Freud’s Theory

1) You fail to study for your final examination stating that â€Å"all work and no play make Jack a dull person. † According to Freud's theory, how will you explain your behaviour? Sigmund Freud developed a theory about adult personality. Throughout the stages of childhood, the first part of personality, which we are all born with, is called the id. According to Freud id contains a reservoir of unconscious instincts, impulses that strives to satisfy basic sexual, and aggressive drives that operates on the pleasure principle, demanding immediate gratification.He said that adults never lost this part of their personality, as they grew older; they just developed ways of coping with it a bit better. As the child grew older, a second part of the personality developed, which was more in touch with outside reality. This he called the ego. The ego (largely conscious) operates on the reality principle, which mediates among the demands of the id, superego and reality. It satisfies the i d's desires in ways that will realistically bring pleasure rather than pain.For example, if you got very angry with someone, then the demands from your id might be to attack them but that is not very realistic, or socially acceptable. So the ego would take over, and find a way that the id's demand could be satisfied, but in a better sort of way, perhaps by making a very sarcastic remark, or something similar. As the child grows older, another part of its personality develops. According to Freud, for a small child, its parents are representations of absolute authority.They represent society and society's demand on the child. They tell it what it ought to be doing and how it should behave. This function is called the superego. In a way, the superego is kind of internal ‘parents' but a very authoritarian one. The superego represents internalized ideals and provides standards for judgment (the conscious) and for future aspirations. Freud saw personality in adults as being about a dynamic balance between these three aspects.There would be continual give and take between the id and the superego, with the ego acting as a go between. If the impulsive demands from the id become too strong, or the authoritarian superego was asking too much, the ego uses defence mechanisms which cuts out things that might destroy the dynamic balance between the three parts of the mind by allowing one side to get too strong. I failed to study for my final examination stating, â€Å"All work and no lay make Jack a dull person. † According to Freud's theory, because of anxiety I may rationalize unconsciously generating an overcome of cognitive dissonance to hide from myself the real reasons for my actions. My impulsive demand from the id became too sturdy, destroying the dynamic balance, thus the ego fears losing control of this inner war and the result ended in a dark cloud of unfocused anxiety. My behaviour will be self-satisfying but for an incorrect reason.

American war for independence II

The American war for Independence was a new revolution that was relevant for various political and social reasons. Due to the changes caused by such revolution, the changes that happened during this event greatly changed the course of American History. In order to fully understand the radical nature of the American Revolution, it is first important to briefly discuss the events during this period. Occurring in the latter half of the 18th century, the American Revolution was the event that allowed the Thirteen (13) Colonies to become the United States of America.This was also the event that finally granted these colonies the independence that they desired from the British Empire. The American War of Independence or Revolutionary War that ensued from 1775 to 1783 was largely radical in nature because of the fact that it was the first instance that a colony had tried and succeeded to gain independence from the British Empire. One of the key developments resulted from this revolution was the birth and growth of enlightenment philosophy in America.The influence of this wave of thinking created a certain sect that was opposed to an absolute monarchy, such as that of the British Empire, and instead embraced a new form of government that was revolutionary for its time. The broad intellectual and social paradigm shifts within the colonies introduced new ideas with regard to republican ideals that began to take hold among the members of the colonies. Democracy soon began to play a larger role in the determination of the new government that was going to replace the absolute monarchy.The steadily expanding role of democracy in government caused the deterioration of traditional social hierarchies that existed. Instead a new ethic was created within the core of American Political values. While the United States was arguably not the first democracy to ever exist, the neo-classical model that arose during this time was largely unheard of in other parts of the world, particular ly from a British Colony.These social and political changes greatly impacted the way that the world saw the Americas from that point on. As the birthplace of modern democracy as the world now recognizes it, the United States of America soon became the symbol of world democracy. The birth of new ideas with regard to government, representation and social class were all altered by this event. It was so influential that it became the foundation of the American Constitution and the reason why the United States will always be known as the land of the free.

