Anti-Social Media: the Role of Technology in Creating Superficial Ties

ANTI-SOCIAL MEDIA: THE ROLE OF TECHNOLOGY IN CREATING SUPERFICIAL TIES INTRODUCTION: The general topic that I would like to explore is communication and relationships through social media. In particular I am interested in the way that social media affects the way that we create or maintain relationships and different identities, and if this alienates us from human understanding in relationships. This topic is connected to the concepts of online communication and personal relationships, the concept of self-disclosure and the construction of identity (Duck & McMahon, 2012).Is the bite-sized world of social media leading to bite-sized and unsubstantial personal relationships? This was a question I asked myself recently when looking at some of my own relationships — friendship, romantic, professional, and family alike. Social media plays a role in many of those relationships these days, and what I noticed is that it isn’t always for the better. The main academic articles I will reference are written by; Pavica Sheldon (M. M. C. , Louisiana State University), a graduate teaching assistant and Ph. D. tudent in the Department of Communication Studies at Louisiana State University, Xin-An Lu, an Associate Professor in The Department of Human Communication Studies at Shippensburg University in Pennsylvania, USA, and Sally Dunlop, a professor at University of Australia, school of public health, and her two co-authors, Eian More and Daniel Romer, both professors at the University of Pennsylvania. This paper will first outline the main points of the aforementioned articles. I will then draw upon their themes to help answer my research questions, and I will conclude with the derivations that can be drawn.THEORY REVIEW: In the Rocky Mountain Communication Review, Sheldon (2009) looks at the motivations for the use of social media, Facebook in particular, and the difference in use between genders. She examines 260 university students across four common factors f or logging onto Facebook; relationship maintenance, passing time, entertainment, and virtual community. She finds through these parameters that â€Å"Females used Facebook to maintain their relationships, to be entertained, and to pass time. Males, on the other hand, used Facebook to develop new relationships† (Sheldon 54).Specifically, she found through her focus groups that those who frequent the social networking site more are doing so out of loneliness (Sheldon 55). This links directly with Xin-An Lu’s paper published in Proteus 27 (2011). Lu takes a much broader approach; looking at the affects of social media on the creation of identity and the modern formation of non-geographical communities. Lu argues that online community helps to reduce and remove social restraints and gives the user the ability to experiment with different identities, coming together based on shared and meaning (Lu 53).However, these new text-based relationships may not have existed before a nd we cannot use them to replace face-to-face interactions as they are ‘media-poor’, which is defined by Lu as â€Å"possess[ing] less immediate feedback, fewer cues and channels, and weakened personalization and language variety† (Lu 52), because â€Å"relationships formed in this environment may be weak, superficial, and impoverished, as compared with those formed in [face-to-face] communication† (Lu 52).We must be wary as we read through this review of the comparisons of studies conducted years apart with different conclusions, and we must remember that technology advances at such a rate that should be taken into account when looking at conclusions of past scholars. Finally, Dunlop, More and Romer discuss the positive aspects for having an enlarged network of support, especially for adolescents who have been exposed to, or are thinking of suicide, stating that â€Å"social networking sites may provide both greater exposure to such information and also greater social support to those who obtain this information† (Dunlop et al. 078). This article, published in The Journal of Child Psychology and Psychiatry, suggests that online forums, which are often anonymous and have no connection back to the user, are â€Å"more strongly related to increases in [suicide] ideation† (Dunlop et al. 1078) than social networking sites. Nevertheless, the study shows that social networking sites increase exposure to stories of other suicides, and increased exposure causes increased suicide ideation, and increased curiosity to research and find forums and blogs.This is important to an article discussing youth and the internet, as new innovations are taking place at an alarming rate, and there are new ways to communicate and receive information every day. This article is succinct and fact based, studying the different uses for the internet and social networking sites, and identity creation and anonymity on the World Wide Web. DISCUSSION: Co mmunication is more than just the exchange of words, it involves a transaction between two people that results in a shared meaning and understanding (Duck and McMahon 82).This greater level of communication involves more than the sending or exchanging of symbols, but more the negotiation of the shared meaning between people based on their personal connections. A key element to creating this understanding is engaged listening which allows the listener to move beyond the words said for a greater understanding of the overall message. Usually, this involves the richness of face-to-face interaction. Online communications lack this richness due to the lack of incorporation of non-verbal communications, such as facial expressions and tone of voice, with the words being said (Duck and McMahon 228).The ease with which online communications become asynchronous cause concern for the development of understanding of social cues that are present in face to face interactions that hinder those who use the failsafe of online interaction to save face and to compensate for their own perceived shortcomings. Duck and McMahan state that online media has significantly increased the number of significant ties that people maintain, while the number of core ties remains the same.We can become so seduced by the ease of connecting with others online that we begin to think that these relationships are more intense, more committed and more complete than they really are. We run the risk of alienating the people who populate our daily lives in pursuit of intimacy with our online friends. Another downside of social media relationships is that we are potentially subject to emotional contagion effects, as illustrated in research by John Cacioppo, a researcher at the University of Chicago. His studies show that loneliness is transmitted via social networks.Cacioppo’s findings suggest that if a direct connection of yours is lonely, you are 52% more likely to be lonely; if the connection is a friend of a friend, 25% more lonely, if the connection is 3 degrees out (a friend of a friend of a friend), it’s 15%. While this research looked at offline social networks, it may have some implications for online social networking as well. If someone in your online social network is angry, lonely, or hostile, and takes it out on you, you are more likely to transmit this mood yourself.This means that even though you may never have met this person or interacted with them in real life, their â€Å"bad behaviour† can still influence yours. I have personally noted people interacting in mean and critical ways that, I imagine, they would find more difficult to do in real life. This is a problem, because any kind of negativity and bad manners has the possibility to multiply exponentially. The Internet is an amazing tool. Even as it is shrinking the world and brought us closer together, it is threatening to push us further apart.Like any useful tool, to make technology serv e us well requires the exercise of good judgment. For whatever reason, the restraints that stop most of us from blurting out things in public we know we should not seem far weaker when our mode of communication is typing. Unfortunately, typed messages often wound even more gravely, while electronic messages of remorse have little power to heal (Lickerman). Perhaps we just do not think such messages have the same power to harm as when we say them in person. Perhaps in the heat of the moment without a physical presence to hold us back, we just do not care.Whatever the reason, it is clearly far easier for us to be meaner to one another online. CONCLUSION: Social networking websites provide tools by which people can communicate, share information, and create new relationships. With the popularity of social networking websites on the rise, our social interaction is effected in multiple ways as we adapt to our increasingly technological world. The way that web 2. 0 users interact and talk to each other has changed and continues to change. These users now socialize through the Internet and it takes away from the in person socialization that has been around forever.Social networking websites effect our social interaction by changing the way we interact face-to-face, how we receive information, and the dynamics of our social groups and friendships. Communicating through the Internet and social networking websites is quite different than communicating in person. When users communicate through these websites, they use things like IM and chatting as well as status or Twitter updates to talk to friends and express themselves. Chatting online is quick and easy and allows you to connect to an almost unlimited amount of people from all over the Earth. Although theInternet connects millions of people and allows them to chat, it changes the traditional in person conversation that is important to our social lives and friendships. This change to our social interaction is not nece ssarily positive or negative. The change expands the different outlets through which we can communicate and as long as we remember the importance of face-to-face contact in our social lives, we can find a healthy balance between the two. These social networking websites also affect the way we receive information and news. The sites open up different portals through which we get information and create a more diverse news outlet.Rather than reading the newspaper or hearing the news on TV, we rely on our â€Å"friends† on the sites to give us updates on the world around us. Through Facebook or Myspace statuses, posts, comments, etc. , web 2. 0 users find new information that is most likely relevant to them. These new diverse outlets lead to users discussing world news or other information on the sites and can remove the need to discuss these events in person. Another way that web 2. 0 sites affect the way we socially interact with one another is by changing the dynamics of our s ocial groups and friendships.Social networking sites create a new model of social interaction and friendships. As people’s social circles grow, the ties of the online friendships are not always as strong as in person close friendships. Although these sites can alter the dynamics of friendships in that way, it also creates lots of new friendships and increases our social interaction. The many effects of social networking websites on our social interaction with one another can be both positive and negative, all that is sure is that there is a definite effect. We must embrace the increasing use of web 2. 0 sites and the different roles they play in our social lives.There is not really a need to focus on the positive or negative effects of these sites because whether the effects are good or bad depends upon the things in society that you value, and that is different for most every person. These sites will most likely continue to grow in popularity and continue to alter the way we socialize with one another and we must embrace it. SOURCES: Duck, Steve & McMahon, David T. The Basics Of Communication: A Relational Perspective. Los Angeles: Sage 2012. Print Dunlop, S. , More, E. , & Romer, D. (2011). Where do youth learn about suicides on the Internet, and what influence does this have on suicidal ideation?Journal o Child Psychology and Psychiatry, 52:10 pp 1073-1080. Landau, Elizabeth. â€Å"Loneliness Spreads In Social Networks. † CNN. 4 December 2009. Turner Broadcasting System Inc. 1 March 2012. . Lickerman, Alex. â€Å"The Effect Of Technology On Relationships. † Psychology Today. 8 June 2010. Sussex Publishers, LLC. 1 March 2012. . Lu, X. (2011) Social Networking and Virtual Community. Proteus 27, 1, 51-55 Sheldon, P. (2009). Maintain or Develop New Relationships? Gender Differences in Facebook Use. Rocky Mountain Communication Review. 6-1, 51-56.

