Use Of Bone Marrow Transplants Health And Social Care Essay

The bone marrow is a sponge-like tissue found in the centre of certain castanetss that contains root cells that are the precursors of ruddy blood cells ( red blood cells ) that carry O to the tissues in the organic structure, white blood cells ( leucocytes ) that aid battle infections and to assistance in the immune system and thrombocytes which help with blood curdling. Each of these cells plays a important function in the organic structure by keeping normal physiological map. The bone marrow is a critical portion of the human organic structure. A bone marrow graft is when particular cells ( called root cells ) that are usually found in the bone marrow are taken out, filtered, and given back either to the same individual or to another individual. It involves pull outing bone marrow incorporating normal root cells or peripheral root cells from a healthy giver, and reassigning it to a receiver whose organic structure can non fabricate proper measures of normal blood cells. Infusion of haematopoietic root cells from oneself or another individual normally follows high dose chemotherapy and/or irradiation. The end of the graft is to reconstruct the receiver ‘s blood cells and immune system and hopefully bring around the implicit in disease In patients with leukaemia, aplastic anaemia, and some immune lack diseases, the root cells in the bone marrow have malfunction, bring forthing an inordinate figure of faulty or immature blood cells as in the instance of leukaemia or low blood cell counts in the instance of aplastic anaemia. The immature or faulty blood cells interfere with the production of normal blood cells, accumulate in the blood stream and may occupy other tissues so bone marrow graft enables the doctors to handle these diseases with aggressive chemotherapy and/or radiation by leting replacing of the morbid or damaged bone marrow after the chemotherapy/radiation intervention. While bone marrow grafts do non supply 100 per centum confidence that the disease will non repeat, a graft can increase the likeliness of a remedy or at least prolong the period of disease-free endurance for many patients. Bone marrow organ transplant is an effectual intervention for a assortment of haematological tumors, furnace lining lymphoma, and some solid tumours. An increasing figure of bone marrow grafts are performed every twelvemonth. The therapy has been used to rectify a assortment of marrow failure provinces, congenital mistakes of metamorphosis, immune lacks, haematological malignances, and even solid tumours. The first successful grafts were performed with root cells derived from the marrow of indistinguishable twins ( syngeneic organ transplant ) ; nevertheless, application of organ transplant therapy broadened with the usage of root cells obtained from either related or unrelated givers ( allogeneic organ transplant ) appropriately matched at the human leucocyte antigens ( HLA ) , or even with a patient ‘s ain root cells ( autologous organ transplant. Deciding on type of BMT depends on type and phase of disease, handiness of root cells, age, public presentation position and the c linical status of patient Bone marrow organ transplant is required in the sense that is to remedies many diseases and malignant neoplastic diseases. When a kid ‘s bone marrow has been damaged or destroyed due to a disease or intense interventions of radiation or chemotherapy for malignant neoplastic disease, a marrow graft may be needed to rectify the abnormalcy. It is besides required to replace morbid, non-functioning bone marrow with healthy working bone marrow ( for conditions such as leukaemia, aplastic anaemia, and reaping hook cell anaemia ) . It is besides indispensable to replace the bone marrow and reconstruct its normal map after high doses of chemotherapy or radiation are given to handle a malignance in a procedure called â€Å" deliverance † which is usually used for diseases such as lymphoma, neuroblastoma, and chest malignant neoplastic disease. The procedure is besides of import in the replacing of bone marrow with genetically healthy working bone marrow to forestall farther harm from a familial disease procedure. Literature reappraisal Bone marrow organ transplant ( BMT ) or haematopoietic root cell organ transplant ( HSCT ) is a medical process in the field of haematology and oncology that involves organ transplant of haematopoietic root cells ( HSC ) .It is most frequently performed for people with diseases of the blood or bone marrow, or certain types of malignant neoplastic disease. Transplant of either allogenic or autologous bone marrow has become an progressively applied and successful therapy for patients with haematological malignances and certain solid tumours. BMT is an illustration of a extremely proficient therapy that offers hope to patients with bone marrow failure or assorted malignances. Bone marrow organ transplant is much more dearly-won â€Å" up-front † but possibly non more dearly-won long-run than alternate therapies. Over the past 40 old ages, bone marrow organ transplant and haematopoietic root cell organ transplant have been used with increasing frequence to handle legion malignant and nonmalignant diseases. Post-World War II â€Å" Cold War † frights of atomic warfare stimulated involvement in the effects of radiation on the human organic structure. Early surveies with animate beings has shown that bone marrow was the organ most sensitive to the detrimental effects of radiation and for that ground the reinfusion of marrow cells was used to deliver lethally irradiated animate beings. In one survey done in 1950s, patients were given deadly doses of radiation to handle leukaemia and many had haematological recovery following this intervention, but finally all patients succumbed to get worse of their malignances or to infections. In the 1950s and 1960s, about 200 allogeneic marrow grafts were performed in worlds, with no long-run successes. However, during this clip, organ transplant utiliz ing indistinguishable twin givers has brought a just sum of success and provided a important foundation to go on clinical research in the field. Hematopoietic root cell organ transplant remains a hazardous process with many possible complications ; it has traditionally been reserved for patients with dangerous diseases. While on occasion used by experimentation in nonmalignant and nonhematologic indicants such as terrible disenabling auto-immune disease and cardiovascular, the hazard of fatal complications appears excessively high to derive wider credence. Although economic analyses appear comparatively simple, reading and usage can be debatable. Several economic analyses have identified complications that occur often and impact the reported cost-effectiveness of high-dose chemotherapy. Attempts to cut down the cost of bone marrow organ transplant have focused on new schemes to more efficaciously command these complications. The debut of new engineerings to rush engraftment, to better patient choice methods, and the shifting of attention to outpatient scenes all have resulted in important decreases in continuance of infirmary stay, treatment-related mortality, and costs. More surveies of long-run results are needed for graft and non graft intervention options to steer present and future applications of this intervention option. Expanded indicants for graft continue to be explored. Preliminary information suggest a possible function for graft in the intervention of autoimmune diseases such as lupus, multiple induration, systemic induration, and juvenile rheumatoid arthritis. In add-on, in utero graft holds promise for early rectification of familial disease, with some success already demonstrated with the immunodeficiency syndromes. The accent of current research is chiefly directed at diminishing toxicity and GVHD while increasing the pool of possible givers by developing techniques to traverse the traditional HLA histocompatability barriers more successfully. Grafts are performed with increasing grades of mismatch. With the promotions in techniques, indicants, and supportive therapy, the graft of haematopoietic root cells continues to be an forward field in the intervention of human disease. Once a disease procedure has been identified and graft is considered as a possible therapy, an appropriate giver must be identified. The best possible lucifer consequences in the least complications. For allogeneic grafts, HLA histocompatability typewriting is performed for immediate household members ab initio utilizing serologic typewriting. Fully matched household members provide the most compatible lucifers because they frequently portion minor HLA antigens non normally included in proving. Before undergoing BMT, patients should undergo a series of trials and processs for testing and readying based on the patient ‘s disease procedure and medical history. There is besides pre-transplant instruction where graft squad and the patient meet to discourse the consequences of the testing, intervention options and the intervention program. Transplant conditioning is the done with the chief purpose of destructing unnatural cells or malignant neoplastic disease cells throughout the pa tient ‘s organic structure utilizing conditioning regimen which consist of chemotherapy, radiation therapy or both. The crop processs for autologous or allogeneic BMT are similar and are depended on the undermentioned factors: The patient ‘s physical status, donor handiness and insurance blessing. The BMT process involves three stages. In the first stage, enduring 5 to 14 yearss, the bone marrow receiver is prepared for the transplant and immunosuppressive and cytotoxic chemotherapy are administered and irradiation is used to enable the receiver to accept the transplant, to forestall transplant rejection, and in instances of acute leukaemia to extinguish residuary leukaemia. In the 2nd stage, bone marrow is from the giver is intravenously administered to the transplant receiver. Donors and receivers of bone marrow grafts must hold HLA compatability. The 3rd stage involves a period of waiting for the bone marrow to ingraft and work usually in the receiver. During the clip required for engraftment, the transplant receiver is vulnerable to infection, hemorrhage, terrible weight loss, rejection of the transplant, and graft-versus-host disease ( GvHD ) . Some of the posttransplant intervention typically includes cyclosporin A and perchance other chemotherapies to either prevent or dainty transplant versus-host disease ( GVHD ) . The results of the therapy depend on many factors such as: Improvements in supportive attention, antibiotic regimens, and DNA-HLA is associated with favourable result. The patient ‘s province of wellness or stable disease or disease in remittal is associated with better results than those transplanted during a ulterior disease stage or with relapsed disease. Young age at clip of graft and besides CMV-negative position of receiver and giver enhance the likeliness of endurance. The sum of haematopoietic cell dose given at clip of graft may besides rush engraftment and