Job - Specific Orientation Plan (Care Giver) Essay

Job - Specific Orientation Plan (Care Giver) - Essay Example The Plan The first step during the orientation shall involve provision of the employees with a handout; this document shall include all the fundamental knowledge that shall guide the new employees during the orientation. The handout shall cover specifically; basic instructions that the new employee shall be required to acquaint her/him with. Additionally, within the handout there shall be information concerning time schedule of the orientation: That is, time allocated for each activity of the orientation process. Consequently, the handout shall provide the employee with the knowledge on who is responsible for provision of guidance during the orientation. Informative notes on a variety of pertinent topics relating to the job shall be included in the handout in order to facilitate the orientation process. The information contained in the handout shall be arranged I respect to each orientation activity and shall be followed strictly. This will ensure that time is not wasted due to confu sions on which program should be covered. In order to ensure that the employees are equipped with all the necessary knowledge concerning the job, they shall be provided with reference documents. This shall act as the employee handbook. It shall contain information concerning the definition as well as description of the employment status of the new job. Additionally, this document shall contain information concerning the employee’s code of conduct: Service and patient’s concerns, how to handle confidential data, integrity of records and reporting mechanisms. The reference document shall also provide the employee with data related to benefits (workers compensation). Further information shall be provided on the reference document concerning hours of work such as; reporting time and leaving time, absenteeism and specific time to conduct a particular duty. Other information that shall be included in the reference document is: Dress code, punctuality,

Implementation Essay Example for Free

Implementation Essay The article by Pressman and Wildavsky analyses the problems associated with the implementation of EDA plan in Oakland. The Congress established the Economic Development Administration which went to different cities with the mandate of empowering the minority groups by providing them with jobs. The administration chose Oakland as a pilot project to experiment how provision of incentives such as loans and public works could create permanent jobs for the minority groups. Years later, the project proves to gain no fruits with the construction work at stand still and the loans plan dead and thus creating no jobs for the minority population. Following the failure of the plan, the authors try to figure out the main reasons why a plan that had big expectations and the federal government invested a lot of money in did not workout. The article also aims at creating an insight in the implementation of future project based on what happened on the Economic Development Administration plan in Oakland. The authors use the situation at the Oakland Economic Development Administration to relate to other similar policies and project and make several recommendations in the implementation of public policies. The article is therefore useful to public administrators who intend to implement project in the future. Due to the high level of unemployment, the political situation and the possibility of riots in Oakland, the city was the perfect choice for the experiment. During the first stages of implementation, there was a lot of hope in the plan. It was a new project and was funded by the central government and therefore was given priority over other projects in the city. Due to this, very many people were concerned with the progress of the project. Leaders and the political elites were very interested in it and were very committed to decisions touching directly on the project. Moreover, the money available for the implementation of the project was sufficiently enough to reduce the unemployment level in Oakland significantly. However, the pressure in the implementation was so high and decisions had to be made fast (Pressman Wildavsky, 1984). Due to pressure that forced quick decisions, projects were chosen and endorsed hurriedly to create the much needed jobs. The original projects included 10. 65 million dollars being allocated for an airport hangar, 10. 5 million dollars for a marine terminal, 2. 2 million dollars for a port industrial park and 414,000 dollars for an access road. Later, other projects like hangars in small airports, air cargo terminal and airport tower were added to the list. Unfortunately, as the project was being implemented, some problems emerged. One of the major problems was the false characterization of the experiment by the Economic Development Administration. Previously, government agencies had worked in the rural settings and therefore had a mindset on how such policies were to be implemented. Therefore, it became very hard for them to change their approach in the case of Oakland which was an urban center. The excitements of the new project faded very fast while the changes in the leadership and the complicated governance in Oakland delayed the implementation of the program. The problems in contracting and delayed implementation resulted in an increase in the total cost of the project. For example the estimated cost of the airport hangar went up by over five million dollars between 1966 and 1968. The changes in the leadership changed the commitment of leadership in the project. As time went on, the leadership in Washington was less committed or concerned with the progress of the project which was basically due to the change in leadership. The Economic Development Administration was also faced with a dilemma of whether to strive to perform and promise since different companies had received loans but had not kept their promise. Many companies did not follow the agreement after receiving the loans. The program was faced with numerous problems such that the number of jobs created was much less than the anticipated at the launch of the program. After analyzing the implementation of EDA in Oakland, the article makes some recommendations based on the failures of the program. The first recommendation is that, in the implementation of a policy, the implementation and the policy cannot be separated. Policy makers should therefore ensure that implementation is part of the initial policy making process. To reduce delays, the policy makers should formulate means that can be used to accomplish the program and eliminate the possibility of quick decisions in the implementation process. If the process of making decisions is made simple by making the process simpler, the likelihood of delays and possibility of failure is greatly reduced. The creations of proper machinery in the implementation and execution of the policy is also essential in the success of the program (Hill Hupe, 2002). The article then relates the analysis of the Oakland scenario with other situations related to the Economic Development Administration such as providing foreign aids. In this situation, there are needs that must be satisfied combined with the need to spend the funds provided in a hurry. These need and the pressure therein does not provide the correct atmosphere for the implementation of the policy. The article concludes that combining different decisions in the implementation of a policy has some positive as well as negative outcomes. Therefore if a policy is good and the execution of the program is also good, then the possibility of positive outcome is high. Similarly, if a policy is bad and the execution is poor, the outcome is also positive. However, if there is a combination of good and bad, there is always a problem associated in the implementation and there will be negative outcome. Rather than the individuals involved in the policy implementation â€Å"knowing that† they should be â€Å"knowing how† if the implementation has to yield fruits. Having knowledge on the facts and methods of implementing the policy and how to make things happen is equally important (Pressman Wildavsky, 1984). The two authors, Pressman and Wildavsky make keys suggestions on how policies should be developed. Their suggestions are based on careful analysis of the Oakland Economic Development Administration experimentation. Although the details is the Oakland project are very interesting to the reader, the way the two authors apply these details to other similar projects in the country is more interesting. Although the project implementation took place over four decades ago, the analysis is still very relevant in administration of programs today. The most important lesson from the article is that policy makers should consider the implementation of the policy as important as policy itself. The article also acknowledges the role of interest groups in the success of any public policy.

