Friday, May 24, 2019

A Marriage Quite Like an Arch Essay

John Ciardis poem Most Like an Arch This Marriage. Ciardi uses symbolism, similes, metaphors, and imagery when comparing marriage to an condescending. Marriage is near strength, when two connections come together and meet each some other in the middle to form a strong bond as they uphold bingle another. The poem describes marriage as an archway that can withstand the forces of nature and gain its strength from two pillars that come together at one point.In the first quatrain, the speaker turns to the description of how a marriage is like an arch, using formal diction to illustrate an image in the readers psyche with similes, Most like an archan entrance which upholds (Line 1). Both sides of an arch hold an entrance up an arch is typically a curved structural atom spanning an opening and serving as a support (Arch Merriam-Webster.com. Merriam-Webster, n.d. Web. 1 June 2014). Mass made idea, and idea held in place A lock in time Inside half-heaven unfolds (3-4). Passion a man has for his woman is sealed by the bond of marriage, a sacred bond locked in time, at bottom half-heaven, a marriage searches for unity and perfection.In the second quatrain, the speaker compares two weaknesses, two fallings, two joined abeyances that mold into one strength. Most like an archtwo weaknesses that lean into a strength two falling become firm / Two joined abeyances become a term naming the accompaniment that teaches fact to mean (5-8). Two individuals leading a single life have many obstacles to face, but when the two individuals conjoin they become stronger as one, and as one they can tackle whatever obstacle that is thrown their way as long as theyre united.In the third quatrain, the speaker portrays a longing, a need between two strengths. Not quite that? Not much less. World as it is, whats strong and separate falter (9-10). A strayed individual maybe strong, but walking alone makes that individual weak. All I do, at piling stone on stone apartfrom you is homeless a round nothing. Till we kiss (11-12). Piling stone on stone, building a wall between them, when you are apart from your significant other it feels like an eternity, like you are missing your other half, apart from you is roofless around nothing (11-12). Till we kiss (12), the separation feels like an eternity until we kiss, and because it feels like we are whole again.In the final quatrain, the speaker explains that even though couples are flawed, they are together through thick and thin. It is by falling in and in we make the all-bearing point, for one anothers sake, in faultless failing, raised by our own weight (14-16). Each person is sack to have their faults and at times both people may fail in something together, but it is with the love and strength of their marriage that they are able to parachute up from whatever obstacle and be stronger for having gone through it together.

