The Legacy Of The Reconstruction Era - 1920 Words

In the years prior to the Reconstruction era, the nation was involved in a brutal civil war—one of the most destructive to ever take place. The North and the South were fighting against each other, with the Confederate States fighting for secession and slavery, and the Union fighting for an in tact country. Abraham Lincoln, the newly elected president, was against secession and blatantly stated so in his inaugural address, â€Å"A husband and wife may be divorced, but the different parts of our nation cannot.† Nonetheless, for four excruciating years, war took place and ended in 1865, with the siege of Petersburg, â€Å"[costing] the nation more than 600,000 lives, nearly as many as in all other American wars combined.† Just before the war ended and the Union won the victory, Lincoln began his second term. Unfortunately, he was assassinated soon after in mid-April. From this point on, the nation began rebuilding itself through reconstruction for the next twelve years. While the Reconstruction period following the Civil War produced many significant results, particularly in the arena of Constitution Amendments, it nevertheless fell short in binding the nation’s wounds. Without a replacement for Lincoln, the Republican Party was tragically unable or unwilling to seize the day and implement an effective, lasting and just national reconciliation. With the loss of a great, progressive president such as Lincoln, our country was left in shambles after the conclusion of the Civil War.Show MoreRelatedThe Legacy Of The Reconstruction Era1473 Words   |  6 PagesThe reconstruction era was a time that then affected America in positive facets and negative aspects as well, and still affects America today. Thanks to the reconstruction era, there are several implementations that geared the world on the path in which it is today. Had it not been for some of the laws that were set in place African Americans may have not had many of the opportunities that were presented during the reconstruction period, therefore the years of oppression and cruelty might still beRead MoreThe Legacy Of The Reconstruction Era1303 Words   |  6 PagesThe Reconstruction Era America was in disarray following the events of the Civil War. Southern economy was in shambles while congress was struggling to find a middle ground between the radical republicans and Lincoln’s lenient policies. Many Southerners faced the aftermath of uprooting their society and their way of life while thousands of newly freed slaves struggled to find a way to support themselves. The country needed a strong leader, however on the 14th of April, 1865 President Lincoln wasRead MoreEssay about The Reconstruction Era: The Planted Seeds1231 Words   |  5 Pageswalked through compared to other American Wars (â€Å"Civil War Facts†). After the Civil War the Reconstruction Era rose up and flourished into a luminous path of freedom for slaves in America. The president’s impact on the Reconstruction Era lit a path to the rights of African Americans. Abraham Lincoln, Andrew Johnson, and Ulysses S. Grant each had their own participation in the movement of the Reconstruc tion Era, for they planted a seed of faith believing that a beautiful rose would rise and become oneRead MoreThe Reconstruction Era Was A Success1490 Words   |  6 PagesThe Reconstruction Era was a Success Shortly after the Civil War ended in 1867, President Abraham Lincoln’s new objective was to unify the union and the confederate states into what was formerly known as the United States of America. This time period is known as the Reconstruction Era, starting with the surrender of Robert E. Lee at Appomattox Court House in 1865 and ending with the implementation of the Compromise of 1877. The Reconstruction Era was a time period full of political, economicRead MoreThe Reconstruction of America after the Civil War1078 Words   |  4 PagesCivil War would become known as the â€Å"Reconstruction Era.† An era that raised just as many questions as it did answers. A reconstruction of America that seems to carry on many decades later. The reconstruction of America would decide how the south would rejoin the Union, what was to become of the nearly 3 million black slaves freed, how America was going to recover from such a devastating internal war. There appears to be phases that the Reconstruction Era went through, roughly three of them. TheRead MoreTime Line 21050 Words   |  5 Pageseconomic disruption caused by the anti-slave Northern States that caused it. The civil war was a war where the most American troops were killed. It also ended slavery. | 5) The phases of the Reconstruction Era and its legacy to U.S. history. | 1863 – 1877 | There are 2 stages of the Reconstruction Era. The first is the post-Civil War U.S. and the second focuses on the Southern United States (Wikipedia, n.d.). | 6) The post-Civil War conquest of the West, including the â€Å"displacement† of theRead MoreAbraham Lincoln And Its Impact On The United States1470 Words   |  6 Pagesthe United States because he abolished slavery. Also, his Reconstruction plan showed the South that they would have a say in the government, despite their size. This was significant because slavery was tearing the country apart. When the South threatened to leave the Union they complained about slavery and about not having a say in the government. Lincoln realized why they would feel that way and helped them out. By the time reconstruction was over, the Southerners had a more stable lifestyle andRead MoreEssay about Jim Crows Legacy 616 Words   |  3 Pagespre-Civil War/Reconstruction era. The insidious nature of Jim Crow easily converted bigotry and intolerance from vile vices to prized virtues. Although Jim Crow laws were settled by the 1954 court case, Brown v. Board of Education of Topeka, where all laws and public policy based on the theory of separate but equal were deemed unconstitutional; they were not fully eliminated until the mid 1960s, almost one hundred years after the end of U.S. Civil War and the beginning of Radical Reconstruction. Read MoreRace And Reunion : The Civil War1581 Words   |  7 Pagesthe war. The two major themes race and reunion, demonstrate how white Americans adjusted and altered the causes and outcomes of the Civil War to reflect their particular ideas regarding this catastrophic conflict between Northerners and Southerners era. Blight, addresses how these differences in cultures collided in the visions that they saw America becoming when reunited as a union after the Civil War, reconciliationists, White supremacy and emancipationist. Blight does an excellent job of showingRead MorePolicy Containment in the Northwest Ordinance and Missouri Compromise576 Words   |  3 Pageswas the end of the Reconstruction Era and allowed the South to â€Å"turn the tables† on the North. Democrats were able to regain control of the Legislative and Judicial branches of government. (http://history.ncsu.edu/projects/cwnc/exhibits/show/second-redemption/redemption-1877) In conclusion, containment was accomplished through stages that included the Establishment of the Northwest Ordinance and the Missouri Compromise that later led to the failure of the Reconstruction Era and allowed the Southern

