Night by Elie Wiesel free essay sample

At the beginning of the book Lie and his father seem very close and his father doesnt really show emotion. At the end or nearing the end of the book Lie and his father seem farther apart or even detached from each other. Lie and his fathers relationship Is similar to the relationship between the Rabbi and his son but It Is also very different. The relationship betweenEel and his father changes very much for In a positive way for Eel throughout the memoir. First, at the beginning of the memoir Eel and his father are very close and his father shows almost no emotion whatsoever. Eel and his father are part of the Jewish community and Eel Is dubiously studying his faith at a SHTML. Eel Is Interested In studying the Kasbah but his father doesnt necessarily approve but leaves him In a sort of Socratic way of thinking about God. We will write a custom essay sample on Night by Elie Wiesel or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Eel believes that the answers are In you and that you have to ask god the right questions to truly understand the answers and is dad agrees.His father is more absorbed in helping others and being a part of the Jewish community. Overall the relationship between Lie and his father seems very close in the beginning of the memoir. Next, Lie and his father begin to drift apart throughout the memoir. Lie and his father slowly lose their love for each other throughout the memoir because being euthanized for that long takes away a persons capacity to love. Also, being under that much physical stress, limited food, and horrible living conditions puts a strong wear on the soul and faith of a person.After a persons faith and humanity is taken away there is not much to live for so the thought of that may cause the loss of love and destruction of a relationship. His father is beginning to become unbearably intolerable near the end of the book and Lie knows his father is nearing the end of his life so he is excited that he will no longer have to take care of his father. Ergo, Lie and his father drift further and further apart nearing the end of the memoir. Last, Lie and his father have a similar but different relationship to the Rabbi and his son. First of all Lie would never intentionally leave his father to die, where the Rabbis son thought if I dont leave him we will both die. Eel sees that the son left the Rabble because of his old age so that he neednt take care of him anymore and Eel compares himself to this situation after he left his father. Eel thinks that he left his father behind so that he wouldnt die but his father would near the end of the memoir. Eel and his father are the last ones In his family struggling to live Just Like the Rabble and his son and they are both Jews who are being euthanized which Is outing them through all the decisions they must make.Thus, Eel and his father are very close at the beginning of the memoir. Eel and his father slowly begin to drift apart throughout the memoir. Eel and his father are very similar to the Rabbi and his son but they are also very different in many ways. Hence, the relationship between Lie and his father is perturbed greatly in a positive way for Lie throughout the memoir. From each other. Lie and his fathers relationship is similar to the relationship between the Rabbi and his son but it is also very different.The relationship between Lie and his father changes very much for in a positive way for Lie throughout the First, at the beginning of the memoir Lie and his father are very close and his father shows almost no emotion whatsoever. Lie and his father are part of the Jewish community and Lie is dubiously studying his faith at a still. Lie is interested in studying the Kasbah but his father doesnt necessarily approve but leaves him in a sort of Socratic way of thinking about God. Lie believes that the answers are in you Rabbis son thought if I dont leave him we will both die. Lie sees that the son left the Rabbi because of his old age so that he neednt take care of him anymore and Lie compares himself to this situation after he left his father. Lie thinks that he left his memoir. Lie and his father are the last ones in his family struggling to live Just like the Rabbi and his son and they are both Jews who are being euthanized which is putting them through all the decisions they must make. Thus, Lie and his father are very close at the beginning of the memoir. Lie and his father slowly begin to drift apart throughout the memoir. Night by Elie Wiesel free essay sample Critical review of account of Jewish authors childhood experiences in Nazi death camps.

William Wordsworth’s “Lines Composed a Few Miles Above Tintern Abbey” Essay Essays

William Wordsworth’s â€Å"Lines Composed a Few Miles Above Tintern Abbey† Essay Essays William Wordsworth’s â€Å"Lines Composed a Few Miles Above Tintern Abbey† Essay Paper William Wordsworth’s â€Å"Lines Composed a Few Miles Above Tintern Abbey† Essay Paper â€Å"Lines Composed A Few Miles Above Tintern Abbey† is a coming-full-circle of kinds for the poet William Wordsworth. By composing the verse form. he had taken stock of all the experiences he experienced over the old ages. every bit good as all the alterations he had gone through. In this twenty-four hours and age. it would be called a re-assessment of one’s life- in this instance. through remembrances of events past. The verse form is written by the persona- Wordsworth himself- five old ages after he had been at that place for the first clip. The vale provides a mirror for him to measure what he had been so. and what he is now. He mentions how he is simply a few stat mis above the abbey. which is abandoned. and is seated under a dark lacewood tree. Wordsworth emphasizes the five-year span before his existent return. and implies that he may hold wanted to make so before but could non. under certain fortunes. Wordsworth refers to the past by reminiscing about the beauty of the vale. and how great its differences from the â€Å"din of towns and cities† . Fretful is how he described the industrial venue where he had come from. contrasting this with the peace and composure of the vale. every bit good as the â€Å"murmur† of the Wye river. Regret is besides a clear emotion running through this portion of the verse form. when the character refers to his being a â€Å"thoughtless youth†- perhaps touching to his deficiency of consistent involvement in nature. which was what the topographic point represents. It is right to presume that he has seen and experienced disturbing times in the five old ages before his return ; for the hurting with which he regards his original visit when he was more in touch with the qualities of nature is rather resonant. He had perchance seen a universe outside that went against the purity of environment and centered on the ailments of humanity and engineering. But in the undermentioned parts. the tone displacement to show tense- and the melancholy that defined the yesteryear now transforms in the persona’s re-discovery of nature. as he has himself. Typical of Romantic poesy. the author relates the alterations he had experienced throughout the authorship of the verse form. and his realisations of the passion and beauty he had abandoned. He declares that he is â€Å"still a lover of the hayfields and the woods† . which validates his 360-degree journey of self-contemplation. climaxing with his avowal that nature is so what he had missed. and what he prefers. It is. in truth. a coming together of the ego and the object of desire- which is nature. The character had to delve up the events that had made him the individual he is now. and combined the lessons learned with what he has ever yearned to be. which is to be one with his darling vale. Yet it is non merely a determination made entirely by the character ; the fact that the â€Å"meadows and woods† still remain every bit beautiful as they were during the first visit shows the mutual credence of both ego and the object. The following parts of the verse forms take on a future mention. which fits absolutely with the equation designed by Wordsworth. If the beginning contained regret. and the in-between portion expressed find. the logical stoping to the piece would decidedly be about hope. At this point. the character alludes to another individual. as he talks about his â€Å"former pleasances in the hiting visible radiations of thy wild eyes† . The existent individual Wordsworth may be mentioning to is his sister Dorothy. of whom he was fond and perchance portions many of Wordsworth’s ain sentiments. Dorothy. in this context. besides represents the reader. who is tasked to partake of the joyous find the character has gone through. and to hold faith in the fact that nature will ever supply peace and composure in life’s every turning point. But as the lines are spoken. the general emotion once more displacements to despair. an imploring for Dorothy ( or the reader ) to retrieve the character at all times. He pleads with Dorothy to maintain nature in her bosom of Black Marias. which is really equivalent to inquiring her non to bury him- for nature. as related to Dorothy or the reader. now represents the character. or Wordsworth himself. Possibly. to his head. he would wish to stay as fresh and alive as the hayfields and woods- something he would wish to be remembered by. The incompatibilities in memory are now evident. for the persona’s image of nature had non changed ; which is rather impossible. after the transition of five old ages. The thought of life and young person may be what the character wanted to retain. the image of it unstained and perfect in the heads of his sister. and of the reader. The three parts and tenses of the poem represent Wordsworth’s rating of his ain life- from his vernal yesteryear. symbolized by the copiousness of nature ; his present province. already tarnished by experience and yearning for the artlessness of times gone by ; to what he believes could be in shop for him in the future- dry. wilting. and abandoned- lest person keeps his memory alive as he did nature.