Dissertation Exploring The Impacts Of Recession

Dissertation Exploring The Impacts Of Recession The purpose of this study is to explore the repercussions of recession on the British Stock Market particularly expounding its impact on Alternative Investment Market. The study aims to utilise qualitative approach to examine and constitute the relative repercussions of recession upon AIM. For this, an exhaustive literature review of the London Stock Exchange is essential to gain indicative factors relevant to account for the associated risks of recession to AIM. According to research on UK firms, uncertainty shocks typically reduce the responsiveness of firms by more than half, leaving monetary and fiscal policy-makers relatively powerless (Bloom et al, 2007). 1.1 LONDON STOCK EXCHANGE LSE is amongst the oldest stock exchanges in Europe and also the most promising out of the 22 active stock exchanges functioning in Great Britain. It was established in 1801 and has emerged as the largest stock exchanges of the world comprising of number of overseas as well as British companies (London Stock Exchange, 2005). The positioning of London city is beneficial as it let the London Stock Exchange to function during American and Asian sessions. Being a public company its shares are traded on stock exchanges and is considered to be the most international trading floor and about 50% of international transactions with shares are concluded on LSE (London Stock Exchange, 2005). The London Stock Exchange has four main quarters that include equity markets which facilitates companies from across the globe to raise capital (London Stock Exchange, 2005). There are the four primary markets that include: The Main Market, Alternative Investment Market (AIM), Professional Securities Market (PSM) and Specialist Fund Market (SFM). London Stock Exchange is a highly active market that provides range of trading services including trading in a range of securities as for example, UK and international equities, debt, covered warrants, exchange traded funds (ETFs), Exchange Traded Commodities (ETCs), REITs, fixed interest, contracts for difference (CFDs) and depositary receipts (London Stock Exchange, 2005). It provides market data information with clarity offering real-time prices, news and other financial information to the global financial community. EDX London, established in 2003serves as a major contributor to derivatives business in order to bring the cash equity and derivatives markets closer together the London Stock Exchange. 1.2 AIM: AN OVERVIEW London Stock Exchange reviewed the unlisted securities market in1993 during the middle of a recession and decided to close it. Quoted Companies Alliance now referred as CISCO was then born and which lead to the establishment of Alternative Investment Market in June 1995 by London Stock Exchange. With its noticeable endurance for several years; AIM has been a considerable success. Rapid growth has been observed in AIM market, commencing its operation in 1995, it has rose over  £24 billion and listed over 2,200 companies, including 276 foreign companies by January 2006 listing1,408 companies from 33 industrial sectors out of which 220 were from overseas countries. Instead of offering shares to the public AIMs 90% of flotations depends on placing the shares with institutions, venture capital trusts and private investors reinforced by European 191 Prospectus Directive (Thronton, 2009). In order to reduce the pool of capital available to buy new AIM shares, the European 191 Prospectus D irective requires that, a full prospectus must be issued in both conditions where; the company offers shares to more than 100 persons, other than qualified investors or if a private client broker proffer such shares to more than 100 of their clients (Thronton, 2009).. Based in the city of London, AIM benefits from competitive supply of leading financial services and decently offers direct access to outsized and sophisticated shareholders. AIM has the potential to provide with all the significant financial services as required by the firm for listing, floating, reporting, auditing, broking, public relations, security analysis, printing, legalities, registering shareholders, etc. Rising higher from a percentage of 35.2% in September 2003, the institutional investors owned 40.9% by value of the shares listed on AIM in September 2005(Growth Company Investor, 2005), that consequently accounts for a very substantial institutional contribution of AIM, in small-capitalization market. 1.2.1 MARKET SIZE The multitude of companies traded on AIM come from different parts of the world and signify huge number of industries. At present there are approximately 1500 companies from more than 26 countries that are quoted on the AIM (London Stock Exchange, 2005). There is one common trait shared by all traded companies on AIM and i.e. a dynamic corporate attitude and a strong ambition for business expansion. AIM welcomes companies of varying sizes to become part of even though it was primarily designed for smaller firms, but companies of varying sizes if possessing a desire for growth and profitability, are equally encouraged to join the Alternative Investment Market. 1.2.2 OPERATIONS The operations of AIM are controlled by the London Stock Exchange, having a tendency to work ideal for companies with a capitalization and valuation from $20 million to $300 million. The costs for filings and entry are approximately $600,000, with ongoing annual costs of around $100,000. The range of capital-raising activities tends to be in between $4 million to $40 million with approximately 9 percent average cost of capital. The percentage of retail investment is higher than on the official list and the investors are largely institutional. 1.2.3 KEY STATISTICS Table: 01 AIM 1,635 UK 1,331 International 304 AIM Market Capitalisation  £94.4 Billion AIM IPOs in 2006 278 UK 201 International 77 Capital raised since 1995*  £40.1 Billion Capital raised in 2006*  £15.7 Billion UK  £10.3 Billion International  £5.4 Billion * New listings and further capital raises 1.2.4 DIVERSITY AND INTERNATIONAL DIMENSION AIM has a diverse market spanning (Figure, 02) in approximately 39 sectors having a number of international companies and investors. The AIM is comprised of key sectors in which there is resource sector that include mining and oil gas, financial sector includes real estate, equity investment instruments and general financial. The industrial sector of AIM is comprise of construction materials, electronic electrical equipment and support services whereas, the consumer services includes media and travel leisure. Apart from US the growth in international companies on AIM is also being driven through Canada, China, India and mainland Europe. 1.2.5 MARKET CAPITALISATION According to LSE statistics the international companies listed as UK Top Co are counted as domestic. The US investors 330 international companies are listed with a value of  £36.6bn equivalent to $73.5bn and over 70 US companies listed on AIM has a value of  £2.9bn that is equivalent to $5.8bn (London Stock Exchange, 2005). It is interesting to note that the international companies on AIM are larger than UK companies, with an average market capitalisation at 31 December 2007 of  £99.2 million compared with  £46.9 million for UK registered companies. The market capitalisation on Alternative Investment Market is expressed in the Figure, 03. It is important to signify that AIM is not subject to more extensive regulation and therefore, it offers a wider pool of investors, and this may result in some decline in the cost of capital (Errunza and Miller, 2000). CHAPTER II LITERATURE REVIEW 2.1 INTRODUCTION Establishing itself as the worlds most successful growth market after being launched by the London Stock Exchange (LSE) in 1995, AIM provides opportunity to raise capital and a liquid market place to trade shares for small and medium sized growing companies. Over 3000 small growth companies have listed on AIM and these companies have raised a total of over  £60 billion, since the commencement of AIM. Global recession has caused complicated market conditions however; there are still some signs of recovery, such as the first major IPO of the year and on the other hand improvement can be observed in trading volumes and average; meanwhile, an improvement in fund raising conditions towards the end of 2009 and through 2010 is also predicted by the brokers and other market commentators (Thronton, 2009). In order to conserve its position in the market AIM has to become accustomed with current market conditions, while not losing sight of its roots and emerge as a market focused on providing growing companies with direct access to capital (Thronton, 2009). The main objective of the literature review is to summarise the existing research work to gain insights on the subject area and also to assess and explain the impacts of recession. The core element of the research is to conduct an empirical study of the relative volatility, analysis of market size, allowance and liquidity ratios of AIM and determining its rate of progression during economic commotion. 2.2 AIM- FACTS AND FIGURES The AIMs trading began on 19 June 1995 and there were only 10 companies listed on the first day of trading. Since the opening of the Third Market in 1987, AIM was Londons first new market and it is split into two indices, the AIM 50 and AIM 100 Index where AIM 50 includes the biggest names on the junior market by attracting fresh, budding and newly expanding firms which were incapable for admittance to the main FTSE lists (London Stock Exchange, 2005). Even after facing criticism for the costs by some experts the market succeeded in making it easier for smaller businesses to raise capital. In accordance with the rules by AIM, the companys costs rose up to 20 times higher in comparison to the earlier system. Notwithstanding the cost of raising capital was approximated to be an average of about  £100,000 for an AIM company, as compared to  £1m for a company on the main market (London Stock Exchange, 2005). There are now 1,276 AIM-listed companies. Liquidity among AIM stocks widely varies and the stocks having highest capitalisation and the largest free float represent comparable liquidity levels to the main market. There are a large number of illiquid stocks on the lower end of the market. AIM provides different trading platforms for different types of stock in order to improve the liquidity of the market but its volatility is not significantly diverse than other markets. 