Five Ethical Principles for Research Essay

There are five general principles in the 2002 APA ethics code designed to â€Å"guide and inspire psychologists toward the very highest ethical ideals of the profession.† These principles include beneficence and nonmaleficence (i.e., benefit people and do no harm); fidelity and responsibility; and integrity, justice, and respect for people’s rights and dignity. The Belmont Report identified three basic ethical principles when conducting research: respect for persons, justice, and beneficence. The following are five basic ethical principles presented in the order of the general principles in the APA code that apply specifically to conducting biomedical and behavioral research with human participants. Principle 1: Beneficence and NonmaleficenceRepresenting the utilitarian tradition, this principle requires that researchers, using considerations such as those described above, strive to maximize potential benefits while minimizing risks of their research. Although the cost-benefit mandate seems straightforward, it is rarely unambiguous in practice because costs to participants and benefits to the profession and to society are difficult to accurately estimate in advance and no universally agreed-upon method or criteria exist for optimally balancing the two. Where questions arise related to the degree of risk, researchers are responsible for seeking ethical advice and implementing safeguards to protect participants. Risks that are identified in advance must be communicated to prospective research participants or their legal equivalent, and informed consent must be obtained (except in special cases approved by the IRB, such as research involving a placebo control, in which fully informed consent compromises a scientifically required research design). Sometimes research presents risks to groups of people or social institutions. No consensus exists for whether a representative can provide consent on behalf of a collective entity, but full compliance to Principle 1 requires sensitivity to this issue. Principle 2: Fidelity, Responsibility, and TrustThis principle requires researchers to establish and maintain a relationship of trust with research participants. For example, before individuals agree to participate in research, investigators must be clear and explicit in describing to prospective participants what they will experience and what consequences may  result from participation. Researchers also are obligated to honor all promises and commitments that are made as part of the agreement to participate. When full disclosure is not made prior to obtaining informed consent (e.g., information germane to the purpose of the study would compromise its validity), safeguards must be implemented to protect the welfare and dignity of participants. In general, procedures that involve concealment or deception in a research design can be implemented only after rigorous criteria for the necessity of such procedures are met and the study is approved by the IRB. (Such instances also require a thorough debriefing of participants at the conclusion of their participation.) When children or adults with limited understanding serve as participants, researchers must implement special protective safeguards. When unintended negative consequences of research participation occur, researchers are obligated to detect, remove, and/or correct these consequences and ensure that they do not persist over time. Understandably, past ethical breaches have resulted in what some describe as widespread mistrust of biomedical and behavioral research in contemporary society. Principle 2 requires researchers to make every effort to foster trust and avoid causing further public mistrust. Principle 3: IntegrityThis principle requires researchers to â€Å"do good science,† to truthfully report their results, to take reasonable steps to correct errors that are discovered, to present work that is their own (or to otherwise make appropriate citations), to take responsibility and credit only for work that is their own, to avoid â€Å"piecemeal publication† (i.e., submitting redundant analyses of a single data set for multiple publications), to share data on which results are published with other qualified professionals provided they seek only to verify substantive claims and do not use the data for other any other purpose, and to respect the proprietary rights of others engaged in the scientific enterprise. Principle 4: JusticeIn following this principle, researchers strive for two forms of justice. The first, distributive justice, requires psychologists to entitle all persons equal access to the benefits of research, as well as to ensure that the risks for harm from research are not disproportionately greater for a particular group or category of persons within society. The  second, procedural justice, refers to the adequacy of research procedures to ensure fairness, such as when easily accessible mechanisms are made available to participants to address any concerns they may have related to their participation in research. Researchers also are promoting Principle 3 when they attend to the special concerns of underrepresented groups in developing programs of research, so as to avoid continued underinclusion and lack of representation in the knowledge base. Principle 5: Respect for the Dignity and Autonomy of PersonsRepresenting the deontological tradition, this principle asserts that researchers respect research participants as human beings with intrinsic worth, whose participation is a result of their autonomous choices. The implications of this principle are far-reaching and relate to matters of obtaining informed consent, avoiding coercive and deceptive practices, upholding confidentiality and privacy, and preserving the selfdetermination of participants. In abiding by this principle, psychologists are also aware of and respect individual differences, including those influenced by gender, age, culture, role, race, ethnicity, sexual orientation, religious identity, disability, linguistic background, economic status, or any other characteristic related to group membership. Ethical Conflicts and Decision MakingThe potential for ethical conflict is ubiquitous in biomedical and behavioral research. When making ethical decisions about research, it may be prudent to develop a systematic approach to reviewing all relevant sources of ethical responsibility, including one’s own moral principles and personal values; cultural factors; professional ethics codes, such as the APA code; agency or employer policies; federal and state rules and regulations; and even case law or legal precedent. A process-oriented approach to ethical decision making may involve some variation of the following: (1) writing a description of the ethically relevant parameters of the situation; (2) defining the apparent dilemma; (3) progressing through the relevant sources of ethical responsibility; (4) generating alternative courses of action; (5) enumerating potential benefits  and consequences of each alternative; (6) consulting with the IRB, relevant colleagues, and/or legal professionals; (7) documenting the previous six steps in the process; and (8) evaluating and taking responsibility for the results of the course of action selected. As previously mentioned, all research studies must be approved by the relevant IRB. However, approval of a research proposal by an IRB does not remove the mandate of ethical responsibility from the researcher. In making ethical decisions, researchers should consider the likelihood of self-serving bias that can lead to overestimation of the scientific value o f a proposed study and underestimation of its risks. ConclusionScientific research with human participants is an inherently ethical enterprise, and ethical conflicts in research are virtually inevitable. Researchers who exercise the privilege to conduct research with human participants bear the responsibility of being familiar with and abiding by the ethical principles and relevant rules and regulations established by their professional organizations and by federal and state governments. However, rigid application of rules is not a substitute for well-reasoned, responsible ethical decision making. bibliography American Psychological Association. Ethical principles of psychologists and code of conduct. American Psychologist vol. 57 pp. 1060-1073 (2002). Bersoff, D. N. (Ed.). (2003). Ethical conflicts in psychology (3rd ed.). Washington, DC: American Psychological Association. Miller, C. (2003). Ethical guidelines in research. In J. C. Thomas, ed. & M. Herson (Eds.), Understanding research in clinical and counseling psychology (pp. 271-293). Mahwah, NJ: Erlbaum. Office for Protection from Research Risks, Protection of Human Subjects. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont Report: Ethical principles and guidelines for the protection of human subjects of research (GPO 887-809). Washington, DC: U. S. Government Printing Office. Sales, B. D., ed. , & Folkman, S. (Eds.). (2000). Ethics in research with human participants. Washington, DC: American Psychological Association. Sieber, J. E. Empirical research on research ethics. Ethics and Behavior vol. 14 pp. 397-412 (2004).

Careers In Early Childhood Education Essay

Part AFredrick Frobel believed that children learn when they are lively and free. He also believed that children’s education should be based on their interests and their active involvement. An activity using Frobel’s’ parquet gifts for 3 – 5 year olds would need to be simple enough that they would be able to manipulate the pieces involved and complex enough to challenge their minds. To start our activity I would take thin pieces of wood about 10Ãâ€"10 inches. I would outline a very simple drawing of different animals on the pieces of wood. The children can use the parquet shapes to fill the animal in, or to trace the outline of the animals. The animals would require 7 – 10 shape pieces to complete. This activity would interest the children because of the puzzles and the animal shapes. The constructive play would develop several skills such as hand/eye coordination and mental activity. The children would also be learning about different animals and their parts, like legs, heads and bodies. It also provides a small step towards the next level of play, symbolic play, by mimicking animals out of other materials. Part BMaria Montessori believed that children are internally motivated to interact with the world. She believed that children’s play was a waste of time they could be using to learn. The activity with Frobel’s parquet gifts would use the same animal outlines on the thin 10Ãâ€"10 inch pieces of wood but they would be hollowed out to create the depression of the animal. By adding small knobs to the shape pieces it would teach the children the correct way to hold a pencil. Together these make the puzzles themselves self correcting and keep the children using the activity in the way it was designed. Montessori believed there was only one way to use her education materials. There is a key difference in Fredrick Frobel and Maria Montessori methods. The activity designed for Frobel’s method allows children to create their  own ways to manipulate the pieces, like outlining the puzzle. Since his method was not self correcting it requires more thought to keep the pieces in the right area when adding another piece. Montessori’s method was much more stringent, while she believed children learned by natural exploration she didn’t allow materials to be used other than the designated way. Scenario 2: Learning Activity 1, Pet ParadePet parade is a learning activity where children make pet masks and take turns describing their pet and showing the things their pet like to do. Children naturally like to create and draw. Letting the children choose which animal they would like to represent encourages them to use their minds to make decisions. The children would be creating art by cutting, gluing and coloring their masks as well as planning how they will represent their chosen animal. Standing in front of a class full of children gets the up and moving. They would be speaking and encouraged to answer questions about their pet from the other children. This activity is a fun way to further nurture many skills. Learning Activity 2, What’s Different?What’s different is a real life version of the popular spot the difference books. Children take turns covering their faces or putting heads on their desks while the child whose turn it is changes something about his/her appearance. The change doesn’t have to be big, just rolling up a pant leg, put a sock on their hand or perhaps a funny paper mustache. Then the other children uncover their eyes and take turns guessing what’s different. This activity helps the children to learn about taking turns and being the leader. It also gets them up and moving and helps them with problem solving skills. When the children Letters don’t have to be precise and artistic; they should be fairly constant and readable. They should not float like a balloon or sink below the line and should be formed from the top and not the bottom. Practice forming letters with letter formation drills promotes reading and writing for all children. Children with a visual impairment may have the materials modified. Use brightly colored pens with a black contrasting paper. Enlarge all workbook pages and lined paper, double lines work well for children with visual impairment. For children with epilepsy traditional approaches need to be modified. Some student struggle with motor skills as a result of their epilepsy and they are especially vulnerable to inattention and work incompletion. Further breaking down the letters into simpler steps has been proven to promote writing skills in a child with epilepsy. A few easy steps can be taken to ensure the classroom is suitable for hearing impaired students. When possible, turn off equipment that creates background noises, such as fans and projectors, when not in use. Eliminating extra noise helps students with hearing impairments focus on the class lecture and assignments. Remember that hearing aids amplify every sound, including tapping pencils and air conditioners. Area rugs and heavy curtains can also eliminate a great deal of extraneous noise. Students with Attention Deficit Hyperactivity Disorder, especially those with the inattentive subtype, may take longer to process information. Be sure to give them extended time to complete their assignments. Practice letters that  are similarly formed (l/t/I; c/d; v/w), and work on those that are more frequently used — s, m, r — before he tries those less commonly found in words — j, q, z. Engage in different sensory methods for letter formation such as sand, or on an iPad white board using their finger. Scenario 4- Cause, technique, solution and reason: Temper TantrumCause: Connor wants attention. Guidance Technique: Ignore negative behavior. Appropriate Solution: Move to the other side of the room until Connors tantrum is over and then invite him to sit beside you while you read a story. Praise him for sitting beside you nicely. Reason: By ignoring the negative behavior and giving attention to the positive behavior it will effectively stop the tantrums. â€Å"Mommy, don’t go!†Cause: Insecure attachment Guidance Technique: Encouragement Appropriate Solution: Encourage Angela to play with her favorite toy or read a book when she is dropped off in the morning; also speak to Angela’s mother about becoming a secure base and not leaving without saying goodbye to help Angela acclimate. Reason: Positive support and encouragement can help the transition to a new place easier. BullyCause: Power Guidance Technique: Restructure and Reinforce Appropriate Solution: Restructure the environment so there are fewer opportunities for bullying. Help Jenny realize she has power over her decision by letting her choose and activity and choosing to play with someone instead of taking over. Reinforce positive behavior when she makes the right choice. Reason: Restructuring the environment will provide an assurance of protection to the other children while reinforcing Jenny’s positive behavior shows her that you respect her decisions and care and care for her while paying attention.

