oedipus thinks he acts with justice, wisdom, and the assurance of success, and these things also cause him to completely destroy himself when he discovers the truth of his situation, as one prominent example. TheRead MoreAnalysis Of Shakespeare s King Lear, Hamlet, Othello And Macbeth1206 Words   |  5 Pagesfor the audience. A Shakespearean tragedy, is a five-act play and they usually revolve around a similar idea of conflict. This is the Internal and external Conflict within the character. The four plays I have chosen to analyse are; King Lear, Hamlet, Othello and Macbeth. I chose these plays specifically because they all have universal themes which depict human emotions. They contain very important messages about internal and external conflict within characters and how this conflict can lead to terribleRead MoreThe Antagonist, Shakespeare1405 Words   |  6 Pagesright and wrong is all about perspective, well-done antagonists can be especially exciting.†(Hansen) Shakespeare develops his antagonists in a way that makes them interesting to the audience and does so especially well in his plays Othello, A Midsummer Night’s Dream, and Hamlet. Each play has an antagonist, or something near one in the case of Midsummer Night’s Dream, but the villains can be very different from one another and strikingly alike depending on the situation. Shakespeare’s creation of profoundRead MoreOthello Character Analysis1555 Words   |  7 Pagesinherent weakness lies in his linguistic capabilities, the very same capabilities Othello uses to win over Desdemona, and to defend himself during his trial in front of the duke. In Smith’s reading, Othello only reverts to his barbarian state when experiencing extreme pressure, as he lacks the other means to express the futility of what is felt, which results in violence. However, when a closer look is taken at what Othello knows about the culture he has tried to hard to assimilate to, it can be seenRead More Sex in Othello and Hamlet Essay4016 Words   |  17 Pagesor the way he acts just by being female and attractive is enough to drive men insane. William Shakespeares plays, Othello and Hamlet, demonstrate on paper, on film, and in other art forms that female sexuality and beauty are a threat to patriarchal society and that they must be controlled. Showalter affirms this in her essay by quoting David Laverenzes essay, The Woman in Hamlet. In this essay he asserts that, Hamlets disgust at the feminine passivity in himself translated into violent revulsionRead MoreSummary Of The Prince During The 1500 S1622 Words   |  7 Pagesof evil as acceptable in itself – despite what his many detractors then and now have said; he concedes, rather, that evil sometimes has to be used’ (2). It is in th is respect that characters such as Hamlet can be viewed as Machiavellian but not truly Machiavellian. Although he is not overtly evil, Hamlet is faced with the task of killing a legitimately elected monarch in order to avenge his father, with no concrete evidence, and only the word of the Ghost for proof. â€Å"The end justifies the means†Read MoreWilliam Shakespeare s The Ghost 2757 Words   |  12 Pagesbecause we can never find any conclusive textual references. In the Ghost’s encounter with Hamlet, he calls his ex-wife his ‘most seeming virtuous queen’. What’s more, he bids Hamlet to ‘Leave her to Heaven/ And to those thorns that in her bosom lodge/ To prick and sting her.’ Although these words suggest that Gertrude is blameworthy of some crime, the verdict of her complicity in the murder of late King Hamlet and of her involvement in conspiring with Claudius to usurp Prince Hamlet’s ascendancy stillRead More The Significance of the Players in Hamlet Essay899 Words   |  4 PagesThe Significance of the Players in Hamlet      Ã‚   Most characters in Hamlet present themselves as something other than themselves or how as we, the audience, or another character thinks they should appear.   Two of the main characters in this play, Hamlet and King Claudius, are constantly acting as something other than their true nature.  Ã‚  Ã‚   Ironically, the characters that invoke changes in Hamlet and King Claudius to reveal their real personalities are the players, merely actors themselves, notRead MoreThe Thematic Elements Of William Shakespeare s Hamlet1031 Words   |  5 Pagesthat of the well-known tragedy of Romeo and Juliet. Shakespeare does not stop at the tragedy of the star crossed lovers, but further goes on to write several more tragedies that deal with suicide such as: Macbeth, Julius Caesar, Othello, and Hamlet. The tragedy in Hamlet gives way for the examination of the ongoing moral views society has upon suicide during the Tudor era, the embodiment suicide portrays towards the development of the s tory, and the motives of contemplated suicide through the character’sRead More Ambiguity, Inconsistency and Uncertainty in Othello Essay example1269 Words   |  6 PagesAmbiguity, Inconsistency and Uncertainty in Othello  Ã‚   The Bard of Avon has in his tragedy Othello a true masterpiece, but not one without flaws. It contains blemishes, imperfections, and minor negative features which detract in lesser ways from the overall evaluation of the play. H. S. Wilson in his book of literary criticism, On the Design of Shakespearean Tragedy, addresses the arbitrariness and inconsistency in the play: Though the action moves in a single line, with none of the

How the Middle East Changed Me free essay sample

When I was twelve years old I found myself in an Egyptian hotel. My sister was studying abroad and my mom and I had come to visit her. This was my great adventure and I had been looking forward to it for weeks. The Middle East was not meeting my expectations though. The boys with dark skin that walked the streets followed my blonde hair with their eyes. The sounds of Arabic filled the air. I was suddenly prejudiced and scared. Over the next few days things changed. I went with my sister to a living area called Garbage City, where the inhabitants were literally surrounded by piles and piles of garbage. Nuns of Mother Teresa called the Sisters of Charity ran an orphanage, and we helped with the infants. I held one of the smaller ones in my arms and thought about what her future would be like. Would she grow up knowing only the smell of garbage? Would she get a decent education? Would she have the same chance to succeed that my own child would have in America? I decided to come back to Africa and help in any way that I could. We will write a custom essay sample on How the Middle East Changed Me or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Egypt changed my views on life. My stay in Egypt put the value placed on materialistic things into perspective. I could live with much less, knowing that other people were forced to survive with much, much less. Now my only dreams are to travel. There are kids waiting for a chance after all.

Persistent Pulmonary Hypertension of the Newborn (PPHN)