Race Assignment Example | Topics and Well Written Essays - 1250 words

Race - Assignment Example Nonetheless, despite there being several different physical traits, racial groupings are seeming based on skin color. As a result of these social division, there emerges a new paradigm, racism, which exerts prejudice and discrimination. Racism is advanced under the assumptions that some races are stronger and more superior to the others. For example, the notion that white people are superior to black people. In a bid to resolve the ambiguity surrounding racism, it is important to delve into an analysis of the history of race based on the works of Lipsitz, Omi and Winant. The illusionary state of race has prompted different standings with considerations of race as either being ideological or an objective condition. However, Omi and Winant differ with both of these considerations simultaneously drawing their own conclusion based on the origins of race. Race has seemingly a rich history and no specific date and time can be allocated to the start of race. For instance, Field’s efforts to place the start of race in the 17th century in the Northern American colonies is met by unending critic since there are prints of race long before. According to Omi and Winant the theory of race must â€Å"apply to the contemporary political relationships, increasingly global context, and across historical time† (Omi and Winant, p.5). This implies that the constraints of race re embedded in these three conditions and an effort to evade them would lead to an absurd conclusion. Additionally, changes taking place in issues revolving around race have contribut ed to greatly in creating a different perspective towards race. In the past race was seemingly inevitable due to the notion that it was a natural condition. Conversely, in the modern day race is perceived as a subordinate to supposedly more concrete material relationships (Omi and Winant, p.7). As such, Omi and Winant argue that the current definition of race may on the verge of extinction paving way to a different

Evaluation and Control on Network Acquisition Essay

Evaluation and Control on Network Acquisition - Essay Example process, the results of which are brought together into a status report, forwarded to the authorities responsible for the cost, budget, and schedule of the project. Risk mitigation strategies are used to analyze and report unplanned changes. Without effective risk mitigation strategies, a project will collapse or will lead to unexpected results because of the unanticipated changes (Royer, 2001, p.77; Adam, 2007, p.140). To handle change control issues, I plan to rank risks according to priority. Each risk should be ranked according to significance and likelihood (Dorian, 2011, par.3). I plan to take into consideration these common mitigation strategies: avoidance, acceptance, transference, and control. I would apply effective controls over risks if they are worth taking and are a part of my core project. To handle change control issues, I will measure the impact of the change in terms of my project’s cost, resources and schedule. I will accept or reject the change after reviewing what will happen if I do not allow the change to occur. I will document the change and will update the project plan

Protecting Trade Secrets Essay Example | Topics and Well Written Essays - 500 words

Protecting Trade Secrets - Essay Example There is reference to ‘reasonable’ in terms of the enforcement of the restraint, with direct bearing upon the protection of the company’s interests, being the clients and trade secrets of that business. The concept of restrictive covenants placed upon an individual has a long history, with legal case references being made as far back as the 17th century where a judgment was passed by Chief Justice Coke that an individual cannot bide himself not to use his trade generally. In 1711, a legal case; Mitchel v. Reynolds, mention was made in favor of the law, but against free discretion. Thus the law stipulated from these early times, that if a clause of restraint is unreasonable, it can be seen as void. Specifically pertinent to individuals; is a term known as the ‘blue pencil test’ which was defined in a 19th century English case namely, Nordenfelt v Maxim Nordenfelt Guns and Ammunition Co. Ltd [1894] AC 535, here elements of a contractual agreement can be enforced legally were reasonable, and the portions that had elements of illegality would be stricken from the agreement (via the scratching out of wording with a blue pencil), this would include individual words that make the clause excessively wide. Having dealt with the a general overview of legal descriptions and definitions of restraints of trade affecting the individual, one has to move on to the subjective viewpoint of the individual that is presented with such a restraint of trade within their offer of employment via their employment contract. Ultimately the individual has to make the decision of accepting or declining the contract, this decision must be made knowing that the restraint can be void if the clauses are worded in a fashion that causes the restraint to be too wide. However if directly relating to the business or company’s clients or trade secrets and the

