The Causes and Effects of Alcoholism

Term Paper 12/7/11 Biology 205 The Causes and Effects of Alcoholism In the United States there are approximately 79,000 deaths annually attributed to excessive alcohol use (NASAIC, 2011). Alcoholism is defined as a medical disease or a neurological disorder. Alcoholism is essentially when a person continues to drink, even when health, work, or family are being harmed (NCBI et al, 2011). Alcohol is not an issue when enjoyed in moderation and responsibly, this however is not always the case. 18. 3 million people in the U. S. are â€Å"heavy drinkers†; among these are 12. million people who have one or more symptoms of alcoholism (NCBI et al, 2011). Some of the many symptoms of alcoholism are hostility when asked about drinking, inability to stop or reduce alcohol intake, or making excuses to drink. The number of problem drinking in the U. S. has increased 8. 2 percent since 1980 and with the growing acceptance of alcohol this number is at risk of rising in the near future (NCBI et al, 2011). Problem drinking can be defined in two categories, alcohol dependence and alcohol abuse. Alcohol abuse is when a person â€Å"binge† drinks as way to escape from personal problems.Alcohol dependence is when a person has an addiction to alcohol and cannot control how much they drink. The person simply cannot just have one drink of alcohol without feeling the need to become intoxicated. The highest prevalence of alcohol dependence and abuse is among ages 18-24. Over 80 percent of college presidents in the U. S. identify alcohol abuse as the biggest problem on campus (nd. edu et al, 2003). College students are in the ideal environment to develop a drinking disorder. Students are away from their families and are caring for themselves for often the first time in their lives.Muscular System: Muscle MetabolismWith the increase in responsibility in their lives students can find themselves stressed and confused. These factors only lead to students drinking amongst other students in efforts to fit in or as an escape from their studies or other social problems. However, drinking too much and regularly only leads to even more social and physical problems in the future and possibly for the rest of their lives. Alcoholism is something that should not just be seen as a socially devastating disease. The life of a person with alcoholism is controlled by their alcohol addiction.The many short term effects of alcohol are minor compared to the long term health concerns from excessively abusing alcohol. Public health organizations are utilizing new methods of prevention and research to combat the further rise in this disease. Demographics Though there are risk factors for developing alcoholism there is no definite cause of the disease. A history of alcoholism in a person’s family definitely increases their risks of developing the disorder. This theory has been validated throughout the years utilizing twins in adoption cases growing up in different famil ies.Current research concludes that certain genes may increase the risk of alcoholism, but the identity and function of which genes are still unknown (NCBI et al, 2011). Ethnic and religious background can also play a role in the development of alcoholism, in relation to the culture's lifestyles and acceptance of alcohol. Cultural, religious values and expectations towards alcohol vary and can either promote or disapprove drinking. Members of different ethnic and cultural groups generally show preferences for different types of alcoholic beverages, which can affect their access and alcohol exposure.Other factors such as a race’s reaction to alcohol can affect the prevalence of drinking. For example, blacks are 3 times more likely to develop an alcohol related disease than white (NIAA et al, 2005). The SAMHSA National Household Survey on Drug Abuse reported that 3. 5% of people in their entire sample could be classified as alcohol dependent. Caucasian and black surveyors had a similar rate of 3. 4 percent of alcohol dependence (NIAA et al, 2005). Alcoholism rates for Native American and Hispanic-Mexican Americans are higher compared to other ethnicities at 5. percent (NIAA et al, 2005). It was found that these groups tend to start drinking at an earlier age and drank more heavily compared to other ethnic groups in the United States. The rates of alcohol dependence were lower among other groups, Caribbean, 1. 9%, Central American, 2. 8%, Cuban, 0. 9%, Puerto Rican, 3. 0% and South American, 2. 1% and Asian/Pacific Islander, 1. 8% (NIAA et al, 2005). The survey also reported that Asian Americans had higher rates of abstention and lower rates of heavy alcohol consumption compared to Whites, African Americans, and Hispanics.Diversity in drinking patterns is very distinguished between subgroups of the same racial or ethnic group. Mexican Americans born in the U. S. report drinking more often, but consuming less alcohol, and have three times higher rates of al cohol dependence (NIAA et al, 2005). This emphasizes that the lifestyle and genetics of a person play a greater role in alcoholism then race or culture. This is also relevant when looking at gender discrepancies. Women and men have the same chances of becoming alcoholics.However, women have a much stronger reaction to the effects of alcohol; therefore there are many more cases of alcoholism in men though there is no research to support gender susceptibility (NIAA et al, 2005). Women’s stronger reaction to alcohol also means that women are more susceptible to alcohol related illnesses after fewer years of heavy drinking. While research has provided many factors that increase the risk of alcoholism the highest risk factor for developing a drinking problem is a person’s lifestyle. This is why college students with their young, eager, and immature demographic are ideal for the development of alcoholism.Effects of Alcoholism on the Brain Alcohol is a central nervous system depressant and unlike other drugs alcohol does not activate a specific receptor in the brain. This attributes to the wide range of side effects of intoxication. Some of the side effects from drinking heavily include slurred speech, loss of inhibitions, slowed reaction times, loss of balance and memory loss. Cleary alcohol affects the brain negatively when causing these reactions. A definite sign that someone had consumed far too much alcohol is a â€Å"black out†. This is when a person has no recollection of events while they were intoxicated.A survey of 772 college undergraduates found that 51 percent of the students reported to having a blackout multiple times in their lives’ (nd. edu et al, 2003). What they do not recall is the altered state that their brains were in at the time. An estimated one-third to one-half of all unintentional and intentional injured Americans in accidents, crimes, and suicides were intoxicated (BSCS et al, 2003). Alcohol’s affect on the outer layer of the frontal cortex region of the brain interferes with the conscious thought process (BSCS et al, 2003).This contributes to the loss of inhibitions and sometimes careless behavior when someone is intoxicated. However, research has shown that these short term effects of alcohol abuse can be immensely more severe than just a hangover. People who drink heavily and regularly greatly increase their risk of developing changes in the brain. Up to 80 percent of alcoholics have thiamine deficiency (BSCS et al, 2003). This is a common occurrence in alcoholics and results from poor overall nutrition. This can eventually develop into serious brain disorders such as Wernicke or Korsakoff syndrome.Korsakoff’s psychosis is a chronic and debilitating syndrome, resulting in persistent learning and memory problems (BSCS et al, 2003). There are also cases where people have had difficulty walking and with hand eye coordination. People with Wernicke’s encephalopathy have mental confusion, paralysis of the nerves that move the eyes and difficulty with muscle coordination (BSCS et al, 2003). Drinking during pregnancy can lead to a range of physical, learning, and behavioral effects in the developing brain of the fetus (BSCS et al, 2003). This is known as fetal alcohol syndrome (FAS).FAS infant’s brains may have less volume and fewer brain cells as well as being smaller than average. Therefore, drinking during pregnancy ensures the child a high risk of developing serious health problems early on in their lives. Effects of Alcoholism on the Body The dangers of alcohol are commonly associated with the altered states of mind people can find themselves in; while the negative physical reactions to alcohol can be much more severe. Alcohol offers very little nutritional value and is high calories. The body treats alcohol as fat, converting alcohol sugars into fatty acids (BSCS et al, 2003).This results in a lack of energy and endurance. When alcohol i s consumed 20% is absorbed by the stomach and 80% by the small intestine. When alcohol enters the blood stream it can affect nearly every tissue in the body. This is because cell membranes are highly permeable to alcohol (BSCS et al, 2003). This absorption can be affected by the amount of food or liquid in a person’s stomach. Other factors such as how quickly the alcohol is consumed or how much a person weighs also affect absorption which leads to intoxication. Women absorb alcohol faster due to their metabolism.The absorption of alcohol is referred to as the BAC, blood alcohol content. (Graph pg. 10) When our society thinks of alcohol related deaths alcohol poisoning is first to come to mind. Not only can a person die from drinking too much alcohol at one sitting but research has shown that consuming alcohol can result in vast amount of different alcohol related disease. One study determined that 3. 6% of all cancer cases worldwide are related to alcohol drinking, resulting in 3. 5% of all cancer death (NASAIC, 2011). Research has also concluded that drinking alcohol heavily can damage brain tissue, heart, liver and reproductive organs.Problem drinking can also cause pancreatitis, nutritional deficiencies, malignancies, and cirrhosis (NASAIC, 2011). The liver is the most vulnerable organ to alcohol abuse because it breaks down the alcohol into harmless by products and years of this can destroy the liver. Therefore, the negative effects on the body substantially outweigh the possible positive social aspects from drinking. Factors causing the problem In our society drinking alcohol has become widely accepted and is associated with a celebratory or ceremonial atmosphere.This is a key component in the current increase in alcoholism. With the current acceptance, stigmas and speculations about alcohol in our country people are unaware of the severity of the drug. The increase in alcoholism is due to the fact that a majority of people in our nation drinks alc ohol rather than profane. The public receives their information about alcohol through family, peers, media, and personal experimentation. The information people and especially college students or children living in homes with alcoholism are receiving often glamorizes alcohol.Therefore, the public knows very little about effects of alcohol and the consequential harm they can inflict on themselves and others. Other factors such as the quantity and frequency a person tends to drink plays a role in the chances of developing a drinking disorder. People with addictive personalities, depression and other social disorders are also at a very high risk of becoming alcoholics (NASAIC, 2011). These people with stressful lifestyles, depression or anxiety problems often use alcohol as a release. Drinking â€Å"numbs† their pain and is an escape from their social issues.A striking 20% of all suicide victims in the United States had a form of alcoholism prior to their suicide attempt (NCBI e t al, 2011). Adolescents that live in a culture where alcohol use is common are often pressured by their peers to partake. All of these risk factors are directly correlated to scenarios most college students find themselves in. In result, this age group is at the greatest risk of developing a drinking disorder. College students are at an impressionable age and are looking to meet and befriend new people. They are peer pressured into going out with their riends to restaurants, bars and clubs. With easy access to alcohol they are often drinking more frequently than any other time in their lives. Research has shown that immaturity of neurotransmitter system and hormonal changes during puberty lead to more pleasure in drinking alcohol (NASAIC, 2011). This means that developing brains introduced to alcohol may trigger long term biological changes developing into an alcohol addiction. The overall public neglect and unawareness of the severity of alcoholism only leads to increasing rates o f alcoholism in our society.Providing the public with a better understanding of the ease in developing this disorder is an immediate necessity in our nation. Public Health Response In most cases a person suffering due to alcoholism does not accept that they have a problem. This makes it very difficult or sometimes impossible to cure. The support from loved ones and friends is essential to help find the person a form of treatment that suits them. Alcoholism is treated with counseling and support groups like any social disorder. There is very large number of national and local help services for people looking for help dealing with their addictions.Impatient treatment centers are closed communities where patients are able to live focused on controlling their addiction. Alcoholism is common to most drug addictions, whereas after being dependent on the drug sobriety triggers withdrawal symptoms and often results in relapses. In these cases having the close support of an impatient rehab c enter is the most effective. Tragically most alcoholics do not have the chance of obtaining impatient sobriety because of lack of money. Outpatient programs are less expensive and are an effective method of treating an addiction.SMART, LifeRing, and  Alcoholics Anonymous are all support groups that attempt to resolve the behavioral effects that led the person to become an alcoholic (NCBI et al, 2011). Participants meet in groups or class a number of times a week and share their own personal alcoholism experiences. As a whole group working towards a sober lifestyle the patients have the counselor or the other participant to turn to when they need help dealing with a possible relapse. In most cases a person will never completely resolve their alcohol addiction.Refraining from drinking entirely after achieving sobriety is recommended to limit the chances of relapsing. Alcoholics struggling with staying sober can be prescribed medications. Acamprosate and Naltrexone are some drugs tha t have been shown to lower relapse rates in those who are alcohol dependent by reducing cravings and withdrawal symptoms (NASAIC, 2011). Prevention methods are currently being utilized to give people a better understanding of the risks and affects of alcohol. Programs such as D. A. R. E and other anti drug and alcohol programs are used to build awareness.Colleges have recognized the vulnerability of college students and have increased student awareness substantially over the past years. Online alcohol education programs are now mandatory for college freshmen to complete prior to admission to most universities. Though these classes are sometimes tedious and time consuming there is no doubt that they give adolescents a better awareness of alcoholisms social and physical effects. Other forms of prevention include warnings on alcoholic packaging and labels. These inform drinkers the percentage of alcohol in the drink and pregnancy warnings are always evident (NASAIC, 2011).Health organi zations are working together to help find out more on the treatment and prevention of alcoholism to combat the prevalence of the disease in the future. Conclusion Alcoholism is not a disorder that only affects the one suffering from the disease. An addiction to alcohol controls the life of the patient, as well as their families. 56 million of Americans say that alcohol abuse has brought trouble to his or her family (NCBI et al, 2011). Getting a person to recognize the harm they are causing to themselves and others from their drinking is the first step of resolving the problem.The immense amount of organizations and support groups in America today provides people the best possible treatment. Studies continue to discover new illnesses that are in result of alcohol abuse. There is still no definite cause of the disease yet the factors attributing to developing alcoholism are definite. With a better understanding of the disease and a raised public awareness alcoholism is something that can be preventable for future generation. The chances of developing an alcohol addiction are higher than ever; which only leads to a new age of alcohol related diseases if the neglect of the negative effects of alcohol continues.Blood Alcohol Concentration| Changes in Feelings and Personality| Brain Regions Affected| Impaired Activities (continuum)| 0. 01–0. 05| Relaxation Sense of well being Loss of inhibition| Cerebral cortex| Alertness ,Judgment, CoordinationVisual tracking, Reasoning and depth perceptionInappropriate, obnoxious social behavior Slurred speech, Lack of balanceLoss of temperature regulation, Loss of bladder controlDifficulty breathing, Slowed heart rate| 0. 06–0. 10| Pleasure Numbness of feelings Nausea, Sleepiness Emotional arousal| Cerebral cortex + forebrain| | 0. 11–0. 0| Mood swings, Anger Sadness, Mania| Cerebral cortex + forebrain + cerebellum| | 0. 21–0. 30| Aggression Reduced sensations Depression Stupor| Cerebral cortex + foreb rain + cerebellum + brain stem| | 0. 31–0. 40| Unconsciousness Death possible Coma| Entire brain| | 0. 41 and greater| Death| | | Advisory committee and NIAAA scientists (bscs. org, 2003)| (Effects of Alcoholism on the Brain continued) Effects of Blood Alcohol Concentration The graph depicts the average person’s emotional and physical altering when consuming a certain amount of alcohol. For most people an hour after the rinking one 12oz beer will result in a BAC of . 02. The amount of alcohol attributes to very different and detrimental side effects the more it is consumed (BSCS et al, 2003). Bibliography 1) U. S. National Library of Medicine and A. D. A. M. Medical Encyclopedia staff, Alcoholism and Alcohol abuse and dependence; ncbi. nlm. nih. gov, March 20, 2011. http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001940/ 2) National Institutes of Health, Alcohol abuse and Alcoholism staff, Information about Alcohol;  bscs. org, 2003. http://science-education. nih. g ov/supplements/nih3/alcohol/guide/info-alcohol. tm 3) University of Notre Dame, Office of alcohol and drug education, Your Body and Alcohol; nd. edu, 2003. http://oade. nd. edu/educate-yourself-alcohol/your-body-and-alcohol/ 4) National Institute on Alcohol Abuse and Alcoholism staff, Model 10h Ethnicity, Culture and Alcohol; NIAA. gov, March 2005. http://pubs. niaaa. nih. gov/publications/Social/Module10HEthnicity;Culture/Module10H. html 5) National Alcoholism and Substance Abuse Information Center staff, Alcoholism; addictioncareoptions. com, 2011. http://www. addictioncareoptions. com/alcohol-help/alcoholism