Abstract PPHN condition results from failure to attain a smooth transition â€Å"from fetal to extrauterine pulmonary circulation after birth†. Diagnosis of this condition can be done through various ways including; physical examinations, looking at the history, undertaking laboratory tests, using chest x-ray, undertaking hyperoxia test, and echocardiogram.Advertising We will write a custom research paper sample on Persistent Pulmonary Hypertension of the Newborn (PPHN) specifically for you for only $16.05 $11/page Learn More The signs and symptoms include; tachypnea or rapid breathing, increased heart beat rate, respiratory distress which may include signs like grunting and flaring nostrils, and cyanosis even at the time the infant is being given extra oxygen to help it in breathing and having heart murmur among others. In this paper, there has also been describing of the causes, treatment, and outcomes of PPHN condition and the role of the respi ratory therapist in dealing with this condition. Introduction PPHN condition is an outcome of failure to attain a smooth transition â€Å"from fetal to extrauterine pulmonary circulation after birth† (Bartle, Patole Rao, 2010, p.845). In most cases, pulmonary circulation experiences a noticeable drop from a high-resistance condition in the utero to a â€Å"low-resistance circuit†, within a very short period of time after birth (Mago, 2012, p.30). Such reduction in the â€Å"pulmonary vascular resistance† or what is simply referred to as PVR, gives room for the lungs to turn out to be a gas exchange body organ (Kraemer, Krijger, Reiss, Rottier, Sluiter Tibboel, 2011, p.245). This paper is going to look at the â€Å"Persistent Pulmonary Hypertension of the Newborn† condition in much detail. The paper will discuss the diagnosis of this condition, its signs and symptoms, the population affected, causes, treatment, outcomes, and the role of the respiratory t herapist. The last section of the paper will present a summary of the discussion. Diagnosis The diagnosis of the â€Å"Persistent Pulmonary Hypertension of the Newborn† condition can be confirmed by echocardiography which gives demonstration of the â€Å"right-to-left shunt with normal anatomy† (Bartle, Patole Rao, 2010, p.845).Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More There is suspicion of PPHN in the newborn children who shows liability in the progressive cyanosis oxygenation condition in the initial twelve to twenty four hours of the child’s life; and in other occasions, after the first good oxygenation period. Establishing of diagnosis is carried out from the physical examinations, the history of the patient, â€Å"laboratory tests, chest x-ray, pre-ductal and post-ductal blood gases, hyperoxia test, and echocardiogram† (Natarajan, Ostrea, Uy, Villanueva-Uy, 2006, p.181). Revelation is made of either a term infant or post-term infant by the history with a perinatal asphyxia’s history or predisposing factors like persistent membrane rapturing, â€Å"oligohydramnios, maternal group B streptococcal colonization, maternal smoking, and antenatal use of NSAIDS† (Natarajan et al., 2006, p.181). The purpose of the physical examination is to help reveal the intermittent or progressive cyanosis, the variable levels of the respiratory distress and an intimately â€Å"split second heart† (Natarajan et al., 2006, p.181). There may be an audible murmur within the tricuspid or pulmonary region or sometimes in mitral area. Systematic BP maybe at the normal level or there may be exhibition of sigs of the congestive heart failure as well as low blood pressure or BP. Moreover, there may be saturations of differential oxygen with either the upper or the lower extremities resulting from deoxygenated blood shunting via duc tus arteriosus (Natarajan et al., 2006, p.181). On the other hand, considering the x-ray method, this is found to be non-specific. This may be either normal or there may be mild or moderate â€Å"parenchymal lung disease† (Natarajan et al., 2006, p.181). This form of diagnosis is mostly important in diagnosing the cause of acute deterioration among the affected children suffering from the PPHN-related conditions like; pulmonary hemorrhage among others (Nakwan, Nakwan Wannaro, 2011, p.311).Advertising We will write a custom research paper sample on Persistent Pulmonary Hypertension of the Newborn (PPHN) specifically for you for only $16.05 $11/page Learn More Diagnosing PPHN by applying echocardiographic diagnosis is carried out on the basis of demonstrating high pressures of the pulmonary artery that are usually higher than the systemic pressures, and a â€Å"right-to-left shunt† via the foramen oval and ductus arteriosus. Indicators that suggest higher levels of the pressure in the pulmonary artery are; prolonged time interval of the ventricular systole and a short â€Å"pulmonary flow velocity ratio† (Natarajan et al., 2006, p.181). A prolonged â€Å"left ventricular systolic† interval of time indicates ventricular dysfunction. Failing of the acceleration of â€Å"systolic blood flow† between the major pulmonary artery and the minor peripheral artery on the Doppler also indicates ductal shunt. Conversely, echocardiogram might be normal and â€Å"the right-to-left shunt across the ductus arteriosus or foramen may not be seen depending on the level of the pulmonary artery pressure at the time of examination† (Natarajan et al., 2006, pp.181-182). Signs and Symptoms The signs and symptoms for the PPHN condition include; tachypnea or rapid breathing, increased heart beat rate, respiratory distress which may include signs like grunting and flaring nostrils, and cyanosis even at the time the i nfant is being given extra oxygen to help it in breathing (Natarajan et al., 2006, p.181). On some occasions when the infant is being examined for PPHN, the physician may be able to hear an abnormal heart sound or what is called a â€Å"heart murmur† (Natarajan et al., 2006, p.181). Affected Population Some sections of the population are affected by PPHN, and this basically depends on the risk factors to which they may be exposed. For instance, Cornfield Delaney (2012, p.18) present a report that in a well-considered, case-control trial carried out in the U.S Army population, it was found out that babies that were delivered through cesarean section were at about five times increased risk of developing the condition of PPHN in comparison with a control population that is well-matched demographically.Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More As on one hand this study encompassed nearly twelve thousand infants, it is only 20 of them that were found to have developed the PPHN condition (Cornfield Delaney, 2012, p.18). In the study, choramnionitis as well deliberated a considerably higher risk of the PPHN (Cornfield Delaney, 2012, p.18). The idea that imply that Cesarean section delivery leads to having increased risk of developing PPHN is offered support to by data that was obtained from a study conducted previously in which the delivery mode, maternal race, and â€Å"high maternal body mass index each increased the likelihood of PPHN† (Cornfield Delaney, 2012, p.18). It is also found that the risk of any woman delivering a baby that is affected by PPHN within the overall population is found to be approximately two babies among every one thousand live births (Cornfield Delaney, 2012, p.18). Causes It has been found that in otherwise fit newborn, â€Å"the cause of PPHN is usually unknown† (Cornfield Del aney, 2012, p.16). Among the researchers, there are those who hold a belief that stress among mothers while they are carrying babies in their wombs, linked to particular pregnancy complications may raise the level of the risk of having the PPHN condition. The occurrence of PPHN may take place with particular congenital conditions or diseases of babies that have some effects on the lungs (Weijerman, Van Furth, Van der Mooren, Van Weissenbruch, Rammeloo, Broers, Gemke, 2010, p.1195). The PPHN condition has as well been associated with such health conditions as hypoglycemia, anemia, birth asphyxia and severe pneumonia. Such conditions may lead to high BP within the blood vessels that subsequently, leads to the lungs to rise to the level where the blood of the infant goes on passing by lungs after delivery. In most cases, these conditions are found to be reversible and are also normally temporary. Some particular congenital conditions which contribute towards having incomplete developm ent of the lungs may as well be linked to PPHN (Cornfield Delaney, 2012, p.17). Treatment Maintaining sufficient oxygenation is the fundamental objective in PPHN management and mechanical ventilation is among treatment modalities that can be applied to realize this objective (Goissen, Ghyselen, Tourneux, Krim, Storme, Bou, Maingourd, 2008, p.437-438). Among the very early strategies within the conventional ventilator therapy was the hyperventilation to raise the level of the blood PH, facilitate the reversing of ductal shunting and inducting pulmonary vasodilatation. In comparing hyperventilation with alkali infusion, it was found out that hyperventilation brought down the level the â€Å"extracorporeal membrane oxygenation† risk (Oden Cheifetz, 2005, p.105). But on the other hand, from some study findings, it has been established that hyperventilation as well as â€Å"metabolic and respiratory alkanosis† induction in PPHN treatment, have not improved the clinical o utcome to a significant level and have been linked to â€Å"adverse neurologic sequelae† (Natarajan et al., 2006, p.183). On the other hand, pulmonary vasodilation using a number of drugs has undergone evaluation for PPHN treatment, but there has been no recommendation of any, apart from NO (Nassi, Daniotti, Agostiniani, Lombardi, Favilli, Donzelli., 2010, p.104). Some special cases of adenosine infusion have indicated improved oxygenation but have some adverse effects of â€Å"bradycardia, hypotension, and prolonged breeding time, which have precluded its clinical use† (Natarajan et al., 2006, p.183). Initially, there was utilizing of tolazoline as a â€Å"vasolidilating, ÃŽ ±-adrenergic blocking agent† (Natarajan et al., 2006, p.183). However, it facilitates inducing of histamine release and brings in adverse effects like having higher levels of gastric secretions as well as bleeding. It also leads to frequent occurrence of oliguria and systematic hypotension . On the other hand, â€Å"Extracorporeal membrane oxygenation† (ECMO) is found to be a final therapy mode among infants that has reversible cardiac or respiratory failure at a time the rest of non-invasive measures have not succeeded. This method is an improved cardiopulmonary bypass which makes sure that there is sufficient delivery of oxygen and gas exchange among the PPHN patients having or not having cardiac support. In this manner, the innate organs of the patient are rested to ensure facilitation of repair as well as to evade barotrauma and also volutrauma of the management of mechanical ventilation. Apart from PPHN, ECMO has as well been employed in â€Å"meconium aspiration syndrome, CDH, and cardiac anomalies† (Natarajan et al., 2006, p.184). Basing on the fact that ECMO is an invasive method, this method or procedure is reserved for the young children that are receiving maximum â€Å"ventilatory support† and the ones that meet Barlett standards, which is suggestive of at least eighty percent risk of incurring death. In the course of the last ten years or so, there has been a decline in the frequency of the utilization of ECMO technique because of the coming up of alternative techniques like inhaled NO or iNO (Natarajan et al., 2006, p.184). Inhaled nitric oxide or (iNO) is a technique that has been identified to be safe and very effective treatment method for PPHN in the near-term as well as term newborns (Fashaw, Hale, Lee, Rosenberg, Vaver, Waas, Werner, 2010, p.27; Hosono, Ohno, Kimoto, Shimizu, Takahashi, Harada, 2009, p.79). It has also been found out that using iNO has contributed to 3.4 percent more lives saved and a six percent rise in â€Å"average utility gained per infant (Lorch, Cnaan Barnhart, 2004, p.417). Moreover, utilization of this technique has helped to bring improvement in oxygenation and also in decreasing the need for having ECMO among term newborns having PPHN (Kinsella Abman, 1998,p.28). In the curr ent day, there has been extending of iNO utilization to the pre-term infants as being a rescue therapy among the infants having respiratory failure in spite of â€Å"surfactant replacement therapy†, and also more prevalent utilization among the infants who are less sick in an effort to bring down the level of frequency of the â€Å"chronic lung disease of the premature† (Fashaw et al., 2010, p.127). While the use of this technique becomes more and more prevalent, it remains vital to go on evaluating short-term as well as long-term outcomes for the infants (Walsh-Sukys Tyson, 2000, p.20). Outcomes The follow-up studies that were conducted previously about the infants who underwent treatment using iNO as â€Å"neonates have not found a short-term increase in medical, neurodevelopmental or behavioral problems when compared historically or concurrently with infants treated conventionally or with ECMO† (Fashaw et al., 2010, p.127). A number of studies of young child ren of up to the age of 2 years, who received treatment using iNO as neonates have been somehow encouraging concerning short-term â€Å"developmental outcomes† (Fashaw et al., 2010, p.127). In addition, the interviews conducted among parents that had children aged slightly above four years, that underwent treatment using iNO for PPHN, did not give out any findings of having increased neurologic, pulmonary, cognitive, â€Å"behavioral or neurosensory outcomes in infants treated with iNO when compared to those managed without iNO† (Fashaw et al., 2010, p.129). Even if neurodevelopmental disabilities are given different definitions depending on the study being carried out, there has been reporting of these disabilities in between ten to thirty percent of the infants having no differences pointed out where comparison was made between the infants that received treatment with iNO and a control population that received treatment for PPHN. Such numbers were as well comparable to those infants that received treatment with ECMO â€Å"followed out to 7 years of age† (Fashaw et al., 2010, p.129). Therefore, outcomes for the infants treated as being neonates for â€Å"Persistent Pulmonary Hypertension of the Newborn† tends not to be related to the â€Å"specifics of individual intensive