Survival Outcome Neonates Early Sepsis Health And Social Care Essay

Survival Outcome Neonates Early Sepsis Health And Social Care Essay A Retrospective Comparative Study on the Survival Outcome of Neoates with Early -Onset Sepsis with Sclerema Given Fresh Frozen Plasma at Davao Medical Centern Nursery-A One Year Review Objectives: To determine and compare the survival outcome of patients with early onset neonatal sepsis with sclerema given fresh frozen plasma plus standard therapy of neonatal sepsis to those who were only given standard therapy alone. Fresh Frozen plasma contains immunologic factors which is deficient in a neonate. This study would help us validate the role of FFP transfusion in a sick neonate with sclerema. Design: Cohort Study design Setting: Tertiary care hospital Participants:All neonates presenting with clinical signs of neonatal sepsis with sclerema admitteded at Davao Medical Center nursery for the year 2008. Results and Conclusion: INTRODUCTION Neonatal sepsis is a clinical syndrome of bacteremia characterized by systemic signs and symptoms of infection in the first month of life1. It has taken so many lives of newborn babies. The mortality rate continuously increases especially in the third world countries like the Philippines so that early recognition, diagnosis and treatment of infection is important because it is largely a preventable disease. Neonatal Sepsis can be divided into two main classes depending on the onset of symptoms related to sepsis- early-onset and late-onset neonatal sepsis2. Early onset is mainly due to antepartum infections vertically transmitted while late-onset is the combination of the former and nosocomial infection. The incidence of neonatal sepsis varies from one institution to another with higher rates in developing countries. In the United States , the incidence of a culture-proven sepsis is approximately 2 per 1000 livebirths and increases to 25 per 1000 livebirths in infants with birthweight less than 1500 grams3. It is considered to be a major cause of fatality during the first month of life contributing to 13-15% of all neonatal deaths with highest rates seen in premature infants and in small for gestational age infants. The mortality rate in neonatal sepsis may be as high as 50% for infants who are not treated3. A local study conducted at MCU-FDTMF Hospital nursery found the incidence of neonatal septicemia to be 9.6 %4 as compared to other studies at UP PGH which is 5.5%. At Davao Medical Center the incidence and the case fatality rate of neonatal sepsis for the year 2008 are about 5/1000 livebirths and 1.3% respectively5. Considering the nonspecificity of the early clinical signs of neonatal sepsis and the neonates relative state of immunosuppression, early diagnosis and treatment is of utmost important. The mainstay of treatment is antibiotic. Supportive management is geared towards thermoregulation to prevent hypothermia or hyperthermia, ensuring good ventilation/oxygenation to vital tissues, provision of optimal nutrition preferably with enteral feeding or TPN, prevention of hypoglycemia and electrolyte imbalance by administration of parenteral fluids and vasopressors for hypotension. Adjunctive therapy includes fresh frozen plasma transfusion, exchange transfusion, immunoglobulin therapy, granulocyte-macrophage colony stimulating factor, and granulocyte transfusion. Sclerema is the uniform hardening of the skin and subcutaneous tissues to the extent that the skin could not be pitted nor picked up or pinched into a fold6.It is considered as a sign of a potentially fatal underlying disease process like neonatal sepsis especially gram- negative sepsis. Neonatal septicemia is invariably fatal when associated with sclerema7. Its reported mortality rates range from 67-88% with death occurring hours to days after onset8. Although literature about the benefits of Fresh Frozen Plasma transfusion in septic neonates with sclerema is scarce, our experienced at SPMC nursery suggests improved outcome from neonatal sepsis with sclerema when given FFP. We do not give FFP to septic neonates without sclerema. We are doing this study to validate if indeed our perception is correct and if this practice is valid. The study will be limited to comparison of septic patients with sclerema only. This preselects the most seriously ill patients. By limiting the study to early onset neonatal sepsis, opportunistic infections from less virulent pathogens like candida and staphylococcus epidermides are likely to be excluded and infection is most likely vertically transmitted and not nosocomial. This is to limit the varaiables due to etiologic agents that may affect outcome and interpretation of the result. Review of Related Literature The defense system of the human body consists of three components: physical , cellular and humoral. Neonates are particularly deficient in all three so that a more aggressive management is mandatory to improve survival outcome when neonates develop septicemia. The physical and chemical barriers to infection in the human body are present in the newborn but are functionally deficient. The skin of a preterm infant is only a few cell-layers thick and is poorly cornified hence can easily be damaged paving the way for infection. The protective fatty acid production is also low making them more vulnerable. At 23 weeks gestational age the fetus possesses T and B lymphocytes, macrophages, monocytes, polymorphonuclear cells and the capacity to synthesize all known immune factors. The ability of the T and B lymphocytes to produce cytokines is less in comparison to adults, however neonates are capable of generating appropriate adaptive immune responses. Langerhans cells are important in local infection and are present in the neonate at 18 weeks gestation. Phagocytes from preterm neonates show normal activity when suspended in normal adult serum, however neonatal serum is deficient in immunoglobulin and complement so there is a marked reduction in adherence and chemotaxis. The neonatal neutrophil or polymorphonuclear (PMN) cell, which is vital for effective killing of bacteria is deficient in chemotaxis and killing capacity. Also neonatal PMNs are less deformable therefore they are less able to move through the extracellular matrix of tissues to reach the site of inflammation and infection. The limited ability of neonate for phagocytosis and killing of bacteria is further impaired when the infant is clinically ill. Lastly neutrophil reserves are easily depleted because of the diminished response of the bone marrow especially in the premature infant. The neonate is capable of synthesizing IgM in utero at 10 weeks gestation, however IgM levels are generally low at birth unless the infant was exposed to an infectious agent during the pregnancy, thereby stimulating increased IgM production. During pregnancy IgG is transported actively and passively across the placenta from about the 20th week of gestation and at full term the neonates IgG levels are higher than his mothers levels. The IgG in an infants plasma has a half-life of about three weeks.Until the infant is able to generate his own IgG, IgM and IgA there is a period of postnatal hypogammaglobulinemia. In a preterm neonate of 26 weeks gestation the plasma IgG levels are markedly lower and diminish to ineffective levels very quickly, increasing the risk of infection. Complement protein production can be detected as early as 6 weeks gestation; however the concentration of the various components of the complement system widely varies among individual neonates. While some infants have had complement levels comparable with those in adults, deficiencies appear to be greater in the alternative pathway than in the classic pathway. The terminal cytotoxic components