Physical and Psychological Domains of Palliative Care

Physical and Psychological Domains of Palliative Care PHYSICAL AND PSYCHOLOGICAL DOMAINS OF PALLIATIVE CARE Taking care of critically ill patients is challenging task and it needs proficiency. It’s very difficult to handle a family and terminally ill patient without any proper knowledge. To solve the problems and handle the difficult situation during palliative care is proper training and knowledge about palliative care. It also needs proper training and experience for caring terminally ill patient. According to Kaasa Loge, (2003) in palliative care quality of life is the basic and central concept. Quality of life is has been used in vast concept which includes physical, psychological, spiritual, and social life of a patient.it is an approach to improve the quality of life of patient who come across life threatening illness for example cancer. The main purpose of palliative care is relief from suffering or to early identification of symptoms as early as possible. During my palliative clinical rotation I have encountered a 60 years old, female patient who was diagnosed with liver ca ncer stage III. Patient was only on palliative care she had not received any chemotherapy or radiation. Now she was admitted in hospital for draining ascetic fluid and for pain management. When I was taking history of patient I came to know that patient was worried about her condition and she was unaware about her diagnosis and prognosis. She was very depressed and anxious about her health. She was unable to do her daily routines due to abdominal distention, pain and tenderness. Furthermore she was physically very weak. While taking care of patient I found all four domains of palliative care in my patient which includes physical, psychological, emotional, spiritual and sociocultural. But physical and psychological domains were the most effected domains in my patient. In this paper I will focus on physical and psychological domain of palliative care. In literature it is stated thatâ€Å"Palliative care is aimed at improving the quality of life for patients and their families who are confronted with life-threatening illness by providing support and care for pain, physical symptoms, psychological and social stress, and spirituality.†(Weiner et al, 2013). While taking care of patient I realized that patient was suffering from pain. Some other physical symptoms which are present in patient are abdominal distention, general weakness, shortness of breath, fatigue, and loss of appetite. According to Skevington Lofty (2003) pain, fatigue, general weakness, loss of appetite, nausea, vomiting are the common symptoms in cancer patients. Furthermoreit is stated inClinical practice guidelines for quality palliative care (2008) regular, ongoing assessment of pain, nonpain symptoms (including but not limited to shortness of breath, nausea, fatigue and weakness, anorexia, ins omnia, anxiety, depression, confusion, and constipation), treatment side effects, and functional capacities should be documented through a systematic process.in case of my patient due to abdominal distention she had pain, feeling fullness and shortness of breath. To relief from pain first I encouraged patient to take deep breathing and staff inserted drain to drain out ascetic fluid. After draining 1000 ml fluid she felt relief from pain. In addition in mypatient due to nausea and anorexia she has low appetite. Due to poor intake she felt lethargic and unable to do her daily activities. Therefore I encouraged patient to eat frequently but in small amount and I also educate her attendant about the importance of proper nutrition. The second important domain affected in my patient was psychological domain. Due to physical deterioration mostly patient become frustrated of their life and do not want to live furtherand end up with sadness, loneliness, anxiety due to hospitalization and they worried about the prognosis of disease. My patient also faced above mentioned problems as she did not know about her prognosis and she was worried about progressive symptoms likeabdominal distention, pain, fatigue and general weakness.Furthermore in case of my patient she was worried because she was unaware of her diagnosis.When I was taking history her attendant said that we did not disclose the diagnosis to the patient because she already worried about disease. As every patient has right to know about their diagnosis and their disease process. According to Jhordy et al (2007) physical weakness and impairment disturb most aspects of life like psychological, social, sexual, spiritualand other daily activities of life. Due to limitations in activities patients at the high risk of psychological problems. Therefore most of terminal patients think that they are dependent on family and they burden on their children and spouse. In literature it is stated that mood disorder, anxiety, and depression are coexist with advanced illness. Psychological distress with terminal ill patient is very common in palliative care setting. Patient’s response in different ways to show the depression, for example sadness, fear and grief in different stages of their progressive disease.35 to 50 % of cancer patient experience psychological problems. The experience of psychological problems effect on an individual coping mechanism with illness, physical symptoms and on their treatment. (Kelly,Chonchinov McClement, 2006).Therefore it’s very important to assess the psychological problems of patient to give a quality care and is as important as to assess physical condition of patient. It is also stated in above mention article. That we should educate patient about different psychologist, social groups who support them. To relief from stress I also encourage patient to verbalize her feelings and e ncouraged her to take deep breathing. We also arrange an activity that we gathered same diagnose patient and encourage them to verbalize their feelings