Net present value vs Internal rate of return Essay

How do the results of the NPV technique relate to the goal of maximizing shareholder wealth? The NPV technique measures the present value of the future cash flows that a project will produce. A positive NPV means that the investment should increase the value of the firm and lead to maximizing shareholder wealth. A positive NPV project provides a return that is more than enough to compensate for the required return on the investment. Thus, using NPV as a guideline for capital investment decisions is consistent with the goal of creating wealth. In theory, why is NPV the most appropriate technique for making capital budgeting decisions? The NPV method is theoretically the most appropriate method for making capital budgeting decisions because it measure wealth creation, which is the assumed goal of financial management. NPV is an absolute measure of a project’s profitability and indicates the expected change in owners’ wealth from a capital investment. As an evaluation technique, NPV considers all expected future cash flows, the time value of money, and the risk of the future cash flows. Thus, NPV can help identify projects that maximize shareholder wealth. If a firm selects a project with an NPV of $75,000, what impact should this decision have on shareholder wealth? If the estimated cash flows and discount rate are accurate, this project should increase shareholder wealth by $75,000. If a project’s NPV is positive, what does this suggest about the required versus estimated return on the project? What does this suggest about accepting the project? A positive NPV suggests that the estimated return on the project is greater than the required return for the project. The NPV decision rule is to accept a project whose NPV is greater than zero because this investment should increase shareholder wealth. The IRR measures a project’s yield or expected rate of return. This return does not depend on anything except the cash flows of the project. Thus, the IRR provides a single number summarizing the merits of a project. Mathematically, the IRR is that rate of return (discount rate) that makes the present value of all expected future cash flows equal to zero. That is, the IRR is the discount rate that causes a project’s NPV to equal zero. Why may using the IRR method as a decision criterion not lead to maximizing shareholder wealth? What factors can lead to misleading results when comparing the IRR with the NPV? If projects are independent and are not subject to capital rationing, using the IRR method in evaluating projects indicates the ones that maximize shareholder wealth. However, using the IRR method as a decision criterion may sometimes lead to selecting projects that do not maximize wealth if the projects are mutually exclusive or capital rationing exists. When evaluating mutually exclusive projects, the IRR may indicate a different decision than the NPV because of the reinvestment rate assumption. The IRR implicitly assumes reinvestment of all intermediate cash inflows at the IRR, whereas the NPV implicitly assumes reinvestment of all intermediate cash inflows at the cost of capital. This reinvestment rate assumption may lead to different decisions in selecting among mutually exclusive projects when any of the following factors apply: (1) differences in timing of cash flows among the projects, (2) differences in scale, and (3) differences in the useful lives of the projects. What are the similarities and differences in decision rules when using NPV versus IRR? For independent projects with conventional cash flows and no capital rationing, the NPV and IRR generate the same accept-rejected decision. Thus, the decision rules are similar for investment projects. The decision rule for NPV is to accept the project if the NPV is positive and reject the project if the NPV is NPV is negative. The decision rule for IRR is to accept the project if the IRR equals or is greater than the required rate of return and reject the project if the IRR is less than the required rate of return. Technically, the firm should be indifferent between accepting and rejecting a project with an NPV equal to zero or an IRR equal to the cost of capital because such an investment would not change shareholder wealth. The cost of capital is the discount rate for the NPV and the hurdle rate for the IRR. The firm should accept the project because it has a positive NPV. However, the discounted payback method is inconsistent with shareholder wealth maximization because the method ignores some cash flows that contribute to the present value of investment. What are two reasons for the superiority of the NPV method in evaluating capital investment projects? The NPV method is the best approach in evaluating projects because it measures the amount by which a capital investment creates wealth. This is because the NPV is an absolute measure of a project’s worth. In addition, NPV has a more realistic reinvestment rate assumption than IRR. It implicitly assumes reinvestment of intermediate cash inflows at the required rate of return. Both reasons supporting the superiority of the NPV method assume that managers invest the cash flows from the investment for the benefit of shareholders. In summary, no other capital budgeting technique does a better job of measuring wealth creation than the NPV method. Which capital budgeting techniques are increasing in popularity? Which are decreasing in popularity? Survey results suggest an increased use of more sophisticated capital budgeting techniques. The use of discounted cash flow techniques, specifically NPV and IRR, has increased in popularity over time. Several reasons may explain increasing popularity of these methods such as the widespread use of personal computers with spreadsheet programs that reduce the knowledge and effort required to calculate discounted cash flow measures and increased familiarity of managers with these techniques. NPV has been the dominant method taught in business schools for many years and many financial managers hold business degrees, especially MBAs. The popularity of the IRR is mostly likely because it is a measure of yield and is easy to explain to people who do not have formal training in finance. Since financial managers often deal in yields, some may be slightly more comfortable dealing with the IRR than NPV. Methods declining in popularity include the use of the payback period, although still popular, and the accounting rate of return. The rationale for this decline in popularity likely results from several factors including their simplicity and failure to consider the time value of money. In addition, the accounting rate of return uses accounting income instead of the cash flows.

Roosevelt – The Great Depression

Franklin Delano Roosevelt, a Democrat, came from a wealthy New York family and was educated at Harvard University. He entered politics in 1910 and elected Governor of New York State in 1928 after surviving a bout of polio. The Democrats choose Roosevelt as their candidate to oppose Hoover in the 1932 Presidential Election. During the campaign he said, â€Å"I pledge you, I pledge myself, to a New Deal for the American people†. He promised to use government money and power to rebuild the economy. Roosevelt won with a landslide victory. One of the main reasons for this was that the previous President, Hoover, had not controlled, or attempts to help the economic downfall of the United States. Hoover thought matters would right themselves and therefore took little action. In 1932 Hoover did eventually find some money to help a number of struggling banks and businesses, but he refused to set up federal relief programmes to aid the unemployed. As the Depression dragged on, a protest movement developed among the hungry and the unemployed. Many Americans had lost confidence in President Hoover and were looking for new leadership that arrived in the form of Roosevelt. Once elected, Roosevelt had many problems facing him and his party that the American people expected him to solve. * Most of the populace was unemployed. Over 12 million Americans did not have a job, and this figure was increasing by 12,000 every day. Families relied on charity to stay alive and breadlines were common in every city. * Over 1 million people were homeless. In 1932, 250,000 Americans stopped paying their mortgages and were evicted from their homes. Because of this, many became ‘hobos' or tramps while others moved to waste ground to build huts from scraps of wood and metal, these unhealthy camps were known as ‘Hoovervilles' after Herbert Hoover. * Total economic collapse followed – With so many people out of work the cities could not afford to buy all the food the farmers produced; and by 1932 – 1 in 2 farm owners had been evicted. * Many veterans living in poverty demanded bonuses immediately. Their annoyance at not receiving their money came to a head when, during summer 1932, veterans from all over the country went to Washington capital to protest. Many hijacked trains to get there and fought with police who tried to stop them. In June of the same year, more than 20,000 veterans had arrived in Washington and set up a Hooverville opposite the White House. Congress voted against paying the veterans their bonuses and Hoover ordered the army to evict the veterans from their Hooverville. The army thought it was necessary to bring in 4 companies of infantry, 4 troops of cavalry, a machine gun squadron and 6 tanks to disperse the veterans. In the ensuing chaos 2 veterans died and 1000 were injured. * Bank failures were another large problem. During the depression, many people with savings in the bank took the money out to stay alive. This led to new problems; small banks did not have enough money to pay their savers and went bankrupt. After a bank failed, savers with deposits in other banks rushed to take out their savings from other banks, leading to more banks going bankrupt- A total of 1616 banks in 1932. * Many people affected by the depression organised protests in hope to improve conditions. In Iowa, the farmers union organised strikes to stop food reaching markets. This aimed to create food shortage and increase food prices. Roosevelt took a tough stance towards these areas of difficulty, and in his inauguration speech he stated that â€Å"the only thing we have to fear is fear itself†. To affect change in America, Roosevelt need more power than he already had. In 1917 congress had allowed President Wilson to change laws without asking and this ‘trading with the enemy† act was still effective when Roosevelt came into power. Roosevelt realised he could use this act to speed the healing process for America's economy. Roosevelt proposed, and Congress passed, a series of measures designed to provide relief for the unemployed and promote economic recovery. Roosevelt also hoped that the New Deal would help America's problems by bringing about a number of long-term reforms. Two days after his inauguration on the 6th of March, Roosevelt ordered all banks to close for a long bank holiday while he and a cabinet worked out a way to solve the problem. Most Americans were glad to see Roosevelt dealing with the problem although some though he was becoming a dictator and leading America down the road to socialism. By 1933, the number of people unemployed was about 13 million. To get America moving again, these people had to have work and be earning money, allowing them buy products from others. Roosevelt decided that a program of temporary jobs should be put in place, as well as food distribution to the hungry and low-interest loans given to home-owners. Roosevelt's most famous actions against the depression were the Alphabet Agencies; so called because all were condensed into a set of initials for ease of use. * The Civilian Conservation Corps (C.C.C.) was set up in 1933 and was a popular Roosevelt idea. Unemployed young men were given six-month jobs in the countryside working on projects concerned with forestry, flood control and soil conservation. By doing this, they received a small wage, food, clothing, and shelter. By the end of the 1930's, two and a half million men had been in the C.C.C. * Another popular program of reform for that year was the Agricultural Adjustment Act (A.A.A.). It was designed to help farmers who were suffering from low incomes, with many being forced off their land. The government paid the farmers to grow less, which forced prices of food up. Crop prices gradually recovered, and within four years the average farm income had almost doubled. * One of the most important New Deal measures was the National Industrial Recovery Act (N.I.R.A.). This comprised of two sections; the first being the Public Works Administration (P.W.A.), which organised and provided money for the building of useful projects: schools, hospitals, roads, bridges etc. The Works Progress Administration (W.P.A.) was another successful New Deal agency that funded a number of projects to create employment, although these were on a smaller scale than the P.W.A. The other section on the N.I.R.A was the National Recovery Administration (N.R.A.) which recommended an eight-hour day, together with a minimum wage, to help create jobs. Employers who accepted these recommendations were allowed to display a ‘Blue Eagle' sign on their goods. Over 2 million people embraced the new standards and benefited because of it; the public was encouraged to buy only from businesses that had joined the scheme. * Roosevelt's many plans were new, and his kinds of tactics for dealing with depression was regarded as blunt by many people. His other plans however were over-shadowed when he decided to set up the Tennessee Valley Authority (T.V.A.) in order to help a poor, badly eroded region which was also prone to flooding. The T.V.A built a network of dams to control the floods and give the area a supply of cheap electricity. This attracted industry and gradually the whole region began to prosper. * Finally, in 1935, the Social Security Act provided pensions for the elderly and benefits for the unemployed, as well as providing help for dependant mothers and children and the handicapped. Roosevelt brought about partial recovery to the United States with the New Deal and ‘Pump priming' strategy. It was not until the Second World War and the demand for American goods however, that the American economy returned to its former prosperity.