Organizational Performance Management Essay

Healthcare organizations have differences and similarities across the board. Some healthcare institutions are faith based and will not allow for some procedures. Others provide small procedures and vaccinations. Some healthcare facilities are for profit and others are non-profit. While other health care providers only take certain types of insurances, either government funded or privately funded insurances. The Mayo Clinic is large not for profit operating healthcare provider and healthcare research entity. They provide a vast array of services in the United States from diabetes to cancer treatment and research. The Mayo Clinic has a worldwide reputation and standard that continues to receive accolade and awards. The Mayo clinic has received the Joint Commission’s Gold Seal of Approval. This award is given to organizations that demonstrate the highest dedication to improving and providing patients with best quality of care. The Mayo Clinic takes pride in being able to provide the highest level of care and to also maintain it. The Mayo Clinic has established a department to manage any infraction that may hinder its goal of achieving this standard it has set forth (Mayo Clinic For Patients, 2013). The Mayo clinic has to maintain a standard that is consistent with the reputation that they have established for themselves through risk and quality management. The Mayo Clinic has a compliance and integrity program established to reinforce safety. This program is put into place to monitor the overall business practices and to ensure they are being conducted with integrity. The program puts all policies and procedures under one chain of command so that they can be monitored and used as a means of communication for employees. The compliance office oversees the directing and receiving of reports, questions, and concerns about the care provided. The Compliance Office works with all department heads and stakeholders to ensure regulations and requirements are met (Integrity and Compliance Program, 2011). They also establish furthering education so that employees are up to date on current rules and regulations. The compliance office is open to receive any and all violations reports. The violations are investigated thoroughly. This program ensures that the company is able to provide statements in relation to its business practices, current and forthcoming law changes, and to protect itself and staff from any civil or legal issues. The integrity and compliance program applies to all individuals who work in any capacity at the mayo clinic from main stakeholder to students and volunteers. Workers are expected to report any violations that are suspected or otherwise known (Integrity and Compliance Program, 2011). The compliance program offers an open door policy and protects its employees from retaliation. The purpose for this office is to identify violations that are against company policy and the company and its employees to be civilly liable, and criminally liable. Each Mayo facility has a compliance officer on staff to ensure its compliance an d integrity program is being fulfilled. Compliance officers are responsible for investigating suspected violations. Each employee is required to take a compliance-training course to ensure that they know what is expected of them when they witness, suspect, or commit a violation. The compliance program further educates new employees on the standard in which Mayo conducts business. The current state of providing healthcare is ever changing and the Mayo Clinic has to stay one step ahead and ensure that their employees are properly educated in all aspects of healthcare laws (Integrity and Compliance Program, 2011). Abrazo recognized as 2011 as Best in Arizona by U.S. News and World Report, One of the Best in Phoenix, ranked #12 for the Arrowhead Hospital are a few of its great recognition as an great health care organization. The Joint Commission name Maryvale Hospital for heart attack, heart failure, pneumonia and surgical care as â€Å"top Performer†. The American Heart Association and American Stroke Association awarded The Sliver Plus Achievement Award for 2012 and 2011 to Phoenix Baptist Hospital and the Arizona Quality Alliance awarded Arrowhead Hospital in 2012 for Excellence. Abrazo Health Hospital has done and continues to contribute the best qua lity care in the valley for its community. Maintaining a fact sheet that include Medical Group, Health Institute, School-Based Health Centers, an Emergency Center in North Peoria, and providing health plans for those who need help in these areas. Abrazo has also contributed to many charitable organizations in the Valley. Like the American Heart Association, Susan G. Komen, YMCA, Leadership Council, and many high schools. They continue to provide information to the community and continue huge amount of support to the American Heart Association, Community Education and Outreach, Fire Service Leadership Conference, Keogh Foundation, School-Based Health Centers, Susan G. Komen, Race for Cure, The Legacy Backpack Buddies, and the Valley of the Sun United Way. Abrazo Health is part of the Nashville-based Vanguard Health System who embraces non-profit health care systems and serves as a bridge for these non-profit organizations to connect, serve as a business partner to for-profit corporation. The Vanguard Health System and Abrazo Health continue to provide top quality care in affiliation with board certified physicians, nursing professionals and well-trained staff, all who were recognized by national organization that share the same values in patient care. Showing Distinguished Awards from American Heart Association, Arizona Quality Alliance, The Joint commission, and named â€Å"Best in Phoenix† by U.S. New and World Report, Abrazo leads in the healthcare industry with a fantastic reputation. Another organization’s risk and quality management that finds themselves in a unique situation between providing the best resources possible to the community and regulation is the Southwest Autism Research & Resource Center. The Southwest Autism Research & Resource Center, also known as SARRC, is a non-profit, community-based organization that conducts research and distributes information, as well as supports individuals with autism and their families. In 2009, SARRC conducted 250 training and orientations, as well as offered information and services to students and staff in 90 Arizona schools. All of the services they offer are of highest quality and evidence based (â€Å"Sarrc†, n.d.). Autism touches on a broad spectrum of conditions and behaviors. In order to provide support for this spectrum, SARRC performs and receives research from many doctors as well as developmental psychologists. Performance is monitored by how the varying levels of success the therapies have on developmental delays such as feeding, speech, and social skills. Autism touches on a broad spectrum of conditions and behaviors. In order to provide support for this spectrum, SARRC performs and receives research from many doctor s as well as developmental psychologists. Performance ismonitored by how the varying levels of success those therapies have on developmental delays such as feeding, speech, and social skills. For SARRC, the main regulatory body that effects accreditation on research and treatment is the Arizona Board of Psychologist Examiners. By following the guidelines set by the Arizona Board of Psychologist examiners, SARRC will be in compliance and be able to perform at expectations above the high standards set by the board. They also have to make sure that they are following regulations set forth by the U.S. Food and Drug Administration. Some of these regulations include the use of electronic records, protection of human subjects, informed consent, and specific safeguards for children. By continuing partnerships with doctors and researchers and following the guidelines set by the regulatory board, SARRC can focus on becoming the center of choice for those seeking assistance Autism spectrum disorders. This will help improve overall organizational performance. The most important part of an organization is to make sure everyone at all levels is working toward a unified goal. Some levels of the organization may have other compartmentalized goals, but overall the message should be clear. Leadership should set the expectations of all incoming employees, but all employees should have a way of giving feedback to leadership on how they feel the organization is progressing to its goal. Staff needs to know that without compliance and accreditation guidelines the organization cannot survive, much less thrive on the assistance it provides to the community. The goal is to have a majority of the staff believe in the direction of the organization and for the organization to listen to its employees. Compliance and regulation set the tone for risk and quality management systems in an organization. Certain aspects may help or hinder performance depending on the particular regulations set by the state. With the guidelines in place, quality management can gauge whether exceeding these standards would help the organization. Besides the level of service provided in quality management, risk management dictate that these actions are responsible from a fiduciary standpoint. Nonprofit organizations aren’t in it to make the big bucks per se, but they still are a business that needs to run and pay employees, facilities, and other services provided. Abrazo Health offers a broad range of medical services, internal medicine, general surgery, cardiology, orthopedics, mother and infant care, diagnostic imaging, and emergency service. Mayo clinic offers cardiology, diabetes, and neurology surgery. SARCC focuses primarily on autism research. Abrazo departments are strictly viewed by the board members to ensure safe and quality care is being provided. Abrazo has over 5,000 employees, 600 volunteers and 2,000 affiliated physicians, and are located all over the Phoenix Valley. The Mayo Clinic is somewhat nationwide with its main facilities in Minnesota, Florida, and Arizona. The Mayo Clinic staffs and employs around 61,000 employees. The mayo clinic also has a research department and an accredited medical school established to train medical professionals and student medical doctors (Mayo Clinic facts – 2012, 2013). Abrazo Health Hospital has five acute who are all accredited by The Joint Commission (TJC) who have accredited hospit al for more than 50 years. Arrowhead Hospital, Maryvale Hospital, Phoenix Baptist Hospital and West Valley Hospital are recognized as a certified Primary Stroke Center and are a part of the Abrazo Health Hospital. All three of these organizations are not for profit. Each facility has its own purpose and mission statement. Not all healthcare facilities are the same as they provide care in their own way established from their own standards and levels of care. Each has a common goal in providing the highest level of care in any treatment they provide. Each has the tough task of always having to update their quality and risk management goals to meet the demands of the public and reimbursement agencies along with maintaining their accreditations. Quality and risk management have to be proactive and stopping incidents before they start. Incidents cost organizations financially and in the long run take away from the level of care that they are trying to provide. References Abrazo Health. (2013). Retrieved from http://www.abrazohealth.com/home.aspx Integrity and Compliance Program. (2011). Retrieved from http://www.mayoclinic.org/mcitems/mc2500-mc2599/mc2570.pdf Mayo Clinic Facts — 2012. (2001-2013). Retrieved from http://www.mayoclinic.org/about/facts.html Mayo Clinic For Patients. (2013). Retrieved from http://health.usnews.com/besthospitals/area/mn/mayo-clinic-661MAYO/for-patients SARRC. (n.d.). Retrieved from http://autismcenter.org/about_sarrc.aspx ————————————————- University of Phoenix Material Organizational Performance Management Table After you have completed your individual research on your chosen type of health care organization, collaborate with your Learning Team to complete this table. Then, refer to this table as you collaborate to write your paper. Include this table as an appendix to your paper. Fill in the necessary information in each cell, but be as succinct as possible. 1. Provide names of or links to specific organizations. Summarize key products or services provided by each type of organization and identify the primary customers they serve. Organization One| Organization Two| Organization Three| MAYO Clinichttp://www.mayoclinic.com/The Mayo Clinic is a non-for-profit worldwide organization that is dedicated to medical care and research. They employee Doctors from all practices and utilize their expertise to work together for the better of the patients. The Mayo Clinic also has school for furthering education for medical professionals. They treat over a million people a year. Their mission is to provide care and let people care for themselves. They provide up to date information and methods for their patients and website | Abrazo HealthCarehttp://www.abrazohealth.com/home.aspx Abrazo Health offers a broad range of medial services, internal medicine, general surgery, cardiology, orthopedics, mother and infant care, diagnostic imaging, and emergency service. Providing new standard care and over 5,000 employees, 600 volunteers and 2,000 affiliated physicians. They are located all over the Phoenix Valley. | Southwest Autism Research & Resource Center (SARRC)http://autismcenter.org/default.aspxSARRC is a non-profit, community-based organizations that conducts research and distributes information, as well as support for individuals with autism and their families. In 2009, SARRC conducted 250 trainings and presentations, as well as offered information and services to students and staff in 90 Arizona schools. All of the services they offer are of highest-quality and evidence-based. | 2. Outline the overall content of the major regulations, accreditation requirements, and other standards that affect each organization. Provide the title, section, parts, or subparts or the numbering system and so on of the specific regulations or accreditation requirements. For example: Use of electronic signatures in electronic medical records is equivalent to handwritten signatures on paper; FDA regulation; Title 21 CFR Part 11, Subpart C,  § 11.200 Electronic Signature: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?cfrpart=11 Organization One| Organization Two| Organization Three| Mayo Clinic and its website are accredited through the Joint Commission. The Joint Commission overseas hospitals that receive Medicaid reimbursements. The Joint Commission has also accredited the Mayo Clinic in its Advanced Stroke Center. Commission on Accreditation of Rehabilitation Facilities (CARF) has accredited Mayo Clinic for their inpatient rehabilitation programs.CEO Cancer Gold Standard Accreditation.Breast Clinic has received the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons.-Educational Accreditations Mayo Clinic’s College of Medicine, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) which provides continuing medical education for physicians. Mayo Clinic College of Medicine designates these educational activities for category 1 credits toward the American Medical Association (AMA) Physician’s Recognition Award.College of Medicine, Mayo Clinic, has achieved Accreditation with Commendation – which is the highest level of recognition offered by ACCME.| Abrazo Health Hospital and the five acute are all accredited by The Joint Commission (TJC). The Joint Commision have been accredited hospital for more than 50 years. Arrowhead Hospital, Maryvale Hospital, Phoenix Baptist Hospital and West Valley Hospital are recognized as a cerified Pimary Stroke Center and are apart of the Abrazo Health Hospital. Also recognized as 2011 Best in Arizona. U.S. News and World Report, One of the Best in Phoenix, ranked #12- Arrowhead Hospital.TJC top Performer- Marvale Hospital for heart attack, heart failure, pneumonia and surgical care. American Heart Association and American Stroke Association- The Sliver Plus Achievement Award for 2012 and 2011 to Phoenix Baptist Hospita l.Arizona Quality Alliance- Award for Excellence to Arrowhead Hospital in 2012. Abrazo Health Hospital have done and continue to contribute the best quality care in the valley for years. | Use of electronic records and electronic cignatures Title 21 CFR Part 11 http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=11 Protection of Human Subjects Title 21 CFR Part 50 http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=50 Informed ConsentTitle 21 CFR Part 50.25 http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=50.25 Safeguards for ChildrenTitle 21 CFR Part 50.55 http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=50.55 | 3. Highlight the effect of each organization’s regulations, accreditation requirements, and other standards on the risk- and quality-management functions and activities. Organization One| Organization Two| Organization Three| Mayo Clinic has a standard of practice, therefore they need the highest of accreditations. They have to maintain their level year round to not only their patients but also their employees. Risk management has to assess any and all possible issues that could cost the company money and loss of productivity due to fines, and employment turn over. Quality management has to ensure that all employees are up to date on education and changes in regulations and procedures. The accreditations aloow the Mayo Clinic to conduct certain researches and also certain procedures such as brain and cardio surgical procedures. Without the accreditation they would not be able to perform said procedure and therefore lose money. | Abrazo Health has 5 acute hospitals in the state of Arizona. Arrowhead, Maryvale, Paradise Valley, Phoenix, and in West Phoenix. Each providing a broad range of medial needs and working with the Arizona Heart Hospital and leading a great reputation in the cardiovascular department. Abrazo has been rewards on numerous occasions which has lead the organization to continue to provide great quality care all over the metropolitan area of Phoenix Arizona. Abrazo Health maintain a fact sheet which include Medical Group, Health Instutute, School-Based Health Centers, an Emerg ency Center in North Peoria, and providing health plans. Abrazo has also contributed to many charitable organizations in the Valley. Like the American Heart Association, Susan G. Komwn, YMCA, Leadershio Council, and many high schools., they continue to provide information to the community and continue huge amount of support to the American Heart Assoication, Community Education and Outreach, Fire Service Leadership Conference, Keogh Foundation, School-Based Health Centers, Susan G. Komen, Race for Cure, The Legacy Backpack Buddies, and the Valley of the Sun United Way.| Since SARRC is a non profit research organization located in Arizona, not only do they have to comply with non-profit laws but also the regulation of the Arizona Board of Psychologist Examiners. This board of examiners regulates how employees of SARRC are licensed to perform work with children and the education they need to keep licenses up to date. From a risk standpoint the board ensures that SARRC employees are li censed to give psychological treatment to children and to use safe methods. This also helps SARRC maintain high quality as the research techniques used exceed the Board of examiners qualifications as per SARRC programs (http://autismcenter.org/programs.aspx)| 4. Specify components of performance-management systems—policies and procedures, self-audits, benchmarking, complaint management, corrective or preventive action, education and training, communication, and other mechanisms—to be used by each organization. Organization One| Organization Two| Organization Three| Mayo Clinic has a compliance department and employs compliance officers that ensure policies and procedures are being followed accordingly. Compliance officers investigate all forms of complaints and work with department directors and managers to manage investigations and look for ways to stop these issues before they start. Education is developed through past incident along with present and future policy and law changes.| Abrazo part of the Nashville-based Vanguard Health System who Abrzo providing top quality care in affiliated with board certified physicians, nursing professionals and well-trained staff who have been recognized by national organization who share the same value in patient care. Showing Distinguished Awards from American Heart Association, Arizona Quality Alliance, The Joint commission, and named â€Å"Best in Phoenix† by U.S. New and World Report, Abrzon leads in the healthcare industry with a fantastic reputation. | SARRC research led by Christopher Smith, Ph. D an experimental psychologist, uses collaboration between different methods and scientists to find the possible causes of autism. Since autism is such a broad spectrum and there is no pinpointed contributing factor, most of the research and progress in the field is experimental. Most patients go in with the understanding that Autism may not be something that is curable. Performance is measured by the proven research methods which are demonstrated to work the most effectively for the child which varies per child for the broad spectrum disorder.| 5. Provide links to any relevant sources that will be useful as your Learning Team completes the paper. Organization One| Organization Two| Organization Three| http://www.mayoclinic.org/mcitems/mc2500-mc2599/mc2570.pdfhttp://health.usnews.com/best-hospitals/area/mn/mayo-clinic-661MAYO/for-patientshttp://www.mayoclinic.org/about/facts.html| | |