Marketing Essentials For Kleenex Essay Example | Topics and Well Written Essays - 3000 words

Marketing Essentials For Kleenex - Essay Example The Kimberly-Clark Corporation was founded in 1872 initially as a paper mill running business and has risen to become a top universal competitor in the market of paper goods. The company deals mainly with customer products which are paper based under a variety of brands such as Depend, Huggies, Scott, Kotex, Pull-Ups and Kleenex. The corporation has also extended into a worldwide Health and Hygiene market and provides a range of tissue and personal care products, and has also obtained a significantly profitable market share strongly attributed to their customer loyalty and strong trademark acknowledgment. In the year 2009, the corporation incurred a total of 19 billion dollars income. Furthermore, it is responsible for 3.3% of special paper products market only coming as a second in the world market. The mission of the company clearly states that it is focused on offering its customers with varieties of quality tissue and personal care products at affordable prices while also offering several career opportunities for workers and maintainable increase and profits to shareholders (Kimberly-Clark Reviews 2010). The company also recognizes the trip sized paper products sector as a good market which is deficient of distinct competitors. The Kleenex Germ Away is a product which market strategies will be analyzed accordingly in the paper and how to maximize the sales in the sector. Introduction Kimberly-Clark Company is a company which deals with the production of personal products. During the early days of its establishment, it manufactured a broad range of paper goods from wrapping paper, magazine grades, and books to newsprint. As the century progressed, the company had implemented conventional but dependable investment plans which had turned it into the biggest Midwestern paper company Current Company Situation The organization has been able to achieve a desirable but exceptional accomplishment in marketing through creating the trademarked brand identity names tantamount with the household goods in the minds of clients. Kleenex is one of the products which were made for consumers and the company uses catchy advertisements to target a large client base. Needing to blow or clean one’s nose, a customer could request for Kleenex tissues and safely anticipate to be given a disposable handkerchief. The company also produces other products apart from Kleenex such as Kotex and huggies (Heinrich & Batchelor 2004). Growth Outcomes The main challenge which was facing the company during its earlier yeas of founding was how to sustain a competitive advantage. The company devoted a total of $400 million in equipment, other programs and plants during this period. The company has managed to be the envy of other companies since the performance increased to that of a financially desirable business. Financial analysis K-C is a universal hygiene and health company providing special care and customer tissue products such as Scott, Kotex, Depend, Pull-ups, Huggies, Scott and Kleenex. In the financial year of 2010, it recorded income of $19,746 million which was a growth of 3.3% from the previous financial year 2009 (Lindsay, Perkins, & Karanjikar 2009). Income growth is credited to a boost in the volume of sales, improvement in product combination and net selling prices. In the financial year of 2010, the company’s operating profit was $2,773 which had decreased by 1.8% when matched up with 2009. However, in the same financial year, it had a net profit of $1,843 which, when matched up against the year 2009, was a 2.2% decline. Figure 1: Graph showing the recent performance of K-C (Dylan 2011) Mission Statement K-C has held fast to a set of uncomplicated yet insightful principles implemented by the founders- service, fair dealing and quality. These three are the regulations of achievement by which the employees and leadership are deliberated. In my opinion, these principles have aided to

Market Research Master Essay Example | Topics and Well Written Essays - 2500 words

Market Research Master - Essay Example There is a growing consensus among management professionals on the role and significance of research in marketing decision-making. While there is a popular belief that more money spent on marketing research may reduce the chance of a bad decision, business owners and marketers are often esoteric, [Chiba, 2005] and even critical of marketing research, considered costly in terms of money and time and lacking accountability and precision, being only a recommended action. [Chee and Harris, 1998; p. 193] The paper attempts to understand and establish the significance of marketing research in decision-making and for business success. As a prelude to the topic, it may be imperative to define and understand the scope of marketing research. "the systematic collection and objective recording, classification, analysis and presentation of data concerning the behaviour, needs, attitudes, opinions, motivations etc., of individuals and organizations (commercial enterprises, public bodies etc.) within the context of their economic, social, political and everyday activities" [Cited Cannon, 1996; p.100] According to Bennett's Dictionary of Marketing Terms, marketing research provides information for identifying and defining marketing opportunities and problems; generating, refining and evaluating marketing actions, monitor marketing performance and improve understanding of marketing as a process. It also designs the method for collecting information; manages and implements the data collection process, analyses the results; and communicates the findings and their implications. [Bennett, 1998; p. 117-18] It is significant to note that the definitions, while placing an emphasis on the measurement and analysis of markets, goes beyond the confines of market research to solve a particular company's marketing problem, encompassing the broad field of marketing. [Cannon, 1996; p.100] Accordingly marketing research essentially encompasses the '4 Ps' of marketing; Lancaster and Massingham present the major types of research, as including: 1. Marketing and sales research, which encompasses Determination of market size of both developed and new markets Identification of market characteristics and segments Identification of market trends Sales forecasting Obtaining information on customers and potential customers Obtaining information on competitors 2. Product research, which covers Generation of new product ideas Product concept testing Product testing Test marketing of products Packaging research focusing on different types of packaging 3. Pricing research focusing on Identifying the relationship between a product or service's price and demand 4. Marketing Communications research covering Effectiveness of advertisement campaigns and marketing communications Media selection research Copy testing Sales territory planning 5.

Discuss the current status of the Electronic Health Record (EHR) in Research Paper - 1

Discuss the current status of the Electronic Health Record (EHR) in the United States. What still must be accomplished to make the EHR a reality - Research Paper Example ividual and an individual is able to get involved in the process of agenda setting when one of the processes of cognition known as accessibility becomes active. This means that the higher the frequency of media covering particular subject, the higher will be the rate at which the subject will become accessible in the memories of the audience. Three different kinds of agenda setting methods have been realized by Rogers, the first kind is public agenda setting (Kaid, 2004, p.258). In the subject that is more important to the public is given great importance. The second kind is denoted as media agenda setting, in this kind the topic that is important to media is given great importance and lastly the third kind is policy agenda setting. In the last kind, the topics that are important to the people who make policies is hotly debated and given importance. This concept came into being under during the election for the position of president during the period of 1968 and the concept was coine d by Shaw and McCombs (Kaid, 2004,

Discussion questions Coursework Example | Topics and Well Written Essays - 250 words - 2

Discussion questions - Coursework Example Developing accurate expectations about the position to be occupied by aspiring employees is vital since it saves both individual and the company considerable time and resources. Inflated job expectations always results in new employees quitting the jobs after short stints (Schmitt, 2012). A Realistic Job Preview (RJP) is a recruitment approach employed by an organization in view of communicating vital aspects of the roles prior to offer of a job. This approach protects the merit system, enhances employee commitment and reduces turnover. Moreover, RJP provides the potential employee with a clear picture of what to expect as regards to the job (Schmitt, 2012). The elements of an effective recruitment action plan comprises of time horizons of recruitment activities. It also stipulates the approach of classifying applicant pool targets while also identifying the most appropriate techniques of contacting the targeted

The Inspiration of Ignatius of Loyola and Why the Society of Jesus is Essay

The Inspiration of Ignatius of Loyola and Why the Society of Jesus is Different - Essay Example According to the discussion a small cannon ball shattered his right leg and although he submitted himself to surgery, it was only so that he would be deformed with a limp that he carried on through life. To relieve his boredom while recuperating, he asked someone for knightly romances, but was instead handed a book of piety, which â€Å"significantly changed the course of his life and indirectly influenced hundreds of thousands of people over the next five centuries.†This paper outlines that although such a prevailing contribution to the Society resulted from his conversion, his time at Manresa was not all an easy path. From the outset, he doubted about sustaining his new life for many decades to come, but was able to recognize God’s grace, which had liberated him from such doubts. Hence, despite obstacles such as money and support, he was able to initiate his new religious order. As Donnelly emphasized, Loyola "was certain God was calling him to help souls," but how wo uld he accomplish such task? This is exactly what makes the Society of Jesus particularly different from other religious orders, from this paper’s point of view.  Loyola's goal for the Society of Jesus was to "win people to Christ and reform their lives," but in order to do so, he and his followers knew that they must fulfill a good classical and theological education. He then decided to study Latin in order to work for his mission of winning souls for God. He went to Barcelona, Alcala, Salamanca, and Paris, where he studied philosophy for three years.

Role of the student in higher education Essay Example | Topics and Well Written Essays - 1000 words

Role of the student in higher education - Essay Example This is also a right approach to ensure that students get the right knowledge so that they can be able to rely on themselves. On the other hand, this form of education will be instrumental in ensuring that the students acquire the necessary job related skills. On the other hands, it provides theoretical knowledge to apply to real work (Kay 2010). These institutions provide social and community incorporated education and hence reinforces the relevance of higher education towards national development. As a result, this strengthens job relevant skills and innovation skills. This will help especially in nursing due to technology influence (Mastrian et al. 2010). Therefore, it can be viewed as a way of making a connection between formal schooling and social/community learning (Baumann & Blythe, 2008). All these ideals help in shaping a career. Higher education is of essence to nursing student as it makes them professional, relevant, and follow regulation. Nursing education is paramount in higher education (HE). This will help in improving nursing knowledge before and after they get their licenses. This is because a difference exist in the practice nurses were educated in the 20th century. These skills are no longer up to quality as compared to the health care needs in the 21st century. This is because patient needs and care setting has become more involved. This has been the case due to the rise of chronic diseases such as diabetes and the ever-increasing aging population. Therefore, nurses need requires competencies to deliver high quality care (Chiarella & McInnes n.d.). Such competencies include leadership, health policy, system improvement, research and evidence based practice, and teamwork as well as collaboration (Institute of Medicine (IOM) 2010). Likewise, competency is needed in different areas. The HE will also help nurses to cater for increasing roles in healthcare and obtain necessary technological skills and data management system (IOM 2010). This will take place as they cooperate and coordinate care across teams of health professionals. On the other hand, nursing should be treated like a profession. In fact, in this decade nursing requires more skill, intelligence, and education. This is because the increasing demand for nurses calls them to have unique and attainments. In the past, uneducated, wicked women were allowed to take care of the sick as nurses. It is also necessary to note that the medical profession was against nurses acquiring education and awareness in the early years (DeNisco & Barker 2012). However, this has changed significantly with the acceptance of health care professionals having learned nurses. Hence, nursing need to be considered as a profession. This way the knowledge they earn will help them in linking theory to practice. Therefore, just as other profession requires a recognised higher education to be able to link theory to practice, the same should apply to nursing. In higher education, nurses get an opp ortunity to learn concepts and put it into practice. In such institutions, nurses get an opportunity to develop critical thinking to manage nursing care and service within a group of intellectuals when meeting the requirements of the patients. For example, they will be able to use the current technology in communicating with doctors in the theatre section. In addition, patient is most likely to be able to trust a nurse based on his or her competency (Price 2013). On the other han

Racial Profiling 2 Annotated Bibliography Example | Topics and Well Written Essays - 500 words

Racial Profiling 2 - Annotated Bibliography Example "Why racial profiling is a bad idea, top seven arguments against racial profiling." About.com, civil liberties 2011: 1. Web. 17 Mar 2011. http://civilliberty.about.com/od/lawenforcementterrorism/tp/Against-Racial-Profiling.htm A popular columnist for the internet site about.com, Tom Head presents a look with seven concise points showing why the use of racial profiling is a bad idea. His list includes, Racial profiling doesn’t work, Racial profiling distracts law enforcement agencies from more useful approaches, racial profiling prevents police from serving the entire community, racial profiling prevents communities from working with law enforcement, racial profiling is a blatant violation of the Fourteenth Amendment, racial profiling can easily escalate into racially-motivated violence and the most important approach, racial profiling is morally wrong. Tom Head is not simply a columnist, he is a well-educated individual who holds a Masters of Arts in humanities from California State University, Dominguez Hills and is a Ph.D. candidate at Edith Cowan University.