Mod 5 Sg

STUDY GUIDE: MODULE 5 Harbin: Chapter 14 How did Rehoboam manage to lose most of his kingdom? He refused to cut taxes and threaten to raise them. Why is Asa viewed as a good king but given a mixed review? His lack of faith in God to assist with attack on Baasha in Northern Kingdom. How did Jehoshaphat show piety on the one hand but political naivete on the other? He went thru the country removing pagan shrines and sent teachers in the land teaching the law. he was judged for helping the wicked. What is most memorable about Athaliah?She proceeded to kill off rest of males in the royal family so that she could rule. How did Joash bring hope to the Southern Kingdom? What did he do that caused him to be assassinated? by repairing the temple restoring the worship and sacrificial system. He ordered , God's prophet Zechariah to be stoned to death on the temple grounds. His heart was turned away from God. In what way did Uzziah demonstrate spiritual foolishness? What were the consequences? H e went into the temple to burn incense, something only the priest could do.Cause he didn't listen, God struck him with leprosy. What is most memorable about Ahaz? Ahaz turned away from YHWH, he served the pagan gods, including Baal, even performed child sacrifices. He promoted the spiritual revival. Compare and contrast Hezekiah with his father, Ahaz, and with David. he was viewed as one of the worst kings in the Southern Kingdom. Hezekiah trusted in the Lord, God of Isreal. What was the role of Isaiah in the Southern Kingdom? Prophet and historian What key prophecies did the prophets of this period give regarding the Messiah? st anticipation of the birth of the Messiah 2ndthe servant songs the Messiah's bearing the sins of His people 3rd which Jesus would later read in the synagogue in Nazareth. What is most memorable about Manasseh? He had the hollow tree where Isaiah hid sawn down with Isaiah inside. His acts of apostasy In what ways was Josiah the last hope for the Southern King dom? Josiah's returning the ark of the covenant to the temple Trace the decline and fall of the Southern Kingdom. the death of Josiah Describe the different ways by which Jeremiah tried to convey his message to the people. burying a linen sash near the Euphrates River to signify the Exile; | |watching a potter remake a flawed item, illustrating how God would remark the nation; breaking a large pot before the leadership, | |demonstrating how God would destroy the Southern Kingdom; | |redeeming a piece of land, showing confidence that God would perserve the people even thru exile; | |remaining single because of the anticipated hard times; and wearing a yoke to symbolize upcomming bondage. | Why was Lamentations written? Focus on city of Jerusalem and its destruction. Chapter 15 What are some reasons that the Exile was not as severe as it might have been? Some of the people listened to the prophets People followed God's instruction the design of the exile was partial punishment Summar ize both the incidents and the visions recorded in the book of Daniel. 1. The account of Daniel and his friends declining to eat Babylonian food 2. Daniel request for stay of execution to interpret the kings dream. 3. The firery furnance 4. Daniel in the lions denVision of 4 beasts that paralled the 4 metals of the statue & what happened to Daniels people in the future. Daniel was given information about the Messiah. What is apocalyptic literature, and how is it different from prophetic literature? serves to show God's sovereignty over the future. Rich in the use of symbols. focused on what God is going to do. serve to show God's soverign control over history. is oriented toward the audience receiving the message. What makes the book of Ezekiel distinctive? It was written in Babylon, it was accepted by Isrealites who devoutly believed in God. What is the significance of Esther? she outwitted Haman and saved her people.Before reading chs. 16–17 in Harbin, read Hindson, ch. 12 and take detailed notes. Harbin: Chapter 16 What was the function of Haggai? Prophet to get the temple rebuilt How was Zechariah’s ministry different from that of Haggai, his contemporary? He focused more on future issues. message was more apocalyptic What was Ezra’s role in the return? The proposal of foreign wives be divorced and returned to their home land. How did Nehemiah help the struggling community in Jerusalem? they were able to build the walls in fifty-two days What is the significance of Malachi? bring the word of god to people of Israel Chapter 17 Why did the OT canon end with Malachi?The Jewish community came to the conclusion that God had nothing more to say to them. What is the Apocrypha, and how was it viewed by the Jews at the time of Jesus? hidden/ secret. The collection of books that is found between the OT and NT in some Bibles, scripture What is the Mishnah? How is it different from the Talmud? Why are they important? also Mish ·na (mish'n? ) n. Judaism The first section of the Talmud, being a collection of early oral interpretations of the scriptures as compiled about A. D. 200. the mishnah is a part of the juwish costom and belief. Repitition. teaching/ learning Gemarah-meaning completion, the learning of oral teaching. hey were interpretive translation of the Hebrew text designed to make the text more understandable to Jews who did not read Hebrew. What are Pseudepigrapha? Pseudepigrapha [Gr. ,=things falsely ascribed], a collection of early Jewish and some Jewish-Christian writings composed between c. 200 BC and c. AD 200, not found in the Bible or rabbinic writings. How did the Sadducees develop? traditionalist were those who followed their roots. -from a Hellenization movement sometime after the Maccabean revolt How did the Pharisees develop? Spending on time, a political party, a social movement, and a school of thought among Jews that flourished during the Second Temple. Who were the Essenes, and why are they import ant? embers of an Jewish sect of the 1st century BC and the 1st century AD. They lived on the western shore of the Dead Sea and wrote the Dead Sea Scrolls. At that time, there were 4 schools of Judaism: Pharisees, Sadducees, Essenes, and Zealots Referred to as sons of Zadok. meaning holiness Who were the scribes, and what role did they play in Judean society? professional title. a generic term that could include both Pharisees and Sadducees. Their role was to copy the Law, to read it, and then to interpret it to the people. Trace the rise and demise of Alexander the Great. What happened to Alexander’s empire after his death? It was divided amoung his 4 generalsWho were the Ptolemies and the Seleucids, and why are they important? The Ptolemies were very successful and managed to capture a large part of the Seleucid Empire, including all of Syria, before local problems called Ptolemy III. peace was established during the marriage of Philadelphus daughter to AntichusII of Syria Who were the Maccabees, and what did they do for Judea? The Maccabees were a family that fought a successful rebellion against the Syrian invaders who attempted to force all Jews into becoming Hellenized. were a Jewish rebel army who took control of Judea, How did Herod, an Edomite, become king of Judea? He was the son of Antipater, n Edomite, who married the daughter of a politically influential family. Herod divorced his wife Doris and married Mariame, a Jewish daughter of the influential priestly Hasmonean family. How did Rome make Judea part of the Roman Empire? because of its troubles, in 6CE it ceased being a client kingdom and became a Roman province. The â€Å"book of the Law† was rediscovered during the reign of: JOSIAH The book of Habakkuk predicts the Babylonian conquest. TRUE According to Hindson Nebuchadnezzar was your typical autocratic egomaniac that was corrupted by power that he eventually lost his mind. TRUE Asa is seems as basically spiritually weak and an evil king of Judah.False Jeremiah advised the king to fight the Babylonians to the last man False What is most memorable about Manessah according to Harbin? He is considered to be the worst king of the southern kingdom. A key theme of the book of Isiah is †¦ NOT Restoration Joash was assassinated in response to his having Zechariah stoned to death. TRUE Around 538 or 539 BC Persian King Cyruis issued a decree allowing all captive peoples to return to their native lands. TRUE According to the text ‘The exile† could not have been any more severve than what it was: False During the reign of Hezekiah the angel of YHWH killed how many Assryian soldiers outside the walls of Jerusalem? 185,000 Often Jeremiah tried to convey his message to the people by via acts of role-playing.TRUE Per Harbin, Nebuchadnezzar destroyed the temple in Jerusalem in 586 BC TRUE Why was Lamentations written? To express the sorrow at the fall and destruction of Jerusalem. The term â€Å"branchâ €  as used by Isiah and Jeremiah emphasized that the Messiah would be from the line of David. True Rehoboam managed to lose most of his kingdom in part due to a tax revolt that he failed to properly settle. True. Joash brought hope to the Southern Kingdom by repairing the Temple. TRUE What kep prophecies did the prophets of this period give regarding the Messiah? All of the above. One of the most memorable things about Ahaz was his closing of the Temple and his worshipping the gods of Damascus. TRUE Isiah was commissioned as a prophet the year Uzziah died? TRUE

