Monday, September 30, 2019
A Hmong Child, Her Doctors and American Tragedy Essay
Introduction            America is known for having a culturally diverse society. The Hmong Group is among the population of the said society. In the story entitled â€Å"The Spirit Catches You and You Fall Down†, which was written by Anne Fadiman, the main character came from the said ethnic group. The Hmong ethnic tribe is known for their knowledge and practice of traditional and primitive medical processes in healing their sick members. Based upon their beliefs of spirits, they usually create their medical observations on the patients and later on apply the practices they know are needed for the patient’s recovery. The question is that â€Å"since their traditional practices have been proven effective for many members of their group for the past years of their history, does it guarantee that their ways of healing the patients that they treat are better than that of medical processes? Is there any possibility that the medical practices of the modern medicine be integrated with the cultural ways of the ethnic groups and still gain better results on the patient’s recovery later on? How effective could the said kind of medical processes be when it comes to actual application? These questions with regards to culture and its effect and influence towards medication would be the main topic of this paper and the subject of the discussions that would follow. About The Case            The story, as written by Anne Fadiman involves a young child who is afflicted with a serious illness. The girl’s name is Lia, a preschooler who has been experiencing developmental delay since she was in her younger years. As she grew up, she developed more serious health problems such as major seizures every now and then accompanied by several series of severe convulsions and cerebral Anoxia. Because of the said situation, the young child was profoundly impaired and physically incapable of doing the normal things that a young child naturally does. She was not playful and she had fewer chances when she used to react on the situations that are happening around her.            The parents of Lia, who were traditional Hmongs, believe in their cultural medication. Hence, whenever she passes out, or looses her consciousness, they claim that it is simply because she has ‘lost her soul’ and thus needs to  receive ritual practices to be able to regain her own self. For several times of having seizures, the ethnic elder of their tribe has tried reviving the young girl through ceremonial ministries and application of herbal medicines which were prayed over for her benefit.            Upon knowing this, the medical experts who used to handle Lia’s case before she went home believed that the further developments of her illness towards becoming worse was caused by the neglect of her parents in giving her anti-convulsant medications. The said anti-convulsants are known to be strong and really affect the system of the child as it tries to ‘repair’ the damaged brain tissues of the child every time she looses her consciousness.            Later on, the medical practitioners who were supposed to both evaluate and take charge of Lia’s health situation was moved to get the child from her parents and bring her to a medical center where they believed she could be more closely observed and cured as well.            However, the medical processes used by the said practitioners were not as successful as they believed it would be. As for a fact, the terminality of the case of Lia even pushed to a worst condition until her parents were advised to take her back home, especially when they started to believe that her case could not be met anymore and that there is only a little time left before she dies.            Upon coming home, the tribe or the ethnic group of Lia performed several rituals again which they strongly believed would help her recover. As a result [as the tribe members claim] is that the young girl did not die. However, she was brain dead. This means that although she still breaths, her brain does not function anymore making the other systems of her body useless as of the said moment.            Knowing the situation behind Lia’s case, a Diagnostic and Statistical Manual (DSM) Protocol shall be created regarding her case. Hence, by doing so, the author of this paper hopes to help in turning the situation around by answering the question â€Å"What could have been done that could have contributed better on the progress of the healing process of Lia?†The DSM Protocol            The process of pre-medication and therapeutical approach towards the illness shall be applied on the DSM protocol that follows: Interview The interview shall be performed for the sake of creating a basis for the creation of the medical protocol that needs to be applied for cases such as that of Lia. The interview then would be addressed to several parties that are involved in the direct healing practice that needs to be applied for the patient. The said interview is subdivided into three major sections. Interview with the Parents of the Patient Since they are the ones who regularly attend to the patient and are also the ones who are directly affected by the illness of the child, it would be best to know how they are able to give the child’s needs amidst her health situation. It would also help if they would be asked on what kind of ‘home nurses’ they are to be able to meet the medical requirements of their child’s health status. The interview shall help the psychology experts to understand the environment of the child and thus identify what factors [may include emotional and social] affects the healing development of the patient. Interview with the Physician The Physician’s records as well as his own opinion towards the health situations of the patient are among the important sectors of this research. To be able to know the medical observations that they have done towards the patient’s situation, the development of the therapeutic process would be more practical and medically authorized. Interview with the Elders of the Ethnic Group An interview with the elders or the chief leaders of the ethnic group that the patient is joined with would help the person analyzing the situation to gain some knowledge about the basic cultural background of the patient and how the said traditional practices could be incorporated into the medical practice that would be applied to then patient afterwards. Tests The tests would involve oral, practical and medical tests: Oral tests This would be done with the patient [Lia]. This test would measure the development of the child with regards to the mental reasoning that she is able to use as she is asked some questions. [the author of this paper preempts that the patient is still at the first stage of her illness when she is still having slight seizures pertaining to the developing status of her illness. Practical tests This test involves both the parents and the child. They would be asked on how they are able to meet the challenges of the situation together. It should also include the ways by which they are able to treat their child during situations wherein their child experiences seizure and other health problems relayed to it. [It could be an inquiry on what they value better, the medical ways of healing their child or the traditional ways of dealing with the said health problem] Medical Tests The medical tests are almost the same as that of the interview with the physician attending to Lia’s case. Only this time, it would be based from the hard copy of the medical tests that have been made to identify the child’s sickness. Observation The observation on the patient would be based on both the written output of the interviews and tests that were done on the earlier part of the protocol, as well as with the actual observation of the situation of the patient during regular days. Life Records This mainly involves the observation and analysis of the life of the child as an infant and how she was taken care of by her parents. It would also be a measure on how the tribe tried to help in the child’s recovery through the application f traditional practices and cultural beliefs. This would allow the one working on the analysis to understand the possible sources of the aggravating health situation of the child. Assessment This process involves a more in depth observation of the situation. Assessment of the results that were collected would be incorporated within the healing [therapeutic] processes of medicating the patient. Clinical Inference After all the processes are done, it could be expected that the clinical application of the healing process could already be done.  The pre-trial and the actual application would help the patient, the relatives and the physicians involved in the case understand the importance of working together to be able to complete the healing process.            With the application of the said protocol comprising of six major processes, it could be noticed that the author of this paper aims to integrate some of the cultural practices within the healing process not only to avoid ethical issues and cultural conflicts in the progress of the healing the patient but also to evaluate ways buy which some of the cultural practices of the said ethnic group could help in the process of healing. Hmong Cultural Sensitivities            There are three major ways by which the Hmongs treat their patients. Most often, they tend to base this from their own diagnosis of the situation. As for Lia’s case, they believed that every time she passes out or losses her consciousness, she looses her soul. Thus they have to apply the three major practices to be able to regain her back. The three practices are as follows: Herbal Medicine application (A leaf that has been prayed over is applied on Lia’s body to regain her strength) Ceremonial Ministrations of a traditional practitioner (involves the prayers ad some group rituals that the ethnic tribe does to call the spirit of Lia back to her body) Sacrificing of Animals (Most often that not, this rituals are focused towards the gods of the tribes as a way by which they ask for the guidance of their gods for assistance in healing the sick member of the group) With the three major traditional ways that the Hmongs use, it could be noticed that the most important factor there is that has strong possibilities of being incorporated in a medical process is the use of herbal medicine. The reason behind this shall be tackled in the paragraphs to follow.            ON HERBAL MEDICATION            Although man’s use of synthetic drugs is a modern medical development, plant extracts have been used as cures for common ills for thousands of years. Early Assyrian records describe the use of the common anemone to alleviate pain. And Egyptian medical papyri from the time of the Pharaohs reveal a widespread use of medicinal plants. (Duke, 54) The World Health Organization has recorded the use of about 20,000 medicinal plants worldwide. In Britain alone an estimated 6,000 to 7,000 tons of herbs are used annually as ingredients in some 5,500 different herbal products, and in the United States, it has been reckoned that over half of all doctors’ prescriptions are for medicines derived from plants. With as many as 250,000 known species of plants in the world, each possessing a potentially unique chemistry, scientists constantly look for clues to find useful medicines (Mowrey, 87). One of the obvious ways is to study how people treat ailments using plants growing in their locality. The discovery of cocaine started with the observation that chewing coca leaves deadened hunger pangs and eased fatigue. By isolating and modifying the structure of the cocaine molecule, chemists produced a synthetic derivative for use as a local anesthetic. Much valuable information on the use of plants is still filed away in botanical collections. Scientists who spent over four years examining 2.5 million specimens in the Gray Herbarium and Arnold Arboretum of Harvard University were able to pinpoint more than 5,000 plant species previously overlooked as potential sources of medicines. (Duke, 54) Another line of inquiry compares the chemical contents of plants. If one species contains useful compounds, related species may also be valuable. When work on a north Australian tree, the Moreton Bay chestnut, isolated castanospermine, a poison displaying antiviral activity, botanists searching for related trees suggested looking at the South American Alexa. (Chevallier, 63) It could be noted that the use of herbal medicines could out do some of the effects of the strong anti convulsant medicines that Lia received from her physicians. Hence, through the incorporation of herbal medication in the healing process it could be expected that the process would yield better results. New Culturally Sensitive Protocol            In any healing process, it should be realized that the involvement of the family, the relatives as well as the society that roams around the patient is a very important factor of the restoration process for the patient being treated Hence, in this section, a more culturally sensitive protocol shall be created: Creation of a Physician-Parent relationship This would help the physician and the parents of the patient work together through the incorporation of the cultural practices of the family in the medical process. The physicians must study if the herbal medicines would do no harm in reaction to the existing medical processes applied towards the patient. In a way, this could take time, but carefully considering things with regards the issues involved in the medication could even shorten the period of healing that is required for the patient. Integration of the Processes Close enough to the first stage; this involves more of the cultural or ethnic chieftains of the group where the patient belongs to. Their realization of the fact that some of their rituals may not be that applicable on the situation of the patient and thus would not be incorporated into the system, would help them cooperate with the healing process provided by the medical experts. Evaluation of the Strengths and Weaknesses of the New Protocol            As clearly seen, the process involves in depth study which may require time and stress on the physicians since they are at some point controlled with the way they are supposed to deal with the situation. However, thru realization of the fact that emotional and social acceptance is important for the patient’s recovery would enable them to meet with the said challenge to their profession.            However, if carefully applied, this process could help both parties [medicine and culture] see the importance of each sectors of medication and thus create better ways of healing the patients based form then practices that both social sectors accept. Conclusion            In this analysis, it could be noted that at some point, giving importance to the cultural background as well as the cultural practices of an ethnic group with regards to medicine could help in the development of medical practices that are used towards patients today. It is seen that by doing so, the integration of two worlds to result to better medical development could be considered as a way by which medicine could further progress its practices.            After all, the ancient times when people lived longer lives and dealt with less complicated diseases, people appreciated herbal and other traditional ways of medication even before modern medicine was discovered. Going back to the original cure would sure not be a hindrance to further medical progress in the future. BIBLIOGRAPHY Anne Fadiman. (1998). The spirit catches you and you fall down. http://www.spiritcatchesyou.com/bookexcerpt.htm. (December 15, 2006). Growth House Incorporated. (1999). A Hmong Child, Her American Doctors, and the Collision of Two Cultures. http://www.growthhouse.org/books/fadiman.htm. (December 15, 2006). Books: Andrew Chevallier. (2000). Encyclopedia of Herbal Medicine: The Definitive Home Reference Guide to 550 Key Herbs with all their Uses as Remedies for Common Ailments. DK ADULT; Revised edition. James A. Duke. (1998). The Green Pharmacy: The Ultimate Compendium Of Natural Remedies From The World’s Foremost Authority On Healing Herbs. St. Martin’s Paperbacks. Daniel Mowrey. (1986). Scientific Validation of Herbal Medicine. McGraw-Hill; 1 edition.