and I also provide a paper to express her feelings on paper. After activity patient mentioned that she felt better and it effects positively on patients.In addition I spend most of the time with patient to encourage her to express her feelings and I also educate her attendant to support her and spend time with her. The challenges that I faced during clinical were to communicate the prognosis of disease. Because patient was unaware of her diagnosis and their family did not want to tell the patient bout her diagnosis. Therefore due to this reason I was unable to communicate the disease process properly and it hinders me to apply the concept of palliative care. Furthermore due to lack of resources I was unable to give holistic care. As a nursing student I want to recommend that palliative course should be compulsory in the nursing school and medical, so they can provide knowledge about end of life.There should be proper training for students so they can easily handle the difficulties while taking care of terminal ill patient. It’s not important to give palliative care to only terminal patient but it’s our responsibility that from the diagnosis we have to taking care of patient. On institutional level different seminar should be arrange to give awareness about the palliative care. In addition we can arrange different sessions for patients and families to give awareness about palliative care and disclosure of life threatening diagnosis.it also important to give proper training to the staff of health care system so they can give comfort and help the patient to end up with a peaceful death. There should be a separate bereavement room for families so they express and spend last time with their patients. Moreover there should be a palliative care team so they give proper training to staff ongoing basis to achieve competency in palliative care.According to Ramjan et al (2010) palliative approach can improve comfort and dignity of patient through the early identification and assessment as well as knowing the patients psychological, emotional, social and spiritual concerns. Furthermore we can give awareness through social media, that everyone can approach aware about the importance of palliative care.Mostly patients want to die in home in the presence and support of family. One of article it is mention that health care provider need to support and give education to the family members on symptom management so they can easily continue care at home also(Luckett et al, 2013). In conclusion, palliative care is very important part of health profession. The basic theme of palliative care is not the treatment of the disease but it is all about to decrease the sufferings of patient.There are different domains in palliative care which are affected due any of progressive disease, such as physical, psychological, spiritual, socio-cultural and sexual domains of life. The most important is physical which disturb other domains of life.Moreover when I reflect back I realized that overall clinical and palliative care is very beneficial and productive. Now I can easily integrate theoretical knowledge in a hospital setting. Furthermore now we can educate patients and their family members abut palliative care and be able to assess all domains of health.

Life and works of John Steinnbeck Essay example -- biographies bio bio

John Steinbeck was probably the best author of all time. He was the winner of a Nobel Prize, and along with many other accomplishments, Steinbeck wrote twenty-five books, including sixteen novels, six non-fiction books and several collections of short stories during his lifetime. Seventeen of his works, including The Grapes of Wrath, Cannery Row, The Pearl, and East of Eden, went on to become Hollywood films, some appeared multiple times, as remakes. Steinbeck also had some success as a Hollywood writer, receiving an Academy Award nomination for Best Story in 1944 for Alfred Hitchcock's Lifeboat. Many of his life experiences are shown through his novels. Someone can tell, by reading one of Steinbeck’s novels that he had been through a lot, throughout his life. Also, Steinbeck worked hard to accomplish everything that he did, during his lifetime. Nothing came easy for him, and had to earn everything on his own, and this helped him in his works. He also had the ability to write about real people and real experiences. John Steinbeck got his inspiration from his life experiences such as people he knew, and places he had spent time at. Many of Steinbeck's views of the world are shown through his novels. Some of Steinbeck’s most influential works are included in this paper and are summarized, to show how many Americans living in poverty today can relate to some of Steinbeck’s works which are also set during a recession era. Growing up in Salinas Valley, Steinbeck had the chance to spend a lot of time outdoors. His uncle used to take him on fishing trips, and spent time visiting his mother’s grand-fathers' farm near King City, it gave him a large respect for nature. Later on he became a caretaker on a large piece of land at Lake Tahoe, ... ...life experiences, events, and people which makes it easier for the reader to connect if they too had the same experiences first-hand. Although John Steinbeck has been gone for awhile, his legacy continues to thrive on Americans today. Steinbeck’s influence not only flourishes across the United States but has also been all around the world. His influnces have also attracted the attention of film production studios in which the have created movies based upon stories from Steinbeck. His legacy is also continued through high school reading, a study by the Center for the Learning and Teaching of Literature in the United States found that Of Mice and Men was one of the ten most often read books in public high and independent schools. Steinbeck has been honored in many ways having, places dedicated to him and having his name inducted into the California Hall of Fame.

