Monday, September 30, 2019
Neoclassical and Romantic Writing Essay
Neoclassical and Romantic movements cover the period of 1750 to 1850. Neoclassicism showed life to be more rational than it really was. The Romantics favored an interest in nature, picturesque, violent, and the sublime. Unlike Neoclassicism, which stood for the order, reason, tradition, society, intellect, and formal diction, Romanticism allowed people to get away from the rational views of life and concentrate on an emotional and sentimental side of humanity. In this movement the emphasis was on emotion, passion, imagination, individual, and natural diction. Resulting in part from the liberation and egalitarian ideals of the French Revolution, the Romantic Movement had in common only a revolt against the rules of classicism. Neoclassicism was an artistic and intellectual movement, beginning in the mid-17th century in England, both progressive and traditional in its goal of rivaling the literary and artistic accomplishments of Augustus Caesarââ¬â¢s day and the classical period in general. This movement could be characterized as a ââ¬Å"religion of the head. â⬠Neoclassical writers imitated great poems of the past because of the belief that men had agreed on certain fixed ways of writing across the centuries. Rules for pastoral poetry, the satire and the epic were respectfully followed Romanticism was an artistic and intellectual movement that spread across Europe in the late 18th and early 19th century. This movement was a reaction in direct opposition to the Age of Reason in its understanding of human happiness and the means to achieve it. This literary revolution could be characterized as a ââ¬Å"religion of the heart. â⬠Romantics, in direct opposition to the previous age, believed in the guiding forces of nature. They believed that nature held all truth, and didnââ¬â¢t search for such in science and mathematics as the neoclassicists did. They were impassioned and fond of beauty, as well as myth.
Sunday, September 29, 2019
Natural sciences Essay
Knowledge involves acquaintance with truth, principles or facts as with a certain subject or a branch of learning. People have various perceptive of knowledge. There are those who belief that knowledge is found in many forms which must be proven with evidence. It is possible to doubt everything that exist because it is a misconception or it may be seen as an illusion. Doubt is important in knowledge because learning through from the senses or through the senses can be deceptive. For example, senses can deceive because one may smell something sweet and senses deceive that it is going to have sweet taste. However, this is wrong because not everything that smells sweet taste sweet. Dreams are also deceptive as they are just false delusions because occasionally when one is asleep one is deceived by the illusions in dreams. These are just ways that knowledge through the senses can deceive. Therefore, it becomes necessary to doubt everything so that one can get the true knowledge. So as the proverb hold doubt is key to knowledge. Knowledge creates doubt and doubt pave way for gaining more knowledge. If its is not for doubt then there would be no knowledge or the knowledge that would be available would be one that is not complete knowledge (Urdahl, pg 27-29). In natural sciences, scientists have a lot of experience with doubt and uncertainty. This is experience that is very necessary in gaining knowledge in natural sciences. When one does not know the answer to a problem then this can be termed as ignorance. Then one has a hunch as to what the results are, for example, of an experiment, then it means that one has uncertainty. When one is darned sure of what the result would be then it means that one has some doubt. Therefore, it is paramount important that in order to have progress it is important to recognize the ignorance we have in natural sciences and leave room for doubt. This is because scientific knowledge is a body of statements, which have varying degrees of certainty. The degrees vary from being unsure, nearly sure and none absolutely certain. Doubt is a good thing in natural science because if one knows the answer or thinks that one knows the answer then it becomes easy to fail to seek more knowledge about that particular subject. Doubt helps to come out of that emotional attachment that people have in certain beliefs or from the theory of determinism. Example of areas where doubt has assisted in gaining and verifying knowledge is in the assumptions in relativity that inertial mass and gravitational mass are equal. In order to show that they are not the model has to be revised. Scientists have engaged in refining their ability to measure the two. It is the doubt that has developed in this area that has made the scientist revise this model until they have realized that inertial mass and gravitational mass are different at finer degrees. Therefore, they doubt has made it known that the two are not equivalent as has been held in the past. In this case, it is not that the same experiment is repeated but the real key to this is to look at the statements and test if they have been examined to the extent that they should. Doubt allow the use of new tools in scientific experiments which allow new discoveries which do away with the old ideas or theories. Science in this case becomes a process of doubt. Natural scientists are always nor sure and this is the reason as to why they repeat the steps in experiments in order to make sure that it is right. Another area where doubt has necessitated growth of knowledge is in the evolution theory. At the beginning people had strong belief that creation theory was the one that provided call the knowledge about the evolution of human being. However, as knowledge grew people started to doubt some aspects of the evolution theory and developed other theories such as the Darwinian theory of evolution. This is a theory which resulted out f the doubts about some of the aspects of the former theory. This is not the end theory because doubts in some aspects of the evolutions theory have also led to development of some other theories (Axtell pg 87-88). Doubt has also contributed to increased knowledge in other areas, for example, in social science and history. There are two areas that information collected or knowledge gained depends on research or theories which were constructed in the past by various scholars. However it becomes tricky to use such kind of theories to their full because history and social sciences are dynamic. For example, the society change as time moves. Therefore, this is also in the same way that the theories are supposed to change. For example, if theories that were constructed in the fourteenth century are used in the twenty first century then there is no doubt that the theory would contain a lot of faults because of the changes that have occurred in the society. People have developed in their way of reasoning as in these days there are more sources of information than in the past. Reason is one part of gaining knowledge that enhances the development of doubt. This is because it is after deductive reasoning that a person is able to develop hypothesis that proves some knowledge as relevant or irrelevant (Gotschl, pg179-180). Historians do their research and base most of their research on the researches that were conducted in the past. The information in the research where they base their research would be biased or exaggerated. This is what cause doubt and enhance new research to be conducted regarding some issues. Despite the fact that some people are emotionally attached to some believes doubt has made them to relent some of their believes. For example, different ethnic groups have their own myths about where they originated or who is their god or where their god lived. In traditional society people had strong emotional attachment to these beliefs (Chang pg 581). However, as time has passed people have developed doubt about these believes to develop other believes. This is because most of the beliefs in the traditions are not well reasoned and are also biased to particular ethnic people. People have developed other believes that are more inclusive of other ethnic groups all over the world. This has risen out of the doubt that people have some of the things that happened in the past (Lamm Norman pg 11-12). Despite that knowledge plays a key role in knowledge I think that knowledge or truth is a fixed situation because truth is not questionable. So if true knowledge is out there to be discovered or to be learned then it means that when we know or acquire knowledge then there should be no room for doubt. I also think that knowledge depends mostly on human perception. Natural sciences have more upper hands in investigating the truth. However these sciences are still subjected tout human brains. Curiosity is also key to knowledge rather than doubt. Human beings are always curious to know more about their nature. The curiosity allows them to make discoveries and also strive to find the truth. Looking critically at the discoveries that have been made in the past it is out of curiosity that this has happened. This curiosity leads to knowledge, which then leads to wisdom. Doubts make us to know hat our knowledge is correct instead on believing in something blindly. However I do not feel that doubt makes us to make any discovery or learn anything that is new to us. It is curiosity that allows us to acquire new knowledge more quickly. Work cited Axtell Guy. Knowledge, belief, and character: readings in virtue epistemology, 1st edition, Rowman & Littlefield, 2000. Chang Larry. Wisdom for the Soul: Five Millennia of Prescriptions for Spiritual Healing, Gnosophia Publishers, 2006. Gotschl Johann. Erwin Schrodingerââ¬â¢s world view: the dynamics of knowledge and reality Vol 16, New York, Springer, 1992. Lamm Norman. Faith and doubt: studies in traditional Jewish thought, 3rd edition, KTAV Publishing House, Inc. , 2007. Urdahl Halvor. Key of Knowledge, New York, Kessinger Publishing, 1998.