of the complement cascade that leads to killing of organisms, especially gram-negative bacteria are deficient. The deficiency is more marked in preterm infants. Mature complement activity is not reached until infants are aged 6-10 months. Neonatal sera have reduced opsonic deficiency against GBS, E. coli, and S pneumoniae because of decreased levels of fibronectin, a serum protein that assists with neutrophil adherence and has opsonic properties. Most common organisms causing early- onset neonatal sepsis include group B streptococci, gram -negative enteric organisms like E. coli. Listeria monocytogenes and Klebsiella are also a common isolates. Less common organisms include staphylococcus, other streptococci, anaerobes, and Haemophilus influenza9. The host-defence mechanism of neonates are immature. They have a markedly decrease levels of C3, Cy properdin and factor B which are very important in the alternative pathway of complement. Levels of IgM and IgA are also low at birth. Although IgG levels may be normal in term neonates, it is low in preterm infants. These relative deficiency of the neonates immune system complicated by low birthweight and decreasing age of gestation makes them more susceptible to life threatening infections10. Sadana,et al mentioned that the incomplete development of the host defense system of the neonate is largely responsible for the high mortality in neonatal sepsis11.In his study an increase in the levels of IgG, IgM, IgA andC3 was noted after exchange transfusion.Exchange transfusion offers removal of bacteria and toxins, improves oxygenation and perfusion as well as decreases hemorrhagic complications. The relative immunodeficiency state and susceptibility to sepsis and complications is the impetus for exploring treatment modalities other than antibiotics. There was an increase in the levels of IgG antibodies in septicemia patients with coagulase negative staphylococcus after FFP administration in the study made by Krediet, et al12 The neonate being deficient in both humoral and cellular immunity is more vulnerable to infection. There are literature that suggests the usage of Fresh Frozen Plasma in patients with neonatal sepsis to compensate for the immunologic deficiencies. FFP improves neonatal chemotaxis, provides humoral or cellular factors13 and increases the levels of immunoglobulin such as IgG, IgA and IgM. FFP remains the only approved source of factors V,XI, protein C, protein S and plasminogen14 and basically all the clotting factors. Others would say that FFP transfusion in neonatal sepsis is good because it increases levels of IgG, IgA and IgM15 that will increase chances of survival. FFP contains immunoglobulins anc complement factors16. Fresh frozen plasma, the plasma separated from a unit of whole blood and frozen at -18 oC within 8 hours of collection. It is a platelet-poor plasma17.Each bag has a volume of 175 to 250 ml and contains between 1 and 2 units of each coagulation factor per ml and 400 to 800 mg fibrinogen. It contains fibrinolytic and complement factors. It carries the same risks of viral transmission as other blood components and can cause allergic reactions and fluid overload. Indications for fresh frozen plasma, once used routinely in the support of critically ill-infants and children, have become more specific as evolving evidence has confirmed or disproved the efficacy of plasma in various circumstances. Fresh frozen plasma is currently indicated to treat the coagulopathies of massive hemorrhage, liver failure, disseminated intravascular coagulation and sepsis18. In an infant the fat has a higher saturated- to-unsaturated fatty acid ratio compared to adult fat and thus a higher melting point. Prematurity, hypothermia and shock and anatomic abnormalities have been postulated to further increase this ratio,possibly as a result of enzymatic alteration allowing precipitation of fatty acid crystals within the lipocytes. This condition has been suggested to result in the dramatic clinical findings in the affected skin. Xray diffraction techniques have confirmed that infants with sclerema have an increase in saturated fats and that the crystals within the fat cells are composed of triglycerides. The exact incidence of sclerema neonatorum is unknown . All studies describe SN as extremely rare. The number of reported case in recent years have declined, probably as a result of a better neonatal care. Because sclerema neonatorum invariably is associated with serious underlying disease process, the mortality rate is high. In different series, the reported mortality rates range from 67-88%, with death occuring hours to days after onset. If the underlying disease is treated successfuly, the skin softens and returns to normal. Sclerema neonatorum shows a slight male preponderance, with an estimated male-to-female ratio of 1.5:1. Sclerema neonatorum is a disease confined to the newborn period. It can present at birth, but onset within the first week of life is more common. The oldest reported infant presented with Pseudomonas septicemia is 106 days old. According to literature one half of the affected infants are premature, , and the others are full term but have a serious underlying disease. They are often of low birth weight and have cyanosis and low apgar scores.In one series, 75% of the mothers were healthy, while 25% had preeclampsia, placenta previa, or infection. Labor is usually normal and the delivery is spontaneous and nontraumatic. Physical findings appear suddenly, first on the thighs and on the buttocks and then spreading rapidly often affecting all parts of the body except the palms and the soles and the genitalia. The involved skin is pale, waxy, and firm to palpation. The skin cannot be pitted or pinched up because it is bound to the underlying tissues. The affected infant often dispalys flexion contractures at the elbows, knees and hips, temperature instability, restricted respiration, difficulty in feeding and decrease in spontaneous movement.17 Recognition and the prompt institution of therapy specific to the underlying disease process are mandatory such as antibiotics, steroids, exchange transfusions and FFP transfusion. Definition of Terms Neonatal sepsis- It is a clinical syndrome of bacteremia characterized by systemic signs and symptoms of infection in the first month of life. Neonatal sepsis encompasses systemic infections of the newborn including septicemia, meningitis, pneumonia, arthritis, osteomyelitis and urinary tract infection of the newborn19. Associated factors for early onset neonatal sepsis include lowbirthweight, PROM, foul smelling liquor, multiple vaginal examinations and maternal fever20 Early onset neonatal sepsis- It usually presents within the first 48 hours of life. In severe cases, the neonate may be symptomatic in utero, (fetal tachycardia, poor beat to beat variability) or within the first few hours after birth. The source of the infection is generally in the maternal genital, gastrointestinal, urinary tract . Clinically neonates usually present with respiratory distress and pneumonia. Presence of some perinatal risk factors has been associated with an increased risk of early onset sepsis. Frozen Frozen Plasma It is the plasma removed from a unit of whole blood and frozen at or below 55 degrees Fahrenheit within 8 hours of collection. It contains all the coagulation factors in normal amounts and is free of red cells, leukocytes and platelets. It is not a concentrate of clotting factors. Sclerema Neonatorum- It is derived from the Greek word sclerosmeaning hard. It is considered best as a sign of a potentially fatal underlying disease process in the newborn period. Physical findings appear suddenly first on the thighs and buttocks and then spreading rapidly, often