Evolution of Health Care Information Systems Essay

Today we have the pleasure of discussing the Evolution of Health Care Information Systems. Specifically we will review a compare and contrast of a health care facilities operations today with the operations of it 20 years ago. We will define HCIS as well as look at different health information systems today and major events and technological advantages that have influenced current Health Care Information Systems (HCIS) practices. We will learn how health care information systems have shaped the delivery of health care today so that we may be a part of the solution. Health Care Information Systems To truly understand the benefit of Health Care Information Systems, it is critical that a clear understanding of its true definition is learned. We know that data consists of raw facts about people, places, events and other things that are of importance in any organization. When that data is processed into a more meaningful form, it is then called information and can be the basis for decision making. According to Wager, Lee & Glaser (2009), â€Å"a health care information system (HCIS) is an arrangement of information (data), processes, people, and information technology that interact to collect, process, store, and provide as output information needed to support the health care organization†. To further put things into perspective, there are two primary classes of health care information systems and they are administrative and clinical. Although they are both health care information systems, they perform totally different functions and contain different information. An administrative information system would contain information specific to financial data or administrative that would help to support management and general operations of the health care organization. These systems might support personnel management, supply management, equipment or human resources management. Clinical information systems are very different from administrative in that  they contain information that is clinical in nature or health-related that is used by health care providers when diagnosing, treating, and monitoring patients care. Wager, Lee & Glaser, (2009). Another interesting fact about clinical information systems is that these systems can be departmental such as radiology, pharmacy or laboratory systems. Wager, Lee, & Glaser, (2009). Skilled Nursing Facilities 20 years later Skilled Nursing Facilities have made leaps and bounds in significant changes over the past 20 years. Tanner Memorial Hospital, which is now Tanner Health System is nothing like it originated 20 years back and has now transformed into a health system with all its specialties and wide range of services currently offered. It did not offer inpatient behavioral care in the same capacity as today and in fact, when the new Willowbrooke at Tanner opened in Villa Rica, GA, it was the newest facility of its kind in the last 20 years and consisted of beds for adults, elder adults, children and adolescents. Tanner Health Systems, (2012). Information technology was slow to take off 20 years ago in the health care industry. Skilled nursing facilities were doing things manually which was hand written documentation or typewritten. This is quite different from today when information technology has exploded and continues to expand and develop at a rapid pace. According to Sheehan (2011), until recent years technology was not a subject that was often mentioned in the long term care environment. There was a perception that the â€Å"LTC industry is somewhat of a late adaptor of technological advancements†. Today all that is changing due to â€Å"provider demand, vendor interest and a growing number of tech-savvy seniors†. (Sheehan, 2011). Although 20 years ago skilled nursing facilities may have been falling behind in recognizing the vital importance of implementing information systems, today skilled nursing facilities relay heavily on technology like telemedine or tele-health. Many facilities that are in rural areas are really dependent on telemedicine and tele-health. Billing operation systems, clinical and administrative information systems are now a necessity for successful daily operations and skilled nursing relies heavily on information technology to process payroll, employee records, updating patient care and treatment plans, insurance and personal information. During the 1980’s, health care systems were for collecting data about patient demographics, insurance information and other information for billing purposes. Today, current health care information systems offer a more flexible and sophisticated framework. There is no longer the daunting tasks of writing things manually and other administrative duties that were time consuming. We now have sophisticated systems that are capable of handling clinical decision support systems, archiving communication systems, and digitization of diagnostic images. (Hebda, Czar, & Mascara, 2009). 