Cognitive Processing Therapy For Post Traumatic Stress...

Evidence-based practices have been gaining a lot importance recently and it was so interesting to search the online libraries to actually see how many exist. It was stimulating to go onto the National Registry of Evidence-based Programs and Practices websites and be in awe of abundance of programs. There were programs for almost every type of social work practice. While looking through the different databases in regards to evidence-based practice (EBP), one in particular really caught my attention. The particular EBP that will be discussed is known as Cognitive Processing Therapy for Post Traumatic Stress Disorder (PTSD). I chose this specific one because I have a great interest in therapies with those suffering from PTSD. As stated by the name of this particular EBP, the focus is on cognition in those with PTSD. Cognitive Processing Therapy (CPT) is a form of the well-known cognitive behavioral therapy. For this particular therapy, the clients taking part are older adolescents and a dults (18-55+) who have a PTSD diagnosis (SAMHSA, 2014). The preliminary focus on CPT is to look at the distorted thoughts about the trauma experienced by the client. Beliefs such as self-blame and denial are initial conative focus, then therapy moves on to looking at the clients how the clients think themselves, others, and the world (Resick, Nishith, Weaver, Astin, Feuer, 2002). Clients who are undergoing this therapy use of worksheets and what is known as â€Å"Socratic questioning† (Resick,Show MoreRelatedPost Traumatic Stress Disorder ( Ptsd ) Essay1453 Words   |  6 Pages84.8% of those diagnosed Post-Traumatic Stress Disorder still show moderate impairment of symptoms, even 30 plus years after the war (Glover 2014). As of today, the Unites States has 2.8 million veterans who served in the Afghanistan and Iraq wars, of those it is estimated that 11 to 20% currently suffer from Post-Traumatic Stress Disorder. As of 2013, a total of 12,632 veterans of the Afghanistan and Iraq wars are currently diagnosed with Post-Traumatic Stress Disorder (Glover 2014). Of course itRead MoreThe Long Term Effectiveness Of Prolonged Exposure Therapy1017 Words   |  5 Pages2013; Ullman Peter-Hagene, 2014). This research proposal intends to explore the long term effectiveness of Prolonged Exposure Therapy (PE) at reducing distress and trauma explicitly for adult victims of sexual assault and rape. Prolonged exposure (PE) is a specific exposure therapy program that derives from Emotional Processing Theory (EPT). The idea of emotional processing is to interpret realistic information and accommodate that information into a fear structure which in turn diminishes the fearRead MorePost Traumatic Stress Disorder ( Ptsd ) Essay1682 Words   |  7 PagesDakota The mind is a very interesting and special aspect of life. A person’s mind is the part of them that enables concentrated thought processes, feelings of emotion, and allows you to perceive the world in many ways. A person’s mind is always processing and receiving information of environmental stimuli, to determine what is happening around them. This is whether you are consciously trying to accomplish a task, un-consciously sleeping, or even if you’re thinking about memories you once had. YourRead MoreA Critical Reflection on Information Processing Theories of Trauma Response1613 Words   |  7 PagesIntroduction Cognitive theories that focus on information processing have been the most influential theories of trauma in terms of generating testable hypotheses and directing current treatments (Salmon Bryant, 2002). For this reason, we will attempt to critically evaluate this area of trauma theory with reference to other popular theories, the research evidence, clinical practice and developmental factors. Information Processing Theories of Trauma Response Information-processing models relatingRead MorePost Traumatic Stress Disorder ( Ptsd )906 Words   |  4 Pages POST-TRAUMATIC STRESS DISORDER Post-traumatic stress disorder, also known as PTSD, is a complicated disorder that begins after a traumatic event ((APA), May 18, 2013). Throughout history, PTSD was also known as railway spine, shell shock, traumatic (war) neurosis, concentration-camp syndrome, and rape-trauma syndrome. This disorder always happens after a personal tragic event. Such events include a natural disaster, murder, war, rape, and vehicular accidents, just to name a few. The importantRead MoreEssay On Ptsd1358 Words   |  6 PagesFor this assignment, I have chosen to create a mock session for a person who is expressing symptoms of PTSD. According to the National Institute of Mental Health, PTSD (posttraumatic stress disorder) is a mental health problem which some develop after experiencing or witnessing a terrifying incident. Flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event are just a few of the symptoms occurring in those suffering from PTSD. These symptoms go a way for most individuals;Read MoreEssay on Women Dealing with Posttraumatic Stress Disorder638 Words   |  3 PagesThis article is based on a study comparing the ethnic differences in Posttraumatic stress disorder (PTSD), among the women’s population of non-Hispanic Whites, African American, and Hispanic. The population of Hispanics and African American female’s veterans, in terms of gender, experience a higher symptom of PTSD than male veterans. The study is aimed at providing analysis demographic characteristics, diagnostic validity, and the normative sampling, among the three ethnic populations of women whoRead MoreThe Factors of Post Traumatic Stress Disorder Essay675 Words   |  3 PagesFactors of Post Traumatic Stress Disorder Post traumatic stress disorder occurs after a person is exposed to a terrifying ordeal which causes either grave physical or psychological harm where harm was threatened. It can become an extremely debilitating disorder to the persons life. The person can have problems interacting in social and family life, occupational instability and the breakdown of marriages can occur. The disorder is triggered after traumatic events suchRead MoreTrauma- Focused Cognitive Behavioral Therapy: an Effective Treatment Modality for Children and Adolescents Who Have Experienced Traumatic Incidents1687 Words   |  7 PagesTrauma- Focused Cognitive Behavioral Therapy: An Effective treatment modality for children and Adolescents who have experienced traumatic incidents * What is TF-CBT and What is it Best Suited for: Trauma Focused Cognitive Behavioral Therapy (TF-CBT) was developed by psychologists J.A. Cohen and, Mannarino, Knudset and Sharon. TF-CBT has been developed for those who have experienced psychological trauma, often on a great scale of magnitude. It is important to define trauma; â€Å"There areRead MorePtsd : Post Traumatic Stress Disorder1462 Words   |  6 PagesPTSD, post-traumatic stress disorder is a mental disorder or serious condition that can develop after a victim who has witnessed or experienced a traumatic event.(American Psychiatric Association, 2013) When PTSD was identified as an mental health condition by the psychologist? The term PTSD first appeared in the 1980s, but the concept of this disorder can be traced back to 1952 when the first edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM was published. The stress reaction

Essay about Organizational Structure - 1080 Words

Organizational Structure MGT/230 Chipotle’s Organizational Structure The reporting structure is a very important tool in an organization. This structure is a chart that serves as a roadmap of management levels and positions. Every business has a chain of command and it is structured uniquely, depending on the organization. The structure of an organization, if not built correctly can destroy the organization just like a building with poor architecture. The blueprints clarify and build a strong foundation in which to grow or build an organization. Chipotle is a Mexican Grill Restaurant in the fast food industry that started out with one location in Colorado back in 1993. Today it has just more than 1,400 locations in the United†¦show more content†¦Dividing the organization into divisions based on the geographic region makes it possible for each region to purchase their ingredients locally and organically. This divisional structure also allows the company to evaluate and compare the regions. This divisional structure is very different from that of others. A functional structure is organized into departments according to the business functions. In this structure each department has its own expectations and responsibilities, they are not like that of any other department, so the tasks in each department are different from one another. In this type of structure each department is built with individuals that have the skills and expertise in relation to that department. All 1,400 plus Chipotle restaurants are owned by the same corporation. If this was not the case and some stores were franchised out, then a network structure would need to be created. A network organization looks for ways for tasks to be completed outside of the organization by outsourcing. A store that agrees to license contracts and franchises with the company would be responsible for delivering and completing the goals at the specific location; these business functions include management, employment, product ordering, etc. Chipotle would be cutting a lot of cost and making money by contributing little in return. This is the main reason an organization would choose a network type of structure. The responsible party for theShow MoreRelatedOrganizational Structure763 Words   |  4 PagesIntroduction It is essential to be conscious of your company s organizational structure because it exposes information concerning who has authority over whom; how and why a company splits the workload by specific people and by groups/teams. Understanding your organizational structure can also reveal important cross-functional relationships to coordinate work efforts for optimum results. It can show where breakdowns can occur in the hierarchy and assist in developing solutions for increasedRead MoreOrganizational Structure4097 Words   |  17 Pagesorganization structures and identify the type of organizational structure that do you thinks suitable for your selected organization? Organizational structure †¢ Organizational structure is the way in witch an organization’s activities (job tasks) are divided, organized and coordinated. †¢ Organizational structure is the way in which and work, authority resources of an organization have been divided among members. Types of organizational structure ââ€" ªRead MoreOrganizational Structure And Functional Structure999 Words   |  4 PagesFor traditional organization structures, departmentalization means that â€Å"how to group work positions into formal teams or departments that are linked together in a coordinated way† (Victoria management school, 2010, p. 272). These decisions have three types of organizational structure: functional, divisional, matrix and hybrid structures. The definition of functional structure is that making the groups which get the people who have the similar skills together for the similar tasks (Schermerhorn,Read MoreOrganizational Structure Paper1161 Words   |  5 PagesOrganizational Structure Paper MGT 230 Organizational Structure Paper The selected organization for the topic is AAA Remodeling AAA Remodeling is a construction company that focuses on remodeling of residential homes along with weatherization on commercial and residential buildings. Description of organizational structure of AAA remodeling will be given. Two other organizational structures will be selected for the use of contrast and comparison. The organizational functionsRead MoreManagement and Organizational Structure1043 Words   |  5 PagesOrganizational Structures Ahmed Bassyouni University of Phoenix Sep 28, 2010 William Noble Some organizational theories could explain the Enron’s failure. Looking at the organizational structure and management of Enron, The structures were flat before the bureaucratic structure developed, then the bureaucratic structures developed in order to increase control. There were vertical structures where there was high level of control and according to theories the organizational circle is movingRead MoreOrganizational Structure Of An Organization Essay1629 Words   |  7 Pages1.2 At least two different organizational structures are identified, described, and compared in terms of their design principles. Ans: - 1. Organisational Structure – It is a structure which is used to elaborate ranking in an organisation. It is also define as an organizational structure which defines how activities such as task portion, division and guidance are directed towards the achievement of organizational purposes. 2. There are different types of organisationalRead MoreOrganizational Design and Organizational Structure Essay1427 Words   |  6 PagesORGANIZATIONAL DESIGN AND ORGANIZATIONAL STRUCTURE An organization is a pattern of relationships-many interwoven, simultaneous relationships- through which people, under the direction of managers, pursue their common goals. These goals are the products of the decision - making processes. The goals that managers develop through planning are typically ambitious, far-reaching, and open-ended. Managers want to ensure that their organizations can endure for a long time. Members of an organizationRead MoreOrganizational Structure And The Organization789 Words   |  4 PagesOrganizations differ from one another in various ways, and that is stated in their mission and vision statement as well as their goals. Every organization has a set pattern that helps to establish the structure on which it will accomplish the goal of the business. According to Prodanciuc, organizational structure is the fundamental concept that helps the organization be organized and administrated. The organizing takes place at the beginning of the organizationâ⠂¬â„¢s existence and it means providing everythingRead MoreOrganizational Structure Of An Organization1361 Words   |  6 Pagesputting a structure to the business so that managers can manage, supervise and coordinate its people and organization’s performance. A structure serves as a framework for the purpose of outlining clear operating guidelines in order to keep the organization functional. It defines the hierarchical lines of authority, establishing job roles and responsibilities, details communication channels to determine how information should flow within the organization. A well-fitted organizational structure will haveRead MoreOrganizational Structure775 Words   |  4 PagesORGANIZATIONAL STRUCTURE Organizational structure refers to the way that an organization arranges people and jobs so that its work can be performed and its goals can be met. When a work group is very small and face-to-face communication is frequent, formal structure may be unnecessary, but in a larger organization decisions have to be made about the delegation of various tasks. Thus, procedures are established that assign responsibilities for various functions. It is these decisions that determine

