Inhumanity of War Essay

In the novel All Quiet on the Western Front by Erich Maria Remarque, one follows the life of Paul Baumer, a private in the German military in World War 1. He and his friends try to survive as the people around them get slaughtered. Slowly one by one his friends die while the others fight for their own lives. This is a war with many inhumane actions that lead to unnecessary death or injury. In the story many inhumane actions spark guilt within a character, causing a humane action to be done in response. The slow inhumane death of Kemmerich, Paul’s best friend, lead him to lie to Kemmerich’s mom about his death due to the guilt he would feel for her reaction and sadness. Kemmerich’s death was slow and painful. It involved getting his leg amputated, â€Å"‘He has a flesh wound in his thigh; a good blighty†¦Ã¢â‚¬â„¢ Kemmerich raises himself off the pillow with his elbow, ‘They’ve amputated my leg (6, 27).’† He had been shot and had his leg amputated when it wasn’t his war to fight. He should not have had to suffer with the hundreds of other innocent lives. The leaders of the countries should be fighting their argument out themselves; not put thousands of men’s lives at risk. Kemmerich should not have to die for something he didn’t start. Also what was meant to save him killed him. He died in the hospital, not on the front. He died in the place where he should be mended, not killed. When Paul goes home on leave he visits Kemmerich’s mom to give details of how he had died so she could have some closure and know he went with dignity: â€Å"I tell her he was shot through the heart and died instantaneously†¦I will never tell her, she can make mincemeat out of me first (180-181).† If Paul had told her the truth he would feel exceptionally guilty because Kemmerich is his best friend, and Paul was not there when Kemmerich was shot. He also could not tell his mom that he died in the hospital because he should have been saved there, and then she would know how close her son was to being saved and being able to spend time with her. Also she would know that Kemmerich had not died in battle, but died slowly behind the front in a hospital because of infection not by a bullet, which is not how one would like to picture their son dying in war. She would know that he suffered before he died. The inhumane injury of the horses, and everyone just listening to them suffer caused Detering to go mad with guilt for the horses and try to put them out of their misery. There had just been a battle and many of the horses had been injured: â€Å"It’s unendurable. It is the moaning of the world, it is the martyred creation, wild with anguish, filled with terror and groaning†¦ We are pale. Detering stands up, ‘For gods sake shoot them†¦Ã¢â‚¬â„¢ ‘They must take care of the men first’† (62-63). The soldiers are ignoring the soldier’s cries and Detering wants to kill the horses. The horses don’t even realize what they’re involved in. They can’t even speak German. As the soldiers are fighting a battle they are not responsible for; at least they have an idea what it is all about. The horses do not. They don’t even know what they’re meant to be doing, or what is happening to them. They do not deserve to be in the war, or to die for its cause, so when they’re injured without any hope of survival, no one will put them out of their misery. It’s barbaric. He gets his rifle, but is batted down. He feels as if he has failed because he could not save or kill the horses. All he can do is watch them suffer. It tears him apart because it is not his nature. Detering is a farmer and cares more for animals than he does people, so to sit and listen to these cries drives him crazy, for he loves them so much. Why can’t a soldier near them hand off the man they are caring for for a second, so they can kill the horses and put them out of their misery. It’s incredibly simple and much more humane than listening to them suffer as they trip over their intestines. Detering is the humane person for at least trying to kill them and for considering them for a second, whilst everyone else is being extremely selfish. The inhumane torture used to dissuade the Germans for using the saw-bayonets led to the humane reaction of Paul and his company not using them, and giving people that had them regular bayonets. They stopped using them for the guilt they would feel if a young clueless man was to be tortured for something he didn’t even know about. The Germans had just moved forward when found out why Germans were being brutally tortured: â€Å"If the fellows over there catch a man with one of those he’s killed at sight†¦ some of our men were found whose noses were cut off and their eyes poked out with their own saw-bayonets. Their mouths and noses were stuffed with sawdust so that they suffocated† (103). The French tortured these men because they were using the German saw blade-bayonet, which hacked apart the French brutally. The French only tortured them because they were using these bayonets inhumanely. The Germans however were just following orders. They did not have the choice of which bayonets they were using. They were being tortured for something that was above them. They did not know how the use of the bayonets would affect the French. The French tortured the wrong people. When Paul sees other recruits he quickly gets to them and takes their bayonets away: â€Å"Some of the recruits have bayonets of this sort; we take them away and give them the ordinary kind (104).† They do this because they know the recruits don’t know any better and, they do not deserve to be tortured so brutally. Also, the bayonets aren’t very useful anymore. They get stuck in people. Paul knows that if he didn’t switch the recruits’ bayonets for the regular one he would be torturing them himself. When he would hear of their torture he would know it was his fault and he knew he could have stopped it if he took the time. So he switched them to avoid the extreme guilt he would feel for sending a man to a torturous death, and devastating a young man’s family. He was saving these men’s lives without being asked. He was going out of his way and against orders to make sure these men would not be tortured. In the story humane actions are sparked from guilt in response to inhumane actions having to do with Kemmerich’s death, Injury of the Horses, and the torture of the Germans. This is very similar if an animal is abused it sometimes is killed after being rescued. They do this for the animal’s own good. If they let him live he may not trust anyone and harm others. Then he would be put down anyway. Also, he is hurt or injured he will not trust a veterinarian to help him so is just put out of his misery before trying. If there is no chance for something to live or an animal to survive with society or in the wild, it should just be put down to stop the creature from going through the stress it would go through for it will most likely suffer or get killed anyway.