Friday, September 27, 2019
Market Strategy Essay Example | Topics and Well Written Essays - 500 words
Market Strategy - Essay Example Hence, while opting for a large scale expansion in China, the company was quiet confident that its traditional organizational structure comprising of well laid out stores backed by time tested retailing concepts and culture would work well in China (Pogoda, 1994). However, Wal-Mart soon realized that the Chinese customers required different sort of merchandize and goods. Therefore, to understand the local markets, the company decided to get actively involved with the local communities and started opting for local suppliers (Taylor, 2009). This strategy of retaining the traditional organizational structure, with localized procurement worked wonders for Wal-Mart in China. Just like Wal-Mart, when McDonalds decided to go global in the 90s, the company was confident that its well-calibrated organizational approach of offering franchises at the local level would work well in the foreign markets also. Luckily, for McDonalds, the things worked well as was expected and its brand of fast food soon became a rage in the New Markets in Asia, Latin America and Africa. However, this does not mean that McDonalds simply transplanted it US based organizational structure in the foreign markets. The company was well aware that food is always about flavors, which differ from place to place and people to people. Therefore, the company not only adapted its distribution strategies and packaging as per the local preferences, but also customized its products to suit the local tastes. For example, McDonalds offers Halal fast food in the Gulf and beer in Germany (McDonalds, 2005). From the very start, Skype succeeded in establishing itself as the most popular voice communication service around the world. The company conducted its business through it internet portal. However, it was not long that Skype realized that the emerging new trends and developments in the digital technology would make it literally obsolete, if it fails to customize and adapt to the novel digital
Methodology for a sociology class Essay Example | Topics and Well Written Essays - 250 words
Methodology for a sociology class - Essay Example Immediately we looked the Mission District which works with a large number of the Latino, Chicano, Central and South American immigrant population. We also looked at the Dolores Street Community Services Center. This center works to provide many homeless people with affordable housing and helps empower some of its low-income residents living in San Francisco. We met Marlon Mendieta, the Housing Program Director of Dolores Street Community Service Center. She gave us a short summary on her center. She explained to us the steps they are taking in order to help underprivileged people in their community. She also provided us with information on how they are trying to create a healthy community where everybody has equal rights regardless of income, immigration or health status. After we spoke with Mrs. Mendieta we went to the womens building where we interviewed Yeni Solis, the Reception Coordinator. She explained the centers mission statement to us and told us that their goal is to empower women and girls in the society by providing them with services and programs to become more self-sufficient. The last stop for our team was The Mission Cultural Center Latino where we met Christina who was originally from Argentina . She told us about her unique experience with the center. She has been taking dancing classes and she told us how she is happy about being more involved with community. All of these centers gave us a more defining picture on the immigrants life in an urban community and a centers role in helping them adjust to life in America. Our group chose to not just browse the internet but to go to these centers and interview the staff and the immigrants. We wanted to have a genuine experience and to see exactly how the immigrants are living and adjusting to life in the Unites
Thursday, September 26, 2019
Drinking and Driving (Cause and Effect) Essay Example | Topics and Well Written Essays - 750 words
Drinking and Driving (Cause and Effect) - Essay Example Nonetheless, the adverse effects of alcohol, when it is already time to take a drive to some other place or back to home, cause people to be susceptible to vehicle ââ¬â related accidents which lead to injuries and deaths. Alcohol is a major cause in vehicle ââ¬â related collisions that lead to injuries and deaths among people (Hingson and Winter 63). The numbers of recorded alcohol ââ¬â related traffic deaths have declined since the early 1980s. However, even if this is the case, in United States, alcohol is still a significant factor which contributes to vehicle ââ¬â related fatalities. In fact in 2002, alcohol had significantly contributed about four (4) out of ten (10) fatalities due to vehicular accidents. Among all the alcohol ââ¬â related clashes, about 42 resulted to injury while about 4 percent caused death. Whereas the case of non ââ¬â alcohol ââ¬â related vehicular clashes, about 31 percent resulted to injury while only 0.6 percent led to death ( Hingson and Winter 64). ... Since the younger population are much more engaged in drinking alcohol than the older segment, the young people are more likely to get injured or die in vehicular accidents. This is supported by Maskalyk in the account of ââ¬Å"Driving and Drinkingâ⬠(313) and Hingson and Winter in ââ¬Å"Epidemiology and Consequences of Drinking and Drivingâ⬠(63 - 78) which are both written in 2003. Apart from that, Hingson and Winter claimed that more males are probably involved in alcohol ââ¬â related vehicular accidents than females (64). This is for the reason that males are more involved in alcohol drinking as well as they are much heavier drinkers than females. Alcohol does not only put the lives of those who are driving while drunk at risk for it has also seriously endangered and destroyed the lives of other people than these drunk drivers. In fact, there are many people other than the drunk drivers who get injured or killed. Hingson and Winter stated in 2002, that about 44 pe rcent of the deaths in vehicular crashes had involved some drunk drivers. In these numbers of fatalities, about 22 percent were the drunk driversââ¬â¢ passengers; about 13 percent comprised the pedestrians; about 7 percent were the drivers of the other vehicles which had been hit by the drunk drivers; and about 2 % happened to be bicyclists (64). On the one hand, Blum has written an article entitled ââ¬Å"Drunk Driving: How it Hurtsâ⬠which talks about a teen activist named Jackie Myers struggle against drunk driving (14 ââ¬â 16). Myers has lost five of her family members on a vehicular collision with a nineteen year old drunk driver. At first, Myers had considered that driving while drunk is just normal until she suffered from the effect
Wednesday, September 25, 2019
Gp3 performance management and employee services Research Paper
Gp3 performance management and employee services - Research Paper Example It will allow them cooperating in a professional manner towards the accomplishment of their goals and objectives. Apple Inc is a real life example that has the following pattern and model in practice. Google inc. is another example of the same kind where free hand and communication means are provided to the employees and they make use of their efforts in a completely cordial manner. The two of them have uniform system of operations where the appraisal systems are intact and the employees get regular and timely feed back with regard to their contributions and efforts in the overall projects at hand. The performance management program which is based on effective communication and equal opportunity imparting to the different domains will allow for the clear goals determination and easy accomplishment of the tasks. Talent management and communication build up models were the two performance management and overall productivity enhancement models and programs suggested and initiated for the purpose of improvement in the organization. Out of the two short listed programs (talent management and communication enabling means), the latter was chosen. This was chosen so based on the realization of the need for an effective communication channel presence in the modern times where enterprises are connected by the virtual means of communication (Lesikar, 2005, p 3). The new program will be communicated to the employees through formal and informal methods. In the informal methods the daily routine activities will encompass the guidance and details sharing. The formal methods of transferring the idea and knowledge would include the seminars, training sessions, visits and other practical demonstrations which will enable them working in a more amicable environment based on effective production and desired outputs at the end of the undertaken objective and plan. The possible consequences of inadequate performance reviews will include failure
Tuesday, September 24, 2019
Major Health and lifestyle Issues Essay Example | Topics and Well Written Essays - 2500 words
Major Health and lifestyle Issues - Essay Example The connection is that the kind of lifestyle that a person exhibits predisposes him or her to a health issue. These issues include the cancers, obesity and cardiac conditions. They are closely related to lifestyles and behaviours such as smoking, diet and nutritional changes and overweight, and alcohol and drugs abuse. This paper will deal with some of these health and lifestyle issues in depth. Cancer is a serious and potentially fatal condition that affects the body cells. The disease is as a result of a combination of hereditary and environmental factors that result to gene mutation (Gray 2005). When cell growth regulatory genes are mutated, they fail to regulate cell growth resulting in an aberrant cell behaviour, uncontrolled expansion of cell masses that destroy the cell surrounding by causing excess pressure on organs and tissues. This affects the functions of the organs. In extensive case, the aberrant cells are disseminated in other parts of the body causing the spread of the cancer, a phenomenon called metastasis (UK 2014). When the cancer metastasis to vital organs, it spreads faster, and the prognosis becomes poor. The environmental factors that result to cancer includes exposure to carcinogens, which are present in some foods, water and air. Tobacco and diet have been found to be the causes of up to 30% of new cancer cases in the world. This means that much o f the cancer is preventable. According to WHO, cancer is among the leading causes of mortality in the world. In 2012, the disease caused an approximate of 8.2 million deaths. There are many kinds of cancers, named according to the affected organ (Naidoo &Wills 2010). Lung, liver, gastric, colorectal, and breast cancers are the most common and the main causes of the cancer-related deaths in that order (DeVita, Hellman, & Rosenberg 2005, p.Ã 26). It is estimated that one-thirds of the cancer deaths are related to behavioural and lifestyle changes
Monday, September 23, 2019
Globalisation , the World Economy and MNE's mini essay - 4
Globalisation , the World Economy and MNE's mini - Essay Example This paper therefore seeks to explore the emerging global markets, the advantages and disadvantages that accrue from venturing into such markets based on a case study of Research in Motion (RIM). The paper further endeavours to ascertain the extent to which RIM has been successful in penetrating this market. Basically emerging markets are developing countries that are experiencing a fast growth rate that are shifting from centrally planned economies to more liberalized economies. There are several advantages that accrue from emerging markets that make it attractive for investment purposes. The main advantage of these markets is target markets. For example in India, there is a large pool of skilled workers that are readily available and at a relatively affordable price (Hansen 2010). On the same note, its counterpart has equally a large pool of highly skilled and technical staff whose rates are affordable. In relation To The case study, RIM through it research and development unveiled a strategy to choose R&D sites that were backed by mature skills and strong technological institutions. For example, RIM curved out a niche as a centre for innovation with doubling number of patents every two years and the R&D ratio to GDP doubling in the previous decade. The two emerging markets have an advantage as manufacturing bases. There is readily available skilled labor at reasonable wages for manufacturing and assembly operation. Due to the cheaper production costs, was able to attract a sharp increase in the foreign direct investments between 1994 and 2007 with a steep increase in 2006. The same case is applicable to India. Under such circumstances, RIMââ¬â¢s strategy of investing in these emerging markets is valid and helps in reducing production cost whilst making the company stay competitive. Another critical advantage is the outsourcing of expatriates (Dolfsma, Duysters, & Costa 2009). RIMââ¬â¢s
Sunday, September 22, 2019
Linear Equality Applied in Real Life Essay Example for Free
Linear Equality Applied in Real Life Essay From the real life situation described in the prior DQ 1, I found out the form of the equation that can be used to analyze situations wherein decisions have to be made. This linear equation is that of the slope: y = ax + b, wherein x is the independent value and its value is fixed. In the problem 40, the x denotes the fixed rate for each minute used. The variable a is the number of minutes consumed for the call and b is the fixed amount the company charged just for using the service. The variable y is the dependent variable and the total amount for the whole service, depending on the number of minutes used. Figure 1, based on problem 40 (McGraw-Hill Companies, 2005) will help to further illustrate the use of the equation. Based on the graph, Company A costs more than Company B up until a certain point, which is when the sum of the calls Rafaella made in one month was 45 minutes. On the other hand, when she made 60 minutes worth of calls in one month, it is seen that Company B started to become a bit more expensive than Company A. Thus, based on the results, Rafaella should choose based on her own estimate of her usage of long-distance calls. If sheââ¬â¢ll rarely make calls or call for only a few minutes each month, she should stay subscribed at Company B. However, if she thinks that her total calls would exceed 60 minutes per month, then it is advisable for her to subscribe to Company A. Table 1. Total charges for total minutes of of long-distance calls in one month for Company
Saturday, September 21, 2019
Gifted Learners in Diverse Classroom Essay Example for Free
Gifted Learners in Diverse Classroom Essay As our nation becomes more culturally diverse we our schools need to begin modeling and preparing for this diversity. The importance of learning about diversity in culture and stereotypes is of particular concern with gifted learners. This article discusses the Ford and Harris model (2000) which combines higher order thinking skills with culturally relevant content to engage students in analysis, synthesis, and evaluation as they examine different perspectives and become involved in social action. There are several different methods to this model that can be used a social studies classroom to engage gifted learners. The first is the transformational approach where the curriculum is set up to show contributions and perspectives of many groups. This allows students to see various perspectives across the spectrum of cultures. Next, the social action approach has students identify issues that they think might need to be changed and make action plans. They are empowered in both of these approaches. Blooms Taxonomy is used at the highest level in both of these models and students are able to learn from themselves, inwardly, and from each other in order to hopefully develop positive relationships. Along with using these two approaches discussions, infusions of literature and poetry, role-playing, examining primary documents, ethnographic research, photojournalism, and service learning are easily applied to middle and high school classrooms. The importance of keeping gifted students engaged has been well documented. High qualities discussions have in the classroom are a great way for student to share, debate, develop original thinking and analyze various perspectives of other gifted students. In a multicultural classroom discussions could become significant learning experiences for young people by allowing participants to challenge the points of view held by others while reexamining their own beliefs Parker (2001). Multicultural literature infused into the classroom and curriculum can give many cultural perspectives for students to reflect upon. Teachers reported gains in self-esteem and academic achievement in diverse students when given literature in which they felt reflected their own culture. Another good technique that teachers can use in a multicultural classroom is role-play. When students place themselves into the role of another it is found that they internalize the culture while also learning about the content. This use of critical thinking skills, along with cooperative learning is a big part of a multicultural classroom. Role-play is one strategy that enriches instruction and supports the unusual sensitivity to the feelings of others evident in gifted learners (Clark, 2007; Piechowski, 2006). Teachers, who have used the process of ethnographic research, or the study and systematic recording of human cultures, have found that gifted students are enriched with the process. Ethnographic research includes interviews, artifacts and observations. Along with Ethnographic research the use of primary documents is an important part of a multicultural classroom. Examples include manuscripts, diaries, letters, photographs, postcards, posters, audio or video recordings, oral histories, speeches, or official documents (Bogdan Biklen, 2006). Primary documents are increasingly becoming a part of the questioning process on the end of course exams so it is vital that gifted students are given access to them and understand their importance. Photographs, or photojournalism can be impactful for the visual gifted learners. Photojournalism supports numerous characteristics of gifted learners, including their emotional depth and intensity, as well as their strong capacity for processing information, generating original ideas, and comprehensively synthesizing ideas and solutions (Clark, 2007; Davis et al. 2011). Finally, service learning is an area were gifted learners are provided the opportunity be creative with their ideas. In service learning students can find a need in the community and find a method to assist. Because many gifted learners have high levels of empathy this suits them well. Terry (2008) noted that service learning can help gifted learners reach their creative potential as they seek solutions to societys problems, while also assisting them in their journey toward self-actualization. There are many methods that creativity and diversity can be brought into a multicultural classroom. With gifted students choice and variety is important so that the student remains engaged. The gifted learners needs will drive much of the instruction. This is just a few of the ideas that would work in a social studies classroom in particular. As with all things creativity, curriculum and enrichment are the key to keeping students engaged with gifted learners.
