Friday, November 29, 2019

Behavioral and Emotional Disorders in Special Education

Behavioral and Emotional Disorders in Special Education Behavioral and emotional disorders fall under the rubric of Emotional Disturbance, Emotional Support, Severely Emotionally Challenged, or other state designations. Emotional Disturbance is the descriptive designation for behavioral and emotional disorders in the Federal Law, the Individuals with Disabilities Education Act (IDEA). Emotional disturbances are those that occur over an extended period and prevent children from succeeding educationally or socially in a school setting. They are characterized by one or more of the following: An inability to learn that cannot be explained by intellectual, sensory, or health factors.An inability to create or sustain reciprocal relationships with peers and teachers.Inappropriate types of behavior or feelings in typical situations or environments.A pervasive mood of unhappiness or depression.Frequent occurrences of physical symptoms or fears attached to personal or school problems. Children who are given an ED diagnosis often receive special education support while participating in general education. Many, however, are placed in self-contained programs to gain the behavioral, social and emotional skills and learn strategies that will help them succeed in general education settings. Unfortunately, many children with diagnoses of Emotional Disturbance are put into special programs to remove them from local schools that have failed to address their needs. Behavioral Disabilities Behavioral disabilities are those that cannot be attributed to psychiatric disorders such as major depression, schizophrenia, or developmental disorders such as Autism Spectrum Disorders. Behavioral disabilities are identified in children whose behavior prevents them from functioning successfully in educational settings, putting either themselves or their peers in danger, and preventing them from participating fully in the general education program. The Behavioral Disabilities fall into two categories: Conduct Disorders: Of the two behavioral designations, Conduct Disorder is the more severe. According to the Diagnostic and Statistical Manual IV-TR, Conduct Disorder: The essential feature of conduct disorder is a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. Children with conduct disorders often are placed in self-contained classrooms or special programs until they have improved enough to return to general education classes. Children with conduct disorders are aggressive, hurting other students. They ignore or defy conventional behavioral expectations, and frequently Oppositional Defiant Disorder Less serious, and less aggressive than a conduct disorder, children with oppositional defiance disorder still tend to be negative, argumentative and defiant. Children with oppositional defiance are not aggressive, violent or destructive, as are children with conduct disorder, but their inability to cooperative with adults or peers often isolates them and creates serious impediments to social and academic success. Both Conduct Disorders and Oppositional Defiant Disorder are diagnosed in children under 18. Children who are older than 18 are typically evaluated for antisocial disorder or other personality disorders. Psychiatric Disorders A number of psychiatric disorders also qualify students under the IDEA category of Emotional Disturbances. We need to remember that educational institutions are not equipped to treat mental illness, only to provide educational services. Some children are seen in pediatric psychiatric facilities (hospitals or clinics) in order to be provided medical treatment. Many children with psychiatric disorders are receiving medication. In most cases, teachers providing special education services or teachers in general education classrooms who will be teaching them are not given that information, which is confidential medical information. Many psychiatric disorders are not diagnosed until a child is at least 18. Those psychiatric diagnoses that are under Emotional Disturbance include (but are not limited to): Anxiety disorderBipolar (manic-depression) disorderEating DisordersObsessive-Compulsive DisorderPsychotic Disorders When these conditions create any of the challenges listed above, from the inability to perform academically to the frequent occurrences of physical symptoms or fears due to school problems, then these students need to receive special education services, in some cases to receive their education in a special classroom. When these psychiatric challenges occasionally create problems for the student, they may be addressed with support, accommodations and specially designed instruction (SDIs.) When students with psychiatric disorders are placed in a self-contained classroom, they respond well to the strategies that help Behavior Disorders, including routines, positive behavior support, and individualized instruction. Note: This article has been reviewed by our Medical Review Board and is considered medically accurate.

