Antiretroviral Therapy Essay

There is no other field of medicine that has been through such dramatic developments as that of antiretroviral therapy. In September 1995, the results of Eurpean-Australian DELTA study, and the American ACTG pointed out that two nucleoside analogues were more effective than monotherapy. This led to the belief, thatlonger survival was possible in HIV. Protease inhibitors (PIs) came about in 1995, and in June 1996, the first non-nucleoside reverse transcriptase inhibitor (NNRTI) neviparine arrived, and so did Nelfinavir which was a new PIs. This led to the start of HAART (Highly Active Anti-Retroviral Therapy). Antiretroviral drugs have been divided into a number of groups on the basis of the phase of the retrovirus life-cycle that the drug inhibits. 1  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Nucleoside & nucleotide reverse transcriptase inhibitors (NRTI) inhibit reverse transcription by incorporating   into the newly synthesized viral DNA and slowing its elongation. Apricitabine (AVX-754) is a heterocyclic cytidine analog, which may enter the market in 2009. Elvucitabine   is currently in phase II trials. Stampidine is 100 times more potent than AZT and has potential role against HIV mutants 2  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Non-nucleoside reverse transcriptase inhibitors (nNRTI) inhibit reverse transcriptase directly by binding to the enzyme and not allowing its function. Efavirenz has been the agent that has been most successful, but is facing lot of viral resistance. Rilpivarine has a long half life of 40 hours. 3  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Protease inhibitors (PIs) target viral architecture by inhibiting the activity of protease, an enzyme used by the virus to form new virons from the older protein framework. PL-100 is given as a prodrug and is active against multi PIs resistant strains. It has a long half life of 37 hours, and can act as a co-drug. 4  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Integrase inhibitors inhibit the enzyme integrase, (integrates   viral DNA into   DNA of the infected cell). Raltegravir became the first to receive FDA approval in October 2007. it is   the most exciting of all anti HIV agents in the market. It acts against HIV-2 also. Elvitegasir has a potential as monotherapy. 5  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Entry inhibitors (or fusion inhibitors) prevent the   binding, fusion and entry of HIV-1 virus into the host cell. It acts via the gp 120 envelope protein to the CD 4 receptor. Maraviroc and enfuvirtide are marketed agents of this group. 6  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Maturation inhibitors- inhibit the last step in gag processing in which the viral capsid polyprotein is cleaved, thereby blocking the conversion of the polyprotein into the mature capsid protein (p24). These virons are thus incomplete and thus uninfective.   Two drugs in this group   are under investigation, bevirimat,`and Viveconâ„ ¢. Immunotherapy. IL-2 is a cytokine from the activated T – cells, which induces proliferation in T, B, and NK cells. It causes an increase in CD 4 and CD 8 cells. It is useful in patients with poor immunological response to antiretroviral therapy to stimulate the immune system. G-CSF, GM CSF are used for treatment of prolonged neutropenia in patients with advanced HIV infection to reduce bacterial infection. Why is treatment of HIV difficult ? The retrovirus has an extremely short life span, as short as 1 ½days. In addition the protective enzymes which prevent mutation in RNA to DNA conversion via reverse transcriptase in absent in the virus. Thus the virus mutates very rapidly, and produces many genotypes, some of which escape the cytotoxic effect of the antiretroviral drugs and proliferate. When the antiretrovirals are combined, the number of genotypically active virons is low, and so combinations are a must, as no single agent has been shown to suppress virus for long. Fixed dose combinations A major change in the therapy today has been the advent of fixed doses combinations. Earlier patients had to take larger number of tablets per day, but now combinations of these complex regimens are available in single tablets, which increases the compliance of patients, thus reducing chances of treatment failure. Current treatment guidelines for HAART The status of ‘hit hard, hit early’ approach which was recomneded earlier has now changed. Some clinicians use the 350 and 500 CD4+ T cells/mm ³ levels to initiate treatment, but this needs individualization. Today it is recommended that HIV patients should start ART after confirmation of the HIV disease and the presence of Clinically advanced HIV disease – WHO Stage IV HIV disease, irrespective of the CD4 cell count; WHO Stage III disease with consideration of using CD4 cell counts less than 350/ µl to assist decision making; WHO Stage I or II HIV disease with CD4 cell counts less than 200/ µl. the guidelines for adults and adolescents for the USA are set by the United States Department of Health and Human Services (DHHS). In this all patients with history of an AIDS-defining illness or severe symptoms of HIV infection regardless of CD4+ T cell count receive ART. Antiretroviral therapy is also recommended for asymptomatic patients with less than 200 CD4+ T cells/ µl. Asymptomatic patients with CD4+ T cell counts of 201–350 cells/ µl should be offered treatment. For asymptomatic patients with CD4+ T cell of greater than 350 cells/ µl and plasma HIV RNA greater than 100,000 copies/ml, most experienced clinicians defer therapy but some clinicians may consider initiating treatment. Therapy should be deferred for patients with CD4+ T cell counts of greater than 350 cells/ µl and plasma HIV RNA less than 100,000 copies/mL. Treatment regimes Important aspects are that the first regimen offers the best chance to the patient, meaning that the viral load must be below detectable level within 3-6 months of treatment initiation. The combination used initially consist of two nucleoside analogs plus a PI or either a NNRTI. A regimen containing an NNRTI is often the regimen of choice for initial antiretroviral treatment when adherence is expected to be good because of convenience, superior virological suppression, lower rates of toxic effects, and fewer interactions between drugs than with boosted protease inhibitor regimens Thus various acceptable regimens are (Wikipedia) two NRTI’S + One NNRTI two NRTI’s + PI. For initial regimens that include a protease inhibitor, those that are ritonavir boosted are recommended because of the improvement in protease inhibitor pharmacokinetics and potency Threre NRTI ( referred to as triple nukes) once daily combinations – like emtriva. This regimen needs strict compliance, as if one dose is forgotten, then that days therapy is lost The preferred initial regimens are (Department of Health and Human Services) 1  Ã‚  Ã‚   efavirenz + zidovudine + lamivudine 2  Ã‚  Ã‚   efavirenz + tenofovir + emtricitabine 3  Ã‚  Ã‚   lopinavir boosted with ritonavir + zidovudine + lamivudine 4  Ã‚  Ã‚   lopinavir boosted with ritonavir + tenofovir + emtricitabine Referance Cahn P, Cassetti I Wood R etal. Efficacy and tolerability of 10 day monotherapy with apricitabine in antiretroviral naà ¯ve, HIV infected patients. AIDS 2006, 20:1262-8. Department of Health and Human Services (August, 2006). HIV and Its Treatment: What You Should Know. Accessed on 31 mar, 2008 United States Department of Health and Human Services (2004). A Guide to Primary Care for People With HIV/AIDS, 2004 Edition Antiretroviral drug – Wikipedia, the free encyclopedia – en.wikipedia.org/wiki/Antiretroviral_drug HAART, HIV Treatment HIV Medicine 2007, 15th edition. Hoffman C, Rockstroh JK, Kamps BS. Flying Publishers. HIV Therapy: Highly active antiretroviral therapy (HAART)