The Example of How Humans Have Fallen into the Pattern of Elucidation Research Paper

The Example of How Humans Have Fallen into the Pattern of Elucidation and War - Research Paper Example Looking at the complicity of the churches, we see that from several different perspectives from a religion and culture student that, even with careful, honest and sensitive approaches, the role of the church in the genocide is still evident. One of the bases on which the latter can be approached is from a cultural view. Despite the fact that the two major ethnic groups were getting along well before the colonialists and missionaries in terms of the cultures and their ways of life, the influence of priests in the uproar of genocide is evident. An example of the above is that during the times, the priests presented themselves as ethnic-based which was one of the major catalysts for the genocide. In addition, the churches at that time allowed the priests to preach ethnic-hatred to the people. Some of the sources also say that the nuns and the nuns and the priests were also involved in the killing of the Tutsis. One of the hardest things to determine with regard to this issue is whether the leaders of the Roman Catholic and Anglican church leaders were informed about the issue and whether they got involved or simply decided to ignore the issue. With the views that have been expressed about the role of the church, one of the things that   I can establish as a religious student is that the clergy did not follow what they preach. A conclusion about the role that the church played in the genocide can be easily arrived at that, looking at the way that the course stood by the values that it preached before the genocide and what they preached towards the genocide, there must have been some political influence.

Digital Marketing Strategies Report for Coca Cola Company Essay

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Dynamic Of Business Assignment Example | Topics and Well Written Essays - 500 words

Dynamic Of Business - Assignment Example Moreover, to continue receiving $7.99 options on trades and stock, 75 percent fee is charged on per option contract and 150 stock or options trades must be executed by the final quarter. IRA TD Ameritrade Account Company offers $100 bonus on new accounts opened and funded with $25,000-$99,999 within 60 days of the account opening. Additionally, $300 bonus, necessitate $100,000-$249,999 funding on the account within 60 days of the account opening. The bonuses continue up to $2,500 bonus, with $1,000,000 funding of account within 60 days. Comparing the three firms, E*Trade seems to be the most appropriate company for investment objective since they offer $7.99 commissions for options trade and stock accumulatively with increasing stock. (a) The pros of investing in exchange-traded funds (ETF) include an increase in personal finance and after-hours trading while cons include down under finance businesses and fast money recap challenges. a) There are various indicators of the performance of the economy, which the Federal Reserve Bank can use to determine how best the economy performs. For instance, the most fundamental aspect is that, which measures the levels of economic growth. For this case, Janet Yelled may monitor the incomes generated by households and the values of the assets that businesses own in the economy. The second alternative is monitoring and tracking the profits and market shares for the corporate institutions in the economy. At the national level, Janet should monitor the national income statistics of the nation, which is the sum of all the revenue sources for the country for each trading period. The last aspect is a measure of the Gross Domestic Product of the nation (Cassidy 1). b) Ben Bernanke, the former Fed Chairperson, worked hard to prevent the country from a major financial meltdown. He worked against the odds of the Federal Reserve by cutting down on the lending rates for the banks and supplying loans to troubled firms, as well as buying debts for some major companies in the country. For such a case, it meant that banks did not have a direct control of the lending rates (Cassidy 1).

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CSI episode - Movie Review Example As the show progresses, it becomes clear that one of the prostitutes has a certain level of first-hand knowledge concerning the young woman in the way in which you might’ve been killed. As it turns out, this young prostitute is in fact the sister of the girl who was murdered and his daughter of a woman was responsible for prostituting. The initial scenes of the episode illustrate what seems to be a functional and loving conservative evangelical Christian mother and father that are distraught over the loss of their daughter. However, as the episode progresses, it becomes clear that the veneer of normalcy is only just that. Ultimately, the mother of the daughter is slowly revealed as a coldhearted killer that is been prostituting both of her daughters for a number of years in exchange for a great deal of money. It is the hope of this analyst that the following discussion will be beneficial not only with respect to understanding the television showed a deeper level but with regar d to understanding the levels of realism and non-realism that are represented merely continually within such TV shows. There were a number of realistic and nonrealistic actions that were taken by the main characters. Obviously, some of the reasons for these nonrealistic actions being depicted was not due to the fact that the writers, producer, or director were unfamiliar or uneducated with the way in which crime scene investigation actually takes place, it had to do with their desire to represent a more compelling, fast-paced, and emotional storyline that would engage the interests of the viewers. However, regardless of the ultimate reason behind depictions of non-realism, the following section will be concentric upon analyzing two of these and denoting how they would have been exhibited if they were in fact performed realistically. The first of these has to do with the representation of the way in which evidence is handled. From the opening scene at the parking lot of

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Explain the theory of Virtue Ethics Essay Example for Free

Explain the theory of Virtue Ethics Essay Aristotle originally introduced virtue Ethics to society in ancient Greek times. Virtue Ethics tells us that we should look at the character of the person instead of the actions or duties a person performs. Instead of concentrating on what is the right thing to do, virtue ethics asks how you can be a better person. Aristotle claims that leading a virtuous life is easy, and those who do, do so to be happy. Happiness is the ultimate goal for everyone in life. To become a better person, you must practice virtuous acts regularly. After a while, these acts will become routine and so the virtuous acts will be nothing more than everyday life and the person a virtuous person. Aristotle said that although virtues should become a habit we must never forget that we behave in such a way because it is right. For example, if a singer practices singing everyday, they will become better at it and used to doing it. This is the same as people who practice their virtues and soon automatically act in the right way, by practicing our skills we improve them, becoming happier. Virtues should not be an effort, but simply a part of everyones personality. Aristotle says that virtue is something that we acquire and are not just born with, people are not inherently good or bad, but become good or bad according to the habits they develop. Aristotle said that a virtue was a Golden Mean in between to vices. These Vices are two extremes of a scale at opposite ends, one of excess and one of deficiency. For example the vices would be shamelessness and shyness, and the virtue modesty. Another example of this would be rudeness and a sense of humour as the two vices and the virtue as wittiness. Such virtues must be cultivated, we must learn when to use certain virtues and to what extent, for example we must not ever use humour in excess to act like a fool, but at the same time we must also not pass into rudeness. Two philosophers, Anscombe and MacIntyre say that there has been a mistake in how virtues have been portrayed. The majority of people look at the actions a person does to judge whether they are virtuous or not. The way in which we behave provides an opportunity for others to judge our virtues and vices. This however is not right. People should look at the character within and look at what the person believes is right and how they think they should help people instead of what they do to help. A famous example of a virtuous person is Mother Theresa. She helped millions of suffering people across the world and for this became well known as a virtuous person. There are hundreds of other virtuous people who would have liked to have helped but were unable to do so in such a huge way who are not considered as virtuous, but these people are just as virtuous but not recognised for it. Aristotle tells us that we are most likely to learn virtuous behaviour from watching others. If we experience others being kind to us and see the happiness it creates we are more likely to practice it then if we were just told to do it. For example, if we were told to be courageous we may occasionally stand up for small things that we disagree with, but if we see someone telling others off for not doing the right thing then we are more likely to not allow bad behaviour towards ourselves. Aristotle said that the best way of becoming virtuous was to follow in the footsteps of a virtuous person, e.g. Mother Theresa and do what they do. Virtue Ethics is relative; Aristotle recognised that virtues in one country may not be the same as virtues in another. He believed that there was no absolute platonic good beyond our world. As virtues have evolved through habits of society it is probable that different societies would deem different actions good or bad. However there is no difference between the virtues of a community and individuals within that community, the supreme happiness that Aristotle talks about is one for the community, and not just and individual. MacIntyre suggests that philosophy is too far removed from ordinary life and said that it is not good enough that philosophers spend their time debating the nature of ethical language or forming reasoned theories of morality in a way that is far removed from real people and real life. All actions are done in order to reach an aim. A successive series of actions are also for an aim, for example getting up in to morning to go to work, is to make money, is to feed our families is to go on nice holidays is to but them nice things etc. all ultimate aims is to make people happy, everything is subordinate to the supreme good, which is happiness. Everyone has different ideas of what happiness is and different things all make different people happy, and Aristotle called this feeling of all round well being eudemonia. Therefore, Virtue Ethics concentrates on what a person is then what a person does. Its aim is to achieve something, which people genuinely want rather then being based on arguably incoherent ideas about the after-life. It is a system, which can be easily applied and understood by all. It fits into a variety of philosophies, and religions, which both do and dont include God. However, there are a few problems with Virtue Ethics. Ones of these which has been pointed out by MacIntyre is that although a virtue is the golden mean between two vices it cannot be applied to all virtues. Virtues such as promise keeping, loyalty, and compassion do not fall between any two vices and so Aristotles theory of this does not really work. Another problem with this theory is that it is of little help to people faced with a moral dilemma. It does not help them make a decision like other theories such a natural law or utilitarianism.