Monday, November 25, 2019

Application of ethical theory to a case study vignette

Application of ethical theory to a case study vignette Critics argue that the principles of business ethics are only theoretical since they are conceived within scholarly boundaries and thus not applicable to real life business. Regardless of this, there are numerous ethical theories which describe the process of ethical decision making. These include the social contact theory, the stakeholder theory, Kantian ethics, among others.Advertising We will write a custom case study sample on Application of ethical theory to a case study vignette specifically for you for only $16.05 $11/page Learn More These theories have different assertions, all of them relevant to modern business ethics. To illustrate their usefulness in the development of modern business ethics, two of these theories are analyzed against the James Company vs. town council scenario. The concept of business ethics varies from one society to another. While an aspect maybe considered as unethical in a given society, the same might be ethically acceptabl e in a different society. Regardless of this, Ostas (2007) argues that the motivation for violating business ethics is multifaceted, more so by pecuniary self interest, which is further complicated by conflict of interest. There are numerous factors which need to be considered in determining whether a situation portends conflict of interest. These include the nature of affiliations between parties in a business contract, employment issues as well as legal and social obligations by firms towards the local community and business partners. Ostas’ (2007) arguments illuminate a number of key issues relevant to this case study. To begin with, the nature of affiliations between James’ Company and the town council portends conflict of interest. James’ Company had previously won tenders fairly. However, the fact that a third of employees in James’ Company come from the town pose crucial questions on the reason why the town council overpaid the Company in the lates t tender. Since this is a fixed price contract, extra payments portends breach of contract agreement, and is likely to be perceived as kickbacks or rewards to James’ Company for providing employment to members of the town’s community. This argument lends itself to the fact that there are three major stakeholders in this case: James’ Company, the town council and the company employees.Advertising Looking for case study on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More These stakeholders are likely to benefit from such unethical practices. Additionally, the dilemma is compounded by the fact that the town council, which is the client, adamantly maintains that the extra unauthorized payments are correct. There are a number of business ethics theories which can be used to analyze this case. Since this case study involves conflict of interest regarding major stakeholders, the stakeholder theory o f business ethics seems relevant. According to the stakeholder theory, business managers have the obligation to manage resources only for the purposes for which they are intended. This implies that there exist fiduciary relationships between major stakeholders, which must be maintained without violating business ethics. The social contract theory is a set of ethical sub theories, which recognizes that business ethics are governed by social contract between a recognized business and the society served by the firm. As such, firms should serve both their interests as well as those of the community without violating normative ethics (Hasnas 1998). In addition to these, while Kantian school of thought is one of the most complicated ethical theories, it postulates that business practices can only be moral if they are motivated by duty as well as goodwill. Additionally, Kantian ethics are based on universally acceptable maxims (Bowie 1999a). All these theories provide plausible bases to an alyze this case. However, the stakeholder theory as well as Kantian ethics override others due their close relationship with issues relevant to this case. The case of James’ Company and the town council revolves around the relationship between major stakeholders and how resources are managed. This relationship portends conflict of interest since all stakeholders are seen as benefiting from unethical business transactions. Using the stakeholder theory, it is evident that the town council violated normative business ethics by paying the contractor over the amount stipulated in the contract.Advertising We will write a custom case study sample on Application of ethical theory to a case study vignette specifically for you for only $16.05 $11/page Learn More According to the stakeholder theory, business managers are the principle custodians of capital extended by stakeholders. As such, managers are obliged to ensure that money is only spent for the purpose s stipulated in a business agreement (Hasnas 1998). Hasnas’ (1998) argument should be considered against the requirements American business contract law which criminalizes making payments especially in cases that portend conflict of interest. The extra $ 10000 seems a reward to the company for employing the towns’ people, and thus illegal. Based on this argument, the town council management breached the contact terms by paying more than the amount agreed in the contract. The stakeholder theory further asserts that stakeholders extend capital to business managers and as such, managers are obliged to cater for the wishes of stakeholders (Hasnas 1998). Since the town council is a major stakeholder, its wish is to use any means to protect jobs for the local population. In this case, the extra $ 10000 seemed to have been paid to maintain trust between the three major stakeholders, but is not part of the business contract. But as Hasnas (1998) asserts, the use of capital for any purpose contrary to contract agreement, despite it being for the best interest of stakeholders becomes unethical. Furthermore, the stakeholder theory postulates that managers are obliged to use business capital for the interest of all stakeholders. In this context the term stakeholders refers to any group or individual who can affect or is affected by the corporation (Hasnas 1998). Thus, the local community, James’ Company, the company employees and the town council become major stakeholders. It is logical to argue that the source of council capital is taxation and rates imposed on the local community. Thus, making such unauthorized payments amounts to misuse of public funds, and is not for the best interest of the public. While the stakeholder theory seems to focus on fiduciary relationship between stakeholders, Kantian ethics focus on categorical imperativism. In this case, an individual must have the will and is duty bound to act on maxims that are universally accepta ble. Therefore, only those actions motivated by universally acceptable maxims are morally permissible (Bowie 1999b).Advertising Looking for case study on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More As indicated earlier, an act portends conflict of interest depending on the nature of affiliations, legal and social obligations as well as issues of employment, which seems to underlie The James’ Company town council scenario; the town council made extra $ 10000 payments to James’ Company, arguably based on profits that would be accrued by all stakeholders. Following Kantian ethics, making extra payments follows the maxim that it is morally permissible for a client to make extra payments to sustain fiduciary business relationships. Thus, the council management ought to ask itself whether making unauthorized payments to a contractor to sustain fiduciary relationships follows a universally acceptable maxim. Kant further argues that people have free will and thus have the ability of follow the law based on reasonable virtues rather than self interest. As such, Kant requires business managers to treat other stakeholders as ends, rather than means to an end. Following this argument, it is evident that the management at the town council treated James as a means to a greater end. Additionally, Kant argues that a business enterprise is part of the moral community. Like the stakeholder theory, Kantian ethics proposes that for moral reasons, all the genuine interest of all stakeholders must be upheld if a business practice is to be considered moral (Bowie 1999b). Making extra payments amounts to breaching the initial contract agreement. This led to misappropriation of public funds. Thus, the town council failed to uphold the interests of one of the stakeholder, the taxpayer. Using the stakeholder theory and Kantian ethics, it is evident that the management at the town council violated normative business ethics. In addition, James seems to have noted the anomaly arising from extra payment and alerted the town council, which remained adamant that the correct payment was made. The fact that the previous contract had lost James’ Company an equivalent v alue to the extra payments made, puts James in a moral dilemma. Choosing to accept the payments compensates the company against previous losses and thus increases company profits. However, according to the stakeholder theory managers do not have the moral obligation to increase company’s profits at the expense of the interest of other stakeholders. This implies that there are ethical constraints which require managers to only increase profitability through honest dealings (Hasnas 1998). Therefore, there are ethical constraints that do not allow James to accept the extra payments. In addition, Kant argues that businesses are moral communities, with stakeholders having a moral duty towards each other (Bowie 1999b). Based on this, James has a moral obligation to maintain honest dealings with other stakeholders and as such cannot accept dishonest payments. Furthermore, Kant’s categorical imperativism asserts that where there are principles that cannot be universalized, it is immoral for businesses to make exceptions for themselves (Bowie 1999b). Thus James cannot make exemptions for his business by accepting illegal payments. According to Duska (2007) parties within a business contract are bound by the contract agreement. As such, any decision that contravenes the contract is unethical. In view of Duska’s (2007), Bowie’s (1999b) and Hasnas’ (1998) assertions, James is bound by the contract agreement which is worth $ 50000. Therefore it amounts to breach of contract if he accepts extra $10000. To abide by the contract agreement, James ought to accept $ 50000 but return the extra $10000 to the client. Additionally, contractors have the right to investigate contract breaches (Summerford 2001). Thus, James should conduct further investigation to reveal the extent of the fraud to determine whether legal action is necessary. Modern business management is complicated, especially with regards to business ethics. This is compounded by the fact that societies have different ways through which ethics are perceived. In this regards, ethicists have developed numerous ethical theories, which form the basis of modern business ethics. These theories have varied assertions, but as evidenced in James’ company vs. town council case study, a business practice is only ethical if it follows laid down agreements. Thus, business managers have an obligation of adhering to established rules since most of the business failures emanate from unethical business practices. When adherence is consistent it sets precedence for successful businesses ventures. Reference List Bowie, N., 1999a. Business ethics: a Kantian perspective. Oxford: Blackwell Publishers. Bowie, N., 1999b. Business ethics and normative theories. [online]. Duska, R., 2007. Contemporary reflections on business ethics. Boston: Springer. Hasnas, J., 1998. The normative theories of business ethics: a guide for the perplexed. Business Ethics Quarterly [online]. Ostas, D., 2007. When Fraud Pays: Executive Self-Dealing and the Failure of Self- Restraint. American Business Law Journal [online]. Summerford, R., 2001. Reserving the right to audit the suspicious vendor [online].