What do we mean by business environment Free Essays

Business Organisations simply mean a group of people working together as a team in a particular organisation by delivering products, goods and services to customer in exchange of profit. But, these organisation are influenced by many factors within the environment in which they operate and said to be the very dominant force in the shaping and moulding of the organisation. What do we mean by business environment? Business environment is a set of influence, which shapes and moulds an organisation. We will write a custom essay sample on What do we mean by business environment? or any similar topic only for you Order Now There are number of factor which shapes and moulds an organisation. In other word, the development and strength of an organisation lies on these seven main influence such as ways of doing thing, rules and regulation, principle and procedures, attitude and behaviour, product and service, framework of an authority and finally the channel of communication. As everyone knows, different people have they own of ways of doing thing because they are not necessary to have the same thought with others and maybe it all depends on some sort of style or tradition, which need to be followed. For an example, a football team has many strategic such as 4-4-2, 4-4-3, 3-5-2 and so on. But, they use different strategic when facing different opponent or maybe changes their strategic when it comes to a certain circumstance e. g. player got sent off or injured, difficulty in defending, urgency to score, etc. No one can declare a particular method or way of doing thing of organisation is the best. This is because each given set of circumstances requires different solution. Rules and regulation is must for an organisation. Without it, everyone will not be bothered to do what he or she supposes in a proper manner within the dateline. Let us take a look at this example, which is sound familiar for some of us. Being an APIIT student, everyone strictly prohibit the wearing of T-shirt, jeans, sneakers or slippers, as well as provocative and immodest attire. Principle and procedure are essential for an organisation. Every job or task given must be done according to a particular principle and procedure to ensure a good output or result in return. For instance, let’s take a look at a football team again. In order to score a goal, the ball must be played to one another until someone has the golden opportunity to score a goal. Attitude and behaviour play an important role for an organisation. Basically, there is two type of business environment, which is external and internal. What do we mean by external environment? External environment is non-controllable environment, which is outside an organisation. This environment can be divided into a number of areas such as politic, economy, social, technology -P-E-S-T- and last not the least globalisation. Political environment refers to the set of law, regulation and government policies existing within a particular country. Some people argued that this is the most powerful influence at work e. g. if a businessman wants to start up a business in a particular country, first he or she must ensure the political stability of that country. For instance, an unstable political climate in a country will not instill confidence in people and this will in turn affect the business climate adversely. If given an option to run a business in Kabul, Afghanistan or Tokyo, Japan, I am pretty sure that everyone will choose the second option. Moreover, the tax treaties, which are agreements between governments to avoid, double taxation of profits by the foreign and the domestic government would serve to accelerate the foreign investment in a country. Two main policies are privatisation (where government sells off some of its existing public corporation to the private sector e. g. MAS, Telekom) and deregulation (removal of government redtape and bureaucracy from the operation of the market or better known as duty tax e. g. same rate). Next, economic environment, which is mainly, emphasizes on customers’ demand for good and services and the resulting supply situation. How an organisation will fare depends on the level of demands for its goods and services. Factors such as buying behaviour, purchasing power, price levels, interest rates, etc. are important determinants of demands. Since, World Cup is this month, let us take another example on football. The football fever starts, as you walk around in the city you can see many football freaks wearing their favourite teams’ jersey. This clearly indicates the demands for jersey increases as the interest rates increases. Beside that, the state of economy in terms of changes in levels of income, employment, inflation and foreign exchange rates affect the level of consumption and the standard of living. Business organisation themselves can boost demand by extending employment and investment, and conversely they can adversely influence the economy when they cut back on investment or retrench workers. For instance, the current state of economy of Argentina will decrease the foreign investment and. As a result, many of their countrymen were unemployed and creating havoc everywhere causing a major setback for the government. Social environment is made up of the attitudes, beliefs, customs and values of people in society. Entrepreneurs must realise that these social factors vary with the different classes of people within a country – the rich and the poor, the educated and the uneducated, the liberal and the conservative, etc. For an example, in India the Indians belief and consider the cow as their mother for providing milk. Therefore, they do not eat beef. But, lately a McDonald outlet in India offers some sort of burger or meal with beef. These turn out to be a disaster for McDonald as many of the citizens got angry and begin to create havoc in the country. McDonalds’ outlet in India finally found a solution. They modified and make slight changes in their recipes, beef burger is replaced by fish burger. An excellent moves which paid off when they got an immediate response from the citizen. This show how important is to know the beliefs and customs of a particular country. It is fool to underestimate the beliefs and customs of a country. Hence, it has become necessary for businesses to analyse and study carefully these factors and issues if their goods and services are to be accepted. Another important and not a new factor in the overall environment is the technology environment. Its increasing importance and influence is now being felt clearly and powerfully than at any other time. The changes in technology are virtually revolutionising how work is perfomed in factories and offices, and indeed the whole market. For instance, massive advancement in technology and rapid changes in information technology helps to increase the productivity of an organisation. The usage of hi-tech machines and equipments will greatly influence the success of organization. It simply save a lot of time, energy and helps to cut down number of employees. Organisations that are not able to keep pace with such changes are left behind, and consequently edged out of competition. One area that has emerged as being vital to business organization is information technology. Assume that an organization dealing with thousands perhaps millions customers data, somehow need to use the the technology employed to collect, process, produced, maintain and update the customers information. Microprocessors have allowed the introduction of small low-cost micro-computers that have household application for monitoring weather conditions. Many industries such as motorcar manufacturers are using microprocessors to control the operation of the car engine. Globalisation environment is an essential factor in organization. With the rapid advancement of telecommunication infrastructure and information technology has forced organization to proceed beyond their national or geographic boundaries in search of ways and means to exploit existing new technology so as to ahead of their competitors. Speed and quality in addressing the needs of world-wide customers and continuously learning of organisations will greatly influenced the success of organizations. As everyone knows, the current business environment is one where the whole world is seen as one market place, borderless world. In short, the ability to think globally while acting locally. One example is the usage of internet and mobile phone which connects you to people all around the globe no matter where they are. Market environment is very much similar to the economic environment, but there are a number of distinguish features. Essentially this is the environment of competitors, buyers and sellers. It is important to monitor these three groups of people. For instance, competitors must also be analysed closely with regards to their strengths and weakness. Customers must also be researched thoroughly in order to establishe needs and trends. Businesses should also be constanly on the look out for new products and materials from existing or new supplier. It actually refers to an organization behavioural system whish is constantly changing as it adapts to the evolving requirement of society. As you can see customers itself influence the demand level because they have the buying or purchasing power. If you look out for mobile phone industries, there are number of companies competing each other to outplay, outwit and outlast one another to become the number 1 leading mobile phone. That is why you can see many mobile phones with different size and outlook out for sales like mushroom to satisfy the customers need. Finally, lets take a look at internal environment. There are number of area which covers internal environment such as the rules and regulation, employee management, produst and service and facilities. Rules and regulation is must for an organisation. Without it, everyone will not be bothered to carry out his or her duties and responsibilities in proper way. There are many rules and regulations in an organisation such as attire (e. g. wear modest attire), punctuality (e. g. always meet the dateline), behaviour (e. g. must be polite and coorperate with other colleagues). As an organization, employee management is important to run business systematically. The management is the backbone of an organization thus it needs to be strong to overcome any difficulty. A good management always productive and try their level best to meet their target or objective. Product and service is the most important factors without it business cannot be run. Customers is fussy and choosy, they always want the best product or service. Therefore, organisation must always upgrade their product and service to meet the need of so called customers. The best quality products with reasonable price always attract the customers. Last not the least, facilities and infrastructures which play an important role too in an organisation. Basically, a high class facilities and latest infrastructures simply help both the organisations and the customers to connect each other. Thus, a country with an excellent network of highways and railroads will definitely be attractive to foreign investment to start business there. It is vital to note that business orgnisation interact with the above environmental factors. This means that the influence and impact is not one-sided. How to cite What do we mean by business environment?, Papers

