Parallel Arrays free essay sample

A variety of structures are normally identical to resemble varieties of the parts. For instance, if every understudy record comprises of an ID number and a GPA esteem, at that point a rundown of understudies can be spoken to as a variety of structure: similar information can be put away as two exhibits that corresponding to one another, as in a similar file in them demonstrate information for a similar understudy: Usually the primary way is increasingly characteristic and advantageous. Points of interest and inconveniences Against Arrays Compared to clusters, connected information structures permit greater adaptability in arranging the information and in assigning space for it. With clusters, we should pick a size for our exhibit for the last time; this can be an expected misuse of memory. A connected Data structure is constructed powerfully and never should be greater than the developer requires. It likewise requires no speculating as far as how much space you should apportion when utilizing a connected information structure. We will compose a custom exposition test on Equal Arrays or then again any comparable point explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page This is an element that is Key in sparing squandered memory. The hubs of a connected information structure can likewise be moved separately to various areas without influencing the sensible associations between them, in contrast to clusters. With due consideration, a procedure can add or erase hubs to one piece of an information structure even while different procedures are taking a shot at different parts. Then again, access to a specific hub in a connected information structure requires following a chain of references that put away in it. On the off chance that the structure has n hubs, and every hub contains all things considered b joins, there will be a few hubs that can't be reached in under log b n steps. For some structures, a few hubs may require most pessimistic scenario up to n - 1 stages. Conversely, many exhibit information structures permit access to any component with a steady number of tasks, autonomous of the quantity of passages. General Disadvantages Linked information structures likewise may likewise bring about in generous memory allotment overhead (if hubs are dispensed separately) and disappoint memory paging nd processor storing calculations (since they for the most part have poor region of reference). Now and again, connected information structures may likewise utilize more memory (for the connection fields) than contending cluster structures. This is on the grounds that connected information structures are not adjoining. Occasions of information can be discovered all over in memory, in contrast to exhibits. In some hypothetical models of calculation that uphold the limitations of connected structures, for example, the pointer machine, numerous issues require a larger number of steps than in the unconstrained arbitrary access machine model.

Spanish Verbs That Mean to Ask

Spanish Verbs That Mean to Ask Spanish has a few action words that can be utilized to mean inquire. They are not all exchangeable, and there are some inconspicuous contrasts in importance among some of them. Among those action words: Preguntar is the action word utilized most generally to intend to pose an inquiry or to get some information about something. It is regularly trailed by the relational word por to show the subject of the request: Preguntã ³ por la situaciã ³n lawful de su hermano. He got some information about his siblings legitimate circumstance. Pablo preguntaba por ti. Pablo was inquiring as to yourself. Preguntã © si habã ­a estudiado la lecciã ³n. I inquired as to whether she had examined the exercise. Preguntar is the action word utilized regularly to show just that an individual had posed an inquiry. -  ¿En quã © pgina est à ©l? - preguntã ³ Juana. What page is it on? Juana inquired. Pedir is generally used to demonstrate an immediate solicitation or to request (as opposed to about) something. Like the English action word to ask for, it doesn't need to be trailed by a relational word. Pidiã ³ un coche azul. She requested a blue vehicle. Sã ³lo pedã ­ que repararan el techo. I just requested that they fix the rooftop.  ¿Te pidiã ³ dinero? Did she approach you for cash? Rogar can intend to officially ask or to make a proper solicitation. What's more, contingent upon the unique circumstance, it can likewise mean to ask or to supplicate. Le rogamos que indique los nã ºmeros de telã ©fono completos. We demand that you demonstrate the total phone number. Se ruegan los clientes que tomen las precauciones oportunas para salvaguardar sus pertenencias. Clients are approached to avoid potential risk so as to secure their effects. Te ruego que tengas piedad con mi madre. I beseech you to have feel sorry for on my mom. Fueron a la iglesia para rogar. They went to the congregation to ask. Invitar can be utilized when requesting that somebody accomplish something or head off to some place, much like the English related welcome. Nunca he invitado a nadie a postear en mi blog. I never have requested that anybody post on my blog. Te invito a mi casa. I am asking you to my home. Solicitar can be utilized similarly as pedir, despite the fact that it is less normal and is destined to be utilized with specific sorts of solicitations, for example, for data, or in lawful or business settings. Solicitan amnistã ­a para ex presidente. They are requesting absolution for the previous president. Solicitaron sus opiniones profesionales sobre el proyecto. They are requesting his expert sentiments about the venture.