Friday, September 20, 2019
The Principles Of Lying
The Principles Of Lying Immanuel Kant, German philosopher, said that lying was always morally wrong. To tell a lie contradicts the part of oneself that gives them moral worth. To receive a lie takes away a persons free choice to decide other than what they would have had they known the truth. The two reasons lying is morally wrong, according to Kant, is lying contradicts the part of me that gives me moral worth and lying robs others of their freedom to choose rationally. Virtue ethicists believe that lying is wrong. Virtues are desirable qualities of a person that makes them act in certain ways. Virtue ethics focus on what a person should be. Lying is wrong because it opposes honesty. If a lie is told in the pursuit of another virtue is it right or wrong? As long as the lie is a step toward being the best person we can be it is acceptable. If it is a step away it is morally wrong. Utilitarian ethics is the balancing of the benefits and harms of lying. The belief is it is morally acceptable to lie if the consequences maximize benefits and minimize harm. In fact it would be immoral not to lie if lying is necessary to maximize the benefits or minimize the harm. The reasoning is logical but the application is flawed. To estimate the consequences of the lie a person must be able to evaluate the degree of the benefit as it is viewed within the standard of the person or group of people being lied to. The same is also true in evaluating the harm of a lie. By the liar standards, the harm may be small such as telling someone they had a fifty percent chance of recovery when in fact they were dying in less than six months. The thought being to let the person enjoy life and not worry of their impending doom. The result being a will wasnt made, people were not given time to say their goodbyes, and life was not enjoyed because they thought there would be more time to do it. Surveys could be taken on how people in general would respond to a certain lie, but unless it resulted in 100% certainty you would not know which way the recipient of the lie would fall. There are three classifications of lies: beneficial lies, spiteful lies, and neutral lies. A beneficial lie can be told to be kind in the attempt to avoid hurting someones feelings. How do I look? Ive seen you look better. Is that what youre really going to wear? You look terrible. The truth can hurt. The little white lie, You look great. Does it matter to you, the liar, no you are on your way. The person being lied to is happy. So no harm, or is there. Every lie there is harm whether intentional or not. If you in fact knew the person being lied to looked bad and still let him/her go out and they were ridiculed for their appearance it will come back to you that you lied. Will your judgment be used again? Children are lied to about death. Your cat ran away. Grandpa went to heaven to be with God. Someday the truth will have to be told but by that time they will already know that you lie. Spiteful lies mean that you gain something while hurting someone else. A spiteful lie can be a rumor started to hurt someone, usually a rival in politics or a rival for the affections of someone you love. An example of a spiteful lie is, I saw your husband having lunch with his old girlfriend. The gain in this is the joy in causing the pain. The neutral lie is the most common lie of all. It is a lie that neither avoids causing hurt nor causes hurt. If youre not good Santa will put coal in your stocking. Put your tooth under your pill and the tooth fairy will leave you money. Similarly, people use a neutral lie to avoid a question, or lead away from private information. Most parents use this type of lie in particular to try and stray children away from investigating the truth. Mom, where do babies come from? Well, a baby comes from the stork, and drops them off at the house. Magicians and illusionist fall into this category. An avoidance of truth is also a form of lying. When a person says they never lie what they are really saying is that they do not actively engage in spiteful lies. When someone doesnt know the answer and says what they think. This falls under this classification of lying. You dont mean to lie, because you dont gain or you dont hurt anyone. It is still considered lying because you arent telling the trut h, but are unaware of it. People for years have been putting falsifications on their rà ©sumà ©s to make it look appealing, and to create a sense that they are perfect for the job. Ethically it is fine to do so as long as you keep it to only one or two lies on it and you keep to a low level. By low level meaning you cant falsify years at college or years in a job you have never obtained. In one example of a woman, Janet Cooke, lied to get onto the Washington Post team. She did plenty of lying to get to the Washington Post, falsifying where she graduated college, the degree she got, the languages she could speak, and writing awards she received. Not long after her hiring into the Washington Post she quickly was looking for an 8-year-old heroin addict. When she came up dry and couldnt locate the young man. It dawned on me that I could simply make it all up. I just sat down and wrote it. (Kidwell, 178) After being found out she was a fraud, she quickly resigned from her dream job at the Washington Post. Lying is it good or bad? It all depends on the person being lied to. Telling a little white lie to a child is seen as good to maintain their innocence. You could just tell a menacing and just plain evil lie to get back at someone or to make someone feel bad. Lying, ethically, is actually accepted in most places, but it can also be frowned upon strongly. It all depends on who it is being lied to and to what extent you are lying to.
Thursday, September 19, 2019
Embryonic Stem Cell Research Provides Revolutionary and Life-saving Bre
"Stem cell research is the key to developing cures for degenerative conditions like Parkinson's and motor neuron disease from which I and many others suffer. The fact that the cells may come from embryos is not an objection, because the embryos are going to die anyway." -- Stephen Hawking The phrase ââ¬Å"stem cellâ⬠calls to mind images of controversy: Pro-life picketers outside abortion and in-vitro fertilization clinics, patients with chronic disabilities waiting on a cure, scientists in a lab experimenting with a petri dish. These cells offer unimaginable opportunities for regenerative medicine because they can retain the ability to differentiate. Stem cells are classified as either adult or embryonic. Embryonic stem cells can reproduce any cell in the body, whereas adult stem cells can only produce somatic cells within their own tissue type. Somatic simply means a cell that is not directly involved in sexual reproduction. What makes research into stem cells exciting is that they can provide a means to regenerate cells in a way that humans cannot accomplish on their own. Spinal cord tissue can be regenerated in paraplegics, giving a new lease on life to war veterans. Mental diseases associated with age such as dementia, Alzheimerââ¬â¢s, and Parkin son's, can be cured. Even entire organs can be reconstructed and implanted into patients that desperately need them, such as in the case of Claudia Castillo, who received a bronchus coated with her own cells. Why then is such a cutting-edge and promising field subject to so much controversy? Because one of the primary sources for stem cells is blastocysts, undeveloped microscopic human offspring only 200 cells large. Generally the opponents of stem cell research are also pro-... ...db0-932e-4bfd-b9ab- 1a874c41df1a %40sessionmgr111&vid=1&hid=110&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ %3d%3d#db=ulh&AN=J0E381453909605>. Obama, Barack. "Finding a Middle Ground." Vital Speeches of the Day 75.7 (2009): 316-319. Academic Search Complete. EBSCO. Web. 5 Aug. 2014. . Scott, Christopher Thomas. Stem Cell Now: from the Experiment That Shook the World to the New Politics of Life. New York: Pi, 2006. Print. Thompson, Tanya. "World first as woman gets organ made from stem cells." news.scotsman.com. Johnston Press Digital Publishing, 18 Nov. 2008. Web. 3 Oct. 2014. . Stephen Hawking Quote Web. 3 Oct. 2014. http://www.brainyquote.com/quotes/keywords/stem_cell_research.html#iM2R1JXFolmB71yF.99
Wednesday, September 18, 2019
Destiny, Fate, Free Will and Free Choice in Oedipus the King Essay exam
The Concept of Fate in Oedipus Rexà à à à à à à à à à à à à à To the first-time reader of Sophoclesââ¬â¢ tragedy, Oedipus Rex, it seems that the gods are in complete domination of mankind. This essay will seek to show that this is not the case because the presence of a tragic flaw within the protagonist is shown to be the cause of his downfall. à In the opening scene of the tragedy the priest of Zeus itemizes for the king what the gods have done to the inhabitants of Thebes: à A blight is on our harvest in the ear, A blight upon the grazing flocks and herds, A blight on wives in travail; and withal Armed with his blazing torch the God of Plague Hath swooped upon our city emptying The house of Cadmus, and the murky realm Of Pluto is full fed with groans and tears. à The power of the gods seems quite awesome in their ability to inflict great injuries such as these on the population. King Oedipus, seeing Creon returning from the oracle at Delphi, addresses a brief prayer to King Apollo as the ultimate source of assistance in time of trial: ââ¬Å"O King Apollo! may his joyous looks /Be presage of the joyous news he brings!â⬠Creon brings to Thebes the message of the gods from the oracle: ââ¬Å"Let me report then all the god declared. /King Phoebus bids us straitly extirpate /A fell pollution that infests the land, /And no more harbor an inveterate sore.â⬠à The gods know that Oedipus is a ââ¬Å"pollution,â⬠a ââ¬Å"sore,â⬠which must be gotten rid of, expelled from Thebes. Charles Segal in Oedipus Tyrannus: Tragic Heroism and the Limits of Knowledge supports this view: à In his growing strength Oedipus begins to act as the ritual scapegoat, the pharmakos, the figure who is ritually laden with all... ...s Rex, edited by Michael J. Oââ¬â¢Brien. Englewood Cliffs, NJ: Prentice-Hall, Inc., 1968. à Segal, Charles. Oedipus Tyrannus: Tragic Heroism and the Limits of Knowledge. New York: Twayne Publishers, 1993. à ââ¬Å"Sophoclesâ⬠In Literature of the Western World, edited by Brian Wilkie and James Hurt. NewYork: Macmillan Publishing Co., 1984. à Sophocles. Oedipus Rex. Transl. by F. Storr. no pag. http://etext.lib.virginia.edu/etcbin/browse-mixed new?tag=public&images=images/modeng&data=/texts/english/modeng/parsed&part=0&id=SopOedi -à à à à à à à -à à à à à à Spengler, Oswald. ââ¬Å"Tragedy: Classical vs. Western.â⬠In Sophocles: A Collection of Critical Essays, edited by Thomas Woodard. Englewood Cliffs, NJ: Prentice-Hall, Inc., 1966. à Van Nortwick, Thomas.à Oedipus: The Meaning of a Masculine Life. Norman, OK: University of Oklahoma Press, 1998. Ã
Tuesday, September 17, 2019
Individual Assignment: Vulnerable Population Article Essay