Motocross

Good morning class. The theme of my IA is motocross but today I will speak specifically on the topic â€Å"The development of motocross as an established sport†. What is motocross?†¦. Motocross is defined as a timed motorcycle race over a closed outdoor course consisting of a winding dirt trail with hills, jumps, sharp turns, and often muddy terrain. This sport originated in Britain as an off-road event called scrambling. The first known scramble took place at Camberley, Surrey in 1924. The earliest motorcycles were little more than bicycles with small internal combustion engines attached. During these early years people sometimes, used the tracks built for bicycle racing for scrambling events. These early scrambling events were used to show case motorcycles entered by manufacturers to publicize their brand in much the same way they do today. By the late 1920’s â€Å"Scrambling† had become very popular in both Britain and France. The French added new dimensions to the sport, they shortened the tracks added laps and man made obstacles such as jumps. They also changed the name to what it is known as today†¦Ã¢â‚¬ ¦Motocross which is a combination of motorcycle and cross country. The bikes used for motocross during the late 1920’s were very similar to those used on the streets at that time such as Harley Davidson’s and Indians, which had rigid frames. By the 1930’s these then gave way to frames containing suspension and more advanced swinging fork rear suspension by the early 1950’s. According to the FIM motocross went international in 1947 when the Dutch national motorcycle federation hosted a competition called the motocross des nations for national teams on an estate in the Netherlands. Three countries were entered in the first year of the competition they were Great Britain, The Netherlands, and Belgium. The riders competed in races consisting of two heats each of eight laps, over a two mile circuit. Scoring was done by computing the total times of the top three riders from each national team. The British who were represented by, Bill Nicholson, Fred Rist, and Ray Scovell riding 500cc bikes manufactured by the British Small arms company won the competition, beating the Belgians by only 9 seconds. The popularity of the event was shown to have greatly improved as the second staging of the event in Belgium attracted thirty thousand spectators. The British continued to show their dominance in the sport as they went on to win the motocross des nations 15 times in the first twenty years of the event. In 1952 the FIM (Federation Internationale de Motocyclisme), the motorcycling’s international governing body, created an individual European Championship, and then upgraded it to a World Championship title in 1957. In 1962 a young engineer in East Germany Walter Kaaden, made a technological breakthrough that greatly improved the two-stroke engine and its usefulness which in turn â€Å"revolutionized† the motorcycle industry. His discovery was that of the principle of the expansion chamber, which when properly shaped, instantly increased the power of a two stroke engine by over 25 percent. This gave the 2 stroke engine a power to weight ratio that easily exceeded the 4-stroke engine. Another benefit of the 2 stroke engine was that it was less complicated and much cheaper to mass produce. As a result of this many industrial nations including Germany, Czechoslovakia, Great Britain, Sweden, Spain, and Japan quickly embraced the new technology. As engine design and power improved competition for 250cc motorcycles the class in which 2 strokes performed their best, began to gain in popularity and in 1962 the FIM created a 250cc world championship. As a result of the introduction of the 250cc class the growth of motocross during the 1970s was nothing less than a motorsport revolution. The growth of motocross when measured by the number of American motorcycle association sanctioned events grew one hundred fold between 1965 and 1975. In the 1980’s the sport developed even more in the US, the 250cc class went through the decade and in 1985 the East/West 125cc class which was created for the younger less experienced riders was formed. During the 1990’s the 250 class remained in the spotlight, with the main focus now moving from Europe where motocross had been more popular, to the USA, where riders such as Jeremy McGrath and Jeff Stanton consistently dominated the sport. Today, as a result of the advancements and achievements in the world of motocross it has allowed for the world to recognize it as an established sport in which many have excelled and shown greatness †¦. persons such as Jeremy McGrath, Ricky Carmichael, and James Stewart are some of the greatest names associated with the sport of motocross. Motocross Good morning class. The theme of my IA is motocross but today I will speak specifically on the topic â€Å"The development of motocross as an established sport†. What is motocross?†¦. Motocross is defined as a timed motorcycle race over a closed outdoor course consisting of a winding dirt trail with hills, jumps, sharp turns, and often muddy terrain. This sport originated in Britain as an off-road event called scrambling. The first known scramble took place at Camberley, Surrey in 1924. The earliest motorcycles were little more than bicycles with small internal combustion engines attached. During these early years people sometimes, used the tracks built for bicycle racing for scrambling events. These early scrambling events were used to show case motorcycles entered by manufacturers to publicize their brand in much the same way they do today. By the late 1920’s â€Å"Scrambling† had become very popular in both Britain and France. The French added new dimensions to the sport, they shortened the tracks added laps and man made obstacles such as jumps. They also changed the name to what it is known as today†¦Ã¢â‚¬ ¦Motocross which is a combination of motorcycle and cross country. The bikes used for motocross during the late 1920’s were very similar to those used on the streets at that time such as Harley Davidson’s and Indians, which had rigid frames. By the 1930’s these then gave way to frames containing suspension and more advanced swinging fork rear suspension by the early 1950’s. According to the FIM motocross went international in 1947 when the Dutch national motorcycle federation hosted a competition called the motocross des nations for national teams on an estate in the Netherlands. Three countries were entered in the first year of the competition they were Great Britain, The Netherlands, and Belgium. The riders competed in races consisting of two heats each of eight laps, over a two mile circuit. Scoring was done by computing the total times of the top three riders from each national team. The British who were represented by, Bill Nicholson, Fred Rist, and Ray Scovell riding 500cc bikes manufactured by the British Small arms company won the competition, beating the Belgians by only 9 seconds. The popularity of the event was shown to have greatly improved as the second staging of the event in Belgium attracted thirty thousand spectators. The British continued to show their dominance in the sport as they went on to win the motocross des nations 15 times in the first twenty years of the event. In 1952 the FIM (Federation Internationale de Motocyclisme), the motorcycling’s international governing body, created an individual European Championship, and then upgraded it to a World Championship title in 1957. In 1962 a young engineer in East Germany Walter Kaaden, made a technological breakthrough that greatly improved the two-stroke engine and its usefulness which in turn â€Å"revolutionized† the motorcycle industry. His discovery was that of the principle of the expansion chamber, which when properly shaped, instantly increased the power of a two stroke engine by over 25 percent. This gave the 2 stroke engine a power to weight ratio that easily exceeded the 4-stroke engine. Another benefit of the 2 stroke engine was that it was less complicated and much cheaper to mass produce. As a result of this many industrial nations including Germany, Czechoslovakia, Great Britain, Sweden, Spain, and Japan quickly embraced the new technology. As engine design and power improved competition for 250cc motorcycles the class in which 2 strokes performed their best, began to gain in popularity and in 1962 the FIM created a 250cc world championship. As a result of the introduction of the 250cc class the growth of motocross during the 1970s was nothing less than a motorsport revolution. The growth of motocross when measured by the number of American motorcycle association sanctioned events grew one hundred fold between 1965 and 1975. In the 1980’s the sport developed even more in the US, the 250cc class went through the decade and in 1985 the East/West 125cc class which was created for the younger less experienced riders was formed. During the 1990’s the 250 class remained in the spotlight, with the main focus now moving from Europe where motocross had been more popular, to the USA, where riders such as Jeremy McGrath and Jeff Stanton consistently dominated the sport. Today, as a result of the advancements and achievements in the world of motocross it has allowed for the world to recognize it as an established sport in which many have excelled and shown greatness †¦. persons such as Jeremy McGrath, Ricky Carmichael, and James Stewart are some of the greatest names associated with the sport of motocross.

Torts; CyberTorts; Strict Liability; Products Liability; Consumer Essay - 1

Torts; CyberTorts; Strict Liability; Products Liability; Consumer Protection Law 3 - Essay Example This is in light with the mandates developed over a timeframe and these levels against the substantive compositions of the developed agreements. As such, the mandates developed as per the required rights exponentially give these coordinates the required protection. In view of the developing individual agreements, the global network itself has reinforced the required attributes by creating a virtual impression that summarily enriches the objectivity of the trademarks. The principle establishment of the required trade laws has independently enriched the efforts aimed at provided national based agreements. (ECT, 2009) Research works of WTO2 and the mergers that transform the entire system created uniformity in the system and this clearly ensured that better review mechanism remained in place to support enforceable laws and create the required impression as per the ideal rule of law. In view of the created laws, better management systems were evaluated and coordinated at all court based levels in order to ensure that proper projections remain tangible. The establishment of remotely controlled trademarks helped to manage the ideal list as per the correlated measures. The global network ensured that replacements within the national platform3 would clearly develop independent evaluation as required in all principled applications. This enacted situation also created total reliance on trademarks as well as interactive laws on active developmental conditions4. This further showed that actions based on continuous analysis of the aided quality initiatives equally allowed information to be shared through t he required levels. The coverage as per the amended factors would flexible give the research initiatives new formation which is naturally developed basing on the domestication of the trademark laws. The certainty of the law has gained more popularity over a period of time and this according to