The Revolutionary Era Took Place From 1763-1789 - 1374 Words

The Revolutionary era took place from 1763-1789. In this era was the Continental Congress. 1774, Carpenter’s Hall in Philadelphia, address many grievances against British, called First Continental Congress, included George Washington and John Adams. October 1774, First Continental Congress petitioned King George lll, Congress called for a general boycott of British goods. May 1775, Second Continental Congress, State house (now Independence Hall) in Philadelphia, new members included Benjamin Franklin and Thomas Jefferson. Thomas Jefferson, Virginian, drafted Declaration of Independence in early summer 1776. Franklin and Adams helped revise the Declaration of Independence in justifying the need for independence. July 4, 1776, Continental Congress approved the Declaration of Independence. Declaration of Independence signed by 56 delegates of the Second Continental Congress. Liberty Bell rung to celebrate first public reading of Declaration of Independence on July 8, 1776 in Phil adelphia. Member of Congress, Bostonian John Adams, fought passionately for independence, became second President of the United States. Printer, publisher, inventor, scientist, and diplomat, Benjamin Franklin, represented the Continental Congress in France during Revolution. Todd 2 Treaty of Paris, signed in 1783, signified conclusion of American Revolution, Congressman John Adams, Benjamin Franklin, and John Jay signed on behalf of the United States. ThereShow MoreRelatedPolitical Change : The American And French Revolutions And The Civil Rights Movement968 Words   |  4 Pagessocial and economic issues trigger movements and revolutions which either influence the government to change their policies or replace the government thus bringing political change. By evaluating prominent and well-known instances of political change from the past, such as the American and French revolutions and the Civil Rights Movement, it becomes clear that political change cannot occur without social and economic upheaval. The contemporary democratic systems of government in the Western world, particularlyRead MoreThe Causes And Consequences Of The French Revolution Essay5309 Words   |  22 PagesAchievement Standard 91435: Analyse an historical event, or place, of significance to New Zealanders. The causes and consequences of the French Revolution: The Tennis Court Oath Introduction The French Revolution was arguably and widely regarded by historians as being one of the most important events in human history. The revolution in France (between 1789 to 1799) accelerated the rise of republics and democracies. It became the â€Å"focal point for the development of all modern political ideologiesRead MoreThe French Indian War And The American Colonization Of North America1326 Words   |  6 Pages(salutary neglect) and they prospered until the French-Indian War (1754-1763). The spirit of independence cultivated in the American colonists during the past era was challenged by the heightened British presence after the French-Indian War. The colonists increasingly resented the high tariffs placed to eliminate British debt and the colonists protested the British until open rebellion was sparked at Lexington and Concord. The Revolutionary War started in 1775, when a small number of colonists, at firstRead MoreAmerican Exceptionalism By George Washington1320 Words   |  6 Pagesexisted from early years and George Washington is one of the key pieces in this issue. The U.S history maintenance the idea of American Exceptionalism because this country have done so much and have incredible stuffs like children and disability support, insurance, study opportunities, etc. George Washington is an example that U.S. and its population are unique in several ways. â€Å"George Washington (1732-99) was commander in chief of the Continental Army during the American Revolutionary War (1775-83)Read MoreEssay on The Three Different French Empires1436 Words   |  6 Pageswith the period of the rule of the ancià ©n regime, known as the Kingdom of France, lasting from 1594 to 1789. Subsequently, one can distinct the empire as created by Napoleon I as a second empire which lasted from 1804 to 1814 (and a brief restoration in 1805), which was the first to be actually named an empire, and finally the second French empire, founded by Napoleons nephew Napoleon III which lasted from if 1851 to 1948. This paper draws a comparison between the French empire during th e time ofRead MoreThe French Revolution And The Civil War2964 Words   |  12 PagesFrench Revolution is the civil war that took place throughout France between July 14, 1789 and July 28th, 1794. The word â€Å"civil war† did not mean only the bourgeois revolution. It included a broader sense than only bourgeois, because it was a whole national revolution for all the people to establish himself as free man, and to hold equal right. The origin of French Revolution are complex (584). There are involve so many connected factors such as political, economic, social, and ideological reasonsRead MoreEssay on The Inevitabilty of the American Revolution1720 Words   |  7 Pagessettled; they were to remain subject to the King and dependent on the kingdom of Great Britain. In return, they were to receive protection. They would also enjoy the rights and privileges of all free-born Englishmen. The British subjects of pre-Revolutionary America should have had, beyond a doubt, equal rights with those in Britain. The first adventurers and their children after them should have had and enjoyed all the freedom and liberty that their counterparts in England enjoyed. The colonistsRead MoreRevisiting, Revising, and Reviving Americas Founding Era6252 Words   |  26 Pagessaga in 1763 when Britain, saddled with debt at the close of the Seven Years War, levied new taxes that prompted her American colonists to resist, and then to reject, imperial rule. Having declared independence and defeated the British, American patriots then drafted the constitution that remains the law of the land to this day. With George Washingtons inauguration as president in 1789, the story has a happy ending and the curtain comes down. This time-honored script renders the road from coloniesRead MoreAge of Enlightenment and Century5169 Words   |  21 Pagesindicating the degree to which they successfull y followed Machiavelli’s suggestion. Choose two: Elizabeth I of England Henry IV of France Catherine the Great of Russia Frederick II of Prussia 13. ’05 Using examples from at least two different states, analyze the key features of the â€Å"new monarchies† and the factors responsible for their rise in the period 1450 to 1550. ’03 To what extent in what ways did women participate in the Renaissance? REFORMATION Read MoreChapter 7 and 8 Study Guide: a Survey American History2026 Words   |  9 Pagesbureaucratic power structure that the Federalists had erected in the 1790s, and he helped ensure that in many respects the federal government would remain a relatively unimportant force in American life. 2. Society and Women, early 1800s MA in 1789 required that its public schools serve females as well as males. Judith Sargent Murray- look at People Mercy Otis Warren- look at People 3. Education, access to (whom?) The Republican administration was keen on giving equal opportunity for

