Cause and Effectof Joining the Military Essay

The U.S. Army is the oldest, most established branch of the military. â€Å"The U.S. Army traces it’s heritage back to the 1600’s and the period of colonization.†(Historcal Dictionary of the US Army) Since then, the Army has changed. The Army has a lot more to offer now than it did Two Hundred and Thirty eight years ago. There are many benefits to joining the Army from medical to bonus pays. College tuition costs are rising faster than ever. Not only do college students have to take out student loans after student loans, most have to work part time or even full time jobs to go to college, which delays their education, sometimes taking an associates four years to complete. Joining the Army, upon entry you are able to choose a GI Bill option. There are different versions of the GI Bill, but all allow you to attend college without having to worry about tuition costs. I am using my Post 9/11 GI Bill and for 36 months, my GI Bill pays full tuition, a book stipend, and a monthly housing allowance. Not only is there the GI Bill option, but while active duty or reserve, you can take advantage of their tuition assistance program. The program covers one hundred percent of tuition costs. As both of these programs are wonderful, there are effects to it. The GI Bill only covers everythign one hundred percent for thirty six months. If you are wanting to get a Bachelor’s Degree, you would need to take at least fifteen credit hours per semester, without taking any semesters off, in order to get your Bachelor’s using your GI Bill with no out of pocket expenses. If using the tuition assistance program, you are working full-time. You have your soldier-duties as well as going to school. There are days that you may need to miss class because you need to pull a twenty four hour watch, which may take a toll on your grade. The Army provides free healthcare to soldiers and their family. The cost of healthcare insurance is expensive, and you still have to pay out of pocket expenses from co-pays to half of a bill from the hospital. With the Army, everything is covered. Even though the healthcare is free, it is for soldiers and their families. There are a small amounts of doctors for a large amount of people. So even though the healthcare is free, you often have to wait longer periods of time for an appointment and when you really need an appointment fast, it doesn’t always work out. If you were to need to go to an urgent care clinic, you need to get permission from the military insurance company. When joining the military, you take a test in order to see what skills you are strongest. You are given a score and depending on your score, determines what job in the Army you can choose. Jobs in the Army range from infantryman to LPN’s. (http://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/combat.html) The higher the score, the more options of jobs there are available to you. Right now there are roughly one hundred and ninety jobs in the Army. Some jobs are in higher demand than others. When joining the Army, if you choose one of the high demand jobs, you might get a bonus for choosing the job. After receiving the bonus money, usually given in a lump sum, if you were to have to get out of the Army during a certain time period after receiving the bonus, you would have to pay the bonus money back. Sometimes the bonus could be up to teh thousand dollars. Even though the Army offers the benefits mentioned, plus many more, you also have to think of the toll it takes on your family. In the Army, you move around roughly every three years. If you were to deploy, you would be gone for 9 months plus, without seeing your family. Some deployments are easier than others, as some let you skype with your family daily to a few times weekly, and others maybe once a month. For children is is hard moving around, making friends and then leaving them, making new friends all over again, and it takesa a toll on them academically. Some children may even have to stay back a year depending on the time of the year they move. With all the benefits available to you and that the military offers, there are many effects to consider. They are all great, but the effects don’t only effect you, but also your family and loved ones. You would have to consider what you choose, how it effects others lives as well. From personal experience, the Army is wonderful and offers a lot to not only myself, but my family as well. It allowed me to provide for my family and also set me up for my future. Flow & Rhythm (Sentence Fluency) All sentences sound natural and are easy-on-the-ear when read aloud. Each sentence is clear and has an obvious emphasis. Almost all sentences sound natural and are easy-on-the-ear when read aloud, but 1 or 2 are stiff and awkward or difficult to understand. Most sentences sound natural and are easy-on-the-ear when read aloud, but several are stiff and awkward or are difficult to understand. The sentences are difficult to read aloud because they sound awkward, are distractingly repetitive, or difficult to  understand. Sequencing (Organization) Details are placed in a logical order and the way they are presented effectively keeps the interest of the reader. Details are placed in a logical order, but the way in which they are presented/introduced sometimes makes the writing less interesting. Some details are not in a logical or expected order, and this distracts the reader. Many details are not in a logical or expected order. There is little sense that the writing is organized. Introduction (Organization) The introduction is inviting, states the main topic and previews the structure of the paper. The introduction clearly states the main topic and previews the structure of the paper, but is not particularly inviting to the reader. The introduction states the main topic, but does not adequately preview the structure of the paper nor is it particularly inviting to the reader. There is no clear introduction of the main topic or structure of the paper. Commitment (Voice) The writer successfully uses several reasons/appeals to try to show why the reader should care or want to know more about the topic. The writer successfully uses one or two reasons/appeals to try to show why the reader should care or want to know more about the topic. The writer attempts to make the reader care about the topic, but is not really successful. The writer made no attempt to make the reader care about the topic. Transitions (Organization) A variety of thoughtful transitions are used. They clearly show how ideas are connected. Transitions clearly show how ideas are connected, but there is little variety. Some transitions work well; but connections between other ideas are fuzzy. The transitions between ideas are unclear or nonexistent. Works Cited Brown, Jerold E. Historical Dictionary of the US Army. Westport, CT, USA : Greenwood Press, Dec 2000. 15 Nov 2004. 4 Nov 2013 .