20 years ago, physicians were a bit reluctant to share patient information with other physician practices, today physician practices are finding creative and innovative ways to exchange patient health information in a timely, efficient and secured manner which enhances coordination of patient care. The implementation of electronic medical record systems prevents the delays attributed to traditional mail or faxing paper medical records. These health care information systems help physician practices to effectively and efficiently share information that can reduce health care costs as well as improve patient care. Two Major Event and Technological Advantages A major event that influence health care information systems is the enactment of the Health Insurance Portability and Accountability Act (HIPAA). This law plays a pivotal role in â€Å"regulating, and increasing the confidentiality, and securing of health care data† (HIPAA, 2003). With the ability to pay and submit claims electronically, there was a definite need for protecting data and it was apparent. Before HIPAA came along, the rules and regulations were quite different from state to state and between health care organizations. There was no consistency and the need for regulation was visible from all stakeholders involved. Another major event was in 2004 when President Bush asked health care providers to implement Electronic Health Records (EHR) by 2014. The Joint Commission for the Accreditation of Health Care Organizations (JCAHO) joined the initiative and also asked health care providers to be compliant with the new legislation. Many community-based physician practices that were once reluctant to conform to the implementation of new technology are now realizing the many benefits of  the health care information systems like computerized physician order entry (CPOE), electronic medical records (EMR), tele-medicine and automated billing systems. The implementation of tele-health and telemedicine brought about many advances in healthcare and continue to prove to be a needed health resource. Conclusion The evolution of health care information systems will continue to have a positive effect and a huge significance to the health care industry. Tele-health and telemedicine are major events that have shaped todays delivery of health care and HIPAA laws will continue to protect the rights of patients and their personal information. In the Mid 1980’s and early 1990’s, physician practices would not have imagines that Health Care Information Systems would play such a vital role in shaping the delivery of health care and yet, here we are. References Czar, P., & Mascara, C. (2009). Handbook of informatics for nurses & health care professionals (4th ed.). Upper Saddle River, NJ: Pearson Prentice Hall HIPAA.org (February 12, 2003).HIPAA. Retrieved July 13, 2014 from http://www.hipaa.org/ Sheehan, P. (2011, July). Technology takes off in health care. Long-Term Living, Retrieved from http://www.ltlmagazine.com/article/technology-takes-long-term-care Hebda, T., Tanner.org (2012) Retrieved July 12, 2014 from http://www.tanner.org/Main/History.aspx Wager, K. A., Lee, F. W., & Glaser, J. P. (2009). Health care information systems: A practical approach for health care management. (2nd ed.). (pp. 87-90). San Francisco, CA: Jossey-Bass Wiley.

The Mayor of Casterbridge, Tess of the D’Urbervilles and William Shakespeare’s King Lear Essay Example

The Mayor of Casterbridge, Tess of the D’Urbervilles and William Shakespeare’s King Lear Essay Example The Mayor of Casterbridge, Tess of the D’Urbervilles and William Shakespeare’s King Lear Paper The Mayor of Casterbridge, Tess of the D’Urbervilles and William Shakespeare’s King Lear Paper this shows how generally male characters are have greater power over women however one could argue the female characters have a greater insight to the people and actions around them, such as Goneril and Regan recognising Lear’s doom. Similarly in â€Å"Tess of the D’Urbervilles†, Tess has a large amount of insight to the world around her, this may possibly be connected to the daughters of Lear. However, Tess’ misfortunes and fate create tragedy’s which eventually destroy her insight â€Å"Why it was that upon this beautiful feminine tissue†¦ been traced such a coarse pattern as it was doomed to receive†¦Ã¢â‚¬ . As Tess is raped, Hardy uses the word â€Å"doomed†, where one could suggest it is Tess’ â€Å"doom† or â€Å"fate† to be raped. The meaning of â€Å"doom† is slightly different to â€Å"King Lear† as we see Tess’ â€Å"doom† from the beginning whereas we see Lear’s by a gradual build up. Differently â€Å"The Mayor of Casterbridge†, the word â€Å"doomed† could be placed in another sense as one could say Henchard shares the same characteristics to Lear with his rash decision making and again his lack of insight, causing the village and the people who are around him to be â€Å"doomed†. However the female characters such as Susan can see clearer into Henchard’s wrong actions and goes with Newson the sailor, â€Å"I’ll try my luck elsewhere. † A justifiable opinion could be Susan’s â€Å"luck† is far from â€Å"doom† by going