better result though it has an increased hazard of GVHD. Bone marrow organ transplant is one of legion new medical engineerings that have raised complex legal and ethical issues. Laws refering to medical progresss have been passed in response to the demand to decide struggles in judicial sentiments instead than expectancy of those issues which impinge on single autonomies. Some of the legal and ethical issues are malpractice claims, proving prospective givers for AIDS, sale of bone marrow, informed consent for both giver and receiver, and inquiries that arise when the giver is a kid. Pre-counseling is done to the patient prior to any intercession since information helps the patients in the undermentioned ways: To build positive attitudes in relation to the disease, enables a better response to the state of affairs, facilitates patient ‘s effectual engagement in the determination devising procedure and future programs and besides plays a important or cardinal function in wellness. Furthermore, the patients have a legal right to be inf ormed about their disease. Decision: The bone marrow is a critical portion of the human organic structure. Bone marrow organ transplant is an effectual intervention for a assortment of haematological tumors, furnace lining lymphoma, and some solid tumours. The most of import cell needed for successful organ transplant is the haematopoietic root cell whose major beginnings are bone marrow, peripheral blood, and cord blood. These can be obtained from assorted givers as either autologous or allogeneic. Deciding on type of BMT depends on type and phase of disease, handiness of root cells, age, public presentation position and the clinical status of patient. The procedure is besides of import in the replacing of bone marrow with genetically healthy working bone marrow to forestall farther harm from a familial disease process.. BMT is an illustration of a extremely proficient therapy that offers hope to patients with bone marrow failure or assorted malignances. Bone marrow organ transplant is much more dearly-won â€Å" up-f ront † but possibly non more dearly-won long-run than alternate therapies. Hematopoietic root cell organ transplant remains a hazardous process with many possible complications ; it has traditionally been reserved for patients with dangerous diseases. The accent of current research is chiefly directed at diminishing toxicity and GVHD while increasing the pool of possible givers by developing techniques to traverse the traditional HLA histocompatability barriers more successfully. With the promotions in techniques, indicants, and supportive therapy, the graft of haematopoietic root cells continues to be an forward field in the intervention of human disease. With the promotions in techniques, indicants, and supportive therapy, the graft of haematopoietic root cells continues to be an forward field in the intervention of human disease. Mentions Frick, E. , Motzke, C. , Fischer, N. , Busch, R. , & A ; Bumeder, I. ( 2005 ) . Is perceived societal support a forecaster of endurance for patients undergoing autologous peripheral blood root cell organ transplant? Psycho-Oncology, 14, 759-770. Holland, J. & A ; Alici, Y. ( 2010 ) . Management of hurt in malignant neoplastic disease patients. Journal of Supportive Oncology, 8 ( 1 ) , 4-12. Jacobsen, P. ( 2009 ) . Promoting evidence-based psychosocial attention for malignant neoplastic disease patients. Psychooncology, 18, 6-13. Jacobsen, P. & A ; Jim, H. ( 2008 ) . Psychosocial intercessions for anxiousness and depression in grownup malignant neoplastic disease patients: accomplishments and challenges. A Cancer Journal for Clinicians, 58, 214-230.A NCCN Clinical Practice Guidelines in Oncologya„? Distress Management ( Version 1.2010 ) . A © 2009 National Comprehensive Cancer Network, Inc. Available at: NCCN.org. Accessed [ Febuary 3, 2010 ] . Ranson, S. , Jacobsen, P. , & A ; Booth-Jones, M. ( 2006 ) . Validation of the hurt thermometer with bone marrow graft patients. Psycho-Oncology, 15, 604-612. Wells, K. , Booth-Jones, M. , & A ; Jacobsen, P. ( 2009 ) . Do get bying and societal support predict depression and anxiousness in patients undergoing hematopoitic root cell organ transplant? Jouranl of Psychosocial Oncology, 27, 297- 315. Williams, S. & A ; Dale, J. ( 2006 ) . The effectivity of intervention for depression/depressive symptoms in grownups with malignant neoplastic disease: a systematic reappraisal. British Journal of Cancer, 94, 372-390.A The usage of allogeneic haematopoietic cell organ transplant ( HCT ) has increased as new techniques have been developed for organ transplant in patients who antecedently would non hold been considered HCT campaigners. However, its efficaciousness continued to be limited by the development of frequent and terrible ague GVHD. The complex and intricate pathophysiology of acute GVHD is a effect of interactions between the giver and host innate and adaptative immune responses. Multiple inflammatory molecules and cell types are implicated in the development of GVHD that can be categorized as: ( 1 ) triggers that initiate GVHD by therapy-induced tissue harm and the antigen disparities between host and transplant tissue ; ( 2 ) detectors that detect the triggers, that is, procedure and present alloantigens ; ( 3 ) go-betweens such as T-cell subsets ( naif, memory, regulative, Th17 and natural slayer T cells ) and ( 4 ) the effecters and amplifiers that cause harm of the mark variety meats. These multiple inflammatory molecules and cell types that are implicated in the development of GVHD have been described with theoretical accounts that use bit-by-bit Cascadess. Herein, we provide a fresh position on the immunobiology of acute GVHD and briefly discuss some of the outstanding inquiries and restrictions of the theoretical account systems. Bone Marrow Transplantation ( 2010 ) 45, 1-11 ; doi:10.1038/bmt.2009.328 ; published online 30November 2009 Fifty old ages ago, Billingham1 identified three requirements for the development of GVHD: ( 1 ) the presence ofimmunocompetent cells in the giver inoculant, ( 2 ) the inability of the receiver to reject the giver cells and ( 3 ) a histocompatibility difference between the giver and receiver. Billingham RE. The biological science of graft-versus-host reactions. Harvey Lect 1966-67 ; 62: 21-78. Some future research waies 1. Impact of type of harm ( programmed cell death V mortification of different cellular subsets ) , specific DAMPs, unfertile redness and complement system. 2. Contribution of host intestine microbiome and the giver immune position. 3. Determine GVHD antigenic repertory, place immunodominant antigens. 4. Understand the function of both professional ( DCs, macrophages ) and semi-professional ( B cells ) giver and host APC subsets, the relevancy and mechanisms of cross-presentation. 5. The mechanisms and function of donor Th distinction, regulative, memory T cell, and NK cell subsets. 6. Functions of specific effecter tracts in doing distinguishable mark organ harm. 7. Determinants of mark organ specificity, the function of mechanisms of fix and neovascularization in the badness of harm. 8. Mechanisms and effect of immunosuppression induced straight by GVHD. 9. Development of an incorporate systems attack for understanding the biological science of GVHD. Biology of ague GVHD S Paczesny et Al 7 BonePatient Education /Curative patient instruction ( TPE )a continous procedure integrated in wellness attention aˆ? patient centred aˆ? adapted to the development of unwellness and patientA?s life-stile aˆ? portion of the long-run direction of unwellness aˆ? structured and organized aˆ? benefited by appropriate pedagogic means* aˆ? multiprofessional, interdisciplinary and intersectonial. *I. Rabbone, 2007 The function of the patient is cardinal in taking attention of himself in order to lend to his conditions and be responsible of his status, and to be a squad resource â€Å" without costs † ( Rabbone I. , 2009 ) . **J. Philips, 1998 Patients have a legal right to be informed about their disease butaˆÂ ¦they assume it is non ever respected ( Visser et al. , 2009 ) . Information is a demand of patients as it allows them: – to build positive attitudes in relation to the disease, – a better response to the state of affairs and – an effectual engagement in the decission doing procedure and hereafter programs aˆ? Information besides has a cardinal function in wellness instruction plans Patient need information about: – Disease – Treatment options – Treatments results – Symptoms – Side effects – Quality of life aˆ? Information should be delivered in an synergistic manner aˆ? Information/education is necessary in all stages of the graft S Setting. Pick a private location. P Perception. Find out how the patient positions the medical state of affairs. I Invitation. Ask whether the patient wants to cognize. K Knowledge. Warn before dropping intelligence. E Empathy. Respond to the patient ‘s emotions. S Strategy/Summary. Once they know, include patients in intervention determinations * W. Baile et Al. â€Å" Out of 5 patients, merely 1 to 2 follow the instructions given by physycians. The others follow a â€Å" ain version † of the therapy and hold their thoughts sing their disease. They will ne'er squeal them. They are incorrect, but who is guilty? † J. P. Assal ( 1999 ) Literature McPherson CJ, et Al. Effective methods of giving information in malignant neoplastic disease: a systematic literature reappraisal of randomized controlled tests. J Public wellness Medecine 2001 ; 23 ( 3 ) : 227-234 aˆ? Thomas R, et Al. Anxiety and depression: consequence on patients ‘ penchants for information following a diagnosing of malignant neoplastic disease. Annalss of Oncology 1998 ; 9: 141 aˆ? Lobb EA, et Al. When the safety cyberspace of intervention has been removed: Patients ‘ unmet demands at the completion of intervention for hematologic malignances. Patient Educ Couns ( 2009 ) ; Department of the Interior: 10.1016/j.pec. 2009.02.005 aˆ? Mank A, et Al. An synergistic Compact disc read-only memory to inform patients about Stem Cell Transplant. Patient Educ Couns 2008 ; 73: 121-126 aˆ? Downs S. Ethical issues in bone marrow organ transplant. Semin Oncol Nurs 1994 ; 10: 58-63 aˆ? Lee SJ, et Al. Discrepancies between patient and physician estimations for the success of root cell organ transplant. J Am Med Assoc 2001 ; 285: 1034-8 aˆ? Andrykowski MA, et Al. â€Å" Returning to normal † following bone marrow organ transplant: results, outlooks, and informed consent. Bone Marrow Transplant 1995 ; 15: 573-81 A elaborate appraisal of BMT receiver ‘s emotional, societal, and psychological wellbeing before BMT is necessary to supply optimum, holistic attention. Distress and depression should be recognized, monitored, documented and treated quickly during the BMT intervention. BMT patients need to be screened at their pre-transplant assignment, at appropriate intervals, and as clinically indicated during the BMT procedure. Distress and depression should be recognized, monitored, documented and treated quickly during the BMT procedure to guarantee positive patient results.