care treatment regimens, rather to events clinically associated with PPHN such as prenatal asphyxia† (Fashaw et al., 2010, p.129). In general terms, the children that receive treatment with iNO have the same outcomes as those that receive treatment with ECMO and those that are treated with the conventional ways for the Persistent Pulmonary Hypertension of the Newborn. The Role of the Respiratory Therapist The respiratory therapist may be requested to offer supplemental oxygen and may also offer supplemental pressure to any patient who may be grunting in order to relieve the patient from some of the breathing hardships. The respiratory therapist can give th is through either the nasal CPAP or through any other more appropriate means. The therapist is then supposed to watch the infant (patient) closely for any symptoms of tiring. By making any observation of any sign of tiring, it may now become essential to apply more interventions. It is quite imperative for the therapist to watch closely this kind of patient. The respiratory rate as well as the oxygen saturation of the patient has to be constantly monitored. In case there is any deterioration in the patient, quick intervention must take place (Tibballs Chow, 2002, p.399). Summary/ Conclusion PPHN condition results from failure to attain a smooth transition â€Å"from fetal to extrauterine pulmonary circulation after birth†. The diagnosis of this condition can be carried by undertaking physical examinations, looking at the history, undertaking laboratory tests, using chest x-ray, undertaking hyperoxia test, and echocardiogram. The signs and symptoms for the PPHN condition incl ude; tachypnea or rapid breathing, increased heart beat rate, respiratory distress which may include signs like grunting and flaring nostrils, and cyanosis even at the time the infant is being given extra oxygen to help it in breathing and having heart murmur among others. It is believed that PPHN is brought about by stress among mothers while they are carrying babies in their wombs, linked to particular pregnancy complications which may raise the level of the risk of having the PPHN condition. Moreover, the occurrence of PPHN may take place with particular congenital conditions or diseases of babies that have some effects on the lungs. Considering treatment, maintaining sufficient oxygenation is the main goal in PPHN management and mechanical ventilation is among treatment modalities that can be applied to achieve the goal. ECMO has been found to be a final therapy mode among infants that has reversible cardiac or respiratory failure at a time the rest of non-invasive measures have not been successful. The technique is an improvement of the cardiopulmonary bypass which makes sure that there is sufficient delivery of oxygen and gas exchange among the PPHN patients having or not having cardiac support. But on the other, in the last few year, there has been a decline in the frequency of the utilization of ECMO technique because of the coming up of alternative techniques like inhaled NO or iNO. This new technique has been found to be very safe and very effective for treating PPHN in the near-term as well as term newborns. It has also been found out that using iNO has contributed to 3.4 percent more lives saved. Moreover, utilization of this technique has helped to bring improvement in oxygenation and also in decreasing the need for having ECMO among term newborns having PPHN. The respiratory therapist can play an important role of offering supplemental oxygen as well as providing supplemental pressure to any patient who may be grunting in order to relieve the pat ient from some of the breathing problems. The therapists also closely watches the patient in order to help carry out any interventions when need arises. References Bartle, D., Patole, S., Rao, S. (2010). Current and future therapeutic options for persistent pulmonary hypertension in the newborn. Expert Review of Cardiovascular Therapy, 8(6), 845-873. Cornfield, D., Delaney, C. (2012). Risk factors for persistent pulmonary hypertension of the newborn. Pulmonary Circulation, 2(1), 15-23. Fashaw, L., Hale, K., Lee, N. R., Rosenberg, A. A., Vaver, K. N., Waas, N., Werner, D. (2010). School-age outcomes of newborns treated for persistent pulmonary hypertension. Journal of Perinatology, 30(2), 127-139. Goissen, C. C., Ghyselen, L. L., Tourneux, P. P., Krim, G. G., Storme, L. L., Bou, P. P., Maingourd, Y. Y. (2008). Persistent pulmonary hypertension of the newborn with transposition of the great arteries: successful treatment with bosentan. European Journal Of Pediatrics, 167(4), 437-4 40 Hosono, S., Ohno, T., Kimoto, H., Shimizu, M., Takahashi, S., Harada, K. (2009). Developmental outcomes in persistent pulmonary hypertension treated with nitric oxide therapy. Pediatrics International, 51(1), 79-83. Kinsella, J. P., Abman, S. H. (1998). Inhaled nitric oxide and high frequency oscillatory ventilation in persistent pulmonary hypertension of the newborn. European Journal Of Pediatrics. Supplement, 157S28-S30. Kraemer, U., Krijger, R. D., Reiss, I., Rottier, R. J., Sluiter, I., Tibboel, D. (2011). Vascular abnormalities in human newborns with pulmonary hypertension. Expert Review of Respiratory Medicine, 5(2), 245-264. Lorch, S. A., Cnaan, A., Barnhart, K. (2004). Cost-Effectiveness of Inhaled Nitric Oxide for the Management of Persistent Pulmonary Hypertension of the Newborn. Pediatrics, 114(2), 417-426. Mago, R. (2012, August). Antidepressants and persistent pulmonary hypertension of the newborn. Psychiatric Times, 29(8), 30. Nakwan, N., Nakwan, N., Wannaro, J . (2011). Predicting mortality in infants with persistent pulmonary hypertension of the newborn with the score for neonatal acute physiology-version II (SNAP-II) in Thai neonates. Journal of Perinatal Medicine, 39(3), 311-321. Nassi, N. N., Daniotti, M. M., Agostiniani, S. S., Lombardi, E. E., Favilli, S. S., Donzelli, G. P. (2010). Sildenafil as ‘first line therapy’ in pulmonary persistent hypertension of the newborn?. Journal Of Maternal-Fetal Neonatal Medicine, 23(1),104-105. Natarajan, G., Ostrea, E. M., Jr., Uy, H. G., Villanueva-Uy, E. T. (2006). Persistent pulmonary hypertension of the newborn: pathogenesis, etiology, and management. Pediatric Drugs, 8(3), 179-188. Oden, J., Cheifetz, I. M. (2005). Neonatal Thyrotoxicosis and Persistent Pulmonary Hypertension Necessitating Extracorporeal Life Support. Pediatrics, 115(1), 105-108. Tibballs, J., Chow, C. (2002). Incidence of alveolar capillary dysplasia in severe idiopathic persistent pulmonary hypertension of the newborn. Journal Of Paediatrics Child Health, 38(4), 397-400 Walsh-Sukys, M. C., Tyson, J. E. (2000). Persistent Pulmonary Hypertension of the Newborn in the Era Before Nitric Oxide: Practice Pediatrics, 105(1), 14. Weijerman, M., Van Furth, A., Van der Mooren, M., Van Weissenbruch, M. M., Rammeloo, L., Broers, C. M., Gemke, R. J. (2010). Prevalence of congenital heart defects and persistent pulmonary hypertension of the neonate with Down syndrome. European Journal Of Pediatrics, 169(10), 1195-1199. This research paper on Persistent Pulmonary Hypertension of the Newborn (PPHN) was written and submitted by user ShaneYamada-Jones to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Reflection Portfolio