Friday, November 22, 2019

HRM Essay Example | Topics and Well Written Essays - 3500 words

HRM - Essay Example be followed by giving a brief outline of downsizing and reward management, rationale and outcomes of implementing the two concepts in the automobile industry today. A detailed explanation of these basic concepts will also be outlined in an attempt to give a definition for easier understanding of these two concepts. This section attempts to outline the rationale of implementing such strategies supported by empirical evidence from the automobile sector based on researches conducted before on the sector. Different researches will be analysed in order to ascertain the rationale of embarking on such practices. This section will then be followed by comments on the relation between HRM and performance, productivity as well as the importance of combining such practices to achieve greater outcomes in the operations of human resources management in the automobile industry. A critical analysis of the application of both concepts to the automobile industry will be drawn in conclusion to sum up t he effectiveness of implementing such kind of strategies in the automobile industry during the contemporary period. From the beginning of the year 2008, the automotive industry witnessed some major changes that affected the whole sector. Whilst South American as well as Asian countries witnessed a major increase in the sales of automotives, the markets in Japan and North America were stagnant (simplyglobal n.d). Research has also shown that the transport system based on the use of cars is highly unsustainable in the face of government bodies advocating the minimisation of the harmful effects of the increasing automobiles which emit dangerous greenhouse gasses that are detrimental to the environment. The year 2008 also witnessed a global downturn of the economy which saw a rapid increase in the prices of oil. This saw a shift in consumer buying behaviour where they in fact preferred to use public transport (Simplyglobal n.d). America was hard hit as the large trucks such as SUV

Wednesday, November 20, 2019

The effects of competitive sports on young minds Essay

The effects of competitive sports on young minds - Essay Example It is claimed that almost dramatic prevalence of organized or competitive sports in the US holds potential threat to children on multiple levels especially those aged between six and twelve. The article also contemplates how whenever there is an element of competition in a game or huge stress is placed by parents or coaches on young participants on winning it, unpleasant consequences occur. This is because many children feel unduly beleaguered during or after the game but unfortunately for them, they have to hide their true emotions from overenthusiastic elders who want them to act as remarkable child prodigies and outperform everyone else on the field by exerting themselves incessantly. However, discussion presented in this essay challenges the argument of Statsky and is meant to convince the readers that â€Å"children who have remained engaged in competitive sports activities since early age turn out to be more enthusiastic when playing games as adults later compared to those who are never encouraged to participate in demanding sports.† Despite Statsky’s argument that organized games like Little League Baseball and Peewee Football place huge burden on children because they incorporate adult standards, the fact worth considering is that it is smart activities like these which motivate many youngsters to shine not just in sports but in every other field of life. Children learn on this platform what it is like to defeat others on grounds of perseverance, bravery, spirit, and confidence. The importance of teamwork is inculcated in their minds and they learn how to treasure and defend their teams. They learn to appreciate how good teamwork lays the foundation of solidarity and success. In contrast to Statsky’s insistence that competitive pattern of sports can negatively influence both mental and physical development of children, attention should be directed at the enthralling assortment of valuable lessons which children take with them to the ir homes. If any negative consequences at all are associated with competitive sports, curbing such activities in the first place is definitely not an answer as promoted by Statsky. Rather people need to realize that any harmful influence exerted on children is not because of the games they play but parents or coaches are to be blamed for that. The authoress is right when she says that sometimes children participating in games like football are afraid to disappoint their mentors because of the looming prospect of harsh criticism. This explains why under such circumstances they try to continue the game despite not enjoying it or despite unusual strain exerted on their developing muscles. It is sadly true that some parents are principally interested in only thwarting other parents and their children and so they excessively pressurize their child to go all the way through to win the game. However, what needs to be done in this area is not arguing against the nature of competitive sports but insisting on regulating behaviors of parents, coaches, and children who participate in these games. Parents and instructors should be counseled about being more tolerant and children should be encouraged to say no to orders they find intimidating or impossible. Sports participation should not be colored in dark demeaning colors by media and journalists, rather poor adult behaviors need to be modified. Statsky defends her argument by claiming that many competitive sports activities often stimulate children to play in accordance with adult standards which understandably push them beyond their limits. This sort of strategic thinking behind competitive sports management is neither appropriate nor beneficial for children. Likewise, contemporary research recognizes that there is always a risk factor in any