Trade Organization

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Financial Services Ombudsman Essay Example | Topics and Well Written Essays - 2250 words

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Opinion paper - Essay Example In fact, my town citizens were painting on the floor when I visited the area; thus, I saw the art form in a different way that day. It made me realize that even this form of art is a possibility which is amazing yet practical. I am sure that the people would have done their homework and decided on what they wanted to project with this floor painting. They perhaps view that art could be done anywhere, without any restrictions at all so they decided to make the floor a canvas. Truly, the colors scattered on the floor were vivid and impressive all the more increasing my admiration for this kind of art. I felt good witnessing this new art being done right before my eyes. Suddenly, I wanted to take part in the activity so I asked one of the painters what he was painting. He told me that they were painting mother earth, with the figures of planet and the earth in relation with one another. Like I, the people gathered there watching the event also felt curious about the whole process of floor painting. In fact, I asked many questions from the people who were present there. The artists were trying their best to paint earth and its different colors. They were using the blue color for the water which is abundant in our planet. As for the continents, other colors like brown, green, red, and orange were used. This made the variety of colors spread on the floor look very astounding. Also, I learned that applying paint on plywood floors is easy and the results are great. When the person trying to paint something in the floor or in any place, he is trying to explain his emotion and deliver it to the people who is watching him.It was pure joy to see such creati on. This activity was very enthralling in the sense that it made all of us feel happy and merry seeing the swirling colors that were spread all around the floor. Because of this, you could feel positive enthusiasm within the people. It reflected their interest and passion in the

See instructions below Term Paper Example | Topics and Well Written Essays - 1500 words

See instructions below - Term Paper Example strategy. The strategy will build on the company’s controlling positions in the market and in turn put them in a great position that will enable them improve profits over time. There are several important factors in the retail business that determine the success or failure of any business. Among them is advertising, product, distribution, pricing, and so on. Even so, pricing remains salient of these factors since it is the only one that generates revenue for the business. Most managers focused on product marketing considered all the other marketing aspects but gave pricing afterthought throughout the strategizing process. Currently, a lot of firms have adopted the guide throughout their pricing process and have seen incredible optimization of the whole marketing process bringing in profits and maintaining a competitive advantage. Wal-Mart, Target, and Amazon are some of the most successful firms in the world. Actually, all top in their specific line of business. Amazon retails goods throughout the world through the internet while Wal-Mart chain is the most successful retailer in the world. Both are household names. The three firms have taken advantage of p ricing as a strategy to increase sales and boost their revenue. As will be discussed later in the paper, pricing is an imperative factor in marketing and has colossal impacts on sale of goods and services. Even if a company adopts the other marketing strategies (advertising, product, and distribution) efficiently, ineffective pricing can have detrimental effects on the financial status of a company. While most firms know that this is the case, research shows that pricing as a strategy is continually being poorly adopted. Researchers and economists such as Thomas T. Nagle have, as a result, sought to create a universal guide where business men and company executives can borrow ideas from if they want to execute

The Weather Makers by Tim Flannery Essay Example | Topics and Well Written Essays - 1000 words

The Weather Makers by Tim Flannery - Essay Example All of the possible natural causes of global warming will have occurred by 2050 and man has control over the speed at which global warming will progress. There is no existing model that can be able to determine the possibility of our saving the earth, and its many habitats and species (Flannery 153-165). Chapter 17: The commitment and Approaching Extreme Danger Several eras and times have had the most impact on climate change. The Baby boomer generation in particular can be held as being the most accountable generation in respect to the levels of CO2 that has been emitted into the atmosphere. The impact of the greenhouse gases that are currently in our atmosphere will be fully felt by around the year 2050. This can mainly be attributed CO2 long life in the earth’s atmosphere. Nearly half of the entire world’s energy that has been generated since the industrial revolution has been consumed within the past 20 years. The effect of the response by the planet to these temper ature changes varies from the earth’s surface, to the atmosphere as seen with the example by the data collected in 2002. The data recorded the planet’s temperature to be over the preindustrial temperature conditions by about 0.8 degrees Celsius. The troposphere also saw an increase of about 0.25 degrees Celsius while the land surface witnessed the highest levels of temperature increase of about 1.2 degrees Celsius (Flannery 166-170). Chapter 18: Leveling the Mountains It is estimated that, for a distance travelled up a mountain of approximately one hundred yards, the temperature drops by about one degree F. This cooling is what makes mountains unique and not just a taller version of the land surrounding it. As the world rapidly warms, the mountain-dwelling species have no option but to move further up to the cooler regions which is a factor that could potentially lead to their extinction (Flannery 171-177). Chapter 19: How can they keep on moving? Various species manag ed to survive climate change in the past by moving up mountains, until they were able to reach temperatures that would ensure their survival. Nowadays water bodies and various human landscapes are impeding their paths and getting in the way of any migration. An example of this is the fynbos found in the Cape Fold Mountains which is one of the six floral kingdoms in the world. It will potentially lose up to half its species by 2050 due to global warming as they will be unable to migrate. If action were to be taken immediately, we would be able to save two species for each species killed, but if we fail to do this, three out of every five species will not live to see the next century (Flannery 178-183). Chapter 20: Boiling the Abyss When deep-sea dwelling creatures are caught by marine biologists trawling nets and are lifted to the ocean’s surface, they die within moments a factor that scientists have been attributing to pressure changes. This has wrongly been attributed to be a result of temperature changes, but modern science has now shown this to be as a result of temperature change. These creatures are used to temperatures hovering around zero and have evolved to withstand and survive in these temperatures.