Sunday, September 29, 2019
Complexometric Determination of Water Hardness Essay
The water hardness for unknown water sample number 40 was determined. From the results of the two complexometric titrations, the water hardness of the unknown sample was calculated to be 250.9 ppm CaCO3, which agrees with the ranges of acceptable water hardness in the city of Phoenix and Tempe Arizona. Introduction When rainfall picks up impurities from the soil, ions of sodium, magnesium, calcium, iron, and other metals are dissolved into the water. These impurities are what cause residues left on glassware from the reaction with the soap used for cleaning. Water hardness is from the metal ions with a +2 charge or higher being dissolved into the rainfall. When reporting water hardness, it is reported in units of mg CaCo3/L of solution, or in ppm due to one mg of solute having one millionth of the mass of a liter of water or dilute aqueous solution. It is reported using only CaCo3 because typically, Calcium is the largest contributor to the water hardness. The purpose of this experiment was to determine the concentration of metal ion impurities in an unknown sample of hard water by performing a complexometric titration with EDTA. The results were then compared to the expected range for municipal water hardness from multiple city websites. Methods All procedures from the CHM 152 Lab, Complexometric Determination of Water Hardness (1) were followed precisely. Unknown water sample #40 was mixed with approximately 20 ml of DI water, 3.0 ml of Ammonia/Ammonium Chloride (NH(aq) Buffer pH=10), and 4 drops of Eriochrome Black T indicator solution. It was then titrated with .004197 M EDTA, which was also made in the lab from 0.7582 g of , added to 500 mL of DI water, that was then standardized with a stock Calcium Ion Solution (CaCO(aq) 1.00g/1.00L) by titration. A total of 3 titration trials were completed to find the average molarity of the EDTA, and the average water hardness of unknown water sample #40. All mass measurements were taken from a AND Balance, serial number 12321601 and all titrations were done using a KIMAX buret, #173. Pipet measurements were taken from a 25mL Bel-Art, and 15mL Bel-Art pipet. The numerical techniques used in this experiment were, stoichiometry with mole ratio for calculating the molarity of the EDTA solution and water hardness and relative average absolute deviation in ppt to show how closely the results from the Standardized EDTA titration of each trial agree with each other. Data Analysis Based on the experiment and calculations, the average calculated concentration of metal ion impurities (water hardness) in unknown sample number 40 from this experiment was 250.9 ppm. From table 1, the average molarity of the titrated was calculated to be 0.004197 M. Table 1 The molarity of the EDTA solution for each trial n was calculated as follows: .0.01000 L CaCO3 SolnTotal EDTA Delivered LÃâ€"1.000 g CaCO31 L CaCO3 SolnÃâ€"1 mol CaCO3100.1 g CaCO3Ãâ€"1 mol Na2EDTA1 mol CaCO3=Molarity of Trial n The Average Molarity of the EDTA solution was calculated as follows: Average Molarity of EDTA Solution =Calculated molarity from each trialNumber of titration trials To determine how closely the results of each trial from the Standard Disodium EDTA titration (Table 1) agreed with each other, a relative average absolute deviation calculation was done. It was calculated as follows: Absolute deviation for trial n= Na2EDTA avg molarity-Total Na2EDTA Trial n absolute deviations3Na2EDTA avg molarityÃâ€"1000=Estimated Prescision (ppt) The results of the above calculation came out to be 14.45 ppt. With the expected range of precision being at most five parts per thousand, it has been observed that the molarity of the standard Disodium EDTA solution includes some obvious error. It seems that the observation of color change when Na2EDTA was titrated to the mixture of CaCO3, DI water, Eriochrome Black T, and ammonia/ammonium chloride was the most error prone. Not knowing when to stop titrating the EDTA solution, would have accounted for a misreading of measurement for the total volume of EDTA solution added to complete the titration, making the final molarity for that trial less than what was expected. Table 2 Based on the molarity results from table 1 and the data from table 2, the average calculated water hardness of unknown water sample 40 was calculated to be 250.9 ppm CaCO3. The water hardness of unknown water sample 40 for each individual trial was calculated as follows: =Total EDTA soln Delivered L0.02500 L CaCO3 solnÃâ€"0.004197 mol EDTA1 L EDTA solnÃâ€"1 mol CaCO31 mol EDTAÃâ€"100.1 g CaCO31 mol CaCO3Ãâ€"1000mg1.0 g Average Water Hardness (ppm)≠¡mg CaCO31 L CaCO3 Interpretation of Results Based on the data, the calculated water hardness of the unknown sample number 40 (250.9 ppm), is within range of the city of Phoenix’s calculated range of 164-291 ppm (2) and the city of Tempe’s calculate range of 150-400 ppm (3). References 1. Complexometric Determination of Water Hardness, Procedures, Mesa Community College CHM152LL website, http://www.physci.mc.maricopa.edu/Chemistry/CHM152/index.html, accessed 9/7/2013. 2. City of Phoenix website. http://phoenix.gov/waterservices/quality/index.html, accessed 9/8/2013. Copyright 2013 3. City of Tempe Az website. https://www.tempe.gov/index.aspx?page=1289#Hardness, accessed 9/8/2013. Copyright
Saturday, September 28, 2019
Abuse of the Innocent Essays - Animal Welfare, Cruelty To Animals
Abuse of the Innocent Is it right to force a mouse to live it's live in a laboratory cage to test anti-cancer drug? How would you like to be squeezed in a cage with many other animals, not being able to touch the grass, run around and play, smell the flowers, or go for a walk in the warmth of the sunshine? Animal cruelty is wrong because we are hurting the Innocent. Animals experience and feel pain, fear , anxiety, stress, depression, boredom, joy and happiness. Animals are very intelligent, some ever learn our own language. Most people experience their first bond with an animal. Not only do they bring a companion and a friend into our lives, but also unconditional love and comfort. Pet shops and puppy mills mass produce, kennels are overcrowded and dirty, with very little nutrition. Cats/dogs are held in metal cages and lead miserable lives breeding continuously. Animals suffer and are neglected, some are sold to research laboratories. A large number of animals are raised for slaughter each year. A cow "has a natural life span of twenty- five to thirty years, but only survives for an average of five".1 An estimated "seventeen million raccoons, beavers, bobcats, lynx, coyotes, muskrats, nutria, and other animals are trapped each year in the United States for fur".2 They suffer from unbearable pain for several hours before their lives are ended by the trapper's club. Is the price of live worth the price of fur? Psalm 104, 27-30. All creatures depend on you to feed them throughout the year: you provide the food they eat, with generous hands you satisfy their hunger. You turn your face away, they suffer. You stop their breath, they die and revert to dust. You give breath, fresh life begins, you keep renewing the world. Disections have been practiced in biology classes for many years. Critics accuse some teachers of killing and argue that disection teaches nothing but cruelty. Nothing is learned by cutting up an animal that cannot be learned from photographs or drawings. Children do not learn about the human body by killing and disecting a person, they learn from diagrams and textbooks. Vivisection means "cutting alive". It is a worldwide practice involving millions of animals. Scientists say that vivisections may not necessarily be painful. Every living being with a brain, spinal column, and central nervous system feels pain. Animals were not created for entertainment. What do zoos really teach children? The animals are stolen from their natural habitats and are brutally transferred. They suffer from boredom and have natural needs such as running, climbing, flying, and natural mating. All of the magic and glitter of the circus hides the true animal cruelty. Several animals are confined to small cages, muzzled, and repeatedly whipped in training. They are declawed, have their teeth removed, and drugged to be obedient. Military research on animals include monkeys, baboons, rats, guinea pigs, sheep, dogs, cats, rabbits, and mice. "... when I see my closest relative locked in a restraining box, his head filled with electrodes, and all he has got to reach out to you is with his eyes, then how can we respond to that if we close ours?".3 Weapons are tested on innocent animals, nerve gas, bullets, and bombs are all used. "One sad insight is gleaned from this statement, made by a Porton workman who lost his bearings: 'I thought I was ill, I thought I was seeing things. It was a little monkey enclosed In a glass cage. Its eyes seemed to be falling out and it couldn't breathe. It was in dreadful, dreadful distress. I forgot everything and went near it and said something to it, and it buried its head in it's arms and sobbed like a child. I never slept that night, and the next day managed to go back to the same room, but it was nearly finished by then. It had sunk to a little heap at the bottom of the glass cage.'."4 Animal cruelty is wrong, we are hurting the innocent. Cruelty of animals can be stopped, not only do we have to open our eyes, but open our mouths as well. Read a book, write a letter, join a group or start a group, either way, an animal will be grateful for the chance of a happy life. 656 End Notes 1. Loraine Kay, Living Without Cruelty, (London: Sidwick & Jackson, 1990), p.15. 2. Laura Fraser, The Animal
Friday, September 27, 2019
International Developments That Have Critical Implication for Essay
International Developments That Have Critical Implication for International HRM - Essay Example A number of important international developments are presently taking place that has critical implication for international HRM. They include; (a) the growth of multinationals in the emerging markets, (b) constant increment levels of foreign direct investments, (c) the growing power of cross-border alliances (M&As) that involve companies from the emerging markets, (d) a growing trend in business process outsourcing, and (e) the challenges posed by the current financial crisis and the way to manage effectively in difficult times. The emerging international economic scenario characterized by the rise of economically stronger emerging markets is creating serious challenges for the IHRM policymakers; however, the same scenario lays immense opportunities for the IHRM researchers. The model of strategic international HRM (SIHRM) is based on the earliest and most famous article by Schuler, Dowling and De Cieri. The model describes endogenous and exogenous factors and strategic components th at have an effect on SIHRM policies, issues, functions, and practices. They, in turn, affect the MNC goals such as efficiency, learning, flexibility, effectiveness, responsiveness, and transfer. According to the model, the external factors (industry characteristics, country-regional characteristics and inter-organizational networks) have an effect on the internal organizational factors, strategic HRM and MNE (multinational enterprise) concerns and goals. The internal organizational factors, strategic HRM and MNE concerns and goals affect each other. The internal organizational factors include; (a) MNE structure – structure of the international operations, intra-organizational networks, mechanisms of coordination, and modes of operations, (b) MNE strategy – corporative level strategy and business level strategy, (c) experience in the management of international operations, and (d) headquarters international orientation. Strategic HRM entails HR function strategy and HR practices. MNE concerns and goals entail competitiveness, efficiency, the balance of local responsiveness and international integration, and flexibility.