affecting all parts of the body except the palms, soles and genitalia. The involved skin is pale, waxy and firm to palpation. The skin cannot be pitted or pinched up because it is bound to the underlying tissues.It can present at birth but onset within the first week of life is more common. Associated underlying conditions include septicemia, pneumonia, hypothermia, metabolic acidosis, respiratory distress syndrome, congenital heart defects, gastroenteritis and intestinal obstruction. Clinical Signs of Neonatal Sepsis: (At least 2 clinical signs supported by laboratory findings) 1.sclerema 2.hypoglycemia/hyperglycemia 3.temperature instability 4.tachypnea/respiratory distress 5.Apnea 6.Poor perfusion Laboratory findings: 1..I/T ratio> 0.2 2.leukopenia 3.Neutropenia 4.Thrombocytopenia Research Question Will FFP transfusion improves the survival outcome of the sick neonates with early onset neonatal sepsis with sclerema given the standard therapy plus FFP? Is the use of FFP justifiable in the treatment of neonatal sepsis with sclerema in terms of cost and survival outcome? Significance of the study Many studies have been done to improve the survival outcome of neonates with septicemia. The progress in terms of the available adjuctive therapies in the treatment of neonatal sepsis entail a higher cost which is an issue to our marginalized patients who cannot afford such expensive add on treatment hence inspired the researcher to study fresh frozen plasma transfusion which is much more affordable and readily available to the neonates with septicemia particularly with sclerema. FFP contains immunologic factors helping the immunologically deficient neonate in fighting serious infections. This study aims to evaluate the effects of FFP transfusion in the subset of neonates with high case fatality rate. They are the candidates that would benefit from the terminal cytotoxic complement with the coagulation cascade that FFP may provide. OBJECTIVES OF THE STUDY General Objective: To determine and compare the survival outcome of patients with early- onset neonatal sepsis with sclerema given the standard therapy (antibiotic + supportive care ) plus fresh frozen plasma to those with early -onset neonatal sepsis given only the standard therapy (antibiotic + supportive care ) at Southern Philippines Medical Center- Nursery for the year 2008 . Specific Objectives: Determine the incidence of sclerema in early onset neonatal sepsis in SPMC. Determine the rate of early onset neonatal sepsis with sclerema in SPMC. Determine the mortality rate of neonates with early onset sepsis with sclerema. Identify the possible the maternal fetal/neonatal factors related to early neonatal sepsis with sclerema Compare the outcome 1.resolution of sclerema Chapter 2 METHODOLOGY Study Design This paper will be an observational descriptive and comparative study on the survival outcome of patients with neonatal sepsis with sclerema admitted at Southern Philippines Medical Center for the year 2008 using a Cohort study design. Population This study will include all neonates with early-onset neonatal sepsis with sclerema admitted at Southern Philippines Medical Center -Nursery for the year 2008. Inclusion criteria: All neonates admitted at Southern Philippines Medical Center -Nursery who presents with the clinical signs of early- onset neonatal sepsis with sclerema. Exclusion criteria: 1.All neonates presenting with clinical signs of neonatal sepsis with sclerema occurring beyond 48 hours of life. 2. All non-institutional deliveries presenting with early onset neonatal sepsis with sclerema. 3. All neonates admitted at the NICU with obvious congenital anomalies like syndromic features, cleft lip and palate etc. Data Collection Data will be collected by the researcher through a retrospective chart review. The researcher will scan and evaluate each chart of the patient with neonatal sepsis for the presence of sclerema in the progress notes. A data sheet will be use for each patient.Research consultant will be asked for validation of diagnosis. Independent variable -Fresh Frozen Plasma transfusion Dependent variable- survival outcome of neonates with early onset sepsis with sclerema Sample Size: All neonates admitted at Southern Philippines Medical Center-Nursery who fulfilled the inclusion criteria for the year 2008 will be used as a sample in this study. Data Analysis: correlation coefficient and odds ratio will be used to summarize the data for the comparative part. Means and standard deviation for the descriptive part and percentage and rates as per standard definition. Ethical Consideration The approval of the hospital research committee and the ethics committee will be sought before the conduct of the study. No identification data or marks will be placed in each patient included in the study. The data will be kept by the researcher for 5 years. Table 1.Patient clinical profile Name: AGA___SGA___LGA___ Age: Weight: AOG: Sex: Medical record number: length of stay in the hospital: Date of admission : Date of discharge: Diagnosis upon admission: Final diagnosis: OUTCOME: [ ] died [ ]survived [ ] HAMA [ ] transferred [ ]transout to blue area Cause of death: Age at onset of sepsis(hours) Age at onset of sclerema(hours) Antibiotics Ampicillin/Gentamycin Cefotaxime/Amikacin Piperacillin + Tazobactam/Amikacin Meropenem Cefepime Neonatal risk factors Birthweight 1.VLBW 2.LBW 3.normal weight 4.LGA APGAR SCORE (5 minute) 0-3 4-6 7-10 Ballard Scoring 34-37 >37 Comorbidities Neonatal pneumonia Meconium aspiration Intubation Pulmonary hypertension Pneumothorax Others (specify) MATERNAL RISK FACTORS Premature labor and delivery Prolong Rupture of membrane Antenatal Steroid Chorioamnionitis Manipulative Operative Delivery Maternal infection within 2 weeks of delivery UTI RTI Preeclampsia/eclampsia Placenta previa/ abruptio Others (specify) SCLEREMA Hours first noted FFP transfusion Yes /hours before transfusion No Resolution of sclerema post FFP Yes- number of hours first noted resolution No- OUTCOME Died Survived COMPLICATIONS NOTED Table 2. ANTIBIOTICS Standard care+FFP Standard care Total No. % No. % No. % Ampicillin+Gentamycin Cefotaxime +Amikacin Piptazo+Amikacin Meropenem Cefepime Total Table 2.BIRTHWEIGHT Standard care+FFP Standard care Total No. % No. % No. % VLBW LBW AGA LGA Total Table 3. APGAR SCORE(5 MINUTE) Standard care+FFP Standard care Total No. % No. % No. % 0-3 4-6 7-10 Total Table 4. BALLARDS SCORE Standard care+FFP Standard care Total No. % No. % No. % 34-37 weeks >37 weeks Total Table 5. Comorbidities Standard care+FFP Standard care Total No. % No. % No. % Neonatal pneumonia Meconium aspiration Intubation Pulmonary hypertension Pneumothorax Others (specify) Total Table 6. Maternal Risk Factors Antibiotic+Standard care+ FFP Antibiotic +Standard care Total No. % No. % No. % Preterm labor/delivery RBOW Antenatal Steroid Chorioamnionitis Operative Delivery Maternal infection UTI RTI Preeclampsia/eclampsia Placenta previa /abruptio Others (specify) Total Table 7. Onset and Resolution of Sclerema Antibiotic+Standard care+ FFP Antibiotic +Standard care only Onset resolution Total time of sclerema Table 8. Outcome Survived Dead Total No. % No. % No. % Antibiotic+Standard care+ FFP Antibiotic +Standard care Total Conceptual framework: Babies admitted at DMC nursery 2008 No sepsis Compare results Sepsis with sclerema Antibiotic+Standard care+ FFP Antibiotic +Standard care Sepsis without sclerema Early-onset neonatal sepsis COST/BUDGET: COUPON BOND.P.400.00 PRINTINGP700.00 RESEARCH MATERIALS ..1,000.00 ______________________ P 2,100.00 TIME TABLE (May 2009- December 2010) May PRESENTATION TO RESEARCH COMMITTEE AND ETHICS June -October DATA GATHERING November PRESENTATION OF RESULTS December SUBMISSION OF HARD COPIES