The Twilight Saga 5: Midnight Sun 24. Blood

There were distant sounds of a fight, the loud noise of a vampire being torn apart, but my eyes were only able to see one thing ?C Bella. She was lying on the ground, crumpled, broken, while the pool of blood continued to grow wider underneath her. The red fluid, spilling, wasting, on the floor, the scent pulsing through the air. The amount was cataclysmic, as each second passed a distinctive, yet intangible, spice of the most delicious aroma left burning lacerations in my aching throat. My knee was placed resolutely in the middle of the puddle, soaking me in her blood†¦her life. I took a deep breath and ignored my longing, my lust, my ravenous desire – I focused on the angel. â€Å"Bella,† I soothed her. â€Å"You're going to be fine.† Unresponsive, detached. A plea entered my voice. â€Å"Can you hear me, Bella? I love you.† I sent a reverent petition to which ever god would answer a creature like me. â€Å"Edward,† she croaked, answering my silent request. â€Å"Yes, I'm here,† I declared earnestly. Slow, small, and irregular quantity of tears trickled down her cheeks. â€Å"It hurts,† she uttered many inarticulate lamentations of grief as her eyes closed tightly. Her words plagued and tormented me. I lightly brushed her hair from her face. â€Å"I know, Bella, I know.† I shifted my posture to Carlisle. â€Å"Can't you do anything?† I asked him urgently, peremptorily. This doesn't look good. I need you to prepare yourself for the worst. â€Å"My bag please,† Carlisle reached his hand out. The scent†¦Alice's eyes were wild when she passed the bag to him. â€Å"Hold your breath, Alice, it will help,† Carlisle declared while grabbing his bag. â€Å"Alice?† Bella questioned in a sustained mournful cry. Alice continued to hold her breath, unable to answer her. Bella, she lamented a sigh silently. â€Å"She's here,† I assured her. â€Å"She knew where to find you,† I silently thanked Alice as our eyes met for a fraction of a second. Alice made a slight and quick bend of her head. Not soon enough, her eyes were deep with sorrow. A quick glance around the room brought the total devastation and destruction back into focus. The mirror was cracked and shiny blood was smeared across the floor and mirrors. â€Å"My hand hurts,† Bella mumbled in an almost unintelligible extent, bringing me back from my distraction. â€Å"I know, Bella.† Another scorch mark broke down my throat as I took in another breath to answer the angel who was lying in front of me. I'm about to administer some morphine into her system. Her pain should go away fairly quick after that. â€Å"Carlisle will give you something, it will stop.† All the noise, the fighting, the sound of cracking wood, it was all drowned out when a sharp and piercing cry echoed through the Ballet Studio. â€Å"My hand is burning,† Bella shouted, her eyes fluttering, trying to open but were restricted because of the blood. â€Å"Bella?† I cried out, frightened. I felt a great mental suffering, as her screams were slowly torturing me. The morphine should be working. Another loud wail. â€Å"The fire! Someone stop the fire!† she screamed and moaned in paroxysms of grief. I looked over my shoulder as Emmett was starting a fire to burn James ?C but it was nowhere near us. I turned back to her, going to the source of her first cries. There were perfect teeth imprints on her wrist where a vampire, I growled in rage, had bit her. â€Å"Carlisle! Her hand!† I yelled in disgust, hoping he might have a remedy or that I was wrong all together. An icy surge of terror filled my lungs. I watched as his eyes looked over the outline of the mark. â€Å"He bit her.† Carlisle stated in revulsion. A deep breath entered my lungs as her scent rippled down my flaming throat, the horror entering my body. My view was obliterated by anger ?C I was seeing red. I can't do it. â€Å"Edward, you have to do it,† Alice commanded while wiping the blood out of Bella's eyes. Her stare was so intent you would think she was trying to force Bella to mend just by looking at her. â€Å"No,† I roared, looking at Carlisle, hoping he would tell me something different. â€Å"Alice,† Bella cried in a low, mournful sound. Edward, if you want her to stay human†¦ â€Å"There may be a chance,† Carlisle persisted. â€Å"What?† I begged, not understanding why they wanted me to do it. â€Å"See if you can suck the venom back out. The wound is fairly clean,† Carlisle explained as he stitched Bella's head wound. The shock from this statement was so huge it rooted me to the spot for several seconds. â€Å"Will that work?† Alice's throat was obstructed by the fear of losing her friend. I assume it would work the same as a snake bite. â€Å"I don't know,† he admitted. â€Å"But we have to hurry.† You have to do this, Edward; I can't do this for you. The thought of consuming her blood, even if it was saving her life sent pleasure and pain flooding into my body. To taste her would be wrong†¦fallacious. I felt utterly disgusted with myself but the temptation was growing. My veins felt like they were being filled with acid as I contemplated putting her life in more danger†¦the liability†¦to place her in mortal peril, where she may never come back to me†¦ I felt like I was choking. â€Å"Carlisle†¦I,† I faltered. The thoughts tilted back and forth in my mind like a see saw. â€Å"I don't know if I can do that,† the words were laced with the agony that was consuming me, I felt like I was being strangled, desperate for air. Carlisle was working quickly over Bella's head, pulling a needle through her skin over and over, sewing her up. He looked at my face. â€Å"It's your decision, Edward, either way. I can't help you. I have to get this bleeding stopped here if you're going to be taking blood from her hand.† Bella jerked a quick sharp pull of her body. Another thrust and a suddenly arrested motion as she thrashed against the burning pain in her hand as my mind was racing for alternatives. â€Å"Edward!† she shouted spasmodically. Her eyes flew open and her dark brown eyes darted around in every direction until they landed on me. Watching her writhing in burning pain, pain that I remember well, burnt me, like I could feel it too. I could take the pain away ?C I could make it all stop ?C but would I take her life in the process? â€Å"Alice, get me something to brace her leg!† Carlisle shouted as he was finishing up the stitches on Bella's head. Maybe he should let her become a vampire; it would make things a whole lot easier. â€Å"Edward, you must do it now, or it will be too late.† At his thoughts ?C to think of Bella as a vampire ?C death would be better than this†¦this†¦life. Bella was beginning to jerk in violent spasmodic muscular movements, the abrupt motions making her leg flail limply around. Carlisle caught her leg to hold it still. Now, Carlisle ordered in his head. I shot him a furtive look. My fingers wrapped around her tiny and delicate wrist, preventing her involuntary reflexes, like she was pulling her hand away from a flame. The desire to taste, the agony of the bite†¦every second I bent closer to her my mind tittered on an unstable line of right and wrong. My mind was traveling between two different worlds. Reason, truth, maybe some standard or principle ?C this had to be the solution; the right answer. Not proper, awry, not appropriate. The thoughts scattered across my already stressed mind as I bent down further. She thrust against my hold making the prolonged pain of my intense mental suffering grow exponentially. Her breathing was harsh and ragged as her wild yells filled the studio, reverberating off the mirrors and walls. My lips touched her skin, the fresh blood soaking into my lips. Hunger. Completely ravenous. I pulled her blood from the bite wound and it rushed into my mouth. The blood was hot and wet in my mouth. Sensations I'd never felt before tingled my tongue, sending a pleasurable warmth down my frozen and dry aching throat. Each second the monster was threatening to take over as he reared his head in appreciation. She screamed and lashed, struggling to get away from my grip. I knew it was hurting her, but my instincts had taken over, I held her tighter, intensely eager to devour the palatable, savory†¦delectable†¦I tried not to moan in pleasure. The luxuriant fullness that had consumed me brought intense satisfaction. I was ultimately determined to seize her, to have all of her, as I sucked down the blood in large gluttonous amounts. I could feel her becoming limp in my strong grasp as I continued my consumption of her gratifyingly warm, red†¦crimson blood. â€Å"Edward,† Bella mumbled incoherently, bringing me from my frenzy ?C like a soft voice had just whispered in my ear. Edward! Please†¦please don't kill her. Stop! Alice cried in her mind, not wanting to scare Bella. â€Å"He's right here, Bella.† Her voice trembled slightly, her visions showing her an unsure course. Bella's eyes rolled in her head like marbles on an unstable surface. She was dying. With a stupendous effort I let go, placing her hand down gently, forcibly reminding myself of her delicate nature. The dazzling sunlight of the day bathed the studio with a natural light, making the pool of blood glitter. Bella was silent and limp, her heart barely pumping the little amount of blood that was left in her body. Did I kill her? I felt like someone had just stabbed me in my heart. Would this be her brutal ending? I felt a horrible compression in my chest at my thoughts. They placed an inexcusable trust in me! I looked at her intently, waiting for another reaction with increasing desperation. She took an unsteady breath ?C the small cry of pain still present. I was devoutly thankful to whatever god had been watching over her this morning. â€Å"Stay, Edward, stay with me†¦Ã¢â‚¬  She barely breathed. I sighed heavily at the beautiful angel voice. â€Å"I will,† I promised, the stress of the situation still evident in my triumphant voice. I put her words on repeat in my mind, realizing even though I put her in this danger and almost sucked her dry of life, she still loved me†¦still wanted me to stay with her. I brushed my hand lightly against her cheek. A small sigh escaped her lips, her pain obviously dulling as her eyes closed lightly. You didn't kill her, Carlisle thought proudly. â€Å"Is it all out?