Why women are more prone to knee injuries than men Essay

Why women are more prone to knee injuries than men - Essay Example Knee injury or disease, therefore, can be badly crippling .(Thibodeau 223). A women's work is never done! So goes the age-old saying. Although in today's world there are many labor-saving devices, the modern woman often carries responsibilities involving long hours of duty. Women employed in industry or with major home-care responsibilities can be involved in a variety of tasks requiring strong mental, physical, emotional and social abilities. For many, additional burdens exist. Te career woman with a family, the pregnant woman with several children, the woman caring for a disabled child or an ageing parent and the wife and mother confined to a wheelchair are all faced with the challenges of coping with prolonged demands on both their energy and time. Some traditionally female jobs in the workforce are also susceptible to special stresses (Sapsford 268). The knee joint is the major weight-bearing joint of the body. Any condition, which interferes with the smooth articulation of the joint, leads to instability and rapid wasting of the quadriceps muscle (Anne 548). Cancellous bone loss begins between the ages of 30 and 35 with yearly decrease in women of 0.6 % to 0.8 % (Linear decrease) or 2.4 % (curvilinear decrease). Age-related cancellous loses in women appear to begin up to a decade earlier than cortical bone loss. Women may lose 50% of cancellous and 30 % of cortical bone over their life times, whereas men may lose only 30 % and 20 % respectively. In addition, women may have an increased risk for osteoporosis because throughout life they have 30 % less bone mass than men of a similar age (Kimble 48.28). Throughout its life bone can respond to external forces (or loads) such as the pull of tendon on bone and weight bearing. These forces can help to maintain bone mass or increase it in some circumstances. As a living tissue, bone material is constantly being turned over in a process called bone remodeling. In this process old bone is resorbed and new bone is formed. Many internal factors dictate the effectiveness of the remodeling process. These can include ageing, hormonal influences, metabolic variations and certain disease processes. Bone is most sensitive to mechanical loading during childhood (Sapsford 134). An increase in osteoblastic activity and thus in bone mass can result from the external forces (or loads) mentioned. Without these forces osteoclast activity (bone resorption) predominates and bone mass decreases (Norkin and Levangie, 1992). If the breakdown or resorption of bone (osteoclastic activity) then decreased bone density or osteopenia will occur. If this process con tinues unchecked it can lead to osteoporosis. Osteoporotic bone is more likely to fracture than bone of normal density (Sapsford 412). Osteoporosis in a major health problem that affects over 9.4 million people on the United States and is especially prevalent among postmenopausal women. The incidence osteoporosis increases with age; 30 percentage of women between the ages of 70 and 79 and 70 percentage of women 80 years of age or older develop osteoporosis without medical intervention (Kimble 48.30). There is much grater risk of women developing osteoporosis than men. Suggested reasons for this include the fact that after menopause women have period of rapid bone loss as a result of a sharp fall in oestrogen levels as overian function ceases. Up to 15 % of bone can be

3.Case Study Transformation at the Universal Manufacturers Group Coursework

3.Case Study Transformation at the Universal Manufacturers Group - Coursework Example The merger is expected to place the group at the same caliber with other competitive companies. The management hopes to reap the benefit accrued with economies of scale. Max Weber expounded on the classical theory and emphasized that there was no need of organization diversifying (Powell, 2003, p.42). In his line of thought, an organization can be successful so long as there are clear lines of authority and control. Weber gave credit on the importance of division of labor. Division of labor will enhance an organization productivity and cut-off some expenses. This however will result to the transformation of the entire human resource. The director of human resource director Mrs. Smithers is faced with challenges on how to transform the current human resource functions while still remain in focus with the organization’s vision, mission, goals, and objectives. UMG is facing two key problems in its human resource transformation. Since it wants to merge the three companies into one based in the newly located headquarter in Reading, England, human resource that was available will have to be downsized. The retrenchment of some employees will be the only way out in ensuring that UMG gets value for its resources. However, retrenchment of the employees should be done on a fair ground. Perhaps the best way to go about would be Mrs. Smithers sending circular to each department on the issue of downsizing, so that who are willing voluntarily to resign can be given the chance. Torrington, and Hall (1998, p.76), argued that proper procedures should always be in place on how to layoff, employees who voluntarily resigned and those who will be â€Å"forced† to resign. This is because if employees are not taken care during the retrenchment period this might have a negative reputation of an organization. Frederick Herzberg’s motivation-hygien e theory identifies job security as one of hygiene factor that will motivated the employees. Frederick

Reading and Writing Skills Essay Example | Topics and Well Written Essays - 750 words

Reading and Writing Skills - Essay Example The book "Rereading America† was very helpful to me. The essay â€Å"Learning to read† by Malcolm X was very inspiring. Malcolm X explained how he learned to read despite the challenging conditions he faced in life. I liked the way he struggled to learn how to read and write. He claimed, â€Å"I had commanded attention when I said something. But now, trying to write simple English, I not only wasn’t articulate, I wasn’t even functional†.His struggle in jail as he tried to learn how to read and write was a great challenge to me. At least, I had helpful and understanding lecturers, friends, as well as useful reading and writing materials. At first, he started by copying everything in the first page of the book he got into his tablet, including the punctuation marks. He went on copying the contents of the dictionary in his tablet, and after some time, he started making meaningful progress. He claimed that after so much practice in writing, he gained up writing speed. I have copied the same idea and I write a lot to improve my writing skills. I believe that I have learned a lot of writing skills. The only challenging part is that I have not yet gained the full understanding of all the vocabulary in the English world. I still need more work to understand the underlying meanings of some of the complicated words. The essay by Jonathan Kozol â€Å"Still ‘separate, still unequal† was the most challenging piece of reading, yet most educative.... The essay by Jonathan Kozol â€Å"Still ‘separate, still unequal† was the most challenging piece of reading, yet most educative. It is undeniable that Kozol gave an extensive research on the status of education in America by exploring the different society issues which affect the education system. Most of his facts in the essay were illustrated with statistical figures. I learned that in order to make a strong point and to be convictive to the readers, facts represented using statistical figures could be very efficient. It is true that the education system in America is changing for the better, but for the times of Kozol, things were out of proportion. He claimed, â€Å"Even these statistics, as stark as they are, cannot begin to convey how deeply isolated children in the poorest and most segregated sections of these cities have become† (Colombo, Cullen & Lisle, 2010, p. 219). The piece of work really developed the title of his work. Indeed, he presented the image of the society just the way it was. Racial segregation and discrimination were the most difficult society issues at the time. Perhaps, the same still remains in some regions. The most luxurious privatized learning institutions serve the whites, whereas the low-end learning institutions serve the less privileged black Americans in the American society. Although the learning environments may be different, I have learned from Malcolm X that determination is what matters most. It is possible to go to privatized luxurious institution and fail or attend a low-class learning institution and become successful depending on your attitude, focus, and commitment to education. I read this essay several times and I feel that it

Risks of Advertising Targeted on Kids Essay Example | Topics and Well Written Essays - 1000 words

Risks of Advertising Targeted on Kids - Essay Example With the increasing media habituation among the kids, the advertising companies are more and more interested in establishing their brand prospects through the persuasion of these pip-squeak customers. Eric Schlosser’s article Kid Kustomers discusses how the children of today are targeted by the advertising companies with attractive ads for their intended materialistic gains. In this essay, I shall discuss briefly the impact of kids-focused advertising among the kids of today. It is obvious that kids-aimed marketing strategies carried out by the advertising companies is causing adverse behaviors among the children, raising concerns in various quarters. Schlosser, in his article, Kid Kustomers introduces the new trend of the advertising firms to target the children for promoting the brands or products or services of their client companies, through enticing and at the same time dubious ads. He briefly describes how this trend came to action, by scrutinizing the working class pare nts who want to compensate for spending less time with the children by spending more money on them. Actually, the advertising companies are well aware of the children’s mentality and know exactly how to get into their heads, for persuading them to nag their parents to buy the products. This makes the advertising marketers to turn the kids as the ‘surrogate salesmen’ for their businesses utilizing the ‘leverage’, ‘the nudge factor’ or the ‘pester power’ of the kids. By discussing the different marketing strategies and research works handled by the advertising companies, Schlosser shows how these ads have increased the sales of the businesses, by utilizing the children’s innocence. He also mentions a few kids-attracting ads by the cigarette and alcohol companies that have caused negative impacts on the children. For instance, The Joe Camel ad campaign by a cigarette company is one of the well-known examples that created adverse effects on the children’s behavior owing to the advertising. It was studied that one-third of the illegally sold cigarettes were of Camels brand, which proves the power of advertising among the young. Similarly, the way that advertising impacts the children is evident from a survey showing that though kids liked the Pepsi and Nike commercials, they are mostly driven by the ads of Taco Bell and Budweiser for its ad characters like talking Chihuahua and frogs. (Schlosser 223). Thus, advertising has a profound impact on the kids, particularly when they are targeted in an enticing way. However, the effects of these ads on the children are still controversial. Though legal measures were taken a few decades ago to protect and regulate the ads aimed at children, the restrictions and bans were later declared as impractical. In the modern days, TV advertisements are broadcast round-the-clock to target children of all ages, and are far from being banned. The advertising compan ies’ focus towards the children for their products’ marketing is mainly because of the great deal of ‘pester power’ and ‘leverage’ by the kids to get their parents’ approval. One marketer notes about this kids-aimed advertising as, â€Å"It’s not just getting the kids to whine, it’s giving them a specific reason to ask for the product.† (Schlosser 223). However, the intended response goes far from the expected reality, as children nag their parents in unhealthy ways. James U. McNeal analyses this nagging and has categorized it into seven kinds, which are used as the requesting styles and appeals by the children to get their pare

Argument synthesis Essay Example | Topics and Well Written Essays - 750 words - 1