Self-management of patients with continuing care needs

Self-management of patients with continuing care needs In essence, patient self-management in relation to their health, encompasses a patients ability to handle an illness experience, to cope with undergoing treatment or make suitable lifestyle changes (Mulligan 2009). The concept was introduced to the health field by Kate Lorig who reached conclusions patients health and subsequently health service costs connected to them being an inpatient can be reduced by encouraging self-management (Lorig 2001). These ideas are utilized in the generic long-term conditions model which emphasizes patients are not happy to be in hospital unless it is completely essential (DOH 2010), (Appendix 1). Effective self-management is also widely thought to reduce the likelihood of hospital admission, and many argue patients prefer to be given access to the information necessary to facilitate a respected voice in decision making processes (Gibson et al 2004, Newman et al 2004). Linked to self-management is also the concept of self care described as a requirement for success in controlling many chronic illnesses including diabetes (Berg 2007), and asthma (Cortes 2004). Self care is also described holistically as essential to the well-being of those with chronic illnesses with continuing care needs in nursing homes (Bickerstaff et al 2003), in the community, (Sharkey 2005), in hospital, intermediate, or rehabilitative settings (Singleton 2000, Coleman 2004). Conversely, low self-esteem, low health literacy, and/or deprivation are barriers to utilization of self-management strategies (Williams et al 2011). Those most likely to participate in self-management are young, middle-class females (Coben 2005). Whilst those lacking literacy skills may not manage as well and family care-giving actions differ between ethnic and socio-economic groups (Larsen 2009). People who suffer a disproportionally high prevalence rate for chronic conditions are those with learning disabilities (Presho 2009) and ability to comprehend and enact management regimes might affect the efficacy of education initiatives with this population. The Expert Patient Program, a 6 week, lay-led course teaching self-care, is a prominent initiative expected to be more cost effective than usual care (NSF 2010, Richardson 2007). Although the EPPs effectiveness to enable improvements in patients self management ability regarding physical symptoms has been disputed (Gately 2007). Perhaps this is due to complex combinations of assorted medications, lifestyle adaptations, and bothersome side effects which are implicated as adversely affecting patients perseverance with management plans (Barlow 2002, Touchette 2008). GP business care plans developed in the UK propose introducing courses using self-management handbooks could reduce expenditure on asthma management (Appendix 4). Yet Cortes argues such asthma education programs neglect specific needs of older people identified as price of medication, problems undertaking management plans, poor quality of life, and troubles accessing health care (Cortes 2004). These opinions contradict the development of Lorigs ideas that self-management enables the best quality of life, but since healthcare information has the greatest effects on outcomes when it is goal orientated (Bodenheimer 2002, Barlow 2002, Kralik et al 2004), maybe older peoples self management goals need more attention. Concurrent with increased longevity and lifestyle factors like poor diet, obesity and related chronic disease is predicted to increase greatly in prevalence (Wang 2010, Mulligan 2009, Armstrong 2005, and Keen 2010). Diabetes has well recognized links between weight and illness progression (Patel 2003), and has also recently been blamed for advancing cognitive deterioration through vascular dementia (Luchsinger 2001). Therefore tightening diabetes control in early stages may vastly improve future health as illness limits mobility, and dementia/retinopathy hamper potential to access self-care resources (Sinclair 2000). Notably due to widespread sensitivity over weight, healthcare professionals should be non-judgmental towards patients with chronic conditions, especially considering psychological and psychosocial implications connected to adjustment to an illness, including guilt, fear, stigma, confidence loss, and isolation (Presho 2008). It was observed during a TIDE (Type 1 Diabetes Education) diabetes specialist nurse led session that those with busy manual working lives find it difficult to take time to self-manage by adjusting insulin to activity levels or establishing a routine of carbohydrate counting and insulin adjustment. Others find calculations following the DAFNE (Dose Adjustment for Normal Eating) structure, hard to understand. Several patients who had suffered previous traumatic hypoglycemic episodes felt anxious about reducing insulin intake, and reported differences in advice from GPs, and nurses as well as confusion over new insulin analogues and devices. This indicates understanding patients as unique individuals, timing and convenience of interventions are important. Furthermore providing clear, consistent advice appeared allied to development of positive attitudes towards nurses education interventions. Studies suggest structured education in type 1 diabetes has improved patients maintenance of glucose targets and a reduction in occurrences of hypoglycemia changed peoples attitudes to education (Heller 2009). Also those with greater understanding of and confidence in adjusting insulin appropriate to activity, with less anxiety over following a fixed regime to avoid hypoglycemia achieve top self-management in type 1 diabetes (Whitehead 2008). On a stroke rehabilitation unit, patients with multiple conditions, particularly diabetes, asthma, and Parkinsons had restricted motor function. Yet nurses could provide encouragement for patients to express concerns, to relieve some psychological distress or help empower patients with the required self-confidence to make decisions (Costello 2009). Patients expressed difficulty with waiting for physios to engage in movement improving circulation, but self-administered some medication and carers views and choices underpinned care planning as recommended in Essence of Care benchmarks, via regular carers group meetings (DOH 2010). Chronic disease is the leading cause of death worldwide (Larsen 2005) and literature establishes dependent peoples needs are equality, rehabilitation, and independence. Furthermore security and dignity are important to older peoples mental health (Presho 2008). On a local scale Manchesters operational plan illustrates emergency admissions for asthma is greatest in the North East and prevention is being addressed with annual health checks provision improving recently. Whilst the national continuing care framework commenced in 2007 promises to ensure national equity of access to NHS funding for continuing care (NHS 2010). Significantly Our Health and Wellbeing Today (DOH 2010) suggests national morbidity is greatest from circulatory disease, which is particularly high in lower socioeconomic groups. These groups also have the greatest prevalence of anxiety and depression and have increased likelihood of having chronic conditions such as diabetes, which has led enquiring researchers to suggest depression as a factor that precipitates and perpetuates chronic conditions (Chapman 2005). Socioeconomics is also reported to determine medication adherence in asthmatics (Kaptain 2009). Victim blame might occur if expectations patients follow structured management programs ignore social contexts of illnesses, (Lindsay 2009) so emphasis should be on developing realistic goals. The kings fund review of self-management highlights that patients perceptions of self management differ according to how they receive a diagnosis, and these attitudes can change over time. Differentiation was noted between diagnosis of asthma or diabetes, where it was felt greater clarity existed, than of Parkinsons disease for which diagnosis takes longer (Coben 2005). Disclosing a medical condition could also have implications for patients quality of life, and a study of anecdotes from Parkinsons patients demonstrated those with confidence to disclose their illness subsequently achieved greater measured anxiety reduction (Presho 2008). Notably research shows patients fret significantly about psychological consequences of physical disability (Miller 2006). Concealment could be due to perceived stigma and misconceptions about the disease or depression about associated decline, physical disability and being a burden (Moore Knowles 2006). Alternatively challenges of symptom management such as sleeping problems and fatigue, sexual dysfunction and cognitive impairment might lead to depression (Schrag, Jahanshahi, Quinn, 2001; Schreurs, De Ridder, Bensing, 2000). Similarly emotional responses to asthma can impact upon attitudes towards taking prevention medication which enables control, and alongside non-adherence patient stress increases leading to depression, anxiety or inability to cope (Kaptain 2009). Interventions aimed at managing pre-diabetes and mild asthma, that miss-managed, could contribute to the development of diabetes mellitus and chronic airway disease (Murphy 2007), are well developed and promoted by the charities Diabetes and Asthma UK (Appendix 3). It is especially important to promote good control since poor control negatively impacts on the affected persons quality of life and also their families (NICE 2008). Also individuals reportedly favor self-management because controlling their health affords greater sense of autonomy (Corben 2005). The EPP has incentives of providing greater knowledge about treatment decisions with the underlying expectancy patients have authentic understanding of their own conditions, and greater recognition of patients roles should give them self-confidence to protect future health (DOH 2001). Illness progression might be reduced by lifestyle changes, therefore nurses have a role in promoting patients independence, well-being, and in encouraging active ageing (NMC 2009). In 2005 the Kings fund report highlighted that major challenges to promoting self management were; developing professionals supportive skills, improving services and information available to facilitate patients self-management, and becoming more flexible to fit compatibly around patients other commitments (Rosen 2005). Dorothea Orem created a comprehensive model of nursing which can be applied to individuals to assess level of self-care ability (Appendix 2). Orem conceptualizes nursing as doing for a disabled person with a self-care deficit, or assisting them/family to do for their selves (Orem 2003). Further to this Orem formulated three systems of nursing to apply, of which partially compensatory nursing seems appropriate for stroke patients, whilst a supportive-educative role suits structured education sessions (i.e. TIDE). The effects of an education intervention delivering the DESMOND program (Appendix 5) for patients with type 2 diabetes to newly diagnosed patients over a period of 6 hours measuring cost effectiveness and quality adjusted years are reported by a randomized trial to have positive effects particularly on reducing patients weight and the amount they smoke (Gillett 2010). Issues of self-efficacy and self-management prominent features of the DESMOND that have been found to build patients confidence (Davies 2008, Skinner 2006) are key to developing a sense of well being in rehabilitation (Presho 2008). Nevertheless, concerns nurses might have include doubts about the patients being experts after what is actually a relatively short training period (Lindsay 2009). Moreover, there could be internal conflicts for nurses between applying structural protocols (i.e.) or professional ethics, and accepting a patients wish to continue a harmful behavior or health neglect. Farrell argued in 2004, active teaching on conditions and problem-solving to address medical issues better promotes self-efficacy than passivity (Farrell 2004). Yet it is important patients are equipped with enough knowledge to act as concordant partners and are supported with taking medications (Murphy 2007) (Appendix 7). Involving relatives in demonstrations of using metered dose inhalers is helpful with dependent asthmatic elders because direct patient observation by nurses supervising medication is often impossible once they have returned from hospital, (Schlenk 2004). Ability to encourage self-management requires nurses to listen, and respond to the concerns and preferences of people in their care (NMC Code), as well as sharing in a way people can understand, the information they want or need to know about their health (NMC code). This may include providing written supplementation to verbal information such as education leaflets or management diaries, and allowing adequate time for adjustment and decision making. Patients whose physical function has deteriorated significantly and continues to decline may be in a too highly dependent illness phase to benefit from strategies to return to normal function (Larsen 2009). Cochrane authors conclude evidence showing contracts improve patient adherence to health-promotion in adult asthma studies is limited (Bosch-Capblanch et al 2007), which suggests patients intentions when agreeing to follow advice is unreliable for predicting management outcomes. Patient self-reports are a simpler method of gleaning non-adherence information, are inexpensive, and possible in most settings (Schlenk 2004 cited by Ruppar 2008). Research observes patients with Parkinsons disease using Alexander Technique had a reduction in depression and improved capacity to manage their disability (Clark 2003). The essence of care is about getting to know and value people as individuals, (NMC Guidance for the care of Older People 2009) and nurses can recognize and respect peoples role in their own care. Evidence also suggests motivational interviewing can reduce depressive attitudes towards illness situations and to encourage positive action to improve health outcomes, therefore perhaps GPs and practice nurses should increase these services (Home and Carr 2009). Nurses can arrange social workers to speak to the patient, to engage with their family, find out their needs, compile appropriate packages of care and request doctors provide explanations of the mechanisms causing a stroke in dedicated wards which usually provide speech and language therapy, occupational, and physiotherapy. Dedicated stroke wards are shown by studies to improve outcomes after two years of patients who were independent prior to their stroke vis-à  -vis ADLs without lengthening stay (Glader 2001 and Cochrane Stroke Unit Trialists Collaboration 2007). It can be a stressful time for patients and family having to make continuing care decisions; therefore patients might seek support from others who have been in their situation (Help the Aged 2009). Gathering information allows patients to manage their illness alongside doctors, and sharing plans with friends and family, explaining their importance, can help them to follow them, there are purportedly around 6 million carers in the UK combining caring with paid employment, saving  £57 billion a year in care costs (Campling 2006, Costello 2009). Not every patient has