Romeo and Juliet by Michael Horwood Essay Example For Students

Romeo and Juliet by Michael Horwood Essay Was the tragedy brought by an overwhelming fate, or did individuals bring it upon themselves? Romeo and Juliet was written by William Shakespeare at a time when fate was believed to control everything, and the position of the stars at the moment of ones birth foretold the path of someones life. In the play, and throughout, nearly all the characters blame fate for the misfortunes that lead to the eventual tragedy. I believe that a small amount of fate but also chance brings upon the deaths of both households, but also some of the characters contribute by the decisions they make, the feud they keep alight, and the quickness with which they act. Fate is mentioned by the chorus at the start of the play: A pair of star-crossed lovers take their life Whose misadventured piteous overthrows Beginning with a reference to fate, then talking about the lovers actions, suggests that fate has a higher priority in the cause of the tragedy, rather then the individuals actions. However, Shakespeare makes the characters acknowledge an overwhelming fate on stage. First we hear Romeo talking about it: Romeo Then I defy you stars Romeo believes in fate, and is constantly referring to it. He uses the word deny, which is a strong word that shows his determination. The friar also refers to fate on stage: Friar Laurence Oh! Unhappy Fortune However, Shakespeare only makes the characters who are weak, and unable to acknowledge their own decisions, blame fate. Romeo blames fate all the time throughout the play, rather than his own actions, which he causes. On the other hand, Juliet never blames fate, and identifies factors like haste and the family feud as the causes of the deaths in the families. A modern day audience may disagree and blame it entirely on the individuals- rather than a cruel overwhelming fate as Romeo sees it. Another factor is chance, which does play a very large part in the tragedy: Benvolio The day is hot, the capels are abroad Benvolio warns Mercutio about the heat of the day, when many people are easily irritated, but Mercutio ignores the advice, and is slain by Tybalt. The Capulet nephew is then killed by Romeo, and as a result Romeo is banished, which is the peripeteia, as the lovers are separated, which leads to the rushed plan, and eventually both the deaths. Another time chance plays a part in the tragedy is during a plague outbreak: Friar John Seald up the doors, and would not let us forth Friar John is held because of a plague in the area he is visiting, and so he cannot give the note to Romeo about the plan about him and Juliet. It is not connected to fate, but the feud, an ancient grudge that is the main contributor. At the beginning of the play, before the reference to fate or individual actions, the audience is told about the rivalry between the two households. It is also shown in the first scene, with both households fighting, showing how many people are involved. The feud affects members of the household and even innocent people who are not blood related (like Mercutio and Paris). At the end, Romeo, Juliet, Lady Montague, Tybalt, Mercutio and Paris all are dead as a result of the fighting between the houses. The Capulets take the feud more seriously: Capulet My sword I say The Capulet servants are the first ones to start the street feud, and Benvolio, a friend of the family, tries to keep the peace. Tybalt is shown as being evil in the 1997 movie version: during the Capulets fancy dress, he is dressed as the devil: Tybalt Turn thee, Benvolio, look upon thy death. The nephew of the Capulets, he often has a fiery attitude, and a very aggressive one. What is responsible for the feud and therefore the tragedy is individual characters actions. This explanation of the cause is the most likely, as the modern day audience would not blame fate. This is also reflected in the last speech, by the prince, who blames individuals rather than a cruel, overwhelming fate: and I, for winking at your discords too have lost a brace of kinsmen. All are punished The prince accepts that he is partly to blame, although I would not name him as a major character that caused the tragedy. He uses the word winking, which gives the effect of him not caring what is going on in his kingdom. Romeo, despite blaming fate does not realise that he himself is to blame, and it is he that also plays a part in the tragedy. Romeos own actions after the death of Mercutio, he blames on fate: Explain how Shakespeare creates dramatic tension in Act 3 Scene 5? EssayThe Friar is an important character in the play, and both Romeo and Juliet come to him for advice. We see him to be a well-intentioned man, and tries to make peace between the families, although he does not consider all the outcomes, and so adds unintentionally to the feud. Most of his plans, like the wedding, he sees as an opportunity to end the feud: For this alliance may so happy prove, to turn your households rancour to pure love. He believes he is marrying them for good, but his plan fails. Later, also he is forced to help Juliet when she uses emotional blackmail on him, saying she will kill herself if he does not help her. Even this plan goes wrong when friar John is held back by plague outbreaks, although this is still not Friar Laurences fault. Although, we can perhaps blame him at the end when he flees from the tomb, afraid of being caught: Come, go good Juliet. I dare no longer stay So, she was left alone. This is the only point when the friar is directly responsible for a death. Although, he could not really have done anything for her, as her Romeo has died, and she has shown earlier that she is willing to die for him. Juliet was in love with Romeo so much that not even he could not stop her from killing herself, so I see that the friar is not largely responsible. The nurse is quite a major character for the tragedy. She helps arrange the secret marriage, and later doesnt help Juliet when her father is angry with her. She turns sides in the middle of the play, despite helping the young lovers through everything: I think it best you married with the county O hes a lovely gentlemen Thus, having being rejected by everyone, including the nurse, whom she has always relied upon. The nurse, may have been trying to think straight, or perhaps she was doing this for selfish reasons; now Juliet is growing up, she will soon lose her job. Juliet then visits the friar who comes up with the plan that eventually leads to her death. Consequently, the nurse is very high in the cause of the catastrophe. Capulet contributes to the tragedy, as he rushes into the fight when it begins in the first scene: Capulet: What noise is this? Give me my long-sword, ho! At the beginning we see a very aggressive side to Capulet, who rushes straight in to the fight, not wanting to know who or what started it. On the other hand, in the next scene he shows a loving father figure by telling Paris to wait a few years, before he can marry Juliet: Capulet: Let two more summers wither in their pride Ere we may think her ripe to be a bride This is ironic, because a few days later he tells Paris he can marry Juliet, and even moves the wedding forward. Moreover, a few scenes later, he tells Tybalt not to disrupt his party (when Tybalt wants to fight Romeo for intruding). However, in act three, he plays a larger part in the tragedy by arranging the marriage with Paris, and because of Juliets refusal, and he consequently disowns her: Capulet: I tell thee what, get thee to church o Thursday Or never after look me in the face Nurse: God in heaven bless her! You are to blame, my lord, to rate her so This is another large decision that adds to the tragedy. It leads Juliet to demand advice from the friar, who comes up with a desperate, rushed plan. It was typical for a father in Shakespeares time to control their daughters, and to be angry if they disobeyed them. On the other hand, Shakespeare shows he is being too harsh on her, as both the nurse and his own wife asks him to calm down. In conclusion I would blame the majority of the tragedy on the individuals I have described, especially Capulet, Tybalt and the Nurse, who I think were very large contributors to the tragedy. Even the ruler of Verona, the prince blames the individuals, rather than fate. Perhaps it just depends what time period ones from: Elizabethan England, where the stars control destinies, or the modern day where we control our own.

