Monkey: Journey to the west Essay

Monkey: Journey to the West is a story of an adventure for enlightenment to India in order to find ancient Buddhist scriptures. The story consists of Chinese legends, tales, and superstitions. Daoism, Confucianism, and Buddhism play a huge role throughout this story. Monkey: Journey to the West is a story that discusses religion, and moral issues. The monkey acts the way he does due to underlying religious themes played throughout the story. At first understanding why the Monkey acts the way he does may seem difficult. However, after reading deeper through the story one learns that social satire in the Monkey is what gives him his rebellious personality. The end of the story reveals the hidden spiritual meaning behind the monkeys change in actions. Monkey: Journey to the West is told in three major parts. The first being the monkeys early life history and spirit, and the second about Tripitakas family and history before leaving to obtain the religious Buddhist scriptures. The remaini ng section has to do with his three animal spirit disciples, monkey, pig, and a fish. The story of the Monkey shows the struggles of educating oneself on a spiritual path. The characters are representations of religious figures in Buddhism, Confucianism and Taoism. The Monkey represents restlessness and powerful energy, which has to be under control before the journey to the religious scriptures can start. After a while he becomes worried about the thought of death and reincarnation. Buddhists believe in cycle of birth, life and death in order to achieve what they call Nirvana. One must release their self desire in order to obtain the ultimate goal. The Monkey desires to be immortal, however Confucianism recognizes death to be one of the most important times in ones life. Monkey decides that he must explore the ends of the world in order to find a way to get around death and reincarnation because he is not happy with the ways on the three religions. His journey leads him across oceans and over mountains to the Cave of the Slanting Moon where the immortal Patriarch lives. Monkey decides to become a student of the Patriarch in order to gain his knowledge on becoming immortal. Monkey abuses the situation and he is let go by the patriarch due to his extremist actions. When Monkey learns ways of being immortal he returns home and he is more greedy than ever. Greed is looked down upon in Buddhism, Confuscism, and Taoism. Monkey then continues his journey to the dragons and takes their treasures in an ungrateful manner. He uses immoral and threatening actions  to obtain his goals, which are clearly looked down upon. At this time the Monkey is beginning to upset a lot of people, and even the Jade Emperor of Heaven is becoming upset. Monkey totally disgregards everyones feelings and continues to act in such a rude and immoral manner. Monkey still has a desire for more so he eats the immortal fruits, drinks the immortal wine, and he even takes Lao Tzu’s special pills. At this point heaven is becoming even more angry over the Monkeys actions. The Monkey returns home and Heaven implements another attack on him. This attack was successful, Heaven defeated the monkey with the help of Buddha and Lao Tzu. In conclusion Monkey is imprisoned for 500 years. At the end of they story the Monkey has a huge change in mind set due to some help.. The Monkey changes when Hsuang-tsang gives him a second chance to prove himself. Hsuang-tsang stays within the same morals and values of Confucianism, Taoism, and Buddhism. The qualities of forgivenes are in each path to reaching great peace. Monkey realizes the way he acted before being imprisoned was not suitable for his pilgrimage he set out on. Monkey becomes a student of Hsuang-tsang and joins his journey to India. The Buddha shows the Monkey. He explains to him how his spiritual mind has opened his inner soul to help interpret and accept forgiveness from others. Thus, helping Monkey reach his own spiritual purpose.

Gender and the Media Essay

Socialisation is the way an identity is defined throughout life for a person. Children are seen a blank slate that is going to have a personality and roles set by the environment he lives in. A child generally has an idea on what gender they are by the time they are 2 years old. A boy will portray himself with the colour blue, would be very hyperactive and tend to bully girls. Females would be more mature, refer themselves to the colour pink and socialise with other girls, this is called primary socialisation. Personalities are defined through interactions with people that are close to them, there society’s values and they learn the attributes of their sex at a young age and they know what is expected of them as a certain sex. The person is reinforced by social praise and punishment so the person can learn from mistakes and good deeds. Media has played a massive part on how socialisation as occurred to an individual. I am directly concerned with how the media affects young women within today’s society, particularly through the use of gender stereotyping within young women’s magazines, mainly through articles and advertisements. Here, the ideas and beliefs already created by the media are useful to advertisers because they are socially accepted ideologies. They know that they will influence women. It has been stated in the past that it is these media interpretations of ‘The Perfect Woman’ that have been the cause for so many women becoming increasingly pressured into looking good and so dieting, keeping fit etc. This can, in extreme cases lead to serious psychological diseases such as anorexia and bulimia, where one of the main causes has been identified as social pressure. Society affects how people perceive themselves, Body Image awareness still exists in our society. Many people living on our society are influenced by the media and the fashion industry. Both are equally responsible for the increased number of people suffering from eating disorders. Fashion industries tend to only feature whose figures vary from eight to ten. Their androgynous waif-like figures are presented as representative of the everyday woman. In doing so the average woman in the street is forced to measure herself against an unrealistic ideal. Most models are above average height, have naturally lithe bodies and are aged between sixteen and thirty. Their image is constructed and manipulated by a predominately male homosexual industry which appears reluctant to show women as curvaceous individuals. Celebrities themselves fall foul of the dominant media representation of women. When society thinks of a family we automatically think of the nuclear family in which there is a mum, dad and often two or three children. This type is seen as the statistical norm until the 1980’s where it was considered abnormal to deviate from this ideal family type and there were characteristics that came with this which were seen as socially acceptable. Children were seen as the outcome of a loving heterosexual couple and each person i. e. the mum and dad should have distinctive roles within the family. The mother should be concerned with motherhood and household chores. The father should protect the family and be a disciplinary role model, as well as their main role being defined as the breadwinner, this meaning they often bring in the most money. The mother should be the housekeeper who attians the house and looks after the children as they grow up. A young male would grow up learning the princilpes of the father and the young female would grow up adobting the mather principles. Post modernism shows that gender is the main topic in an individual’s life as events that have occurred are directly linked to a individuals gender. Post modernism gives the individual more choice and that is the basis of post modernism, choice! The individual is more independent on their life choices; such old life ambitions of marriage and children are not compulsory but are a option that some people may seek. Unlike pre modernism and modernity where marriage and kids are ultimate goals and people automatically assume that this is the right path to follow. This gives way to new events that once were either not existent or unethical such as unisex and inter-racial marriages. It shows a deterioration of religion and supernatural belief, which leaves great division among people in identity and lifestyles. People are now working more flexible times, fashion has changed in such away that people can wear what they want, food is more oriental and music comes in a wide variety. Identity has separated into many huge groups such as social classes, ethnic group, age and gender. This leads to unrest to certain groups that want change as people now have a sense of spreading opinion and arguing their rights. Certain groups such as feminists, Marxist ideology and ageist rights. As choice and individual opinion now can be widely credited it gives chance for concern to be broadcasted such as the feminist supporters wanting females to be treated as equals among men. The first wave of feminism gave people the ideology in 1928 when they got the vote, which provoked the idea of gaining more such as the 2nd wave of feminism in the 1960’s when women burned the bra’s, this caused great reasoning between the two gender differences. Karl Marx however says that society not the individual is the important issue as that eventually the working class will soon rule society. This radical change has brought in new changes such as ‘the new man’ that is a unique gender that of a masculine and unemotional male, the new man focuses on his physical appearance and pays attention to diet, personality and self image, he is more emotional and doesn’t fit in with a patriarchy idea. As post modernism has totally effected today’s society it shows how an individual can make all the differences and how self concern and freedom is the new ideal but this idea could change and evidence suggests that it could lead to pre modernism of the old age as though it is a long term cycle of a society but critics say this is the final situation of society and the end solution is total equality among genders, races and age. This idea of choice could lead in any direction depending on current affairs within society yet time is not a important issue as this process could last a log time.

Case study Human Social Behavior

Case study Human Social Behavior Introduction- This article is about the human behavior and the various factors which affects the human behavior. One of the factors that have a great impact on the behavior of human is the social environment and here all types of sociological effects are discussed. Various individual environmental factors and their impact on behavior are also discussed here. Inheritances also affects the human behavior and in this article two types of inheritances are discussed and that are cultural and the genetic inheritances. Nature and nurture both has impacts on the development of humans and nurture has some of the effects on behavior of humans. In the end of the article there is a detail discussion about the evolutionary thinking and the factors like psychological and the biological which changes the human behavior Body 1-7 – Behavior of the human being decides the overall personality and this behavior of human are influenced by many factors like cultural, economic, and sociological. Hu man behavior is influenced by the most discussed effect that is the sociological effect. The most complex society of any creature on earth is of humans and it means self-preservation beyond the level of persona; physical survival is extended by us. Humans live in a very typical society in which there is bonding between the groups for the purpose of mutual and protection. Families, friendships, associations etc are included in these groups. Due to the formation of society and humans social links increases the bond between different people which is a human behavior. One of the bad behavior that every human being have is of greed and this behavior of human finishes them completely but due to society and links with different families and groups decreases the human greed of money or anything else. Due to increase of population and the urbanization, the people have started neglecting the social relationship and everyone is giving importance to the money rather than social relationship and behavior. Because of this, the rate of crime and deviant behavior of humans are found in cities. All these sociological effects have impacts on the behavior of the human beings and the social environment plays an important role in the development of the child which includes the attainment of full genetic and human potential. (Conklin, 2004) The biological and the psychological changes occurring in the human beings are basically during time period from birth and the end of adolescence. Genetic factors are the factors which are related to the genes of the child and also refer to the changes that occur at every point in growth. Social environment plays a very important role in the development of child and a new born baby do not experience any fear to contact with any specific people but after the time period of 8-12 months there is a change in them and they start to prefer the people who are familiar and also start showing the feelings like anxiety and distress when they are separated from their family members. Social environment helps the child to understand the social rules in the period of preschool and adulthood. The time period of middle childhood have the characteristics of friendship with age mates and also the beginning of romantic love. Another social effect on the child development is of bonding between the different groups of people and the idea of maintaining social relations develops in the child which helps him/her lifelong. There are various processes which are controlled genetically and they are known as maturation. Maturation is related to the mental and the physical development of the child and a child is said to be matured when he/she becomes capable of taking their own decisions and are well aware of the things which are good or bad for them. According to the some doctors and live examples it is seen that usually maturity comes at the age of 18 and the main thing to consider here is that is maturity comes from the social environment. All the social factors like relationship in society, working in society etc, helps in the attainment of complete genetic and the potential of human. But along with social environment there are factors which are known as individual environmental that affect the social behavior of human.