Money at the Movies Which Avenger Gives Marvel the Most Bang for Its Buck

Money at the Movies Which Avenger Gives Marvel the Most Bang for Its Buck Money at the Movies: Which Avenger Gives Marvel the Most Bang for Its Buck? Money at the Movies: Which Avenger Gives Marvel the Most Bang for Its Buck?Some financial lessons for Marvel Studios as they move into a new phase following Avengers: Infinity War.Over the past ten years, the Marvel Cinematic Universe (MCU) has completely rewritten the rules for how Hollywood makes movies. Heck, remember when the phrase “cinematic universe” wasn’t even a thing?All of that comes to a head this weekend with the release of Avengers: Infinity War, the first of two Avengers team-up movies that will bring the current incarnation of the MCU to a closeâ€"with a pretty big bang.This got us thinking: As the MCU moves into a new phase, what can Marvel Studios learn from their past successes. We took a look at every single superhero in the Avengers that headlined their own film(s), and we tried to figure out which ones made for the most profitable investment.We looked at how much each hero’s movie(s) cost to produce, and how much they grossed worldwide. This way, we can truly find out which hero delivered the most bang for Marvel’s buck, and what lessons Marvel can learn as they move into their post-Infinity War life.We’ve laid out the results below from least profitable to most profitable. Some of the answers were pretty surprising …(All dollar figures via The Numbers)9. The HulkMovies: The Incredible HulkBudget: Hulk: $137 millionBox Office Gross: $265 millionReturn on Investment: 193 percentThe Hulk has had a big come-up in recent years, especially with his scene-stealing turn in Thor: Ragnarok. But the fact remains that the only time The Hulk starred in his own film, it didn’t even make back twice its production budget. He is Marvel’s least profitable Avenger by a country mile.Then again, that movie was only Marvel’s second film after Iron Man, before they had perfected their successful (if formulaic) combination of pithy dialogue, punch-em-up action, and anonymous Atlanta office park locales. Also, The Incredible Hulk starred Edwar d Norton as the titular giant green rage monsterâ€"not Mark Ruffalo, who assumed the character from the first Avengers film onward.Maybe a Mark Ruffalo-starring Hulk film would do gangbusters? Or maybe the big guy only really works when he’s part of a larger ensemble? No one knows for sure, but another Hulk solo film would be a pretty risky bet (or one heck of a heat check) from a studio that wants to keep those money presses rolling.The Lesson. Some characters don’t needâ€"or can’t supportâ€"their own movies. Don’t be afraid to recast when absolutely necessary. Don’t cast Edward Norton in the first place.8. Ant-ManMovies: Ant-ManTotal Budget: $130 millionTotal Box Office Gross: $519 millionReturn on Investment: 396 percentSpeaking of heat checks, people at the time thought that Marvel was crazy for making a film based around this less-than-well-known character, especially once visionary director Edgar Wright, who’d been with the film since the very beginning, departed f rom the project over “creative differences.”Turns out that they needn’t have worried. While Ant-Man didn’t do huge business compared to some of his more well-known teammates, the film still did very well, making almost $520 million worldwide against a $130 million budgetâ€"a return on investment (ROI) of 396 percent!Casting Paul Rudd helped (casting Paul Rudd always helps), as did the film’s breezy, heist movie tone and inventive action sequences. A sequel, Ant-Man and The Wasp, is scheduled for later this summer. And if the trailers are anything to go by, audiences can expect more of the same plus approximately 500 percent more butt-kicking Evangeline Lilly. Sounds like a hit to us!The Lesson: More obscure characters can succeed, just make sure that you cast a ludicrously likable actor and maybe don’t break the bank budget-wise. Giving non-white dudes top billing for new and future movies is a plus.7. Captain AmericaMovies: Captain America: The First Avenger, Captain Am erica: The Winter Soldier, Captain America: Civil WarTotal Budget: $560 millionTotal Box Office Gross: $2.238 billionReturn on Investment: 399 percentOk wow. This is our first big shocker on the list. How could Captain America, one of the two main linchpins of the Avengers franchise, be ranked third to last? People love the Captain America movies! They love Captain America! Or at the very least, they love looking at Chris Evans in form-fitting t-shirts. What gives?!So, a couple things give. First of all: People do love Captain America, which is why these movies have made a ton of money. A $2.238 billion box office for three films is not too shabby! Second of all: these numbers are dragged down slightly by the first Cap movie, which made only (only!) $370 million worldwide relative to its $140 million budget.Lastly, the third Captain America movie, Captain America: Civil War, was basically a stealth Avengers movieâ€"possibly to make up for the relative low point that was Avengers: Ag e of Ultronâ€"and it had the budget to match: $250 million, more than the first Avengers movie cost to make.Still, the fact remains that Captain America, considering how beloved he is, doesn’t have quite the return on investment that some might think. You could even argue that Civil War, the highest-grossing film of the trilogy by far, barely counts as a Captain America movie, given its full roster of heroes.While it might tempting for Marvel to continue the Captain America mantle in its next phase, possibly by having Falcon or Bucky Barnes pick it up from Steve Rogers, they might want to go in another direction. Cap might be all about the red, white, and blue. But he ain’t so much about that greenâ€"at least not as much as previously thought.The Lesson: Don’t feel so much pressure to keep Captain America going past Infinity War. If you screw up a film, don’t be afraid to shoehorn in a stealth re-do.6. ThorMovies: Thor, Thor: Dark World, Thor: RagnarokTotal Budget: $480 mill ionTotal Box Office Gross: $1.943 billionReturn on Investment: 404 percentLook Chris Hemsworth is truly great as Thor. But if you had told us that Thor’s movies were more profitable for Marvel than Captain America’s, we would have thought you were out of your Infinity Stone-addled mind. Because while Hemsworth might be fantastic as Thor, his movies have been, well, something of a mixed bag. It wasn’t until the third movie in the trilogy, Thor: Ragnarok, that Marvel made an honest-to-goodness great film about the Asgardian prince.And yet here we are. So what gives?It’s a couple of things. Thor’s first film did quite a bit better than Cap’s, making almost $80 million more worldwideâ€"though it also cost $10 million more to produce. And while that’s the last time that a Thor movie would outgross a Captain America flick, Thor’s budgets haven’t grown nearly as much either. Thor: Dark World cost $20 million less than Captain America: The Winter Soldier, while Ragnarok co st $70 million less than Civil War.Ragnarok did very well, grossing $850 million worldwide, which feels generally in line with the film’s positive reception. But Dark World? That movie is widely seen as one of the worst Marvel films and yet still grossed well over $640 million. If you want to look for a culprit to explain Thor’s surprise victory over Captain America, look no further.The profitability of Thor really goes to show how Marvel’s big hits can really help carry buoy some of its misses. So much so, in fact, that they don’t end up being misses. They’re just slightly smaller hits!The Lesson: Casting the right actor is super important. So long as you make movies that are pretty good, you’ll make a lot of money. Don’t give up on a franchise too early.5. Doctor StrangeMovies: Doctor StrangeTotal Budget: Doctor Strange: $165 millionTotal Box Office Gross: $677 millionReturn on Investment: 410 percentThe most interesting thing about Doctor Strange’s placement on th is list is what it says about the MCU’s present and it’s future. The film’s massive box office haul can be chalked up, in large part, to the trust that Marvel has built up over the past decade. When the studio launched Thor and Captain America: The First Avenger back in 2011, both films did reasonably well. But now, after so many hitsâ€"and after building an audience that knows they need to see every film to fully grasp the larger pictureâ€"they can launch Doctor Strange and have it gross over four times its original budget.The film also marks an interesting step forward stylistically for the company. Doctor Strange’s trippy, reality-splintering action scenes and trips to the astral plane are unlike anything we’ve seen in other MCU films. And this is a good thing! After years of consistently solid but unimpressive filmmaking, Marvel is now broadening its palate before audiences get bored. Between Doctor Strange, Black Panther, and Thor: Ragnarok, audiences can have three f airly unique experiences within the MCU at large.Anyway, while Marvel hasn’t announced a date for Doctor Strange 2 yet, it seems like a pretty safe bet. Given how heavily the character is being featured in the marketing for Infinity War, we are confident in predicting that he’ll be a majorâ€"and majorly profitableâ€"part of the MCU for years to come.The Lesson: 10 years in, you can get away with things you couldn’t do before. Use that to your advantage. Elements like not-so-famous characters and weird, psychedelic effects aren’t risky anymoreâ€"they’re a welcome change of pace.4. Iron ManMovies: Iron Man, Iron Man 2, Iron Man 3Total Budget: $556 millionTotal Box Office Gross: $2.421 billionReturn on Investment: 435 percentLook. Without Robert Downey Jr. and his instantly iconic performance as billionaire genius playboy Tony Stark, there would be no Marvel Cinematic Universe. Full stop. There would have been two moviesâ€"Iron Man and The Incredible Hulkâ€"after which all of Marvel’s rights would have been sold off to other studios for relative pennies on the dollar. Edward Norton wasn’t getting the job done, we can tell you that much!The only thing that is keeping Iron Man from ranking higher on this list is the relatively blah performance of Iron Man 2. Why didn’t Iron Man 2 perform better, you ask? Because it wasn’t very good! It’s the kind of movie that is fine for a lazy, half-attentive re-watch on a Saturday afternoon, but it was a huge letdown in theatres and only grossed $36 million more than the original.Luckily, all was forgiven by Iron Man 3, which was a massive successâ€"not to mention a much better film. On a $200 million budget, Iron Man 3 grossed over 1.2 billion dollars. It is the second highest-grossing solo Marvel movie, beating out even Captain America: Civil War. What was the first highest-grossing? It hasn’t appeared on this list yet, but we’re pretty sure you can guess what it is.The odds that they make more Iron Man movies is slim, as RDJ is getting a bit long in the tooth to play Tony Starkâ€"and his paychecks are getting a bit long in the number of zeroes they contain. Downey’s combined salary for both Infinity War movies is a whopping $200 million. For reference, the first Iron Man movie cost $186 million total. Downey’s definitely earned it, but the odds of him staying on are indeed slim.The Lesson: You can spend all the money you want on fancy special effects, but it takes a great performance to make a movie successful. Even at $100 million per film, Downey is a steal.3. The Guardians of the GalaxyMovies: Guardians of the Galaxy, Guardians of the Galaxy Vol. 2Total Budget: $370 millionTotal Box Office Gross: $1.634 billionReturn on Investment: 441 percentOkay, so we talked about Ant-Man as a major heat check for Marvel, but the riskiness of that film pales in comparison to the Guardians of the Galaxy. These characters were so obscure that they couldnt even be called a deep cut. They w ere more like a secret song.Thats why the success of the first Guardians of the Galaxy proved once and for all that characters didn’t need to be popular for their movie to succeed. Just by letting audiences know that this was film was a part of the MCU, Marvel could guarantee millions of butts in seats come opening weekend. From there, the only tricky part was making a good movie.Still, lots of studios have failed to follow through on that second part. Luckily, for Marvel, they knew that a Guardians of the Galaxy movie might have to clear a slightly higher bar in order to enjoy widespread success. So they turned to indie filmmaker James Gunn, who turned around and produced a summer popcorn flick that was the perfect combination of brash, funny, rocking, and more than a little weird.The lesson Marvel can draw from Guardians of the Galaxy