Thursday, September 26, 2019
Theology Essay Example | Topics and Well Written Essays - 500 words
Theology - Essay Example By nature, man is a religious being. His belief systems, and his concept of his Maker, make up a very core part of his personality. Religious activities, such as going to church, are the norm in every society. Non-believers constitute a miniscule minority in the world. Culture, social activities and even politics, are all based on religion. In this context, religious studies serve as an essential tool to the understanding of ourselves and of the society in which we live. It is no longer possible to live in a ‘religious vacuum,’ solely consisting of the knowledge of one’s own religion. The magic of technology has shrunk the world, and borders are increasingly becoming mere geographical features. The free movement of people has brought all religions together in close proximity. For example, practices such as transcendental meditation and yoga, which were previously considered to be a part of religion, are now a part of the culture of healthy living. When I consider my choice of a liberal education, I realize that the main attraction is the opportunity to gain a holistic education, which will help me develop a well-rounded personality.
Expanding a Business from UK in Canada (International Business Law) Essay
Expanding a Business from UK in Canada (International Business Law) - Essay Example All other important legal and labor details pertaining to the creation of the business will be included in this report. Background Alan Brandon, who has a stake in several UK companies plan to expand two of his companies by opening either a branch or a subsidiary in Canada. These two companies are doing well in the past three years and he believes that it be profitable to start expanding abroad. The two companies are Definitely-Maybe PLC, a public limited company that produces chocolates and Ultra-educators Software Limited, a Software services company that designs educational Software. The Board of Directors has given their go signal to expand given the report of Mr. Brandon’s team that the business is feasible in Canada and is likely to succeed. This report is made, at Mr. Alan Brandon’s behest, to show to the Board of Directors what is in store for them when they bring the business in Canada. Objectives It is the objective of this paper to show to the mother companie s of both UK-based Definitely-Maybe and Ultra-Educators what entails the expansion of their businesses from UK to Canada in terms of new jurisdiction, legal, sale, technical and tax aspects. This report is basically presented from the legal perspective to ensure the management of possible legal risks. Failure to do so could result into substantial impact on the profitability or commercial transactions that could be detrimental to the life of the company. Scope This report will be enumerating the possible risks Definitely-Maybe may be exposed to if it embarks on the exportation of chocolates to Canada. It will also present the options open to Ultra-Educators in terms of the form of corporate entity that is best suited to it in Canada, including the details and requirements in implementing it. This report will also touch on the treaties and agreements that could be applied to the business and how it may benefit the company as well as the other pertinent labor and immigration issues th at the new companies are likely to come across with. Results Importing Chocolates in Canada It is considered to be a regulated activity if commercial goods are imported into Canada. The government agency in charge of such activity is the Canada Border Services Agency. It is the entity that enforces the regulations for import. Before a company can begin importing products to Canada, an import/export number must first be obtained from the Canada Revenue Agency (CRA) and added to the company’s regular business number. Second, the products to be imported must be identified clearly and explicitly. In what country the products are from and in what country they are manufactured must also be determined. The company must see to it that the products are not prohibited in being imported to Canada. Examples of such products include products manufactured by prisoners, reprints of Canadian works with copyright protection, certain birds, counterfeit currencies, all kinds of second-hand airc rafts, with no exceptions, all kinds of second-hand automobiles, except those from the US, all materials regarded as child pornography, hate propaganda, rebellious, treasonable, or obscene, etc. Next, the company should see whether or not the products to be imported are subject to other requirements or restrictions. Once the company has guaranteed that the products can be legally imported to
Wednesday, September 25, 2019
Perception and Cognition Essay Example | Topics and Well Written Essays - 2000 words
Perception and Cognition - Essay Example The things we do consciously are influenced by the unconscious mind - our actions are the effects of stimuli which we are unaware of. There have been various interpretations in this regard. According to cognitive psychology, unconscious information processing likened to subliminal message processing (idea opposed by authors because they thought the definition was unnatural and restrictive). (09No) In Evolution: evolutionary changes occurred as a result of unconscious processes - there was no conscious thought that went into evolution and adaptation; For example, things like culture and early learning - we don't think about our culture - we are surrounded by it from an early age and information gets stored in our unconscious mind without our being aware of it - it is inherent. Same with Early Learning - we learn lots of things at a very young age, which are inherent traits of human kind, which we again, don't consciously think about (for instance, kids, especially infants, learn behavior by "passive imitation" of parents or friends; as infants we unconsciously learn by experience - as we grow up, those learned behaviors/actions/values stay with us, and are stored in the unconscious mind - later in life, we don't consciously think about these things - we just know them to be true) All these characteristics have been oft associate... There is a distinct line between conscious and unconscious goal pursuit. Keeping in perspective the recent evolutionary arrival of modes of though and behavior, it is probably that the conscious goal is directly or indirectly related to unconscious motivational structures. We are predisposed, conditioned (genetically predisposed - this is an effect of evolution) as a human race to prefer certain "aspects of our environment over others" -these are perhaps linked to the behaviors we learn as infants. For instance in various Muslim families, it has been inculcated in the minds of their females that physical intimacy with men is a no and nor are revealing clothes allowed. They are asked to adapt and mould themselves in this peculiar lifestyle where they shun themselves from the society in general and set their goal in such a way where nurturing their kids and serving their husbands in future becomes central to their survival. This is result of environmental and social pressure most of which becomes innate in the female inhabitant in such families. (Iceberg Metaphor and Unconscious Mind) Another theory suggests that impulse to act upon a stimuli is an unconscious behavior - the impulse is produced unconsciously, and then the conscious mind takes over; plethora of impulses that are driven by behavioral and cultural norms and or our values/traditions. Some people react at the sight of lizards or their mention without even without seeing the poor animal. This is because a certain kind of unconscious fear exists in the back of their mind about it. Their reaction for the same is involuntary. It rests at the back of their mind subconsciously which tends to act as prime motivator for the same. We are unconsciously inclined towards certain things over others (certain
Tuesday, September 24, 2019
Compare Dante (the divine comedy) and Odyssey Essay
Compare Dante (the divine comedy) and Odyssey - Essay Example ‘The Divine Comedy’ by Dante and ‘Odyssey’ by Homer are two such pieces that can be compared. The former is the story of the â€Å"Christian afterlife†and the journey through the various circles of Heaven and Hell, that stand for the various sins committed in life on Earth. The latter, is the story fo the journey of Odyssey or Ulysses, after the Trojan War, to Ithaca which is his home. One of the striking similarities between the two pieces is the form. Both the pieces of Literature are written in the form of an Epic Poem. This form is inclusive of journey, heroic acts, tests and sacrifices, teachings and other transitions. The Divine Comedy is an Italian epic poem, while the Odyssey is a Greek one. Both the pieces of literature begin medias res. In other words, they start off in the middle of action or in the mid-life. The Divine Comedy, for instance starts off after the individual has lived his transient life on earth and progresses towards the permanent life in Heaven. The Odyssey, on the other hand, starts of after the Trojan War and describes the ten years of Ulysses’ journey back to Ithaca. Thus, both start of mid-action. The structure is more or less similar, on account of the segregation and demarcation of the whole epic poem into different segments. Be it the Inferno, Purgatorio and Paradiso or the twenty-four books of the Odyssey, it is more or less the same. However, there are quite a number of dissimilarities as well. While the form of the epic poetry is similar, the theme varies. While The Divine Comedy deals with the theology of the Christian faith and the elements of medieval belief as kindled
Monday, September 23, 2019
Psychology (personality) Essay Example | Topics and Well Written Essays - 250 words
Psychology (personality) - Essay Example Adler’s strategies can be compared to various points of scripture from the Bible. From the point of both aggression and withdrawal, the section of Genesis in which the Lord expels Adam and Eve from the Garden of Eden is applicable. â€Å"Because thou hast†¦ eaten of the tree, of which I commanded thee, saying Thou shalt not eat of it: cursed is the ground for thy sake; in sorrow shalt thou eat of it all the days of they life†(Holy, 1945). This passage shows both agression and withdrawal, because the Lord is aggressively expelling the couple, and they are being made to withdraw into the world. There tends to be more about punishment in Genesis, showing more aggression. Excuses can also be explained and correlated to scriptures and sections of the Bible, including passages from Job. In terms of applying Adler’s theories to scripture, one can see how the three major safeguarding strategies are put forth as described by Adler in terms of personality, and of cou rse, human beings are still human beings, just as in the Biblical
Saturday, September 21, 2019
Army Regulation Essay Example for Free