The History of Greek Theater Essay Example For Students

The History of Greek Theater Essay Theater and drama in Ancient Greece took form in about 5th century BCE, with the Sopocles, the great writer of tragedy. In his plays and those of the same genre, heroes and the ideals of life were depicted and glorified. It was believed that man should live for honor and fame, his action was courageous and glorious and his life would climax in a great and noble death. Originally, the heros recognition was created by selfish behaviors and little thought of service to others. As the Greeks grew toward city-states and colonization, it became the destiny and ambition of the hero to gain honor by serving his city. We will write a custom essay on The History of Greek Theater specifically for you for only $16.38 $13.9/page Order now The second major characteristic of the early Greek world was the supernatural. The two worlds were not separate, as the gods lived in the same world as the men, and they interfered in the mens lives as they chose to. It was the gods who sent suffering and evil to men. In the plays of Sophocles, the gods brought about the heros downfall because of a tragic flaw in the character of the hero. In Greek tragedy, suffering brought knowledge of worldly matters and of the individual. Aristotle attempted to explain how an audience could observe tragic events and still have a pleasurable experience. Aristotle, by searching the works of writers of Greek tragedy, Aeschulus, Euripides and Sophocles whose Oedipus Rex he considered the finest of all Greek tragedies, arrived at his definition of tragedy. This explanation has a profound influence for more than twenty centuries on those writing tragedies, most significantly Shakespeare. Aristotles analysis of tragedy began with a description of the effect such a work had on the audience as acatharsis or purging of the emotions. He decided that catharsis was the purging of two specific emotions, pity and fear. The hero has made a mistake due to ignorance, not because of wickedness or corruption. Aristotle used the word hamartia, which is the tragic flaw or offense committed in ignorance. For example, Oedipus is ignorant of his true parentage when he commits his fatal deed. Oedipus Rex is one of the stories in a three-part myth called the Thebian cycle. The structure of most all Greek tragedies is similar to Oedipus Rex. Such plays are divided in to five parts, the prologue or introduction, the prados or entrance of the chorus, four episode or acts separates from one another by stasimons or choral odes, and exodos, the action after the last stasimon. These odes are lyric poetry, lines chanted or sung as the chorus moved rhythmically across the orchestra. The lines that accompanied the movement of the chorus in one direction were called strophe, the return movement was accompanied by lines called antistrophe. The choral ode might contain more than one strophe or antistrophe. Greek tragedy originated in honor of the god of wine, Dionysus, the patron god of tragedy. The performance took place in an open-air theater. The word tragedy is derived from the termtragedia or goat-song, named for the goat skins the chorus wore in the performance. The plots came from legends of the Heroic Age. Tragedy grew from a choral lyric, as Aristotle said, tragedy is largely based on lifes pity and splendor. Plays were performed at dramatic festivals, the two main ones being the Feast of the Winepress in January and the City Dionysia at the end of March. The Proceeding began with the procession of choruses and actors of the three competing poets. A herald then announced the poets names and the titles of their plays. On this day it was likely that the image of Dionysus was taken in a procession from his temple beside the theater to a point near the road he had once taken to reach Athens from the north, then it was brought back by torch light, amid a carnival celebration, to the theater itself, where his priest occupied the central seat of honor during the performances. On the first day of the festival there were contests between the choruses, five of men and five of boys. Each chorus consisted of fifty men or boys. On the next three days, a tragic tetralogy group made up of four pieces, a trilogy followed by a satyric drama was performed each morning. This is compared to the Elizabethan habit of following a tragedy with a jig. During the Peloponnesian Wars, this was followed by a comedy each afternoon. The Father of the drama was Thesis of Athens, 535 BC, who created the first actor. The actor performed in intervals between the dancing of the chorus and conversing at times with the leader of the chorus. .ua96ee7ed691c193bb9a9477128b0cf50 , .ua96ee7ed691c193bb9a9477128b0cf50 .postImageUrl , .ua96ee7ed691c193bb9a9477128b0cf50 .centered-text-area { min-height: 80px; position: relative; } .ua96ee7ed691c193bb9a9477128b0cf50 , .ua96ee7ed691c193bb9a9477128b0cf50:hover , .ua96ee7ed691c193bb9a9477128b0cf50:visited , .ua96ee7ed691c193bb9a9477128b0cf50:active { border:0!important; } .ua96ee7ed691c193bb9a9477128b0cf50 .clearfix:after { content: ""; display: table; clear: both; } .ua96ee7ed691c193bb9a9477128b0cf50 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ua96ee7ed691c193bb9a9477128b0cf50:active , .ua96ee7ed691c193bb9a9477128b0cf50:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ua96ee7ed691c193bb9a9477128b0cf50 .centered-text-area { width: 100%; position: relative ; } .ua96ee7ed691c193bb9a9477128b0cf50 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ua96ee7ed691c193bb9a9477128b0cf50 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ua96ee7ed691c193bb9a9477128b0cf50 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ua96ee7ed691c193bb9a9477128b0cf50:hover .ctaButton { background-color: #34495E!important; } .ua96ee7ed691c193bb9a9477128b0cf50 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ua96ee7ed691c193bb9a9477128b0cf50 .ua96ee7ed691c193bb9a9477128b0cf50-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ua96ee7ed691c193bb9a9477128b0cf50:after { content: ""; display: block; clear: both; } READ: The Development of the Novel EssayThe tragedy was further developed when new myths became part of the performance, changing the nature of the chorus to a group appropriate to the individual story. A second actor was added by Aeschylus and a third actor was added by Sophocles, and the number of the chorus was fixed at fifteen. The chorus part was gradually reduced, and the dialogue of the actors became increasingly important. The word chorus meant dance or dancing ground, which was how dance evolved into the drama. Members of the chorus were characters in the play who commented on the action. They drew the audience into the play and reflected the audiences reactions. The Greek plays were performed in open-air theaters. Nocturnal scenes were performed even in sunlight. The area in front of the stages was called the orchestra, the area in which the chorus moved and danced. There was no curtain and the play was presented as a whole with no act or scene divisions. There was a building at the back of the stage called a skene, which represented the front of a palace or temple. It contained a central doorway and two other stage entrances, one at the left and the other at the right, representing the country and the city. Sacrifices were performed at the altar of Dionysus, and the chorus performed in the orchestra, which surrounded the altar. The theatron, from where the word theater is derived, is where the audience sat, built on a hollowed-out hillside. Seated of honor, found in the front and center of the theatron, were for public officials and priests. he seating capacity of the theater was about 17,000. The audience of about 14,000 was lively, noisy, emotional and unrestrained. They ate, applauded, cheered, hissed, and kicked their wooden seats in disgust. Small riots were known to break out if the audience was dissatisfied. Women were allowed to be spectators of tragedy, and probably even comedy. Admission was free or nominal, and the poor were paid for by the state. The Attic dramatists, like the Elizabethans, had a public of all classes. Because of the size of the audience, the actors must also have been physically remote. The sense of remoteness may have been heightened by masked, statuesque figures of the actors whose acting depended largely on voice gestures and grouping. Since there were only three actors, the same men in the same play had to play double parts. At first, the dramatists themselves acted, like Shakespeare. Gradually, acting became professionalized. Simple scenery began with Sophocles, but changes of scene were rare and stage properties were also rare, such as an occasional altar, a tomb or an image of gods. Machinery was used for lightning or thunder or for lifting celestial persons from heaven and back, or for revealing the interior of the stage building. This was called deus ex machina, which means god from the machine, and was a technical device that used a metal crane on top of the skene building, which contained the dressing rooms, from which a dummy was suspended to represent a god. This device was first employed by Euripides to give a miraculous conclusion to a tragedy. In later romantic literature, this device was no longer used and the miracles supplied by it were replace by the sudden appearance of a rich uncle, the discovery or new wills, or of infants changed at birth. Many proprieties of the Greek plays were attached to violence. Therefore, it was a rule that acts of violence must take place off stage. This carried through to the Elizabethan theater which avoided the horrors of men being flayed alive or Glousters eyes being put out in full view of an audience King Lear. When Medea went inside the house to murder her children, the chorus was left outside, chanting in anguish, to represent the feelings the chorus had and could not act upon, because of their metaphysical existence. The use of music in the theater began very simply consisting of a single flute player that accompanied the chorus. Toward the close of the century, more complicated solo singing was developed by Euripides. There could-then be large-scale spectacular events, with stage crowds and chariots, particularly in plays by Aeschylus. Greek comedy was derived from two different sources, the more known being the choral element which included ceremonies to stimulate fertility at the festival of Dionysus or in ribald drunken revel in his honor. The term comedy is actually drawn from komos, meaning song of revelry. The second source of Greek comedy was that from the Sicilian mimes, who put on very rude performances where they would make satirical allusions to audience members as they ad-libbed their performances. In the beginning, comedy was frank, indecent and sexual. The plots were loosely and carelessly structured and included broad farce and buffoonery. .u555db98ce37fb735099a42ed3a433b41 , .u555db98ce37fb735099a42ed3a433b41 .postImageUrl , .u555db98ce37fb735099a42ed3a433b41 .centered-text-area { min-height: 80px; position: relative; } .u555db98ce37fb735099a42ed3a433b41 , .u555db98ce37fb735099a42ed3a433b41:hover , .u555db98ce37fb735099a42ed3a433b41:visited , .u555db98ce37fb735099a42ed3a433b41:active { border:0!important; } .u555db98ce37fb735099a42ed3a433b41 .clearfix:after { content: ""; display: table; clear: both; } .u555db98ce37fb735099a42ed3a433b41 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u555db98ce37fb735099a42ed3a433b41:active , .u555db98ce37fb735099a42ed3a433b41:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u555db98ce37fb735099a42ed3a433b41 .centered-text-area { width: 100%; position: relative ; } .u555db98ce37fb735099a42ed3a433b41 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u555db98ce37fb735099a42ed3a433b41 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u555db98ce37fb735099a42ed3a433b41 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u555db98ce37fb735099a42ed3a433b41:hover .ctaButton { background-color: #34495E!important; } .u555db98ce37fb735099a42ed3a433b41 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u555db98ce37fb735099a42ed3a433b41 .u555db98ce37fb735099a42ed3a433b41-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u555db98ce37fb735099a42ed3a433b41:after { content: ""; display: block; clear: both; } READ: Animation History and Forms EssayThe performers were coarse and obscene while using satire to depict important contemporary moral, social and political issues of Athenian life. The comedy included broad satire of well known persons of that time. Throughout the comedic period in Greece, there were three distinctive eras of comedies as the genre progressed. Old comedy, which lasted from approximately 450 to 400 BCE, was performed at the festivals of Dionysus following the tragedies. There would be contests between three poets, each exhibiting one comedy. Each comedy troupe would consist of one or two actors and a chorus of twenty-four. The actors wore masks and soccus, or sandals, and the chorus often wore fantastic costumes. Comedies were constructed in five parts, the prologue, where the leading character conceived the happy idea, the parodos or entrance of the chorus, the agon, a dramatized debate between the proponent and opponent of the happy idea where the opposition was always defeated, the parabasis, the coming forth of the chorus where they directly addressed the audience and aired the poets views on most any matter the poet felt like having expressed, and the episodes, where the happy idea was put into practical application. Aristotle highly criticized comedy, saying that it was just a ridiculous imitation of lower types of man with eminent faults emphasized for the audiences pleasure, such as a mask worn to show deformity, or for the man to do something like slip and fall on a banana peel. Aristophanes, a comic poet of the old comedy period, wrote comedies which came to represent old comedy, as his style was widely copied by other poets. In his most famous works, he used dramatic satire on some of the most famous philosophers and poets of the era. In The Frogs he ridiculed Euripides, and in The Clouds he mocked Socrates. His works followed all the basic principles of old comedy, but he added a facet of cleverness and depth in feeling to his lyrics, in an attempt to appeal to both the emotions and intellect of the audience. Middle comedy, which dominated from 400 to 336 BCE, was very transitional, having aspects of both old comedy and new comedy. It was more timid than old comedy, having many less sexual gestures and innuendoes. It was concerned less with people and politics, and more with myths and tragedies. The chorus began its fade into the background, becoming more of an interlude than the important component it used to be. Aristophanes wrote a few works in middle comedy, but the most famous writers of the time were Antiphanes of Athens and Alexis of Thurii, whose compositions have mostly been lost and only very few of their found works have been full extant plays. In new comedy which lasted from 336 to 250 BCE, satire is almost entirely replaced by social comedy involving the family and individual character development, and the themes of romantic love. A closely knit plot in new comedy was based on intrigue, identities, relationships or a combination of these. A subplot was often utilized as well. The characters in new comedy are very similar in each work, possibly including a father who is very miser like, a son who is mistreated but deserving, and other people with stereotypical personas. The chief writer of new comedy was Menander, and as with the prominent writers of the middle comedic era, most of his works have been lost, but other dramatists of the time period, like Terence and Platus, had imitated and adapted his methods. Menanders The Curmudgeon is the only complete extant play known by him to date, and it served as the basis for the later Latin writers to adapt. Adventure, brilliance, invention, romance and scenic effect, together with delightful lyrics and wisdom, were the gifts of the Greek theater. These conventions strongly affected subsequent plays and playwrights, having put forth influence on theater throughout the centuries.

Progress of Technology essays

Progress of Technology essays Personal computers were officially introduced just around 15 years ago and already changed our lives dramatically. People that were born around that time rely on computers a lot more than older generations. We use computers for just about everything like instant messaging, games, homework, music and e-mail; just to name a few. I think that advances in technology and, therefore, computers have mostly a positive effect on humans. They replace peoples jobs and do them millions of times faster. We wouldnt be able to launch any spaceships if it wasnt for the computer helping humans control it. Homework and research would take hours to complete because you would have to look for different sources everywhere and now you just log onto the internet and all known encyclopedias are at your fingertips. Computers these days can be found everywhere from being the brain of new cars and helping you drive without getting lost to just sitting on your arm and telling you the correct time. A computer isn't just the thing that sits on your desk to be used for word processing. They are amazing machines able to do things some people don't even think possible. Computers are helping humans live. They take off many responsibilities so people just watch the numbers on the screen and not worry about anything else as the computer does the rest. Computers also save lives. SWAT teams use them inside radio controlled robots that can disarm all sorts of bombs or even serve as a camera to go through small spaces that people can't get through. A computer is something not to be underestimated. Computers are not only becoming faster every day but they are also becoming smaller. Around 40 years ago, computers were as big as several rooms and needed thousands of times more power than a personal computer today. All they could do was simple arithmetic operations that nowadays can be performed on any tiny hand-held calculator. Soon people will carry their...