11 Movie Reviews Review Example | Topics and Well Written Essays - 1000 words

11 Reviews - Movie Review Example This movie is just as good as the first two, and I would say that it is one of the funniest movies that I have ever watched. What makes the script so good is the interplay between Chief Inspector Lee, played by Jackie Chan, and Detective James Carter, played by Chris Rock. Some of the lines that these two actors used had me laughing nonstop. The movie begins with the introduction of the Triads, a Chinese criminal organization, and Lee and Carter pursuing an assassin at the World Criminal Court. The next scene is perhaps the best scene of the whole movie. The clues lead Carter and Lee to a martial arts studio, where a giant martial arts expert confronts them. The conversation goes back and forward between Carter and the martial arts expert, with the words â€Å"you† and â€Å"me† used in a confusing manner. After this, the clues lead the two of them to Paris, France. The first place they go to is a triad hideout, where Lee manages to kill a Triad assassin called Jasmine, and Carter meets a beautiful lady, Genevieve. After Carter and Lee are told that Shy Shen, the leader of the Triads, is not a person but a number of leaders, they discover that Genevieve has the list of Triad leaders tattooed onto her forehead. The action then switches to the Eiffel Tower, where Lee and Carter go to get back Soo-Yung, an old friend of Lee. Lee manages to defeat Kenji while Carter saves Soo-Yung. The movie ends with Jackie Chan and Chris Rock walking off into the distance while dancing to the hit song â€Å"War.† Some of the scenes in this movie are similar to the prequels, but the movie still provides plenty of entertainment. Movie Review #2 – Avatar This movie was perhaps the coolest movie that I have ever watched. In fact, Avatar has now become the highest grossing film of all time. This is largely due to the fact that the movie was made in 3-D. The director of this movie was James Cameron, who is an Oscar award winning director for his work on the film Titanic, which was the previous highest grossing movie of all time. The movie starts off showing humans invading a foreign world, Pandora. The lead character, Jake Sully, played by Australian actor Sam Worthington, has been chosen to replace his brother on the mission to Pandora. Where it gets complicated is that Sully is a paraplegic, but this all changes when he gets to use his very own avatar, which is a creature similar to the local population but used by humans. On a mission into the woods, Sully gets separated from the rest of his crew. While he is lost, a local Na’vi, Neytiri, played by Zoe Saldana, finds him and brings him back to her people. Back at the human base, the head of the security force is convinced to let Sully build a cover with the local population in order to gain their trust. The humans have the goal of getting hold of a mineral that is more valuable than anything else. To achieve this, the local Na’vi population must move so that the humans can go in and use the resources. This does not happen because Sully chooses to stick with the Na’vi and fight the humans for control of the land. The last scene is a huge battle between the humans and the Na’vi, which the Na’vi triumph in of course. At the end, Sully is accepted into the local culture and becomes one of them. In my opinion, Avatar is the greatest movie spectacle of all time. Movie Review #3 – Shrek The movie Shrek is one that became very successful all around the world in large part due to the quality of actors in the movie. Mike Myers (Shrek), Cameron Diaz (Princess Fiona), and Donkey (Eddie Murphy) all brought star power to a movie that was

THE FINAL BUSINESS IDEA PLAN PowerPoint Presentation

THE FINAL BUSINESS IDEA PLAN - PowerPoint Presentation Example ized plan is your opportunity to take the weekly assignments and improve them based on the feedback you have received from the instructor and from your classmates from previous weeks. Page 1  -- Cover Sheet with Business Name, and Logo Concept†¨Page 2 –  Mission Statement, Vision Statement, Value Proposition, Business Model (5 points)†¨Page 3  - Market Research Market Needs & Wants, -- Your Competition – Opportunities & Threats & Inspiration!   (5 pts.)†¨Page 4  Ã¢â‚¬â€œNiche Development, Your Ideal Customer   (5 pts.)†¨Page 5  - Products and/or Services, Basic Financials & Sales Strategy– Break-even Analysis (5 pts.)†¨Page 6– Brand Identity – Brand Mood Board, Brand Personality, Logo Concept/Theme   (5points)†¨Page 7–Business Website Plan, Site Map or CMS with Domain (5 points)†¨Page 8  Ã¢â‚¬â€œSocial Media & Marketing Communication Strategy (5 Points)†¨Page 9– Elevator Pitch or 30 Second Commercial (5 Points)†¨Page 10– A To-Do List of Action Items to Complete Post this Class (5

SS310 Final Project Research Paper Example | Topics and Well Written Essays - 1500 words

SS310 Final Project - Research Paper Example Assassination To begin with, some of the events that took place during this era were the assassination of many leaders in the U.S. For example, it was during this period that President John F. Kennedy was assassinated by two gunmen who short him several times (Anson, 1975). Findings upon investigation revealed that Kennedy was assassinated in 1963 due to political rivalry. Investigations regarding his murder revealed that senior people in government including the Vice president at the time and the former Cuban president conspired with the CIA, KBG, and the FBI to kill Kennedy (Maga, 2009). We discovered that the murder was a conspiracy when after digging several meters underground, we came across a report book by the U.S. House Select Committee on Assassination (HSCA) detailing the identities of those who conspired to assassinate Kennedy in a cold blood shooting. At the same time, we discovered an item detailing how Malcolm X, a religious leader, and American nationalist was assassin ated on stage by a rival Black Muslims group. The item reveals that, on 21 February 1965 while Malcolm X was addressing his Afro-American Unity organization at Audubon Ballroom in Harlem, New York, three men drawn from the Nation of Islam entered the room and immediately shot him while he was just about to start addressing the gathering (Breitman, Porter & Smith, 1991). He was pronounced dead on arrival to the nearby Columbia Presbyterian Medical Center. In addition, the capsule reveals that the assassinations of Malcolm soon triggered revenge attacks from his followers against the Black Muslims that saw several Mosques belonging to the Black Muslims torched in San Francisco and Harlem (Maga, 2009). In fact, one of the items discovered and resembled are the remains of a Dome of a Mosque thought to have been buried underground after the incident. Another item found in relation to assassinations during the 1960s relates to how Martin Luther King Jr. was assassinated in the evening of April 4, 1968. King was a vocal civil rights activist and leader. He was very vocal in fighting for equality for the black Americans and other races that were being discriminated against in the U.S. (Maga, 2009). Because of his stand, he was assassinated by a stray bullet. Archeologists’ findings of his skull reveal that the bullet hit him on the right cheek before traveling through his neck and finally rested on this shoulder. Analysis of the bullet casket found buried underground reveals that it was a 0.30-caliber rifle bullet. Significance of Assassinations in Defining the 1960s The assassinations witnessed during this era are of great significance because it reminds many of the struggles that leaders such as Martin Luther King Junior, John F. Kennedy and Malcolm went through in an attempt to ensure that America becomes a good country to live in - one without discrimination based on color, race, nationality, religion or language. As a result, the assassinations of these le aders signify how insecure America was during the 1960. People risked their lives by voicing out their concerns. It also shows the extent to which impunity and racism was the order of the day during this period (Maga, 2009). Feminist Movement History tells us that American women in the 1960s were limited in almost everything. As such, they were only

Bank management report Essay Example | Topics and Well Written Essays - 2500 words

Bank management report - Essay Example This requires a combined effort on the part of the organization as well as the individual employee to ensure a fit with the job responsibilities and work profile with the career goals of an individual. The present study would highlight the aspect of occupational analysis to ensure job fit and organizational excellence. Analysis of Occupation Business organizations need to include aspects of labour demand and supply in addition to determining price and output if they want to maintain sustainability of their businesses in the prevailing competitive business environment. The labour demand curve which highlights the marginal productivity of labour as a constant function of the labour quantity is largely determined by the price of output and changes in technology. The supply of labour is largely based on the premise that humans largely tend to make a trade off between leisure and work. They largely assume that work is not enjoyable and work is not enjoyable. However they also realise that leisure normally requires a cost for the individuals. It is widely assumed that an hour of leisure requires a person to sacrifice an hour of wage (University at Albany, 2008, p.1). Figure 1: Labour Demand and Supply Curve (Source: Cuthbertson & Gripaio, 1993, p.7) The figure above shows a typical labour demand and supply curve in a perfect economic scenario. However the equilibrium between demand and supply can be shifted due to change in the individual’s perception towards work. For example previously women were largely discouraged from working which reduced the total supply of labour however with changing times women have become an integral part of the labour force causing the number of workers to increase thereby causing a shift in the supply curve. Alternative work opportunity including immigration also play a role in the shifting of the equilibrium between labour demand and supply as attractive markets outside home would cause a shift in the supply curve to the left (Un iversity at Albany, 2008, p.1-2). Human Capital Human capital or the labour force is largely affected by the aspect of wages. The marginal theory of productivity states that under purely competitive market conditions the wage rate is largely constant and hence a firm has the opportunity to decide on the total number of workers to be hired thus determining the market demand for labour on their own. The element of additional or marginal worker largely helps in determining marginal productivity (Chakravarty, 2009, p.600). Employees also have a propensity to go in for higher studies or look for alternative work options. In both these cases the labour supply reduces and the equilibrium wage price gets increased owning to greater propensity and increased marginal wages of the employees in lieu of their higher education or attractive wages in other organizations. Higher education options among the workers would largely tend to shift the labour demand curve to the rightward direction ensuri ng a shift in the equilibrium point between labour demand and supply (Hubbard & O’Brien, 2008, p.504). Labour Migration In a market characterised by elements of perfect market competition labour