Final Paper - Building a More Just Society Research

Final - Building a More Just Society - Research Paper Example Moreover, the code of ethics was meant to addresses bad governance and malpractices such as corruption. The need for ethics laws came to the attention of the Special Legislative Committee on Integrity and Ethical Standards in the Government several years back. The committee argued that there was a problem with proper ethical standards. This problem was traced to the lack of checks and balances in the various arms of governments and other agencies. The lack of check and balances provided a conducive environment for unjust acts such as bribery, nepotism and misuse of public office. The end result of this was injustice in the society in general. It was therefore prudent to come up with a set of rules to help counter this problem Following the 1970 Watergate scandal, Congress passed the Ethics in Government Act of 1978 (EGA). This act was to restore public confidence in the government officials as well as the political process. The Act ensured that no branch of the government assumes power THAT may allow it to be involved in malpractices such as corruption, nepotism or bribery (Sleight & Mancuso, 2010). In the United States of America, the US constitution recognizes and empowers the police to help in regulating public behavior and maintaining peace and order. Law and order is maintained so as to build a safer, more just, morally upright and healthy community (Sleight & Mancuso, 2010). The Tenth Amendment of the US constitution divides the power of the Federal government and the State government in order to protect the public from any form exploitation from either state or federal government. The constitution gives the law enforcement agencies the duty to serve the public by safeguarding lives and property. This code of ethics is bidding to every Law enforcer in the United States. Furthermore, these agencies usually take an oath of office to protect the innocent from deception, weak from oppression and

Robert Bolts play A Man for All Seasons Essay Example | Topics and Well Written Essays - 500 words

Robert Bolts play A Man for All Seasons - Essay Example Observing Henry VIII we see that he is the King of England who has only a minor role in Bolt’s play. King Henry VIII was More’s friend, but he was strict in his desire to demand his friend’s head when he refused to go along with his royal marriage. Thus, the conflict between English monarchs throne and the Holy See, which arose in 1529, sucked More in itself as a funnel, and drowned him in it. Comparing two characters we can mention that More and King Henry VIII are very different people by their nature. Thomas More is presented as a completely enlightened, erudite person, with excellent oratory skills and, equally importantly, firm principles and beliefs; while King Henry VIII is described as a purposeful, eccentric tyrant, a person in whose charisma something rotten and very dangerous lies in contrast to More. Referring to the Republic and the Nichomachean Ethics in comparing and contrasting two characters we can mention that Thomas More and Henry VIII have different positions towards social justice and attitudes towards what a happy life consists in. Discussing Thomas More’s position in the play we see that More hurriedly resigned and honorably interrupted all relationships with friends.

Evaluating a Website of Mayo Clinic for Credibility Coursework

Evaluating a Website of Mayo Clinic for Credibility - Coursework Example Further, it is known for its collaborative strategy by either lending its research department to other specialists from different countries. Outside of the research and collaboration with other institutions, Mayo Clinic also allots 40 percent of its own resources to research instead of medical practice as customary to other hospitals. This openness is motivated by the institution’s commitment to prioritize patients’ welfare and medical advancement. Its efficiency and reputation are carried on to its website. All of its contents are written by resident specialists or guest specialists that are certified to practice their profession. However, even with the personal credentials, content contributors refer to certified research whenever possible. Site Objectives The site serves two purposes. First, it is a business platform as it allows patients and other possible partners to look for specialists, discover studies and researchers being pursued by mayo clinic. It also aims t o educate the mass market by publishing, through its newsroom, articles by affiliate doctors and specialists. It also links to different researchers that are internationally accepted. Topics cover anything from cancer research progress to diet and nutrition. The site has four major target markets: (1) Patients, (2) Doctors, (3) Medical Practitioners, and (4) Academe and researchers. Contents for each section are written by employees/practitioners of Mayo Clinic and approved by the same people who run the clinic. Each market segment is allotted their own section which makes navigation easier and efficient. Content Providers Mayo Clinic contents come from different doctors, research institutions, and other kinds of a medical practitioner. Published articles range from simple diet tips to maximize the health benefits of different food groups to breakthrough genetic research. Each article is written by authorities in the field. Most often, medical related articles are authored by reside nt doctors. Their contents are also continued, duplicated or expounded on Mayo Clinic’s monthly newsletter providing a more reliable and qualified reference. They also publish simplified versions of new researchers and finding. Quality of Contents Opinions and Substantiations Mayo Clinic articles are always, at the very least, written by certified doctors or practitioners in various medical fields. The author is always someone considered qualified to talk about the subject at hand. The contents are written with the same efficiency and dignity as its medical practice. Each recommendation is properly supported and balanced. The voice and opinion of the authors, however, are not compromised. Like many disciplines, medical recommendations are also dependent on a doctor’s opinion. For example, two doctors might differ on what diet to recommend a certain patient. Some doctors recommend raw food diet while others believe a balance of fiber and protein is better. Occurrences l ike this happen on the site and it is expected. Like any professionally written articles, all claims are properly substantiated. Maintenance Mayo Clinic is one of the well-maintained websites. Links work and dated information are not taken down but it has a clear tag that indicates it is an old information but is kept online as a reference.

Classical argument Essay Example | Topics and Well Written Essays - 250 words

Classical argument - Essay Example These regulations are adopted in most airlines although they are in constant conflict between the newly introduced smoking law introduced in 1989 in The United States and the human rights laws. Among the pros is that nonsmokers travel in a conducive environment. The passive-smoker is exposed to more harm than the direct smoker himself in terms of effects such as lung cancer, colds, and sore eyes as a result of dwindling air circulation. Therefore, in-flight smoking law has achieved its purpose to offer comfort and enhancing safety in flights. There are those who argue that flights are also like work places and similar to allowing smoking there, so should smoking be done in flights to observe the right of free will provided flight attendants utilize all air channels in the plane. Some talk of introduction of smoking zones in the planes. I do not agree that this should justify allowing in-flight smoking compared to the disadvantages that include even possible fires on the plane and health challenges. In-flight smoking ought to be emphasized in or airlines and banned for

Building and construction Safety Technology Assignment

Building and construction Safety Technology - Assignment Example The paper tells that the construction workers are the people who will be using the hoist frequently, and therefore more likely to be injured by the hoist. To avoid accidents that might be caused by their negligence, it is important for them to be trained on how to use the hoist and some safety precautions. A material hoist should be manually controlled by a well trained operator so as to ensure safety of other workers lacking the technical knowhow of a material hoist operation. All the workers should be provided with a simple list of do’s and don’ts safety information to reduce the risk of self injury due to carelessness. The material hoist must be designed in such a way that it is enclosed in a compartment which has openings on each floor which will act as doors. Each opening should have a landing plate which will clutch the hoist when loading and offloading. The material hoist motor should have a speed governor and an equipment to measure the weight of the load being lifted. The maximum weight to be lifted by the hoist should be effectively communicated to the workers responsible for loading the hoist to avoid overloading. The lubrication of the bearings and gears should be as often as possible to avoid friction and wearing out of joints and wheels. This will also ensure that the hoist motor is not overloaded and reduce the risk of malfunction. The material hoist should be suspended from steel wire ropes of highest possible quality which corresponds with the weight to be lifted. ... This will also ensure that the hoist motor is not overloaded and reduce the risk of malfunction. The material hoist should be suspended from steel wire ropes of highest possible quality which corresponds with the weight to be lifted. The steel wires should have an allowance for environmental factors such as cold and hot weathers which cause expansion and contraction of the ropes. If overstretched, the ropes may break during cold seasons. A number of steel ropes should be used so that when one breaks others hold the hoist before repair is done (Craighead 210). The minimum diameter of the steel ropes should not be less than 8 millimeters. Other requirements Sound reduction is one of the emerging trends in the field of escalators. The sound of a material hoist should be as low as possible therefore increasing the ability to identify a problem with the hoist when it arises. Sound reducing rubber pads should be installed to eliminate noise and vibrations that might otherwise cause weakeni ng of the beam and the hoist’s frame work. It is recommendable to use stainless steel for the material hoist housing since it has a relatively small weight and yet high capacity of not getting torn apart when lifting heavy loads. Unless stated otherwise, stainless steel should be of EN 10029, EN 10048, EN 10095, EN 10259 or EN 10258 grades 316 or corresponding. Question2. Crane Safety Precautions A crane should be properly maintained and repaired when damaged to avoid its malfunctioning while lifting loads. Before a crane can be employed to lift iron bars, its capacity should be considered. A crane which has a low capacity to lift the weight of the iron bars should not be used; otherwise it may cause injury to those operating it. The hoist rating of the crane should be

Gym usage in afro Caribbean men and its influence on acquiring the Essay

Gym usage in afro Caribbean men and its influence on acquiring the perfect body - Essay Example The thesis aims to identify some of the main aspects of gym use among Afro Caribbean men. The quest for beauty is not limited to women only. Men and women both have from time immemorial strived for better looking features and physique. While the standards of beauty have continued to evolve, the quest remains the same. The growth of the fashion, beauty and health care industry has been significant in increasing awareness about the physical aspects of the body to a new level that was never before. Previously, only women seemed to be affected by the societal and media demands of having the perfect physique and facial features. Now, even men are not spared with the new wave of fashion industry putting men under as tight scrutiny as women. Therefore, the new beauty trend is not only woman, but also man (Hatoum et al, 2004). This is however, only one aspect of the growing awareness about the physical features and their aesthetic requirements. The effect of these projections on the media and the social adverse reactions to other forms of physique have created effect on almost all, and therefore, the newer generations are becoming increasingly brand and beauty conscious. There is no family and parents spared now, who do not complain about the vanity that has entered their children’s mind, instead of the good moral and personal qualities. The introduction of the thousands of brands for skin, hair, nails, and makeup and others has increased this madcap rush towards beautification. This along with the increase in the number gyms, health spas, beauty salons and various beauty service providers with uncounted names continue to increase this desire for more beautiful bodies. Part of this need for beauty is not entirely false. The social prerequisites became more physical and material with the advent of the industrial age. There is now a certain image and look to be

Dependent clause Essay Example for Free

Dependent clause Essay TRANSLATION: The process of turning an original or source text into a text in another language. TRANSLATION TECHNIQUES Direct Translation Techniques are used when structural and conceptual elements of the source language can be transposed into the target language. Direct translation techniques include: * Borrowing * Calque * Literal Translation Borrowing Borrowing is the taking of words directly from one language into another without translation. For example software, funk. English also borrows numerous words from other languages; abbatoire, cafe, passe and resume from French; hamburger and kindergarden from German; bandana, musk and sugar from Sanskrit. Calque A calque or loan translation is a phrase borrowed from another language and translated literally word-for-word. Examples that have been absorbed into English include standpoint and beer garden from German Standpunkt and Biergarten; breakfast from French dejeuner. Literal Translation A word-for-word translation can be used in some languages and not others dependent on the sentence structure: El equipo esta trabajando para terminar el informe would translate into English as The team is working to finish the report. Sometimes it works and sometimes it does not. And one sentence can be translated literally across languages does not mean that all sentences can be translated literally. El equipo experimentado esta trabajando para terminar el informe translates into English as The experienced team is working to finish the report (experienced and team are reversed). Oblique Translation Techniques Oblique Translation Techniques are used when the structural or conceptual elements of the source language cannot be directly translated without altering meaning or upsetting the grammatical and stylistics elements of the target language. Oblique translation techniques include: * Transposition * Modulation * Reformulation or Equivalence * Adaptation * Compensation Transposition This is the process where parts of speech change their sequence when they are translated. It is in a sense a shift of word class. Grammatical structures are often different in different languages. Transposition is often used between English and Spanish because of the preferred position of the verb in the sentence: English often has the verb near the beginning of a sentence; Spanish can have it closer to the end. This requires that the translator knows that it is possible to replace a word category in the target language without altering the meaning of the source text, for example: English Hand knitted (noun + participle) becomes Spanish Tejido a mano (participle + adverbial phrase). Modulation Modulation consists of using a phrase that is different in the source and target languages to convey the same idea: Te lo dejo means literally I leave it to you but translates better as You can have it. It changes the semantics and shifts the point of view of the source language. Through modulation, the translator generates a change in the point of view of the message without altering meaning and without generating a sense of embarrassment in the reader of the target text. It is often used within the same language. The expressions es facil de entender (it is easy to understand) and no es complicado de entender (it is not complicated to understand) are examples of modulation. Reformulation or Equivalence Here you have to express something in a completely different way, for example when translating idioms or advertising slogans. The process is creative, but not always easy. Adaptation Adaptation occurs when something specific to one language culture is expressed in a totally different way that is familiar or appropriate to another language culture. It is a shift in cultural environment. Should pincho (a Spanish restaurant menu dish) be translated as kebab in English? It involves changing the cultural reference when a situation in the source culture does not exist in the target culture (for example France has Belgian jokes and England has Irish jokes). Compensation In general terms compensation can be used when something cannot be translated, and the meaning that is lost is expressed somewhere else in the translated text. Peter Fawcett defines it as: making good in one part of the text something that could not be translated in another. One example given by Fawcett is the problem of translating nuances of formality from languages that use forms such as Spanish informal tu and formal usted, French tu and vous, and German du and sie into English which only has you, and expresses degrees of formality in different ways. WORD: It is one of the units of speech or writing that native speakers of a language usually regard as the smallest isolable meaningful element of the language, although linguists would analyze these further into morphemes There are eight different kinds of words in the English language. Nouns| Pronouns| Adjectives| Verbs| Adverbs| | Prepositions| | | Conjunctions| | | Interjections| | | NOUNS and VERBS are the most common and most essential. Every English sentence MUST contain a NOUN and a VERB. NOUNS name: people, places, things, ideas. They are always singular or plural. They are always common or proper. They may show ownership. PRONOUNS replace nouns. They have person, number, and case. ADJECTIVES describe nouns. They answer three questions: Which one? What kind? How many? VERBS have three jobs: show action, act like an equals sign, or hang around a main verb to show tense. They also have person, number, and case. ADVERBS describe verbs. They answer four questions: When? Where? How? How Much? PREPOSITIONS tell anywhere a mouse can run. CONJUNCTIONS connect things. INTERJECTIONS jump into show emotion. Sentence: it is a sequence of words capable of standing alone to make an assertion, ask a question, or give a command, usually consisting of a subject and a predicate containing a finite verb. Kinds of sentences. Simple Sentence it is a sentence having no coordinate clauses or subordinate clauses. Complex Sentence it is a sentence composed of at least one main clause and one subordinate clause. Compound Sentence it is a sentence composed of at least two coordinate independent clauses. Phrase it is a group of words forming an immediate syntactic constituent of a clause. Clause it is an expression including a subject and predicate but not constituting a complete sentence. Pre-modifier is a word (or words), usually adjectives or adverbs, that comes before the word that it describes. Basic Modifiers * Adjectives * Adverbs * Prepositional Phrases More Modifiers * Degree Modifier * Presumptive Modifier * Summative Modifier Post-modifier is a word, phrase, or clause that functions as an adjective or adverb to limit or qualify the meaning of another word or word group. Adjective Order Adjectives can be used to describe lots of things, from physical size, age, shape, colour, material, to more abstract things like opinion, origin and purpose. We can use adjectives together to give a detailed description of something. Adjectives that express opinions usually come before all others, but it can sometimes depend on what exactly you want to emphasize. For instance: That nice, big, blue bag. (You like the bag. ) That big, nice, blue bag. (You like the colour. ) When adjectives are together there is a general rule for the position of each type adjective, these are: Position| 1st*| 2nd*| 3rd| 4th| 5th| 6th| 7th| 8th| | Opinion| Size| Age| Shape| Colour| Material| Origin| Purpose| | Nice| Small| Old| Square| Black| Plastic| British| Racing| | Ugly| Big| New| Circular| Blue| Cotton| American| Running|.