BSN & MSN Program Essay Example | Topics and Well Written Essays - 750 words

BSN & MSN Program - Essay Example Moreover, the curricula designed for the bachelors degree programs in nursing are quite different from the curricula designed for the masters programs in the same field even though they may be offered in the same institution. This paper analyzes and compares the nursing degree curricula that are used for undergraduate programs as well as for the masters programs in nursing within a university college. Moreover, the paper will evaluate the curricula programs and education outcomes postulated by these designed curricula with an aim of establishing how the undergraduate programs and the postgraduate masters programs in nursing profession build on each other. II. Difference in Outcome and Content The BSN as well as MSN programs have competitive provisions that are all geared towards the production of holistic and competitive nursing professionals. There is little notable difference though between the curricula content and the outcome as shown by the nursing regulatory and management bodi es. The visionary track of a nursing education follows through the levels of a generalist, an advanced generalist that is later followed by specialization programs. The generalist nursing education is what is offered at an undergraduate level while the advanced generalists refers to what is offered at the masters level programs. ... include ‘scholarship for evidence based practice’ ‘liberal education for baccalaureate generalist nursing practice’, and‘basic organizational and systems leadership for quality care and patient safety’ (Anon, 2008). ‘Information management and application of patient care technology, healthcare policy, finance, and regulatory environments’, ‘inter professional communication and collaboration for improving patient health outcomes’ and ‘clinical prevention and population health’(Anon, 2008). Moreover, ‘professionalism and professional values and baccalaureate generalist nursing practice’ (Anon, 2008) form part of these essentials. The major notable difference between these essentials for the undergraduate programs in the contents and the outcomes expected from the courses offered. On the other hand, the masters programs in nursing education equally run on stipulated essentials, which define the el ements of the adopted curricula not based of such factors as intended practice settings, focus or major. Masters programs differ in regard to the undergraduates in that they employ programs which are different in content in order to have variations in outcomes. The outcomes for masters programs are professionals who besides practicing can address available gaps in the field. The masters essentials are ‘background for practice from sciences and humanities’, ‘organizational and systems leadership’, ‘quality improvement and safety’ and ‘translating and integrating scholarship into practice’(Anon, 2011). Moreover, ‘informatics and healthcare technologies’, ‘health policy and advocacy’, ‘inter professional collaboration for improving patient and population health outcomes’, ‘clinical prevention and population health for

Confusing Harder with Better by Alfie Kohn Essay

Confusing Harder with Better by Alfie Kohn - Essay Example The paper throws light on the essay â€Å"Confusing Harder with Better† which expresses that the more schools commit themselves to improving performance on these tests, the more that meaningful opportunities to learn are sacrificed. He also said that there is an inverse relationship with high scores and the quality of the standards that the schools want to achieve. Though schools are aiming to be competitive with other schools, they are also aiming for their students to be competitive not just on the scholastic world but also when they step out of the academe and into the real world. Most of the students are now being educated through the book and by the book. There is a certain scare that one’s talent and creativity will be shadowed by the books. As the educational standards are being raised, there are points that are being shadowed and overlooked upon. There is nothing wrong with raising the standard of education especially when there are a lot of things the country i s facing now which the students of today may answer in the future. All things should be done in moderation. Raise the standard of education moderately that the students still have the freedom to choose other activities where they can excel. It is not all about the books. A well-educated person knows how to apply what he have learned in the academe to his daily life. There are a lot of things beyond what are written in the books. Tests are not just in the school but also in real life. There are things in life that are not taught in schools.

Eval 4 Essay Example | Topics and Well Written Essays - 750 words

Eval 4 - Essay Example The data collection process has various steps that require expertise in formulation and implementation and this is done best by properly trained data collectors. Regardless of the preference for defining data whether qualitative or quantitative, accurate data collection is important to ensure that the integrity of the research is maintained. Data collection by improperly trained data collectors leads to the inability to accurately answer the research questions, distorted findings therefore wasted resources, inability to validate or repeat the study, compromising decision in regard to public policy, misleading of other researchers pursuing the same or related research topic and causes harm to the participating agents. Improperly trained data collectors lead to poor results and if the results are used to support recommendations of public policy, it will cause disproportionate harm. Improperly trained data collectors will not comply to the research questions and may collect data that is not a true reflection of the natural situation. The goal of a research is to help improve a situation or come up with amicable solutions to a problem. This involves accurate data collection and carrying out a relevant data analysis through careful planning and thorough thoughts (Bedi, Bhatti , Gine, Galasso, Goldstein and Legovini, 2006). Collection of sub standard information and data implies that the evaluator will arrive at the wrong conclusion and that the wrong recommendations will be implemented. Outcome evaluation seeks to establish the effectiveness of the research, reaching at an accurate conclusion from the collected data and making recommendations. Thus if the data collected is inaccurate, the analysis and conclusion will be wrong. To overcome these problems, the evaluator is required to design the needs of the data collectors especially where there are multiple data collectors. The evaluator

Child Care Aboriginal Australia Essay Example | Topics and Well Written Essays - 1750 words

Child Care Aboriginal Australia - Essay Example "Assimilation" refers to the attempts of white Australian government to intermesh Aboriginal and white culture, often with the purpose of eventually eradicating Aboriginal culture. Under the 1940's assimilation policy, many Aborigines were removed from their own territory and forced to settle n new areas. Indeed, many Aborigines intertwined with whites. Sally Morgan's autobiographical novel, My Place, serves as an example of this mixed generation. "Dispossession" occurred when the White Australian government forced many Aborigines away from their original home. As a result, land which had originally been deemed sacred became the possession of white Australia. These occurrences of "dispossession" were particularly hard for Aborigines, who tied their beliefs and religion with particular geographic areas. This strong Aboriginal emphasis of land can be seen particularly in Aboriginal paintings and other forms of artwork. "Personal racism" refers to the subconscious idea that exists among some white Australians that Aboriginal identity is less valuable than white identity. This racism occurs on a personal level because white Australians believed that the darkness of someone's skin reflect their Aboriginal identity. ... The belief emphasized that it was up to Aborigines to gain land rights and reclaim their native lands. This period marked a great period of social progress for Aborigines and would eventually result in reclaiming many lost lands. "Invasion" occurred when English natives began to establish posts and reservations in Australia. In an Aboriginal perspective, the "invasion" of whites into Aboriginal culture resulted in the destruction of traditional Aboriginal society and the dispossession of most Aboriginal settlements. "Land rights" refer to the battle Aborigines face in reclaiming their own land. Within the past century, Aboriginals have won various land claims which provided back certain territories. Beginning with the Aboriginal Land Act of 1976, Aborigines have begun to reclaim their native lands. This phrase also represents the clash in thought between Aborigines and white Australians over who owns certain areas. Although white Australians physically own certain native Aboriginal lands, Aborigines claim that their religious and cultural beliefs entitle them to possession of sacred Aboriginal territory. Although the white Australian government attempted to mix Aboriginals with white society, "segregation" was still practiced in Australia and separated Aboriginal people from whites. On a basic level, Aboriginals were given certain areas to live apart from whites. "Segregation" was also practiced within society and many people who contained even one Aboriginal ancestor were segregated against as being less than people of entirely white heritage. "Terra nullius", a Latin phrase meaning "empty land", refers to a 17th century legal concept that allowed

Research workplace safety issues and disabilities of job applicants Paper - 1

Workplace safety issues and disabilities of job applicants and report your findings and analysis in a - Research Paper Example The common practice of alienating people in the work place has been through biasness in hiring, promotion, in termination, job assignment and when compensating employees. It is also expressed through retaliation and other forms of harassing employees in terms of their gender. State constitutions and the federal statutes provide rulings of law on discriminatory acts. The issue is addressed fully under the Fourth and Fourteenth Amendments of the United States Constitution with some relevant Acts and provisions which limit the power of both the federal and the state governments to discriminate. The Fifth Amendment has the requirement that individuals should not be deprived of life, liberty or property by the state without the due use of the law (OBrien 216). This section has also highlighted the cases which govern alienation and the provisions as well as the penalties due in case of failure to comply with the constitution. The amendment has also provided a guarantee that all individuals have an equal and explicit protection of the law. The fourteenth amendment has provided for full protection of human rights and prohibits the states from violating these rights. This paper analyses the various forms of allowable and unethical forms of discrimination as has been provided in the constitution and their impacts on the employer or organizations, the applicants and the coworkers. Firstly, the constitution under the fourteenth amendment has provided that a person shall not be discriminated upon in the practice of employment because of membership in a certain group whether such an individual is a former employee or a job applicant. In case of termination, the law has stated that an individual should receive fair treatment and process of termination before he or she is acquitted and especially if the termination is related to property interests, liberty or freedom. Intentional

Talk about the economic system in china and then the U.S Essay

Talk about the economic system in china and then the U.S - Essay Example The growth rate of China economy is higher than other developed countries due to restructuring of the old economic structures and policies. The revamp and growth was necessitated by the enabling environment that was created by the economic class. For instance, they shifted the cities and urban areas to be wealth creation centers while using the rural areas for manufacturing (Ikenberry, 27). The economic wealth and prosperity is however shared or distributed by the state to all the devolved units of government. This is to say that the government has a hold on the economic patterns and regulates the ownership of private businesses. The regulation bby the government is aimed at balancing the socialistic aspect and capitalism. In principle, the economy is structured or macro-organized in such a way that wealth created in a particular area must live positive externality on the lives of that area, either through employment or construction of infrastructure which are all marks of economic growth and excellence. The United States of America has a free market economy where the activities of the buyers or consumers and the sellers or the producers determines the equilibrium. Equilibrium refers to the price level in the money and commodity markets and the profits. In principle, the government hold in the process of wealth creation is very minimal. Therefore, individual owners of business who could also be called capitalists have the free power to control their business make profits and use the proceeds thereafter as they please (Bruinsma, 9). There are economic policies such as the minimum wage policy and the trade unions which strive to ensure that the business owners or capitalists operate in a fair manner. The trade unions or the labour organizations are also a critical component of the economic system because they present a room and chance for collective bargaining so that the capitalists do not misuse their

Computer Networking Management Essay Example | Topics and Well Written Essays - 5500 words