Thursday, May 23, 2019

Osteoporosis

AbstractAs the worlds population lives longer, the significance of osteoporosis and fractures increases.IntroductionOsteoporosis is an age-associated disease, which is influenced by genetic, epigenetic and environmental factors. Age is a richly hazard factor for osteoporosis.Lack of vitamin D and insufficiency of calcium absorption are the most popular reason for the osteoporosis in the elderly. (Jakob et al, 2014)Jakob, F., Seefried, L., Schwab, M. (2014). Alter und Osteoporose. Der Internist, 55(7), 755-761.?Jakob F, e. (2018). Age and osteoporosis.Effects of aging on osteoporosis, the diagnostics and therapy. PubMed NCBI. online Ncbi.nlm.nih.gov. Available at https//www.ncbi.nlm.nih.gov/pubmed/24903137 Accessed 16 May 2018.It is mostly a disease of old age people. The preponderance of osteoporosis increase significantly with age and it is an independent risk factor for the improvement of osteoporosis and osteoporotic fracture.As taperd by National Health and Nutrition Examina tion Survey (NHANES) info the diffusion of osteoporosis based on reduce density of hip b unmatched was estimated at 4% in women 50 to 59 years of age compared to 44% in women 80 years of age and older. The number of precedentials in risk for osteoporosis will continue increasing with the aging of society. (Vondracek et al , 2009).Vondracek, S. F., Linnebur, S. A. (2009).Diagnosis and management of osteoporosis in the older senior. Clinical interventions in aging, 4, 121.? I choose this topic because when I was in clinical area I saw many old persevering they came to do x-ray and when I read the justification I saw they have osteoporosis. So I want to know how the x-ray help to diagnosis this disease.In this assignment I will talk about first the principles of the osteoporosis, the equipment components required for carrying out the osteoporosis examination and their functions. Also, I will discuss the role of radiographer and technical foul and radiation exposure considerations of it.Finally, I will talk about one clinical example for osteoporosis patient with clear images.PrincipleOsteoporosis was described as a morbid in which there is non-attendance of bone tissue, however that tissue which remains is completely calcified. Osteoporosis creates when bone resorption happens too rapidly and substitution happens too gradually. (Makhdoom, et al,2014)The older senior is at higher(prenominal) risk for osteoporosis. It is important for healthcare providers to be fully aware of the potential risks and benefits of diagnosing and treating osteoporosis in the older senior population. Data indicate that bone mineral density testing is under-utilized and drug therapy is often not initiated when indicated in this population.Bone mineral density testing with central dual qualification x-ray absorptiometry is essential and cost-effective in this population. All elder people should be instructed on a bone-healthy lifestyle containing age-appropriate weight-bearing exe rcise and smoking cessation if necessary. The actually important role in the risk for osteoporotic fractures, especially in the older senior is a falls play.The risk for vitamin D insufficiency and deficiency is high in the older senior and can contribute to falls and fractures. To treat this problem they should intake sufficient amount of calcium and vitamin D. (Vondracek et al,2009) Vondracek, S. F., Linnebur, S. A. (2009). Diagnosis and management of osteoporosis in the older senior.Clinical interventions in aging, 4, 121.?DEXA procedure detects the osteoporosis disease and this early diagnosis will improve the disease management practices and would help in impeding subject area productivity losses by mass screening and awareness. Also, it can help prevent osteoporosis. (Makhdoom, et al,2014)Makhdoom, A., Rahopoto, M., Siddiqui, K. A., Qureshi, G. A. (2014). Early Detection of Osteoporosis by Dual Energy X-ray Absorptiometry. Pakistan ledger of medical sciences, 30(6), 1265. ? Equipment component and functionThe technique used to measure the mineral bone density and the average concentration of mineral in a define section of bone is the Dual-energy x-ray absorptiometry (DEXA).It performed with a low radiation dose and accurate (exact measurement of BMD), precise and flexible (different regions can be scanned). A DEXA digital scanner consists of a low-dose x-ray tube with two energies for separating mineral and soft-tissue components and a high-resolution multidetector array.It has one of two different system a fan-beam device that emits alternating high (140 kVp) and low (70100 kVp) x-rays and sweeps across a scan area or a constant x-ray beam with a rare-earth filter and energy-specific absorption, which separates photons of higher (70 keV) and degrade (40 keV) energy.( Lorente-Ramos et al,2011).Lorente-Ramos, R., Azpeitia-Armn, J., Muoz-Hernndez, A., Garca-Gmez, J. M., Dez-Martnez, P., Grande-Brez, M. (2011), Dual-energy x-ray absorptiometry in th e diagnosis of osteoporosis a practical guide.American Journal of Roentgenology, 196(4), pp 897-904.Role of radiographer with osteoporosis patientsUnderstanding every step of the procedure is important for maximizing the avail of the imaginativeness evaluation to patients and referring clinicians in this procedure the radiographer play a great role in preparing the patient and taking care of the patient before, during and after examination. to begin with the examination, the radiographer must be Check patient history, old x-ray, Select the optimum exposure factors, Prepare the room for examination and Prepare the patient for the examination. During examinationThe radiographer must be Explain the procedure to patient and relative ,Reassure and care for patient during examination, Position the patient, Place radiation protection and Constantly assess the patients condition and then Expose. afterwards examination they should be Move the tube away from patient, lower x-ray table down a nd finally given instructions to patient.Radiation exposure in X-ray-based imagery techniques used in osteoporosisIn old patients, central DEXA measurements of the lumbar sticker and proximal femur are recommended.Two regions should be measured so that if one is unavailable, the forearm can be imaged. Appropriate patient positioning is essential for optimizing BMD measurement. The patients are placed in the supine position for poster anterior imaging of the lumbar spine and femoral neck and sitting next to the table for imaging of the forearm. Images are assessed for patient movement.The area of interest exceeding 12 cm and superior and inferior limits should be included to verify that the complete anatomic region is scanned. The bone axis should be straight and centered and the less(prenominal)er trochanter should not be seen on images of the proximal femur. Equipment from various manufacturers generates automatic ROIs, which should be reviewed. Correct numbering of vertebral bod ies is the main goal in DEXA of the lumbar spine.The indicators of catch up with positioning are as follows the ribs appear at T12, the largest transverse processes are L3, the vertebral area values increase from L1 to L4, BMD increases from L1 to L3, and the BMD of L4 is similar to or slightly less than that of L3. Sometimes radiographs are necessary for correlation.Altered vertebrae (deformed or with lesions or artifacts in them) should be excluded from the analysis. If only one vertebral body is left, the region is not profitable for diagnosis. In hip scanning, it is important to avoid undesired bone. The anatomic landmark selected for femoral neck ROI placement is the greater trochanteric notch.( Lorente-Ramos et al,2011)Case studyA 70 years old patient was admitted to Khawla hospital overdue to forepart of lower back pain and restricted waist movement. A lumbar x-ray was through with(p) to the patient and showed sever narrowing of the disc space between L3 and L4 with no f ractures over the lumbar bodies. For further investigation, a bone densitometry test was done that showed the presence of severe presence of osteoporosis with increased risk of fracture.Thus, discectomy was done for the herniated portion of the disk between L3 and L4 that compresses the nerves and causes the pain and instrumented fusion of L3 and L4 was also done to stabilize and strengtnus the spine after the intervertebral joint space reduction that occurred between L3 and L4. Finally, the patient was prescribed with vitamin D and calcium tablets to compensate the calcium and vitamin D reduction due to the osteoporosis.(khawla hospital,2018) .(khawla hospital,2018)Conclusion Over all, Osteoporosis is a systemic disorder of the skeleton that is characterized by a reduction in bone mass. Although the condition affects a higher pct of old people. The importance of osteoporosis lies in the fact that osteoporotic bones are more fragile and susceptible to fracture than normal bones.DEXA is a quick, accurate, low-cost imaging regularity for the diagnosis of osteoporosis. It comprises adequate performance (symmetry, morphology, positioning), ROI placement, detection of artifacts, pathologic evaluation (incidental findings and those affecting analysis), and evaluation of bone mineral density.