Financial Markets and institutions Assignment Example | Topics and Well Written Essays - 2000 words

Financial Markets and institutions - Assignment Example March 16 saw an even worse situation in which economic data of the US painted a dismal outlook for the economy. Whole sales prices were seen increasing more than expected, while a lower than expected demand in the housing sector pushed the investors over the edge and panic selling took place. Investors sought sanctuary in US Treasuries instead of the stocks. Another key factor that lowered the stock index was the fact that option prices jumped up by 21% given the situation in Japan. However, the index saved grace and climbed up by almost 2.2% in the following two days, owing to the fact that G& offered their assistance in helping to control the Japanese fiasco. At the same time, the US manufacturing sector registered steady growth figures which boosted the S&P index. Another key factor was that investors displayed a slightly higher risk appetite and this saw Treasuries going down as yields rose to 3.26% from 3.19%. The most primary determinant of any index is the economic outlook of the region. S&P was highly influenced by the economic data that was coming forth. The disaster in Japan nudged the fact that US imports from the region would suffer. This could cause production issues in the US, which depended on machinery and raw material from Japan. Furthermore, the economic indicators such as inflationary pressure and weak demand elucidated the fact that the GDP growth would slow down. These assumptions triggered the rise in US treasuries which were seen as a safe haven. Oil prices not only raised the energy costs in US, but also created a sense of dread in OMCs’ who were at risk of supply shocks. Investors offloaded these stocks, judging that the P/E measures would drop due to lower earning concerns. Present valuation of future cash flows, or rather the ability to generate future cash flows was the major determinant in the decline and the rise in the market during this week. As mentioned above, the rise in manufacturing growth suggested that the sector wo uld show positive returns, hence the market jumped up. International support for the Japanese boosted sentiments that their production capacity would soon normalize. Investors took this as a positive sign and the S&P 500 gained ground on this. The economic theory apart from present value of cash flows which applies to the S&P’s fluctuation is the inflation development. If inflation persists, then monetary tightening could occur. Any hike in interest rates would hurt economic growth, and such sentiments can cause a decline in the indices. As mentioned earlier, the biggest determinant of price movements of stock indices are the economic indicators and expectations of these indicators. If expectations lead to believe that there will be a positive change, then the prices of these indices will jump up. The flip side of the coin is that if sentiments perceive the market factors to be unfavorable, then a downward spiral can ensue. Financial Crisis 2008-11 Introduction The global fin ancial crisis which started in early 2007 has proven to be perhaps the great financial catastrophe in history. Although it traces its roots back to the starting of the millennia, the subsequent meltdown was most gruesome over the past 3 years. What began as a crisis of the sub-prime mortgage market in the United States quickly transcended national borders and developed into an

Fast Food and Free

Fast Food and Free Time Essay MIt is common for university students to have a semester break in between each semester in a year. It usually lasts for about 3 to 4 months. Consequently, students will feel bored during the semester break because they have nothing to do. In my opinion, university students nowadays do spend their free time wisely because they will find some job to fulfil their semester break before starting their studies, doing a short semester and making small business to earn money for their expenses. Firstly, university students nowadays do spend their free time wisely because during semester break, they will find a job to fulfil their semester break before resuming their studies. Usually, their popular choice would be part time job in fast food outlets such as KFC, McDonald’s and Pizza Hut. By working, they learn the hardships of earning money and at the same time they are doing something beneficial. Besides, they can also use their salary to pay the fees for their next semester and thus they can reduce their parents’ burden. Secondly, university students nowadays do spend their free time wisely because some of students doing short semester for spend their free time in semester break especially for those repeaters, they can finish the repeat subject earlier and have no burden to take the subject again for the next semester. Beside that, repeater students will not taking a long time to finishing their studies and grading earlier. Lastly, university students nowadays do spend their free time wisely because most of them do a small business when semester break. For example they open a stall burger. They can help their family finance and also can pay for their expenses. Moreover they also can get more experience on how to make a business. At the same time, they also can spend some money for their personal saving. So, university students nowadays do spend their free time wisely.