Procurement in Construction Essay Example for Free

Procurement in Construction Essay A basic definition for the procurement is â€Å"the way the building is realised† and â€Å"involves assembling and organising the skills and services of a team of construction professionals†. (the Construction Round Table, 1995). More precisely, the construction industry describes procurement as â€Å"a system that establishes the roles and relationships which make up a project organisation†; hence the overall organisation and communication structure for the management, administration and control of a project is established by the procurement system. (D.C.H Coles, 2010) * Procurement Systems essentiality: Choosing the most suitable procurement method for the specified construction project is a long term hard decision; it is a crucial task â€Å"it is one of the most crucial decisions on any building project† (Gillespie, 1994). Choosing the appropriate procurement system is the determinate for a successful project (Building Procurement, 2006) this statement is supported by the investigation done on 25 National Audit Office (NAO) reports, were it was concluded that choosing the wrong procurement method is a major risk source (covering 29% of the risk source percentage) for public sector project failure. Furthermore, an American study concluded the total project cost can decrease about 5% by choosing the correct procurement methodology. â€Å"Failure to choose the appropriate procurement approach is recognised as the primary one source for project failure (Building Procurement, 2006) * Role of the Project Manager â€Å"The presence within the client company of a Senior Executive willing and able to act as a single point of contact throughout the building process, gives the client a distinct advantage† (Construction Round Table, 1995) Within the last fifteen years, the role of the Project Manager has developed in the construction industry, what is mentioned above proves that having someone to manage and supervise the project is the key for a successful project. The client can appoint a project manager from his company â€Å"in-house† or an external consultant appointment. Overview for the Project Manager’s duties: A project manager can be appointed by the client (especially if it was an inexperienced client in the construction industry where the majority of clients in the UK fall into this category), in order to help him build up his business needs case for the project development, find alternatives and options that are more suitable in order to achieve his business needs, work out the investment appraisals and risk assessments, choose the most suitable procurement method for the project, select the project team, establish and supervise the performance. An important task the project manager must perform before adopting the procurement method is to approach the client, and understand specifically what does he requires and what the outcomes from the new construction building are, more specifically the objectives and the products of the building. After performing this action the project manager will look at all the alternatives if there are any. Comparing the past with nowadays, when the architect and the engineer had the major role in the project during the past, if the client requests a new building to be constructed they will support his case while the project manager will look at all the alternatives that might be better for the client and his business, the alternatives might include: * Building an extension to the client’s existing building or carrying out alterations and refurbishments to it. * Moving the building to a position that might be more suitable to the business of the company. After understanding the needs of the client and finding all the alternatives, it is the project manager’s task then to choose the most appropriate procurement method for the project. As mentioned earlier, choosing the most suitable procurement method for the project is one of the most crucial decisions on any building proje ct. The Construction Round Table (1995) covers a list of priorities that the project manager must take into account referring to the client’s objectives in order to choose the most appropriate procurement system, these include: * Timing For most of the clients, timing is a crucial factor that must be taken into major consideration, especially for clients with a required known completion date. For example, supermarkets such as Tesco, the cost might not be their major concern but time is since the earlier they open the supermarket the earlier they can make profit. Timing might not be an important issue for Public Schools since there will be a predicted birth rate. * Price certainty The price of the project generally includes the total constructional cost (design fees, construction contracts, financing costs and client management costs); it may also include the land costs, sales costs and the associated agency costs together with developer’s margin. Nowadays, with the global credit crunch existing, most of the clients and companies are critically focusing on cost, they simply cannot go over budget, and hence cost plays a major role when deciding the procurement method. * Quality/Performance level Quality must be appropriate to what the client request; it is a variable issue, for example the quality for constructing a five stars hotel in central London is different than the quality from building a seven stars hotel in Dubai, most importantly the quality of the design and materials should be appropriate to the standard and functional use of the building. For shops such as Next or Marks and Spenser, the layouts change every now and then, hence the project manager must make ensure that the layout won’t be designed for more than a considerable period since it will be a waste of money. A basic definition for performance is how the building is going to be used (how the goods flow). * Complexity Within the early life of the project, it should be clear whether the project is a complex one or not. Complexity won’t affect simple projects whereas if the project is technically complex (advanced design and high serviced construction requirement), then this will affect the project could be procured in another way. An example for complexity is the British Library; the temperature for every floor was required not to be more than a half degree different. * Competition Suitable competition methods must be includes in the chosen procurement method for Public projects (publicly funded 50% or more) in order to satisfy the EU Procurement Directives 2004/17/EC and 2004/18/EC and the U.K.s Public Contract Regulation 2006. * Controllable variation This mean making decisions as late as possible in the construction process. Some projects won’t have sufficient detail to enable the contractor to prepare a tender, such as high complex projects, hence a procurement method that allows change in a controlled manner must be chosen. An example on controllable variation is Heathrow Terminal five, the client did not make decisions about a number of issues within the terminal design, such as baggage claims, check in online system. Hence what is ideal for the project manager is to have a procurement system (one or more) that can make decisions as late as possible. * The division of the management responsibilities An important procurement assessment criterion involves the clients choice whether he wants to manage separate consultants and contractors or to manage one company (single point responsibility). Furthermore, the project manager must make sure about the client’s objectives for the fact whether he wants to be in charge or not and if so how much does he want to be included. A good idea for the project is to produce a project management handbook for all the parties involved in the project. For the contracts case, recently the ICE7 contract has been withdrawn from the construction industry and so the projects now have to follow the NEC3 contract. * The extent of the professional responsibility/accountability required For the case of accountability, copies of all the variation, money and extension of time must be provided in order to be accounted, this is very important for local authorities and government departments. * Risk avoidance Assigning and managing the risk has an important effect of the procurement assessment criteria. With the aid of a risk register, the project risks can be carried out in three stages: * Name the risks linked with the client’s objectives and priorities. * Sort out the number of times the risks might occur and their impact on the project. * Choose the best party involved to sort out the risk. The client has a major role in this issue, more specifically if the client does not wish to deal with any of the risks that might occur, then the project manager might choose the Design and Build method since it is the ideal procurement method, since the contractor will carry most of risks existing, but the cost of his tenders will increase since he is carrying most of the risks. If the client does not wish to pay more for the contractors tender for carrying out the risks on site and does not mind carrying most of the risks, then the project manager would go for the Management procurement method which might be the ideal solution for the issue. The next step for the project manager is to relate the client’s objectives and priorities with the primary issues by using Diagram1 (shown on page6), this way the choices of the procurement methods suitable for the project will be narrowed down. Diagram 1 shows the relationship between the client’s objectives and the priorities and the various procurement methods. (Source: Construction Round Table, 1995) The project manager can review the reports of similar successful projects from organisations such as Constructing Excellences in order to guide him for the present project. Generally, the focus of the clients is upon time, cost and quality. Most of the clients request their buildings to be constructed in high quality level, in a small period of time and in a low price. This is very unlikely to happen (does not exist) and if the client did not have a priority of criteria even with the aid of the project manager, disappointment and project failure will exist (Building Procurement, 2006). The project manager must understand exactly the client’s objectives and his criteria, in order to relate it to the ideal procurement method. All of the procurement methods provide satisfactory levels of performance in time, cost and quality but each method have different levels of risks and control on the client (as previously mentioned). Diagram 2 below, shows the three common favourable priorities for the clients and which procurement method is best to follow.