Descriptive Writing in Literature Free Essays

Literature indulges us in a different world by using descriptive writing that paints a vivid picture in our mind. Every author has a different way to accomplish that, but the main purpose is to draw the reader into the desired place and time of the literature. I will compare two poems and one story that capture the imagination by a descriptive writing. We will write a custom essay sample on Descriptive Writing in Literature or any similar topic only for you Order Now First we will take a closer look how these authors accomplished their transition of us into their world and then we will compare if those works have something in common. Grabbing the attention of a reader is not an easy thing especially that each person has a different view of the world, and one thing that can be understandable to some can be an enigma to others. In the poem â€Å"The Fish† written by Elizabeth Bishop we can see a simple act of catching a fish that is translated into a powerful descriptive poem that shows how this catch not only defined time, but is also a renewal of life after the release. When we hear a person describing a fish it is usually pretty simple: small, big, long, had large teeth, heavy etc†¦ In the poem Elizabeth Bishop uses great synonyms and metaphors (change the words) that grab our attention from the first verse:† I caught a tremendous fish and held him beside the boat half out of the water, with my hook fast in a corner of his mouth. † We can clearly imagine the fish that has just been caught still breathing being held next to the boat. Next she uses synonyms that start to describe the appearance of it: â€Å"He hung a grunting weight, battered and venerable and homely. But the great description does not end on those couple lines she goes into details about its skin and how it looks like an old wallpaper, discolored, faded, torn apart: â€Å"his brown skin hung in strips like ancient wall-paper, and its pattern of darker brown was like wall-paper: shapes like full-brown roses stained and lost through age. † Just from reading this couple lines we can see that the fish was old, because of its skin and the color of it, some fish can even grow up to a hundred and now we can see that the catch could be even older that the fisherman. The author goes into further detail about the age of the fish when he writes: â€Å"hung five old pieces of fish-line†¦ with all their five big hooks† and â€Å"Like medal with their ribbons frayed and wavering, a five-haired beard of wisdom trailing from his aching jaw. † These lines have great power of showing us that the fisherman realized that the fish had fought many battles throughout his years, and the reminders that were left in his jaw look like medals worn by soldiers after their fights. The image that we can develop thanks to this descriptive writing is bright and clear this metaphor of medals is a great way to picture the old, tired fish that has overcame many obstacles on its path (Bishop, 2007). The story that we will look at that has also caught my imagination through its playful and colorful writing is â€Å"The Bride Comes to Yellow Sky† by Stephen Crane. In this short story not only the surrounding is described to details, but characters feeling and thoughts are written in a way that we can place ourselves in their shoes. This way we can accomplish a greater similarity with characters and also show some emotion that we have never felt before â€Å"She continually twisted her head to regard her puff sleeves, very stiff, straight, and high. They embarrassed her. † In those two lines we can see that the character is not used to this king of attire and it is making her uncomfortable. Same thing probably happened to everybody in their life once, when we had to wear something that was not chosen by us, but the dress code or the occasion required it, like a bridesmaid who wears a dress that thinks it is the ugliest in the world only to please the bride. Those simple feeling transferred to paper can make the reader transfer in time and place to the action of the story. For example when Stephen Crane describes the drunken challenger and his eagerness to pick a gun fight with anybody he shows us how determined and fearless the man felt â€Å"Often he yelled, and these cries rang through a semblance of a deserted village, shrilly flying over the roofs in a volume that seemed to have no relation to the ordinary vocal strength of a man. It was if the surrounding stillness formed the arch of a tomb over him. These cries of ferocious challenge rang against walls of silence. † We can picture a man who is screaming so loudly that his voice can be heard across town almost begging to find a challenger, but his calls are unanswered and the silence of the town shows how serious this man is. Descriptive writing is a great way to narrate a story that way there is no room for misplacing the feeling that the author is trying to show us (Crane, 2007). The second poem that I have chosen is â€Å"I dwell in the Possibility† by Emily Dickinson. This poem is much different than other two literature works, because it leaves more room for our imagination to fill in the gaps. Emily tells us through her poem how much she loves poetry and how limitless it is. She compares it to a house â€Å"A fairer House than Prose-â€Å"and with this single line she burns an image of a house in our mind, but how does it look? How big is it? In that split second after reading that line we can imagine a house of our dreams without limitations. She goes on comparing windows to opportunities and endless options that can be achieved through poetry. Our house starts taking a sharper and clearer image in us, and to achieve her desired influence on us she paints an extraordinary picture in our imagination. The second stanza holds the key to the incredible descriptive writing that took us on a journey: â€Å"And for an Everlasting Roof The Gambrels of the Sky-â€Å". No house could be complete without a roof; or could it? How could we imagine a house without a roof, or could the sky be our roof? The options are limitless the metaphor is excellent and the descriptive writing although not detailed still fulfilled its purpose of invoking a vivid picture that will last in our mind forever (Dickinson, 2007). Each author used different method of descriptive writing; some left us more room to play with our imagination than others. What matters the most is that not only a colorful picture is painted in our mind, but also emotions are clearly portrayed. To indulge the reader all three authors use the power of words. In poem â€Å"The Fish† I stared and stared and victory filled up the little rented boat†¦ until everything was rainbow, rainbow, rainbow! † We can imagine the sight of a fisherman that caught a tremendous fish and is really happy, and more importantly in those few lines we can fell that joy and positive energy that illuminates this image in our head. The emotions are almost screaming through the fisherman and the renewal of life after releasing the fish can be felt in us the readers as well. Also the author accomplished sympathy toward the fish without ever mentioning fear or agerness to escape the terrible future that was meant for it. He accomplished that through descriptive writing of its appearance when he compared hooks left in his jaw to medals of soldiers which sway in the wind or when he looked into his eyes that were larger than fisherman’s. Those few moments subconsciously build sympathy in us toward the catch and also build some tension when we read from line to line in hope that it will somehow survive (Bishop, 2007). Stephen Crane also portrays great emotions in his story. This story builds up a tension that was heading towards a gunfight were the main character Jack Potter could not even live long enough to enjoy his first day of marriage. When we compare typical Western movies to â€Å"The Bride comes to Yellow Sky† we can see allot of differences. Nobody has died or even been shot and most importantly even the tough Sheriff is scared of something; people’s reaction to his marriage. The author uses descriptive writing while narrating through the train ride, saloon, and mad gun slinger on the path for blood. What might be a surprise from the first page we can see the emotions of Jack Potter which normally we did not see in Westerns where all lead characters are tough, emotionless, and invincible. The author wants to show real emotions even in a feared man like Jack that was freshly married on his way with the bride to his hometown. The emotions shown between the newlyweds are a big part of this story â€Å"A sense of mutual guilt invaded their minds and developed a finer tenderness. †(p. 484). The joy and happiness that people receive after their marriage is incredible; so many thoughts and feeling are experienced at the same time that are hard to describe and thanks to describing those feeling we become sympathetic with the couple. As we read we develop almost friendship with them and we can start envisioning the unstoppably gunfight which builds even greater emotions in us. Page after page Stephen Crane paints a clearer picture of tension in the town before the main battle erupts â€Å"Oh, there’ll be a fight fast enough, if any one wants it. Anybody can get a fight out there in the street. There’s a fight just waiting. † The description of the gunslinger shows that the man is serious and eager to kill which might be Jack Potter â€Å"His eyes, rolling, and yet keen for ambush†¦. He walked with the creeping movement of the midnight cat. As it occurred to him, he roared menacing information. † Tension reaches climax at the end where both men collide unexpectedly. This story not only transferred us in time and place to a small Western town, but also painted a clear picture of emotions that even toughest man goes through when they get married (Crane, 2007). Descriptive writing is one of the most creative ways to indulge the reader in literature’s world. Thanks to descriptive writing the authors can stimulate reader’s imagination that will leave an everlasting imprint. The proper usage of words can transfer us in time and location, and also into a different emotion that we might have never experienced. This method brings heart into any work that pumps blood which is so vital at keeping the reader interested and on the edge of their seat. We could see it clearly in story â€Å"The Bride Comes to Yellow Sky† where tension builds up with each page turned and the closer we get to the end the closer we get to a tragedy than somehow never happens. Even in poem â€Å"The Fish† emotions are building up to sympathies readers with the fish although usually we do not associate feeling with fishes. The final literature work â€Å"I Dwell in the Possibility† incorporates a different descriptive writing. It is not guided by usual details that are followed, but single lines that are just as powerful, and are left to roam our mind and take on shapes and forms that only readers can see and feel. How to cite Descriptive Writing in Literature, Essays

IT Infrastructure Management for Transmitting-myassignmenthelp

Question: Discuss about theIT Infrastructure Management for Transmitting. Answer: Introduction Information technology is the utilization or study of systems for manipulation, transmitting, sending and even storing information (Schwalbe, 2015). I am a student of information technology infrastructure management. Discussion Importance of IT in Career Information technology is considered as the subset of ICT or information and communications technology. Personal computers, electronic mails, Internet connection, all of these comprise of information technology (Holtshouse, 2013). IT is extremely important for my career. Any type of security related issues could be easily solved with the help of IT. Moreover, my technical knowledge can be increased with information technology. Achievements after Studying IT After studying information technology, I want to understand the entire concept of technology. My technical knowledge could be easily increased once I will complete studying IT (Cai Zhu, 2015). Security is the most important and significant factor in any organization or work. Information technology provides the best security to any organizational resource or asset. I want to gain proper knowledge of technology after studying IT. Plans after Finishing Study I want to join the industry of information technology after completing my studies. Various job opportunities are present in this domain (Schwalbe, 2015). Moreover, I will be able to know about technology more precisely. My knowledge and skills will be a great help to the organization and thus I will be satisfied with my job. Main Functions of Data Centres A data centre is the facility that is utilized in a computer system and various related components like storage system or telecommunication (Schwalbe, 2015). It involves backup as well as redundant power supplies and several security devices. The major functions of a data centre include providing of faster growing cloud service and centralizing any particular organizational IT operations (Holtshouse, 2013). Furthermore, data centre helps to continue with the daily operations of information technology. There are three different types of data centres. They are as follows: i) Corporate Data Centres ii) Web Hosting Data Centres Data Centres with Web 2.0 Technology Importance of Data Quality Quality of data is another significant factor in information technology for any organization (Cai Zhu, 2015). Without the higher quality of data, it is not possible to keep contact with the clients. Moreover, in this data driven era, it is extremely easy to search for the major information regarding the potential and recent clients. This information helps to enable to market more effectively and also encourage factor of loyalty (Holtshouse, 2013). The main benefits of data quality include low mailing costs, improvised relations with customers, consistent data and even effective marketing. Problems with Cloud Computing Cloud computing is the easiest and the most popular mode of data transfer through the Internet connection (Almorsy, Grundy Mller, 2016). It is extremely fast and can be done cost effectively. However, in spite of having these advantages, there are some of the major issues or problems that make cloud computing tougher to use. The main problems of cloud computing are as follows: i) Privacy Issues: This is the most important issue in cloud computing (Almorsy, Grundy Mller, 2016). Often data is hacked and thus the confidentiality is lost. ii) Migration: This is another significant problem in cloud computing. Data is needed to be migrated regularly and this makes it tedious to use. Complexity: The third major issue in cloud computing is complexity. This type of service is complex to use. iv) Availability of Data and Services: The fourth problem of cloud computing is the lack of availability of data and services (Almorsy, Grundy Mller, 2016). It is not easily available in the market and thus it becomes a major issue for the customers of cloud computing. Conclusion Therefore, it can be concluded that, information technology is the most important sector in todays world. The above report has clearly given a brief description of information technology and how it is important for my career. Moreover, the achievements and plans after studying IT are given here. The final part of the report comprises of data centres, data quality and cloud computing. References Almorsy, M., Grundy, J., Mller, I. (2016). An analysis of the cloud computing security problem.arXiv preprint arXiv:1609.01107. Cai, L., Zhu, Y. (2015). The challenges of data quality and data quality assessment in the big data era.Data Science Journal,14. Holtshouse, D. K. (2013).Information technology for knowledge management. Springer Science Business Media. Schwalbe, K. (2015).Information technology project management. Cengage Learning.