Monday, November 18, 2019

Summary Assignment Example | Topics and Well Written Essays - 500 words - 28

Summary - Assignment Example The government advocated socialist ideologies but which however could not be marketed on the global market since these did not appeal to the post modern types of films. It is for this reason that the Fifth Generation films took a radical approach in their development and could be viewed as rebellious. Though they were banned on the domestic market, they received significant appreciation on the global market. The fifth generation films specifically moved from a usual Chinese Kung fu movie towards depicting a disintegrating socialist background. This is illustrated in the film tilted (Platform 2000) which shows the successful troupe of cultural workers from Fenyang to the countryside. The other issue is that Jia’s films are primarily concerned with portraying a sociological perspective with regard to the social problems caused by the Chinese development. For instance, the films focused on issues such as destruction of the environment, neighborhood s as well as the destruction of families as some of the problems caused by contemporary Chinese development. Jia also incorporated pop music in his films as a form of entertainment given that his childhood was characterised by complete lack of entertainment. The arrival of Japanese pop music and Hollywood films had a liberating effect since these revolutionized the Chinese film. The other issue that characterized Jia’s films is tha t he was concerned about portraying reality through the camera. The sixth generation on the other hand not only rejected the metaphysical image of China but reflected a polarized society. However, the sixth generation film is of the view that a paradigm transformation about the way the camera portrays reality should be confronted and all the contradictions should be captured. For instance, xiancheng is is a true reflection of socialist industrialization failure. This has in fact led to cultural poverty as depicted in Jia’s films. The