Wednesday, May 22, 2019

Modernization theory and Dependency theory Essay

Skidmore and Smith present two theories, Modernization guess and Dependency theory. Modernization theory is that positive material growth yields positive social equality. Dependency theory states that a dependent economy yields or brings social disparity, which in turn understructure lead to political authoritarianism.Skidmore and Smith state that dependency theory distorts modernizations predicted outcomes. Mercantilism is a form of dependency.The social, economic and political outcomes from Modernization seem positive. Socially, the transition from a rural to an urban society will bring a change in values. People would begin to participate in voluntary organizations which only an veritable democracy requires. A middle class would emerge to play a progressive and economic role in society. This theory shows that they werent different however behind. Skidmore and Smiths modernization theory is used to describe the nature of development.The social, economic and political outcomes of a dependant economy are negative. Social inequality will appear and the different classes will become further and further apart. Economically Latin America would depend on foreign markets, which during the 20s a depression occurred. Economically Latin America exported raw materials and imported finished goods. This leads to growth without development. Economic dependency leads to a political authoritarianism.The causative versatile for these outcomes that Skidmore and Smith stated is economic dependency. There are two forms of economic dependency that Skidmore and Smith explain. They are mercantilism, the colonial period, and the ECLA dissertation, post 1880 period. Mercantilism is a fit(p) economic policy that emerged during the colonial period. Mercantilism required colonies to produce raw materials for the mother country. The mother country would supply the colonies with finished products in return. This arrangement was gear toward the economic enrichment of the mother count ry at the expense of the colonies. The ECLA thesis developed by Presbish, it states that overtime the prices of finished products rise faster than the prices ofprimary products, raw materials. The ECLA thesis explains the nature of dependency during the post-independent, 1880 period to the present.

Tuesday, May 21, 2019

Java: United Arab Emirates and Saudi Arabian Culture Essay

International business and information technology are two pregnant aspects of globalization. We live in a world that requires farming awareness, which is also the first step in doing international business. In the case The Java Lounge Adjusting to Saudi-Arabian Arabian Culture, the business has been successful be try its entrepreneurs spent time and money to research their expectation that enough Saudis had become sufficiently westernized and affluent to frequent the restaurant. Its entrepreneurs have maintain strong culture awareness and had put them into actions.The Java Lounge had gone through culture collisions. Foreigners often find Saudi laws and customs at odds with their own value systems. For example, Saudi culture limits male-female interaction. That explains why the city of Jeddah was chosen to locate the Java Lounge it was a port and it enjoyed more contact with foreigners and was less(prenominal) conservative than much of the rest of the country. The dress codes a re more relaxed thus more acceptable to foreigners. If the location was chosen to be in a handed-down place, it would not have been this successful. The culture collision would be so huge that it is hard for other cultures to digest and get close to. Thus when a participation such as the Java Lounge implements practices, they would be less effective. Also, the employees as well as gusts would encounter difficulties in accepting or adjusting to foreign behaviors, which would cause unnecessary confusions and conflicts.Religion plays a key role in Saudis culture and religion is a cultural stabilizer. As the book says, umpteen strong values are the result of a dominant religion. A good religion would make the nation united and its people strong. What is more, religion plays a part in business. In Saudi, religious proscriptions prohibit pork products, alcohol, and live music at the Lava Lounge. In the holy period of Ramadan, when people fast during the day, the restaurant serves custo mers only in the evening. When doing business in Saudi Arabia, one has to be careful in adjusting to the religious culture of Saudi Arabia because religion could also be a taboo sometimes. For example, when Muslim men are called to prayer, McDonalds dims its lights, closes its doors, and suspend service during the five times per day. It is very important to respect one culture no matter how odd it looks to you.Behavioral practices are also affecting business. The term ascribed group memberships refer to the case that at the Lava Lounge, the entire staff is male. all the same though laws and rules were signed to abolish discrimination against women, women in Saudi Arabia cannot work in some profession. There are rigid rules about what women can and cannot do. A research shows that Saudi women only accounts for 7 percent of the total workforce. It is still a man-dominant world, but women are so important. However, in Saudi, affiliation is determined by birth. One needs to pay attenti on in the gender-based employment practices in Saudi Arabia. When doing business in other countries such as in the get together States, this might not be a problem.To summarize, what we could learn from the case The Java Lounge are that firstly, as an international businessman or businesswoman, one has to fortify culture awareness as a starting point. Secondly, culture shock would occur frequently when doing international business. When culture collisions occur, we do not need to be afraid. Learn about the other cultures you are involving in, respect other cultures, ask a native friend for help, and embrace the shocks. Thirdly, pay attention to religions and other special(a) cultural rules, they will help you with your business.