Divorce Essays (1064 words) - Family Law, Childhood, Parenting

Divorce It seems that more and more marriages are falling apart everyday. Divorce rates seen to be climbing astronomically. In so many of these divorces there are children to be considered. What is best for the child? Who will get custody? Will the child be scarred for life? Its really hard to say. The overall effects on our children vary according to the factors involved. I am going to attempt to discuss a few of the problems that can occur with children of divorced families and what parents can do to ease the transition. I will limit this discussion to infantile age thru early elementary aged children. Lets start with understanding the parents role concerning being together or being apart. Obviously, two parents can provide children with far more guidance, sustenance, and protection than one, and are more likely to prevent the kinds of psychological disturbance that may result from deprivations of these necessities ...When one parent is temporarily absent from the intact home, it is likely that the other will be available to ratify the childs needs in a loving way. This is not so readily the situation in the divorced home. ( Gardner, 1977). In this statement he illustrates the importance of having both parents together. This can be emphasized further with a statement from Buchanan, Maccoby, and Dornbusch (1996). Childrens parents are their anchors. Parents provide the structure for childrens daily lives, and even when parents are not functioning very well, children depend on them for a sense of security that enables them to cope with their developmental tasks. When one parent leaves the home, the child realizes a shattering possibility; parents are not always there. It is not hard to realize that divorce can have a devastating effect on children. Lets brake it down by age groups; infants, toddlers, and so on. DeBorg (1997) states that infants do not understand conflict, but may react to changes in parents energy level and mood. She goes on to list possible reactions like loss of appetite; upset stomach - may spit up more; more fretful or anxious. She says that parents should keep their normal routines, and stay calm in front of the child. Toddlers understand that a parent has moved away, but doesnt understand why. I know that my son was very confused. He was only two when my wife and I separated. He seemed to display allot of anger and insecurity. DeBorg says that a toddlers reactions could include more crying, clinging; problems sleeping; regression to infant behaviors; and worry when parent is out of sight. My son, his name is Cody, definitely fits this profile. He cried constantly. It seemed that nothing would calm him down. If you got him to go to sleep, good luck keeping him there. As far as infant behaviors go, his biggest problems were wanting to be rocked like when he was younger and trying to go back to the bottle. DeBorg say to allow some return to infantile behaviors, but set clear limits. Easier said than done I can assure you. Pres choolers dont understand what separation or divorce means, they realize one parent is not as active in his or her life (DeBorg, 1997). Their reactions could include pleasant and unpleasant fantasies; feeling uncertain about the future; feeling responsible; and they may hold their anger inside. Deborgs first strategy listed for parents is to encourage the child to talk. This makes sense if you are concerned with straitening out these issues of anger and feeling responsible. It seems to be the only way to really understand your childs problems. Gardner (1977, p. 42) talks of something called the oedipal phase. He explains that this occurs between ages three and five. This is the period... when a child develops a strong possessive attachment to the opposite-sexed parent. Gardner says that at times the attraction can take on mildly sexual overtones toward the opposite-sexed parent..., but the sexual desires are generally not for intercourse, the child being too young to appreciate that act. He explains that if a boy begins sleeping in Mothers bed thoughout the night, an a continual basis, the likelihood that oedipal problems will arise is great... this holds true for

Fossil Fuels essays

Fossil Fuels essays We get energy from sunlight, wind, nuclear plants, and damns... However, most of the energy that we use comes from fossil fuels. There are three major fossil fuels: Coal, oil and natural gas. These are composed of carbon, hydrogen, nitrogen, oxygen and sulfur. Carbon is the major element in fossil fuels. We obtain energy from fossil fuels by burning them. Coal is the most abundant fossil fuel in the U.S. Yet it has a major disadvantage. It is a strong pollutant. When it is burned, it releases impurities like nitrogen and sulfur, which combine with water vapor to create acid rain. Also, coal is a major contributor to the imbalance of the carbon cycle. When coal burns, it forms carbon dioxide. Scientists believe that carbon dioxide traps the earths heat in a process called the greenhouse effect. However, scientists have developed new methods to burn coal more efficiently, filter impurities before they are released in the atmosphere, and cut down on the release of carbon dioxide. Oil is another important fossil fuel. It is found under tons of rock, deep in the earths crust. Precisely, oil is found in rocks, trapped in little pores. When an oil well is dug in the earth, pressure from the reservoirs will make the oil spurt to the top of the well. When oil is pumped out of reservoirs, about only  ¼ of the oil available will be accessible to the pumps. Scientists and engineers have yet to discover a method to collect the remaining  ¾ of oil. Often, natural gas is found with oil. In some cases, oil companies separate the two fossil fuels and inject the natural gas back into the reservoir, creating enough pressure to allow more oil to spring to the surface. Natural gas is a colorless, odorless gas. It is responsible for fueling over half of the United States homes appliances. Some countries have discarded natural gas because they think it is worthless. Precisely, there isnt enough natural g ...