Argument synthesis - Essay Example However, no matter the age of the child, the ultimate goal that the parents have established in the minds of these young girls is either the tiara or ribbon or trophy along with the prize money. To my consideration, I strongly consider that these children beauty pageants should be either outlawed or they must be regularized by government administration. There are numerous things that can be considered regarding these beauty pageants, such as parenthood, ethics, mental health, competition, development or interpersonal associations. A toddler has no knowledge of what the world is all about but their innocence is being cashed by their parents for the sake of acquiring money in future. As the mothers consider these competitions will provide a future to their child and let them earn various scholarships. These mothers forget about the mental well being of their child while offering their child to such competition where they are needed to pose not their real personality but instead one that is in the minds of those judging the competition. The children are being forced to these competitions by their parents and in this way they are instructing them that the only way to earn money is through manipulating their bodies. These competitions can impact negatively on the way children presume themselves. Being the focus of these competitions, the participating kids are taught that their looks, is the most vital thing in this world that is to be considered. And this particular beauty consciousness may cause lower levels of self-esteem in the children who are not able to meet the standards defined in the competition. This may in turn cause various problems like eating disorders amongst children who consider a perfect body to be their ultimate goal. In addition, it is particularly hard for children to consider they are beautiful, when they are insisted by parents to put on heavy make ups, flippers, fake eyelashes and spray tans at these pageants. Issues also arise on the way

Business Economics Essay Example | Topics and Well Written Essays - 1500 words - 4

Business Economics - Essay Example The manufacturers also are faced with a situation where they have to lower the supply of laptops and instead focus on the production of tablet computers. An example of tablet computers is the iPad. In the last one year, netbooks and laptops have been hit the hardest by the new consumer appetite. Due to this; netbook shipments declined by 53%, while desktop PC’s demand fell by 15.4%, over the same period. (Halliday, 2011) The process above can be explained economically using the demand and supply theory. Demand is simply the purchaser’s desire and ability to pay for a price of a given commodity. Supply and demand meet due to one thing- Supply. Thus, where a seller is offering to dispose a commodity at the level of price that a purchaser is ready to pay; then, the purchaser and the seller are at an agreement point known as market equilibrium. (Ball and Seidman, 2011 pp9, 10) Demand and supply concepts are basically the most primary concepts of the field of economics. It forms the core of a market economy like that of the U.K. Price serves as a reflection of the effects of demand and supply on the market. This relationship that exists between supply and demand is the one that drives resource allocation. To understand this concept further, and to be able to understand it in the context of laptops, the laws of demand as well as supply are going to be looked at. The demand law, simply states that, ceteris paribus, the higher a commodity’s price is, the less will the demand be for that commodity. That of supply states that, the higher the price of a commodity, the higher the supply of the same commodity will be. Therefore, the higher the levels of prices, the lesser the demanded quantity of a commodity. In the scenario of the study, it is the demand of laptops that declines due to an introduction of a new substitute product in the market. Due to this, the demand curve would shift leftwards to reflect a decline in laptop’s demand. Also, as the laptops

UNit 8 Written Assignment Essay Example | Topics and Well Written Essays - 1250 words

UNit 8 Written Assignment - Essay Example The clients rights include: to be diligently served in the management of his business; to be informed of its progress, and; that his counsel shall not disclose what has been professionally confided to him. (Garner, 2007) The term witness is defined as one who can give a firsthand account of something seen, heard, or experienced. (Garner, 2007) An example is â€Å"a witness to the accident†. For legal purposes, a witness is :One who is called on to testify before a court; One who is called on to be present at a transaction in order to attest to what takes place; One who signs ones name to a document for the purpose of attesting to its authenticity and an attestation to a fact, statement, or event. (Garner, 2007) The initial interview is, of course, the one unit of service that is constant across all forms of legal service delivery. It is also one of the most critical units of service. The initial interview: (1) shapes client perception of the lawyer; (2) defines the service to be provided in terms of both problem and goal; and (3) is an important opportunity for client education, e.g. confidentiality, substantive legal rights, what the client can do for himself or herself, and the need to preserve evidence. (Alfieri 1991) In many cases the initial interview may in fact be the most significant communication before outcome determinative events such as hearing or settlement. The duty of confidentiality exists to inspire client trust and prompt candor. To achieve these purposes, clients should be informed about confidentiality at the very outset of the relationship. The most important the time to bring up attorney-client confidentiality is when you start asking questions, and offer the followin g sample statement: The witness is not interviewed in the same way as the client. The witness does not have confidentiality protections, thus they are

How a project different from operations work Essay Example for Free

How a project different from operations work Essay A project is very different from an operation work. In fact, projects and operations comprise the only two aspects of work existing in any organization. Of course, depending on the size and the needs of the organization, projects may or may not be part of existing programs or portfolios- both of them can be broken into several projects (PMI, 2013). Projects and operations are different in various ways. Here I list some of them in contrast: initiation, duration, operation process and budget. 1. Initiation. Projects are initiated by organizations for a variety of reasons, such as to meet a business need, attain a strategic objective or meet a market demand. Projects are created under specific needs. While operations work are to make sure the organization run smoothly, effectively, and professionally. Operations consist of all the activities that contribute directly to an organizations main areas of work (Wetfeet, 2012). Consider a clothing manufactory, which manufactures and sells clothing in its own stores. Operations would include everything from the manufacturing of clothing, to the shipment of that clothing to its retail stores, to the systems the company uses to track clothing thats sold at regular prices, at sale prices, returned by the customer, and so on. It would also include the fulfillment of orders placed on the companys website, and the customer service staff that helps customers with problems, complaints, or other issues. However, if the company has decided to produce a series of special clothing for this year’s Christmas, which will be sold only during the Christmas season, this initiative has become a project. 2. Duration. Projects are temporary in nature with a definite start and end. A project will end when it reaches its goal, or is terminated for various reasons (eg. the organization has changed the goal of the project, or the goal is not achievable†¦etc.), while operations start and end with the establishment and the closing of the company. It is also notable that a project can last for years or months and the effect and impact can last even longer far beyond the end of the project. 3. Operation process. Each project is aimed to create a unique outcome- a product, service or result. The operation process might be very different from one project to another, and the expertise involved can also be very distinctive. For instance, the operation process of a construction project is very different from an agriculture project, and the specific knowledge required will also be different.

School System Essay Example for Free

School System Essay I. Introduction In this chapter, the researchers would like to propose an automated billing system in AMA Computer Learning Center (ACLC) College of Gapan City, Nueva Ecija. In our generation so many things are different. The advent of technology has changed the way we live, work and spends leisure time. Computer was considered the lifeblood of society; they are everywhere. And the advancement in discoveries, both in hardware and software, keep coming, day in and day out. Technology changes and improves at a rapid pace and companies and institutions have cope with it. This is because as the latest knowledge of development in computer technology grows people’s standard increase. They seek and crave for better and more efficient ways to accomplish tedious task. The group of Companies was built upon the dream of the late Amable M. Aguiluz Sr. (AMA), Auditor General and National Treasurer during the term of President Diosdado Macapagal, to build an institution that would provide world-class education to Filipino y0uth. That dream bore fruit on October 20, 1980 when his son Dr. Amable R. Aguiluz V. (ARA), established the AMA Institute of Computer Studies and blazed the trail for popular computer education in the country. Originally located along Show Boulevard, the pioneering school offered EDP Fundamentals, Basic Programming and Technology Career courses. In June 1981, AMA Computer College (AMACC) was launched offering a four-year degree course in BS Computer Science – the first to be offered in the country. From only 13 students, the population of AMACC surged to 600 in 1983 and to 1985. To meet the growing demand for computer courses, AMACC established its first campus in Makati in 1983. A second campus followed in 1986 in project 8, Quezon City. In 1987, AMA Computer Learning Center (ACLC) was established to offer short courses in computer programming and two-year technical vocational courses. Today, there are today more than 100 learning centers nationwide. In the same year, AMA Basic Education was formed to offer courses elementary, high school and eventually pre-school education. Now known as the St. Augustine International School, its branches are located in Metro Manila, Laguna, Cebu, and Davao. In 1996, AMA set up the AMA Telecommunications and Electronics Learning Center (AMATEL) – the country’s first-ever telecommunications school. It is now called AMA International Institute of Technology (AIIT). In 1998, ABE International Business was established to offer courses in Hotel and Restaurant Management (HRM), Business Administration and computer-related courses. Today, ABE has several branches nationwide. ABE is an international school affiliated with ABE in the United Kingdom. It offers not just local, but also international diploma and international practicum program. The AMA school network also expanded overseas with branches in Los Angeles, California; Manama; Bahrain; Bangladesh; China; and Hong Kong. In 2000, AMAES launched its most ambitious expansion program with no less than 14 branches being set up nationwide. To help it graduates finds employment, AMA established in the same year its own manpower placement agency called INFOTECH Professional Services Inc. The year 2002 saw AMA expanding into maritime education, medicine, nursing, care-giving and allied health courses. Now, the Norwegian maritime Academy (NMA), the AMA school of Medicine (ASM), and the St. Augustine School of Nursing (SASN) are making a mark in their respective fields with IT-based curricula. AMA Education System (AMAES) – the umbella for AMA schools, currently boasts of more than 200 branches nationwide and in key foreign cities. It has proudly produced more than 150,000 professionals who have been gainfully employed locally and overseas. On August 20, 2002, AMA was granted University status by the Commission on Higher Education (CHED) – a well-earned tribute to the first ISO-certificated computer educational Institution in the Philippines. Founding Chairman Dr. Amable R. Aguiluz V was installed as the first AMA University president. The billing system throughout the school has relied on pens and papers. The information of the students with regards to their billings, school fees, projected additional expenses, and other expenses within the year are done computing using pens and papers, they have a computer to encode the billing information, using the V-Look UP and Microsoft Office Excel 2007. Due to manual usage, they noticed that certain problems cannot be avoided like data redundancies, missing records of the students. Furthermore, some could not be able to handle the massive volume of the students. Under the old manual billing scenarios, getting rid of paper improves efficiency, reduces human errors and allow information to flow to their system without a time consuming data input process. And also a higher student turnaround as enrollees will be saved faster. And as the population of ACLC continues to grow, many difficulties in handling their billing in a manual process and one of the solution in this problem is to make their manual billing into a computerized system. With this, the proponent of this research sought to find the way to facilitate all the students billing records â€Å"an automated billing system† to replace the manual operations. The developer wants to improve especially to meet the needs of ACLC, also through this system, billing information is easily obtained hence, school tends to rely less in manual operations. II. Statement of the Problems The proponents would like to develop the ACLC to address the following problems of their school in terms of their billing system. 1. How the proposed enrollment system will help the school? 2. What are the advantages and disadvantages of the current manual enrollment to the proposed enrollment system? 3. How the proposed system helps the daily operations of the school? 4. How can ACLC come up to the solution that may possibly solve their manual enrollment process? 5. Who are those beneficiaries of the proposed billing system? 6. What are the difference in using the current and the proposed system? III. Objectives of the Study Creating a computerized enrollment system of ACLC is the main objective of the study. The following are the specific goals: 1. To develop the system that will minimize the processing time in accessing records, and calculating fees of students. 2. To provide a proper computer-based database for ACLC. 3. To build a user-friendly system that produces accurate and error-free data results. 4. To monitor the integration of the different operations, which includes billing data, database system, and payments, it is a need for computerization. 5. To secure all the billings, payments, fees of the students. 6. To lighten the load of the staff in accessing records. 7. To improve their billing system. IV. Scope and Delimitation The study covers the billing process in ACLC (AMA Computer Learning System). The centered on means of speeding up the billing report, computation of transactions of billing. This study will be a great help in converting the manual system to computerized system for great speed retrieval. The system developed in such way that the company will be able to obtain the following: Maintain the complete files in computerized form, prepare billing report in an easiest way, updates record time to time. The proposed system has the limitations, does not include time to time printing of transactions and does not retrieve data if have power interruption. V. Significance of the Study In the development of the study, the main goal of the developer is to develop a program that could be beneficial to as many people as possible. The computerized billing system is developed to provide constructive significance to the following: The Registrar – Student registration or enrolling will going to be much easier because of the proposed system, saving student files and adding subjects is convenient and faster. The Cashier To make their work easy and also they could handle all the billings of the students without time consuming data input process and can make the computation of every transaction in the easiest way. The Proponents the development of the system challenges the programming skills of the researchers whereby searching for a new programming platform to make the common and simple program through a more sophisticated and advance approach. Students they will accommodate in a short period of time during setting up their bill immediately. Management of the School – it helps to organize and supervise its company especially the students who give fund to operate the school properly in the process of giving correct billing. Parents – it helps them to know the total bill and load that their sons or daughters have for the whole semester and they are enrolled VI. Hypothesis of the Study The researchers will provide some predictions about the proposed billing system: 1. The proposed enrollment system will upgrade its manual enrollment process into an automated enrollment system. 2. It will lessen the works of the staff/ personnel through the help of proposed billing system. 3. The proposed system helps in minimizing the time and efforts and gives a convenient, more accurate, reliable, and there would be a consistent operations and procedures. 4. Through the help of proposed system, it will decrease the data handling errors of the students in their billings and information. 5. The proposed enrollment system could be the answer to the problems of the school in processing their billings. 6. The proposed enrollment system can change the current data management more efficient, secured, save more space for the office, handle or search student information easier and lessen data reiteration.