Monday, May 20, 2019

Bloodlines Chapter Twenty-Seven

I THINK ADRIAN would excite agreed to whatsoeverthing to get his own place. He didnt waste any time in moving his expectantly a(prenominal) possessions all over to Keiths gray apartment, much to Clarences dismay. I had to admit, I felt kind of bad for the old man. Hed enceinte fond of Adrian, and losing him right after lee side was specially tough. Clarence quiesce opened his home and feeder to our assemblage nevertheless ref utilize to believe anything we told him close lee(prenominal) and Strigoi. Even once he accepted Lee was dead, Clarence go on blaming vampire hunters.Shortly after his move, I went to check on Adrian. Word had come to us that the explore party from the Moroi was due to arrive in town that day, and wed decided to meet with them front before transport in Jill and Eddie. Like before, Abe was apparently escorting the new-madecomers, who included Sonya and Jills new roommate. I had the impression t here(predicate) index be others with them solely hadnt hear the details yet.Whoa, I verbalize when Adrian let me into his apartment.Hed totally been on that point a bridge days, except the transition was startling. With the exception of the TV, no(prenominal) of the original furniture remained. It was all different, and even the apartments lay step forward-moving had changed. The decorating scheme was new as well, and the scent of fresh paint hung heavy in the air.Yellow, huh? I asked, staring at the liveness room walls.Its called Goldenrod, he corrected. And its supposed to be cheerful and calming.I started to point reveal that those two traits didnt have the appearance _or_ semblance the like theyd go together but thusly decided against it. The color, slightly obnoxious though it was, solely transformed the living room. Between that and the blinds that had replaced Keiths heavy drapes, the room was now filled with color and light that went a long way to obscure the memory of the battle. I shuddered, recalling it. E ven if the apartment hadnt been needed to buy Adrians help, I wasnt undisput able-bodied I couldve accepted it and stayed here. The memory of Lees death and the two Strigoi womens was too strong.How did you afford new furniture? I asked. The Alchemists had given him the place, but there was no other stipend involved.I sold the old stuff, Adrian said, seeming very pleased by this. That lounger He faltered, a troubled look concisely crossing his features. I wondered if he too could imagine Lees disembodied centre bleeding away in that chair. That recliner was worth a rophy. It was appallingly overpriced, even by my standards. provided I got enough for it to replace the rest. Its used, but what choice did I have?Its nice, I said, running my hand along an overstuffed plaid sofa. It looked nauseated with the walls but appeared to be in good shape. Plus, much like the brightness of the yellow, the clashing furniture helped decline the memories of what had happened. You must ha ve finished with(p) roughly savvy shopping. Im guessing you dont buy a lot of used stuff.Try never, he said. You have no idea the things Ive had to lower myself to. His pleased smile dimmed as he regarded me carefully. How are you holding up?I shrugged. Fine. wherefore wouldnt I be? What happened to me isnt nearly as bad as what Jill went through.He crossed his arms. I dont know. Jill didnt watch a guy die in front of her. And lets not forget that same guy indigenceed to kill you plainly moments before in order to rise again from the dead.Those were things that had unimpeachably been on my mind a lot in the termination week, things that were expiry to take a epoch to get over. Sometimes, I didnt musical note anything at all. Other times, the human cosmoss of what had happened descended on me so swiftly and heavily that I couldnt breathe. Strigoi nightmares had replaced the ones of re-education centers.Im in reality better with it than you might look at, I said slowly , gazing off at nothing particular. Like, its terrible slightly Lee and what he did, but I feel I can get over it in time. Do you know what I relieve cerebration round the most, though?What? asked Adrian gently.The speech seemed to come forth without my constraint. I hadnt expected to say them to anyone, certainly not to him.Lee declareing me I was wasting my life and staying aloof from people. And then, during that last meeting with Keith, he told me that I was naive, that I didnt understand the world. And its true to a certain extent. I mean, not what he said about you guys being evil but well, I was naive. I shouldve been more careful with Jill. I believed the best of Lee when I shouldve been more wary. Im not a fighter like Eddie, but I am an commentator of the world or so I like to signify. But I failed. Im no good with people.Sage, your first mistake in all of this is listening to anything Keith Darnell says. The guys an idiot, an asshole, and a dozen other words that arent suitable for a lady like yourself.See? I said. You just admitted it, that Im some kind of untouchable, pure soul.I never said any such thing, he countered. My point is that youre leagues above Keith, and what happened with Lee was dumb, ridiculous bad luck. And remember, none of us saw it coming either. You werent alone. It casts no reflection on you. Or His eyebrows rose. maybe it does. Didnt you say that Lee considered killing Keith for Alchemist blood?Yeah but Keith left too soon.Well, there you go. Even a sociopath recognized your worth enough to want to kill someone else first.I didnt know whether to laugh or cry. That doesnt make me feel better.Adrian shrugged. My earlier point remains. Youre a solid person, Sage. Youre easy on the eye, if a microscopical skinny, and your ability to memorize useless information is going to totally hook in some guy. commit Keith and Lee out of your head because they have nothing to do with your future.Skinny? I asked, hoping I wasnt blushing. I also hoped if I sounded outraged enough, he wouldnt notice how much the other comment had disarmed me. Easy on the eyes. Not exactly the same as being told I was hotness incarnate or expire gorgeous. But after a lifetime of having my appearance judged as acceptable, it was a heady compliment especially coming from him.I just set up it like it is.I almost laughed. Yes. Yes, you do. Now tell me about a different subject, please. Im tired of this one.Sure thing. Adrian infuriated me sometimes, but I had to admit, I loved his pitiful attention span. It made dodging ill-fitting topics so much easier. Or so I thought. Do you smell that?An image of the bodies flashed into my head, and for a moment, all I could think he meant was the smell of decay. Then I sniffed more deeply. I smell the paint, and wait is that pine?He looked impressed. Damn straight. Pine-scented cleaner. As in, I cleaned. He gestured to the kitchen dramatically. With these hands, these hands that dont do manual labor.I stared off into the kitchen. What did you use it on? The cupboards?The cupboards are fine. I cleaned the traumatise and the counter. I must have looked more puzzled than amazed because he added, I even got see on my knees.You used pine cleaner on the floor and counters? I asked. The floor was ceramic roofing tile the counters were granite.Adrian frowned. Yeah, so?He seemed so proud to have actually scrubbed something for once in his life that I couldnt bring myself to tell him pine cleaner was generally only used on wood. I gave him an encouraging smile. Well, it looks great. I need you to come over and clean my new dorm room now. Its cover in dust.No way, Sage. My own housecleanings bad enough.But is it worth it? If youd stayed at Clarences, you had a live-in cook and cleaner.Its definitely worth it. Ive never really, truly had my own place. I kind of did at Court but it might as well have been an over-glorified dorm room. This? This is great. Even with the housec leaning. Thank you.The comic look of horror