Based on my understanding of what I have read over the past week, I would define a vulnerable population as any individual or group of people with a decreased capacity to communicate effectively in a given setting. The term vulnerable populations is be defined as ââ¬Å"people with questionable capacity.â⬠It is further stated that, ââ¬Å"children, comatose patients, fetuses, prisoners, or mentally ill patients, among othersâ⬠are considered vulnerable populations (Miracle, 2010). As a clinical research nurse, it is my responsibility to ensure that all of my patients (or subjects) submit a signed and dated informed consent (IC) form prior to enrollment in a study. The Food and Drug Administration (FDA) requires that all clinical trials or study sponsors (pharmaceutical manufacturer of the study drug) maintain proof of IC for each subject, in every trial, without exception in their respective trial master file (TMF). Potential barriers for participants in clinical research studies might be patients or subjects who are uneducated, and or, patients who are not able to assure his or her health care provider that they fully understand information that is provided, and IC may not be obtained. The NIH defines consent capacity as an ââ¬Å"adultââ¬â¢s ability to understand information relevant to making an informed, voluntary decision to participate in research.â⬠This information includes a description of the study, its potential risks and benefits, the right to give voluntary consent, the right to withdraw from the study, anonymity, confidentiality, and ways to lessen any risks. However, many people do not understand these components of an informed consent for a variety of reasons. These include people with ââ¬Å"mental disorders, neurological disorders such as stroke or dementia, metabolic impairment, psychoactive medications, substance abuse, and head trauma.â⬠Others who may be unable to provide consent include children, fetuses, prisoners, the terminally ill, and pregnant women (Miracle, 2010). Most of my experience with vulnerable groups, while working as a clinical research nurse, has been with young women who became during the study period, after IC was obtained. Generally speaking, pregnancy should be avoided at all costs during participation in a clinical trial in which a woman is ingesting a study drug. Depending on study design or how a studyââ¬â¢s protocol is written, it may require that the women participants not get pregnant for a specified period after study drug is completed, in order to avoid harm to the woman and her unborn fetus. When a patient becomes pregnant during the study drug period or within the specified period after study drug completion, the study sponsor) is required to report this as an adverse event (any untoward and/or unexpected event during the clinical trial that could potentially harm the patient). The patient must then be followed by her trial physician throughout her pregnancy, and through the babyââ¬â¢s first year of life, to ensure the health of both mom and baby for one year after study completion. If any complications arise, the sponsor is responsible for all necessary care. Reference Miracle, V. A. (2010). Vulnerable Populations in Research. Dimensions of Critical Care Nursing , 242-245.
Monday, September 16, 2019
MAC Brand Analysis Essay
1.0 Introduction The cosmetic industry is very competitive industry where product benefits and brand image are keys to success. The purpose of this report is to present an analysis of the brand M.A.C and its product lipstick with focus on T-C-B and I-D-U analysis, a clear positioning statement and target audience (s) including brand loyalty categories. The purpose at the end of this assignment is to have an understanding of what objective M.A.C needs to focus on for a creative strategy in the second part of this assignment. 2.0 Brand & Product Description The type of product selected for the positioning exercise is lipstick; the specific brand selected is M.A.C cosmetics owned by Estlee Lauder Corporation. It is noted that ââ¬Å"lipstickâ⬠is a product description and is not owed but the company thus demonstrating M.A.C is one brand corporation. To determine if M.A.C has a strong market positioning within the womenââ¬â¢s cosmetic industry particularly with their lipstick product both secondary research (trade publications) and individual ââ¬Å"depthâ⬠interviews were conduct (see Appendix A ), and will be used for evaluation and conclusion. 3.0 Analysis The tools/models used for determining M.A.Cââ¬â¢s market position were T.C.B & IDU models. The T-C-B model was used as a baseline for a serious of questions to guide a particular set of respondents that M.A.C caters for and is aiming to achieve a strong market position in this select category. 3.1 T-C-B 3.1.1 The Target Customer (T) Positioning The primary target demographic for any brand of lipstick is female. The types of consumers that are interested in bold colour selection, wanting to feel sexy and fashionable and want a lipstick that fit into their own personal style are M.A.Cââ¬â¢s target audience. Thus the respondents used for this analysis are young fashionable conscious individual who seeking a look without compromising on the fashion trends. 3.1.2 The Category need (C) Positioning There are many needs that the product lipstick needs to satisfy to the consumer. The general needs that all lipstick must fill are coverage or ââ¬Å"staying powerâ⬠and hydration (lips not drying out) this was concluded form appendix A. The needs that M.A.C lipstick specifically fills can be divided into physical needs and the emotional needs. The most important physical needs as identify by ââ¬Å"in-depth interviewsâ⬠were a good range of colours and appealing packaging. The most important emotional needs stated through in depth interviews were the social and individual needs. 3.1.3 Benefits (B) Positioning To conclude that the following Key benefits were important to M.A.C target audience and the company and fill the category needs were drawn from the various responses from the in-depth interviews. These benefits are a ââ¬Å"way inâ⬠to increase and maintain the target market (T). M.A.C fills the physical need being the large range of colours of lipstick by having the largest range of lipstick colours with 136 shades in their permanent collection not including the releases of new limited every few week. Compare to Bobbi Brown have only 36 shades in their permanent collection and Chanel which has 67 shades this was discovered through secondary research and by confirming this with in-depth interviews.When comparing the pictures of various packaging of different brands of lipstick in the in-depth interviews stimuli used to help identify benefits of the lipstick category to understand the various competing it was concluded that M.A.C packaging as describe by the respondents as simple , plastic/glass, eye-catching, chic, stylish and high product. Social needs is satisfied by belonging to a group. M.A.C associates itself with fashion, prestige beauty and youth culture and markets their product through testimonials and word of mouth via fashion shows and celebrities. Consumers who use M.A.C lipstick are ââ¬Å"automaticallyâ⬠introduced to the M.A.C culture and their social need is satisfied. The need of individual is the biggest focus of M.A.C lipstick. An individual may have a need for self-expression and this is expressed by fashion and style. M.A.C realised that it could satisfy this need by simple product packaging made of plastic or glass; products have straight forward names and trend setting colours. 3.2 I-D-U Analysis 3.2.1 Central versus differentiated benefit positioning M.A.C lipstick adopts differentiated positioning on at least one important benefit. For instance M.A.C is functionally different bright range of colours and its target user is ââ¬Å"individualists who express through fashionâ⬠. Rather than central positioning as the womenââ¬â¢s industry is so competitive and to be successful M.A.C lipstick positioning will deliver better results for the corporation. As M.A.C lipstick is not seen as the consumer as ââ¬Å"best of its kindâ⬠through in-depth interviews. 3.2.2 Emphasized benefit: Instinctual, archetypal, emotional or rational The benefit to be emphasized as the key benefit of M.A.C lipstick is the large range of colours to select from. This is emphasized as an both a functional benefit and emotional benefit proposition and uses type 2 of emotion. As M.A.C lipstick uses the strong appeal of being fashionable and sexy with a large range of colours to choose from as a transformational positive ending motivating emotion as evidence by the in-depth interviews. 3.2.3 Entry-tickets benefits The benefits what the consumer expects for M.A.C is to have a large range of colour for being a lipstick product category. However the consumers of M.A.C lipstick are told that M.A.C lipstick have the biggest range of colours through the professional make-up artist as employees through the M.A.C social network (twitter, Facebook) It was concluded that M.A.C lip colour range is the key benefit that make M.A.C should focus on promoting to the target consumer as it is the closes to the ââ¬Å"ideal brand in that benefit when comparing 5 other brands. M.A.C clear delivery of the range of lip colours and their uniqueness set them apart from other brand. 4.0 Positioning Statement & Target audience 4.1 Positioning statement Determine the positioning statement for M.A.C from the TCB and IDU analysis the findings from the brand analysis are the following; The competitors of M.A.C are not just the leaders in womenââ¬â¢s cosmetics lipstick but range from all companies that have a stake in the cosmetics industry. A perceptual map was devised from the in-depth interviews for an easy diagram showed all the competitors. (Appendix) These are all the competitors that must be taken into consideration when developing the positioning statement. Using the Rossiter-Percy-Bellman Grid it is establish that the product is acceptable in the low involvement, transformational sector this was further confirmed with the in-depth interviews. The attribute that were important to the consumers when evaluating the product of womenââ¬â¢s lipstick these were discovered as; fashionable, sexy, range of colours, smoothness, staying power and hydration these where then rank or delivery and uniqueness by the top 5 main competitors and no-brand as all the other competitors see appendix B and C. Based on the IDU analysis and consumer research see appendix A, B &C it was determined how each competitor is positioned in the vision of the consumer. The top two main competitors of M.A.C were to be considered as Chanel and Bobbi Brown based on both higher end pricing and a large colour option pallet and are to be consider the leaders in the womenââ¬â¢s cosmetics:- lipstick industry. So M.A.C needs to offer the consumer something very unique in the positioning statement to have brand differentiation to increase and maintain the target market. The various factors that distinguish the M.A.C consumer and their lifestyle, their purchase motivations and their different attributes that are important to them were concluded from the research (Appendix A). The positioning statement:- M.A.C is the womenââ¬â¢s cosmetic brand that provides consumers lipstick to women who are 18-30 and belongs to the socioeconomic class of middle-high (T), M.A.C lipstick satisfies the need of self-expression in every women to be fashion forward and be accepted in the M.A.C culture (C) M.A.Cââ¬â¢s benefit intention is to have the largest selection of lip colours, the most fashion forward of its kind in the industry and be artistic and creative for all women. (B) M.A.C needs to constantly work on their positioning statement to increase their brand market share via T-C-B & I-D-U brand analysis by doing this the company can always increase the perceived delivery of the M.A.C lipstick. 4.2 Target audience The target audience should be broadly described as 18-35 female in the middle-high social economic class. These are the follow segments that M.A.C is enter in with their differentiation marketing. M.A.C divides the market of their lipstick product into demographic segmentation being female and a specific age group because over 90% of their users belong in this specific category. However the product is not limited to this demographic segmentation. M.A.C furthermore divides the market on the basis of personality being fashion forward, artistic and creative which is a form of psychographic segmentation. The buying situations in which target market purchase M.A.C lipstick (that were discovered form in-depth interviews) where; outlets both direct through online shopping and in-store department store (David Jones), benefits sought as in the large colour range M.A.C product provides.. The consumers of M.A.C lipstick are brand loyals, however they can be routinized favourable brand switchers as well this is due to the positioning of M.A.C lipstick in the Rossiter-Percy-Bellman grid.