is to choose filmmakers who will bring a more distinctive voice and style to their individual films. The consistency of the early MCU movies have helped set a baseline for audience expectations, but Guardians was one the first movies that felt a little bit different. And it turns out that audiences like different! Or at least, they do after they’ve watched a bunch of movies that feel kind of the same. Without James Gunn and the work he did on Guardians, who knows where the MCU would be.The Lesson: Don’t be afraid to let unique voices shine. Famous characters are overrated. Even super obscure titles can be turned into massively successful franchises.2. Spider-ManMovies: Spider-Man: HomecomingTotal Budget: $175 millionTotal Box Office Gross:  $880 millionReturn on Investment: 502 percentConsidering that he is the best-selling star in Marvel Comics history and has a proven record of box office success. it’s not surprising that Spider-Man ranks so high on this list. But that doesn’t mean that Spidey did all the work himself. This 2017 film marked the 6th Spider-Man movie in 15 yearsâ€"so why did it feel so fresh?Once aga in, Marvel cast the role of Peter Parker perfectly. Not only does Tom Holland have charm, acting chops, and comedic timing to spare, but he was also only 21 when he filmed Spider-Man: Homecoming. For comparison: Tobey Maguire was 26 when he played the high school-aged web slinger, while Andrew Garfield was 28. Maybe, just maybe, casting someone who can actually pass as teenager is important to portraying a character who is, wait for this, a teenager.Furthermore, let’s not sleep on Marvel introducing Peter Parker in Civil War, which meant skipping over his origin story. Next to Batman, no superhero has had their tragic origins rehashed as many times as poor Peter Parker. We get it. Uncle Ben was, like, pretty great. By introducing Peter in Civil War, Marvel set up Homecoming for success. It was an entirely new story, not the same old retread audiences had come to expect.A Spider-Man: Homecoming sequel is already confirmed for 2019. Marvel knows what’s up.The Lesson: Origin storie s are overrated, especially for more famous characters. Spider-Man is good, Tom Holland as Spider-Man is better. A good villain (shouts to Michael Keaton) goes a long way.1. Black PantherMovies: Black PantherTotal Budget: $200 millionTotal Box Office Gross: $1.323 billionReturn on Investment: 650 percentCould it ever have been anyone else? With only one movie under his belt (plus his introduction in Civil War), King T’Challa of Wakanda has already made over $1.3 billion dollars at the box office. Even with a much larger budget ($200 million) than most Marvel get for their first movie, that still gives Black Panther a profit margin of 650 percent. Holy wow.Black Panther is not only a great filmâ€"quite possibly Marvel’s bestâ€"but it also came at the perfect time. After 10 years of headlining heroes who were all white dudes, audiences were clamoring for something different. The fact that director Ryan Coogler delivered a stone-cold classic took a film that was likely to succeed a nd sent it to the stratosphereâ€"and buried any and all ideas that movies with non-white leads wouldn’t perform as well overseas.When everybody goes and sees a movie, that translates to a lot of money. When everybody goes and sees a movie and then goes back and sees it again (and again and again), that translates to a “Scrooge McDuck’s gold-filled swimming pool” amounts of money. One way Marvel can make more of the latter is to continue hiring great filmmakers and then getting out of their way.Marvel has famously controlled a large part of the filmmaking process, which is why TV vets like Joss Whedon and the Russo brothers (who are helming Infinity War) proved such great fits for their systemâ€"though even Whedon crashed out after disagreements during Age of Ultron. But with Coogler, Marvel gave him a great deal more leeway to make the film his own way. And the result was a movie that felt both epic and deeply personal.Black Panther sets a bar for success that pretty much an y other Marvel superhero will have trouble clearing. You know what could do it though? That’s right. Black Panther 2.The Lesson: Don’t only make movies starring white dudes. Trust talented filmmakers to bring it home. Make more Black Panther movies.For the past 10 years, the MCU has been Hollywood’s standard-bearer for financial and franchise-based success. They’ve done so by being consistent and conservative, but by taking small, calculated risks when they needed too and by always trying to stay one step ahead. Those are lessons we could all use.Enjoy Avengers: Infinity War!If you liked this post, check out these related posts and articles from OppLoans:Money at the Movies: Does Box Office Gold Mean a Best Picture Win?How Much Would it Cost to Travel to Every Star Wars Filming Location?What did Life Cost in Hawkins, Indiana in 1983 vs Today?Whos your favorite Marvel hero?  We want to hear from you!  You can  email us  or you can find us on  Facebook  and  Twitter.

Essay on Kate Chopins The Story of an Hour - 911 Words

Women should be powerful, beautiful and intelligence. Nevertheless, women in the eighteenth century were portrayed as servants did not have any say in anything just like the story of an hour by Kate Chopin, where even in a good marriage you could not do the things you wanted to do. What if their husbands died what would come of them? How would they feel? And the irony of gaining freedom but losing everything? In the eighteenth century, Women were portrayed as powerless beneath the men because, men were powerful everything was given to them once they became men and wife. According to Hicks, Jennifer â€Å"Divorce was quite rare in the 1800s and if one was to occur, men were automatically given legal control of all property and children†,†¦show more content†¦Literature: A World of Writing â€Å"When she abandoned herself a little whispered word escaped her slightly parted lips. She said it over and over under her breath: free, free, free! The vacant stare and the look of terror that had followed it went from her eyes. They stayed keen and bright. Her pulses beat fast, and the coursing blood warmed and relaxed every inch of her body† this could only mean that she was free from being powerless or maybe she was unhappy with her life and when her husband died she felt a big weight lifted off her shoulders Kathleen, Wilson Said â€Å"Once Mrs. Mallard accepts the feeling , even though she knows that her husband had really loved her, she is ecstatic that she will never have to bend her will to his again. Now that her husband is dead, she will be free to assert herself in ways she never before dreamed while he was alive† Mrs. Mallard then goes on to welcoming this new feeling she would never have to clean up after him never going to worry about if he’s okay or not, never going to only think about him. She then says â€Å"There would be no powerful will bending hers in that blind persistence with which men and women believe they have a right to impose a private will upon aShow MoreRelatedAn Analysis of Kate Chopins The Story of an Hour1150 Words   |  5 Pagesï » ¿ Kate Chopins The Story of an Hour is a perfect example of literature that glorifies the commonplace event: the story depicts a gigantic event in the life of its protagonist by using a minimalist economy of means. The opening sentence of The Story of an Hour carefully sets up the conclusion of the story. Chopin is working with such limited space here that it resembles more the crafting of a poem than a fictional narrative. We are told that Mrs Mallard was afflicted with heart trouble so greatRead MoreEssay on Kate Chopins The Story of an Hour537 Words   |  3 Pages In Kate Chopins short story quot;The Story of an Hour,quot; there is much hatred. The first hatred detected is in the way that Louise reacts to the news of the death of her husband, Mr. Mallard. Before Louises reaction is revealed, Chopin turns to how the widow feels by describing the world according to her outlook of it after the bad news. Louise is said to quot;not hear the story as many women have heard the same.quot; Rather, she accepts it and goes to her room to be alone. Now the personRead MoreSymbolism In Kate Chopins The Story Of An Hour1013 Words   |  5 PagesWhile most of Kate Chopin’s short stories were well received, â€Å"The Story of an Hour† was originally rejected by publishers until 1894 when Vogue decided to publish the short story. However after her death most of Chopin’s work was forgotten, that was until the 1950s when her work again was recognized as insightful and moving, setting into motion a Kate Chopin revival which was both successful and remarkable (Biography). â€Å"The Story of an Hour† focuses on the liberation and new found freedom of a newlyRead MoreKate Chopins The Story of an Hour Essay560 Words   |  3 Pages In Kate Chopin’s short story, â€Å"The Story of an Hour†, the author shows us the response of a young woman to her husband’s presumed death. Before the news, the widow, Mrs. Mallard, felt trapped in a situation she found to be inescapable. Her marriage made her feel as though her will wasn’t really her own, that she wasn’t really free. However, when the news of her husband’s death reaches her, she finally begins to feel that she has a chance to be fre e. nbsp;nbsp;nbsp;nbsp;nbsp; During her mingledRead MoreKate Chopins The Story of an Hour Essay803 Words   |  4 PagesIn Kate Chopin’s â€Å"The Story of an Hour† allows one to explore many ironic instances throughout the story, the main one in which a woman unpredictably feels free after her husband’s assumed death. Chopin uses Mrs. Mallard’s bizarre story to illustrate the struggles of reaching personal freedom and trying to be true to yourself to reach self-assertion while being a part of something else, like a marriage. In â€Å"The Story of an Hour† the main character, Mrs. Mallard, celebrates the death of her husbandRead MoreCriticism In Kate Chopins The Story Of An Hour830 Words   |  4 Pagesintroduction to any other writer with this kind of writing style to verify my assertion of Kate Chopin’s work, nonetheless Chopin does a brilliant job of exhibiting her Creole background in her work coherently. Although many may argue that modern feminism has taken a new meaning compared to its’ early beginnings. Chopin exhibited a hint of feminism through characters like Clarisse and Mrs. Mallard. In The Story of An Hour, Chopin crafted Mrs. Mallards Character as woman who seem to yearn for freedom to theRead MoreKate CHopins Story of an Hour Essay1271 Words   |  6 Pages In Kate Chopins Story of an Hour the author portrays patriarchal oppression in the institution of marriage by telling the story of one fateful hour in the life of a married woman. Analyzing the work through feminist criticism, one can see the implications of masculine discourse. Mrs. Mallards medical diagnosis is an example of the male-dominated society in which she lives. They are able to tell her that she indeed has a heart condition, but are unable to treat her effectivelyRead MoreEssay on Kate Chopins The Story of an Hour655 Words   |  3 PagesKate Chopins The Story of an Hour In â€Å"The Story of an Hour† by Kate Chopin, the author depicts how someone can be trapped in an unproductive and unsatisfying reality because of other’s thoughtlessness, exploitation, and domination. When combined with the contemporary society’s belief, presumably the later half of the 19th century, a further understanding of Chopin’s thoughts and feelings can be realized. Mrs. Louise Mallard, the victim and messenger of this story, is the image of such aRead More Irony in Kate Chopins The Story of an Hour Essays1295 Words   |  6 PagesIrony in Kate Chopins The Story of an Hour A very dull and boring story can be made into a great story simply by adding in something that is unexpected to happen. When the unexpected is used in literature it is known as irony. An author uses irony to shock the reader by adding a twist to the story. The author of â€Å"The Story of an Hour† is Kate Chopin. Her use of irony in the story is incredibly done more than once. Irony is thinking or believing some event will happen but in return the unexpectedRead MoreThe Story of a Widow in Kate Chopins The Story of an Hour Essay840 Words   |  4 Pagespersistence with which men and women believe they have a right to impose a private will upon a fellow-creature.† Kate Chopin’s â€Å"The Story of an Hour† is the story of a woman’s reaction to the news of her husband’s passing. Mrs. Louise Mallard is a young woman most would conclude to be saddened by the passing of her husband. Yet it is in that very moment we find her true feelings. Kate Chopin was born Katherine O’Flaherty on February 8, 1850 in St. Louis Missouri. She was the only child born to her