† he checked. I didn't kill her. The relief was so exquisite it was nearly pain. The ache†¦anxiety, my oppression was slowly dissipating. â€Å"Her blood tastes clean,† I breathed a sigh of relief. â€Å"I can taste the morphine.† Let's make sure before we take her to the hospital. The morphine might be covering up the pain. â€Å"Bella?† Carlisle called out, bringing Bella from an almost slumber. Bella didn't bother to open her eyes, her body lying limp on the ground. â€Å"Mmmmm?† â€Å"Is the fire gone?† Carlisle stared at me, waiting for the answer. Bella's voice was slow and sluggish. â€Å"Yes,† she sighed. â€Å"Thank you, Edward.† I felt a profound feeling of warmth radiate from my body. â€Å"I love you,† I breathed in deep affection. To taste something so sensational and be able to stop†¦ I sighed, the benevolent reverence I had for her grew suddenly, like she was divine in nature. â€Å"I know,† she breathed once more, her words becoming incoherent with sleep. At her words ?C her almost sarcastic words, a low chuckle escaped my lips. The sound was doused in relief. Did you see her mother? Is she dead? Carlisle's face looked grave. We both listened for a moment, trying to hear a heart beat†¦someone breathing, but there was nothing. I shook my head. â€Å"Bella?† Her lips twitched into a frown. â€Å"What?† she mumbled. â€Å"Where is your mother?† he asked. â€Å"In Florida,† she sighed. Then her face barely distorted in anger. â€Å"He tricked me, Edward. He watched our videos.† I gritted my teeth in anger, the reminder of James came to the forefront of my mind as I looked over my shoulder at the rapidly growing flames that were licking up the walls of the studio. â€Å"Alice.† Bella's eyes fluttered and failed to open. â€Å"Alice,† she called again. â€Å"The video ?C he knew you, Alice, he knew where you came from,† her voice drifted off weakly. â€Å"I smell gasoline,† she added quietly. This building is going to be up in flames shortly, we need to leave. â€Å"It's time to move her,† Carlisle looked at me. Can you carry her? You must be careful not to hold her too tightly. We don't want her ribs protruding into her organs. I nodded my head. â€Å"I want to sleep,† Bella protested. â€Å"You can sleep, sweetheart, I'll carry you,† I tried to soothe her as I brought her gently into my arms, like she was a delicate soap bubble. She's more fragile than a soap bubble, I laughed internally, the first real signs of the ending danger.†Sleep now, Bella,† I kissed her lightly on the forehead, the blood unaffecting me in this most relief filled moments. She fell limp in my arms, her eyes shut lightly, like she was in a deep slumber. I emerged from the flames of the studio as Alice opened the car door of the Cadillac for me. I slowly laid her down in the backseat. I sat beside her, pulling her into my lap. I wanted to keep her as close to me as possible. I looked up through the shining sunlight, where Alice was glittering like millions of tiny facets were embedded in her skin, and noticed the relief on her face also. â€Å"Where's Emmett and Jasper?† I wondered, catching a glimpse of the Mercedes still parked out front. â€Å"They've gone back to the hotel. I'm not riding with you, I'm going to meet them there. We are going to set up a†¦scenario.† I saw in her mind the plan ?C they were going to break the glass wall of one of the stair wells ?C saying Bella had fallen down the stairs and through the window, causing her injuries. â€Å"Will that work?† I asked. â€Å"Yes.† She stated while shutting the door and sprinting off in the dark shadows around the buildings. Carlisle was already in the driver's seat, the car starting. I didn't speak, and neither did he during our ride to the hospital, though I could always hear his thoughts. I guess the glass from the window and falling down stairs could account for her injuries. Hum†¦ Alice is truly clever. I can't believe Edward was able to stop when Bella's blood calls to him so absolutely. Two lefts and a right†¦ We pulled into the emergency room lane, Carlisle helped Bella out of the car and handed her back to me. I carried her through the large glass doors as they slid open for me automatically. The nurse at the front desk stood immediately, gasped at the sight of the blood, her thoughts becoming panicky, and ran to get help. Soon there were doctors and more nurses running through the halls, all ready to help her. It pained me to see the slowness that they moved, though their pace was particularly fast considering they were just mere humans. I brushed her face lightly as I placed her on the gurney. â€Å"My name's Dr. Carlisle Cullen. I would like to help in any way that I can. She is like family to me,† Carlisle spoke quickly to the doctor on duty. I knew he was beginning to feel this away about her, but he had never thought or said that statement out loud. She was family, though. To see all of the Cullen's, even Rosalie, ban together to protect the one fragile human that I loved so deeply made me realize that maybe she was my destiny†¦that even after tasting her blood, I was able to keep her alive. I shook my head. It was idiotic to think that way. I would have never tasted her blood if it weren't for me putting her in danger in the first place. This was entirely my fault. She was being rushed to surgery because of me. Her bones are broken†¦she was bit by a vampire! Each thought was a struggle, I saved her, but she wouldn't have needed saving had I never invited her into my secret life. Another thought. When I left Forks†¦if I never returned†¦she would be dead now. I saved her! The battle between right and wrong was taking over my body as I sunk down into the nearest chair and waited for some news. A couple of very long minutes later Alice came prancing through the doors, exultant at her prized display of a fake accident, her eyes were reminiscent. Carlisle came bursting through the big white emergency doors. â€Å"We need permission from her mother or father before she can have surgery.† â€Å"Already done,† Alice trilled. â€Å"She should be calling the hospital in three seconds.† Suddenly the phone rang and the nurses' station picked up. â€Å"Hold on just one minute, Mrs. Dwyer,† the nurse pressed the hold button and then another button to send the call back to the doctor on duty. â€Å"That's my cue,† Carlisle said. â€Å"I'll keep you informed.† He turned on his heal and walked smoothly and gracefully through the doors sending an everything will be all right, thought my way. I sighed and sank down into a chair. I sat still for an hour. A very long hour. I still hadn't recovered from the shock of seeing Bella in such a broken state as I sat there frozen and unmoving. Hate and revulsion were there, squarely in my chest, reminding me of the monster I am. I sat there, silent and unmoving ?C rigid as a wax work while the battle raged inside me. I kept turning cold thinking about what would have happened if I hadn't shown up. I shuddered. Another hour passed, and this one was longer than the first. I begged the earth to crack open and swallow me whole. Alice didn't say anything, just sitting quietly next to me, realizing it wasn't a good time to talk. I hoped to deflect any invitation to join into a conversation with her. Alice continued to gaze dreamily out the window. I heard feet racing down the hall way and I looked to my right as Carlisle busted through the big white emergency doors to report on how Bella was doing. â€Å"She's going to be fine. She will be out of surgery shortly. There was a lot of damage to her leg, but they were able to fix it. She should have no permanent damage,† Carlisle informed me, placing his hand on my shoulder, speaking bracing words of comfort. â€Å"Relax. I'll show you where her room will be.† I leapt to my feet. We walked slowly through the hallways of the hospital; the walls were bland and off white. There was a sickening smell in the air†¦the smell of iodine and death. We reached big metal doors to an elevator. Alice pressed the button to go up, already knowing which room we were going to be in. I waited impatiently for the doors to open. Ding. The elevator doors opened to admit us and we all three stepped through them, Alice once again pressing the button, one that said four. I felt a shifting under me as my stone like body was slowing ascending the many floors of the building. Ding. The doors opened to admit us onto the fourth floor, which was just as boring as the first. â€Å"This way,† Alice said. I followed her until we reached room four-oh-eight. I stepped through the threshold. No Bella. I sank down in the chair next to the bed, waiting once again impatiently. I leaned over and put my head in my hands, trying to dislodge the thoughts and feelings that were consuming my body, setting it aflame and then dousing it with cold water. The scent was still strongly present on my hands. I pulled them away to examine the damage. There was no white space, my hands were covered in scarlet blood. A stubby nurse walked into the room. â€Å"Oh,† she gasped. â€Å"I didn't realize anyone was in here.† I looked up at her and she jumped back several feet. His eyes! I looked away quickly. â€Å"I'll just come back†¦Ã¢â‚¬  she bustled out of the room quickly. â€Å"That's right! I almost forgot,† Alice chimed in. â€Å"What is it, Alice?† I groaned. She tossed me a small white box. I flipped it over in my hands. Contacts. Crap, another reminder, I thought angrily. I went into the bathroom to place the contacts over my bright red eyes†¦bright red because of Bella's blood. All of this because of my†¦need. It was true, I needed Bella. Would I ever be able to leave her and stop bringing danger to her door step? I fluttered my eye as an obstruction fell over my vision. I could see every line and contour of the wretched thing. I pulled the other contact out to place in my other eye. I brought my face close to the mirror, studying it. I was oddly flushed and more pink than normal; my eye was scarlet red because I was full of human blood. The gleaming red eye reminded me of the monster that I am. I sighed and placed the contact in my eye as my vision became obstructed again. I washed my hands thoroughly, watching the water turn red and run down the drain. I walked out of the bathroom. â€Å"Much better,† Alice said. I heard a squeal of wheels being pushed down the lament floor. Be prepared, Carlisle warned. Worry and anxiety filled my stomach like acid as I stood to open the door, realizing I had less resolution than ever.