An Interpretation of “Dulce et Decorum Est” Essay -- Literary Analysi

What would it feel like to be in the middle of the bloodiest war in history? Surrounded by death on all sides it seems impossible that anybody would write poetry about this very subject. Thanks to the poem â€Å"Dulce et Decorum Est,† Wilfred Owen gives the reader a small window into the horrors that he witnessed firsthand in the carnage of battle. Faced with death at every turn, Owen takes the time to chronicle these terrible events that happened shortly before his own death. Owen uses rhythm, rhyme, and imagery to convey the message that people should be careful glorifying war because it is a very traumatic event that takes many innocent lives. When a reader tries to understand the rhythm of â€Å"Dulce et Decorum Est† it becomes a bit tricky to find any type of rhythm. When reading shortly into the poem, one notices that there does seem to be a heartbeat to the poem when it states in line 3: â€Å"Till on the haunting flares we turned our back†. Owen uses iambic pentameter to achieve this pattern as almost all of the lines which have a rising meter and 5 feet. Having this underlying heartbeat to the poem speaks to the humanity and allows the reader to personalize with what is being said. Owen then contrasts the use of iambic pentameter in several lines including line 23 when he says, â€Å"Bitter as the cud†, as if to make that really stand out to the reader. Owen then further chops up the rhythm to make it seem as if he were telling a story to the reader. This is evident when an individual starts to encounter the heavy use of punctuation in when it says, â€Å"But limped on, blood-shood. All went l ame, all blind† (6). It also makes the poem more vivid throughout and makes the reader really stop and think about what is happening in the line. Owen a... ... that â€Å"someone was yelling out† (11), and that there was â€Å"blood† (22) â€Å"gargling from the froth-corrupted lungs† ( 23). With rich imagery being used throughout the poem, it becomes clear that Owen intended to use imagery to help the reader feel as if they were present in the situation along side of him. This allows the reader to personalize this situation and gain a better understanding of the message that is being sent. Through the use of rhythm, rhyme, and imagery Owen forces the reader to ponder about the thought that war isn’t an event that should be taken lightly. Many kind and brave soldiers have lost their lives over the history of humanity and that loss of life, while honorable, is extremely tragic. Thanks to Owen’s poetry people are able to look back at this time in history and hopefully learn valuable lessons about the value of human life.