Idiopathic parkinsons disease

Idiopathic parkinsons disease Introduction: Idiopathic Parkinsons disease (IPD) is a movement disorder associated with loss of dopaminergic neurons in the substantia nigra and the development of Lewy bodies. A reduction in normal striatal dopamine levels of 80% or more results in the cardinal symptoms of IPD, namely bradykinesia, rigidity, rest tremors and postural instability (1). Although the motor symptoms of Parkinsons disease are well defined, the non-motor features of this disorder are under-recognized and, consequently, undertreated. Non-motor symptoms and their management have been recognised by the UK National Institute for Clinical Excellence as an important unmet need in IPD (2). Results from a recent international survey show that up to 62% of non-motor symptoms of IPD, such as apathy, pain, sexual difficulties, bowel, urinary incontinence, and sleep disorders might remain undeclared to health-care professionals because patients are either embarrassed or unaware that the symptoms are linked to IPD (3). Results from early studies suggested that urinary dysfunction (UD) affects between 37% and 70% of individuals with IPD (4). However, many of these studies may have overestimated the prevalence of UD since they were published prior to the recognition of multiple system atrophy (MSA) as a separate disease entity. In addition, many studies recruited patients with symptomatic bladder dysfunction from tertiary referral centers. The use of non-validated questionnaires and the inclusion of patients with other forms of Parkinsonism such as cerebrovascular Parkinsonism may have led to further bias (5). More recent studies, using accepted diagnostic criteria for IPD, have found the prevalence of UD to be between 27% and 39%. When compared to a control group the relative risk of bladder symptoms in IPD is 2-fold (6). The aim of this work is to evaluate the urinary symptoms at different stages of IPD severity and its relation to urodynamic tests. Patients and methods: This study was conducted on 57 patients with probable IPD attending Urology and Neurology departments, Tanta University Hospital for evaluations of the lower urinary tract symptoms. ALL patients were subjected to, history taking including International Prostate Symptom Score (IPSS), physical examination and neurological examinations. IPD patients were stratified into 5 stages according to Hoehn Yahr disability stages (7). The IPSS questionnaire was administrated to each patient by one of us to help the patient understand the questionnaire. All men underwent digital rectal examinations and pelvic ultrasonography to exclude prostatic hyperplasia. Eight patients diagnosed with prostatic hyperplasia were excluded from the study. All patients (49 patients) were subjected to urodynamic studies. Statistical analysis: Data are presented as mean  ± SD. Analysis was performed with SPSS statistical package version 12 (SPSS, USA). For statistical purpose the disease severity stages were divided into mild (stages 1 and 2 HY), moderate (stage 3 HY) and severe (stages 4 and 5 HY). Results: Demographic and clinical characteristics of the patients; This study was carried on 49 patients with probable IPD, 31 male patients and 18 female patients, their age ranged from 56-73 years (mean 63.73 ±7.21 years).The duration of illness was 4-11 years (mean 7.81 ±3.27 years).According to Hoehn and Yaher classification of Parkinsons disease disability stage, we had 4,10,29,5,1 patients distributed into stages 1 to 5 respectively. The number of patients in stage 3 was higher than other stages; this may be due to few lower urinary symptoms in early stage of the disease and severe motor and psychiatric symptoms that affect daily life activities in advanced stages. Antiparkinsonian drugs received by the patients were levodopa (41patients), dopamine agonists (39 patients) and anticholinergics (24 patients). Lower urinary tract symptoms; The most frequent symptoms of lower urinary tract dysfunctions were symptoms due to storage disorder which include nocturia (77.5%), urgency (36.7%) and frequency (32.6%) (Table 1). The IPSS index scores; The total IPSS scores and irritative index scores were correlated significantly with disease severity while obstructive index scores did not (Table 2). Also, there was significant correlation between total IPSS score and quality of life score (Table 3). Urodynamic parameters; In this study, we found 33 (67.3%) patients with detrusor hyperreflexia, 6 (12.2%) patients with hyporeflexia, 10 (20.4%) patients with normal detrusor function (Table 4). Volume at initial desire to void and maximum bladder capacity (urodynamic parameters associated with filling phase) were correlated with disease severity while detrusor pressure and post-void residual urine(urodynamic parameters associated with voiding phase) did not (Table 5).There was significant correlation between irritative symptoms score index and volume at initial desire to void and maximum bladder capacity meanwhile the obstructive symptoms score index had no significant relations with any of urodynamic parameters (Table 6). Antiparkinsonian drugs; The patients were divided into 2 groups, one group was taking anticholinergic drugs (24 patients) plus Levodopa or dopamine agonists, the second group was taking Levodopa and dopamine agonists(25 patients). There was no significant difference between the 2 groups as regard the mean of urodynamic parameters (Table 7). Table 1. Frequency of the of lower urinary tract symptoms of IPD patients Symptoms Patients NO % Nocturia 38 77.5 Urgency 18 36.7 Frequency 16 32.6 Incomplete emptying 4 8.1 Intermittency 3 6.1 Weak stream 1 2 Table 2. Total, irritative, and obstructive symptom indexes of IPSS at each stage of disease severity Stages of disease severity No Pts Mean IPSS ±SD Irritative obstructive total Mild(stages 1,2) 14 6.3 ±2.1 1.4 ±1.2 7.6 ±2.4 Moderate(stage 3) 29 7.9 ±3.2 3.3 ±2.6 11.2 ±4.5 Severe(stages 4,5) 6 10.4 ±2.7 6.2 ±3.5 16.6 ±5.1 One-way ANOVA P =0.001 Table 3. Correlation between IPSS and Quality of life scores at different stages of disease severity Stages of disease severity Total I-PSS mean ±SD Quality of life score mean ±SD Mild (stages 1,2) 7.6 ±2.4 2.8 ±1.9 Moderate (stage 3) 11.2 ±4.5 3.7 ±1.4 Severe (stages 4,5) 16.6 ±5.1 5.2 ±1.1 One-way ANOVA P=0.003 Table 4. The frequency of urodynamic findings in IPD patients Stages of HY No. Pts Normal Hyperreflexia Hyporeflexia 1 4 3 1 0 2 10 3 7 0 3 29 4 20 5 4 5 0 4 1 5 1 0 1 0 Total No. (%) 49 10(20.4) 33(67.3) 6(12.2) Table 5. Urodynamic parameters at different stages of severity of IPD Stages of disease severity Volume at initial desire to void (mean ±SD)(ml.) Maximum bladder capacity (mean ±SD)(ml.) Maximum void phase. detrusor pressure (mean ±SD)(cm.water) Post-void residual urine volume. (mean ±SD)(ml.) Mild (14Pts) 115 ± 28 195 ± 60 55 ± 15 13 ± 12 Moderate (29Pts) 95 ± 25 191 ± 59 57 ± 20 20 ± 18 Severe (6Pts) 89 ± 20 184 ± 56 59 ± 25 22 ±20 One-way ANOVA P=0.006 Table 6. Correlation between urodynamic parameters and IPSS scores Urodynamic parameters Irritative score Obstructive score R P r P Initial void desire vol. 0.95 0.001 0.92 0.35 Max Bladder capacity 0.76 0.04 0.68 0.27 Detruser pressure 0.96 0.24 0.89 0.17 Post residual Urine Vol. 0.89 0.43 0.94 0.06 Table 7. Correlation between urodynamic parameters (storage phase parameters) and antiparkisonian drugs Urodynamic parameters Anticholinergic drug group N0=24 Non anticholinergic drug group No=25 P Initial void desire vol. 102 ±27 97 ±25 ≠¥0.05 Max Bladder capacity 192 ±58 188 ±56 ≠¥0.05 Discussion: Urinary dysfunction in IPD is most frequently caused byurinary storage problems, rather than voiding dysfunction, and manifest as an overactive bladder (8). In the current study, the most prevailing urinary symptom in IPD, was nocturia (up to 77.5%), followed by urgency (36.7%) and frequency (32.6%) and these results are going with previous studies (9, 10). These may lead to urinary incontinence, which may be in part functional if immobility or poor manual dexterity complicates the situation. Since many patients with IPD have a disturbed sleep pattern and nocturnal polyuria, the actual prevalence of definite nocturia may be overestimated (12). In this study, the most striking finding of bladder dysfunction in IPD patients is detrusor hyperreflexia, which is reported in 67.3% of symptomatic patients whereas detrusor hyporeflexia is reported in 12.2% of IPD patients and normal bladder function in 20.4%. Another study which evaluated voiding function in IPD found that 67% had detrusor hyperreflexia, 16% had hyporeflexia, 9% had detrusor hypereflexia with impaired contractile function, 3% had hyperreflexia with detrusor-sphincter dyssynergia and only 6% had normal detrusor functions (11). Dopaminergic mechanisms are thought to play a central role in normal micturition control and dysfunction of these may lead to detrusor overactivity. Dopaminergic neurons have both inhibitory and stimulatory effects on micturition acting via D1 and D2 receptors respectively. Such neurons are of particular abundance in the substantia nigra pars compacta (SNC) and the ventral tegmental area (VTA) of the midbrain. The most widely accepted theory is that the basal