Prescription Drug Abuse in Teenagers Essay

Although prescription drugs are not harmful if used correctly, prescription drug abuse is high in teenagers. Most parents would never think their teenagers are helping themselves to prescription medicine sitting on ones counter. The truth is, prescription drug abuse in teenagers has become very common nowadays. The drugs are easily accessible at home, or cheap to buy at school. They are highly addictive and can even cause death. Putting one’s prescriptions in a safe place may save a childs life. Prescription drug addiction usually starts with experimentation. Teenagers may be trying prescription drugs because their friends are doing it or it may just be out of curiosity. Some teenagers will turn to prescription drugs to forget their problems. As the addiction progresses, it becomes harder and harder to stop using the prescription drugs (Smith, 2010). Experimentation rarely leads to a good outcome. If one’s child starts with a simple experiment of prescription drug use, odds are it will ultimately end with addiction. Smith (2010), states â€Å"Addiction is a complex disorder characterized by compulsive drug use. People who are addicted feel an overwhelming, uncontrollable need for drugs† (Drug abuse and addiction, para. 1). When one has repeated drug use it will permanently alter the brain. The long-lasting effect on the brain changes ones ability to think, use good judgment, control ones behavior, or feel normal without the drug. It is the drug cravings and compulsions to use that make the addiction so powerful. These cravings and compulsions to use are partly cause by the changes the drugs make to one’s brain (Smith, 2010). The average prescription drug abuser will start between the ages of 12 and 17. Every day about 2,500 teenagers in this age group abuse a prescription drug for the first time (Havens, 2009). â€Å"The number of high school students who are abusing prescription pain relievers such as oxycodone (OxyCotin), a potent and highly addictive opiate, or sedative is on the rise† (Freedman, (2006), para. 3). Stimulants are the most common used, next is opiates, followed by tranquilizers, and then sedatives (Parenting Teens, 2005). The pain relievers such as Vicoden or OxyCotin are used to achieve a high, whereas the sedatives such as Xanax and Valium are used to relax or calm. These drugs can lead to dependence and addiction. Stimulants such as Adderall, Ritalin, Dexedrine, or Provigil decrease ones appetite but increases ones alertness and attention. These are dangerous because they can cause addiction, seizures, or heart attacks. Stimulants are often used to lose weight of for studying. Steroids are used to built ones bodies or promote athletic performance. The dangers involved in consuming steroids are mental and physical health effects as well as serious sexual effects (Havens, 2009). Findings from a 2005 survey conducted by the National Survey on Drug Use and Health â€Å"indicates that approximately 21% of the U. S. population age 12 and older report using any type of prescription drug nonmedically in their lifetime, 16% report us of opiate-type pain killers, 8% report tranquilizer use, 8% report stimulant use, and 2% report sedative use† (Ford, 2008, para. 10). The study also found that substance abuse can cause users to offend the law as well as impair good judgment. However, it has been found that the violations of the law are followed by the abuse of prescription drugs, or other illegal substances. Therefore if one’s teenager is addicted to prescription drugs, legal difficulties will probably follow. The researchers believe substance abuse is a definite road to a delinquent lifestyle (Ford, 2008). Reported prescription drug abuse by high school seniors in 2005 Parenting Teens (2005). According to Freedman (2006), an 18-year-old who lives in San Francisco believes as long as the prescription medication is taken properly, it is much safer than any street drug. According to the findings of the Partnership for a Drug-Free America study, forty percent said prescription were much safer than illegal drugs; while 31 percent said that there was nothing wrong with using prescription drugs once in a while† (â€Å"Prescription-Drug Use by Teens,† (2006), para. 1). Teenagers think that because a medication has a prescription for an individual, it makes it safe for everyone. Several factors are involved in prescribing certain medications such as medical conditions, age, other prescriptions on may be taking and the diagnosis of the individual. Most teenagers do not consider these factors when helping themselves to medications prescribed to someone else. Prescription drugs are easy for a teenager to acquire either from their doctors or from their own medicine cabinets. Most parents are not aware of the risks involved in leaving a bottle of prescription medication lying on the counter for everyone to have access. It will start with taking one or two at a time and then the teenager ultimately proceeds to steeling the entire bottle, buying the prescription medications at school from classmates or even lying to their doctors to obtain their own prescriptions. The increasing popularity of nonmedical prescription drug use is based on the putative advantages of prescription drugs over â€Å"street† drugs: the drugs are easier to obtain, there is less likelihood of arrest, use is more socially accepted, and there is a perception the prescription drugs are safer† (Ford, (2008), para. 10). Prevention is the best tool concerning teenagers and prescription drug abuse. Havens, (2009), â€Å"Most teenagers say parents are not discussing the dangers of prescription drugs with them† (6 Steps to Prevent Prescription Drug Abuse in Teens, para. ). It is the parent’s responsibility to monitor closely the prescription medication in the home and purchase a lock box if necessary to keep one’s teenager safe. One needs to educate one’s teenagers in the dangers of prescription medication and the factors that go into prescribing those medications to each individual. Take it as far as asking the family physician to speak with one’s teenager if necessary. Sometimes they listen to strangers better than their own parents. Take the time to ensure there are no or out-of-date medications in the home. If these medications are no longer needed, dispose of them properly by flushing those (Havens, 2009). Parents are not always aware of how dangerous their own medication can be to their teenagers. MSNBC (2010). Parents also need to educate themselves in the signs associated with prescription drug abuse. Some of the thing one needs to watch for with their teenager behavior is neglecting responsibilities, getting into legal trouble, and even problems with the relationships with one’s friends. If ones teenager is starting to fall on school grades, not do chores at home, or even skipping school a pattern of neglecting responsibilities in beginning to develop. Behavior to watch for in relationships with friends would be losing longtime friends, and sometimes fist fighting with them. One may also be fighting more than usual with one’s siblings or ones boss at the job. The signs of legal trouble can be anywhere from simple disorderly conduct to any type of major crime. If ones teenager suddenly becomes involved with the law, something is wrong (Smith, 2010). The most noticeable physical signs of a prescription drug addiction is if ones pupils are bigger or smaller than normal, ones eyes are bloodshot, grooming habit deteriorate, unusual odor on breath or clothing, slurred speech, bad coordination, and tremors (Smith, 2010). Psychological warnings one can detect are (Smith, 2010), â€Å"Unexplained change in personality or attitude, sudden mood swings, irritability, or anger outbursts, periods of unusual hyperactivity, agitation, or giddiness, lack of motivation; appears lethargic or â€Å"spaced out†, appears fearful, anxious, or paranoid, with no reason† (Drug abuse and addiction, para. 9). Warning signs that tend to show more in teenagers are when one starts being secretive about their friends, one has a new interest in one’s clothing styles, and ones teenager is suddenly in need or more privacy then usual. If one has money, valuables, or prescription medication missing, one may need to consider the possibility of one’s teenager developing a prescription drug addiction. Other common signs are depression, withdrawing from the family, using incense to hide the smell, or eye drops to cover the dilated or bloodshot (Smith, 2010). Drug rehabilitation can be a costly, but necessary, adventure. According to ChooseHelp, (2010), â€Å"the professional staff involvement at any comprehensive and quality rehab facility disallows bargain treatment, and you need to be prepared to spend a significant amount of money to get a quality and effective treatment program (The Cost of Drug Rehab, para. 3). † Considering all cost involved in housing, feeding, drug therapies, and professional involvement, prices can range from a few thousand dollars a month all the way up to $30,000 per month (ChooseHelp, 2010). Several insurance companies will absorb most of the financial burden. One needs to contact one’s private insurance company and receive all details pertaining to this type of treatment. If one contacts one’s local State Drug and Alcohol Rehabilitation Council, there are programs available to those that cannot pay nor have any insurance. One needs to take into consideration the seriousness of this addiction. When it involves a prescription drug addiction, one cannot let the cost be a factor in the determination of the treatment. According to ChooseHelp (2010), â€Å"family programs can help to heal a family harmed by the destruction and heartache of abuse; and bring back a healthier dynamic to the family as a whole (Families Need to be a Part of the Process, para. 3). † One needs to decide how much family involvement will be in the rehab process. Family involvement is extremely important not only for the family but for the addict as well. When family member are learning about the addiction from trained professionals as well as other families facing the same situation, families are taught what is most beneficial for the teen and it assures the family that they are not esponsible for the addiction (ChooseHelp, 2010). When seeking a prescription drug treatment center for teenager one needs to consider a program involving patient education as well as family education. The program should offer counseling sessions with a therapist or psychologist as well as peer group session involving several families. One needs to choose a facility close to home to achieve adequate family involvement (ChooseHelp, 2010). When the rehabilitation program is successfully completed it is also important to continue care in an outside group such as Alcohol Anonymous or Narcotics Anonymous. Information for these meetings can be obtained in one’s local phone book. If the teenager in the home has been acting differently and medication is running out sooner than usual, take the steps necessary to help him or her. Admitting he or she may be addicted to prescription drugs is not easy but the help one can receive for him or her may save his or her life. Pay attention to the warning signs, ask questions at the doctor appointments and try not to have addictive medication prescribed to one’s child, especially if the child has had a problem in the past with any type of addiction. Be careful where prescription medications are located and consider investing in a lock box. It may be a decision that saves ones teenagers’ life. If one discovers one’s teenager has a prescription drug addiction, or any other addiction, do not be afraid to seek help. Money does not need to be an issue in saving ones life. References http://www.choosehelp.com/drug-rehab/families-need-to-be-a-part-of-the-process http://www.choosehelp.com/drug-rehab/the-costs-of-drug-rehab http://today.msnbc.msn.com/id/12803776/ns/health-addictions/