supportive family members so professionals and expert patients, and charities can be significant. Especially interventions tailored to marginalized patients needs such as X-PERT education for type 2 diabetics undertaken in Urdu (Diabetes UK 2009). In critical phases of illness, which may be the point where a patients continuing care needs begin, patients relatives main needs are for information, support and proximity (Henneman 2002). In the case of Parkinsons disease conveying to patients families the hope that there are strategies for managing the condition, particularly in early stages, might reduce fear, negative impact and sense of stigma (Moore Knowles 2006). Managing pain and discomfort is often considered a challenging aspect of caring, and psychological aspects also cause pain. Total illness effects make it important for patients to have supportive family members to listen to them to find out potential causes/remedies (Costello 2009). Practitioners should be sensitive to needs of carers as well as patients, and evidence suggests nurse-led stroke carer sessions, responding to individuals concerns would be helpful (Smith 2004). A study using the stress and coping model (Lazarus and Folkman) to identify a relationship between sleep deprivation and depression in family care-givers found that individuals self-reports underestimated their problems (Carter 2003). People may feel that because they know their relative they are capable of best comprehending and providing for them, and this could lead to guilt about accepting assistance with care (Nolan 2000). Research into respite care suggests family carers expressed needs for information, skills training or education and emotional support (Hanson 2001). To decrease feelings of powerlessness and support independence for those with chronic conditions Larsen proposes five interventions to recommend to carers (Appendix 6) (Larsen 2009). Peak-flow monitoring, allergen avoidance, and the Buteyko method of symptoms control for mild asthma, based on correctly dosing steroids to maintain safe asthma control are found to be effective (McKeown 2003), as are diet, exercise, supplements and anti-diabetic medication as preventative strategies for type 2 diabetes, reducing heart attacks, microvascular disease, and death (Patel 2003). Though some studies suggest effectiveness reduces 1-3 months post intervention (Siminerio 2007). Subsequently insight into self-management adherence remains complex and under-researched, but supports identifying barriers to adherence and taking action to remove these (Touchette 2008). In liberating the NHS the symbiosis of adult social care, carers, and the NHS is recognized and promises are made to improve the convenience of services to patients (DOH 2010). To reiterate, according to the UK governments policy overall evidence suggests self-care results in beneficial outcomes and better service utilization, but this is largely based on primary studies as systematic reviews are reportedly too time consuming (DOH 2005-7). Systematic reviews also indicate clinical benefits for diabetic and hypertensive patients (Jordon and Osborne 2007). Although psychological benefits to patients appear widely well recognized (Lindsay 2009), patient self-determination requires more than medical management, (Greenhalgh 2009). Contrary to commissioners intentions studies show attendance at health services does not necessarily decrease following education sessions, although this may not indicate poor management as it could reflect success of techniques teaching patients confidence to converse with clinicians (Griffiths 2007). Since GPs are also accused of stalling EPP progress, dubious about its efficacy and under referring patients (Jordon Osborne 2007) it follows that nurses might take a key role in involving patients. The basis behind the EPP being best practice are aims to increase patient beliefs in health services efficacy, personal confidence, and ability to self manage (DOH 2010), therefore nurses are following policy implementing programs RCTs suggest achieve these outcomes (DOH 2005-7). Finally research highlights the importance of having clearer, comprehensive, shared definitions of self-management between health disciplines to reduce patient confusion and so professionals collaborate better (Godfrey 2011). References Armstrong, D. (2005) Chronic Illness: Epidemiological or social explosion, Chronic Illness, 1: 26-7 Barlow, J. H., Sturt, J., and Henshaw, H. (2002) Self-management interventions for people with chronic conditions in primary care: arthritis, asthma diabetes: Health Education Journal; Vol 61, issue 4, p 365-78 Barlow, J., Wright, C., Sheasby, J., Turner, A. and Hainsworth, J. (2002) Self-management approaches for people with chronic conditions: a review, Patient Education and Counseling, Vol 48, p 177-87 Berg, G.D., Wadhwa, S. (2007) Health Services outcomes for diabetes disease management program for the elderly: Disease Management; Volume 10, p 226-234 Bickerstaff, K. A., Grasser, C. M., McCabe, B. (2003) How elderly nursing home residents transcend losses of later life: Holistic Nursing Practice; Vol 17; Issue 3, p 159-165 Bodenheimer, T., Lorig, K., Holman, H., Grumbach, K. (2002) Patient Self-management of Chronic Disease in Primary Care: The Journal of the American Medical Association; Vol 288, Issue 19, p 2469-2475 Bosch Capblanch X, Abba K, Prictor M, Garner P (2007) Contracts between patients and healthcare practitioners for improving patients adherence to treatment, prevention and health promotion activities. Cochrane Database of Systematic Reviews (2): Art. No.: CD004808 BTS/SIGN (2008) British Guideline on the Management of Asthma: British Thoracic Society (21.02.11) http://www.britthoracic.org.uk/Portals/0/Clinical%20Information/Asthma/Guidelines/sign101%20revised%20June%2009.pdf Carter, P. (2003) Family Caregivers Sleep Loss and Depression Over Time: Cancer Nursing; Volume 26 Issue 4 p 253-259 Campling, F., and Sharpe, M. (2006) Living with a long-term illness: Oxford University Press Chapman, D. P., Perry, G. S, Strine, T. A., (2005) The Vital Link Between Chronic Disease Depressive Disorders: Preventing Chronic Disease, Public Health research, practice and policy; Volume 2, No 1 Clark, Chambers, C. (2003) Parkinsons disease: Self-Care Measures You Can Take: American Holistic Nurses Guide to Common Chronic Conditions: John Wiley Sons; New Jersey Cochrane (2011) Organised inpatient (stroke unit) care for stroke: Stroke Unit Trialists Collaboration; The Cochrane Database of Systematic Reviews, Issue 3 http://www2.cochrane.org/reviews/en/ab000197.html Corben, S., and Rosen, R. (2005) Self-management for Long-term Conditions, Patients perspectives of the way ahead; The Kings Fund: UK Cortes, T., Lee, A., Boal, J., Mion, L., Butler, A. (2004) Using focus groups to identify asthma self care and education issues for elderly urban-dwelling minority individuals: Journal of Applied Nursing Research; Volume 17, Issue 3, p 207-212 Costello, J. (2009) Caring for someone with a Long-term Illness: Manchester University Press; UK Davies. M. J., Heller, S., Skinner, T. C., Campbell, M. J., Carey, M. E., Cradock, S., Dallosso, H. M., Daly, H. Doherty, Y. Eaton, S. Fox, C., Oliver, L., Rantell, K., Rayman, G., Khunti, K. (2008) Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial: British Medical Journal, Volume 336, No 7642 DOH (2010) BENCHMARKS FOR THE FUNDAMENTAL ASPECTS OF CARE: Benchmarks for Self Care; Essence of Care 2010 (Access 02.03.11) http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_119968.pdf DOH (2010) Equity and Excellence: Liberating the NHS; Her Majestys Stationary Office, UK DOH. (2010) Generic Long Term Conditions Model; (Accessed online 14/02/2011) http://www.dh.gov.uk/en/Healthcare/Longtermconditions/DH_120915 DOH (2005-7) RESEARCH EVIDENCE ON THE EFFECTIVENESS OF SELF CARE SUPPORT http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_081251.pdf DOH. (2010) Self Care Local Business Case Tool User Guide http://selfmanagement.co.uk/self-care-resources (Accessed Online 14/02/2011) DOH. (2010) Making the case for self care education: http://selfmanagement.co.uk/self-care-resources DOH (2001) The expert patient: a new approach to chronic disease management 21st century Gately, A., Rodgers, C., Sanders, A. (2007) Re-thinking the relationship between long term condition self-management education and the utilization of health services: Social science and Medicine; Volume 65, p 934-945 Farrell, K., Wicks, M, Martin, J. C. (2004) Chronic Disease Self-Management Improved with Enhanced Self-Efficacy: Journal of Clinical Nursing Research; Volume 13, No 4, p 289-308 http://cnr.sagepub.com/content/13/4/289.full.pdf+html (04.04.11) Gibson PG, Powell. H., Coughlan J., Wilson A. J., Abramson M., Haywood, P., Bauman, A, Hensley MJ, Walters, E. H. (2004) Self-management education and regular practitioner review for adults with asthma: The Cochrane Library Issue 2. Chichester: John Wiley Sons. Gillet M, Dallosso HM et al (2010) Delivering the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cost effectiveness analysis; British Medical Journal, Issue 341, p 4093 Glader, E. L., Stegmayr, E., Johansson, L., Wester, P. O. (2001) Differences in Long-Term Outcome Between Patients Treated in Stroke Units and in General Wards: Journal of Stroke; Volume 32, p 2124-2130 Godfrey, C. M., Harrison, C. M., Lysaght , R., lamb, M. (2011) Care of self care by other care of other: the meaning of self-care from research, practice, policy and industry perspectives: International Journal of Evidence Based Healthcare; Volume 9, Issue 1, p 3-2 Greenhalgh, T. (2007) Chronic Illness, beyond the expert patient: British Medical Journal; Vol 338, p629-31 Griffiths, C., Foster, G., Ramsay, J., Eldridge, S., Taylor, S. (2007) How effective are expert patient (lay led) education programs for chronic disease? British Medical Journal: Volume 334, p 1254-1256 Hanson, E. J., Tetley, J., Clarke, A. (2001) Respite care for frail older people and their family carers: concept analysis and user focus group findings of a pan-European nursing research project: Journal of Advanced Nursing; Volume 30, Issue 6, p1396-1407 Heller, S., Shearer, A. Bagust, D., Sanderson, A, and Roberts, S. (2004) Cost-effectiveness of flexible intensive insulin management to enable dietary freedom in people with Type 1 diabetes in the UK; Journal of Diabetic Medicine, issue 21, 460-467 Heller, R. S. (2009) Structured education in type 1 diabetes: British Journal of Diabetes Vascular Disease; Volume 9, no 6, p 269-272 http://dvd.sagepub.com/content/9/6/269.full.pdf+html (02.03.11) Help the Aged (2009) Common Assessment Framework for Adults proposals to improve information sharing around multi-disciplinary assessment and care planning Jordon, J., Osborn, R. (2007) Chronic disease self management education programs: Challenges ahead; Medical Journal of Australia, Volume 182, Issue 2, p 84-87 Keen, A., Hillson R. (2010) Six years on: delivering the Diabetes National Service Framework; Parliamentary Under State Secretary for health National Clinical Director for Diabetes; DOH (19.02.11) http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_112511.pdf Kaptein, A. A., Klok, T., Moss-Morris, R., Brand, L. P. B. (2010) Current Opinion in Allergy and Clinical Immunology: No 10, p 194-199 Kennedy, A., Reeves, D., et al (2007) The effectiveness and cost effectiveness of a national lay led self care support programme for patients with long-term conditions: a pragmatic randomised control trial J. Epidemiol. Community Health Issue 61; pages 254-261 Larsen, P., Lubkin, I. M. (2009) Chronic Illness: Impact and Intervention; 7th ed, Jones Bartlett, Canada Lindsay, S., Virjhoef, H. J. M. (2009) A sociological focus on expert patients: Health Sociology Review; Vol 18, Issue 2, p 139-144 http://www.atypon-link.com/EMP/doi/pdf/10.5555/hesr.18.2.139?cookieSet=1 Luchsinger, J. A., Tang, M., X., Stern, Y., Shea, S., Mayeux, R. (2001) Diabetes Mellitus and Risk of Alzheimers Disease and Dementia with Stroke in a Multiethnic Cohort: American Journal of Epidemiology; Volume 154, No 7, p 635-641 http://aje.oxfordjournals.org/content/154/7/635.full.pdf+html Michie S, Miles J, Weinmann J (2003). Patient centeredness in chronic conditions: what is it and does it matter? Patient Education and Counseling, vol 51, pp 197-206 Miller, N. (2000) Hard to swallow: Dysphagia in Parkinsons disease; Journal of Age and Ageing; Volume 35, issue 6, pages 614-618 Moore, S., Knowles, S. (2006) Beliefs and Knowledge about Parkinsons Disease: E-Journal of Applied Psychology: Clinical and Social Issues, Volume 2, Issue 1, p 15-21 Mulligan, K., Steed, L., Newman, S. (2009) Chronic Physical Illness: Self-Management and Behavioral Interventions; Open University Press, England Murphy, A. (2007) Asthma in Focus: Royal Pharmaceutical Society of Great Britain; Cornwall Newman S, Steed L, Mulligan K (2004) Self-management interventions for chronic illness Lancet, volume 364, pp 1523-37 NICE (2008) Inhaled corticosteroids for the treatment of chronic asthma in adults and in children aged 12 years and over; http://www.nice.org.uk/nicemedia/live/11945/40099/40099.pdf NHS (2004) NHS Continuing Care Report to the House of Commons Health Committee: Stationary Office; http://www.parliament.the-stationery-office.co.uk/pa/cm200405/cmselect/cmhealth/399/399i.pdf (27.03.11) Nolan, M., Delasegga, C. (2000) `I really feel Ive let him down: supporting family carers during long-term care placement for elders; Journal of Advanced Nursing, Volume 31, Issue 4 p 759-767 Orem., D. (2003) Self Care Theory in Nursing: Selected papers of Orem Springer Publishing Company Patel, A. (2003) Diabetes in Focus: Understanding inevitably leads to hope; Pharmaceutical Press, UK Rosen, R., Asaria, P., Dixon, A. (2007) Improving Chronic Disease Management, an Anglo-American Exchange: The commonwealth Fund Report; The Kings Fund Rosen, R., Corben, S. (2005) Self- Management for Long Term Conditions, Patients Perspectives on the way ahead: Managing Long Term Conditions; Working report, Kings Fund Ruppar, T. M., Conn, V. S., Russell, C. L. (2008) Medication adherence interventions for older adults: literature review: Journal of Research and Theory for Nursing Practice, Volume 22, Issue 2, p 114-147 Schlenk E. Dunbar, J., Engberg, S. (2004) Medication non-adherence among older adults: a review of strategies and interventions for improvement: Journal of Gerontological Nursing, Volume 30, Issue 2, p 46 Schrag, A., Jahanshahi, M., Quinn, N. P. (2001) What contributes to depression in Parkinsons disease? Journal of Psychological Medicine, Volume 3, Issue 1, p 65-73 Schreurs, K. M. G., De Ridder, D. T. D., Bensing, J. M. (2000) A one year study of coping, social support and quality of life on Parkinsons disease: Journal of Psychology Health; Volume 15, p 109 Sharkey, J., Ory, M., Browne, B. (2005) Determinants of self-management strategies to reduce out-of-pocket prescription medication expense in homebound older people: Journal of the American Geriatrics Society; Vol 53, Issue 4, p 666-674 Siminerio, L. M. (2007) Is the Diabetes Educator Our Next Endangered Species? Lessons From the American Bald Eagle: Diabetes Spectrum; Volume 20, no 4, p 197-198 Sinclair, A., J., Girling, A. J., Bayer, A., J. (2000) Cognitive dysfunction in older subjects with diabetes mellitus: impact on diabetes self-