The Art Of Modern Burlesque Drama Essay

The Art Of Modern Burlesque Drama Essay The meaning of burlesque has changed throughout its varied history; the earliest form of burlesque can be traced back to Chaucer and his story of Sir Thopas. This piece of writing had no rivals or predecessors at the time and the next form of burlesque was Shakespeare. The playwright John OKeefe is another early burlesque writer; his plays were light-hearted and mocked the upper classes, the operas and plays in a cheeky way. His plays were the foundation of the earliest burlesque shows in London. This form of burlesque is often confused with satire because of the use of humour however they are very different forms of entertainment. Satire is the schoolmaster attacking dishonesty with a whip, Burlesque is the rude boy attacking pomposity with a peashooter Unfortunately the original burlesque shows which were full of comedy and skits have died out; they were considered a very English form of entertainment as the English people were able to mock their upper classes without causing offence. In England burlesque continued to develop and with the introduction of the Music Halls in the 19th century the shows had a permanent home. It was when it went into the music halls that it changed format from a full length comedy play to a series of sketches. Unfortunately burlesque died out in England after the world wars. Simultaneously there was a form of burlesque evolving in America; the popularity dramatically increased in 1868 with the troupe the British Blondes. Their show included comedy sketches and parodies of plays performed by ladies in scanty costumes. By 1873 the parodies had disappeared and the show mainly comprised of dances and political satires. The modern image of burlesque started in the 1920s when the term became synonymous with the striptease. Carrie Finnell performed the first true striptease in 1917; she would take one garment off each night with the promise that she would take another item off in the next show. In this way she inspired the audience to come back to each show. In the 1920s the striptease became the main draw of the show with the variety acts and comedic performances that accompanied it seen as fillers. This view is still popular today. A major part of the modern burlesque show is the use of gimmicks, such as the giant props and over the top costumes; these gimmicks also have their roots in the burlesque shows of the 1920s. At that time there was a saying: Youve got to get a gimmick, if you want to get ahead The popularity of burlesque seems to be directly related with times of unrest and depression. Its popularity increased in the 1930s at the time of the depression, it rose again in the early millennium when the terrorism threat increased and it has become popular again with this latest recession. The main explanation for this is that in times of hardship people seek out cheap, sexy entertainment and burlesque fits this description. When burlesque returned to England it was in the form of the American variety shows with striptease. Historically the majority of burlesque performers are female; this is still the case although male performers are becoming more common. The modern female performers have a great respect for the performers of the past. Females become burlesque performers for a variety of reasons, for many women it is a way of expressing themselves in a way that they would never dream of doing in real life. Burlesque allows the performer to act out their own fantasies and embrace their sensuality. Many performers cite their desire to be a drag queen as the main reason for becoming involved in burlesque performance. When I started doing burlesque, I would tell people it was because I couldnt be a drag queen Many burlesque performances involve exaggerated femininity with the use of heavy make-up; false eyelashes and rhinestone covered costumes which are often associated with drag acts. The women who perform burlesque feel empowered on stage, they often feel like they are empowering the female audience by proudly displaying their body which doesnt necessarily conform to the medias idea of a desirable woman. Feeling sexy and powerful onstage and knowing that you are possibly Changing the way the world looks at you and others who look like you Is an incredibly rewarding by product of the burlesque experience Some female performers have negative experiences and there are some clubs which make the performer feel cheap and exploited by forcing them to expose more that they are comfortable with and to perform to please the male audiences. There are a lot of  ­burlesque clubs that are really oversexualized,  ­really horrible. And I think a lot of girls feel  ­pressured to strip. However these clubs are rare now but were more common in the early 1990s revival; unfortunately many people still hold this opinion of burlesque clubs. The comedy and variety sections of the show are overlooked by many people eager to criticise the whole movement. It is easy to assume that all burlesque performers are arrogant and natural exhibitionists; this is not the case for the majority of the performers and the amount of control they have over their acts gives them the confidence to perform. Like any woman, put me in the wrong light and its not good! I definitely have moments when I feel very hyper-aware of my body some of my stage positions could potentially be unflattering. So I do my own lighting. Being able to control the lighting of a show is a rare thing for a performer and unique to burlesque. The relationship between burlesque and feminism is a much discussed issue, the changing face of burlesque means some feminists are embracing it as a feminist movement and many performers feel they make a feminist statement when they perform. When looking into this it is important to understand the feminist point of view. To deny a womans sexuality is certainly to oppress her but to portray her as nothing but a sexual being is equally to oppress her This statement is undeniably true and some burlesque performers have felt exploited as sexual objects and nothing more; this is demonstrated in Laurie Pennys article in the Guardian. The feminist views on the burlesque striptease are very contradictory. Some feminists are completely against any form of sexual imagery or exhibitionism; Andrea Dworkin was outspoken in her views on sexual imagery. Women are reduced to sexually subordinate vile whores Many people consider the burlesque striptease as a form of subordination which only exists to entertain and fulfil the male fantasy. When arguing against this opinion it is important to acknowledge that the original performances did begin as a fulfilment of the male fantasy. When the burlesque girls began attracting male attention in the 1860s they were managed by men and therefore did not have much control over their acts. At that time the majority of the audience was male so the show was geared towards them. There is always going to be an aspect of the male fantasy in the performance because without it the whole movement would not have developed. The contrasting feminist opinion is that women are sexual beings and should be free to express their sexual desire and pleasures; there is a feminist movement which formed the Feminist Anti-Censorship Taskforce (FACT). This group has published essays that celebrate womens sexuality and have said: Yes, sexual abuse exists and, yes, some images do degrade, But this should not prevent women from being able to represent Their experience as sexual beings This statement is supportive of the burlesque performer as when they are performing they are expressing their sensuality. It is important to understand the difference between the burlesque striptease and stripping in strip clubs. Since they are both forms of stripping the boundaries are indistinct but there are definite differences. The strippers in a strip club will expose much more of their bodies and gyrate to please the audience; their performance changes and becomes more sexual with the tips they receive. A burlesque stripper has a routine, which has been rehearsed, and perfected, it does not alter with tips. A burlesque stripper will never take off all their clothes, their nipples and are never exposed and the performance is more about the tease and what the audience cannot see. A womans greatest asset is a mans imagination This quote was particularly true in the 1920s when many of the stripteases lasted fifteen minutes with the performer teasing the whole time. The acts are significantly shorter in the modern burlesque shows but the tease aspect has continued. Another important difference between strippers and burlesque performers is the costume. In burlesque the costumes are a huge attraction and add to the spectacle of the show. Many of the performers start in a corset; the attraction of the corset is that it emphasises the female form and adds to the exaggerated femininity of the performers. According to Michelle Baldwin a burlesque costume is designed to sparkle shine and flow in the spotlight they are therefore covered in beads, rhinestones and feathers. The more spectacular costumes will move and flow with the dancer so they are often made from a light fabric or covered in tassels. To add to the tease of the show the performers will wear several layers; the final layer consisting of decorated pasties and matching thong. In a strip club less emphasis is placed on the costume and more emphasis is placed on the condition of a dancers body and what men will find attractive. Its an unfortunate truth but the slimmer you are the more money you will make. You dont have to be fashion model skinny but you do have to be tight if you expect to make good money. I personally find that a combination of yoga and weight training is ideal for the kind of look that men like. The costumes in a strip club vary from club to club but a common costume is micro minis and Lycra. A major difference in the costumes of the burlesque performer and the stripper is that the majority of burlesque dancers customise and create their own costumes. They will buy a basic garment and attach the rhinestones and glitter themselves. The main reason for this is that a burlesque dancer will not make much money performing; they do it simply for the love of performing. The audiences of the new burlesque shows are different from the audiences of the early shows and strip shows s that it appeals to men and women. An important difference from earlier burlesque is that the audience is as likely to consist of women and gay men as the heterosexual men who comprised the traditional audience for such shows The new wave of burlesque epitomises the glamour of the past in a way that previous revivals didnt; this is one of the major attractions of the modern burlesque shows; the audience who attend many modern burlesque nights in clubs such as Volupte and The Pigalle Club are encouraged to dress up in vintage clothing. Another reason could be the amazing costumes and spectacle of the show as a whole. The female spectator also come to the show to see a woman who has the same body as them performing a striptease as it makes them feel better about themselves. It is so popular because the burlesque world embraces women off all shapes and sizes. Unfortunately there is a counterargument to this opinion; burlesques most famous face is Dita Von Teese. She has trained her waist to 16; visually she possesses every womanly attribute the media say is desirable; the small waist, porcelain skin and large breasts. She could be said to be consolidating the negative images constantly displayed to the publi c but in a different way to the emaciated models. However she is a strong public figure and her unique appearance encourages women to be individuals and express themselves to be happy. The increased number of female spectators could also be due to the messages behind the show; the performers bring current issues and politics into their shows and react on stage, one example of this is the show of the world famous *BOB*; in one of her shows she plays a voice over of every hurtful thing ever said to her and reacts to it in her performance. Images laced with humour are so much easier to ingest for a consuming public. The nature of the burlesque show means that the performers are able to express the issues they want to without worrying about what is appropriate. The question of whether burlesque can be feminist is complicated as there are so many different clubs that are managed in many different ways. It is difficult to ignore the feminist arguments about the negative objectification of women and some personal accounts do support them. Laurie Penny had a bad experience as a burlesque performer and was made to feel exploited and when Jacki Wilson was an audience member in a burlesque show she was left feeling vulnerable and unsettled. However there are a huge number of positive reactions when it comes to the performances. A lot of current performers believe they are feminist; they have this opinion because of the positive reaction from the female audience members; however a strong feminist would dispute this opinion citing that their objectification was negative. When fledgling performers are taught how to perform burlesque they are taught to enjoy their bodies and the spotlight and not how to please men. We were not taught to please men, we were taught to enjoy ourselves, to revel in our bodies, to enjoy our sexuality, the thrill of the tease and the sensation of being in the spotlight. This is a very significant quote as the thrill of the body and the tease is echoed by many performers. Another positive aspect of burlesque is that it doesnt discriminate against women who are curvy or short; the public are constantly bombarded with images of the size zero models, burlesque embraces all body types; the routines and lighting are all designed to make the performer feel comfortable in their own skin. This is a very important part of the movement as modern day women are made to feel inferior and ashamed of their bodies by exposure to the constant images of airbrushed, surgically enhanced models. Despite the passionate opinions of some feminists who believe burlesque to be a form of negative female objectification it is a mistake to view it in this way. Females are sexual beings should not be repressed or denied their freedom of expression; if they choose to express themselves by performing a striptease they should not be criticized. Burlesque performers are often wrongly associated with sex workers and prostitutes and there is a stigma attached to the name as a result of some of the seedy aspects of its past. Many critics of the movement have not witnessed a true burlesque performance and have a strong opinion that they are unwilling to change. A very clear example of this is seen in the interview conducted with Von Teese by Hannah Pool. Pool was very dismissive of burlesque stripping and would never set foot in a club as she felt the women who attended them let the side down. This is an incredibly narrow-minded and unacceptable argument; no one can criticize a movement so passionately without experiencing it first hand. Burlesque is growing in popularity; the glamour aspect of the movement is attracting a new audience who agree with the opinion that it is empowering. One of the major attractions is that the female audience members see a performer similar to themselves on stage. Unfortunately there are some clubs that are not respectful of their performers and make them feel exploited so there will always be people who oppose burlesque. However the true spirit of vintage burlesque is one that should not be opposed and should be enjoyed by men and women alike.