Submit a report to the Directors of USPS diagnosing the state of Assignment

Submit a report to the Directors of USPS diagnosing the state of affairs and offering some prognosis on what might be a more sustainable business model - Assignment Example proud tradition in which the roots of the agency can be traced back to 1775 when the agency was formed for providing postal services on the pre independence era of America. Currently, the USPS is the largest Federal and civilian employer in the country with more than 600,000 direct and on direct employees working for the organization. The contribution and impacts of the USPS can be prominently noted in the society of America. However, in the current times, the USPS as an organization is facing a number of challenges and is showing declining revenues and financial performances at the end of every financial year. Thus, the threat of solvency for the agency has been raised which makes it necessary to analyze the root cause of the depleting competitiveness and efficiency of the organization and to find out ways in which the sustainability of the organization as a value adding agency in the country can be ensured. This report is prepared with the aim of identifying the main reasons that have driven the current low performing state of the USPS and suggesting suitable recommendations and strategies that may enable the agency to regain its position in the market. For this purpose, the product market conditions, the capital market conditions, the external environment of the agency and the challenges faced by the agency are evaluated along with a comparison drawn to another very successful postal agency, the Royal Mail Services in the United Kingdom. The unique feature of the legal and regulatory environment in which the USPS operates is also studied in the report. The strategic business model of the USPS is analyzed and the ways in which modifications can be made to the business model to negate the challenges for the agency are proposed. The business model of any organization or agency comprises of the financial and corporate strategies, philosophies of the organization and the resources and capabilities of the organization. The ways in which a company competes and

Identify the various demographic characteristics of today's workforce Essay

Identify the various demographic characteristics of today's workforce - Essay Example Hall and Hall classified different cultures under the categories of ‘high context and low context’ (1990). Chinese people belong to the high context culture in which context and non-verbal cues are important to assign meaning to spoken words. This means that the same words can have different meanings in different contexts. Further, work discipline like obedience to command, commitment to a word given and personal relationships are important to the Chinese. This is in contrast to the low context culture, typically as in the US, where the spoken words are precise and unambiguous irrespective of the context, individualism and frankness is more pronounced, and personal relations are subordinate to task completion on time. While on the subject of time, a high context workforce handles multiple tasks simultaneously unlike its counterpart in low context cultures, which concentrates one task at a time (Hall and Hall, 1990). These ideas are reinforced by the five dimension classification of Hofstede and Bond and the seven dimension classification of Trompenars (as quoted by Amant, K.S., 2007). An organization benefits from the services of a Chinese migrant worker due to his/her ability to handle multiple tasks simultaneously, respect for authority, collectivism and long-term commitment. Respect for authority implies disciplined approach to complete assigned tasks; collectivism implies the ability to be a good team-member and working to achieve team goals rather than individual goals. Organizations benefit by such workers and teams for whose career development and welfare, long-term planning can be initiated. In order to maximize the benefits of demographic diversity in an organization, the manager should foremost recognize and develop a positive attitude for the culture-specifics for each variety and understand the beneficial aspects. Since Chinese workers in a US plant may be new to the local

Julie Taymor Movie Review Example | Topics and Well Written Essays - 1250 words

Julie Taymor - Movie Review Example She also moved to Japan where she studied puppetry, Japanese plays and general theatre. Julie has stood up as an iconic figure in the film industry, she is among the first female film directors to have a successive conversion of pieces in theatre to film. She has won many awards due to her immense ability. She directed different classic operas in Japan and in the United States. Notable was the â€Å"Oedipus Rex† which earned her an Emmy award; the lion king which earned a Toni’s award and many others that have earned her a place in history books. She is an all round director working well in theatre, operas and films. Titus Titus originally was a play; that is, Titus Andronicus by William Shakespeare. It was adapted and crafted into a movie by the famous and artistic producer; Julie taymor. The movie was released in the year 2000 by Julie. Titus Andronicus is one of the bloodiest and the most gruesome play ever written by Shakespeare. It is a story of betrayal and vengea nce (Berardenelli, 21). In this particular film, it is easy to understand the artistic ability in Julie as she takes to task one of the relatively most unloved plays by Shakespeare and creates it into a huge movie success. There is fusion of times all depicted in the props in use. The costume take us back into the ancient Roman Empire and brings us back to the modern day Italy with an ease that may not be usually simple to depict by most directors. The story which is based on Titus Andronicus who is an aged commander of the Roman Empire’s army return to Rome. He returns after a finished conquering expedition on the Goths. This introductory part has the most artistic directorial ability being manifest; first the idea of casting, Julie here chose to have Anthony Hopkins play the part. Anthony with his powerful voice and steady posture depicts the legendary command in a near perfect way. The role played by his brother Marcus (Colm Feore) was intelligently done as the physical si milarities of the two people is not of great dispute. Titus returns and his brother wants to install him as emperor but he refuses and supports the candidature of one Sartunius who is quickly confirmed and announces that he will get married to his benefactors’ daughter Laviniah. Sartunius’ own brother rejects the claims by Sartunius that he has already been engaged to Laviniah (Titus’ daughter). The emperor chooses another girl and the lucky one being Tamora the Queen of the Goths who had been captured. She schemes’ her way a round to get revenge against Titus who had been responsible for the death of her son. With the help of her lover she causes the death of Bassiunus, allows Laviniah to be raped and mutilated, and further causes the abduction of Titus’ two sons. This revives the violent spirit of Titus. The rage and vengeance creates the subject matter of the film. Julie portrays the reality of the situation without having to make the viewers go through the agony of seeing the violent scenes. She on the contrary indicates the aftermath of the violent scenes perfectly and leaves the rest to imagination without leaving out the nity gritty’s of the script (Holden, 23). Taymor sets pace for the other filmmakers, giving a platform to showcase any script without having to include aspects that may injure the viewer of acts that may not in essence do justice to the piece and their removal does not affect the

Experimentation, Research and Consent for Ethics in Healthcare class Essay - 1

Experimentation, Research and Consent for Ethics in Healthcare class - Essay Example The next question which was raised to importance was when there was no such statement and there existed conflicting interest between the guardians of the patient then whose say would hold importance, that of the spouse or the parents? Along with these two questions, when the media got active a third conflict arose, regarding the rights of the disabled, whether their condition could be misconstrued to be an accent against pro life treatment? The hype was addressed by the then President of the US by passing a bipartisan Bill via which he had invalidated the ruling of the state judge by passing the matter to the federal courts. The reason why this was done was because it was felt by the Senate and the House of Representatives who had passed the Bill that the matter involved Terri’s Constitutional rights.1 The biggest conflict which came into being was also regarding the case being a right to die case or the disability rights case! But life cannot be charted into black and white words, and that’s what public opinion forced the courts to consider-ethical questions. Every person has the right to choose against medical treatment, against any sort of bodily intrusion. Then there is the right to life and personal liberty in contrast to the state’s right of preserving health and its duty to not allow people to commit suicide. This is called the duty of the state to maintain the sanctity of life. To add to this debate, many argued that the basic provision of food and water should not be removed as it is not covered within the ambit of medical treatment and as such law regarding the medical perspective could not guide removal of pipes which ensured regular basic nutrition. The third issue that was raised was whether a doctor is capable to decide on the issue about a miraculous breakthrough in a patient’s condition, especially when the same is steady if not improving. On removal of medicines which reduce

Proposal document Dissertation Example | Topics and Well Written Essays - 750 words