Similarities In Frankenstein And A Dolls House English Literature Essay

Similarities In Frankenstein And A Dolls House English Literature Essay A Dolls House, written by Henrik Ibsen, and Frankenstein, written by Mary Shelley, have many connections between them. Different characters and view points were established in both books, characters in both the novels share similar and different personality traits, and the themes and tones of the two are common. Torvald Helmers character in A Dolls House is a husband who is hardworking, gives in to his wife, and a man who must maintain his title. He is a father of three children and a soon-to-be manager of a bank. Be at rest and feel secureHer is shelter for you; here I will protect you like a hunted dove that I have saved from a hawks claws; I will bring peace to your poor beating heart (Ibsen 65) Torvald says this to his wife after he finds out what his wife has done and that his wife no longer wants to be with him. The wife of Torvald Helmer, Nora Helmer, is always happy, lovable, but yet naÃÆ'Â ¯ve. She is characterized as a doll who is played with. I have been your doll wife, just as at home I was Papas doll child (Ibsen 67). She later finds out that she has been played with just like a doll when the truth of her forging her fathers signature is exposed. She states that it was because she was treated like a doll that she has made nothing of her life and soon decides to leave her husband and kids after the truth behind her secret was spilled by Nils Krogstad.. Nils Krogstad is lawyer and works under Torvald Helmer. Krogstad was in an unhappy marriage which led him to be a widower with several children. He suffers from a diseased moral charactersnuffing about to smell out moral corruption and , as soon as they have found some, put the person concerned into some lucrative position where they can keep their eye on him (Ibsen 15). His character is one who is trying to gain back his good title which he lost when he, himself, forged a signature. In trying to do so, he is blackmailing Nora Helmer. Robert Walton, who Victor is telling his story to, starts off the novel Frankenstein. He is a captain traveling to the North Pole. Walton is an explorer, chasing after non-possessed knowledge. I may there discover the wondrous powerI shall satiate my ardent curiosity with the sight of a part of the world never before visited (Shelley 2). As he goes on his voyage, he begins to feel lonely and sad, seeking for a companion that is able to relate and communicate to. Soon enough, he finds Victor, his new companion, at the brink of death and nurses him back to health. Victor Frankenstein is the main character in Frankenstein. He is a Swiss man who grew up in Geneva reading many alchemists works. He then gains interest about modern science and the secret of life. From this day natural philosophy, and particularly chemistry, in the most comprehensive sense of the term, became nearly my sole occupation (Shelley 36). With this new knowledge, he then creates a monster. The monster is Victor Frankensteins creation. He was made from old body parts and enters life with super-human features, such as being strong and having a good endurance. Remember, thou hast made me more powerful than thyself; my height is superior to thine; my joints more supple (Shelley 86). Along with the monsters strength, height, and endurance, it gained knowledge and learned the ability to speak and read. He turns compassionate, gentle, and kind nature but soon seeks revenge against Victor. From the novels A Dolls House and Frankenstein, the characters from both novels are similar but yet different at the same time. Krogstad and the monster are both characters living a hard life where no one is willing to accept them. If necessary, I am prepared to fight for my small post in the bank as if I were fighting for my life (Ibsen 21). Nils Krogstad was wanting to keep his position in the bank because he felt that it was the only way people will accept and re-give him the respect that he has lost. Also, it was his way of making money for his kids that he also wanted to gain the respect back from. Here then I retreated, and lay down happy to have found a shelter, however miserable, from the inclemency of the season, and still more from the barbarity of man (Shelley 94). The monster that Victor created was completely shunned from people. His grotesque features made people scared and disdain him, making him feel sad and misunderstood. Both characters are also seeking for revenge. But let me tell you this-if I lose my position a second time, you shall lose yours with me (Ibsen 24). Krogstad said this to Nora Helmer when he found out that he was losing his job position. He was trying to get Nora to persuade her husband, Torvald Helmer, to keep him in Torvalds business. In doing so, Krogstad blackmailed Nora. Your hours will pass in dread and misery, and soon the bolt will fall which must ravish from you your happiness foreverrevenge remains-revenge (Shelley 155). Victor Frankenstein made a deal with the monster that he would make a companion for it so the monster wouldnt be alone. After Victor decided to destroy the next monster he was going to create, the monster became angry and warned Victor that he will get his revenge for Victor breaking the deal. In the endings of the novels, both characters change and are now different from one another. I have never had such an amazing piece of good fortune in my life! (Ibsen 55). Krogstad life, in the end, is now brig htening up. He found a new companion, which was Noras childhood friend, and was able to support his family again. In time, he knew he will once again be able to be respected. Farewell! I leave you, and in you the last of humankind whom these eyes will ever beholdI shall die, and what I now feel be no longer felt (Shelley 210). After Victor has passed away, the monster did not feel a need to live anymore. He regretted what he has done and to demolish the regrets and wounds he felt, he vanished in the darkness and distance. These two characters started off with similar feelings of sadness and wants of being accepted. Going towards the end of the novels, both changed into two different people, Krogstad being happy with the life that he will soon be getting and the monster having regrets then disappearing into the sea. A Dolls House and Frankenstein have similar themes. Themes are explored in a literary and are the main ideas of the works. Within the two novels, these themes are discovered: secrecy, role of women, and misleading of appearances. In both of the books, it contains secrecy that separates one from another. Victor felt that sciences secrets must not be shared with others out in the world. He began created a monster in secrecy, which came alive, and planned to destroy it without anyone knowing either. In doing so, he isolates himself from the outside world. Nora Helmer kept her secret of forging her fathers signature from her husband. To Nora, the secret was more meant to protect her husband than lie to him, hoping that they would remain together. The theme of a womens role is noticed in both novels. Women in Frankenstein have the roles of the innocent, loving, and sacrificial mother. This, to my mother, was more than a duty; it was a necessity, a passion-(Shelley 20). In this quote, Vict or is describing her mothers passion of helping the poor. The sacrificial role held by women is shown in A Dolls House. After her father passed, Nora gives herself up to Torvald, her husband. Her abandonment of her family once her secret has been found out is another sacrifice that she had taken. Appearances are misleading and are clearly shown as the novel is unraveled. The monster in Frankenstein is first seen as only a ugly creature with super-human traits and no heart. Later in the novel, the monster is able to speak, read, and feel just like a regular human. This is shocking both to the narrator and reader. A Dolls House, appearances of the characters are mislead to fit with them, then reveals the reality of the plays characters and situations.