Essay Example | Topics and Well Written Essays - 1500 words - 21

Essay Example It might not help in generating additional revenues in the short-run. But, it can enhance employee productivity in the long-run through maintaining a healthy relation with them and becoming responsible for their personal well-being. Again, through maintaining a good customer relation, the company can create a positive image in the society that will definitely help it in winning customer loyalty. Moreover, a good image can help a company in preventing implementations of government regulations on its activities that are sometimes known to be a consequence of popular public demands. This paper however, concentrates upon corporate social responsibilities, i.e., a corporate house’s concern towards environmental sustainability and climate changes and the strategies that a corporate should adopt to protect them (Social Responsibility and Organizational Ethics, 2001). Environmental sustainability implies the measures that an organisation can take for the purpose of environmental protection and thus social welfare. It becomes a very important aspect of corporate responsibility since the well-being of the entire population as well as the future generation depends on it. Some important terminology being used in this paper while discussing the strategies that a company should ideally undertake for environmental protection and making room for climate changes are – Natural Resources – these are resources that are found in nature and are not necessary to be created artificially. Natural Resources can be of two types – exhaustible and inexhaustible. The former ones are those that cannot be restored once they are spent and hence need to be used with much care and concern. On the other hand, inexhaustible resources are those that could be restored and thus do not have a diminishing stock. So, it becomes an important corporate responsibility to protect these exhaustible natural resources and make as little use as possible of them, since everything in our nature

Business Ethics Essay Example | Topics and Well Written Essays - 2000 words - 10

Business Ethics - Essay Example Marine Stewardship Council is a nonprofit organization that has dedicated its operations to ensure sustainable fishing (MSC, 1998). Their mission states, that they are focused, contribute towards the health of the oceans and bring about environmental and economic benefit. This paper seeks to discuss the Corporate Social Responsibility undertaken by Walmart and explain the theories by Levy and Kaplans on the same. In addition, the paper will discuss how the initiative has offered opportunities for civil regulation in reference to the Levy and Kaplans framework. MSC was set up in London in 1997. Since MSC was inception, it has experienced rapid growth and focused on its role in promoting sustainable fisheries. The organization is able to counter this through the establishment of concrete criteria and principles for fisheries assessment. To ensure credibility, MSC follows the UNFAO guidelines that govern eco labeling of fish and any products related from the marine capture fisheries. MSC takes the role of an accreditor and facilitator through provision of a framework and guidelines regarding sustainable fishery. Most at times, the organization does not involve itself in the whole physical process of certifying fisheries; they focus on endorsing the list of ASI (Accreditation Services International) for the companies that show capability of engaging in the process. In 2006, Walmart announced the availability of MSC product in their stores. Walmart is one of the largest American multinational retail corporations whose main significance is to help people save money and live better lives within the global context. It came into operation in the early 1960s having been founded by  Douglas McMillon, operates a chain of stores, and warehouses whose main headquarters are in Arkansas. Walmart operates in close to thirty countries all over the world and has various business units  that seek to make a difference in the community.  Moreover, Walmart observes the

Business and social Responsibility Essay Example | Topics and Well Written Essays - 1000 words

Business and social Responsibility - Essay Example Since, they have to face the end users, their stake is quite critical. Each stakeholder of the company is as important as the other. The management is responsible for the overall strategy and production enhancement of the company. They are also responsible to take care of their workers and their channel partners. At the same time they have a social responsibility to the area where they are operating. Their decision is crucial for the future of the rest of the stakeholders and dependants. They need cooperation from the workers as well as the distributors and stockists, which will help them to increase their productivity and sales. It is up to them how they wish to run the company and what issues and objections they need to overcome. The issues could be varied and may not have direct relation to the company’s primary objective, which is turnover and profitability. Similarly the workers have a huge role to play in the organization, since they are the only source of manpower in the area. It is a coexistent for both the groups. Each of the group is dependant on the other for their existence. They are responsible for the efficient productivity at the plant and their decision is important for the company to survive and grow. But they also need to be aware of their well being and the effect it will have in Teesside. Also, their cooperation and understanding of the company’s requirements is essential, so as to come to a consensus with the management. The same applies for the distributors, who must ensure the availability of the company’s product at their sales point. They are the direct contact point for the company to the end user and they are to ensure a positive image to the customers. Hence, any negative vibe or feelings of the customer needs to communicated to the company. If one considers the ethical issues surrounding Chemdex Chemicals, then we need to understand the difference between ethical and unethical business practice.

The Adventures Of Huckleberry Finn

The Adventures Of Huckleberry Finn In his episodic novel, The Adventures of Huckleberry Finn, Mark Twain fabricates a journey as the platform for the narrators symbolic rite of passage. The protagonist, Huckleberry Finn, discovers the true colors of his individuality, as he voyages through his many adventures and gains priceless experiences. While he matures and advances, Huck discards his disposition as an ignorant and juvenile adolescent craving for joy and peril and becomes a man, being able to firmly identify and establish his morals and ethics. During this intricate process, he develops a comradeship with a Jim, a runaway slave, ultimately learning the true horrors of the flawed society, in which he lives in. As a role in Hucks learning process, Mark Twain realistically utilizes the social perception of whites during the time period to assist Huck in discovering the blemishes of slavery, rejecting many critics assumption that he is a racist. Huck, a thirteen-year-old son of a drunkard, is recurrently strained to survive on his own wits where sometimes it contradicts societys standards and laws. As he seems to trek down the Mississippi River, he also journeys down his inner mentality, as Huck encounters challenges between his social conscience and individual conscience. Huck always seems to look up to the educated, the high and mid-class. He appeared to make himself believe that his judgment was inferior or abased to theirs because he was illiterate, and not truly part of society or a civilized human being. He blindly follows Tom Sawyer, due to the fact that he was educated and brought up in a refined urbane setting. As the novel opens, Huck is forced to be integrated in society and civilization. Though he struggles, he persuades himself to sublime in. In the beginning, Huck is perplexed by the fatuous purpose of religion. As Widow Douglas and Miss. Watson try very hard to reform Huck to become sivilize, he doesnt see the purpose of heaven and hell. Its these first signs of society (religion) that plays an impact on Huck, where he makes a connection that his actions will determine his destination after death. Huck also can be portrayed as an innate philosopher, where he is very skeptical of the societal dogmas (religion) and in fact perceives these ideas in his own ways, as he tries to reform. This is seen with Hucks idea that hell might actually be a better place than the Widow Douglass heaven. Thus this issue only engenders Hucks moral development. When Huck encounters Jim on Jacksons island, and attends his story of a runaway slave, Huck sees Jim as a human being rather than a slave. Huck feels empathy and remorse, as he hears Jims sad tale of his family being ripped apart. Huck, who just wasnt able to properly fully mold with society, and Jim, a run-away slave, both were alienated from society in fundamental ways. Both now in some form freed from the insincerity and injustice of society, but knew this would not last long. When Huck realizes that his fate was wrapped around Jims, he questions the morality of helping a run-away slave, this in which was against law, and breaking a law would lead him to hell. More subtly, Twain criticize the American South for its phony romanticism and hypocritical Christianity. Huck decries the idea that the Christianity of the South is a living contradiction. Huck does not comprehend the fact how society accepts slavery yet ignores the Biblical notion of the equality of all believers. (The Adve ntures of Huckleberry Finn pg1). Nonetheless, Huck conceded and acknowledged that he would go to hell, in which a sacrifice he was willing to make. In further context, Twain in his works is not a racist. In the manner he depicts Jim as a real person, who carries feelings and emotions, shows in fact that Twain is an opponent of slavery. Huck had the common sense to see how slavery was a genuine blight to humanity. Contrarily the so called sophisticated society accepted it, even the good people such as Miss. Watson. Huck matures further as he breaks that mask that society gave Jim, and accepts him as a normal person. Huck refers to Jim, I knowed he was white inside. (Twain, pg 46). It shows how Huck, who was brought up in a very bigoted section of the country, that ingested all the hypocrisy of slavery, was still able to transcend it by just knowing this one nigger, Jim. Furthermore, Hucks character changes as Jim teaches him about friendship. Their relationship becomes tighter, after the Hucks joke about him never had gone missing in the fog. Huck learns that Jim is a person is with feelings, and ultimately Jim induces this movement into Hucks maturity. This is the critical point of Hucks transformation, where Huck apologizes to Jim. Hucks voyage down the Mississippi taught him much, but was mainly a frolic. But once it resumes, when Huck is taken up the Grangerfords, he journeys to the dark side of American civilization. The benevolent family who offer Huck to stay is in a burning feud between another family, the Shepherdsons. Twain uses these two families to employ in some deriding absurdity and to mock an overly romanticizes ideas about family honor. Ultimately, the families sensationalized feud gets many of them killed. Huck truly refutes society once he saw his new friend Buck, be shot and killed. Twain uses this incident to comment on all systems of principle that rebuffs the humanity of another set of people. Huck becomes befuddled in this episode. The Grangerfords are a mix of contradictions where they treat Huck well, but they own slaves and behave more foolishly with other family by killing one other. Is this what society dawns upon? In the denouement, Huck transmogrifies into a full adolescent who now truly believes in his values, and deems that it should not be tractable and tarnished by societys laws. Near the conclusion of the novel, Huck and Tom make an attempt to free Jim who is held captured. After Toms ludicrous plan fails, everyone learns that Jim was actually a free man for weeks (because Miss. Watson, in her will, allow Jim to be free when she died). This idea of freeing a free black man had a special resonance at the time Twain wrote this novel. Blacks during this time had much trouble integrating with society because of the racial subordination that was still present preceding the Civil War. Work Cited The Adventures of Huckleberry Finn Essay. Novelguide.com. December 14, 2009. . Twain, Mark. The Adventures of Huckleberry Finn. United States: Bantum Books, Inc., 1884.

Papaya :: Health, Food Safety

Our results of PRSV CP digestibility in gastro-intestinal fluids as well as bioinformatic analysis have shown that the transgene CP protein expressed in Rainbow and SunUp papaya is not allergenic. The PRSV CP is the major protein expressed in Rainbow papaya along with widely used nptII and GUS plant transformation markers. Here we will discuss about CP protein only as food safety of NPTII and GUS have been addressed elsewhere (24-26). The prediction of allergenicity of novel proteins are based on either bioinformatic and/or experimental approaches (6, 7). Following the bioinformatics analysis, PRSV CP did not show significant similarity to known allergenic proteins based on the criterion of an eight amino acid identical match (27). However, we performed more stringent similarity search criterion of a six amino acid identity match to the query CP sequences which identified only five entries in the SDAP database. Although we identified very small number of matches to known allergens based on a six amino acid similarity search, numerous reports indicate that the high percentage of allergenic proteins identified using this criterion are false positives (31, 32) and thus in practice does not accurately predict allergenic proteins. A computer based allergenicity prediction report by Kleter and Peijnenburg (28) identified a peptide of six amino acids (EKQKEK) shared by PRSV CP and a proposed allergen ABA-1, a protein of the human parasite Ascaris lumbricoides or the pig parasite Ascaris suum. However, as noted previously by Suzuki et al.(29), the PRSV CP match to ABA-1 is not relevant with regards to allergenicity for several reasons: 1) the amino acid sequence is not repeated in the coat protein sequence, therefore it will not trigger the IgE response associated with allergens, 2) the ABA-1 proposed allergenic peptide was found to be not inherently allergenic outside the context of other Ascaris proteins (30), and 3) it is not among the officially recognized allergens found in the International Union of Immunological Societies (IUIS) allergen database (http://www.allergen.org). An important aspect of assessing potential allergenicity is experimental testing for properties common to allergenic proteins such as stability in simulated gastro-intestinal fluids which include SGF and SIF. SGF was developed to represent the conditions in the human stomach (20) and basically consists of the main gastric protease pepsin in low pH medium. Some data suggests that proteins that are susceptible to gastrointestinal digestion are inherently safer than those that are stable especially in terms of allergenicity (5).