Relativism and Morality Essay Example for Free

Relativism and Morality Essay Is it ethical? Will it be right? Is it a small sacrifice for the betterment of the future? All these questions do not have exact answers. You can never give a straight cut answer to all the above questions. You can never exactly say that a particular thing is completely right or completely wrong. All this varies from people to people and culture to culture. Individual personalities have different philosophies regarding particular thought and belief. There is never completely a black or white it is in between. It is grey. This is relativism. Relativism can be defined â€Å"as the concept that points of view have no absolute truth or validity, having only relative, subjective value according to differences in perception and consideration†. According to relativism all views are considered valid. Well relative truth varies with people for example, a person prefers a red coloured car over black coloured car, where other person may disagree. True for one person is not true for another. So relative truth can’t be right or wrong. But greater than relative truth is Morality, where you see whether your actions are causing any harm to another and stop doing such things. Here which causes problems or harm someone should be considered as wrong. It is absolutely wrong on the part of our moral values to harm someone. There is a very fine line between morality and relative truth, moral values also varies from people to people and culture to culture but morality will never do any bad(even if it’s right for the other person). It is rightly said about moral by Ernest Hemingway â€Å"About morals, I know only that what is moral is what you feel good after and what is immoral is what you feel bad after. † There are some things that are absolutely wrong and therefore I agree with Lenn Goodman. He is right on his part in challenging relativism and I fully support him. Just suppose if everyone was allowed to do as they wish, what a horrid place this could have been. If everything was so relative and there was no right or wrong then one person could have killed other for his better future, and he would never have got any punishment. Because on his part, he was right. Also sometimes we have to rise above principles to challenge wrong. For example, America would have never got independence if slavery was discussed on principles. But if we see overall, it was a good thing going against the principles because slavery was the wrong being done. Same goes with the case of India’s independence where the freedom fighters were called terrorists just because they fought against the government for their own rights. But not every compromise is that easy to digest. It was wrong what happened with Germany in the first world war was bad but what followed in the second world war by Nazis may be a reaction was not tolerable. It was like removing a whole community from the world, that was worst. How can one have the right to destroy the being of the whole community or clan, just to satisfy one’s own selfish motives. Or you thing this is right for your own community or culture, but this is completely wrong. It is not human. Our moral values and love and respect for each other is what differentiates us from ruthless animals. Every human deserves respect, love and moral behaviour even if there is culture difference or some other difference. We all are made of same thing and thus have the same needs which mainly includes Respect. The main examples which truly challenge relativism are genocide, famine, terrorism, slavery, chid warrior and rape. Everyone has the right to life, no one can take away that right just because he thinks it’s right. Killing a single person and killing the whole community is different. Killing of whole community(genocide) being uglier, because it destroys not only dreams but destroy the being of the whole community, it can then well said to be extinct just like the bird Dodo. Genocide simply destroys a way of life. This is not humane. What the soviets did to Ukraine or Mao to China, was the part of a so called bigger plan, a small compromise. But a compromise which is difficult to live by. Millions of people lost their lives, and people lost their mother, father, brother and what not. This was simply wrong and cannot be considered relativism. The cultural revolution in China which was brought about by Mao, was wrong. It was relatively a right thing on the part of Mao. But it was wrong on the moral, ethical and human part. The number of Deaths during Mao’s period was about 70 million and he was ready to sacrifice 300 million. He had no right to control people’s life like that. This is where relativism should be challenge, because this is simply unfair and unacceptable. The other example is of terrorism, it’s also like mass killing of a community out of frustration and anger, which is illegal. As compared with the above example which is considered legal, as it is for some revolution; terrorism is you can say illegal. You don’t have the power to destroy someone’s life but you want to have that power, power is confused with violence. Terrorists say that they fight for some values, but they themselves destroy values by guns and bombs, by killing innocent people. By bombing school bus or by exploding some monument, to build fear in people. This is what the terrorists are doing, how can this be said to be fighting for your rights when today you can be creating people who want to take revenge from you, the same way you did, and someone else did to you. This is a never ending chain. Humanity will be the sufferer and this is completely wrong. It is unacceptable. The damage is devastating and not by any chance humane. Child warriors is also very wrong on the part of humanity. The innocence of child is lost, he becomes emotionless after all the what he suffers. There are around 300,000 child soldiers, it is legal to have children below 15 in the army, no one is convicted of it till now. They are even used as sex slaves and exploited. They grow up with these scars and in return are ready to give scars to others. War, genocide or terrorism whatever is there, whosoever is the winner, humanity will always be the looser. Innocence of people, their dreams to live a happy life, their achievements, what good they could have given to the world all get killed along with them because of the inhumane ways of so called humans, the ways being war, genocide, famine or terrorism. Slavery can be equalled to murder, but here it is the murder of one’s wishes, desires and dreams. The person is alive but his soul is no less then dead. Human trafficking mainly includes women and children. Women and children are mainly used in prostitution, as labors and for agriculture mainly men are trafficked. Around four million people are trafficked and people from Thailand, Vietnam, China, Mexico, Russia, and the Czech Republic are the victims. This is completely wrong. The use of humans here is not tolerable and unfair. It is taking advantage of other people’s weakness. This is not fair on part of humanity. Rape is also exploitation, it aims to abuse and humiliate the sufferer. It violates one’s personhood. It is an act of hate and not love. Rape is used even today in wars or genocide wars, it is a weapon to humiliate and abuse the opponent. This is not good at all, and should be stopped. It is wrong on the part of humanity. Here also humanity is the one that suffers. Exploitation of people for your own benefits has always been wrong and should be stopped. It takes away one’s freedom to live life his own way. Whether it is the case of genocide , warfare, murder, slavery, rape or child warrior, nothing can be considered right and can never be right even according to relativism. It is not moral, it is not humane. Even if there are relativistic truths in this world. And ethics and morals have evolved over time. It changes from people to people, culture to culture, with time and with place. Even then somehings are simply wrong when it comes to humanity. It is well known that two hundred years ago there was slavery in America. It was considered right at that time, we can consider it was right, that doesn’t mean it was actually right. It was inhumane. If this was not thought at that time, then slavery would have existed till now in America. If it was not wrong even at that time, then no one would have made an effort to stop this exploitation of human being. There should be global moral norms made, inorder to stop this evil on human race. Everything should not be left on relativism and such logics should not be given, that is is right according to me and it is for the betterment of the society. Then it should be made clear that by doing genocides and practicing slavery, the society will never get better. People should rise above their culture limitation, to achieve a greater goal, i. e. success of humanity. By practicing norms that benefit us but without compromising other people’s life, dreams and freedom. This will make the world a better place to live. People should see to it that everyone has the right to life, and we are no one to take it away from him. Everyone should take care of others emotion, ritual, feeling and should not violate it, this is right for sure. Individuals should see to ot that everything contributes in the success of humanity, and then everything can be considered right. This I can say for sure is Absolute Truth and not Relative Truth. It is rightly said by Martin Luther King â€Å"The first principle of value that we need to rediscover is this: that all reality hinges on moral foundations. †