Computer Networking Management - Essay Example As there is continuous progress in information technology, we move further and further into becoming a paperless society, and there is increased need for people to be connected to large networks to be able to exchange data just as quickly as when handing a piece of paper to another person. This can be achieved by connecting groups of computers in a network, so that the data can be accessed immediately by various when data is entered into one computer, no matter the distance from the originating computer. There is quite a lot of work involved in networking, including a lot of math, from equations to basic problems. This paper discusses the issues around the setting up a computer network and its management. A computer network is a connection of two or more computers in order to share resources and data. These shared resources can include devices like printers and other resources like electronic mail, internet access, and file sharing. A computer network can also be seen as a collection of Personal computers and other related devices which are connected together, either with cables or wirelessly, so that they can share information and communicate with one another. Computer networks vary in size. Some networks are needed for areas within a single office, while others are vast or even span the globe. In the vastly technological en... Most companies employ a network administrator or manager to oversee this very important aspect of the company's business. This is a significant position, as it comes with great responsibilities because an organization will experience significant operational losses if problems arise within its network. Computer networking is a discipline of engineering that involves communication between various computer devices and systems. In computer networking, protocols, routers, routing, and networking across the public internet have specifications that are defined in RFC documents. Computer networking can be seen as a sub-category of computer science, telecommunications, IT and/or computer engineering. Computer networks also depend largely upon the practical and theoretical applications of these engineering and scientific disciplines. Computer networking also involves the setting up of any set of computers or computer devices and enabling them to exchange information and data. Some examples of computer networks include: Local area networks (LANs) that are made up of small networks which are constrained to a relatively small geographic area. Wide area networks (WANs) which are usually bigger than local area networks, and cover a large geographic area. Wireless LANs and WANs (WLAN & WWAN). These represent the wireless equivalent of the Local Area Network and Wide Area Networks Networks involves interconnection to allow communication with a variety of different kinds of media, including twisted-pair copper wire cable, coaxial cable, optical fiber, and various wireless technologies. The devices can be separated by a few meters (e.g. via Bluetooth) or nearly unlimited distances (e.g. via the

A Road to Life Movie Summary Essay Example | Topics and Well Written Essays - 1500 words

A Road to Life Movie Summary - Essay Example The movie concentrates upon the activities of the orphan children, who are kept and looked after with proper care and concern in a rehabilitation camp. The movie shows that the camp commission provides them with comforts and trains them to learn various technical skills under an affectionate, nurturing and congenial environment, which is helpful for the socialization of the orphan boys; as a result a large number of boys learn how to behave like civilized persons while interacting with other members of society. Nevertheless, two of the boys keep on deviating from the rules and regulations, and commit the crimes, which create much disturbance and annoyance in the locality. It clearly demonstrates the bitter fact that there certainly exist some people in every society, which have natural inclination towards committing crimes.Since it was the age of black and white films, the director has sought support from shades, shadows and dark colors. For instance, the evening and night scenes of the camp life have been supported with the same techniques. Moreover, being the first sound film, the director has also applied the written words on the screen in order to demonstrate various areas and situations going to be displayed in the movie. The words appear on the screen in order to guide the audience in respect of the location, where the specific part of movie is being established. In addition, close and remote camera skills can also be witnessed in order to show distance between different characters. and objects and places as well. Establishing shot technique has been exercised in Zighan’s catching the shoes stolen by the deviant boy at the railway station. In addition, close up technique has been applied in order to reveal the face expressions and body language of the characters. The film takes the audience from one place to the other through the wonderful application of cross-cuts technique. For instance, the scene showing the main characters standing and wanderin g at the railway st

Carl Jung and His Theories Essay Example for Free

Carl Jung and His Theories Essay Carl Jung’s theories are interesting. He studied the personality as something very important to a personit is embedded within us and is what emerges to the outside world so as to be seen by others. His three principles: opposition, equivalence and entropy is quite great and for me, really describe every humans’ way of interacting with their environment and the way they come to pursue and continue everyday life. I find it true enough that humans have this general life energy (libido) and uses it in everything they do. All of us are rational beings and we always have these drives to get on with things we often feel that need to be done. Through our consciousness and unconsciousness, we are able to get past every obstacle and track our â€Å"missions† in life. Carl Jung explained in his theories that humans do tend to become someone in order to be accepted by other people and to succeed in life. And for me, he is trying to convince all of us that every human, young or old, are born to have visions and views in life, different aspect within us, and a will to be free and be happy—yet all of these are not totally within our reach because of our differences. That’s why Jung, for me, was able to explain why and how people uses different mechanisms to live happily or even just be able to go on with life with his theories. I, as a person, can relate my personality to some of Jung’s theories. I can say that I am an: †¢Introverted feeling type because in this personality type, it is said that one is capable of deep emotions but avoid any outward expression of it. Yes, this describes me because I am the type of person that is strong on the outside yet fragile on the inside. I tend to really suppress all my emotions because I am afraid to be criticized and be rejected by the people around me especially that most of them are stereotypes. †¢Extraverted thinking type because an individual having this type represses one’s feelings and emotions, is objective in all aspects of life, rigid and cold, and scientist. As what I have said earlier, I hide my emotions to avoid criticism. Also, I always have plans in everything I do in order to achieve positive outcomes even in the simplest things I make, thus making me  rigid and cold since in line with achieving in life, I lean on focusing to myself and not with others. †¢Introverted thinking type because this personality type describes the person as intensely concerned with privacy and understanding to oneself rather than other people. I always prioritize privacy and I can’t live without it. I always keep secrets because I don’t trust the people around me that much and I can’t risk my privacy to them†¦ and due to this, I am more understanding to myself than others because my philosophy in life is to make the best out of myself first before others. Some may say that I am selfish and greedy but that’s what I am, I always give myself the most priority I could give. Every person is different and unique. You may find someone who is like you or like the person you know but lying deep within us is someone only us can discover—if we can. We must respect each other in every way because we are made equal and that everyone should be treated in the same way.