Restriction Endonuclease Digestion of Plasmid Dna

Introduction: With the execution of this experiment, we began to go deeper into the Cell and Molecular Biology course. The main focus of the experiment would be how the Restriction Endonucleases cleave the strands of DNA. For this experiment, pBR322 was the specimen to use. Restriction Endonucleases work by cleaving the sugar phosphate backbone of specific DNA sites. Restriction enzymes that have been isolated from bacteria have a defensive role. This idea is illustrated when an attacking foreign cell DNA is trying to alter the bacteria; restriction enzymes cleave the DNA rendering it inert.The second part of the experiment deals with Gel Electrophoresis. The samples are loaded into wells on an 1% agarose slab and subjected to electrical currents both positive and negative. Our current target here is DNA, therefore since nucleic acid as a negative charge, the bands will migrate toward the positive cathode. This process of migration is called sieving and smaller strands move faster th an longer strands due to their ease in going through the gel. The objectives of the experiment include:Learning the principles behind Restriction Enzymes and Gel Electrophoresis Applying the concepts in the experiment to produce bands at the end of the Gel Electrophoresis stage Interpreting what these bands mean with accordance to how the plasmid was cleaved Methods and Materials: For the experiment we used several restriction endonucleases (BamHI, EcoRI, HindIII, PstI, ScaI, SaII), ppBR322 plasmid DNA, TAE/TE Buffer, DNA Ladder (50 Bp), Restriction Buffers, 1g of Agarose, 700ml of Distilled H2O. Equipment used for the experiment included: Agarose Gel Electrophoresis System, Uv-vis illuminator and Camera or a Gel doc-it documentation system.The first procedure began by adding 8. 5  µL sterile distilled H2O, 1. 0 µL of the appropriate 10x buffer, 1. 0 µL combination of the restriction endonucleases and 1. 0 µL of pBR322 plasmid DNA (the DNA would be added last) in 5 separate 1. 5ml microcentrifuge tubes, one tube is not to have an RE in it. The mixture was then incubated for 1 hour at 37  °C. No dry block heater was available so body heat was used. After incubation, 2 µL of gel loading dye (Bromphenol Blue) was added to each mixture and loaded in 1% agarose gel. The 50bp DNA ladder was placed in lane 1.It was then subjected to electrophoresis at 100V 250mA 50W. Agarose gel was prepared by dissolving 1g of agarose gel powder in 100mL distilled H2O in a microwave over. It was then cooled at 60 °C then poured in a gel casting tray. A comb was then put and the gel was left to solidify. Afterwards, the gel casting tray was placed into the submarine gel electrophoresis system. The TAE buffer was then placed. The samples were then loaded from left to right starting with the DNA ladder on lane with and the sample without any restriction enzyme on the extreme right.It was then covered and the anodes were connected on the side of the walls. They were connec ted to the power supply set at 100V 250 mA 50W and then run. When the tracking dye reached near the end point, the power supply was turned off. The gel was then removed and transferred into a developing try containing a 10 µL ethidium bromide pero 100ml buffer. It was then shook for 15 minutes. The get was then transferred to the documentation system and Rf values were measured. Pictures were taken and the gel was immersed in hypocholorite (chlorox) solution before discarding. Results and DiscussionThe group did not include a mix without restriction enzymes because doing so will lead to undigested or incompletely digested DNA. The DNA methyltransferase (DNA MTase) family of enzymes catalyze the transfer of a methyl group to DNA. DNA methylation serves a wide variety of biological functions. All the known DNA methyltransferases use S-adenosyl methionine (SAM) as the methyl donor. In prokaryotes, the major role of DNA methylation is to protect host DNA against degradation by restric tion enzymes. In eukaryotes, DNA methylation has been implicated in the control of several cellular processes, including ifferentiation, gene regulation, and embryonic development. Structural work on HhaI DNA methyltransferase demonstrates that the substrate nucleotide is completely flipped out of the helix during the modification reaction and has provided much insight into the enzymatic properties of S-adenosyl-L-methionine (SAM)-dependent DNA-modifying enzymes. Structural comparison of three enzymes, HhaI C5-cytosine methyltransferase, TaqI N6-adenine methyltransferase, and catechol O-methyltransferase, reveals a striking similarity in protein folding and indicates that many SAM-dependent methyltransferases have a common catalytic-domain structure.This feature permits the prediction of tertiary structure for other DNA, RNA, protein, and small-molecule methyltransferases from their amino acid sequences, including the eukaryotic CpG methyltransferases. Ethidium bromide is an interca lating agent commonly used as a fluorescent tag (nucleic acid stain) in molecular biology laboratories for techniques such as agarose gel electrophoresis. It is commonly abbreviated as â€Å"EtBr†, which is also an abbreviation for bromoethane.When exposed to ultraviolet light, it will fluoresce with an orange colour, intensifying almost 20-fold after binding to DNA. Ethidium bromide is an â€Å"intercalating dye†, that is, it is able to slip itself into the DNA while essentially stacking itself between the bases of the helix. When it is inserted into the DNA, it becomes much more fluorescent when exposed to ultraviolet light as compared to ethidium bromide just in solution. So we can use it to visualize the DNA that has been resolved on a gel by electrophoresis.

Free Essays on Offensive Language

Offensive and Assaultive Due to the differentiating lifestyles and the changing values of today’s society, the line between assaultive and offensive language is unclear. To know the boundaries of certain people or groups is important when discussing particular issues or subjects that some hold close to heart. Figuring out these boundaries is a problem that people experience everyday. The audience judges what language is offensive and what is not. Then again, it is a subject that depends mostly on the ideas of the audience. For example, you would not discuss detailed sexual interactions with a kindergarten class. You would also not tell your grandmother how nice women’s breasts appear. These are all things that can be found offensive. Offensive language is rude, in that it is not polite or accepted in the place where it is being spoken. It disagrees with the personal beliefs of those who find it offensive. The line between offensive and assaultive language is so narrow and unclear that many of today’s disputes come by misinterpretations of both. Assaultive verbal language is at times taken simply as bad language or crude comments. It lies much deeper that many realize. To degrade something that many are proud of or hold dear to them is assaultive. It makes someone feel that they are less than what they are. If someone told a military general that the army was a waste of time, that would degrade the things he believes in. Telling a baseball player that sports are a waste of time is assaultive. Assaultive is anything that takes away from a person’s mental piece of mind. Telling someone that you will kill him or her is the more typical type of assaultive language, but there are many things such as petty name calling and childish insults that people never take into account. Many assaultive comments are taken for granted because in many places they are very common. It, however, is our constitutional right t... Free Essays on Offensive Language Free Essays on Offensive Language Offensive and Assaultive Due to the differentiating lifestyles and the changing values of today’s society, the line between assaultive and offensive language is unclear. To know the boundaries of certain people or groups is important when discussing particular issues or subjects that some hold close to heart. Figuring out these boundaries is a problem that people experience everyday. The audience judges what language is offensive and what is not. Then again, it is a subject that depends mostly on the ideas of the audience. For example, you would not discuss detailed sexual interactions with a kindergarten class. You would also not tell your grandmother how nice women’s breasts appear. These are all things that can be found offensive. Offensive language is rude, in that it is not polite or accepted in the place where it is being spoken. It disagrees with the personal beliefs of those who find it offensive. The line between offensive and assaultive language is so narrow and unclear that many of today’s disputes come by misinterpretations of both. Assaultive verbal language is at times taken simply as bad language or crude comments. It lies much deeper that many realize. To degrade something that many are proud of or hold dear to them is assaultive. It makes someone feel that they are less than what they are. If someone told a military general that the army was a waste of time, that would degrade the things he believes in. Telling a baseball player that sports are a waste of time is assaultive. Assaultive is anything that takes away from a person’s mental piece of mind. Telling someone that you will kill him or her is the more typical type of assaultive language, but there are many things such as petty name calling and childish insults that people never take into account. Many assaultive comments are taken for granted because in many places they are very common. It, however, is our constitutional right t...

Blanches psychological breakdown Essays - English-language Films

Blanche's psychological breakdown Essays - English-language Films Blanche's psychological breakdown English Blanche's psychological breakdown In Tennesse Williams' play, "A Streetcar Named Desire" the readers are introduced to a character named Blanche DuBois. In the plot, Blanche is Stella's younger sister who has come to visit Stella and her husband Stanley in New Orleans. After their first meeting Stanley develops a strong dislike for Blanche and everything associated with her. Among the things Stanley dislikes about Blanche are her "spoiled-girl" manners and her indirect and quizzical way of conversing. Stanley also believes that Blanche has conned him and his wife out of the family mansion. In his opinion, she is a good-for-nothing "leech" that has attached itself to his household, and is just living off him. Blanche's lifelong habit of avoiding unpleasant realities leads to her breakdown as seen in her irrational response to death, her dependency, and her inability to defend herself from Stanley's attacks. Blanches situation with her husband is the key to her later behavior. She married rather early at the age of sixteen to whom a boy she believed was a perfect gentleman. He was sensitive, understanding, and civilized much like herself coming from an aristocratic background. She was truly in love with Allen whom she considered perfect in every way. Unfortunately for her he was a homosexual. As she caught him one evening in their house with an older man, she said nothing, permitting her disbelief to build up inside her. Sometime later that evening, while the two of them were dancing, she told him what she had seen and how he disgusted her. Immediately, he ran off the dance floor and shot himself, with the gunshot forever staying in Blanches mind. After that day, Blanche believed that she was really at fault for his suicide. She became promiscuous, seeking a substitute men (especially young boys), for her dead husband, thinking that she failed him sexually. Gradually her reputation as a whore built up and everyone in her home town knew about her. Even for military personnel at the near-by army base, Blanche's house became out-of-bounds. Promiscuity though wasn't the only problem she had. Many of the aged family members died and the funeral costs had to be covered by Blanche's modest salary. The deaths were long, disparaging and horrible on someone like Blanche. She was forced to mortgage the mansion, and soon the bank repossessed it. At school, where Blanche taught English, she was dismissed because of an incident she had with a seventeen-year-old student that reminded her of her late husband. Even the management of the hotel Blanche stayed in during her final days in Laurel, asked her to leave because of the all the different men that had been seeing there. All of this, cumulatively, weakened Blanche, turned her into an alcoholic, and lowered her mental stability bit-by-bit. Her husband's death affects her greatly and determines her behavior from then on. Having lost Allan, who meant so much to her, she is blinded by the light and from then on never lights anything stronger than a dim candle. This behavior is evident when she first comes to Stella's and puts a paper lantern over the light bulb. Towards the end, when the doctor comes for Blanche and she says she forgot something, Stanley hands her her paper lantern. Even Mitch notices that she cannot stand the pure light, and therefore refuses to go out with him during the daytime or to well lit places. Blanche herself says "I can't stand a naked light bulb any more than ...". A hate for bright light isn't the only affect on Blanche after Allan's death - she needs to fill her empty heart, and so she turns to a lifestyle of one-night-stands with strangers. She tries to comfort herself from not being able to satisfy Allan, and so Blanche makes an effort to satisfy strangers, thinking that they need her and that she can't fail them like she failed Allan. At the same time she turns to alcohol to avoid the brutality of death. The alcohol seems to ease her through the memories of the night of Allan's death. Overtime the memory comes back to her, the musical tune from the incident doesn't end in her mind until she has something alcoholic to drink. All of these irrational responses to death seem to signify how Blanche's mind is unstable, and yet she tries to still be the educated, well-mannered, and attractive person that Mitch first sees her as. She tries to not let the horridness come out on top of her image, wanting in an illusive and magical