Technique Of Video Streaming Using Opnet Tools Computer Science Essay

Technique Of Video Streaming Using Opnet Tools Computer Science Essay With the popularization of mobile technique, many users obtain various multimedia services through heterogeneous internet. Among these services, video streaming application is most challenging. Because of time constraint and VARIABLE BITRATE (VBR) property of a video, the problem of streaming high quality video in insufficient external WAN bandwidth. To solve this problems we are reviewing different technique like OPTIMAL CACHE ALGORITHM, MOSES (mobile streaming for video surveillances) etc. To make the good quality video streaming, we have to work on some different parameters like latency, image quality, video fluidity and frame losses. The mobile technique is most popularized and brought a great revolution in this 21stcentury.There are some terms like mobile video surveillance,video streaming which helps to do the mobile technology more and more advanced. This paper is basically focus on how the video streaming done using OPNET tools. For this we refer to the broad class of emerging real-time video surveillance. In mobile video streaming all the issues related with video garbing, processing, interpretation and dispatching of multimedia data becomes more challenging due to the presence of mobile platforms either in the transmitting or receiving side, wirelessly interconnected. For video streaming Givaldi and Prati proposed a streaming system called MOSES (mobile streaming for video surveillance), that effectively implements the described general purpose architecture for mobile video surveillance. MOSES supports video streaming in different condition, aiming at low-latency transmission over limited bandwidth network. The video stream is provided with a sufficient quality to be correctly analyzed by both human-based and computer-based video surveillance layers. To this aim we propose a optimization of the streaming process with an adaptive control of the streaming parameters. In this paper we also discussed how OPNET can be applied in modern video streaming technique. Network simulation is a major part of this OPNET modeler. It is useful to create the network and for the video streaming process. Basic steps which are used for video streaming technique are following:- Video Compression Principles and practice of video coding Basics behind MPEG compression algorithms Current image video compression standards Video Communication Video Streaming I Video application contexts examples: DVD and Digital TV Challenges in video streaming over the Internet Techniques for overcoming these challenges Video Communication Video Streaming II Video over loss packet network and wireless links à ¢Ã¢â‚¬  Ã¢â‚¬â„¢Error-resilient video communications Today There are lots of streamed video techniques are available till now. JPEG :- It is a joint photographic experts group, which is basically a single frame image compression. It mainly consists of minimum implementation, which are required to support some specific applications. MPEG:-It is a moving picture experts group. This process will work under the direction of ISO (International Standard Organization). In this basically, the ISO do coding of moving pictures. H.261:-This is one of the best processes found in the field of video compression. This process was completed with the help of algorithm known as motion compression algorithm. The H.261 video technique is use for the communication channel. RELATED WORKS:- In this paper we are reviewing different algorithms which are proposed by some reacher fellows on video streaming technique. They proposed different algorithms to resolve the problems of video streaming. In this paper, we are reviewing the following algorithms which are already proposed in the video streaming field. Cut-off Cache (CC) Algorithm :- This algorithm was proposed by Zhang et al. This algorithm use to handle the video staging process. In cut-off cache algorithm, the frames which are available inside the given video are sequentially compare with given cut-off rate. Cut After Smoothing Algorithm:- This is the next version of CC algorithm which was also proposed by Zhang et al. In this he had given the information about the utilization of WIDE AREA NETWORK bandwidth. This is also used to handle the video staging in more effective way. Optimal Cache (OC) algorithm:- The Optimal cache (OC) algorithm, is basically proposed to compute the video caching with linear complexity (O(n) , where n is the number of frames). The concept behind the OC algorithm is same as the CC algorithm but the main advantage is we can also use the concept of WAN bandwidth. Cache Selected After Smoothing Algorithm (CSAS). In this algorithm the researcher integrates two video processors and then combine it with cache selected process. After some years Chang,Ho and Oyang gave some other contribution on this field.They just tried to propose some other algorithms which is helpful for video streaming of high bandwidth. Priority Selected Cache(PSC) algorithm:- PSC algorithm is the modified version of the optimal cache algorithm. In this we have to select the frame data which are having maximum number of high priority. In this we have to replace the low priority frame with the high priority frames. Review Analysis:- In this paper we are basically dealing with the OPNET modeler. The original OPNET simulation model for MPEG-2 streaming was developed in the year 2000 by Srinivas Kandala and Sachin Despande. Theoretical Concepts:- Any video if we will take for an experiment it basically contain certain frames and that frames are having particular size. The following three variables which helps us for video streaming. Scene Length Distribution :-A particular movie or video which we have to compress is having certain scene in it. We have to divide those scenes with particular length. That process is called scene length distribution. Frame Size Distribution :- We know that one particular scene will contain certain frames . Now the frame type or size is essential aspect of model. Each and every frame has certain size. Stream Structure:- When we divide the particular video in certain scene and frame length than we can see that each scene containing certain pictures thats called GOP( group of pictures).This is called the stream structure. Node Model Design:- Now in this paper we are theoretically defining how we can create a node model using OPNET which helpful for us in video streaming technique. There are certain processes in OPNET by the help of that we can create a video streamed model. In OPNET we have to use constant bitrates stream (CBR). When we use CBR, the process model in OPNET is very simple, just use the standard. Simple source module and set the frame size and frame interarrival time to the desired value. When a stream is used scenes with high entropy get more bandwidth resulting in a higher visual quality. Because different streams tend to have high entropy. A scene at different moments in time, a bitrates is divided very efficiently, when several streams are transmitted over a packet switched network. Hence, by the help of this process we can easily make an OPNET model which helps in video streaming. CONCLUSION:- The theoretical concepts of video streaming using OPNET modeler are explained in this paper. An OPNET model was used to program low level process modules. The packet segmentation support allows the model to be used over several underlying protocols. The simulation results shows that it is based on the high level characterized in the time domain, the behavior of streamed video using OPNET models and streamed video using different algorithm is similar. For video streaming we basically have to follow some steps like video compression, video streaming 1, video streaming 2 etc. Current image and video compression standards:- STANDARD APPLICATION BITRATE JPEG Continuous-tone still-image compression Variable H-261 Video telephony and teleconferencing over ISDN P * 64 kb/s MPEG-1 Video on digital storage media (CD-ROM) 1.5 Mb/s MPEG-2 Digital Television 2-20 Mb/s H.263 Video telephony over PSTN 33.6-? Mb/s MPEG-4 Object-based coding, synthetic content, interactivity Variable JPEG-2000 Improved still image compression Variable H.264/MPEG-4 AVC Improved video compression 10s 100s Kb/s After reviewing all the above algorithm which are proposed till today we can conclude that , all the algorithm are used for different purpose in video streaming technique. Like some algorithms are used only for normal streaming but Cache Selected After Smoothing Algorithm (CSAS) and Priority Selected Cache (PSC) algorithm are basically used for the video streaming which are having very good quality with less bandwidth and low latency. The upcoming techniques for video streaming process are peer-to-peer, internet technique, wireless video streaming technique.

A Comparative analysis of Roger B Taney and William Rehnquist :: essays papers

A Comparative analysis of Roger B Taney and William Rehnquist Roger b. Taney and William Rehnquist are two Supreme Court Justices separated by a time span of one hundred and fifty years. This distance between them means that while they may share the same views on some political issues, the majority of them will differ. Such differences have had and everlasting impact on the United States and made Taney and Rehnquist two highly recognized historical figures. In his early years, Rehnquist fluctuated between moderate and conservative tendencies. Taney on the other hand, was just the opposite. He seemed intent on agitating the conservatives with his outlandish opinions. One such opinion was delivered in the Charles River Bridge case in which Taney declared that " A state charter of a private business conferred only privileges expressly granted and that any ambiguity must be decided in favor of the state." This outraged conservatives who opposed any modification of the view that state issued charters are inviolable. Taney's action would have been opposed by Rehnquist if he had been alive at that time because he shares the views of conservatives meaning that he favors little or no change in the way that things are done. Rehnquist's conservatism and Taney's Democratic ways have led to many of the historic decisions of the Supreme Court of the United States. Although Taney and Rehnquist wanted things to be done at different rates, they shared a common bond when it came to the limitations on federal interference in the affairs of state governments. Taney felt that a state should be entitled to make regulatory laws even if they appeared to override the provisions of the Constitution. When it came to federal interference with the states Rehnquist believed that the federal government should stay out of the way until needed. On the same note, Rehnquist held that executive agencies should be given considerable leeway in carrying out laws. These similar views provide insight into how the nation was shaped. Roger B. Taney made significant contributions to American constitutional law, but the case most closely associated with him inflicted enormous injury to the court as an institution was the Dred Scott v. Sanford case of 1857. Taney held that "Slaves (and even the free descendants of slaves) were not citizens and could not sue in court, ant that Congress could not forbid slavery in the territories of the United States".