Effectiveness of Primary Realignment on Stricture Urethra

Effectiveness of Primary Realignment on Stricture Urethra THE EFFECTIVENESS OF PRIMARY REALIGNMENT IN TRAUMATIC POSTERIOR URETHRAL DISTRACTION INJURIES ASSOCIATED WITH FRACTURE PELVIS. ABSTRACT Aim: To study the effectiveness of primary realignment on the incidence of stricture urethra and its impact on the incidence of complications. Methods : From 2005 to 2008, a total of 27 patients of posterior Urethral distraction injuries were studied, out of which 15 patients were treated with the aim of reestablishing Urethral continuity immediately or early after injury and 12 patients were treated with SPC alone followed by definitive management after 6 months. Follow up ranged from 6 months to 2 years. Of the 15 patients who were treated with the Urethral Catheteric alignment, 6 patients underwent open procedure as there was an indication for emergency Laparotomy. Rest 9 patients were treated with endoscopic alignment with in 1 2 weeks. Out of 9 Patients, Endoscopic alignment was successful in 8 patients. Rest 12 patientswere managed with SPC alone as these patients were not stable for primary alignment due to associate Orthopaedic, Head or Chest injuries. All these 12 patients required a major Urethroplasty later. RESULTS: Of the 15 patients managed with primary realignment, 7 patients developed stricture at the site of injury of which 3 patients required major Urethroplasty and 4 patients could be managed by endoscopic procedures. All 12 patients in SPC group required a major Urethroplasty later. The incidence of Incontinence and impotence were comparable in both the groups. Conclusion: We conclude that careful Urethral Catheteric realignment after acute trauma is safe and useful as it obviates total Urethral closure in majority of cases. KEY WORDS: Traumatic rupture urethra , primary realignment, Urethroplasty , endoscopic realignment, Pelvic Fracture, Suprapubic Catheterization, Retrograde Urethrogram. Introduction Pelvic fracture with posterior Urethra rupture is associated with morbidity such as Urethral Stricture, Erectile dysfunction and incontinence 1. There is still controversy on the immediate management of these injuries. Some Urologists advice initial placement of Suprapubic Cystostomy followed by delayed Urethroplasty 3 to 6 months later 2, while others suggest immediate realignment. The patients managed with Suprapubic Cystostomy results in Stricture formation in 95% of cases requiring a delayed Urethroplasty 3. Thus it carries the morbidity of being on SPC for 3 to 6 months followed by the morbidity of undergoing a major Surgery and its attendant complications. Some Urologists suggest that early Urethral realignment as initial treatment for posterior Urethral disruption associated with Pelvic fracture with or without Surgical repair may adversely influence out come. Where as others attribute the morbidity of Pelvic fracture Urethral avulsion to trauma magnitude rather than to management of the acute disruption of the membranes Urethra 4. The current definition of Primary realignment refers to immediate stenting of Urethral distraction with a Catheter without Pelvic dissection or sutures5. More recently realignment has been performed endoscopically, under fluoroscopic guidance or by using magnetic urethral catheters 6, 7, 8. Primary realignment with above techniques obviates the need for long term Suprapubic drainage, and reapproximates the proximal and distal ends of Urethra before significant malalignment develops and incidence of Stricture formation is found to be much less compared to the patients managed by SPC alone. Virtually 100% of patients managed with SPC alone result in complete obliteration requiring a major Urethroplasty later, while only 50% of patients with primary alignment go on to development strictures most of which can be managed with endoscopic procedures like visual internal urethrotomy or visual dilatations . Materials and Methods We treated 27 men with posterior Urethral injuries from August 2005 to August 2008. Of the men, 12 were managed with Supra pubic Catheter and delayed Urethroplasty and 15 were treated with the aim of establishing Urethral Continuity either immediately or with in two weeks after trauma. Mean patient’s age was 34 years (16-58). 24 patients were involved in motor vehicle accidents and 3 had fall from height. Diagnosis is established by clinical examination and retrograde Urethrogram in all patients. 12 out of 27 men had associated severe injuries like fracture lower limbs, fracture Spine and Chest and head injuries. All of the above patients were managed by SPC alone followed by a delayed Urethroplasty. Of the remaining 15 patients, 3 patients had Bladder injuries and 3 patients had intra peritoneal Bleeding (1 case of Splenic trauma and 1 case of liver trauma and 1 mesenteric tear) For the above patients emergency Laparotomy was done and Urethral trauma dealt by early Urethral Catheteric realignment and open Suprapubic Cystostomy. In this open procedure a 6-8 Fr. infant feeding tube was gently passed perurethrally and retrieved through retropubic space. Another infant feeding tube passed antegradely through the Bladder neck and retrieved through retropubic space without much disturbing the hematoma in retropubic space. Both are tied together and brought out through the Urethra. A 16 Fr. Foleys Catheter tied to the end of the Infant feeding tube outside the Urethra and gently negotiated into the Bladder. The above procedure did not involve any retropubic dissection, the Pelvic hematoma not disturbed, Pubo prostatic ligaments are not divided and vest sutures or traction not applied. The above procedure was successful in 4 out of 6 cases. In other two cases the Per urethral feeding tube directly entered the bladder and Foleys Catheter negotiated into the bladder. In all cases 16 Fr. Foleys Catheter kept as SPC. In rest of the 9 patients emergency laparotomy was not required; these patients are initially dealt by SPC. Once the patient is stable, patient is taken up for Endoscopic alignment within 7 to 14 days. In our procedure of Endoscopic alignment patient was kept in modified lithotomy position under general anaesthesia and Urethroscopy done with 10 Fr. rigid pediatric scope. Once the injured area is located, guide wire or 4Fr. Ureteric Catheter is gently passed across the injured area. If any resistance is encountered a second guide wire is passed by the side of it. The entry of the guide wire or Ureteric catheter into the Bladder through the Bladder neck is confirmed by antegrade scopy through the SPC tract. Then a 16Fr. Foley’s catheter is then negotiated over a guide wire into the Bladder and confirmed by antegrade Scopy through the Supra pubic tract and the Bulb inflated with 15cc of water. The procedure was successful in 7 out of 9 patients. In one patient where the above pro cedure failed the guide wire was passed antegradely by antergrade Cystoscopy through SPC tract and could be retrieved through retrograde scopy by grasping the guide wire with an alligator. In one patient the guide wire or ureteric catheter could not be negotiated across the injured area either antegradely or retrogradely and hence the patient was left with SPC alone and was managed with Urethroplasty later. Thus the procedure was successful in 8 out of 9 cases. All the patients with catheter realignment are followed up with pericatheter studies after 4 weeks. If there was no extravasation, perurethral catheter removed, SPC blocked and patient is allowed to void. If the patient had extravasation, perurethral catheter is maintained for another 2-4 weeks and if extravasation subsided perurethral catheter is removed. Then the patient is kept on Clean Intermittent Catheterization. RGU repeated after another two months and SPC removed if there is no stricture. Patient is kept on regular follow up every three months for 2 years. Results Table I Methods of management and results. The results of the 27 patients managed differently are shown in table I. In 13 out of 15 patients in Catheteric alignment group, the RGU shows complete rupture of Urethra and in 10 out of 15 patients the Ureteric Catheter or guide wire could be passed across the injured area easily indicating they are partial injuries. The Urethral Catheters were kept for a mean of 6.5 weeks (Range 4 to 9 weeks). Table I also shows the relationship between the method of early management and the development of Urethral Stricture. Of the 15 patients treated with Catheterization 7 (46%) patients developed Urethral Stricture out of which 3 (20%) patients had to undergo a major Urethroplasty and 4(26.6%) patients could be managed with Visual Internal Urethrotomy and visual dilatation. No patients of this group required Pubectomy or abdomino – perineal approach. 11 (91.6%) out of 12 patients managed with SPC alone developed complete obliteration out of which 10 (83%) patients required a major Urethroplasty later. One patient could be managed with core through VIU. 2 out of the 11 patients required transpubic approach for associated fistulous tracts to the perineum and 2 patients required abdomino perineal approach as these patients had a cavity requiring omental packing. Rest 7 patients could be managed with progressive Perineal Urethroplasty. 4 out of 12 patients in SPC group were permanently Impotent after injury and 1 patient has become impotent after Uretrhoplasty (transpubic approach) i.e., totally 5 (41.5%) patients have become permanently impotent in SPC group. In Urethral alignment group, 11 out of 15 patients have regained their potency within 1yr i.e., 4 (26.6%) out of 15 patients were permanently impotent. No patient was incontinent in both the groups. Discussion The management of posterior Urethral injuries associated with fracture Pelvis is still controversial. The main controversy is between Suprapubic drainage with delayed repair 2, 9 and immediate open realignment or Endoscopic alignment. The diagnosis of a Urethral rupture as complete or partial has been made on the basis of acute retrograde Urethrogram 3. Herschorn etal. have questioned the accuracy of RGU after trauma in distinguishing complete partial injuries9 . A Complete rupture is diagnosed when there is contrast extravasation and by the absence of contrast medium in the Prostatic Urethra or Bladder. In acute trauma the external Sphincter and Pelvic floor spasm may prevent the entry of contrast medium into the prostatic Urethra or Bladder and hence most of the traumatic posterior Urethral injuries are diagnosed as complete ruptures based on RGUs. Thus in the SPC and delayed repair group 11 out of 12 patients were diagnosed as complete ruptures based on acute RGU, where as in primary realignment group all but one patient were diagnosed as complete rupture on acute RGU and in 10 out of 15 patients the mere passage of a Ureteric Catheter, Guide wire or infant feeding tube retrogradely or antegradely across the rupture site could successfully establish the continuity which indicates all these patients had partial injuries. Other realignment series also show the high incidence of partial ruptures as the diagnosis was made not just on the basis of RGU but additional diagnostic procedures are used such as Catheterization, cystoscopy and operative procedures . The above findings show that most of the cases of complete ruptures on RGU are in fact partial ruptures and if they are left alone by doing SPC, will go for complete obliteration requiring a major procedure later and hence if the patients general condition permits it is better to give an attempt of Catheteric realignment to prevent the partial injuries going for complete obliteration. Miguel. L. Pedesta etal12 have compared primary alignment with delayed Urethroplasty and found urethral alignment not beneficial in avoiding urethral obliteration. In 1972, Morehouse and colleagues 2 reported high impotence and incontinence rates in patients treated with primary realignment. Sender Herschorn etal9 have compared delayed Urethroplasty and primary realignment in the treatment of posterior Urethral rupture and noted a significant advantage with early catheterization. Ellrott and Barrett 5 analysed the long term results of treatment of posterior Urethral rupture with primary realignment in 57 men and showed that primary realignment resulted in low incidence of erectile dysfunction (21%) incontinence (3.7%) and stricture (34%) with no requirement for intervention . Mehdi Salehipour and colleagues 10 reported no incontinence with primary realignment, 76% having no Urethral Stricture on follow up with 24% developing Stricture requiring only dilation and VIU. 84% of patients reported a normal erection, while 16% responded to Sildinafil. The present series shows a Stricture rate of 91.6% for SPC group and 46.6% (7/15 patients) in realignment group. 10 (83%) out 12 patients with Strictures in SPC group required a major Urethroplasty later where as only (20%) 3 patients in realignment group required a major Urethroplasty. Other Stricture in realignment group were easily managed with visual internal Urethrotomy and Visual Dilatation. The incidence of impotence was similar in both the groups and there was no case of Incontinence in primary realignment group. While Suprapubic drainage with delayed repair has been the procedure of choice for long time, several disadvantages of the therapy have been recognized. Stricture developed in nearly all cases managed with delayed repair and these Strictures are dense with considerable length between disrupted ends 7. All patients required at least 1 major operative procedure to remove the Stricture, necessitating urological expertise usually at a tertiary care centre. Even after Urethroplasty Stricture may develop in 20 to 30% of the patients who needs further Surgery. Recent advances in Endourological techniques have led primary realignment methods that are easy to perform and require minimal manipulations 7. These techniques realign the Urethra without disturbing the Pelvic hematoma and produce shorter, more anatomically aligned strictures. The resultant Strictures are short and easily opened with Urethral dilatation or visual internal Urethrotomy 8. After realignment Stricture develops in 45 to 6 0% of patients 7, 9 although the majority requires only 1 endoscopic repair and most Strictures stabilize with in a year. When the results of delayed Urethroplasty are compared to those of primary realignment using recently developed endourological techniques, the complication rates are comparable. Hussman et al reported no significant difference in the rates of impotence and incontinence in patients treated with Endoscopic alignment versus those who underwent delayed Urethroplasty 4. Follis et al noted 80% potency rate in patients treated with primary realignment versus 50% in those treated with delayed Urethroplasty 7. There were no incontinent patients in the primary realignment group versus a 7% incidence in the delayed Urethroplasty group. Webster et al stated that the rates of impotence associated with primary open realignment in the past were probably a result of the severity of Pelvic disruption and not a consequence of the procedure 9. Conclusion We believe that most of the traumatic ruptures of urethra associated with fracture pelvis are in fact partial injuries even though they are diagnosed as complete ruptures on acute RGU and hence an attempt of catheteric realignment either by open procedure or by endoscopic procedure with in 2 weeks of injury will help in diagnosing most of these partial injuries. All these successfully stented partial injuries can be prevented from developing complete obliteration requiring a major Urethroplasty later. For patients with complete ruptures the primary realignment helps in stenting the urethra preventing the development of longer, malaligned complicated strictures .For these patients if Urethroplasty is required at a later date , it becomes a much simpler procedure . The incidence of impotence and incontinence are not affected by the method of acute management. References: 1. Mc Annich JW, Santucci RA Genito Urinary trauma, In: Walsch PC, Retik. AB, Vaughen ED Jr. et al.editors. Campbell’s Urology.8th ed. Philadelphia:WB Saunders:2002 P:3707-44 2. Morehouse, D.D., Belitsky, P. and Mackinnon, K; rupture of the posterior Urethra J.Urol.,107;255,1972. 3. Koraitim.MM. Pelvic fracture urethral injuries: the unresolved controversy. J.Urol, 1999:161:1433:41 4. Husmann, D.A.Wilson, T.D.Boore.T.B and Allen, T.D: Prostatomembranous urethral disruptions:management by Suprapubic cystostomy and delayed Urethroplasty, J.Urol.,144:76,1990 5. Elliot DS, Barrett DM. Long term follow up and evaluation of primary realignment of posterior urethral disruption. J.Urol.1997;153:814-6 6. Cohen,J.K., Berg.G.,Carl,G.h.andDiamond,D.D:primary endoscopic realignment following posterior urethral disruption.J.Urol.,146:1548,1991 7. Follis,H.W.,Kock, M.D. and Mc. Dougal, W.S: Immediate management of prostatomembranous urethral disruption. J.Urol.,147;1259,1992 8. James R.Porter, Thomas K.Takayama and Alfred J. Defalco,. Traumatic posterior urethral injury and early realignment using magnetic urethral catheters. J.Urol;158:425,1997 9. Herschorn, S., Thijissen, A. and Radowski, S.B: The value of immediate or early catheterization of the traumatized posterior urethra J.Urol.,148:1428,1992 10. Vladimir B.Moura viev,Michael Coburn and Ricard A. Santucci: The treatment of posterior urethral disruption associated with pelvic fracture.comparative experience of early realignment versus delayed Urethroplasty. J.Urol.,173:876,2005 11. Mehdi Salehipour, Abdolaziz Khezri, Rashid Askar, Parham Masoudi: Primary realignment of posterior urethral rupture.Urology.2005:2:211-215 12. Miguel.L.Pedesta, Ricardo Medel., Roberto Castera and Adolfo Ruarte: Immediate management of posterior urethral disruption due to pelvic fracture. Therapeutic alternatives. J.Urol.157:1444,1997