with Newson, as one visualises Henchard’s personality from the beginning of the novel. In â€Å"King Lear† one could argue Lear does not notice his own faults, â€Å"I am a man more sinned against than sinning† presenting Lear to self-pity himself as he displays himself to be the victim. However on the other hand Lear’s favouritism for Cordelia makes Goneril and Regan despise Lear â€Å"He always loved our sister most†¦Ã¢â‚¬  showing how Lear could possibly be â€Å"sinned against† by his daughters. This portrays how women who are more â€Å"opulent† have more chances of being liked. Similarly in â€Å"Tess of the D’Urbervilles†, â€Å"Tess was now carried along upon the wings of the hours, without the sense of a will. † As Hardy relates back to the theme of â€Å"time† in the novel, Tess has waits â€Å"passively† for the wedding to take place as it is not under her responsibility anymore. One could say Tess is â€Å"more sinned against† as Hardy uses another theme of fate and free will as a symbolism for Tess’ life. She uses her free will to choose or determine her own actions; however these actions she makes, seems like fate always brings her down. In comparison Henchard in â€Å"The Mayor of Casterbridge† could possibly be seen as â€Å"more sinned against† as well as â€Å"sinning†. Henchard had sold his wife displaying him â€Å"sinning†, however on the other hand one could possibly argue how it was not his fault as it was his fate and he cannot change his actions, making him â€Å"more sinned against†. This could create sympathy for Henchard although he has done wrong, where usually the sympathy is for the female characters. In â€Å"King Lear†, Shakespeare uses pathetic fallacy by using a storm in Act 3 to conclude Lear’s insightful decisions. The storm is presented as a microcosm of Lear’s madness, as he encourages the storm to continue he shouts â€Å"Blow winds and crack your cheeks! †. Lear personifies the wind as he asks the elements to destroy him, â€Å"his little world of man† as he sees no importance of man or nature after his death. This shows how the word â€Å"man† is the centre of importance and how the power of the storm is imagined to be originating from Lear, a male character. The â€Å"fretful elements† are metaphors for Goneril and Regan where Lear is contending with his family. Kent being disguised gives the knight â€Å"a ring† for Cordelia, being symbolic as the shape of a circle is seen with the â€Å"one bearing a coronet†. This could also be seen with Edmund using a dramatic device, holding a â€Å"letter†. This follows a theme of a cyclical story with the letter being passed around as well as the circular shape from the theme of fate and destiny. Likewise Hardy uses the Ring in â€Å"The Mayor of Casterbridge† to be a Roman amphitheatre, where he invites Susan to meet. Hardy uses this setting as there were ghosts of the past rumoured to be a wife and her husband, where a woman â€Å"murdered her husband was half-strangled and then burnt †¦ of ten thousand spectators. † The ghosts of the past were metaphors for Susan and Henchard, who both have the past haunting them. This shows how although the woman was seen to be powerful to be able to murder her own husband, men are still seen to be stronger as she was â€Å"half-strangled† and â€Å"burnt† for what she had done. In contrast â€Å"Tess of the D’Urbervilles† Hardy uses the past and compares it to the present â€Å"Phases of her childhood lurked in her aspect still. †, one could argue Hardy uses the past and the present similarly to Shakespeare and â€Å"Mayor of Casterbridge† as the circular shape is used not visually but literally. Hardy describes Tess as an image of femininity â€Å"As she walked along to-day, for all her bouncing handsome womanliness, you could sometimes see her twelfth year in her cheeks†¦Ã¢â‚¬  Similar to Lear with Cordelia’s looks being â€Å"opulent†, Hardy presents his female characters to be feminine and attractive. Hardy uses Tess’s appearance to be the only powerful aspect of her, similar to Cordelia in â€Å"King Lear†. The power which is usually seen in male characters could be seen as â€Å"defeated†, as in â€Å"King Lear†, Shakespeare uses hyperbole to make the event seem larger than it is as Lear tragically says to the storm â€Å"I stand your slave† where we see Lear as a â€Å"weak† and â€Å"poor† â€Å"old man†. Ironically Lear says â€Å"I will say nothing† which could suggest Lear thinking of Cordelia as well as continuing this theme of â€Å"nothing†. One could say Lear’s power has been destroyed from himself â€Å"sinning† and becoming â€Å"nothing†. Lear’s daughters had more power than Lear from Act 1 however it is seen clearer in Act 3. Similarly the idea of being a â€Å"slave† continues in â€Å"The Mayor or Casterbridge† where â€Å"His old feeling of supercilious pity for womankind in general was intensified†¦Ã¢â‚¬ . Henchard is seen to be a tall and strong, male figure, as he tends to feel more dominant and controlling over women. Since women are physically weaker, he feels a â€Å"pity† for â€Å"womankind† because of their weakness. This could