Book Review: Gone Girl

The deception and Lies, that were motivated by the secrets that Amy and Nick were hiding, are what led to the demise of their marriage. The Sir Walter Scott quote â€Å"O what a tangled web we weave when first we practice to deceive† is a perfect way to sum up this story. Amy creates the ultimate act of deception In the novel when she tries to frame Nick for her murder, that she fakes. Amy decides to frame Nick after she learns that he has been having a secret affair. Once Amy is on the run, because she faked her murder, the tables of deception turn n her when she is robbed by two people she befriended while she was hiding out.Amy flips the tables back on a man she had been deceiving since high school, Despond. Despond is blind to Amoy's deception because he loves her and he loves to help women with issues. Amy uses Despond for his money and a new hideout and he willingly gives it to her. She tells Despond these horrific stories of Nick and paints him out to be this abusive mo nster that she Is fleeing from. Little does Despond know that Amy has also painted this same facade for him, she tells her parents and Nick that Despond is this creepy ex and that he tried to kill himself over her when they were back in high school.Amy is then forced to live up to Deacon's ideals of a perfect women when he has her stay with him and he restricts what she's eating and tries to get her to be loving and affectionate with him. While Despond thinks he Is In control, It Is really Amy who has the cards In her hand. She eventually ends up betraying Despond when she murders him and runs back to Nick. She paints yet another picture of Despond as this monster who was holding her hostage and she fled from. Amy is constantly deceiving everyone in the story, she even ends up getting screwed over herself because of all the lies.Amy gets the true final say, in the story, when she finally traps Nick by Impregnating herself with his old sperm she had saved which forces Nick to stay In this loveless marriage. Had Amy not lied and deceived Nick numerous times she might have been able to save her marriage but she is so used to being deceitful that I don't think she even realizes that just being truthful might have been the easier route to take. â€Å"You can put a face behind a mask but be careful because someone else might be retesting. † is a warning that Nick needed.Nick is a man who is betrayed many times In this story. Initially you almost feel sympathy towards him until you learn of his Infidelity. For Nick he never realized all these deceitful things Amy was doing Amy and then the public causes him to lie to his sister and many more people. Nick and Amy are very self absorbed and because Nick is so self absorbed throughout the entire book he ultimately never sees any of the lies Amy tells him. He also ends up flipping the tables on Amy when he gives these interviews depicting a husband who till loves his wife and Just wants her to return safely.Amy fa lls for it because that is all she wanted in the first place, for him to need her and miss her and want her. Amoy's return is what makes Nick believe that he will be freed from this marriage but it ultimately is what causes him to become trapped in the marriage. Nick is so consumed with screwing over Amy as bad as she did to him that he never realizes that Amy is always two steps ahead of him. While he pretends to be this loving husband in the beginning he is really cheating on Amy, and Amy is planning on ramming him for her murder because of the infidelity.While Amy is deciding on her next move after she's in hiding, Nick pretends to be this loving husband who misses his wife to get her to come back. When Amy comes back and realizes Nicks true intentions, to try and get her to confess to Deacon's murder, she pretends to be completely oblivious to it so she can trap Nick in their marriage. The characters almost play a game of cat and mouse throughout the whole story. They are consta ntly trying to get over on each other and in the end it may seem likeAmy wins but the truth is there were so many lies and so much deceit that happened that no one really ever got what they wanted. Nick will never love Amy and ironically he grew to hate her more when she came home then before she left. The sad thing is that Amy thinks that Nick will Just learn to accept the fact that he is trapped and learn to love her again once the baby is here but he will only end up resenting her even more because of the fact that he is trapped. While these lies were created to save and protect a marriage, they only ended up destroying it and that is the true irony of the story.

Elaboration Theory in Learning Psychology Essay

The concept of elaboration theory centers greatly on progressive learning. That is, the steps in learning are built upon each other in a series of increasingly complex steps. In other words, rather than plateau the learning progress, it increases in complexity as time goes on. However, what was learned in the earlier portion of the progression is not discarded. So, the concept of elaboration can be visualized as an upside down pyramid. It starts at a small point and expands. However, the progression is always connected to its origination point. An example of this is as follows: a student is taught basic sentence structure. Then, the basics of sentence structure are expanded into the proper way to devise a paragraph. This later extends further as the students is taught to the create a series of paragraphs that form a coherent essay. An essay can later be expanded into a lengthy research paper. Really, there is no limit to the progression as long as it never deviates from the origination point of proper grammar and structure. Why theorists recommend that learners elaborate as much as possible. Many theorists believe that the elaboration theory provide a cohesive approach to learning. This provides for an increase in retention and overall improvements in learning. How schemas and scripts are often involved in elaboration. The way schemas and scripts work in the realm of elaboration is that they involve the individual’s prior accumulation of knowledge. This can be a help or a hindrance depending upon whether the prior knowledge improves or impedes the facilitation of new knowledge. Why different people may elaborate differently on the same information. Different people may have different strengths and weaknesses. They also may have different goals for learning the material. Since elaboration is a process and not a product, it is understandable that different approaches to present the same material are needed. Why elaboration sometimes leads to the storage of inaccurate information. No system of learning is perfect and elaboration theory is not free of such problems. One possible reason that elaboration theory can lead to inaccurate information is because the progression of learning goes off on tangents. If this occurs, then it may prove difficult to develop a coherent learning paradigm.

Storytelling, the Meaning of life and The Epic of Gilgamesh Research Paper

Storytelling, the Meaning of life and The Epic of Gilgamesh - Research Paper Example A., â€Å"Story Telling, the Meaning of Life, and the Epic of Gilgamesh†). The close inspection of these lines will lead the readers of Arthur. A. Brown to the life that is between realms of mortality and immortality. The switching of codes between the imagination and pragmatism is what we call life. This is the underlying vision of the author and so he focuses that any story can easily launch us to a world of imagination which can be termed as an escapade from the harsh realities of life but then it is always essential because it refreshes our mind, soul and body. According to the author here lies the greatness or importance of story telling and this code switching between the mortal and the immortal world is the true essence of life. According to Arthur, stories are informative and they inform us about life and death and sometimes life after death and with a commendable rhetorical description of the story of Gilgamesh, he describes this in his essay. To the narrator, the story of Gilgamesh is not merely an ancient story telling about the life of a king and people living in the land between Tigris and Euphrates, also it is not a parable of their lifestyle, myth and beliefs but much more. It is a story about something beyond our comprehension which author describes in his essay as â€Å"things we cannot fix†. These are the things which are beyond the day – to – day life of the people living in the second and third millennium BCE and worshiping a king called Gilgamesh, but by delving deep into the epic. One can find out, according to Arthur, the reconciliation between human and mortality. One must try to understand things beyond his perceptions and our reflections regarding story telling. Relat ing life with a story is the greatest work and to successfully fit into the scheme of a character’s action is the utmost transcendental phenomena in life, views Arthur. The title of the essay is aptly suitable for bearing the crown of being the

Profiling -marketing plan Essay Example | Topics and Well Written Essays - 750 words

Profiling -marketing plan - Essay Example As part of market plan, this paper analyses the segmented markets of this business and addresses its marketing opportunities in relation to its marketing mix elements. Mission Statement and marketing objectives of the GGI ‘To deliver quality home decor and gift items to the customers, by importing from quality suppliers abroad’ is the main mission that GGI would like to communicate to its customers. in order to achieve this mission and goal, the GGI plans to conduct its business based on following key marketing strategies: provide quality home decor and gifts to the customers, value their perceptions, make regular quality assurance and checks, take care of employees and respect the customers. This mission will be communicated to all of its stakeholders, because, as Ferrell and Hartline (2008) noted, a mission statement is an important portion of strategic marketing plan which mustn’t be kept confidential (p. 33). Market Profiling of GGI Market profiling is a metho d of plotting market action by organizing and collecting market-generated time, price and volume information in relation to specific product or service marketing. A market profiling helps a firm identify where from its majority of buyers come towards selecting its products (Person, 2004, p. 40). GGI has been successfully operating its business by selling home decors and gift items and based on the information it collected, the company plans to conducts its future marketing operation. Most customers are very likely to appeal to Asian decors and the company therefore plans to continue importing from Asian countries. It has been observed that the company gained more number of customer when the home decors and gift items have been priced between $20 to $80 per item. A high price, as observed, yields relatively less appeal from customers and therefore relatively less margins to the company. Targeted Markets The major segments that GGI targets consist of the following groups. 1) Generatio n A, mainly comprising of baby boomers who are married with kids, average educated and home owners who all are likely to stay in their own home. Their income is more than $20,000 and less than $50,000. 2) Generation B, mainly comprising of Affluent, who are married, average educated and their income is more that $50,000. 3) Generation C, who are well educated, married and are experiencing tremendous growth. They are sophisticated achievers and 30 + savvy business and other people. Out of 30+ million population in those three regions, the target market of GGI is between 5- 6 million, comprising of 2 million from Generation A, 1.5 million from Generation B, 1.3 million from Generation C and .2 million from other un-targeted groups. Marketing Mix strategies Product Element: The GGI plans to deliver quality home decors and gift items to the above detailed three segments and find quality goods according to varying needs and requirements of its customers. in order to ensure customer satis faction in relation to product quality, GGI plans to assign quality departments duties of regular check ups and make necessary actions to improve the quality of imported items. Company will focus on its brand GGI in a way that can be positioned better in customers’ mind so that it will create long term profitability as well as make them loyal customers (Wreden, 2007, p. 13) Price: GGI never plans to charge any higher amount than the reasonable price, being fixed on margin plus pricing policy. The

Examine Best Buy recycling program Case Study Example | Topics and Well Written Essays - 250 words