How Vacancies in the US Congress are Filled

The methods for filling vacancies in the U.S. Congress vary greatly, and for good reason, between the Senate and the House of Representatives.   When a U.S. representative or senator leave Congress before the end of his or her term, are the people of their congressional district or state left without representation in Washington? Key Takeaways: Vacancies in Congress Vacancies in the U.S. Congress occur when a senator or representative dies, resigns, retires, is expelled, or is elected to another office before the end of their regular term.Most vacancies in the Senate can be filled immediately through an appointment made by the governor to the former senator’s state.Vacancies in the House can take as long as six months to fill, because representatives can only be replaced through a special election. Members of Congress; senators, and representatives, usually leave office before the end of their terms for one of five reasons: death, resignation, retirement, expulsion, and election or appointment to other government posts. Vacancies in the Senate While the U.S. Constitution does not mandate a method by which vacancies in the Senate are to be handled, vacancies can be filled almost immediately through an appointment made by the governor of the former senators state. The laws of some states require the governor to call a special election to replace U.S. senators. In states where replacements are appointed by the governor, the governor almost always appoints a member of his or her own political party. In some cases, the governor will appoint one of the states current U.S. representatives in the House to fill the vacant Senate seat, thus creating a vacancy in the House. Vacancies in Congress also occur when a member runs for and is elected to some other political office before his or her term is over. In 36 states, the governors appoint temporary replacements for vacant Senate seats. At the next regularly scheduled election, a special election is held to replace the temporary appointees, who may run for the office themselves. In the remaining 14 states, a special election is held by a specified date to fill the vacancy. Of those 14 states, 10 allow the governor the option of making an interim appointment to fill the seat until the special election is held.   Since Senate vacancies can be filled so quickly and each state has two senators, it is highly unlikely that a state would ever be without representation in the Senate. The 17th Amendment and Senate Vacancies Until ratification of the 17th Amendment to the U.S. Constitution in 1913, vacant seats in the Senate in the same way Senators themselves were chosen — by the states, rather than by the people. As originally ratified, the Constitution specified that Senators were to be appointed by the legislatures of the states rather than elected by the people. Similarly, the original Constitution left the duty of filling vacant Senate seats solely to the state legislatures. The framers felt that granting the states the power to appoint and replace senators would make them more loyal to the federal government and increase the new Constitution’s chances of ratification. However, when repeated lengthy Senate vacancies began to delay the legislative process, the House and Senate finally agreed to send the 17th Amendment requiring the direct election of senators to the states for ratification. The Amendment also established the current method of filling Senate vacancies through special elections. Vacancies in the House Vacancies in the House of Representatives typically take far longer to fill. The Constitution requires that member of the House be replaced only by an election held in the congressional district of the former representative. When vacancies happen in the Representation from any State, the Executive Authority thereof shall issue Writs of Election to fill such Vacancies. -- Article I, Section 2, Clause 4 of the U.S. Constitution According to the U.S. Constitution and state law, the governor of the state calls for a special election to replace the vacant House seat. The full election cycle must be followed including political party nominating processes, primary elections and a general election, all held in the congressional district involved. The entire process often takes as long as from three to six months. While a House seat is vacant, the office of the former representative remains open, its staff operating under the supervision of the Clerk of the House of Representatives. The people of the affected congressional district do not have voting representation in the House during the vacancy period. They can, however, continue to contact former representatives interim office for assistance with a limited range of services as listed below by the Clerk of the House. Legislative Information from Vacant Offices Until a new representative is elected, the vacant congressional office cannot take or advocate positions of public policy. Constituents may choose to express opinions on legislation or issues to your elected Senators or wait until a new representative is elected. Mail received by the vacant office will be acknowledged. The staff of the vacant office can assist constituents with general information concerning the status of legislation, but cannot provide analysis of issues or render opinions. Assistance With Federal Government Agencies The staff of the vacant office will continue to assist constituents who have cases pending with the office. These constituents will receive a letter from the Clerk requesting whether the staff should continue assistance or not. Constituents who do not have pending cases but require assistance in matters relating to federal government agencies are invited to contact the nearest district office for further information and assistance.

Julius Ceasar Free Essays

Brutus gives his thoughts of killing Caesar in William Shakespeare’s tragedy Julius Caesaract 2 scene 1. In Brutus’s soliloquy he reveals how Caesar â€Å"might change his nature† (4). Brutus also states â€Å"he may do danger† (8). We will write a custom essay sample on Julius Ceasar or any similar topic only for you Order Now What Brutus is referring to is if Caesar gets crowned he might abuse his power. Brutus is an honorable man who is for the people of Rome. Although this might not be his reasoning for killing Caesar. It may be that Brutus himself wants power. Therefore Brutus is willing to do anything necessary to get what he wants. The metaphor Brutus uses in his soliloquy is how Caesar may climb â€Å"young ambitions ladder† (13). Brutus repeats that Caesar is climbing a ladder to get what he wants. To repeat Brutus declares â€Å"whereto the climber-upward turn’s his face but when he once attains the upmost round he then unto the ladder turns his back† (14-16). To be sure Brutus wants to join the conspirators to kill Caesar, Brutus articulates how Caesar will turn his back on the people that he once used to get to the high place he wants to be at, which is the crown. â€Å"So Caesar may† (18). Which means Caesar might do all these bad things. Therefore Brutus thinks of Caesar as a â€Å"serpent’s egg† (23). Thus Brutus thinks it’s necessary to â€Å"kill him in the shell† (25). At the end of Brutus’s soliloquy Brutus has made up his mind to join the conspiracy and kill Caesar. There could be many topics from this quote but the two most important topics are projection and ambition. In this soliloquy Brutus projects how he feels about Caesar. In doing so, Brutus manipulates what Caesar actions to get what he wants. Brutus wants what is best for the people and himself and Brutus thinks that Caesar will do harm to the people if he is crowned. Brutus also suggests that Caesar will change and be a different person. Everything that Brutus projects about Caesar, Brutus is construing to his own fashion. To be correct Brutus states that Caesar is ambitious. Brutus implies that Caesar is striving for the crown. Although Caesar doesn’t show his ambition literally he shows it other ways. Granted that Brutus may also be ambitious, due to the fact that he wants to kill Caesar and join the conspiracy. Brutus says that Caesar is ambitious for power but that might not be the case. It might be that Brutus is more ambitious than Caesar for power. Brutus does not show how ambitious he is for power until the end of his soliloquy. In this soliloquy it shows how ambition can be a negative connotation because desires something. Brutus esires Caesar to die and to make him self seem like honorable man to the people. Although in reality Brutus is just trying to get one of his desires. And Caesars desires were the crown. If Caesar desires the crown then Caesar is in the way of Brutus’s desire. So therefore Brutus needs to think that killing Caesar is the right thing to do for himself. To conclude Brutus must kill Caesar to get what he desires the most. Although Brutus was not only influenced by his desires but the desires of Cassius. By the end of this quote it shows how Cassius projected Brutus’s thoughts of Caesar. Therefore Brutus must kill Caesar. How to cite Julius Ceasar, Papers

Role of Language in Oppressing Aboriginal People

Question: Discuss about the Role of Language in Oppressing Aboriginal People. Answer: Introduction: Australian indigenous tribes had lived with each other harmoniously until the entry of western colonizers (Dodson, 1994). This marked the oppression of Aboriginal people by the missionaries. The Aboriginals rights were never respected, and they had to conform to the demands of the missionaries (Human Rights and Equal Opportunity Commission, 1997). Among all the Australian indigenous tribes, Aboriginal seemed to suffer more from missionaries oppressions. The missionaries perceived Aboriginal culture as inferior, and therefore they had to be assimilated into white society (Broome, 2010, p. 8). The language used by the missionaries towards the Aboriginal was oppressive in nature(Dudgeon, et al., 2010, p. 28). Just as the rest of the society, missionaries had an attitude that Aboriginals were the inferior race that had no right to live (Dodson, 1994). This perception developed into a language that each missionary directed towards the Aboriginals. The churchs attitude towards Aboriginals is well portrayed in the scenarios where they applied all the means to destroy Aboriginal culture. The church criticisms on the Aboriginals way of life was the language of the day. To perfect their mission, missionaries intentionally tried to get rid of Aboriginal culture through families separation (David Denham, 2006, p. 60). Same as Carol puts it in her story Bringing Them Home the church was on the front line in separating Aboriginal children from their parents with an excuse that they will be educated in a more civilized way. Additionally, the structures in the learning centers did not allow the interaction of Aboriginal people. Alternatively, the missionaries divided Aboriginal clans into several missions to cut off the development of their culture. The missionaries oppression directed towards Aboriginal people was out of the perception that Aboriginal people were of an inferior race. References Broome, R. (2010). Aboriginal Australians A history since 1788 (4th ed.). (Ch. 1 pp. 5-14 Ch. 3 pp. 36- 56). Crows Nest, Australia: Allen Unwin. Available High use collection David, B., Denham. T. (2006). Unpacking Australian pre-history. In B. David, B. Barker I. McNiven (Eds), the Social Archaeology of Australian Indigenous Societies, pp. 52-71. Canberra, Australia: Aboriginal Studies Press. Dudgeon, P. et al., 2010. The Social, Cultural and Historical Context of Aboriginal and Torres Strait Islander Australians , Canberra: Australian Institute of Health and Welfare. Dodson, M. (1994). The end in the beginning: Re (de)finding Aboriginality. Paper presented at The Wentworth Lecture, the Australian Institute of Aboriginal and Torres Strait Islander Studies, Canberra, ACT. Retrieved from the Australian Human Rights Commission Website: https://www.humanrights.gov.au/about/media/speeches/social_justice/end_in_the_beginning.ht ml Follow link Human Rights and Equal Opportunity Commission. (1997). bringing them Home: Report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from Their Families. Sydney, Australia. Australian Human Rights Commission. Available https://www.humanrights.gov.au/publications/bringing-them-home-stolen-children-report-1997.