possibly be argued how women were portrayed as â€Å"slaves† as men have the physical and stereotypical power to rule against them. In contrast Tess in â€Å"Tess of the D’Urbervilles† could be seen as a â€Å"slave† to her own family, as she goes to work in the D’Urberville household to collect money for her family at home, â€Å"she ought to make her way with en, if she plays her trump card aright. And if he dont marry her afore he will after. . Tess’ mother sends Tess away for work, however she realises Alec’s love for Tess and hopes for marriage. One could suggest her mother wants her to be married to Alec for the money which could present Tess to be a â€Å"slave† in another meaning. However she includes â€Å"if she plays her trump card aright. †, which is ironic for Tess as it seems as if she has no â€Å"trump† card in her pack. In â€Å"King Lear†, Shakespeare relates grown men to compare with â€Å"babes† â€Å"†¦to shake all cares and business from our age; conferring them on younger strengths, while we unburthen’d crawl toward death†. It seems as if Lear is ready to retire, as he adopts the â€Å"royal we† making the event seem important. Shakespeare has displayed Lear as a â€Å"weak†, â€Å"old man†, however he gives another mental image of Lear â€Å"crawling toward death† like a baby. One could argue old age is similar to being a baby as it leaves you â€Å"weak† and powerless. Goneril and Regan’s distaste to Lear humiliates him as they say â€Å"O, sir, you are old†¦Ã¢â‚¬  showing how they as female characters have greater power and order over Lear. The image of a baby in seen in â€Å"Tess of the D’Urbervilles†, however it is used in another sense. Tess’ baby could be seen as a symbolic feature for Tess’ bad luck which Tess could not control. The baby could symbolise innocence like Tess as she has done nothing wrong however she is still punished by society, for an act she could not control. This is ironic as a baby could suggest new beginning, purity and usually visualised with a mother figure. In comparison a baby is presented in â€Å"The Mayor of Casterbridge†, where Elizabeth-Jane is the step daughter of Henchard, as the previous baby died, â€Å"the little one too – the more the merrier! † The baby could symbolise the past and change, as when she died another baby was born – Elizabeth- Jane which could suggest a new beginning. Hardy used Elizabeth-Jane’s hair colour to foreshadow the future how she was not Henchard’s legitimate daughter. As Hardy’s novels were in the form of serialisation the theme of â€Å"foreshadowing† became present in most of his novels. Differently in â€Å"King Lear† there is no mother figure for Lear’s daughters. Goneril and Regan are seen to be violent female characters in the play; it raises the question would they be more feminine and caring if they had a mother to look out for them? Women are seen to be able to nurture and care for their children whereas one could say Lear caused his own downfall by failing to provide a mother figure. As Lear says â€Å"Come on, my boy. How dost my boy? Art cold? † this is the first time Lear is aware of the suffering of others, and acts like a â€Å"mother figure† to the fool, however it is the wrong time. Similarly the absent role of a mother figure is seen in â€Å"The Mayor of Casterbridge†, as Susan dies Elizabeth- Jane is left with Henchard. Elizabeth –Jane begins to like Farfrae as she believes he seemed to feel exactly as she felt about life, presenting how although she has no mother figure to look out for her, her strong insight helps her to continue her life. As Susan left Henchard a letter explaining how Elizabeth-Jane was not his daughter, it seems as if he â€Å"disowned† her by making her leave his house. The mother figure was seen to have a responsibility which Henchard as a male could not adapt to although Elizabeth-Jane was seen to be a step daughter to him. Differently Hardy uses the mother figure in â€Å"Tess of the D’Urbervilles† however she is not present too often. We see her control Tess unlike in â€Å"King Lear† and â€Å"The Mayor of Casterbridge† where there is a father figure with no sense of control. Tess is made to go to the D’Urberville’s house by her mother, where one could say Tess’ misfortunes began. She could represent time as although she is seen to be uneducated she still believes in â€Å"old superstitions†, â€Å"Between the mother, with her fast- perishing lumber of superstitions, folk-lore†¦Ã¢â‚¬  Mrs Durbeyfield could also represent pre-industrial England with the â€Å"folk-lore† at that time. Both writers discuss the theme of women, however they are portrayed differently. â€Å"King Lear† focuses on women gaining power and having control over the male characters. The female characters in â€Å"The Mayor of Casterbridge† again have different roles, although this is mainly because the novel is set in the Victorian period where women’s roles were to take care of their husbands and children. Lastly â€Å"Tess of the D’Urbervilles† displays how male characters have a strong control over women, and how this affects their overall lives.