Examine Best Buy recycling program - Case Study Example e-cycle program also recycles audio and video cables, cell phones, computer monitors, DVD players, gift cards, inkjet cartridges, rechargeable batteries (Best Buy- Recycling Program). Recycling of consumer electronics is beneficial because of its environmental and health benefits. To ensure that the whole process is fruitful, Best Buy ensures compliance with policies for hazardous and non-hazardous material handling. It only employs competent employees that are conversant with the recycling process. The company does not accept air-conditioners and refrigerants because their output presents hazardous materials that they cannot handle. Best Buy has a take-back program as an alternative in case there are no federal or state policies for e-waste. Even so, it observes The Resource Conservation and Recovery Act (RCRA), which governs hazardous waste regulations, in its waste management process. In this policy, they measure factors such as corrosiveness, ignitability, reactivity, and toxicity to ensure proper the recycling and disposal process does not harm the environment. Figure 1 indicates the variety of products that Best Buy recycles. Best Buy is likely to remain in operation because of the continuous evolution of electronic products, which means there will always be junk that requires

Functional Foods Essay Example | Topics and Well Written Essays - 750 words

Functional Foods - Essay Example The most important issue about the functional foods is the disturbance they cause in the natural mineral balance of the food products. Nature has created the consumable food products in a balanced form and no single mineral or vitamin exists in the excessive form in ordinary food materials. However, when certain vitamins and minerals are added to these food products, the natural balance is disturbed which consequently changes the nutrition value of the food. As the nutrition value of the food product is changed the intake of such foods must also be varied accordingly. Unfortunately, FDA does not put any restriction regarding the addition of nutrients to food materials. Functional foods are not treated with drugs and they can be marketed as foods without any prior permission from FDA. The only restriction that FDA puts on the manufacturers of these functional foods is regarding their advertisement and labeling; the manufacturers are required to provide all the nutrients labeled on the packing in correct proportions. Since the consumers are not aware of the use of multivitamins and additional minerals in their diet, the increasing trend of using functional foods can be harmful to the health of consumers. Some of the physicians, trainers, and physiotherapists are also unaware of the use of dietary supplements and they recommend these products to athletes and other consumers for enhancing body performance and energy levels; no such effect of these products has been observed in healthy adults. Each supplementary mineral and vitamin has specific application in human body and additional amount of these products are required in specific scenarios. Therefore the unchecked and random use of functional foods can deteriorate human health and greater amounts of these minerals could result in toxic depositions in human body. Unfortunately mineral supplements and multi vitamins are added in ordinary and everyday use foods and consumers are forced to buy and use them, thus a check and regulatory mechanism is r equired in order to ensure safe use of functional foods and dietary supplements (Thompson and Manore 187). The United States Pharmacopeial Convention is a nonprofit organization

Toyota Motor Manufacturing and its Problems Essay

Toyota Motor Manufacturing and its Problems - Essay Example In terms of purchasing, the seat made up the highest expenses of all purchased parts. The fabric made up almost half of its $740 cost (Mishina & Takeda, 2015). As a result, the company wishes to find out the immediate actions that should be taken so as to address the Camry seat problem. The company also wishes to examine whether the current method of handling seat defects that are the TMM method has been in line with the Toyota Production System’s philosophy. When the Toyota Motor Manufacturing was established in 1988 in Georgetown, the plant had a sole objective of producing 200,000 Camry seats that would replace the bulk of similar model imports from Japan. Toyota has an objective of providing cheaper and better cars for more people meaning that the company has to produce cars that meet the wide range of customer preferences with minimal flaws. The company also has to provide vehicles with perfect timing and at an affordable price. As Toyota was forced to cut its cost dramatically without large economies of scale compared to the American firms, the company needed a new source of economies in order to satisfy its customers with a wide variety, timeliness and quality at a reasonable price (Mishina &Takeda, 2015). The Toyota Production system, therefore, evolved as an answer to this challenge through eliminating wastes. The Toyota Motor Manufacturing sole supplier for seats was the Kentucky Framed Seat. As the cars went down the TMM’s assembly line, the seat assembly pieces in KFS had to do the same with the matching pieces emerging at one end fully inspected. A truckload of the fifty-eight seats would then arrive at TMM after thirty minutes. Upon reaching TMM, the seats would be offloaded to the staging line that was not big enough to accommodate the whole truckload. The seats, therefore, had to have to wait in the specific line until a space in the overhead conveyor. The conveyor line is  synchronized with the assembly line and runs above a panel of steel mesh that protects the cars and people below. The seats travel a quarter of a kilometer to the Final 1 which has the rear seat loading workstation.

Book Analysis Essay Example | Topics and Well Written Essays - 1000 words

Book Analysis - Essay Example His efforts in the fight for the rights of different people gained him respect and admiration across the globe. This is the first ever written hypothetical book that highlights the plights that arose when Castro left office. The book explains the truth on the life of Che Guevara on his mission during his lifetime. Che Guevara went for an exile when his was in his revolutionary mission in Bolivia. Many thought he had passed on after he went missing during the period he was away in exile. Later he came back to the public face and fights for the good of the people as his main mission and aim. The book is a biography on the life and death of Che Guevera. Body This section highlights different thematic issues that surround this book. It is important to highlight that this themes will be explained in a vivid manner. I will also highlight different justifications for the themes and how they relate to the author and Che Guevara. Revolution Revolution is seen as the main theme. In the novel, the main theme that is clearly highlighted, and comes out clearly is Che Guevara’s fight for revolution. In the novel, the author talks much of Che Guevera in his mission as a revolutionist. He fought a guerilla type of warfare and his main target in the revolutionary mission was on the call for unity and fights against the racial discrimination on the country. In the novel, John Blackthorm has discussed the various conferences where Che was giving his speech on the call for unity in the country. Unity This book has highlighted the theme of unity. Unity is an aspect that has been stressed by the author. The author has connected this theme with Che Guevara in a better manner. Such issues have been explained in vibrant manner. Che was seen to unify different people in the fight for people’s rights. This book has noted that one of the instances where Che was calling on the unity of the people was in the international conference on the global disarmament and his message wa s that there should be unity among all the anti-colonialists and the imperialist’s movements and there should be a common cause between them and the community. Che worked closely with Castro in the role they undertook of fighting against individualism in the society. He rather encouraged unity and people to work as a whole unit in the state. In brief, it is true to note that Che Guavara has earned respect for his efforts in ensuring unity. Discrimination The book reveals clearly that Che worked for the benefit of the people and not a spy on the people. In the speeches that Che made in various conferences, He in many times wanted for free soviet help. In the partnership that Che made with Washington, this was for the strengthening of the economy of Cuba and against the Soviet Union. Che referred to the racial discrimination that led to the apartheid system in the country. In his speech, Che Guevera said, "How can countries that murder its own children and discriminates between them daily, because of the color of their skins and allows the Negroes murderers to go scot free. Actually protects them and punishes the Negroes for demanding for respect for their lawful rights as human beings, claim to be the guardian of liberty?" In the novel, the instances that remains unforgettable in my entire life. The first one is the case where the writer acknowledges the fruits