Important Skills To Teach Children

Important Skills To Teach Children Has your child ever thrown a temper tantrum at the check register when you said no to a candy bar? (Sheldon) Most parents have had this experience with their child at some point, and at the time the parent may feel like their child will never grow out of this. There are things parents can teach their child to make these situations become less frequent. Parents should teach their child how to deal with these situations, and respond with a better reaction, which comes from self-control. However, sometimes parents can fail at teaching their child these important skills and values because they are more concerned about being their childs friend, and not being their parent which can lead them into influencing their child in the wrong ways. Even though sometimes parents can influence their children in the wrong ways , one of the most important skills and values parents can teach their children is self control because having self-control can lead to better social skills, and money management skills, and with having these skills and values will lead the child to a more successful life. In todays society more and more parents are becoming more concerned about being their childs friend then parenting them.Teaching self-control has become a big focus for early childhood education. (Shute) Parents need to focus on teaching their children these skills and values in the childs younger years. With failure to teach their children these skills when they are younger can cause the child to have a more difficult future. Parents need to step up and stop trying to be friends with their children when they are younger, in order to teach their kids the skills that will mold their future. When parents have the wrong attitude toward their child, their negativity can play a big role with the influences the parent has on them. The informal education that the family provides for their children makes more of an impact on a childs total education than the formal education system (Northrup) Parents are the childs first teachers, and if parents fail to teach important skills to their child, it could possibly affect their childs future. Having a caring parent in a childs life is one of the strongest influences towards the child having a successful life.(Northrup) If parents fail at this, their child will suffer in the long run because of the lack of the strong positive influences they need from their parents. A new study says that self-control makes the difference between getting a good job or going to jail, and we learn it in preschool. (Shute) Parents desperately need to be a part of their childs life, teaching them the important skills and values that will shape the rest of their life. Children need their parents to be there for them and teach them the skills and values needed, so they can have a successful life. Even though parents can influence their children in the wrong ways, one of the most important skills and values any parent can teach their children is self control. Having self control can lead to better social skills and money management skills. Self control is something that needs to start being taught at a young age. By learning self-control, kids can make appropriate decisions and respond to stressful situations in ways that can yield positive outcomes (Tyna). When kids learn this at younger age, it will only benefit them in the years to come. They will be able to make better decisions, and respond to difficult situations in a way that will help them gain a better and brighter future. For example, if you say that youre not serving ice cream until after dinner, your child may cry, plead, or even scream in the hopes that you will give in.(Tyna) With self control, the child can see that throwing a huge fit will only get the ice cream taken away, but if they wait patiently without ha ving a temper tantrum, they will get their ice cream. Another example that shows that having self control can lead to better social skills and money management skills is, It is widely believed that the everyday experiences in relationships with their parents are fundamental to childrens developing social skills (Mize) Parents need to take advantage of this precious time they have with their children. When their child is young, it is important to start being a positive influence in their lives. Being a positive influence can give their children the confident they may need to develop better social skills. Children look to their parents to learn these important skills, so when children looks to their parents for social skills, the parents need to be a positive influence. With self control, parents will see their child stand out with their social skills among other children, and they will be able to use these social skills in whatever they do in their future. Along with having better social skills, children with self control will also make wiser money management decisions. In addition to providing for their childrens immediate needs, parents need to provide for their childrens future temporal needs by teaching them to be financially independent adults.(Sheldon) Teaching your child how to manage money will only benefit them later in life. Parents, who teach their child how important managing money is and how to manage it, will have great success in their adult years. If children learn to make smarter money decisions now, they will take that with them the rest of their lives. Teaching children money-management skills takes practice and patience. Both parents and children will have to make adjustments and correct themselves when they make mistakes. (Sheldon) It will take time and patience for both the parent and child when they are learning the importance of money and how to handle money. Learning about how to manage money can start as young as the age of 3 years old.(Sheldon) It is never too early for parents to start teaching their child. So, whenever kids start asking and wondering about money, it is a good time to start teaching them about the importance of making wise money decisions. It does not matter the age that parents start instilling these skills into their child because they will grow with them all though their life, making the children more successful in their future. The most important skills and values parents can teach their children is self control because having these skills/values leads to better success later in life. Parents teaching these values to their children at a young age will help them, The children who struggled with self-control as preschoolers were three times as likely to have problems as young adults.(Shute) Learning self control at a younger age will simply put the child ahead and make their future a more successful one. Parents have the responsibility to teach their children these skills that will ultimately play a part in how successful the childs success is later in life. Another example that shows that having these skills/values leads to better success later in life is: The later you wait in life to try to learn self-control skills, the more problems you have to reverse and overcome.(Shute) Parents need to start instilling this knowledge when their child is young so the child can start learning how to make important decisions based the right choice not on how they feel. Having self control can help them either if it is with their social skills or with money management. Having these skills will also benefit them their whole life, not just when they learn them. Having good self control is a lot like learning math, starting off with the basic adding and subtraction, and then go into more depth from there. With self control by learning the basics first, it then allows learning more skills because of the presence have self control. So, parents need to start teaching their child these important skills and values at a young age. Some of the important skills and values parents can teach their children are self control for two main reasons. First, having self control can lead to better social skills and money management skills, but most importantly, having these skills and values will lead to better success later in life. It is important that these skills and values are taught to children when they are young. Parents are the first teachers any child will have, and they need to set the example for their child. Parents should live a life that they want to see reflected into their children. When these skills and values are beginning to be taught, parents need take the time however long it make take, letting the child know that they care and are doing this for them. Children will not like the process in which it takes to teach self control. There will be many fits thrown, but at the end of it all parents will see their child having a better and brighter future. So, having a child with self control, parents will no longer be the ones with the screaming child at the cash register having a melt down because they are not getting what they want.

Piercing :: essays research papers

A Piercing Look at Society â€Å"If it sticks out, pierce it† is a motto for body piercing. In the past decade, body piercing has â€Å"steadily evolved† to be part of a trendy fashion statement that is spreading like Parkey throughout the American society. â€Å"Body piercing is an American style fad.† (Wattenberg) The influence of fashion is the most powerful pressure there is. The once rebel art of body piercing done only by so called â€Å"freaks† of society is now a trendy fashion practiced by many. The trend of body piercing was partially sparked by models and MTV. â€Å"Piercing gradually shed its outlaw image and was mass marketed to the impressionable generation by music videos, rock stars, and models.† (Leo) Piercings are also found on celebrities whose lives are so torn apart by the media that nothing is kept secret. News would eventually reach the public, which would spark a trend in admirers. Piercing also appears on the Tattoodles Doll in toy stores, and as games on the Internet such as Piercing Mildred. Through these style of piercing has grown to become acceptable by all ages from children means the playing with Tattoodles, to teens watching MTV, to adults on the Internet. Body piercing has excelled so much that it is now on a level referred to as body art along with tattoos. â€Å"Piercing is part of the broader â€Å"body modification† movement.†(Leo) It is figured that 1 out of 10 people have a piercing some where other than their ear. Today’s social standards are not what they once were. Society has begun to relax on what is viewed as the ideal image. It has gone from the conservative middle class look to the open-minded, anything goes creative look. The point is not to look like the crowd anymore; rather to differentiate oneself and make a statement to the rest of society. One doesn’t have to have the nicest or most business like look to get far. â€Å"Society has a tendency to indefinitely relax its standards to accommodate even more bizarre and anti- social extremes of behavior.† (Wattenberg)   Ã‚  Ã‚  Ã‚  Ã‚  Piercing achieved mainstream recognition in American society in the 1990’s. More people began to accept it. One newspaper put it well – â€Å"It moved from society’s margins to the mainstream.† (Leo) Piercing used to be done by â€Å"outcasts of society and was often looked down upon, but now, body piercing studios expand by about one studio per day.

Hypercholesterolemia :: Diseases, Disorders

In the simplest terms, hypercholesterolemia may be any excessive amount of cholesterol in the blood. The clinical definition however, as outlined by the University of Maryland Medical Center [UMMC] (2010), considers a total cholesterol level of 240 mg/dL or higher to be high cholesterol. Within this total is the level of high-density lipoproteins (HDL or â€Å"good† cholesterol) and low-density lipoproteins (LDL or â€Å"bad† cholesterol). Below 40 mg/dL is considered poor for HDL, while an optimal level of 60 mg/dL or above is more desirable. A LDL level of 160-189 mg/dL is considered high, and the optimal level is 100-129 mg/dL. In addition to LDL and HDL cholesterols, a third type of fatty material, collectively known as triglycerides, may be found within the blood. A triglyceride level above 200 mg/dL is high, but the desirable level is below 150mg/dL. Generally, as triglyceride levels rise, HDL cholesterol falls (UMMC, 2010). Tortora & Derrickson (2009) further illuminates the distinction between LDL and HDL cholesterols and why these differences incur such conflicting effects in the body. LDLs convey about 75% of the total cholesterol in blood and deliver it throughout the body to cells so that they may repair cell membranes and create steroid hormones and bile salts (p. 991). However, when their number exceeds what is necessary, LDLs leave cholesterol in and around the smooth muscle fibers in arteries (p. 991). Thus, LDLs have earned a â€Å"bad† reputation. In contrast, HDLs remove excess cholesterol from body cells and blood and transport it to the liver for subsequent elimination, preventing its accumulation in the blood (p. 991). Thus, their â€Å"good† reputation is safe. It is important to remember though that both LDL and HDL cholesterols, as well as triglycerides, are essential in certain amounts, and LDLs and HDLs together make up the total cholesterol level used in the dia gnosis of high cholesterol. According to the UMMC (2010), there are usually no symptoms of high cholesterol, especially in the early stages of the condition. The only way to diagnose an individual with high cholesterol is with a blood test, and doctors recommend that patients fast beforehand so that results only reflect usable HDL and LDL levels (â€Å"How to get†, 2012). Since too much cholesterol circulating within the blood can create sticky deposits called plaque along the artery walls, a diagnosis of hypercholesterolemia may have very real health significance for the patient.

Essay on The Supernatural in Toni Morrisons Beloved :: Toni Morrison Beloved Essays

Supernatural in Beloved Elements of the supernatural pervade Toni Morrison's novel, Beloved. These elements include evidence of African-American folklore and tradition in the everyday lives of the inhabitants of 124 Bluestone Road. Beloved's character is another obvious use of the supernatural: she's a ghost for part of the novel and a "ghost-in-the-flesh" for the major part of the book. In Beloved, Morrison extracts African folklore from history in order to enrich the authenticity of an account of the lives of ex-slaves during the late 19th century. Her extractions include medicinal, religious, and superstitious components from African life. As doctors were not available to most blacks during this time -- slave or free -- they were forced to depend upon their intuitive nature and upbringing. For instance, spiderweb is used as first aid for cuts, while grease is spread liberally over these same cuts as a long-term ointment of sorts. For slaves, church was simply another segregated part of life which forced them to develop their own way of practicing their faith. African roots are very visible in Baby Sugg's "sermons" in the Clearing. White men go to church, sit down in wooden pews, and settle in for a lengthy dissertation on their sins. On the other hand, Baby Suggs calls her people into Nature to dance, cry, and finally, to laugh. Her version of a sermon is actually an outpouring of the vast contents of her heart. Superstitions are a natural part of any culture's make-up. However, some superstitions are firmly rooted in one specific culture. This is evident in Baby Sugg's statement to Sethe where she says, "Not a house in the country ain't packed to its rafters with some dead negro's grief" (Morrison 5). Similarly, Ella comments to Stamp Paid, "You know as well as I do that people who die bad don't stay in the ground" (188). Morrison's style embodies an additional aspect of African philosophy. According to John S. Mbiti, "[it] emphasizes that the spiritual universe is a unit with the physical, and that these two intermingle and dovetail into each other so much that it is not easy, or even necessary, at times to draw distinctions or separate them" (Samuels 138). One can see how Morrison fits this definition with her constant interweaving of the spiritual world along with the physical world. Stereotypical thinking says that a fine line exists between the spiritual world and the natural world.