2.2.1 STOCK TRADING Large and frequently traded stocks are listed on AIM and there are small, infrequently traded stocks also listed with it therefore; no single trading mechanism is applicable to AIM stocks. Considering the time from the institution of AIM, it has exhibited very rapid growth in trading volumes (London Stock Exchange, 2005) as represented in Table, 02. The average annual growth rates over the period of a decade starting from1996 to the year 2005 are as follows; the turnover was around 36%; number of trades was 28%; and the number of shares traded were 35% approximately. The average number of shares per trade grew by 5% per year, whereas the average value per trade grew by 6% per year, over this period. The growth of trading on AIM occurred in two phases. There was a substantial drop in stock market prices observed during 2001- 2002 where there was negative volume growth which gradually recovered in the year 2003 followed by rapid growth of trading. 2.2.2 UNDERSIZED REGULATORY LOAD AIM regulations are designed to reduce burden for companies listing on this exchange. The admission process for AIM takes about three months, depending on circumstances (Audley, 2005) and in order to list on AIM; There is no need for trading record and on the spot listing of start-ups and cash shells; Smaller companies can also list as there is no minimum market capitalization; Reduced costs and time for listing as the admission documents are not pre-vetted by AIM or the U.K. Listing Authority; The lack of a minimum free float for preventing firms to sell off a substantial part of the business to list in AIM; Approval from prior shareholder is not required for acquisitions that also reduces the time and cost of acquisitions. There is an obligation to employ a Nomad at all times for each AIM-listed company. The Nomads carry out three main functions; To make a decision that if a company should be admitted to AIM or not; Managing the floatation process; and Advice the company regarding rules, before and after it has been listed. 2.2.3 COSTS FOR LISTINGS The admission fee of AIM is  £4,180 with a listing fee of  £4,180 per year and a value-added tax to these admission and annual fees is applied to UK companies. The total costs of admission to AIM are about  £350,000 to  £450,000 and a brokers fees of 3% 6% of any funds raised (Audley, 2005). Nomads are liable to undertake most of this process followed by any subsequent capital-raising and this keeps admission and listing costs under control. The costs to the firm of listing on AIM include: The initial costs to obtain the listing; Followed by initial floatations costs of any subsequent capital raising; and The annual costs of maintaining the listing. 2.2.4 THE MAIN MARKET London Stock Exchange is one of the worlds leading stock exchanges and AIM offers a great deal of progression to it and vice versa. During a period of January 2000 to December 2004, a total of 160 companies switched between AIM and the main market. About 81% went from the main market to AIM and almost 19% went from AIM to the main market concluding that out of every company graduated from AIM to the main market, four moved in reverse course (Dufour, Sutcliffe and Wells 2005). In accordance with a survey (Baker Tilly, 2005b) 17 firms moved from the main market to AIM and their reason (Table, 03) for moving as constituted by the survey were; Less regulation 53% More Flexibility 41% Less Expensive 24% Tax Benefits 12% Suitability 12%Table: 03 Furthermore, the survey (Baker Tilly 2005b) reveals that 64% of the main market companies considered moving in and back to AIM, out of which 26% actually planned to move whereas the rest of 34% companies considered it beneficial due to lack of provisional parameters, trouble-free acquisitions, greater flexibility and tax advantages. 2.2.5 TAXATION The following areas of tax relief are available for individual investors in U.K. companies listed on AIM (Baker Tilly, 2005a): The business asset taper relief tends to minimise the effective tax rate of capital gains tax up to 40% 10%. In gift relief a capital gains tax is overdue until a subsequent disposal by the recipient. Investment in AIM trading companies leads to indemnity from inheritance tax. Enterprise investment scheme offers relief from both income tax and capital gains tax. From the initial investment in new AIM shares about one fifth of the cost can be counterbalanced against income tax. In addition any capital gain is exempt from capital gains tax, while any capital loss (less the 20% income tax relief) can be offset against capital gains elsewhere. Investors are exempt from tax on dividends from the Venture Capital Trusts, and capital gains on their shares in the VCT. Investors also receive an initial income tax relief equal to 40% of their investment in new VCT shares. 2.2.6 REQUIREMENTS AND LISTING PROCEDURE Companies listed on AIM have to assign a nominated adviser to serve as their sponsor or representative and is responsible to prepare the prospectus in order to admit the issuer for trading on AIM. The function of a nomad is to assists the company in raising its initial capital provide market making and research for the issuers stock with the help of its brokerage and research departments. The contractual activities and correlation between the issuer and its nomad extends well beyond the initial public offering. Nomad remain active even after the initial listing on AIM so that a small issuer does not end up being left alone in a stock market crisis. New rules and regulations were instituted both for nomads and companies listed on the AIM exchange, in Feb, 2007. To provide further guidance and to illuminate the regulatory issues concerning disclosure requirements the rules for nomads and companies were put into practice. Although the changes to AIM rules are evolutionary rather than re volutionary, Nomads should not under-estimate the Exchanges emphasis on the responsibility of nomads for preserving the reputation and integrity of AIM (Audley, 2005). 2.3 ASSOCIATED RISKS AND BENEFITS The listing procedure is much more simplified in London Stock Exchange as there is no regulatory authority in the UK so it becomes the responsibility of the sponsoring nomad as a result of which the complete process becomes substantially quicker and inexpensive. The prospectus discloses all information that an investor needs for making an informed investment decision and its less comprehensive in most cases where the SEC-filed registration statement and the review process, for the most part, is absent (Audley, 2005). Therefore, the SEC governmental review process of the prospectus, the massive amount of periodic regulatory filings and compulsory financial reporting needs are eradicated by listing on AIM. The emerging growth companies are offered with very greater options by eliminating the need for underwriters that are only interested large deals so a great number of foreign companies are flocking to AIM (London Stock Exchange, 2006). Listing on AIM gives an emerging growth company the opportunity to go public and raise capital for reasonable fees and under reasonable terms and conditions. AIM rules require not only a nominated broker but also a nominated adviser. There were companies on AIM which caused regulatory nervousness and the big guns at the DTI, Treasury and Stock Exchange focused their canon on nominated advisers. This had a knock-on effect on costs. Nominated advisers lay off their responsibilities on solicitors and accountants who duly reproduce and costs shoot up (London Stock Exchange, 2006). Professional advisers, anxious to minimise the risk of adverse criticism by the regulatory authorities, are now applying Official List standards. This has driven costs up and has damaged the purpose of AIM (London Stock Exchange, 2006). 2.4 FISCAL AGITATION AND AIM Economic recovery is gradual but consistent followed by the recession that hit the stock markets worldwide and for London Stock Exchange, particularly AIM market; there is a need for investment by small companies. The number of companies quoted on AIM, which is the London Stock Exchanges Alternative Investment Market, is now just 1,276 compared with more than 1,600 in the year 2007, which constitutes that, more than one company a day delists from AIM throughout last year (Northedge, 2010). It is also noticeable that notwithstanding the soaring share prices up to 66 per cent in the year 2009, outperforming the main stock market, only 36 new companies joined AIM. It is the lowest annual total since the launch of AIM in1995 and a tiny fraction as compared to the joining of 462 companies that in 2006 (Northedge, 2010). About 290 companies delisted compared with 218 in the year 2008, and others have been liquidating their assets and returning the proceeds to shareholders. Reported by (Wac hman, 2009) in Guardian, The number of companies having a capital under  £5m or  £10m has halved within two years and approximately two-thirds of AIMs companies are capitalised at less than  £25m and almost10 per cent are valued at below  £2m. Despite share prices falling, the delisting of the small firms has become a basis for the average AIM Companys estimation twofold to  £43m since the year 2006. The continued loss of small firms from AIM and some Britains top 200 companies remain there give rise to a fear that AIM will become another version of the main market leaving no alternative for smaller businesses to be quoted. That is already making it harder for small firms to raise capital to invest in Britains economic recovery (Northedge, 2010).