Sunday, September 15, 2019
American Response to Revolutionary Nationalism in Asia
In the aftermath of World War II revolutionary nationalism emerged as a powerful force in Asia. As a response to this, the American foreign policy evoked three main images that identified the United States with the power it had over other states. The first image was that of a firefighter. America was seen as firefighting machinery that moved forward to put out the military and political blazes. The United States after the Second World War was seen as the missionary who came to save the souls for democracy in Asia. The last type of image that America presented was that of an accountant.As an accountant, America intervened in Asian countries to add up the balance sheets as well as warning the individuals who the economical policies considered to be unfair to the United States. The rise of nationalism in Asia was seen as the era of decolonization and a principle of self-determination. Particularly the issues that involved Japan and the World War II had exploded the myths of western supr emacy and America was ready to rebuild the tattered perception. Asia had so much contact with the western culture and their allied technology which had almost taken up the societies in the Asian states.Some factors enabled the emergence of India to become a state and to make Asia be for Asians. Perhaps it can be identified that the society propaganda together with the British labor party played a pivotal role in the enabling revolutionary nationalism that became a powerful force in Asia. The revolutionary nationalism took three major phases development where the first phase took place as early as 1885 to 1905. During this period, the Indian National Congress was mainly dominated by the moderates. During the first phase, the Indians who were taught in English had strong beliefs that the British would lead the country into self-governance.The second phase ensured after the first phase and lasted for thirteen years from 1906 to 1919. Here, the extremists emerged shaking the faith of th e Indians in Great Britain. The key architect for this swindle was the Rouwlatt Bill, the repressive methods that were adopted by the British government and the Bagh massacre which led to the death of several people as the British troops closed the only fire exit without giving any warning. The third phase was mainly characterized by the Indian father, Mohandas Karamchand Gandhi from 1920-1947.Gandhi offered to bring India out of suffering and ensured that India attained its independence. The third phase experienced a lot of transformation in the entire Asian continent when activists rose up to fight for their rights to be free. The success of Gandhi was mainly due to his six main principles which he followed during his mission and in his entire life. The truth, vegetarianism, non-violence, faith, simplicity and brahmacharya were the main principals that Gandhi lived by in his life and became a father and a man to emulate in the entire Asia.The phase marked the end of the struggles of nationalism and after the World War II, India attained independence in 1947. The purpose of America in fulfilling its roles was perceived to be invariably successful although they were played in a simultaneous manner. The United States emerged as an imperial power during the World War I and after the postwar period, the America came in posing as a missionary, accountant and more of a firefighter. The main instrument after the World War II was Bill Knowland who was one of the ten most influential members of the Congress.William F. Knowland was named as a man who hardened the United States policy towards the Asian communism. He was also recognized as a man whose convictions spoilt his mission as a leader. As it was expected, in the aftermath of the second world war, almost the entire Asia was very fragile with a number of pressures which helped move towards the order of authoritarian as that to provide the rapid economic growth directed by the state and stability. The United States provided an authoritarian order which came in the form of one party system of authoritarian.Another form of machinery was communism which was seen to be very dynamic. The mass mobilization using communism capacity combined with the skilful application of the visionary promises and the military powers resulted to a major challenge to the individuals who wished to preserve and create an open system. The American goal was in Asian continent was to set up security structure in China which could not halt any further communism expansion. The communism expansion was characterized by the rising Chinese and Soviet powers.In this effort, a major disagreement resulted whether the United States commitments should be limited to the island chain away from the extensive continent of Asia or the commitments should also involve the individual needing some assistance. At a very great cost, the United States se up a strategic balance in the Asia pacific that centered upon the bilateral ties with the ROK and Japan. The bilateral ties were also established with the Philippines as well as Thailand.This balance was greatly assisted by the split between the Soviet Union and the Peopleââ¬â¢s Republic of China. This led to a critically important liaison between the PRC and the US. The plan was also supported by the increasing economic growth of the market economies of the East Asia where Japan served as a guide and a forerunner. It may not be said that the United States succeeded in its response towards the powerful force in Asia brought by the revolutionary nationalism.As it can be seen of today, the Asian societies are facing great economic hurdles and the Americas effort to act as a missionary and accountant have not been seen to be successful. There are problems related to excessive exuberance and insufficiency in regulatory measures together with the unhealthy ties between the government and the corporate sector. These problems have been outshined by the new and complex proble m of globalization. It is expected that majority of Asian states will start the recovery process shortly with the hope of a more improved economic sector.There is one strong lesson which can be learned from the intervention of the United States into the revolutionary nationalism in Asia. The economic strategies, however successful they may look like, cannot be exhaustive and entirely good for all times. This typical scenario can be seen in Japan. At the same time, it should be recognized that the changes that are required in states go beyond the economic circles and touch deeply into the cultural spheres. Bibliography Chen Jan. 1997.The Myth of Americaââ¬â¢s Lost Chance in China: A Chine Perspective in Light of New Evidence. Diplomatic History, Vol21: 77-86 Hershberg James. 1996. The Cold War in Asia. London: DIANE Publishing Jian Chen. 2001. Maoââ¬â¢s China and the Cold War. University of North Carolina Press. Newman, Robert. 1961. Recognition of Communist China? A Study in A rgument. New York: Macmillan Offner, Arnold. 2002. Another Such Victory: President Truman and the Cold War; 1945-1953. Stanford University Press
Saturday, September 14, 2019
Key Terms Essay
ACEs ââ¬â an entry in an objects acl that grants permissions toa user or group ACL ââ¬â A collection of access control entries that defines the access that all users and groups have to an object ATA ââ¬â A disk interface that uses parallel communications to connect multiple hard drives to a computer Authorization ââ¬â The process of making sure someone is who they say they are Basic Disk ââ¬â The default disk type, it can have up to four partitions, three primary and one extended Direct-attached Storage ââ¬â a computer whith hard drives stored in it Disk Duplexing ââ¬â Method of fault tolerance, duplicate data is stored on two disks in seperate host adapters Disk Mirroring ââ¬â Method of fault tolerance, duplicate data is stored on two seperate disks DiskPart. exe ââ¬â Command line method to do all your disk related deeds Dynamic Disk ââ¬â Alternative to basic disk, able to have an unlimited number of volumes Effective permissions ââ¬â A combination of all the permissions from various sources External Drive Array ââ¬â Hard disks attached to a computer through a network medium File System ââ¬â A part of the OS for storing and organizing files Folder redirection ââ¬â A useful feature that lets users save thier files to a network location LUNs ââ¬â An identifier assigned to a specific component within a SCSI device which enables the SCSI host adapter to send commands to that component. NAS ââ¬â A dedicated file server that is connected to a network and provides users with file based storage Offline Files ââ¬â Lets people keep copies of files on their machines so that if the server goes down they can still work Partition Style ââ¬â The ways disks are organized in windows RAID ââ¬â Multiple disks working together as pals to do great things such as fault tolerance or increases to read/write speeds SID ââ¬â Every active directory object gets one of these, kinda like a social security number Security Principal ââ¬â Whoever is an administrator assigns permissions to SATA ââ¬â Newer version of ATA that users serial communications Shadow Copies ââ¬â Makes copies of a file that users can use to restore to vaious times SCSI ââ¬â Lets computers transfer data to multiple storage devices Standard Permissions ââ¬â The common special permissions SAN ââ¬â A dedicated high speed network wevice that connects storage devices to servers.