Women Contribution to Psychology Essay Example for Free

Women Contribution to Psychology Essay The essay is written about Margaret Flow Washburn. The essay speaks of her background from her early teenage years and progressing through her career as a psychologist, her battles of a woman during an American period where women equal rights of educational progress was not the same as men. The essay also speaks on the contributions to her field of psychology presenting theories on the animal mind and her motor theory. Women Contributions to Psychology Margaret Floy Washburn started out as a decisive student who attended Vassari College upon graduation was divided between science and philosophy. Margaret Floy Washburn would go on to be a one of the few Pioneers for women who would go onto be successful Psychologist. Today Margaret Floy Washburn is known best for her work in comparative psychology and her book The Animal Mind would go to be four editions, become the standard textbook of its day (Goodwin, 2008). Her experimental research and focus toward cognitive process of perception, attention, and consciousness of various species would go on to be groundbreaking, contributing to scientist of today experimental theories. As with any Psychologist of past time her theory or experiments should be looked as steppingstones, to apply corrective action to information they may have missed or did not at the time have the capabilities of requiring. Margaret Floy Washburn Throughout this essay briefly discussing on Margaret Floy history, struggles as a woman trying to break the barrier, and her some of her best known work as a psychologist below. Brief early history of Margaret Floy Washburn Margaret Floy Washburn was born July 25, 1871 in New York City Biography of Margaret Flow Washburn, Para. 1). At the age of 15, she attended college at Vassar College in Poughkeepsie and soon became a member of Kappa Alpha Theta Sorority. Ladd-Franklin had also attended the same college many years before Margaret and soon after Margaret graduation she applied for graduate studies at Columbia University. Women were not permitted to study at Columbia at the time, she had entered the college only as observer where she was noticed as a serious student by Cattell but could only attend his classes unofficially (Goodwin, 2008). Cattell recommended her to apply at the Sage school of Philosophy at Cornell because they were accepting women graduate students and seen the un-keen potential in her. Margaret would encounter E. B. Titchener, who accepted Margaret into his laboratory, and she would go on to be responsible for experiments and research under E. B. Titchener. Margaret will go on to be the first woman to earn a PhD in Psychology in 1894. During the rest of her adult life, Margaret taught at several colleges, including Sage College, Wells College, and University of Cincinnati and in 1903 returning to her Alma mater as Associate Professor of Philosophy for Vassar up until her retirement in 1937 (Biography of Margaret Flow Washburn, Para. 1). She died on October 29, 1939 at her home in Poughkeepsie, New York. Breaking through the Barrier Margaret Floy Washburn fought many battles as woman trying to break into Psychology. First, she had been accepted into the graduate school of Columbia University as only a â€Å"hearer† because women were not permitted entry into Columbia University graduate program. She only attended Columbia University for a year before applying at the Sage School of Philosophy at Cornell University where she became the first woman to obtain her Ph. D. in Psychology in 1894. Margaret Floy Washburn was considered a pioneer for her fight for equal educational opportunities for women. She initially had encountered resistance to her academic pursuit at Columbia University. Margaret had to wait three months before convincing the trustees to let her attend Cattell’s classes at Columbia. Some say Margaret success came because of the contributing factor that her family was financially and emotionally supportive of her academic pursuits and Rodkey (2010) stated, â€Å"the large family inheritance allowed for her to attend private school, and which in turn led to her rapid completion of public school. † Margaret was pushing her career to limits during a period in American history when women were excluded from many academic programs and did not hold prestigious positions. This was a reason she never married. Women who married during this American period who worked in the academic field would be expected to resign their position upon marriage. Not marrying put Margaret at advantage over other women psychologist who did marry. This allowed her to hold numerous positions during her career, becoming a well respected teacher and researcher. Margaret positions were assistant professor of the Department of Psychology, professor of psychology, philosophy, and ethics, lecturer for social, animal psychology, and undergraduate psychology professor. Not only did she hold different positions through her pursuit as Psychologist she also published 69 experimental studies, and ranked top 50 psychologist of in America (Rodkey, 2010. ) Margaret became well known for her argument against Titchner’s structural psychology. After had already backing Titchner’s view’s early in her career. Margaret Floy Washburn went on the record of stating that Titchner’s views were worth while to describe conscious states, but not, in describing them, to turn them into something unrecognizable (Pillsbury, 1940, pg. ). Psychological Research and Views As stated above Margaret Flow Washburn psychological research views became unique as, she progressed in her career. With the development of her own system she would provide others with skepticism of their own formulas between the relationship of sensation and attribute and also of the exclusive use of introspection as the method of psychology. Motor Theory. She stated â€Å"While consciousness exists and is not a form of movement, it has as its indispensable basis certain motor rocesses, and†¦ the only sense in which we can explain conscious processes is by studying the laws governing these underlying motor phenomena† When discussing Margaret earlier work, she attempted to find a common ground with Tutchener, by coming up with the motor theory. Her theory argued that bodily movement and thought are similar, and cannot use one without using the other; the consciousness would arise when movement is inhibited by a tendency toward another move ment. Learning is associated with movement with a set of regular series and combinations. The motor theory is about thoughts traced back to bodily movement. This theory was presented in her early papers and chapters of her books â€Å"Feelings and Emotions: The Wittenberg Symposium and Psychologies of 1930† and Movement and Mental Imagery: Outlines of a Motor theory of the Complexer Mental Processes† (Wikipedia contributors, 2013, Margaret Floy Washburn, Para. 11). The Animal Mind. Margaret Floy Washburn would best be known for her work in comparative psychology. Her well-known text, â€Å"The Animal Mind† published in 1908. The textbook was a compiled research on experimental work in animal psychology, and covered a range of mental activities. The textbook was written during a time when research was done predominantly on rats. Margaret had cover more than 100 species, including the simplest of animals. She would look into their sense of perception; this includes hearing, vision, kinesthetic, and tactual sensation. Her main focus of the textbook is animal behavior. Her textbook would go through four editions (1917, 1926, and 1936) and became the standard textbook of its day (Goodwin, 2008). In her chapters of â€Å"The Animal Mind† suggested the animal psyches contained mental structures similar to that of human being and suggested that an animal consciousness is not qualitatively different from that of human beings. Margaret stated in her words â€Å"Our acquaintance with the mind of animals rests upon the same basis as our acquaintance with the mind of our fellow man: both are derived by inference from observed behavior. The actions of our fellow man resemble our own, and we therefore infer in them like subjective states to ours: the actions of animals resemble our less completely, but the difference is one of degree, not of kind†¦ We know not where consciousness begins in the animal world. We know where it surely resides—in ourselves; we know where it exists beyond a reasonable doubt—in those animals of structure resembling ours which rapidly adapt themselves to the lessons of experience. Beyond this point, for all we know, if may exist in simpler and simpler forms until we reach the very lowest of living being† (Wikipedia contributors, 2013, Margaret Floy Washburn, Para. 10). Conclusion Margaret Flow Washburn has been viewed as pioneer because of her push to become equally accredited for her success a woman, argumentative theories with Tutchener, and the development of her successful textbook â€Å"The Animal Mind. † She has been viewed a woman of success when encountered by obstacles would find ways to bi-past them and continue with her drive. Margaret Flow Washburn is an influential woman who has successfully set up all women after her pursuing a career in psychology to be successful and to have the same educational rights as men. This resulted in Columbia University to start Faculty of Philosophy who admits women to classes with instructor permission; authorizes the awarding of PhDs to women. Margaret has gone on to be one the most respected female Psychologist of her time and present day.

The Electric Power Consumption

The Electric Power Consumption In parallel with swift economic growth, energy demand and consumption grow at a faster rate. Like other countries, Malaysia heavily relies upon fossil fuels as their primary energy source in generating electricity. At production level in 2005, it is proven that oil reserves in Malaysia are expected to last another 19 years while natural gas reserves are expected to last for about 33 years (Apec energy demand,). Hence, a crucial move needs to be done to diverse energy source in order to delay the energy depletion as well as to meet the current energy demand. Referring to Figure 1.1, Malaysiaà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s primary energy demand is projected grow at an annual rate of 3.5 percent, to reach 146.7Mtoe in 2030, a 2.6-fold increase from 2002. Energy demand continues to rise in order to meet the rising electricity demand (Apec energy demand,). In addition, combustion of fossil fuel in electricity generation contributes significantly to air pollution as it emits greenhouse gases which lead to global warming. Referring to Figure 1.2, electric power consumption (kWh per Capita) in Malaysia was reported at about 800 in 1985, at 3428 in 2008 and finally risen up to 3613.53 in 2009 (Electric power consumption, ). This also indicates that the rate of GHGs emission rises over years. Some renewable energy sources such as solar energy, hydropower and biomass are promising alternative energy sources in reducing the dependency of fossil fuel and to diversify energy sources, as well as to reduce pollution to the environment. The future success of bioenergy developments in Malaysia depend on many factors, such as the policy framework conditions, the availability of suitable and high efficient conversion technologies, the long term and cost effective biomass fuels supply security, and the impacts on environmental and social issues. Malaysia is a tropical country and the climate is providing an excellent environment for biomass production. Also, Malaysia is known as one of the leading producers of paddy and is endowed with abundance of agricultural biomass resources. Bioenergy is the most important renewable energy in use today. The demand for biomass as energy source will inevitably increase over time, putting pressure on fuel supply security and associated topics. If sustainability requirements do not receive the necessary consideration, this pressure might affect pricing for agricultural products and food security supply aspects too. For this reason, the use of agricultural residues as energy sources offers a promising opportunity to promote the future development of bioenergy utilisation. Since using agricultural residues as energy sources will not interfere with food security, such fuels will meet the requirements for a future sustainable based energy supply. Problem Statement Normally, paddy cultivation leaves a huge amount of paddy waste such as paddy straws and paddy husks. Although there are a few methods in reusing paddy straws, such as animal feed, cooking fuel, a significant amount of paddy straw remains unused and in order to get rid of the paddy waste, open burning of paddy waste is the most common way, contributing environmental and safety issues, such as air pollution and fire disaster. However, paddy waste is a very useful organic material in producing biogas through anaerobic digestion, thus providing an alternative use and mitigating the pollution problems. In order to utilise biogas produced by paddy waste, conversion techniques have to be technically efficient, economically competitive and environmentally friendly. Biogas and its Potential of Paddy Waste Biogas is generated by the digestion of biodegradable organic wastes in the absence of oxygen, so called anaerobic process. A range of organic wastes can be used as raw materials for the production of biogas; they are agricultural wastes, animal manure, sewage sludge and many more. The major component of biogas, which is methane, is nowadays considered as one of the most important source of energy for heating and electricity generation as well as vehicle fuel. Aims and Objectives As a whole, the aim of this project is to study the production and utilisation of biogas from paddy waste. Several specific objectives are listed as follows: To review current status of energy demand and consumption in Malaysia. To understand the technologies available for biomass power plant, develop and incorporate a concept of sustainable process in the current technologies. To determine process equipments sequence and create process flow diagram. To perform process mass balances through the simulation of the entire system. To access safety and health factors in designing and minimise impacts to the environment. To consider other factors for a successful and sustainable system and operation.