Atomic Bomb1 essays

Atomic Bomb1 essays The use of the atomic bombs on Japan was necessary for the revenge of the Americans. These bombs took years to make due to a problematic equation. The impact of the bombs killed hundreds of thousands of people and the radiation is still killing people today. People today still wonder why the bombs were dropped. If these bombs werent dropped on the Japanese the history of the world would have been changed forever. The Atomic bomb took 6 years to develop (1939-1945) for scientists to work on a equation to make the U-235 into a bomb. The most complicated process in this was trying to produce enough uranium to sustain a chain reaction. The bombs used on the cities cost about $2 billion to develop, this also making the U.S. wanting to use them against Japan. Hiroshima was a major military target and we have spent 2 billion dollars on the greatest scientific gamble in history- and won. (3) The bomb dropped on Hiroshima weighted 4.5 tons and the bomb used on Nagasaki weighted 10 kilotons. On July 16, 1945, the first ever atomic bomb was tested in the Jamez Mountains in Northern New Mexico, code named Gadget. The single weapon ultimately dropped on Hiroshima, nicknamed Little Boy, produced the amount of approximately twenty- thousand tons of TNT, which is roughly seven times greater than all of the bombs dropped by all the allies on all of Germany in 1942. The first Japanese City bomb was Hiroshima on August 6, 1945. An American B-29 bomber, named Enola Gay, flown by the pilot Paul W. Tibbets, dropped the Little Boy uranium atomic bomb. Three days later a second bomb named Fat Boy, made of plutonium was dropped on the Japanese city of Nagasaki. After being released, it took approximately one minute for Little Boy to reach the point of explosion, which was about 2,000 feet. ...

According to the United Network for Organ Sharing, Essays - Medicine

According to the United Network for Organ Sharing, Essays - Medicine According to the United Network for Organ Sharing, there are 119,709 people waiting for a transplant in the United States, out of those, 8,030 people die every year while waiting to receive an organ (United Network for Organ Sharing, 2015). The increasing global demand of organs is currently considered a major problem by many governments and the World Health Organization (WHO). The main concerns behind the increasing demand of organs are the low number of donors and the creation of black market networks. Many governments have moved towards better regulation of organ donations, but these efforts have had little influence on the major global " organ heavens " , where individuals from richer areas are able to buy organs from third world countries (Jafar, 2009). This essay will look into the black market of kidneys while focusing on the exploitation of third world countries and the mechanism to counter these illegal markets. In many countries, the demand of trans plants is way higher than the supply and availability of organs. In the United States, only 1/4 of the people in need receive a transplant. There are two ways in which a person can receive a transplant. The first one, where the organs of an individual are donated after his/her death; the second case relies on the donation of organs by individuals while they are alive, the most common organ donated is the kidney (United Network for Organ Sharing, 2015). Yet, the amount of post-mortem organs donated is way less than the demand, leading to the creation of illegal organ markets supplied by living individuals. The global black market of organs is fueled by the practice of transplant tourism. This term refers to individuals who travel to less privileged countries in order to get a transplant; it also involves any aspect relating to the commercialization, sale and purchase of organs (Shimazono, 2007). According to a survey conducted by the WHO in 98 countries in 2004, 66,000 ki dneys were transplanted in that year, while 10% of those were transplanted to individuals from developed countries who travelled overseas in order to get their transplants (The Lancet, 2007). Although we should consider that those people travelling for a transplant are just aiming to save and expand their lives, the practice of transplant tourism is contributing to the exploitation of thousands of individuals from the poorest countries of the world. In many cases, the information received by governments and organization is just the tip of the iceberg. In many countries, the lack of accountability and transparency contributes to the continuous practice of undocumented organ trafficking (Budiani-Saberi Delmonico, 2008). This poses a problem not only for those trying to seek for a solution, but more importantly for those that are at the risk of being drawn into the market. Inequalities of social and economic conditions is one of most alarming aspects of organ trafficking. This is because, those in poor countries who are part from the lowest classes of the society risk their lives in order to hold onto the economic scraps of the pyramid of organ trafficking. In many countries like Pakistan, Peru, India, Philippines, and China, networks of organ trafficking take advantage of individuals by making them sell their kidneys. In many situations, these individuals risk their lives as they undergo poor surgical operations and receive no recovery treatment. It is quite regular that " donors " pay with their health the consequences of poor surgical methods years after selling their kidneys (Jafar, 2009). In most cases, these multimillion dollar networks pay an insignificant amount between 1,000 - 10,000 USD to the " donors " , while they generate hundreds of thousands of dollars in profit. According to the WHO, the cost of a kidney transplant overseas can range between 60,000 - 100,000 USD (Shimazono, 2007). The discrepancy betw een these numbers show the inequality in profit distribution between those who are in the suffering front (donors) and those who are part of the network. Throughout this practice, there is one clear pattern in the donor-recipient relations of kidneys ' black market. Ric Esther Bienstock, director of " Tales From The Organ Trade " , documentary filmed in the Philippines, talked to CNN in 2014 about

Second part Essay Example | Topics and Well Written Essays - 500 words

Second part - Essay Example Currently, a number of studies indicate that many employers still have this notion, and this makes them discriminate against these people when recruiting new employees. Exterior appearance is usually significant for those positions where an employee directly associates with suppliers, customers and other stakeholders. Therefore, an employer can decide not to hire a person with a tattoo for such positions with a notion that most stakeholders will consider them as members of criminal and other outlawed gangs. Therefore, this paper primarily focuses on discussing why employers should discriminate against people with tattoos at workplace. In different societies, tattoos symbolize certain cultures or events. For example, in certain cultures, tattoos portray a person’s status. This is mostly common in the western world. For instance, a person wearing a tattoo of his or her mother or father may indicate his or her love for the family. Moreover, it may also symbolize that a person belongs to a certain clan or community (Bredeson & Goree, 2012). In the 19th Century, tattoos were common phenomena among criminal and outlawed gangs, which differentiated them as anti-social members of the society who only complied with their own rules and beliefs. For example, bikers wore tattoos to indicate that they were against their society’s values and norms. In some circumstances, tattoos also affiliated a person to a given political party or religion. For example, the Catholics may wear a tattoo of a cross to signify their religious affiliation (Bredeson & Goree, 2012). Current studies, on the discrimination of people with tattoos at the workplace, have established that 40 percent of people aged between 19 to 30 years at least have a tattoo (Bredeson & Goree, 2012). These studies further indicate that 40 percent and 18 percent of people with a tattoo have more than two or more and six or more tattoos respectively (Bredeson & Goree, 2012). Therefore, this data calls for an

Neighborhood walk report and ecological analysis using your six senses Case Study

Neighborhood walk report and ecological analysis using your six senses - Case Study Example For that reason, walking in our neighborhood at around 6 PM, on a Saturday afternoon, when people are out for fun with families, the environment is still very serene and quite peaceful; regardless of the fact that Brooklyn is merely one borough of one of the largest metropolitan areas within the United States. We live in an area that has three residential blocks closely built next to one another; with some other blocks built close by. They blocks are of the typical brick red color; with small balconies opening at the front. The windows have black square frames. All the blocks have around three floors and are well equipped with both stairs and lifts. There occasionally are dresses hanging in the balconies, or even at times, brooms or dusters hanging down the railing. The face of the last block in the row is somewhat decayed because of frequent rain; probably combining the affects of not having been painted with the long term impact of acid rain. At around this time, people are moving in and out of their blocks. There are very few cars in the front area since the parking lot is built towards the back of the building. Children are coming off the blocks, returning to their homes for dinner. Some small boys are sitting in the block entrances fixing their helmets, putting on their knee pads; one was even seen fixing his hair in the motorbike side mirror. Some grownups, mostly dressed up casually are seen heading towards the beach for walk. As we walk out of the block, the serenity seems to slowly and gradually disappear from the surroundings. The mental tranquility and environmental serenity often gets interrupted as the cars move closer to our blocks. The most cited traffic nuisance is normally created by a garbage truck driver; who visits our neighborhood around this part of the day. He oftentimes appears to me as if he is an angry and frustrated man; seemingly suffering from some type of internal depression. At the same time, people in cars and cabs are seen looki ng occasionally to their watches. They must be getting late for home or other plans they must have sequenced for Saturday evening. If we walk closer to the cars with their glasses drawn downwards, we hear people in different languages; mostly in a thick accent of one form or another cursing the other drivers. The cab passengers are seen with equally aggressive and frustrated expressions. Sometimes they are even cursing their driver or quarrelling to drive faster. Some people reach for cell phones or quickly glance at the screen; as if reading the text or punching a rapid succession of buttons on the screen in order to type an urgent message to someone. Certain of them make calls and talk loudly, sounding as if they are explaining or apologizing for being late. In this busy hassle, some people are at times seen very calm. In fact, there seems to be an occasional dating couple. The men usually sit calmly on the driving seat, with shades on and smiles, along with a lady, sitting adjace nt generally as equally happy. The Three Blocks in a Row Some Local Eastern Residents The Famous Neighborhood Gang The library Close to our Blocks 2. Analytical Report of Neighborhood The people in the neighboring areas are very busy with their own lives. In the past 10 years or so, many different cultures have arrived in this area. New York has always been a melting pot of different religions, races, and ethnicities;