Saturday, November 16, 2019

Septic Shock: Acute Generalised Exanthematous Pustulosis

Septic Shock: Acute Generalised Exanthematous Pustulosis An illusion of Septic Shock: Acute Generalised Exanthematous Pustulosis with Multi organ Dysfunction Acute Generalised Exanthematous Pustulosis (AGEP) is a rare cutaneous eruption, most often caused by commonly used antibiotics. It is characterized by an acute onset of non-follicular sterile pustular rash and erythema within hours or days of drug exposure and usually resolves spontaneously within 1-2 weeks once the drug is discontinued. Hemodynamic involvement in the form of shock is rare. Here, we present a severe case of AGEP, manifesting with systemic involvement and hemodynamic instability resulting into shock with multi-organ dysfunction. The associated drugs were Erythromycin and Fluconazole with a possible combined effect of these two drugs that resulted in systemic involvement. Our patient improved markedly, both his hemodynamically and dermatologically, after discontinuation of the drugs and with systemic steroid therapy. BACKGROUND Why you think this case is important why did you write it up? Acute Generalised Exanthematous Pustulosis (AGEP) is a rare condition which presents with rapid onset of several non-follicular sterile pustules occurring diffusely on an edematous and erythematous background (1) (2). Systemic manifestations are typically restricted to fever and leukocytosis. Reversible mild hepatic and kidney injury have been reported in some cases (1) (3). AGEP is caused by drugs in 90% of the cases (3) and spontaneously resolves rapidly after the offending agent has been discontinued. Topical steroids are used for symptom relief and systemic steroids have been used in atypical severe presentations with systemic involvement (4) (5). Here we describe a unique case of Erythromycin and Fluconazole induced severe form of AGEP presenting with shock requiring vasopressors and multi-organ dysfunction requiring CVVHD. Despite prompt discontinuation of the offending agent, patients condition continued to deteriorate until systemic steroids were initiated. CASE PRESENTATION Presenting features, medical/social/family history A 61-year-old man with morbid obesity, COPD, hypertension, and Type 2 diabetes mellitus was admitted to the hospital for acute onset rapidly progressive diffusely erythematous rash within the deep folds of his pannus and scrotum, which was refractory to over-the-counter topical therapy. There was concern for erythrasma so he was started on erythromycin and fluconazole. Within three days, the patients rash spread diffusely across his trunk and extremities to form erythematous morbilliform papules which coalesced to form plaques. Within 12 hours of noticeably worsening rash, the patient acutely decompensated, became short of breath and developed metabolic and respiratory acidosis, requiring transfer to the Intensive Care Unit. He was initially started on BiPAP, however due to increasing somnolence he was intubated. He was noted to be hypotensive with blood pressure of 66/42 mmHg, not responsive to intravenous fluid resuscitation. Patient was started on vasopressor support with norepine phrine. On laboratory analysis, he was found to have leukocytosis (WBC 31.10 10^3/uL), a mixed metabolic and respiratory acidosis, lactic acidosis, as well as hepatic injury with AST of 4902 units/ml and an ALT of 3073 units/ml. He subsequently developed acute renal failure with a creatinine of 3.06 mg/dL, hyperkalemia of 6.3 mmol/L and phosphorus of 7.0 mg/dL and was started on CVVHD. INVESTIGATIONS If relevant More detailed The patient was thoroughly evaluated for an infectious source with radiographic studies and blood and urine cultures, however all work up was negative. Skin biopsy was performed which showed diffuse spongiosis, as well as numerous subcorneal pustules filled with a mixed inflammatory infiltrate, predominately consisting of neutrophils, with some associated lymphocytes consistent with AGEP. DIFFERENTIAL DIAGNOSIS If relevant Other differentials included septic shock, pustular psoriasis, Toxic epidermal necrolysis, Stevens- Johnson syndrome TREATMENT If relevant Erythromycin and Fluconazole were immediately discontinued upon acute decompensation. Due to concern for septic shock initially, he was started on broad spectrum antibiotics, with Vancomycin, Meropenem and Micafungin. However, when the infectious work up was negative, antibiotics were discontinued. With suspicion of AGEP, he was treated with methylprednisolone 80 mg every 8 hours for three days and eventual slow taper on oral steroids. OUTCOME AND FOLLOW-UP The patient had marked improvement in both hemodynamics and rash once started on steroids. He no longer required vasopressor agents and was extubated on Day 3 of methylprednisolone. He required four days of CVVHD and had complete recovery of both kidney and liver function. He was maintained on oral prednisone with slow taper for 2 weeks. DISCUSSION Include a very brief review of similar published cases Acute Generalised Exanthematous Pustulosis (AGEP) is a relatively rare cutaneous condition provoked by drugs- mainly by anti-infective agents, less commonly by infections (3)(4) and sometimes the cause remains unclear. It is believed to be a T-cell mediated neutrophilic inflammation and the histological hallmark is a spongiform subcorneal/intraepidermal pustule. The rash typically starts in the intertriginous area, as seen in our patient, or the face and rapidly spreads to involve the rest of the body. Systemic manifestations are typically just limited to include fever and neutrophilic leucocytosis and organ involvement is rare. In a few patients, mild hepatic and kidney dysfunction has been reported (1)(6)(3). Our case of AGEP was an atypical presentation with severe systemic involvement leading to hemodynamic instability and multi-organ dysfunction, thereby giving an illusion of septic shock. To the best of our knowledge,ÂÂ   there have been only a few reported cases of AGEP w ith such severe presentation and none of these cases were associated with the use of Erythromycin and Fluconazole (7)(8)(9).ÂÂ   In most of the severe presentations, Vancomycin was the culprit medication (7)(8)(9). It is possible that the combined effect of Erythromycin and Fluconazole which are both hepatically metabolized and alter each others metabolism leading to increased drug levels resulted in the drug reaction being severe with systemic involvement as an affect. Other differentials to consider would be pustular psoriasis, Stevens-Johnson syndrome and Toxic epidermal necrolysis. The patient had no history of psoriasis and the concern for SJS and TEN was low based on the history, lack of mucosal involvement and the timing of the drug eruption within a few days of the antibiotics was more in favour of AGEP which was later confirmed by the biopsy results. Treatment of AGEP involves prompt removal of the offending agent which typically leads to improvement in symptoms within a few days. Topical steroids can be used for symptom relief. Systemic steroids are not indicated , but have been used in rare cases with severe presentations such as in our case, but currently there is not enough data to support the use of systemic steroids to reduce the duration of the symptoms and early recovery (11)(5)(4)(10). LEARNING POINTS/TAKE HOME MESSAGES 3 to 5 bullet points this is a required field AGEP is a rare cutaneous drug eruption which can be severe and mimic septic shock. It should be suspected in patients being managed as septic shock with negative infectious work up and the patients condition continues to deteriorate while on anti-infective agents. Several medications have been known to cause AGEP, but it is unclear as to which factors contribute to its severity. Discontinuation of the culprit agent might not always result in clinical improvement , especially in severe cases and there might be a role for systemic steroids to promote early clinical recovery.