LM3 Assignment Example | Topics and Well Written Essays - 2000 words

LM3 - Assignment Example The major characteristics that make it difficult to define leadership include; people from both public and private organization barely know the components of leadership whether it exist or it doesn’t. According to Denhardt, Denhardt & Aristigueta, p-189 â€Å"leadership is becoming one of the most widely debated but least clearly understood concepts† Secondly people have not yet understood that leadership has become so dynamic whereby, society has been described as â€Å"highly turbulent subject to sudden and dramatic shift† (Denhardt, Denhardt & Aristigueta, pp-189). Thirdly, people have not yet understood leadership requires corporation among all the concern parties, whereby, according to Denhardt, Denhardt & Aristigueta, pp-190, â€Å"Moreover, clients or citizens also want to participate, as well they should†. Additionally, lack some aspect of creativity and innovativeness with respect to leadership style has made it quite challenging to define leaders hip (Denhardt, Denhardt & Aristigueta, pp-190-192). This is because leadership style that may be applied in a particular organization may not be effective in another organization. Additionally, different organizations have different structures and may require different leadership styles (Denhardt, Denhardt & Aristigueta, pp-189-195). In above connection, future leadership is more of a shared process because current leadership was build based on the past leadership theories. This is according to Denhardt, Denhardt & Aristigueta, p-190 â€Å"we need to understand how leadership has been studied and practiced in the past†. Therefore, through past leadership, future leadership can have a reference point as well as a fundamental base of formulating the appropriate leadership styles to be applied in future organizations (Denhardt, Denhardt & Aristigueta, pp 189-192). However, it is important to consider that â€Å"leadership is changing in many ways, and we should be attentive to those changes† (Denhardt, Denhardt & Aristigueta, pp-190). In above connection, it can be scrutinized that, â€Å"In the past, a leader was considered the person who held a formal position of power in an organization or a society† (Denhardt, Denhardt & Aristigueta, p-190). However, through evolution of leadership, people have come to understand that leadership is a process that requires corporation and integration among all people within and outside the organization (Denhardt, Denhardt & Aristigueta, pp190-193).Additionally, leadership has taken a certain angle, whereby, decision makers should not only involve people from top management but should also involve those from lower levels of management (Denhardt, Denhardt & Aristigueta, pp 190-195).This is because when everybody is involved in decision making, people feel that they own those decision(Denhardt, Denhardt & Aristigueta, pp 190-195 2. How to our text authors define â€Å"moral imagination†? When is this t o be used? Why? What does it involve? The author has employed the concept of moral imagination to explain what moral leadership entails as well as moral issues. According to Denhardt, Denhardt & Aristigueta, pp 224-225, moral imagination entails â€Å"not just heightening attention to moral con-cerns, but rather carefully and thoughtfully understanding and evaluating

The Import-substitution Industrialisation (ISI) Failure in Argentina Essay

The Import-substitution Industrialisation (ISI) Failure in Argentina - Essay Example Center of discussion in this paper is import substitution industrialization in Argentina that depended on the exchange rate and trade restrictions. They included several exchange rates, import licenses, quotas, protective tariffs, and export taxes. The main aim was to limit external trade and prepared the domestic market for local manufactures. Further, another aim was to protect the domestic industries from stiff competition arising from external industries. The domestic industries were expected to compete internationally. However, these policies typically led to inefficient firms and high cost industrial substitutes. The consequences were diverse, for instance, the local industries could not pose any competitive challenge internationally. As a result, Latin Americans had to pay high prices for substandard goods that could not satisfy their need for quality. Further, Argentina was not able to have foreign exchange to pay for the much required imports; they had spent much time de-emp hasizing exports. ISI had actually led to some economic gains, however, by 1980s, it had been exhausted. During 1980s and 1990s, Argentina was forced to injstitute a number of policies with the aim of opening its economy, decrease the size of the government as well as improving efficiency. Other countries in the Latin America such as Brazil and Paraguay experience government involvement in infrastructure development and in the production sectors. However, the major difference between these countries and Argentina was the issue of funding. This issue was not well addressed in Argentina. The country began to use inflation taxation as the best solution to their problems. Inflation taxation occurs when the government decides to print money to pay the state bills. From the mid 1940s, Argentina witnessed huge difference in its rising inflation figures from the low inflation figures in other countries of the world (Zanetta, 2004). High inflation rates, high fiscal deficits and huge governm ent debts were the main challenges facing Argentina from 1940s to the end of the century. Several argentine citizens argued that the excessive government interference in the economy and the fiscal laxness were not the only problems that led to economic down turn in Argentina. Another challenge that faced Argentina was the relatively trained administrative personnel. The argentine government was not prepared to put in place policies that could lead to stable economic growth. Corruption also affected this problem as well (Birkbeck, 2011). President Peron’s earlier economic gains in Argentina quickly ran into a number of challenges. In 1949, Peron’s government witnessed inflation of about 31percent. This was due to Peron’s strategy of demand expansion through wage increases. At this time, employment was already high. Further, the controlling of imports and the stronger purchasing power siphoned off exports and led to inflation in Argentina (Birkbeck, 2011). In 1949 , Argentina was affected by its first foreign trade deficit since the First World War. In addition, the drought that affected Argentine’s agricultural export further affected argentine’s economy. Further, the terms of trade had started to work against the country. The terms of trade included the rising prices of imports and the decreasing prices of exports. Peron’s approach to economic growth was making the problems worse. For instance, in giving artificially low prices to farmers, to ensure that urban food

Political science Essay Example | Topics and Well Written Essays - 1500 words - 2

Political science - Essay Example In fact, national democracy is one of the key sources of such transactional cost, since it provides sovereign risk and regulates rules at the border. In addition, national democracy reduces chances of global risks by providing regulations and supervision of financial intermediaries (Rodrik, 212). Therefore, it is important that global federalism be adopted where democratic politics is aligned with global markets. Consequently, it is important that the national state is maintained and the needs of international economy are also catered for. As a result of this, the nation will in most cases pursue the objective of achieving global economic integration before considering other objectives. The national democracy can also be used in order to reduce the goals and visions of the international economic integration and going for limited globalization as was witnessed in post war in Bretton Woods’s regime where there was more capital control and minimal trade liberalization (Rodrik, 102). Although, this system led to failure of the approach given, it is thus important that for more globalization to be achieved, national democracy or national sovereignty must be reduced. Furthermore, this clearly illustrates that national democracy is one of the factors that determine the state and pace of globalization in a country. The potential effect of globalization is the reduction of national democracy, which also reduces global fiscal competition. In that sense, it is important that democracy be provided in a way that promotes civil rights, although this will lead to low economic growth but cause high social stability. In addition, this can help in expanding global civil rights (Rodrik, 110). This also clearly indicates that economics is an important political decision-making processes that requires global order. Furthermore, although globalization is one of the factors for economic growth in both rich and poor countries, it is currently producing a different result