Multiple Sclerosis: Therapeutic Options Effectiveness

Multiple Sclerosis: Therapeutic Options Effectiveness Effectiveness and Controversies of Disease Modifying Treatments (DMTs) Pharmacists consider Type I Interferons (IFNs) a safe long-term treatment option for RRMS and they have widely used IFNs in the past two decades. The activity of Interferon-Beta (IFNB) is similar to that of the interferon produced by the body. Studies indicate that they have the ability to reduce the rate of relapse compared to placebos. However, based on comparisons of historical data, scientists also report that the ÃŽ ²-Interferons contribute significantly to the progression of multiple sclerosis (Buzzard, Broadley, Butzkueven, 2012). Incomplete recovery from MS episodes can lead to permanent disability, especially during the relapsing remitting stage of MS. Two types of interferon-beta occur and include Interferon beta-1a and non-glycosylated interferon beta-1b. Initially, medics used the type-1 Interferons for the treatment of the MS because of their antiviral nature. This was because of the tendency of viral infections to prompt the relapse of the disease (Compston Coles, 2002). One of the arguments toward the mechanism of the type 1 interferon revolves around the down regulation of the expression of the MCH class II antigens. However, researchers believe that other complex mechanisms are associated with the activity of the type-1 interferon. The side effects associated with the administration of the ÃŽ ²-Interferons are dependent the frequency, route, and dose of administration. Acyclovir can nullify the side effects before the treatment with the ÃŽ ²-Interferons (Buzzard, Broadley, Butzkueven, 2012). Another DMT approved for the treatment of RRMS is Glatiramer Acetate (GA). Initial experiments showed it suppressed MS in animals. Several clinical trials indicated that GA reduced the rate of relapse of the MS compared to the placebo and this led to its approval in 1996. Medics administer the polymer through a subcutaneous injection. Reports show that the route of administration reduces the number of parameters of the disease shown during MRI (Buzzard, Broadley, Butzkueven, 2012). Additionally, recent studies have reported a balance in the treatment of both GA and Interferon Beta. Since experiments show that GA lacks long-term side effects, significant in the progression of the MS, its use in the routine treatment of MS has been ongoing for over 15 years. Experiments show that the immunomodulatory activity of the GA improves the cells of the inborn and adaptive resistant system. In 2004, the FDA approved the use of Natalizumab for the treatment of RRMS. Natalizumab is a monoclonal antibody that directs its activity towards the ÃŽ ±-4 subunit of the integrin ÃŽ ±-4 beta 1 and the lymphocyte receptors of the ÃŽ ±-4 beta 7 lymphocytes (Buzzard, Broadley, Butzkueven, 2012). The drug blocks the interaction between the VCAM-1 ligand and the VLA-4 receptor by binding to the ÃŽ ±-4 integrin on lymphocytes. Prior to its approval, different clinical studies demonstrated remarkable activity on the relapse of MS. Of all the approved treatment, the FDA reports Natalizumab to be the most efficacious, though it has some side effects. Buzzard, Broadley, and Butzkueven, (2012) report that Progressive Multifocal Leukoencephalopathy (PML) occurs in over 200 patients treated with Natalizumab some of which have been fatal. Fingolimod is a drug administered orally. In 2004, the FDA approved it for the treatment of MS. The drug is a lysophospholipid original used in organ transplantation. Initially, medics used Fingolimod in combination with cyclosporine, but the drug was not efficacious in the prevention of organ rejection after renal transplant (Buzzard, Broadley, Butzkueven, 2012). Despite this setback, clinical trials conducted later demonstrated that it reduced the progression of MS. Since the route of administering the drug is oral, it has an advantage over all the agents administered through an injection. The activity of the Fingolimod occurs through the interaction with G-protein-coupled sphingosine-1-phosphate receptors. However, no study has been done to prove the immunomodulation activity of the drug. Alemtuzumab is another monoclonal antibody whose activity gears toward CD52, found on the surface of natural killer cells, and B and T lymphocytes (Azzopardi Coles, 2011). The CD52 also exists in some dendritic cells and monocytes. In addition, the Alemtuzumab is involved in the lysis of cells that express the CD52. One of the clinical trials that researched on the activity of the agent on MS patients was the CARE-MS 1 study and the researchers compared the activity to ÃŽ ¼g beta-IFN. The scientists reported a reduction in the occurrence of RRMS at the rate of 54% (Cross Naismith, 2013). The CARE-MS II study compared the agent with beta-IFN 1a in relapsed patients and reported a reduction in the rate or relapse (49%). However, the drug was reported to have adverse side effects in the two different clinical trials. The side effects reported ranged from mildly to moderately severe and the most common was the development of secondary autoimmune diseases. Additionally, scientists repor ted cases of thyroid carcinoma in the CARE-MS 1 trial. As the result of the increased interest in the use of oral therapy, in an effort to improve the compliance of the MS patients, medics are using a number of emerging agents as DMTs (Buzzard, Broadley, Butzkueven, 2012). Fumaric acid is one of the emerging agents. It is administered as Dimethyl Fumarate, which is a product of the citric cycle. Medics have used Dimethyl Fumarate for many decades in the treatment of Psoriasis, especially in Germany. Studies have suggested that the agent is effective against pro inflammatory mediators, such as adhesion factors, cytokines, and chemokine in MS. Its activity is directed toward reducing NF-ÃŽÅ¡b activity and thus reducing the expressions of molecules that cause inflammation. The progression of the MS is associated with damage to cells in the central nervous system and researchers report that Fumaric acid esters offers protection against damage to these cells. Several clinical trials have used BG-12, which is a derivative of the Fumaric acid as it contains DMF. Researchers report a reduction in the rate of relapse. Lastly, medics have used other emerging agents as DMTs for MS that include Teriflunomide, Laquinimod, Alemtuzamab, Daclizumab, and B-Cell therapies. Effectiveness and Controversies of Symptomatic Treatments A collective symptom reported in patients with MS is fatigue. According to Kaminska, Kimoff, Schwartzman, and Trojan (2013), there has been an inconsistent finding in the correlation between fatigue and the extent of disability. The Expanded Disability Status Scale (EDSS) measures the physical fatigue attributed to physical impairment. Depression and pain in the MS patient is also considered an indicator of the level of fatigue in the patients. The treatment used for the management of the fatigue is non-pharmacologically based CBT therapy. In addition, medics have used drugs, such as amantadine, modafinil, and pemoline in the management of the fatigue. However, the presence of undiagnosed sleep disturbance disorders is one of the confounding factors reported in testing the efficacy of these drugs. Other non-pharmacological treatments involve energy-conservation techniques and exercise, such as pacing and spacing activities (Ben-Zacharia, 2011). In cases where medics use pharmacologic al interventions in fatigued MS patients, the tolerance levels and effectiveness should determine the doses. Although walking impairment occurs gradually in patients with MS, it may be characterized with a gradual onset in some patients (Ben-Zacharia, 2011). This affects the patients balance and gait and could have emotional effect on the patients. Medics administer Dalfampridine (Ampyra) to patients with walking impairments but it is contraindicative in patients with history of renal diseases and seizures. Its activity acts toward the repair of damaged nerves as it acts as a blocker for the potassium channel and medics administer it orally. The recommended dosage for the drug is one tablet (10 mg) taken two times in day. Moreover, in two randomized controlled trials, the conclusions made by the researchers were that the dosage of 10 mg taken twice a day improved the walking speed of MS patients. However, the drug has side effects that include dizziness, nausea and nervousness (Patti, et al., 2009). The occurrence of tremors and ataxia occurs in patients with MS and the treatment is challenging. Medics manage Ataxia through rehabilitation or pharmacology through the administration of Levetiracetam, Clonazepam, Topiramate, Propranolol, and Clonazepam. Researchers report the medications to have modest effects on the Ataxia. In addition, surgical interventions that involve deep brain stimulation have been reported to be effective in some patients (Ben-Zacharia, 2011). Spasticity occurs in patients with MS and it is dependent on the increase in velocity of the muscle tissues, because of increase in tone and rigidity of the motor pathway. The symptom occurs in about 75 % of the MS patients and medics can manage it through conservative techniques or drugs; either injected into the patient or administered orally (Pappalardo, Castiglione, Restivo, Calabrese, Cimino, Patti, 2006). The conservative methods involve bracing, casting, and stretching exercises (Mori, et al., 2011). Baclofen and tizanidine are the most common form of first line treatment for spasticity but are associated with side effects, such as weakness and sedation (Rizzo, Hadjimichael, Preiningerova, Vollmer, 2004). The second and third line treatments used for spasticity include dantrolene, gabapentin, and benzodiazepines. Another common system in MS is pain and it is usually because of the loss of inhibitory pathways in the spine. Demyelination or axonal loss cause acute pain in the MS patients while bladder spasms and vertebral compression cause sub-acute pain. The drugs used for the management of pain include gabapentin, pregabalin, antiepileptics and carbamazepine and they are first line treatment forms for neuropathic pains (Ben-Zacharia, 2011). Cannabinoids are also efficient in pain management and medics use them to manage spinal injury and spasticity (Pertwee, 2002). Clinical depression affects about 50% of MS patients and the available treatments regimes include serotonin, norepinephrine, and dopamine reuptake inhibitors, which are all anti-depressants (Ben-Zacharia, 2011). Pseudo Bulbar Affect (PBA) is a neurologic disorder that presents with symptoms such as laughing and crying and researchers report it in about 10% of the patients. The management of PBA involves the administration of quinidine sulfate, and dextromethorphan hydrobromide (Ben-Zacharia, 2011). Cognitive dysfunction occurs in 50% of MS patients and it affects the speed at which the patient processes information, losses memory and vision, reduces verbal fluent, and reduces the attention span (Patti, et al., 2009). Researchers have tested Acetylcholinesterase in MS patients with promising results. However, a recent clinical trial disputed the efficacy of the drug. The FDA has approved other drugs, such as memantine and rivastigmine for use on Alzheimer’s patients but not MS. The conservative management of this dysfunction involves use of methods that retrain and improve on the memory and visual ability of the patients. Conclusion Current Research Strength For over two decades, researchers have conducted research on MS and the available treatments. However, even with all the research the currently available treatments have been unable to reduce the occurrence of symptoms in all the patients. The immunopathogenic factors in different patients determine their responses to the different treatments. Research conducted on the current forms of treatment shows that immunopathogenic factors have varying and unexpected results in different patients. Researchers have also been unable to determine the exact mechanisms that affect the disease process of MS. Additionally, several studies done regarding the disease reported disparities between clinical trials and animal models. Researchers agree that no single intervention is effective for halting the disease or reversing the effects of axonal degeneration and demyelination. This is an indicator that more research about MS is still in need to establish the mechanisms associated with the progression. Future Perspective Although there has been progress in research on the pathological, clinical and treatment of MS, some aspects remain unsolved. Researchers have based current research on the effort to repair the damage caused by the MS. Future researchers should aim at determining the treatments intended at healing the disease or reversing the disability attributed to MS. References Azzopardi, L., Coles, A. (2011). Alemtuzumab in multiple sclerosis. Archives of Neuropsychiatry, 48 (2), 79-82. Ben-Zacharia, A. B. (2011). Therapeutics for multiple sclerosis symptoms. Mount Sinai Journal of Medicine, 78 (2), 176–191. Buzzard, K. A., Broadley, S. A., Butzkueven, H. (2012). What do effective treatments for multiple sclerosis tell us about the molecular mechanisms involved in pathogenesis? International Journal of Molecular Science, 13 (10), 12665-12709. Compston, A., Coles, A. (2002). Multiple sclerosis. The Lancet, 359(9648), 1221–1231. Cross, A. H., Naismith, R. T. (2013). Established and novel disease-modifying treatments in multiple sclerosis. Wiley, 1-19. Kaminska, M., Kimoff, R. J., Schwartzman, K., Trojan, D. A. (2013). Association between sleep disorders and fatigue in multiple sclerosis. CML Multiple Sclerosis, 5 (2), 29-38. McQualter, J. L., Bernard, C. C. (2007). Multiple sclerosis: a battle between destruction and repair. Journal of Neurochemistry, 100(2), 295–306. Mori, F., Ljoka, C., Magni, E., Codeca, C., Kusayanagi, H., Monteleone, F., Centonze, D. (2011). Transcranial magnetic stimulation primes the effects of exercise therapy in multiple sclerosis. Journal of Neurology, 258 (7), 1281–1287. Pappalardo, A., Castiglione, A., Restivo, D. A., Calabrese, A., Cimino, V., Patti, F. (2006). Pharmacologic management of spasticity in multiple sclerosis. Neurologic Science, 27 (4), S310–S315. Patti, F., Amato, M. P., Trojano, M., Bastianello, S., Tola, M. R., Goretti, B., Luccichenti, G. (2009). Cognitive impairment and its relation with disease measure in mildly disabled patients with relapsing–remitting multiple sclerosis: baseline results from the Cognitive Impairment in Multiple Sclerosis. Multiple Sclerosis, 15 (7), 779–788. Pertwee, R. G. (2002). Cannabinoids and multiple sclerosis. Pharmacology and Therapeutics, 95 (2), 165– 174. Rizzo, M. A., Hadjimichael, O. C., Preiningerova, J., Vollmer, T. L. (2004). Prevalence and treatment of spasticity reported by multiple sclerosis patients. Multiple Sclerosis, 10 (2), 589-595.