Reflective Account: Ethical Dilemma Treating Cancer

Reflective Account: Ethical Dilemma Treating Cancer This reflective account will discuss an ethical dilemma which arose during a placement within a community setting. To assist the reflection process, the Gibbs (1988) Reflective Cycle which encompasses 6 stages; description, thoughts and feelings, evaluation, analysis, conclusion and action plan will be used which will improve and strengthen my nursing skills by continuously learning from both good and bad experiences, and develop my self confidence in relation to caring for others (Siviter 2008). To comply with the Nursing and Midwifery Code of Conduct (NMC) (2008) and maintain confidentiality all names have been changed and therefore for the purpose of this reflection the patient will be referred to as Bob. Bob is a forty four year old man who has been receiving aggressive and invasive treatment for several months in the form of chemotherapy in an attempt to cure his Hodgkinsons lymphoma cancer. Throughout the treatment Bob remained positive that he would be able to put the worries behind him and live a normal life with his partner and teenage daughter. However, Bob was unable to control his body temperature, which was a possible sign the chemotherapy had not been successful and was offered further investigations to establish his prognosis. Whilst my mentor who is a Community Matron, was talking to Bob, his partner Sue took me to one side and asked me if the investigations revealed bad news would it be possible to withhold this information from Bob because she felt he would not be able to deal with a poor prognosis and would give up hope. Prior to Bobs original admission the possibility of f the chemotherapy failing was discussed but he refused to consider this was an option and was convinced the condition could be treated successfully. I explained to Sue that this situation was outside of my area of expertise but with her permission would discuss it with my mentor and ask her to contact Sue at a mutually convenient time to discuss further. My mentor contacted Sue and advised her that she would discuss the situation with Bobs Consultant once they had received the results of his tests. However, my mentor diplomatically informed Sue that she has no legal right to insist that information be kept from Robert (Dimond 2005). As expected Bobs test results concluded the chemotherapy treatment was unsuccessful. Considering what he knew of Bob, the consultant agreed it would be advantageous to withhold the diagnosis from him. Therefore it was agreed to discuss Bobs test results with his partner. Thoughts and feelings In the first instance I felt that the Consultant was ethically wrong to withhold the results of the investigations from Bob and not necessarily acting in his best interests. I felt that in order to ensure Bobs rights were protected and to give him the opportunity to be involved in his own plan of care he should be informed of the outcome of the tests. Bob had the capacity to consent and as during my placement would be acting as an advocate for him. I felt that if I was in Bobs position, I would want to know what the outcome of any investigations were and it did not seen right that the diagnosis would be documented in his records and his family and possibly friends around him would be aware of his diagnosis whilst he was kept in the dark. I felt that if we were to visit on a regular basis that I would feel very uncomfortable knowing something that had been kept from him and possibly have to lie to him or avoid answering directly when asked difficult questions. I felt that I would be a ble to have a better relationship and understand the care he wanted if he was told the truth about his condition. I also felt that his family were taking denying him the right to autonomy and th right to make informed choices in his end of life care. Analysis The situation was complex in terms of ethical principles. It was not just a matter of clinical practices but providing the best holistic care to Bob during his forthcoming terminal illness. This situation gave rise to multi-disciplinary team discussions to assess whether the diagnosis should have been delivered to Bob. Standing back from the situation, I realize that my own feelings were perhaps judgmental and that I should have taken a more holistic approach rather than just clinical. It also made me aware of the importance of promoting advance directives to patients in situations where an illness may lead to terminal care Evaluation Today patient autonomy is a highly regarded principle that healthcare professionals promote at all times and is fundamental for all patient interactions of which telling the truth to a patient about their diagnosis and prognosis is part (Dimond 2005). Lo (2009) says to be totally autonomous competent patients have to be told the nature of their illness, recovery prospects, how their illness will develop, treatments available and the consequences of any such treatments to enable them to make an informed choice in order to grant consent to treatment of their choice or refuse treatment they do not want. However this has not always been the case, traditionally, paternalism, where the doctor alone would make a decision about whether or not to inform their patient of the diagnosis used to be the preferred method of treating and caring for patients (Lo B 2009). It is only over the past 20 years or so where it is the norm to share decision making with the patient to enable them to make informed choices in their preferred care and treatment (Boyle 1995). However not all patients want to know their prognosis or take part in their end of terminal treatment and care. A study which took place in 1995 concluded that some ethnic groups were less likely to approve of truth telling in respect of diagnosis than others (Blackwell 1995). The UK is culturally diverse and not all patients and families want or accept autonomy. When a person is sick in some cultures, the family prefers to take responsibility for the medical decisions and often wish to receive the diagnosis and nursing plan before the patient. Although this is often the case within Chinese and Japanese cultures, it does not automatically mean that the request to withhold diagnosis from the patient will be upheld. To add to this complex issue, there may be differences within these cultures, such as recent immigrants and older family members wishing to adhere to cultural traditions and younger family members wishing to practice autonomy (Lo B 2009). Advanced care directives definition are used to enable a person to have autonomy. These ethicalBarbosa da Silva (2002) defines an ethical dilemma as: A situation where a person experiences a conflict where he or she is obliged to perform two or more duties, but realizes that whoever action he or she chooses will be an ethically wrog one. Many experts agree healthcare professionals are faced with many ethical dilemmas when caring for terminally ill cancer patients. Communicating the diagnosis and subsequent prognosis is one of the most common (Kuupelomaki and Lauri 1998)(Roy and MacDonald 1998). It is not unusual for relatives to ask a Consultant to withhold information (Alexander et al 2006) which Kenworthy et al (2002) says family members request out of compassion and love. However, (2006) disagrees and suggests it is often the relatives who are unable to cope and have difficulty coming to terms with the impending prognosis. Dimond (2005) suggests withholding the truth can be harmful or lead to a conspiracy of silence but may be justifiable if it is in the patients best interest not to know. In agreement, Lo (2009) points out receiving bad news can have a negative and drastic effect on a patients view of their future. Nurses have a duty in accordance with their professional code of conduct to act as a patients advocate. Whatever their personal thoughts are in relation to withholding diagnosis from a patient, if the Consultant deems it in the best interest of the patient then a nurse has a duty to adhere to the Consultants decision (Dimond 2005).However Georges and Grypdonk 2002 suggest this can lead to nurses feeling powerless, frustrated and concern when involved in palliative care. Evidence suggests that if a Consultant establishes it is not advisable to inform the patient of the diagnosis or prognosis then it is right to give information to the family (Rumbold 2006). Dimond (2005) states patients have no legal rights to information and therefore if a Consultants believes it is in the best interest of the patient they can refuse to give a diagnosis to them. However, some would argue to withhold information would be considered paternalism (Lo B 2009). Paternalism is when an individual, in this case the Consultant, believes they are in a position to act in the best interest of another individual. Although Bobs welfare is key, the consultant has taken away his right to his autonomy to make future healthcare choices including important end of life decisions by making the decision not to inform him of his diagnosis (Sandman and Munthe 2010). Tingle and Cribb (2005) define this as hard paternalism as opposed to soft paternalism in which Bob would not have the capacity to make an informed decision regarding treatment and care following his diagnosis. The may be in beneficience to the patient but conflicts with autonomy. While considering the decision to not tell Bob the truth regarding his diagnosis, the consultant would have taken into account the ethical principles of beneficence (to do good) and non-malifience (to cause no harm) (Dimond 2005). In Rumbolds (2006) opinion it is wrong to not tell the truth or withhold information from a patient as it denies the patient autonomy and is in conflict with the ethical principles of beneficence and non-malificience. Research carried out by Sullivan (2001) suggests patients believe that Doctors should tell them the truth with a staggering ninety nine per cent of patients wanting to be informed of their diagnosis. However there is evidence to suggest the consultant was right to withhold diagnosis as it can initiate denial, and cause the patient psychological damage (Kenworthy et al 2002). Patients react differently to bad news and Elliott and Oliver (2007) suggests information should given slowly enabling the patient to have enough time to absorb the information given. Sadness, despair, anxiety and depression are feelings patients suffer when faced with life threatening illness. >believes that if healthcare professionals have an open and honest relationship with their patients it enables greater trust (Elliott and Oliver 2007). Bowers and Arnold (2010) agrees with this and adds that an open relationship based on trust enables healthcare professionals to support patients to be in control and make preferred choices with issues relating to their end of life care. However, Kenworthy, Snowley, Gilling (2002) are in disagreement with these statement say to force a patient into to face the trust regarding their diagnosis is both unethical wrong and damaging. Millard and Florin (2006) (nursingtimes) says that patients have different needs which can often be complex and it is important to recognise that some patients choose not be involved, that some individuals do not want to be part of their care but put their trust in health care professionals who are t rained in what they do. Elliott and Oliver (2007) states that a hope is fundamental to a terminally ill persons wellbeing and as such is something to be protected. She adds that hope of a cure whilst facing a terminal illness is an individuals right and helps them to face the final stages of life and points out that if hope is taken away it leaves a patient with only fear. Conclusion This experience has made me aware that good listening, hearing and communication skills are vital to gain a holistic view when dealing with patients and close ones in end of life care. It is also important to liaise with other members of the multi-disciplinary team to ensure that the best possible approach and care is delivered to the patient. It is important not to be judgemental but to incorporate all issues when taking a holistiv view in order to make the right decision. As this was my first experience of end of life care in the community, I was in unfamiliar surroundings and as such not experienced enough to make the right decision in Bobs case. The consultant was correct in determining that Bob was not in a position to accept a poor diagnosis and therefore withholding the information was the correct decision. Action Plan. My action plan is to promote advanced decision and power of attorney Assess holistically and taken into account I also feel than advance directives may have cleared some of this issues and will read about their importance in would have resolved some of this issues and read about their importance and promote their importance when the opportunity arises However, the circumstances surrounding this decision could only be applied to Bobs situation. I believe that as a Nurse I will be involved in ethical dilemmas again however I feel that now I my decisions will be based on each unique patient recognising their own individual needs and wants. Delegation This essay is a reflection of a situation I came across whilst on Community Placement. To assist with this process, Driscolls model of reflection will be used to focus my thought processes whilst learning. Driscolls is a straight forward model which encourages one to return to a situation to understand it better and improve future experiences (Driscoll 2000). To comply with the Nursing and Midwifery Code of Conduct (NMC) (2008) and protect the confidentiality of patients pseudonyms have been used throughout. As required by the first stage of Driscolls model I will describe the event s which took place whilst my mentor was on annual leave and I was assigned to Dianne, another district nurse within the community team. The reason I have decided to return to this situation is because registered nurses should ensure their practice does not compromise duty of care to individuals and at the time I felt that Dianne was delegating duties inappropriately and therefore may have been in breach of NMC requirements (NMC 2004). Whilst assigning the days work Dianne said that it would be a good opportunity for my personal development to go out unsupervised to visit patients within the area to carry out their care and treatment. I was asked to visit a 92 year old patient called Rose who the team visited on two or three times a week to treat a couple of problems. Firstly, she had ulcerated legs which the team were treating with four layer compression bandaging which evidence suggests is the best way to encourage venous return in order to maximise the healing process (OMeara et al 2009). Secondly she had a small sacrum sinus which was packed and redressed. Diannes request put me in an awkward position as I had visited Rose on a number of occasions with my mentor and with her supervision had been able to assess, treat and care for Roses problems appropriately with the exception of applying compression bandages as my mentor had explained to me were only to be applied by staff who had received appropriate training . I am keen to take advantage of any professional development opportunities and improve my clinical skills. However I felt that although I was able to manage most of the delivery of care to Rose as required by the NMC Code of Conduct (2008) applying the compression bandaging was outside my remit and would have been unsafe practice. My feelings were that Dianne was not doing this for my personal development but for her own personal reasons resulting in her abdicating her responsibilities. She did not ask me how I felt about attending patients without supervision or check I had the necessary clinical skills. With this in mind I agreed I would visit Rose, take down her dressings, assess and debride the wound, apply appropriate dressings and the first two layers of bandages. However I requested that Dianne called in after me to apply the compression bandages. Dianne did not appear to be very happy with my request but reluctantly agreed. When I arrived at Roses I introduced myself and explained the purpose of my visit and that Dianne would follow me to apply the compression bandages. I explained at each stage what I was doing, to put Rose at ease, remembering look up and face Rose, so that she could hear clearly what I was saying or read my lips and facial expression as she was partially deaf. As agreed with Dianne I took down the existing dressings, debrided and assessed the wound against the current wound care plan. The wound bed had reduced considerably and although an Inodine dressing had been applied previously, the wound had dried considerably and in my opinion did not require replacing. Therefore I telephone Dianne to let her know of my assessment and it was agreed to dress the wound with a simple NA dressing before bandaging. Whilst at Roses I took the opportunity to update the wound care plan and therefore documented the size of the wound, excudate, smell etc etc and documented all my findings and actions in the care plan. Whilst at Roses I also required to redress the sacral sinus in accordance with her care plan. When assessing the wound I noticed that although her skin was not broken, her sacrum was very red. I had also previously noticed that although she had a pressure cushion sitting on another chair I had never actually seen her sat on it. Therefore I took the opportunity to encourage her to become involved in promoting her own health and explained that her sacrum was very red and that as she sat for long periods of time, it was possibly that her skin would break down, which was why she had been issued with a pressure cushion. We discussed why she did not use the pressure cushion, she said that she did not find it very comfortable in her favourite chair, I explained the benefits of the pressure cushion and we agreed that she would sit in another chair with the pressure cushion in situ for a least part of the day and that we would discuss how she got on next time I visited. Before leaving Roses I documented my assessments, nursing interventions, evaluation and actions in her care plan. The second stage of Driscolls entitled now what will look at the chain of events which has led me to reflect on when it is appropriate to delegate care. Delegation involves entrusting and transferring a task or responsibility to another person who is able to accept responsibility for the task, typically one who is less senior than oneself (Sullivan and Decker 2005, Oxford dictionary 2011). However Wheeler (2004) argues that delegation and abdication amount to the same thing. On the other hand MacKenzie (1998) states that abdication is giving up either by abandonment or resignation and says that whilst delegation can offer potential benefits to both individuals and organisations, many nurses practice abdication which can be attributable to the current economic climate of underpaid and overstretched employees. Whilst I did appreciate that Dianne thought I was capable to deliver appropriate care to Rose I also suspected that she thought it she would have an easier day if she asked me to carry out the more routine and mundane tasks. The NMC standards of proficiency (2004) state whilst nurses should delegate care to others they should also accept responsibility and accountability for such delegation. As a registered nurse under the NMC Code of Conduct (2008) nurses have a duty of care to ensure that patients receive care in a safe and skilled manner. Dianne was not aware if I was competent or not to carry out compression bandaging as she had neither previously worked with me or questioned me about my clinical skills. In line with the NMC Code of Conduct (2008) I understand that I must work within the scope of my professional competence and it is for this reason I refused to apply the compression layer. It is important for organisations and individuations to delegate in order for them to develop and function resourcefully and successfully (Ellis and Hartley 2004). Effective Delegation requires skills in planning, analysis and self-confidence. The tasks to be delegated should be assessed, planned, communicated, implemented, monitored and evaluated (Royal College of Nursing 2006). In the UK, the rate of change is accelerating and the delivery of services are regularly restructured in an attempt to provide the most effective and efficient care to patients (Shepherd 2008). This environment has lead to the evolvement of work from junior doctors to nursing staff such as giving intravenous therapy and with the evolvement of nursing practitioners many agree that the role of the nurse is increasingly difficult to define as the boundaries are constantly changing (Shephard 2008, Spilbury and Meyer 2005, McKenna et al 2006). A study conducted by Ulster University condones that there is much ambiguity amongst the nursing role. It concluded that although nurses are happy with role extensions they have less patient contact as they would like. Some nurses like the role extension of technical jobs, however others see it at the menial tasks Doctors do not want to do (Allen 2002). However this was only a small survey of 26 nurses and therefore may not be a true representation of all RGNs (McKenna et al 2006). It can be assumed therefore that demands on nursing care at times are greater than RGNs can cope with, and therefore increasing expected to to delegate some tasks routinely, traditionally carried out by RGNs, such as personal care (Curtis and Nicholl 2004). Effective delegation can give RGNs more time for other activities which enables them to focus on doing fewer tasks well rather than many tasks poorly and offer HCAs the opportunity to become competent and improved confidence (Kourdi 1999). Shepherd (2008) articulates that it is important for these tasks to be defined and when devolved it should not be at the detriment to the patient. As a result health care assistant (HCA) roles have increased in both numbers and cope of activity undertaken and it is therefore important that all health care staff understand their roles and accountability in the delegation process. Health care staff need to work together in order for patients to receive safe and effective care from the most appropriate personnel (Pearcey 2007). However some nurses find it difficult to relinquish any part of their role and find it difficult to delegate (Wheeler 2004) Zimmerman (1996) suggests this might be because some nurses were trained before delegation skills were required. However Nicholl and Curtis (2004) state that delegation is not an art and but a nursing skill which can be learned and is becoming increasing important in changing times. Delegation also enables health care professionals to train in new skills and broaden their skill range. However Wheeler argues that some could abuse their power of delegation for example to provide themselves with extra breaks while their subordinates may have to forfeit theirs to complete additional tasks. Or one nurse could favour a subordinate resulting in some always receiving more appealing tasks than others. Delegation is a complex process and to successfully delegate consideration should be given to both existing workload and skill mix of staff should be known. Delegation of too many tasks may result in loss of control, but failing to delegate may lead to one member of staff being overwhelmed, overworked and can lead to incompletion of duties and de-motivated and un-cooperative team. Most HCAs give personal care due to the fact they are usually more available than RGNS. Many studies have indicated that RGNS favour the employment of HCAs (McKenna and Hansson 2002). However the MIDRIS (2001) study suggests that care provided by HCAS is task based and fragmented. There are many pros and cons for delegating tasks. Detailed Job Descriptions (JD) may result in staff being reluctant to take on new responsibilities that are not specified on their JD. Others will be reluctant and believe if you want a job done properly do it yourself. This can inhibit delegation leading to nurses being overworked stressed with little job satisfaction (Kourdi 1999). On the other hand Wheeler (2001) suggests effective delegation encourages staff to have a better understanding and be able to influence the way in which work is carried out. She also says that by participating in decision-making it will increase motivation, morale and ultimately job performance enabling the organisation to become more flexible and responsive to change. Effective delegation will enable a business to move forward as new ideas and viewpoints will be encourage and it will better prepare nurses to be able to cope when career opportunities arise (Wheeler 2001). Delegation frees up time to enable a nurse to carry out other duties which cannot be delegated. Although at first the time saved might me minimal once the HCA becomes proficient more time will become available. Fewer tasks are better than many that are inefficient (Kourdi 1999). In order to delegate effectively it important to decide which task to delegate , select the best person to carry out that task, assessing the task in detail and offer clearly the level of authority associated with it, , check the skills and experience of the delegates, follow the task process and assess and discuss the progress (Curtis and Nicholl 2004). Cohen suggests it is right to delegate in order to carry out an organisations needs as long as certain criteria is met such as right task, right circumstance, right person right communication and right supervision. The third stage, of the Driscolls reflection model requires what can be done differently in the future and what actions to be taken. Dianne was right to delegate the more junior tasks in order to ensure the fewer tasks she had were carried out more effectively. However should have verified my competence prior to delegating. If she had communicated with me effectively to assess my competence I would not have felt awkward having to point out that I did not have the skills to carry out compression bandaging and only practice within my capabilities (NMC 2008). In the future in such a situation I would not do anything differently as I believe I have a responsibility for practicing within my own capabilities in line with the NMC Code of Conduct (2008). Had I been a permanent member of staff I would have asked for compression training, however this would have been impractical as I was on placement for only a short period of time. When I qualify this situation I will be aware that I am ultimately responsible for the care of patients even when tasks are delegated to HCAs. I will also ensure that I do not delegate anything that involves critical thinking skills such as nursing assessments, planning and evaluation of patient care and nursing judgement. (take off 90 for references)