Case Summary On The Effects Of Unstable Angina Nursing Essay

Case Summary On The Effects Of Unstable Angina Nursing Essay Mr AR is a 41 years old male. His calculated BMI was 20.9kg/m2. His presenting complaint was chest pain which has lasted for three days before being admitted into the hospital. His chest pain was of pressing type, it occurred even at rest and lasted for 5-10 minutes each time. It was relieved slightly by rest and it was always accompanied by numbness on his left hand. He had shortness of breath, orthopnea, headache and low effort tolerance. He complained of abdominal discomfort also. He had stopped taking all his medications for the past three days. He had a pacemaker fixed 16 years ago for his atrial fibrillation (AF), but the pacemaker stopped functioning 3 years ago. Due to financial constraint, he did not go for a new pacemaker replacement. He underwent an angiogram last year and was found that he has 2 blocked vessels. He has a history of hypertension too. Before being admitted into the hospital, he has been taking frusemide 40mg twice daily, hydrochlorothiazide 25mg once daily, perindopril 8mg once a day and amlodipine 10mg once a day for his hypertension. For his AF, he has been taking warfarin 5mg once daily and digoxin 125microgram once daily. In addition, he took simvastatin 40mg at night for the prevention of cardiovascular events. Mr AR was found to have poor compliance. He always missed the dose, took the medications at the wrong time and was unsure the reason behind taking all his medications. He was first admitted to the acute and emergency department. ECG was carried out and there was no ST-elevation. His blood pressure was found to be high, 172/126mmHg. No troponin test was done on Mr AR, the only available test results on cardiac enzymes were that of creatine kinase (CK), aspartate amino transferase (AST) and lactate dehydrogenase (LDH). All three were not elevated. Hence, he was diagnosed with unstable angina, gastritis and hypertensive urgency. He was given nifedipine 10mg, aspirin 300mg, Sublingual GTN and plavix 300mg in the acute and emergency department. His management plans were to monitor his vital signs every hourly for two hours followed by every two hourly and to carry out dextrostix test three times daily. He was given 60mg enoxaparin subcutaneously immediately and twice daily thereafter, intravenous ranitidine 50mg three times daily, sublingual glyceryl trinitrate (GTN) one tablet when required and IV frusemide 20mg twice daily. He was restricted to fliud intake of 800mL per day and started on fliud input and output monitoring. He will also be started on low salt diet for the management of his hypertension. On day 2, he no longer complained of chest pain. His potassium level was found to be slightly lower than normal range (3.3mmol/L). His BP was still high throughout the day, fluctuating at around 150/120mmHg. He was started on tablet clopidogrel 75mg once daily. On day 3, IV frusemide was changed to oral frusemide. On day 4 his blood pressure has already dropped to around 120/90 mmHg. He was planned for discharge and enoxaparin was to be stopped on that day. Disease overview and pharmacological basis of drug therapy Mr AR was diagnosed with 3 diseases. Only unstable angina will be discussed. Unstable angina (UA) is categorized under acute coronary syndrome (ACS) which is very common in the UK. According to the hospital episode statistic year 2002-2003, there were 83842 cases of UA in England and 4421 cases in Wales.1 UA happened when there is insufficient myocardial oxygen supply to meet the oxygen demand of the heart. The reduction in the oxygen supply is due to the disruption of artherosclerotic plaque, causing the formation of intracoronary thrombus and hence narrowing of artery. Abnormal vasospasm of the coronary arteries or coronary dissection may also lead to UA. UA is closely related to non-ST elevated myocardial infarction (NSTEMI) as they have the same pathogenesis and both are presented as chest pain. The only difference between them is that in NSTEMI, there is a rise in the cardiac biomarkers such as cardiac troponin or the MB isoenzyme of creatine phospokinase (CK-MB), which indicate s myocardial injury. In UA, the ischemia is not severe enough to cause damage to the myocardial cells and thus releasing these biomarkers in detectible amount. For the diagnosis of unstable, the patients history of anginal symptoms should be obtained. Physical examination like cardiac examination and vital signs monitoring may also be done. Patient with ongoing chest discomfort should have a 12-lead ECG performed within 10 minutes of onset to check if there is any ST-elevation or depression. If there is no ST elevation, STEMI will be ruled out and the level of serum cardiac biomarkers will be used to determine if the patient has UA or NSTEMI. Troponin I or T are normally the biomarker chosen for detecting myocardial cell death as it is detectable in the serum 3-6 hours after a myocardial infarction and remained raised for 14 days. If the serum troponin level is less than 0.01 Ã‚ ­g/L, then the patient will be diagnosed to have unstable angina. CK-MB may also be used when troponin test is not available. In Mr AR case, the results on the cardiac enzymes available, namely AST, CK and LDH are all non specific cardiac biomarkers as those enzy mes can also be elevated in skeletal muscle injury or liver disease. The treatment of UA can be divided into emergency treatment and secondary prevention treatment.2,3 Patients must rest in bed and ECG monitoring should be continued during the early phase of hospital stay. Sublingual glyceryl trinitrate (GTN) tablet or spray should be given for the relief of angina symptoms. GTN is a fast acting coronary vasodilators. Dilatation of veins going to the heart reduces ventricular volume and preload, while dilatation of systemic conductive arteries together with the decrease in ventricular volume causes a reduction in afterload. These effects will all reduce the myocardial oxygen demand.4 GTN also found to dilate collateral vessels, thus the areas of ischemia will receive a higher blood flow. If the chest pain is not relieved by GTN, intravenous morphine sulphate can be given to ensure patient comfort. Patient with ongoing chest pain or high risk patients should be given inravenous beta-blockers followed by oral route if there is no contraindication. Inter mediate or low risk patients can be given oral beta-blockers. If beta-blocker is contraindicated such as the in presence of uncontrolled heart failure, or the chest pain is not relieved by GTN and beta-blocker, nondihydropyridine calcium channel blocker can be given. Antiplatelet therapy should be given immediately by giving aspirin 300mg initially, followed by 75mg once daily for long term secondary prevention. In addition, clopidogrel 300mg should be given initially and 75mg daily thereafter for 3 months. Aspirin works by inhibiting the cyclooxygenase (COX) 1 enzyme on the platelet, thus preventing the production of thromboxane which stimulates platelet aggregation.5 Clopidogrel is an antiplatelet which acts by inhibiting adenosine diphosphate (ADP) from binding to its receptor, hence blocking the activation of ADP-mediated glycoprotein GPIIb/IIIa complex, a step involved in aggregation of platelets.6 Unfractionated heparin (UH) or low molecular weight heparin (LMWH) is an important antithrombotic agent in the management of UA. LMWH is normally preferred over UH as it can be given subcutaneously and no coagulation monitoring is needed. LMWH like enoxaparin should be given for 2-8 days. Heparin binds to antithrombin and the complex formed deacti vates a series of enzymes involved in the coagulation process. Thus thrombus formation will be inhibited.7 Patients with high risk of MI or death should also be given glycoprotein IIb/IIIa antagonist such as eptifibatide, tirofiban or abciximab. For the secondary prevention treatment, in addition to aspirin and clopidogrel, beta-blockers should be continued indefinitely. Statins can be started regardless of the patients cholesterol level for the preventing cardiovascular events. Statins are 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, which act by inhibiting the biosynthesis of cholesterol.8 Angiotensin converting enzyme (ACE) inhibitors are useful in patients with UA also. They work by inhibiting the production of angiotensin II which is a potent vasoconstrictor and reducing the breakdown of bradykinin which is a potent vasodilator.9 Evidence for the treatment of the conditions When the patient was admitted to the acute and emergency department, he was given clopidogrel 300mg, aspirin 300mg immediately and was then continued with long term treatment of 75mg of clopidogrel. The use of clopidogrel for the long term treatment of unstable angina was supported by two large trials. First, the CAPRIE trial which compare the beneficial effect of clopidogrel versus aspirin in patients at high risk of ischaemic event.10 In this trial, patients were either given 75mg clopidogrel once daily or 325mg of aspirin once daily. The clopidogrel group has a marginally lower risk of ischaemic stroke, myocardial infarction, or vascular death (5.32%) compared to the aspirin group (5.83%). The side effects reported were similar in both groups, indicating that clopidogrel has a comparable safety profile to that of aspirin. The second trial is the CURE Trial which investigate the beneficial effect of adding clopidogrel to aspirin therapy in patients with non-ST elevation acute coronary syndrome.11 In this trial, 12,562 patients were given either 300 mg clopidogrel innitially, then 75 mg once daily or placebo plus aspirin for 3 months to a year. It was found that there was a lower rate of death from cardiovascular causes, nonfatal MI or stroke in the clopidogrel group. However, the risk of major bleeding was significantly higher in clopidogrel group. Hence, it can be concluded that long term clopidogrel should be used in patients with acute coronary syndrome in addition to aspirin. In addition, according to a meta-analysis done by the Antithrombotic Trialists Collaboration, long term treatment of aspirin in the range of 75-150mg was found to be beneficial in patients with acute coronary syndrome. In cases where antithrombotic effect is needed immediately such as during acute attack of MI or UA, aspirin at a dose of 300mg should be given.12 In Mr AR case, only 300mg of aspirin was given in the acute and emergency department, no long term treatment of aspirin was given. This might be due to his newly diagnosed gastritis. NSAIDs were found to cause or worsen gastritis.13 According to the AHA/ACC guideline, clopidogrel will be the alternative for patients intolerant to aspirin due to gastrointestinal problems. According to a study done by Harker LA et al. where the tolerability and side effects of aspirin and clopidogrel were compared using the results from the CAPRIE trial, it was found that the group of patients receiving clopidogrel has a lower percentage of gas trointestinal side effects, with a rate 27.1% compared to 29.8% in those taking aspirin (p < 0.001).14 This finding support the reason behind clopidogrel being the only antiplatelet given to Mr AR. However, The difference in the incidence of side effects between the two treatment group was small and higher rate of occurrence of gastrointestinal problem in aspirin group might be due to the high dose of aspirin used (325mg). The policy of the ACC/AHA guideline of using clopidogrel instead of aspirin in patient with a history of GI complication was also refuted by Chan and colleagues.15 In this study, 320 patients who had recovered from aspirin-induced upper GI bleeding were given either 75 mg of clopidogrel daily or 80 mg of aspirin daily together 20mg of proton-pump inhibitor esomeprazole twice daily. When the patients were followed up after one year, it was found that patients in the aspirin group has a lower rate of recurrent upper GI bleeding compared to those receiving clopidogrel plus esomeprazole (8.6% versus 0.7%, P=0.001). No protective effect was conferred by esomeprazole in aspirin-induced lower GI bleeding. Hence, low dose aspirin is still deemed appropriate in Mr ARs case if given with a proton pump inhibitor or H2-antagonist like ranitidine. On day 1 Mr AR was given 60mg of enoxaparin immediately and twice daily thereafter. A comparison between the efficacy of UH and LMWH was carried out in the ESSENCE trial.16 In this trial, patients were allocated either subcutaneous enoxaparin plus placebo bolus and infusion or bolus and infusion unfractionated heparin plus placebo subcutaneous injection. In addition, they were all given oral aspirin. It was found that the enoxaparin group has a lower rate of recurrent angina, MI or death and also the need of revascularization process. Hence it was concluded that enoxaparin is more advantageous than UH, as there is little protein binding, longer plasma half life and more resistant to neutralisation by platelet factor IV as compared to UH. The dose given to Mr AR is justified according to a trial where the dose of enoxaparin was adjusted according to the weight of the patients. 