Cardiovascular Disease

Cardiovascular Disease Cardiovascular Disease Introduction This paper utilizes qualitative data drawn from a series of focus group discussions with patients living with coronary heart disease which explored their understanding of and adherence to a prescribed monitoring and medication regime. These findings are drawn upon in order to contextualize, from the patients perspective, the outcomes of the Departments of Healths Coronary Heart Disease National Service Framework strategy. The paper focuses attention on the consequences of this regulatory approach to clinical and risk management for those patients already living with coronary heart disease. Case Study Patient is 59 yrs old and had a myocardial infarction 2 years ago. He is obese, a smoker and poorly motivated. The case exemplifies many of the difficulties that frequently arise in managing cardiovascular disease, and suggests potential avenues for improving outcomes through the application of a disease management programme. The Coronary Heart Disease National Service Framework By the mid 1980s, it had been generally accepted by most clinicians that there was strong evidence to support the existence of a linear relationship between cholesterol levels and cardiac mortality (Shaper et al. 1985, Stamler et al. 1986), and that therefore lowering total cholesterol levels would reduce the risk of individuals developing coronary heart disease. This opened the way to the process of establishing a recommended cholesterol threshold level at which treatment should be instigated (Leitch 1989). Since then, the trend has been towards setting ever-lower threshold targets for treatment for those designated as being at high risk of developing coronary heart disease and for those already living with the disease. In 2000, the Department of Health published its Coronary Heart Disease National Service Framework which set out 12 standards for the prevention, diagnosis and treatment of the disease (Department of Health 2000). The National Service Framework standard Number 3 recommended that GPs identify and develop a register of diagnosed patients and those patients at high risk of developing coronary heart disease. Dietary and lifestyle advice (what the document terms ‘modifiable risk factors) was to be offered to these patients, and their medication reviewed at least every 12 months. It was also recommended that statins be prescribed to anyone with coronary heart disease or having a 30% or greater 10-year risk of a ‘cardiac event, in order to lower their blood cholesterol levels to less than 5 mmol/l or by 30% (which ever is greater). These recommendations were vigorously promoted when they were incorporated into the new General Medical Services contract that came into operation in 2003. The relative performance of an individual Primary Care Organization in meeting each of these indicators attracts points on a sliding scale that are then converted into payments for individual GPs. In relation to the management of patients with coronary heart disease, higher payments are received if a Primary Care Organization increases the percentage of patients with coronary heart disease who have their total serum cholesterol regularly monitored, and whose last cholesterol reading was less than 5 mmol/l (Department of Health 2004a). The most recent Department of Health progress report on the National Service Framework argues that the massive growth in statin therapy since 2000; ‘. . . is one of the most important markers of progress on the NSF, and was directly saving up to 9,000 lives per year (Department of Health 2005: 19). Statin prescriptions have been rising at the rate of 30% per year since 2000, and in 2004/5  £750 million was spent on statins, equivalent to some 2.5 million people on statin therapy in England (Department of Health 2005). In July 2004, low doses of statins became available over the counter without prescription for the first time, for those at moderate risk. The Public Health Discourse(S) Of Cardiac Risk The application of risk discourses in the field of public health (or more precisely the ascription of health risk to particular behaviours) as conceptualized within those elements of the risk literature most influenced by Foucauldian notions of governmentality, are seen as serving to construct the socially recalcitrant as distinct from the responsible citizen (Foucault 1977, Turner 1987, Lupton 1995). In a similar way, Dean (1999) argues that once risk has been attributed to particular health behaviours, the distinction is then drawn within public health policies between ‘active citizens who are perceived as able to manage their own heath risks, and ‘at-risk social groups who become the object of targeted interventions designed to manage these risks. Two distinct dimensions or approaches to the conceptualization and public health management of cardiac health risks also emerge from an examination of the ‘guiding values and principles which inform the Department of Healths Coronary Heart Disease National Service Framework (Department of Health 2000).While one approach (described below as the ‘epidemiological model of risk) largely conforms to the individualized ‘at-risk discourse, a second discourse (described below as the ‘social model of risk) which is much more concerned with health risk at a social and material level can also be discerned within the National Service Framework. These two distinct and arguably competing discourses of risk point to a complexity in current public health policy that might not be anticipated from a reading of the governmentality literature alone. The first conceptualization of cardiac risk within the Coronary Heart Disease National Service Framework is one that can be termed the ‘social model of health risk. This model essentially reflects a socio-economic understanding of the determinants of population health, and draws attention to the importance of addressing material, social and psychological risk factors in addition to the known biological factors in heart disease. In the National Service Framework, this social model is reflected in the endorsement (albeit at a rhetorical level) of an interventionist role for the state in addressing these wider determinants of the disease: ‘The Governments actions influence the wider determinants of health which include the distribution of wealth and income. A wide range of its policies will have an impact on coronary heart disease including social and legal policies and policies on transport, housing, employment, agriculture and food, environment and crime (Department of Health 2000: Section 1, Para 17). There is also an explicit acknowledgement that these risk factors disproportionately disadvantage particular sections of society, demonstrated in the higher incidence of coronary heart disease among the manual social classes. It is also acknowledged that there is inequity in health service provision; ‘. . . there are unjustifiable variations in quality and access to some coronary heart disease serv ices, with many patients not receiving treatments of ‘proven effectiveness (Department of Health 2000: Section 1, Para 13). This formal acknowledgement of the governments role in addressing the wider social and economic influences on cardiac health risk could to some degree be said to conform to Becks (1992) notion of the ‘risk society; wherein many of the health risks faced by the population are a consequence of unchecked scientific and industrial ‘progress. Beck asserts that in response a greater public awareness or ‘reflexivity of risk has emerged which reflects a shift from ignorance or private fears about the unknown to a widespread knowledge about the world we have created. The question of whether a reflexivity concerning the social and environmental factors associated with cardiac risk can be discerned in a patients own discourses of cardiac risk is something that will be explored in the discussion below. The second risk discourse emergent within the National Service Framework (Department of Health 2000) is one which reflects a predominantly epidemiological understanding of health risk. In this model, the relative risk of an individual developing heart disease is based upon a calculation of the mean values associated with certain ‘lifestyle behaviours such as smoking, diet and exercise that are drawn from aggregated population data for heart disease incidence. This is a statistical approach that all too often perceives such calculated health risk factors as being realities or causative agents in their own right, often with little acknowledgement of the social and material context of these health behaviours. Nevertheless, it is on the basis of this epidemiological model of health risk that the Department of Health has confidently set national guidelines that now require General Values and principles underlying the CHD National Service Framework Nine stated values underlying development of national policies for CHD Provision of quality services irrespective of gender, disability, ethnicity or age. Ready availability of consistent, accurate and relevant information for the public. Consideration of health impact in regard to social and legal policies and policies on transport, housing, employment, agriculture and food, environment and crime. Public health programmes led by health and local authorities to ensure targets for CHD are met. Reduction in health inequalities. Resources will be targeted at those in greatest need and with the greatest potential to benefit. Evidence-based. CHD policies are to be based on the best available evidence. Integrated approach for the prevention and treatment of CHD in health policy, health promotion, primary care, community care and hospital care. Maintenance of ethics and standards of professional practice. Recognition of the importance of voluntary organizations and carers at home in addressing CHD. Four stated principles underpinning the CHD NSF . Reducing the burden of CHD is not just the responsibility of the NHS. It requires action right across society . The quality of care depends on: ready access to appropriate services ii. the calibre of the interaction between individual patients and individual clinicians iii. the quality of the organization and environment in which care takes place. . Excellence requires that important, simple things are done right all the time. . Delivering care in a more structured and systematic way will substantially improve the quality of care and reduce undesirable variations in its provision. Practitioners to identify and monitor ‘high risk patients and to prescribe the recommended drug treatment regime. It can be argued that this regulatory or ‘managerialist approach to clinical decision-making constitutes a challenge to the discretion that has been traditionally enjoyed by general practitioners in relation to the clinical management of patients. This second ‘official discourse of health risk could be seen as indicative of the regulatory and surveillance forms of governmentality identified within Foucauldian social theory. From this perspective, those social groups whose health behaviour or lifestyle are seen to fall outside the acceptable bounds of self-management then become constructed as ‘at-risk. These are social groups who are seen to, ‘deliberately expose themselves to health risks rather than rationally avoiding them, and therefore require greater surveillance and regulation (Lupton 1995: 76); once identified these groups and individuals then become subject to various health promotion or ‘health improvement initiatives. Implicit in such forms of governmentality as applied within health policy interventions designed to manage risk are a set of assumptions about the nature of human action predicated on the notion of the ‘rational actor model. Jaeger, Renn, Rosa and Webler (2001) have argued such models of rationality operate at three levels of abstraction. In its most general form, it presupposes that humans are capable of acting in a strategic fashion by linking decisions with actions. That is, human beings are goal-orientated who have options available from which they are able to select a course of action appropriate to meeting these goals. The second level of abstraction which the authors term the ‘rational actor paradigm, and which is the level at which rationality is probably understood by policy-makers, contains the following assumptions: all actions are individual choices; individuals can distinguish between ends and means to achieve these ends; individuals are motivated to pursue t heir own self-chosen goals when making decisions about courses of action/behaviour; individuals will always choose a course of action that has maximum personal utility, that is it will lead to personal satisfaction; individuals possess the knowledge about the potential consequences of their actions when they make decisions. Finally, that rational actor theory is not only a normative theory of how people should make decisions about in this case health behaviour, but is also a descriptive model of how people select options and justify their actions (Jaeger et al. 2001: 33). Many of these rational actor assumptions underpin and inform the Coronary Heart Disease National Service Framework. Such assumptions manifest themselves in a seemingly unproblematic approach to the promotion of ‘risky health behaviour change which plays down the influence of culture, habitus and the material basis of group socialization. This uncritical rationality also threatens the sustainability of the National Service Framework strategy in other ways. The social psychological and sociological literature see the notion of ‘trust as constituted through two dimensions, the deliberative or rational and the affective or non-rational. As Peter Taylor-Gooby (2006) has pointed out in his work on the problematic of public policy reform, the rational deliberative processes associated with the achievement of greater efficiency in the provision of public services have unwittingly served to undermine the non-rational processes that contribute to the building of trust in public institutions and in public sector professionals. In this context, the National Service Framework will need to build trust both in terms of the presentation of the biomedical evidence for the effectiveness of statins and other cardiac drug interventions, as well as the more affective elements associated with the belief that the national targets are designed with the best interests of patients in mind rather than being driven by financial considerations alone. Significantly, given