Army Regulation Essay Chain of command a. The chain of command assists commanders at all levels to achieve their primary function of accomplishing the unit’s assigned mission while caring for personnel and property in their charge. A simple and direct chain of command facilitates the transmittal of orders from the highest to the lowest levels in a minimum of time and with the least chance of misinterpretation. The command channel extends upward in the same manner for matters requiring official communication from subordinate to senior. b. Commanders are responsible for everything their command does or fails to do. However, commanders subdivide responsibility and authority and assign portions of both to various subordinate commanders and staff members. In this way, a proper degree of responsibility becomes inherent in each command echelon. Commanders delegate sufficient authority to Soldiers in the chain of command to accomplish their assigned duties, and commanders may hold these Soldiers responsible for their actions. Commanders who assign responsibility and authority to their subordinates still retain the overall responsibility for the actions of their commands. c. Proper use of the chain of command is vital to the overall effectiveness of the Army. Commanders must acquaint all their Soldiers with its existence and proper function. Effective communication between senior and subordinate Soldiers within the chain of command is crucial to the proper functioning of all units. Therefore, Soldiers will use the chain of command when communicating issues and problems to their leaders and commanders. Open door policies Commanders will establish an open door policy within their commands. Soldiers are responsible to ensure that the commander is made aware of problems that affect discipline, morale, and mission effectiveness; and an open door policy allows members of the command to present facts, concerns, and problems of a personal or professional nature or other issues that the Soldier has been unable to resolve. The timing, conduct, and specific procedures of the open door policy are determined by the commander. He or she is responsible for ensuring that Soldiers are aware of the command’s open door policy. Performance counseling Commanders will ensure that all members of their command receive timely performance counseling. Effective performance counseling of officers, noncommissioned officers (NCO), enlisted Soldiers, and DA civilian employees helps to ensure that they are prepared to carry out their duties efficiently and accomplish the mission. AR 623–3 and AR 690–400 contain counseling requirements in conjunction with the evaluation reporting systems. Unit commanders will determine the timing and specific methods used to provide guidance and direction through counseling. FM 6–22 provides advice and makes suggestions concerning effective counseling. Providing regular and effective performance counseling to all Soldiers, not just those whose performance fails to meet unit standards, is a command function. All commanders will ensure that their subordinate commanders have implemented and are maintaining an effective performance counseling program. Staff or technical channels Staff or technical channels may be used for sending reports, information, or instructions not involving variations from command policy and directives. Command of installations, activities, and units a. Responsibility. The senior regularly assigned United States Army officer present for duty normally has responsibility for the command of units, platoon level and above, except as shown in paragraphs 2–8a, 2–15, and 2–16. b. Command of installations. Command of Army installations is subject to policies, procedures, and regulations promulgated by HQDA. (1) Command of Army installations is exercised by a senior commander (SC). The SC is designated by senior Army leadership. The SC’s command authority over the installation derives from the Chief of Staff, Army (CSA) and Secretary of the Army’s (SA) authority over installations. This is a direct delegation of command authority for the installation to the SC. The SC’s command authority includes all authorities inherent in command including the authority to ensure the maintenance of good order and discipline for the installation. (2) Army installations are identified in one of two categories as follows: (a) Installations managed by Installation Management Command (IMCOM). Installations that are managed by IMCOM are discussed in paragraph b(4)(e), below. (b) Installations not managed by IMCOM. Installations that are not managed by IMCOM are discussed in paragraph 2–5b(4)(f), below. (3) Joint bases. Army installations designated for management under Department of Defense (DOD) Joint Basing 6 AR 600–20 †¢ 18 March 2008 Guidance shall be operated in full compliance with DOD requirements. In the event of a discrepancy between this regulation and the DOD policies or procedures for Joint basing, the DOD policies or procedures take precedence. (4) Roles and responsibilities. (a) Senior commander. The SC is normally the senior general officer at the installation. The SC’s mission is the care of Soldiers, Families, and Civilians, and to enable unit readiness. While the delegation of senior command authority is direct from HQDA, the SC will routinely resolve installation issues with IMCOM and, as needed, the associated ACOM, Army service component command (ASCC), or direct reporting unit (DRU). The SC uses the garrison as the primary organization to provide services and resources to customers in support of accomplishing this mission. All applicable commands support the SC in the execution of SC responsibilities; therefore, the SC is the supported commander by the IMCOM region director (RD), the garrison and tenants. The SC 1. Normally is a dual-hatted position. When this occurs the commander exercises discrete authorities as the SC and as a mission commander. The SC responsibilities and authorities are installation focused; the responsibilities and authorities as the mission commander are mission focused. 2. Can, in rare cases, be an HQDA-appointed civilian versus a uniformed SC, who will assume the SC roles and responsibilities with the exception of UCMJ and command authority. In these instances, the individual will be referred to as the senior manager. Prior to the appointment of the senior manager, command and UCMJ authorities for the installation will be specified. 3. Is responsible for synchronizing and integrating Army priorities and initiatives at the installation. On IMCOM managed installations there is a requirement for a strong collaborative relationship between the SC and the IMCOM RD. The SC commands the installation but funding of almost all installation activities flows through the RD. 4. Assumes the duties and responsibilities of the installation commander where that title is mentioned in U.S. Code or DOD or Army policies and regulations. 5. Assumes the duties and responsibilities of the senior mission commander where that title is mentioned in Army regulations except for regulations involving operational duties and responsibilities. Mission commanders will retain operational duties and responsibilities. 6. Unless prohibited by law or regulation, the SC may delegate, as necessary, assigned duties and responsibilities to the garrison commander (GC). Such delegation shall be made in writing and specifically state the duties and responsibilities so delegated and the termination date of the delegation. 7. Establishes installation priorities among all resident and supported units. 8. Prioritizes base operations support consistent with HQDA priorities and approved common levels of support (CLS) bands. 9. Oversees the CLS services and capabilities provided to customers. Ensuring that those services are provided within the HQDA guidance, designated priorities, and approved CLS bands and coordinates with the IMCOM RD to change HQDA approved CLS from green, amber, or red. 10. Approves and submits the installation master plan consistent with HQDA long-range plans and goals through the ACOMS, ASCCs or DRUs, and IMCOM. For IMCOM installations the SC collaborates with the IMCOM RD before the SC submits the installation master plan. 11. Approves the military construction, Army (MCA) and military construction, Army Reserve (MCAR) project priority list at the installation level. For IMCOM installations the SC collaborates with the IMCOM RD before the SC approves the MCA and MCAR project priority list for the installation. The U.S. Army Corps of Engineers executes MCA/MCAR projects for the Army. 12. Reviews and approves the prioritization of Family and installation programs. For IMCOM installations the SC collaborates with the IMCOM RD before the SC approves Family and installation programs for the installation. 13. Installation force protection (FP) is as follows: (a) continental United States (CONUS) SC: as directed by U.S. Army North (USARNORTH) and in coordination with the installation management headquarters (IMCOM and Non- IMCOM), oversees FP on the installation; (b) outside continental United States (OCONUS) SC: in coordination with the ASCC and IMCOM is responsible for FP oversight on the installation. 14. Is normally designated as a General Court-Martial Convening Authority (GCMCA). The GCMCA orders will specify the appellate and review channels for SC GCMCA actions. 15. The appellate and review authority for administrative actions taken by the SC pertaining to individual Soldiers and DA Civilians will flow through ACOM, ASCC, or DRU channels unless otherwise specified in Army regulations. The terms next superior authority, next higher authority, next higher commander, and next higher headquarters as used in other Army regulations, mean ACOM, ASCC, or DRU commander or headquarters. 16. Serves as the senior Army representative to the surrounding community. 17. Senior rates the GC. (b) Garrison commander. The GC is a military officer, lieutenant colonel or colonel, selected by HQDA. The GC commands the garrison, is the SC’s senior executive for installation activities, is rated by the IMCOM RD, and is senior rated by the SC. The GC is responsible for day-to-day operation and management of installations and base support services. The GC ensures that installation services and capabilities are provided in accordance with HQDA AR 600–20 †¢ 18 March 2008 7 directed programs, SC guidance, CLS, and IMCOM guidance. The GC provides additional service support in accordance with HQDA directives and provides reimbursable services in accordance with memorandum of understanding or agreement (MOU/MOA). The GC is responsible to deliver Family and installation programs, coordinates and integrates the delivery of support from other service providers, and obtains SC approval of the installation master plan. The GC may be appointed as a Summary Courts-Martial Convening Authority or the Special Courts-Martial convening authority for the installation and its support area; in rare cases the GC may be appointed as GCMCA. In some cases, the senior official on an installation may be the garrison manager. A garrison manager (the civilian equivalent of a GC has the same responsibility and authority as the military counterpart with the exception of UCMJ and command authority. Prior to the appointment of the garrison manager, command and UCMJ authorities for the garrison will be specified. The GC responsibilities are 1. Represents the Army and the installation in the surrounding community as directed by the SC. 2. Approves and issues garrison policies in accordance with respective Army regulations, or installation level policies involving tenant units as directed by the SC. 3. Approves and issues policies for IMCOM civilian workforce. 4. Develops and implements the Force Protection Program. 5. Supports mobilization station requirements. (c) The ACOM, ASCC, or DRU on IMCOM managed installations. 1. Provide to IMCOM a prioritized list of MCA/MCAR projects and requirements that impact subordinate units to support the development of the military construction (MILCON) program and the program objective memorandum. 2. Provide IMCOM with subordinate mission priority requirements for MILCON and base operations. 3. Identify to IMCOM, through the CLS process and other requirements development processes, the required levels of garrison support needed to meet mission requirements. Also, identify to IMCOM any support requirements not included in CLS services. Collaborate with IMCOM in developing garrison support requirements that are applicable to all garrisons. 4. Evaluate the effectiveness of installation services and support and participate in the prioritization of these services and support. 5. Responsible for mobilization of subordinates as specified in AR 10–87. 6. Provide prioritization requirements for information technology and training enabler support to IMCOM. 