New York The Symbolic City of Symbolic Statements and the Everyday City of Necessities.

New York The Symbolic City of Symbolic Statements and the Everyday City of Necessities. â€Å"The City and The Pillars† by Adam Gopnik was written after the 11th September terrorist attack on The World Trade Center. It is a description of the New York after the catastrophe. A motionless and descriptive narration about the city and aftermath of the events express fear and anxiety that captured it peoples’ minds and changed their attitude to the city itself.Advertising We will write a custom essay sample on New York: â€Å"The Symbolic City of Symbolic Statements and the Everyday City of Necessities† specifically for you for only $16.05 $11/page Learn More The author focuses on the subject of the New York appeal before and after the attack, and describes a real and symbolic New York. Through the article, the author makes use of various devices to provide the reader with the in-depth analysis and understanding of the real NYC and a symbolic one that was created during ages of its development. Thus, the author builds his narrat ion on two extremes. As it has already been mentioned, the author uses various stylistic and literary devices in order to describe the city. The article begins with the description of an ordinary day in the New York City: â€Å"On the morning of the day they did it, the city was as beautiful as it had ever been. Central Park had never seemed so gleaming and luxuriant- the leaves just beginning to fall, and the light on the leaves left on the trees somehow making them at once golden and bright green† (Gopnik 411) Broad use of epithets and comparisons creates the image of a beautiful day and beautiful city. People live their ordinary day and in seems that nothing pointed to the catastrophe. But there was something in the air that worried everyone†¦ The author compares the safety which people thought was surrounding them with the â€Å"protective bubble† that â€Å"had settled over the city, with a bubbles transparency and bright highlights, still seemed to be in pl ace above us† (Gopnik 411). One day, on September 11, this â€Å"bubble† burst. The author describes this event metaphorically, which produces the effect of suspense. With the help of the metaphors, epithets, metaphoric descriptions and comparisons, the other explores the themes of the New York life, real and symbolic city and vision of attack from the point of view of people who live in the city and out of it.Advertising Looking for essay on social sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More The real New York appears as a busy city. Gopnik describes it as: â€Å"In the uptown supermarkets, people began to shop. It was a hoarding instinct, of course, though oddly not brought on by any sense of panic; certainly no one on television or radio was suggesting that people needed to hoard. Yet people had the instinct to do it (Gopnik 411). It is a real life, and a real city that people got used to see. And even after the attack, when their image of the town had changed, they tried to live an ordinary life, but there was something unusual and extraordinary in their behavior that made them value â€Å"the real city† more that its â€Å"fashionable image†, â€Å"we will probably never be able to regard the city with quite the same exasperated, ironic affection we had for it before† (Gopnik 415). The symbolic city appears as a world of tourism, attraction and fan. The author presents it through the bright description of the famous places, such as Central Park, SoHo, the 7th Avenue, Times Square, and of course, The World Trade Center. But the image of the symbolic city was erased after the attack. Gopnik says that the advantage of living in New York was that it provided the opportunity of living in both real and symbolic city, â€Å"the symbolic city of symbolic statements (this is big, I am rich, get me) and the everyday city of necessities† (Gopnik 414). But one da y, the symbolic city was attacked by terrorists and people understood that the real city was important and necessary and it is the city that will go on because, â€Å"we now know what it would be like to lose it, and it feels like losing life itself† (Gopnik 415). Another theme explored by the author is the impact of the attack on The World Trade Center which was not so important before it was ruined. It became a â€Å"symbol of America† due to the media and journalists. This exemplifies how the social consciousness changed and how people reevaluated their vision of the New York City. The author does not provide actual details of the attack and does not show any dates. In fact, he reveals the memories and describes how the disaster influenced all people and each one separately. He writes, â€Å"people in Europe say America attacked and people in America say New York attacked and people in New York think, Downtown attacked.) For the financial community, this was the So mme† (Gopnik 412).Advertising We will write a custom essay sample on New York: â€Å"The Symbolic City of Symbolic Statements and the Everyday City of Necessities† specifically for you for only $16.05 $11/page Learn More Thus, â€Å"The City and The Pillars† is a profound analysis of the New York society and the impact of the 9/11 attack on the people’s lives. The other provides the images of the real and symbolic New York though the social references, stylistic devices and metaphoric descriptions of the terrorist attack. Gopnik provides the idea that the image of the symbolic city was changed forever that influenced the â€Å"world image of the city†, as well as the way New Yorkers regarded it. Gopnik, Adam. The City and the Pillars in The Conscious Reader. Eds. Caroline Shrodes, Michael Shugrue, Marc Dipaolo, and Christian Matuschek. Pearson Education Canada, 2008. 411 – 415. Print.