Genes Encoding HLA Antigens

Genes Encoding HLA Antigens The genes encoding HLA antigens are clustered on chromosome 6p21 at the telomeric end of the HLA region. Relatively few HLA class I genes are transcribed or translated.The expressed class I genes are subdivided into class Ia, which includesHLA-A, -B,and -C, and class Ib, which includes HLA-E, -F, and -G. As a non-classical major histocompatibility complex class I molecule, HLA-G is expressed predominantly and restrictedly in extravillous trophoblast cells at maternal–fetal interface. Alternative transcription of spliced HLA-G mRNAs encodes at least seven different HLA-G iso- forms, namely the membrane-bound HLA- G1, -G2, -G3 and -G4, and the soluble HLA-G5 and -G6 and –G7 proteins (1, 2). Experiments in vitro showed that HLA-G may contribute to maternal acceptance of the semi-allogenic fetus, by suppressing the maternal immune system during.it has been shown to bind to the immunoglobulin-like transcript (ILT)-2 and killer inhibitory receptor (KIR)2DL4 (p49) inhibitory r eceptors on NK cells and confer protection to extravillous trophoblasts (EVTs) via these receptors (3)(Figure2). This suggests that the interaction between HLA-G and immunocompetent cells at the placental interface could be critical in determining the outcome of pregnancy. In this regard, it may be helpful to look for deviations in these interactions by studying early pregnancy disorders of unknown aetiology (4). Among its several limited polymorphisms, the 14-bp ins/del polymorphism at 3 ´ untranslated region (3 ´UTR) of HLA-G gene has been shown an important role in post-transcriptional regulation of HLA-G molecule(5). Reports indicated that 14-bp polymorphism is associated with HLA-G mRNA stability and isoform alternative splicing patterns, therefore may influence functionality of HLA-G in pregnancy (6). In the present study, we analysed the 14-bp insertion ⠁„ deletion polymorphism in normal pregnancy and recurrent miscarriage patients with different miscarriage frequencies and discovered a possible correlation between the 14-bp polymorphism and recurrent miscarriage. Material and methods We carried out a case–control study. Peripheral blood samples were obtained from iranian women who had been seen at the infertility center in Yazd city during 2013 to 2014 for the evaluations of recurrent miscarriage. All of these women had regular menstrual cycles and were health. We analyzed a total of 200 patients with three or more recurrent spontaneous abortions (as a case group) and 200 healthy women without any history of abortion (as a control group). During the entire investigation period the current laws of ethical committee were followed; the patients gave their informed consent for use of their blood collected. Studied patients were without anatomical, microbial, viral, genetical disease and hormone profile tests and tests for ovulation and tubal patency were normal. Male partner’s semen analysis were included in the study. According to medical evidences, etiology of these abortions are unexplained. The following data for the patients were obtained: age, age at each abortion, numbers of abortions, time of abortion during each pregnancy, familial history of abortion, occurrence of bleeding and pain during abortion. Genotyping of the 14-bp insertion ⠁„ deletion polymorphism The blood samples of the control group and of the patients were collected in tubes containing EDTA. The molecular analyses were performed using DNA extracted from peripheral blood leukocytes with a routine salting out procedure. The 14-bp insertion ⠁„ deletion polymorphism was genotyped using the polymerase chain reaction (PCR). The amplification was done using the forward primer 5 ´-GTGATGGGCTGTTTAAAGTGTCACC-3 ´ and the reverse primer 5 ´-GGAAGGAATGCAGTTCAGCATGA-3 ´ for the HLA-G 14 bp insertion/deletion polymorphism analysis. PCR products were run on 1% agarose gel electrophoresis. The sizes of the PCR products were confirmed by sequence analysis. The PCR products of exon 8 were analysed by 10% nondenaturing poyacrylamidel gel electrophoresis containing ethidium bromide and visualized under ultraviolet light. PCR products were of either 224 or 210 bp, respectively,depending on the insertion/deletion of the 14 bp in exon 8. The cycling conditions used were: 94  °C for 5 min; 35 cycles of 94  °C for 1 min, 55  °C for 1 min, 72  °C for 30 s; and a final cycle extension at 72  °C for 5 min. Statistical analysis The data were analyzed by using the Chi-square test in the presence and absence of 14-bp insertion ⠁„ deletion polymorphism expressing individuals. Odds ratio was calculated with a confidence interval of 95 %. The data were processed by SPSS 16 software. The significance level of the tests for considering Pvalues as significant was set to Results HLA-G genotype frequencies were in agreement with a Hardy–Weinberg equilibrium in this study. Depending on the 14-bp deletion homozygotes, 14-bp insertion homozygotes or +14-bp ⠁„-14- bp heterozygotes of exon-8, the size of the amplified PCR products was either 224 or 210 bp or both in the case of heterozygotes (Figure 1) and was confirmed by DNA sequencing (Figure 2). Our results showed that both the +14-bp ⠁„-14- bp and -14-bp ⠁„-14-bp genotype frequencies were not significantly different between patients with recurrent miscarriages and fertile controls. However, the genotype frequency of +14-bp ⠁„ +14-bp homozygotes was significantly increased in those with recurrent abortions (three or more abortions) as compared with normal fertile controls. The mean age in the case group was: 35.3 yr  ± 5.8 (range 19–43), the mean age in the control group was: 34.9 yr  ± 3.2, (range 20–41) (Pvalue =0.40), in addition, some features of patients shown in Table 1. Distribution of the genotypes in the RSA patient and control groups is shown in Table 2. Frequencies were consistent with those previously reported by other investigators. (p value =) Discussion For more than two decades, the non-classical human leucocyte antigen (HLA) class I molecule HLA-G has been supposed to be an important immunoloregulation molecule in the maintenance of foetal–maternal immunotolerance. HLA-G has the ability to inhibite immune cell functions like natural killer cells, cytotoxic T cells and dentritic cells. In our study, we focused on the 14-bp deletion ⠁„ insertion polymorphism in the 3 ´ UTR of exon 8 of the HLA-G gene,which may contribute to the regulation of HLA-G expression. Our results showed that there were more women who were heterozygous in RSA group than in the fertile controls. Also the frequency of the +14-bp variant showed a significant increase in patients with three or more miscarriages. Thus, our data suggest that there is a detectable relationship between susceptibility to recurrent miscarriages and +14-bp homozygotes of the HLA-G locus.A report by Hviid et al. showed a significant over representation of the 14-bp +⠁„ + 14-bp HLA-G genotype in a recurrent miscarriage group. Although no significant difference was observed for the 14-bp +⠁„+14-bp genotype between the recurrent miscarriage and the control groups in their study, the same trend was found by Yan et al. Their hypothesis was that the frequencies of the HLA-G genotype, homozygous for the + 14-bp sequence, would be higher in women with several unsuccessful IVF treatments or with recurrent miscarriage than in control groups. This hypothesis was based on a previously published study. HLA-G alleles may result in different levels of HLA- G proteins. To date, the 14-bp deletion has been assigned to the G*010101, G*0102 and G*010401 alleles, and the 14-bp insertion to the G*010102, G*010103, G*0103, G*0105N and G*0106 alleles. Rebmann et al. reported that alleles G*01013 and G*0105N with the +14-bp sequence are known as ‘lowsecretor’ alleles, and are associated with reduced soluble HLA-G levels . Thus, The 14-bp insertion in ex on 8 of the HLA-G gene may be associated with low levels of plasma soluble HLA-G. Low concentrations of soluble HLA-G in maternal serum appear to be correlated with adverse pregnancy outcomes in IVF pregnancies .If the HLA-G ‘low-secretor’ allele is a factor involved in the pathogenesis of recurrent miscarriage, one would expect an increase in the number of carriers with the number of recurrent miscarriages , which is in agreement with the results of this study. The HLA-G 14 bp insertion ⠁„ deletion polymorphism may, in turn, affect the serum levels of sHLA-G and pregnancy maintenance, although the exactm mechanisms will require further study. The reason may be explained as follows, serum secreted HLA-G is conductive to early embryo implantation, as insufficient serum sHLA-G pro- motes trophoblasts attack by the mother’s immune cells induced by early embryonic trophoblast invasion of spiral arteries. This can result in a loss of implantation andpregnancy mai ntenance, leading to embryo loss as unexplained recurrent miscarriage .Based on these observations, our data indicate that the difference in HLA-G 14-bp genotype frequencies is not highly significant in this study. Probably, HLA-G as a single factor has a very modest effect in relation to risk for recurrent miscarriage. However, more genotyping investigations and functional studies on immune regulation are essential