Effect of consumerism on society Research Paper

Effect of consumerism on society - Research Paper Example Starting with the rise of the department store, and culminating in advertisements that show females the way to live the good life, consumerism for women is all about achieving the life and identity that she is â€Å"supposed† to have. The possible exception to this is the Dove real beauty campaign, that tells the woman that she is fine the way that she is. However, in a way, consuming this product is also buying into an identity, albeit this identity is one that is not constructed by purchasing the product, but, rather, is an identity that is internal to who she is. For the male, the evolution has been a bit different, as the modern and pre-modern male was discouraged from consumption - he was the provider, not the consumer. However, post-modernism has arguably changed this, and has made the male more of a consumer because of the rise of branding and designer labels. Branding and designer labels has given the post-modern male a way to construct his identity with consumption, j ust as females have done. How Consumerism Has Affected the Female Identity Modern consumerism, as explained below, was typically associated with the female, as opposed to the male. This was affected by the rise of the department stores in the late 1800s, and this was where the culture of consumption observed a turning point (Martin, 1993, p. 149). ... Advertising plays a role in shaping female consumerism, as it does male, as explained below. For the female, she is shown, through advertising, what it is to aspire to and what it is to be afraid of. Female-directed advertising explains to women that they must aspire to a physical ideal that is unattainable by many, and also must aspire to a youthful appearance. Thus the prevalence of advertisements for products such as weight-loss pills and hair dye (Dyer, 1989, pp. 3-4). The advertising succeeds in selling these products through the process of modeling and mirroring. The advertisements model what the good life should be, and what a woman should aspire to – being fit, youthful, vigorous, sexual and fun. At the same time, they hold up a mirror to the woman’s life, and how her own life does not match that of the ideal. The advertisements seem to imploring the woman to buy the product so that she can reach the ideal that is portrayed in the ad (Dyer, 1989, pp. 3-4). This puts pressure on the woman to reach this ideal, which she can only reach through consumerism - buying products that maybe she does not really need, but feels that she does, because she wants to attain the good life that is portrayed on her television screen. Sometimes advertising actually ties products in with a certain feminist ideal, such as the Virginia Slims campaign back in the seventies, whose tag line was â€Å"You’ve Come a Long Way Baby† (Johnson & Taylor, 2008). That said, at least one advertising campaign, Dove, has attempted to use a different message to sell its products to the female audience. Their â€Å"Real Beauty† campaign featured women with less-than-perfect bodies in their underwear, and the message was that women

Alcohol and the average teen Essay Example for Free

Alcohol and the average teen Essay Many teens today face the situation of alcohol and alcohol abuse. Although we cannot make their choices for them, we can persuade them into not taking alcohol by knowing the risks first; a lot like warnings on smoke packages. Alcohol can have a big affect on the adolescent mind. The brain of a an average human being keeps developing to the age of adolescence; people believe that the brain stops developing at the age of adolescence, but in fact, the brain develops into the early 20s. At the age of adolescence, the brain goes under remodelling and rewiring. The underdeveloped brain of an adolescent can suffer irreversible brain damage and may have long lasting effects on the brain. That is why there is an age limit of 19 in Canada and the age limit of 21 in the United States. Many side effects of drinking alcohol are: slurring of words, memory loss, difficulty walking, blurred vision, slow reaction times, dehydration, blackouts(being unconscious) and even death. Alcohol is a dangerous thing a teens should not take the risks. Long term effects of alcohol unintentional injuries: car crash, falls, burns. e. t. cintentional injuries: firearm injuries, sex assault and domestic violence increase on the job injuries and loss of productivity increase of family and relationship problems alcohol poisoning high blood pressure, stroke and other heart diseases liver disease nerve damage sexual problems permanent brain damage mouth and throat cancers. Short term effects of alcohol slurred speech drowsiness vomiting diarrhea coma blackouts unconsciousness blurred vision and hearing problems breathing difficulties After drinking alcohol, many people experience difficulty to walk, unable to gain balance, motor control, timing and awareness. This is because your body will not completely absorb all of the alcohol; some of it will travel into the brain and into your cerebellum. Your cerebellum controls motor control, awareness, coordination and thoughts. The alcohol will tend to make your hands shake a lot, unable to pick up stuff and to lose balance and maybe even fall. After you drink alcohol(ethanol), reaction time or reflexes slow, because the cerebellum controls awareness which is affected by alcohol. For example, after drinking large amounts of alcohol, a person would often stumble, lose control and fall over. A person might not be aware that they are drunk until they wake up from a hangover. A second example for motor control is when a person has no control of their hands and cannot grasp at any object. One more example of balance is that a person has difficulty walking, often grabbing objects to support their body. Drinking alcohol can have effects such as mood swings, and unable to control one’s self and can sometimes become very violent. The frontal lobes control planning, forming ideas, making decisions/judgement and using self control. Alcohol disrupts the frontal lobes and can create these effects. It is illegal to drive while having more than 0. 08 % blood alcohol concentration because the alcohol will affect decision making while driving and become very dangerous if poor decisions are made. Violent tendencies also come from the induce of alcohol. Two thirds of victims who suffered violence by an intimate have reported alcohol has been a factor. Drinking alcohol can also have suicidal thoughts and attempts. In 2002, 3 million youth were at risk of suicidal attempts. The suicidal thoughts and attempts are because the frontal lobe controls thoughts and judgement while under the influence of alcohol. An example of poor decision making is when a person decides to jump down two stories from a balcony. An example of mood swings is that a person will be happy when drinking, but depressed later can be common effects. An example of self control, is when a person has violent rages that he/she cannot control that causes reckless damage. When a person thinks of an action, their body will act it out. The brain sends messages through the spine and to a certain part of the body carrying out the instructions through a set of nerves in the nervous system. Alcohol slows down the central nervous system which makes actions/movements, speech and thoughts slower by inhibiting signals between the head, spinal cord and nerve endings . Alcohol is a central nervous depressant and have life threatening effects on the bodys nervous system. The nervous system takes more damage than any other part of the body. Alcohol decreases the central nervous systems activity, and reduces anxiety, tension, and inhibitions. Drinking on a empty stomach can make the alcohol rush through your bloodstream faster, although drinking while eating doesnt necessarily mean that you wont get drunk. Stroke, heart attack and dementia can be the results of alcohols effect on the nervous system. Another example of when alcohol acts on the nervous system is when your words slur and vision will start to blur. Memory loss and unconsciousness/blackout can happen when a person drinks too much alcohol. The alcohol affects the hippocampus part of the brain, and is located in the medial temporal lobe of the brain. The hippocampus is vital to learning and memories and also vulnerable to chronic alcohol consumptions. When induced alcohol, it can affect the brain and can make you forget the recent memories of events. And having drunk alcohol has been shown to decrease the volume of the hippocampus; having induced too much alcohol in very little time can make you black out and forget whole events. If alcohol damages the hippocampus, people may find hard to grasp at memories and may find it hard to learn. This affects teens because of learning disabilities which could make them fall behind in school. An example of memory loss is, when Joe stays at his friend Bobs house, but he got drunk, passed out and woke up the other day not remembering what he was doings at his friends house. Alcohol can affect the hippocampus and affect your learning and memory. Blood pressure, hunger, thirst and the urge to urinate, even death are the effects of alcohol on the hypothalamus. The hypothalamus controls/ regulates the bodys functions. Some of the functions that the hypothalamus performs are: autonomic nervous system controls that help regulate eating and drinking, controls body temperature, body fluid, electrolyte balance and weight. When teens drink, they get a warm feeling inside their body. What actually happens is their blood pressure and body heat are rapidly decreasing. Death occurs because the body temperature and blood pressure are dropping, also because there is too much alcohol in ones system(alcohol blood concentration 0. 40%) Each year, approximately 5, 000 youth die from alcohol. Hunger and thirst occur because the hypothalamus regulates eating and drinking and is disrupted by the alcohol. That is also the reason for the urge to urinate because of the regulation of bodily fluids. Alcohol can affect your hypothalamus and disrupt your bodys natural functions. unconsciousness, low body temperature and slow breathing are the effects of alcohol on the medulla. The medulla controls automatic functions such as breathing, consciousness and body temperature. By acting on the medulla, alcohol induces sleep, which causes blackouts and unconsciousness. This also means that a person’s breathing would be affected and would be life threatening because their breathing would slow. A persons body temperature also decreases below normal creating hypothermia, especially if the person drinks in cold temperatures. Alcohol is a life costing drug that should be precautioned. Alcohol and the body Alcohol also has huge impacts on health and the human body. The alcohol first passess through the mouth and into the body. From there, it goes into the stomach. Some of the alcohol goes into bloodstream in the stomach, but most of it goes on to the small intestine. In the small intestines, the alcohol enters the bloodstream through the walls of the intestines. Then, the heart pumps the alcohol throughout the body. Next, the alcohol reaches the brain. After that, the liver works to oxidize the alcohol at a rate of 0. 5 oz per hour. Finally, the alcohol converts into water carbon and energy. Health problems that alcohol can cause are: high blood pressure, osteoporosis(bone disease), stroke and cancer, including breast cancer. Alcohol can have big impacts on the body. Alcohol can has huge impacts on the heart and health. The heart is a pump for your blood to flow throughout your body and is the biggest muscle in your body. The effects of alcohol on the heart can cause good and bad effects. The benefits of drinking alcohol are: youre less likely to get cardiovascular disease. One way is that the alcohol can increase good cholesterol which prevents clots and heart attacks. There are also many dangerous effects of alcohol on the heart when heavy alcohol consumptions occurs: excessive intake of alcohol will more likely give you high blood pressure and puts extra strain on the heart, increases the amount of fat circulating in the bloodstream, people who drink too much will increase their risk of experiencing stroke and would cause atrial fibrillation-irregular heartbeats which could increase stroke. Alcohol has both benefits and risks depending on the consumption. Through the pathway of alcohol, it passes through the digestive system. The alcohol can irritate the stomach, causing it to produce more acid than usual, causing inflammation of the lining of the stomach. The side effects are stomach pain, vomiting, diarrhea and in heavy drinkers, bleeding. The long term consequences of alcohol are the increase of getting cancer of your mouth, tongue, throat, stomach and pancreas. Alcohol can also make it difficult to digest food and absorb any nutrients from the food you just ate. This is because the alcohol reduces enzyme production in the pancreas making it hard to break down and absorb the fat and nutrients. A possible way to protect your stomach is to eat rich carbohydrates and drink a lot of water that would slow down the the rate of which your body absorbs alcohol. Death is possible too. If your unconscious, it is possible that you will throw up in your mouth and die of choking on the vomit; it would be stuck in your respiratory system and your lungs would not get air. Alcohol, if not, is a very unhealthy substance to your stomach and digestive system. Your liver is one of your most vital organs in your body. Your livers main job is detoxification-to filter your blood for toxins coming from the digestive tract. Liver disease is used to describe the damage done upon your liver from the alcohol. There are two main types of liver disease: acute meaning liver problems develops over a few months and chronic liver disease is damage done to the liver over a number of years. Some reasons why alcohol causes liver disease are: 1. Oxidative stress. The liver takes up a lot of stress filtering the alcohol and the chemical reaction can cause damage to the cells. This could cause inflammation and scarring as the liver tries to regenerate itself. 2. Alcohol causes damages to the small intestines releasing bacteria that is carried out onto the liver. Long term effects on the liver can cause many liver disease, fat deposited due to absorbing of alcohol leads to fatty liver disease and cirrhosis-a complete shutdown of the liver because it is so damaged. Heavy alcohol consumptions can have a great deal to the liver and your health. Alcohol also damages the kidney. Whether it’s acute or chronic alcohol consumption, the alcohol will damage the kidneys. The functions of the kidneys is to filter blood-the kidneys remove metabolic waste, controls the body’s fluid balance, regulates the balance of electrolytes, regulation of blood volume and pressure and maintaining electrolyte levels in blood. As the kidneys filters blood, urine is created and stored in the kidneys’ pelvis. Alcohol can cause all kinds of damage to your kidneys. Alcohol alters the filtering system of the kidneys and damages the balance of water and ions in the body. Drinking alcohol can cause high blood pressure and is the second leading cause to chronic kidney disease. The alcohol also alter filtering levels that will increase urination when drinking which is why you have to go to the washroom every five minutes, but is important to keep hydrated because by urinating, you get rid of your body’s water. Alcohol impacts the kidneys and kidneys are vital to the human body. How alcohol impacts teens and families Alcohol impacts teens and families a lot. Alcohol abuse among teens is a common problem. Statistics say that 80% of high school students report drinking alcohol and 40% of high school students report trying alcohol by the eighth grade. Some effects of alcohol abuse are emotional problems. Alcohol abuse can cause emotional problems like depression and anxiety. Alcohol abuse can cause severity in these problems. Statistics say that eighth grade girls that have alcohol abuse are more likely to attempt suicide. Some of the reasons that teens drink are: peer pressure. E. x. Your friends are all drinking and youre the one who doesn’t. Your friends will make fun of you and say you’re a loser. Fun and adventure. E. x. You want to try beer of alcohol for fun or for adventures and you try a sip. Then gulps and are not able to control yourself. Curiosity. E. x. You’ve seen them in the television. You’ve seen it in movies: people(mostly adults) drinking alcohol and getting crashed. Your parents warned you about the effects of alcohol and becoming an alcoholic. But you still wonder what it feels like to drink a sip of alcohol. So you take a bottle of beer take a drink. You get a warm feeling inside. Then you can’t control yourself and drink way too much and have a hangover. Self esteem. Some teens have a low self esteem and they want to boost it. Drinking alcohol will not boost self esteem, but causes depression instead. To cope with stress. E. x. You are under a lot of stress from school, relationships, e. t. c. When drinking alcohol, a feeling of happy and carefree. Scientists have discovered that drinking alcohol releases serotonin which is a happy chemical. Alcohol also affects teens when driving. It is not a good idea to drive with someone who is impaired that drives. Having more than 0. 08% of blood alcohol concentration can affect judgement, judgement to know if you’re intoxicated , especially when driving and is considered illegal to drive with above 0. 08% blood alcohol concentration . Statistics show that in 2010, 10,228 were killed in alcohol impaired driving crashes, almost one third of all the traffic related deaths in the United States. Impaired drinking continues to be the number one road safety issue in Canada. Alcohol also affects the family around you. When teens are killed in car accidents, their families are greatly impacted. The family would be burdened with sadness as they hear the police tell that your son or daughter was killed by drunk driving and would never forget. Not only does it impact parents, but children as well. There’s a same possibility that the parents/ guardians could’ve died in a car accident as well. The children have to take care of themselves and for each other now that their parents, unless taken to foster parents and can sometimes never recover from the tragedy. Not only does drunk driving affect families, but alcoholics too. Alcoholism is a family disease that affects everyone in the family. Usually, the alcoholic doesn’t know that they’re an alcoholic until it’s too late. The child works extra hard trying to be a perfect that they don’t upset the alcoholic, but always takes the blame is called the scapegoat. The other family member tries to make the alcoholic drink more and tries to hide the fact that alcohol is the problem and is called the enabler. Alcohol impacts teens and also families as well.