hed ill-defined while discussing housecleaning had been traded away for utter seriousness now as those green eyes weighed me.I suddenly felt uncomfortable under the scrutiny and was reminded of the spirit dream, where Id questioned if his eyes really were that green in real life.For what? I asked.For this I know you must have twisted some Alchemist arms. I hadnt told him that Id actually passed on taking the place for myself. And for everything else. For not giving up on me, even when I was being a major asshole. And, you know, for that saving my life thing.I looked away. I didnt do anything. That was Eddie and Jill. Theyre the ones who saved you.Not accepted I wouldve been alive for their rescue if you hadnt set that bitch on dismiss. How did you do that?It was nothing, I protested. Just a, uh, chemic chemical reaction from the Alchemist bag of tricks.Those eyes studied me again, weighing the truth of my words. Im not sure he believ ed me, but he let it go. Well, from the look on her face, your aim was right on. And then you got backhanded for it. Anyone who takes a thrill for Adrian Ivashkov deserves some credit.I turned my back to him, tranquillise shy with the praise and nervous about the fire reference and walked over to the window. Yeah, well, you can rest easy that it was a selfish act. You have no idea what a pain it is to file paper employment for a dead Moroi.He laughed, and it was one of the few times Id heard him laugh with genuine humor and warmth and not because of something twisted or sarcastic.Okay, Sage. If you say so. You know, youre a lot spunkier than when I first met you.Really? entirely the adjectives in the world at your disposable, and you pick spunky? Banter I could handle. So long as I focused on that, I didnt have to think about the meaning behind the words or how my heartbeat had increased just a little. Just so you know, youre a little more stable than when I met you.He came ov er to stand by me. Well, dont tell anyone, but I think acquire away from Court was a good thing. This weather sucks, but Palm Springs might be good for me it and all the wonders it contains. You guys. Art classes. Pine cleaner.I couldnt help a grin and looked up at him. Id been half-joking, but it was true he had changed remarkably since wed met. There was still a hurting man inside, one who bore the scars of what Rose and Dimitri had done to him, but I could see the signs of healing. He was steadier and stronger, and if he could just continue to hold the course, with no more crises for a while, a remarkable transformation might truly happen.It took several seconds of silence for me to realize that Id been staring at him while my mind spun out its thoughts. And, actually, he was staring at me, with a look of wonder.My God, Sage. Your eyes. How have I never noticed them?That uncomfortable feeling was spreading over me again. What about them?The color, he breathed. When you stand in the light. Theyre amazing like melt gold. I could paint those He reached toward me but then pulled back. Theyre beautiful. Youre beautiful.Something in the way he was looking at me froze me up and made my stomach do flip-flops, though I couldnt quite articulate wherefore. I only knew that he looked as though he was seeing me for the very first time and it panic-struck me. Id been able to brush off his easy, joking compliments, but this intensity was something different altogether, something I didnt know how to react to. When he looked at me like this, I believed that he thought my eyes were beautiful that I was beautiful. It was more than I was ready for. Flustered, I took a step backward, out of the sunlight, needing to get away from the energy of his gaze. Id heard spirit could send him off on supernatural tangents but had no clue if thats what this was. I was saved from my rachitic attempts to muster a witty comment when a knock at the door made twain of us jump.Adrian bl inked, and some of that rapture faded. His lips twisted into one of his sly smiles, and it was as though nothing eldritch had happened.Showtime, huh?I nodded, reeling with a confusing mix of relief, nervousness, and excitement. Except, I wasnt entirely sure if those feelings were from Adrian or our impending visitors. All I knew was that suddenly, I was able to breathe more easily than I had a few moments ago.He walked across the living room and opened the door with a flourish. Abe swept in, resplendent in a gray and yellow suit that coordinated bafflingly well with Adrians paint job. A wide grin stony-broke out over the older Morois face.Adrian, Sydney so lovely to see you again. I believe one of you already knows this young lady? He moved past us, revealing a lean dhampir girl with chromatic hair and big blue eyes filled with suspicion.Hello, Angeline, I said.When theyd told me Angeline Dawes was going to be Jills new roommate, I thought it was the most ridiculous thing Id ever heard. Angeline was one of the Keepers, that separatist group of Moroi, dhampirs, and humans who lived in the wilds of West Virginia. They wanted nothing to do with the civilization of any of our races and had a number of bizarre customs, not the least of which was their abominable tolerance for interracial romance.Later, when Id thought about it, I decided Angeline might not be such a bad choice. She was the same age as Jill, possibly giving Jill a closer connection than I could manage. Angeline, while not trained the way a guardian like Eddie was, still could hold her own in a fight. If anyone came for Jill, theyd have their work cut out for them getting through Angeline. And with the aversion Angelines people had toward tainted Moroi, she would have no reason to further the politics of some rival faction.As I studied her and her threadbare clothes, I wondered, though, just how well she was going to lodge to being away from the Keepers. She wore a cocky look on her face that Id seen when visiting her community, but here it was underscored with some nervousness as she took in Adrians place. After living in the woods her entire life, this venial apartment with its TV and plaid sofa was probably the height of modern luxury.Angeline, said Abe. This is Adrian Ivashkov.Adrian extended his hand, turn of events on that natural charm. A pleasure.She took his hand after a moments hesitation. Nice to meet you, she said in her odd southern accent. She studied him for a few more seconds. You look too pretty to be useful.I gasped in spite of myself. Adrian chuckled and shook her hand.Truer words were never spoken, he said.Abe glanced over at me. I probably had a look of terror on my face because I was already imagining the damage control Id have to do with Angeline saying or doing something completely wrong at Amberwood.Sydney will undoubtedly want to debrief you on what to expect before you develop school, said Abe diplomatically.Undoubtedly, I repeated.Adrian had s tepped away from Angeline but was still grinning. Let Jailbait do it. Better yet, let Castile. Itll be good for him.Abe shut the door but not before I got a glimpse behind him to the empty hallway. Its not just the two of you, is it? I asked. I heard there were others. Sonyas one, right?Abe nodded. Theyll be right up. Theyre parking the car. Street parkings terrible some here.Adrian looked over at me, hit by revelation. Hey, do I inherit Keiths car too? horror-struck not, I said. It belonged to his dad. He took it back. Adrians face fell.Abe stuffed his hands in his pockets and strolled casually around the living room. Angeline remained where she was. I think she was still sizing up the situation.Ah, yes, mused Abe. The late, great Mr. Darnell. That boys really been beset with tragedy, hasnt he? Such a hard life. He paused and turned to Adrian. But you, at least, seem to have benefited from his downfall.Hey, said Adrian. I earned this, so dont give me any grief about bailing on Cla rence. I know you wanted me to stay there for some weird reason but And you did, said