Wednesday, November 13, 2019

A Comparison of the Divided Self in Wuthering Heights and Frankenstein :: comparison compare contrast essays

Wuthering Heights and Frankenstein - Theme of the divided self Theme of the divided self within Emily Bronte's Wuthering Heights and Mary Shelley's Frankenstein. Thematically, the divided self is one of the most interesting themes within both novels and is of great importance to the development or ruin of the characters in both 'Wuthering Heights' and 'Frankenstein.' Both authors when primarily exploring this theme focus upon the physical, mental or spiritual division within certain characters. In Emily Bronte's novel 'Wuthering Heights,' the principal characters Cathy and Heathcliff are presented as needing this division within themselves to recognise their need for each other. This endurance of physical, mental and spiritual division whilst alive, allows them only tragically to experience when in death, complete entity within themselves. Primarily Cathy is not depicted as divided; instead, she is presented as belonging to a family unit, which seems to stay intact until the arrival of a 'gypsy brat.' Although Heathcliff creates a divide within the family due to his arrival, Cathy is seen to gain a friend with whom she feels she has an affinity both physically, spiritually and mentally, which will become increasingly evident as the novel progresses. However, this alliance throughout the novel is frequently thrown into turmoil by outside influences or factors. As we are informed from the onset, the "greatest punishment" that could be bestowed upon Cathy was separation from Heathcliff. Cathy and Heathcliff's separation only therefore ensues as a result of their initial outing to Thrushcross Grange. Their promise to grow up together as 'rude as savages,' is destroyed when Cathy and Heathcliff are separated physically by many factors resulting from this visitation. Just as the Linton's dog 'holds' Cathy, so too is the Linton's house symbolically presented as separating her from Heathcliff, when Heathcliff resorts to peering in through their 'great glass panes' to see Cathy, after being physically 'dragged' out of Thrushcross Grange. Cathy is also depicted as physically separated from Heathcliff even when she returns to Wuthering Heights. Instead of a 'wild, hatless little savage' with whom Heathcliff has an affinity with, she returns as a 'very dignified person.' Heathcliff is now therefore separated physically from Cathy, not only by appearance but as he said in the previous chapter, her superiority "to everybody," including him. The presentation of Cathy and Heathcliff as physically divided is not only literally seen through the differing households but also through Cathy's own actions and attire.

Monday, November 11, 2019

Is Walmart Good for America?