Mass Marketing Is Dead

Mass market advertising was once an effective marketing tool. The â€Å"one product suits all† approach had its heyday and is now declining. Hallerman (2006) wrote that in an American Association of Advertising Agencies (AAAA) survey, only 28.7% of respondents now believe that untargeted advertising will be very effective by 2010. The survey is validating the consensus that mass marketing is dead. Increasingly, business leaders, marketing and advertising practitioners are looking at niches, market segments and differentiated audiences as targets.Emergence of Mass MarketingAccording to Lake (2007), marketing is the systematic conduct of business activities to result in a mutually advantageous exchange of products between buyers and sellers. It started off from the sales techniques used by traders and the promotional methods of skilled artisans. Mass marketing is a marketing approach in which the marketer addresses all segments of the market as though they are the same. It refer s to the treatment of the market as a homogenous group and offering the same marketing mix to all customers. (â€Å"Market Segmentation†. n.d.)Companies that employ this strategy expect to generate profits through economies of scale. Marketing, particularly mass marketing, became a discipline as we know it today after the emergence of (1) the mass production of goods; (2) channels of mass distribution of products; and (3) media for mass communication.Mass marketing required a mass supply of goods and the Industrial Revolution facilitated reaching greater volumes of production. New technologies engendered better machinery and production processes. Large quantities of products could now be manufactured at lower costs. This placed the goods within the reach of a greater number of consumers. It made little business-sense to encourage the purchase en masse of a product if such product was non-existent or not readily available for transfer to the buyer.The mass production of goods would have been, however, useless if the products did not reach the consumers. Again, the Industrial Revolution helped bring this forth. The invention of the steam engine led to the establishment of railways that brought the products en masse to distant markets at cheaper rates. Essentially, the railways brought isolated communities closer. Where before, produce of the area could only be sold within the locality, these may now be transported to and sold in far-away areas through the railway system.Now that products are easily reaching distant markets, their existence had to be brought to the attention of potential buyers. The message that â€Å"products were available for purchase affordably† had to be communicated. Again, the Industrial Revolution helped realize this. First, the Gutenberg press allowed the wide-scale dissemination of information through newspapers. Later on, we had the radio, television (broadcast and cable) and the internet.Of course, mass marketing did not magically emerge as soon as the objective condition of having mass production, mass distribution and mass communication existed. The subjective element had to exist. Entrepreneurial vision, drive, organization and resources had to implement the strategy. (Meyer and Dailey. n.d.)A classic example for mass marketing would be Henry Ford’s Model T car. Ford adopted mass production techniques and standardized output that resulted in lower costs. To generate demand for the Model T, it marketed as an automobile that would meet the needs of all buyers at an affordable price.Changing Consumer DemandA big impetuous for mass marketing came after the close of the Second World War. The war effort resulted in increased production capacity, new technology and most importantly, increased demand.A large segment of men went into the military service during the war. Women replaced them in the production of goods. Factories that used to produce consumer goods shifted towards producing weaponry and other resources needed to fight the war. This resulted in full employment of the labor force with greater spending capacity. However, due to the war and the limited supply of consumer goods, spending was â€Å"curtailed† and incomes were saved. According to McCann (1995), there was high pent-up demand when the war was over and the men returned home. Mass demand for consumer products logically followed this pent-up demand considering that the populace had wealth to spend.The new production capacity and improvements in electronics resulted in inexpensive radio and affordable television set. Households easily got hold of radio and television sets giving manufacturers a channel through which they may address the consumers. An almost universal audience for the manufacturers’ pitch was created.Bianco, et al. (2004) wrote the United States was far more uniform not only in terms of ethnicity but also of aspiration in the 1950s and 1960s. The ideal was to own the same model of car or lawnmower or products as the Joneses, or at least ones neighbors. This changed in the 1970s and 1980s due to greater affluence. From â€Å"I want to be normal†, says McDonald’s Light, it became â€Å"I want to be special†. (Bianco, et al., 2004)Multiplicity of Communication MediaThe development and widespread use of printed text in Europe in the1500s produced a brand new form of communication. A single message could now be duplicated with little error and distributed to thousands of people. (â€Å"Tutorial: Mass Communication†. n.d.) McCann (1995), however, said that it was broadcast media that served as the cornerstone of mass marketing.Print media is usually read by individuals even though a standard message may be printed in each copy. Broadcast media, on the other hand, can create a â€Å"monolithic eyeball† – millions of consumers tuned in to a single program. By its nature, broadcast media was for a long time a very viable c hannel for marketing. Bianco, et al (2004) reported that an advertiser in the 1960s could reach 80% of U.S. women by airing simultaneously on CBS, NBC and ABC a commercial spot.However, the hegemony of mass media in influencing consumers has diminished. Business competition and technological advances have resulted in a diversified mass media environment. We have the giant broadcast networks and a multitude of narrowcast cable TV stations. A Nielsen Media Research reported that the average U.S. household receives 100 TV channels in 2004 compared to only 27 in 1994. (Bianco, et al. 2004)Traditional broadcast media is also being affected by new media technologies. The internet has opened a new channel for marketing and is increasingly affecting advertising revenues traditional mass media. In fact, we now have an online version of almost every television station, newspaper and magazine.The internet has also allowed a democratization of mass communication. Now, every person can send out his message through blogs, personal websites and online forum. This in turn creates even more niches that the mass marketer must consider and contend with. Each website can potentially promote or demote a consumer good.Where the communication flow through traditional mass media channels was one-way, new media allowed interactivity. Readers or viewers can interact with the source of information being viewed. A blogger establishes a regular audience by addressing special interests. As with online forums, viewers are encouraged to respond.Current technology now also allows the consumer to by-pass even the most targeted advertising that a marketer may come up with. Personal video recorders are allowing consumers to watch a program when they want to. This has increased television viewing. Research, however, shows that personal video recorders were used to skip about 70% of ads. (Bianco, et al. 2004)SummaryThe same elements that gave rise to mass marketing are tearing it apart. Technologi cal advances brought forth mass production, mass distribution and mass communication. The ordinary consumer is faced with tons of consumer goods. Production techniques now allow mass production of custom products. Automobiles can now be produced in different styles, color, and accessories preferred by the consumer with minimal disruption in the assembly and at little additional cost.Products and consumer goods can now be easily distributed. Shipping of consumer goods is accessible to all. Individual sellers can easily sell and ship products as shown by the success of such online auction site as eBay. More importantly, information and communication technology has developed to the extent that access to information can not be limited. This allows consumers to be more discriminating.Mass marketing is a thing of the past. Mass marketing requires a mass market, a single market without differentiation. In fact, M. Lawrence Light, McDonald's global chief marketing officer said that the mass market never really existed. It was just that the available technologies of the past did not allow companies to reach the individual markets that existed then. (‘Marketing in the â€Å"Age of I†. 2004) While the world has grown smaller due to technological advances, it has magnified the diversity of consumers. Disparate communities are brought closer but proximity does not always translate into homogeneity.Since advances in technology will enable better data gathering, marketers will also be better at connecting with consumers. The marketing message can be refined to the point that it is not intrusive or invasive. According to James Stengel, Procter ; Gamble’s global marketing officer, the future of marketing will be oriented to permission marketing wherein marketing and advertising will be welcomed by consumers because they are viewed as relevant. (Bianco, et al. 2004) This, however, can no longer be done through mass marketing.ReferencesBianco, A., Lowry, T., Berner, R., Arndt, M., and Grover, R. The Vanishing Market. BusinessWeek (July 12, 2004). September 28, 2007. ;http://www.businessweek.com/magazine/content/04_28/b3891001_mz001.htm;Hallerman, David. June 16, 2006. The Death of Mass Marketing: eMarketer looks at the rise of ad targeting. September 28, 2007. ;http://www/imediaconnection.com/content/10063.asp;Lake, Laura. n.d. Marketing vs. Advertising: What’s the Difference? September 28, 2007. ;http://marketing.about.com/cs/advertising/a/marketvsad.htm;â€Å"Market Segmentation. n.d. September 29, 2007.   ;http://www.netmba.com/marketing/market/segmentation/;â€Å"Marketing in the ‘Age of I’†. BusinessWeek (July 12, 2004). September 28, 2007. ;http://www.businessweek.com/magazine/content/04_28/b3891011_mz001.htm;McCann, John M. March 10, 1995. The Changing Nature of Consumer Goods Marketing ; Sales. September 28, 2007. ;http://www.duke.edu/~mccann/cpg/cg-chg.htm;Meyer, Earl C. and Dailey, Lori A. n.d. Ma ss Marketing. September 29, 2007. ;http://www.answers.com/topic/mass-marketing?cat=biz-fin;â€Å"Tutorial: Mass Communication†. n.d. September 29, 2007. ;http://www.rdillman.com/HFCL/TUTOR/Media/media2.html;