Friday, September 13, 2019
Communication Skills Article Example | Topics and Well Written Essays - 500 words
Communication Skills - Article Example The tone of the teachers displays concern for the students and their futures. The teachers have made a clear attempt to try and find out solutions, tactics, and techniques to help the students develop better manners and display courtesy. There is a clear tone of personal interest in the work they do and an urge to learn newer techniques. The teachers display how well they lead by example and how their style of talking and teaching can affect the learning process of the children as well. There is a clear sense of responsibility, and active listening among all the members in the video. The body language and the non ââ¬â verbal communication displayed shows a genuine interest in the discussions and is portrayed by taking notes of essential parts of the discussion. All the participants have been very alert throughout the discussion and have displayed all the basic skills of active listening. The teachers also display understanding and empathy with the fellow teachers and acknowledge the issues that they go through each day at work. This has been done in very simple actions like nodding their heads and taking notes of essential elements of the conversation and allowing the other to finish their statements rather than cutting the co ââ¬â teachers off between sentences. Active listening allows a person to listen intently to what is being said, either in groups or even one on one. A person who actively listens should be able to restate in their own words, what the speaker has spoken. This displays understanding of the topic of discussion. The major skills that are involved in effective active listening include (StudyGS, 2009): a) To be ââ¬Ëother ââ¬â directedââ¬â¢: It is essential for a listener to focus on what the speaker is communicating and to follow and understand the speakerââ¬â¢s point of view (StudyGS, 2009). It is essential to not only listen to what is being said but to also study body language and other senses to recognise the
Thursday, September 12, 2019
Women in Policing Research Paper Example | Topics and Well Written Essays - 1750 words
Women in Policing - Research Paper Example Their only source of help was from the temperance leaders, progressive era reformers, social workers, and social hygienist (Archbold &Schulz, 2012). With time, the number of women and their role in law enforcement increased. This was evident in the World War II. However, the gains were affected by the economic downturn experienced in the first half of the 20th century. However, there was more hope for women in the second half of the century (Archbold &Schulz, 2012). In the 1960s, women surfaced from their traditional roles to become patrol officers (Archbold &Schulz, 2012). At this period, there was more concern about their safety and that of their colleagues. The focus now shifted on how women policing styles would be different from men and whether they might change the nature of the police organization (Archbold &Schulz, 2012). Currently, women have been assigned roles similar to male officers within police departments. Today, women comprise 11.9 percent of all sworn position in po lice agencies, in various parts of United States (Langton, 2010). The history of women in policing begins in the last half of 19th century. In this period, women were hired to protect and administer to women and juveniles in prison. New York was the first city to hire two women in 1845. Women worked as matrons in the cityââ¬â¢s two jails (National Center for Women and Policing, 2013). This was after a comprehensive campaign by the American Female Moral Reform Society for the creation of matron position. Their hope was that police would find it prudent to hire matrons for the police stations. However, this was not the case, and the idea received opposition from the police department. One of the notable women in the era was Mary Owens. Owens received the rank of a police officer from the Chicago Police Department in 193 (National Center for Women and Policing, 2013). She gained this position due to the death of her husband who had been an officer for the
Why online classes better then regular classes Essay
Why online classes better then regular classes - Essay Example The capabilities of the Internet are astounding, and have prompted others to discover additional methods in which they can harness the power of this limitless cyberworld. One of the newer technologies developed is online education, which allows people in any level of schooling, from elementary to graduate school, to obtain their diploma or degree solely online. Though many people still prefer traditional in-person classroom education, online classes have proven to have their perks, all of which provide students with the freedom they need to achieve their educational goals. One of the primary reasons that students choose to attend online classes as opposed to in-person classes is due to the flexible schedules that online schools offer. Prior to online education, obtaining oneââ¬â¢s college degree was difficult since people were unable to find time for school in their busy schedules of work, family, and other responsibilities. College or post-graduate education was just a dream that would have to be tended to when they found more time. Online schooling fixes this by giving students the option to do their coursework around their own schedule instead trying to complete their other responsibilities around the expectations of school. ... fast learners and easily become bored due to a slow pace of learning in their classroom; others prefer to learn at a slower pace and are overwhelmed when they are expected to learn something new when they are still attempting to understand the last lesson. Either way, if a student is bored or if they cannot keep up with the class, their education can become jeopardized. The concept of pace differing with each student is the reason why many online schools have appeared that cater to students in elementary, middle, and high schools, when education is vital. When primary school students feel more confident about their regular education, they are more likely to seek further education. Similarly, online classes allow students to get the attention and instruction that they require to successfully complete their education. In a regular classroom, the teacher has to divide their attention to accommodate the needs of every student. This is difficult as each student needs something different, and there is not enough time for the teacher to tend to every need. As a result, many students suffer academically. Online schooling has two answers to this issue: either smaller class sizes or one-on-one instruction. For most online colleges, the classes are small enough so that teachers can afford the time to focus on the needs of each individual student (Larreamendy & Leinhardt 577). In primary school programs, one-on-one instruction is available, allowing the student to claim the undivided attention of the instructor. Students are able to get the help they need when they need it. Another perk of attending online classes, which is one of the most beneficial, is the difference in environment between a regular class and an online class. The environment of regular classrooms is one of
Wednesday, September 11, 2019
Research paper summary Example | Topics and Well Written Essays - 500 words
Summary - Research Paper Example This is largely due to the fact that adults and experts alike have dominated the portrayal of this message labeling teenagers and their behavior as either good or bad without paying any attention to their point of view. With growing technology and increasing economy, internet usage is becoming an integral and common part of any society with both adults and teenagers going online. Two surveys conducted in 1997and 2001 by the U.S. and Canada respectively, concluded that adults actually spend more time on the internet than teenagers. This was confirmed by China Internet Network Information Center who conducted their own survey and revealed that 66.3% of internet users were between the ages of 20-35 where as teenagers only made up 17.2% (Zhiyong 2007). However society feels that it is easier to blame the teenagers and their internet addiction for the prevailing problems of drugs, sex etc. Instead of hearing their voices and acknowledging that the problem of addiction exists in both adults and teenagers, experts mold the public opinion against the youth often leading to their low self esteem and confidence. Dick Hebdige summed this up very nicely when he stated "In our society, youth is present only whe n its presence is a problem, or is regarded as a problemâ⬠(Zhiyong 2007). It is easy to label the teenagers as bad and ignore why they get hooked on the internet in the first place. Internet offers adolescents an escape from their every day stressful lives and allows them to interact freely with others, play games, and read information online complete with privacy and increased comfort. This freedom from pressure and even parents for a little while is misunderstood as being lazy and displaying improper behavior by the adults. This often leads adults to feel that the teenagers are undermining their authority. For, internet isnââ¬â¢t something reserved
Tuesday, September 10, 2019
Minitab work Assignment Example | Topics and Well Written Essays - 500 words
Minitab work - Assignment Example Report your conclusion clearly. In an experiment to investigate the effect of fertiliser on mean yield of an arable crop, 20 different plots were used. Fertiliser A was applied to 10 randomly plot and B was applied to the remaining plots .After a specified time, the yield (in coded units) for each plot was measured giving the following data i)Perform an F test to see whether assumption of equal variances in the two fertiliser yield group is reasonable .To three decimal places, what is the p value from this F test? is it reasonable to assume that the two fertiliser yields have equal variance ii)Assuming that the F test suggest that we can pool the variances ,perform a hypothesis test to test whether there is significant difference in fertiliser mean yields (using a two sample t test with pooled variance). What is the value of the t-statistic? What is the value of the pooled variance used in this test ?To three decimal places, what is the p value from the test? Is there evidence to reject the null hypothesis of no difference in means at 5% significance level? iii)Suppose that instead of the data arising from 20 different plots, there were in fact only 10 plots ,each of which was divided into 2 subplots. For each plot, Fertliser A was applied to randomly selected subplot and fertiliser B was applied to other subplot. Perform an appropriate hypothesis test to see whether there is evidence that the average difference between the yield from Fertiliser A and B is not zero .To three decimal places, what is the p value from the test? Is there evidence to reject the null hypothesis that the average of the differences is zero, t the 5%signifcance level? Condition ââ¬Ëxââ¬â¢ is a medical condition from which 70% of people recover within 7 days if left untreated. The health service would like to increase this proportion by treating sufferers .An experiment was, therefore, conducted to test a new drug
Monday, September 9, 2019
Management Theories Assignment Example | Topics and Well Written Essays - 750 words
Management Theories - Assignment Example The both are geared towards improving the productivity of organizations as well as their effectiveness which is quite evident in the scientific theory as it tries to follow all the simplistic and universal set rules in order to realize higher productivity in the organizations and make everything run smoothly. A similar spirit is seen in the humanistic theory as it stresses on situational suitability and coming up with principles that assure them of their success without having to rely on the universal ones (Robbins, 2006). All this is geared towards achieving success in the management of these organizations as well as their effectiveness.Both theories try to make an improvement on the relationship between managers and their workers as seen with the scientific theory through emphasis of working with togetherness between the workers and managers. On the same note, the humanistic theory also insists on managers understanding organizational situations before figuring out the best way to work with and through other people as they co-ordinate activities. As all these are done for the better of the managers and the workers, it is meant to improve the relationship between them and make the work environment comfortable.Both the scientific and humanistic theory have diversified views on how to improve management and create efficiency in the organizations and be sure that their goals are achieved. Though they have common goals of improving management and efficiency in organizations.
Sunday, September 8, 2019
Reading Responses Essay Example | Topics and Well Written Essays - 500 words
Reading Responses - Essay Example The storm ends and Alcee quickly leaves before Bobinot arrives home, worried that his wife will be upset about her son getting wet and dirty from the storm. She says she is just happy to have her family back at home with her and tells her husband nothing of the encounter with Alcee, and he suspects nothing. That night, Alcee sends his wife, Clarisse a letter saying he misses her, but that she and the children should stay in Alabama for another month and enjoy the summer. Clarisse receives the letter and is happy for her husbandââ¬â¢s permission to stay in Alabama, where she is enjoying a freedom she hasnââ¬â¢t felt since her days as a single woman. The first thing I noticed was the way the dialog was written. It wasnââ¬â¢t proper English, but instead written so the reader hears the way the characters sound when reading it. For example, when Bobinot tells his son that his mother is home alone during the storm, the sentence is written, ââ¬Å"No; she ent got Sylvie. Sylvie was helpinââ¬â¢ her yistidayâ⬠(129) as opposed to proper English of ââ¬Å"No, she doesnââ¬â¢t have Sylvie. Sylvie was helping her yesterday.â⬠Because of this, I can easily hear what the characters sound like. I think that adds a lot to the story and helps us understand where the story takes place ââ¬â Louisiana.