Abe simply.Adrian frowned. Huh?You did exactly what I wanted. Id suspected something odd was going on with Clarence Donahue, that he might be selling his blood. Id hoped keeping you on hand would uncover the plot. Abe stroked his raise in that mastermind way of his. Of course, I had no idea Mr. Darnell was involved. Nor did I expect you and young Sydney to aggroup up to unravel it all.Id hardly go that far, I said dryly. A strange thought occurred to me. Why would you care if Keith and Clarence were selling vampire blood? I mean, we Alchemists have reasons for not wanting that but wherefore would you feel that way?A surprised glint flashed in Adrians eyes, followed by insight. He eyed Abe carefully. Maybe because he doesnt want the competition.My jaw nearly dropped open. It was no secret to anyone, Alchemist or Moroi, that Abe Mazur trafficked in illegal goods. That he might be moving large a mounts of vampire blood to willing humans had never occurred to me. But as I studied him longer, I realized it should have.Now, now, said Abe, never breaking a sweat, no need to bring up unpleasant topics.Unpleasant? I exclaimed. If youre involved in anything that Abe held up a hand to stop me. Enough, please. Because if that sentence ends with you saying youll talk to the Alchemists, then by all means, lets get them out here and discuss all sorts of mysteries. Say, for example, like how Mr. Darnell lost his eye.I froze.Strigoi took it, said Adrian impatiently.Oh, come now, said Abe, a smile twisting his lips. My faith in you was just being restored. Since when do Strigoi do such preciseness maiming? Very artful maiming, I might add. Not that anyone probably ever noticed. Wasted talent, I tell you.What are you saying? asked Adrian aghast. It wasnt Strigoi? Are you saying someone cut his eye out on determination? Are you saying that you Words failed him, and he simply looked back and forth between me and Abe. Thats it, isnt it? Your devils bargain. But why?I cringed as three sets of eyes stared at me, but there was no way I could acknowledge what Adrian was starting to put together. Maybe I could have told him if we were alone. Maybe. But I couldnt tell him while Abe looked so smug and certainly not with an outsider like Angeline standing there.I couldnt tell Adrian how Id install my sister Carly a few years ago, after a date with Keith. It was when hed still been living with us and just before she went off to college. She hadnt wanted to go out with him, but our father loved Keith and had insisted. Keith was his prospering boy and could do no wrong.Keith believed that too, which was why he hadnt been able to take no for an answer when he and Carly were alone. Shed come to me afterward, creeping into my bedroom late at night and sobbing while Id held her.My instant reaction was to tell our parents, but Carly had been too afraid especially of our father. I was young and nearly as scared as she was, ready to agree with whatever she wanted. Carly had made me promise I wouldnt tell our parents, so I sank my efforts into assuring her that it wasnt her fault. The whole time, she told me, Keith had kept telling her how beautiful she was and how shed left him no choice, that it was impossible for him to take his eyes off of her. I finally convinced her that shed done nothing wrong, that she hadnt led him on but she still held me to my promise to stay silent.It was one of the biggest regrets of my life. Id hated my silence but not nearly as much as I hated Keith for thinking he could rape someone as fragrance and gentle as Carly and get away with it. It wasnt until much later, when I had my first assignment and met Abe Mazur, that Id realized there were other ways Keith might pay that would allow me to keep my promise to her. So, Id made my deal with the devil, not caring that it bound me or that I was stooping to barbaric levels of reven ge. Abe had staged a fake Strigoi fervidness and cut out one of Keiths eyes earlier this year. In return, Id become Abes sort-of retainer Alchemist. It was part of what had goaded me to help Rose with her jail break. I was in his debt.In some ways, I reflected bitterly, maybe Id done Keith a favor. With only one eye left, maybe he wouldnt find it so impossible to keep it off uninterested young women in the future.No, I certainly couldnt tell Adrian any of that, but he was still looking at me, a million questions on his face as he try to embodiment out what in the world would have reduced me to hiring Abe as a hit man.Laurels words suddenly rang back to me. You know, you can be scary as hell sometimes.I swallowed. Remember when you asked me to consider you?Yes said Adrian.I need you to do the same for me.Long moments followed. I couldnt bring myself to look at Abe because I knew hed be smirking.Spunky was kind of an understatement, Adrian said. After what felt like forever, he sl owly nodded. Okay. I do trust you, Sage. I trust that you have good reasons for the things you do.There was no snark, no sarcasm. He was pestilent earnest, and for a moment, I wondered how I could have earned his trust so intently. I had a weird flash to the moments just before Abe had arrived, when Adrian had spoken of painting me and my feelings had been a jumble.Thank you, I said.What, demanded Angeline, are you guys talk about?Nothing of interest, I assure you, said Abe, who was really enjoying this all too much. Life lessons, sheath development, unpaid debts. That sort of thing.Unpaid? I surprised myself by taking a step forward and fixing him with a glare. Ive paid that debt a hundred times over. I dont owe you anything anymore. My loyalty is only to the Alchemists now. Not you. Were finished.Abe was still smiling, but he wavered slightly. I think my standing up for myself had caught him off-guard. Well, that remains to be ah. More knocking.Heres the rest of our party. He hurried to the door.Adrian took a few steps toward me. Not bad, Sage. I think you just scared old man Mazur.I felt a smile of my own begin to form. I dont know about that, but it felt kind of good.You should backtalk people more often, he said. We grinned at each other, and as he regarded me fondly, I felt that same queasy feeling return. He probably wasnt experiencing that exact sensation, but there was an easy, bright mood about him. Rare and very appealing. He nodded toward where Abe was opening the door. Its Sonya.Spirit users could sense each other when they were close enough, even behind closed doors. And sure enough, when the door opened, Sonya Karp strode in like a queen, tall and elegant. With her red hair swept into a bun, the Moroi cleaning lady could have been Angelines older sister. Sonya smiled at us all, though I couldnt help a shiver as I thought back to the first time Id met her. She hadnt been nearly so pretty or handsome then. Shed been red-eyed and trying to ki ll us.Sonya was a Strigoi whod been restored back to a Moroi, which really made her the ideal choice to work with Adrian on figuring out how to use spirit to prevent people from being turned.Sonya hugged Adrian and was walking over to me when someone else appeared in the doorway. In retrospect, I shouldnt have been surprised at who it was. After all, if we wanted to figure out what special spirit magic in Lee had stopped him from being turned again, then we needed all the data possible. And if one restored Strigoi was good, then two were better.Adrian paled and went perfectly still as he stared at the newcomer, and in that moment, all my high hopes for him came crashing down. Earlier, Id been certain that if Adrian could just stay away from his past and any traumatic events, hed be able to find a purpose and steady himself. Well, it looked like his past had ground him, and if this didnt qualify as a traumatic event, I didnt know what did.Adrians new research partner stepped through the door, and I knew the uneasy peace wed just established in Palm Springs was about to shatter. Dimitri Belikov had arrived.