Wid and Gad

COMPARE AND CONTRAST THE WOMEN IN DEVELOPMENT (WID) APPROACH AND THE GENDER AND DEVELOPMENT (GAD) Gender by definition refers to the characteristics, trades, attributes or even roles that are expected for males and females by a given culture or society. Some can say the general social meaning of being male or female. The WOMEN IN DEVELOPMENT (WID) this approach was developed in the early 1970’s this came to use during the United Nation Decade of women (1972-1985).This approach viewed women as passive beneficiaries of the development according to Miller, C and Razavi, S 1995 , in actual fact there was a growing realization that women were being left out of the economic development or that they were not benefiting significantly from it. The WID therefore views women’s lack o participation as the main problem. While on the other hand the GENDER AND DEVELOPMENT (GAD) approach emerged in the early 1980’s , it emerged from the limitations of both the WID and WAD (WOMEN AND DEVELOPMENT) its main objective was to remove disparities in social, economic and political equality between men and women.Back to the WID it mainly focused on women, the approach seeks to integrate women into economic development through legal and administrative support. The WID approach has enhanced peoples und erstanding of the women’s developmental needs particularly the need to improve statistical measures of women’s work and to provide women with more opportunities for education and employment. WID has helped mainstream gender issues in many developed agencies and polices as well as increase women’s visibility. However the GAD approach argues that women’s status in society is in the national, regional and global economies .It is not just on moment but also on the social relations between women and men, be it the workplace or in other settings. Gender relations are seen as the key determinant of women’s position in society , not as immutable reflections of order but as socially constructed patterns of behavior. The GAD approach sees gender division of labour the work done by women in the household. Women are usually in a disadvantage position in the work place as compared to men , promotion of gender equality implies explicit attention to women’ s needs , interest and perspectives .The GAD approach looks at the impact of development on both women and men, it seeks to ensure that both men and women participate in and benefit from development. However the GAD also recognizes that women’s may be involved in development but not necessarily benefit from it (Moyoyeta, 2004). The GAD also pays special attension to the oppression of women in the family or the â€Å"family sphere† of women’s lives as a result we have seen projects develop addressing issues such as domestic violence, and violence against women. The GAD approach assumptions were that they were unequal power ratios between man and womenPrevents equitable developments (Makombe, 2010) Moreover the biggest contribution of GAD is the inclusion of man into the approach, it does not exclusively emphasize the solidarity of women. This approach acknowledges that women spent a lot of time bearing, raising children , cooking , washing , fetching water caring for the sick and elderly attending to fields and small stock. It also observes that women have no control over their fertility and over productive resources. It also helped us to understand that the gender division of labor gives triple roles thus the reproductive productive and community to women in society.The WID had the following limitations that however as already mentioned led to the formation of the GAD, the limitations of the WID are by exclusively targeting women WID creates tension, suspicion and hostility. It also does not challenge gender relations and assumes that these will change as women become economic partners in development. Furthermore the approach focuses on integration of women into ongoing development strategies. In as much as the GAD was a better approach to WID it also had its limitations, the GAD advocates for the re-examination or deconstruction of gender roles hence it is likely to depend on the goodwill of men.In a nutshell the GAD approach was a better approach to the WID; therefore the gad approach liberates, empowers and promotes partnership and equitable distribution of resources and benefits. WHICH OF THE TWO APPROACHES HAS CONTRIBUTED MORE TO INVOLVEMENT OF WOMEN IN DEVELOPMENT [4] The WID approach hoped to bring women into development through providing them with opportunities for employment or engaging them in income generating projects. This would, as it were, remove them from the private sphere into the public sphere.The GAD approach goes beyond seeing development as mainly economic well being but also that the social and mental well being of a person is important. It should also be noted that the biggest contribution of GAD is the inclusion of men into the approach. The approach brings in the part played by some women in perpetuating gender inequality when these women connive with patriarchy to exploit, subordinate and oppress young women in the third world. Women in Development wanted to remove patriarchy and replace it with matriarchy as they believed that every man has a woman to exploit, oppress and subordinate.GAD concentrate more on the idea that women must be lifted from poverty and contribute more to the developments efforts. It argues that women have a role to play both in reproduction and in production process, it acknowledges their economic roles and class decisions for development to take place. GAD argues that understanding women and men`s roles and responsibilities as part of the planning of development interventions helps to improve project effectiveness and ensures that both men and women plays their part in national development activities.GAD approach does not only concentrate on economic development for women and men only but it also views the social and mental being of person as very important. 1. Boserup, E (1970) Women's Role in Economic Development. St. Martin’s Press, New York 2. Hazel Reeves and Sally Baden, (2000) Gender and Development: Concepts and Definitions, ins titute of Development, Brighton 3. Schaefer, RT 2006 , Sociology: A brief introduction, 6th Ed , McGraw Hill, New York. 4. Makombe K . (2010) â€Å"Young Women Speak† Sable Press : Harare 5.MIDLANDS STATE UNIVERSITY Faculty of Science and Technology Name Christine T Mhike Reg Number R12960Y Programme BSc Computer Science Mode of Entry Conventional ModuleGS 201 – Gender Studies Lecturer Mrs Mukoni Level 2. 1 Due date22 March 2013

Why You Shouldnt Drop Out of High School Essay Example

Why You Shouldnt Drop Out of High School Essay Example Why You Shouldnt Drop Out of High School Essay Why You Shouldnt Drop Out of High School Essay Essay Topic: High School Why Does High School Fail So Many? Majority of students decide to drop out because of not having the support they need from their parents or the fact that school is uninteresting to them. Once the students’ self-esteem goes down, the thought of them doing well in school is impossible. When their self-esteem drops the students may to think â€Å"why even attend school† or â€Å"what is the point of going to class†. Students find it hard to pay attention in class while learning when the material given out is boring. If students start to lose interest in the subject or topic they are learning about, it may lead them falling asleep in class, staring at the clock waiting until class is over, or disturbing another person in class to communicate about something else. Once a student has lost interest in school its highly expected students will not start to show up for class. High school students drop out of school because the teachers don’t make the class more interesting. Students would go in to class and ones it starts the students would start starring into space thinking and using their imagination. Teachers sometimes don’t have that ability to try and get the students more motivated in what the whole class is about. Mr. Brownlee class is a perfect example of why students don’t learn and achieve in school. For my 10th grade geometry class, he would go in class give us a minute to sit down have a seat and then he starts lecturing. Students would go into class late because of how boring it would be, or not making it interesting. Math was a subject to teach students how to work the numbers and how to use them, but he never really made any sense to what he was saying or doing. For the rest of the semester it would just be ditching his class, playing around or slacking on his work because there was never homework. Mr. Bownlee ended up passing the kids without trying on their own and making their grade easier. In my opinion teachers should always make an attempt