Proposal document - Dissertation Example This can be in form of services industry, business ventures or medical and health care industry. Aims and Objectives: The aims and objectives behind the entire dissertation are to investigate the new modes of communication in form of VOIP. In this regard, making use of VOIP in a particular field and providing benefits not only to the organization but the clients related is one of the main objectives. This would be done by checking its feasibility, its costs, its compatibility and other factors, and this in turn is subject to the study of its infrastructure. The dissertation would further allow for clear understanding of the technology incorporated in VOIP, which will be done so through critical analysis and comparison with other technologies present. Abstract: Using the VOIP services for better services in form of medical and health care sector with focus on the understanding and defining of the core infrastructure and understanding of VOIP. Usage in Medical Alert Systems: For purpos e of sending an alarm and signal, it can be used in times of emergency, the phone line that is synced with the monitoring setup that is established in connection with the phone line that is in place and once the call is established, the infrastructure in place would allow for monitoring and tracing of the location and then based on the VOIP features can provide the desired situation by alerting the other elements. Outlines: Understanding the working of VOIP, the technologies incorporated its strengths and weakness, the adjustments needed in the particular organization under study, checking the compatibility, assessing the present state of technology, potential advantages and possible areas of improvement would be investigated in the overall dissertation. The project will broadly consist of the introduction and abstract part, followed by the literature review part which would investigate the methodical and periodical work that has been conducted over period of time in the field of VO IP and other communication technologies. Work of different experts and technologists who have researched in this field would be brought to light. This would be followed by the research methodology phase of the dissertation which would include the explanation and discussion of the ground level activities and facts related to VOIP. Finally the last part of the dissertation would constitute the findings and analysis portion which would allow for better implementation of the technology in the physical domain. Using the software is also part of the overall project for purpose of pilot test and evaluation. Implementation of VOIP software, providing the data base, and other resources within the hospital and medical field which would facilitate its usage are few of the steps and actions that must be taken into account prior to its implementation. Software tool application would enable for practical demonstration of the VOIP features, its services and its compatibility with other underlying technologies and hardware applications. Software compatibility and designing a software manual according to the desired technological requirements is another core function contained in the overall project. Literature review: The concept of VOIP gained prominence in the early days of 21st century when the technology took a shift towards further enhanced means

8 short essays no more than 1000 words Essay Example | Topics and Well Written Essays - 1000 words

8 short essays no more than 1000 words - Essay Example The failure of a developed education system hinders innovations, decision-making processes and mismanagement of funds. Developed education will change the world since it will also provide equal opportunities for all due to globalization. Business will also benefit from developed education since the major players know what is best for the economy and the industries they are operating thus limiting exploitation. Education is the basic element for societal and industrial development. Acquiring a degree in an economic and business program is a huge step to help me change the world. This degree will equip me with analytical skills, leadership skills, better judgments and decision-making. These values are essential in formulating the best way to assist my government to develop a better education system that will equip the youths with important knowledge that will raise their living standards, make them more innovative knowing that improving their earnings will improve the economy of the country (Avery, Walker & Murphy, 2001). Lack of qualified personnel in major government offices is a major contributor of developing countries suffering during any global crisis. Acquiring this degree will be the first step towards being employed in the government finance office, treasury or corporation whereby I will use the acquired skills to prove to the government the need of changing and developing the educ ation system. I would help the government in major decision-making processes and ensure more funds are invested in developing education. In the next 10 years, technological changes will affect business in various ways both positively and negatively. The Internet is a major technological change that has shaped the current globalization strategy by easing communication thus ensuring that companies can sell or advertise their products via the internet. The companies thus lower advertisement costs. The buyers benefit from

Week 2 email 1 Essay Example | Topics and Well Written Essays - 250 words

Week 2 email 1 - Essay Example After reading Erickson Page 357, something interesting can be learned from this. The physicist, of which we would possibly describe as wise and learned, is unable to articulate the properties of light and acknowledges light as a mystery; however, he does acknowledge that light does exist. Therefore, we as believers in God acknowledge His existence because we have been enlightened by the Holy Spirit. The light of Christ shines in us; as believers we have also experienced general and special revelations because of our faith in Christ Jesus. We live in the Spirit, not in the flesh, so now we have peace with God through the righteousness of Christ Jesus’ blood. As we read in Romans 8:6 â€Å"for to set the mind on the flesh is death, but to set the mind on the Spirit is life and peace.† Our old self is dead, for we were crucified with Christ, and we were born again. God does exist because we have new life in Christ. This new life does not come from our own self, as the self is

Reconstruction Writing Assignment Example | Topics and Well Written Essays - 750 words - 1

Reconstruction Writing - Assignment Example Notably, President Lincoln wanted people to forgive one another and the defeated states to rejoin the Union immediately (â€Å"Houghton Mifflin Company† 1). Conversely, the Radical Republicans in Congress sought to change the South and protect the rights of African Americans (â€Å"Houghton Mifflin Company† 1). Ideally, the United States Congress passed four statutes known as Reconstruction Acts after the civil war, which sought to support Reconstruction by creating five military districts in the South (â€Å"Houghton Mifflin Company† 1). Most specifically, President Lincoln assumed that the defeated states did not seceded from the Union and hence should suffer any punishment. Nevertheless, the Congress opposed his plan. Indeed, when Lincoln died, his successor, President Johnson adopted Lincoln’s plan to the dismay of the Congress. In the reconstruction plan, President Johnson pardoned all Southerners under oath and recognized the governments of defeated states (â€Å"Houghton Mifflin Company† 1). Indeed, by the end of 1865, only one Southern state lacked a new government and suffered from slavery. Nevertheless, the results of the mid-term elections in 1866 eliminated the Presidential Reconstruction and instituted the Congressional Reconstruction as the Radical Republicans gained dominant control in both houses. ... The Congress Reconstruction plan included the establishment of a Freedmen's Bureau to help freed slaves, enactment of the Civil Rights Act of 1866 to protect the freed slaves from black codes, passing the 14th Amendment to protect the Civil Rights Act, and passing the Passage of Reconstruction Acts to bar defeated states from rejoining the Union. More specifically, the Reconstruction plan guaranteed universal manhood suffrage, mandated public school systems, and established progressive tax structures. The Thirteenth, Fourteenth, and Fifteenth Reconstruction Amendments to the United States Constitution sought to help in the implementation of the Reconstruction plan after the Civil war. The amendments empowered the national government over the states where the Thirteenth Amendment ended slavery, Fourteenth Amendment gave blacks full citizenship, and The Fifteenth Amendment recognized the right of African American men to vote (â€Å"Houghton Mifflin Company† 1). Nevertheless, Pre sident Andrew Johnson attempted to veto Congress Reconstruction plans where the Congress had curtailed his powers through the Tenure of Office Act. However, President Andrew Johnson violated the restraining act, which propelled the Congress to impeach him (â€Å"Digital History† 1). Personally, the Congress Reconstruction plan is seemingly the best plan subject to its encouraging results. Indeed, under the Congress Reconstruction plan, black and white people were able to access public schools, homestead exemptions, and there was equal distribution of public resources (â€Å"Prentice Hall† 1). Furthermore, although President Johnson’s plan was significant in appointing military governors to