17 It was found that giving 1mg/kg of enoxaparin to patients with UA or non-Q wave MI resulted in a lower ris k of major bleeding compared to giving a dose of 1.25mg/kg (6.5% versus 1.9%). Mr ARs weight was 59kg, thus a dose of 60mg is appropriate and evidence based. Sublingual GTN was given to Mr AR for the relief of his chest pain. According to the British Medical Journal evidence centre, no good evidence was found on the angina. There is one randomized placebo controlled study done by Karlberg et al. where they compared the effectiveness of intravenous GTN versus placebo in reducing ischaemic attack in unstable angina.18 In this trial, they found that patients given GTN have a fewer new onset of chest pain compared to placebo group. No trial was done to investigate the effectiveness of sublingual GTN in preventing ischaemic attack. However, according to a methodological study done by G Nyberg to determine the time of onset of sublingual GTN, it was found there was a significant reduction in the intensity of exercise induced chest pain and an improvement in the ST-depression when 0.5mg of GTN was given sublingually at the onset of chest pain.19 Hence, there is a consensus that sublingual GTN can be used for symptomatic control of unstable angin a. Mr ARs previous medications were continued during the hospital stay. Among those medications, perindopril, an ace-inhibitor, is also proved to be beneficial in the prevention of MI. There are two well known studies done on the effect of ace-inhibitors in preventing cardiovascular event in patients with cardiovascular disease, namely the HOPE trial and the EUROPA trial.20,21 In the HOPE trial, ramipril was chosen as the treatment drug. As for the EUROPA trial, perindopril was chosen to investigate if there is any beneficial effect in preventing MI, cardiac arrest or mortality in patients with stable coronary disease. It was found out that in the group of patients receiving perindopril, there was a 20% relative risk reduction in the primary end point as compared to the placebo group. Hence, it was concluded that perindopril should be given to all patients with coronary heart disease, including Mr AR who has unstable angina. In addition, Mr AR was continued with 40mg simvastatin once daily at night. According to a trial on simvastatin, it was found that giving simvastatin to high risk patients lowers their cholesterol level and reduces the incidence of cardiovascular events.22 In this trial, 20536 adults in the UK with high risk of getting cardiovascular event were given simavastatin 40mg daily or placebo. It was found that the simvastatin group has a lower percentage of all cause of death (12.9%) and major vascular event (19.8%) compared to the placebo group (14.7% and 25.2% respectively). There was a difference of about 1.0mmol/L in the LDL cholesterol level between the two groups after treatment regardless of the initial cholesterol level. This indicates that there is a reduction in the LDL cholesterol level in the simvastatin group which is independent on the initial cholesterol level. For patient given simvastatin, the risk reduction of the first major vascular event is similar no matter the patient s were taking ace inhibitors, aspirin, beta blockers or antihypertensive drugs or not. This shows that simvastatin provides additional benefits when added to the existing treatment with these drugs. Thus, it can be concluded that simvastatin will be beneficial to Mr AR who was taking ace inhibitor and antihypertensive drugs concurrently. Mr Ar was newly diagnosed with gastritis and was commenced on IV ranitidine. In a double blind clinical study, patients diagnosed with gastritis were given 300mg ranitidine daily for 4 weeks or placebo only.23 It was found that patients from the ranitidine group improved significantly faster than the placebo group and 80% of the patients had their symptoms completely resolved. Only 45% of the patients from placebo group achieved improvement in their symptoms while the remaining showed no change in their gastritis. Hence, it was concluded that ranitidine is an effective treatment option for gastritis. However, this trial only involved 52 patients and this small sample size renders the finding from trial inconclusive. In another trial where the effectiveness of ranitidine and sucrafate was compared, it was found out that both have a similar activity in relieving the symptoms of gastritis.24 77.6% of the patients receiving sucralfate and 79.4% from the ranitidine group had their symptom s completely resolved at the end of the study period (8 weeks). However, ranitidine was found to act faster in relieving pain compared to sucralfate. Hence, it can be concluded that the management of Mr ARs gastritis with ranitidine is justified. Mr AR was given nifedipine 10mg for the treatment of his hypertensive urgency. Even though nifedipine was found to be effective in reducing blood pressure within 20 minutes, this fast release, short-acting calcium channel blocker are not recommended in this case as Mr AR did not receive any beta-blocker before. According to the results obtained from the Holland Interuniversity Nifedipine/metoprolol Trial (HINT), monotherapy with nifedipine in patients with unstable angina naà ¯ve to beta blockers was associated with a higher risk of recurrence ischaemic attack or MI.25 The event rate ratio compared to placebo for beta blocker naà ¯ve, nifedipine only group was 1.15. As for the group receiving both nifedipine and metoprolol, the ratio was lower (0.80). Patients who were already receiving beta blockers and were added with nifedipine also showed lower rate ratio (0.68). Hence, it was concluded that nifedipine was only beneficial in patients who were treated with beta blocker at the sa me time. Moreover, it was found from the Trent study that nifedipine does not show any beneficial effect in patients with MI.26 In this trial, the death rate for patients receiving nifedipine 10mg four times daily and placebo was similar. When the number of death and MI were compared among patients taking beta blocker and not taking beta blocker among admission, it was found that the latter group has a higher rate of death and MI. This result is comparable to those from the HINT trial. Hence, the use of nifedipine in treating Mr ARs hypertensive urgency is not justified, other drug should be chosen. Conclusion The immediate treatment of UA with high dose of antiplatelet agent aspirin and clopidogrel together with the antithrombotic agent LMWH are justified as they help preventing the progression of UA to MI. Sublingual GTN on the other hand helps relieving his chest pain. As for his previous perindopril and simvastatin that were continued, these help in preventing recurrent angina also. Choosing clopidogrel for the long term prevention treatment of UA due to the presence of gastritis might not be the best option for Mr AR. Once his gastritis has resolved, life-long aspirin at the dose of 75mg should be added in with oral ranitidine 300mg twice daily prescribed as prophylaxis against NSAID induced gastritis. However, the use of nifedipine in the management of his hypertensive urgency is not justified. Instead, he should be given labetalol, atenolol or clonidine which were found to be better alternatives to nifedipine in treating hypertensive urgency.27 PATIENT MEDICATION PROFILE Patient details Name: AG Consultant: General Practitioner: Address: Gender: Male Weight: 59kg Height: 168cm Community pharmacist: Age: 41 Known sensitivities: NKDA Social history: Non-smoker, No alcohol abuse. Patient hospital stay Reason for admission Admission date: Chest pain. Discharge date: Relevant medical history Relevant drug history Date Problem description Medication Comments 1994 Pacemaker fixed Warfarin 5mg OD Atrial fibrillation 2007 Pacemaker not functioning, did not go for replacement due to financial constraint T digoxin 125mcg OD Atrial fibrillation 2007 Angiogram, 2 blocked vessels T frusemide 40mg BD Hypertension Hypertension Perindropil (coversylƒ’) 8mg OD Hypertension T amlodipine 10mg OD Hypertension Hydrochlorthiazide 25mg OD Hypertension T simvastatin 40mg ON Prevention of cardiovascular event Prescribed medication Route of administration Start Stop Nifedipine (adalat) 10mg PO Day 1 Aspirin 300mg PO Day 1 Day 1 Clopidogrel (plavixƒ’) 300mg PO Day 1 Day 1 Clopidogrel (plavixƒ’) 75mg OD PO Day 2 Enoxaparin (Clexaneƒ’) 60mg stat, BD subcutaneous Day 1 GTN 1 tablet PRN sublingual Day 1 Simvastatin 40mg ON PO Day 1 Amlodipine 10mg OD PO Day 1 Hydrochlorothiazide 25mg OD PO Day 1 Warfarin 5mg OD PO Day 1 Furosemide (Lasix) 40mg stat, BD IV Day 1 Day 3 Furosemide 40mg BD PO Day 3 Perindopril (Coversylƒ’) 8mg OD PO Day 1 Ranitidine (zantac) 50mg tds IV Day 1 Digoxin 125mcg OD PO Day 1 Clinical/ Laboratory Tests Date Results Potasium (3.5-5.0 mmol/L) Day 2 3.3 BP Day 2 150/118 Day 3 134/100 Day 4 122/86 Pharmaceutical Care Plan Care Issue Action Actual output/ Desired output Long term treatment with aspirin. Patient should be given 75mg of aspirin for the secondary prevention of UA. Patient has gastritis. He should be started on long term treatment of aspirin once his gastritis has resolved and ranitidine should be prescribed as prophylaxis against NSAIDs induced GI complications. Long term treatment with beta blockers. Beta blocker should be given to the patient as the secondary prevention treatment. Patient should be started on labetalol 100mg twice daily and titrate up to 200mg twice daily. Inappropriate use of nifedipine for the management of hypertensive urgency. Nifedipine should be substituted with labetalol 200-300mg every 3-4 hours when required. Not taken. Interaction between digoxin and diuretics when hypokalaemia occur. Potasium level should be monitored. Inform the patient on signs and symptoms of digoxin toxicity. Patients potassium level was lower than the normal range on day 2. He should be given potassium sparing diuretics or potassium supplement if the potassium level keeps going down. Monitoring should be continued. High risk of bleeding due to warfarin, aspirin, clopidogrel and enoxaparin. Bleeding tendency should be monitored. Patient should be told to inform the GP if there is any unusual bleeding like blood in the stool. Patients INR and prothrombin time were within the normal range. Monitoring was continued. Changing of IV ranitidine to oral ranitidine. Patient should be switched to oral ranitidine150mg twice daily after being discharged. Not taken. GTN for relief of angina symptoms. Patient should be prescribed GTN spray or sublingual tablet for the relief of chest pain shoul the patient has another angina attack. GTN sublingual tablet was prescribed as discharge medication. Poor patient compliance Patient should be informed on the reason behind taking his medication, the importance of compliance. Compliance aid should be given. Patient was counselled on the importance of compliance. Side effects of simvastatin -muscular side effects -liver disease Patient should be advised to report immediately any unexplained muscle pain, weakness nor tenderness. Regular LFT monitoring should be done. No monitoring of cholesterol level. Cholesterol level should be monitored suring the hospital stay so that the dosage of simvastatin can be adjusted accordingly. Cholesterol level should be maintained below 5.2mmol/L. Patient education on healthy lifestyle. Patient should be told on the importance of low salt diet for his HT and encouraged to exercise more. Patient was counselled on the importance of healthy lifestyle before being discharged.