My motivation Essay Example for Free

My motivation Essay My motivation to attend a Historically Black College or University has a lot to do with black history but not for the most common reasons. For me to be able to properly express my sentiments in making this selection, I would like to begin by speaking of my experience as a black woman and the experience of being black in America. This, I feel, is the only way that I can clearly explain my decision to attend a Historically Black College or University. In the very beginning of this nations history, Americans were under the power of Englands monarchy. The Americans were able to overthrow the shackles of bondage and created a Constitution that declares its steadfast belief in the ideals of freedom, equality and the pursuit of happiness. But immediately after the Declaration of Independence and even after the Constitution was signed and accepted by leaders of the new government, not every American citizen is treated fairly. This led to the development of several plans that were aimed at making things equal. Among which, affirmative action was praised and pilloried as the answer to racial inequality. First introduced by President Kennedy in 1961, â€Å"Affirmative action† was designed as a method of reducing the discrimination that had remained despite the civil rights laws and constitutional guarantees. It was a method that was put in place as a â€Å"Temporary Measure to Level the Playing Field† through the offering of the same opportunities to all Americans. While the â€Å"Affirmative Action† plan was intended to have good effects, it resulted in exposing the flaws in the system as â€Å"Reverse Racism† began to emerge and the â€Å"Bakke† case came about where a white male was rejected two years in a row in favor of admitting other minorities through a quota system. This â€Å"Reverse Racism† and other flaws led to a mounting anger against â€Å"Affirmative Action† and soon it became a Zero Sum Game as jobs and opportunities became open to minorities but not to whites. During this period, Preferential treatment and quotas became expressions of contempt. This is where my drive to apply at this Historically Black College or University comes from because I am a firm believer in the progress that has been made to address this situation. The recent victory of Barack Obama in the United States Presidential Election of 2008 is one of the biggest issues among many other big events that have occurred in America this year. This year’s election was even more controversial because of the racial issue, which they barely, if at all, had in previous elections. During the course of the campaigns, other candidates may have mentioned the racial difficulties in their speech or public pledge, but no candidate ever represented him-self as a minority. The United States, I am proud to admit, has begun the long process of change. The idea of having a Black President was unthinkable and unimaginable ten years ago. Yet, it must be pointed out that it was only achievable because America is blended by multi-ethnicity, which means America is like a melting pot, where all different races and cultures are mixed in one particular land, often called â€Å"a country of immigrants†. Many other countries aside from than the United States were and still likely to deny minorities as their presidents. This recent success is a clear sign that Obama’s successful run for president has broken through the ‘last racial barrier’. America no longer has to be rudely awakened by the Civil Rights Movement to realize that there is still much work to be done with regards to racism in this country. When Martin Luther King, Jr. died, the nation was ready for a major change. Ending segregation in the South and improving the status of the Negro race is now the correct thing to do. The victory of Barack Obama sends a message of change that resounds with all the voters; it speaks of change and opportunity for all those who had none and all those who have none. It is this same message of change that has prompted me to embrace my country for taking steps in initiating this change. These Historically Black Colleges and Universities have been trying to change this trend since their inception and I feel that it is my duty to be a part of that proud history and continue the message of change by pushing back the barriers. As the United States continues to grow in population size, the impact that the minorities have on the future of America will no longer be a minor one, to say the least. Without any effective action, these minorities will not be able to take advantage of the opportunities that America has to offer. Affirmative action was supposed to be the future of a great America. An America as envisioned by the forefathers who declared that no person shall be denied the right to life, liberty or property just on the basis of the color of his skin. Any effective action, such as taking an active role by applying to Historically Black Colleges and Universities, with regard to improving society should not be about segregating people or creating a different class. It should instead focus on creating opportunities for those who have none and building relationships that will ensure that America can remains as the great country that it has been and is for ages to come. It is said that the future belongs to those who believe in the beauty of their dreams. I am one of those individuals who firmly believe in my dreams and am not afraid to work hard to attain them. I know that I have a long road to travel but I am neither daunted nor intimidated by this because I know that I can succeed. I am also confident in the fact that with the experiences that I can gain from this university there is so much more that I can accomplish in life and I look forward to the day that this dream becomes a reality.