Comparing Imperial Presidency by Arthur Schlesinger and Presidental Power by Richard Neustadt :: Arthur Schlesinger Imperial Presidency

Comparing Imperial Presidency by Arthur Schlesinger and Presidental Power by Richard Neustadt   Ã‚  Ã‚  Ã‚  Ã‚  In his book, The Imperial Presidency, Arthur Schlesinger recounts the rise of the presidency as it grew into the imperial, powerful position that it is today. His writing reflects a belief that the presidency is becoming too powerful and that very few people are making a real effort to stop it. He analyzes the back and forth struggle for power between Congress and the Presidency. Schlesinger breaks up the first half of the book chronologically. He begins by discussing the areas concerning the presidency where the founding fathers agreed and also the areas where they disagreed. He then goes on to analyze the rise of the imperial presidency through war and recovery, with emphasis on the events of the twentieth century. After the war in Vietnam, Schlesinger divides the book based on the specific nature of the events that had an impact on presidential power. He divides it based on domestic policy, foreign policy, and the affairs that go on in secrecy.   Ã‚  Ã‚  Ã‚  Ã‚  Schlesinger provides an incredible amount of evidence to recount the ups and downs of the imperial presidency. He provides a base for his argument with an in-depth view of what the framers intended and how they set the stage for development over the next two centuries. An issue that Schlesinger focuses on is the presidents ability to make war. The decisions of the founders in this area would have a huge impact on the power contained in the office of the president. The consensus amongst the framers was that the president, as Commander in Chief, had the ability to defend the United States and its interests, but the ability to declare war was vested in the Congress. This decision set the stage for the struggles between the president and congress. He also discussed the debate over the power institutionalized in the presidency. At the time, there were two schools of thought on the subject. Hamilton supported an active president, while Jefferson argued in favor of a passive president. The final draft included a compromise of the two theories. There was also some debate over the power of the president versus the power of congress. Additionally, there was a compromise made over this issue when writing the final draft. The spirit of compromise amongst the founders was what provided a viable and secure base for the future of the presidency.   Ã‚  Ã‚  Ã‚  Ã‚  After his discussion of the founders, Schlesinger shifts to the president's powers of war. He analyzes every war, excluding the Revolution, that the United States has participated in up to and including the war in Vietnam.

Genetic Engineering Essay -- science

Genetic Engineering Two years ago, genetically engineered bacteria, which unexpectently killed beneficial soil fungi, escaped into sewers through human error and have become toxic to plants and survived when expected not to.3 These are the sorts of consequences that come with playing God. DNA (deoxyribonucleic acid) - the chemical compound that makes up the genes and determines the type of proteins a cell can make - is the core of genetic engineering. It can be manipulated in ways we could never dream of such as a new species of a catwoman or fishman. There are so many questions that each person must ask each other before making any sort of decision that would effect the future of genetic engineering towards humans. The risks of DNA combinations can be enormous and unexpected such as the formation of bacteria resistant to antibiotics, linkage of DNA molecules with tumour-causing viruses and the introduction of toxin-formation or antibiotic resistant genes.1 Thus all risks must be taken into consideration. Genetic engineering has already been demonstrated in cattle and studies have shown linkage of DNA molecules with ulcers, cancer and heart disease.1 Unfortunately, regulation of biochemical research ethics has been erratic and half-hearted for years. The United States allowed its only national bioethics commission to expire in 1989. 2 As for in-vitro research, the Reagan Administration cancelled federal funding a decade ago. 2 So work in this area has been priv...

Case study Essay

This paper addresses the principles of Choice Theory with the origin of Classical Theory, as well as the Trait Theory which originated from the Positivist Theory. It establishes the differences between the two criminological theories. The defining characteristics are addressed to help the reader understand the relation between the two as well. The distinctions and descriptions are supported by various scholarly authors, and will be listed below. The ideas of the Choice Theory originated from the principles and ideas of the Classical Theory. Back in the late 1700’s it was the understanding of the criminologist, that criminals would typically assess the possible benefits of conscious and rational choice before committing a crime. Choice theory establishes a mindset focused on the benefits they will render by becoming involved in a criminal act over the possibilities of punishment or rather conviction of the crime in question. Classical Theory was developed by Cesare Beccaria, an Italian social thinkers as stated in the text (pg. 84) after which, about a hundred years later the idea of Positivist Theory was developed and became the focus of the criminologist. Although the Positivist Theory made an appearance within the study, not much longer after they shifted back to the original thoughts of Cesare Beccaria. As the years went on Beccaria original idea of Choice Theory developed into something greater and more advanced in its description. According to one article â€Å"Rational Choice Theory, Crime Control Policy, and Criminological Relevance† states it is matured into a more comprehensive perspective that ultimately appreciates the complexity of the nature of criminal behavior. Within this crime theory, suggest that criminals are typically not fearfully of breaking the law because the excitement and thrill of the crime is far too enjoyable for these criminals. However if the criminal believe the punishment was too severe they will not engage in or every think to repeat their criminal offense. The notion that physical and mental traits distinguish a criminal from another is the principles of the Trait Theory. These criminals commit crime based on environmental effects as well the diet or food in which they may consume. It originated from the Positivist Theory that rejects the idea that the criminal makes a conscious and/or rational choice to commit a crime; but rather their character differences is what constitutes their criminal behavior. These differences suggest the criminologist conclusion of deviant member within society and helps them identify them as such. The idea of this theory suggest that criminals have a distinct characteristics that causes them to commit a crime but it is in fact an unconscious act because it a personal trait in which only few possess. It is easy to distinguish the difference between the Choice theory of Classical criminology and the Trait Theory of Positivist criminology. These differences include the free will of the classical criminology philosophy where the criminal calculates or determines if the crime is worth the risk of being convicted, whereas positivist criminology philosophy indicates the criminal is subject to external forces causing them to commit a crime. Choice theory suggest that the solution to this philosophy is any form of deterrence. And the solution for Positivist criminals is also some form of intervention. Classical criminology places importance on the idea of agency verses positivist places it concern on structure. Classical criminals must be punished whereas positivist criminals need rehabilitation. The similarities include they are both criminals act that need to be addressed to prevent them from occurring. Whatever form to therapy, rehab or intervention that needs to take place has to occur. Another similarity is the time it was founded. Both theories were established around the same time era.

Unit 2 Cache Level 2 Coursework

Shalini Karsan 10/680 846 Unit 2- The developing child. D1- Describe the expected stage of social development of the children aged 4 years. The child at 4 years will start to develop a knowledge about different genders e. g. females and males. They can make friends, and they are also interested in having them. This age group, should know how negotiate, and to give and take objects.D2- Describe the expected stage of social development of the children aged 5 years. They can help and take responsibility of other children, for example helping them out in the setting. Most 5 year old children like working in groups, with others as this will let them interact amongst each other. At this age friends are important, they are independent. When playing games in the setting they can understand the rules of the game. D3- Describe one suitable method of observing and recording the social development of children aged 5 years.The suitable method of observing children at the age of 5 years, at the s ocial development stage, is to record it by a narrative observation. It can be used to record social development. A narrative ‘observation is a detailed account of everything that you see the child doing’ (Thornes. N, 2009) When doing observations in the setting, the child’s name should not be included because of confidentiality. The children should be named as ‘A’ and ‘B’ instead of the name. ‘You should record the date you made your observation. ’(Thornes.N, 2009) D4- Explain one advantage and one disadvantage of this method of observing children. The advantages of this observation are so that practitioners understand the child as individuals, and their likes and dislikes. They can collect relevant information about the children or child. They can also know what development stage the child at. The disadvantage of this observation is that it could interfere with confidentiality. The teachers may not want this information to be observed, as it can be passed around to other people.D5- Identify the main influences that may affect the social development of children. Children’s social development can be affected by negative influences such as, speech and language, money problems, English as a second language, violence abuse, disability, family break ups, and moving house. It can also be affected by positive influences such as children making new friends in their new setting, they have started. D6- Describe how snack and mealtimes can support the social development of children.Snack and mealtimes can support social development by the children washing their hands before eating their snack in the setting, or meal in their home; they can talk amongst each other, and the teacher’s this will allow the children to socialise freely. They can be taught how to share and wait for their turns to take their meal or snack, they can serve themselves at the table, this will give them a choice to pick what th ey would like to eat. Table manners can be involved because it teaches the child to do things independently. D7- Show an understanding of diversity and inclusive practice.As a practitioner we should encourage a child to explore. Practitioners can show an understanding of diversity and inclusive practice, by mixing all the genders together when the children are doing their activity. All children should be treated equally, despite of their ethnicity, ability, religion and needs. ‘A stereotype is a fixed image of a group of people’ (Tassoni. P 2007). Stereotyping, should not be shown, as children may get the wrong idea of the opposite sex. Children with (SEN) Special Education Needs will need extra support in the activities, played in the setting.

Whatever Happens Happens for the Best

Whatever Happens, Happens for the Best Once upon a time there was an old man called Bob, who lived alone in a village. He would go about his business alone, even in his old age. He was a nice, friendly man who was liked by all the people in the village. Bob had only one son and he moved to a school far away from the village. Many people in the village always felt sorry for Bob, they knew he must be lonely. The villagers would always ask Bob if his son would ever return. To all of them, Bob would always say, â€Å"Whatever happens, happens for the good. One day, the old man’s son returned to the village. The entire village was very happy for Bob, and a lot of villagers came over to congratulate him. Like always, the old man was polite. He thanked all of them for coming over and said, â€Å"Whatever happens, happens for the good. † A few days had passed, when one day, Bob’s son fell off a horse’s back and broke his leg. Once again the entire village came ov er to Bob’s house to visit his son. And once again the old man thanked them for their care and said, â€Å"Whatever happens, happens for the good. Some of the villagers were surprised to hear this and wondered what good could there possibly be in a broken leg. A few days later, a small army of the local king came to the village and made all the young healthy men join the army. When they came to Bob’s house they found his son with a broken leg. So they left him behind. Once again, all the villagers came to the old man’s house to congratulate him for his good luck. And like always, the old man thanked them for their care and said, â€Å"Whatever happens, happens for the good.