The Death Penalty Is Dead Wrong :: Capital Punishment

Why the Death Penalty is Dead Wrong Most people argue that the death penalty is not a form of cruel and unusual punishment. However, this is extremely inaccurate. Electric chair victims can take up to 14 minutes to die, maintaining full consciousness as their flesh begins to scorch and burn off. During lethal injection, "even a slight error in dosage or administration can leave a prisoner conscious but paralyzed with pain, serving as a witness for his own demise." The following is an eye witness account of an Arizona gas chamber execution given by Supreme Court Justice John Paul Stevens: "When the fumes enveloped Don's head he took a quick breath. A few seconds later, he looked again in my direction. His face was red and contorted as if he were attempting to fight through tremendous pain. His mouth was pursed shut and his jaw was clenched tight. Don then took several more quick gulps of the fumes. His body started convulsing violently and his skin turned a deep red...the viens in his temple and neck began to bulge until I thought they might explode. After about a minute, Don's face leaned partially forward, but he was still very conscious. He was shuddering uncontrollably and his body was racked with spasms. His head continued to snap back. His fists were clenched tightly. After several more minutes, the most violent of the convulsions subsided. At this time, the muscles along Don's left arm and back began twitching in a wavelike motion under his skin. Spittle drooled from his mouth. Don Harling took exactly ten minutes and 31 seconds to die. Approximately three months later, he was found innocent." And it wasn't the first time. Amnesty International sites that "from 1900 to 1985 over 350 people sentenced to death were later found to be innocent of the crimes charged. Some excaped execution by only minutes, but 23 were actually executed. Within the last 20 years, 54 Americans under sentence of death have been released because of evidence of their innocence." Unlike a life imprisonment, death offers no second chance. If new evidence surfaces after the person has been executed, it's too late to do anything about it. The death penalty doesn't save tax payers any money, either. Many people have the misconception that criminals should not be allowed to "rot in jail" wasting tax payers money. However, a study conducted by the Death Penalty Information Center (DPIC) concludes that tax payers pay an average of $3.2 million dollars per each death penalty case -- enough to sentence someone to 120 years in a maximum security facility. The death penalty is also not a detterent to crime.