Role of Triage in Emergency Care

Role of Triage in Emergency Care OVERVIEW There is a consensus on the fact that there has been a significant increase in traffic to emergency rooms which has resulted in rapidly growing demand on the limited resources of emergency rooms worldwide. In 1980, there were more than 82 million visit to hospital Emergency rooms in the USA, and a large percentage were for non urgent medical conditions. One reason for this trend is that people know they can get medical attention immediately in the Emergency departments without the long wait for appointments. This has led to very high load of patients visit to emergency rooms; a pattern that holds true globally for non urgent patient visits to most pediatric emergency rooms ( Wilson FO etal ). Another reason given for overcrowding is the increase rural to urban migration of populations and also the increase in the standard of care provided in most emergency room. However, the resulting increase in demand for emergency medical care has not been matched by availability of resources in most healthcare systems and hence there is need for emergency room managers to adopt or develop tools and protocols to prioritize the urgency and acuity of conditions to allocate appropriate level of care. If this is not done, then there is a likelihood that very ill patients may end up waiting long hours with increased risk of morbidity and some may even die as a result of delay in life saving treatment or interventions. (Mirjam van veen and Harriette a Moll) DEFINITION Triage as a term actually originates from the French verb ‘trier’, which translates ‘to sort’. It was originally used by the military as a concept to deal with large number of casualties managed by very few human and material resources. The decision is made to prioritize who had the best chance of survival, and what level of care for the survivors (LE Slay,WG Rislan ) In the last 20 years, this concept has become applicable in response to the increasing traffic to the emergency rooms and several tools have been developed to assess, prioritize and sort patients coming to the emergency department according to a determined severity of illness or injury, the level of suffering, the likely prognosis and need for intervention with available resources. It must be clarified, that triage in itself is not a diagnostic tool but a systematically structured and methodical way of assessing the severity of patients conditions to determine their clinical priorities using their presenting symptoms and measurable physiological parameters and it aims to optimize the provision of emergency care efficiently to produce the best outcome for every patient by channeling patients to appropriate level and quality of care. Hence the factors that are considered are severity of illness, level of urgency and impact of life saving intervention to reduce mortality, as well as level of care needed baring limited resources. These factors can be measured objectively using mortality rate, number of admissions to critical care unit and wards as well as patients referred to low urgency care services. The development of different assessment scoring systems and other pediatric-specific scales were attempts to have an objective approach to the assessment of severity acuity and to help predict illness or injury outcomes in children. Hence the Pediatric Glasgow Coma Scale, the Yale Observation Scale, the Pediatric Trauma Score, the PRISM score (Pediatric Risk of Mortality score), different pain scales and various respiratory severity scoring systems were all attempts to provide common nomenclature and standardize the assessment of severity of sickness and to predict prognosis in the pediatric age group. However in practice the emergency room triage nurse needs a comprehensive, simple and efficient acuity stratificaton of the severity, to make rapid and effective decisions(Dieckmann, 2002). These led to development of various decision making tools or triage scales. Gerber Zimmerman and McNair had tried to described triage as simply a rating of patients clinical urgency, that eventually evolved into 2 levels of urgent, and non urgent. Triage scales are hence developed with the aim to rapidly identify very urgent cases requiring immediate or urgent life saving treatment, or efficiently direct them to appropriate level of care, and the variations of triage scales are due to functional differences in service provision as well as availability of resources. Though there is no fail proof scale of stratification because invariably cultural adaptations, level of sophistication of data collection, personal and environmental factors do influence every measurement tool. (Christ et al 2010 as per Azeredo et al) Fittzgerald in his doctoral thesis in 1989, showed it is actually a far more complex decision making tool using defined criteria to classify patients as either a simple 3, 4 or 5 level urgency scale, pioneering the objective distinction of the earlier urgency scales(Fitzgerald GT. Emergency department triage. Department of Medicine. Queensland, Australia: University of Queensland, 1989.) TRIAGE IN CHILDREN Laskowski-Jones and Salati (2000) had strongly elucidated that children should not be seen as little adults and must not be treated as such by healthcare professionals. This is because of obvious anatomical, physiological, as well as emotional and intellectual differences between children and adults which directly alter the presentation of this group of patients in the emergency department[Laskowski-Jones]. This makes it inapplicable to use adult triage criteria for children of pediatric age due to unique clinic-pathological characteristics that creates the potential for sudden and rapid deterioration when children present to the Emergency department, creating an absolute necesity for very accurate focused triage. There are evidence that in mixed emergency departments, adults tend to ‘be seen earlier than equally ill children resulting in unacceptable waiting times for very ill children, therefore again creating a need for specific pediatric triage scales.(Cain P, Waldrop RD, Jones J; improved pediatric patient flow in a general emergency department by altering triage criteria. Acad Emerg Med 3:65-71, 1996) The UKs Manchester Triage Systems MTS, the USAs Emergency Severity Index ESI, the Canadian Triage and Acuity Scale CTAS, and the Australian(National ) Triage Scale, the most widely used triage scales and by consensus the most studied were all eventually modified to contain specific parts for children, are all also made of five level of triage urgencies (van Veen and Moll) It is important to note that none of them had been developed ‘de novo’ specifically for the pediatric age group. The initial three-level systems which predominated in the United States typically used either levels 1, 2, and 3 or emergent–urgent–nonurgent classification assignments. These methods are driven by the underlying question, ‘‘How long can patients wait?’’ When evaluated, these three-level methods had been found to be highly unreliable and have been criticized because they lack validation with clinical outcomes. (Travers DA, Waller AE, Bowling JM, Flowers D,) The 5-level scales provided a better discriminated tool for pediatric patient triage in emergency department, which was shown to be more efficient in predicting resources utilizations including hospital admissions, length of stay, and resourse utilization.(Chang, Hsu) Though 5-level scales are similar to the adults, but they have pediatric clinic-pathological parameters. Level 1 is critical, level 2 is emergent, level 3 is urgent, level 4 is non-urgent and level 5 is fast track.(O’Neil KA, Molczan K: Pediatric triage: a tier, 5-level system in the United States. Pediatr Emerg Care 19:285-290, 2003) The MTS is a five-level scale that incorporates the UK National Triage Scale. It was developed in 1996 and then revised ten years later after thorough input by various experts.(Mackway-Jones et al 2006). Though it was designed predominantly for adults, the MTS eventually adapted six flow charts that relate specifically to children and hence in 2007 it became endorsed by the Royal College of Pediatrics and Child Health. WHAT IS ALREADY KNOWN? What is already established is that the true functional capability of an effective triage system is determined by their reliability and validity. Reliability is measured as both inter rater reliability which is a measure of the agreement between two or more separate individuals using the same scale. It is an affirmation that the agreement is beyond that presented by chance, and this can be statistically determined and analyzed using Cohen’s kappa k. Where K is equal to 1 if the raters are in perfect agreement, and K is equal to 0 if their agreement is absolutely by chance. So k is rated from 0.1-0.9 ( as poor to excellent agreement). Intra rater reliability measures the agreement of one triage rater agreeing on the same level of urgency when two different cases of same scenario present on separate occasions. Validity is a determination that a conclusion of a true urgency is in fact the true value for every clinical presentation. Whereas internal validity measures of the ability of the triage system to predict this true urgency within a system, external validity measures its reproducibility in a different setting. Hence experts agree that any triage has to have these characteristics to be seen as a legitimate tool of assessment and to perform as intended [Fernandez C]. It is also known that the four major triage scales, the MTS, ESI, CTAS, and ATS have been studied and validated for both internal validity and reliability in adults and have been used in ED triage by different health institutions. Some studies reported that the MTS and the Pediatric-CTAS both seem to be valid and reliable to triage children in pediatric emergency care. (Ma, Gafni and Goldman)This has been confirmed by van Veen and Moll in another review in 2009. The CTAS enables rapid stratification of patients at the time of first encounter based on 5 levels of urgency (risk and symptom severity). Each level has a targeted waiting period until the patient is examined by the doctor or to be reassessed again in the triage area to consider the possibility of waiting longer or to be seen immediately by the physician. The standards recommended by CTAS is that waiting time is 0 minutes for level 1, 15 minutes for level 2, 30 minutes for level 3, 60 minutes for level 4, and 120 minutes for level 5. (Murray M, Bullard M, Grafstein E; CTAS National Working Group; CEDIS National Working Group. Revisions to the Canadian Emergency Department Triage and Acuity Scale implementation guidelines. CJEM 2004, 6: 421-427.)

Art, Literature And Society From 1955-1970 Essay -- essays research pa

Fear and Loathing in a Clockwork AgeAh! The noble search for identity. That intangible achievement that all artists lust after and lay in torment over. And during the post war era that struggle reached incredible magnitudes. The world cried out for legions of anti-heroes, who were only virtuous in their unapologetic and brutally honest lack of virtue. And the art world provided as many counter culture messiahs as was needed to "Damn the Man". The Beats, hippies, and punks are evidence that behind the white picket fence of suburbia lay an America that wanted more out of life than the sugar coated portrayals of domesticity and patriotism it received from pop culture. The unfortunate side of authenticity often lead to the conclusion that autonomy was an impossible dream and that just mere existence required an individual to compromise his integrity. The post-war generation developed an interesting love-hate relationship with the mass culture of it’s time. Some, like Andy Warhol, embraced the inevitability of mass culturalization in order to control the beast (yes, this is a reference to Revelations). While others recognized the American Dream as being a hypocrisy and so chose the Golden Eternity instead.The Beat generation and early hippies sought to separate themselves from mainstream society where they believed they could start anew and fully experience life, liberty, and the pursuit of happiness. The flower child p hilosophy was in fact very Transcendental, minus the stuffy New England mentality. The sexual, spiritual, and intellectual freedom and autonomy that characterized the Haight-Ashberry scene were closer to the Whitmanesque ideal than anything achieved during his life time. Postwar America was extremely prosperous from the stand point of the middle class white suburbanite. The only problem was that not everyone fit that mold. And even those who were born into that environment often found it’s conventions limiting and unfufilling. At home the issues facing minorities went, for the most part, ignored. Jim Crow laws were allowed to stand in the south until major Supreme Court decisions like Brown v. Board of Education declared segregation to be unconstitutional. But even still that did not solve the problem of good old fashioned prejudice, which was as rampant as ever. And not every woman was delighted to once again be her husband’s hous... ...ller: Rock and Roll in the Age of Celebrity. New York: St.Martins Press.1990Bessman, Jim. Ramones: An American Band. New York: St.Martins Press. 1993Doyle, Jennifer, Jonathan Flatley, and Jose Munoz. Pop Out: Queer Warhol. Durham and London: Duke University Press.1996Banes, Sally. Greenich Village 1963. Durham and London: Duke University Press.1993Lippard, Lucy R. Pop Art. London: Thames and Hudson.1985Milbank, Caroline. New York Fashion: The Evolution of American Style. New York: Harry N. Abrams, Inc. Publishers.1989All Other SourcesAli, Tariq, Susan Watkins.1968: Marching in the Streets. New York: Free Press.1998Allen, Donald M.ed. The New American Poetry. New York: Groves Press.1960Burgess, Anthony.A Clockwork Orange. New York: Ballatine Books.1963De Castelbajac, Kate. The Face of a Century:100 Years of Makeup and Style. New York: Rizzoli.1995Dodd, David. The Annotated Grateful Dead Lyrics: A Web Site. <a href="http://arts.ucsc.edu/gdead/agdl/#songs">http://art s.ucsc.edu/gdead/agdl/#songs. June 1, 1999Piccoli, Sean. The Grateful Dead. Philidelphia: Chelsea House Publishers.1997Thompson, Hunter S.Fear and Loathing in Las Vegas. New York: Vintage Books, a Division

Marketing Paper -- essays research papers

Barnes and Noble is one of the biggest booksellers in the world. This wasn’t always so. B&N started off as a small bookstore in New York City. During that time, the store was not doing very well. Actually, it was about to close when it was bought by another store. Being bought out was one of the best things that could have happened to the store. Barnes and Noble today, has changed the way people shop for books; whether it is in one of their stores, or online. B&N has revolutionized the book buying experience. I want to discuss two ways in which they have done that. One way that B&N has done this is by making their stores so comfortable and inviting, and two is by opening their online store. Walking into a Barnes and Noble, I feel immediately comfortable. The way they have their stores set up makes it easy to browse, explore, and even to sit and read. With their cafes, comfy couches and chairs, B&N encourages customers to enjoy themselves. They are selling a whole experience, not just a book (Barnes and Noble.com). That is what makes them so unique in the book business. With the opening of their online store, B&N at first had problems. It was in 1996, that they first launched and estimated expense was over 50 million dollars (Trafficlabs.com). The reason for the problems was that the internet was relatively new, and Amazon had already carved out a niche for books online. It was in the combining of the brick and mortar store, and online services that saved ...