Wal-Mart: An Epic Idea â€Å"Save Money, Live Better. † A greeter welcomes you into the phenomenal discount store we Americans call Wal-Mart. A one stop shop for just about anything and everything you need, Wal-Mart is a major investment to America: 1) Wal-Mart is one of Americas most leading discount stores 2) Wal-Mart employs many people 3) Wal-Mart sells its products for a lower price, making it more favorable to consumers. In 1962, the first Wal-Mart was founded in Rogers, Arkansas. Its growth and succession has lead to its spread around the world. One man, one vision; Sam Walton’s mission was to save people money to help them live a better quality lifestyle. With its earnings and its improvements, Wal-Mart has played a major role in America’s economy. The first Wal-Mart was found in 1962. The year the birth of discount retailing began. The chain of variety stores that Sam Walton owned during the 1950’s faced stiff competition from the many regional discount stores. Before the opening of Wal-Mart, Mr. Walton traveled the country studying just about everything about discount retailing. He noticed that American consumers wanted a fresh new type of store. Acting on instinct, Sam and his wife Helen invested about 95 percent of their income into their first Wal-Mart store in Rogers, Arkansas. In 1972, many other discounters expanded, yet Wal-Mart only opened 15 stores. Later, Wal-Mart stock was offered to the New York Stock Exchange. With the infusion of capital, the company then grew to 216 stores in 11 states by the end of the decade. By the year of 1981, there were 1402 Wal-Mart stores. Employment had increased tenfold; sales had grown from 1 billion in 1980, to 26 billion. Today, 8416 stores and club locations have been opened. Wal-Mart employs more than 2. 1 million associates, serving more than 176 million customers a year. Wal-Mart is a perfect example of how to manage growth without losing sight of your values. America’s most popular discount store, Wally’s World beats all saving stores that promise you some sort of discount. Sam Walton quotes â€Å"If we work together, we’ll lower the cost of living for everyone†¦we’ll give the world an opportunity to see what it’s like to save and have a better life. † In the past 40 years, Wal-Mart has opened 16 markets worldwide. Wal-Mart works with their suppliers to introduce more energy efficient products that can save money for customers’ money for years to come. Wal-Mart saves us as consumers’ money, to improve our way of living. Wal-Mart has teamed up with Mercy Corps and USAID to help small farmers in Guatemala, that’s why you see the Fair Trade Coffee on shelves at Sam’s Club. By collaborating with their communities and suppliers, Wal-Mart helps improve the lives of others. Wal-Mart has a major impact on America’s economy. A leader in sustainability, corporate philanthropy, and employment opportunity, Wal-Mart has ranked number one among retailers in Fortune Magazine’s 2009 Most Admired Companies. Since 2005, Wal-Mart stores have averaged a net sale of 342. 14 billion dollars. Wal-Mart Stores cash flow gas increased 5943 million dollars from Jan, 31 2008- Jan, 31 2009. For the past five years, Wal-Mart has been excelling in their business. Now, more than ever, Wal-Mart is there for their customers. There has been a strong growth; net sales have increased 6. 8 percent to 255. 7 billion. Segment operating income has also increased 7. 1 percent to 18. 8 billion. Wal-Mart has introduced the Project Impact store remodeling plan, under this plan, Wal-Mart expects to update 700 new and existing stores this year, with over 3600 stores in the United States. Walmarts main goal is to save consumers money to improve the quality of their lives. I can definitely say that Wal-Mart is a positive for America. A discount store opened up in Arkansas, now only 40 years later, a major corporation. Wal-Mart helps people, its philanthropic ways have encouraged the store to help others outside the circle of consumers. Economically, Wal-Mart has increased and improved. Who knew one man with a vision could encourage so much growth. Wal-Mart is indeed, good for America. Is Walmart Good for America? Wal-Mart: An Epic Idea â€Å"Save Money, Live Better. † A greeter welcomes you into the phenomenal discount store we Americans call Wal-Mart. A one stop shop for just about anything and everything you need, Wal-Mart is a major investment to America: 1) Wal-Mart is one of Americas most leading discount stores 2) Wal-Mart employs many people 3) Wal-Mart sells its products for a lower price, making it more favorable to consumers. In 1962, the first Wal-Mart was founded in Rogers, Arkansas. Its growth and succession has lead to its spread around the world. One man, one vision; Sam Walton’s mission was to save people money to help them live a better quality lifestyle. With its earnings and its improvements, Wal-Mart has played a major role in America’s economy. The first Wal-Mart was found in 1962. The year the birth of discount retailing began. The chain of variety stores that Sam Walton owned during the 1950’s faced stiff competition from the many regional discount stores. Before the opening of Wal-Mart, Mr. Walton traveled the country studying just about everything about discount retailing. He noticed that American consumers wanted a fresh new type of store. Acting on instinct, Sam and his wife Helen invested about 95 percent of their income into their first Wal-Mart store in Rogers, Arkansas. In 1972, many other discounters expanded, yet Wal-Mart only opened 15 stores. Later, Wal-Mart stock was offered to the New York Stock Exchange. With the infusion of capital, the company then grew to 216 stores in 11 states by the end of the decade. By the year of 1981, there were 1402 Wal-Mart stores. Employment had increased tenfold; sales had grown from 1 billion in 1980, to 26 billion. Today, 8416 stores and club locations have been opened. Wal-Mart employs more than 2. 1 million associates, serving more than 176 million customers a year. Wal-Mart is a perfect example of how to manage growth without losing sight of your values. America’s most popular discount store, Wally’s World beats all saving stores that promise you some sort of discount. Sam Walton quotes â€Å"If we work together, we’ll lower the cost of living for everyone†¦we’ll give the world an opportunity to see what it’s like to save and have a better life. † In the past 40 years, Wal-Mart has opened 16 markets worldwide. Wal-Mart works with their suppliers to introduce more energy efficient products that can save money for customers’ money for years to come. Wal-Mart saves us as consumers’ money, to improve our way of living. Wal-Mart has teamed up with Mercy Corps and USAID to help small farmers in Guatemala, that’s why you see the Fair Trade Coffee on shelves at Sam’s Club. By collaborating with their communities and suppliers, Wal-Mart helps improve the lives of others. Wal-Mart has a major impact on America’s economy. A leader in sustainability, corporate philanthropy, and employment opportunity, Wal-Mart has ranked number one among retailers in Fortune Magazine’s 2009 Most Admired Companies. Since 2005, Wal-Mart stores have averaged a net sale of 342. 14 billion dollars. Wal-Mart Stores cash flow gas increased 5943 million dollars from Jan, 31 2008- Jan, 31 2009. For the past five years, Wal-Mart has been excelling in their business. Now, more than ever, Wal-Mart is there for their customers. There has been a strong growth; net sales have increased 6. 8 percent to 255. 7 billion. Segment operating income has also increased 7. 1 percent to 18. 8 billion. Wal-Mart has introduced the Project Impact store remodeling plan, under this plan, Wal-Mart expects to update 700 new and existing stores this year, with over 3600 stores in the United States. Walmarts main goal is to save consumers money to improve the quality of their lives. I can definitely say that Wal-Mart is a positive for America. A discount store opened up in Arkansas, now only 40 years later, a major corporation. Wal-Mart helps people, its philanthropic ways have encouraged the store to help others outside the circle of consumers. Economically, Wal-Mart has increased and improved. Who knew one man with a vision could encourage so much growth. Wal-Mart is indeed, good for America.

Saturday, November 9, 2019

Free Essays on The Shroud

of John Walsh, â€Å"the facts here have always been available in newspapers, books, documents and human memory, but they have been difficult to gather. I have sought them, off and on, for four years, finally visiting Europe in the search. But I have not set them down here in any effort to convince. Indeed, the reader must come to his own conclusion.†(Walsh 1963, p: 1.) Being open minded to both parties the pros and cons plays an important part in conducting this research paper, as what authors Pickenett and Prince said â€Å" Undertaking this study with a completely open mind, being equally ready to affirm that the shroud was absurd fraud, or to recognize its authenticity, but gradually forced to agree, on every single point that its markings were exact.†(Picknett & Prince 2000, p:5.). Thus, it was a test for scientist and experts to show how these evidences support the possibilities of its authenticity. Statement of the problem The purpose of this paper is twofold. It aims to excavate some of the evidences that supports the authenticity of the Holy Shroud of Turin specially for the skeptics, secondly is to furnish some brief and clear explanations to the evidences gathered. To achieve the said purpose the researcher formulated these question... Free Essays on The Shroud Free Essays on The Shroud Shroud of Turin Essay written by: augusto Introduction: Millions of words have been written about the remarkable cloth preserved at Turin. More recently, most of these writings dealt with one basic question, was it the actual winding sheet of the crucified Christ, bearing an imprint of His body? Or was the whole thing a gigantic hoax? A fantastic forgery of the Middle Ages? Erudite men have lined up on both sides of that compelling query. Some of the facts about the Holy Shroud have something to do with the presence of human blood and other strong evidences of its authenticity, it intensified man’s curiosity. The researcher himself was also puzzled and came up with this study. In the words of John Walsh, â€Å"the facts here have always been available in newspapers, books, documents and human memory, but they have been difficult to gather. I have sought them, off and on, for four years, finally visiting Europe in the search. But I have not set them down here in any effort to convince. Indeed, the reader must come to his own conclu sion.†(Walsh 1963, p: 1.) Being open minded to both parties the pros and cons plays an important part in conducting this research paper, as what authors Pickenett and Prince said â€Å" Undertaking this study with a completely open mind, being equally ready to affirm that the shroud was absurd fraud, or to recognize its authenticity, but gradually forced to agree, on every single point that its markings were exact.†(Picknett & Prince 2000, p:5.). Thus, it was a test for scientist and experts to show how these evidences support the possibilities of its authenticity. Statement of the problem The purpose of this paper is twofold. It aims to excavate some of the evidences that supports the authenticity of the Holy Shroud of Turin specially for the skeptics, secondly is to furnish some brief and clear explanations to the evidences gathered. To achieve the said purpose the researcher formulated these question...