7. Responsibilities for FP are: (a) OCONUS: The Geographic Combatant commander exercises Combatant Command (Command Authority) (COCOM) authority over all aspects of FP in the AOR and delegates authority for FP as deemed appropriate and necessary. This includes all aspects of FP on Army installations without exception; (b) CONUS: Commander, USNORTHCOM has tactical control (for FP) over all DOD personnel and assets in the AOR. USARNORTH is designated as USNORTHCOM’s ASCC; the authority to execute the FP mission in CONUS is delegated from Commander, USNORTHCOM; (1) USARNORTH has direct command and control authority over commands when executing FP responsibilities for installations/facilities (FP reporting commands/SCs when executing FP responsibilities for installations/facilities); (2) USARNORTH has a supported/supporting relationship with commands not executing responsibilities for installations/facilities (FP supporting commands). (d) Assistant Chief of Staff for Installation Management. The ACSIM is the proponent for all Army installations and in this capacity is responsible for installation policy development and implementation Armywide. The ACSIM does not exercise command authority over Army installations. 1. The ACSIM ensures that real property accountability and reporting is implemented at all installations (see AR 405–45). 2. The ACSIM manages HQDA level MILCON in accordance with HQDA priorities and guidance. 3. The ACSIM is the proponent for environmental policy Armywide. (e) Installation Management Command. The ACSIM is dual-hatted as the Commander of IMCOM. IMCOM is a DRU reporting to the ACSIM as described in AR 10–87. IMCOM manages Army installations assigned to it. IMCOM executes installation readiness missions, provides equitable services and facilities, optimizes resources, sustains the environment, and enhances the well-being of the military community. IMCOM is accountable for the efficient delivery of installation services and support. The IMCOM is responsive to ACOMs, ASCCs, and DRUs through a supporting to supported relationship. 1. IMCOM commands the garrisons assigned to it. 2. IMCOM and its subordinate organizations are supporting commands to the SC on IMCOM installations. There is a requirement for a strong collaborative relationship between the SC and the IMCOM RD. The SC commands the installation but funding of almost all installation activities flows through the RD. 3. The relationship between IMCOM and the commands of tenant organizations is analogous to the supporting to supported†command relationship described in Joint Doctrine. 4. The IMCOM RD rates the GC. 5. IMCOM ensures compliance with HQDA directed programs and CLS bands. IMCOM staffs and coordinates with 8 AR 600–20 †¢ 18 March 2008 HQDA funding requests for garrison support requirements identified by ACOM, ASCC, or DRUs that are not included in CLS services. 6. There is a difference between command relationship in CONUS and OCONUS for IMCOM installations. These relationships are depicted in figure 2–1..
Friday, September 20, 2019
Guidance for the Prevention of Falls in the Elderly
Guidance for the Prevention of Falls in the Elderly According to the Centers for Disease Control and Prevention (CDC), one out of three older adults have fallen each year and twenty five percent of these incidents result in severe injuries such as head traumas, hip fractures or lacerations. The quality of life of older adults who fall decreases due to the injuries or fear of future falls which might limit their activities, reduce mobility and body fitness and in turn increase the risk of falling. The direct medical cost of falls was estimated to be around $30 billion. Indirect cost of falls is long-term effects: such as disability, lost of independency, lost time from house duties, and reduced quality of life. (CDC, 2012). Guideline Description Clinical practice guideline, prevention of falls in older persons is published on the American Geriatrics Society’s Web site (http://geriatricscareonline.org/FullText/CL014/CL014_BOOK003). The guideline was developed by American Geriatric Society (AGS) together with British Geriatric Society (BGS). Panel members came from different professional organizations. Most of them were medical doctors who work or teach in very prestigious hospitals and universities. Some other members included: the public health worker, the pharmacist, the physical and occupational therapist and Registered Nurse with PHD who works at New York University. There was no psychotherapist, psychologist, social worker or recreation worker on the panel. Old 2001 guideline was intended to support health professionals in assessment of fall risk and also help management of older adults who had a history of fall or were at risk of falling. (Journal of American Geriatric Society, 2001) This was update to the previous version of 2001 guideline which was developed by American Geriatrics Society, Geriatrics Society, American Academy Of and Orthope dic Surgeons. 2010 guideline was endorsed by The American College of Emergency Physicians, the American Medical Association, the American Occupational Therapy Association, and the American Physical Therapy Association. Most panel members had no financial interest or commercial interest for the work they provided. Only one doctor received grants from the American College of Emergency Physicians and one member National Association for Home Care and Hospice held shares in various pharmaceutical companies. A preliminary draft of 2010 guideline was peer reviewed by many professional organizations. The Rating System To analyze all studies and grade the evidence, the U.S. Preventive Services Task Force (USPSTF) rating system with 40 years of experience was used. This organization has volunteer members of national experts in prevention and evidence-based medicine. Quality of evidence rating system used a grade of A, B, C or D for each recommendation and I for insufficient evidence. A grade meant strong recommendation that physicians provide intervention to eligible patients, B grade meant a recommendation that clinicians provide this intervention to these patients, C grade meant no recommendation for this intervention and D grade meant when recommendation is made against the routinely providing the intervention to asymptomatic patients. Different clinical algorithm annotations were used. The guidelines made for different settings or situations: community residing elderly, screening for falls or risk of falling, screening positive for falls or risk for falling, screening falls last 12 months, evaluating gait and balance and determining multi factorial risks for falling. This new guideline doesn’t consider fall risk assessment to be done for elderly who reported just one fall without reported or demonstrated unsteadiness. The Quality of Evidence Selection of evidence was well organized three step process. In the first step, researchers collected studies from high level: meta-analyses, systematic reviews, randomized controlled trials (RCTs) and cohort studies between May 2001 and April 2008. The databases were Medline/PubMed, Cochrane Central Register of controlled Trials, Database of Abstracts of Reviews of Effectiveness and Centre for Reviews and Dissemination/Health Technology Assessment. They also added some studies conducted before 2001 since, in some areas, there were no recent studies available. In a second step, members performed review of abstract of these studies and also the exclusion and inclusion process. Ninet-one studies met inclusion criteria. Only high level of studies published in English and population in those studies age 65 and older were included. In a final step they obtained full texts of these ninety-one studies and made an evidence tables. Since some interventions were different in those studies, res earchers mostly focused on the individual studies, however, they still submitted five most recent meta-analysis and evidence based guidelines. Since guideline was intended for fall preventions in community, some topics such as hospital based fall preventions, bone health and protection, syncope and restraints were excluded. Those included specific recommendations for elderly residing in long term care settings such as nursing homes and elderly with cognitive impairment. These extra recommendations make this guideline used on broader settings. Practice Applications To address identified risks and to prevent falls â€Å"Multifactorial†and â€Å"Multicomponent†interventions were used. Multifactorial is most used in long term settings where set of interventions are offered to all participants when Multicomponent is used in community settings where customized set of interventions that target risk factors are offered. Most components of both kind of intervention are: different kind of exercises and physical activity, medication adjustment, especially psychoactive medications, medical assessment and management, environment adjustment and education. Considerable evidence, two meta-analyses proved that this kind of approach prevents falls in elderly. Multiple studies with high number of participants groups found Gait/Balance, Strength and Flexibility type of exercises very effective. And multiple studies in high risk of fall 140 participants showed that functional type of exercises are even harmful. The management of visual and medical problems and postural hypotension remained particularly effective. A Systematic review found no compelling evidence that verified effectiveness of vision correction in falls reduction in community or long-term setting residents except for first eye cataract surgery. This conclusion is made primarily with the lack of well-designed randomized studies. The strongest risk-relations arise with psychotropic medications and polypharmacy. Even dose reductions of these medications when discontinuation is not possible due to medical conditions found to reduce falls, while multifactiorial interventions: assessment, adjustment and discontinuation found to be very affective. Medication review provided inconclusive evidence whether it is effective in reducing falls in Long Term Care (LTC) setting Three RCTs showed benefits with treating of postural hypotension in addition to medication reduction, optimization of fluids and behavioral interventions in community and LTC settings and tree RCTs were ineffective in LTC settings. About 30 percent of patients 65 and older do experience syncope and they will not be aware of fainting. Instead they will report the falling. (Kenny, Bhangu King-Kallimanis, 2013). Two RCTs showed significant reductions when this intervention was incorporated with environment assessment and modification in LTC setting. Several meta-analysis and RCTs showed benefit of vitamin D supplementation in fall prevention. AGS recommends to the healthcare providers to use Vitamin D 4000 IU per day for their patients.. Even in old people with normal serum vitamin D levels, vitamin D supplementation showed benefits. Vitamin D is safe and inexpensive, improves uptake of calcium to reduce osteoporosis and loss of muscle mass which both can contribute to falls. (Tangalos, 2013) Although AGS/BGS guideline discusses overall importance of managing foot and footwear problems it does not significantly make any recommendations for LTC residents. However best practices should be a foot screening to be completed on an admission day to an LTC facility and quarterly evaluation at least to make sure that any skin integrity issues are identified and addressed in a timely manner. To review resident’s footwear for any poor fitting, unsafe shoes should be accompanied to these screenings (Willi Osterberg, 2014). Guideline discussed modifications of environment home and LTC settings. While two studies found a use of home environment modification intervention alone in community elderly effective, one study didn’t support it. Fifteen studies found that this type of intervention as a part of multifactorial fall prevention programs will make a big difference by reducing risk of falls. Patients and caregiver education was discussed as primary and secondary prevention measures. Examples of educating patients were: how to use assistive devices correctly, how to participate in local exercise program, or how improving health and building fall preventions skills was found effective in community settings. Education in long term care staff in some large number of studies got mixed results while some studies showed effectiveness of healthcare staff