Cuban Missile Crisis: The Brink of Global Nuclear War Essay -- History

Cuban Missile Crisis: The Brink of Global Nuclear War The Cuban Missile Crisis had a huge impact on society even years after it was resolved because the incident had brought our nation and the world so close to the brink of nuclear war. Before the Cuban Missile Crisis had occurred, many other factors had been piling up and building undesirable tensions between many countries. Along the way new allies and enemies were made causing more stress to the Cold War. The new bonds that formed after Cuba was taken over by Fidel Castro pushed nuclear war to the very edge. Many changes in Cuba caused tensions to mount between the United States, Cuba, and Russia. At the time before the Bay of Pigs incident, Cuba had a corrupt dictator that ruled the people without giving them much freedom. President Fulgencio Batista was an ally to the United States because American companies that were based in Cuba did not have many restrictions. Many wealthy Americans owned plantations on the island of Cuba because of the lack of restrictions. This all changed in 1959 when Fidel Castro took over. Castro wanted to limit American influence and cut ties with the United States. Castro quickly made attempts to be allies with the Soviets. For Castro's attempt to woo the Soviets, the United States stopped the importing of sugar from Cuba. Cuba's economy would have suffered terribly if they could not find a buyer. The Soviets agreed to buy all of the sugar. After this the United States cut off all relations with Cuba. The United States and Cuba were no l onger allies even though they were only separated by a mere 100 miles. While the Cold War loomed over the heads of the world, the President of the United States tried to think of way... ...ry.navy.mil/faqs/faq90-1.htm>. Naval Historical Center, 1993. "Cuban Missile Crisis - John F. Kennedy Presidential Library & Museum." John F. Kennedy Presidential Library & Museum. Web. 22 Jan. 2012. . Web. . Web. through . Web. Pike, John. â€Å"Cold War in the 1960s†. 2012. ops/cold-war-1960s.htm>. Web. â€Å"Limited Test Ban Treaty.† U.S. Department of State. January 22, 2012. . Sting. "Russians." The Dream of the Blue Turtles. A & M Records, 1985. Vinyl. Berkin. Making America : A History of the United States. Wadsworth, 2012. P. 354

Man and Woman

Sam Keen is an American author, philosopher and professor born in the year 1931 whose writings and teachings have explored areas such as religion, philosophy and psychology. Sam Keen's writings have been focused on the countless questions of love, life, religion, and being a man in a modern society; which he discusses in his book ‘Fire in the Belly: On Being a Man' (1991). From the book ‘Fire in the Belly' the essay ‘Man and WOMAN' was extracted. Along with these literary pieces, popular books such as Apology of Wonder (1969), Faces of the Enemy (1986), and Learning to Fly: Trapeze- Reflections on Fear, Trust, and the Joy of Letting Go (1999) are all products of Keen's literary works of art. After Keen's academic pursuit of graduating from Ursinus College in 1953 with his undergraduate degree. Keen obtained obtained his graduate degrees from Harvard University and Princeton University. Keen was then a professor of the philosophy of religion at a seminary known as the Louisville Presbyterian Theological Seminary for six years. Keen later became an editor for Psychology Today magazine and thereafter ventured in to the field of writing. The focus of this essay will be on the extract ‘Man and WOMAN'. Man and WOMAN as was mentioned before, was extracted from Keen's book ‘Fire in the Belly: On Being a Man' that is based on the examination of the stereotypical perceptions and myths surrounding the idealistic concepts of man and WOMAN, and the roles both sexes play. This essay will discuss what is required of a man to attain true manhood as they examine their trinomial views of WOMAN as Goddess and Creatrix, WOMAN as Mother and Matrix, and WOMAN as Erotic-Spiritual Power. The concept of ‘manhood' has been falsely identified for several generations now. The qualities believed to be possessed by a male in order to be considered a ‘man' are commonly those that are contrary to the characteristics actually possessed by a true man. In past generations and even more so today, being manly involves being ‘macho' – in full control of any and everything, being Mr. Know It All, being strong and mighty, fierce, and a cocky braggart. However, these traits in no way contribute to manhood. In Man and WOMAN, Keen expresses that ‘men' in fact are those responsible for their struggles in reaching the state of true manhood. Keen mentions that â€Å"one of the major tasks of manhood is to explore the unconscious feelings that surround our (men's) various images of WOMAN, to dispel false mystification, to dissolve the vague sense of threat and fear, and finally to learn to respect and love the strangeness of womankind† (Verburg, 2000, pg. 332 ). However, without a doubt, more than half the males in society that regard themselves as ‘men' are no way near even sharing the same opinion or train of thought as Keen's in regards to evaluating one's self and validating and embracing the being of a woman to reach the destination of true manhood. In fact, their efforts of becoming a man is focused solely on themselves. The input or significance of woman in the opinions of males today have no relevance whatsoever throughout the course of them becoming true men. In Keen's essay, he opposes the idea of males solely becoming men. Keen argues that in order for a child; who later becomes a man-child, to evolve into that of being a man, he must first purge his mind of the misconceptions of a WOMAN, and the â€Å"unconscious feelings† (Verburg, 2000, pg. 32 ) that surround those misconceptions. The first of the three views on WOMAN males must address in the journey of becoming a man is WOMAN as Goddess and Creatrix. As the title WOMAN as Goddess and Creatrix would imply, it is referring to the fact that women are the sex that brings about creation. Only females possess the ability to bring forth a child, which males often times feel threatens their significance and importance as ‘men'- the sex believed to be the dominant ly essential. However, what ‘men' fail to realize as what Keen expresses as the challenge ‘WOMAN as Creatrix' presents to a man to â€Å"justify his existence† (Verburg, 2000, pg. 334), is that both sexes are equally important. It is impossible for a female to impregnate herself without the sperm of a man. Women are actually knowledgeable of the impossibility of self-conception as well, and would readily accept that the participation of man is equally important in procreating. Though, the ‘macho' aspect of males that drive them to desire preferable superiority over women wouldn't allow males to freely accept equal importance to females. The reason the conscience of males constantly haunts them is that, hands down, child bearing is dumbfounding and an honorable thing which males cannot deny nor carry out. Thus, males constantly feel inferior to females in regards to creation and continue to believe that the males' participation in procreating is still inadequate. Therefore, males resort to trying to find every possible justification of their existence which is not the manliest thing to do. Keen expresses the males justification efforts in the essay as he stated â€Å"much of the meaning men attribute to their work is a response to the question posed to us by WOMAN'S capacity to give life† (Verburg, 2000, pg. 334 ). Instead of competing with the importance of women's existence, men should not only become aware of the significance of women as child bearers but rather wholeheartedly embrace the divine capability of women and accept, and respect the worth of both women and men. Secondly, in regards to WOMAN as Mother and Matrix, Keen describes the roles of a WOMAN as the mirror through which a child starts seeing themselves, as the initial teacher that molds the child's eventual thoughts, opinions, and perspectives, as nurturer, and as an information system through which the child begins to view and understand the world, the surroundings, and last but not least themselves. WOMAN as Mother and Matrix is the first influential person encountered by a child with whom a strong bond is established; if not the strongest. Keen's support of how critical the relationship between mother and child is was established as he made the statements â€Å"She exists; therefore I am. Within the warp of her womb our bodies are woven- flesh of her flesh† (Verburg, 2000, pg. 335). The child delivered after nine months of pregnancy is literally a part of the mother, a part of her being, was developed and nurtured within her body. Thus, there is an immediate bond that comes into existence even before the child is delivered. Hence, the instant attachment between a mother and child is inevitable. However, it is the extent to which the attachment prevails that becomes a concern. Keen's focus on the attachment issue between mother and child was based on the parental situation involving a son. Because of the very important and fundamental role a mother plays in raring her son; there comes a point in her son's life that he falls in love with his mother and disregards the role and significance of a father (Freud, 1899, pg. 296). However, according to Keen the son eventually â€Å"renounces his desire to be his mother's lover and makes common cause with his enemy- the father† (Verburg, 2000, pg. 336). Reestablishing a relationship with the father then provides the opportunity for the son to become exposed and grasp the qualities and values of being a man. The fact of today's family oriented reality however, lacks that of a father figure in the household. Numerous homes in today's society are composed of single mothers and their child/children. In order to emphasize on the imagery of lacking a father in modern families, Keen went on to say â€Å"where once there was a father, there is now a vacuum† (Verburg, 2000, pg336). A vacuum is defined as the â€Å"absence of a normal or previous content of a place, environment, etc. (Oxford, 1982, pg. 1185). Thus, Keen could not have compared the lack of a dad to anything better that that of a vacuum. The emptiness left in a family as a result of lacking a father is in fact like that of a vacuum. The empty space is the absence of a father figure (the previous content) that had formerly played a role in the family. As a result, Keen a rgues that lacking a dad leads the son to become and remain a mama's boy, and that the son therefore becomes disconnected from an exemplary person who would guide him to manhood. Keen stated â€Å"The powerful father has been all but replaced by the powerful mother. Dad is no longer present to teach his sons how to be men. † (Verburg, 2000, pg. 336). Mothers have boldly taken on the challenge of working, maintaining a household, raring their children, and paying the bills. Women are no longer dependent on a male partner as bread winner and provider in a home. And the strength and courage mothers display by being both mother and father in the homes is what results in sons becoming more attached to their mothers. The sons admire and greatly appreciate the efforts and responsibilities taken on by the mother to meet their needs. Therefore sons begin to live their lives with the ultimate purpose of pleasing mom and being the ideal son. Though, growing up in a single-parent home with only a mother and greatly respecting and honoring her is no excuse for a son not to be able to develop into a fully fledged man. A father figure might be absent in the home, but there are uncles, grandfathers, older male cousins, and even exemplary male figures in society that the sons can look up to for guidance to achieve manhood. Achieving manhood in such a modern family might in fact make the task even more challenging, but in no way it makes reaching manhood impossible. Lastly, men's view of WOMAN as Erotic-Spiritual Power is focused on the argument that ultimately, a woman is the â€Å"prime mover† (Verburg, 2000, pg. 338) in the sexual aspect of life. Based on Eastern mythology â€Å"the female principle is seen as active and the male as responsive† (Verburg, 2000, pg. 338). Whether the woman out rightly suggests sexual intercourse or seduces a man into the act by her attire, the woman is considered the sexual initiator. Even in extreme situations such as rape, the rapist would justify his act with the defense that the woman was the initiator of the act. The rapist would make claims such as the woman tempted him, and that â€Å"she wanted it† (Verburg, 2000, pg. 338). However, in a consensual situation or an unfortunate one such as rape; no one individual is responsible for the actions taken by the other person but of themselves. Hence, the WOMAN as Erotic-Spiritual Power is free of any connection whatsoever to the train of thought or moral decision a man would make in regards to his sexual perception of the WOMAN'S behavior or intention. Manhood entails taking responsibility for your own actions, each and every one of them. A true man dominates his thoughts and opinions. A man knows what he wants, and knows exactly why he does what he does. A woman, regardless of how provocative she might dress, or how appealing she might be, has no responsibility or dominating sexual influence on a male who's achieved manhood. In essence, Keen's opinion on achieving true manhood involved exorcizing the numerous â€Å"archetypical creatures† (Verburg, 2000. pg. 332) men have of women in their heads, understanding and embracing the existence and being of womankind, and evaluating themselves as men and the unconscious feelings attached to their many imageries of women. Unlike what many would believe, manhood is not obtained by nature but is rather nurtured (Denee, 2005). Keen concluded his essay with frank statements such as â€Å"As ‘men' we need to recollect our experience, reown our repressed knowledge of the power of WOMAN, and cease to establishing our manhood in reactionary ways. So long as we define ourselves by our reactions to unconscious images of WOMAN we remain in exile from the true mystery and power of manhood† (Verburg, 2000, pg. 339).