Reflection Portfolio Reflection Portfolio My vision towards health care is to enhance sustainable health care through consideration of modern health care strategies. In order to enhance this vision my personal visions entail: Values Relating to the System Foster Community Involvement in the Dissemination of Health Care The provision of critical health care services should always take into account the communitys input in the achievement of system objectives. This is primarily achieved through incorporation of the desired participatory approaches in the achievement of health care objectives (Albert 2003, p.37). Enable Equitable Access to Health Care All individuals in the community should essentially be in a position to access competent health care regardless of race, ethnicity, and economic background. These aspects provide a platform for the establishment of equity Competent, Efficacy and Efficiency of Health Strategies in Solving Health Problems Health care professionals need to be from accredited institutions, posses a proven track record of performance, and uphold professional principles. This will enable the achievement of desired efficacy, efficiency and effectiveness of the health care strategies (Albert 2003, p.38). Moreover, technological provisions need to meet the needed standards in providing health care. Promote Individual Autonomy The health care strategies used need to recognize different individual/personal backgrounds, cultural boundaries, ethnic practices, religious principles, and other unique traits of an individual such as presence of disabilities. Values Relating to Patient Care Always Consider Context During provision of health care there should be a mechanism in place for identifying contextual variations during actual care, for instance, in as much as an individual may be in need of acute services, this should recognize other needs, which could be contributing to the problem. Proper Coordination among Health Care Professionals Health care needs to be properly coordinated along the service chain (primary, secondary and tertiary). This should be achieved through the establishment of proven communication strategies that enable a seamless transition from one institutional setting to another with an aim of saving lives (Albert 2003, p.45). Right of Individuals and Communities to give Consent The fact that health care is being provided for the sustenance of life, this should also recognize and individuals choice, for instance, as seen in palliative care where individuals can choose to end their suffering through euthanasia. Hence, health providers need to recognize individual preferences in the proper context that warrants the application of such principles. Link between the Values An analysis of NSWs health care values and my personal collage values show a seamless link, which is illustrated as follows: Values Relating to the Health System NSWs Respect for individuals and communities shares common objectives with my personal values promoting the recognition of individual autonomy. In essence, some aspects relating to individual autonomy include culture, dignity, personal needs, and privacy (NSW Health 2010, p.5). Moreover, religion has a great influence in terms of cultural dimensions hence, it is necessary to use this as a guide in recognizing individual and community perceptions affecting health care provision. NSW encourages participation and share responsibility, which shows significant linkages with my personal health care values fostering community involvement in the dissemination of health care. In essence, individuals and communities need to work towards the achievement of desired health outcomes through personal efforts and proper help from professionals (NSW Health 2010, p.5). This is enabled through implementation of adequate and efficient participatory approaches. NSW values on equity, access and stewardship show significant linkages with my personal goals fronting for the promotion of equitable access for all members of the population. NSWs approach promotes access/equity and stewardship through affordable health packages, timely delivery, proper resource allocation, accountability, efficient management, and monitoring (NSW Health 2010, p.5). However, in order for these goals to be achieved especially focusing on resource allocation, the incorporation of ethnic, race, and economic background variables also play a significant role in fostering equity/access. NSWs values on quality, effectiveness, and safety show significant linkage to my personal values fostering for competency, efficacy, and efficiency of health care strategies. For instance, the fundamentals of quality and effectiveness can only be achieved by monitoring track record of performance to ensure professional services, and inspecting upcoming technological health care innovation to ensure safety provision. NSWs focus on the patient links well with my goals fronting for the recognition of contextual differences, which adequately takes into account present individual needs, in addition to health care needs. This puts the centre of focus on the patient as opposed to the system (NSW Health 2010, p.5). NSWs values on honest information and communication support my values fostering for the rights of individuals and communities to give consent on their health. For instance, by informing patients on what is a condition entails, what to expect, when changes may occur or future predictions of a particular condition (NSW Health 2010, p.5). In this case, patients are in a better position to decide on the best option for their health care like illustrated in the case of palliative care where patients may choose to undergo euthanasia. NSWs values on coordination of health care fundamentally share the same virtues as those expressed in my personal values. For instance, the fact that patients need to know rightful places for health access, in-charge in a medical process or other persons to be involved (brings in the aspect of institutional chain especially on account of transfers). Moreover, fundamentals of a well supported team run through the primary, secondary, and tertiary levels of health care. Fostering respect for individuals and communities enables individuals in the health teams to sufficiently recognize the essence of certain elements of culture in delivering specialized health care services. Promoting access and equity enables members of the health team to deliver services in a timely fashion, while suiting the unique needs of each population group Fostering participation and shared responsibility among team members provides members with the opportunity to incorporate members of the community during formulation of unique strategies focusing on health care management. Fostering quality, effectiveness and safety in the provision of health care ensures the health teams maintain the required professional standards and ethical perspectives. In essence, through provider performance measures it will be possible to establish the professional actions among providers to the relative outcomes and outputs of services (Adams et al 2002) Through proper stewardship health teams are in a better position to respond to health needs of the population using allocated resources in an efficient manner. Leaders need to sensitize their health staff on the need to elevate patient focus so as to distinctively separate system functions, career expectations, and consumer gratification elements. Leaders need to design and implement communication strategies and information access portals that will be used by patients in providing individualized and community health care. According to Atwal and Jones (2009), Communication also involves conveying the information that the client needs to make decisions and explaining this information thoroughly so that the client clearly understands what you are saying (p.55) Ensuring respect for individuals and communities will encourage patients to consult health care services knowing that their reservations on certain procedures will be taken into consideration. Moreover, it will enable to identify cultural barriers towards the achievement of a desired community/personal health status. Ensuring access and equity will make patients aware of problems in the health system, which leads to their inadequate consultation for appropriate services. In addition, this will be done under timely and appropriate circumstances; hence saving more lives and improving patient recovery potential (Albert 2003, p.77). Encouraging participation and shared responsibility will ensure members of the population become proactively involved in the decision making cycles, evaluation and monitoring exercises, which foster their knowledge of the health system and its functions. Ensuring quality, effectiveness and safety has a positive impact by improving trust and faith in the current health care system with regard to professional treatment, which leads to positive feedback resulting from patients during assessments. Each of these components can be achieved by setting short term targets. According to Atwal and Jones (2009), Achievement of each short-term target, in turn, demonstrates successful outcome of a treatment, objective progression associated with patient improvement and recovery or maintenance (p.32). Proper stewardship ensures prioritization of resources to the most important health care needs of the patients, which consequently decreases the prevalence of such conditions among patients. Moreover, patients will be in a much better position to access health care during the most critical times of need (Albert 2003, p.22). Making the patient become the centre of focus decreases negative judgment of health institutions by patients based on a biased performance assessment as seen in some settings (Albert 2003, p.49). Promoting the right of care enables patients to demand for appropriate health care services and proper settings. This entails technology provisions, timely attendance, appropriate prescriptions and proper referral systems (Albert, 2003, p.93) Well-coordinated care enables patients to forward health related problems to the most relevant departments, which has a positive impact in increased utilization of specialized health care services. The provision of honest information and communication empower patients by enabling them to prepare personal health care management plans, since they will be aware of the status of their health care, and using the information they can restructure their needs to include emerging health problems. Having the government produce objective information about health plan, hospital or physician quality because consumers would find it difficult to make a utility-maximizing choice without it; markets tend to under produce public goods such as information (Rice 2001) Respect for individuals and communities can be efficiently be achieved by learning the different cultural elements of the community, which I will be serving, so that I have a proper understanding of the perceptions impacting negatively or positively on health care delivery. Access and equity fundamentals can be effectively incorporated by learning the different modes of communication available to patients and community members and population parameters needed to implement equitable distribution. The achievement of participation and shared responsibility among patients will involve recognizing technical and legal aspect impacting upon delivery of health care services. On quality effectiveness and safety, Atwal and Jones (2009) observe that, Therefore, in order to manage time efficiently and maximize professional effectiveness, strategies and plans need to be regularly re-evaluated and prioritized accordingly (p.24) Learning stewardship will entail looking into the various resource allocation criteria and establishing the relevance of each to a distinct group of population. Learning preparation objectives for focus on the patient care will entail the identification of critical factors affecting patients in different health settings. This will also involve identification of barriers hindering health care access within the health system. Enhancing right of care will entail learning the structures and patterns of interaction impacting upon the provision of care. According to Atwal and Jones (2009), This provides an organized structure to the treatment plan, maintains a focus of treatment while outlining the attainable steps required to ultimately reach the long-term goal (p.32). Learning proper coordination of health care will entail the identification of the health care structure, communication points and decision centers that affect the provision of well-coordinated care. In essence, effective communication leads to the provision of high quality services as it focuses on understanding, individual satisfaction, therapeutic adherence, conflict resolution among team members, community interaction, and general health outcomes (Pan American Health Organization 2009, p.20). Values Relating to Patient Care Influence of values on teams Values Relating to the Health System Values Relating to the Patient Care By focusing solely on the patient enables health teams to articulate functions of the health system such that they match the population health objectives. Through right of care, the health teams are able to establish meaningful relationships with their patients through instantaneous delivery of health information. Moreover, this also impacts positively in the dissemination of health information focusing on urgent measures and patient education (Albert 2003, p.87). Through well coordinated care, the health teams are able to plan they services such that there is a seamless transition in the provision of health services within institutional settings and a positive impact on competency levels. Competencies entail focus on the combination of skills, knowledge, and attitudes leading to timely and appropriate delivery in different contexts (Pan American Health Organization 2009, p.18). Incorporation of Values in teams by leaders Values relating to the health system Leaders/administrators to health care teams can sufficiently incorporate the fundamentals of respect to individuals and communities through formulation of strategies that recognize individual traits and cultures. Leaders can ensure access and equity for all by providing specific plans aimed at encouraging staff members to disseminate critical health information affecting all vulnerable health groups, without putting special focus on one group, as this fosters inequality. Leaders can play the front line in promoting participation and shared responsibility by integrating members of the population into the development of context specific health plans, by collecting their views/contributions during the design or evaluation stages (Albert 2003, p.46). Leaders can implement regular evaluation exercises focusing on team performance indices, which have a potential impact on health care, in order to ensure effectiveness and safety. Leaders need to identify a working allocation criterion for resources, which ensure proper stewardship. The resource allocation will essentially be based on utilitarian fundamentals, which improves access to number and satisfying targeted aims (Atwal and Jones 2009, p.101). Values relating to patient care Impact and Influence of values on patients and on patient care Values relating to the health system Values relating to patient care Personal Preparation for Professional Practice Values relating to the health system Values relating to patient care Honest information and communication fundamentals can be effectively by learning the different modes of communication available to patients and community members, and which can be used to enhance personal health management practices.