ganglia inhibits the micturition reflex in the ‘normal situation via D1 receptors, and that cell depletion in the SNC in IPD, results in loss of this D1-mediated inhibition and consequently detrusor overactivity (12). However, 12.2% of our patients had hyporeflexia which may be explained possibly by drugs especially anticholinergic and dopammiergic drugs which can inhibit bladder function and impairment of autonomic nervous system in advanced IPD. In this study, both pathological urodynamic parameters, volume at initial desire to void and maximum bladder capacity decreased with disease severity. These findings can be explained by detrusor hyperactivity. In contrast, other studies showed that post-void residual urine volume increased with disease severity (13, 14). This finding was not fully understood, but this was explained on the assumption that with advanced disease process, long standing hyperreflexia may eventually lead to impairment of bladder contractility together with the hypokinesia of pelvic floor muscles resulting in bladder outlet obstruction with consequent increase in post-void residual urine volume (13, 14). Others believe that they may be secondary to anticholinergics, obstructive uropathy, or point to the presence of multiple system atrophy (15). Because many IPD patients are on multiple drug therapy, which can inhibit bladder function, the current study, demonstrated that the mean of urodynamic parameters did not differ in patients who did or did not receive anticholinergics or dopaminergic drugs, which suggests that it is part of the IPD itself. These results are going with that of Araki et al. (11), who found no difference in the mean of urodynamic parameters among patients on different antiparkinsonian drugs (11). On the other hand, many studies showed conflicting results(16-18)that some suggest cortical dysfunction (18) or a possible implication of nondopaminergic lesions in the occurrence of bladder dysfunction in IPD (16). Lower urinary tract symptoms quantified by IPSS showed that irritative symptoms index score correlated with disease severity and with detrusor overactivity that was manifested urodynamically by decrease in volume at initial desire to void and maximum bladder capacity(storage phase) whereas the obstructive symptoms index score did not correlate with disease severity nor urodynamic parameters. In contrast, some other studies show that, irritative symptoms index score correlated with detrusor overactivity and obstructive symptoms index score correlated with voiding underactivity. Additionally, both irritative and obstructive symptom index scores increased with disease severity (13, 21).This discrepancy between the present study and other studies may be explained by fewer numbers of patients in advanced disease stage and the patients evaluated under multiple drugs therapy in advanced disease. In conclusion, most of the patients with IPD suffer from urological disorder; most commonly is detrusor hyperactivity which results in irritative urinary symptoms that correlate well with disease severity. These disabling symptoms significantly affect quality of life of IPD patients. References: 1-Clarke C. Parkinsons disease in practice. 2nd ed. London: Royal Society of Medicine Press Ltd; 2006 2-Chaudhuri KR, Healy D, Schapira AHV. The non motor symptoms of Parkinsons disease. Diagnosis and management. Lancet Neurol 2006; 5: 235-45. 3-Mitra T, Naidu Y, Martinez-Martin P, et al. The non declaration of non motor symptoms of Parkinsons disease to healthcare professionals. An international survey using the NMSQuest. 6th International Congress on Mental Dysfunctions and other Non-motor Features in Parkinsons disease and Related Disorders. Dresden October, 2008. Park Related DisordersP0II: 161. 4-Andersen J. Disturbances of bladder and urethral function in Parkinsons disease. International Urol and Nephrol 1985;17:35-41. 5.Blackett H, Walker R, Wood B. Urinary dysfunction in Parkinsons disease: a review. Parkinsonism Relat Disord 2009 Feb;15(2):81-7. 6- Hobson P, Islam W, Roberts S, Adhiyman V, Meara J. The risk of bladder and autonomic dysfunction in a community cohort of Parkinsons disease patients and normal controls. Parkinsonism Related Disorders 2003; 10:67-71. 7-Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson disease. Arch Neurol 1999;56:33-39. 8-Eckhardt MD, van Venrooij GE, Boon TA; Symptoms and quality of life versus age, prostate volume, and urodynamic parameters in 565 strictly selected men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Urology 2001 Apr; 57(4):695-700. 9-Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967; 17: 427. 10-Defreitas GA, Lemack GE, Zimmern PE, Dewey RB, Roehrborn CG, OSuilleabhain PE. Distinguishing neurogenic from non-neurogenic detrusor overactivity: A urodynamic assessment of lower urinary tract symptoms in patients with and without Parkinsons disease. Urology2003 Oct;62(4):651-5. 11-Araki I, Kuno S. Assessment of voiding dysfunction in Parkinsons disease by the international prostate symptom score. J Neurol Neurosurg and Psych 2000;68:429-433. 12- Porter B, Walker R. The night time problems facing Parkinsons patients. CME J Geriat Med 2007;8:99-103. 13- Araki I, Kitahara M, Oida T, Kuno S. Voiding dysfunction and Parkinsons disease: urodynamic abnormalities and urinary symptoms. J Urol2000 Nov;164(5):1640-3. 14-Seki S, Igawa Y, Kaidoh K, Ishizuka O, Nishizawa O, Andersson KE. Role of dopamine D1 and D1 receptors in the micturition reflex in conscious rats. Neurourol Urody2001; 20:105-13. 15-Yoshimura N, Mizuta E, Yoshida O, Kuno S. Therapeutic effects of dopamine D1/D2 receptor agonists on detrusor hyperreflexia in MPTP lesioned parkinsonian cynomoglogous monkeys. J Pharmacol Exper Therap 1998;286(1):228-233. 16-Pavlakis AJ, Siroky MB, Goldstein I and Krane RJ. Neurourologic findings in Parkinsons disease. J Urol 1983; 129:80-83. 17-Stocchi F, Carbone A, Inghilleri, et al. Urodynamic and neurophysiological evaluation in Parkinsons disease and multiple systems atrophy. J Neurol Neurosurg Psych 1997;62:507-11. 18-Wing K, Werdelin L, Nielson K, Stimpel H. Effects of dopaminergic treatment on bladder function in Parkinsons disease. Neurourol Urodyn 2004;23:689-96. 19-Aranda B, Cramer P. Effects of apomorphine and L-dopa on the Parkinsonian bladder. Neurourol Urodyn 1993;12:203-209. 20-Christmas TJ, Chapple CR, Lees AJ, Kempster PA, Frankel JP, Stern GM. Role of subcutaneous apomorphine in parkinsonian voiding dysfunction. Lancet1988 Dec 24-31;2(8626-8627):1451-1453. 21- Dubow JS. Autonomic dysfunction in Parkinsons disease. Dis Mon 2007;53:265-274.

Conflict in August Wilsons Fences and How it Affects the Work Essay ex

Fences, by August Wilson, is a drama that focuses on the characteristics of black life in the mid to late twentieth century and the strains of society on African Americans. Set in a small neighborhood of a big city, this play holds much conflict between a father, Troy Maxson, and his two sons, Lyons and Cory. By analyzing the sources of this conflict, one can better appreciate and understand the way the conflict contributes to the meaning of the work. The first conflict in this play develops between Troy and his 34-year old son Lyons. This conflict is introduced when Lyons appears at the house on Troy?s payday to borrow 10 dollars, an occurrence that is common at the Maxson household. Although Troy knows that he will let Lyons have the money, he harasses Lyons over the issue saying, ?...The only time I see this nigger is when he wants something. That?s the only time I see him.? The source of this conflict lies in Troy?s experiences and attitude toward the black cause. Troy is the victim of a generation with limited opportunities in the industrial world and toils everyday to support his family and stay on top of his struggle for survival. Troy has come to believe, from his experiences, that blacks cannot get something for nothing and that life does not owe blacks anything. Due to this, Toy ?fences in? everything that he loves to protect his possessions from the monster of society. Thus there is a symbolization of Troy building a physical fence in the yard but building an emotional fence of protection around his family and friends. He believes that blacks owe it to themselves to make an honest, hard-earned living and that is the only way to survive. Troy states sarcastically that Lyans is blowing his... ... and Rosa will do regarding their relationship. The couple face each other here and admit truths that they have seldom ever talked about and Rosa stands up to Troy realizing that he is imperfect and full of flaws. This conflict jeopardizes Troy and Rosa?s relationship and digs a whole in which they never truly overcome. This conflict emphasizes Troy?s weakness and Rosa?s strength and dignity. In the drama Fences ,by August Wilson, Their is much conflict entangling a black family living in the twentieth century. This conflict involves Troy trying to live his life through his sons, Lyans and Cory, while trying to keep them from making the same mistakes in life that he did. Also, there is conflict including Troy and his young daughter Raynell. By looking at the root of this conflict, one can better grasp the contribution it makes to the drama.