The Mid-life Crisis in Love Song of J. Alfred Prufrock :: Love Song J. Alfred Prufrock

T.S. Eliot's "The Love Song of J. Alfred Prufrock" is a poem which enters the dynamic consciousness of its title character, whose feelings, thoughts and emotions are displayed in a motley but organized sequence, as they ride the man's wavering mood. His is a mood wavering more often towards haplessness than fulfillment, because Prufrock is a man caught in a vicious cycle of introspection, journey, and retreat. More specifically, J. Alfred Prufrock, as developed by Eliot, is a man experiencing a mid life crisis, brought about by society, and sustained by his own fear and reluctance. Throughout his "song," Prufrock questions himself. He does so not after a performed action, nor during, but nearly always before. Seemingly inbred in him is the tendency to think deeply into everything he does, so that the consequences of his actions may not attract the attention of a society he sees constantly lurking behind him. Nervous and fearful of this hovering critic, Prufrock finds himself considerably shaken by life actions as simple as descending a staircase. A task considered perfunctory and performed without conflict by others, Prufrock, when atop the staircase asks himself, "'Do I dare?' and 'Do I Dare?'"(Eliot 811). His reluctance comes with the response to the question, which Prufrock in his self-consciousness answers for society, answering, "(They will say: 'How his hair is growing thin!') and "('But how his arms and legs are thin!'." Prufrock's conflict thus arises because in his consciousness it is not the end of the stairs which await him as he stands at the top, but a society crouched in the shadows and poised to attack. Henceforth, the cycle is revealed; Prufrock professes an intention, hesitates in paranoia at the prospect of achieving it, and then retreats into self consciousness upon contemplating what society would think of him, and his 'thinning hair' as he did it. This fact incites one to wonder if Prufrock, who repeatedly asks himself, "And how should I presume?" is trapped by and within his own mind, as it continues to engage in the aforementioned cycle. It is within this 'thinning hair' and these 'thin arms and legs' where Prufrock's inhibitions, and consequently the crises he finds himself in, are rooted. Only a man in a mid-life crisis could be so shaken by a bald spot, so unnerved by silent comments aimed at his 'thin arms and legs' (which leads one to envision his torso to be the opposite) by a society which fuels its oppression of Prufrock with his own self-consciousness.

disciplining a child :: essays research papers

Disciplining A Child Relationships between children and parents are unique and intense. Families are often the happiest when parents and children have the skills to relate and communicate with each other in a positive manner, when parents feel competent in helping their children behave appropriately, and when children can express their emotions and behave appropriately. But behavioral problems among children are very common, and such problems might occur in daily life in the home and in the school, with peers or with other adults. My eight-year-old son’s performance at school recently started to decline. At the beginning of the school year, he was an A student with no problems in reading and writing. After a few months, he becomes a C student. First, I thought that he could not understand a particular topic or exercise, but after meeting with his teacher, I found out that he did not pay enough attention in the class. I and his father discussed the problem with our son. Also, I explained to him why his education is important for his future. He agreed with me and promised to change his behavior in the classroom. Despite that, the low grades continued. It was then I decided to use operant conditioning as a type of learning in order to bring out an entirely new response, with a non-physical punishment (the negative secondary reinforcer)such as time out and loss of privileges (TV watching and video games playing). I prefer to avoid the use of physical punishment with my child. Physical punishment usually happens when a parent is angry and this does not create a positive learning experience for a child. Physical punishment models and teaches hitting and physical aggression, often making a child want to avoid the parent and can have a negative effect on a child’s self-esteem. The non-physical punishment worked for a short time: however, very soon I discovered that my son started to hide his low-graded papers from me. I discussed the situation with him and told him that he chose an incorrect way to avoid punishment. I decided to try another kind of reinforcer, positive one, such as a reward. My son was told that if he would get an A in the next two reading and writing tests he would go to play to his favorite place â€Å"Chuck E. Cheese’s†. He was very excited about that and started to respond: to spend more time reading

Diversity :: Title VI, Public Organizations, Race Relations

Diversity is an increasingly important factor in organizational life as organizations world-wide become more diverse in terms of the gender, race, ethnicity, age, national origin, and other personal characteristics of their members. By the year 2000, the American workforce is likely to be gender-balanced, with only 58% of the workforce comprised of White, native born Americans (Jackson et al., 1995). Due to the increasing globalization of business requires employees from different cultures to work together in cross-national teams. Firms are being forced to form cross-functional, inter-departmental, cross-divisional, and inter-organizational alliances in order to make maximum use of scarce resources and thus increase their competitive advantage. People tend to think of diversity as simply demographic, a matter of color, gender, or age. However, groups can be disparate in many ways. Diversity is also based on informational differences, reflecting a person's education and experience, as well as on values or goals that can influence what one perceives to be the mission of something as small as a single meeting or as large as a whole company. Diversity among employees can create better performance when it comes to out-of-the-ordinary creative tasks such as product development or cracking new markets, and managers have been trying to increase diversity to achieve the benefits of innovation and fresh ideas. Informational diversity stirred constructive conflict, or debate, around the task at hand. That is, people deliberate about the best course of action. On the other hand, demographic diversity can sometimes whip up interpersonal conflict. This is the kind of conflict people should fear.