Multinational firms are a force for progress‟. Discuss Essay

Multinational firms are a force for progress‟. Discuss - Essay Example That is exactly what we will be discussing in this paper. Let us first see what a MNC really is. According to D. H. Robertsons â€Å"Multinational corporations are a substitute for the market as a method of organizing international exchange. They are islands of conscious power in an ocean of unconscious cooperation† (Hymer,S. 1994). They are powerful organizations whose power commands most countries and governments. Now my question is that how can that be a wonderful thing, when there is no one to protect you interests. It in layman term means ‘survival of the fittest’. But what happens to those who don’t have the strength that others have. Well they are doomed. In the long term as well as short term. So is that a good thing. If you are one of the weak would you be happy about this? In this research paper I am going to outline, as stated by Margaret House, the costs MNC’s incurs for Developed/Advanced nations and Developing/Underdeveloped nation. I am going to outline the implications MNC’s has on the world as a whole. First let us look at the terms Developed/Advanced nations and Developing/Underdeveloped nations. Developed countries are those nations having an elevated level of development in regards to GDP, Industrialization, Human development index, etc. In other words countries which are economic super powers like the Japan, United States in North America, Canada, Australia, New Zealand, most of Europe, etc. (United Nations, 2009). On the other hand developing economies  are nations that posses low levels of material well being. Countries such as Bangladesh, Pakistan, India, Nepal, Mongolia, Zimbabwe, Mexico, etc. (United Nations, 2009). Now moving on to the diverse effects MNC’s is bound to have. First let us see what effect MNC’s will most definitely have the on jobs in developed economies. As it is well known that the cost of

Application for scholarship Essay Example | Topics and Well Written Essays - 500 words

Application for scholarship - Essay Example Features of mathematics and its ‘divine’ principles have always haunted my leisure times. Some specific conundrums that I find appealing include phi constant and the magic squares. Based on my love for math I have selected an Associate Degree in Math, and later Masters in Statistics as a worthwhile course to study, as it alone can quench my thirst to break into the fields of math. In reality Statistics is a course which lures many into its realms, but only a few diligent personalities in the end, can climb the stairs to reach the top of the building of success, a dream which I have been looking forward to fulfill since the last five years. All work and no play make (writer) a dull boy. Certainly, but this is not true in my case as for me sports is the medium through which I release my enthusiasm and stored energy. Perhaps one would say how someone interested in math, a subject involving hard, strenuous exercises, be equally interested in sports. My answer to that is the sensational Barclays Premier League, which I have been following since 2001. If we notice, as I have mentioned earlier, everything is related to math. Little do we notice that with 20 teams, each to play the other twice the selection for total number of matches is 20P2/2 or 20C2*2.