Wednesday, November 6, 2019

Reaction Paper essays

Reaction Paper essays In her article, author Nada Elia describes what she refers to as the privileging of Arab-American women, at the same time that their male relatives are being subjected to an increasingly hostile environment. She criticizes the governments of both the United States and Israel as oppressors of Arabs and Arab-Americans. She discusses the fact Arab-American women are not seen as the same type of threat as Arab-American males, but as victims of their religion. She blames American culture at large, but also Western feminism, which she feels is very exploitative of non-mainstream American culture. She believes that the othering of Arab-Americans has occurred since the beginning of the country. She attributes some of this to the unsuccessful claims of separation of church and state, the fact that Christianity (especially Christian fundamentalism) has had a major impact on American political thought, and what she considers Americas Zionist worldview. She believes that Americans have tra ditionally shown the least tolerance in the areas of religion. She believes that Americans view the clash between Christianity and Islam is the most significant clash in modern society. She believes that Arabs are overtly discriminated against because they are not present in political discourse, recognized as a minority group, or represented in American popular culture. Moreover, when Americans are featured in popular culture, they are frequently villianized. She discusses the facts that since 9-11, Arab-Americans are portrayed as being hostile to democracy, subjected to racial profiling, and disappeared. She believes that the Bush Administration has no desire to improve womens position in the world or in the United States, and says that doing so would actually be at odds with Bushs Christian fundamentalist ideology. She also believes that Americans have failed to address racism and religious intolerance as major so...

Monday, November 4, 2019

Case study Example | Topics and Well Written Essays - 1750 words - 2

Case Study Example There are a number of products and approaches for acquiring systems, starting from ‘in house development’ to ‘commercial off-the-shelf’ packages. At Power IT, the chief executive officer and finance director decided to purchase an ‘Enterprise Resource Solution’ to replace the ‘Material Resource Planning (MRPII). The Organization has its own internal IT system; however, the staffs are not capable enough to develop software at a large scale. The employees lack sufficient application domain knowledge which will enable them to develop such a system within the required timescale. Therefore, the company has decided to ‘buy in’ expertise, rather than putting large scale development into risk. After evaluating the level of required knowledge within the employees, the Organization has opted for ‘3rd party modified off-the shelf solution’ system. In this system, the software expertise and the application domain expertise ar e quite high. As the whole software includes large and complicated application; so surely, the ‘Third party modified off the shelf solution’ system is required to enjoy higher end of expertise in software development and in application domain of the same. A ‘Modified off the shelf’ product typically refers to a product or system whose source code can be modified by the purchaser to meet the requirements of the consumers (Information Leader, â€Å"Introduction†). â€Å"Many of these products feature modifiable or modular designs which increase flexibility, facilitate rapid prototyping of proof-of-concept designs, and are easy to install to insure quick start-up† (Cyber Research, â€Å"MOTS/ROTS Products†). By minimizing the requirement to develop new products from its scratch, the Organization can save on huge information technology expenses. However, to modify the codes as per the requirements of the consumers, demands some amount of ex pertise in this arena. This is why the

Saturday, November 2, 2019

Write a review of the movie And the Band Played On Research Paper

Write a review of the movie And the Band Played On - Research Paper Example During this he comes in contact with numerous public personalities such as politicians, gay leaders, etc who reject his theory to fulfil their personal agendas. He suggests closing all the local bathhouses and attempts to do the same. But he is met with resentment from many quarters as people view it as an unwanted inconvenience that would negatively impact their lifestyle. On the other hand, CDC tries to explain and prove to the American Red Cross that the disease is also transmitted through blood but American Red Cross does not accept it without any conclusive proof. Meanwhile, American and French scientists headed by Dr. Robert Gallo and Dr. Luc Montagnier fight over the credit of discovering the virus first. Through all this the death toll keep raising. The film has had a major influence on the way I think and definitely will play on my decision making in the future. The safety of my patients will be my first priority. Whenever there is any information, supported by conclusive evidence or not, that suggests that my patient is at risk, I will do everything under my control to prevent it. I wouldn’t repeat the mistake of American Red Cross of sidelining or rejecting CDC’s