Influence of Aristotle’s Poetics on William Wordsworth’s Poetry and William Shakespeare’s Plays :: Aristotle Tragedy Tragedies

The Influence of Aristotle on William Wordsworth’s Poetry and William Shakespeare’s Plays Aristotle’s Poetics is not one of his major works, although it has exercised a great deal of influence upon subsequent literary studies and criticism. In this work Aristotle outlines and discusses many basic elements that an author should adhere to in order to write a great tragedies and/or poetry. Two important topics that Aristotle addresses and believes to be crucial to the art work is the mimesis, or imitation of life, and that the audience has an emotional response from the work, or a catharsis. Both William Wordsworth and William Shakespeare were believers in Aristotle’s philosophy concerning tragedies and poetry, and employed these two elements within their works. The basic definition for mimesis is the act of creating an image or images in someone’s mind, through an artistic representation such as, a play, a poem, or a painting, idea or ideas that will then be associated with past experiences. Aristotle is concerned with the artist’s ability to have a significant impact on others. First though the idea or belief that the artistic representation should be occurrences that people could relate to, or experiences that they would be familiar with. William Wordsworth intentions were made clear in the Preface to Lyrical Ballads when he states that a â€Å"†¦poem was to [chuse (sic) incidents and situations from common life, and to relate or describe them†¦ (650)† This mimesis can be seen throughout Wordsworth poem Tintern Abbey. Wordsworth is reflecting upon his memories of the effect that Tintern Abbey had on him while he was away, and describing them to his sister. Wordsworth grew up around Tintern Abbey and with his belief that nature taught humans moral lessons, he was very descriptive in his language describing the landscape and the basic affect that it personally had upon him. Aristotle also believed that the use of simple language in the poetry will keep the ultimate meaning from becoming blurred by complicated figures of speech. Wordsworth basically rejects the ideas of â€Å"personification of abstract ideas (652)† and â€Å"poetic diction (653)† in The Preface to Lyrical Ballads, because his main goal is to imitate the language that the common men speak everyday. Wordsworth’s Tintern Abbey is written in journal style, which is not known for loftiness in speech or complicated language, but for an easy flowing style which employs common everyday language and description. This allows the audience to understand and develop a picture of the image in their mind.

Graduation Speech: May You Have Joy and Sorrow :: Graduation Speech, Commencement Address

I would like to begin my speech with these beautiful words of wisdom: "Not enjoyment and not sorrow is our destined end or way but to act that each tomorrow brings us farther than today." Did you hear that? "Not enjoyment and not sorrow is our destined end or way, but to act that each tomorrow brings us farther than today." What, do you all have hearts of stone? Where are the tears? Don't you see it even rhymes? Way-today, today-way, see that? I guess I sound a little too bitter about this don't I? I don't mean to. I am actually excited to be speaking here today, even to be speaking about the class motto. I don't agree with it, but that doesn't mean I can't spend three minutes talking about it. Those of you who know me reasonably well know that there's not much I couldn't spend three minutes talking about. I've been told that I talk a lot. But there I go already, back to the class motto. Not enjoyment and not sorrow, but to act. There are some things that I regret about the last four years of my life, but the enjoyment and the sorrow certainly aren't among them. Life is all about the happy and the sad, and it should be. I don't want every day of my life to be measured by what I accomplished over the day before. Certainly, there are areas in which we as a society could use progress and action, but that should never exclude enjoyment and sorrow from being a part of living. Today, especially of all days, we should be thinking of these things. I am not worried this 8th of June about what I can do to advance myself past where I was on the seventh. I am worried about the fact that it is entirely possible that I may never see some of you again in my life after tonight. Not my best friends certainly, but all of those people we enjoy saying "Hi" to between periods, someone from an old team or a class in ninth grade. That's sorrow. But then it's surely not all bad. It's summer, maybe not on the calendar, but in our mi nds. This is the summer of our senior year. These are the three months out of our lives that most of our parents can only dream of returning to.

Research Paper on Teen Pregnancy

Teenage Pregnancy: Who's To Blame? Over the past 10 years, teenage pregnancy has escalated about 10%. As the years pass, more blames for teen pregnancy come up. The first few years that teen pregnancy became a problem, the people blamed the girl that became pregnant. Then as it progressed worse and worse, the blame pointed to the father of the unborn child. When the movie â€Å"June' came out in around 2009 that became blame. Then came â€Å"16 and pregnant† and â€Å"Teen Mom†.Hollywood started clamoring teen pregnancy pretty much saying its okay to be a teen mom because you can become ammos. This made the girls of the U. S think â€Å"Maybe since these girls are becoming famous for being a teen mom maybe I can too†. Then there's the no sex education in the schools. Schools these days think that all teens know about sex so why teach it? Teenage pregnancies are 100% preventable. Teenagers should make the right decision and choose abstinence. If they choose to ha ve premarital sex then they should take the right precautions to prevent pregnancies.Media and society plays a huge role in teen pregnancy. â€Å"16 and pregnant† is a show that publicizes pregnant teenage girls. It shows their struggles in life as a pregnant teen, how they try to deal with the Judgment of their peers, trying to go through school, having the baby, and trying to be a teenager. Another blame for teen pregnancy is peer pressure. Friends getting pregnant and boyfriends are the main peer pressure girls get. When a friend gets pregnant some girls get Jealous of the attention their friend is getting so they go and get pregnant so they can have the attention too.Then there's the boyfriend factor; most teenage boys are sexually active and continue that way with all the girls he boy comes in contact with. Most guys think â€Å"Oh well since all these girls she hangs around with are doing it I'll push her into doing it with me†, or they'll pull the â€Å"if you love me† card. As a teenage girl there are many things going through your mind when a boy likes you and wants to have relations with you. You think about if he really loves you, if he'll leave you if you don't do it, etc. Cost teenage girls that become pregnant will tell you miss, I became pregnant to maintain a stable relationship with my boyfriend†. There are also many schools that don't offer sex education. Most schools already have a high number of teenage pregnancies so they don't think they need it because most of the kids there are already sexually active. The other half of schools that do offer sex education, don't have any kids that sign up for the class. In 2009-12 there are more teenagers out there that are sexually active then there ever has before.Sex education is the place where kids learn about sex and how to take the right precautions to maintain health. A living environment is also to blame. If a teenage girl lives in a not so good part of town and her m other was also a teen mom, that girl might become a teen mother. Yes, a girl may not become a teen mom in those living environments, but they also can come in contact other bad influences. Most girls that are pregnant, and or have had sex stated that they were either intoxicated or under the influence of illegal drugs.Parent's are also a blame for teenage pregnancies. When parent doesn't have tell the child about sex or having babies, it hurts the child in the long run because when contraceptives. Also, when a parent drills into their kids' heads â€Å"don't have sex or lull be tramp† â€Å"don't get pregnant or I'll kick you out and you'll be homeless†, and try to restrict the kid from dating, talking to, hanging out with, or any type of contact with the opposite sex will cause the child to rebel against their parent's thus having sex and getting pregnant.In 2009, 1 of 11 year olds have had sex, 2. 4% of 12 year olds, even though pregnancy at these ages is very rare, sexual activity is more likely to be in the teens. 5. 4% of 13 year olds, 11% of 14 year olds, 20% of 15 year olds, 33% of 16 year olds, more than half of the teens 17 to 19 said that they were sexually active UT 25% said they have not until the age of 20 (Gale, 2007). The average age of a teen having premarital sex is 16. 4 years in Caucasians and 15. 5 years in African Americans (Talk of the Nation, 2008).It is estimated that 19% of teenage girls who get pregnant opt for abortion, with about 52% of women younger than 25 years old getting abortions. Of the girls who give birth, most decide to keep their babies. Between 1982 and 1988, only 3% of Caucasian girls gave up tier babies for adoption, compared to the 19% between 1965 and 1972. That figure is even smaller for African American arils. These figures still hold generally the truth now days (World of health, 2007). Not only does premarital sex without contraceptives lead to pregnancy it also leads to Studs that can lead to perma nent sickness and even death.Teenage mothers are at more risk of health problems than adult mothers. They are more open to dieses such as tootsie, anemia, and upperclassman. The number one contraceptive used by teenagers is birth control. It is 100% effective if taken the right way. The pro side of teen pregnancy is that you get to have a baby and that's about it. The con side of teen regency is that you are a child your self and you are in your teens you are suppose to have fun and live life.Teen pregnancy is becoming an epidemic and it needs to stop because the abortion rate is sky rocketing, babies are being left out in the rain with no parental guidance. Yes, there are some teens out there that are great parent's but they are very slim. When it comes to having children, teenagers are not able to raise them because they are children themselves. If teenagers think they are mature enough to have premarital sex then they should make the mature decision to prevent pregnancies.