Saturday, September 7, 2019
Education Essay Example | Topics and Well Written Essays - 1000 words - 3
Education - Essay Example Throughout the lesson Lila approaches the teacher to ask for clarification of certain steps of the task. From my classroom observations I notice that Lila has a certain motivation for learning, she is keen to learn and the teacher fosters an environment where Lila feels comfortable. Huitt (1999) claims, dyslexic students require constant repetition in order to learn words and sentence structure. Lila has demonstrated a skill in memorising words and facts rather than understanding or sounding out words. This was apparent when the teacher asked Lila to repeat the sights words and he repeated them without looking at them and in the order they were written on the board, obviously she has memorized them in order to do this. However, Lila tends to lose concentration easily as well; even though she is motivated in the task she tends to lose concentration and give up after attempting the task a few times. Her failed attempt at the task overrides her curiosity to learn. Lila enjoys creative a rts lessons where she is able to explore her creative ability, especially music lessons which unfortunately the teacher finds difficult to incorporate on a regular basis. However, the teacher allows Lila to play independently on a keyboard, on a regular basis, in order to keep her motivated and passionate throughout the year. During visual arts lessons Lila creates artwork with lots of patterns and similarities, for example during a lesson where students were learning about patterns, the teacher had Lila paint the patterns in order to demonstrate her understanding, and he created amazing pieces of work which demonstrates understanding beyond the Stage 1 level. Due to Lilaââ¬â¢s dyslexia he is reading at an early stage 1 level and requires help with tasks that involve a large amount of reading. The teacher modifies tasks for Lila in order to ensure she builds upon her existing skills rather than providing work beyond her understanding. For instance: during a lesson on writing info rmation reports the teacher had a sample information report printed on paper, cut out and jumbled up. Instead of writing Lila was expected to identify the features of an information report and put the sentences in an appropriate order. After which Lila glued the sentences in her English workbook. During this task Lila demanded less attention than normal from the teacher, as she wasnââ¬â¢t struggling to write, rather she was aiming to learn and understand. This is a great activity as it takes Lilaââ¬â¢s mind away from writing and allows her to concentrate on putting the sentences in chronological order. Huitt (1999) believes that repetition is the key to dyslexic students suffering from sequence problems. Lila is very vocal and assertive at times in the classroom. She prefers to work independently as she feels that her peers thinking are not of her liking. During group work Lila raises her voice and quarrels with her peers on the logistics of the task, she feels that her way is superior and expects her peers to follow. At times Lilaââ¬â¢s creativity and intellectual abilities are beyond the task, therefore she find group work boring and irrelevant during these times. There are also instances where Lila is not concerned with
Friday, September 6, 2019
Natural Selection through Competition and Isolation of Species Essay Example for Free
Natural Selection through Competition and Isolation of Species Essay The struggle for life results in differences in form which Darwin called ââ¬Å"incipient species. â⬠Darwin says that variations, no matter how small or big they are, will necessarily be passed down to offsprings because they will tend to make those individuals survive. He called this process natural selection to relate it to mans ability to select objects in their lives. Herbert Spencer, an English philosopher, had previously described the struggle for life as the ââ¬Å"survival of the fittest,â⬠which Darwin though was also appropriate for the process of evolution that goes on among organisms. Competition is constantly happening between organisms because of the rate of population increase. This leads into a Malthusian struggle that eliminates the nonadaptive individuals from the group (Cuvier et al. , 2003, p. 20). The divergence in the forms of species may result from changes in living conditions. Darwin pointed out that some species may be wiped out because of the immigration of other groups more adapted to the environment where they live in. Man-induced selection practiced by breeders of animals often results in sharp cases of divergence within species, although this is also possible through natural processes (Cuvier et al. , 2003, p. 24). Some experts point out that Darwin anticipated the concept of ââ¬Å"ecological nicheâ⬠because he suggested that all individuals who survive in the environment were not necessarily higher or better. They just have their own features that made them better adapted to the environment. According to Darwin, natural selection is facilitated by the isolation or seclusion of a population of organisms. Its pace can also quicken if the species is composed of a large population in open areas, since this indicates that there are many variations within the group (Cuvier et al. , 2003, p. 26). Darwin measured and described the divergence in species through a tree diagram with branches that stopped or fell off while extinction happens. New buds also spring from the tree to symbolize new species, leading to Darwin call it the ââ¬Å"tree of life. â⬠Heredity in Darwins Theory of Natural Selection Evolution had already been discussed before Darwins theory was published. Darwin only added substance to the science of evolution by proposing the idea of natural selection as a tool of evolution. Despite the soundness of his theory however, it was still difficult to form a coherent story of the evolution of organisms because there was no acceptable model or standard of heredity to explain natural selection. In fact, Darwin admits that the laws of heredity are still unclear (Endler Endler, 1986, p. 36). Since there was no guiding standard for heredity, Darwin borrowed Lamarckââ¬â¢s idea of acquired characteristics through use and disuse. He believed that when animals regularly use certain parts of their body, those parts become stronger or larger. In contrast, disuse results in certain parts being weaker or decreasing in size. These acquired characteristics are then passed on to newer generations either through domestication or through nature. While use and disuse had some role in evolution, Darwin said that some developments in the characteristics of animals, such as the loss of wings of some insects, might have resulted from natural selection.
Thursday, September 5, 2019
Refractory Monosymptomatic Nocturnal Enuresis Treatment
Refractory Monosymptomatic Nocturnal Enuresis Treatment Role of Posterior Tibial Nerve Stimulation in the Treatment ofà Refractory Monosymptomatic Nocturnal Enuresis: A Pilot Study Ali Abdel Raheem,* Yasser Farahat, Osama El-Gamal, Maged Ragab,à Mohamed Radwan, Abdel Hamid El-Bahnasy, Abdel Naser El-Gamasyà and Mohamed Rasheed Purpose: We evaluated the early clinical and urodynamic results of posterior tibialà nerve stimulation in patients with refractory monosymptomatic nocturnal enuresis. Materials and Methods: We randomly assigned 28 patients with refractoryà monosymptomatic nocturnal enuresis to 2 equal groups. Group 1 received aà weekly session of posterior tibial nerve stimulation for 12 weeks and group 2 wasà the placebo group. Evaluation was performed in each group at baseline and afterà posterior tibial nerve stimulation to compare clinical and urodynamic findings. Another clinical assessment was done 3 months after the first followup. Results: The 2 groups were comparable in baseline clinical and urodynamic data. Overall, 13 patients (46.4%) had detrusor overactivity and 14 (50%) had decreasedà bladder capacity. After treatment 11 group 1 patients (78.6%) had a partial or fullà response to posterior tibial nerve stimulation but only 2 (14.3%) in group 2 had aà partial response (p 0.002). Also, the average number of wet nights in group 1 wasà significantly lower than at baseline (p 0.002). All urodynamic parameters significantlyà improved in group 1. In contrast, the number of wet nights and urodynamicà parameters did not change significantly in group 2. At 3-month followup the numberà of patients with a partial or full response in group 1 had decreased from 11 (78.6%)à to 6 (42.9%). No change was evident in group 2. Conclusions: Posterior tibial nerve stimulation can be a viable treatment optionà in some patients with refractory monosymptomatic nocturnal enuresis. However,à deterioration in some responders with time suggests the need for maintenanceà protocols. Key Words: urinary bladder, nocturnal enuresis, transcutaneous electricà nerve stimulation, urodynamics, treatment outcomeà NOCTURNAL enuresis is usually associatedà with severe psychological and socialà distress to children and their families. 1 In recent years several treatmentà modalities emerged to treat NE, suchà as behavioral therapy,2 alarm treatment,à 3 medical therapy with desmopressin,à oxybutynin and imipramine,à and combination therapy.4ââ¬â6 However,à none has been completely successful andà the relapse rate of all of them is significant. 7ââ¬â9 Therefore, there is a great needà to find other treatments that could beà more effective and durable than currentà therapy.à The pathogenesis of refractory NEà was discussed in many studies and attributedà to decreased bladder capacityà and/or PTNS was introduced with earlyà promising results as neuromodulativeà therapy for diseases that involve theà lower urinary tract and for refractory conditions inà adults and children.15ââ¬â19 These beneficial effects ofà PTNS for controlling various bladder disorders ledà us to try it in patients with refractory primary MNE.à MATERIALS AND METHODS A total of 28 patients were included in this prospective,à randomized, placebo controlled, single blind study fromà January 2010 to March 2012 at the urology department atà Tanta University Hospital. The study protocol was reviewedà and approved by the Tanta University institutionalà review board. Informed consent was obtained fromà all participants or from parents if the patient was youngerà than 18 years. We recruited patients with severe (3 or more wet nightsà per week) primary MNE at least 6 months in duration inà whom available conventional and combination therapiesà had failed, including desmopressin, anticholinergics andà an alarm. We excluded those with secondary NE, nonMNE,à nocturnal polyuria and any neurological abnormality. All patients provided a detailed history and underwentà complete physical examination, urinalysis, x-ray of theà lumbo-sacral spine and ultrasound of the urinary system.