Archimedes Essay -- biography biographies bio

Archimedes (287BC-212BC) was truly one of the greatest mathematical minds of all time. The discoveries and inventions of Archimedes formed the basis of many of the fundamental concepts of modern physics and mathematics. Born 287 BC Archimedes grew up in the thriving commercial hub of the port city of Syracuse, Sicily. His father, Phidias, was an astronomer and mathematician and it is thought his family enjoyed the life of aristocracy. Very little is known about his life, what is has been reported by the Roman writer and historian Plutarch. He studied for a short time in Alexandria, Egypt. Alexandria was a great place of learning, and at this time Euclid studied there and undoubtedly influenced Archimedes thinking. At the end of this study, Archimedes returned to Syracuse were he spent the rest of his life actively discovering and explaining important concepts. He is one of the few geniuses in history that enjoyed his own fame in his lifetime. Both his peers, his king, and even his enemies respected him for his work. Most of Archimedes writings were lost in the burnings of the Library of Alexandria. What we know of Archimedes treatises is from three manuscripts. Two of them have been lost in history (one was last heard of in 1311, another in 1550) and the third is The Archimedes Palimpsest, now at The Walters Art Museum in Baltimore. (PW) The Archimedes Palimpsest is very important and contains many ideas of Archimedes. During the medieval ages, the parchment on which his work was written was re-used as a prayer book. In order to reuse his parchment, the medieval monks palimpsested (in Greek â€Å"scraped off†) the text and then wrote over the remains. It is currently being refurnished at Rochester Institute of Techn... ... Wikipedia. Archimedes Spiral. Last updated.19 March 2007. http://en.wikipedia.org/wiki/Archimedes_spiral Wikipedia. Archimedes. Last updated 1 April 2007. http://en.wikipedia.org/wiki/Archimedes Archimedes Spiral. Last updated July 20, 2003. http://www.2dcurves.com/spiral/spiralaa.html) NOVA. Infinite Secrets. Created September 2003. http://www.pbs.org/wgbh/nova/archimedes/pi.html Math Refresher. Archimedes and the Area of a Circle. Created May 02, 2006. http://mathrefresher.blogspot.com/2006/05/archimedes-and-area-of-circle.html Buzzle.com. Vishwas Purohit. Could Archimedes have lifted the Earth? Created 7/30/2004 http://www.buzzle.com/editorials/7-30-2004-57259.asp J J O'Connor and E F Robertson. A History of Calculus. February 1996. http://www-groups.dcs.st-and.ac.uk/~history/HistTopics/The_rise_of_calculus.html

Salem Witch Trials Essay -- essays research papers

The Salem witch trials began with the accusation of people in Salem of being witches. But the concept of witchcraft started far before these trials and false accusations occurred. In the early Christian centuries, the church was relatively tolerant of magical practices. Those who were proved to have engaged in witchcraft were required only to do penance. But in the late Middle Ages (13th century to 14th century) opposition to alleged witchcraft hardened as a result of the growing belief that all magic and miracles that did not come unambiguously from God came from the Devil and were therefore manifestations of evil. Those who practiced simple sorcery, such as village wise women, were increasingly regarded as practitioners of diabolical witchcraft. They came to be viewed as individuals in league with Satan. Nearly all those who fell under suspicion of witchcraft were women, evidently regarded by witch-hunters as especially vulnerable to the Devil’s blandishments. A lurid picture of the activities of witches emerged in the popular mind, including covens, or gatherings over which Satan presided; pacts with the Devil; flying broomsticks; and animal accomplices, or familiars. Although a few of these elements may represent leftovers of pre-Christian religion, the old religion probably did not persist in any organized form beyond the 14th century. The popular image of witchcraft, perhaps inspired by features of occultism or ceremonial magic as well as by theology concerning the Devil and his works of darkness, was given shape by the inflamed imagination of inquisitors and was confirmed by statements obtained under torture. The late medieval and early modern picture of diabolical witchcraft can be attributed to several causes. First, the church’s experience with such dissident religious movements as the Albigenses and Cathari, who believed in a radical dualism of good and evil, led to the belief that certain people had allied themselves with Satan. As a result of confrontations with such heresy, the Inquisition was established by a series of papal decrees between 1227 and 1235. Pope Innocent IV authorized the use of torture in 1252, and Pope Alexander IV gave the Inquisition authority over all cases of sorcery involving heresy, although local courts carried out most actual prosecution of witches. At the same time, other developments created a climate in which alle... ...urse was accused as well, but found not guilty in the trial. Over 40 friends and neighbors testified in her favor, telling of her good faith and character. But the verdict from the jury caused such an outcry of fear, that the jury was asked to re-consider and she was then found guilty and hung. Mary Esty, Rebecca Nurses sister was also accused of being a witch, but she argued her case so well and in such a convincing manner, that the girls relented and she was found not guilty. She was released, a first in the witch-trials, but before long she was arrested once again on the claim that the girls had been haunted by her ghost. She was convicted and hung on September 22, 1692. Although all of the "witches" were hung, a certain man named Giles Cory was killed in a traditional English manner. He was pressed, pressing was where they would place heavy stones on a person till they died. Cory died two days later, crushed. 25 lives were taken during these Salem trials. 19 "w itches" were hung at Gallows hill. One was tortured to death by pressing. And five others died in prison, including an infant. The Salem witch trials were mainly caused by these two girls imagination.

Benjamin H. Latrobe :: essays research papers fc

Benjamin H. Latrobe was born in 1764 in Fulneck, England. He was raised in England. As a young man Latrobe was taught at the Morvian school in Fulneck. This was where Latrobe received a base for his further education. After Morvian, he transferred to Nieski school in Germany. There he received an impressive education. Which was composed of a broad curriculum. He was taught in all the liberal arts and also classical and modern languages. Latrobe started his career training under England's most renowned engineer of the day John Smeaton. Under Smeatons teachings Latrobe gained a strong grasp of technical and theoretical English civil engineering and meticulous draughtsmanship (Carter 1981, 1-2). Latrobe's interests in engineering soon led him to develop an interest in architecture. Latrobe decided to pursue his interest in architecture. He decided to work with S.R. Cockrell and become his apprentice. While Latrobe worked along with Cockrell he gained further experience and rapid advance ment in architecture. Latrobe did many side jobs designing public works where he also gained experience and individuality. During Latrobe's partnership with Cockrell he also met other renowned architects of the time. Two of which were Gorge Dance and John Soane. Both of these architects were very influential to Latrobes own work. In fact, all three architects were very influential. They all helped mold and create Latrobe's architectural style. During this advancing time period in architecture there were mainly three distinct styles of architecture. The first style was Old school. This style was strict Palladianism which was inspired by Palladio himself. The second school was Roman in origin and had a lot of functional space and had a lot of decorative detail. Latrobe found both these styles to be over rich and also to elaborate in detail. Latrobe found the Third school to be the most attractive. This style was sometimes called the "Plain Style," which was characterized by simplicity, geometric power and rationalism. With all these great teachers and mentors. Latrobe was able to develop his own style which would start a new form of architecture and create the Greek revival (Carter 1981, 12). 	Latrobe decided to move to the United States. With him be brought his architectural gift and curiosity. He was very interested in the US and he studied its history, its legends, the dress and manners of its people, and of course its architecture. Geological formations, waterfalls, the courses of rivers, and the nature of the soil and terrain were all carefully observed.