Ocd Research Paper

Obsessive-Compulsive Disorder OCD stands for obsessive-compulsive disorder. An individual with OCD tends to worry about many different things. On average, one out of fifty adults currently suffer from this disorder, and twice that many have had it at some point in their lives. When worries, doubts, or superstitious beliefs become excessive then a diagnosis of OCD is made. With OCD it is thought that the brain gets stuck on a particular thought or urge and just can't let go. Most often people with OCD describe the symptoms as a case of mental hiccups that won't go away. This causes problems in information processing.OCD was generally thought as untreatable until the arrival of modern medications and cognitive behavior therapy. Most people continue to suffer even though they had years of ineffective psychotherapy. Today treatments tend to help most people with OCD. OCD is not completely curable but is somewhat treatable. OCD is a potentially disabling condition that may persist through out a person's life and get worse without treatment. An individual with OCD becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but are extremely powerful and hard to overcome.OCD can occur in cases from mild to severe, but if left untreated can destroy a persons life and capacity to function at work, school, and even at home. Some of the worries and rituals can get out of control. An individual life becomes dominated by thoughts and behaviors they know make absolutely no sense but they are powerless to control. People with OCD tend to fear uncertainty; these people are plagued by persistent and recurring thoughts or â€Å"obsessions† that they find very disturbing. These thoughts usually reflect exaggerated anxiety or fears that have no basis on reality.A person who suffers from OCD has constant doubts about their behaviors and constantly seeks assurance from other people. Many people who suffer from this disorder feel compell ed to perform certain rituals or routines to help relieve the anxiety caused by their â€Å"obsessions†, however the relief is only temporary. Some rituals or â€Å"obsessions† include cleaning, checking, repeating, slowness, and hoarding. Usually an individual has both obsessions and compulsions, though sometimes they have only one or the other.A person with OCD usually wants everything around them to be perfect. {What is 1}? Most common symptoms of OCD go along with a certain compulsion for instance: A need to tell, ask, or confess goes along with praying. A need to have things â€Å"just so† goes along with hoarding or saving. Forbidden thoughts equals arranging. Excessive religious or moral doubt = counting. Intrusive sexual thoughts or urges cause touching. Imagining losing control or aggressive urges causes checking. Imagining having harmed ones self or others creates the symptom of repeating.Fear of contamination or germs causes constant washing. Compulsi ons are intrusive thoughts, impulses, and images that feel out of control and occur over and over again. A sufferer does not want to have these ideas and knows that they don't make any sense but find them intrusive and disturbing. A person with OCD may be obsessed with the idea they are contaminated or may contaminate someone else and worry excessively about dirt and germs. This person could also have an intense fear that they harmed someone else although they usually know it is not realistic. {What 3}Some of the most common obsessions of OCD in children are extreme concern with order, concern that a task or assignment has been done poorly or incorrectly, concern with certain sounds or images, fear that a disaster will occur, there is also the fear of AIDS, fear of getting dirty, fear of losing important things, recurring thoughts, and a fear of saying something wrong. Checking compulsions are rituals that are precipitated by fear of harm to oneself or others and this includes the c hecking of doors, locks, heaters, alarms, faucets, switches, and other objects that could be a threat.This can create problems for the learning of a child. For example while getting ready for school a child may check his or her books several times to make sure they are all there even to the point where the child is late for school. Once the child is in school they may call to return home and check their books once more. These rituals may also interfere with the completion of homework. This could make a child work late at night to complete an assignment that could have taken ten minutes to complete. Repeating compulsions are rituals in which some one repeats a certain action over and over again.These rituals can in some cases be anxiety driven and in other cases have to be done â€Å"just so†. For instance a person might walk backward and forward or get up and down from a chair many times until the ritual is performed â€Å"just right†. These rituals are also connected with counting rituals. In children the rituals can assume many forms in the classroom. This could lead to many repeated questions because the child may need to remember or know something. On written assignments the student could endlessly cross out, trace, or rewrite letters or words.Lockers can also cause a problem because the combination may need to be repeated several times till it feels right. Note taking is most likely impossible because the student is compelled to take every word down. Computer scored tests are a nightmare because the student has to fill in the circles perfectly. Uncomfortable feelings such as fear, disgust, doubt, or a sensation that things have to be â€Å"just so† usually accompany obsessions. A person tries to make their obsessions go away by performing certain compulsive rituals. These compulsions are acts that an individual may perform repeatedly, often according to certain â€Å"rules†.OCD symptoms do not give a person pleasure but a sense of temporary relief for a short period of time. The relief is only temporary and the discomfort always comes back. These relieve make up a lot of time and interfere with a person's social life and relationships. The less common form of OCD is hoarding which is the excessive saving of typically worthless items. A most commonly thought form of OCD is contamination. This is the awareness of germs, disease, or the presence of dirt that evokes a sense of threat and an incredible inspiration to reduce the presence of contamination.The compulsion of contamination involves a cleaning response such as hand washing and chronic cleaning. {Steven1} Another common form of OCD is checking. Checking involves door locks, lights, switches, faucets, stoves, or items left unchecked that might pose a threat to ones well being or the well being of others. It is not uncommon for people to check items between 10 to 100 times a day. The impulse to recheck can remain until the person experiences a reductio n in tension despite the realization that the item is secure.One other less common form of OCD is ordering in which a person feels compelled to place items in a designated spot in order. Although contamination fears frequently lead to excessive washing they can also have the opposite affect, shoes may be untied, teeth unbrushed, clothing may be slovenly and hair may be dirty. In these cases, fear of contamination of personal objects or body parts leads to the individuals’ refusal to touch them. A combination of excessive hand washing and sloppiness in other areas of grooming had even been reported. Obsessions revolving around a need for symmetry may result in compulsive arranging.Children who engage in symmetry-related rituals may also feel compelled to have both sides of their bodies identical. For instance a child my spend an inordinate amount of time tying and retying shoelaces so that each side of the bow is perfectly even or â€Å"balanced†. Symmetry rituals may c onsist of taking steps that are identical in length or speaking with equal stress on each syllable. In a classroom, symmetry rituals may be seen in the student's compelling need for order. Books on a shelf, items on a desk, or problems on a page must be arranged in a precise manner so that they can appear symmetrical to the student.Most people recognize at some point that their obsessions are not just worries about real problems but are coming from their minds. Compulsions are excessive or unreasonable but the sufferer has to perform them. OCD poor insight is an individual that not recognize that their beliefs and actions are unreasonable and unreal. Extreme severe distress tends to happen when the symptoms wax and ware over time. OCD symptoms can start at any age from as early as preschool too as late as adulthood. 1/3 of 1/2 of adult sufferers said that their symptoms started during their childhood.On an average people spend 9 years seeking a diagnosis and see up to 3 to 4 doctors . Studies also show that it takes an average 17 years from the time OCD begins for an individual to find appropriate treatment. {What 3} OCD may be under diagnosed and untreated for a number of reasons. People with OCD may be secretive about their symptoms or lack insight on the illness. Many healthcare providers are not familiar with the symptoms and are not trained to provide treatment. Some people may also not have access to treatment resources. This is unfortunate since early diagnoses and proper treatment can help an individual.Research suggests genes do play a role in development of the disorder yet no specific genes have been found for OCD. Childhood onset tends to run in the family. An increasing risk for a child getting OCD is if the parent has it. When OCD runs in families it seems to be inherited but not the specific symptoms. One example is if a child has checking rituals his mother might wash excessively. There is no single proven cause for OCD. Research suggests that O CD could involve problems in communication between the brain and deeper structures although this is not proven. what 4} For many years only a small minority of healthcare professionals patients had OCD there for it was thought to be rare. OCD went unrecognized often because many of those afflicted with it kept their repetitive thoughts a secret and failed to seek treatment. This led to the underestimate of the number of people with the illness. {obsessions 1} In approximately 80% of all cases, people performing the rituals are painfully aware that their behavior is unreasonable and irrational. OCD is an anxiety disorder the thought associated with OCD is bizarre.The thoughts associated with OCD are recurrent obsessions that create an awareness of alarm or threat. Obsessions can take form of a threat or physical alarm to oneself or others. People typically engage in some avoidance or escape response in reaction to the obsessive threat. There are three main branches of OCD. The most c ommon and well-known branch of OCD is known as OC where the undoing response generally involves some overt behavior. The next branch of OCD is purely obsess ional this involves the escape or avoidance of noxious and unwanted thoughts.There are a number of treatment strategies, which are specific to obsessive problems. For example, motivations neutralizing behavior and other counter-productive strategies, increasing selective attention and increased negative mood. These serve to maintain the negative beliefs and therefore the obsessive-compulsive problem. Most recently developments in cognitive therapy suggest that the key to understanding obsession problems lies in the way the intrusive thoughts, images, impulses and doubts are interpreted. The general and specific aspects of cognitive-behavioral treatment are described.The important negative interpretations usually include the idea that a person's actions can result in harm to onset to others. This responsibility interpretation has several consequences. { steven 1} OCD can change and affect a person’s life in many ways sometimes alienating them from their friends and family. Many sufferers with OCD are never diagnosed because they are so secretive about their symptoms. They are afraid to let people know and are even embarrassed about their compulsive reactions. It is a fact that approximately one million children and adolescents in the United States alone suffer from OCD.This means that 3 to 5 children in an average elementary school and 20 teenagers in a large high school are currently suffering. OCD affects adolescents during an important time of social development. Schoolwork, homework, and friendships are affected most often. Most children are to young to realize that there obsessions and compulsions are unusual. Adolescents are embarrassed because they don't want to be different from other people and they worry uncontrollably about their behavior. These adolescents usually hide their rituals in fr ont of friends at school or at home and become mentally exhausted and strained.Children and adolescents that suffer from OCD are different from adults because they express their disorder in special ways. Young children often say their rituals are silly. Young children's OCD is never really recognized by their parents until they are about 3 or 4 sometimes even older. To get a proper diagnosis the child should be brought to a doctor or psychiatrist. While a child is at school they usually erase and redo their assignments, which usually results in late schoolwork. Classroom concentration is usually limited because a child is obsessing about their fears and rituals.Parents should tell a child's teacher about the OCD and may ask for occasional progress reports. OCD is not contagious and parents are often blamed for the disorder they are said to have parental perfections, inappropriate toilet training, or even under parenting. The cause for OCD is neurobiological. Although life events can also aid in the onset of OCD. Children's OCD is often said to be started by a death of a loved one, a divorce, moving to a new location, or unhappiness with changes in school. Approximately 80 percent of children and adolescents with OCD at some point during their illness will develop a washing or cleaning ritual.The most common compulsion is hand washing. An individual may feel compelled to wash their hands extensively and according to a self-prescribed manner for minutes or hours at a time. Other individuals may be less thorough about washing or cleaning but may engage in the act a number of times a day sometimes even hundreds. During school these rituals may manifest themselves in the school setting as subtle behaviors not obviously or immediately related to washing or cleaning. The student’s teacher should be alert if the student frequently excuses himself or herself from the classroom under voiding or guise.This child could actually be seeking a private area in which to carry out the cleaning rituals. Another sign is the presence of dry, red, chapped, cracked, or even bleeding hands. Bleeding hands are a result of washing with strong cleaning agents such as â€Å"Mr. Clean† to free themselves of â€Å"contaminants†. OCD sufferers usually experience obsessional thoughts that lead to compulsive avoidance in these cases, individuals may go to great lengths to avoid objects, substances, or situations that are capable of triggering fear or discomfort.For example, fear of contamination may result in the avoiding of objects usually found in the classroom, things like paint, glue, paste, clay, tape, and ink. A child may even inappropriately cover their hands with clothing or gloves or may use facial tissue, shirts, or shirt cuffs to open doors or turn on faucets. A student with an obsessive fear of harm may avoid using scissors or other sharp tools in the classroom. A child may even circumvent the use of a certain doorway because a passage t hrough that entry may trigger a repeating ritual.Children and adolescents with OCD may also engage in compulsive reassurance seeking. In the school setting, they may continually ask teachers or other school personnel for reassurance that there for example are no germs on the drinking fountain or that they have not made any errors on a page. Although reassurance may serve to allay the anxiety or discomfort that frequently accompanies their fears the relief is often short lived, different situations typically arise in the classroom that pose new fears or discomfort for the student.Number obsessions are typically common among young boys. Only certain numbers are â€Å"safe† other numbers are â€Å"bad†. An obsession with a particular number may result in a child's having to repeat an action a given number of times or having to repeatedly count to a particular number. Some children with strong religious ties have an obsessive fear that they are doing something evil. This s ymptom of OCD is called â€Å"scrupulosity† and causes an individual to tell themselves that they constantly commit sins, and they must pray constantly or find ways to condone their imagined sins.Members of the catholic religion who suffer from this may go to confession many times a week. Some individuals create elaborate systems to avoid certain thoughts, memories, or actions, or to replace or equalize â€Å"sinful† thoughts with pure good ones. One of the most reported obsessions in youth with OCD is a fear of contamination. This fear may center on a concern with germs, dirt, ink, paint, excrement, body secretions, blood, chemicals, and other substances. Recently, an increase in obsessions with AIDS had also been witnessed.Preoccupation with contamination may lead to the avoidance of suspected contaminants or constant findings in studies such as testing the effectiveness of different therapies; strongly suggest that it is the working alliance or bond between therapis t and patient, which is paramount to therapeutic success. Interpersonal aspects of treatment such as 1. comfort 2. confidence and 3. a true commitment from both patient and therapist make a great deal of difference in fostering an atmosphere of collaboration. To be successful both the patient and the therapist need to bring their fullest devotion to the explicit and implicit contract of therapy.By saying this it means that at the end of each session both parties need to come to an agreement of the next week's challenges. The patient must except the responsibility and be willing to participate in his or her challenges. Clients can choose to share the challenges of this therapy with an experienced partner or they can choose to decline. The principles of this therapy focus on fostering a sense of therapeutic independence on the part of the client. Equally important to training, knowledge, experience, and credentials are understanding, compassion and warmth.Most often the cognitive-beha viorist believes that self-disclosure is a healthy part of any relationship, including a therapeutic one. Therefore when a client answers questions about themselves it is considered a natural and healthy part of the therapeutic exchange. {steven phillipson 1} The basic premise of this therapy is based on the belief that at the heart of depression exist distorted and irrational thinking patterns. Such patterns revolve around our automatic reactions toward life circumstances, which create upsetting emotional consequences.CBT was developed to assist patients to respond rationally to automatic irrational thoughts. Here automatic thoughts are said to be mental reflexive reactions to upsetting events. Typically, the approach teaches people to learn to identify our reflexive reactions or â€Å"beliefs† that occur as a consequence to upsetting events, that are responsible for the periodic upset we experience. Traditional therapist that specialize in CBT focus on teaching clients to s ubstitute rational thinking for automatic irrational thinking. {steven phillipson 2}Basic CBT believes that within all of us exist irrational ideas. This therapeutic intervention is based on therapists' faith in our ability to learn how to sort out the difference between being rational and irrational. At the heart of learning is the belief that we learn from society, family, and religion how to think in dysfunctional and irrational ways. Traditional CBT for patients suffering with OCD is therefore likely to be counter productive toward achieving a beneficial therapeutic outcome. This approach assumes that persons are reacting irrationally to a rationally safe situation.The problem is that the majority of OCD patients are aware that what they are doing is bizarre and irrational. Most can even predict that the risk of danger is infinitesimal. Yet they feel overwhelmingly compelled to act out some escape response. Therefore using traditional CBT: activating event, automatic thought, em otional reaction, and rational response would be futile. Traditional CBT was developed as a treatment for depression. The two basic components entail, 1. the behind the scenes strategizing and 2. the front line conflict.It is very important not to mix up the appropriate application of these two separate strategies when dealing with OCD. The manner in which one conceptualizes a battle and the behavior exerted in fighting it, are very different. {steven phillipson 3} Cognitive therapy for OCD predominantly focuses on the two mentioned aspects of this disorder. The first aspect initially involves having sufferers develop a healthy and informed understanding of how the mechanisms of OCD operate. This focus will be referred to as cognitive conceptualization.Cognitive conceptualization includes having the sufferer separate themselves from the emotional or moral implications of what the disorder seems to represent. Many people who suffer from the purely obsessional form of this condition a nd responsibility experience tremendous amounts of guilt and shame for having these thoughts or being responsible for the wellbeing of others. Also involved with the first aspect is having clients appreciate that giving in to a ritual or embracing the risk of the obsession, requires making a series of genuine choices and are not pre-programmed reflexive reactions.Critical aspects of this focus involve reshaping one's response set to the risk. This involves concentrating on one's relationship with their condition as that of making choices in the matter of giving in the ritual, or not. This viewpoint is in difference to perceiving the reaction to cognitive threats as obligatory or as having no choice in the matter. In practice this translates into having patients reframe their disposition from, â€Å"I had to† to â€Å"I chose to†.Research has clearly showed that acknowledging our choice in the matter of facing difficult life challenges increases one's tolerance to adver sity. Consistently studies have demonstrated that our ability to tolerate pain is greatly increased as we acknowledge our choice in relation to the decision to seek relief or to tolerate the discomfort. As our perceptible sense of control increases so does our willingness to tolerate discomfort. A minor but crucial aspect of cognitive-conceptualization involves educating people about the actual risks pertaining to their specific concerns.Unfortunately medical science doesn't offer total certainty. Therefore telling someone that the chances of getting AIDS from a door knob is slim at best, does little to take away the general concern. Some people claim to have been guided by their disorder for so long that they have forgotten their real instincts. In addition, becoming informed that people who spike about being a danger to others rarely actually do damaging things or that person with anxiety disorders almost by no means develops schizophrenia might educate, but rarely provides lastin g relief. Steven Phillipson 4} Cognitive-management is the second goal of CT; this involves teaching individuals to respond to obsessive threats in a way that there is little to no debate in response to being spiked. The main goal is to reduce conflict or mental escape in formulating a response to the upsetting thought. The end product is referred to as habituation. Principles are also included in cognitive-management. These principles enhance greater levels of tolerance toward the physical discomfort, generated by the anxiety.The principles include making space for the discomfort and looking upon it as something to be managed effectively, rather that just achieving a period of relief. The search to eliminate the spike is more than likely the greatest cognitive misconceptualization that people bring to the therapeutic process. Eventually the goal of CT for OCD is to manage he spike effectively, not to focus on its existence or disappearance. The same thing could be said about the ex perience of anxiety. Tolerating anxiety focuses on developing room for the experience.Developing room for its presence enables the brain to focus on other information. Cognitive conceptualization focuses on helping take out a sense of culpability, guilt and shame, which is pervasive among obsessive-compulsive sufferers. To access the ideas and philosophy of cognitive-conceptualization in the midst of the challenge would be unadvised because it would tend to be reassurance oriented. The goal for later on in the treatment is instructive in aiding a person's respond effectively to the cognitive prompt of the danger with the least resistance, which thereby allows habituation.Creating an aggressive disposition toward a challenge is tremendously advantageous toward a successful recovery. Aggressiveness is defined as actively looking for anxiety provoking challenges. Paradoxically, when a person seeks an anxiety provoking challenge there tends to be a greater likelihood that experiencing r educed levels of anxiety is achieved. This comes out due to changing the condition's momentum from endless escape to approach. â€Å"As we seek challenges there is less likelihood of finding them†. Cognitive therapy for OCD has two main applications 1. o help people understand the guidelines of anxiety disorders overall plan 2. to provide specific suggestions in response to the moment of being challenged by awareness that there is some imminent danger. Cognitive principles to assist sufferers develop a healthy disposition in the direction of their anxiety is The statement â€Å"within the question lies the answer† proposes that when confronted with a seemingly sincere risk, relying on the consciousness that there is doubt and therefore making the strength of mind to receive the possibility will get rid of a enormous quantity of difficulty solving. steven phillipson 6} The ultimate aspect of cognitive management entails deliberately creating the consciousness and nature of the chance while engaging in the uncovering exercise. This strategy suggests that combining the behavior a compulsive act with a self-talk enhances the impact of an uncovering exercise. Making the choice to put up with the risk tends to close down the brain's natural propensity to alert its host, through physical uneasiness and cognitive warnings, that you should feel unpleasant until the danger is removed.Overall CT involves providing a sufferer with specific responses to the spikes and educating them about the distinction between having these concerns and separating one's identity from the topics of the condition and highlighting general strategies which facilitate anxiety management. This goes to say that providing reassurances and attempting to educate the sufferer about the truly limited risks involved in the spikes is counterproductive and alienating. {steven phillipson 7} lead to excessive washing.