The Worst Natural Disasters In History History Essay

The Worst Natural Disasters In History History Essay The Black Death had many long-term consequences. One was a series of vicious attacks on Jews, lepers, and outsiders who were accused of deliberately poisoning the water or the air. Lepers were singled out and persecuted. Anyone with a skin disease such as acne was thought to be a leper. They were, for the most part, exterminated throughout Europe. The attacks against Jews began in the south of France, but were most dramatic in parts of Switzerland and German areas with a long history of attacks on local Jewish communities. Jews were rounded up and burned or drowned in marshes. Sometimes there were attacks on Jews even where there was no plague. This persecution was often done, not solely out of religious hatred, but as a way of attacking the Kings or the Church who normally protected the Jews. Jews were often called the Kings property and it was a way for people to lash out at the institutions who they believe had failed them. Fewer Jews died from the Black Death, in part due to rabb inical law which called for a lifestyle that was, in general, cleaner than that of a medieval villager. It is estimated that between one-third and one-half of the European population died from the outbreak between 1348 and 1350. As many as 25% of all villages were depopulated, mostly the smaller communities, as the few survivors fled to larger towns and cities. The Black Death hit the towns and cities disproportionately hard. Some rural areas, for example, Eastern Poland and Lithuania, had such low populations and were so isolated that the plague made little progress. Larger cities were the worst off, as population densities and close living quarters made disease transmission easier. Cities were also infested with lice, fleas and rats, and subject to diseases related to malnutrition and poor hygiene. The influx of new citizens facilitated the movement of the plague between communities, and contributed to the longevity of the plague within larger communities. Bremen in Germany lost almost 7,000 of its 12,000 inhabitants. The prosperous city of Florence, Italy, may have lost 40,000 of it s nearly 90,000 inhabitants. Nearby Siena probably lost two-thirds of its urban population. Paris, the largest city north of the Alps, lost more than 50,000 of its 180,000 inhabitants. Most major cities were quickly forced to create mass graveyards where the dead could be buried. Many towns and villages lost almost all of their populations, and some eventually disappeared altogether. Larger towns declined drastically, as their workforces and merchant classes either died or fled. European population only began to grow again in the last decades of the 15th century. The precise demographic impact of the disease in the Middle East is impossible to calculate. Mortality was particularly high in rural areas. Many surviving rural people fled, leaving their fields and crops, and entire rural provinces are recorded as being totally depopulated. Surviving records in some cities reveal a devastating number of deaths. The 1348 outbreak in Gaza left an estimated 10,000 people dead, while Aleppo recorded a death rate of 500 a day during the same year. In Damascus, at the diseases peak in September and October 1348, a thousand deaths were recorded every day, with overall mortality estimated at between 25 and 38 percent. Syria lost a total of 400,000 people by the time the epidemic subsided in March 1349. In contrast to some higher mortality estimates in Asia and Europe, scholars believe the mortality rate in the Middle East was less than one-third of the total population, with higher rates in selected areas. The plague did more than just devastate the mediev al population. It caused a substantial change in the economy and society in all areas of the world. Economic historians have concluded that the Black Death began during a recession in the European economy that had been under way since the beginning of the century, and only served to worsen it. Europe had been overpopulated before the plague, and a reduction of thirty percent to fifty percent of the population should have meant less competition for resources. There was more available land and food, and higher wages. The great population loss brought economic changes based on increased social mobility, as depopulation further eroded the peasants already weakened obligations to remain on the land. In Western Europe, the sudden scarcity of cheap labor provided an incentive for landlords to compete for peasants with wages and freedoms, an innovation that, some argue, represents the roots of capitalism. The resulting social upheaval caused the Renaissance and even Reformation. In many ways the Black Death improved the situation of surviving peasants. In Western Europe, because of the shortage of labor, they were in more demand and had more power. Because of the reduced population, there was more fertile land available. However, the benefits would not be fully realized until 1470, nearly 120 years later, when overall population levels finally began to rise again. The death of so many people concentrated wealth in the hands of survivors. In many cases, those workers who remained alive could earn up to five times what they had earned before the plague. In the towns, plague had the effect of consolidating wealth somewhat, especially among the middle class. The drop in population was accompanied by a corresponding rise in per capita wealth. There where large increases in spending in the towns at this time. Profits, however, for property owners and merchants declined as they found themselves having to pay higher wages and getting less when they sold their products. Property owners tried to collect higher fees from tenant farmers as a way to increase declining incomes. Higher payments to landowners and legal limitations on the rights of some peasants were implied. Economic and political unrest occurred in most parts of Europe during the second half of the 14th century. The Black Death changed religion drastically. The old religious moorings were weakened. Many believed the wrath of God seemed to be raining upon earth. Symptoms of mass neurosis appeared. Some people sought refuge in merriment or luxury and self-indulgence. Others became preoccupied with grisly subjects. Inspired by Black Death, Danse Macabre (Dance of Death) is an allegory consisting of the personified death leading a row of dancing figures from all walks of life to the grave. They were typically with an emperor, king, pope, monk, youngster, and beautiful girl, all in skeleton-state. They were produced to remind people of how fragile their lives were and how vain the glories of earthly life were on the universality of death. Many frantically performed the Dance of Death in cemeteries, while others secretly celebrated the Black Mass, mimicking religion in a mad desire to appease the devil. The Black Death led to cynicism toward religious officials who could not keep their frequent pr omises of curing plague victims and banishing the disease. No one, the Church included, was able to cure or even explain the plague. In fact, most thought it spread somehow through air. This increased doubting of the clergy. Pope Clement VI reigned during the plague years in Europe during a time when the papacy was based in Avignon, France. This period in papal history, known as the Babylonian Captivity to its detractors, was a concurrent cause of the peoples lack of faith in the Catholic Church. The Avignon popes were seen as having subordinated themselves to the French monarchy and their ineffectiveness regarding the Black Death only compounded the common mans disillusionment. Extreme alienation with the church culminated in support for different religious groups such as the Order of Flagellants, which grew tremendously during the opening years of the Black Death angering church and political officials greatly. Flagellants practiced self-flogging to atone for sins. Its members wen t into the streets, two by two, beating each other with chains and whips. Flagellants traveled from town to town and were often looked upon as spreaders of the disease. The Black Death hit the monasteries very hard because of their close quarters and their kindness in helping the sick. There was a severe shortage of clergy after the epidemic cycle. This resulted in a mass influx of new clergy members, most of whom did not share the life-long convictions and experiences of the veterans they replaced. The result was abuses by the clergy in the years afterwards and a further deterioration of the position of the Church in the eyes of the people. The Black Death had an effect on the arts. After 1350 European culture in general turned very morbid. The general mood was one of pessimism, and the arts turned dark with representations of death. Both sculptors and painters began to portray the dead and dying, as well as images of death and the grim reaper. Peoples attitudes towards music and art changed as they began to see the depression surrounding them. The horrific nature of the Black Death was reflected in the realistic depictions of human suffering and carnage as well as the symbolic use of the skeleton. In Giovanni Boccaccios Decameron, a group of young people fleeing the plague takes refuge in a house outside of Florence where they entertain each other with colorful and irreverent stories. While these stories are often seen as a rejection of traditional medieval values, Boccaccio himself was critical of those who abandoned relatives and friends in the face of the plague. Like the artists of the day, Boccaccio continued to h old traditional social and religious values. The primary impact of the Black Death on painting and sculpture was the willingness of the newly rich to invest in religious art for churches and chapels. These contributions were often made in gratitude for being spared the plague, or with the hope of preventing future infection. The science of alchemy was also affected by the plague. As a specialty and method of treatment, it was considered the norm for most scientists and doctors prior and during the Black Death. However, after the plague had taken its toll, the practice of alchemy slowly began to wane. The citizenry began to realize that, in most cases, it did not affect the progress of the epidemic and that some of the potions and cures used by many doctors throughout Christendom and the Islamic world only helped to worsen the condition of the sick. Because the stench of decaying bodies from those who had succumbed to the plague was so noxious, many thought that the plague was spread via the atmosphere and so used pungent scents hoping to keep it away. Scents such as pine and rosemary were burned like incense or processed into oils in which handkerchiefs were dipped and placed over the mouth and nose. Church bells were chimed in a futile bid to ward off the plague. Merchants sold charms and spells to ward off the plague. Rumors that claimed a person had done or worn something particular to survive led to the newest fad to prevent or cure the disease. Liquor, originally made by alchemists, was commonly applied as a remedy for the Black Death, and as a result the popularity and consumption of liquor in Europe rose dramatically after the plague. The Black Death was a historical event of great magnitude, and one with many consequences. The indirect influences on history are significant and give rise too many speculations on what might have happened had there been no Black Death. The impact of plague was greater on England than any other European country. The Black Death struck such a blow to the already weakened feudal system that it lost much of its meaning within two generations and had entirely disappeared within 150 years. On the European continent, the system was more rigid and lingered on for centuries, giving way year by year in one country after another to monarchy and other forms of government. The Black Death greatly accelerated social and economic change during the 14th and 15th centuries. It also led to peasant uprisings in many parts of Europe, such as France (the Jacquerie rebellion) and in Italy (the Ciompi rebellion, which swept the city of Florence). One of the groups that suffered the most was the Christian church. It lost prestige, spiritual authority, and leadership over the people. The church promised cures, treatment, and an explanation for the plague. They said it was Gods will, but the reason for this awful punishment was unknown. People wanted answers, but the priests and bishops did not have any. Many of the clergy abandoned their Christian duties and fled. People prayed to God and begged for forgiveness. After the plague ended, angry and frustrated villagers started to revolt against the church. The survivors were also enraged at doctors, who said they could cure patients but did not. Soon after the last eruption of the Black Death, the views on children also changed. Although carrying on the family name was still considered important, the birth rate dropped. Children were considered not worth the trouble to rise since they would probably die anyway. It took four hundred years before Europes population equaled the pre-Black Death figures. The demand for agricultural workers ga ve survivors a new bargaining power. Workers formerly bound to the land could now travel and command higher wages for their services. In addition, people left rural areas and migrated to cities for higher wages. The economic structure of land-based wealth shifted. Portable wealth in the form of money, skills, and services emerged. Small towns and cities grew while large estates and manors began to collapse. The very social, economic, and political structure of Europe was forever altered. One tiny insect, a flea, toppled feudalism and changed the course of history in Europe.