to elucidate the role of HLA-G in pregnancy. HLA-G gene encodes four membrane-bound and three soluble HLA-G isoforms by alternative splicing (16). The 14- bp insertion/deletion polymorphismin exon 8 of the HLA-G gene has been reported to be associated with HLA-G mRNA stability and splicing patterns, thus may play a role in the context of HLA-G functionality during pregnancy (17). Few studies on 14-bp polymorphism have been carried out in the association with RSA to date. A study by Tripathi et al. (14) indicated that 14-bp polymorphism is not a susceptible risk factor fo r RSA, but the number of heterozygotes (14bp1/2) was increased in the RSA group. However, another study indicated that homozygosity for the presence of the 14-bp polymorphism was higher in women with RSA than in the control groups (13). Recently, a report by Hviid et al. (15) showed a significant over- representation of 14bp 1/1 HLA-G genotype in the RSA group. Although no significant difference was observed for the 14bp 1/1 genotype between the RSA and the control groups in the current study, the same trend was found. In regard to the frequency of 14bp 1/2 heterozygotes, our study is inconsistent with that by Tripathi et al. (14) where more number of heterozygotes was observed in the RSA group. The discrepancy may be the result of ethnic variations, for a significantly different distribution of the 14-bp genotype was observed among Chinese, Danish, and Indian populations (Table 2) (14, 15). The 14-bp polymorphisms are involved in the stability and splicing patterns of the HLA-G mRN A isoforms. A rather detailed study by Hviid et al. (10) addressed that the HLA-G isoform transcripts were at a significantly lower level than the corresponding HLA-G isoform mRNA with the 14-bp sequence deleted, and an additional alternative splicing pattern, especially the HLA-G2 mRNA, could be observed with the presence of the 14-bp sequence. In accordance with this, a study by Rebmann et al. reported that HLA-G allelic variants are associated with plasma-soluble HLA-G levels. Alleles G*01013 and G*0105N with the 14-bp sequence are known as ‘low-secretor’ alleles, whereas alleles without the 14-bpsequence such as G*01041 are known as ‘high-secretor’ alleles, which are associated with elevated soluble HLA-G levels (18).Therefore, particular HLA-G alleles may result in different levels of HLA-G proteins. In the current study, higher frequencies of the 14-bpinsertion allele in RSA group may be a reflection of the association between the 14-bp insertion and the altered balance in HLA-G mRNA isoforms and probably the protein concentration. A recent report by Yie et al. (19) addressed that the embryos that express HLA-G benefit a higher in vitro fertilization rate. To the contrary, low soluble HLA-G seems to be correlated with an adverse pregnancy outcome (20). Taken together, our data indicated that the 14-bp insertion allele might have importance in the outcome of pregnancy. However, more genotyping investigations and functional studies on immune regulation are essential to elucidate the role of HLA-G in pregnancy.

Alexanders divinity Essay -- essays research papers

What evidence is there that Alexander may have believed that he was of divine descent? And how convincing would this evidence have appeared to one of his followers? From studying the sources of the ancient world that talk about Alexander The Great, it is clear that many of them present Alexander as being some type of heroic figure or Demi-god. However you could question whether Alexander believed this himself. Only by studying his actions and the actions of those around him can we draw any type of conclusion on this matter. This can be done through the use of sources that exist from the time of and around his death. Most of these sources have been lost or are incomplete however, so I feel that it would be best to mainly consult the sources of Arrian and Plutarch Although both of these were written a couple of hundred years after Alexander’s death they are still the most complete. Plus Arrian would seem to have many sources to consult in his writing, all from Alexander’s time. His main two sources were Ptolemy and Aristobulus, both of whom were on Alexander’s campaigns. Plutarch’s account is more a biography than a his tory since it is full of stories and anecdotes, however it contains some information that Arrian doesn’t so it is still a worthy source to consult. In this it would first be prudent to study all those events in Alexander’s life, which would seem to suggest that he did have some belief that he was of divine origin. The primary example of this would appear to be his visit to the shrine of Ammon. While in Egypt, Alexander had an urge to visit the temple since he wanted to consult the oracle there, which had a ‘reputation for infallibility’. Arrian also states that both Perseus and Heracles had consulted it at some point. And since it is clear from Arrian’s account that Alexander longed to duplicate, if not surpass, the feats of both Perseus and Heracles, so surely he must consult this oracle too. Arrian (book 3) claims that ‘the blood of both flowed’ within Alexander, which suggests that Arrian was of the opinion that Alexander did have some divine heritage since Heracles was supposedly the son of Zeus. In any case, Arrian also states that Alexander also visited the temple because he himself felt that he might be descended from Ammon in some way. If this is true then it would certainly seem that Alexander did in some way believe that he was of d... ... countries that he defeated. Alexander, being the great tactician that he was must have realised the benefits of people believing that he was more than just a great ruler and actually connected to the gods themselves. As far as the beliefs of his followers go, I believe that the willingness of the Persians to prostrate themselves in front of him and his Macedonian troops loyalty were important indicators. This is seen when they followed him across the vast desert in which the temple of Ammon was situated, just to answer the question of whether or not he did descend from the Egyptian god; this suggests that they too believed in his claim to being of divine descent. And it can be seen that there are not many men that were as revered and honoured by the people of the time as Alexander was. Leaving no doubt in my mind that both Alexander and his followers were convinced that he was of divine descent and that they felt that he was worthy of all the tribute that was paid to him after he died. Word count: 3298  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  

The Speech of Marcus Antonius in Julius Caesar -- William Shakespeare

The speech made by Marcus Antonius, called Antony, in Act Three, Scene Two of Julius Caesar shows that despite being considered a sportsman above all else, he is highly skilled with the art of oratory as well. In the play by William Shakespeare, this speech is made at the funeral of Caesar after he is killed by Brutus and the other conspirators. Brutus claimed earlier, in his own funeral speech, that the killing of Caesar was justified. He felt that Caesar was a threat, and too ambitious to be allowed as ruler. Much of this sentiment, however, was developed by the treacherous Cassius. Antony, on the other hand, felt that the conspirators were traitors to Rome and should be dealt with. This speech used a variety of methods to gradually bring the crowd to his side, yet maintain his side of the deal with Brutus. This deal was that he, â€Å"shall not in your funeral speech blame us...† (3.1.245) for the death of Caesar. Antony holds his end of the deal for the majority of the speech, yet by doing so convinces the crowd of Brutus' and the others' disloyalty. In many ways, this speech can be seen as the ultimate rhetoric, and it includes all three of Aristotle's methods of persuasion. This are the appeal to credibility, called ethos, the appeal to emotions, called pathos, and the appeal to logic, called logos. All three of these devices are used to great effect during the speech of Marcus Antonius. Antony begins with the now famous words, â€Å"Friends, Romans, countrymen, lend me your ears.†(3.2.62) In referring to the commoners as equals, they feel a sense of empathy even at the first line. This can be seen as a sort of ethos. He goes on to say that Brutus has said that Caesar was ambitious, and that this, if true, is a serious... ...2.248) Antony, though he kept to his bargain, brought the audience to his side in a variety of ways. He used all three methods of persuasion to his advantage. He claimed the killers of Caesar to be honorable and noble, and in the very act of doing so turned Brutus' followers against him. This shows the true ability of Marcus Antonius, and that he is a far greater threat than the conspirators recognized. This power of words is well known, and Aristotle's three methods of persuasion live on in modern speechwriters. Ethos, logos, and pathos are just as effective in our time as in that of Shakespeare, the Roman Empire, and wherever there are people to speak and people to listen. Thus even today, this speech of Shakespeare through Antony shows the sheer impact that mere words can have. Works Cited Shakespeare, William. Julius Caesar. New York: Simon, 1975.