Addiction to Science Fiction

What do you think rough promotes assessment most science metaphor books My earnest reader I leave behind be delighted to discuss this topic with you do you think that p atomic number 18nts would accept placing their electric s pay backrrens minds in an notional mannikin- fancytedity for similarly pine that it whitethorn even affect them, would you, if you were a p bentScience fiction is a world that is liberal of the writers fancy or the producers, and its full of imaginary creatures, much(prenominal) as lamias, fairies, hosts, ghosts, and stainlessly the things that atomic number 18 not re eithery, its ad cutting ed studyage is, expanding the imagination of the reader, when I read the science fiction book that I wipe break through, I discoer to live whats in the book, and for a fleck I do, and if I got interrupted by someone, I and liveliness fazed and annoyed, completely p argonnts would reckon that its some winning of an addiction, which some of them think its wrong, or genuinely most of them, they go like we indigence you to learn from the books that you digest read, and we populate that you are cap able-bodied of interlingual rendition capaciouser books, they value it, thats what I in reality tire let ont agree to the highest degree with parents,Because, well, I am addicted to science fiction, and it actually arrives me learn some things and at the same(p) conviction, I oblige fun because I lived whats in the book by scarcely indication it, better than a movie, that whitethorn ruin the humans view of things, books t individually (what of all time the musical genre of the book was), movies bankrupt (not always just most of the time, especially this generations movies). So I need parents to listen for their kids for erst man, dear parents taket just talk, sometimes I guess you father to listen at least for at a time let us give you our take of view. Parents, bear witness me, do you rather give your kidren books that would make them shun the whole idea ab step forward breeding or would you go misuse by step with me. Just by bountiful them the freedom to choose the book, know that you actually achieved your goal.Science fiction books teach, as a prove, my booster unit, when you ask her whats the goal she achieved by reading the twilight saga, she would say I just had fun, and read, because I know that reading is meaning(a) however when when you ask her ab surface what she learned, she would say, I learned to give my enemy a chance, because I know that in that location is no such a thing called enemies, and its desires that ruins the humans under patronageing And in that location is this new(prenominal) serial publication VA ( lamia academy) an amazing series that me and my companion read, we had so more than fun reading it, and at the same time I d like to tell you that I am actually clinging to it, more than each other book that I ever read. Its evidently irresistible, and teaches to keep on stand up whenever you fall. I guess there is no harm in reading science fiction book, so male parentt make it a essential that we take a crap to read realistic books, or some kind of a historical book, because it isnt a mustiness.My dear reader, that was my opinion, so tell me yours, plainly after con cheekring my sample, I hope I reached my goal by writing this essay Twilight (summary) Isabella disgorge leaves Phoenix, Arizona and scratchs to a naked infinite in branchs, Washington to live with her dad. She does it so her mother send packing travel slightly with her baseball player husband Phil Dwyer. Bella didnt utilize to stir much urine in Phoenix, but after her move to Forks, she currently notices herself in the spotlight at her new school. To her astonishment and alarum legion(predicate) of the guys in class compete for her attention. Fork is rainy and Bella doesnt enjoy it much to her its boring and pretty lame. on t hat read/write head is one saving grace though Edward Cullen, the stunningly affordsome guy she drives coterminous to in Biology.As shes stressful to adjust out more to the highest degree this mysterious man, she realises of The Cullens being un-human. Despite all the talk, Bella finds it infeasible to believe theres anything magic about him and his grotesque behavior. During Bellas for the first time day of school, Edward Cullen displays a strange train of tension toward her. She drives that its because he doesnt like her that much. Shortly after though, he begins to change his attitude and starts starly talk. then(prenominal) one day on a position lot, an out of give van take places flying at Bella and is about to pressing her to death when all of a sharp the van is deliverped by an noncitizen force just beforehand it would baffle squashed her against her protest truck.Completely unharmed realizing she should return been dead, Bella turns her take and bump intos Edward, whom she saw crossways the parking lot just a encourage ago, kneeling next to her with his overhaul against the van. Bella looks at the hand shaped dent on the van and realizes that Edward halted speeding van with his hand. Bella didnt tell anyone about how Edward thod her carriage, but when she approached him to explain how he could get to her across the lot so apace and loot the van with his hand, he isnt overly keen to confess and refuses to comment. The spark in the midst of the two continues to grow despite Edwardss attempts to a pervert her. When confronted about it by her, Edward simply comes with excuses Bella is not leave behinding to accept.However he mentions that its in their best inte simplicity to retard outdoor(a) of each other, as acquire involved with her would put her in considerable danger. Bella has no more doubts that Edward and the entire family of Cullens are un-human. She is hinted by her friend Jacob Black that The Cullens are a clan of lamias. When attraction in the midst of the two grows to a point that incomplete evoke be without each other, Edward reveals the honor about his family. He even tells her about his ability to read peoples minds and that hes beat by his inability to ascertain what she is thinking. Edward and Bella fall profoundly in have it sullen, despite the obvious difficulties a pick out amidst a human and a vampire presents. Edward is facing his biggest individual(prenominal) challenge in resisting Bellas look.The scent of her wrinkle is extremely ardent and desirable, and Edward is horror-stricken that the natural instincts of a vampire he is would take over to a point that he wouldnt be able to contain himself and would harm the woman he loves. Bellas scent is then picked up by a tracker vampire band who make outs on a mission to extend Bella deplete for sport. The Cullens, who now consider Bella transgress of her family are determined to cheer her and un wrap Bella from Edward, sending the girl back to Phoenix. Bella rest in a hotel and receives a bring forward call from pile express her he had her mom and gave her instructions on what she needs to do if she destinys to front her alive.Bella surrenders herself to James, but Edward shows up and shifts him. The rest of Cullens joins in to fight the tracker but he manages to bite Bella in her hand before hes despatched. Edward doesnt want Bella to turn into a vampire and begins to suck malice infected occupation from the wound. He now tastes the blood, the smell of which he found so threatening to resist. He was urged to stop by his adopted contract Carlisle Cullen. Bella was saved and after shed recovered, she returned to Forks to construe prom with Edward. As the two head into the night, Bella ex flummoxs herself and pleads with him to embrace her and turn her into one of his kind with a bite to her neck.Edward refuses, although the reason for this defense team is unkn own innovative moon Edward Cullen and Alice throw Bella an 18th birthday conk outy. Edward is the vampire shes deeply in love with. In attendance are the entire Cullen family, Alice, Carlisle, Emmet, Rosalie, Esme and Jasper. Bella apropos cuts her hand with a piece of paper, this leads to a tense and somewhat violent moment. Jasper cannot laterality himself at the sight of her human blood and pounces upon her with the intention to feed. Edward has to protect her, an action that forces him to secernate the concomitant keeping Bella near his family puts her in danger. As they clean her wounds a pivotal point in the plot occurs.As they speak, Carlisle tells of Edwards intuitive intent that lamias lack a soul and that there is no better place than booby hatch for them if they are killed. He speaks boost, telling Bella of Edwards interior(a) struggle, the feature that he doesnt want to risk turning Bella into one of the damned. Edward becomes emotionally retracted as the study continues, until ulterior his family leave Forks in an effort to cut back the risk of harm to Bella and en undisputable her natural rubber. He unwittingly upsets Bella by taking the items she puddle dear with him. Photographs and pictures that can be used to prove he is alive. Four colossal months pass, a time in which Bella enters a zombie like state.She exists but authentically isnt living like she at one time was. Charlie is disquieted and tells her to wake up. To help her get through this difficult time she goes to see a movie with her friend Jessica. Upon the windup of the film she notices some guys with a salient resemblance to the stalkers who followed her the year before. She hears Edward in her head fears for her sanity. She actually believes its her mind giving a wish of fulfillment. Feeling these delusions are her subconscious mind she seeks out option methods to trigger them. Jacob Black, her spacious lost friend who suffered grievous injures in Twiligh t makes some other appearance in New Moon.Bella stumbles upon a pair of motorbikes by the road side and realizes theyre the perfect method to hear Edwards vowel system once again. She notices they need deeds and remembers Jacob unusual tendency to fix things. She takes them to see him on the back of her truck and compact one to him should he get them outpouring once more. Soon they become be quiet and she begins to depend on him, he fills the void in her heart. Jacob on the other hand is romantically attracted to Bella, who is aware of this, she tells him they are simply good friends. As their friendship develops, Jacob begins to arrogance Bella and tells of the growing unrest and occurrences at La Push a reservation.Jacob tells her of his fear of the attractor of a group of guys by the anticipate of Sam Uley. A close friend of his had the same feelings he was missing for a few days and upon his return had someway joined the gang. Jacob elaborate by telling of their stra nge behavior and his belief theyre up to no good. He worries he too could go missing and be targeted. On an outing, Jacob feels ill and develops a strong fever. Shortly after Bella has difficulty getting in touch with him before she finds out he too has returned from his absence as a member of Sams gang. She goes to visualise him at his house and is told that he must stay well out-of-door from her. He doesnt explain the reason for this when she asks. by and by the fight and argument Jacob is feeling refine and very regretful. He creeps into her agency in the middle of the night and tells her what is happening. The solo hint he gives her is to remember the legends he in smorgasborded her of when first they met. Bella thinks back and remembers a story about Werewolves and Vampires. She short realizes that Jacob and his new gang of friends are werewolves. This doesnt sit well with Bella there is animosity amongst Edward and Jacob because deep down they both love Bella. Plus the y are enemies because of the natures of the kind. There is real cause for concern because of the rivalry between these two and the item vampires and werewolves truly hate one other(prenominal).The return of capital of Seychelles further complicates the situation. She wants vengeance for the death of her friend James the vampire tracker. He was slain by Jasper and Emmet side by side(p) his attempt to kill Bella. As opposed to cleaning Edward, she feels killing his girlfriend is a fair trade. Therefore, it is down to Jacob to protect her. Jacob and his new found pack encourage Bella and her father to die time with them at La Push where they can provide adequate protection. Bella begins to send away a lot of time on the beach. She longs to hear Edwards voice again and misses him dearly. Sick of eitherthing she leaps take out the cliff and plunges into the see where she almost dies in the hands of the ocean.Jacob comes to her rescue and tells of her friend stimulate Clearwaters plight. He is in hospital following a severe cardiac arrest. Bella immediately feels remorse for diving into the ocean and returns to Jacobss house to rest and chance her strength. She begins to wonder what her look would bring if she unexpended Edward and became romantically involved with Jacob. Billy, Jacobss dad, returns plate to break the news show that Harry has passed out in his peacefulness. Bella then gets a put one over home with Jacob. On the journey she notices Carlisles vehicle and jumps to the conclusion that the Cullens have returned to Forks. Jacob rages and leaves quickly. Alice is waiting for Bella by herself.Alice tells Bella that she witnessed her fall into the sea and worries that she was committing suicide. Bella denies this but Alice is still unsure and wonders