Sunday, May 19, 2019

Communication Skills for Health Professionals Essay

IntroductionCommunication skills are important for health professionals because they deal with different situations and heap all daylight. Furthermore, an example to use the charm communication is when the professional has to give no-good parole of an unfavourable nosology. For instance, the tooth doctor to give the diagnostics of oral toiletcer for their uncomplaining, this situation is requirement to have correct communication to do the treatment and to give the correct plunk for for their patient such as empathy and slur.BodyFirstly, most of people who seek a professional health is because they are in unfarovable health condition and need peculiar(prenominal) care. Also, it is in truth common in dental treatment because many people feel afraid when to go the dentist. It is proved that many of them feeling very anxious when they go to a dental treatment (Cockburn and Walters).Principally, in unfavourable diagnostics, for example oral cancer. In this context, the heal th professional have ability to provide the appropriate communication such empathy. For professional to be empathy is very important for all principally in bad news that involves patient and sometimes to their family fully to give information and to second continuing the treatment.(Mundada, 2012). A patient with an unfavourable diagnostics need of feel comfortable on various parameters and the empathy as communications is very helpful like dealing with your anxiety, expectations for your family can follow the treatment. The empathy step ins On impacts of the treatment procedure and the expectations of what willing be the treatment. This type of communications is extremely important in case the conversation, clarify doubts and speak as will be the treatment for the patient to be aware of what can happen and not have unannounced reactions.Secondly, it is very important factor and has a good ability of communication such as touch because it helps to support psychological care during treatment. Sometimes many doctors have difficult to deal with kind of situations such as painful, physical suffering impending death and bereavement (Cockburn and Walters, 1999). Also, it is known that many undergrade students are not trained in communications skills and many medical schools do not insist in this subject. Its represents the deprivation oftouch in a long time (Cockburn and Walters, 1999). The communication such as touch in the treatment sometimes is difficult to many doctors because they attend many people in the same day and they will have this situation for a long time.(Cockburn and Wlaters,1999) that occurs common factor and many times it is interfere in the patient treatment because they do not have the adequate type of this. Principally, with bad diagnostics that usually is not expected for anyone.One of the most difficult tasks for some doctors is to break bad news to a patient, such as a diagnosis of cancer. (Cockburn and Waterls, 1999) That may causes stres s, familiars problems, emotional factors. The most appropriate commination skills is helpul to pee-pee a field to the patient feel comfortable and freely to do the procedure and touch in extremely important in this situation. The most important factor for the communicate is with professionalism and use the communication that can better confidence and quality of care in the patient.(Mundada,1992).Its helps the patient expects dentists to listen and understand their needs.(Mudunda,1992).Conclusion keep back everything into account communications skills are essential for all health professionals. Sometimes, in medical schools this subject in not trained to undergrade (Cockburn and Walters). Also, lack of communication can interfere the patient treatment principally when is necessary give bad news that involves many emotional problems such as psychological and anxiety. Obviously, the professional cannot support all problems to their patient but give the appropriate support with profess ionalism and empathy and touch good cues of communication and it help the professionals to have a great impressive and attend the necessity of their patients.(Mundada and Walters).ReferenceAnnette Hannah, Ph.D. C. Jane Milliamp, Ph.D. Kathryn M.S. Ayers, M.D.S. A Communication Skills turn tail for Undergraduate Dental Students. Journal of Dental Education. Volume 68, Number 9J. Cockburn and W. A.W. Walters. Communication between doctors and patients. trustworthy Obstetrics & Gymecology (1999) 9, 34400 1999 Hat-court Brace & Co. Ltda.Mundada,Vikek. Effective communication skills and professionalism for better dentistepatient relationship. Indian Journal of Dentistry 2012.July e kinfolk Volume 3, Number 3 pp. 182 e 183.