Iron Crowned Chapter 7

I signed the tax return and left a check before heading out. It figured: I owed. Self-employed people always owe. It was a credit to Lara that she'd managed my books well enough that the amount was low, but after seeing her run off with my roommate, I decided it was a good thing our working relationship didn't include performance reviews. She'd also left me a jam-packed day, which turned out to be beneficial. A busy schedule kept my mind off Dorian (mostly) and what was transpiring in the Otherworld. I fought with ferocity, as though each ghost or monster I battled was Katrice herself. It was the drives in between that were the roughest on me. There was no action then. Just my own thoughts. My last job of the day was the most difficult, undoubtedly scheduled that way on purpose so that I didn't walk into the little ones tired and injured. True, I was feeling weary, but concern for Dorian kept a spike of adrenaline burning through me, one that I knew would get me through this last job. Yet, walking up to the client's house, I couldn't stop asking the same questions in my mind. Why hasn't Volusian reported to me yet? Isn't the fight over? A nervous-looking young woman answered the door, introducing herself as Jenna. She was the one who had made the call, though it wasn't exactly on her own behalf. â€Å"She's in the living room,† Jenna whispered to me, letting me inside the foyer. Her eyes were wide with fear. â€Å"Just sitting there. Staring.† â€Å"Does she speak?† I asked. â€Å"Does she answer your questions?† â€Å"Yes †¦ but †¦ it's not her. I know that doesn't make sense, but it's not. The people at work think she's just gone crazy. I'm pretty much the only one who still talks to her. She's about to lose her job, but †¦Ã¢â‚¬  Jenna shook her head. â€Å"I swear, it's just not her.† â€Å"You're right.† I held my wand in my left hand and my silver athame in the right. â€Å"Is she †¦Ã¢â‚¬  Jenna's voice dropped even lower. â€Å"Is she possessed?† â€Å"Not exactly.† Lara had warned me about this one. It had initially sounded like possession, but further data suggested otherwise, unfortunately. A possession would have been easier. â€Å"It's a fetch. It's like †¦ I don't know. Her double. Kind of.† â€Å"Then †¦ what happened to Regan?† I hesitated. â€Å"I don't know.† I didn't want to tell Jenna there was a strong possibility that Regan was dead. That was the usual fate for a fetch's victim. Of course, fetches usually left once they'd sucked all the energy and goodness from someone's life. If this one was still here, the odds of Regan still being alive were marginally higher. â€Å"If †¦ er, when we find her, she may be in bad shape.† I stared off down the hallway, where I could hear the sound of a TV in the living room. I shifted my grip on my weapons and prepared myself. â€Å"What should I do?† asked Jenna. â€Å"Wait outside. Don't come back inside until I tell you to – no matter what.† Once she was safely away, I set off down the hall. There, in the living room, I found a woman sitting perfectly straight on the couch, her hands folded neatly upon her lap as she stared at the TV. There was a blankness in her brown eyes that told me she wasn't really watching. She didn't even acknowledge my arrival. Glancing around the living room, I took in its space and features, assessing them for a fight. I also noticed a couple pictures on the wall, group shots with Jenna and a smiling brunette who looked exactly like the woman on the couch. Yet, glancing between them, I knew Jenna was right. This wasn't Regan. â€Å"Where's Regan?† I asked. The fetch didn't look at me. â€Å"I am Regan.† â€Å"Where's Regan?† I repeated harshly. â€Å"What have you done with her?† Please, please let her be alive. This time, the fetch turned her head, those cold eyes taking me and my weapons in. â€Å"I told you. I am Regan.† I had a moment's debate on what to do. Killing the fetch without learning Regan's location would make the next part of this job even more difficult. Yet, as the fetch continued staring at me, I knew she'd recognized what I was and what threat I represented. I had to take her out now, banking on the fact that fetches usually kept their victims close. I held out my wand and began chanting the words that would drive this creature back to the Otherworld. It was where fetches came from, and a forceful enough banishing was usually enough to deter them from returning. I'd only have to get the Underworld involved if she decided to – She attacked. The fetch didn't transform into her true shape as she sprang at me. Rather, she turned into something in the middle. She still wore Regan's face, but it had a sickly green hue. Her eyes were bigger and darker and looked like they'd been stretched out. Her hands and feet were bigger too – and clawed. She came at me with her full strength, knocking me into a wall mercifully free of furniture. I kneed her in the stomach, needing to get distance between me and the claws trying to rake my face and neck. She fell back a little, not much, but enough to give me more maneuvering room. I swung out with the silver blade, and she recoiled. Iron could inflict lethal blows on the gentry, but silver was the metal of choice for almost any other creature. â€Å"Tell me where Regan is,† I said, advancing forward. â€Å"Tell me, and I'll simply banish you back to the Otherworld. Make this difficult, and you die.† I was managing that balance I always did: weapon ready to attack while part of my mind focused on a connection to the Otherworld. Hecate's tattoo, a snake on my upper arm, began to tingle. The fetch decided I wasn't a full threat yet and rushed me again. I dodged this time, anticipating her movements based on the last attack. A fetch might be able to replicate someone, but their fighting style was mostly brute force. My athame caught her arm as I moved, and she snarled in pain, showing fangs that dripped with green saliva. It hurt her but didn't slow her down as she lunged back at me. I sidestepped her again but overlooked what was behind me, hitting painfully against a cabinet. I winced, and she pressed her advantage, swinging those claws at me. I barely escaped them, managing to squirm away and hurry to the other side of the room. A banishing, I decided. I'd just keep my distance and do a banishing. I just needed a couple minutes – and to stay alive. I began chanting words to send her from this world, words that didn't have to follow any ancient form so long as my power and intent were clear. She paused briefly, realizing what I was doing, and seemed to consider her options. A circle. I should have put a circle of protection around the house. There was a very real possibility she might try to flee. That and killing me were pretty much her only options. The former would probably be easier for her – and would release Regan. But I didn't want this fetch freely walking the world. I needed to send her on. Power surged in me and through me, out to the wand and toward her. This was her last chance to run – or, as it turned out, throw a coffee table at me. I admit, I didn't see that coming – literally or figuratively. I should have, though. Furniture, props, whatever †¦ they were all fair game in a fight. The fetch had no reason to rely simply on hand-to-hand combat, and my athame gave her good reason to attack from a distance. The coffee table was a simple one, a smooth circle of glass on iron legs. A wood-framed one would have been better. The frame would have slowed the spread of glass. This table had nothing to stop it, except me. I tried to jump out of its way, saving my head