Philippine Code of Ethics For Radiologic Technologists Essay

Article I: RELATION WITH THE STATE AND SOCIETY Section 1. Radiologic technologists and X-ray technologists should be aware of the supreme authority of the state and should adhere tothe Constitution, R.A. No. 7431 and other laws, the rules and regulations promulgated pursuant to such laws. Section 2. They should, above all, consider the welfare and well-being of the public and the interest of the state. Section 3. They are encouraged to involve themselves in civic affairs and cooperate with other organizations to promote the growth and welfare of the community. Article II: RELATION WITH PATIENTS/CLIENTS Section 1. Patients/clients are the focus in the practice of Radiologic Technology and X-Ray Technology. Hence, Radiologic Technologistsand X-Ray Technologists must at all times act with dignity and sincerity and must express genuine concern in the discharge of their work. Section 2. They should keep in confidentiality any data or findings obtained in the performance of their duty. Disclosure, if warranted, should be done by the Radiologists concerned. Section 3. They should not discriminate against anybody and should attend to all patients/clients regardless of creed, race, belief, or political affiliation. Section 4. They should provide the highest level of technical Knowledge in the performance of their work, employing courtesy, empathy, compassion, and privacy to the patient/ client and his family. They should try to perform the examination within reasonable time to avoid the risk of repetition to minimize the radiation exposure to the patient. Article III: RELATION WITH OTHER ALLIED PROFESSION Section 1. Radiologic Technologists and X-Ray Technologists should bear in mind that their profession is a public trust, and that they at all times maintain and uphold the dignity and integrity of their profession and protect it from misinterpretation. Section 2. They should not directly or indirectly assist in any unauthorized practices of the profession. They should report any violations of R.A. 7431, the rules and regulations and this Code of Ethics for registered Radiologic Technologists and X-Ray Technologists to the Board of Radiologic Technology. Section 3. They should share information and experiences with their fellow paramedical professionals, participate, and be active members of the accredited association of Radiologic Technologists and X-Ray Technologists. Schools and Colleges with courses on Radiologic Technology and X-Ray Technology should be encouraged to conduct research to enhance the growth and advancement of the profession. Section 4. They should observe punctuality and keep appointments, particularly in the discharge of their duties with patients/clients. Section 5. They should avoid instances where their personal interest and financial gains will be in conflict with those of theirpatients/clients, colleagues or employers. Section 6. They should at all times perform their tasks with honor and dignity and should be fair and impartial to all. Section 7. They should at all times keep their reputation above reproach and conduct themselves with proper decorum to gain public esteem and respect for the profession. Section 8. They should at all times strive to enhance professional growth through continuing education and subscriptions for professional journals. Section 9. They should not degrade the reputation, competence, and capability of a colleague to aggrandize themselves. Section 10. They should encourage and provide opportunities for professional development and advancement of their colleague. Section 11. They should adhere to the principles of due process and equality of opportunity in peer relationship and personnel actions. Section 12. They should align personal philosophies and attitudes with those of the institutions they serve. Section 13. They should help to create and maintain conditions under which scholarship can exist, like freedom of inquiry, thoughts and expressions. Section 14. They should be receptive to new ideas, knowledge, and innovations that contribute to the development and growth of the profession. Article IV: RELATION TO AGENCY Section 1. Radiologic Technologists and X-Ray Technologists should assist in the improvement of governmental Agencies’ functions and the lightening of their patient’s work load. Section 2. They should be vigilant in the protection of equipment and materials needed to perform their duties. Section 3. They should perform the tasks assigned them by their governmental agency employer in good faith and to the best of their abilities utilizing their technical skills and diligence, particularly in instances where the patients safety maybe jeopardized by their neglect. Section 4. They should help promote, support, assist, and establish goodwill and camaraderies towards their peer employees in the paramedical professions. Article V: RELATIONSHIP WITH ONESELF Section 1. Radiologic Technologists and X-Ray Technologists should always be honest, dependable, levelheaded, and morally upright. Section 2. It is incumbent for them to provide for their professional growth through continuing education, attendance in seminars or subscriptions for professional journals and research materials. Section 3. They should be entitled to a just and fair compensation for services rendered. Section 4. They should not allow their names to be advertised by any person or organization, unless they are employed therein.