The renaissance art world and its classical origin Essay Example for Free

The renaissance art world and its classical origin Essay Titan was born in one of the remote areas of Pieve di Gadore, however, he grow to work in Venice. He picked up quickly and become one of the dominant painters, if not the dominant painter of Europe. His oil paintings were the most sort after especially by the courtly and aristocratic patrons. His paintings were considered to be more naturalistic by the art theorists and hence of low perfection in design than the works from Rome and Florence. Towards the end of the eighteenth century, his works began to be appreciated up to the current time where the current scholars have intensified this contextual works. The most famous works by this artist was the Venus of Urbino and it is also the most disputed of his artworks. The intertwined possession themes of a beautiful woman and her image creation permeated the conception of female art by the renaissance. As the old thoughts always asserted that anyone who depicts a beautiful woman will always deserve her, the people of the renaissance may like to transfer these assertions to the art maker. This being the people’s notion, there are many questions which are raised from this. Taking this into account we take this to the paragon extent between Titans and Michelangelo. In renaissance times, the beauty of any female was the lodestone of aesthetics, inspire of the male being taken to be the norm and the female an aberration. The Titan’s woman picture can not only be used to portray his artistic gift but also can be seen as his booster to his rivals of all times. In his competition with his most contemporary rival, Michelangelo, titans uses this artwork to assert of his superiority and his primacy of sculpture paintings of colorito over design and feminine over masculine. The two, Michelangelo and Titan, came to confrontations of the diseno i.e the design and colorito for themselves. Michelangelo tried to make his name by the heroic men like that of David while Titan made reference to the female subject along with their style. Michelangelo shown the inability of the Venetian to draw and equated their disadvantages to their focus on femininity. In his evaluation of the Michelangelo artworks, Aretino allusion that he is more than a angel Devine, shows his promotion of Michelangelo angelic status which were conferred by Aristotle. References Preimesberger, Rudolf (2011). Paragons and Paragone: Van Eyck, Raphael, Michelangelo, Caravaggio, Bernini. Getty Publications John T. Paoletti; Gary M. Radke (2005). Art in Renaissance Italy (3 ed.). Laurence King Publishing. Source document

Eating Together The Culture Of Friday Family Dinner

Eating Together The Culture Of Friday Family Dinner Once in a few hours we think of food and chances are that we at least eat once per day. In the family setting food is easily accessible and for others it may be scarce because of the economy or the geography (Fieldhouse, 2008). At least, a large portion of families can afford what they want whenever they want while others must carefully plan on what they purchase. Nonetheless, no one can escape the biological need of food. This is to say that, everyone must eat at regular intervals whether the food is more or less nutritious. It is true that eating is a necessity of life itself but food also forms a crucial part of the cultural rituals and social relationships. Most importantly this paper addresses the family meal tradition as a symbol and material means of bringing family members together (Fieldhouse, 2008). Across different cultures and time, the aspect of food sharing is a universal medium that expresses fellowship in regards to the values of duty, sacrifice, hospitality and compa ssion. Food sharing is a gesture of friendship also symbolizing trust and interdependency. My family in particular views the Friday night dinner as a window into social bonding and relationship. As my father has always said, people you eat with define the members of your social group and the kind of food you share is a clear indication of the closeness of the relationships. For instance, there are coffee-breaks with colleagues, casual lunch or dinner with acquaintances, and of course informal dinner around the family table for family and friends. Perhaps a common picture that comes in our mind when it comes to the aspect of family dinner is a happy nuclear family with a mom, dad, and kids sitting in a nicely laid table. This is an image that perpetually describes my familys Friday night dinner. This is a tradition that my great grandparents firmly inspired as a cultural idea to be emulated as ultimate symbol of family stability and unity. This paper will look at the different roles of family members in the sustainability of Friday night family dinner examining the traditio n using the Freudian theory, the family theory, and ecological system theory. The paper also takes special considerations on the reflection of this tradition in regard to the influence on the future and its influence on the family. Family Dinner And Family Members The Purpose As a tradition, the family meal symbolizes a shared family life. Family dinner on Fridays in our family organizes the family bringing us together. This heavily contributes to our social well-being while providing predictable structure to our Fridays which is often psychologically reassuring. The success of family dinners depends on a number of factors such as the skills for preparing the food and food-buying (Fieldhouse, 2008). The appearance of the family table requires a lot of time and skilled activities that calls for both physical and mental decision making. In our family, everyone is involved in this activity; that applies to the food buying, preparations, laying the table, and serving. With our participation, it not surprising that the provision of this family meal is a symbolic demonstration that we care for our family unity and stability. This veers more on love, obedience, respect, and gratitude. From the shopping to table clearing, each family member participates in a resp onsible exercise that promotes solidarity in the family. For the longest time we havent experienced a family tension because we share a lot in our conversations at the dinner table. To The Parents During our family dinners my parents focuses on teaching us the way forward on behaviour and in particular civilized behaviour such as saying thank you and please. Excusing yourself before you the table, placing your elbows on the table, and talking on mouth full is normally discouraged. At this time, my parents taught us developmental skills such as manipulating chopsticks, literacy skills through family conversations when exchanging stories. This may seem sheepish but these are the basic fundamentals toward life and social interactions. During conversations, my parents learn more on our interests and attitudes. From these meals, my mother in particular gauges our moods and needs in the end help us solve our problems. My parents monitor the family and ensure that everyone attends to maintain the stability and unity in the family. To The children (Me) For the children the dinner table is crucial place for socialization (Fieldhouse, 2008). This is a prime setting for socialization concerning the norms and rules on family values, accepted behaviour, and expectations. From a nutritional perspective, the children learn what is considered acceptable; basically the foods and non-food. From the family dinners my siblings and I have learned manners and restraints on behaviour that the wider world requires. Through family conversations we learned of our parents attitudes and interests in relations to the world. We always help our mother prepare for the family dinner. As the eldest, I helped my mother prepare the foods and especially the vegetables and desert while my younger siblings have always prepared the table. Though a happy family, we have our setbacks. At the end of the day family members who are already tired after a busy day at work or school and probably maybe irritable meet for a family meal. Discord may arise perceived at the table maybe because of the unacceptable behaviour and injustices. Refusal to eat, complaint on bad cooking or lack of gratitude on what was served on the table are some of the things that can lead to these discord at the dining table. This can turn the peaceful mealtime into battlegrounds were verbal arguments are used as weapons which leads to a resentful silence. Therefore, family dinners have many positive virtues that are occasionally fought with difficulties and negative outcomes which greatly depend on the parenting styles. The Examination Freudian Theory Of Defense Mechanisms In psychology, Freuds input cannot be discredited in the psychodynamic theory. Even though people are no longer believing and utilizing many theories and conclusions, the basis of psychodynamic theory still form a role in theories in psychology. Frauds ego defense is one of the last remaining theories. This is also known as defense mechanism said to actively operate without the consent of the person. These defenses are significantly important when dealing with individuals inter threats. Typically, the ego defense pacts with the thoughts that are unconsciously threatening. Denial. This is perhaps the best known defense mechanism that describes situations where individuals are unable to acknowledge the obvious or face reality. This is the outright refusal to recognize what had happened or what is currently occurring. There was a time my brother and I boycotted the Friday family night dinner and we were hit the movies instead. This started bothering us as we kept thinking of the freshly made lasagne and the family conversations. We were defending ourselves from the happening of our family tradition but the realty soon checked in and we were unable to hold it anymore. Repression. On its basic form, this mechanism is self explanatory. The mechanism acts to keep the information away from the conscious awareness. Keep in mind that memories do not just disappear but they tend to continue influencing our behaviour in the future. For instance, my family and I have repressed memories of shared meals since my childhood which I intend to pass on to my kids. Fixation. This is the stunted movement that individuals feel between psychosexual stages when they experience excessive anxiety and frustration in regards to the next stage of progression. The individual remains fixed on a particular stage. My family and I are fixed to our Friday night dinner and the values it carries. This is a legacy that has been there since the times of my great grandparents. Displacement. This involves taking out the feelings, frustrations, and impulses on less threatening people and objects such as the spouse, pets, and children. A good example to this form of defense mechanism is displaced aggressive that would otherwise lead negative consequences such as urging with the supervisor and instead expressing the anger to people who are less threatening. I remember there was a time that my father had a bad day at work possibly from the pressures from the upper management passing this bitterness to us at the family table. The Theories Ecological Systems Theory (Human Ecology Theory) This theory states that the development of the human beings is inclined to the various types of ecological systems. Urie Bronfenbrenner formulated this theory to explain why we normally behave differently comparatively to how we behave in the presence of our family, work or at school. The human ecology theory accounts that throughout our lifespan we encounter dissimilar environments therefore influencing the way we behave in degrees that vary. These environments are: Micro system. This is the environment setting that we directly have in life such as the parents, friends, teachers, neighbours, and people who surrounds us. We directly have social interaction with these social agents in this setting. In this system, individuals are not passive recipients in regard to experiences, but interactive in the establishments of the social settings. In the course of the family dinner we interact with each other in the establishment of a harmonious family setting. Mesosystem. This involves the interaction of Microsystems in an individuals life. In other words, a work-related experience can be connected to the family experience. For instance, from the family dinners, my parents have taught me civilized manners and respect for others which have helped me establish positive attitude toward by siblings, peers, and teachers. This has also made me feel wanted by people who are actively involved in my life. The exosystem In this system there exists a link where an individual does not have any actively involving role and the context where he or she can actively participate. I am attached to my father than my mother and a few ago my father got a promotion and here and then he was travelling to Africa for a few months for work for several months. We all missed our father and during our Friday night dinner my mother spearheaded and listened to mealtime conversations sometimes she was supportive and sometimes she was not. In the end this made my bond with my even tighter because she was always there when my father was away. The macrosystem This is the actual culture of a person that involves the socioeconomic status of the individual, race, ethnicity, and most importantly the family. Being born in middle class family makes us hard workers and thus the reason why we meet as a family once in a week for dinner- Friday nights. The chronosystem This environment entails the shifts and transitions throughout our lifetime. This engages the socio-historical context influencing an individual. For instance, my great grandparents emphasized on family meals and culture that been passed over in different generations which has positively affected our lives, relationships and how we view the world. The family systems theory This is a theory that considers family as an emotional unit integrating systems thinking when describing complex interaction. For instance if there is anxiety among family members, the anxiety may escalate infectiously affecting all of them. And if this anxiety goes up, the connectedness of the members become stressful than comforting eventually making them feel isolated, out of control, and overwhelmed. Triangles `These are the basic units of stable relationships. These are a system that entails three-person relationships which is seen as the smallest building block of a larger emotional pool. There is no stability in a two-person system and therefore calls for a third party. This is because the tension keeps on shifting between two people is higher than the one involving a third person. When there is too much tension to be contained in one triangle it spreads to a series of interlocking triangles. This is what happens in our family dinner conversations. Sibling position In every family each sibling has a certain position which defines how the children will interact. This influences the childs behaviour and development which predictably have common characteristics. For instance, as the first born in my family i tend to gravitate the leadership position which makes my siblings the followers. During the family dinner meal, my siblings look at me to tell them what to do if i am the one preparing the meal.- who to prepare what or even shop. Differencing This is the capability of separating thinking and feelings. Undifferentiated individuals can separate the way of thinking and the feelings because their intellect is controlled by the way they feel. Thinks makes them not to think rationally while at the same time they are unable to differentiate their feelings form others. Therefore, differentiation is the abily to free yourself from the family, the realization of your involvement in a conflict and not blaming others, and being able to relate with others at emotionally. At times during our dinner times conflicts may arise but we have always solved it before it escalates. We admit to our faults and forgive each other which make us differential. The Reflection On The Tradition (1 page) Is it positive or negative? As a socially integrative function, a share meal brings people together in a web of reciprocal obligations and shared social relationships. Well, we suppose can say that one important aspect that brings people together is a family meal and if people do not gather for this family meal then the crucial weft of the family is sent to abyss (Fieldhouse, 2008). As a routine tradition, Friday family dinner has been most frequent planned ritual in our family which normally take place in our family house. The understanding over time The family meal and dinner in particular has come to represent the dynamics of the family and overtime generations are lamenting on its demise. As early as the 1920s, people were expressing worries on how the leisure activities such as the invention of the car came undermine the value of the family meals (Fieldhouse, 2008). In the times of change, family meals represented stability and perhaps the lament of the lost family may actually be the reactions to feared change in the arrangements and structures of families. The influence and the future In the olden days, dinner was seldom as a ceremonial event (Nancy, Carolina, Time, 2006).