and face. I wasn't far enough away when it hit the wall and shattered, though. Stinging, burning pain went through my back and left arm as glass scraped and – no doubt – embedded itself in my flesh. My sense of self-preservation kept me moving through the pain, but my connection to the Otherworld had shattered with the glass. The fetch knew this and leaped forward, risking the athame in the hope I was too addled and injured from the glass to stop her. I wasn't. I had never let go of my weapons, and my athame was ready and waiting when she came. I plunged it into her heart and started the banishing again. Over the years, as I'd grown in power and spent so much time in the Otherworld myself, these banishings had become easier. Not easy, but easier. There was a time when I couldn't have held a fetch off with my athame while simultaneously attempting a quick banishing. But now, the power flowed through me as the fetch pulled herself off my blade. She had no time to react, attack, or flee. The magic seized her, and she disappeared before my eyes, fading into sparkles and then nothing. I didn't know the extent of the athame's damage. I might have just sent her back to die. Or, she might survive and come after me in the Otherworld as some creatures tried. I wasn't worried. My abilities stayed consistent in both worlds, but my magic was a bit stronger over there – especially in the Thorn Land. I took a deep breath of relief and stuck the weapons back in my belt as I hurried toward the front door. Jenna was sitting on the lawn, face pale with worry. She sprang up when she saw me. â€Å"What happened? Is she okay?† â€Å"I'm not sure,† I said, wiping sweat off my brow. My hand came away red with blood. â€Å"We have to find her. Does she have a basement?† â€Å"No.† Jenna followed me inside and then halted. â€Å"Oh my God †¦ your back †¦Ã¢â‚¬  â€Å"It's nothing. I'll deal with it later.† â€Å"At least – † She reached toward a spot between my upper arm and shoulder blade, wincing as she did. I yelped in pain and watched as she pulled away a huge piece of jagged glass. â€Å"That's bleeding †¦ really bad †¦Ã¢â‚¬  â€Å"I'm in better shape than Regan,† I said brusquely, trying to ignore both pain and the sight of my blood all over the shard she'd taken. â€Å"No basement. Closets? Attic?† â€Å"Both.† We checked the closets with no luck, and Jenna stuck her head in the attic's tiny space. Still nothing. â€Å"Shit,† I said. I shouldn't have let the fetch go without getting Regan's location. What if Regan wasn't nearby? What if the fetch had broken habit and hidden her victim far from home? Jenna looked as defeated as I felt, then her head shot up. â€Å"The shed. There's a shed out back.† We were out the back door in a flash, jerking open the door to a little garden shed that was mercifully unlocked. There, curled up on the ground in a fetal position, was Regan. Jenna let out a strangled cry, and we both dropped to the ground. Jenna propped Regan up while I gently shook her. â€Å"Regan, Regan. Wake up. Please wake up.† For a few moments, I feared the worst. Then, Regan's eyes fluttered open, her expression frightened and confused. Her breathing came in short rasps, and she futilely tried to sit up on her own. Her failure didn't surprise me. When a fetch took over someone's life, it put its double into a sort of magic coma. It required no ropes or gags, simply leaving behind a silent and immobile victim. Regan's ability to wake up verified that the fetch was gone, but the woman had spent days without food, water, or using her muscles. â€Å"She's dehydrated,† I said. Studying Regan's state, I knew this was beyond a few glasses of water. â€Å"Let's get her to the hospital.† Jenna drove, with Regan laid out carefully across the backseat. She said little, only making the occasional moan. Meanwhile, in the passenger seat, I attempted to clean myself off with baby wipes and to pull glass bits out of my back. The blood on my face was cleaned off when we reached the ER, as was most from my body, but I didn't want to answer questions about what had happened to me. I borrowed Jenna's jean jacket, figuring the few scratches on my face weren't enough to attract attention. We told the staff that Regan had been depressed and starving herself. We went on about how we hadn't seen her for days and had only just found her tonight. Since there was no ostensible bruising or signs of binding, they took us at our word and hurried to hook her up to fluids. We'd also probably landed her in therapy, but that was of little concern now. I waited with Jenna just outside Regan's room as a nurse finished attaching the appropriate tubes and a doctor performed further examination. When they were done, they told us we could go in and that Regan would recover once her body had sustenance again. I had no intention of going with Jenna. Now that Regan was safe, my plan was to get a taxi back to my car and go home to clean up before an Otherworldly jump. Lara could bill these women later. â€Å"Wait,† said Jenna, as the doctor and nurse were about to leave. â€Å"My friend's hurt. She broke a window to get in Regan's house and got cut.† I shook my head. â€Å"No, really, I'm fine – â€Å" I shut my mouth when I followed everyone's gaze. Even I could see that the left sleeve of the jacket was soaked with blood. There was little argument to make after that. Jenna stayed with Regan, and I was ushered off to a cubicle in the ER. The nurse shut the curtain, and I took off my shirt. The doctor's eyebrows rose. â€Å"You broke a window? With what, your entire body?† He called for another nurse, who began assisting the other with glass removal and sanitizing. â€Å"I threw a rock,† I said. â€Å"It didn't make a very big hole, but I didn't have time to make it bigger. I just had to get to Regan.† â€Å"Noble,† said the doctor, whose attention was on the larger shoulder gash. â€Å"If stupid.† Someone with a better understanding of physics might have realized my injuries didn't quite line up with what I'd get crawling through a jagged hole in a window. Fortunately, this group's talents were elsewhere. The myriad scratches and cuts were dealt with by bandages and painful antiseptics. The big cut required a fair number of stitches. I was restless the whole time, wanting only to get back and see what had happened to Dorian. The medical staff was thorough in its work, however. I decided I should just be grateful that they were letting me go and not forcing a longer stay. I was the walking wounded, in bad shape but not in life-threatening danger. â€Å"Here,† said the doctor, just before letting me go. He scrawled out a prescription and handed it to me, along with reams of paper on wound care and cleaning. â€Å"Antibiotics. Get it filled tonight.† â€Å"I will,† I said glibly. He gave me a warning look. â€Å"I mean it. I know your type. You think you're invincible, but any of that could get infected. Get the prescription. Clean and change the bandages on the cuts.† He was right that I thought I was invincible. I'd had stitches and wounds before, my gentry blood usually expediting the healing. But I nodded meekly, promising I'd obey. â€Å"Good,† he said, following me out to the waiting room. â€Å"Follow up with your family doctor in a week. I think your ride's over there.† â€Å"My ride †¦?† I stared around the room, freezing when I saw a familiar face. â€Å"Mom?† She'd been leaning against a wall, eyes anxiously studying everyone in the room. Spotting me, she practically ran over, staring at my bandages in alarm. I had no coat, and the tank top showed my battle wounds. â€Å"Eugenie! Are you okay? What have you done now?