à All patients were asked to keep a nocturnal enuresis diaryà for 2 weeks, which included the time of sleep and arousal,à and whether they had a dry or wet bed in the morning. Nocturnal urinary output was measured as the total urineà volume collected in the diaper after voiding during the lastà night (assessed by weighing the diaper in the morning)à plus the first morning urine volume. Nocturnal polyuriaà was defined as nocturnal urine output 130% or greater ofà EBC for age.20 The Arabic version of a 2-day frequency-volume chartà (adapted from the Pan Arab Continence Society, www.pacsoffice.com) was obtained from all patients to confirmà that the problem was MNE. Daytime functional bladder capacity was considered the recorded MVV. EBC for ageà was calculated by the formula, 30 _ (age in years _ 30). Children with MVV less than 65% of EBC for age wereà considered to have a small bladder.20 All patients also underwent urodynamic tests, as performedà by the same urodynamicist using a Delphis-KTà device (Laborie, Toronto, Ontario, Canada), includingà 1) uroflowmetry with PVR estimation by ultrasound for atà least 2 voids and 2) cystometrogram, including 1 fillingà cycle using an 8Fr double lumen urethral catheter withà the patient supine and a slow filling rate of 10 ml perà minute. Patients were randomly divided into 2 equal groups byà method. Randomization was done blindly by having anà independent nurse randomly take a card from an envelopeà containing 14 cards for group 1 and 14 for group 2. Groupà 1 received active PTNS treatment sessions using theà Urgentà ® PC Neuromodulation System, while group 2 underwentà a sham procedure. Treatment Protocol We applied the technique described by Stoller.21 The patientà lay supine with the soles of the feet together, and theà knees abducted and flexed (frog position). A 34 gaugeà needle was inserted percutaneously approximately 2à inches (5 cm) cephalad to the medial malleolus and 1 cmà from the posterior margin of the tibia at an angle of 60à degrees from the skin surface and the lead wire attachedà to it. The surface electrode was placed on the same legà near the arch of the foot over the calcaneus bone. Theà device was turned on and amplitude was slowly increasedà until the largest toe of the patient began to curl, the digitsà fanned or the entire foot extended, indicating proximity toà the nerve bundle (see figure). If this response was notà achieved or pain occurred near the insertion site, theà device was turned off and the procedure was repeated. When the needle was inserted in the correct position, theà current was set at a tolerable level (pain threshold) andà the session continued for 30 minutes. For the sham procedure we tested only the foot responseà to the electrical impulse and then turned off theà apparatus during the whole session. To avoid patientà identification of the type of procedure all participantsà were informed that they may or may not feel a sensoryà stimulus in the lower extremities during the treatmentà sessions. Groups 1 and 2 underwent 12 weekly outpatient treatmentà sessions. All participants were advised to stop allà medical treatment for NE at least 1 month before startingà PTNS but to continue behavioral therapy, including fluidà A, neuromodulation system. B, system in use with flexion of left largest toe.à restriction at night, complete bladder emptying beforeà sleep and awakening 2 hours after sleep to void. Patient Assessment The first patient evaluation was done in the first 2 weeksà after the last session. This evaluation involved repeatingà the clinical and urodynamic assessments. The clinical partà included a nocturnal enuresis diary for 2 weeks in whichà the number of wet nights/week was reported as well as aà 2-day frequency-volume chart. The clinical response to treatment was assessed asà outlined by the International Childrenââ¬â¢s Continence Society,à including no responseââ¬âless than a 50% decrease inà the total number of wet nights, partial responseââ¬â50% toà 89% decrease, responseââ¬â90% or greater decrease and fullà responseââ¬â100% decrease.20 Urodynamic assessment includedà uroflowmetry, PVR measurement and cystometry. The second evaluation was done 3 months after the lastà session. It involved clinical evaluation using nocturnalà and voiding diaries only. Statistical Analysis All statistical analysis was performed using SPSSà ® 17.à Data are shown as the mean SD unless otherwise specified. The Student t and paired sample t tests were usedà for comparison between groups and in the same group,à respectively. Nonparametric data were compared by theà Wilcoxon signed ranks or Mann-Whitney U test. Statisticalà significance was considered at p 0.05. RESULTS Recruited for this study were 28 patients with refractoryà NE who met inclusion criteria. Initial assessmentà and baseline characteristics of each groupà showed no significant difference in clinical and urodynamicà parameters (table 1). Overall, in the 2à groups DO was present in 13 patients (46.4%) andà 14 (50%) had decreased bladder capacity.à The procedure was performed easily with no adverseà effects in all cases. No patient discontinuedà the planned sessions. At the end of the PTNS sessions clinical assessmentà revealed significant improvement in the average numberà of wet nights per week in group 1 (decrease fromà 4.7 to 2.6, p 0.002, table 2). Compared to the placeboà group, the number of wet nights after treatment wasà significantly lower in group 1 (p 0.041, table 2). Atà that time 4 group 1 patients (28.6%) had a completeà response to PTNS, 7 (50%) had a partial response andà 3 were nonresponders. However, in group 2 there wereà 2 patients (14.3%) with a partial response, while theà remainder did not respond. When we compared the 2à groups, the difference in this response rate was statisticallyà significant (p 0.002, table 2). At first evaluation after the end of treatment, theà active group showed significant improvement in allà urodynamic parameters compared to baseline, includingà first and strong desire to void, and MCCà (p 0.002, 0.01 and 0.000, respectively, table 2). Inà group 2 these parameters did not significantly differà compared to baseline (table 2). Also, DO disappearedà in 2 of 7 group 1 patients but this improvement wasà not noted in the sham treated group (table 2). Statisticalà analysis revealed that the difference be- Table 1. Patient characteristics Active Placebo p Value No. boys/girls 8/6 9/5 1 Mean SD age (yrs) 13.7 2.8 14 2.8 0.8 Mean SD body mass index (kg/m2) 24.95 4.40 26.27 4.23 0.43 Mean SD max urine flow (ml/sec) 26.85 6.74 23.28 5.49 0.13 Mean SD PVR (ml) 6.21 7.11 5.86 5.48 0.9 Mean SD daytime frequency 3.9 0.67 4.29 0.64 0.07 Mean SD MVV (ml) 266.57 82 288.93 106.29 0.27 Mean SD No. wet nights/wk 4.7 1.3 5.1 1.4 0.42 No. detrusor overactivity: Present 7 6 1 Absent 7 8 ââ¬â Mean SD void desire (ml): 1st 148.46 25.89 153.50 21.65 0.59 Strong 260.43 84.18 271.79 75.43 0.71 Mean SD MCC (ml) 291.21 86.82 322.21 76.04 0.32 Table 2. Intragroup and intergroup comparisons of clinical and urodynamic findings after PTNS at first evaluation Active Placebo Baseline After Treatment p Value Baseline After Treatment p Value Posttreatment p Value Mean SD void desire (ml): 1st 148.46 25.89 177.71 35.48 0.002 153.50 21.65 154.14 20.71 0.59 0.041 Strong 260.43 84.18 283.64 72.03 0.01 271.79 75.43 271.6 72.8 0.94 0.67 Mean SD MCC (ml) 291.21 86.82 322.5 65.89 0.000 322.21 76.04 323.57 77.44 0.57 0.97 No. detrusor overactivity: Present 7 5 0.44 6 6 1 0.7 Absent 7 9 8 8 Mean SD MVV (ml) 266.57 82 280.14 71.81 0.022 288.93 106.29 291.07 96.84 0.73 0.6 Mean SD No. wet nights/wk 4.7 1.3 2.6 2.2 0.002 5.1 1.4 4.7 2.1 0.08 0.041 No. response: ââ¬â ââ¬â ââ¬â ââ¬â Full 4 0 0.002 Partial 7 2 None 3 12 1516 POSTERIOR TIBIAL NERVE STIMULATION FOR REFRACTORY NOCTURNAL ENURESIS tween the 2 groups in this regard was not statisticallyà significant (p 0.7, table 2). Furthermore, inà this evaluation urodynamic parameters showed thatà bladder volume at first desire to void was significantlyà higher in group 1 than in group 2 (p 0.041). On the other hand, bladder volume at strong desireà to void and MCC did not significantly differ betweenà the groups (p 0.67 and 0.97, respectively, table 2). Five of the 8 group 1 patients with decreased EBCà showed improved capacity. MVV also significantlyà increased after treatment from a mean of 266.57à 82 to 280.14 71.81 cc (p 0.022, table 2). When we studied the relationship between the responseà to PTNS and initial urodynamic findings, weà noted that all 10 group 1 patients with small bladderà capacity and/or DO showed a good response to treatment,à including 4 and 6 with a full and partial response,à respectively. However, when we compared the type ofà response in those with normal vs abnormal urodynamicà results, the 4 patients with normal urodynamic findingsà in this group had a poor response to the sessions, includingà 3 with no response and 1 with only a partial response. This difference was significant (p 0.007). Clinical results at 3 months after the last sessionà showed some deterioration in early results in theà active group. In this group the number of patientsà à ith a full response decreased from 4 to 2 and theà number of those with a partial response decreasedà from 7 to 4. No change was detected in the otherà group. However, when we compared the responseà rate in the 2 groups at this time, we detected noà significant difference (p 0.13). In addition, theà average number of wet nights per week at that timeà was 2.9 in group 1 and 4.2 in group 2, which did notà significantly differ (p 0.07). DISCUSSION This study demonstrates that PTNS could be of valueà in some patients with primaryMNEin whom previousà conventional therapies failed. To our knowledge thisà treatment modality has not been tried before in suchà cases but it has been successfully used for overactiveà bladder syndrome,22,23 lower urinary tract dysfunctionà in adults and children,15,18 refractory overactive bladder,à 16 refractory vesical dysfunction19 and refractoryà nonneurogenic bladder sphincter dysfunction.17à Absent daytime lower urinary tract symptoms inà patients with NE does not necessarily mean that theà bladder functions well because DO and/or decreasedà bladder capacity was previously reported in suchà patients.10,11 The clinical response to desmopressinà therapy is less satisfactory when NE is associatedà with decreased bladder capacity and/or DO.12ââ¬â14 Inà our study we detected DO and decreased bladderà capacity in 46.4% and 50% of patients, respectively,à although patients with MNE only were included inà analysis. These values agree with previous reportsà showing bladder overactivity24 and small bladderà capacity25 in 49% and 50% of children with MNE,à respectively. These findings may partially explainà the mechanism of resistance to the previous treatmentà trials in our patients. Our results and those of others reveal that PTNSà can be applied easily and safely in children.18,19à After the 12 PTNS sessions in our series, patientsà showed a significant increase in MVV and urodynamicà parameters, including first and strong desireà to void, and MCC, compared to the placebo group. These results agree with those in previous reportsà demonstrating that PTNS increased cystometric capacityà from 197 to 252 cc26 and from 243 to 340 cc,27à and increased MVV by 39 cc, which was statisticallyà significant.23 However, at 3-month followup we detected someà deterioration in the response rate compared to earlyà results. The overall number of full and partial respondersà decreased from 11 (78.6%) to 6 (42.9%) inà group 1. This deterioration during followup suggestsà that PTNS may have temporary efficacy and its effectà decreases gradually with time. This finding was alsoà noted in patients with overactive bladder treated withà PTNS. van der Pal reported that 7 of 11 patients withà an initially good response had evidence of subjectiveà and objective deterioration after PTNS.28 They suggestedà the need for maintenance treatment. The early promising results of this study encouragedà us to suggest that PTNS might be effectiveà in patients with refractory primary MNE inà whom nocturnal polyuria is not an etiological factorà but in whom the main underlying pathologicalà condition is decreased bladder capacity and/or DO. However, the exact mechanism that could explainà the mode of action of this treatment modality isà still unknown. PTNS may induce some inhibitoryà effects on DO. The existence of this functionalà abnormality in the bladder implies that the detrusorà is not completely relaxed between voids.à Therefore, the capacity of the overactive bladder isà usually smaller than that of the bladder with aà normal detrusor. Consequently, the clinical responseà usually occurs when bladder capacity increasesà and DO improves after PTNS. This explanationà may be supported by the improvement inà bladder capacity (functional and cystometric) andà the disappearance of DO in patients who respondedà to PTNS in our study. The main limitations of this study are the smallà sample size and the short 3-month followup. Inà addition, we did not repeat urodynamic tests atà the second followup at 3 months to avoid patientà discomfort but depended only on the patient clinicalà response. However, this information could be important for assessing the cause of the deterioration in PTNS efficacy after treatment wasà stopped. CONCLUSIONS PTNS appears to be a viable treatment option inà some patients with refractory primary MNE. However,à deterioration in the response rate with timeà raises important questions about the long-termà efficacy of this therapy and the need for furtherà maintenance sessions. More studies are needed toà support our findings and select patients whoà would be good candidates for this therapy.
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