The Things They Carried Rhetorical Analysis

The Things They Carried Prompt: How do the symbols, imagery, and anecdotes in The Things They Carried help to contribute to the meaning of the text? The Things They Carried, written by Tim O’Brien, recounts the horrible experiences of soldiers at war in Vietnam. Throughout the novel, the author not only tells war stories, but tales about his own life, often referencing and dwelling on those who have made an impact on his life. He stresses the importance of these people and stories, often referring to them as â€Å"war stories† although many of these are not true.They serve as an outlet for O’Brien, allowing him to let go of these horrible memories but also letting him keep the importance that they had on his life. These stories and messages are emphasized through the symbols displayed in the novel, the imagery used throughout, and the anecdotes that recount his memories. The symbols in The Things They Carried help to make the text more meaningful and further comm unicate the theme the novel displays. One of the symbols, the dead Vietnamese soldier, represents the horrors of war and what soldiers have to experience on the battlefield.Although it was never completely clarified whether O’Brien did or did not kill the man, the guilt he relays through the text shows that he does not want to be in war, but it is expected of him to kill others since he is involved. He does so to prevent scorn from society upon his return. The author copes with the death of the Vietnamese soldier as he does with others throughout the novel; he fantasizes about what kind of person the soldier was, what he did before the war, and what he will do after.He creates the soldier’s life in his mind, saying that â€Å"After his years at the university, the man I killed returned with his new wife to the village of My Khe, where he enlisted as a common rifleman with the 48th Vietcong Battalion† (O’Brien, 130). The man is a symbol of who the author h oped to be instead of who he was at war. The author himself was about to go to college, but was unable to do so in his life, so fabricated the soldier’s past to live out his dreams in a different manner.Even though he did not know the man, he still feels and remembers the loss like the soldier had a significant impact on his life. O’Brien keeps those that have passed on alive in his memory, and this is one of the many continuous themes of the novel. The uses of imagery throughout the novel help to bring more meaning and importance to the theme the novel holds. In many of the important events in the novel, imagery is utilized to stress the significance of the event. When Kiowa dies in the novel, the use of imagery shows the importance of Kiowa to the entire troop, and how his death happened.When describing his dead body, O’Brien includes the details that â€Å"A piece of his shoulder was missing; the arms and chest and face were cut up with shrapnel. He was cove red with a bluish green mud† (O’Brien, 175). This description of Kiowa’s dead and decomposing body helps to bring the reader into the war itself, and what the author was feeling at this point in his life. Not only does this imagery convey to the reader the condition of the body, but it also communicates the reality of war and the effect it has on the people involved.However, the author keeps Kiowa both alive through the text and in his memory, stating that a true war story is never completely true. This shows that although most of the novel is most likely fabricated and completely false, it still relates the general experience of the war and these experiences keep the war alive in the author’s memory. Many of the stories within The Things They Carried are short anecdotes, and they give examples of the war stories that O’Brien has both experienced and heard. These tales essentially make up the book, and thus are very important to the meaning of the n ovel.The author often recounts his experiences with those who have passed on even though these stories seem to have no relevance to the text itself. For instance, he remembers his first experience with love and loss on meeting Linda when he was in elementary school. â€Å"When I write about her now, three decades later, it’s tempting to dismiss it as a crush, an infatuation of the childhood, but I know for a fact that what for each other was as deep and rich as love can ever get†(O’Brien, 228). This love he felt for Linda was true, and even similar to the love he felt for many of the men in his troop.Even though O’Brien has not seen Linda or heard of her for three decades, she is immortalized within his memory, and as a result, he thinks about her often, as he does with other deceased characters in the book, such as Kurt Lemon and Kiowa. This memory of Linda shows that the book was not written only to recount his experience in the war, but to also remembe r those who have passed on through the text, and this shows that even when people die, they are never truly forgotten. The symbols, imagery, and anecdotes used throughout the text help to prove that no one single person is every truly gone from someone’s memory, and every memory has an mpact on one’s life. O’Brien uses symbolism to refer to the war at many points, and his memory of the man showed who he wished he was rather than what he really became. The symbolism used when describing Kiowa’s death shows the horror and reality of war, and well as the immortalization of people in the author’s memory. O’Brien’s anecdote involving Linda and his first experience with love shows this remembrance of the dead as well. This anecdote, along with others, brings more meaning to the story. These messages involved in the book help to bring more meaning and importance to the text, and help to leave an impact on the reader’s life.

Lesson plan for special education Assignment Example | Topics and Well Written Essays - 750 words

Lesson plan for special education - Assignment Example Integrate of a wide scope of methods of instructions that are suited to learner’s distinct styles of learning. This is aimed at creating an intended program for Tom success in tertiary institution preparatory curriculums Stress on the need to ensure that Tom fits in the school curriculums and with co-joined traditional aspects of the school such as co-curricular activities. Tom will be to pursue his core based courses as well as take part in other classes, co-curricular activities like athletics together with the rest of learners in the school This lesson plan seeks to explore Tom, a 10 year old kid in the 5th. He will be engaged in a handy activity aimed at helping him distinguish different conditions that act as trigger factors to asthma. Tom will be engaged in research of various ways to prevent these conditions and also on possible methods of treatment. Through internet sources and a Brain POP utility, Tom is to develop from them, research skills (Dawson, 1989). The research activities will involve finding, compiling, and summarizing information regarding asthma. It will uplift awareness not only on asthma but also of other possible ill health. Lastly, Tom will also get to learn on ways to uplift awareness in his community regarding the conditions of ill health (Dawson, 1989). He will be able to indulge in a related activity or engage in charity work geared towards the same. 1. Give cards, with conditions that trigger Asthma, to the students to cut them apart. Begin with a related activity and challenge Tom to work in groups. Let the group members classify cards provided in a criterion that is comfortable to them. In case the members are not able to classify a few of the cards allow a quick research on the internet through a computer. This is to ensure that the students, especially Tom, come up with solutions of their own. 2. Lead a discussion to help the students to compare and contrast. At this point they can be made familiar on the condition

Applying the Chronic Illness Trajectory Framework to a past client Coursework

Applying the Chronic Illness Trajectory Framework to a past client - Coursework Example Doctors performed a diagnosis of CORP exacerbation alongside uncontrollable blood glucose that has a link to the respiratory treatment. Through cross-examining the victim, I apprehended that the he had been diagnosed with a chronic ailment. I attributed the cause of his illness to his exposure to toxic materials while serving in the American Air force. Here, I linked the cause to the first assumptions that indicate that the courses of chronic conditions are dynamic and changes with time. As the interrogation continued, I realized that the course of the patient’s condition would have been altered if he would not have denied his condition. As a result of his denial, his COPD evolved and soon he realized that he faced an elevated intolerance phenomenon that caused the supplementation of oxygen during exercises and medication. The patient’s condition would have been shaped and managed before it developed into the chronic state. The patient would have changed his career to a void getting exposes to more of the combustions fumes that his work entailed (Whittemore & Dixon, 2008). The technology involved in the treatment of the victim’s case was oxygen treatments machines. Long term oxygen therapy treatment that is subject to controversy based on its effectiveness was also administered. With the continual administration of the therapy, the condition of the patient worsened depicting that there was a way in which the technology used in the treatment affected him negatively. He later developed the symptoms of dyspnea and coughing and this necessitated hospitalization to attain a status of control. It seems the consequences of the technological effects led to the attraction of Type 2 diabetes that the patient’s diagnosis confirmed. Consequently, the patient could not acquire some of the biographical fulfillment and perform his daily activities such as dressing and taking a shower. As a result, his

Prepare a case analysis of Case 1, Facebook vs. Twitter Essay

Prepare a case analysis of Case 1, Facebook vs. Twitter - Essay Example as an energy source and rallying point for the organization to the extent that it could make that particular company’s site more relevant than other social networking sites. Twitter’s mission reads: â€Å"We want to instantly connect people everywhere to what’s most important to them.† Whereas this mission statement is 80 characters long Huffstetler (2011) argues that it need not be more than 40 because the keywords are four: instantly, connect, everywhere and important. Twitter’s mission statement is brief, easy to remember and the organisation can relate to it. However as we analyse these four keywords we realise that the company needs to add more precision and clarity so that anyone who reads it may be able to identify its core competence and also be able to distinguish it from its competitors. The way it is it could easily be confused with any of the other numerous social networking sites. Of the four keywords, we believe that the organisation identifies well with â€Å"connect†, â€Å"everywhere† and â€Å"important† but it needs to re-consider the use of â€Å"instant†. Twitter’s real-time attribute is what makes it different from other platforms. This is Twitter’s competitive edge. Google and Facebook, the major rivals have tried to mimic this ability unsuccessfully. The problem though is that in modern technology’s lexicon the word instant could imply speed or ease. Twitter therefore needs to consider what to tradeoff between ease and speed and then use the selected choice to replace the word instant on its mission statement. On the other hand, Facebook’s mission is to give people the power to share and make the world more open and connected (Facebook, 2012). Using Huffstetler (2011) approach we delineate the key words here as being: power to share, open and connected. â€Å"Open† and â€Å"connected† are attributes that are provided by other social networking sites as well including Twitter. The key differentiator for Facebook lies in the

Organizations and Behavior Essay Example | Topics and Well Written Essays - 1250 words

Organizations and Behavior - Essay Example However dealing with how organizations behave, it is necessary to see how the concept of leadership is in an organization. Leadership is all about the needs of the individuals of an organization. Leadership styles are mostly related to the situation in hand. They are used by considering the requirements of people involved and the particular challenges that the organization is facing. There are apparently six different leadership styles or approaches (Kotter and Cohen, 2002, p124). The first one is Visionary. This style is needed when an organization is looking for a new direction and its aim is to move people towards a new goal. Second one is coaching. This style deals with the development of individuals and showing how they can improve their performance and connects their aims to the aims of the organization. Coaching is best for organizations in which the workers who are initiative and want more professional development (Hatch, 2006, p19). Thirdly there is the Affiliate style. This style talks about team work and how a good connection between groups is important. This approach is important in improving and increasing team harmony and morale and improving communication or repairing any type of broken trusts within an organization. However too much praise can lead to poor performance as well. The fourth one is the Democratic style. This style deals with people’s knowledge and skills and introduces a commitment towards goals. However this style will fail in times of crises and in times of urgent decisions. The fifth style is Pacesetting. This style deals with the high standards of performance. The leaders want a perfect work and better and faster things. This style fails in if used too much hence it should be used sparingly. The final and sixth style is Commanding style. This style is also known as the military model. This is the most often used one but the least effective though. It deals with less praise and more criticism; it

Business Assignment about leadership as a business strategy

Business about leadership as a business strategy - Assignment Example Center of discussion in this paper is leadership as one of the best strategies that can assist the companies on the pathway towards growth and success. There are different types of leadership styles that can be practiced by the organizational leaders. A leader can be defined as the person who is capable of influencing and monitoring a cluster of people towards the attainment of common goals. A leader can also be examined as such person who has numerous followers. Furthermore, a leader requires performing his duties well and capable of showing proper path to his group members so that the goals can be achieved. He must be able to convince the followers to follow his path as well as reward them for doing so. Leaders who are focused upon their principles and values tend to be successful at larger scale. There are majorly seven principles that need to be followed by the leaders to be successful. They are accepting accountability, continuation of learning through practice, sincerity, antic ipation of the results, admiration for individuals and families, leading with integrity and establishment of the goals. There are theories presupposing that as the group tends to mature, the leaders are capable of varying his or her leadership style. However, there are leaders who may not change and therefore have a preferred leadership style. There are situations when the leaders may require adapting their leadership style so that they can fit any given situation. Therefore, it is significant for the leaders to be self-aware.... During the times of tough competition and other challenges, the company was engaged in preparing a model that demonstrates the way automakers as well as the CEOs of the company needs to handle the harsh conditions and do the needful. It had been noticed that Mulally was trying to integrate constancy of purposes along with lucidity and teamwork in managing culture at Ford Motors (Yale School of Management, 2010). It was Alan Mulally who had accelerated the company’s restructuring plan. Under his leadership, the huge losses incurred by the company along with the falling market have been reversed, thereby ensuring that the company had a strong balance sheet. It can be noted that it was under his leadership that Ford Motors was successful at selling off Aston Martin, Land Rover as well as Volvo (Yale School of Management, 2010). The esteemed Taurus brand had been revived and the company was capable of expanding the Lincoln brand under the leadership of Alan Mulally. Furthermore, t he stakes held by the company in Mazda was withdrawn. Ford Motors was capable of delivering high quality products which were fuel efficient, elegantly designed and safe. The strategies were so developed by Alan Mulally that the company was successful in meeting the needs and demands of the customers by making complete utilization of the resources. This led to full year profit as noted in 2009 and in the first quarter of 2010. The sales of the company surmounted for all types of products and the best thing to notice is related to the fact that the sales of the company was capable of earning triple to the overall growth of the industry (Yale School of Management, 2010). It had been

SOCIAL CONTEXT OF HEALTH Outline Example | Topics and Well Written Essays - 250 words