its centrality to a ‘disease management strategy, neither the Coronary Heart Disease National Service Framework (Department of Health 2000) nor the NHS Improvement Plan (Department of Health 2004b) which sets out the governments priorities Coronary heart disease and the management of risk 363 for primary and secondary healthcare up to 2008, attempts to define the use of the term ‘risk, and by extension ‘higher risk. Nevertheless, the conception of risk that shapes the practical interventions proposed within both these strategy documents is clearly the epidemiological one that is described above. In the past, such public health interventions have been largely concerned with bringing about health behaviour change, however now the strategy would appear to be less focused on encouraging greater responsibility for the ‘self management of cardiac risk and more on ensuring compliance with clinical management regimes of monitoring and drug treatme nt. Optimising Care Through Disease Management In the last 15 years, there have been dramatic advances in the pharmacotherapy of heart disease, most notably the introduction of angiotensin converting enzyme (ACE) inhibitors. (Jaeger et al. 2001: 33) Unfortunately, numerous studies have suggested that ACE inhibitors are substantially underutilised in heart disease patients. Moreover, there are a multitude of factors which may confound heart disease management heart disease virtually never occurs in isolation, and comorbidities such as hypertension, diabetes, coronary artery disease, chronic pulmonary or renal disease and arthritis occur frequently. The presence of these comorbid conditions may interfere with heart disease management in several ways. In PATIENTs case, pre-existing renal insufficiency may have contributed to her intolerance to ACE inhibitors. In addition, her use of NSAIDs could promote salt and water retention and antagonise the antihypertensive effects of her other medications. (Jaeger et al. 2001: 33) Multiple comorbidities may also result in polypharmacy, which, in turn, may compromise compliance and lead to undesirable drug interactions. Adherence to dietary sodium restriction is often problematic (as in patients case), particularly in older individuals who are either not responsible for preparing their own meals, or who rely heavily on canned goods and prepared foods. Depression, anxiety and social isolation are common in patients with heart disease, and each may interfere with adherence to the heart disease regimen or with the patients willingness to seek prompt medical attention when symptoms recur. Similarly, the high cost of medications may limit access to therapy in patients with restricted incomes. Physical limitations, such as neuromuscular disorders (e.g. stroke or Parkinsonism), arthritis and sensory deficits (e.g. impaired visual acuity), may compromise the patients ability to understand and comply with treatment. Finally, cognitive dysfunction, which is not uncommon in elderly heart disease patients, may further confound heart disease management. Impact on Clinical Outcomes Despite the widely publicised effects of ACE inhibitors, b-blockers, angiotensin receptor blockers and other vasodilators on the clinical course of heart disease, morbidity and mortality rates in patients with established heart disease remains very high. heart disease is the leading cause for repetitive hospitalizations in adults, and in 1997 Krumholz et al. reported that 44% of older heart disease patients were rehospitalised at least once within 6 months of an initial heart disease admission. Remarkably, this rate was no better than that reported in several prior studies dating back to 1985. (Krumholz et al. 1998) From the disease management perspective, it is important to recognise that the majority of heart disease readmissions are related to poor compliance and other psychosocial or behavioural factors, rather than to progressive heart disease or an acute cardiac event (e.g. myocardial infarction). Thus, Ghali et al. reported in 1988 that 64% of heart disease exacerbationswere attributable to noncompliance with diet, medications or both and that 26% were related to environmental or social factors. Similarly, in 1990 Vinson et al. (Vinson, 1995) found that over half of all readmissions were directly attributable to problems with compliance, lack of social support, or process-of care issues, and these authors concluded that up to 50% of all readmissions were potentially preventable. More recently, Krumholz et al, reported that lack of emotional support among older heart disease patients was a strong independent predictor of adverse outcomes, including death and hospitalization Rationale and Objectives The above considerations provide the rationale for a ‘systems approach to heart disease management. The objectives of this approach are as follows: To optimise the pharmacotherapy of heart disease in accordance with current consensus guidelines. (Vinson, 1990) To maximize compliance with prescribed medications and dietary restrictions. To identify and respond to any psychological, social or financial barriers that might interfere with compliance with the prescribed treatment regimen. To provide an appropriate level of follow-up through telephone contacts, home visits and outpatient clinic visits. To enhance functional capacity by providing an individualized programme of exercise and cardiac rehabilitation. To enhance self-efficacy by helping the patient and family understand that heart disease can be controlled, largely through the patients and familys efforts. To reduce the frequency of acute heart disease exacerbations and hospitalizations. To reduce the overall cost of care. The Disease Management Team Although the composition of a disease management team may vary both from centre to centre and from patient to patient, a suggested list of team members are given below: nurse coordinator or case manager dietitian social services representative clinical pharmacist physical therapist/occupational therapist exercise/rehabilitation specialist  · home health specialist patient and family primary care physician cardiologist/other consultants. Each team member provides their own unique expertise and/or perspective, and these are then woven into an integrated package tailored to meet each individual patients needs, expectations, and circumstances. Importantly, not all patients will require the services of all team members, and it is therefore essential to identify a team leader. In most cases, this will be the nurse coordinator or case manager, who, in addition to being the patients primary contact person and educator, is also responsible for coordinating the efforts of other team members, including the selective activation of appropriate consultations on an individualized basis. In addition to the team itself, several other components are essential for effective disease management. First, the patient and family should be provided with comprehensive information about heart disease, including common etiologies, symptoms and signs, standard diagnostic tests, medications, diet, activity, prognosis and the role of the patient and family in ensuring that heart disease remains under control. This information should be provided in a readily understandable patient-friendly format and several patient-oriented heart disease brochures are now commercially available. In addition to these materials, the patient should be given a scale (if not already owned) and a chart to record daily weights, an accurate and detailed list of medications supplemented by medication aids if needed (e.g. a pill box), and specific information about when to contact the nurse, physician, or other team member in the event that questions or new symptoms arise. In this regard, the importance of establishing an effective one-on-one nurse-to-patient relationship cannot be overemphasized, as this interaction will often be critical to the early diagnosis and effective outpatient treatment of heart disease exacerbations. Patient Perspective While the above studies indicate a beneficial effect on costs, hospital readmissions, etc., they do not address concerns related to the patients perspective on this interdisciplinary care. What issues are important to the patient, and what the advantages are to the patient of participating in an heart disease disease management programme? In recent years, it has become increasingly evident that it is insufficient to merely provide high quality medical services. In a competitive market, it is essential that the patient is also satisfied with the medical encounter, both in terms of the process of care as well as the clinical outcomes. Healthcare is an industry, and like all industries, customer satisfaction is critically important. However, unlike most industries, which deal with a tangible product, the healthcare industry deals with a multifaceted service, the myriad qualities of which are difficult to quantify. As a result, the assessment of patient satisfaction is often complex, and the development of a valid and universally accepted instrument for measuring patient satisfaction has been elusive. Despite these problems, several patient satisfaction questionnaires have been developed, (Garg, 1995) and these have been helpful in defining those issues which are important to patients, and in identifying specific concerns that patients often have with respect to current approaches to healthcare delivery. (Garg, 1995) Factors which have been consistently shown to play a pivotal role in determining patient satisfaction include: communication, involvement in decision- making, respect for the individual, access to care and the quality of care provided. (Philbin, 1996) Not surprisingly, problems in each of these areas are frequently cited as factors which diminish patient satisfaction. Several components of the heart disease disease management system will be of direct assistance in answering patients questions and helping her cope with this new and frightening diagnosis. In particular, the nurse case manager will establish an effective rapport with the patient and her family, and provide an ongoing source of information and emotional support. The patient education brochure and other printed materials will help answer many of Patients questions and assist in relieving some of her anxieties. The nurse, clinical pharmacist and physician (s) can provide detailed information and teaching about the medications used to treat heart disease, and the dietitian can directly address the dietary questions and provide an individualized diet that takes Patients current dietary practices and food preferences into account. The social service representative can assist patient with any financial concerns she may have, make provisions to ensure an adequate social support network, and serve as an additional source of emotional support. The physical therapist or exercise specialist can help in providing recommendations about activities and in the development of an exercise or rehabilitation programme. The nurse case manager, social service representative, home care specialist, and physician will provide assistance to patient in making the transition from the hospital back to the home environment, and they also will ensure a high level of follow-up care. Perhaps most importantly, the comprehensive care provided by the disease management team will reassure patient that she truly is being cared for, and that all of her needs and concerns are being met. Invariably, this will lead to a high level of patient satisfaction. In addition, in the case of patient there is good reason to believe that implementation of a disease management programme at the time of her initial hospitalization may have eliminated the need for a second hospitalization. (Young, 1995) To the extent that patient might have to pay for some of the costs of readmission (e.g. deductible or copayment), the disease management programme would also save her money, a benefit which is universally viewed in a favorable light. And finally, based on compelling data from recent clinical trials, optimizing Patients medication regimen should translate not only into an improved quality of life, but also into increased survival. Conclusion In summary, heart disease management systems provide a win-win-win situation. They are a ‘win for the providers, because they improve clinical outcomes and quality of life. They are a ‘win for the payors, because effective disease management programmes decrease health care expenditures. And they are clearly a ‘win for the patients, who reap multiple benefits, including improved quality of life and well-being, enhanced self-efficacy due to a greater sense of health control, improved exercise tolerance and functionality, increased survival (as a result of more optimal utilisation of heart disease medications), and, in some cases, reduced out-of-pocket expenditures. References Department of Health (2000) National Service Framework for Coronary Heart Disease (London: DoH). Department of Health (2004a) GMS Statement of Financial Entitlements (SFE) 2004/5 (London: DH). Department of Health (2004b) The NHS Improvement Plan: Putting People at the Heart of Public Services Cm 6268 (London: The Stationary Office). Department of Health (2005) The Coronary Heart Disease National Service Framework: Leading the Way-Progress Report 2005 (London: DH Publications). Foucault, M. (1977) Discipline and Punish: The Birth of the Prison (London: Allen Lane). Garg R, Yusuf S, for the Collaborative Group on ACE Inhibitor Trials. Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. JAMA 1995; 273: 1450-6 Ghali JK, Cooper R, Ford E. Trends in hospitalization rates for heart failure in the United States, 1973-1986. Evidence for increasing population prevalence. Arch Intern Med 1990; 150: 769-73 Jaeger, C., Renn, O., Rosa, E. and Webler, T. (2001) Risk, Uncertainty, and Rational Action (London: James James/Earthscan). Krumholz HM, Butler J, Miller J, et al. Prognostic importance of emotional support for elderly patients hospitalized with heart failure. Circulation 1998; 97: 958-64 Leitch, D. (1989) Who should have their cholesterol concentration measured? What experts in the United Kingdom suggest. British Medical Journal, 298(6688), 1615 1616. Lupton, D. (1995) The Imperative of Health: Public Health and the Regulated Body (London: Sage). Philbin EF, Andreou C, Rocco TA, et al. Patterns of angiotensin-converting enzyme inhibitor use in congestive heart failure in two community hospitals. Am J Cardiol 1996; 77: 832-8 Redfern, J., MacKevitt, C. and