Saturday, May 18, 2019

My Bondage, My Freedom Fredrick Douglass Essay

It was non color, but crime, not God, but piece of music that afforded the true bill of the existence of slavery nor was I long in finding out another important truth, what man can make, man can unmake (Douglass 59). In My Bondage and My Freedom, Fredrick Douglass explains in detail the harsh and cruel realties of slavery and how slavery was an institution that victimized not only slaves, but slave toters, and non-slave holding whites.Fredrick Douglass could not have been more than right with his observation of slavery. In my opinion, slavery is not only an institution, but is a prime example of a corrupt business model that thrives on free labor, ultimate control, and wealth. A business is only as good as its workers. Its a common saying in modern day America. That saying would hold true during slavery, however slaves were not considered workers. Workers have rights and wages slaves on the other hand had no rights as charitable beings and no wages.Slaves were considered a p roperty, no more usable than a mule or cattle. Slaves were apart of a system and in that system they were dehumanized to the point in time that they became an expendable commodity. Slaves were stripped of there individuality. Fredrick Douglass rec boths not the date, month, or year when he was born. He also verbalize that the institution of slavery did away with the concept of family. Douglass had neither recollection of a father nor any estimate of his existence.Further more, Douglass had only a handful of encounters with his mother before her death and had become nothing more than a stranger to his brothers and sisters. It had made my brothers and sisters strangers to me it converted the mother that bore me, into a myth, it shrouded my father in mystery, and leave me without an intelligible beginning in the world (Douglass 39). In 1840, 20 years before the Civil War, 60% of American exports were cotton and was produced mainly by slaves (Shaping America Lesson 16).Therefore, t he business of slavery favored the slave holders, who were capitalizing on free labor to produce and distribute products across the world. Greed is the undertone upon which Douglass states that slavery corrupted souls and sullen good people into bad people. The institution of slavery was based on the ultimate control and origin over a human to whom he is stripped of all in all of his identity and becomes sub-human. Consequently, the institution forces slave holders had to bargain into this concept in order to justify any and all cruelty toward slaves.Douglas states Slave holders resort to all kinds of cruelty and later describes various ways of torture and punishment all are in sequestration to keep the slave in his condition as a slave in the United States (Douglass 272). Slave holders showed no mercy when reprimanding slaves. The brutality and cruelty of these punishments were more of a statement of power and control and ofttimes times the punishment was worse than the offens e. Racism was used aggressively to divide poor white southerners from slaves.The alliance between the wealthy and the poor was aggressively exploited by the rich white slave holder to ensure the poor whites non-slave holder that they had a similar cause (Shaping America Lesson 16). This caused non-slave holding whites to have a similar view as latter. Non-slave holding whites were in direct competition with slaves and more often than not were forced out of work due to the free labor slavery had offered. In conclusion, Slavery is forever and a day slavery always the same foul, haggard, and damning scourge, whether found in the eastern or in the westerly hemisphere (Douglass 294).Fredrick Douglass could not have been more right with his observation of slavery. Slavery is a cruel and great(p) way to oppress any human. The slave is a human being, divested of all rights reduced to the level of a brute, a mere chattel in the eye of the law placed beyond the circle of human brotherhood cut off from his kind his name, which the recording angel may have enrolled in heaven, among the blest, is impiously inserted in a masters ledger, with horses, sheep, and swine (Douglass 293).The business aspect of slavery is even more disheartening. However, any parties involved (slaves, slave holders, and non-slave holders) were all affected by the institution of slavery and in the mist of all the hardships that he endured for over twenty years of his life Fredrick Douglass became a free man.