Whats at Stake in The Graduate :: Movie Film comparison compare contrast

What's at Stake in The Graduate    Every time somebody rents a video or watches a movie on television there is always that little blurb right before they begin viewing about the picture being formatted for the screen. Usually, it is ignored or merely taken as a cue that the film is about to start. That little forewarning actually holds a lot of significance, for when one views a movie in its original, wide screen version, a whole new world opens up. When a movie is altered from its initial state, and cropped in the editing room for home viewing, an overwhelming amount of the film is unsuspectingly missed. This has become extremely obvious when viewing any movie, and in The Graduate a lot of innovative things are adjusted and lost. There are various shots edited, cut off, and many dynamic camera techniques lose their effect when The Graduate is transformed from the intended wide screen version to the formatted television edition. Edits are a very apparent change in The Graduate when one witnesses the wide screen version compared to the cropped format. For example, in one of the beginning scenes, when Mrs. Robinson is asking Ben for a ride home, she casually tosses his keys into the fish tank behind him. In the letter boxed edition, the viewer is able to see her deliberately throw the keys over Ben's shoulder and into the fish tank in one single shot, thereby watching Ben actually follow the arc of the keys' path, and their decent into the water. In the formatted version there is an edit, splitting the two characters into different shots. All the viewer sees is a medium shot of Mrs. Robinson throwing the key, then an immediate medium shot of Ben turning around and then all of a sudden the keys are floating in the tank. The viewer does not see the obvious attempt of the throw, the actual flight of the keys, nor Ben's reaction to it, therefore missing the important effect that reveals Mrs. Robinson's immediate c ontrol over Ben. Another example is in the scene at the Robinson's house, immediately following Mrs. Robinson's seduction as Ben is talking with Mr. Robinson. The two of them are talking in the foreground, when Mrs. Robinson is finally seen descending the stairs. In wide screen, Mrs. Robinson is shot walking in the distance right between Ben and Mr.

Contradicting Character of The Sniper Essay -- The Sniper

Contradicting Character of The Sniper In this Irish war we have two sides, but this can also be reflected in the two sides within the Sniper himself. The Sniper seems experienced yet amateur, cold yet emotional, lusting for war yet hating it, self-assured yet vulnerable, and clear-minded yet mad; he is a living contradiction. The Sniper exhibits qualities that are both experienced and amateur. O’Flaherty describes the Sniper as â€Å"a man who is used to looking at death†, from which we can infer that the sniper has seen many deaths, since a person who is exposed frequently to death gradually grows senseless to it. In the passage, â€Å"There was a flash and a bullet whizzed over his head. He dropped immediately.†, we can tell from the â€Å"dropped immediately† that the sniper has exceedingly quick reflexes, something usually apparent in those who are experienced in the techniques of war. By contrast, the Sniper also possesses many traits of an amateur soldier. He is described as having â€Å"the face of a student†, and had been fasting because â€Å"he was too excited to eat†. The word â€Å"student† has the connotation of one who is young, inexperienced, and still learning, while his excitement implies that this fighting was new to him, because most people tend to be excited at new experiences.   Furthermore, when passage states that as he heard the enemy car draw nearer â€Å"his heart beat faster†, which is another portrayal of his eagerness and desire to fight. Thus we see a disparity in the Sniper’s character, which is both experienced and amateur. Another contradiction with the Sniper is that he is both apathetic and emotional. O’Flaherty described his eyes as having a â€Å"cold gleam†, and â€Å"cold† has the connotation of lacking feeling. In the scen... ...his mental strain grows as in the midst of anger he â€Å"laughs†, although he has no reason to laugh what we picture as a maniacal laugh. Moreover, the sniper was drunk: â€Å"Taking the flask from his pocket, he emptied it at a draught. He felt reckless under the influence of the spirit†. The feeling of recklessness combines with his already crazy state of maniacal laughing to portray a sniper that has gone quite mad. In conclusion, the Sniper is, interestingly, a complete contradiction in himself. He is both experienced and amateur, cold and emotional, lusting after war and hating it, self-assured and vulnerable, and logical and mad. This stark paradox may create much of the inner conflict that goes on within the Sniper, and also reflects the outer conflict of the Irish war- a war where both sides are essentially opposing parts of the same whole.         

Jean Toomer Biography Essay

Jean Toomer was born as Nathan Eugene Pinchback Toomer on December 26, 1884 in Washington, D.C. His father was a wealthy farmer, who was originally born into slavery in Georgia. Nina Pinchback was also of mixed descent. Jean’s father abandoned his family when he son was an infant, so he and his mother lived with her parents. As a child in Washington, Toomer attended all-black schools. After his mother remarried, they moved to New Rochelle, New York, and he attended an all-white school. After his mother’s death, Jean returned to Washington to live with his grandparents. He graduated from an academic black high school. By his early adult years, he refused to be segregated and wanted to be identified only as an American. Between 1914 and 1917 Jean Toomer attended the University of Wisconsin, the Massachusetts College of Agriculture, the American College of Physical Training in Chicago, the University of Chicago, New York University, and the City College of New York. He majored in agriculture, fitness, biology, sociology, and history but he never completed a degree. After leaving college, Jean published some short stories and continued writing after World War I. In 1923, Toomer returned to New York where he became friends with Waldo Frank, who became his mentor and editor on his novel Cane. In 1923, he published the novel Cane, in which he used material inspired by his time in Georgia. Below is an excerpt from his novel, Cane. â€Å"whisper of yellow globes gleaming on lamp posts that sway like bootleg licker drinkers in the fog and let your breath be moist against me like bright beads on yellow globes telephone the power-house that the main wires are insulate (her words play up and down dewy corridors of billboards) then with your tongue remove the tape and press your lips to mine till they are incandescent† ReadingWoman.com states, â€Å"Cane is one of the works of fiction that announced the arrival of the Harlem Renaissance. Though a slim volume, this collection of sketches, stories and poems makes up a dense and powerful book. Through vivid imagery and authentic dialects, Jean Toomer realistically portrays the lives and experiences of African-Americans, from the Southern peasant to the urban black in the North. Neither glorified nor stereotyped, Toomer’s characters speak in their own voices and are completely themselves, their behavior reflecting the truth about who and what they are. Cane compels the reader to feel its power on a physical level. At the time the book was published, and still today, these full, rich characters and images lead us to a greater understanding of the human condition.† He stopped writing literary works in 1950. Jean Toomer died on March 30, 1967 in Doylestown, PA after years of poor health. Works Cited â€Å"Jean Toomer – ENotes.com Reference.† Enotes.com. Enotes.com. Web. 02 Apr. 2012. . â€Å"Writers of the Harlem Renaissance – Book Reviews.† Great Books for You to Read. Web. 02 Apr. 2012. . â€Å"Jean Toomer Biography.† Department of Mathematics, University at Buffalo. Web. 02 Apr. 2012. .