Female Performers in Country Music Essay -- Women Gender Papers

Female Performers in Country Music During the early twentieth century, southern music began to be known by a somewhat more precise and diverse set of classificatory designations such as "country," "blues," and "jazz," Through the phenomenal development of the radio and recording technology, the music of the south rapidly became known throughout the nation. The contributions of early performers such as the great Jimmie Rodgers, Vernon Dalhart, Bob Wills, Milton Browne, the singing cowboys and many others are well documented. But where are the female musicians during the early development of country music, specifically during the 1920s and 1930s? In the "blues" field, the names of the legendary Billie Holiday, Bessie Smith, Mamie Smith and Ma Rainey are well known along with male performers such as Blind Lemon Jefferson, "Peg Leg Howell," and many others. In the opera, women had long held important places in the music and the same may be said of vaudeville. In earlier country music, female performers were much less prom inent and their roles more muted. Furthermore, until recently, there has been a woeful lack of scholarly attention to the early roles of women in the formation of the music in its modern commercial form. A part of the problem lies in the fact that recorded country music from the pre-1940 period is difficult to find, but it is also likely that women performers were far less numerous during this period. Coltman (1978:161) reports of that of the 377 pieces of recorded country music from the period 1922-1931 he had heard, only 12 (3%) were female soloists or all female groups, only 5% of the records were male groups who would feature a female soloist, and only about 5% were known to feature women as instrumentalists.... ...liche, "You've come a long way, baby." 1Jill McWhorter is a 1990 graduate of Middle Tennessee State University and is currently a reporter and staff writer for the Review Appeal in Franklin, Tennessee. 2There is some evidence that Billie Maxwell, "The Cow Girl Singer," may have been the first to record in this genre. (Cf Coltman, 1978:164). 3In the Summer of 1990, Patsy visited Murfreesboro and appeared as a surprise guest in my Elderhostel class on country music. She delighted us with a rendition of "I Wanna Be a Cowboy's Sweetheart" and graciously consented to an interview. Some of the material in this section is drawn from that interview. BSA 4Female performers are only beginning to compete in the songwriting arena and lag woefully behind in the music publishing business. They have made great strides, however, in the area of artist management.

Chinese Religion Essay -- Taoism, Buddhism, Confucianism

Chinese Religion The region of China is extensive and profound. â€Å"In China lay people did not belong to an institutionalized sect, nor did their religious life have anything to do with signing articles of faint. Religion in China was so woven into the broad fabric of family and social life that there was not even a special word for it until modern times, when one was coined to match the Western term† (Thompson, 1). In China, Taoism, Buddhism, and Confucianism are all blended. In the earliest period, Shang Dynasty (2000 BC), people in China had worshipped a lot of different gods (polytheism) such as weather god, river god. People in the Shang Dynasty believed that their ancestors become like gods after they died, so people worshipped their own ancestors. The basic features of Chinese Ancient Philosophy consist of five stresses, spiritual existence, practice, morality, harmony, and intuition. The philosophy in Pre-Qin times was marked by the emergence of various ancient philosophical views. The most influential schools were Confucianism, Taoism, Mohism and Legalism. In China lay people did not belong to an institutionalized sect, nor did their religious life have anything to do with signing articles of faint. Religion in China was so woven into the broad fabric of family and social life that there was not even a special word for it until modern times, when one was coined to match the Western term (Thompson, 1). The school takes the teachings of Confucius as its core of thought and regards the words and deeds of Confucius as it highest code of behavior. It advocates the benevolence and justice, allegiance and forbearance, the doctrine of the golden mean and values the ethical relations of men. In the Chinese world view there was an ... ...ey hoped to avoid plagues, ensure rain in due season, and to be granted children. Believing their livelihood, both present and future, to be guaranteed y the favor of the hallowed place of their assemblies, the members of the local community felt themselves bound to it by a relationship teeming with benefits, which caused them to adhere to it as faithful vassals to a powerful lord† (Liu, 30). Liu, James T.C. China Turning Inward Intellectual-political Changes in the Early Twelfth Century. 4th ed. Vol. 23. Council on Ast Asian Studies, 1919. Print. Shankman, Steven, and Stephen W. Durrant. Early China/Ancient Greece. Albany: State University of New York, 2001. Print. Thompson, Laurence G. Chinese Religion: An Introduction. Belmont: Dickenson Company, Inc, 1969. Print. Thompson, Laurence G. The Religious Life of Man. Belmont: Dickenson Company, Inc, 1973. Print.