SOCIAL CONTEXT OF HEALTH - Outline Example Once every individual takes care of his/her health in a community, it will lead to a healthy community. Most minor cases of illnesses are treated and can be managed at home. The traditional approach of health has become common in the day to day world (Helman, 1978). In the past, illnesses were believed to be a result of satanic possessions or witches. Good health was brought about by balance in people, which included a balanced diet, exercises and sleep. If you got sick, it meant there was some imbalance (Heaman and Hardy, 2002). The theory of Miasma, developed in mid-17th century, leads to the interest of improving hygiene and sanitation. It resulted from poisonous gases that came from decayed matters in the soil and stagnant water and unhealthy jobs (Hardy, 1999). It made people be careful of their environment and make it clean and clear stagnant water. Helman’s work was based on the concept of ‘feed a cold, starve a fever’. Changes in temperature for example a fever is seen as ones carelessness (Helman, 1978). If a person exposes him or herself to cold, rainy weather he is bound to get sick so if people keep warm when needed it can prevent infection and for those who already get a cold can manage the sickness at home by resting in bed and eating and drinking hot food and drinks(Hardy, 1999). Helmans work tried to explain treatment in a lay-man’s language instead of scientific ways that are complicated to understand especially for ordinary people (Helman, 1978). Although sickness at times is beyond our control, the best way of preventing sickness and promoting health is by people to take responsibility of their own health. Hardy, A. (1999). Edwin Chadwick Revisited Christopher Hamlin, Public health and social justice in the age of Chadwick: Britain, 1800–1854, Cambridge History of Medicine series, Cambridge University Press, 1998. Medical History, 43(2),

Reducing Video games with Children Essay Example | Topics and Well Written Essays - 750 words

Reducing Video games with Children - Essay Example The repetition and consistency of the violent games, such as Death Race, Mortal Combat and Doom, that include reward system is effective tool of learning how to behave. No wonder, children who enjoy playing violent games are said to be able to commit violent crimes in future, thus, increasing the number of violent people in society. Excessive playing of video games isolates children from normal social life, as well as does not leave any time for doing homework or sporting. Video games are believed to give children wrong values, such as violent behavior, vengeance and unmotivated aggression, since these are rewarded (Gardner, 2012). Video games seem not to entertain good values such as negotiation, nonviolent solutions and portrayal of women as weaker and sexually provocative beings. Children playing video games are not able to differentiate between realism and fantasy. Playing video games may also affect academic performance of a child because most of the time is taken on video games . Students may even skip their homework to play games as well as taking lots of time arguing with their tutors and their friends. Video games played online are said to make children imitate terrible languages and behaviors in real life, which does not make communication any easier. Playing video games further damages long time concentration of children and may have bad effects on kid’s health. ... Counter-argument However, there are some positive effects of video games that should also be addressed. Video games assist in exercising the brain of the kids due to the skills and tactics required to win the games. These skills and tactics require high level thinking which is not taught in schools. The mental skills acquired while playing video games include problem solving skills, eye coordination and fine motor and spatial skills. Other skills acquired are accuracy, quick thinking, and situational awareness, development of reading skills, perseverance, pattern recognition and inductive reasoning. Playing video games may create bonding between the parent and the kid especially games that are attractive to kids and adults. This may make a parent learn new and hidden things about a child. Kids enjoy learning through video games because of the interactivity and animations used, thus, motivating the kid to keep on practicing. Video games aid children in developing creativity skills. Pl aying video games improve the decision making process in children. These games help people in making choices. These games are also believed to enhance self confidence and self esteem since the levels of games are adjustable starting from the easy one to the most challenging ones. Video games played by several players help kids to work cooperatively by listening to other people’s ideas. Moreover, playing video games is much better compared to other immoral behaviors such as doing drugs and drinking alcohol (Nauert, 2013). Response to Counter-arguments: Due to the advantages obtained from playing video games, a kid should be closely monitored on the kind of

Are attitudes, policies and procedures for dealing with female Essay

Are attitudes, policies and procedures for dealing with female offenders difficult to justify when compared with their male counterparts - Essay Example In line with this, this research will answer the question ‘Are the attitudes, policies and procedures for dealing with female offenders difficult to justify when compared with their male counter parts?’ the methodology employed in order to address this question is documentary research. The study, utilising the documentary research methodology, relied on using secondary data collected from various scholarly literatures written about female offenders, UK Case Laws, crimes, and legislation. In the documentary analysis undertaken, the answer to the primary question is NO. It is not difficult to justify. This answer to the question is supported by the following suppositions: 1. Justice is impartial. The gender and sex of the offender is immaterial in the resolution of the case 2. There is a need to redefine the court system in such a way that it will accommodate female offenders and workers in the justice system 3. There is a need for restructuring of the justice system. 4. Reformation in the justice system 5. Training among the workers on treatment of female offenders. The notion of women committing crimes have been considered as a deviancy from the cultural image and gendered expectations that society has of women.1 Being such, traditional theories pertinent to female delinquency and female offending have been focused on how women are biological destined in committing crimes or by explaining it away via citing pathological explanations that confound the criminal act. Recognizing the importance of these views as necessary in understanding the criminal behaviour of women, does not preclude the fact that women ‘do’ commit crimes and that there are factors and explanations behind their criminal acts and not simply because of their gender or sexuality.2 Although Table 1 shows that compared with men, women commit less crimes but it does not show the fact that there is an increase in the number

Chemistry and Anatomy Essay Example for Free

Chemistry and Anatomy Essay My life began as a simple and talented student in Geneva. My father was Alphonse Frankenstein, who was a wealthy, rich and benevolent man. I was the first son of my father, Alphonse Frankenstein. My mother Caroline visited a beautiful orphan girl, Elizabeth Lavenza, fair-haired girl. She was adopted by my family and was my cousin. I had two brothers who were very lovely and they loved me and Elizabeth a lot. My best friend was Henry Clerval, who was a considerate man. I became a student of Chemistry and Anatomy in the quest to determine what gives life. I was a young man who led a happy and peaceful life, but the events happened after, made a great change to my living. The world according to me was a secret of research, creation and experimenting. I learnt the theories of electricity and galvanization. I also initiated a theory of how to create human life using the principles of electricity. I became devoted to the human creation and the spark of life that I had abandoned earlier. I asked my University for specimens to make my creation. I figured out what gives life.  Ã¢â‚¬Å"I have begged my University for specimens. They say I’ve had all their best material for years, and produced nothing to show for it.† I feel that I have begged my University for some specimens to make my creation, but they refused to afford me the specimens because they say that they have given all the best pieces of specimens to me for creating nothing. Finally, I got the body parts from the graveyard. Then I went out without my meals to buy some chemicals. I took the body parts from the corpses. I stored my chemicals and specimens in the dissecting room so that it would be safe. I constructed a giant man, 8 feet tall, with super human strength and endurance from harvested body parts that I took from the corpses. I worked secretly without rest for almost a year. I can tell you that I was a bit disappointed with my creation. My perfect creation was a frightening disaster. My creation was a result of horror.  Ã¢â‚¬Å"No, this isn’t what I wanted. Oh, dear god, what have I done?†Ã‚  I was not at all happy with my monstrous creation. So, I rejected, abandoned and left him away. I was also scared, frightened and afraid of him. I also avoided my scientific studies because it remained me about the disastrous experiment. I wanted him to help and like mankind. This was not what I expected. I wanted my creation to be helpful rather than being a nuisance. My excitement soon changed when my creature came into life. My lovely, little brother William was murdered by my creation, the monster. Elizabeth cried a lot and I was not able to convince her. She also told me that my five- year-old brother, William and she went for a walk. She also told me that she saw William disappear. She was searching for him all over. I examined what had happened and found out that it was the monster, who was responsible for the murder of my brother. I was very angry with the behaviour of my creation. I created him to help human life and not to destroy them. He came to my room. I was very angry at him and wanted to destroy him. He told me to control my temper and he asked me to listen to him. He told me that the only person to be kind to him was Agathe, a young blind lady. The other villagers chased him away through their dogs. He also told me that his intention towards William was not to kill him. Then he explained to me about what had happened. He told me, â€Å"I put my hands to his mouth to silence him, because I was afraid.†Ã‚  The monster asked William to play with him for a while. But William shouted and refused to play with him. So, he just kept his hands in William’s mouth to silence him and request him to play with him. He also convinced me by telling the truth, but I am very sad that my brother is being murdered by my creation.  I was asked by the monster to make a bride to the monster. I agreed to him because as a creator, I should have to fulfill the wishes of my creation. He said to me that,  Ã¢â‚¬Å"I am alone and miserable; man will not associate with me; but one as deformed and horrible as myself would not deny herself to me. My companion must be of the same species and have the same defects. This being you must create.† He conveyed me his feelings of how it was to be alone without a companion or a comrade. He also gave me two years time to make a complete creation. He also told me that he would not trouble me in the time in between. I repulsed myself to make a bride for the monster. I wanted to finish the bride before marrying Elizabeth. I was also worried that the monster may harm my family. I still found it difficult to make the second monster. I made it because he told me that he wanted to love. I also made it, but this creation was spoilt by the monster, himself. The thing where he went wrong was, giving wrong wire connections to the creation and made it destroy. I explained to him that,  Ã¢â‚¬Å"She’ll never live now! Monster, what have you done?†Ã‚  He thought that he knew to make his own creation. He acted over- smart by giving the wrong wire connections and destroying his bride by himself. I beautifully laid out the bride in white colour clothes, to symbolize that she was going to get married. There is no use for him to commit the murders of Elizabeth and Clerval, by knowing that was his fault. I was really angry when he killed my brother, William. Then, he explained to me about what had happened. He told me that,  Ã¢â‚¬Å"I put my hands to his mouth to silence him, because I was afraid.†Ã‚  It was my fault to create him and abandon him. Since I have created him I lost my Elizabeth, Clerval and my dear brother William. I got the feelings of how it was to face death. If I think of him, my first thoughts were, why did I create him? I found it like a battle of â€Å"Evil vs. Good†.