† For some reason, that made the doctor snort a laugh before walking away. â€Å"I'm fine,† I told her automatically. â€Å"What are you doing here?† â€Å"I'm your emergency contact. And that is not fine.† I was still stunned to see her. It felt like it had been so long. Ages. â€Å"It is now,† I said dazedly. â€Å"All patched up. And I've got all this †¦ stuff.† I waved my stack of paper around. She brushed dark hair from her face, her expression both weary and distraught as we headed for her car. â€Å"It never gets easier. Not with you, not with him.† I gave her a sidelong look. â€Å"Does he know you're here?† â€Å"No,† she said, getting out her keys. â€Å"Not that it would matter if he did. Nothing could have stopped me from coming when they called me. I thought †¦ Well, I never know what to think†¦.† I couldn't look at her as I sat gingerly in the car. My eyes were filling with tears. I'd missed her so much. I'd missed her, well, momness. Lots of people cared about me, but it wasn't the same. Plus, I felt horrible, horrible that I made her worry. And because of me, Roland was out endangering himself again too. I hastily ran a hand over my eyes and turned to her as we pulled out of the parking lot. â€Å"When did you get glasses?† I asked in surprise. Delicate wire frames rested on a face very similar to mine. It was our coloring that was different. My red hair and violet eyes had come from Storm King. â€Å"A few weeks ago. They're just for night driving.† I looked away, fearing the tears would return. Glasses. Such a stupid thing. There was a time, though, when I would have known every little detail of her life. There was so much distance between us now. My churning, guilty thoughts only came to a standstill when she turned into a pharmacy a few blocks from the hospital. â€Å"Mom, no! I have to get back to my car and – â€Å" â€Å"You can go back to endangering your life again soon enough. Here, let me see those.† â€Å"It's not my usual pharmacy,† I said petulantly. She was skimming the wound care instructions. â€Å"Yes, well, I'm sure this one still has a couple bandages stashed away somewhere.† â€Å"You're such a mom.† She glanced up, a small twinkle in her eyes that reminded me of how things used to be between us. â€Å"I'm your mom.† I followed her sullenly as we waited for the prescription, and she forced me to get a basketful of gauze, bandages, and other first aid supplies. I already owned a lot of them, but she wouldn't rest easy until she actually saw them in my hands. â€Å"I really appreciate you coming,† I admitted as we waited. â€Å"It †¦ it's good to see you.† Her expression softened. â€Å"It's good to see you too, baby. I've missed you.† â€Å"I don't suppose Roland's forgiven me?† â€Å"It's more complicated than that,† she told me. â€Å"He still loves you. Really. But he's worried. And he doesn't like you being over †¦ there. Neither do I.† I averted my eyes again. I knew she didn't – and she had good reason. My conception was the result of her captivity and rape in the Otherworld. She'd spent years keeping that knowledge from me, hoping to protect me from both my heritage and the agony she believed that place caused. â€Å"Well, that's complicated too. I have to be there, Mom. I know you guys don't approve, but there are people counting on me. They're not all like you think. I can't let them down. They're †¦ they're dying because of me.† â€Å"Is there a man involved?† I considered a flippant remark, then chose honesty. â€Å"Yes.† â€Å"The obvious problem aside †¦ would I like him?† I tried to picture my mom meeting Dorian and couldn't stop a small smile. â€Å"Probably not.† â€Å"Do you ever talk to Kiyo anymore?† I looked up sharply, my smile fading. â€Å"It's over with us. He let me down. You know that. This other guy †¦ he won't.† I was saved from further conversation when my name was finally called. I added the prescription to my portable hospital bag and felt grateful that my mom didn't pursue the topic of my love life anymore. I was equally grateful when she drove me back to Regan's house. It wouldn't have surprised me if she'd left me carless in Tim's care. Leaving my mom stirred conflicting feelings in me. After missing her so much, part of me just wanted to stay and gaze at her, to drink in those features I loved so much. I wanted her to hold me, to be my mom and take care of everything. And yet †¦ always, always, the Otherworld was pressing on me. I didn't have the luxury of being a little girl right now. I didn't have the luxury of being her daughter. â€Å"Thank you,† I said, giving her as careful a hug as we could manage. â€Å"Thank you for †¦ I don't know. Everything.† She held me for a few moments and then pressed a kiss to my forehead. â€Å"There's nothing to thank me for. Just be careful.† She broke from the embrace. â€Å"Do what the doctor says. And for God's sake, don't end up there again. I don't want another call.† â€Å"I'll try,† I said. This made us both smile, largely because we knew my trying to stay out of harm's way was pretty futile. â€Å"And tell Roland †¦Ã¢â‚¬  I couldn't finish, but she nodded. â€Å"I know.† I left her then, loading my loot into my own car and driving home. Regan didn't live too far from me, only about ten minutes. The time flew by. I had so many things to think about that when I arrived at my house, I hardly knew how I'd gotten there. Tim's car was parked out front – as was Lara's. I dragged myself out of my own self-pitying miasma, uneasily wondering what I'd find inside. Seeing the two of them naked on my kitchen table would not be cool. Instead, they were cuddled up on the living room couch, watching a movie. All seemed innocent, but some vibe made me suspect they hadn't been actually watching too much of it. I shook my head in exasperation. â€Å"How is this my life?† I muttered, setting my bag on the counter. â€Å"Did you say something?† called Tim. The living room and kitchen were mostly open to each other. He muted the film. â€Å"Nothing important.† â€Å"We figured you'd be out for the night,† he said. I was pretty sure there was an accusatory tone in his voice. I opened the cupboards, rummaging for food. I was suddenly starving. â€Å"Well, rest easy. I'll be gone soon enough, right after I get dinner.† Lara turned and peered over the couch's back. â€Å"Pop-Tarts aren't – oh my God! What happened to you?† Tim noticed my bandages now too. He didn't look as shocked as her – he saw me come home after fights a lot – but worry had replaced his snark. â€Å"What have you been doing?† â€Å"Earning the mortgage.† I put two blueberry Pop-Tarts in the toaster. â€Å"Isn't that what you told me to do?† â€Å"Jesus, Eug. I didn't – â€Å" â€Å"Forget it,† I told him. â€Å"Everything's fine. But you're going to have to send a bill to Jenna Benson, Lara. I wasn't able to collect.† Lara nodded without a word, still aghast at seeing what my real life looked like. I poured some water and choked down one of the antibiotics while waiting for the Pop-Tarts. As soon as they were done, I retreated to my room, eating quickly as I threw together an overnight bag. While I was packing, my eyes lingered on a half-finished puzzle on my desk. I sighed. How long ago had I started that one? A month ago? I loved jigsaw puzzles. I used to do one a night. I was almost finished packing – I even included the first aid supplies, thanks to some residual mom-guilt – when the temperature dropped. An unsettling yet familiar presence filled the room, and soon Volusian appeared before me. I nearly dropped the bag. â€Å"Mistress,† he said with a mock bow. â€Å"I've come to report on the battle.†