Morality of Homosexuality According to Rachels

The ethics and morality of homosexuality and homosexual acts have been debated and questioned by many groups of people using several moral approaches to argue their point. It seems that the group of people who are most against homosexuality are religious groups, specifically Christians. Homosexuality however is not morally wrong and many arguments will be presented to refute the claims by those who do believe that homosexuality is unethical and morally wrong.The approaches that is used the most to argue that homosexuality and the acts that are involved are morally wrong which is used most by Christians is the Theory of Natural Law. Now there are three main points to this theory and the first point is that it is believed that â€Å"everything in nature has a purpose† (Rachels & Rachels, 2012). Aristotle, who is very well known and respected stated that if everyone believes that nature makes objects for a specific purpose, and that this believe is correct, then, nature makes thi ngs for the sake of man.Christians believe that God created things in nature for a specific plan and so if that specific plan can not be carried out, then it should not be done and therefore is morally wrong. To connect this part of the Theory of Natural Law to thoughts about homosexuality, one of the main arguments against homosexual acts is that it is â€Å"unnatural. † Christians believe the act of homosexual sex is immoral because it does not end in the production of life, which according to them are the main purposes of sex, to create life.This argument is easily refuted however. When using the evolutionary sense of the term â€Å"unnatural,† which is how most Christians use it in their arguments, they mean that homosexuality is morally wrong because it involves the unnatural use of body parts. It is believed by some, that because God had created genitals and the act of sex for procreation, and homosexual sex can not end in procreation, that those individuals enga ging in those acts are using their body parts for something it they were not intended for. Therefore, what they are doing is wrong.However, there are many couples that are sterile, who will never have the opportunity to procreate, and yet as long as the sex is heterosexual, Christians do not condemn them. The Roman Catholic church who does not agree with the use of birth control, still allows couples to have sex if they are infertile or during pregnancy (Mappes, Zembaty & DeGrazia, 2012). Therefore the Catholic church can claim that if the body parts are not being used for the purpose of procreation then it is unnatural and immoral otherwise they would be contradicting their own practices.Besides, as pointed out in the book by Mappes, Zembaty & DeGrazia (2012), we have multiple purposes for our organs and body parts. Just because we use our mouths to not only breath, consume nutrients and communicate, but also to chew gum and lick stamps, does not mean that those acts are immoral. E ven though our moths were not originally intended to chew gum or lick stamps, does not mean that those acts are unethical. Besides, it is also recognized by Christians that a second purpose of heterosexual sex is to bond and connect with your partner and to express love.Homosexuals use their genitals during sexual acts for those same reasons as well. So, it stands to show that Homosexuality and Homosexual sex are not immoral and unethical due to the â€Å"unnatural† use of their sex organs. A second part to the Theory of Natural Law is the belief that all things unnatural are bad and that what is and what ought to be should be the same or else it is morally wrong. The example that Rachels & Rachels (2012) gives is that Beneficence is morally right. That we should always act in the best interest of others because we care.If we do not care and therefore are not working in the best interest of others, then were are not being beneficent and that is morally wrong. Those who do not care and do not practice beneficence are often regarded as wrong. For example, these such individuals may be diagnoses with a mental illness called antisocial personality disorder because those who do not care, couldn't possibly be well. It is believed that these individuals ways of thinking are wrong and therefore should be fixed. So, because society believes that people ought to be beneficent and therefore if they are not, then their actions are morally wrong.Rachels & Rachels (2012) then points out that sex produces babies, that is fact. But does it then follow that sex ought to produces babies? Not necessarily. Those who have genetic mutations that could produce offspring with those same genetic mutations or diseases could be said ought not to have babies because it would perpetuate pain and suffering. Should it follow then those individuals ought not to have sex at all? It is not considered morally wrong for those with genetic illness to have sex, but it maybe thought to be mo rally wrong for them to produce a child.So, what is and what ought to be are different. In regards to Homosexuality, some believe that those individuals ought not to have sex because it is not an innate desire and therefore is unnatural. And as stated before that in which is unnatural ought not to occur according to the Theory of Natural Law. It is argued that References Rachels, J. , & Rachels, S. (2012). The elements of moral philosophy. New York, NY: McGraw-Hill. Mappes, T. A. , Zembaty, J. S. , & DeGrazia, D. (2012). Social Ethics: Morality and Social Policy. New York, NY: McGraw-Hill.

Deception Point Page 25

Sexton hung up, looking pleased with himself. â€Å"New Sexton fan?† Gabrielle asked. â€Å"They're multiplying,† he said. â€Å"This guy's a heavy hitter.† â€Å"Must be. Meeting him in your apartment?† Sexton usually defended the sanctified privacy of his apartment like a lion protecting its only remaining hiding place. Sexton shrugged. â€Å"Yeah. Thought I'd give him the personal touch. This guy might have some pull in the home stretch. Got to keep making those personal connections, you know. It's all about trust.† Gabrielle nodded, pulling out Sexton's daily planner. â€Å"You want me to put him in your calendar?† â€Å"No need. I'd planned to take a night at home anyway.† Gabrielle found tonight's page and noticed it was already shaded out in Sexton's handwriting with the bold letters â€Å"P.E.†-Sexton shorthand for either personal event, private evening, or piss-off everyone; nobody was quite sure which. From time to time, the senator scheduled himself a â€Å"P.E.† night so he could hole up in his apartment, take his phones off the hook, and do what he enjoyed most-sip brandy with old cronies and pretend he'd forgotten about politics for the evening. Gabrielle gave him a surprised look. â€Å"So you're actually letting business intrude on prescheduled P.E. time? I'm impressed.† â€Å"This guy happened to catch me on a night when I've got some time. I'll talk to him for a little while. See what he has to say.† Gabrielle wanted to ask who this mystery caller was, but Sexton clearly was being intentionally vague. Gabrielle had learned when not to pry. As they turned off the beltway and headed back toward Sexton's office building, Gabrielle glanced down again at the P.E. time blocked out in Sexton's planner and had the strange sensation Sexton knew this call was coming. 27 The ice at the center of the NASA habisphere was dominated by an eighteen-foot tripod structure of composite scaffolding, which looked like a cross between an oil rig and an awkward model of the Eiffel Tower. Rachel studied the device, unable to fathom how it could be used to extract the enormous meteorite. Beneath the tower, several winches had been screwed into steel plates affixed to the ice with heavy bolts. Threaded through the winches, iron cables banked upward over a series of pulleys atop the tower. From there, the cables plunged vertically downward into narrow bore holes drilled in the ice. Several large NASA men took turns tightening the winches. With each new tightening, the cables slithered a few inches upward through the bore holes, as if the men were raising an anchor. I'm clearly missing something, Rachel thought, as she and the others moved closer to the extraction site. The men seemed to be hoisting the meteorite directly through the ice. â€Å"EVEN TENSION! DAMN IT!† a woman's voice screamed nearby, with all the grace of a chain saw. Rachel looked over to see a small woman in a bright yellow snowsuit smeared with grease. She had her back to Rachel, but even so, Rachel had no trouble guessing that she was in charge of this operation. Making notations on a clipboard, the woman stalked back and forth like a disgusted drillmaster. â€Å"Don't tell me you ladies are tired!† Corky called out, â€Å"Hey, Norah, quit bossing those poor NASA boys and come flirt with me.† The woman did not even turn around. â€Å"Is that you, Marlinson? I'd know that weenie little voice anywhere. Come back when you reach puberty.† Corky turned to Rachel. â€Å"Norah keeps us warm with her charm.† â€Å"I heard that, space boy,† Dr. Mangor fired back, still making notes. â€Å"And if you're checking out my ass, these snow pants add thirty pounds.† â€Å"No worries,† Corky called. â€Å"It's not your woolly-mammoth butt that drives me wild, it's your winning personality.† â€Å"Bite me.† Corky laughed again. â€Å"I have great news, Norah. Looks like you're not the only woman the President recruited.† â€Å"No shit. He recruited you.† Tolland took over. â€Å"Norah? Have you got a minute to meet someone?† At the sound of Tolland's voice, Norah immediately stopped what she was doing and turned around. Her hardened demeanor dissolved instantly. â€Å"Mike!† She rushed over, beaming. â€Å"Haven't seen you in a few hours.† â€Å"I've been editing the documentary.† â€Å"How's my segment?† â€Å"You look brilliant and lovely.† â€Å"He used special effects,† Corky said. Norah ignored the remark, glancing now at Rachel with a polite but standoffish smile. She looked back at Tolland. â€Å"I hope you're not cheating on me, Mike.† Tolland's rugged face flushed slightly as he made introductions. â€Å"Norah, I'd like you to meet Rachel Sexton. Ms. Sexton works in the intelligence community and is here at the request of the President. Her father is Senator Sedgewick Sexton.† The introduction brought a confused look to Norah's face. â€Å"I won't even pretend to understand that one.† Norah did not remove her gloves as she gave Rachel's hand a half-hearted shake. â€Å"Welcome to the top of the world.† Rachel smiled. â€Å"Thanks.† She was surprised to see that Norah Mangor, despite the toughness of her voice, had a pleasant and impish countenance. Her pixie haircut was brown with streaks of gray, and her eyes were keen and sharp-two ice crystals. There was a steely confidence about her that Rachel liked. â€Å"Norah,† Tolland said. â€Å"Have you got a minute to share what you're doing with Rachel?† Norah arched her eyebrows. â€Å"You two on a first-name basis already? My, my.† Corky groaned. â€Å"I told you, Mike.† Norah Mangor showed Rachel around the base of the tower while Tolland and the others trailed behind, talking among themselves. â€Å"See those boreholes in the ice under the tripod?† Norah asked, pointing, her initial put-out tone softening now to one of rapt fervor for her work. Rachel nodded, gazing down at the holes in the ice. Each was about a foot in diameter and had a steel cable inserted into it. â€Å"Those holes are left over from when we drilled core samples and took X rays of the meteorite. Now we're using them as entry points to lower heavy-duty screw eyes down the empty shafts and screw them into the meteorite. After that, we dropped a couple hundred feet of braided cable down each hole, snagged the screw eyes with industrial hooks, and now we're simply winching it up. It's taking these ladies several hours to get it to the surface, but it's coming.† â€Å"I'm not sure I follow,† Rachel said. â€Å"The meteorite is under thousands of tons of ice. How are you lifting it?† Norah pointed to the top of the scaffolding where a narrow beam of pristine red light shone vertically downward toward the ice beneath the tripod. Rachel had seen it earlier and assumed it was simply some sort of visual indicator-a pointer demarking the spot where the object was buried. â€Å"That's a gallium arsenide semiconductor laser,† Norah said. Rachel looked more closely at the beam of light and now saw that it had actually melted a tiny hole in the ice and shone down into the depths. â€Å"Very hot beam,† Norah said. â€Å"We're heating the meteorite as we lift.† When Rachel grasped the simple brilliance of the woman's plan, she was impressed. Norah had simply aimed the laser beam downward, melting through the ice until the beam hit the meteorite. The stone, being too dense to be melted by a laser, began absorbing the laser's heat, eventually getting warm enough to melt the ice around it. As the NASA men hoisted the hot meteorite, the heated rock, combined with the upward pressure, melted the surrounding ice, clearing a pathway to raise it to the surface. The melt water accumulating over the meteorite simply seeped back down around the edges of the stone to refill the shaft.