training about fall prevention strategies, some found insignificant reduction in falls. While cognitive impairment can be independent risk factor for falls, guideline did not find sufficient evidence to recommend, for or against, single or multifactorial interventions in home setting elderly with cognitive impairment. One systematic review found physical activities effectiveness in reducing falls in cognitively impaired patients. A study of patient education in addition of staff education, environmental modification, drug review, exercise and other multicomponent intervention programs was associated significant effect on falls in groups with higher Mini-Mental State Examination scores, not with lower scores. Implementation Feasibility Although considerable guidelines exist on fall prevention, there is no solid evidence that demonstrates the cost benefit on investment of all prevention and injury protection programs in LTC settings. While there are a lot of recommendations and interventions outlined in the guideline, there is still no clear guidance for specifying the right combinations of interventions to protect specific risk-population, residents with dementia or osteoporosis. (Quigley, Bulat, . Kurtzman, Olney, Powell-Cope Rubenstein, 2010). Historically, calcium and vitamin D administration improved bone health but in 2013 some controversy regarding these supplements arose when the USPSTF issued statement that evidence was insufficient whether more than 400 International Units of vitamin D3 and more than 1000 mg of calcium can be primary preventions of fractures. Although USPSTF guideline was for younger men and women and nonistitutionalized postmenopausal women and not for institutionalized elderly questions were still raised about use of this vitamin. Vitamin D supplement not routinely prescribed in LTC settings. While it is a routine in LTC facilities to include orthostatic hypotension assessments to evaluate residents risks and reevaluate after each fall, usually they are often administered by licensed practical nurses or certified nursing assistants who maybe unaware or resident’s recent medication change or history of heart arrhythmias. If the measurements are not taken accurately at correct time intervals, the errors will arise. (Parry % Tan, 2010). Modification of medications should be communicated among nursing staff to enable them to take appropriate interventions. This recommendation can make big difference for my patients. Environment assessment and interventions should be a part of fall risk management protocol but it should be incorporated with multifactorial interventions since no date supports that environment change alone will decrease risk of falls. Addressing staffing issues also can be very important. The consistent assignment of staff to same resident s can be very effective to reducing falls. It allows staff to anticipate the residents’ unsafe and high-risk behaviors and have a better ability to intervene before a fall occurs. *(Quigley, Neily, Watson, Wright Strobel, 2012). Caregivers would be more effective if they are not moved to different units. Finally, all staff making frequent rounds and checking on patients regardless of call light use can further support an environment of heightened safety awareness. In the LTC facility where I work we do in-service not only nursing but every disciplinary staff members about awareness of fall strategies. We came with 4P strategies which stand for: Pain, Positioning, Personal items, and Potty/toileting. Every disciplinary member is assigned scheduled hourly rounds check if all four problems are addressed. While guideline never discussed using personal alarms on residents as an intervention to reduce falls it is still used as first intervention after fall happens. Meanwhile staff response to an alarm sound hardly ever results in prevention of falls. (Rader, Frank Brady, 2013). While we still continue to use â€Å"personal alarms†in LTCs these alarms in dementia residents can result more agitated behaviors, physical aggression, and attempt to escape the stimulation. To replace these auditory clutter with silent alarms, visual monitoring system, motion detectors and staff presence will make difference. (Guildermann, 2013). Our facility also use overhead paging system 24 hours of day which can cause overstimulation of residents. LTC facilities should be more home-like unlike the hospitals and healthcare staff should change our culture how we communicate. We started giving personal phones to the staff while in the facility to cut use of overhead paging. Summary and Final Recommendation AGS/BGS guidelines do not make recommendations for hip protectors, however, the Veterans Administration Safety Center adopted their use as best practice. Hip protectors use will benefit residents with a history of unresolved fall risk, diagnosis of osteoporosis and level of compliance with regard to these devices. Recent literature found that compliance as a challenge, and â€Å"compliance issues must be tackled if hip protectors are to be part of a resident-centered approach. (Combes Price, 2014). Most people discontinue its use due to discomfort and dislike of how these devices made them look but new designs to high impact pads may resolve this issue. Newly designed hip protectors are made from polyurethane foam, which absorb about 90 percent of the impact of a fall. They are thinner and new clothing is designed to place these pads in such a way that would make it more practical and attractive, making daily tasks easier.Two meta-analyses showed that hip protectors’ effecti veness in community or institutional settings. (Quigley et al., 2010). While guideline didn’t discuss pain assessment, one study (Eggermont, Penninx, Jones Leveille, 2012) published in the Journal of American Geriatrics Society found that depressive symptoms are associated with fall risk and are mediated in part by chronic pain. When Interdisciplinary team (IDT) meets to discuss risk management of actual fall residents who tried to attempt to transfer unattended or fell after sliding from well-chair, first thing team looks at is a urinary tract infection, thinking that resident may want to use toilet or blame resident behavioral problems most of the times they miss recognizing pain, discomfort and desire to move. Residents should be regularly evaluated for pain and non-pharmacologic interventions should be used first. If that does not alleviate the pain, mild analgesics should be administered. In my opinion exact combinations of interventions for specific population should be built on the assumption that all residents are risk for falls in order to provide a better protection. And prevention will be most effective when based on understanding of fall risk factors at individual, staff and organization levels.
Thursday, September 19, 2019
The Irish Troubles: Yeats Poetry Essay -- Writing Writers Literature
The Irish Troubles: Yeat's Poetry William Butler Yeats, born in Dublin, Ireland [June 13, 1865], is considered by many to be one of the greatest English-language poets of the 20th century. The following exposition, grounded on the hypothesis that Yeats’ poetry was resolutely influenced by the political occurrences of that time period, will give biographical information, a recounting of the political upheaval during that period, specific poetry excerpts/critical analysis and validation of hypothesis. William Butler Yeats is one of the many famous names to come from the original Golden Dawn. "His poetry and writings were a display of his passion for mysticism and the Occult Sciences"(www.webus.com/hogd/bioyeats.html). He received the Nobel Prize for literature in 1924. Yeats realized early on the oppression and austerity that both he and his fellow countrymen endured. Yeats’ father was a lawyer, who later pursued a career as a painter. In 1867, the family followed him to London, where William spent most of his youth. Upon his return to Dublin, Yeats furthered his studies at the Metropolitan School of Art. "As a writer Yeats made his debut in 1885, when he published his first poems in The Dublin University Review"(www.kifjasto.sci/wbyeats.htm). In 1887 the family returned to Bedford Park and Yeats devoted himself to writing. Later in 1889, Yeats met his undeniable love, Maude Gonne, an Irish Nationalist, who greatly inspired his poetry. However, Maude later married Major John MacBride. "At the start of the Irish Civil War Yeats went to Oxford, but returned then to Dublin, becoming a Senator in the same year. As a politician Yeats defended Protestant interests and took pro-Treaty stance against Republicans. In 1932 Ye... ...likely that anyone reading this article can image "sensible" violence and most of us simply find the lack of civil behavior to be far beyond anything we can understand. It seemed to me that it would be appropriate to try and shed some light on the so-called "troubles" because the situation in Northern Ireland exceeds several lifetimes and yet appears incomprehensible" (//www.ftlcomm.com/ensign/ireland/ireland2.html). To conclude, Ireland has faced years of prejudice, suppression, and tyranny. Yeats, like many other nationalists recognized this and in his own way attempted to address these issues by publicly announcing his contempt for this discrimination, through poetry, but to no avail. As we can see, these troubles continue to challenge the citizens of Ireland. Perhaps, one day this persecution will cease to exist, but for now it is an existing way of life!
Wednesday, September 18, 2019
Reduce, Reuse, Recycle: Television Resources Essay -- Conservation
Americans are doing whatever they can to go green, and not the color. The â€Å"green†movement is about people making small lifestyle changes that could help the environment. Recently the economy has been bad enough that the housing market in a state of crisis; therefore, home owners with a need of change are resorting to remodeling and construction in their existing homes instead of moving. In order to save money on products for their home and be compliant with a green lifestyle, people are making decisions and buying products that are more resourceful and less wasteful. The green movement has people educating themselves about how they can better their environment. People with a greener conscious are buying the more eco-friendly products, choosing products that are or will be recycled. This green home movement is coming to consumers from news sources or word of mouth instead of being pressed by the media, such as home media networks that are viewed as the authorities on this matter, to create an effective attitude about environmentalism. In fact, most viewers are immediately hooked by the showing of demolition of furniture and cabinets that could easily be donated to a family in need instead of being hauled away to the dump. Home media networks, such as Home and Garden Television (HGTV) and Do It Yourself (DIY) Network, have the responsibility to portray and educate their viewers about recycling options for household goods that are not easily disposable. People concerned about their home should also worry about the environment; a short walk and neighbors can see the rising depths of nearby landfills. The problem lays in our landfills that poison the soil, water, and air. While this is no surprise to ecological news, the statistics a... ...h Premier. Web. 21 Apr. 2012. Intini, John. "The Treasure In Other's Trash." Maclean's 118.20 (2005): 32-N.PAG. Academic Search Premier. Web. 17 Apr. 2012. Kulpinski, Dan. "Human Footprint: Where Does All the Stuff Go?" Trash Talk. National Geographic. Web. 21 Apr. 2012. . Lee, E. Bun. "Environmental Attitudes And Information Sources Among African American College Students." Journal Of Environmental Education 40.1 (2008): 29-42. GreenFILE. Web. 19 Apr. 2012. Shanahan, James, Michael Morgan, and Mads Stenbjerre. "Green Or Brown? Television And The Cultivation Of Environmental Concern." Journal Of Broadcasting & Electronic Media 41.3 (1997): 305. Academic Search Premier. Web. 20 Apr. 2012. "Unfinised-Finished Basment." Rehab Addict. Do It Yourself Network. DIY, 26 May 2012. Television.