Literary Devices Essay

LITERARY DEVICES Copyright  © 2007 by Jay Braiman www. mrbraiman. com Literary devices refers to specific aspects of literature, in the sense of its universal function as an art form which expresses ideas through language, which we can recognize, identify, interpret and/or analyze. Literary devices collectively comprise the art form’s components; the means by which authors create meaning through language, and by which readers gain understanding of and appreciation for their works. They also provide a conceptual framework for comparing individual literary works to others, both within and across genres. Both literary elements and literary techniques can rightly be called literary devices. Literary elements refers to particular identifiable characteristics of a whole text. They are not â€Å"used,† per se, by authors; they represent the elements of storytelling which are common to all literary and narrative forms. For example, every story has a theme, every story has a setting, every story has a conflict, every story is written from a particular point-of-view, etc. In order to be discussed legitimately as part of a textual analysis, literary elements must be specifically identified for that particular text. Literary techniques refers to any specific, deliberate constructions or choices of language which an author uses to convey meaning in a particular way. An author’s use of a literary technique usually occurs with a single word or phrase, or a particular group of words or phrases, at one single point in a text. Unlike literary elements, literary techniques are not necessarily present in every text; they represent deliberate, conscious choices by individual authors. â€Å"Literary terms† refers to the words themselves with which we identify and designate literary elements and techniques. They are not found in literature and they are not â€Å"used† by authors. Allegory: Where every aspect of a story is representative, usually symbolic, of something else, usually a larger abstract concept or important historical/geopolitical event. Lord of the Flies provides a compelling allegory of human nature, illustrating the three sides of the psyche through its sharply-defined main characters. Alliteration: The repetition of consonant sounds within close proximity, usually in consecutive words within the same sentence or line. Antagonist: Counterpart to the main character and source of a story’s main conflict. The person may not be â€Å"bad† or â€Å"evil† by any conventional moral standard, but he/she opposes the protagonist in a significant way. (Although it is technically a literary element, the term is only useful for identification, as part of a discussion or analysis of character; it cannot generally be analyzed by itself. ) Anthropomorphism: Where animals or inanimate objects are portrayed in a story as people, such as by walking, talking, or being given arms, legs, facial features, human locomotion or other anthropoid form. (This technique is often incorrectly called personification. ) †¢ The King and Queen of Hearts and their playing-card courtiers comprise only one example of Carroll’s extensive use of anthropomorphism in Alice’s Adventures in Wonderland. Blank verse: Non-rhyming poetry, usually written in iambic pentameter. †¢ Most of Shakespeare’s dialogue is written in blank verse, though it does occasionally rhyme. Character: The people who inhabit and take part in a story. When discussing character, as distinct from characterization, look to the essential function of the character, or of all the characters as a group, in the story as a whole. †¢ Rather than focus on one particular character, Lord assembles a series of brief vignettes and anecdotes involving multiple characters, in order to give the reader the broadest possible spectrum of human behavior. Golding uses his main characters to represent the different parts of the human psyche, to illustrate mankind’s internal struggle between desire, intellect, and conscience. †¢ Characterization: The author’s means of conveying to the reader a character’s personality, life history, values, physical attributes, etc. Also refers directly to a description thereof. †¢ Atticus is characterized as an almost impossibly virtuous man, always doing what is right and imparting impeccable moral values to his children. Climax: The turning point in a story, at which the end result becomes inevitable, usually where something suddenly goes terribly wrong; the â€Å"dramatic high point† of a story. (Although it is technically a literary element, the term is only useful for identification, as part of a discussion or analysis of structure; it cannot generally be analyzed by itself. ) †¢ The story reaches its climax in Act III, when Mercutio and Tybalt are killed and Romeo is banished from Verona. Conflict: A struggle between opposing forces which is the driving force of a story. The outcome of any story provides a resolution of the conflict(s); this is what keeps the reader reading. Conflicts can exist between individual characters, between groups of characters, between a character and society, etc. , and can also be purely abstract (i. e. , conflicting ideas). †¢ †¢ †¢ The conflict between the Montagues and Capulets causes Romeo and Juliet to behave irrationally once they fall in love. Jack’s priorities are in conflict with those of Ralph and Piggy, which causes him to break away from the group. Man-versus-nature is an important conflict in The Old Man and the Sea. Context: Conditions, including facts, social/historical background, time and place, etc. , surrounding a given situation. †¢ Madame Defarge’s actions seem almost reasonable in the context of the Revolution. Creative license: Exaggeration or alteration of objective facts or reality, for the purpose of enhancing meaning in a fictional context. †¢ Orwell took some creative license with the historical events of the Russian Revolution, in order to clarify the ideological conflicts. Dialogue: Where characters speak to one another; may often be used to substitute for exposition. †¢ Since there is so little stage direction in Shakespeare, many of the characters’ thoughts and actions are revealed through dialogue. Dramatic irony: Where the audience or reader is aware of something important, of which the characters in the story are not aware. †¢ Macbeth responds with disbelief when the weird sisters call him Thane of Cawdor; ironically, unbeknownst to him, he had been granted that title by king Duncan in the previous scene. Exposition: Where an author interrupts a story in order to explain something, usually to provide important background information. †¢ The first chapter consists mostly of exposition, running down the family’s history and describing their living conditions. Figurative language: Any use of language where the intended meaning differs from the actual literal meaning of the words themselves. There are many techniques which can rightly be called figurative language, including metaphor, simile, hyperbole, personification, onomatopoeia, verbal irony, and oxymoron. (Related: figure of speech) †¢ The poet makes extensive use of figurative language, presenting the speaker’s feelings as colors, sounds and flavors. Foil: A character who is meant to represent characteristics, values, ideas, etc. which are directly and diametrically opposed to those of another character, usually the protagonist. (Although it is technically a literary element, the term is only useful for identification, as part of a discussion or analysis of character; it cannot generally be analyzed by itself. †¢ The noble, virtuous father Macduff provides an ideal foil for the villainous, childless Macbeth. Foreshadowing: Where future events in a story, or perhaps the outcome, are suggested by the author before they happen. Foreshadowing can take many forms and be accomplished in many ways, with varying degrees of subtlety. However, if the outcome is deliberately and explicitly revealed early in a story (such as by the use of a narrator or flashback structure), such information does not constitute foreshadowing. †¢ Willy’s concern for his car foreshadows his eventual means of suicide. Hyperbole: A description which exaggerates, usually employing extremes and/or superlatives to convey a positive or negative attribute; â€Å"hype. † †¢ The author uses hyperbole to describe Mr. Smith, calling him â€Å"the greatest human being ever to walk the earth. † Iambic pentameter: A poetic meter wherein each line contains ten syllables, as five repetitions of a two-syllable pattern in which the pronunciation emphasis is on the second syllable. †¢ Shakespeare wrote most of his dialogue in iambic pentameter, often having to adjust the order and nature of words to fit the syllable pattern, thus endowing the language with even greater meaning. Imagery: Language which describes something in detail, using words to substitute for and create sensory stimulation, including visual imagery and sound imagery. Also refers to specific and recurring types of images, such as food imagery and nature imagery. (Not all descriptions can rightly be called imagery; the key is the appeal to and stimulation of specific senses, usually visual. It is often advisable to specify the type of imagery being used, and consider the significance of the images themselves, to distinguish imagery from mere description. ) †¢ The author’s use of visual imagery is impressive; the reader is able to see the island in all its lush, colorful splendor by reading Golding’s detailed descriptions. Irony (a. k. a. Situational irony): Where an event occurs which is unexpected, in the sense that it is somehow in absurd or mocking opposition to what would be expected or appropriate. Mere coincidence is generally not ironic; neither is mere surprise, nor are any random or arbitrary occurrences. (Note: Most of the situations in the Alanis Morissette song are not ironic at all, which may actually make the song ironic in itself. ) See also Dramatic irony; Verbal irony. Metaphor: A direct relationship where one thing or idea substitutes for another. †¢ Shakespeare often uses light as a metaphor for Juliet; Romeo refers to her as the sun, as â€Å"a rich jewel in an Ethiop’s ear,† and as a solitary dove among crows. Mood: The atmosphere or emotional condition created by the piece, within the setting. Mood refers to the general sense or feeling which the reader is supposed to get from the text; it does not, as a literary element, refer to the author’s or characters’ state of mind. (Note that mood is a literary element, not a technique; the mood must therefore be described or identified. It would be incorrect to simply state, â€Å"The author uses mood. †) †¢ The mood of Macbeth is dark, murky and mysterious, creating a sense of fear and uncertainty. Motif: A recurring important idea or image. A motif differs from a theme in that it can be expressed as a single word or fragmentary phrase, while a theme usually must be expressed as a complete sentence. †¢ Blood is an important motif in A Tale of Two Cities, appearing numerous times throughout the novel. Onomatopoeia: Where sounds are spelled out as words; or, when words describing sounds actually sound like the sounds they describe. †¢ Ouch! EEK! Crash! Oxymoron: A contradiction in terms. †¢ Romeo describes love using several oxymorons, such as â€Å"cold fire,† â€Å"feather of lead† and â€Å"sick health,† to suggest its contradictory nature. Paradox: Where a situation is created which cannot possibly exist, because different elements of it cancel each other out. †¢ In 1984, â€Å"doublethink† refers to the paradox where history is changed, and then claimed to have never been changed. †¢ A Tale of Two Cities opens with the famous paradox, â€Å"It was the best of times, it was the worst of times. † Parallelism: Use of similar or identical language, structures, events or ideas in different parts of a text. Personification (I): Where inanimate objects or abstract concepts are seemingly endowed with human self-awareness; where human thoughts, actions, perceptions and emotions are directly attributed to inanimate objects or abstract ideas. (Not to be confused with anthropomorphism. ) Personification (II): Where an abstract concept, such as a particular human behavior or a force of nature, is represented as a person. †¢ The Greeks personified natural forces as gods; for example, the god Poseidon was the personification of the sea and its power over man. Plot: Sequence of events in a story. Most literary essay tasks will instruct the writer to â€Å"avoid plot summary;† the term is therefore rarely useful for response or critical analysis. When discussing plot, it is generally more useful to consider and analyze its structure, rather than simply recapitulate â€Å"what happens. † Point-of-view: The identity of the narrative voice; the person or entity through whom the reader experiences the story. May be third-person (no narrator; abstract narrative voice, omniscient or limited) or first-person (narrated by a character in the story or a direct observer). Point-of-view is a commonly misused term; it does not refer to the author’s or characters’ feelings, opinions, perspectives, biases, etc. Though it is written in third-person, Animal Farm is told from the limited point-of-view of the common animals, unaware of what is really happening as the pigs gradually and secretively take over the farm. Writing the story in first-person point-of-view enables the reader to experience the soldier’s fear and uncertainty, limiting the narrative to what only he saw, thought and felt during the battle. Protagonist: The main character in a story, the one with whom the reader is meant to identify. The person is not necessarily â€Å"good† by any conventional moral standard, but he/she is the person in whose plight the reader is most invested. (Although it is technically a literary element, the term is only useful for identification, as part of a discussion or analysis of character; it cannot generally be analyzed by itself. ) Repetition: Where a specific word, phrase, or structure is repeated several times, usually in close proximity, to emphasize a particular idea. †¢ The repetition of the words â€Å"What if†¦Ã¢â‚¬  at the beginning of each line reinforces the speaker’s confusion and fear. Setting: The time and place where a story occurs. The setting can be specific (e. g. , New York City in 1930) or ambiguous (e. g. , a large urban city during economic hard times). Also refers directly to a description thereof. When discussing or analyzing setting, it is generally insufficient to merely identify the time and place; an analysis of setting should include a discussion of its overall impact on the story and characters. †¢ The novel is set in the South during the racially turbulent 1930’s, when blacks were treated unfairly by the courts. †¢ With the island, Golding creates a pristine, isolated and uncorrupted setting, in order to show that the boys’ actions result from their own essential nature rather than their environment. Simile: An indirect relationship where one thing or idea is described as being similar to another. Similes usually contain the words â€Å"like† or â€Å"as,† but not always. †¢ The simile in line 10 describes the lunar eclipse: â€Å"The moon appeared crimson, like a drop of blood hanging in the sky. † †¢ The character’s gait is described in the simile: â€Å"She hunched and struggled her way down the path, the way an old beggar woman might wander about. † Speaker: The â€Å"voice† of a poem; not to be confused with the poet him/herself. Analogous to the narrator in prose fiction. Structure: The manner in which the various elements of a story are assembled. †¢ The individual tales are told within the structure of the larger framing story, where the 29 travelers gather at the Inn at Southwark on their journey to Canterbury, telling stories to pass the time. †¢ The play follows the traditional Shakespearean five-act plot structure, with exposition in Act I, development in Act II, the climax or turning point in Act III, falling action in Act IV, and resolution in Act V. Symbolism: The use of specific objects or images to represent abstract ideas. This term is commonly misused, describing any and all representational relationships, which in fact are more often metaphorical than symbolic. A symbol must be something tangible or visible, while the idea it symbolizes must be something abstract or universal. (In other words, a symbol must be something you can hold in your hand or draw a picture of, while the idea it symbolizes must be something you can’t hold in your hand or draw a picture of. ) †¢ Golding uses symbols to represent the various aspects of human nature and civilization as they are revealed in the novel. The conch symbolizes order and authority, while its gradual deterioration and ultimate destruction metaphorically represent the boys’ collective downfall. Theme: The main idea or message conveyed by the piece. A theme should generally be expressed as a complete sentence; an idea expressed by a single word or fragmentary phrase is usually a motif. †¢ Orwell’s theme is that absolute power corrupts absolutely. †¢ The idea that human beings are essentially brutal, savage creatures provides the central theme of the novel. Tone: The apparent emotional state, or â€Å"attitude,† of the speaker/narrator/narrative voice, as conveyed through the language of the piece. Tone refers only to the narrative voice; not to the author or characters. It must be described or identified in order to be analyzed properly; it would be incorrect to simply state, â€Å"The author uses tone. † †¢ The poem has a bitter and sardonic tone, revealing the speaker’s anger and resentment. †¢ The tone of Gulliver’s narration is unusually matter-of-fact, as he seems to regard these bizarre and absurd occurrences as ordinary or commonplace. Tragedy: Where a story ends with a negative or unfortunate outcome which was essentially avoidable, usually caused by a flaw in the central character’s personality. Tragedy is really more of a dramatic genre than a literary element; a play can be referred to as a tragedy, but tragic events in a story are essentially part of the plot, rather than a literary device in themselves. When discussing tragedy, or analyzing a story as tragic, look to the other elements of the story which combine to make it tragic. Tragic hero/tragic figure: A protagonist who comes to a bad end as a result of his own behavior, usually cased by a specific personality disorder or character flaw. (Although it is technically a literary element, the term is only useful for identification, as part of a discussion or analysis of character; it cannot generally be analyzed by itself. ) †¢ Willy Loman is one of the best-known tragic figures in American literature, oblivious to and unable to face the reality of his life. Tragic flaw: The single characteristic (usually negative) or personality disorder which causes the downfall of the protagonist. †¢ Othello’s tragic flaw is his jealousy, which consumes him so thoroughly that he is driven to murder his wife rather than accept, let alone confirm, her infidelity. (Although it is technically a literary element, the term is only useful for identification, as part of a discussion or analysis of character; it cannot generally be analyzed by itself. ) Verbal irony: Where the meaning of a specific expression is, or is intended to be, the exact opposite of what the words literally mean. (Sarcasm is a tone of voice that often accompanies verbal irony, but they are not the same thing. ) †¢ Orwell gives this torture and brainwashing facility the ironic title, â€Å"Ministry of Love. †