Pleasures of Eating Essay

In â€Å"The Pleasures of Eating† Wendell Berry wants the reader to recognize that eating is a cultural act. He believes we are eaters not consumers and that we should have more knowledge about the food we eat. Berry wants the reader to questions where the food is coming from, what condition is it produced in and what chemicals may it contains. He has found that the food industries blind us to what we are consuming and the effect it has on us. At last Berry believes that we must eat responsibly to live free. Berry first begins with eating as an agricultural act. We think of food as an agricultural product rather than think of ourselves participating in the agriculture. Berry sees us believing we are just consumers, as we buy what we want within our limits and what â€Å"they,† the industrial food companies, want us to buy. With this we ignore the most certain critical questions, â€Å"how fresh is it? How pure or clean is it? How pure or clean is it? How free of dangerous chemicals? How far was it transported? And what did transportation add to the cost? † (Berry 231). Berry recognizes that we are naive to believe that the food we buy is produced on an agriculture farm when we have no knowledge of what kind of far or where it is located. We only know of one process, when it appears on the grocery shelf. Industrial food companies blind us with product commercialization. â€Å"This sort of consumption may be said to be on of the chief goals of industrial production† (Berry 231). Industrial food companies have persuaded us to prefer the consumption of food that is already prepared. They have eliminated the agricultural work giving you the connivence of growing, delivering and cooking it all you for. If industrial food companies could find a way to gain profit from pre-chewing your food and feeding it to you they would do it. â€Å"When food in the minds of eaters, is no longer associated with farming and with the land, then the eaters are suffering a kind of cultural amnesia that is misleading and dangerous. † What Berry means by this is we give up knowing the history of our food and hand over all control and freedom. Like any politics it involves our freedom. By giving someone else the control we, â€Å"neglect to understand that we cannot be free unless our food is free† (Berry 232). Our food wars a much make up as actors (Berry 232). Berry expresses that the food industry wants little to do with our health but more to do with volume and price of their product. As scales increase, diversity declines when this happens so does health. From there the dependence on drugs and chemicals becomes necessary. Food advertising leads up to believe that what we eat is good, tasty, healthy and guaranteed to give us a long life (Berry 233). Industrialism is a trap. Berry believes how to escape this trap is to recognize the food problem as a whole and how eating is inescapable. In order to participate in the agricultural act you must; participate in food productions, prepare your own food, learn your foods origin, cut the middle man when you buy, learn about industrial food companies, good farming and gardening and learn from observation and experience. Berry takes pleasure in eating meat from non-suffering non-farm raised animals. As well as, fruits and vegetables that lived a plentiful life. He believes eating should be an extensive pleasure and the more we participate in agriculture and gain knowledge the more we live, â€Å"free from mystery, from creatures we did not make and powers we can not comprehend† (233). Although Berry made very good points on the importance of a healthy lifestyle he uses excessive amounts of emphasis on knowing what you are eating all the time. I believe if you set limits on the amount of industrialized food you consume, you will still be able to live a healthy and fulfilling life. â€Å"The consumer, that is to say, must be kept from discovering that, in the food industry-as in any other industry-the overriding concerns are not quality and health, but volume and price† (Berry 233) This direct quote was very strong and caught my attention. This made me realize that industrial food companies can be compared to any kind of business as their chief objective is increasing profit. There are, however, certain ways to get around the conventional food industry. It is possible to avoid the trap because after all â€Å"the trap is the ideal of industrialism† (Berry 233). Even though I agree with this certain point, I feel as if there might be a more effective approach that Berry could have taken when describing this so called â€Å"trap. † The way that Berry expresses his views makes it seem as if food industries are out to get you. The description of their goal to make consumers fall into a trap is on the extreme side. Wendell Berry seems to be very into the details of farming and how our meals are processed, but as someone who has been given a very fortunate life style, it is hard for me to relate. When I read I find myself to be having contradictory thoughts as this whole time I have disagreed with most things Berry said; with that being said, the main point of his article is that people take for granted their meals and have no idea the process farmers go through to make our lives the happy ones we live. So yes, Wendell Berry is right in saying people, like myself, should know more about the process and food we absorb each and every day. He does a great job of bringing in his arguments with the tone of his article and repetition of ideas. When he makes a point, he wants to â€Å"hammer it home. † Therefore, I have to applause him for his writing as he is a convincing writer with a strong knowledge base. His position on the food industry and the roles that consumers need to play in order to eat pleasurably is grand but some of his views were too extreme to persuade me.

Reflective Story

At first, I did not expect that I would regret not being emotionally and spiritually prepared. I was really overwhelmed with the different things I experienced. Not only did I get to experience dorm life with my fellow classmates, got to sleep at dawn and bond with other people, I got closer with God. How you ask? I finally felt someone's presence. Not like when there is someone with you or a so-called ghost appears, I felt a powerful presence. I felt accompanied. I never felt alone. That presence was masked by friends, great advice and strong faith.And to think I was very, very busy on what clothes to wear, toiletries to bring and everything else required. Also, I never thought that I would release all my negativity during session time. Somehow, It made me feel whole. I felt complete. I felt happy. I felt that God was beside me throughout everything. He blessed us all with trust for one another. I was mostly moved with Sir Regis's difficult encounters in life. It made me realize tha t the greatest happiness I was blessed with was people who would love and accept me for who I am.Just by Ewing surrounded by them is the only blessing that, I bet, would be the best thing you would ask for. I am not saying that you should take advantage of their presence but you should savoir and appreciate their love and care for you. This recollection gave me more on the Inside scoop of reality and the different hardships you will encounter as you face it twists and turns. This also made me realize that I should be thankful for my days to come. I was taught to fall silent and listen. Life is exciting and thanks to this experience, I came to appreciate life's meaning and hungry to unravel some of Its secrets.