Obesity Essay Example | Topics and Well Written Essays - 250 words - 5

Obesity - Essay Example A big size of the budget on farm subsidies is spent on crops like wheat, corn, soybeans, rice and cotton. (Edwards). This is how nutritionists link obesity to farm subsidies. The products made from these crops are mostly unhealthy and contribute to the disease. Data from the U.S. National Health and Nutrition Examination Survey shows 35.7% of adults and 17% of children and adolescents are obese. (Ogden) Americans have been battling obesity for a long time. One cause of the disease is eating unhealthy foods. I do not agree that farm subsidies should be blamed for American’s obesity problem. It is true that farm subsidies make food items cheap. However, Americans can choose not to buy these foods. Farm subsidies are not forcing consumers to buy their products. Currently, there are other healthier options in the market. There are Americans who are not obese by choice. If an individual really wanted to overcome obesity, it should not start and stop with just food choices. Also, the fast food industry should be challenged into creating their menu more health-friendly. Fast food is a necessary aspect of American culture because of how busy people are. Despite this, I believe sufficient research on the part of these fast food companies will enable them to create fast food items that are nutritious as well. Lastly, continuous information about the dangers of obesity and its causes should be given to schools and neighborhoods. Media can help with this. I think if people are constantly re minded about obesity they will start eating for their health and not for their

A Research on the marketing strategies of Meritus Mandarin Hotel and Dissertation

A Research on the marketing strategies of Meritus Mandarin Hotel and its position in the tourism industry - Dissertation Example The objective of the research paper is to analyze the reasons behind the adoption of various marketing strategies by the hotel. The research study will assess the present strategic position of the hotel and the tourism industry of Singapore. The study will also analyze the various factors which lead to increase in customer satisfaction and also provide recommendations for improving the marketing strategy and the brand positioning of the hotel. The first section of the study is the introductory part which includes a background analysis of Meritius Mandarin hotel and the tourism industry of Singapore. It also includes the academic objectives of the company. The second section of the study includes analysis of Mandarin Orchard Singapore’s branding position, pricing and revenue strategy, service recovery and complaint handling procedure of the Mandarin Orchard Singapore. In the third and the fourth section, analysis is done through correlation and regression to find out the attrac tive factors of the hotel. Finally, it concludes with recommendation to improve the ambience of the hotel, recreational facilities, food of the restaurant etc. Acknowledgements I would take this opportunity to thank and express my gratitude to my supervisor Mr. Justin Kung for his exemplary guidance in topics related to customer satisfaction, service quality and market. The constant guidance given by him throughout the project has helped me in attaining knowledge related to the project. I could not have completed the project without his help and guidance. I would also like to thank my classmates for sharing their opinions and experiences related with this project. Lastly, I would also like to thank my librarian for assisting and guiding me through a section of books related to marketing and hotel industry of Singapore. I could not have completed my project without the detailed information provided in the library books. Regards Desta lee Chapter 1 Introduction 1.1 Reasons for choosin g the topic Tourism has become a global activity because it is a part of the global process of change and development (Connell and Page, 2006). The importance of tourism has changed gradually over the years; it is an economic activity which promotes economic development and increases the economic growth of a country. Tourism is no longer confined to developed countries but also includes travel to the developing countries. Firstly, the mindset of the tourist has changed and they are seeking new destinations which offer relaxation and creative thinking. Secondly, the purchasing power of the people has also increased which has led to the increase in global tourism. Singapore has become one of the popular destinations of the world also known as food paradise of the world

NCLEX-RN article review Essay Example | Topics and Well Written Essays - 1000 words

NCLEX-RN article review - Essay Example NCLEX-RN ® pass rates are of interest to the faculty in professional nursing programs, institutions, and the profession, as they represent a measure of faculty and program effectiveness; accreditation agencies and state boards of nursing expect graduate success; and the profession of nursing needs prepared practitioners as it faces a shortage of licensed professional nurses in the workplace. NCLEX-RN ® pass rates are of special interest to potential students who may choose a program due to reported rates, and graduates who are not successful may face anxiety and financial loss. Keywords: NCLEX-RN ®, nursing, logistic regression December 2010 NCLEX-RN ® Success: Are There Predictors The National Council Licensure Examination for Registered Nurses (NCLEX-RN ®, hereafter NCLEX-RN) was instituted in 1984, moved to computerized testing (CAT) in 1994, increased in difficulty in 1998, 2004,[ 7] and again in 2010. Since the beginning of licensure examinations for nurses, there has been variable interest in studying factors related to pass rates with interest heightened during periods of declining pass rates. Success on this examination has widespread ramifications for students, nursing schools, and employers. The stakes are high related to first-time pass rates. The identification of factors affecting NCLEX-RN success is useful for nursing schools in making decisions about admission requirements and curriculum issues. Variables associated with performance on the NCLEX-RN may be categorized as academic and nonacademic. Academic variables include scores on the Scholastic Aptitude Test (SAT) or the American College Test (ACT), performance in pre-nursing courses and selected nursing courses, and scores on standardized nursing assessment tests. Nonacademic variables associated with NCLEX-RN ® performance include the taker's age, gender, ethnicity, English as the primary language, and critical thinking skills.[ 4] The purpose of this study was to examine student academic variables from a baccalaureate nursing program to determine which factors may be predictive of student success on the NCLEX-RN examination. This nursing program, like many others, saw a decline in NCLEX pass rates after the difficulty of the examination was increased in 2004. Rather than attempting to make changes to the curriculum haphazardly, the faculty decided to do a systematic assessment of variables that could be influencing the pass rates. Systematic assessment provides evidence so that students who are at risk for failure can be identified early and remediation and/or curriculum changes may be instituted. Review of Literature Beeman and Waterhouse used a convenience sample of 289 baccalaureate nursing students who graduated between 1995 and 1998 to examine predictors of success or failure on the NCLEX-RN examination.[ 1] The most significant predictor of NCLEX-RN failure was the number of C+ or lower grades received in nursing theory courses (r = -.394, P†¦000 1). Higher grades in other core nursing courses and pathophysiology were also correlated with NCLEX-RN success. Discriminant analysis was used to predict 94 percent of the students who passed and 92 percent of the students who failed NCLEX-RN. The authors noted that "all this data is available by the end of the first semester of our students' senior