A Literature Review About Mecication Errors Essay

Introduction An error rate of 5% is acceptable in most industries, however, in the health care industry; one single error can result in death. (Berntsen, 2004, p5) This paper discusses medication errors in relation to pharmacology and drug treatment. It will summarize three academic peer reviewed journal articles, followed by general information in relation to medication errors, the impact of medication errors on client care, strategies to prevent medication errors  and conclude with the relationship to nursing. Summary of Articles Related to Medication Errors. The first article is by Karin Berntsen, 2004, and is entitled â€Å"How Far Has Health Care Come Since ‘To Err is Human’? Exploring Use of Medical Error Data†. This is a review of what changes have been made since a medication error report written by the Institute of Medicine was published in 1999. This article depicts how the health care system has changed since this 1999 report was written, and how the information was utilized for our benefit. They concluded that in the USA, medical errors were one of the top 8 leading causes of death. They reported the cost for these errors was between $17 Billion to $29 billion dollars. Until a new report is completed, health care providers will be unaware whether their goals in increasing patient safety were accomplished. The article finalizes that there has been progress in regards to prevention of medication errors and health care leaders feel passionate about increasing patient safety. (Berntsen 2004) The second article is by William N. Kelly, 2004, and is titled â€Å"Medication Errors: Lessons Learned and Actions Needed† and highlights the death of a one year old child who was diagnosed with cancer. She subsequently died, not from the cancer, but from receiving an incorrect dosage of a drug that she was being treated with. This report indicates that medications are systematically checked and balanced and errors are usually caught before a drug is administered to a patient. The article states that problems are not being solved in a timely manner since the industry has been â€Å"putting ‘band aids’ on problems that need ‘major surgery’.(Kelly 2004). In conclusion, the article questions whether or not they are taking the right approach in preventing errors. Many people are trying to fix this problem however; errors are still made too frequently. (Kelly 2004) The final article is by Rosemary M. Preston, 2004, and is titled â€Å"Drug Errors and Patient Safety: A Need for Change in Practice†. This article presents that errors continue to happen for many reasons. It concentrates upon calculations errors, lack of knowledge of drugs, over/under dosing drugs,  interactions with drugs and food, and legalities regarding drug administration. It also presents recommendations to minimize the risk of drug errors with good communication and honesty. The article closes by stating that â€Å"nurses should never estimate the skills needed for safe administration of medicines.† (Preston 2004) Key aspects: medication errors and their causes. To understand the impact that medication errors have on a patient, we have to understand what a medication error is. According to Health Canada online, a medication error is defined as: Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labelling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use.† [Developed for use by the National Coordinating Council on Medication Error Reporting and Prevention]( http://www.hc-sc.gc.ca/english/index.html) Medication errors occur for a variety of reasons. An error can affect all areas of a health care facility from health care management, staff, physicians, pharmacy and especially patients. Studies have indicated that errors will usually occur when the staff demonstrates signs of fatigue, stress, are over-worked or encounter frequent interruptions and distractions. When physicians display bad handwriting, ineffective communication with patients, and do not educate staff and patients effectively, a medication error is more likely to happen. Poor management can result in more medication errors when there is an emphasis on volume, over service quality. This results in inadequate staffing and disorganization. Medication errors affect all components of the health care environment. (http://www.napra.org/docs/0/95/157-/166.asp) Impact on client care. As disturbing as it sounds, one miniscule error can result in a patient’s injury or can even lead to their death. According to the American Journal of Medicine, statistics reveal that â€Å"more than two million American hospitalized patients suffered a serious adverse drug reaction in relation to injury within the 12-month period and, of these, over 100,000 died as a result.† http://www4.nationalacademies.org/news) Death and injury is a sad reality to any single error. The government established six rights of drug administration to prevent medication errors and ensure accuracy. These six rights include: Right drug, right dose, Right client, right route, right time and right documentation. (Kozier & Erb 2004) Injuries that result from a medication error are called adverse drug events. Usually, these unpleasant effects can be eliminated and injury can be avoided. However, every drug produces harmful side effects, but the severities of these effects vary from individual to individual. These side effects also depend on the drug and the dose given. (Kozier & Erb 2004) Health care professionals must report all errors and are accountable for their actions. No matter how insignificant, nurses are taught to document and report all mistakes. When statistics show what types of errors are made, an analysis can be done. This analysis can be used to plan ways to prevent them medication errors. (Berntsen, 2004)When a nurse does not report a mistake, the probability that it will happen again will increase. Medication errors have a huge impact on client care. They can result in death, injury, and result in unwanted effects of drugs. It is our responsibility as nurses to comply with the clients’ six rights of drug administration, to prevent errors from taking place. Strategies to prevent medication errors. There are many efficient ways to prevent nurses from making an error. To ensure patient safety in all aspects of client care, nurses are taught to think critically, and to problem solve. Nurses use critical thinking to ensure safe, knowledgeable, nursing performance and they must be able to keep up with updated health facts by constantly educating themselves with new information. (Kozier & Erb 2004) Critical thinking assists in the prevention of medication errors. The six rights in drug administration help prevent medication errors from occurring. It is important to maintain the highest standards of practice of these rights for a drug to be prepared properly. Failure to adhere to any one of these rights will definitely result in a medication error. (Clayton & Stock, 2004) Take your time when preparing medications and research any unknown drugs. Rushing should be avoided when preparing, administering and reading medication labels. Proper research must be done before an unfamiliar drug is administered it to a client. Even when in a rushed emergency situation, drugs should be looked at carefully to know the correct concentration and name of the drug, to prevent injury. (http://www.hc-sc.gc.ca/english/index.html) Labels should be read carefully and accurately. Before a drug is given to a patient, three checks should be done to ensure you are giving the proper drug and dose. In a situation where you are unsure of a drug order, you are expected to refuse the order and clarify it by law. If an individual is unfamiliar with a particular drug, the drug should not be given. (http://www.napra.org/docs/0/95/157-/166.asp) When a label is unclear, do not try not to examine the drug order yourself. Do not ask an associate, or ask for anyone else’s interpretation of the drug. To get the correct information, contact the individual who ordered the drug to clarify the label. In order to decrease the chances of error, verify all unclear hand writing, abbreviations, decimal points, decimal places and dosages. (http://www.napra.org/docs/0/95/157-/166.asp) Use of dosage abbreviations should not be used to avoid drug miscalculations. Dosage abbreviations are misinterpreted more often, than any other type of abbreviation. Using standardized abbreviations, would assist in preventing misinterpretation of abbreviations. (Preston 2004) A drug check should be done three times prior to the administration of a drug. The drug label should correspond with the physician’s orders. The three checks should be done; â€Å"Before removing the drug from the shelf or dosage cart, before preparing or measuring the actual prescribed dose, and before replacing the drug on the shelf or before opening a unit dose container, just before administering a dose to a patient.† (Clayton & Stock, 2004) Do not make assumptions regarding drugs. Physicians, pharmacists, make mistakes and other parts of the health system may be flawed. For example, when documentation shows the patient has no drug allergy, it is wrongful to assume the patient will have no adverse reaction to a new drug. This could result in detrimental results to a client’s health. Therefore no assumptions should ever me made. (http://www.ismp.org-/ToolsAllina-Orientation.html) A quiet environment for preparing medications will prevent prescription errors from occurring. Sometimes, nurses are repeatedly interrupted when preparing a medication. Distractions interfere with processing information and decision making. Errors will least likely occur when preparations are done when there are no distractions. (http://www.ismp.org-/ToolsAllina-Orientation.html) When preventing errors, staff must be certain all dosage calculations are correct and clarified. It may be beneficial to ask a colleague to assist you in checking doses, to minimize the chance of miscalculations. Other suggestions to minimize error include; â€Å"making pre-calculated conversion cards, always use a leading zero before a decimal, never use a zero after the decimal and include indications whenever possible. Miscalculations are preventable if proper methods of inspecting calculations are used.† (Preston  2004, p.72) Assess for the effects of drugs to avoid harming a client. A client must be assessed before and after a drug is given. For instance, before giving an oral medication, assess whether the client can swallow or feels nauseated. An appropriate follow up should be done after a medication is administered. It is important to check if the client experienced the desired effect of the drug. Significant abnormal responses to drug should be reported to the physician. (Kozier & Erb 2004) Conclusion. To finalize this assignment, medication errors are mistakes that can cause harm to patients and can even result in death. The articles that have been summarized illustrate situations where medication errors have occurred and review what the health care industry is doing to prevent errors. A medication error is preventable and errors can be caused by a variety of reasons. This paper has discussed the impact medication errors have on client care and strategies of how to prevent errors from occurring. As a nurse, this knowledge will assist me in keeping beneficence a priority for client care. References Clayton, Bruce D., BS, RPh, PharmD, and Yvonne N. Stock, MS, BSN, RN. Basic Pharmacology for Nurses. 13th ed. United States of America: Mosby, 2004. Government of Canada Online. (2004, Summer). Retrieved July 18, 2004, from Health Canada Web site: (http://www.hc-sc.gc.ca/english/index.html) Kelly, William N. â€Å"Medication Errors.† Professional Safety 49: 35. Academic Search Elite. EBSCO. Assiniboine Community College. 22 July 2004 . Government of Canada Online. (2004, Summer). Retrieved July 18, 2004, from Health Canada Web site: (http://www.hc-sc.gc.ca/english/index.html) Kozier & Erb, Barbara, et al. Fundamentals of Nursing. 7th ed. Upper Saddle River, New Jersey: Pearson Prentice Hall, 2004. Minimizing Medication Errors. (n.d.). In NAPRA: National Association of Pharmacy Regulatory Authorities. Retrieved July 17, 2004, from NAPRA: National Association of Pharmacy Regulatory Authorities Web site: http://www.napra.org/docs/0/95/157/166.asp Preston, Rosemary M. â€Å"Drug errors and patients safety: the need for a change in practice.† British Journal of Nursing (BJN) 13: 72. Academic Search Elite. EBSCO. Assiniboine Community College. 22 July 2004 .

Rebecca’s Structure Essay

Explain the effectiveness of the structure of the text, Rebecca Daphne du Maurier’s Rebecca is structured in a circular form, which is effective in displaying elements of the gothic genre and producing a sense of mystery and ambiguity. The fact that details are revealed gradually creates tension, and a desire to know, so that by the end of the novel the audience is satisfied with the complete story, despite the horrific truth regarding Rebecca’s murder. The text virtually revolves around a murder By using a BAB form, with a reference to the ending at the beginning of the novel, a sense of confusion and abstruseness is evoked among readers. The first chapter, in which the narrator supernaturally returns to Manderley, relives her experiences and mourns for the loss of such an exquisite property, is perplexing for the reader as the scene, characters and setting have not been established. This causes the audience to disregard the first chapter, as the second chapter begins with an entirely different setting and mood. Upon reaching the end of the novel, the reader grasps the meaning of the dream sequence, and the forgotten abstruseness is resolved. The audience is left content with all details of the story revealed, but, like most gothic tales, also chilled and unsettled with the shocking conclusion. Rebecca shows elements of the horror genre through the structure, in which the details are revealed throughout the story, by being analogous to many crime shows of today. In television programs such as CSI, a section of the fictional offense is shown, after which the team investigates the murder or other wrongdoing, and eventually discovers the callous yet complete truth. This order of events matches exactly with those in Rebecca, and it has the effect that we have an idea of the story, but become alarmed yet intrigued as more shocking details are revealed. The text is structured in a way that the scene is set and elaborated on throughout the book as the story and events take place, which causes the reader to experience confusion and a sense of incompetence. The fact that we are put in the place of the speaker allows us to experience everything she feels, knows and says. The narrator’s lack of knowledge concerning Rebecca’s death and murder is unnerving, as it makes us feel just as naive and oblivious as Mrs. de Winter. This is relevant to the gothic genre as it plays on the idea of being put in someone else’s place, which seems supernatural and ghost-like, as if the murder is something we can only learn about through the narrator, as everyone else is already in the know. This idea is further explored when Mrs. de Winter goes to live at Manderley, and unintentionally takes Rebecca’s place. The ingenuousness of the narrator, and how she gradually learns the truth about the murder, allows us to relate, and displays the ghost-like element of the gothic genre. In conclusion, the structure of Rebecca is effective in exemplifying the gothic genre because it references the end of the book at the beginning which creates confusion and mystery. Its effect on the readers is significant because it follows the structure of many crime shows, and makes us feel clueless, like the narrator.