Comparing Relationships in E. M. Forster’s A Passage to India and Virg
Comparing Relationships in E. M. Forster’s A Passage to India and Virginia Woolf’s To the Lighthouse E. M. Forster’s A Passage to India and Virginia Woolf’s To the Lighthouse are concerned with the lack of intimacy in relationships. Forster’s novel is set in English-run India, the difference between race and culture being the center of disharmony. Woolf’s novel is set in a family’s summer house, the difference between genders being the center of disharmony. Despite this difference of scale, the disharmonies are much the same. Unity and intimacy are intertwined in both novels. Whereas the definitions of intimacy vary with each person, all of the characters strive for unity through their relations with others. The difference in ideas of intimacy are what prevent unity from being achieved. For the Indians, intimacy is a sharing of possessions and personal information that acknowledges equality. For the English, intimacy is similarity of background and allegiance. Thus, Heaslop tells his mother that he made a mistake by asking one of the Pleaders to sm oke with him because the Pleader then told all the litigants that he was in with the City Magistrate (Forster, 20). To the Pleader, this sharing of cigarettes and leisure time is an act of intimacy because it seems an acknowledgement of equality. To Heaslop, this is only a friendly act of social convention because equality is based on race and class, is something inherent, not given. The idea of intimacy as unity is a strain throughout A Passage to India. When Aziz thinks of his wife on the anniversary of her death, he wonders if he shall meet her in an afterlife, but does not have specific faith in an afterlife. He believes that â€Å"God’s unity was indubitable and indubitably ... ...ziz is frustrated that his attempt at conciliation is not successful. Unity requires intimacy because intimacy is an acknowledgement of equality. Only when one transcends limitations of gender and race, extends oneself beyond social codes that emphasize division can true unity be achieved. Both authors end their novels with an insinuation of a future that will be friendlier to intimacy and unity: Lily finally achieves unity in her painting and the final words of the land to Aziz and Fielding are â€Å"’No, not yet†¦No, not there.†(Forster, 282). Sometime, somewhere the English and the Indians will unite and man and woman will achieve gendered unity within the self. Works Cited Forster, E.M. A Passage to India. London: Everyman’s Library, 1991. Woolf, Virginia. To the Lighthouse. Introduction by D.M. Hoare, Ph.D. London: J.M. Dent and Sons Ltd., 1960.
Tuesday, September 17, 2019
The Importance of History
The Importance of History History is an important part of anyone’s life. History helps understand the past so the people of the country can understand where they come from. The subject helps children understand who they are and where they came from. History is basically knowledge about the past events. It is a part of everyday life that goes partially un-noticed. Everybody, people talk about past events without even knowing that they are performing the task. One needs to know and understand the past at doctor’s offices and solving arguments between children. I would have to know my past and my family past in order to fill out the information at my doctors. This is the way the doctor can know what to expect from my health issues. I could use history to find out the solution and the start of the problem of sibling arguments. If my two children got in a fight and one of them told me one thing and the other told me another, I would be able to tell from their history on how the fight actually went. History helps the people of today realize why their country enters wars, where their beliefs come from, and understand their culture of their country. According to the author of â€Å"Importance of History,†David Crabtree, the definition of history is that it is a story about the past that is significant and true. This simple definition contains two words that are packed with meaning which must be understood in order to understand history, which are significance and truth. Significance is determined by the historian. The historian sorts through the evidence and presents only that which, given his particular world view, is significant. No one could record everything that is true about an event in the past. Everything can be entered in history because every factor can be used in studies, teachings, and certain other possibilities. Most historians use the word â€Å"true†to mean any perspective well supported by facts. Several people can have different perspectives on history itself or bits of pieces of history (Crabtree, 1993). So it is important that we, as the people, can get all of the correct information and learn as much as possible to fully understand the full outlook and meaning of history. The resources that I can use are the school library and the public library. If I want a personalized story to be told to me, so that I can have a personal answer I can talk to something that lived through the time that I need to find research on. This person can give me a perspective that I could not get from a book, computer, or the library. Another resource that I could use is movies and television. I could watch documentaries about the event since the documentaries are based on facts and truth. They provide an in-depth view on the topics and they give more sources than necessary. I could watch the television channel National Geography or the History Channel, because they give the most honest and truthful facts to the viewers. Works Cited Crabtree, D. (1993, November). Importance of History. Retrieved October 28, 2011, from McKenzie Study Center, an institute of Gutenburg College: http://www. mckenziestudycenter. org/2001/02/the-importance-of-history/
Monday, September 16, 2019
Robber Barons
Savannah Noss Period 1 3/2/13 APUSH Robber Barons, a term used in the late 1800’s and early 1900’s to describe a businessman who made an enormous amount of money, today we would call them billionaires essay writer price. It was not really the fact they made a myriad of wealth, it was more the way they made it. In all the cases the acquiring of wealth was done in what was considered a ruthless manor and unscrupulous ways. A robber baron was more interested in acquiring wealth than the safety of his employees, the amount of work hours performed in a week, or the amount of wage being paid for a days work.A great example of a robber baron would be Andrew Carnegie. The robber baron of the steel industry. He was instrumental in starting the 72 hour work week, paying out less than fair wages and having dangerous working conditions. Andrew Carnegie cornered the market on the steel industry and made the first high rise building. He was the only business in his field, therefore, he could set his prices and up his profits. The robber barons were known for their business tactics that would enable them to amass a wealth by monopolies.They would corner the market on a product or service and make it almost impossible to get, accept through them. One thing that robber barons of today and yesterday have in common is monopolies. If at all possible, the robber baron or billionaire as we call them today, would try to corner the entire market on their product or service, making it difficult for competition in their particular industry. A second robber baron of that time was John D. Rockefeller. The robber baron of the oil industry.Rockefeller monopolized the oil industry with Standard Oil Company. When Edwin Drake discovered oil in 1859, Rockefeller saw the future. He introduced techniques that completely reshaped the oil industry. He used all of his methods to reduce the price of oil to his consumers. His profits soared and his competitors were crushed one by one. Ro ckefeller forced smaller companies to surrender their stock to his control. Another great example of a robber baron is Thomas Edison. The robber baron of the electricity, the light bulb.In 1876, Edison opened a lab where hundreds of inventions were created, including the first ever electric light bulb and an improved version of Graham Bell’s telephone. His light bulb would come to serve as an important part of industrialization. Because of his invention, factories could stay open longer and produce more goods, His power station in New York City gave power to almost the entire city. Within ten years, almost all of the United States had power. Those men earned the title of being called a robber baron because of all the things they created that benefitted society. They were and are robber barons of their time and ours. Â
Sunday, September 15, 2019
Victorian Era
The Victorian Era During the Victorian Era, social classes of England were newly reforming, and fomenting. There was a churning upheaval of the old hierarchical order, and the middle classes were steadily growing. Added to that, the upper classes' composition was changing from simply hereditary aristocracy to a combination of nobility and an emerging wealthy commercial class. The definition of what made someone a gentleman or a lady was, therefore, changing at what some thought was an alarming rate. By the end of the century, it was common that a gentleman was someone who had a liberal public (private) school education, no matter what his antecedents might be. There continued to be a large and generally disgruntled working class, wanting and slowly getting reform and change. Conditions of the working class were still bad, though, through the century, three reform bills gradually gave the vote to most males over the age of twenty-one. Contrasting to that was the horrible reality of child labor which persisted throughout the period. When a bill was passed stipulating that children under nine could not work in the textile industry, this in no way applied to other industries, nor did it in any way curb rampant teenaged prostitution. The Victorian Era was also a time of tremendous scientific progress and ideas. Darwin took his Voyage of the Beagle, and posited the Theory of Evolution. The Great Exhibition of 1851 took place in London, lauding the technical and industrial advances of the age, and strides in medicine and the physical sciences continued throughout the century. The radical thought associated with modern psychiatry began with men like Sigmund Feud toward the end of the era, and radical economic theory, developed by Karl Marx and his associates, began a second age of revolution in mid-century. The ideas of Marxism, socialism, feminism churned and bubbled along with all else that happened. The dress of the early Victorian era was similar to the the Georgian age. Women wore corsets, balloonish sleeves and crinolines in the middle 1840's. The crinoline thrived, and expanded during the 50's and 60's, and into the 70's, until, at last, it gave way to the bustle. The bustle held its own until the 1890's, and became much smaller, going out altogether by the dawning of the twentieth century. For men, following Beau Brummell's example, stove-pipe pants were the fashion at the beginning of the century. Their ties, known then as cravats, and the various ways they might be tied could change, the styles of shirts, jackets, and hats also, but trousers have remained. Throughout the century, it was stylish for men to wear facial hair of all sizes and descriptions. The clean shaven look of the Regency was out, and mustaches, mutton-chop sideburns, Piccadilly Weepers, full beards, and Van Dykes were the order of the day. Due to the lack of modern technology that we have today such as televisions and the internet, the Victorian era (the era in which Queen Victoria reigned, this was between 1837 and 1901 was renowned for famous for the short stories that the authors of the time wrote. The birth of the railway also took place during the Victorian era and as one would expect, many people used it for transportation over long distances. There were no televisions so at times of boredom and during these long train journeys the people of the time depended solely on books and short stories for entertainment. The Ghost story genre proved to be most popular amongst the Victorian people. At the beginning of the nineteenth century in Britain, religious faith and the sciences were generally seen to be in beautiful accordance. This harmony between science and faith, mediated by some form of theology of nature, continued to be the