why then she felt the need to plunk so removed into the water. Jacob bumps into Bella during Alices visit and she sees he is still huffy with her for choosing Edward over himself. During Jac obs time at the house Edward peal and masquerades as Carlisle. Jacob picks up the phone. Hes asked where Carlisle is by Edward and responds by telling him hes at the funeral. Edward believes its the funeral of Bella in light of the news Alice told him. He attempts suicide. Upon news of this surfacing Bella and Alice leave for Italy to find Edward who is beg a Volturi to kill him.The Volturi deny his wishes so he attempts to enrage them by stepping into the sun and revealing the existence of Vampires to all. Bella arrives just in time and prevents Edward from following through with his threats. ball over and mixed-up that she is still alive and hasnt been buried Edward shows affection toward his love. He believes these are the last few minutes the correspond go away ever spend together. Bella is confused she believed Edward had no feelings toward her. The pair meets a Volturi drawing card by the name of Aro he informs them that Bella must become a Vampire to asseverate the se cretive nature of the vampire kind. Edward vehemently disagrees but is shown conclusive proof that Bella will indeed become one of the vampire kind in the next.At first Bella is affect and in virtual disbelief that her long lost love Edward has returned. She wonders if she actually died while leaping from the cliff and whether or not this entire episode is in accompaniment a dream. Edward soothes her concerns and explains that he loves her and that he didnt wish to leave her at all. He tells her it was for her own benefit and an act to protect her. After a long treatment she realizes that his love for her burns as strongly as hers for him, and that they belong with one another for all eternity. Edward is still unsure about turning Bella into a vampire. She sees this and takes the finis out of his control.They visit the Cullen house and start a vote over her mortality, requesting the opinion of all involved and whether they believe she should join the Vampire kind. The results are definitive, all but Edward and Rosalie feel she should become a vampire. Edward is angered but loath(p)ly agrees she should be turned following her graduation the following week. Carlisle is the one who they make up should perform the embrace considering the fact hes able to maintain control in the presence of human blood. Bella isnt happy, she would of preferred the act to be carried out by Edward but settles with whatever the Cullens feel is best. Edward agrees but only on the assign they marry first.During the epilogue of the story Bella reminisces and recalls her zombie like existence. She claims it was as if the previous seven months didnt occur. Jacob returns the motorbike to Bella in an attempt to stop Edward from eyesight her, unaware that he visits her every night by creeping into her room. Charlie is incredibly angry with Bella and case her immediately. She isnt fazed though, she knows with the love her life Edward by her side there is nil she cannot achieve and that when the dust of turmoil settles everything will be perfect Eclipse This slice of the story starts with the note Jake sent to Bella. It speaks of him missing her and that it changes little.Charlie blames Edward for Bellas disappearance in New Moon as she traveled to Italy and her unembellished craziness. He no longer likes Edward and shows with every ounce of his being that the vampire is receive in the home. Seattle is also hit by a string of unsolved killings. Bella and Edward spend some time filling in college application forms and she tells Edward her plans and need to see Jacob once again. Naturally, Edward is against it, telling her werewolves are random and unpredictable, painful sensation those slightly them. In the meantime, Alice has a strange vision in which Bella is being hunt down by a vampire. Edward hides this information from Bella and plans a trip to Florida with Charlie to see her mother out of town.Upon their return Edward is confronted by an angry Jacob , he demands to know why the return of capital of Seychelles is being kept secret to Bella and why they crossed into were eat territory chasing Victoria. Bella is dumbfounded as Edward informs her that the trip away from Forks was for her own personal safety. Once again, Edward insists Bellas banning from see Jacob is to keep her safe and away from the precarious werewolf. Bella, unbelieving insists that the pack are quite a safe and that shes never in harms way around Jacob. Finally, Edward yields and travels to the border with Bella where they meet Jacob and travel on to his house. During one such visit Jacob pleads his love for her and forcefully kisses her against her will. Unable to resist his major power she fights him off with all the strength she can muster.When he ceases the kiss she punches him as hard as she is able but only manages to break the bones in her subtile hands. Werewolves incidentally, are nearly as durable and tough as vampires. When Bella returns home and he learns of this Edward threatens Jacob angrily. Jacob tells Edward what occurred and they finally settle on a deal to work in consistency to deal with Victoria. Later on that eve when Jacob has leftfield, Edward and Bella decide to marry but only on the one condition that is they sleep together before she is turned into a Vampire. Edward realizes the severity in Bellas voice and eventually agrees to try in the future but only once they have married first.Bella speaks of her concerns of what people will say and think if she marries at such a spring chicken age, this is partly confounded by her mothers life and the fact she too married at such a young age. Spending the rest of eternity with Edward is of the utmost importance to her though, and when Edward proposes she quickly accepts. In an effort to keep her reluctant marriage secret she refuses to place the net ring on her hand. Bella soon realizes that her possessions have been stolen from her room to use for scent and localization purposes. Also, it becomes apparent that the recent killings in Seattle are being perpetrated by a coven of young vampires. Bella realizes the connection and the fact Victoria has been guide these neonates.Alice predicts an epic battle between the feature force of Cullens and Werewolves and the Victoria coven. A meeting between the Quileutes and Cullens is scheduled in the forest. During the congregation Jasper highlights and demonstrates some skills and points needed to excel in combat versus a newborn Vampire. Bella, worried Edward will be harmed asks him to stay away when the combat begins. Bella and Edward camp in the hills as the preparations for battle are made. They are soon joined by Seth and Jacob who too wait for the coming war. They use Bellas scent and lay a bunker to lead the newborns into the hands of the conjoined vampire and werewolf force.Bella enters a state of hypothermia in the freezing cold mountain conditions. Jacob taunts Edward by climbing in the sleeping sweetheart with his girl. Bella pretends to be asleep and eavesdrops on the talk between the vampire Edward and werewolf Jacob. Jacob speaks of his feeling towards Bella and confesses to Edward. Upon hearing this, Edward realizes that Jacob can give Bella something he cant and the two come to an musical arrangement. Later in morning once they have risen, Edward speaks to Bella about the engagement, Jacob, who was hiding and sense of hearing to their conversation lets out an angered and trouble howl of pain. He leaves quickly before they can catch him. Bella speaks with Edward and asks him to go and find Jacob.Upon their return Edward leaves to allow Jacob and Bella to speak. Jacob threatens to get himself killed by joining in the conflict, upon hearing her dismay and the fact she doesnt want him to Jacob blackmails her into fondling him. He says kissing him will stop him joining the fight and getting killed. Edward returns, having overheard the entire conversa tion. He explains that he isnt angry with her for having such deep feelings for Jacob. This is a fact that makes Bella even more miserable than she was before. Victoria and the newborns attack during the groups stay at the camp. The have werewolf and vampire force completely decimate and slaughter the inexperienced newborn army.Victoria had this planned though she skirts the fight and arrives at the camp to confront Edward and Bella alongside a newborn by the name of Riley. Edward pleads with Riley, trying to put him off the fight and explains the fact Victoria is victimization him. Victoria convinces Riley other and he refuses to switch allegiance. A fight occurs in which Riley is killed by the Lupine form of Seth and Victoria is killed by Edward. Bella watches the entire episode, causing Edward to worry for her thoughts and feelings toward him after seeing him as the unstoppable killing motorcar he is. She is unperturbed and throws herself into his embrace. She loves him dearly and has concerns for his safety and wellbeing alone. The war is over long before the Volturi arrive to tidy things up.Edward is reminded of his agreement to turn Bella into a vampire. Alice replies that they have set a date. Bella goes to visit Jacob who was injured in the fight. She reveals her final decision is Edward. Her love for him is far greater than anyone else alive and she hasnt the will or desire to live another day without him around. Bella later returns home from La Push. She speaks with Edward who announces that they dont have to marry, that Bella can have her way without completing her wishes. Bella states that she wishes to do things Edwardss way, and they agree to continue with the conjoin first. He puts the ring on her digit and they both agree to reveal the great news to Charlie. Breaking dawnBreaking Dawn is crash into three separate parts. The first part details Bellas marriage and honeymoon with Edward, which they spend on a private island off the coast of B razil. Two weeks into their honeymoon, Bella realizes that she is pregnant and that her condition is progressing at an supernaturally accelerated rate. After contacting Carlisle, who confirms her pregnancy, she and Edward immediately return home to Forks, Washington. Edward come to for Bellas life and convinced that the fetus is a monster as it continues to develop with unnatural rapidity, urges her to have an abortion. However, Bella feels a connection with the child and refuses.The novels second part is written from the perspective of wolf shape-shifter Jacob Black, and lasts throughout Bellas pregnancy and childbirth. Jacobs Quileute wolf pack, not knowing what danger the unhatched child may pose, plan to eradicate it, also killing Bella. Jacob vehemently protests this decision and leaves, forming his own pack with Leah and Seth Clearwater. Bella soon gives birth, but the baby breaks many of her bones and she loses massive amounts of blood. In order to save her life, Edward changes her into a vampire by injecting his venom into her heart. Jacob, who was present for the birth, almost immediately imprintsan nonvoluntary response in which a shape-shifter finds his soul mateon Edward and Bellas newborn daughter, Renesmee.This ends the bitterness between Jacob and the Cullens, leading Edward and Jacob to regard each other as brothers. The third member of Breaking Dawn shifts back to Bellas perspective, finding her changed into a vampire and enjoying her new life and abilities. However, the vampire Irina misidentifies Renesmee as an idol child, a child who has been turned into a vampire. Because immortal children are uncontrollable, creating them has been outlawed by the Volturi. After Irina presents her allegation to the Volturi, they plan to destroy Renesmee and the Cullens. In an attempt to survive, the Cullens gather other vampire clans from around the world to stand as witnesses and prove to the Volturi that Renesmee is not an immortal child.Upon co nfronting the gathered Cullen allies and witnesses, the Volturi discover that they have been misinformed and immediately execute Irina for her mistake. However, they remain opened on whether Renesmee should be viewed as a threat to vampires secret existence. At that time, Alice and Jasper, who had left prior to the confrontation, return with a Mapuche called Nahuel, a 150-year-old vampire-human crossbreed like Renesmee. He demonstrates that the crossbreeds pose no threat, and the Volturi surrender. Edward, Bella and Renesmee return to their home in peace. I HoPe I do My PoInT Start with an interesting beginning, or lead, to get your readers attention.For example if you were writing about recycling newspapers, you could open your essay by asking how many people have huge stacks of old newspapers in their garages. Let your readers know what your issue and point of view by including an opinion debate In each paragraph, give a reason that will convince your auditory modality 1-star t or end the body of your essay with a bang by organization your reasons according to their order of importance 2-be sure that you logically support your reasons by using testify and that you elaborate on your reasons and evidence Restate your opinion in diametrical words, and summarize your reasons in one or two sentences. Close your essay with a call to action that tells your readers what you want them to do or with what strong closing statement.