Original writing assignment Essay

   It was a beautiful sight, picturesque even, all around were fields of lush green grass with steep hills, deep valleys and evergreen trees. In front of him there was a lake with beautiful sparkling blue water, with beavers going about their daily business, fishes swimming and birds singing. However, as he glanced across to the other side of the lake the boy laid eyes upon an almighty cave. The water on this side of the lake was brown with dead fish floating on the surface. The banks surrounding this part of the lake were simply bare rocks threatening to crush anything with the misfortune of touching them. There were no birds singing or beavers playing. Not a single living thing dwelled on those premises and it was obvious why. Who in there right minds would rather live there than on the stunning view that was just meters from the grim scene? The boy drew his gaze away from the lake and noticed many little buildings with thatched roofs and only one floor. In front of these unusual and certainly old-fashioned buildings stood small families of people all dressed in pretty much the same way. The women wore long brown and white frilly dresses. They all looked like servants. The men also wore brown and white but these were brown tattered trousers and a white V-necked shirt. At a glance down at his attire, the boy noticed he was wearing exactly the same as the other boys that he had seen. He was tired and decided that he should get some rest; a fall from the sky into unfamiliar territory can really take it out of you. The young boy slowly advanced towards the nearest house. He was walking straight towards the 3 people stood in front of it, but the didn’t even seem to have noticed him. The boy was only 20 metres from them now but their gaze was still fixed to where he had first landed. He was now only 10 metres from them and could clearly see every single crevice on their skin. That was then he noticed the boy in front was not only dressed identically to him he was also exactly the same height and build with the same blonde hair blue eyes. He even had exactly the same horseshoe shaped birthmark on his neck. The young boy looked extremely confused and turned to the women in a desperate search for an explanation. To his horror, the woman was looking straight through him. This feeling of horror rapidly swapped itself with a feeling of utter disbelief, he recognised this women but where from. He opened is mouth to ask if she too recognised him. However, as soon as the first letter rolled of his tongue and dissipated into the air the almighty rumbling started again. This was much worse then the soft rumbling he had become accustomed to during his dreams. This was a full-blown earthquake style rumbling. The whole ground was shaking. The voices started again. He could finally make sense of the voices â€Å"Help David, the cave, help† it started of with just the women but very quickly the rest of the people joined in. He finally realised where he recognised that woman from. It was his mum, but it wasn’t. It couldn’t be it had to be a bad dream. The voices were unbelievably loud now. He could not take much more of this. David dropped to his knees willing himself to wake up. He didn’t. Of course, he didn’t: He couldn’t. There was only one thing he could do. The young boy sprinted to the cave, as soon as his size 7 shoes made contact with the cold grey stone the voices stopped, and the rumbling subsided. The inside of the cave was massive. David was standing in what seemed to be an ally. It had a grey floor and red-stone wall. In this alley of a cave ran a small, dirty brown stream. David decided to follow the stream. The silence was deafening. He was right in the centre of his worst nightmares yet the scene he was now living resembled his dreams in no way what so ever. He was expecting an increasingly loud rumble as he became ever closer to the source of all his sleepless nights. However, it was in no way at all like this. All David could hear was the ‘splat’ as his feet slapped against the wet floor. All he could do was walk straight into the caves belly, he could not go back outside, he couldn’t face the screaming. He had to sort this, now, once and for all. The relatively small walk was taking forever, a whole hour seemed to have passed as David walked through the cave however in reality it was closer to a minute. At last, the young boy had reached his destination. It certainly was not what he had expected. He was standing on a floor of grey stone. In front of him was a ring of water. Inside this ring was a small island containing one thing and one thing only; a white, round crystal. A rickety rope bridge hung loosely over the deep murky water. This was the end; he had reached the end of the cave, the end of the nightmares. It had to be something to do with that crystal, but what? David had obviously made his mind up as he cautiously walked to the bridge. He checked the ropes, it seemed secure enough but there was only one way to find out. He raised his foot and slowly but surely placed his foot on to the bridge. As soon as his foot connected with the nearly rotten wood an almightily high-pitched scream pierced through the silence, the rumbling once again shook David’s brain, and a short stab of bright light temporarily illuminated the area before subsiding into a low shimmer. The rumbling didn’t stop, it got considerably worse. The bridge was shaking; water was spraying from the stream in huge waves. He had to keep going, this torture had to end. David lunged and grabbed the crystal. A searing pain swarmed through David’s entire body. A brilliant light blinded him. Everything went white. David could no longer hear the high-pitched screams; he did not feel the ice-cold water flooding over the top of him. The rumbling stopped, so did the screaming and the crystal returned to the dull colourless state in which it started. David was nowhere to be seen.   All this happened 14 years ago. I have been all alone here ever since, still experiencing the same horrific dreams. Although now it’s all changed. You are here. The man thrust his hands forwards, palms out. There was writing burnt into the skin. Help David Our Saviour. Harry Litchfield Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE Miscellaneous section.

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Looking for Alibrandi by Melina Marchetta Josie Essay Example for Free

Looking for Alibrandi by Melina Marchetta Josie Essay In this novel (Looking for Alibrandi) Josephine Alibrandi is seen as an illegitimate 17-year-old girl who is self-centred, ignorant and sensitive about her illegitimacy and her reputation and what people say about her behind her back. She is also described as confused because she isnt sure where she stands in life, whether she is an Australian or and Italian, and is paranoid in thinking because she is of Italian background she is constantly being victimised and society wouldnt see her for who she is as an individual instead as an Italian or an Australian. During her final year in High School, many events take place in her life that changed her attitudes towards both her self and others, those events ranged from the most life changing events like the discovering of Nonna Katias secret, the reunification of herself and her long lost biological father and the tragic suicide of her best friend John Barton to the most least important events like the incident involving one of the beautiful people Carly Bishop. Firstly, the sudden and unexpected suicide of Josephines best friend John Barton turns her life around, The day John died was a nose-dive day and I hit the ground so hard that I feel as if every part of me hurts. I remembered when we spoke about our emancipation. The horror is that he had to die to achieve his. The beauty is that Im living to achieve mine. John Barton was one of the closest people to Josephine and they shared many things in common, she later realises how lucky she is to have to choose her own path and destiny and that some people like John Barton had their life planned out by others for them and they had no freedom over their future. Although Josephine is portrayed as a confused teenager who doesnt who she really is and where she stands in society, her emancipation changes all that, even though her emancipation didnt happen like the way she expected it to Id wake up one morning and see the light. Feel liberated from everything. Maybe one particular incident would see me through it. Her emancipation began after she believed she was wrong on what she did on St. Marthas day and she had put little kids in danger, as a result of that she became more accepting in the fact that you are not always right, and just because she wore a badge saying she was school captain doesnt make her one, its whats inside her that makes her a leader. Furthermore, Josephines emancipation-in my opinion- was the main reason for her change in maturity and personality, because after she realises she is emancipated she begins to know who she really is and where she stands in life asks me what nationality I am, Ill look at them and say Im an Australian with Italian blood flowing rapidly through my veins. Ill say that with pride, because its pride that I feel. This proves that she is proud in being an Australian with an Italian heritage. Additionally, Josephine overcomes her nature in being paranoid when it comes to racism and multiculturalism, and how she is always being victimised by society because of her upbringing, her incident with Carly Bishop makes her realise that not everyone understands multiculturalism, Im not sure whether everyone in this country will ever understand multiculturalism and that saddens me, because its as much part of Australian life as football and meat-pies. Her relationship with Jacob Coote teaches her that not everyone has a problem with her been an Italian and that it is only a small minority of people who are racist, and she learns that its not because she is Italian that she and Jacob are separated. In conclusion, Josephine makes major changes in her life, which were somehow provoked by inevitable incidences, she learns to accept the fact that no matter what happens people wont stop whispering behind her back If I lived by the rules and never committed a sin, people would still talk. She learns what responsibilities really is about and learns to appreciate and cherish every minute of her life and to not take life for granted.