Server-side scripting of web pages part 2 Essay Example for Free

Server-side scripting of web pages part 2 Essay

Pathophysiology Of Emphysema

Pathophysiology Of Emphysema This essay will describe the pathophysiology of emphysema and the effect it had on a specific patient that I have chosen for this assignment. It will accomplish this by referring to the patients presenting symptoms and diagnosis and then by examining the changes that occur in the airways of an individual suffering from this chronic disease. The essay will continue by exploring the aims of treatment and how they may control the symptoms relating to the specific patient chosen. It will consider the relevant guidelines to treatment options in order to demonstrate evidence based practice. Emphysema is chest condition that falls under the umbrella term of chronic obstructive pulmonary disease (COPD). This term also includes chronic bronchitis and asthma. Shahab, Jarvis, Britton and West (2006) suggest that COPD is a major contributor to global mortality and morbidity and its worldwide prevalence is likely to increase further. They continue by suggesting that it is well established that smoking is the single most important cause of COPD, increasing the risk of developing and dying from this condition by a factor of thirteen. COPD is characterised by airflow obstruction and is usually progressive, not fully reversible, and does not change markedly over several months. Sharafkaneh, Hanania and Kim (2008) suggest that an imbalance between protease and antiprotease activity in the lung is proposed as the major mechanism resulting in emphysema. Patients with emphysema complain of breathlessness, particularly on exertion, cough, chest tightness and often a reduction in their quality of life. This essay will explore the changes that occur in the lungs of a patient with emphysema and how these changes transpire. The National Institute for Health and Clinical Excellence (NICE 2010) state that an estimated three million people in the UK have COPD. They also suggest that out of this figure only nine hundred thousand of these cases are confirmed, the remainder are people that have not yet presented with symptoms to their doctor. Exacerbation of COPD requiring hospital admission places a great burden on NHS resources. Davies (2009) suggests that costs directly related to caring for patients with COPD are over  £500 million annually. Background of patient.http://faculty.washington.edu/alexbert/MEDEX/Spring/Spirometry.jpghttp://www.ispub.com/ispub/ijtm/volume_1_number_1_66/strongyloides_induced_respiratory_failure_6/strongy1a.jpg To maintain patient confidentiality and for the purpose of this essay, the patient will be referred to as Janet. Janet is a 57 year old married woman. She has a history of smoking since the age of 15 and this equates to 42 pack years. She has worked in an office for her whole working life and enjoys walking. She attended the surgery as she was finding walking her dogs increasingly more difficult and was experiencing breathlessness on exertion. Janets weight was stable and she had not experienced any haemoptysis. Her baseline blood pressure and pulse where within normal limits and her body mass index (BMI) was in a healthy range. A full blood count (FBC) identified that Janet was not anaemic nor did she have polycythaemia which represents an abnormally high red blood cell count with a haematocrit greater than fifty percent. Janets peripheral oxygen saturation using a pulse oximeter was shown to be ninety four percent on air. Chest x-ray showing hyperinflation mdguy available at medpreponline.com Pulmonary Function Tests Medex Objectives 2003On examining Janets computerised records it was noted that she did not expectorate much sputum and she had only been prescribed one course of antibiotics for a chest infection in the past three years. Janet had been sent for a chest x-ray on her second visit to the surgery which had revealed hyperinflation of the lungs. Janet was subsequently referred for lung function tests at the local hospital where an obstructive pattern was identified. Spirometry is the test performed to demonstrate airflow obstruction however NICE (2010) state that airflow obstruction alone cannot be used as a diagnosis of COPD; it should only be used in conjunction with the patient demonstrating symptoms such as breathlessness or cough. A comprehensive history taking is very important as this can often identify COPD unaided. Janet was symptomatic and therefore was diagnosed with moderate COPD. Her spirometry showed she had a forced expiratory volume in the first s econd (FEV1) of 55% of her predicted value and a FEV1/forced vital capacity (FVC) ratio of less than 0.7. Predicted values for patients are predicted according to their height, gender, age and ethnic origin. The severity of airflow obstruction is graded according to the FEV1 reading. The updated NICE 2010 guidelines for COPD have reviewed the severity scales which mean that Janets spirometry readings fall into the moderate category. Janets degree of breathlessness was discussed and she graded herself as a level 3 on the Medical Research Council (MRC) dyspnoea score (Fletcher 1960). Emphysema often results in the patient having an increased residual lung volume which in due to air trapping; an inability to expel all the air from the lungs. Aetiology and pathophysiology Human lungs are the functional structure of the respiratory system. To understand Janets condition it is useful to look at how the normal respiratory system works. Its function is to supply the body with oxygen and to remove carbon dioxide (Marieb, 2004). Breathing is the movement of gases between the atmosphere and the lungs. For this to occur, there needs to be a system of open airways and pressure changes resulting from the action of the respiratory muscles in changing the volume of the chest cage. The diaphragm is the principal muscle of inspiration, assisted by the external intercostal muscles. The sternocleidomastoid and scalene muscles elevate the ribs and act as accessory muscles for inspiration. Expiration is aided by the elastic recoil of the respiratory muscles that were stretched during inspiration. Pulmonary gas exchange is conventionally divided into three processes: (1) ventilation or the flow of gases into and out of the alveoli of the lungs, (2) perfusion or flow of blood in the adjacent pulmonary capillaries, and (3) diffusion or transfer of gases between the alveoli and the pulmonary capillaries (Porth 2010). In addition to their gaseous exchange function, the lungs deactivate vasoactive substances such as bradykinin, convert Angiotensin 1 to Angiotensin 2 and serve as a reservoir for blood storage. COPD is characterised by an intense inflammatory process in the airways, parenchyma and pulmonary vasculature (Sinden and Stockley 2010). The lung inflammatory response is characterised by increased number of neutrophils, macrophages and T lymphocytes. The accumulation of inflammatory components contributes to the lung injury in these patients. The mobilization of inflammatory cells to the lungs leads to the release of potentially destructive mediators including proteases and cytokines, which directly contribute to the remodelling and destruction of tissues. Truder, McGrath and Neptune (2003) believe that a delicate balance between protease and antiprotease activity is required for proper lung maintenance. Sharafkaneh, Hanania and Kim (2008) suggest that derangements of this balance results in destruction and inappropriate repair of lungs. They also suggest that macrophages are activated by tobacco smoke and recruit neutrophils and lymphocytes leading to elastolysis and emphysema. Si milarly tobacco smoke activates airway epithelium to trigger airway remodelling. Both of these processes result in airflow obstruction. http://www.scielo.br/img/revistas/mioc/v100s1/a27fig02.jpg In addition to inflammation, oxidative stress caused by tobacco smoke inhalation plays a significant role in generating emphysema. Therefore Janets long history of smoking will have ultimately resulted in loss of elasticity to her lungs, retention of air in the lungs due to hyperinflation, expansion of the rib cage and flattening of the diaphragm. When the diaphragm is flattened, the muscles of the rib cage and abdomen take over the bulk of the work which is a less efficient and more tiring way of breathing. The alveoli are the terminal air spaces of the respiratory tract and the sites of gaseous exchange between the air and the blood. Each alveolus is a cup-shaped sac with thin walls and each structure is separated by alveolar septa. A single network of capillaries occupies most of the septa, so blood is exposed to air on both sides. There are approximately three hundred million alveoli in the human lungs. Emphysema jpg available at www.moondragon.orgEmphysema is characterized by a loss of lung elasticity and enlargement of the distal air spaces to the terminal bronchioles, with destruction of the alveolar walls and capillary beds. Several adjacent alveoli may rupture forming one large air sac that has a reduced ability to exchange oxygen and carbon dioxide. There is progressive destruction of the alveoli and the surrounding lung tissues as air is trapped in the damaged alveoli. This causes them to stretch which leads to hyperinflation and a reduced inability to exhale.http://www.moondragon.org/images/emphysema.jpg Smoking tobacco is a well established cause of COPD (Shahab et al 2006). The Department of Health (2010) indicate that tobacco is the leading cause of preventable death and of health inequalities. They also state that in 2008, more than 80,000 premature deaths in England were caused by smoking. Callum (2008) suggests that the current level of tobacco use is estimated to cost the NHS around  £2.7 billion every year. Cigarette smoke contains a range of toxic products and these have to be dealt with by the body. When cigarette smoke is inhaled into the lungs the cilia that normally sweep irritants out of the airways become paralyzed. The irritants therefore remain in the lungs infiltrating the alveoli where the damage process begins. Other causes of emphysema can be an inherited condition called alpha1 antitrypsin deficiency, an antiprotease enzyme that protects the lungs from injury. This accounts for approximately one percent of all cases of COPD. Occupation risks such as coal minin g can also be a cause of COPD as the irritants inhaled act as the instigators of the disease process. Interventions and treatments Smoking cessation advice would be the most important intervention for Janet. Smoking cessation has been shown to be the most significant intervention to slow the rate of decline of lung function (Fletcher and Peto 1977). http://www.biomedcentral.com/content/figures/1471-2458-7-332-2-l.jpg The use of the Fletcher and Peto graph that demonstrates decline in lung function and the benefit of stopping smoking could be utilised in the process of addressing Janets smoking habit. The use of a smoking addiction calculator such as the Fagerstrom (1978) test was used to determine the extent Janet was addicted to nicotine. Parkes, Greenhalgh, Griffin and Dent (2008) found that informing a patient of their lung age appears to encourage higher levels of successful smoking cessation and Janet was surprised by her lung age of seventy seven. The damage to Janets lungs could not be repaired however the rate of disease progression could be reduced by her stopping smoking. Janet was referred to a specia list stopping smoking service in order to achieve a higher success rate. Encouraging patients with COPD to stop smoking is one of the most important components of their management. All COPD patients still smoking, regardless of age, should be encouraged to stop, and offered help to do so, at every opportunity (NICE 2010). Gruffydd-Jones (2006) recommends that all patients with any chronic lung condition should have an annual influenza vaccination and a one-off pneumococcal vaccination unless contraindicated. This is beneficial in reducing the risk of severe lung infections precipitating potentially fatal exacerbations of COPD. Bronchodilators such as Salbutamol are frequently used as first line treatment for COPD. Treatment objectives include relieving symptoms such as dyspnoea and cough, slowing the accelerated decline in lung function, decreasing exacerbations, and improving quality of life. The NICE (2010) guideline for COPD recommends beginning treatment with bronchodilators. NICE are the guidelines used predominantly in primary care and will be used as guidance for treatment options in this assignment. In theory, bronchodilators, which act directly on the airways, should have limited benefit in emphysema. However, Diaz, Bruns, Ezzie, Marchetti and Thomashow (2008) claim that in clinical practice many patients with emphysema, benefit from bronchodilator therapy. Pellegrino, Antonelli and Mondino (2010) agree that it is clinically justified to use short acting bronchodilators (SABA) in patients with emphysema. The pharmacology of beta-2 receptorsSalbutamol is a beta-2 agonist. These bind to the beta-2 receptors on the smooth muscle of the trachea to the level of the terminal bronchioles. Binding of the beta-2 agonists to the beta-2 receptors activates a receptor associated G protein that in turn activates adenyl cyclase. This then converts adenosine triphosphate (ATP) to cyclic 35-adenosine monophosphate (c-AMP), which then activates protein kinase A. The activated protein A prevents phosphorylation of the myosin light chain as well as activation of the Na+/Ca2+ exchange pump. This results in a fall in intracellular calcium and leads to smooth muscle relaxation, as less calcium is available for the calcium-dependent myosin-actin interaction required for smooth muscle contraction (Barnes 1995). Black, Oliver and Roth (2009) suggest that short acting beta-2 agonists can mediate further physiological responses to include the stimulation of beta-2 receptors on mast cells, leading to the suppre ssion of inflammatory mediator release and the inhibition of extracellular matrix (ECM) protein release from airway fibroblasts.http://www.uky.edu/~mtp/adrenergic_pics/Beta2Effect.jpg Janet was commenced on Salbutamol one hundred micrograms, two puffs as required and was reviewed after a four week period where it was identified that Janet remained breathless particularly on exertion and therefore her symptoms had not been improved upon. Following the NICE (2010) guidelines for COPD it was agreed with Janet to add in a long acting bronchodilator (LABA). She was commenced on Salmeterol twenty five micrograms two puffs twice a day. Diaz, Bruns, Ezzie, Marchetti and Thomashow (2008) claim that long acting bronchodilators such as Salmeterol have an affinity for the beta-2 receptor that is approximately one hundred times higher than that of short acting bronchodilators such as Salbutamol. The duration of action of Salmeterol is around twelve hours and hence only needs to be taken twice daily often helping with concordance. The benefits of LABAs are to improve respiratory symptoms, airflow, quality of life, rate of exacerbations and exercise tolerance. Patients with emph ysema typically have a greater degree of hyperinflation than others with COPD and bronchodilators have been shown to improve hyperinflation at rest and during exercise. As Janet rated herself as level three on the MRC dyspnoea scale, NICE (2010) recommend that the patient be referred for pulmonary rehabilitation. Pulmonary rehabilitation is defined as a multidisciplinary programme of care for patients with chronic respiratory impairment that is individually tailored and designed to optimise each patients physical and social performance and autonomy (NICE 2010). The rehabilitation process should incorporate a programme of physical training, disease education, and nutritional, psychological and behavioural intervention. The aims of pulmonary rehabilitation are to increase a persons exercise tolerance and give support and advice which may include smoking cessation. It incorporates people with COPD who have undergone additional training to act as buddies to fellow sufferers. Many patients look upon pulmonary rehabilitation as a social occasion and this aspect helps to improve their quality of life. Discussion. This essay has examined the case of Janet who presented at primary care with dyspnoea on exertion. Janet has a history of smoking and following a chest x-ray and lung function tests, she was diagnosed with having COPD. Due to the nature of her symptoms and hyperinflation demonstrated on x-ray, it was concluded that Janet had emphysema which falls under the umbrella term of COPD along with chronic bronchitis and asthma. The rest of Janets history was unremarkable and her observations and blood tests were found to be normal. COPD is characterised by airflow obstruction and is usually progressive, not fully reversible, and does not change markedly over several months. Patients with COPD often present in primary care with symptoms such as shortness of breath on exertion, cough or excessive sputum production. Usually the patient will already have damage to their lungs when they present with symptoms. The symptoms of COPD are extremely subjective and do not correspond to the FEV1 reading. For instance, two people could be seen with exactly the same reading of FEV1, but one patient would have very few symptoms and perhaps only need occasional use of a short acting bronchodilator whereas the other patient could be using two or more inhalers. Airway obstruction is diagnosed using spirometry and an FEV1 of