Risk Factors For Neutropenic Fever Health And Social Care Essay

Risk Factors For Neutropenic Fever Health And Social Care Essay Cancer patients, who receive cytotoxic antineoplastic therapy sufficient to harmfully affect myelopoiesis and the developmental integrity of the gastrointestinal mucosa, are at high risk for invasive infection due to the translocation of colonizing bacteria and/or fungi across intestinal mucosal surfaces. Since the level of the neutrophil-mediated component of the inflammatory response are typically attenuated in neutropenic patients 1, physical findings of exudate, fluctuation, ulceration or fissure, local heat, swelling, and regional adenopathy are all less prevalent in the neutropenic patient1. Thus, fever might be the earliest and only sign of a severe underlying infection 2. With the increasing use of myelo-suppressive agents in the treatment of neoplastic and nonneoplastic diseases, the increased rate of infection in patients with neutropenia has been clearly established 3. Sadly, many of these commonly fatal infections go unrecognized until autopsy 4. Therefore, in order to avoid unfortunate outcomes such as sepsis and possibily death, it is critical to recognize neutropenic fever early and to start empiric systemic antibacterial therapy promptly. It is also crucial to assess the risk of serious complications in patients with febrile neutropenia, since this assessment will dictate the approach to therapy, including the need for inpatient admission, IV antibiotics, and prolonged hospitalization 2. An overview of the concepts related to neutropenic fever, including definitions of fever and neutropenia and categories of risk are reviewed here. The risk assessment and the diagnostic approach to patients presenting with febrile neutropenia are also discussed. This topic also provides a general approach to the management of neutropenic fever syndromes in cancer patients at high and low risk for complications, and the prophylaxis of infections in such patients. DEFINITIONS Fever: The definition of fever as an indicator of infection in patients with neutropenia has varied. Carl Wunderlich proposed in 1868, that the mean normal body temperature was 37 ¿Ã‚ ½C (98.6 ¿Ã‚ ½F) with an upper limit of normal of 38 ¿Ã‚ ½C (100.4 ¿Ã‚ ½F), above this limit, fever was defined 5,6. Although it has been observed that there is a range of normal body temperatures, according to a survey of 270 medical professionals, 75 percent of subjects reported that normal body temperature is 37 ¿Ã‚ ½C (98.6 ¿Ã‚ ½F)5,7. While, a survey of members of the British Society for Hematology concerning their institutional definitions of fever identified ten definitions of fever, ranging from a single temperature >37.5 ¿Ã‚ ½C to either a single temperature >39 ¿Ã‚ ½C or two successive temperatures >38.4 ¿Ã‚ ½C 5,6. Despite these beliefs, the mean oral temperature was reported as 36.8 ¿Ã‚ ½0.4 ¿Ã‚ ½C (98.2 ¿Ã‚ ½0.7 ¿Ã‚ ½F) with a range of 35.6 ¿Ã‚ ½C (96.0 ¿Ã‚ ½F) to 38.2 ¿Ã‚ ½C (100.8 ¿Ã‚ ½F), after observation of 148 healthy adults ages between 18 and 40 years 6. The definition of fever in neutropenic patients, according to The Infectious Diseases Society of America, was proposed as a single oral temperature of >38.3 ¿Ã‚ ½C (101 ¿Ã‚ ½F) or a temperature of >38.0 ¿Ã‚ ½C (100.4 ¿Ã‚ ½F) sustained for >1 hour2. Similar definitions have been provided from South America, Europe, and Asia. It has been approved to use this definition of fever in neutropenic patients9 ¿Ã‚ ½11. Neutropenia: The definition of neutropenia differs from institution to institution, but it is usually defined as an absolute neutrophil count (ANC) The absolute neutrophil count (ANC) is defined as the product of the white blood cell count (WBC) and the percentage of polymorphonuclear cells (PMNs) and bands: ANC = WBC (cells/microL) x percent (PMNs + bands)  ¿Ã‚ ½ 100 Based upon the level of ANC, neutropenia is categorized as mild, moderate or severe. An absolute neutrophil count between 1000 and 1500/microL corresponds to mild neutropenia. While, an ANC between 500 and 1000/microL corresponds to moderate neutropenia. Severe neutropenia is usually defined as an ANC As the neutrophil count drops below 500 cells/microL, the risk of clinically serious infection increases and is higher in those with a prolonged duration of neutropenia (>7 days). However, the risk is also related to the adequacy of the marrow reserve pool of granulocytes. Two terms, leukopenia and granulocytopenia are often used interchangeably with neutropenia, although they are somewhat different:  ¿Ã‚ ½ Leukopenia is defined as a low total white blood cell count that may be due to any cause such as lymphopenia and/or neutropenia; yet, almost all leukopenic patients are neutropenic since the amount of neutrophils is so much higher than the amount of lymphocytes.  ¿Ã‚ ½ Granulocytopenia is defined as a reduced absolute number of all circulating cells of the granulocyte series (neutrophils, eosinophils, and basophils); yet, almost all granulocytopenic patients are neutropenic since the amount of neutrophils is so much higher than the amount of eosinophils and basophils.  ¿Ã‚ ½ Agranulocytosis is defined as the absence of granulocytes, but the term is often inaccurately used to denote severe neutropenia. CATEGORIES OF RISK RISK FACTORS FOR NEUTROPENIC FEVER The risk factors for the development of neutropenic fever can be divided into three sub-categories including patient-related, disease-related and anti-cancer treatment-related predictors. Patient-related predictors include: age = 65 years, female sex, high body surface area, poor performance status based upon preexisting active comorbidities (e.g., cardiovascular, pulmonary, renal, endocrine, etc.) and poor nutritional status12 ¿Ã‚ ½19. Disease-related predictors include: Elevated lactate dehydrogenase (LDH) in patients with lymphoreticular diseases, bone marrow failure due to replacement of hematopoietic tissue by anomalous tissue which is know as myelophthisis19, lymphopenia20,21 and advanced stage of the underlying malignancy 13,16,20 ¿Ã‚ ½22 Treatment-related predictors include: administration of the planned dose-intensity of high-dose chemotherapy regimens15,20 ¿Ã‚ ½23 and failure to administer prophylactic hematopoietic growth factor support to patients receiving high-risk regimens14,21. RISK OF SERIOUS COMPLICATIONS This risk assessment is essential to determine the management of patients, including the need for inpatient admission, IV antibiotics, and prolonged hospitalization. High-risk patients require hospital admission for IV antibiotics, and often a prolonged length of stay. In contrast, low-risk patients may be treated as outpatients with oral antibiotic after a short period of observation or hospitalization. Definitions of low-risk and high-risk patients: The Infectious Diseases Society of America (IDSA) and National Comprehensive Cancer Network (NCCN) use different definitions in their guidelines:  ¿Ã‚ ½ Low-risk patients are those who are expected to have neutropenia (absolute neutrophil count [ANC]  ¿Ã‚ ½ High-risk patients are those expected to have neutropenia (ANC 7 days. While, neutropenic febrile patients with comorbidities or evidence of significant hepatic or renal impairment are considered high risk, regardless of the duration of neutropenia. Some experts have identified patients at high risk as those who are expected to have profound neutropenia (ANC = 100 cells / microliter) for > 7 days on the basis of experience that these patients are more likely to have serious and potentially fatal complications2,24. Nevertheless, formal studies to clearly differentiate between patients with a neutrophil count Some studies combine these groups to define high-risk patients. Deep prolonged neutropenia (ANC = 100 cells / microL expected to last > 7 days) is more likely to occur in the pre-transplant hematopoietic cell transplantation (allogeneic in particular) and in patients undergoing induction chemotherapy for acute leukemia. Risk based on underlying disease Patients who suffer from neutropenia after induction chemotherapy for acute myelogenous leukemia or as part of the conditioning regimen for allogeneic hematopoietic stem cell transplantation (HCT) are at a high-risk for serious infections. Other factors that are considered as high-risk status include gastrointestinal and oral mucositis, uncontrolled cancer, chronic obstructive pulmonary disease, advanced age and poor functional status. Patients receiving consolidation chemotherapy for leukemia or undergoing autologous HCT may also have long periods of neutropenia, but seem to be at somewhat lower risk, especially if they received prophylactic hematopoietic growth factors. In contrast, patients with solid tumors are mostly at low risk for serious infections. Guidelines An assessment of risk (high versus low-risk) for medical complications related to neutropenic fever should be obtained at the initial assessment of neutropenic fever episode. The Infectious Diseases Society of America (IDSA), the European Society for Medical Oncology (ESMO), the National Comprehensive Cancer Network (NCCN) as well as the American Society of Clinical Oncology (ASCO)2,24,25 , has recommended this. The IDSA and ASCO defined high-risk neutropenic patients as those who are expected to have profound neutropenia (ANC = 100 cells / microliter) for > 7 days or those with evidence of current comorbidities or hepatic or renal dysfunction2,24 . The National Comprehensive Cancer Network (NCCN) has used similar criteria for definition, but also includes a category of intermediate risk [21]. Multinational Association of Supportive Care in Cancer (MASCC) risk index that can be used as an alternative to clinical criteria, is a validated tool to assess the risk of medical complications associated with neutropenic fever (calculator 2)26 ¿Ã‚ ½29 . IDSA Risk assessment: The Infectious Diseases Society of America (IDSA) has established the following criteria for the definition of high risk or low risk patients with neutropenic fever 2: High-risk febrile neutropenic patients are defined as having one or more of the following criteria: ? Profound neutropenia (ANC = 100 cells / microliter) expected to last for > 7 days. ? Proof of current comorbidities, such as (but not limited to): ? Hemodynamic instability ? Oral mucositis limiting swallowing or gastrointestinal tract mucositis causing severe diarrhea ? Gastrointestinal symptoms such as abdominal pain, nausea and vomiting or diarrhea ? Changes in neurological status or mental appearance of new onset ? Intravascular catheter infection ? New pulmonary infiltrates or hypoxia ? Underlying chronic lung disease ? Signs of hepatic insufficiency (serum transaminase> 5 times normal) or renal insufficiency (creatinine clearance Low-risk febrile neutropenic patients are expected to have a relatively short duration of neutropenia for 7 days or less, with an absolute neutrophil count (ANC) Patients with evidence of severe sepsis (sepsis syndrome in end organ dysfunction) should be considered at high risk and managed as in-patients with initial intravenous antibacterial empirical treatment. While, patients with signs of septic shock should be managed in an intensive care unit based upon goal-oriented therapy30 . NCCN risk assessment The National Comprehensive Cancer Network (NCCN) has developed certain criteria to classify patients as high risk or low risk, which must be performed during the initial evaluation [21]. High-risk febrile neutropenic patients are those having one or more of the following criteria: [21] ? The patients are hospitalized at the time of the development of fever ? Evidence of significant medical comorbidity or the presence of clinical instability ? Expected profound prolonged neutropenia (ANC = 100 cells / microliter expected to last> 7 days) ? Hepatic insufficiency (serum transaminase> 5 times normal) or renal insufficiency (creatinine clearance ? Any patient with leukemia not in complete remission, or any non-leukemic patient with signs of disease progression after more than two courses of chemotherapy. ? Any complex infection such as pneumonia at clinical presentation ? Alemtuzumab (antineoplastic agent) in the last two months ? Grade 3 or 4 mucositis ? MASCC risk index score Low-risk febrile neutropenic patients are those who do not meet any of the criteria for high-risk described above and meet most of the criteria as follows [21]: ? Ambulatory status at the time of the development of fever ? No acute comorbid illness requiring hospitalization and close monitoring ? Expected short duration of severe neutropenia (ANC = 100 cells / microliter should last for 7 days or less) ? Good performance status (Eastern Cooperative Oncology Group [ECOG] 0-1 (Table 2)) ? No hepatic or renal insufficiency ? MASCC risk index score of = 21 risk index Intermediate risk neutropenic patients are defined as those meeting one or more of following criteria: [21] ? Patients undergoing autologous HCT ? Lymphoma ? Chronic lymphocytic leukemia ? Multiple Myeloma ? Patients receiving purine analogue therapy ? The expected duration of neutropenia is 7 to 10 days For patients at intermediate risk, the NCCN recommends consideration of fluoroquinolone prophylaxis. Multinational Association of Supportive Care in Cancer (MASCC) score As an alternative to the IDSA and NCCN risk assessments described above, the MASCC risk index is validated for assessing the risk of medical complications associated with febrile neutropenia. Using the MASCC risk index, the following features are assessed and given a weighted score2,26 : ? Burden of disease (clinical condition of the patient at the time of presentation with neutropenic fever): ? No symptoms or mild symptoms (5 points) ? Moderate symptoms (3 points) ? Severe symptoms or dying (0 point) ? No hypotension (systolic blood pressure> 90 mmHg) (5 points) ? No chronic obstructive pulmonary disease COPD (4 points) ? Solid tumor or hematologic malignancy without prior history of fungal infections (4 points) ? No dehydration that requires parenteral fluids (3 points) ? Ambulatory status at the time of the onset of neutropenic fever syndrome (3 points) ? Age The highest possible score is 26. Patients with a score = 21 are considered to be at low risk of serious medical complications, and for whom outpatient treatment with oral empirical antimicrobial can be safe and effective29 . While, patients