Niche Theory and the Human Consciousness :: Psychology Essays

Niche Theory and the Human Consciousness Alice started to her feet, for it flashed across her mind that she had never before seen a rabbit with either a waistcoat-pocket, or a watch to take out of it, and burning with curiosity, she ran across the field after it, and fortunately was just in time to see it pop down a large rabbit-hole under the hedge. In another moment down went Alice after it, never once considering how in the world she was to get out again. -Lewis Carroll How do we create something new in this world? In an age where the issues of increasingly diminishing natural resources are available and the amount of consumption is growing, this question is becoming increasingly important. The niche theory gives us a partial answer. Mayr, in his book What Evolution Is tells us that a niche is a "constellation of properties of the environment that make it suitable for occupation by a species". Niches for organisms can not only be found on the topological surface of the earth (which in itself is a niche in the universe) but also inside already existing organisms, given the right conditions of adaptability. Examples of this would be to look at some viruses that inhabit living organisms and in some cases, are limited to specific species. The human consciousness seems to me to fit many of the characteristics of a niche, barring the obvious fact that it in itself is not an independent organism. Niches in my opinion can not only be limited to being filled by living organisms, but also by its bi-products. We define our consciousness as the fundamental characteristic that makes us human. Early philosophers defined out consciousness as "reason": our consciousness in fact gives reason and meaning for our existence and transcends the purely biological needs of the species. It is the motivation that propels us to seek knowledge and to "fill" ourselves. Our consciousness creates a second world – one in which humans are capable of examining and having a deep understanding of ourselves. We create a new place for ourselves to inhabit inside ourselves. The reason as to why or how it came about that humans developed a consciousness is still unknown. Why is it that humans (and potentially one or two other species) evolved to the point of being able to create this new inner world, new niche to inhabit while other species did not?

Congress of the United States Essay

The chronology of events during the revolution era are: Black Loyalists, A century of Law making for a new constitution, The Revolutionary Diplomatic Correspondence of the United States, The Writings of George Washington from the Original Manuscript Sources-1745-1799, Letters of Delegates to Congress- 1774-1789, The Rochambeau Map Collection, American Revolutionary War – (dead link). The date for the Declaration of Independence is July 4, 1776, and the US constitution is September 17, 1778. Authority granted to the following government branches; Congress- article 1 states that all legislative powers herein granted shall be vested in a Congress of the United States, which shall consist of a Senate and House of Representatives. The President- article II states that the Executive Power shall be vested in a President of the United States of America. He shall hold his Office during the Term of four Years, and, together with the Vice-President chosen for the same Term. Lastly is the section three of the judiciary that says; the judicial Power of the United States, shall be vested in one supreme Court, and in such inferior Courts as the Congress may from time to time ordain and establish. The Judges, both of the supreme and inferior Courts, shall hold their Offices during good Behavior, and shall, at stated Times, receive for their Services a Compensation which shall not be diminished during their Continuance in Office. Framers’ rationale for a separation of powers in the US Constitution attempts to move beyond the general functional/formal debate by analyzing the views of the contemporary Court’s leading separation of powers functionalist, Justice White, and his effort to create a meaningful doctrine. Faction is the conflict within a nation. Madison in federal paper 10 addresses the question of how to guard against factions, groups of citizens with interests contrary to the rights of others or the interests of the whole community. Republic is an authority derived through the election by the people of public officials best fitted to represent them, while Democracy is a government of the masses whereby authority is derived through mass meeting or any other form of direct expression. When we compare and contrast the political view of young Madison with mature Madison, it depicts that when he was young, he distrusts political parties and democracy; while he believed that government should reflect the will of the majority, when he got mature. Dahl argues that an individual voter in a state with a smaller population has greater weight than a voter in the more populated state. The reason is that both African Americans and Hispanics are substantially underrepresented due to their greater presence in high-population states as compared to in low-population states. Dahl likes the proportional representation of national elections using a parliamentary system. The advantages are; Parliamentary systems are characterized by no clear-cut separation of powers between the executive and legislative branches, leading to a different set of checks and balances compared to those found in presidential systems, are usually have a clear differentiation between the head of government and the head of state, with the head of government being the prime minister, and the head of state often being the president. The disadvantages of parliamentary systems are; In Presidential system, executive branch in separately elected, meaning that there’s no direct responsibility, numerous, fragmented party system, fusion of powers, dangerous for young democracies. First-past-the-post election system is a single-winner voting system often used to elect executive officers or to elect members of a legislative assembly which is based on single-member constituencies. Having a right to vote has helped due to the expansion of various amendments like; universal suffrage which describe a situation in which the right to vote is not restricted by race, gender, belief or social status. Framers decide to use an electoral college for presidential selection because Electors are technically free to vote for anyone eligible to be President, but in practice pledge to vote for specific candidates and voters cast ballots for favored presidential candidates by voting for correspondingly pledged electors. The electoral college works by allocating each state a number of Electors equal to the number of its U. S. Senators (always 2) plus the number of its U. S. Representatives (which may change each decade according to the size of each State’s population as determined in the Census). A constitution can be amended by proposing an amendment and ratifying an amendment. The president can be removed from the office on impeachment for, and Conviction of, Treason, Bribery, or other High crimes and misdemeanors. â€Å"The powers delegated by the proposed Constitution to the federal government are few and defined†¦Ã¢â‚¬  is what Madison said and it is still true up to date. Intent bill of rights was meant to protect the state from the federal interference. The most important on e is the English bill of rights. The tenth amendment states that â€Å"The States should be left to do whatever they can do as well as the federal government†. It reassures the states that they would remain largely in charge within their own borders. Majoritarianism is a traditional political philosophy or agenda which asserts that a majority (sometimes categorized by religion, language, or some other identifying factor) of the population is entitled to a certain degree of primacy in society, and has the right to make decisions that affect the society. The political theory of pluralism holds that political power in society does not lie with the electorate, or with small concentrated elite, but is distributed between a wide numbers of groups. Elite theory is a theory of the state which seeks to describe and explain the power relationships in modern society. It argues that a small minority, consisting of members of the economic elite and policy-planning networks, hold the most power no matter what happens in elections in a country. Yes, the judicial is independent of the other branches of the government and external forces. The reason for this is to prevent corruption. The first amendment is an absolute right. John Peter Zenger was a German-born American printer, publisher, editor and journalist in New York City Zenger’s trial was significant because he was fighting for the freedom of speech. Libel is the communication of a statement that makes a false claim, expressly stated or implied to be factual, that may give an individual, business, product, group, government or nation a negative image. Obscenity is a term that is most often used in a legal context to describe expressions (words, images, actions) that offend the prevalent sexual morality of the time. Business administration consists of the performance or management of business operations and thus the making or implementing of major decisions while public administration is the development, implementation and study of branches of government policy. Common law refers to law and the corresponding legal system developed through decisions of courts and similar tribunals, rather than through legislative statutes or executive action. Case law is that body of reported judicial opinions in countries that have common law legal systems. It includes courts’ interpretations of statutes, and also constitutional provisions and administrative rules. Statutory law is written law set down by a legislature or other governing authority such as the executive branch of government in response to a perceived need to clarify the functioning of government, improve civil order, to codify existing law, or for an individual or company to obtain special treatment. The U. S. House of Representatives and then the U. S. Senate are the one who declares war. Yes, the Congress has the authority to veto state legislation. One of the intentions of the founders in designing a new constitution was to ensure that the federal government had sufficient power to run the country. The Supremacy Clause is the common name given to Article VI, Clause 2 of the United States Constitution, which reads: â€Å"This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; and all Treaties made, or which shall be made, under the authority of the United States, shall be the supreme Law of the land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwithstanding†. Public administration is boring because it’s full of bureaucracies. Politics is the process by which groups of people make decisions. Politics is generally applied to behavior within civil governments, but politics has been observed in all human group interactions, including corporate, academic, and religious institutions. Politics consists of social relations involving authority or power, and refers to the regulation of a political unit and to the methods and tactics used to formulate and apply policy.

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