mainstream position for most men of science right up to the 1860’s, at least. But it did come under threat. Many scientists questioned the literal meaning of the Genesis and opposed to the authoritarianism of organized Christian religion. Charles Darwin was the one, who with his Origins of the Species in 1859, proved things that could not be tolerated by the Church. It attracted widespread interest on publication. The book was controversial because it contradicted religious beliefs that underlay the then current theories of biology, and it generated much discussion on scientific, philosophical, and religious grounds. Of course a longer period had to pass to accept Darwin’s ideas, but it did affect the Christian mind, it did raise questions about the institution of the Church. The values that were based on religion were shaken greatly as well and the roots of the 20th century’s search for new values could be originated from here. Attitudes toward values and morals in those times also depended on, which social class a person belonged to. As the population increased, the gap between the lower and upper classes grew larger and also the differences in social behavior. Lower working classes struggled with everyday life, large families often did not have anything to eat, and children had to go working from an early age. There, the morals were drawn to the background. Even though, every felony was punished strictly, people often ended up stealing, robbing and murdering. Cities were full of slums, hygiene was non-existent and the drinking water spread diseases. Among these circumstances there was one rule that existed: to survive the day! Opposing the upper classes’ primness, prostitution and child labor was not scorned as a livelihood for the common people. Society as a whole, was called and often talked about in connection with the Victorian Era, did not help them, did not do anything for them, only despised them. Victorian values included a strict moral code and an obsession with social status. Upper classes always liked to lead their life in an exemplary way, regarded the morals highly and lived accordingly. Their occupation and social standing was largely determined by family background and social connections. We have to take into consideration that the Victorian era was the one when educated and wealthy people knew that the period they were living in is great and society, if everyone in it lived according to the Victorian values, could be happy. Although by looking back at the way they treated these values, most of them seem hypocritical. In their life religion, family, home, wealth and primness played an important role and proud as they were of themselves of belonging to these great times, rejected anyone whose life was not based on these things. They were the lucky ones that were educated and could easily afford forming opinions about the rest of the society, making references to morals, making up their own and forming the old ones as well. The Victorian era became notorious for employing young children in factories and mines and as chimney sweeps. Child labor played an important role in the Industrial Revolution from its outset, often brought about by economic hardship, Charles Dickens for example worked at the age of 12 in a blacking factory, with his family in debtor's prison. The children of the poor were expected to help towards the family budget, often working long hours in dangerous jobs and low wages. In England and Scotland in 1788, two-thirds of the workers in 143 water-powered cotton mills were described as children. Agile boys were employed by the chimney sweeps; small children were employed to scramble under machinery to retrieve cotton bobbins; and children were also employed to work in coal mines to crawl through tunnels too narrow and low for adults. Children also worked as errand boys, crossing sweepers, shoe blacks, or selling matches, flowers and other cheap goods. 7] Some children undertook work as apprentices to respectable trades, such as building or as domestic servants (there were over 120,000 domestic servants in London in the mid 18th Century). Working hours were long: builders worked 64 hours a week in summer and 52 in winter, while domestic servants worked 80 hour weeks, children worked from 12 to 16 hours a day; they often began w orking at the age of six or seven. Children had to be beaten to keep them from falling asleep while at work; in spite of this, many failed to keep awake and were mutilated or killed. Parents had to submit to the infliction of these atrocities upon their children, because they themselves were in a desperate plight. Craftsmen had been thrown out of work by the machines; rural laborers were compelled to migrate to the towns by the Enclosure Acts, which used Parliament to make landowners richer by making peasants destitute; trade unions were illegal until 1824; the government employed agents provocateurs to try to get revolutionary sentiments out of wage-earners, who were then deported or hanged. Such was the first effect of machinery in England. Children as young as three were put to work. A high number of children also worked as prostitutes.. In coal mines children began work at the age of five and generally died before the age of 25. Many children worked 16 hour days. As early as 1802 and 1819 Factory Acts were passed to regulate the working hours of workhouse children in factories and cotton mills to 12 hours per day. These acts were largely ineffective and after radical agitation. A royal commission recommended in 1833 that children aged 11–18 should work a maximum of 12 hours per day, children aged 9–11 a maximum of eight hours, and children under the age of nine were no longer permitted to work. This act however only applied to the textile industry, and further agitation led to another act in 1847 limiting both adults and children to 10 hour working days. By 1900, there were 1. 7 million child laborers reported in American industry under the age of fifteen. The number of children under the age of 15 who worked in industrial jobs for wages climbed to 2 million in 1910. The accepted reasoning was that the career for women was marriage. To get ready for courtship and marriage a girl was groomed like a racehorse. In addition to being able to sing, play an instrument and speak a little French or Italian, the qualities a young Victorian gentlewoman needed, were to be innocent, virtuous, biddable, dutiful and be ignorant of intellectual opinion. A wealthy wife was supposed to spend her time reading, sewing, receiving guests, going visiting, letter writing, seeing to the servants and dressing for the part as her husband's social representative. For the very poor of Britain things were quite different. Fifth hand clothes were usual. Servants ate the pickings left over in a rich household. The average poor mill worker could only afford the very inferior stuff, for example rancid bacon, tired vegetables, green potatoes, tough old stringy meat, tainted bread, porridge, cheese, herrings or kippers. The Catholicism of the Oxford Movement, the Evangelical movement, the spread of the Broad Church, and the rise of Utilitarianism, socialism, Darwinism, and scientific Agnosticism, were all in their own ways characteristically Victorian; as were the prophetic writings of Carlyle and Ruskin, the criticism of Arnold, and the empirical prose of Darwin and Huxley; as were the fantasy of George MacDonald and the realism of George Eliot and George Bernard Shaw. One could say that Queen Victoria personified the spirit of nineteenth-century England; she was Queen of the United Kingdom, Great Britain, and Ireland as well as Empress of India. She put the â€Å"Victorian†in the Victorian Era.
Saturday, September 14, 2019
Letter from Birmingham City Jail Essay
Reverend Dr. Martin Luther King wrote the â€Å"Letter from Birmingham Jail†in an exceedingly effective way. King used his intelligence, virtue, and honesty to write an appropriate reply to the criticism he received. He also used logic and emotional appeal. In the first paragraph King says, â€Å"†¦ Since I feel that you are men of genuine good will and your criticisms are sincerely set forth†¦Ã¢â‚¬ He gives the ministers importance. He recognizes that these men are of â€Å"genuine food†and accepts their sincere criticism with humbleness. Dr. Martin Luther King says, â€Å"I am sure that each of you would want to go beyond the superficial social analyst who looks merely at effects and does not grapple with underlying causes.†He demonstrated that he knows and respects that the ministers are intelligent and that they are in agreeance in some aspects. He later says, â€Å"But I have tried to say that this is normal and healthy discontent can be channelized through the creative outlet of nonviolent direct action. Now this approach is being dismissed as extremist. I must admit that I was initially disappointed in being categorized.†King expresses his beliefs as to be called an extremist. He does not believe his nonviolent actions should be labeled â€Å"extremist.†Dr. King says, â€Å"If I have said anything in this letter that is an overstatement of the truth and is indictive of an unreasonable impatience, I beg you to forgive me.†In this statement, he not only apologizes for any exaggerations, he also shows a great deal of respect to them. King says,†Anyone who lives in the United States can never be considered an outsider anywhere in this country.†King gives the ministers a feel of belonging. As long as they live in the Unites States they will be accepted. King later says, â€Å"Like so many experiences of the past, we were confronted with blasted hopes and the dark shadow of a deep disappointment settled upon us.†King describes his disappointments as dark shadows creating an image for his audience to relate to. He says, â€Å"For years now, I have heard the word†Wait!†It rings in the ear of every Negro with a piercing familiarity. This â€Å"wait†has almost always meant â€Å"never†even though this may have been written in a placid manner, the ministers can feel that his actual emotions behind this sentence was anger. Further on in the letter he says,††¦when you suddenly find your tongue twisted and your speech stammering as seek to explain to your six-year old daughter why she can’t go to the public amusement park that had just been advertised on television, and see tears welling up in her little eyes when she is told Funtown is closed to colored children, †¦and see her begin to distort her little personality by unconsciously developing a bitterness towards white people†¦Ã¢â‚¬ once again his audience can feel his anger. He creates images of this innocent little girl crying of disappointment slowly changing into someone resentful of White people. A great deal of this letter was logical. In paragraph 6 King says, â€Å"In any nonviolent campaign there are four basic steps (1) collection of facts to determine whether injustices are alive, (2) negotiation, (3) self-purification, (4) direct action. We have gone through all these steps in Birmingham. There can be no gainsaying of the fact that racial injustice engulfs this community.†King states the four basic steps and recognized that there is a certain way to behave. Later King also says, â€Å"I submit that an individual who breaks a law that conscience tells him is unjust, and willingly accepts, the penalty by staying in jail to arouse the conscience of the community over its injustice, is in reality expressing the very highest respect for law.†Martin Luther King used a very logical appeal by saying; when a crime is committed consequences are inevitable. Anyone who commits a crime is punished. King later says, â€Å"One day the South will know that when these disinherited children of God sat down at lunch counters they were in reality standing up for the best in the American dream and the most sacred values in our Judeo-Christian heritage, and thusly, carrying our whole nation back to those great wells of democracy which were dug deep by the founding fathers in the formulation of the Constitution and the Declaration of Independence.†He used God and religion as a logical appeal and to his audience, as ministers, God and religion are indeed especially logical. Reverend Dr. Martin Luther King used his knowledge, values, and integrity to generate a suitable reply to the ministers. He replied in an effective manner with elegance and tranquility. He used reason and emotion to make his response further successful.
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