How the media negatively effects women's body image Essay

How the media negatively effects women's body image - Essay Example In movies, particularly, but also in television shows and the accompanying commercials, womens and girls appearance is frequently commented on: 58 percent of female characters in movies had comments made about their looks, as did 28 percent in television shows and 26 percent of the female models in the accompanying commercials† (â€Å"Media’s Effect on†). The definition of a beautiful woman has undergone a radical transformation over the last few decades, and no factor’s role is as dominating in causing this effect than media. The trend of a skinny woman being defined as beautiful started around the mid-20th century. It would not be wrong to state that the new definition of beauty is just as old as the television itself. Hollywood has played a pivotal role in bringing a transformation in the definition of a beautiful woman. By offering roles to skinny and beautiful actresses from as early as the later half of the 20th century in movies, television and media has been slowly but progressively reincarnating the image of a beautiful woman. Today, the transformation has completed and its biggest victims are ordinary women. When women look at the skinny actresses and models at the cover pages of their famous magazines and in the soaps, even the most beautiful women who are naturally beautiful according to all reasonable and right standards find themselves losing to the beauty of these cover girls. Women are trying a range of techniques and strategies in an attempt to meet the standards of beauty in the contemporary age. From changing diet plans, adopting an intense exercise regime, to undergoing liposuction surgery to get that supposedly extra fat sucked out, women are doing it all. â€Å"The mindset that a person can never be "too rich or too thin" is all too prevalent in society, and it makes it difficult for females to achieve any level of contentment with their physical appearance† (Serdar). All of this comes at a great cost. Some women have to pay a lot of

Institute for Regenerative Medicine (CIRM) Essay

Institute for Regenerative Medicine (CIRM) - Essay Example This, therefore, has resulted to an open innovation concept where organizations discover that all the components of innovation do not have to originate from within the institution. However, they can increase or accelerate their efforts by obtaining the required technology from external sources. Sources, that is of the same minds with them but use a different method in producing their goods and services. Henry in his book, ‘The New Imperative for Creating and Profiting from Technology’, describes external innovation as the â€Å"act of allowing external information derived from sources such as cooperation with universities or (corporate) venture capital efforts to be part of a company’s innovation process and permeating the company`s boundaries from outside to inside† (Henry, 2006). The concept of outdoor innovation is one of many pathways shaped in the company. This is to allow new product thoughts to tour inside and outside the firm’s borders and to be bundled with exterior skills and knowledge. One of the organizations that have undergone enormous innovation due to the external thoughts is the California Institute for Regenerative Medicine (CIRM). California Institute for Regenerative Medicine is an organization that improved the development of therapies and potential cures based on the stem cell science (Michael & Panetta, 2005). In November 2004, voters provided three billion dollars for the stem research. California has a massive biotech industry that spreads around San Diego and San Francisco, this pool of funds is used for innovation. The funds also helped in enhancing research and creating job at the university level and in confidential sectors. The California Institute for Regenerating Medicine created an oversight that determined how and where grants were to be made and the organization. The California institute for regenerating medicine also defined on the allocation of funds in order to meet the set mission. The org anization had to focus on innovations both internal and external by carrying out research on product development and clinical trials. The California Institute for Regenerative Medicine later specially made an external evaluation of its strategy procedures and policies that they afterward implemented. The main purpose of employing an external review was to come up with ways of evaluating CIRM`s precedent performance. The review also provided a recommendation on what to be put in place for long term success. CIRM conducted a public meeting on different days with Governing Board`s heads and those who took part in the Review. This helped them to understand fully what CIRM entails, and what is needed for CIRM to achieve its goals. Towards the end of the year 2006, the CIRM published the first magazine to define its scientific strategic plan. This plan served as an outline for the procedures and programs implementations. This plan has helped the institute in its progress thus, being able to register a remarkable progress in the subsequent years. The institute has progressed much in areas of management or leadership, industry appointments, product growth and group prioritization. The institute achieves this while it continues to look after the people and science that will drive them forward CIRM’s first objective has been to support research at the uppermost level of scientific merit. These objectives have been achieved and in return, significantly improved