with a score The MASCC risk index has classified 98% of patients as low-risk and 86% as high risk with a sensitivity and specificity of 95%, and positive and negative predictive value of 98, and 86 percent, respectively 28. Patients with complicated infections have been reclassified as high risk for serious medical complications, which further increased the predictive value of the model. Complicated infections include non-necrotizing skin or soft tissue infection (SSTI) of >5 cm diameter, necrotizing SSTI of any size, grade 2 oral mucositis, sepsis syndrome or the presence of a visceral site of infection. [28]. The classification error rate has been 10 to 29 percent. [4] In addition, the MASCC risk index can predict the probability of death as follows:27 ? Score = 15: 29 % ? Score = 15 but ? Score = 21: 2 % The MASCC risk index has been criticized for the lack of a standard definition of this criterion the burden of febrile neutropenia, which could be a source of confusion2, or it could be interpreted differently by different clinicians. I addition, the MASCC risk index does not include the duration of neutropenia as a criterion, though it is considered as an important predictor of risk2. The MASCC risk index has been also criticized because it was developed using heterogeneous patient populations; thus, it might not function optimally in all populations. For example, in a retrospective study of patients with solid tumors who seemed to be clinically stable, the MASCC risk index had a low sensitivity to detect complications (36 percent)31. The low sensitivity was likely to be attributed to the fact that patients were all outpatients, and the rates of hypotension, dehydration and invasive fungal infections were low; hence, only three criteria were present to distinguish prognosis. The serious medical complications are provided by the MASCC risk index as follows 26: ? Hypotension defined as systolic blood pressure ? Respiratory failure defined as arterial oxygen pressure ? The admission to ICU ? Disseminated intravascular coagulation ? Presence of confusion, delirium, or altered mental status ? The development of congestive heart failure documented by chest imaging and requiring treatment ? Bleeding diathesis sufficient to require a blood transfusion ? Electrocardiogram changes or arrhythmias requiring treatment ? Renal failure sufficient to require an investigation and / or treatment with IV fluids, dialysis, or other intervention ? Other complications judged serious and clinically significant by the health care team All patients who were treated with systemic antineoplastic therapy six weeks prior to a systemic inflammatory response syndrome (SIRS) are assumed to have neutropenic sepsis syndrome until proven otherwise. SIRS is defined by the presence of two or more of the following conditions: temperature >38 ¿Ã‚ ½C or 90/minute, respiratory frequency > 20/minute, PaCO2 Patients presenting with altered mental status, hypotension, hypoxia, oliguria or any other sign of new organ impairment must be managed emergently for severe sepsis. RISK OF TREATMENT FAILURE The risk of failure to respond to initial empirical antibacterial therapy is a composite outcome to be considered clinicians. Treatment failure is proposed if one or more of the following events occur within 30 days after the start of treatment 33,34: ? Persistence, progression or recurrence of signs of infection ? Modification of the initial empirical antibacterial treatment ? Readmission to the hospital for outpatients ? Death Patients with documented clinical or microbiological infections are more likely to be at risk for treatment failure, clinical or microbiological than for unexplained neutropenic fever (39 against 18 percent33. High-risk patients are more likely to be at risk for treatment failure than those with low risk. For example, patients with hematologic malignancies have a higher percentage of treatment failure than those with solid tumors (44 against 18 percent) 33. Observations have shown that among all febrile neutropenic patients at low risk of medical complications, adult patients at higher risk for treatment failure than children with 16% against 5% respectively34. PREVENTION In order to prevent neutropenic fever and infectious complications in patients at increased risk, the administration of an antimicrobial drug should be used as a prophylaxis. Antibacterial prophylaxis Pseudomonas aeruginosa and other gram-negative bacilli is the target of the antibacterial prophylaxis, because these pathogens are virulent and may cause life-threatening infections. INDICATIONS The beneficial effect on clinical outcomes has been sought from the administration of prophylactic antibacterial agents. The fluoroquinolones, levofloxacin (500 mg orally once daily) and ciprofloxacin (500 mg orally twice daily) have been the most studied antibacterial agents. Levofloxacin in particular is preferred in patients at increased risk for oral mucositis-related Streptococcus viridans infection 2. Results have been mixed with respect to effectiveness and have incited concern about toxicities and antibacterial resistance35 ¿Ã‚ ½37. A systematic monitoring of the prevalence of fluoroquinolone resistance among gram-negative bacilli should be done, at the intitutions that use fluoroquinolone prophylaxis. Based upon the available data, high-risk neutropenic patients defined by those who are expected to have an absolute neutrophil count Fluoroquinolone should be used with caution in patients at risk of a prolonged QT interval particularly in those who may require other QT prolonging agents, such as voriconazole. In addition, the potential to promote resistance among gram-negative and gram-positive should be considered when deciding whether to give a fluoroquinolone prophylaxis or not37. Concerns about the possibility of increasing the risk of Clostridium difficile infection has also been present, though this has not been proven in neutropenic patients receiving fluoroquinolone prophylaxis37. The use of prophylactic agents in institutions and geographic areas where the levels of resistance to fluoroquinolones are high is less likely to be efficient36,38.The use of antibacterial prophylaxis varies from one center to another with some centers avoiding such practices. For most patients with chemotherapy-induced neutropenia expected to be of short duration particularly patients with solid tumors, the use of antibacterial prophylaxis is not recommended. TIMING The ideal timing for the initiation and cessation antibacterial prophylaxis has not been sufficiently studied2. Many clinicians begin anti-bacterial prophylaxis, the first day of chemotherapy or the day after the administration of the last dose of chemotherapy cycle. Antibacterial prophylaxis is usually withheld when neutropenia resolves, or when empirical antibacterial regimen is initiated for patients who become febrile during neutropenia. Antifungal prophylaxis Among cancer patients and HCT recipients, a high rate of life-threatening invasive fungal infections such as candidemia has been observed since the late 1980s, which incited interest in antifungal prophylaxis for patients receiving chemotherapy. Antiviral prophylaxis INFLUENZA Annual immunization with an inactivated influenza vaccine is recommended for all cancer patients undergoing treatment2. The influenza vaccine is generally administered >2 weeks before the initiation of chemotherapy or, when circumstances dictate, between chemotherapy cycles and at least seven days after the last cycle. However, the best timing for such immunization has not been established2. All family members and other close contacts should get annual immunization too. HSV and VZV Reactivation of herpes simplex virus (HSV-1 and HSV-2) and varicella-zoster virus (VZV) occur commonly in HCT recipients who are not receiving prophylaxis and are important causes of morbidity. However, reactivation of both HSV and VZV infections can be effectively prevented with antiviral prophylaxis. Antiviral prophylaxis with acyclovir (400 mg orally three to four times daily or 800 mg orally twice daily) or valacyclovir (500 mg orally once or twice daily) is recommended in all patients who are seropositive for HSV and who are undergoing allogeneic HCT or induction chemotherapy for acute leukemia39. Antiviral prophylaxis with acyclovir or valacyclovir is also recommended in all HCT recipients who are seropositive for VZV. Based upon randomized trials, benefits of antiviral prophylaxis in these populations have been demonstrated; thus, recommended41. CMV CMV prophylaxis is indicated for HCT recipients because they are at are at significant risk for reactivation. In contrast, prophylaxis is not indicated in patients with chemotherapy-induced neutropenia, because it does not occur commonly. HEPATITIS B Antiviral prophylaxis should be considered for the following categories of patients and should be sustained for at least six months after the completion of chemotherapy40 : ? Patients receiving chemotherapy who have a previous history of hepatitis B virus infection, due to the risk of reactivation and hepatic failure. ? Patients with elevated circulating hepatitis B DNA or detectable levels of circulating hepatitis B surface antigen (HBsAg) ? Patients with a previous history of infection with detectable levels of antibody to HBsAg or to hepatitis B core antigen. This has been demonstrated to be able to reduce the risk of reactivation from 24 to 53 percent to 0 to 5 percent. Colony stimulating factors Granulocyte colony stimulating factors (CSFs) have been widely evaluated for prophylactic use following the administration of intensive cytotoxic chemotherapy when neutropenia is expected (primary prophylaxis). CSFs have been also evaluated for their prophylactic use during retreatment after a previous cycle of chemotherapy that caused neutropenic fever (secondary prophylaxis), and have been shown to minimize the extent and duration of severe chemotherapy-induced neutropenia in afebrile patients (afebrile neutropenia). Their use is not recommended in febrile chemotherapy-induced neutropenia2. However, prophylactic use of granulocyte CSFs has not been shown to have an effect on survival in most clinical situations. PRIMARY PROPHYLAXIS Primary prophylaxis denotes the use of granulocyte CSFs during the first cycle of myelosuppressive chemotherapy in order to prevent neutropenic complications. The goal of primary prophylaxis is to decrease the incidence of neutropenic fever and the need for hospitalization, to maintain dose-dense or dose-intense chemotherapy strategies that have survival benefits. Updated 2010 guidelines from the European Organization for Research and Treatment of Cancer (EORTC), the Infectious Diseases Society of America (IDSA), consensus-based guidelines from the National Comprehensive Cancer Network (NCCN), and The 2006 guidelines from the American Society of Clinical Oncology (ASCO), all recommend primary prophylaxis when the expected incidence of neutropenic fever is over 20 percent, to reduce the need for hospitalization for antibiotic therapy2,22,41. These recommendations are based upon randomized trials that have shown that primary prophylaxis was cost effective when the risk of neutropenic fever with a specific regimen was over 20 percent42,43 . In contrast, guidelines recommend against the routine use of granulocyte CSFs for primary prophylaxis in adult patients receiving chemotherapy regimens with an anticipated low probability ( However, when the anticipated risk of neutropenic fever is between 10 and 20 percent, the decision of primary prophylaxis should be individualized and may be appropriate in a number of clinical settings in which patients are at risk or increased complications22,41 :  ¿Ã‚ ½ Age >65 years  ¿Ã‚ ½ Preexisting neutropenia  ¿Ã‚ ½ More advanced cancer  ¿Ã‚ ½ Poor performance and/or nutritional status  ¿Ã‚ ½ Renal or hepatic impairment  ¿Ã‚ ½ In the case of epithelial ovarian cancer  ¿Ã‚ ½ Extensive prechemotherapy surgery, particularly if it included a bowel resection. In patients receiving concomitant chemoradiotherapy for either head and neck cancer or lung cancer, the use of granulocyte CSFs has been associated with adverse outcomes, therefore, it better be avoided. Despite the lack of comparative data from randomized controlled trials, that could recommend one CSF over the other for prophylaxis of infection during chemotherapy-induced neutropenia, in practice, most institutions use G-CSF. SECONDARY PROPHYLAXIS Secondary prophylaxis denotes to the use of a granulocyte CSF in subsequent chemotherapy cycles after a prior cycle has caused neutropenic fever. Secondary prophylaxis with CSFs reduces the risk of reccurence of neutropenic fever by approximately one-half 44. ASCO and EORTC guidelines recommend that secondary prophylaxis with granulocyte CSFs be limited to patients for whom primary prophylaxis was not given and who experience a neutropenic complication from a prior cycle of chemotherapy if neutropenic fever would prevent the administration of full dose chemotherapy and if reduced dose intensity might affect treatment outcome22,41 . TIMING G-CSF and GM-CSF therapy is usually initiated 24 to 72 hours after cessation of chemotherapy and is frequently continued until the absolute neutrophil count reaches 5000 to 10,000/microL. A reasonable alternative is continuation until clinically adequate neutrophil recovery. MANAGEMENT Initial Assessment Since, fever might be the first and only sign of infection in a neutropenic patient, its occurrence should be considered a medical emergency. Therefore, empiric broad-spectrum antibacterial therapy should be started immediately after blood cultures have been obtained and before any other investigations have been completed. The Infectious Diseases Working Party of the German Society of Hematology and Oncology and the Northern Ireland Cancer Network has recommended this. It has been recommended that empiric broad-spectrum antibacterial therapy should be administered within 60 minutes of presentation for all patients suffering from neutropenic fever at presentation. (algorithm 1) Diagnostic Approach At presentation, a detailed history and physical examination should be done, as well as a complete laboratory, microbiologic and imaging work-up for all febrile neutropenic patients. The table below summarizes the diagnostic approach to patients with febrile neutropenia.