Lipase Essays - Enzymes, Hydrolases, Lipase, Phenolphthalein

Lipase Essays - Enzymes, Hydrolases, Lipase, Phenolphthalein Background information: Enzymes are biological molecules (proteins) that act as catalysts and help complex reactions occur. The enzyme grabs on to the substrate at a special area called the active site. The combination is called the enzyme/substrate complex. Enzymes are very specific and don't just grab on to any molecule. The active site is a specially shaped area of the enzyme that fits around the substrate. The activity of enzymes is affected by three factors; temperature, concentration, and pH. Changes in any of these factors affect the activity of an enzyme. Lipase is an enzyme the body uses to break down fats in food so they can be absorbed in the intestines. Lipase is produced in the pancreas, mouth, and stomach. Most people produce enough pancreatic lipase, but people with cystic fibrosis, Crohn disease, and celiac disease may not have enough lipase to get the nutrition they need from food. Uses of lipase: Most people do not need additional lipase. However, people with the following conditions may find lipase supplements helpful. Celiac disease, Indigestion, Cystic fibrosis Lipase supplements are usually derived from animal enzymes, although plant sources have become increasingly popular. Lipase may be taken in combination with protease and amylase enzymes. These pancreatic enzymes are available in tablet and capsule form. Research question: How different concentrations levels (1%, 2%, 3%, 4%, and 5 %,) of the enzyme lipase affect the enzymatic activity that will be allowed to act on the same amount of milk( Triglycerides are the major type of lipid in milk fat. Triglycerides are composed of three fatty acids covalently bound to a glycerol molecule by ester bonds) and the time taken for the phenolphthalein to turn from pink to white compared? Hypothesis: With higher lipase concentrations, there will be more active sites in the solution to be fit in by the substrates, which means more collisions between the active sites and the Substrates and quicker breakdown of lipids in the milk within shorter period of time. At Enzyme concentration of 1% or 2%, reactions can happen at a relatively slower pace, with lipids broken down and phenolphthalein turning from pink to white over a relatively longer time period. At 3%, enzyme activity will speed up with lipids broken down and phenolphthalein turning from pink to white over a relatively shorter time period. At 4% or 5%, enzyme activity will happen significantly faster. Important note: During the experiment, sodium carbonate solution and pH indicator, phenolphthalein will be added ahead of lipase enzyme; when the pH is below 8.2, phenolphthalein will turn from pink to colorless. Sodium carbonate solution is added in order to turn the solution alkaline and the indicator pink then back to colorless after lipase is added to catalyst the chemical reaction and speed up the breakdown of lipids into fatty acid in the milk. Fatty acid produced then is going to neutralize the solution with sodium carbonate solution added previously; phenolphthalein will finally turn from pink back to colorless. Variables: Independent Variables:Enzyme concentration- effectiveness of enzyme concentration will be tested at 1%, 2%,3%, 4%, and 5%. Enzyme lipase at the concentrations of 1%, 2%, 3%, 4% will be made by mixing lipase at 5% and distilled water; all these solutions will be contained in different beakers to keep them pure. In order to make 1% lipase, for each 1ml lipase, 4ml distilled water will be added and poured into a beaker; to make 2% lipase, for each 1ml lipase, 3ml distilled water will be added; to make 3% lipase, for each 1ml lipase, 2ml distilled water will be added; in order to make 4% lipase, for each 1ml lipase, 1ml distilled water will be added. Dependent variable: The time for the phenolphthalein to turn from pink to colorless will be taken using the stopwatch. Controlled Variables: Volume of milk used, pH of substrate, Volume of lipase solution, Temperature Controlled Variables: Controlled Variables: why they are controlled 1- Volume of the milkVolume of the milk used for every test will be kept constantly at 5ml; substrate concentration will be kept the same since full-cream milk will be used. Different volumes of milk will allow different amount of substrates to be contained in the milk. Therefore, more substrates contained in the milk will take it more time for the

Amazon Utilizes a Unique Method in Delivering Books to Consumers, This Research Paper

Amazon Utilizes a Unique Method in Delivering Books to Consumers, This Network Is Called Whispernet - Research Paper Example E-commerce has profoundly altered the mode through which people used to traditionally buy goods and/or services as well as conduct business activities. The major markets of e-commerce can be identified as United States, United Kingdom and Japan in the current scenario. In the e-commerce segment, Amazon faces competition from several players. In North American region, the major players of e-commerce apart from Amazon are Apple, Wal-Mart and Sears, while in Latin America, BuscaPe.com, Groupon.com, Mercado Livre, and UOL play a dominating role among other e-retailers. In European region, the major players are eBay, DailyDeal.com, Weltbild.com and CooleDeals.com among other websites. Similarly, in Asian region the major e-commerce players are 360buy.com, Suning.com and Meituan.com among other websites. As these websites also operate in similar segment, they tend to act as major competitors for Amazon (yStats, â€Å"Global B2C E-Commerce Players Report 2011†). Irrespective of sever al competitors in the e-commerce sector, Amazon has shown significant growth in terms of its business and revenue. Thesis Statement The paper aims to develop an unambiguous understanding towards the impact of e-commerce over the business functions of Amazon. The paper describes how Amazon has utilized e-commerce in several aspects of business in order to gain higher revenue. The paper also describes the strategies used by Amazon analysing the telecommunication approaches used by the company. Company Characteristics Historically, Amazon has tangled itself strictly with e-commerce trends and was successful in developing its business functions from mere book selling to an e-retailing company. By recognising the growth trend of internet, Amazon had commenced offering ‘virtual bookstore’ facilities providing opportunities to buyers to view books along with reviews before purchasing. Amazon commenced its operations online in 1997 with a vision to retail books with low-cost co mpared to other traditional book retailers. In 1998, Amazon expounded the product line from books to other items to strengthen its position in e-commerce (Pearson Education, â€Å"Introduction to E-commerce†). The mission of Amazon is to emerge as a customer oriented company and attain the leadership position in the online retailing market. Amazon’s objective is to satisfy the requirement and desire of customers in e-commerce segment. It is the goal of the organisation to increase the efficiency and productivity of business and turn into a preferable website for online shopping of books along with other products. Organizational Structure Presently, Amazon follows the virtual organisational structure which is a modern form of business introduced in the 21st century. As a virtual organization, Amazon possesses a widespread geologically dispersed work culture, empowered by innovative telecommunication

Fashion Designer versus Stylist Essay Example | Topics and Well Written Essays - 500 words

Fashion Designer versus Stylist - Essay Example Suffice it to say, that lots of TV-stars and celebrities prefer having their personal stylists, who is always ready to create a fantastic image for them. As for the fashion shows, they are, as usual, above all praises. Designers are to satisfy the most sophisticated clients, there are notorious for the ability to create the masterpieces of clothing, which never keeps you indifferent. Nevertheless, most of us do not distinguish between the professions of people connected with fashion industry. We just apply to these people and trust them during the procedure of creating our perfect style without looking deeply into their tasks and the peculiarities of this or that job. Stylists, designers, whatever, we know that their vocation is to make us more beautiful and thus, self-confident. But it is hard to imagine that, in case of need of a gorgeous dress, you will address the stylist at once, as well as it is impossible to dress your hair at the Fashion House. It is obvious that both fashion designer and fashion stylist belong to the same sphere of activity; their efforts are directed to satisfying the aesthetic tastes of various people, they bring beauty, refinement and preciosity in their lives. These professionals work with the same materials, communicate with the similar categories of people, they are to monitor the world’s most popular trends and respond to the particular needs of the customers.