Five Days At Memorial

The book approached the ethical dilemmas faced by those physicians and staff involved n the key roles of the rescue effort at Memorial Medical Center, one of the many medical facilities that were devastated by this category 5 hurricane. The physicians who remained to care for the patients were put in the difficult position of deciding who was most appropriate for rescue, and what to do with those left behind. Staff members, nurses in particular, were put in the position of whether or not to obey seemingly unjustified orders.The catastrophe was worsened by the backlash from the patients' families, the community, and the nation regarding their decisions, including arrests and wrongful death lawsuits. This paper will focus on just this; was the aftermath of the disaster warranted? Should the physicians and nurses who put their lives at risk to care for these patients have been put through so much consternation? Had they not stayed, it is quite likely that many more deaths would have occ urred.Was there anyone to blame? And most importantly; what could be done to keep this situation from happening again? Sheer Fink's descriptions of the disaster that took place at Memorial Medical Center after Hurricane Strain ravished New Orleans, shed light on some of the ethical dilemmas experienced by the physicians and nurses who stayed at he hospital to care for the patients in the wake of the storm. The unfortunate circumstances were beyond anyone's imagination.Because natural disasters and their aftermath cannot be predicted, those left in charge had no way of knowing how to respond to the situations that they were faced with. Being forced to care for patients without clean water, electricity, sanitation, and food, puts healthcare workers in an entirely different environment. Moreover, the pressure that comes with the unfortunate responsibility of deciding which patients should be rescued and which should not, is more than any person should ever have to experience.Upon the a dministrative decision to evacuate â€Å"critical† patients last, the healthcare providers who were willing to risk their own lives by staying in the hospital were faced with the unfortunate responsibility to decide which patients should receive treatment, and which ones should be left to suffer until more resources became available. Ethically speaking, Dry. Pop and her staff should have divided resources equally to provide the most number of people with the best possible care.Rationally speaking, however, they had to make the decision to allocate the limited resources to those patients who had the best chance of surviving the disaster tit the greatest potential quality of life, rather than distributing them equally and risking the livelihoods of every patient left stranded at MAC. Due to the extreme circumstances of the situation, the decision was made to administer â€Å"lethal doses† of morphine to four black patients on the seventh floor, each of who had chosen to be designated as Do Not Resuscitate (DNA) patients.The controversial events that took place on the seventh floor of Memorial Medical Center (MAC) in the midst of such chaos serves to illustrate the inconsistencies inherent within the context of rational and ethical decision- aging during disaster situations. Some argue that Dry. Pop chose to play the role of â€Å"God† in that moment of confusion and chaos, using involuntary euthanasia to preemptively end the lives of four patients who were not necessarily going to die.Viewed in this way, her actions can be seen as murder; however, when viewed as an act of rational compassion, the administration of lethal doses of morphine can be seen as providing palliative care and â€Å"comfort to the end. † Whether or not this was the best possible course of action, the decision made by Dry. Pop was one that few people have ever been faced with making.Aside from illuminating the lack of precedence and procedural guidelines for acti on during times of disaster and mass- casualty, the controversy also sheds light on the failures of all levels of government to provide assistance, shelter, and care for people living in poverty who are unable to evacuate from their homes in the midst of impending destruction and chaos. Review of Literature To understand the ethical principles at odds, a review of the literature included on this situation is necessary for the reader to more fully comprehend the competing interpretations of Dry.Pop's decision to bring an ND to those four lives comfortably, rather than respecting their autonomy and leaving them to slowly deteriorate and presumably die on their own terms. Paternalism According to Dry. Gerald E. Drink, DO, professor of moral, political, and legal philosophy at the University of California, Davis, paternalism is defined as, â€Å"the interference of a state or individual with another person, against their will, and defended or motivated by a claim that the person interf ered with will be better off or protected from harm. We can see how the decision of Dry. Pop fits within this conceptual framework by interpreting her actions as a way o provide those four patients with a comfortable end to their lives, with the assumption that they were better off drifting peacefully into eternal sleep than being left and subjected to a slow and potentially painful death. Understanding her actions as an example of paternalism does not necessarily justify her assumption of the role of â€Å"God,† but it does explain why she believed she was acting in accordance with ethical principles.Though arguably at odds with the ethical principal of malefaction, her actions must be judged within the context of the disaster at hand. Because resources ere limited, and because the primary provider for those patients on the seventh floor had seemingly left them for dead, she was faced with making a decision that would ultimately impact every single patient in the hospital.Wh en understood from this perspective, her neglect for patient autonomy and informed consent is superseded by the ethical principle Of paternalism, in the sense that it was her utilitarian duty to provide the most possible care for the most number of people and to reduce the overall suffering endured by patient population. By eliminating the potential suffering of four patients with elatedly low qualities of life, Dry. Pop was able to ensure that the resources available would be used in the most efficient way for the providence of care for those patients who had better chances of survival and higher qualities of life.Decision-making can be a daunting task in any situation, but the decision that Dry. Pop was forced to make was undoubtedly harder than any of us have ever been faced with. It is easy to condemn her as a racist murderer, but it is just as easy to praise her as a hero as well. Regardless, we can rightfully assume that the decisions she made in the midst of such chaos and co nfusion ere the farthest things from being easy for her. She was put in a situation that none of us could possibly imagine, and she acted according to her moral and rational instincts with the best interests of the whole in mind.Paternalism has been subordinated to the principle of self-determination within the medical community over the past century; however, without consistent protocols and enough resources during disaster situations, the principle of paternalism justifies the act of preemptively ending four low- quality lives in the interest of allocating limited resources to the rest of the tenets that had more life left to live and were more likely to survive the ordeal.Leadership in this situation carries with it the burden of choosing who will live and who will die, which is not an easy thing for anyone to do. Dry. Pour in the absence of outside support and guidance, took it upon herself to make that decision so that nobody else had to. Informed Consent This section is dedica ted to defining the ethical principle of informed consent, and discussing why Dry. Pop failed to adhere to this principle when she admit sisters morphine to those four DNA patients on the seventh floor of MAC.The right to informed consent was included in the right to bodily integrity and patient consent by the federal court system in 1 972, with the reasoning that without informed consent, no meaningful and intelligent consent can be given. By only telling those patients that she was treating their pain, she actively disregarded the law. Limiting the scope to just those four people, Dry. Pop was most certainly in the wrong. She knew she was breaking the law, as evidenced by her vocal assumption of total responsibility.Though she was aware of the implications of such actions, her disregard was fueled y her ethical responsibility to ensure the care of the remaining patients in need of treatment. When one expands the scope to include every person present that day, it becomes apparent t hat her failure to adhere to the law of informed consent was an act of civil disobedience. Due to the context of the situation, she was forced to break the law in order to provide the most care for the most number of people.Disasters happen, people die, and tough decisions must be made; this is precisely what happened with Dry. Pop and the patients Of MAC in the wake of Hurricane Strain. Discussion In discussing the situation that Dry. Pop and the patients at MAC were facing in the aftermath of Hurricane Strain, various issues are brought to light. First off, the situation was an unprecedented one, and as such, left those in leadership positions with the task of forming the best possible course of action under disastrous circumstances.This in itself points to the need for consistent protocols and better training for disaster preparedness. Another issue illuminated by Dry. Pop's decision is the failure of all levels of government to ensure the livelihoods of people in poverty with no way to evacuate during incidents of natural disasters. Finally, by analyzing the various ethical principles at odds with each other, we can understand that certain situations force actors to promote certain ethical principles above the rest.Further, we can see how people view the concept of death and end-of- life care in a variety of ways, which allows us to understand how the administration of lethal doses of morphine to four unwitting patients, for the good of the whole, was interpreted by some as murderous, yet by others as heroic. Upon reading the provided literature, I have come to the conclusion that Dry. Pop's actions are justified by the context in which they were made. In cases of disaster and mass-casualty, reality becomes temporarily altered and survival of the group takes precedence over the survival of individuals.Surely Dry. Pop would not have decided to end those four lives if she did not believe that it would benefit the rest of the patients, as well as reduce the a mount of suffering that the DNA patients would ultimately endure. Had their provider risked his life like Pop to care for the seventh floor, or had better training and protocols been in place, or had the government been more prepared and deadly available to provide shelter and care for the poverty-stricken population of New Orleans, those four patients may have survived the disaster.To place the blame of this unfortunate incident on the shoulders of a single individual is to disregard the failures of government and the medical community at large that rendered the hospital incapable of ensuring everyone's survival in the wake of Hurricane Strain. The controversy that arose should serve as a catalyst for increased preparedness and more consistent ethical and procedural guidelines in cases of natural disaster and mass-casualty. Moreover, it should not be used as a way to seek justice for those four lives by biblically indicting Dry.Pop and her nurses. They did what they thought was bes t in an unprecedented situation, and were able to minimize the suffering endured while maximizing the overall benefit for the remaining patients. Summary and Recommendations The administration of lethal doses of morphine by Dry. Pop to those four patients in the aftermath of Hurricane Strain was an unfortunate result of a disastrous situation. With little or no precedence to provide guidance to those in charge of the hospital, Dry. Pop was forced to make a controversial decision.Ultimately, she was able to reduce suffering and increase overall benefit for those seeking care. Unfortunately, it came at the cost of ending four lives. As appalling as this was for their families, the patients themselves were able to drift peacefully into eternity and escape the imminent suffering and difficulties of end-of-life existence that they would have themes been forced to endure. Understanding that they would die soon anyways, we can assume that those four people had come to terms with death.Inst ead of allowing them to fight the inevitable while deteriorating and suffering further, he morphine that coursed through their veins in the final moments of life acted as an â€Å"Angel of Death,† liberating them from the imminent suffering caused by the blatant disregard of their doctor. It is impossible to tell whether or not this peaceful death was preferable to the alternative, but one can at least understand how Pop felt upon deciding to take this course of action.Given the circumstances, she and her nurses did what was best for everyone, even if it did mean emotional suffering for the families of those four patients who were involuntarily euthanized. No one person can be blamed for what happened that day. It comes down to a failure of leadership and lack of foresight by the medical community and government alike. Though I believe Dry. Pop's actions were aligned with the best interests of all involved parties, there are recommendations I would make to ensure controversia l situations like this do not happen in the future. For one, Dry.Pop could have tried to obtain informed consent from the patients and their families before administering palliative care. This could have saved her from legal implications, but it may have also forced her to allow the deteriorating patients to consume the limited resources as they anointed to approach death. The other recommendation I would make is that the leaders should have asked for volunteers to stay behind and allow the DNA patients to be transported elsewhere. Surely there would have been four people willing to give up their spots for the survival of those four DNA patients from the seventh floor.Introduce the story behind the book and the decision making behind the evacuation process that led to such controversy after the rescue. The patients at Memorial Medical Center (MAC) were not given much choice in their fate, unlike the individuals that make the choice to die with dignity ND take their life into their o wn hands. Of the individuals who's deaths were hastened through lethal injection at MAC, someone in their life, whether it be they or their family members, had made a decision for them to have a do not resuscitate (DNA) order on their chart.Although a DNA order was in effect, the decision for dying with dignity had not officially been made by these individuals. They did not choose to end their own life and take their fate into their own hands. The decision was made for them. The physicians, who were in charge of the care of each individual that underwent lethal injection, took n oath to do no harm. The decisions they were faced with in the circumstances that followed hurricane Strain were by no means easy ones.On one hand, harm was caused by lethally injecting the patients; on the other hand leaving these dependent individuals to fend for themselves in the aftermath of a catastrophe would have caused, very potential, pain and suffering. One might say ethical euthanasia took place in these cases; others will disagree. Only those who faced the storm head on will ever truly know the full capacity of the decisions that were made. Review of Literature paternalism Paternalism†¦.. Theories are b Define and discuss the use of paternalism in the decision making process at the end of the evacuation process.Informed Consent Define and discuss the lack of informed consent as the DNA patients were given morphine to hasten their impeding deaths Discussion Detailed discussion surrounding the events leading up to the decision to use morphine and other sedatives to hasten the deaths of the DNA patients that were not going to be evacuated and instead be left behind to die a potentially horrendous death. Summary and Recommendations Summary and Recommendation Should have used informed consent with all cases where the patient and/or Emily members were available to discuss.