Right Ventricular and Left Ventricular Cardiogenic Shock

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

Essay --

What is type I hypersensitivity? Type I hypersensitivity is also called immediate or anaphylactic hypersensitivity. The reaction may include skin, eyes, nasopharynx, bronchopulmonary tissues and gastrointestinal tract. Hypersensitivity may cause a variety of symptoms from minor health problems to death. The reaction usually takes 15 - 30 minutes from the time of exposure to the antigen, although sometimes it may have a delayed onset from 10 - 12 hours. (#1) Immediate hypersensitivity is mediated by IgE and the primary cellular factor is the mast cell or basophil. The reaction is intensified or modified by platelets, neutrophils and eosinophils. While the mechanism of this reaction is involved in favored production of IgE in response to certain antigens. Some people are more susceptible to type I hypersensitivity then others and the precise mechanism is not known. However, it has been shown that such individuals preferentially produce more of TH2 cells that secrete IL-4, IL-5 and IL-13 which in turn favor IgE class switch. IgE has very high affinity for its receptor (FcÃŽ µ; CD23) on mast cells and basophils. (#1) A succeeding exposure to the same allergen can cause the cross links of the cell-bound IgE and activates the release of numerous pharmacologically active substances. Cross-linking of IgE Fc-receptor is imperative in mast cell activating; mast cell degranulation is followedby increased Ca2+ influx, which is a crucial process; ionophores which increase cytoplasmic Ca2+ also promote degranulation, while agents that deplete cytoplasmic Ca2+ suppress degranulation. Mast cells may be activated by other stimuli such as exercise, emotional stress, anaphylotoxins. These reactions, mediated by agents without IgE-allergen interacti... ...nclude T lymphocytes and monocytes or macrophages. Cytotoxic T cells cause direct damage while helper T cells secrete cytokines which activate cytotoxic T cells that recruit, activate monocytes and macrophages, which cause the bulk of the damage.(#1) The delayed hypersensitivity lacerations mainly contain monocytes and some T cells. Major lymphokines involved in delayed hypersensitivity reaction include monocyte chemotactic factor, interleukin-2, interferon-gamma, TNF alpha/beta, etc. (#1) Analytical tests in type IV hypersensitivity include delayed cutaneous reaction and patch test. In vitro tests for delayed hypersensitivity include mitogenic response, lympho-cytotoxicity and IL-2 production. Corticosteroids and other immunosuppressive agents are used in treatment. The diseases associated with type IV hypersensitivity are tuberculin test, poison ivy and granuloma.

Poe :: essays research papers

Edgar Allan Poe   Ã‚  Ã‚  Ã‚  Ã‚  Literary critism is extremely essential in the understanding of literature works. Critism on Edgar Allan Poe varies with poems, short stories, and other literary works. Harold Bloom has published two books maybe even more on the critism and interpretation of Edgar Allan Poe’s works. In both of these books there are other authors and critics, explaing and evaluating Poe’s works. Some critical view points are on his poems, others are on his short stories, and some are just on his style of writing. Since Edgar Allan Poe has published many poems and short stories over a period of time it is no wonder why there is so much critism on his works.   Ã‚  Ã‚  Ã‚  Ã‚  In Daniel Hoffman’s book â€Å" Poe Poe Poe Poe† , he tells a story about a professor who is to lecture about Poe’s poetry. Before the professor begins to read one of Poe’s poems, he states â€Å" No poet in the English tongue who is still read with reverence has committed such gaffes against the genius of our language, nor has written lines of comparable banality.† ( Hoffman, p. 20 ). This explains how other poets respect and admire the poems written by Edgar Allan Poe . There is not just admiration and respect for Poe’s poems, there is also negative critism. A critic named John Neal stated If Edgar Allan Poe of Baltimore whose lines About â€Å" Heaven† , though he professes to r- Egard them as all together superior to any thing in the whole range of American poetry, Save two or three trifles referred to, are non- sense, rather exquisite nonsense- would but do himself justice (he) might make a beautiful and perhaps a magnificent poem. (Neal, p. 35). This is not exactly negative critisim, but it is not recognizing Poe as a magnificent poet as most other people do. Shoshana Felman does not give her own opinion of Poe, but tells how the rest of society sees him. She states the Poe is both highly acclaimed, and violently disclaimed as a poet. She also says that he is the most controversial, and thoroughly misunderstood figure in the American literary scene.   Ã‚  Ã‚  Ã‚  Ã‚  Not only are Poe’s poems controversial and misunderstood, but so are his short stories or â€Å" tales â€Å". Not everybody finds them controversial though, some people admire them and find â€Å" genius â€Å" in them. D.H. Lawrence sees Poe more as a scientist than an artist. D.H.