Introduction to Ethics & Social

Medicine at Tufts University, wrote a version of the oath that talks about how a doctor should care for the sick with compassion, humanely, and says nothing about working to get rich off of those who are suffering (Lasagna, 1964). In the United States, there should not be anyone who cannot see a doctor because they are poor; a doctor takes an oath to heal the sick wherever he can, not to heal the sick only if they are rich. If being alive is an inalienable right, as documented by the Declaration of Independence, would it not be common sense that healthcare would also be a right rather than a privilege?The United States is the only wealthy, industrialized nation that does not make sure that all of its citizens receive proper health coverage. In 2004 lack of coverage is estimated to have caused 18,000 deaths that have been considered unnecessary (loom. Due, 2004). It is common knowledge that if a parent has an extremely ill child, and refuses to take that child to the doctor, the paren t can be charged with neglect. If the child is the healthy one, and her single father is diagnosed with cancer, who will be charged with neglect when he dies for no other reason than he doesn't have insurance?Could you imagine being so desperate for health care that you were willing to commit a federal crime in the hopes of going to prison to get the care you need? Richard James Vernon handed a teller in an ROB Bank in Gaston, N. C. A note, claiming he had a gun but was unarmed (Mousse, 2011). Mr.. Vernon, who had a growth in his chest, two ruptured disks, and no Job said that he asked for only one dollar. He wanted to show that his motives were medical, and not about the money (Mousse, 2011). The charge he was booked on was Larceny and would not give him the prison stay he hoped to get in order to get the treatment he desperately wanted.In a country as wealthy as the United States, why should any citizen even be tempted to do such a thing? It is terrible that a person who was law-a biding beforehand would have to become a criminal in order to save his life. Should health care be something that should only be available to the highest bidder? In 2005 the per-capita health care spending reached $6797, this is 40% higher than any other nation with health care outcomes ranking 37th according to the World Health Organization (Beebe, 2009).Between 2003 and 2007, the combined profits of the largest insurance impasses rose by over 170%, which left their approval rating lower that tobacco companies. This was the resulted as worker's out-of-pocket spending for health care shot into the atmosphere 87% since 2000 (Beebe, 2009). It is estimated that 47 million Americans lived without insurance before our economy fell apart and unemployment's rise did nothing but add to those numbers (Beebe, 2009).It is estimated that half of all personal bankruptcies stem from drowning in the expenses of medical care, and in 76% of those cases, it was the main income that had insurance cove rage for the family (Beebe, 2009). Could there really be a better example that something needs to be done than what Mr.. Vernon did Just to get healthcare? Ethnologists of ethics don't look at the consequences of actions before coming up with an idea. One way they might see the healthcare debate could be that healthcare should be a personal responsibility. It could be argued that healthcare is something is a personal responsibility.It is up to the individual or family to make sure that they have the coverage that they need. A Ethnologist might say that by the government ensuring that there is healthcare available for people, it s government interference into people's affairs. If people want health insurance, than they can but it, or become employed at a Job that provides healthcare. However, when healthcare costs are so high that they are choking on the gases in Supplier's atmosphere, those who may wish to have a family doctor so they can get regular checkups yet cannot afford it.Lo oking at it from a utilitarian point of view, the majority of the public would benefit from healthcare being available for all. For example, a hospital in Costa Mesa, California, dumped Steven Davis in skid row at the New Image Shelter in 2008. The thirty-two year old man was diagnosed as schizophrenic and was considered to be dangerously delusional and paranoid (LA times, 2009). Not only did Mr.. Davis need care and medication, the hospital dumping him on the street could have turned out to be dangerous for someone else. Sadly, his is not the only case in which a hospital negligently dumped a patient for not having insurance.James Booking, a veteran of this country, was dumped in the parking lot of a shelter in California by the Department of Veteran Affairs medical center after his toe was removed due to a bone infection. He was wearing hospital pants, carrying urine bottle, and screaming for help from the wheelchair he was sitting in (Winston According to the 2006 Human Developme nt Report, the life & saves, 2011). Expectancy of someone living in the United Kingdom is 78. 5, France is 79. 5, Canadians can expect 80. 2, with the American expecting around 77. 5 (Watkins, 2006).The only major difference between these countries is that all but one ensures that their citizens have healthcare. The only one would be America that doesn't. Common sense should indicate that if we as Americans had access to preventative care, we might be able to save some change in our pockets by avoiding costly ERE In 2004, retiring representative Billy Taught of Louisiana stepped down visits. Early with the intention of taking a Job as the new president and CEO of the drug industry top lobbying group, Pharmaceutical Research and Manufacturers of America (Welch, 2004).According to watchdog groups such as the Center fro Responsive Politics, prior to this event, Taught received $218,000 in campaign contributions from those in the pharmaceutical industry with contributions reaching $91 , 500 for 2002 which was the year he first became chairman of the committee with jurisdiction over the drug industry (Welch, 2004). There have been so many arguments over the separation of church and state, how about we start the argument over the separation of corporations and the state? In Cuba, 75% of the people are feeling positive regarding their education and healthcare systems (Worldpublicopinion. Rig, 2011). While many may not be so happy with their individual freedoms, they are happy with the fact that they can be seen by a doctor when they feel like it, considering their healthcare is universal. If a dictatorship which our government sees as an enemy will ensure that its citizens have healthcare, what goes that say about the government of a free country like ours? Should a woman be forced to choose between buying groceries and paying for her prescription medications in the United States? In a personal interview, Melissa Tearful shared her story about how she lost her health insurance, Just when she needed it the most.In 2006 she was diagnosed as having bipolar depression and post- traumatic stress syndrome. She started going to therapy once a week and got on medication which she said greatly improved her situation. â€Å"It was unbelievable, the difference I felt after I got on the right medications. It was like a weight had been lifted off of my shoulders. For the first time in years I was able to think clearly' (M. Tearful, personal interview September 21, 2011). She was on state health insurance and was kicked off of it because of a political decision by former Governor Blunt.Previously, single mothers were allowed to get state health insurance until their child became 18, but a recent bill passed saying that after the child turned one, the mother would lose the insurance. This meant more money for the state of Missouri, but it also meant that single mothers like Melissa were left without healthcare. She stated that she tried to apply for disabilit y insurance so that she could continue with her therapy and medications, but was rejected. Because she was able to maintain a Job, she was not considered eligible for any assistance. L felt like I was being punished for actually trying to better myself. You hear all the time how people with the same condition I have are not able to hold down a Job, or care for their kids, but because I am trying and making it, I cannot get any help. † (M. Tearful, personal interview, September 21 , 2011). Soon after losing her healthcare, she had to abandon both the medications and the therapy. Melissa stated that it was very difficult going off of the medications â€Å"cold turkey. † She shared that it was a very emotion-filled time for her.According to Melissa, her moods fluctuated frequently and she experienced many panic attacks in the first months afterwards. She said that as time went on, it became easier for her to cope, but that there are times when it is extremely difficult. Me lissa stated that she â€Å"can handle herself when she is manic by keeping herself busy, but when I am depressed, I can't think straight. Right and wrong sometimes go out the window when I get really into that state. It's like what ever feels good at the time seems so logical† (M. Tearful, personal interview, September 21, 2011).We tell our children that money is not everything, but yet when it comes down to the choice of more money or the well-being of a human, more often than not it is the money that wins out. Melissa Tearful went on to share with me the story of her coworker of seven years, Bruce Patterson. According to Ms. Tearful, Mr.. Patterson has been on high-blood pressure medicine for quite sometime, but when his hours got cut at work, he had to make some drastic changes n his lifestyle to be able to stay on his pills. Just to stay on the medicine that he very much needs, he stopped paying his electric bill for months in his trailer.Melissa said that it was during the winter of this year when he lost power for his home and would do things like stay at his Job at Burger King for many hours after his shift, sometimes even napping at the store in order to sleep some place warm (M. Tearful, personal interview, September 2, 2011). Via electronic communication Ms. Patti Hollies shared her sister's story of how she was left in pain because of lack of healthcare overage. According to Ms. Hollies, her sister had been experiencing pain in her leg and hip so she went to the ERE in Gerard, Ohio.The doctors did a CAT scan, which revealed nothing that would cause her to be in so much pain. They gave her a shot and sent her home. Over the next days she her condition did not improve, even after going to the ERE three more times. Because she had no insurance, the doctors refused to continue to seek out the cause of her condition. Her sister then brought her to SST. Elizabeth Free Medical Clinic in a wheelchair because, by this time, her sister was not blew to walk. Here X-rays were conducted, which also revealed nothing, so her sister was told that there was nothing more that they would do.She asked if maybe and MR. would help, but the nurse practitioner refused to order that test. Seeing her sister crying in pain, and knowing they were running out of options, she placed a phone call her own doctor (P. Hollies, electronic communication, September 26, 2011). This doctor recommended her sister be taken to the ERE in SST. Elizabethan Clinic by ambulance. She followed her doctor's advice, and her sister was admitted into the hospital. After getting an MR., her sister learned she had a herniated disc and had to have surgery. They also learned that she was diabetic.Once the surgery was performed, the pain went away and was doing very well. However, even after diagnosing her with having diabetes and prescribing her insulin, at no point was she taught how to take the medicine. A phone call was placed to the director of the hospital about the po or treatment her sister received at SST. Elizabethan and she was assured that her sister would be taken care of. It is the firm belief of Ms. Hollies that her sister's suffering was totally unnecessary. Had her sister had health insurance, she believes that the doctors would have been much more inclined to order tests.